Negative Experiences

Some Mild Unpleasant Events Occur as a Result of Mindfulness-Based Programs

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Some Mild Unpleasant Events Occur as a Result of Mindfulness-Based Programs

 

By John M. de Castro, Ph.D.

 

“Potential side effects are often front and center when considering taking medicine for physical or mental conditions, but information is less clear with treatments like meditation that don’t come in pill form.” – Marianne Spoon

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

Many practitioners never experience these negative experiences or only experience very mild states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

In today’s Research News article “Frequency of Self-reported Unpleasant Events and Harm in a Mindfulness-Based Program in Two General Population Samples.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920887/ ) Baer and colleagues recruited teachers who were participating in a study of an 8-week mindfulness training in schools and undergraduate and graduate students enrolled in an 8-week group-based mindfulness courses. The participants completed online measures of anxiety and depression and questions about difficult experiences during or after the mindfulness training including difficult thoughts, emotions, and sensations.

 

They found that 77% of the teachers reported never or occasionally having unpleasant experiences while 22% reported having unpleasant experiences more often. Of those who had unpleasant experiences 88% reported they were not at all or somewhat upsetting while 12% reported them to be quite a bit or extremely upsetting. The unpleasant experiences reported were “difficult emotions, cognitions, or sensations such as frustration, anxiety, distressing thoughts or memories, bodily pain or discomfort, and sleepiness.”

 

The 61% of the students reported never or occasionally having unpleasant experiences while 39% reported having unpleasant experiences more often. Of those who had unpleasant experiences 92% reported they were not at all or somewhat upsetting while 8% reported them to be quite a bit or extremely upsetting. The unpleasant experiences reported “involved difficult thoughts, emotions, and physical sensations; others described recognition of personal patterns” and guilt about not practicing enough.

 

These results suggest that the unpleasant experiences occurring during and after mindfulness training are common but generally mild. The experiences are most often the same as those expected by mindfulness teachers. These experiences are to some extent the goal of mindfulness training to increase awareness of one’s own internal experiences and these can be sometimes upsetting. In rare instances, the experiences are quite upsetting and this is to be expected as some people will discover things about themselves that are difficult to deal with.

 

Psychological therapies in general are designed to uncover and deal with unpleasant thoughts, memories, emotions etc. It is thus not surprising the this is true also of mindfulness training. This suggests that mindfulness teachers, like other therapists, have to be sensitive to these unpleasant experiences in their students and be prepared to deal with extremely difficult experiences.

 

So, some mild unpleasant events occur as a result of mindfulness-based programs.

 

“It’s really important to know the prevalence of people who are having adverse reactions.” – Matt Hirschberg

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Baer, R., Crane, C., Montero-Marin, J., Phillips, A., Taylor, L., Tickell, A., Kuyken, W., & MYRIAD team (2021). Frequency of Self-reported Unpleasant Events and Harm in a Mindfulness-Based Program in Two General Population Samples. Mindfulness, 12(3), 763–774. https://doi.org/10.1007/s12671-020-01547-8

 

Abstract

Objectives

Evidence-based mindfulness programs have well-established benefits, but the potential for harmful effects is understudied. We explored the frequency and severity of unpleasant experiences and harm in two nonclinical samples participating in an adaptation of mindfulness-based cognitive therapy (MBCT) for the general population.

Methods

Study 1 included 84 schoolteachers; study 2 included 74 university students. Both studies were uncontrolled. Participants completed self-report questionnaires about psychological symptoms before and after the 8-week mindfulness course. After the course, they responded to a survey designed for this study that included Likert ratings and free-text questions about unpleasant experiences and harm. All data were collected online.

Results

In both samples, about two-thirds of participants reported unpleasant experiences associated with mindfulness practice during the course. Most participants (85–92%) rated these experiences as not at all or somewhat upsetting; some indicated that difficult experiences led to important learning or were beneficial in some way. The proportion of participants reporting harm from the mindfulness course ranged from 3 to 7%. The proportion showing reliable deterioration on symptom questionnaires ranged from 2 to 7%. Those reporting harm and those showing reliable deterioration on questionnaires were largely separate subgroups; only one participant fell in both.

Conclusions

Findings highlight the need for mindfulness teachers to manage expectations about benefits and difficulties that may occur in mindfulness-based programs and to work skilfully with participants experiencing difficulties. Experiences of harm may not be captured by symptom questionnaires and should be explicitly assessed in other ways.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920887/

 

Mindfulness Area Research: Negative Experiences with Mindfulness

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Mindfulness Area Research: Negative Experiences with Mindfulness

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

Many practitioners never experience these negative experiences or only experience very mild states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

Summaries of recent studies on negative experiences with mindfulness can be found at the Negative Experiences link http://contemplative-studies.org/wp/index.php/category/research-news/negative-experiences/  on the Contemplative Studies blog http://contemplative-studies.org/wp/ .

