Let’s answer the question that certainly brought you to this page: is meditation another snake oil claim, with no scientific basis concerning its benefits? No. There is good, well conducted and well published research on its benefits and, even more, on its existence as a study object.
Does that mean that you can rely on it for your health concern? No, not yet (you can use it as adjuvant therapy and we will explain each case). Because of one tiny phrase that is present in every serious scientific review: “the underlying neural mechanisms remain unclear”.
In other words, it works (for some things), it is seductive, there is anecdotal evidence of incredible results everywhere but the truth is: we don’t know why, when or how.
Hey, chances are that you not only tried, but you had what you strongly suspect were truly good results. I did, too! Let me tell you a story: when I was in college, it was mandatory to take one semester of physical education practice at the Center of Sports Practice. I looked at the menu, the things I really liked weren’t there and there was yoga.
Humm, yoga… how about that? It’s different.
The university yoga coach happened to be an international authority. He had been to India, studied yoga for years and was originally a major in exercise science. Half of the students were expecting to do “energy stuff”. In the first class, he went right at it: “This has nothing to do with religion or mysticism.
What I will teach you here is a set of techniques that will help you relax your body and, with that, relax your mind and become more attentive. By the second part of the semester, I will teach you some breathing techniques that will help you even more. And the very last classes I will give you an introduction to meditation, which requires you to master all the previous techniques. If you manage to practice that every single day, you may be able to meditate for almost 60 seconds. Be very happy if you manage 60 seconds: most people can’t”.
Oh. Well, we had much more room for practice after the second class (most people gave up). And I remained with him for six years. All through my undergraduate years, then through Master’s work, pregnancy and finally the doctoral work. My final months of doctoral work were a train wreck. It was 1994, Windows 3.1 was new and full of bugs.
My computer crashed with the final copy of the dissertation. Nobody could open the floppy disks (you don’t even know what that is, look here because, well, bugs. When I finally managed to print the dissertation, I was cramping bad and all my muscles were stiff. I went to yoga practice to feel a little better. Even then, Marcus set me up on the “damaged people” corner because I was so sore and so freaked out that I had no mind to perform positions I was skilled at for 5 years.
I can tell you with first hand experience: there is nothing easy or fast about meditation.
Now look at this picture here:
This is my new meditation device. It makes life so much easier! Those three little white clips are sensors that should measure skin impedance, heart rate and blood pressure. There is a software that integrates the information from the sensors with cute animations where you need to move a ball up or down with increased focus (“cardiorespiratory synchrony”). Ooo! You move things with your mind! It is a simplified biofeedback device.
Basically, it is meditation with a screen giving you constant feedback about how well you are managing to keep intruding thoughts out, to control your anger or anxiety, all of which will send the golden ball flying into the space and you will want to throw the computer out the window.
Again: there is nothing easy about meditation.
I believe this simple introduction can tell you where I’m going with this article. Meditation is not a substance that can be taken as a pill or injected into the bloodstream. It is a technique that must be mastered before any potential benefits are observed.
There is research suggesting that mastery, and its effect on the brain, can take very, very long.
The problem is that the readership for the published material that ends with “the underlying mechanisms are unknown” and “more studies are needed to support meditation as treatment for ___” is tiny. It requires special training to understand it and being a member of a scientific community to have access to it. What the immense majority of the population will find is this:
Basically, what they are all saying is the opposite of what I said: it is easy, available to all, not time consuming, free and “good for you”.
The sources for these (heavily overrated) claims are what most people consider the reliable sources of information: mainstream media. We’re not talking about some obscure guru blogs that promoted a fad. These are the newspapers and magazines that “reasonable people” read.
The result couldn’t be different: meditation became big business. There are hundreds of meditation and mindfulness apps for mobile devices. Some even turn into “meditation social media”, promoting competition, “inspiration” and socializing in general, besides, of course, selling items, referrals to instructors, etc.
On mainstream media, very few cautious voices will dial down the optimism to a more realistic perspective.
