April 25, 2014

Meditation Nation

How convincing is the science driving the popularity of mindfulness meditation? A Brown University researcher has some surprising answers.

Given the widespread belief that meditation practice is scientifically certified to be good for just about everything, the results of a recent major analysis of the research might come as some surprise. Conducted by the Association for Health and Research Quality (AHRQ)—a government organization that oversees standards of research—the meta-study found only moderate evidence for the alleviation of anxiety, depression, and pain, and low to insufficient evidence to suggest that meditation relieved stress, improved mood, attention, or mental-health-related quality of life, or had a substantial impact on substance use, eating habits, sleep, or weight. It looks like the scientific evidence for the benefits of meditation aren’t as solid as many might claim.

If it is indeed proven that meditation works for some purposes but not for others, in what sense does scientific proof translate into proof of its liberative efficacy? Does any of this scientific research prove that what we do as Buddhists works? And as Buddhists, why should we care about the science?

For an insider’s perspective on these questions, Tricycle turned to clinical psychologist, neuroscience researcher, and Buddhist practitioner Willoughby Britton. Assistant Professor of Psychiatry and Human Behavior at Brown University Medical School, Britton specializes in research on meditation in education and as treatment for depression and sleep disorders. Britton has long focused on sorting out confusion about meditation within the realm of science. Responding to the first AHRQ meta-study of meditation (2007), which observed the imprecision of scientists’ understandings of words like “mindfulness” in interpreting and correlating study results, Britton won National Institutes of Health backing to create standards for consistent terminology in research. She is currently studying the underlying neurobiology of how and why particular practices seem to work better (or worse) for particular kinds of people.

Britton is also one of first researchers to explore possible adverse effects of meditation. In a groundbreaking study known as “The Varieties of Contemplative Experience” project, she is interviewing dozens of advanced meditation practitioners, teachers, and Buddhist scholars regarding what she calls “difficult or challenging mind (or body) states” that can occur as a result of intensive meditation practice. Her observations have been cautionary, highlighting the need to develop a more nuanced and informed view of (and also more respect for) the power of meditation.

—Linda Heuman

As a scientist and as a Buddhist, what do you make of the AHRQ report? The report sounds pretty fair. This review—and pretty much every one before it—has found that meditation isn’t any better than any other kind of therapy.

The important thing to understand about the report is that they were looking for active control groups, and they found that only 47 out of over 18,000 studies had them, which is pretty telling: it suggests that there are fewer than 50 high-quality studies on meditation.

What are active control groups and why are studies based on them of higher quality? There are different levels of scientific research, different levels of rigor. I think this is a place where the public could use a lot of education. Because they don’t know how to interpret science, they assume much higher levels of evidence.

The first level is a “pre-post” study, which looks something like this: We go learn to meditate for eight weeks and at the end of it we feel better. We took a stress and anxiety scale before and after, and our stress or anxiety improved. So we say, “Meditation helped me!” That is actually not a valid conclusion. The conclusion you can make in science is that something helped. We didn’t control for the idea that just deciding to do something is going to help. Just that factor—intentionally deciding to make a commitment to your health and well-being—can make a big difference.

One problem is that just filling out the questionnaire changes you. In my recent sleep study, I had people fill out a questionnaire and keep a sleep diary. That is all they did for eight weeks. They didn’t meditate. And their sleep improved a lot. So, you have to control for the effect of taking the questionnaires.

You also have to control for the passage of time. Sometimes people just feel better after two months compared with when they started. So you can’t actually conclude that meditation had anything to do with it. A lot of the studies on meditation are pre-post studies like this. They shouldn’t count at all as evidence.

The next level of rigor is “wait-list controls.” Half the participants begin meditating immediately while the other half acts as a control group, and only later participate in the actual meditation. Those in the control group might be thinking, “I’m in the study. I’m going to learn to meditate!” They’re psyched. Their depression is already getting better because they’ve decided to do something about it. These are effects of expectation; they aren’t doing meditation.

But even at this level the study is not considered in any way conclusive. If I have an inspiring teacher, for example, it can be a helpful factor that is not meditation. Even to know that somebody felt depressed and anxious at one point and then got better is helpful. There’s the normalization of my symptoms. There’s the social support. I meet other people who have my problem. I thought I was the only person in the world who had anxiety, and now there are all these other people who have anxiety and we’re all talking about it. And I really get along with them. So I’m making friends. I’m less lonely. That’s not meditation either. There are all these things that are not meditation that could be helping me feel better.

If we really want to be able to say that meditation was the active ingredient, the control group has to do everything the other group is doing except meditation, and they can’t know that they are in the control group. This level of scientific study is called “active control groups.” But that largely isn’t what is happening in meditation research, although it’s starting to.

Why do people conduct pre-post studies if they don’t count as evidence? A lot of times they are not really doing research. They are running a clinic and they want to see if the clinic is having any beneficial effects. For example, the Center for Mindfulness gives people some questionnaires when they sign up for the mindfulness-based stress reduction (MBSR) program, and the participants fill them out on the last day and hand them in. It is better than nothing, but it’s not the same thing as having participants randomly assigned to either MBSR or a control group.

It is not that these sorts of studies are worthless. They are valuable at different stages of the game. When you are first starting out and wondering if something works, you measure pre-post. At early stages, that level of rigor is appropriate. But it is not appropriate for as much hype as “we should give this to children” or “we should give this to everyone.” You need a much higher level of evidence for that.

Public enthusiasm is outpacing scientific evidence. The public perception of where the research is way higher than the actual level.

Have the claims for the scientific evidence supporting the efficacy of meditation been overstated by proponents of meditation? Definitely. Because they take all those studies that I was just describing (like pre-post studies) as evidence. You really shouldn’t cite those as evidence.

Are meditation researchers perhaps a bit biased? When we first started research on meditation, there was this principle that the scientists should be meditators because they understood it. But we are all also incredibly biased! Meditation is not just a practice we do like, “I like to run.” It is an entire worldview and religion. I worry about this kind of bias in meditation research.