 

Links to the Research on Negative Experiences with Mindfulness

 

Mindfulness Training can Produce Harm but Much can be Avoided

http://contemplative-studies.org/wp/index.php/2019/10/08/mindfulness-training-can-produce-harm-but-much-can-be-avoided/

 

Yoga Injuries are Common but Most Can Be Avoided

http://contemplative-studies.org/wp/index.php/2019/10/01/yoga-injuries-are-common-but-most-can-be-avoided/

 

The Variety of Meditation Experiences

http://contemplative-studies.org/wp/index.php/2018/01/26/the-variety-of-meditation-experiences/

 

Meditation Can Produce Uncomfortable Effects

http://contemplative-studies.org/wp/index.php/2017/11/03/meditation-can-produce-uncomfortable-effects/

 

What’s Wrong with Meditation II – Improper Instruction

http://contemplative-studies.org/wp/index.php/2017/03/05/whats-wrong-with-meditation-ii-improper-instruction/

 

 

Mindfulness Training can Produce Harm but Much can be Avoided

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Mindfulness Training can Produce Harm but Much can be Avoided

 

By John M. de Castro, Ph.D.

 

“meditation was designed not to make us happier, but to radically change our sense of self and perception of the world. Given this, it is perhaps not surprising that some will experience negative effects such as dissociation, anxiety and depression.” – Hackspirit

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

Many practitioners never experience these negative experiences or only experience very mild states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

In today’s Research News article “Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6575147/), Baer and colleagues review what little research there is regarding negative experiences with mindfulness training. They report that negative experiences and harm are relatively common and occur with a variety of physical and psychological therapies, drug treatments, exercise, and also with mindfulness-based practices. Most people practicing meditation have emotional or challenging experiences arise, including troubling thoughts, anxiety, depression, confusion, depersonalization and alienation. These tend to be short-lived and often are thought to be part of the therapeutic process and lead to healthy outcomes. Only a small percentage of participants (1% to 7%) experience severe negative experiences such as psychotic symptoms, disorientation, and depression at a severe enough level to prompt cessation of meditation.

 

The authors identify three categories of potential sources of adverse events, program factors, participant factors, and teacher/clinician factors. In terms of program factors the most significant appears to be the intensity of the practice with a large percentage of adverse events occurring on retreats. In terms of participant factors, prior psychiatric and/or traumatic issues appear to be risk factors for adverse events. In terms of teacher/clinician factors, it appears that teacher ability and competence is important including “empathy, understanding of the client’s problems, communication about the nature of the program, skillful implementation of the program, managing difficulties that arise, and encouraging adherence to recommended practice.” Harm avoidance emphasizes taking these factors into consideration at the outset and monitoring for participant discomfort with appropriate intervention when needed.

 

One of the key judgements to be made is the cost/benefit analysis. Mindfulness training produces major physical, psychological, and spiritual benefits and these must be weighed against potential harm. It is generally true that the benefits are substantial and long lasting while the adverse events are mild and short-lived. But for a fraction of participants the harm is so debilitating to make the practice totally ineffective. It is incumbent on mindfulness teachers and clinicians to carefully assess potential risk factors and screen out particularly vulnerable participants and to rigorously monitor participant distress during the training to intervene or stop training when necessary to prevent harm.

 

“Mindfulness can have negative effects for some people, even if you’re doing it for only 20 minutes a day. It’s difficult to tell how common [negative] experiences are, because mindfulness researchers have failed to measure them, and may even have discouraged participants from reporting them by attributing the blame to them.” – Miguel Farias

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Baer, R., Crane, C., Miller, E., & Kuyken, W. (2019). Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clinical psychology review, 71, 101–114. doi:10.1016/j.cpr.2019.01.001

 

Abstract

The benefits of empirically supported mindfulness-based programs (MBPs) are well documented, but the potential for harm has not been comprehensively studied. The available literature, although too small for a systematic review, suggests that the question of harm in MBPs needs careful attention. We argue that greater conceptual clarity will facilitate more systematic research and enable interpretation of existing findings. After summarizing how mindfulness, mindfulness practices, and MBPs are defined in the evidence-based context, we examine how harm is understood and studied in related approaches to physical or psychological health and wellbeing, including psychotherapy, pharmacotherapy, and physical exercise. We also review research on harmful effects of meditation in contemplative traditions. These bodies of literature provide helpful parallels for understanding potential harm in MBPs and suggest three interrelated types of factors that may contribute to harm and require further study: program-related factors, participant-related factors, and clinician- or teacher-related factors. We discuss conceptual issues and empirical findings related to these factors and end with recommendations for future research and for protecting participants in MBPs from harm.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6575147/

 

Yoga Injuries are Common but Most Can Be Avoided

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Yoga Injuries are Common but Most Can Be Avoided

 

By John M. de Castro, Ph.D.

