Meditation: A stress reliever, but not a panacea

Nik Wallenda, wikipedia
Nik Wallenda, wikipedia

Do you believe all you read about meditation? It’s easy to interpret the latest news or article that confirms your biases that meditation is a proven cure for what may ail us in body, mind, or soul. It’s also difficult to be mindful of our own presuppositions, to be aware of our thoughts, during our daily lives, while reading and filtering an avalanche of data coming at us.

We all benefit from slowing down, turning off our devices once in awhile, breathing slowly and getting centered in the moment. Observe your thoughts. Know your mind. I’m all for meditation and being present in the moment- and the next. That’s why I advocate reason WITH meditation. Without reason, our meditation (which is led and perceived by our mind) easily drifts into fairy-tales and fantasies. Head in the clouds. Feet on the ground (in reality) or we will topple and smack our heads.

Read this brief article below, and may we all keep our head in the clouds and our feet on the ground.

Los Angeles Times: Science

Meditation: A stress reliever, but not a panacea

By Melissa Healy

March 3, 2014, 5:26 p.m.

Take a deep breath, meditation enthusiasts: A new study finds that research on mindfulness meditation has yielded moderate evidence that the practice can reduce anxiety, depressive symptoms and pain, but little to no evidence that it can reduce substance abuse or improve mood, sleep or weight control. And no evidence was found that meditation programs were better than drugs, exercise or other behavioral therapies at addressing issues of mental health.

The latest word on meditation’s effects comes from a meta-analysis–essentially a study of existing clinical trials that sifts, consolidates and distills their findings. It’s published in JAMA Internal Medicine.

Read the full article Meditation: A stress reliever, but not a panacea – latimes.com.

5 comments

  1. Lawson ENglish

    Only studies that examined clinical populations were evaluated, and only psychological tests of stress were evaluated.

    Regardless of outcomes on other measures of stress, studies that showed no change in psychological measures because they were already scoring low on such measures, were counted as “no effect” studies.

    This lead to the finding that a study hailed by editors of the journal _Circulation: Cardiovascular Quality and Outcomes_ as one of the most important articles published in that journal in 2012: http://circoutcomes.ahajournals.org/content/early/2012/11/13/CIRCOUTCOMES.112.967406.abstract

    for its finding that TM practice reduced mortality by 48% compared to the control group over a 5 year period.

    the meta-analysis you cite ranks the same study as “no effect.”

    The meta-analysis uses a binary rating system: either active controls are used, or not. If active controls are not used, the study is simply ignored.

    This means that two recent pilot studies on TM and PTSD, which have already prompted international relief agencies to contact the researchers, would not be included in any future version of the same analysis:

    Background: 3 Ugandan, Africa citizens recently returned from the 5-month, in-residence TM teacher training course. One of them happened to be fluent enough in the major dialect of the Congo that they could teach meditation to Congolese refugees, so True Believer™ TM researchers traveled to Uganda for a few months and set up a research program.
    Researchers offered bags of cooked food to participants who showed up to the pre-test phase (about 100 showed up and accepted the bags of food).

    About 70 returned for the actual study, so researchers redesigned the study on-the-fly and ended up with 21 subjects learning TM and 21 wait-list matched controls.

    Subjects were living on floors of churches, in crude mud huts, or outside. Subjects were in survival mode, unable to speak the language of the host country, unable to find work, often barely able to find food from relief organizations (hence the 100 showing up for the bags of cooked beans). They had been through exceedingly traumatic experiences, such as watching their husbands killed, then gang-raped by the murderers while their children watched -the usual stuff that war movies avoid mentioning.
    Subjects were administered the Posttraumatic Stress Disorder Checklist-Civilian (PCL-C), which asks 17 PTSD-related questions on a scale of 1 to 5. 17 is the lowest possible score, 85 the highest possible. Below 35 means “non-symptomatic.”