There are many people doing studies who are making money off of some kind of meditation-based program, and that is technically considered a conflict of interest. They have something to gain by finding a positive effect, and therefore are not one hundred percent objective. When an experimenter is also the person who created the therapy, there is a factor called “experimenter allegiance.” This factor can count for a larger effect than the treatment itself. That is something we haven’t looked at in our field.

In the Buddhist community, there are a lot of people who are excited about the scientific findings that support the efficacy of meditation because it seems to be confirming what we already knew. But that is not the purpose of science—to confirm the dharma. And if that is what people are doing as scientists, they need to seriously step back and look at the ethics of that. To use science to prove your religion or worldview—there is something really wrong with that.

Do you see that happening in the world of science? I’ll talk about myself so I don’t point fingers. My first ten years of practice, when I was also a researcher, I was in that bright-faith phase of “Meditation can fix everything! Everybody should do it!” I wrote a mega-article, the precursor to my dissertation, on all of the neurological and biological concomitants to stress and depression. And then I cited all of the studies that suggested meditation could reverse those processes. And I submitted that mega-article to three different journals and it got rejected three times. It finally dawned on me that I was cherry-picking the data. I wasn’t actually being a scientist or doing a scientific review; I was writing a persuasive essay. I think that is much more common. 
Our natural bias to confirm our own worldview is very much at work. People are finding support for what they believe rather than what the data is actually saying. Ironically, we need a lot of mindfulness to “see clearly” the science of mindfulness.

This is why these meta-analyses are important. They reviewed over 18,000 articles. They were not cherry-picking. 

Is the data better for some applications of meditation than others? I have done very careful reviews of the efficacy of meditation in two areas in which there are high levels of popular misconception about how much data we have: sleep and education. The data for sleep, for example, is really not that strong. And the AHRQ article concurs: it judges the level of evidence for meditation’s ability to improve sleep as “insufficient.”

What I found from my study was that meditation made people’s brains more awake. From a very basic brain point of view, what happens in your brain when you fall asleep? The frontal cortex deactivates. Nobody agrees what meditation does to the brain, but across the board, one of the most common findings is that meditation increases blood flow and activity in the prefrontal cortex. So how is that going to improve sleep? It doesn’t make any sense. It is completely incompatible with sleeping if you are doing it right. And we know that people stop sleeping when they go on retreats. That is never reported in scientific publications, even though it is well known among practitioners.

This is a very interesting example of the confusion that arises in the confluence between modern secular and traditional Buddhist contexts. In the buddhadharma, meditation is never used to promote sleep. It is for waking up. Sleep is a hindrance. Often in the modern use of meditation for everything—and especially here in the case of sleep—we’re using meditation in ways basically the opposite of what Buddhists were using it for. People aren’t trying to dismantle themselves: they want a stronger sense of self; they want more self-esteem; they want more sensuality.

In a study I’m doing on the “Varieties of Contemplative Experience,” people are having all kinds of unexpected meditation effects, and it’s scaring the hell out of them. Many of the meditators in my studies in clinical settings are reporting classic meditation side effects like depersonalization. De-repression of traumatic memories is another really common one. People have all this energy running through them; they are having spasms and involuntary movements; they are seeing lights. They check themselves into psychiatric hospitals. Some of the people I’ve seen in my study come from a health and medicine framework and are not Buddhist, and yet they are reporting meditation effects that are well documented in Buddhist texts. But these are not well documented in the scientific literature because nobody is asking about them. That’s the chasm I am trying to bridge.

Not all effects are so adverse. The fact that somebody’s sense of self disappears for a second is not necessarily a problem for that person. They might think, “Oh, that was weird.” Effects can be transient and mild. But a lot of people have charged emotional material or memories coming up. No MBSR teacher is going to be surprised by that. If you sit down on a cushion and count your breath for two months, all sorts of things— wounds, memories, traumas—are going to come up. It is a very common experience. But there is only a single paper on that, written three decades ago. Catharsis of that sort (what Buddhists call “purification”) is just not part of the model. The model is: meditation is going to calm you down.

What are other aspects of the model? I think the term “insight,” instead of being insight into the three characteristics [suffering, impermanence, and non-self], is now insight into “my own personal patterns of neurosis.” So I think there is maybe a little of the idea that you are facing your demons and getting insight into your patterns, but here “insight” is being used in a very personal way. We could all use that kind of insight, but it’s not really Buddhist insight in the traditional sense.

The fact that adopting meditation may be very disruptive to your life, that you might require supplemental therapy, or that you might be a little less functional and lower performing while stuff gets kicked up and you are working through it... that is not really in the current marketing scheme.

I think there are a lot of people who think meditation will have a Buddhist effect, even if it is not done in a Buddhist context. What do you think of that? I’m seeing people who came to meditation through MBSR or who are not Buddhist but are meditating “to be happy.” They are following their breath or doing a mantra. And then they eradicate their sense of self. They freak out. That is a pretty common experience in my study.

If “getting happy” is the context in which you have adopted meditation, will meditation in fact lead to that end? It might, but the next questions are: What’s in the middle? At what price? I think the people who have stuck with meditation for a long time, and who have cultivated some kind of wisdom or enduring change, have paid for it dearly with a lot of pain. It is very hard to extract some sort of enduring positive gain from dharma practice without taking a really thorough look at your own mind. The first step is a very close look at the nature of suffering: seeing what suffering is and getting to know our own suffering. It is through that deep intimacy with our own suffering that there is liberation. It’s not like, “Let’s take that and put it under the rug and be happy and connected with everyone!” Wisdom and enduring change are born out of really looking at every little piece of your own suffering and how it is generated and held together and maintained. How can it not be painful to do that?

What would you say is the way forward for scientific research on meditation? What would you like to see happen? As my research is showing, along with this mass enthusiasm for meditation has come an epidemic of casualties. That needs to be part of the picture going forward. No more denial. Let’s just admit that this is happening and have a mature support system for it. There needs to be more dialogue and collaboration between Buddhists and dharma teachers and the medical community—clinicians, people with training in all psychiatric problems, but particularly in trauma, which is something not really addressed in traditional Buddhist frameworks.