 

“By now, you’ve heard all about the benefits of yoga. But, if you’re not careful, yoga can also cause injury, particularly to your wrists, lower back, shoulders, elbows, knees, hamstrings, and neck.” – Aaptiv

 

Yoga practice has been shown to have a myriad of benefits for psychological and physical health. It is both an exercise and a mind-body practice that stresses both mental attention to present moment movements, breath control, and flexibility, range of motion, and balance. Yoga, however, can be a challenging physical discipline and injuries are quite common. Indeed, it has been estimated that 20% of yoga practitioners have been injured. It is important to study these injuries to determine their sources in order to reduce their severity and rate of occurrence.

 

In today’s Research News article “Adverse effects of yoga: a national cross-sectional survey.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6664709/), Cramer and colleagues recruited a large sample of German adult yoga practitioners and had them complete a questionnaire on their personal characteristics and the nature of their yoga practice. They were also asked “Have you ever experienced an acute injury or other acute complaint during yoga practice? (Note: here, adverse effects should be listed that occurred suddenly in a specific yoga practice situation).” They were also asked about chronic adverse events. In addition, they were asked to identify the nature of the adverse event and how and when it occurred, how long they had been practicing, had they recovered, and did it occur during a supervised practice.

 

There were a wide variety of yoga practices represented among the respondents. Adverse events were in fairly infrequent with only 0.6 events per 1000 hours of practice. The injuries were for the most part minor involving strains and sprains, but 2% were considered serious. Power yoga was found to be the practice type producing the most adverse events and Hatha yoga the least.

 

21% of the practitioners had experienced an acute adverse musculoskeletal event. Almost 30% of the events occurred during hand, shoulder, or head stands, 24% during forward or backward bends, and 12% during sitting positions. 55% of the events occurred during teacher supervised practice, 22% at home repeating what they had learned in class, and 23% at home self-taught. Only 4% of the adverse events had they not recovered from.

 

Chronic problems occurred in 10% of the practitioners, 91% of which involved chronic back, neck or shoulder pain, tendon shortening or sciatica. They were less likely to occur with Hatha Yoga practice than other types of practice. 52% of the chronic problems were associated with teacher supervised practice, 28% at home repeating what they had learned in class, and 20% at home self-taught. The practitioners had not recovered from only 15 % of the chronic adverse events.

 

The results are interesting and informative and although there were substantial numbers of adverse events reported they were generally minor and significantly less than the numbers that occur per 1000 hours of practice with other exercises such as running, soccer, tennis, skiing, and weight lifting. Exercise is needed to maintain health but it is not without risks. Yoga practice appears to be less risky than most other exercises. So, it should be considered to be a generally safe exercise, particularly with supervised practice avoiding hand, shoulder, and head stands.

 

So, yoga injuries are common but most can be avoided.

 

“Often times people are referred to yoga by their doctors or therapists who may not understand that there are many different styles of yoga asana, and that it isn’t a one-size-fits-all system,” – Coral Brown

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cramer, H., Quinker, D., Schumann, D., Wardle, J., Dobos, G., & Lauche, R. (2019). Adverse effects of yoga: a national cross-sectional survey. BMC complementary and alternative medicine, 19(1), 190. doi:10.1186/s12906-019-2612-7

 

Abstract

Background

While yoga is increasingly used for health purposes, its safety has been questioned. The aim of this cross-sectional survey was to analyze yoga-associated adverse effects and their correlates.

Methods

A cross-sectional anonymous national online survey among German yoga practitioners (n = 1702; 88.9% female; 47.2 ± 10.8 years) was conducted from January to June 2016. Participants were queried regarding their yoga practice, i.e. yoga styles used, length and intensity of yoga practice, practice patterns, and whether they had experienced acute or chronic adverse effects of their yoga practice. Independent predictors of acute or chronic adverse effects were identified using multiple logistic regression analyses.