    Reduction in posttraumatic stress symptoms in Congolese refugees practicing transcendental meditation
    http://www.ncbi.nlm.nih.gov/pubmed/23568415

    “All participants completed the PCL-C measure of PTS symptoms at baseline, and 30-day and 135-day posttests. The PCL-C scores in the control group trended upward. In contrast, the PCL-C scores in the TM group went from 65 on average at baseline indicating severe PTS symptoms to below 30 on average after 30 days of TM practice, and remained low at 135 days.”
    90 percent of the test subjects scored “non-symptomatic” after only 30-days of TM practice. None of the control subjects tested non-symptomatic during the same period.

    In the next study, researchers managed to keep contact with 11 of the non-assigned subjects and tested them several times on the same PCL-C before teaching TM. They then examined how fast TM worked on PTSD.

    Significant Reductions in Posttraumatic Stress Symptoms in Congolese Refugees Within 10 days of Transcendental Meditation Practice
    http://www.ncbi.nlm.nih.gov/pubmed/24515537

    This follow-up pilot study tested whether Transcendental Meditation® (TM) practice would significantly reduce symptoms of posttraumatic stress in Congolese refugees within 10 days after instruction. The Posttraumatic Stress Disorder Checklist-Civilian (PCL-C) was administered to nonmatched waitlist controls from a previous study 3 times over a 90-day period. Within 8 days of the third baseline measure, 11 refugees were taught TM, then retested 10 days and 30 days after instruction. Average PCL-C scores dropped 29.9 points from 77.9 to 48.0 in 10 days, then dropped another 12.7 points to 35.3 at 30 days. Effect size at 10 days was high (d = 4.05). There were no adverse events. All participants completed the study and were able to practice TM.

    Skeptics might want to consider if meta-analyis that can’t take the above studies into account when evaluating the effects of meditation on stress, should be considered valid in the first place.

  2. Scott at SkepticMeditations.com

    Hi Lawson: You’ve shared plenty to consider in your comments, especially about some research on Transcendental Meditation (TM). Thank you for engaging and sharing your thoughts on Skeptic Meditations.

    Regarding why I used the JAMA meta-analysis referenced in two of my posts — you commented that “Only studies that examined clinical populations were evaluated, and only psychological tests of stress were evaluated”.

    Correct! Wouldn’t we want to only evaluate scientific or medical claims that meditation is a “treatment” for physical or psychological ailments using clinical data and scientifically verifiable methodologies?

    I’m skeptical of the meditation studies you cited in your comments for several reasons, including:
    1) 21 participants in your cited Schneider AHA study. 21 participants! Way too small a sample to come to any reliable conclusions. The Goyal JAMA study, I cited in my posts, was a meta-study of 47 clinical trials with 3,515 participants. I’d say that quantity provides a much higher probability the results of the study are reliable. At least, until better, more thorough studies are conducted Goyal JAMA appears to be the best evidence (or lack thereof) of the efficacy of meditation for psychological interventions.
    2) Potential conflicts of interest with participants or sponsors of the Schneider AHA study. Looks like Maharishi University (proving TM is their primary product or agenda) sponsored Schneider study.
    3) Confirmation bias: I wonder how many researchers and sponsors of the Schneide study are themselves TM practitioners or followers, as they’d have a tendency to favor information that confirms their beliefs or hypotheses (eg. confirmation biases).

    The flaws above are enough to case doubt these and most other studies. We need to see much more scientific methodology and better studies before we should warrant belief to the extraordinary claims of the faithful meditators or mystics.

    Hope this helps answer your questions about why skeptical, rational-thinking is required. Especially, to evaluate studies and claims about meditation, indeed any extraordinary claims about products, ideas, or faiths.

    Regards,
    Scott

  3. Lawson ENglish

    You’ve conflated several studies and their results.

    For example, the Schneider study on hypertension in blacks was 201 (two hundred and one) subjects divided into two groups, not 21 (twenty one) subjects: http://circoutcomes.ahajournals.org/content/early/2012/11/13/CIRCOUTCOMES.112.967406.abstract

    This was, as I understand it, the largest long-term ( average 5+ years) randomized, controlled study of meditation’s effects on a serious medical condition ever conducted on any form of meditation.

    http://circoutcomes.ahajournals.org/content/early/2012/11/13/CIRCOUTCOMES.112.967406.full.pdf

    The review you mention was NOT on clinical populations of people with physical conditions, but mental conditions. The TM study was coincidentally included in the review because the researchers happened to test anxiety as a secondary end-point, and anxiety was the primary endpoint examined in the AHRQ review. Because the subjects tested low on anxiety at pre-test and at post-test, the review counted the study as showing that TM had “no effect” on anxiety. The review did NOT deliberately include studies results on any physical test of stress other than weight-loss. Physical effects commonly associated with stress such as stroke, heart attack, high blood pressure. insulin resistance, heart-rate variability (did you know that a perfectly regular heart rate is considered an extremely dangerous medical condition?), etc., were not counted as measures of stress in the AHRQ review -only weight loss.

    Due to the exceedingly lopsided publication rate of mindfulness vs TM studies that has arisen in teh past 7 years (see this graph -the last data-point is for the first month of 2014: https://www.facebook.com/photo.php?fbid=10203006996966605&set=pb.1555020826.-2207520000.1394415539.&type=3&theater) it is trivially easy to devise a meta-analysis that will favor mindfulness, simply due to the (currently) 50:1 mindfulness to TM publication rate.

    However, when you happen to use criteria where TM research has been focused -such as physiological measures of stress- impartially conducted reviews show a different story.

    The American Heart association examined 1,000 (one thousand) studies published between 2007 and 2012 on the effects of alternative treatments for hypertension, and reported that only TM currently had sufficiently high quality research with consistent enough results to justify recommending it for clinical use in the treatment of hypertension. The rating they gave was not the highest possible by any means, but in an exchange of Letters to the editor between Richard Schneider and lead author of the AHA statement, Robert Brook, Brook commented that TM research was unique in its quality amongst meditation research with respect to hypertension. This shouldn’t be surprising as the NIH has given $20+ million in grants to study TM’s effects on hypertension and other heart-associated medical conditions (specifically in Black Americans).

    Which is the point: with 50x as much research appearing for mindfulness, only those areas of research where major grants exist, will TM research be available in the numbers sufficient to conduct a decent meta-analysis.

    As I said before, there’s only a handful of TM studies on PTSD, but already, if you simply do a pubmed search of

    ((PTSD stress) OR (“posttraumatic”) OR (“post traumatic”) OR (“post-traumatic”) ) AND ((((mindfulness stress) OR mindfulness meditation) OR MBSR stress) OR MBCT stress) OR vipassana

    http://tinyurl.com/lo4r3kp
    you find 85, many of which are often hand-waving about how effective mindfulness will prove to be, rather than real research.

    A pubmed search on

    ((PTSD stress) OR (“posttraumatic”) OR (“post traumatic”) OR (“post-traumatic”) ) AND (“Transcendental Meditation”)

    http://tinyurl.com/n74wwk6
    yields only 8 studies, half of which are genuine studies on treatment outcome.

    And yet, you can already see a marked difference in treatment outcome between TM and mindfulness.

    The US military is currently studying how PTSD is affected by mindfulness, generic mantra meditation and TM. About $2.4 million is going into a 4 year longitudinal study of TM’s effects on PTSD vs the most commonly used psychiatric treatment. Assuming the results of the preliminary studies on each practice are confirmed by larger, better designed studies, TM should prove vastly superior.

    And PTSD is the worst example of stress, by definition.

    By the way, your point about experimenter bias applies to studies on all forms of meditation. In fact, publicly funded TM studies these days are arguably less biased than studies on other forms of meditation, if for no other reason than TM researchers have been publishing for nearly 45 years and have 2 generations of accumulated experience in how to approach potential collaborators outside their inner circle of true believers.

  4. Scott at SkepticMeditations.com

    Hi Lawson, I appreciate your passion and detail about these studies on TM (Transcendental Meditation). Before we get further, let me share my goals for Skeptic Meditations.

    1) explore meditation and godless spirituality;
    2) promote skeptical- and critical-thinking methods and attitudes when examining any and all claims, especially any fantastical and supernatural claims require greater scrutiny and skepticism;
    3) examine, with an open heart and mind, various breakthroughs in science and human-rational understanding of how we view the world and ourselves.

    My personal disclosure is that I was a monk of Self-Realization Fellowship (SRF) Monastic Order for 14 years. I practiced Kriya Yoga meditation, as taught by SRF, for 20+ years. Kriya is a pranayama technique of breathing and supposed “life force” control, coupled with many other supernatural beliefs and metaphysical practices. Some meditation was beneficial to me, others not so much. I intend to share more on this website.

    Let me know if you have particular questions about me personally or my past or present beliefs. I’m a skeptic-humanist, atheist, if you have to label me now. I think I’ve made that apparent on this site. I have no personal agenda to promote one particular method of meditation over any others. Or, to deny or to debunk meditation as a whole. My primoary goal is to promote SKEPTIC meditations. That is encourage practical rationality, compassion, and scientific methodology in exploring spiritual, meditative, or mystical claims.

    I won’t deny that TM (and other meditation practices) provide many benefits to practitioners. I find many of these benefits can be obtained in many other ways worth considering, including controversial ones. Skeptic Meditations is intended to encourage the goals I set forth above. When I have more time I’ll try to explore the studies in the links you provided and let you know if I have questions or comments. Maybe there’s some potential content in there for a blog post on this site?

    More importantly. I’d be interested in understanding you: What meditation method do you practice? Are you associated with any particular religious or meditation organizations? If so which ones and what tenets and beliefs do they/you hold? If you care to reply, please keep your comments brief and concise as possible. I’ll do my best to reply soon. (Sorry, it took my a few days to get back to you post above. I’ve had some personal and technical challenges I’m dealing with). Scott

  5. Lawson ENglish

    I’ve been practicing TM for 40 years, and the Yogic Flying, etc, techniques for nearly 30 years. I’m not affiliated in any way with any spiritual organization, TM-related or not. (Assume I’ve denied any other kind of affiliation with TM etc as well, if I missed something you are concerned about). I accept that the above practices have measurable, beneficial effects on at least some people (including myself) and relatively few, if any, detrimental effects (as long as they are practiced “properly” or “appropriately”). I’m not committed to practicing the above because I am certain that all traditional descriptions (i.e. the “hopping like a frog” stage of Yogic Flying eventually gives rise to “sitting in the air” stage), of such practices are valid, but simply because the practice itself seems to be of value on some level.

    I accept Maharishi Mahesh Yogi’s definition of, at last, the “first type” of enlightenment he defined because it is so straightforwardly trivial, easy to study scientifically, and almost certainly is correct within the context of TM: the physiological effects of TM start to become a trait outside of meditation, and eventually become noticeable such that these changes give rise to self-evident changes in mental functioning outside of meditation as well.

    I’m friends with many, if not most, of the people who regularly publish scientific research on TM in standard scientific journals, and tend to trust their scientific integrity more than some people might. I accept that this article by Fred Travis isn’t completely crazy, for example: http://onlinelibrary.wiley.com/doi/10.1111/nyas.12316/full

    I believe that most other meditation practices are rather different in their physical effect than TM is, and that this difference becomes more and more noticeable, at least on a physical level, the longer people practice their respective meditation techniques.

    I rather like Maharishi Mahesh Yogi’s radical advaita vedanta perspective that allows for the scientific investigation of “higher states of consciousness” as quoted below:

    “Every experience has its level of physiology, and so unbounded awareness has its own level of physiology which can be measured. Every aspect of life is integrated and connected with every other phase. When we talk of scientific measurements, it does not take away from the spiritual experience. We are not responsible for those times when spiritual experience was thought of as metaphysical. Everything is physical. [human] Consciousness is the product of the functioning of the [human] brain. Talking of scientific measurements is no damage to that wholeness of life which is present everywhere and which begins to be lived when the [human] physiology is taking on a particular form. This is our understanding about [human] spirituality: it is not on the level of faith –it is on the level of blood and bone and flesh and activity. It is measurable.” -Maharishi Mahesh Yogi

    I happen to go somewhat further than Maharishi does above because I don’t assume that any specific bit of spiritual/religious tradition is correct in any absolute sense, though I am willing to consider that, in the context of the above quote, there might be scientific explanations for why people in different traditions believe that their own spiritual traditions are valid that can be scientifically investigated or even validated, in some context.

    Does this help?

    Lawson

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