One of the statistics that blows my mind is that the main delivery system for Buddhist meditation in the modern West isn’t Buddhism; it is science, medicine, and schools. There is a tidal wave behind this movement. MBSR practitioners already account for the majority of new meditators and soon they are going to be the vast majority. If Buddhists want to have any say, they better stop criticizing and start collaborating, working with instead of just against. Otherwise, they might get left in the dust of the “McMindfulness” movement.

Where would you say we are now in the scientific investigation of meditation? With any new discovery, there is usually some initial craze before it gets too popular, and then there is a backlash. A lot of things that were overhyped get torn down. And whatever is really legitimately true is left standing in the end. So I think we are at the peak of this first phase. There have already been a couple rounds of criticism.

What kinds of criticism? The biggest criticism is coming from the more traditional Buddhists who think these new applications of mindfulness are a denaturing of the dharma.

A related criticism is: “What is mindfulness?” People still aren’t clear about that. What are these different practices? And which practices are best or worst suited to which types of people? When is it skillful to stop meditating and do something else? I think that this is the most logical direction to follow because nothing is good for everything. Mindfulness is not going to be an exception to that. A lot of people would probably have a strong reaction to that statement, which tells you something right there. If we think anything is going to fix everything, we should probably take a moment and meditate on that.

Linda Heuman, a Tricycle contributing editor, is a freelance journalist based in Providence, Rhode Island. Follow her on Twitter: @lindaheuman

With support from the John Templeton Foundation, Tricycle’s Buddhism and Modernity project is initiating a conversation between Buddhists and leading thinkers across the humanities and social sciences. Tricycle is exploring how perspectives drawn from research on the nature of religion, culture, science, and secularism can shed light on unexamined assumptions shaping the transmission of Buddhism to modernity. This project offers Western Buddhists new ways of thinking about their spiritual experiences by demonstrating how reason can be used as a tool to open up—rather than shut down—access to traditional faith.

Image: Flickr/Litchenstein

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myers_lloyd's picture

I've sat seven day Zen sesshins for many years, and for several of those I wept throughout, and was very lucky if I didn't cry noisily. I can't attribute this to visiting painful memories; it was just how it was.
You cannot imagine what crosses my mind when I hear about people undergoing this for more zest or creativity or wealth or any other yummy possibilities. What I read in this article feels real: people eradicate (or get a taste of eradicating) their sense of self, and "they freak out" (or maybe weep out.)
Can one benefit? Yes, hugely- beyond one's capacity to imagine.
Does one pay a price? Do I need to tell you?

jackelope65's picture

I think the typical "quick fix" attitude toward benefits with mindfulness will be as helpful as exercise machines for the heart that allow you to lay down and sleep while the machines move your body. Eight weeks total in an exercise program would not be expected to produce lifetime benefits to reduce blood pressure, heart disease, stroke, diabetes,etc.. We have seen linear changes in the brains of lifetime meditators in f-MRI studies. I think randomized long term studies will need to be done to realize true scientific outcomes. As an MD, I do not expect long lasting permanent benefits with any short term lifestyle changes in my patients that do not change sensibly over years. Although anecdotally and personally, I feel much improved with years invested into my personal Buddhist practice, with at least 2 hours a day of study and meditation, as many practitioners reporting in and/or reading Tricycle may have invested, I doubt much of the 'mindfulness' "research" involves much of this type of meditator in well performed studies. We will have to be patient and some of us will continue to have "faith" in our own practices and not be overly concerned about Western medical research already addicted to quick fixes.

John Haspel's picture

About 2,600 years ago a human being set out to understand the cause of all manner of human confusion, disappointment and suffering. After a frustrating six year search, encountering all of the popular “spiritual” teachings and meditation techniques of his time, he rejected all as “low, common and leading to further delusion.”

He realized that disappointment and suffering were inherent in human life due to the impermanence of all phenomena and the insistence of the ego-personality, what he described as anatta, not-self, to establish itself in every impermanent object, view, and idea. This compulsive need for continual establishment of the ego-self in all impermanent phenomena he described as dukkha, or the truth of suffering.

Anicca, (impermanence) anatta, (not-self) and dukkha (all manner of confusion, disappointment, and stress) are the linked characteristics of human life, often called “the three marks of existence.” Upon his awakening the Buddha now understood what he set out to understand: Dukkha was the direct result of ignorance. The Buddha awakened to the understanding that from ignorance, through 12 observable causative links, all manner of suffering arises.

Born from ignorance, constant ignorance and ongoing delusion is required to sustain the distraction of dukkha. The ignorance necessary to sustain the ego-self is known as wrong view. Awakening is dependent on acquiring right understanding, or Right View. Vipassana, seeing clearly, is the refined insight and refined mindfulness that is fully developed in an awakened human being.

This understanding is known as “dependent origination.” This basic and easily understood original teaching of the Buddha was expressed in his first formal teaching when he taught The Four Noble Truths and set the (only) wheel of truth in motion. Included in The Four Noble Truths is the Buddha’s path to recognizing the cause of ignorance and resulting dukkha: clinging to views that attach the ego-personality to objects, views, and ideas.

The Eightfold Path is grounded in Right View. Right View is initially the understanding that views arising from ignorance lead to all manner of suffering and that The Four Noble Truths describe the problem and the direct solution.

This article points out how the ego-personality’s need to establish itself in every object, view, and idea, indeed in every thought that arises, distorts the Buddha’s teaching to such a manner that any accommodation seems reasonable. Beginning with the foolish notion that the Buddha’s teachings and stated purpose of his Dhamma must be scientifically validated in order to be accepted is laughable.

Nearly every declaration of truth via evidence-based science has eventually been shown to be “true” only so far as the truth fits the confirmation bias of the “scientist.” Even if the studies being done actually studied individuals that were actually practicing the Buddha’s original teachings, the findings would still be subject to the “scientist’s” bias. The Buddha himself would likely fail the biased and confused view of a modern scientist seeking to defend their own ego-personality’s view.