Results

Ashtanga yoga (15.7%), traditional Hatha yoga (14.2%), and Sivananda yoga (22.4%) were the most commonly used yoga styles. 364 (21.4%) yoga users reported 702 acute adverse effects, occurring after a mean of 7.6 ± 8.0 years of yoga practice. The most commonly reported yoga practices that were associated with acute adverse effects were hand-, shoulder- and head stands (29.4%). Using Viniyoga was associated with a decreased risk of acute adverse effects; practicing only by self-study without supervision was associated with higher risk. One hundred seventy-three participants (10.2%) reported 239 chronic adverse effects. The risk of chronic adverse effects was higher in participants with chronic illnesses and those practicing only by self-study without supervision. Most reported adverse effects concerned the musculoskeletal system. 76.9% of acute cases, and 51.6% of chronic cases reached full recovery. On average 0.60 injuries (95% confidence interval = 0.51–0.71) per 1000 h of practice were reported, with Power yoga users reporting the highest rate (1.50 injuries per 1000 h; 95% confidence interval = 0.98–3.15).

Conclusions

One in five adult yoga users reported at least one acute adverse effect in their yoga practice, and one in ten reported at least one chronic adverse effect, mainly musculoskeletal effects. Adverse effects were associated with hand-, shoulder- and head stands; and with yoga self-study without supervision. More than three quarters of of cases reached full recovery. Based on the overall injury rate per 1000 practice hours, yoga appears to be as safe or safer when compared to other exercise types.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6664709/

The Variety of Meditation Experiences

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The Variety of Meditation Experiences

 

By John M. de Castro, Ph.D.

 

“One can have almost any type of physical sensation during meditation in any area of the body. . .  The ticklish sensation in your heart just means that some normalization is occurring there, allowing for a more full expression of your emotions. The sense of anxiety or fear is a by-product of that clearing process.” – Depak Chopra

 

Meditation is a wonderful practice that has many documented beneficial effects on mental, physical and spiritual health. For the most part, people have positive experiences during meditation, but it is not all positive. People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories sometimes emerge.

 

Many practitioners never experience these issues or only experience very mild states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

In today’s Research News article “The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5443484/ ),

Lindahl and colleagues recruited experienced adult meditation practitioners and teachers from a variety of different traditions. Meditators were excluded if they had a history of unusual psychological experiences prior to learning meditation. They conducted extensive semi-structured interviews that consisted of open-ended questions regarding meditation-related experiences. Interviews with the participants were conducted either in person, by videoconferencing, or by telephone. Transcripts of the interviews were then subjected to qualitative data analysis focusing on challenging or difficult experiences.

 

They found that most practitioners had experienced at least some challenging experiences. 29% encountered challenges in their first year of practice while 45% encountered them in their first 10 years. For 73% of the practitioners, challenging experiences were associated with meditation retreats, while the rest were associated with daily practice. The more meditation per day the greater the likelihood of negative experiences with only 25% who practiced for 30-60 minutes per day having negative experiences, 34% who practiced 1-9 hours per day, and 41% who practiced over 10 hours per day. One of the most striking findings was the duration of negative experiences. They were not brief or fleeting. In fact, on average they were reported to persist from 1 to 3 years and as long as 10 years.

 

Thematic content analysis of the transcripts revealed 59 different categories of experiences that occurred in 7 higher order domains; cognitive, perceptual, affective, somatic, conative, sense of self, and social. 73% of practitioners had experiences falling into at least 6 domains.

 

The Cognitive Domain consisted in “Changes . . . to mental functioning, including the frequency, quality and content of thoughts, as well as . . . planning, decision-making and memory.” Most experiences in this domain were pleasant but unpleasant experiences also occurred including inability to concentrate for extended periods, problems with memory, the disintegration of conceptual meaning structures, “mind racing,” vivid imagery, and delusional, irrational, or paranormal beliefs.

 

The Perceptual domain consisted of ”changes to any of the five senses: vision, hearing, smell, taste and somatosensory processing” and interoception and proprioception. Unpleasant experiences in this domain included hypersensitivity to stimuli, illusions, hallucinations, dissolution of perceptual objects, distortions in time and space, and sensations appearing dreamlike, as if in a fog.

 

The Affective domain consisted of changes in the type, frequency, or intensity of emotions. For many the affective experiences were pleasant including bliss and euphoria, sometimes verging on mania. But, unpleasant experiences were very frequent and involved both increased and decreased emotionality including anxiety fear, panic, re-experiencing trauma, irritability, anger, and paranoia with 82% reporting it. For some flat affect occurred with a loss of swings in emotion.

 

The Somatic domain consisted of “changes in bodily functioning or physiological processes.” Unpleasant experiences in this domain included sleep disruption, feelings of pressure, tension, and hot and cold, electricity like voltages or currents through the body sometimes resulting in involuntary movements.

