New Data on the Adverse Effects of Meditation and Mindfulness

Study reports on the less-examined findings of difficult and painful meditation-related experiences

Zenobia Morrill
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Recent findings from a mixed-methods study explore the under-reported experiences of Western meditation practitioners who encounter unexpected, difficult, distressing, or functionally impairing effects of their practice. The Varieties of Contemplative Experience (VCE) study, published in PLOS ONE, attempts to broaden Westernized notions of meditation experiences through qualitative interviews and quantitative data.

“The limited focus on the benefits of meditation for physical and psychological health and well-being is a modern and largely Western creation that neither represents the diversity of meditation practices nor the range of possible or even likely effects of those practices.”

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Already-existing literature has primarily focused on the health benefits of meditation practice, often discounting both its religious roots and the diverse range of experiences and associated effects. Traditional Buddhist sources recount blissful and painful meditation-related experiences alike, the latter including body pain, physiological disorders, paranoia, sadness, anger, and fear. Yet a delineation between positive and negative side effects may be reductionist, as traditional accounts relay that neither experiences of pain nor pleasure are certain markers of greater insight.

While the relationship between insight and the nature of practice experience is not portrayed systematically in traditional sources, Western representations of Buddhism attempt to brand it in concordance with values such as empiricism, secularity, and science. Mindfulness-based interventions (MBIs) are derived from this paradigm and have gained support in alleviating symptoms related to stress, addiction, chronic pain, mood disorders, psychiatric disorders, and medical conditions.

Interestingly, however, accounts of meditation-induced psychosis, seizures, depersonalization, mania, and other adverse effects are noted to occur and have even culminated in a DSM description, but the evidence of their origin, management, and prevention continue to be unexplored.

Lindahl and co-researchers sought to expand upon this research by investigating the following questions in the VCE study:

  • What is the range of meditation-related effects described by Buddhist practitioners in the West?
  • What types of experiences do they report as unexpected, challenging, difficult, distressing, or functionally impairing?
  • What are the hypothesized causes of those experiences?
  • What interpretations are they given by others?
  • What impact do these experiences have on the lives of meditation practitioners?
  • How do practitioners prevent, manage, navigate, or integrate such experiences?
  • How do teachers guide their students through such experiences?

“Because the widespread practice of Buddhist meditation in the West is a relatively recent phenomenon, and because Buddhist-derived meditation practices such as ‘mindfulness’ are increasingly being deployed in various novel settings such as schools, clinics, and hospitals, more information is needed on the range of experiences associated with the practice of Buddhist meditation in the West.”

Western meditation experts and practitioners were interviewed across Theravāda, Zen, and Tibetan traditions totaling 60 interviews overall (57% male, 43% female). Participants were excluded if they endorsed any prior experiences that could be causally related to the meditation-related symptoms explored in this study. The team of researchers consisted of those with backgrounds in clinical psychology, neuroscience, religious studies, qualitative methodology, behavioral anthropology, and behavioral medicine.

Following the interviews, participants completed a quantitative survey. Responses to this survey underwent a comprehensive causality assessment, to assess whether reported symptoms were attributable specifically to meditation experiences, and a severity assessment to determine the degree of meditation-related distress and impairment. Lindahl and team acknowledge, however, limitations to claims of causality, noting that the best research design to determine this would involve the implementation of a randomized control trial (RCT) design accompanied by validated pre-and post-measures.

In this process, researchers discovered that a consistent distinction between positive and negative meditation-related changes was not evident. Rather, appraisals of experiences were personalized through interpretive frameworks shaped by systems of thought and sociocultural contexts.

Results of this study supported the notion that no consistent appraisal system could be applied across meditative experiences, and that practitioners encounter a diverse range of meditation-related experiences and intensities of those experiences. Participants’ experiences were categorized into “cognitive,” “perceptual,” “affective,” “somatic,” “conative,” “sense of self,” and “social.”