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In this article, I will dissect the different ideas related to meditation and give you tools to handle the information overload about it. I will also explain what, in scientific terms, we think is happening to cause whatever benefits we observe. I will highlight certain important applications where meditation is claimed to be effective and show you the evidence either in favor of it or not. In this context, I will emphasize the difference between the novice and the experienced meditator, not only in terms of the benefits they may obtain, but in their “hardware” (their brain structure).
Table of Contents
What actually is Meditation?
The first thing to do when we want to understand a certain topic is get a definition, circumscribe its content and find equivalents or synonyms. As you will see, to understand meditation this is the crucial first step out of a jungle of confusing claims.
Let’s take a look at a couple of authoritative definitions:
Meditation refers to: a family of self-regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calm, clarity, and concentration (24).
In technical terms, meditation is mindfulness. Mindfulness may not always refer to meditation in the scientific literature, but most of the time it does:
While significant differences exist between Buddhist views of mindfulness and modern psychological adaptations, there is broad agreement that a clearly formulated mental training, usually referred to as meditation, is required for developing and improving levels of mindfulness (5).
Their definitions are practically the same:
For the purposes of the present paper, and for the sake of consistency with most of the research that is reviewed subsequently, mindfulness is defined as a moment-to-moment awareness of one’s experience without judgment. In this sense, mindfulness is viewed as a state and not a trait, and while it might be promoted by certain practices or activities (e.g., meditation), it is not equivalent to or synonymous with them (7).
Although there are several disciplines and practices that can cultivate mindfulness (e.g., yoga, tai chi, qigong), the majority of theoretical writing and empirical research on the subject has focused on mindfulness developed by mindfulness meditation (7).
Most authors point to serious issues when it comes to conceptualizing meditation:
- There are too many different practice traditions that fit into the same category, yet, most neurological studies don’t make a clear distinction concerning what practice was performed by the study subjects or even if it was one single practice;
- There may be differences between the effects of different practices
- There are many differences between novice practitioners and experienced practitioners
What most authors agree with:
- Meditation involves alterations in whatever is conceptualized as “consciousness” (awareness, focus, etc)
- Meditation is a trainable practice
- Meditation aims at self-regulation and attention
- There is no difference in the results obtained from religious (or spiritual) or non-religious meditators
From this, we have some important elements to work with during the following sections:
- Meditation requires a proactive attitude and discipline because it is (or is a result of) training
- One highly important idea for every research about meditation is self-regulation, or the ability to exert control over one’s functions, actions and reactions (some of which are usually considered out of voluntary control, such as blood pressure)
- Yoga (includes a set of physical postures, breathing techniques and other exercises)
- Qi gong, tai chi chu’an
- Religious practices to achieve enlightenment (nirvana, awakening of the Kundalini, samadhi, experiencing of different deities):
- Prayer bead meditation (many religions use prayer beads to reach states of consciousness that match the definitions of meditation and mindfulness, such as Buddhism, Jainism and even Christianity)
- Mantra chanting (loud or silent)
- Contemplation (when the practitioner focuses on one specific spiritual idea)
- Breathing meditation and techniques (associated or not to spiritual practices)
- Biofeedback mediation
- Relaxation techniques
- Autogenic training
- Progressive muscle relaxation
The majority of neuroscience studies conducted about meditation refer to the Buddhist practices. Studies that refer to “meditation and mindfulness” or “relaxation and meditation” may refer to any combination of the above techniques.
Some studies about the state of extreme focus attained by high performance athletes in some sports have pointed out the similarities between this state, also known as “the zone” or “flow”, and meditation (14, 25). Here I may have some experience to share, as a world record breaker and world champion in a sport that requires extreme focus: powerlifting. During some heavy (or very heavy, or even competitive) lifts, “something” happens. I don’t know what it is.