 

The Conative domain consisted of “changes in motivation or goal-directed behaviors.” Unpleasant experiences in this domain included loss of desire for previously enjoyed activities and loss of motivation to achieve goals.

 

The Sense of Self domain consisted of “changes in how a practitioner conceives of himself or herself over time.” Unpleasant experiences in this domain including a dissolution of boundaries between the individuals and others and the environment, loss of a sense of ownership of thoughts, emotions and agency (the doer), and loss of a sense of self entirely.

 

The Social domain consisted of “changes in interpersonal activities or functioning, including level of engagement, quality of relationships, or periods of conflict, isolation or withdrawal.” Unpleasant experiences in this domain included problems re-integrating into society after a retreat or intensive practice, impaired functioning at work or with family, and doubt and loss of faith. In fact, many of the negative experiences bled over into everyday life affecting all social interactions.

 

These findings need to be kept in perspective as most experience with meditation are pleasant and positive and even the negative experiences are mainly brief and manageable. But the results emphasize that it’s not all what people are led to believe. It can turn unpleasant or even ugly. It is important that this be taught and managed in the meditation community. In the monasteries this is well understood and managed. But in the secular world, these negative experiences are rarely taught, understood, reacted to properly, or managed. For many negative experiences can lead to stopping practice, but for others they can lead to grave psychological harm. It is important that the practitioner be made aware of these possible experiences before they begin, so they are better able to understand them a handle them astutely.

 

Meditation should not be engaged in blindly without proper instruction. It can produce great benefit but sometimes great harm. In order to maximize the benefits and minimize the harm proper education and management is needed.

 

“Emotions that come up during meditation represent one of two things: 1) undigested past negative emotions that are rising up to be processed, or 2) a present-moment experience of raw emotion from something happening now, which can be positive or negative. Either way, it can make for an uncomfortable meditation and is one of the most common reasons people stop meditating.” – Trista Thorp

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

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 ONE, 12(5), e0176239. http://doi.org/10.1371/journal.pone.0176239

 

Abstract

Buddhist-derived meditation practices are currently being employed as a popular form of health promotion. While meditation programs draw inspiration from Buddhist textual sources for the benefits of meditation, these sources also acknowledge a wide range of other effects beyond health-related outcomes. The Varieties of Contemplative Experience study investigates meditation-related experiences that are typically underreported, particularly experiences that are described as challenging, difficult, distressing, functionally impairing, and/or requiring additional support. A mixed-methods approach featured qualitative interviews with Western Buddhist meditation practitioners and experts in Theravāda, Zen, and Tibetan traditions. Interview questions probed meditation experiences and influencing factors, including interpretations and management strategies. A follow-up survey provided quantitative assessments of causality, impairment and other demographic and practice-related variables. The content-driven thematic analysis of interviews yielded a taxonomy of 59 meditation-related experiences across 7 domains: cognitive, perceptual, affective, somatic, conative, sense of self, and social. Even in cases where the phenomenology was similar across participants, interpretations of and responses to the experiences differed considerably. The associated valence ranged from very positive to very negative, and the associated level of distress and functional impairment ranged from minimal and transient to severe and enduring. In order to determine what factors may influence the valence, impact, and response to any given experience, the study also identified 26 categories of influencing factors across 4 domains: practitioner-level factors, practice-level factors, relationships, and health behaviors. By identifying a broader range of experiences associated with meditation, along with the factors that contribute to the presence and management of experiences reported as challenging, difficult, distressing or functionally impairing, this study aims to increase our understanding of the effects of contemplative practices and to provide resources for mediators, clinicians, meditation researchers, and meditation teachers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5443484/

Meditation Can Produce Uncomfortable Effects

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Meditation Can Produce Uncomfortable Effects

 

By John M. de Castro, Ph.D.

 

“While the benefits of mediation are being recorded in scientific journals, what’s not discussed as often are the negative meditation side effects. It can be a frustrating, sometimes agonizing process that will bring you into contact with your limitations and inner conflicts. Rather than a metamorphosis, you can experience a setback.” – Linda Kaban

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But, often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

Meditation practice can also produce some troubling experiences beyond unmasking deep psychological issues. Not the least of these experiences are awakening experiences themselves. If they are not properly understood, they can lead to sometimes devastating consequences. These experiences are so powerful and unusual that they can be misinterpreted. Awakening experiences have been misdiagnosed as psychotic breaks and the individual placed on powerful drugs and/or institutionalized. At the very least, the individual may believe that they are losing their sanity or as one has said, “I just got used to the idea that occasionally I would have just one of those days.”