Cognitive experiences refer to effects related to mental functioning including thought content, decision-making, planning, and memory. Some cognitive side-effects, mental stillness, clarity, and meta-cognition, were reported as negative or positive depending their intensity and intersection with daily functioning. Respondents sometimes expressed that some side effects, such as changes in their world view, resulted in confusion. Similarly, one was more likely to report side effects as unpleasant if they had experienced a disintegration or disconnection between their perceptions and concepts, or if changes in concentration and memory felt problematic. Delusional, irrational, or paranormal beliefs were reported as well, but their impact varied according to the practitioner’s accounts and their social context.

Perceptual experiences include changes to the five senses. A common change reported was hypersensitivity to light, sound, or sensation. In some cases, cessation of visual perception was reported in addition to instances involving the general dissolution of perceptual objects. Vision-related distortions of time and space, and a general “derealization” were described, in addition to experiences of illusions and hallucinations that occurred both independently from and in conjunction with “delusional beliefs.”

Affective, or emotional, changes capture the type, frequency, or intensity of an emotion. Fear, anxiety, panic, and paranoia were the most frequently reported increased emotions (reported by 82% of practitioners). Others described experiencing a decrease in emotions overall, or “affective flattening.” Emotions that are typically interpreted through a positive valence, such as increased empathy, bliss, and euphoria were described. However, experiences of bliss and euphoria were sometimes accompanied by later depressive symptoms, or “destabilizing conditions resembling mania or psychosis.” Affective experience is a broad category encompassing changes in doubt and faith, self-conscious emotions, the re-experiencing of traumatic memories, involuntary crying or laughter, and agitation, irritability, or anger.

The authors included this note:

 “It should be noted that neither ‘mania’ nor ‘psychosis’ were phenomenological categories in our coding structure, even if practitioners, or more commonly, experts used such terms to describe an experience.”

Somatic changes refer to meditation-related changes in observable bodily sensations and physiological processes. Commonly reported changes were alterations in sleep patterns, parasomnia (resulting in vivid dreaming, lucid dreaming, or nightmares), changes in appetite, and thermal changes. Some respondents spoke of feeling pressure, tension, or pain. These feelings would sometimes be described as growing more acute and releasing in session, a sensation that was oftentimes experienced pleasantly, yet other times alongside a re-experiencing of traumatic memories associated with negative affect.

Conative experiences were changes related to motivation. Practitioners described a generally positive sense of having to exert less effort in their meditative practice. Two reported changes were anhedonia, or the loss of desire to engage in activities previously enjoyed, and decreased motivation to pursue goals.

“Sense of self” changes were most often reported by participants as a change in their perception or self-world boundaries, typically involving reports of the self and world “merging.” This experience could be described as blissful and euphoric, but also as terrifying as one feels a loss of agency and ownership. For some, they no longer felt they had a self, and believed that they were at times nonexistent or invisible from others. Alternatively, some experienced neutral affect in response to this merging of world and self. Another “sense of self” change involved a general alteration or re-writing, of one’s personal narrative.

Social changes, which included changes in interpersonal activities and functioning also ranged in terms of diversity of experiences. While some reported estrangement, others reported increased extraversion and valuing of relationships. At times, respondents experienced a social destabilization, especially if they were transitioning between a practice context and a non-practice context. Participants also spoke about the widespread changes they experienced regarding their relationship to their meditation community.

Taken together, the researchers found that “The vast majority (88%) of participants reported that challenging or difficult meditation experiences bled over into daily life or had an impact on their life beyond a meditation retreat or beyond a formal practice session. The term “symptoms” is used here to denote the subset of experiences that were experienced as challenging, difficult or functionally impairing.”

The findings of this study demonstrate not only that appraisals of meditation-related experiences are dictated by complex personal, interpersonal, and sociological factors, but that there exist “multiple, and sometimes conflicting,” paradigms that influence Western Buddhist concepts.

