The Truth About Meditation

Intro

An author who interviewed 200 world-class performers discovered that 80% perform some sort of meditation/relaxation routine. “Everyone else has an agenda for your time, so if you’re in a reactive mode, if you’re playing defense instead of offense, you’re going to get at best, average results” – he says. In a  general sense, we could say that successful people are mindful about how they spend their time. So not only does it appear that meditation is a common factor among successful people, it even makes sense that it is.

There are also a lot of blogs posts out there about meditation’s supposed benefits. But there’s an agenda from the get-go which is to show how meditation is beneficial. This bias results in only showing hand-picked articles that confirm the idea that meditation is indeed beneficial. Some examples: Liveanddare, HealthLine, PsychologyToday. It might not even be consciously biased.

If you wanted to know whether meditation is good or just a waste of time, you could, for example, google search of “science benefits of meditation”. But this search is already flawed, it will mostly show results that confirm that meditation has scientific benefits.

We’re all looking for simple ways to improve our lives. But being that meditation involves a significant time investment, isn’t it better we know it is being well spent?

So for this article I focused on systematic reviews and meta-analysis (studies that study and summarize the findings of several studies). There are many studies with methodological limitations (shortcomings in the method used to draw conclusions). For example, one problem with many studies is that they don’t account for selection bias. I want to find people for this meditation study I’m doing, and I don’t want them to dropout because that means I have to include more people, and that’s more costly (because I have to pay each person to participate in this). So I go to a meditation group or only recruit people that in the pre-screening reported that they were interested in meditation (so they’re less likely to drop out because they are motivated for reasons other than making a quick buck).

This is were systematic reviews and meta-analysis come in handy, because the authors analyze the quality of the studies and try to compare the findings to see if under similar conditions the results were replicable. In fact, systematic reviews “adhere closely to a set of scientific methods that explicitly aim to limit systematic error (bias), mainly attempting to identify, appraise and synthesize all relevant studies (of whatever design) in order to answer a particular question (or set of questions)” (Petticrew and Roberts,2006). Great!

Findings from Meta-Studies

Mental Health

Let’s get our hands dirty and dive into the scientific meta-studies. The one thing most of what I read had in common is that meditation does appear to have a significant benefit in reducing experienced anxiety and in some cases depression and its relapse. On a systematic review Manzoni et al. (2008) found consistent and significant efficacy of meditation in reducing anxiety. A later review by Chen et al. (2012) however then “(…) demonstrates some efficacy of meditative therapies in reducing anxiety symptoms.” This means that meditation appears to be effective in reducing how anxiety presents itself, but it’s still unclear whether it prevents its onset (as most studies focused on measuring the symptoms only).

Another systematic review by (Gu et al.,2015) identified “strong, consistent evidence for cognitive and emotional reactivity [meaning people who meditate tend to become less reactive to external stimuli, become calmer], moderate and consistent evidence for mindfulness, rumination, and worry, [worry less] and preliminary but insufficient evidence for self-compassion and psychological flexibility.” They end the paper by stating that “Most reviewed mediation studies have several key methodological shortcomings which preclude robust conclusions regarding mediation.” Hence why a lot of studies need to be taken with a grain of skepticism.

Loving kindness meditation systematic review reports that meditation practice “was moderately effective in decreasing self-reported depression, and increasing mindfulness, compassion, and self-compassion against passive controls. Positive emotions were increased against progressive relaxation.” (Galante et al.,2014).

Another systematic review found that “mindfulness meditation improves pain and depression symptoms and quality of life” (Hilton et al.,2017). Mars and Abbey (2017), state “the higher quality studies analyzed in this review have demonstrated replicated statistically significant improvements in spirituality and positive health measures and decreases in depressive relapse, depressive recurrence and psychological distress” for the practice of mindfulness meditation.

Mindfulness based therapy is an effective treatment for a variety of psychological problems, and is especially effective for reducing anxiety, depression, and stress (Khoury et al.,2013)

Jacob et al. (2012) on their systematic review stated that the existing studies vary considerably in terms of quality, but on the high quality ones “there appears to be some positive evidence (…) to support the use of Mindfulness Based Therapy for cancer patients and survivors with symptoms of anxiety and depression”

In another review, Piet (2011) found mindfulness based cognitive therapy to be an effective way to prevent relapses in people with major depression.

Mindfulness based cognitive therapy (TEDx Talk by Dr. Zingel, U. Toronto and MBCT website) was designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness (being consciously aware and accepting of one’s own present state, physical and emotional feelings and surroundings). The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them (basically Cognitive Behavioral Therapy + Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction program).

Physical Health

Another systematic review reported that mindfulness meditation “decreases binge eating across a variety of samples; reduces emotional eating for individuals engaging in this behavior” but does not “consistently produce significant weight loss”. (Katterman et al.,2014). However an earlier review found no such effect… “We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight.” (Goyal et al.,2014). Ouch, this one is hard to digest. This same review, though, finds that “Mindfulness meditation programs had moderate evidence of improved anxiety, depression, and pain and low evidence of improved stress/distress and mental health-related quality of life.”

(Gard et al.,2014) “While most studies were small pilot studies, they provide preliminary evidence that a variety of meditation techniques may be able to offset age-related cognitive decline and perhaps even increase cognitive capabilities in older adults.”

Winbush et al., (2007) didn’t find any clear demonstration that mindfulness meditation improves sleep quality and duration.

Even though the findings reviewed provided initial evidence that suggests that meditation could enhance cognitive functions (namely attention, memory and motor functions), this should be considered with caution and further high quality studies are needed (Chiesa et al.,2011).

Black and Slavish (2016) found “possible effects of mindfulness meditation on specific markers of inflammation, cell-mediated immunity, and biological aging” but that the results were still shaky and needed further research.

A systematic review concerning heart disease (Dixhoorn and White, 2005) found usefulness in “supervised relaxation practice as a treatment per se and warrants the inclusion of full relaxation therapy in cardiac rehabilitation, because it enhances recovery from an ischaemic event and it contributes to secondary prevention, independently of the effect of psycho-
education and of exercise.”

Another systematic review evaluated the efficacy of stress reduction programs in patients with elevated blood pressure (Rainforth et al.,2008) and found reductions on the order of -2 to -5 mm Hg for systolic (the higher pressure) and -1 to -3 mm Hg for diastolic (the lower one) pressure for  progressive muscle relaxation, stress management training, and the Transcendental Meditation program, being that the latter one resulted in the highest values.

Findings from individual studies

Systematic reviews and meta analysis are hard to execute and they need a good number of high quality studies analyzing the same things, which limits the number of subjects that get studied by these meta-papers. Because of this I decided to include a few studies concerning other subjects. Three that I find particularly interesting and that weren’t analyzed by the meta-studies is how it impacts the ability to focus, to be creative and how it influences social relationships.

This article shows that a group randomly assigned to 5 days of meditation practice with the integrative body–mind training method shows significantly better attention and control of stress than a similarly chosen control group given relaxation training. (…) Compared with the control group, the experimental group of 40 undergraduate Chinese students given 5 days of 20-min integrative training showed greater improvement in conflict scores on the Attention Network Test, lower anxiety, depression, anger, and fatigue, and higher vigor on the Profile of Mood States scale, a significant decrease in stress-related cortisol, and an increase in immunoreactivity. (Tang et al., 2007)

One such paper (Davidson and Lutz, 2008) stated that “expert meditators also showed less activation than novices in the amygdala during FA meditation in response to emotional sounds. Activation in this region correlated negatively with hours of practice in life. This finding may support the idea that, advanced levels of concentration are associated with a significant decrease in emotionally reactive behaviors that are incompatible with stability of concentration.” What this means is that the more they found people to meditate the more non-reactive they became to emotional sounds

Meditation appears to have some positive influence on intimate relationships. The findings of a study I found interesting suggest that “couples who are more mindful appear to be more likely to enjoy greater relationship health and stability, and within that, increases in satisfaction and affectionate behavior, as well as greater inter-partner harmony on a range of life issues. Examination of several emotion skill domains in conjunction with mindfulness further suggests that at least one of the avenues to enhanced relationship functioning may be through partners’ more relationally skillful emotion repertoires. We posit that mindfulness puts one in closer contact with one’s own experience relative to the more typical mode of consciousness which, according to Buddhist thinking, is akin to a perpetual state of distraction, if not full-on experiential avoidance.” (Wachs and Cordova,2007). In other words, in mindfulness meditation we practice the act of being conscious of how we are feeling. Thus it does make sense that this results in us becoming more aware of distress feelings that may arise, which in turn enables us, for example, to prevent those feelings of spiraling out of control.

Another study expands on this ideia: “Study 1 found that higher trait mindfulness predicted higher relationship satisfaction and greater capacities to respond constructively to relationship stress. Study 2 replicated and extended these findings. Mindfulness was again shown to relate to relationship satisfaction; then, using a conflict discussion paradigm, trait mindfulness was found to predict lower emotional stress responses and positive pre- and postconflict change in perception of the relationship. State mindfulness was related to better communication quality during the discussion” (Branes et al.,2007)

To end, I also stumbled upon another study that suggests that meditation improves creativity: “These findings lend support to the notion that mindfulness involves cultivation of a “beginner’s mind”, and demonstrate that mindfulness practice reduces cognitive rigidity via the tendency to overlook simple novel solutions to a situation due to rigid and repetitive thought patterns formed through experience. [that is, improves creativity]. (…) The present findings coincide with previous findings in which meditators outperformed non-meditators in tasks such as verbal fluency, and visual perspective switching, in the respect of exhibiting an improved ability to generate varied responses to the same stimuli following mindfulness practice. (…) Our findings additionally converge with findings regarding decreased rumination in the sense of a reduction in repetitive and perseverance negative thoughts.”  (Greenberg et al. 2012)

While these claims are not as convincing as the ones from the systematic reviews, they at least point us to a few possibilities. If nothing else, we may try this and improve the placebo effect.

Meditation vs Relaxation

Maybe meditation is not that much better than simply relaxing. Maybe the reported benefits of meditation come from the fact that you’re sitting down, relaxing, not thinking about your worldly concerns for a few precious moments. If only we could compare both meditation and relaxing… And we can, thanks to a study by Jain et al., (2007).

In this study, they compared a group of people meditating with another group of people simply relaxing. They had four 1.5 hour sessions, spread over four weeks. The exercises included “(…)

  • body scan meditation, in which the practitioner focuses attention on each part of the body to notice sensations that arise;
  • sitting meditation, where the practice is focusing non-judgmental awareness on whatever arises moment by moment;
  • Hatha yoga, where one practices gentle stretching while maintaining attention on subtle movements in the body;
  • walking meditation, where one practices walking slowly, with awareness;
  • and loving-kindness meditation, where one focuses attention on feelings of caring and love for one’s self and others to cultivate compassionate awareness and action in everyday life.”

The relaxation exercises “[integrate] techniques of autogenic relaxation using the six autogenic phrases used by Schultz,

  • progressive muscle relaxation (using tension and release of muscles throughout the body to relax),
  • simple breathing techniques (such as simple diaphragmatic breathing and breathing with counting),
  • and guided imagery to give a comprehensive course on stress reduction via a focus on bodily relaxation.”

It concludes that “both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group. There were no significant differences between meditation and relaxation on distress and positive mood states over time.” They continue by saying the effect was significant in terms of distress reduction for both but that the meditation group showed a larger effect size for positive states of mind than relaxation”.

In a way, meditation is basically relaxing without ruminative thoughts. If we think of meditation as an improved for of relaxation, and being that relaxation in itself is self-evident to be healthy, then it becomes obvious that meditations needs to, at least, borrow some of the benefits from simply relaxing.

Meditation as a Form to Improve Awareness

Sometimes, your body is too unsettled to sit and focus your mind. When this happens, externalizing your focus can be very helpful, e.g, focus on a repetitive task, like dish washing, shampooing your hair, brushing your teeth, etc. Here it’s important to make a distinction. We frequently read the words mindfulness and meditation together, but they can exist also separate. Mindfulness is just being in the moment, in the present. Sometimes we are mindful without noticing. If we’re playing a hard instrument that requires all our focus, we’re just in that moment and nowhere else. If we’re doing a competitive sport, practicing a skill or mindlessly washing the dishes we can be mindful. Mindful meditation is then just the combination of the two. We can also be mindful in any moment to notice what our body is feeling, what thoughts are racing through our mind, to notice our habitual behaviors (as if we were looking at ourselves from the outside as a loving friend).

Mindfulness Meditation is NOT necessarily going to calm your mind, although this can be a pleasant outcome. It really is about building the skill of noticing, and of having control over your attention. It is not about clearing your thoughts, but noticing what’s going on in a non-judgmental way. It is about noticing our default way of thinking. To allow the thoughts to be there, without judging or avoiding them. This can 1) let you build a curious relationship with the stuff going on inside yourself, body and mind, even the stuff that feels awful and that you try to push away and pretend it’s not there 2) initially lead you to notice that you are anxious, but then you can use tools to calm the anxiety 🙂 The more comfort you becoming noticing the discomfort, the more it will reveal itself to you, and the better you can then deal with it. As a disclaimer, for traumas and severe feelings, it may be better to approach the situation with a therapist, because it may be too hard to look into it just by yourself.

If you have parts of you that are hurting/afraid, getting access to those parts/emotions and hopefully processing them in a gentle/effective way can be helpful. Just to let them be there… showing to yourself “I accept this, I accept you, it’s okay to feel this, it’s safe, …” is helpful.

But It doesn’t ‘resolve’ them, or answer why they are there, or help us fully understand and change the behaviors we are still doing to keep the hurt/fear alive and reoccurring in new situations and new relationships.

Also you need to feel safe/stable/be grounded for mindfulness meditation to work. If it hurts too much and you’re not ready, and you don’t feel safe, yelling at yourself to ‘do it anyway’. Forcing yourself to do it isn’t helpful. The core of mindfulness meditation is to stop trying…… to say “It’s okay right now, I’m good enough right here, right now, I’m safe right here, right now. Through that you can then simply experience what’s around and in you as it is. That’s mindfulness.

Some painful feelings may appear to be a banner of the truth. Mindfulness meditation allows you to see that even though they’re real, they may not necessarily come from a place of truth. What I mean by that is that, you’ll see the feeling is real, what is causing it also real, but not necessarily true. For example if someone in the past consistently put you down, you may feel very hurt. The feeling is real, the cause is real, but it doesn’t mean you are what they made you to be.

  • Emptiness – Something is missing, that there is no point, that you don’t know who you are, the things that make you you, maybe because someone constantly criticized you.
  • Fear – Something or someone is dangerous.
  • Guilt – You’ve done something bad.
  • Inadequacy – That you don’t fit in. That you’re not good enough, and others are better than you.
  • Jealousy – Envying someone else’s good fortune.
  • Powerlessness – Lack of control / influence over situation.
  • Rejection – Having you and your feelings invalidated. Someone telling you shouldn’t feel as you do, or that they’re not real and only in your mind. Or that you’re not loved and lovable.
  • Resentment – When you believe you’ve been treated unfairly.
  • Shame – Belief that you and your feelings are wrong / bad.
  • Worthlessness – That you have no value, that you deserve contempt.

For more on this subject I would recommend the book Radical Acceptance by Tara Branch.

How to Meditate

Most types of meditation follow this general process:

Being in a comfortable, relaxed state.
Directing and sustaining attention on X.
Detecting mind wandering and distractors (e.g. thoughts).
Disengagement of attention from distractors and shifting of attention back to X.
Cognitive reappraisal of distractor (e.g. ‘just a thought’, ‘it is okay to be distracted’).

As for getting into a relaxed state, here’s a process that was recommended by a friend and which has worked best for me personally:

  1. Diaphragmatic breathing – breathing with your belly, not your chest. When you’re doing this on autopilot, proceed to 2).
  2. Progressive muscle relaxation – Start on the head or feet. Notice those muscles and relax them. As you feel them resting, move on to the next nearby muscles or body part and do the same. A slight variation is to imagine each body part with a different color (which requires more brain power, making it harder to drift from the relaxation and to start thinking about random things). At the end merge all the colors into white or black and feel yourself into a deeply relaxed state, as your mind, too, relaxes, as if it were a muscle.

Now that we’re relaxed, this is where most meditative practices tend to diverge. Let’s define X, from the table above, according to the type of meditation:

Focused Attention – Pick one thing (object, sound, breath, …). Focus on it (texture, colors, design, smell, …)

Transcendental (Mantra) – Pick a word or sound. Repeat it over and over again.

Loving Kindness – Think of someone. Wish them, from the bottom of your heart, well. Cultivate compassionate awareness and action for everyday life.

Body scan – Focus your attention on specific parts of your body and notice sensations.

Open Monitoring / Mindfulness – Monitor non-judgmentaly and non-reactively the content of experience from moment-to-moment. Recognize the nature of emotional and cognitive patterns.

To make it even more concrete, if you just want to start:

Start small and simple. And in a way that brings you pleasure. If you can get pleasure out of it, you will want to come back and do it more:

  1. Focus on your breath.
  2. When you noticed your mind has wandered from that, with a non-judgemental and kind voice (“That’s fine”, “No problem”, “That’s part of the process”, “If this was not happening it would be strange :)”, “As many time as it takes, I will be here, and I will not be angry or disappointed, because that’s just how it is.”) return the attention to the breath.

Conclusion

Meditation appears to have strong benefits in reducing anxiety, making us calmer, decreasing depression and ruminative thoughts. Try it for the minimum amount of time you’re comfortable doing, and if you feel good with it, slowly increase that time. Try for 30 days and note how you feel. If science was done right, you should feel better :).

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