 

Meditation practice can sometimes produce energetic states that can vary in intensity, location, and duration. If and when these occur, they are usually quite surprising and unexpected. They can be readily misinterpreted. They involve energy focused in specific parts of the body or overall. They can feel like nervousness, tension, or almost like electrical currents flowing through the body and can produce spontaneous and undirected movements. These energy states are usually found to be aversive and difficult to cope with.

 

Many practitioners never experience these issues or only experience very mild states. There are, however, no systematic studies of the extent of this problem. In today’s Research News article “Unwanted effects: Is there a negative side of meditation? A multicentre survey.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584749/, Cebolla and colleagues conducted an on-line survey of meditation practitioners that engaged in a variety of different meditation techniques. They were asked if they had experienced any unwanted experiences. If they had, they were asked to describe the nature of these experiences. These incidents were categorized into 8 clusters; anxiety symptoms (including panic attacks), pain (stomach, headache, muscular, nausea), depersonalization and derealization, hypomania or depressive symptoms, emotional lability, visual focalization problems, loss of consciousness or dizziness, and other symptoms. They also completed a checklist of unwanted experiences.

 

They found that the incidence of negative events was quite high with 25.4% of the respondents reporting unwanted experiences. But most reported that the experiences were mild and transitory and most did not lead to the need for medical assistance or the cessation of meditation practice. These unwanted experiences occurred more frequently with individual rather than group practice and with focused meditation practice, particularly when practices was longer then 20 minutes. The most frequently described reactions were anxiety symptoms (including panic attacks) and depersonalization or derealization (“when I began to focus on my breath, a shift seemed to occur in my spatial awareness quite quickly. I felt like my awareness was becoming very close to me, and everything around me was becoming very distant.)

 

The results suggest that unwanted (negative) experiences are quite common with meditators, but for the most part are short-lived and mild. It should be kept in mind, however, that practitioners who had more severe and long lasting negative experience may well not continue meditation and not be included in the sample. So, the actual frequency and severity of unwanted (negative) experiences may actually be higher. There was also no comparison condition. It is possible that similar unwanted experiences occur over time in people who do not meditate.

 

The results suggest that better instruction is needed for beginning meditators regarding the types of experiences that meditators may have and resources provided for dealing with these experiences. In the West meditation has been promoted as a completely positive and beneficial practice. For the most part, it is. But, it can have significant, unpleasant, and potentially harmful consequences. It is important that practitioners be aware of this and have access to experienced teachers who can help them navigate through the difficulties if they appear.

 

It needs to be publicized that meditation can produce uncomfortable effects.

 

“To put things in perspective, many millions of people have meditated, over the past several thousands of years, and written about it extensively – there is a vast literature. If you look at this history as a vast trial run of a new drug, there are remarkably few negative side effects for such a powerful process.” – Lorin Roche

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cebolla, A., Demarzo, M., Martins, P., Soler, J., & Garcia-Campayo, J. (2017). Unwanted effects: Is there a negative side of meditation? A multicentre survey. PLoS ONE, 12(9), e0183137. http://doi.org/10.1371/journal.pone.0183137

 

Abstract

Objectives

Despite the long-term use and evidence-based efficacy of meditation and mindfulness-based interventions, there is still a lack of data about the possible unwanted effects (UEs) of these practices. The aim of this study was to evaluate the occurrence of UEs among meditation practitioners, considering moderating factors such as the type, frequency, and lifetime duration of the meditation practices.

Methods

An online survey was developed and disseminated through several websites, such as Spanish-, English- and Portuguese-language scientific research portals related to mindfulness and meditation. After excluding people who did not answer the survey correctly or completely and those who had less than two months of meditation experience, a total of 342 people participated in the study. However, only 87 reported information about UEs.

Results

The majority of the practitioners were women from Spain who were married and had a University education level. Practices were more frequently informal, performed on a daily basis, and followed by focused attention (FA). Among the participants, 25.4% reported UEs, showing that severity varies considerably. The information requested indicated that most of the UEs were transitory and did not lead to discontinuing meditation practice or the need for medical assistance. They were more frequently reported in relation to individual practice, during focused attention meditation, and when practising for more than 20 minutes and alone. The practice of body awareness was associated with UEs to a lesser extent, whereas focused attention was associated more with UEs.

Conclusions

This is the first large-scale, multi-cultural study on the UEs of meditation. Despite its limitations, this study suggests that UEs are prevalent and transitory and should be further studied. We recommend the use of standardized questionnaires to assess the UEs of meditation practices.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584749/

What’s Wrong with Meditation II – Improper Instruction

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Image result for upset with meditation

What’s Wrong with Meditation II – Improper Instruction

 

By John M. de Castro, Ph.D.