All I can say is that I have no idea about what is happening around me: when I watch the videos later, I’m amazed, because there is a lot happening including loud music, people screaming their lungs out, and at least three individuals in very close proximity (spotters who supervise safety). And for a brief period, that I don’t know the length of, I completely lose the perception of time and of my own body. Two words: weird and awesome.
What I am telling you is very similar to what any high performance athlete in certain sports report. But again: it takes many years of training and it takes being physically gifted to reach that state. I’ve been a powerliftereen a powerlifter for ten years and a competitive athlete for more than forty.
How much research is there?
First answer: not so little.
Second answer: not enough.
Let us give you a measure of its magnitude: the graphs below express the publication trend in four different subjects from 1950 to 2010. I’ve chosen a rare disease, alkaptonuria, as example of something we would expect not much research interest on. Cancer, on the other hand, is possibly one of subjects that most attract research interest, funds and result in publication.
In the middle, the common Tylenol (acetaminophen). The numbers in the ordinate (Y axis) represent the number of documents matching the query (word in the title of publication on Medline), divided by the total number of publications per year and corrected for the increasing number of publications.
Since 2010, the trend in growth in research publication about meditation has remained constant:
|Year||Number of published articles||% of total articles on the subject|
If we perform an advanced search on Pubmed for title words since 2011, this is the result:
|Search term for article title||Number of articles since 2011|
|“meditation + cardiovascular”||13|
|“meditation + chronic + pain”||12|
|“meditation + anxiety”||33|
|“meditation + skin”||0|
|“meditation + substance + abuse”||1|
|“meditation + stress”||64|
|“meditation + neural”||20|
That doesn’t mean there is no research about dermatological issues or substance abuse. It just means it is not a title expression. This is a “by proxy” measure about the importance of a subject for the scientific community. Also, interest in basic research, meaning the neural, neurobiological and molecular aspect of meditation is growing.
This is where the real scientific “juice” is, with articles published in reputable journals such as Nature, Frontiers in Human Neuroscience, Perspectives in Psychological Science, The Journal of Neuroscience, PNAS (Proceedings of the National Academy of Science) and Neuroscience Letters. Reaching “Nature” or “PNAS” means big time scientific recognition. In a sense, we can say basic research in meditation made it into mainstream science.
What do we know about the mechanisms of meditation?
What research has offered up to now in terms of mechanisms of action is a wealth of neuro-physiological information considered insufficient to satisfactorily explain the observed effects. In other words, meditation causes acute and chronic functional and structural changes in the brain that “make sense” concerning the observed effects, but are still not enough to positively claim they are responsible for them.
There are promising routes, though, especially in terms of methodology. Scientists are already aware that the mechanisms underlying effects observed in novice meditators are quite different from the ones observed in experienced ones, for example. They are also aware that different types of meditation practices produce different results, for different types of people.
First, neuro-scientific research has considered important to create two broad categories of meditative approach:
|Category of meditative practice||Main characteristics||Main neuro-physiological findings|
|Focused Attention Meditation (FA)|
|Involves skills for monitoring the focus of attention and detecting distraction, disengaging attention from the source of distraction, and (re)directing and engaging attention to the intended object||Capacities have been associated with dissociable systems in the brain. They have been correlated both with neural functioning indicators (EEG signaling, MRI evidence for activation, etc) and structural changes in the brain (tissue thickness, among others). Identified functional indicators:|
|Open Monitoring Meditation (OM)||OM is seen as an advancement of FA. Monitoring skill becomes the main point of transition into OM practice. One aims to remain only in the monitoring state, attentive moment by moment to anything that occurs in experience without focusing on any explicit object. To reach this state, the practitioner gradually reduces the focus on an explicit object in FA, and the monitoring faculty is correspondingly emphasized|
The research reviewed for this article suggests three classes of study subjects:
- Very short term training novice meditators (less than 10 days, daily practice)
- Short term novice meditators (2-3 months, daily practice)
- Long term (experienced meditators – years)
The problem with the functional and structural changes observed in experienced meditators is that we are talking about monk-level practice, for many years: “Whereas expert meditators with an average of 19,000 hours of practice showed stronger activation in these areas than the novices, expert meditators with an average of 44,000 practice hours showed less activation (18)”. Do you have any idea what 19K hours means? If you do something for 2 hours, every single day (you can’t cheat and skip a day), it will take you 26 years.
Tang and collaborators (22) suggested that different levels of expertise were correlated to different effects in the following manner:
The question at the base of most neuro-physiology research concerns the existence (or not) of structural changes in the brain and their relation to function. Studies that examined ‘morphometric’ neuroimaging of meditation practitioners suggest that there are consistent differences in the gray and white matter in meditators, specifically in prefrontal cortex and body awareness regions (9). This is a meta-analysis study, so the authors point out important discrepancies in the analyzed studies. Results suggest consistent and medium-sized brain structure differences.
However, there is still hope at the present embryonic stage of the scientific understanding of underlying mechanisms in meditation: even short term novice meditators can derive some benefit from meditation.
It seems that most of the beneficial effects observed in laboratory studies derive from the self-regulation effect produced by meditative practices. Those, in turn, are a result of heightened attention. So attention seems to be the key to start talking about meditation for anyone (19).
Apparently, all the short term effects observed in meditation interventions are in one way or another related to these mechanisms (23).
Is meditation helpful for cardiovascular disease?
With respect to cardiovascular disease and function, the word to be watchful for is “may”. Meditation may be beneficial. That doesn’t mean it is or that we understand why it is: “The regular practice of Transcendental Meditation may have the potential to reduce systolic and diastolic blood pressure by approximately 4.7 and 3.2 mm Hg, respectively. These are clinically meaningful changes” (1), for example. Most studies remain skeptical (20). In any instance, it seems that whatever result is observed is related to the stress reduction and increased attention mentioned before.
Is meditation helpful for chronic pain?
A recent review (26) compared studies conducted on the effect of meditation over different clinical pain conditions, including fibromyalgia and irritable bowel syndrome. The authors concluded that those studies provided evidence for the effectiveness of mindfulness meditation, but not necessarily its efficacy, meaning to what degree the observed effects were a result of the meditation practices themselves.
The authors separated those studies that used “focused attention” practices (where the practitioner was trained to disengage from distracting sensory input) from “open monitoring” practices (non-directed acknowledgement of any sensory, emotional or cognitive event that arises in the mind). They also discriminated studies performed with novice and experienced meditators.
Electroencephalography and image studies with experienced meditators showed that the activation of certain areas of the brain was related to less pain anticipation and perception of unpleasantness in pain. At the same time, brain activity decreases were observed for meditators in regions involved in emotion, memory and appraisal. Zen practitioners exhibited thicker gray matter in pain-related regions, which overlapped with the functional effects. The observed thickness was correlated with the number of years of experience in practitioners.
Many other structural and functional permanent brain alterations were identified in experienced meditators even when they were not meditating, indicating that the long term practice had promoted those changes. All of them are associated with either a higher pain threshold, a higher pain acceptance, decreased pain sensitivity and even an altered interpretation of pain. More interestingly, these chronic effects seem to be evidenced only in “open monitoring” types of meditation practice.
Although even a two month meditation instruction period for non-practitioners seems to alleviate pain, it appears that it does so by reducing stress and anxiety and not the pain mechanisms themselves.
What does that mean for you?
First, that meditation may be helpful anyway as long as you take some time to learn and practice it systematically and seriously. It will help you deal with anxiety, stress and depression that are a big part of the burden of chronic pain. But don’t expect to observe the significant decreases in pain that only highly experienced meditators can experience. You are not a monk, you are not going to become one fast enough.
For a collection of publications on meditation and pain, click here.
Is meditation helpful for panic & anxiety disorders?
Meditation is helpful in anxiety disorders even in short term instruction meditators. Studies have shown the main biomarkers for anxiety to be significantly reduced in the meditators groups (11, Kieran et al 2017). Studies have also shown meditation to reduce anxiety symptoms in panic disorder patients (21).
Is meditation helpful for substance abuse?
Again, it may or may not be helpful. If it is helpful at all, it is a secondary effect of stress reduction. This is not a minor contribution, since substance abuse is frequently associated to trauma and other stress related conditions (16).
Is meditation helpful for dermatological disorders?
Most research concerning meditation on dermatological disorders is related to psoriasis. Psoriasis is an auto-immune disease where patches of skin show an abnormal pattern with itching, infection or burning. It is thought to be generic in origin and triggered by environmental factors, where stress plays a predominant role. The studies that show meditation to be beneficial in reducing psoriasis symptoms may be evidence of a secondary effect of stress reduction (13, 10).
Are there risks to meditation?
There are no risks to meditation (unless you neglect important treatment strategies and place all your hopes on it). That doesn’t mean it is nice or pleasant. As I have been insisting from start: meditation is training, it requires discipline, patience and a lot of resistance to frustration. First, there are several types of meditation practices. Some easier, some harder. Some more relaxing and some more arousing. Research shows that it can actually be quite arousing and suggests that the type of practice must be chosen according to the goals, trainability and individual characteristics (17).
Is meditation helpful for the average person?
If you have read this article from the beginning, you know that the effects of meditation, or mindfulness approaches, are real. Probably all of them derive from the self-regulation, attention pathway. It is no wonder that it has been shown to benefit such a wide variety of disorders and conditions, and even improve normal, healthy performance (4, 12).
Meditation can help – to a lesser or higher degree – literally everybody who can meditate. To be honest, most people will only derive minor benefits from meditation because they simply won’t be able to develop the necessary skills. These minor benefits can be huge, depending on the person.
Ironically, it is the healthy, normal individual who will probably be able to benefit the most. As with all lifestyle long-term changes, that is where the profound, chronic effects will be observed.
Is it worth trying?
This is a question you need to ask yourself: is it worth making a lifestyle change that will improve your general awareness, but will consume your time and require effort?
Scientific evidence will inform your decision to go ahead and adopt this change. As it will suggest you adopt other changes, such as consistent exercise, refraining from toxic substance use and others.
Meditation, in this sense, is not a question of adopting a therapeutic measure or not. It is a question of adopting a lifestyle change or not. Maybe it is not for you. Maybe you are too distracted to isolate yourself for some time, every day, every single day, and expect results in years. Maybe you will take whatever is offered to you because you are in extreme suffering. In this case, don’t expect miracles.
There is no doubt you will experience some benefit. Some stress reduction will take place. How long will it take to notice that, nobody can tell. And only you can decide whether it is something you are willing to invest in.
For the average person, my answer would be yes, please begin. Begin before you really need it. Because when you do, it might be too late to obtain any benefits.
Life is stressful. It has to be: otherwise, you won’t grow. Personal growth is an adaptive response to stress.
All the research about meditation shows that even for novice meditators, it is an interesting tool for many serious discomforts in chronic illness and stressful life in general. But there is a problem: novice or not, meditation requires a change in attitude, the adoption of new habits and training. The bitter truth is that this is not for everyone. For a myriad of social, cognitive and cultural reasons, most people will not be able to engage in such practice or obtain any benefit from it.
For most people, two months is a long time, and it is the shortest time required to obtain any significant benefit from meditation. I’m pretty sure interest in more neurological research has an eye on speeding up this process and adapting meditation to our modern, attention-deficit times through pharmacological or other technological interventions.
Should you do it?
My advice is yes. Any form of mindfulness practice that you are capable of engaging in will at least help you cope with distress a little better, and that is not a small benefit.
But (and there is always a but), do not expect miracles. You won’t become significantly (or at all) happier, smarter, pain-free or cure your insomnia. And don’t rely on it as your main therapeutic approach to a serious illness.