“Without sufficiently attending to the role of appraisal processes at both individual and interpersonal levels, scholars may fundamentally misconstrue differential diagnosis as being about identifying inherent differences between religious experiences and mental illnesses, rather than seeing them as potentially more ambiguous categories or closely related phenomena that may well be grounded in common cognitive, perceptual, and behavioral mechanisms.”

This obscuring between social and cultural processes also serves to uphold a discourse that experiences fall neatly between religious and pathological, write Lindahl and team. In addition to honoring the complexity inherently existent in these experiences, the researchers argue that this study offers helpful implications that may allow meditation and MBI teachers to identify students who may need additional support.

 

 

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Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PloS one12(5), e0176239. (Abstract) 

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Zenobia Morrill
MIA-UMB News Team: Zenobia Morrill is a graduate of the dual master’s counseling psychology program at Columbia University. As a doctoral student and researcher at the University of Massachusetts in Boston, she seeks to understand the context informing psychology research and the underlying social factors that influence individual psychology. She is currently involved in projects examining the impact of structural violence.

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28 COMMENTS

  1. This is really good and its important info that most don’t seem to know. I want to point out that I have never heard a mental healthcare provider warn of negative experiences related to mindfulness meditation. It’s the newest greatest thing that will make everything all better it seems. However, the intro to mindfulness meditation class I took with a Zen Buddhist sangha did very explicitly warn us we could have negative experiences, flashbacks of traumatic memories, pain, dissociation, etc.

    The only time I have a problem with meditating personally are in low lighting and silent environments. My boogeyman are far more likely to rear their ugly heads when experiencing this level of sensory deprivation. So I meditate in daylight or with lights on and play soft music in the background and this helps.

    • As an experiencer of depression and a meditator, none of the above effects surprises me (although I’d note the cultural bias in lumping paranormal experiences and beliefs in with negative delusional states).

      Meditation can be a very powerful tool so it’s not surprising that negative experiences occur as well as positive. My sense from reading buddhist sources is that having the ego dissolve or seem to dissociate can indeed be frightening and disorientating.

      I think that one big reason why mental health and other medical practitioners downplay or ignore negative effects is that they underestimate the power of these techniques, and see it in shallow terms as a stress reliever. (One reason for this problem is a blanket refusal to take the traditional sources, and alternative, transpersonal models of consciousness seriously.)

      However, a cursory glance at the traditional sources make it clear that the goal is a profound transformation of one’s consciousness and the induction of very different states of consciousness. This means that it’s important to attend to what those sources have to say.

    • These experience are well known in Buddhism, and in Tibetan are called Nyam. They are well described in Alan Wallaces book “The Attention Revolution”.

      They differ from Schizophrenia in that they are transient, and have many psychosomatic symptoms and provided one does not either become obsessed with reproducing them or frightened by them (avoiding attachment and aversion) they will pass and the meditator will settle to a normal mental state afterwards. Usually you need to be meditating a lot to get them- -ie 4-8 hours a day on a retreat going for some days.

      They are actually regarded as a good sign- that your mind is still enough to pick up on these things (which I suspect would only come to you in dreams).

      If they occur on retreat you have the advantage of being able to discuss them with your teacher- but they could be frightening if you did not have that support.

      I do use a Buddhist based meditation technique (Mindfulness Integrated CBT) as a therapy in come cases, and it interests me (as a Buddhist) that there is little discussion of these possible symptoms, as some patients do get very inspired and go off and do lots of meditation without supervision.

      Equally, I suspect that as one progresses further down the meditation path, one may get little hints of the experience called emptiness, or Sunyata. That may well be unsettling as well- again highlighting the need for support.

      So- appropriate support by an experienced teacher is always important, as is access to ongoing advice and support if the patient wishes to pursue an ongoing practice, as many do. However the possibility of some of these difficult experiences is NOT a contraindication to using these therapies.

      • Hi — Thanks for this. I have a copy of Alan Wallace’s book, I’ll look this up. (It’s a very useful guide).

        RE: Saccharine versions of meditation. I think that practises that suggest you need to empty your mind and just think happy thoughts derive more from things like Mary Baker Eddy’s Christian Science movement than the buddhist traditions with which I’m (relatively) familiar. Barbara Ehrenreich provides some caustic critiques of these approaches in her book ‘Bright sided.’ I’m afraid that such mindlessly positive approaches do not work for me either!

        • Re Alan Wallace’s book- pages 105-107 (Stage 6: Pacified Attention). Alan directly references “The Vajra Essence”- and enumerates a long list of anomalous psychophysical experiences that can occur.
          “while many of us would likely respond to some of those disagreeable experiences by stopping the practice or seeking medical help, Dudjom Lingpa actually calls them all signs of progress…. whatever comes up was already there, previously hidden by the turbulence and dullness of the mind”.
          We can see already from the tone of the paper that there is a tendency to look upon these experiences as pathological or harmful, and this may be the trap in the approach of Western psychology which adopts and teaches mindfulness practices, often without being aware of the fine print.

          • It’s discussions like these (and Lucinda Jewell below) which are a clear pointer that the folks who did the study were not familiar with meditation and how it works.

            And then – pathologizing the experiences that come up. Instead of omg a negative emotion! You must have an underlying “disorder”!

            We should be celebrating them! LOOK! You learned a thing! It hurt? AWESOME! Learn again, learn some more! The more you learn, the better you will get at exploring these places.

            (exception: the many Eastern – and Western practices – which include abuse and trauma as part of the curriculum. I never celebrate these, even though they can make you mighty.)

          • Omgosh, JanCarol!

            “We should be celebrating them! LOOK! You learned a thing! It hurt? AWESOME! Learn again, learn some more! The more you learn, the better you will get at exploring these places.”

            This x 1000!!

  2. Its hilarious to me how vehemently people defend mindfulness. When those defenses clearly indicate an ignorance of what meditation, is or is not. For it is clear that Mindfulness is not meditation in any sense of the world. Clearly religious leaders from Krishnamurti to Osho, have stated that meditation is not a doing, it is a happening. It happens, and any effort to practice meditation, or deliberately enter a meditative state is by definition not meditation. Meditation is a happening, not a doing. Mindfulness is really just autohypnosis, which makes the mind very suggestible, susceptible to false meditative states.

  3. I think it helps some people like me. It is a big part of Acceptance and Commitment Therapy (ACT) which is an offshoot of Cognitive Behavioral Therapy (CBT).

    It’s definitely not for everyone, though.

    One of the reasons I like it is because I can do it on my own without the need for a therapist.

  4. Mmm.

    All things in moderation.

    Decades of experience in seated and moving meditations, at least 5 types – and there are a number of factors to consider. I’ve been abused in practice before, too. I’d say it was more traumatic than any psychiatric or therapy experiences I’ve had – because it shattered everything I was before the practice.

    For example, meditation should be at dawn and/or dusk. (midday or midnight meditation can be used to disrupt your circadian rhythms as a form of mind control) Meditation should be no more than 2 x 20 minute sessions daily. The extreme experiences of meditation are usually found beyond these beneficial limitations.

    Also not discussed is meditation under a Master. Did he beat you about the head with his bamboo stick? Did he tell you that you needed to “correct” your thinking, feeling, behaviour, that you were “doing it wrong?” Were you sitting incorrectly? Did you bring the right fruit or flower to honor the guru? Did he try to destroy everything you knew before?

    There are many ways meditation can go wrong – similar to therapy. Put in appropriate places and fences, using techniques that are appropriate for you (can’t sit still? try moving or active meditation), are the ways this can be a useful tool for growth and well being.

    So – there is no “this is the perfect meditation for everybody,” which is the kind of reproduce-able results mainstream medicine would like to achieve.

    Everyone has different times, practices, methods, teachers, non-teachers, places of comfort and well being. Meditation can help one heal, but it is probably best to come from within. If you’re not compelled, it’s not for you. And if your guidance comes from within – then you are less likely to end up in a practice which is bad for you.

    Nothing is 100% “safe.” But like with anything, choose what is best for you.

  5. I hated being forced to empty my brain and think of nothing for 2 hours a day! The same case worker who ran that workshop forced us to fake smile for 5 minutes once. Hurt my mouth and made me feel worse.

    Hopeful Coping was the name of the class. I felt it was violating my inner being in a way not even the drugs were.

  6. Meditation practice isn’t for everyone. I was being forced to medicate my whole life, so I decided to become proactive and meditate.

    I took refuge in Buddhism, and even though my path hasn’t been without issues, it’s better (for me) than the alternative.

    American beliefs are often centered around a profit motive, so choosing the correct guides can be tricky.

    My advice is, stay far away from those seeking to abuse your mind and body. Abuse is abuse, and one should not be subject to it. If the teacher does not respect your mind or body, then one must respectfully walk away. I believe, the Dalai Lama has said this. However, I don’t have an exact quote.

    When money becomes an issue, be certain the teacher isn’t ruled by it. I believe, the worship of money is one of the most dangerous forms of desirous attachments. You may disagree, and that’s Ok.

    I also try to gauge the humility of a teacher because I value humility in a teacher as one would value a precious jewel.

    Finally, I think, the Dharmapada is a very good place to start. The historical Buddha Sakyamuni had some wonderful things to say. However, the reader must make his, or her determination as to what he or she finds useful. Do what is best for you. Best hopes for everyone!

  7. Because some western applications of meditation are done without creating the appropriate “container” for the experience, it does not surprise me that some people experience subjective ‘negative’ sensations. The purpose of meditation practices within the context of spiritual evolution is to transcend the ego (the perceiver of negative interpretations, discomfort, fear, etc.) to experience the Eternal/Infinite Oneness that is the true Self or Source. This is far from “emptying the brain” or mind though both are involved in initializing access to Cosmic Consciousness. If the ego is unprepared for the intensity of energies meditation can create, it’s breaking up can be unnecessarily painful. Too late in the article is this addressed. Subjects are like the unfortunate student of magic in the Sorcerer’s apprentice, conjuring forces s/he has not learned sequentially to master.

  8. I sometimes recite the Lord’s Prayer. (As well as deeper, more thought forms of Christian prayer/meditation.)

    I have a real problem with forcing people to go through religious acts against their will. Meditation and prayer are both religious at their roots. Nobody should be forced to go through TM any more than therapists or case worker stooges should be allowed to force us to recite certain rote prayers in unison. Neither will do those so forced any good! Like those permanent smiley faces we had to make! 😀 Hated it!!! 😛

    • The point of the recently developed therapies involving meditation is specifically to move away from any religious framework, and nobody is forced to engage in them.

      Most of the therapies involve being able to establish a calmer mind with less unnecessary wandering and less tendency to get trapped in obsessive negative thinking. They also involve greater awareness of body sensation, and learning to be calm and non-reactive to bodily sensations.

      This is important as it is now well established that most of our actions and responses are driven by emotional reactions- that these emotional reactions all have a distinctive key signature of body sensation and those sensations feed in to our brain where they will drive actions which are sometimes too impulsive and potentially harmful to ourselves and those around us. These therapies will not cure everything (acute mania, severe depression, and florid psychosis would all be major barriers to success).

      However they are distinct from TM- which as i understand it is only based on achieving stable attention.

      Meditation really only becomes religious when it is coupled with religion specific practices. I agree 100% – those have no place in therapy. It sounds like your experience was pretty awful.

    • I agree with you, religion in any form should never be forced on anyone for any reason, period. It should never be part of anyone’s “treatment”. But, as we all know, more abuse has taken place because of religion than just about any other thing. I am very glad that you found your way here to MIA.