 

“The next biggest danger is that no one thinks there are or can be any dangers to meditation, so there is almost no discussion and information-gathering on the subject. Everyone is just going blah blah about the benefits. As a consequence, meditators are constantly being blindsided and derailed by things that should be trivial hazards, easily dismissed or bypassed. If we compare meditation to a day at the beach, it is as if people are saying, “Oh, don’t worry, you can never get enough direct sunlight. Just soak it up. You don’t even need a hat. And swim out in the ocean as far as you want. It’s a lake. With dolphins that will love you.”” – Lorin Roche

 

As was discussed in the prior essay on What’s Wrong with Meditation I – Expectations there are three essential problems with the way meditation has been presented in the west that have produced problems, misconceptions, and misunderstandings. First, meditation has been presented in a way that has evoked beliefs, ideas, and images that are overly idealized and not reflective of the typical experiences of meditation practice. Secondly, is the focus of the present essay, that immediately jumping into meditation practice has been encouraged, without the provision for proper background information, study, or instruction. Lastly, the jargon used to describe the process, experiences, obstacles, and results is extreme, evoking images and expectations that far exceed normal experience.

 

The Dalai Lama was brought on a tour of a major new meditation center in the United States. At the end of the tour, he simply asked “where’s the library?” He was astonished when he was told that there wasn’t one. He commented that before any of his new monks were allowed to meditate that had to spend at least a couple of years studying before they were allowed to meditate. He stressed that it is imperative that the practitioner have a proper background to understand the practical and theoretical basis for meditation before starting. This story exemplifies the difference between ancient Tibetan practice and meditation as it’s taught in the west where practitioners are launched into meditation practice with only minimal instruction. Hence people dive in without knowledge of obstacles and dangers hidden beneath the surface.

 

This western practice would be fine if meditation was straightforward and there weren’t any difficulties and traps that could ensnare the meditator. But, meditation practice is not simple and straightforward and without instruction in what to expect and how to recognize true progress, the practitioner is left to grope and stumble their way through the process. Beginners are generally not instructed, except in very general terms, as to what is the goal and how to recognize it if they attain it. They are frequently told to just follow and/or count the breath but receive no instruction as to what to do when their mind inevitably wanders. They are told simply return to following the breath. This was exactly how I was instructed when I began meditation practice.

 

As a result of this lack of instruction, beginners deride themselves for mind wandering making the process unpleasant. They are not told that this is effectively punishing themselves for recognizing that their mind has wandered. This makes it less likely that the individual will recognize and return from mental discursions. With a little instruction, they can learn that minds do what minds do, and that’s OK. They’re going to wander. Get used to it! But, they also need to be instructed to celebrate their recognizing it and returning to the meditative focus. This instruction produces reward for recognizing that the mind has wandered making it more likely that it will be recognized again and sooner. If beginners were simply given this much simple instruction their meditation practice will be much more enjoyable and productive and they’ll be much less likely to give up the practice.

 

Beginning meditators are frequently told that they should quiet the mind but are never instructed as to exactly what that means. They often confuse a quiet mind with a total blank, believing that a quiet mind is one without content. If they are simply instructed that they are to quiet the internal chatter, not everything. There’ll still be sounds, sights, odors, touches, etc. But when the mind is quiet there is no verbal commentary accompanying them. They are simply observing these stimuli as they are without categorization, judgment, labelling, reflection on past stimuli, or projections as to the future course of the stimuli. That’s a quiet mind. But few beginners are taught this. A completely blank mind can and will happen later in practice, but only after the mind has been quieted, not stopped. If beginning meditators were simply provided instruction about what is their goal and what a quiet mind is actually like their meditation practice will be much more enjoyable and productive.

 

A very important instruction for beginners is to warn them about the troubling kinds of thoughts and memories that often spontaneously arise during meditation. People come with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But, often the thoughts or memories are overwhelming. Proper instruction is needed on how to work with issues gradually, avoiding delving too deeply too soon. At retreats, there are always boxes and boxes of tissues available for the inevitable copious tears shed by some of the participants as they are dealing with deeply troubling issues. Yes, in meditation you try to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The practitioner needs proper instruction beforehand of the likelihood of this happening and how to deal effectively with it. Knowing that this is normal, healthy, and part of the process, helps immeasurably to lessen the impact of these thoughts and memories on the individual and increases the likelihood that they can be effectively resolved. At times, professional therapeutic intervention may be needed. Once again, if this is understood ahead of time, the individual is more likely to seek assistance.