Imagine Sariputta insisting that before he accepts the Buddha’s teachings and develop his own understanding the Buddha provide scientific evidence as to the safety and efficacy of his dhamma!

I mean no disrespect of Ms. Britton, certainly no more than she has shown to the Buddha’s teaching. I do find her answers and suppositions typical of one accommodating the Buddha’s teachings to fit their own views. This can only lead to more confusion to those seeking an understanding based on the original teachings of the Buddha.

Ms. Britton’s answers shows a misunderstanding of the Buddha’s teachings. This misunderstanding always occurs from taking the teachings out of the context of Dependent Origination and The Four Noble Truths:

• The AHRQ report that meditation is no better than any other therapy: The Buddha’s teachings are not intended as therapy whose intention is to support and mollify an ego-self. The Buddha’s teachings develop an understanding of the suffering that arise from the belief in a substantial ego-self and the continued delusion and suffering that ensues from attempting to maintain the ego-self in all objects, views, and ideas.

• The only “control group” that would matter would be practitioners that are actually practicing the Buddha’s teachings and a “scientist” who had abandoned all confusion born of a clinging ego-self, an “awakened” scientist.

The foolishness of claiming that meditation is overstated and meditation could and should be ignored if found too difficult or “dangerous.” Meditation is one factor of the Eightfold Path and is as necessary to develop as the other seven factors. Meditation is only useless or dangerous when practiced without the framework of the entire Eightfold Path.

Another point to be made here. The Buddha did not intend his dhamma to be a universally salvific religion that should be accommodated to fit all views. He taught a very specific and very refined Dhamma for those few that had “only a speck of dust in their eyes.”

It is in the insistence that the Buddha’s original teachings be accommodated to fit all views and be universally applied and accepted that has led to foolish arguments such as this article presents, and to the confusing, contradictory, and antagonistic teachings presented as “Buddhism” today.

Fear arises from taking meditation out of the context intended and using methods never taught by the Buddha. The Buddha taught Shamatha-Vipassana meditation to develop samadhi, a non-distracted quality of mind. He taught mindfulness of the breath-in-the-body while remaining dispassionately mindful of feelings and thoughts that arise and pass away. As the mind calms he taught to be dispassionately mindful of the current quality of mind. This is known as the Four Foundations of Mindfulness and when Shamatha-Vipassana meditation is practiced within the framework of the Eightfold Path and with a correct understanding of the intention of the Dhamma, reactions such as fear are understood and with vipassana, clear insight, is seen as a product of clinging to an ego-self.

The final question and answer sums this article up in its bias towards dismissing the Buddha’s teachings if the teachings don’t support the ego-self’s desired experience or conclusions wanted. Of course anyone is free to decide or declare what should be practiced or what should be dismissed in relation to the Buddha’s original teachings. It should be made clear though that what is left is not a teaching that was presented by the Buddha. Unhappiness with the results are the responsibility of those making the accommodations, not in the Dhamma.

The Dhamma wasn’t taught as a scientific or psychological exercise that could, or should be subjected to subjective scrutiny with the resulting conclusions fitting a pre-determined view. The Dhamma was presented for those that would engage with the Eightfold Path whole-heartedly to bring an understanding of anicca and the clinging nature of anatta and bring to cessation clinging and the resulting distraction of dukkha.

The questions in this article, if asked of the Buddha would have been answered by the Buddha with silence as inappropriate questions, or, as he consistently replied when a question would only further establish anatta: “your question can only lead to more confusion and suffering as it arises from ignorance.”

The Buddha’s teachings were never intended to answer the endless questions (unskillful doubt) that the clinging mind of an ego-personality compulsively churns out. The quality of mind of samadhi, non-distraction, developed in Shamatha-Vipassana within the framework of the Eightfold Path meditation is necessary to bring calm to this compulsive quality of mind.

This article demonstrates a lack of understanding of anicca, anatta, and dukkha, and the purpose of the Buddha’s original teachings:

“Just as in the autumn a farmer, plowing with a large plow, cuts through all the spreading rootlets (compulsively accommodating views) as he plows; in the same way the perceiving of impermanence, developed and frequently practiced, removes all sensual passion... removes and abolishes all conceit of "I am." (SN 22.102)

John Haspel

jagmad's picture

Well written response John. As the author also mentions, it is not the purpose of science to 'prove' the dharma.
You're absolutely right when you talk about the de-contextualizing of one arm of the 8-fold path. It appears that Buddha's holistic 8-fold path has been converted into a 1-fold de-contextualized path of mindfulness.
More like mindlessness than mindfulness!

trailpaloma's picture

Blah blah blah

Iridescence's picture

Just wanted to add: How cool is it that the authors name is Heuman? I assume it's pronounced like HUMAN. I wish that was my last name - that or Peese (Peace) or Luhv (Love) or Weirahleenittugetuhr. ;-)

tmark.com's picture

Hi, Iridescence, I love your name, also.

I also liked your comment about science, and the fact that it never gives up. I had skipped to the last few paragraphs of the article, as I usually do, to see where the author was going, to be able to better understand the article. Your comment caught me, though, before going back and reading the article, so I cannot comment on your perspective that the author was trying to sell something.

You also mentioned being new. There is a dichotomy in what you will read and it has been helpful to me to keep that in mind. They are both of value and can be helpful. Some seek and use meditation and mindfulness to more successfully find happiness in the ephemeral world of dreams. They do find some, temporary, ephemeral success; and move on in their development. Others seek to find something in meditation because of a profound discontent with the possibility of ever finding anything satisfying in this ephemeral world; and they hope in the promises of others that there is a better way, and something better, and it MAY be true, please god.

Both are true. Both can be helpful. Both can be called Buddhism. It would be better, I think, if they had different names; but I am probably wrong, or they would have had.

Afterlife and religion? Those are secondary beliefs of those who cling to the primary beliefs in time, space, matter, energy. Advanced meditators no longer have those primary beliefs so the secondary beliefs are of no interest and are BORING. They do still love and care about the lost parts of themselves who are still deluded, and must be recovered, though, so they are boddhisatvas.

Perhaps "selling something" was just experience reaching out to you to say, "don't give up and don't let your intellect trick you again." We have ALL been there and been through it but trusting the hands reaching out to you will make it easier, and quicker, for you.

Welcome to the party, we love us as ourselves.


Iridescence's picture

Just speaking as someone who is new to mindfulness therapy, even newer to the Tricycle community and not at all familiar with Buddhism (optimistically looking forward to learning), this article felt to me as if the author was trying to sell something, though I can't tell what. Maybe just an attempt to sell the idea that meditation shouldn't be abandoned by anyone just because it can't be proven to have a measuarable benefit. I especially agree that if one practices meditation and it has any positive effect, then it doesn't matter if it can be positively proven scientifically. I have faith that it will be proven eventually. The good thing is scientists never give up, and they are always coming up with better ways to test hypotheses.

My own experience is that meditation has helped enormously with quieting a racing mind, and in catching judgmental thoughts and learning not to judge the judging. It sounds terribly juvenile (again with the judging lol), but for someone like me, who doesn't believe in god or an after-life, any positive difference now is invaluable. My "religion" is knowing that we're all in this together, and figuring out how I can be an active participant in that philosophy while accepting that mean-spirited and abusive people are part of that "all". It's my job to figure out how to accept that fact without having it change me. I'm thankful to the author for standing up in support of mindfulness and meditative practices (even if she is selling something) because it really does change lives, even if it can't be proven scientifically for the time being.

NancyLanceAlot's picture

Another lamp on a rocky road! Like any seeker/gypsy/outcast, stumbling on talking, writhing rocks, terrifying myself with my unconscious self, I thank teachers in all forms, and here's another one.... A great teacher said "Better to suffer than to be miserable!" "Miserable" is akin to "miserliness" and the opposite, to be "generous," is the first of all paramitas, the one that begins the growth of all the virtues. So... give it up! give up! give! Shed your little "self" and begin your acquaintance with "Self" (not easy; truly worth it).

buddy's picture

A scientist judging another scientist. I'm more objective than you. Really?

I see one statement and can stop reading.

"The first step is a very close look at the nature of suffering: seeing what suffering is and getting to know our own suffering. It is through that deep intimacy with our own suffering that there is liberation."

You've spent all these years meditating, and this is what you think the path to liberation is?

bradrgarrison@gmail.com's picture

Well, what she is saying about scientific rigor seems fair enough to me: There are different levels of it, therefore, we should not just latch any to any "evidence" that conforms to our pre-existing bias. Perhaps it would be wise to scrutinize a little more?

Is the avoidance, or denial, or ignorance of suffering the path to liberating? I'm not trying to be too smart, I hope, I'm just interested in what you mean. Isn't the first noble truth, the truth of suffering?

Thank you for your comment and have a good weekend!

buddy's picture

I too respect the practice of discerning details and rigorous scrutiny. But presumably we are doing this from an inside perspective, and not necessarily from an outside results perspective.

I see the arguement, as to measuring results, as a path in the wrong direction. We don't measure how we train kids or other ways of learning... Why the preoccupation on measuring meditation? To motivate us to mediate.,, I see that as wrong view. My practice has taught me that I meditate in order to make better choices concerning the stress I am causing myself and others. The how's and the what's are easy if I understand the why. Introspection of any kind can only be beneficial if it is done for the right reasons. Measuring the efficacy of introspection seems pointless to me.

My understanding of the 1st truth/practice is that "there is suffering". A subtle, but important difference in the identification of the cause and effect when we practice. I'm causing the problem because I'm not understanding all aspects of stress/suffering. The practice as I understood from the original teachings were pointing us to not identify with understanding stress, it's causes, it's cessation, and the way out. The "I" is merely a convention that we have to work through and use skillfully... In order to unravel the misunderstanding of it.

Bradford Hatcher's picture

You might perhaps investigate the Upanisa Sutta and the twelve supporting or proximate causes of liberation, also called "Transcendental Dependent Arising" (lokuttara-paticcasamuppada).
This is a reverse chain of causes that leads from suffering to liberation, with suffering as the first step.

Saraha's picture

Who would go on 10 day retreat if your teacher told you all the mental and emotional crap that would come up ?? How many teachers in the Asian tradition do that ? How many Asian teachers tell their students "hey, you know this meditation practice can bring up some scary stuff and you might get freaked out?". None.


So why are western teachers being held to a higher standard than their Asian counterparts. Why are we expecting Western teachers to warn everyone about the so called 'dangers' of the practice.

Guess what ? Life is dangerous. You can die.

So let's stop with the "meditation is/can be dangerous" malarky and get each man and women to honestly face their trauma and fear square on. It won't kill you...

The Buddha himself faced the trauma of his mothers death. He never knew his mother. She died after he was born. It would be safe to assume he had to work through some painful stuff around that...as well as the doubt, guilt and fear of abandoning his own new born son and family...(hence his meeting with "Mara").

Let's face it, encountering the terror of existence with love is the fundamental pre-requisite for liberation. Is that not the Buddha's example?

mattbard's picture

tough guys fall the hardest. the way it is............

Saraha's picture

Everyone likes to take pot shots at Macmindfulness as if it's the 'poor, dyslexic cousin' of noble Buddhism. The stench of condescension on this site is becoming stifling.

Buddhism in the West is a pale commodity. It's a joke. Buddhism in the West is a caricature of the Buddha's teachings and the Buddha's experience and his struggle. The true teachings of the Buddha is contained in Mahamudra. If you are not learning Mahamudra, which every Buddhist should be, then you are not serious about attaining awakening.

Look at the proliferation of ads on this site ! How can you talk about "Macmindfulness" and the "marketing of mindfulness" when on this very site you can see that "Buddhism is for sale".

Let's stop with the holier than thou attitude and the hypocrisy and take a good look Buddhism itself. It didn't even consider women equal to men until it came to the West and got it's arse kicked by woman practitioners who put the record straight. In some pockets of Theravada tradition in Thailand and Burma, nuns are still struggling for equal rights. Buddhism has a lot to learn from the West.

Buddhism has become commercialised no less than macmindfulness: If I see another white upper middle class lama with two degrees and a book for sale I think I am going to choke on my yak stew.

(I see we now have Thich Nhat Hahn calligraphy jewellery (he rolls eyes) advertised on this very page.)

hector.duzont's picture

"The real is not a unity, but a manifold of differences" —T.R.V. Murti in The Central Philosophy of Buddhism.

MindfulnessTherapistOnline's picture

As a scientist as well as a mindfulness therapist and dharma teacher I tend to be disappointed my most of these studies on meditation for two reasons: 1) They do not use proper controls. Meditation vs non-meditation is not a proper design. A better one might be mindfulness meditation vs transcendental meditation, or meditation vs visualization, or meditation vs yoga, etc. 2) There is little attempt to define what is meant by meditation. Somehow it is assumed that it is all the same. For example, mindfulness meditation is so often equated as awareness of breathing or body scan. But meditation as the Buddha taught is so much more than that. I teach mindfulness meditation of feelings and emotions and rarely body sensation or breathing. The outcome of feeling-centered meditation will likely be completely different than breathing-centered meditation when it comes to examining efficacy for anxiety or depression.
More rigor is needed in experimental design before we can even begin a meaningful discussion of efficacy.

xyzzy's picture

Thank you for writing this. I was taught a form of meditation/mindfulness long ago as a dangerously asthmatic little kid, as it was critical for me to be able to stay perfectly calm while monitoring my lung capacity and getting help. I then had plenty of time to "practice" focusing on each breath, since I spent weeks at a time each winter in bed using a hospital treatment machine for pneumonia or bronchitis.

I say "thank you" for writing this article because I've become very alarmed by a new trend in the medical world of forcing disabled people with (usually undertreated) severe chronic pain to cut their medication in favor of "mindfulness therapy" regardless of what the cause of the pain is. There seems to be (as you said) a general sense of belief that it really works, but as far as my research has turned up, it's a matter of doctors believing it because other doctors they know believe it. As my doctor admits she only tenatively thinks this "might" help but says all physicians are being put under extreme pressure by the health insurance industry to go along with it, I'm going to bring the linked study & this article to her attention.

mattbard's picture

....... for those makin a fuss one way or the other.... an open mind is helpful. Many times my view has changed when I was so sure of myself. Humbling , but nice too. The dear Doc doesn't have all the answers, but, I get a sincerity that she'd like to know. Me too, and hope she stays scientific, and hope she gives credit to subjective wisdom too- a tough act there. Some of my meditation has been wonderous; the sleepless, and idenitity loss I have known. Over the years I have been intense long hours meditator, and have also had month breaks to digest and rest my psychic batteries. It remains one of my essential challenges - meditation is a fabulous gift developed by immeasurably great and compassionate souls. I am so thankful to all gone before me. Another side effect, for me, whereas I used to think the "world" was kinda crazy, these days I feel so much more concerned that it is . thank you, matt

sanghadass's picture

well said. thanx for your insight.

Danny's picture

This says a lot: "we’re using meditation in ways basically the opposite of what Buddhists were using it for."

drleroi's picture

As Jack Kornfield says, "it is hard to mediatate after a day of lying and cheating" or something like that. Meditation will point out to you all the cobbling together of the daily ego we use to justify our actions. This can be uncomfortable. I knew an expert yoga practitioner who was among the most unfeeling dishonest humans I have met. He seemed to be able to maintain his calm despite his own actions. I suspect he is headed toward a special hell realm of his own making. The basic techniques of meditation are a tool. They can be used like any tool for good or bad purposes.

Rocket's picture

meditation is poorly understood, few westerners get more than a liittle bit of relaxation from it.

Moving into deeper states, ie Samadhi is another ball game. Most of us moderns are too mentally agitated, unstable to train the mind to go into such states.

Meditation is not effective therapy. Therapy first, get your mind relatively stable and servicable, then get great training. Great training is RARE.

For example the way the frightening experiences ( called "nyam" by the Tibetans) people pretty much always encounter are not at all understood in this context. They are a big challenge but are also the 'dweller on the threshold", like the demons flanking the entry to a timple. ONe mush pass through them, by them, to enter the temple. Pretty much no exceptions. They are the rotting corpses that meditaiton dredges up from the mud of the psyche.

We westerners are quite lame in this respect. Except those of us who have done serious experiential psychotherapy, psychedelic drugs , etc etc. Those things furnish a rough preview, approximation of what we will encounter, prepare us to pass thru such challenges and are thus almost manditory immeditate precursors, for most of us.

sanghadass's picture

Everything is grist for the mill. What benefit we derive from our dukkha depends on how we relate to it and what we learn as a result.

The visionary experience of a mind that is moving towards deep tranquility and natural stillness is expansive, beautiful, and uplifting. Thoughts about the joy of letting go and freedom. Death may appear as a beautiful release in a mind that is free from fear. Samadhi is a kind of death. Often preceded by a perception of light - as in death. Or, the abeyance of the sense of self in the experience of a sublime emotion. Saint Theresa would have a vision of Jesus and swoon - inwardly. Swoon - in a state of rapture - at the sight of the beloved! When the sense of self is lost in natural stillness there is samadhi. Samadhi helps in freeing up the mind in daily life. It can produce a deepened sense of ease, joy, and presence. Providing openings and opportunities for insight. A wider variety of experiences arise when the mind is not in the neighborhood of samadhi. Samadhi happens when diversity falls away.

Rocket's picture

I've made similar comments to those I made here on "buddhist" discussions in many different web settings. Most commonly the reaction is energetic hateful invective.

Its so very nice to see the responses we see here.

sanghadass's picture

We are all in it together dear Mitra! Yours in the Dharma!

aj1's picture

In my view, the effects of meditation are "in the eyes of the beholder" - if you feel it works for you, keep doing it. I just read another great article made available by Tricycle on misconceptions about Buddhism and meditation as part of now wide-spread Buddhist practice. Some meditate, others do not, some recite the sutra, others do not. I am not sure we need science to tell us what is good for us to learn to shed our attachments. There is an element of duality in seeking to understand meditation through science. I am not anti-science by any means but to me, meditation is such a personal experience that is almost defies being labelled or categorized in scientific terms. Meditation does not work for all, I accept that. There are days it does not work for me. When it does not, I gently set it aside and come back to it later....certainly, people for whom it does not work overall should not feel guilty about it (or look for scientific explanations for why it might not) - like mothers who cannot nurse. I am not sure we need to polarize the debate further by clinging to this scientific research or that.

Ericinthegarden's picture

Interesting article and love the meta analysis. Has there ever been study done of vajrayana or tantric Buddhist meditation? It is a very different practice than mindfulness.

candor's picture

It appears there are so many possible factors influencing potential benefits of mindfulness meditation that it will likely take many years of many properly controlled studies to gain scientific knowledge of benefits, and what contexts -- specifically what philosophical and psychological contexts -- are best for attaining certain benefits.

For example, not only can questionnaires and "doing something about it" influence the benefits, but world views and what kind of mental activity one is aware of (psychological dispositions) can strongly influence benefits. There are likely big differences in benefits, for example, when a fundamentalist monotheistic religious person fearing a jealous, wrathful God practices "mindfulness meditation" as compared to metaphysical naturalist who accepts dukkha, impermanence, and dependent origination taught by the Buddha in a way compatible with metaphysical naturalism. This is just one broadly defined comparison. The potential comparisons in the world views and psychological dispositions of practitioners are numerous to say the least. These world views and psychological dispositions, when providing the context of mindfulness meditation, will likely make properly controlled studies of "benefits of mindfulness meditation" quite complicated.

Stitchintime's picture

This is something that I have been saying for close to twenty years to no avail. There are a number of problems here. 1.) No 2 MBSR teachers teach MBSR the same way 2.) Each person comes to MBSR from a different place with different life experiences and coping mechanisms 3.) MBSR teaches basic Shamata equilivant. The purpose of this practice is to calm the mind of distractions- the monkey mind
4.) Once the monkey mind is calmed then the process of insight needs to begin. The Sanskrit word is Vipasana which literally means looking within ( and looking outside) studying the teachings and oneself. How do these teachings apply to me? Where have I strayed in my ignorance? How can I remedy it? This piece often brings up things we don't like in ourselves, life difficulties, our selfishness etc. At this point we have to remember what we are aspiring to is to possess bodhicitti, to be the bodhisattva, the one who is awake. Awake to the sufferings of the world and dedicated to the alleviation of that suffering. This is the place where the rubber meets the road and if at that point we cannot transmute our own sufferings into something that benefits others, If we cannot translate our own sufferings into compassion and wisdom, then huge difficulties will arise.5.) Then came all the trials and roadblocks. Life often doesn't get easier, it gets harder. The closer one gets the more the temptations and obstacles arise...opportunities for spiritual practice. Like the Buddha being tempted by Mara. There are not just one but many Dark nights of the soul.They may manifest in any number of ways and psychosis are one. There may be kundalini awakenings such as discussed in the kundalini emergencies. http://www.mudrashram.com/kundaliniemergencies.html these need to be discussed, because what happens after step one may land the participant in a worse place than they started.

djlewis's picture

I think this article misses the important point that Goyal et al was a study by MDs, for MDs, using medical research standards, and that almost nothing in psychology, psychiatry or behavioral health would do much better against these levels of research rigor.

The mind is simply too complex and mufti-faceted, and we know too little about mental "disorders" by comparison with physical ones. Of course, those facts call into question the very use of the "medical model" for problems of the mind, which is implicit in this meta-study.

mattbard's picture

..good entry level discussion aimed at foundational beliefs and misconceptions... a good place to begin. Meditation inquiry can show the reality of ego ; that can be unpleasant and disorienting....adding the other parts of mix, such as the 4 immeasurables; compassion , open heart, etc., helps smooth the road. The old masters were kind as well as wise. Matt

nichole.moorman's picture

Thank you for this article. As a mental health professional, who uses mindfulness in the context of cognitive therapeutic modalities, a meditation practitioner, and aspiring mindfulness teacher I found the article to be spot on. I have encountered both clients and clinicians expecting and teaching respectively that beginning mindfulness practice, and even more concerning the concept without the practice in place, can and should bring peace and calm. While this take can initially offer hope, it is not accurate and is contradictory to the process of self discovery, aka insight.

djlewis's picture

Regarding sleep and meditation...

First -- I am unaware of any traditional Buddhist teaching, formal or informal, that says meditation will improve my sleep or that sleeping better is a goal of dharma practice. If you are aware of such teachings, Dr. B, please cite them. If not, why are you even studying sleep with respect to meditation, except in the following frame?

Second -- in my personal experience and that of many friends who meditate, meditation substitutes for sleep. In other words, if I am meditating (and doing it well, of course) I simply need less sleep than otherwise to function. This effect is particularly notable at retreats, both meditation retreats and teaching retreats, the latter because I meditate more and deeper even during a teaching retreat. For me, this effect can reduce my sleep needs by as much as two hours a night. I particularly notice the effect after the retreat, as I return to daily life -- my sleep needs increase again.

So, Dr. B, are you aware of this effect? It seems pretty important to anyone interested in sleep and meditation. In fact, your results showing that meditation interferes with deep sleep may simply be an artifact of needing less sleep when meditating more.

Or, of course, maybe I am wrong, or it's idiosyncratic. Some good science might help here, but it needs to be framed in this way, not on the basis of an internet search that says meditation helps people sleep.

audiac's picture

I think you didn't read the blog post fully. It actually says that generally, within Buddhist circles, meditation often has a reputation for interfering with sleep. This is exactly saying what you are saying.

Richard Fidler's picture

I am curious if research upon meditation is based upon a scientific framework. From the article, it sounds as if it is not--witness the inability to define the term "mindfulness" in terms investigators can agree on. Studies should access our understandings of neuroscience and behavior generally, and not simply compare the performance of meditators and non-meditators on certain outcomes: responses to surveys and physiological reactions. Surely there are models that describe brain functioning in areas such as visual and auditory processing, memory, attention, various kinds of learning, and so on. Are the studies on meditation grounded in any of these models?

Imagine the power of a study about evolution that looks at the role of separation of gene pools by sheer chance (genetic drift). We think we understand how evolution works in this regard so we provide observations to back up our ideas. That is what is missing in so many meditation studies: a model that can provide a guide to investigations. I think we have a long way to go before meditation research can draw conclusions that we all can rely on.

Tdawson48's picture

Excellent and interesting article. I disagree with the comment that the views of science and Buddhism are fundamentally incompatible. I think they are necessarily distinct in perspective and aims, but fundamentally compatible and potentially mutually enhancing.

Dominic Gomez's picture

Incompatibility is an illusion. Science and Buddhism are 2 sides of the same coin, the coin being life itself.

Tdawson48's picture

Or warp and woof of the fabric of life. We need to mindfully acknowledge both sides of the coin -- or both types of strands.

Dominic Gomez's picture

both sides of the coin/both types of strands=enlightenment

Jakela's picture

Thank you Dr. Chicken Little. The fact that Dr. Britton has very little counter-studies to her assertions only bolsters my feelings that she knows not of what she speaks.
Besides, even if meditation has only a placebo effect, it is a positive one and in the end who really cares as long as it works for the individual.
Bottom line; The buddha said "See for yourself." And he didn't mean you needed to read what some random PhD has to say.

conroy.r's picture

What an unkind comment! I suggest that you have a look at Dr Britton's publications. Far from being a 'random PhD' (whatever the heck that is) she has a solid track record of research that, I think, is both scientific and grounded in Buddhism.

Perhaps, too, you underestimate the degree to which mindfulness is being commoditised as a cure for everything, even chocolate cravings! (See Lacaille J, Ly J, Zacchia N, Bourkas S, Glaser E, Knäuper B. The effects of three mindfulness skills on chocolate cravings. Appetite. Elsevier Ltd; 2014 May 1;76(C):101–12. )

It is important to ensure that claims used to sell mindfulness are based on valid data, and, I think, it is important to engage with this runaway sales movement to ensure that mindfulness doesn't end up being utterly disconnected from the wider life context – in much the way that training shoes have gone from being the work wear of athletes to the street signage of drug dealers.

Rocket's picture

Conroy, Id like to point out that (this will anger a lot of folks) most of what is happening in "Buddhism" among westerners in the west is a far cry from depth authentic meditative experience. Its mostly some low level relaxation. If that. Some people become "caualties", not meditatiors who actually got somewhere. Like Samadhi. That happens due to training and guidance from so called instructors who have not been into depth experiecn themselves. They are all over the place. Teaching reduced westernized phony balony meditation.

The disturbing, frightening, intense "crazy making" experiences people encounter during meditation are a normal cleansing and are being dismissed , apparently, by this researcher as more or less trouble. This interpretation closes the door on the actaul fruits of meditative experience. Holy cow.

Meditation dredges up the rotting corpses from the mud of the psyche. Negotitate that phase and the next step is Samadhi.

We in the west are geared to expect all sweetness and light. Right away. The actaul "reward" is a fullfillment we are unable to imagine before the direct experience. You do have to clear out those rotting corpses first. Its harrowing. Similar to the difficult times during a challenging psychedelic experience. That is one of the ways psychedelics have helped some of us progress into deeper, aithentic, meditatiive experience.

Dominic Gomez's picture

Meditation dredges up corpses from the mud of the 7th level of consciousness: http://www.sgi.org/buddhism/buddhist-concepts/the-nine-consciousnesses.html

sanghadass's picture
Rocket's picture

My reference may be a little different. Effective samatha practice usually brings intense, frightening, very very real, "bad day on a dose of acid" type emotional experience to us as a cleansing process. These things are latent in our emotional composition. Getting thru that process to the other side leaves us at, or closer to, the threshold of samadhi, if not up to our eyeballs in it.

I allude to the rotting corpses in our mind, the emotional body, that control us, require us to expend energy walling them off from consciousness/ awareness since such things are taboo in western culture, except within the psychotheapy, self exploration , Jungian setting and then with skilled and stable support and specific iintent to expose them for personal growth reasons. They are our mental afflictions. They rob us of our creativity, our authenticity, our access to intuition, even paranormal abilities.

Psychedelic drugs ... on a good day ... can provide a "temporary rough or coarse approximation" of a samadhi like state thru a similar sequence of "uncovering, purge, aquire new expanded mental emotional freedom and open space. And of course we can thank Carl Jung for spelling this or a similar process out in some detail.

I gather the link provided is a reminder from religous agencies, from a bigger picture perspective, that we are all literally on our way to being corpses in the physical sense and getting real about that is worth while. I'm referring to the period we still inhabit the present body.

sanghadass's picture

We are not talking about - or referring to - the same things in our exchanges. There are some words that we have both used but we have not used them with the same meanings. Thats ok. Best wishes, sangha dassa.

Rocket's picture

After listening to #5 most of it then #1 the instruction you offer is pretty much identical so far to what I got so much benefit.

1- Good sleep, really total good sleep is necessary
2- #1 importance is relaxation to the max first and foremost
3- did not hear you refer to the bone rattling frightening difficult emotions that are part of the process called nyam by Tibetans. LSD can furnish a "preview" and also can help clean up emotional afflictions that are absolute obstacles, if its a good day and you are motivated properly

Rocket's picture

Yes I believe you are more educated, in a serious scholar way, about these things. It does seem apparent.

I have some experience with certain things but not good knowledge of the centuries of religous background, and in depth understanding.

If you care to you could post links to sites on the web where I can gain better depth of knowledge.

Many thanks.