 

Meditation practice can also produce some troubling experiences beyond unmasking deep psychological issues. These are rarely presented or discussed with people before engaging in meditation. Not the least of these experiences are awakening experiences themselves. These can occur at any time and even to beginners. If they are not properly understood, they can lead to sometimes devastating consequences. These experiences are so powerful and unusual that they can be misinterpreted. Awakening experiences have been misdiagnosed as psychotic breaks and the individual placed on powerful drugs and/or institutionalized. There are no systematic studies of the extent of this problem, but a number of psychiatrists who meditate and understand awakening experiences have said that it is quiet extensive. At the very least, the individual may believe that they are losing their sanity or as one has said, “I just got used to the idea that occasionally I would have just one of those days.” This is one of the reasons why the Dalai Lama insists that beginners study first, so they can recognize what is happening to them if and when these experiences arise.

 

Meditation practice can sometimes produce energetic states that can vary in intensity, location, and duration. If and when these occur, they are usually quite surprising and unexpected. Many practitioners never experience these states or only experience very mild energy states. But, for those that do, if they have no prior instruction they can readily misinterpret them. They are sometimes called Kundalini energy states and involve energy focused in specific parts of the body or overall. They can feel like nervousness, tension, or almost like electrical currents flowing through the body and can produce spontaneous and undirected movements. These can be minor or overwhelmingly intense and can last from a few days to years. With these states sleep can be quite difficult and the individual may go days at a time without any sleep whatsoever. These energy states are usually found to be aversive and difficult to cope with. If the practitioner hasn’t been instructed about these states, they may seek out medical help. Unfortunately, the medical professions are not trained to recognize these states and often prescribe powerful anxiolytic drugs that can stupefy the individual but not affect the energies. Monasteries and major retreat centers are often equipped to recognize and treat these energies states. But, the vast majority of meditators and meditation instructions are completely devoid of an understanding of Kundalini energies. A little prior study and instruction can go a long way toward preventing misinterpretations and getting assistance from experienced teachers.

 

Another state that can be produced by awakening experiences has been termed as the “dark night of the soul.” After awakening there is, almost inevitably, a honeymoon period of happiness and bliss. But this is frequently followed by an aversive state that has been described as a spiritual desert. These have been reported by awakened individuals throughout the centuries, including the Christian and Sufi mystics and saints, Buddhist masters, and everyday practitioners. In these states the individual loses interest in life and seemingly has no motivation to do virtually anything. They feel emotionally dry and lament the loss of what they call the juice of life. Everything is flat and the individual often becomes deeply depressed. This dark night can last for months or years. To deal with dark nights the individual needs sophisticated instruction from accomplished teachers. No preparatory instruction will help to stop or prevent this from occurring. But, with proper instruction the individual can be better prepared to understand what is happening to them and what to expect in the future. This again can prevent misinterpretation and consequent maladaptive responses and harmful consequences.

 

At this point it should be clear why the Dalai Lama is so insistent upon extensive study and instruction prior to engaging in meditation. It can prevent potential negative reactions and consequences to some of the unexpected consequences of meditation. It has been my experience that the less instruction a person has prior to engaging in meditation the greater the likelihood that problems occur and the greater the likelihood of them being misinterpreted and counterproductive and even damaging responses occurring. So, study about meditation, work with an experienced teacher, and prepare yourself ahead of time before getting deeply involved in meditation practice. If you do, the rewards can be maximized and the pitfalls minimized, making practice productive and potentially profoundly altering.

 

The issues discussed above can seem off putting. You may be asking yourself if it makes any sense at all to engage in a meditation practice with all these potential problems. The answer is a resounding yes. The amazing benefits of meditation practice on your psychological, emotional, physical, and spiritual health make it well worth the effort. In fact, it has the potential to change you in profound ways for all of existence. The above caveats should be taken as indicators that study and guidance should be undertaken and that meditation should be practiced with understanding of what to expect both good and bad ahead of time. These warnings are important but should not be taken a stop signs, only caution signs. Know what you’re getting into, be prepared, and then reap the extraordinary benefits.

 

“It’s a kind of re-birth.  The dark night of the soul is a kind of death that you die.  What dies is the egoic sense of self.  Of course, death is always painful, but nothing real has actually died there – only an illusory identity.  Now it is probably the case that some people who’ve gone through this transformation realized that they had to go through that, in order to bring about a spiritual awakening.  Often it is part of the awakening process, the death of the old self and the birth of the true self.” – Eckhart Tolle
CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch