The Psychological Risks of Meditation

Miscellaneous and Personal Stuff I Must Share
1

As someone who has practiced Zen meditation on and off for the last 20 years, I find this article distressing. It suggests that real psychological harm can come from meditating for long periods (more than 30 minutes per day) and that meditation might trigger psychosis in some individuals. This flies in the face of a fairly large body of research demonstrating the psychological benefits of meditation.

A 2014 study from Carnegie Mellon University subjected two groups of participants to an interview with openly hostile evaluators. One group had been coached in meditation for three days beforehand and the other group had not. Participants who had meditated reported feeling less stress immediately after the interview, but their levels of cortisol—the fight-or-flight hormone—were significantly higher than those of the control group. They had become more sensitive, not less, to stressful stimuli, but believing and expecting that meditation reduced stress, they gave self-reports that contradicted the data.

Meditators also reported diminished emotions, both negative and positive. “I had two young children,” another meditator said. “I couldn’t feel anything about them. I went through all the routines, you know: the bedtime routine, getting them ready and kissing them and all of that stuff, but there was no emotional connection. It was like I was dead.”

In 2017, Britton and her team published their findings in PLOS One, a prominent scientific journal. The report presented a taxonomy of “meditation-related difficulties,” including anxiety and panic, traumatic flashbacks, visual and auditory hallucinations, loss of conceptual meaning structures, non-referential fear, affective flattening, involuntary movements, and distressing changes in feelings of self. Some of the study participants were new to meditation, but nearly half had at least ten thousand hours of practice. The majority of the sample—forty-three out of sixty meditators representing Theravada, Zen, and Tibetan traditions—had experienced moderate to severe impairment in their day-to-day functioning. Ten had required inpatient hospitalization.

What’s most unsettling is that I find meditation to be a pretty stressful experience. I have a number of mental health issues including anxiety and PTSD and that shit seems to always come up when I sit down to meditate. While I have found it helpful, I’ve often encountered a lot of resistance to sitting and doing it because of how distressing it can be.

Any Zen teacher would argue that this is how it should be. The idea that meditation is supposed to be relaxing is kind of a new one. You’re just supposed to sit with all of that and be uncomfortable and observe it. And that’s fine. On the whole, I feel like I do better when I meditate regularly (I rarely go over 25 minutes.)

But am I really doing better? And am I playing with fire? I’ve been a proponent of Zen because the evidence points to it being helpful for most people, because meditation causes neurogenesis and can improve baseline mood, and because it’s been integrated with many evidence based treatments (ACT, DBT) so I haven’t felt like I’m engaged in some kind of woo spiritual practice. This is the first time I’ve really seen contradictory evidence (and if anyone has more, please do share.)

This is a bit of a crisis of faith for me. It suggests that the goal of non-attachment - so central to the Buddhist philosophy - is maybe not a good thing.

Thoughts?

2

Sorry to be of almost zero utility, but I’ve seen headlines concerning the possible adverse effects of meditation for a number of years now. Haven’t looked into it, and don’t have the time to do so.

I’ve been practicing meditation very on and off for some 15 years myself. I have had wonderful experiences (and also lots of frustration) with it. At the same time, it is not really surprising to me that I may be playing with fire.

3

we used to have a poster that would endlessly argue that the end result of Buddhism was nihilism … and no I’m not saying his name cause he was an argumentative twit …

4

It depends what kind of meditation. There are many different meditation techniques, and they have very different effects, as shown by brain scans.

So asking about the risks or benefits of meditation is like asking about the risks and benefits of physical exercise. What kind of exercise? For how long? By a person in what state of health, with what degree of fitness?

If you are finding Zen meditation stressful and unpleasant - after 20 years - then I’d say it’s certainly not doing you any good. Perhaps you should look into trying a different meditation technique that would be more helpful and good for dealing with PTSD.

5

I find walking meditation to be less stressful than sitting meditation.

6

This is the 2021 paper, published in The Journal of Traumatic Stress, they are referring to:

A Pilot Randomized Controlled Trial of Transcendental Meditation as Treatment for Posttraumatic Stress Disorder in Veterans

Abstract

Preliminary studies have demonstrated the efficacy of Transcendental Meditation (TM) for treating posttraumatic stress disorder (PTSD). The present study extended previous research with a pilot trial of TM as a treatment for PTSD via a single‐blinded, randomized controlled design. veterans with PTSD ( N = 40) were assigned to a TM intervention or treatment‐as‐usual (TAU) control group. Participants in the TM group engaged in 16 sessions over 12 weeks, primarily in a 60‐min group format. Change in PTSD symptoms, measured via the Clinician‐Administered PTSD Scale for DSM‐5 (CAPS‐5) was the primary outcome. Secondary outcomes included self‐reported PTSD symptoms, depression, anxiety, sleep difficulties, anger, and quality of life (QoL).

Assessments were conducted at baseline and 3‐month follow‐up. Mean CAPS‐5 score decreases were significantly larger for participants in the TM group ( M = ‐11.28, 95% CI [‐17.35, ‐5.20]), compared to the TAU group ( M = −1.62, 95% CI [‐6.77, 3.52]), p = .012, d = ‐0.84. At posttest, 50.0% of veterans in the TM group no longer met PTSD diagnostic criteria as compared to 10.0% in the TAU group, p = .007. Adjusted mean changes on self‐report measures of PTSD symptoms, depression, anxiety, and sleep difficulties indicated significant reductions in the TM group compared to TAU, d s = .80–1.16. There were no significant group differences regarding anger or QoL.

These findings demonstrate the efficacy of TM as a treatment for veterans with PTSD and for comorbid symptoms. Combined with other research, they suggest that TM may be a tolerable, non–trauma‐focused PTSD treatment.

 
Another study was published in The Lancet in 2018:

Non-trauma-focused meditation versus exposure therapy in veterans with post-traumatic stress disorder: a randomised controlled trial

Findings

Between June 10, 2013, and Oct 7, 2016, 203 veterans were randomly assigned to an intervention group (68 to the TM group, 68 to the PE group, and 67 to the PTSD HE group) … 61% of those receiving TM, 42% of those receiving PE, and 32% of those receiving HE showed clinically significant improvements on the CAPS score.

Interpretation

A non-trauma-focused-therapy, TM, might be a viable option for decreasing the severity of PTSD symptoms in veterans and represents an efficacious alternative for veterans who prefer not to receive or who do not respond to traditional exposure-based treatments of PTSD.

Funding

Department of Defense, US Army Medical Research.

7

The study in the first link was funded by The David Lynch Foundation, which is dedicated to promoting Transcendental Meditation.

8

And…?

Most pharmaceutical studies are funded by pharmaceutical companies that are dedicated to promoting pharmaceuticals.

The point is that it was conducted by reputable scientists and published in a reputable peer-reviewed scientific journal.

The second study was funded and carried out by US Army Medical Research. Is it also invalid?

Your attitude seems ideological and unscientific. Do you also believe that physical exercises have no effect on physical health? Or that practicing any mental skill does not affect mental states?

9

First, I will say that I am not a long term practitioner of zen or “sitting”, though I am someone that practices meditation of a sort- I come from a yoga background. So my 2 cents are more in the Thoughts category.
I don’t disagree with the idea of meditation having risks- this is why finding a good guide(or community or teacher) is helpful. Not to take your power away or tell you you’re “doing it wrong”, specifically. Even though sitting is a solitary practice (and something you do yourself most times)having the energy of the sangha or a teacher (or both) can keep you on the path when things get rocky - or scary. Which isn’t to say that any of this can “cure” PTSD- just that the meditation practice can be a helpful or hurtful tool in your experience. And you already know that any practice is not cupcakes and kittens, all the time, so run away from anyone promising this in regular practice. : )
It’s been mentioned earlier that another stripe of meditation could be helpful- perhaps sensory/mindfulness based, or movement incorporated? Feel to Heal is what I’m thinking. There’s also somatics. This is body-mind centering, I will preface this that it’s for your perusal, not my personal practice. https://www.bodymindcentering.com/

ETA: great subject to discuss.

10

You beat me to saying that meditation is the analogue of physical exercises, for the mind. One can then imagine how under certain circumstances it might trigger strong emotions (could be bliss, though, not necessarily anxiety) or even “hallucinations” (nimitta). Also, someone may start out finding it far from effortless and relaxing to concentrate or to empty the mind. Unfortunately, I have no experience with Zen meditation or transcendental meditation specifically.

Heh. Not sure there is supposed to be an “end result” to meditation, but eventually there is supposed to be a cessation of things like pleasure, pain, consciousness, perception, and even nothingness. And it follows that if one is really that much of a yogini, one has a chance to be less susceptible to ordinary mental frailties or even the effects of past trauma.

11

It seems that the article rests heavily on clinical anecdotes, but it sounds like the problems may arise from people with a disposition to psychosis or other mental disorder. It’s like anything that dramatically perturbs mental state; you might be interfering with some other coping or stabilizing mechanism.

I wouldn’t worry so much about it. The number of people who surface problems seems to be very small compared to those who get help (or get nothing) out of it. Just be aware that it could cause problems, so if you experience problems, it’s not your fault for doing it wrong, and you are allowed to cut back hours.

12

You sure read a lot into a simple statement of fact.

13

This. AFAIK, heavy duty meditation exercises like a ten-day vipassana should not be undertaken lightly. Even shorter periods of continuous silence or incessant prayer or meditation, especially in group settings, can trigger psychosis or anxiety in vulnerable people. At the same time, exploring negative thoughts and injuries from a medidative perspective, i.e. without attaching to the specific content but just observing, can be extremely helpful.

I remember from my MBCT (Mindfulness based cognitive therapy) therapist training that on my way to a training session I experienced a sudden onslaught of suicidal thoughts, and I wasn’t depressed at the time. It upset me to no end, but at the same time my training helped me make space and just let it be. So I guess it’s a bit of both.

@Spice_Weasel Sounds like you know what you’re doing IMHO. Don’t let it scare you off, be gentle with yourself and see what works for you. If sitting brings up too much shit, try a meditative activity like knitting or crafting. I’ve benefitted immensely from both over the years and I’m worse off if I don’t do either.
For the record, a LOT of things that seem beneficial can do tremendous harm. High intensity group psychotherapy or stuff that induces regression like hypnosis can also trigger psychosis. So it seems that moderation is key, as is trusting your intuition above teacher’s opinions if necessary.

14

Well, I should clarify. It’s not always a problem and even when I’m feeling stressed it usually ends well. I think it does help me. This article just made me nervous because I can kinda sorta see how something negative could happen, based on my experience.

Upon reflection, my overall takeaway is that mindfulness and non-attachment can be useful to a certain extent, but there’s such a thing as overdoing it. I don’t want, for example, to be so non - attached that I can’t feel love for my child. (But come to think of it, that sounds like clinical depression.)

I also couldn’t help but notice in the anecdote that is used to frame the article, the woman in question abruptly stopped taking SSRIs when she started the retreat. That is dangerous in and of itself.

15

This is what I wondered about. How could they account for the people who were psychologically at risk from all sorts of activities? In addition, the mind can be fragile, we see that anybody may be at risk of psychological problems from many of life’s circumstances, it is not impossible to self induce such issues. Again, that in itself could be an indicator of such problems eventually arising in other circumstances.

16

There are recurring findings that mindfulness (especially) may increase ‘selfish’ behavior, where ‘selfish’ here seems to be used as antithetical to prosocial (link to original study here). There are also some indications that it may lead to narcissism and spiritual superiority.

Furthermore, the ‘industrialization’ of mindfulness (‘McMindfulness’) has its own issues—for one, sometimes, learning to cope better with external stressors isn’t the right response: some stressful situations should be changed, instead. By putting the onus of change on the individual, rather than, say, the corporate climate, the failure to properly function is transformed into an individual, rather than a structural one, with all the added stress and anxiety that comes with that.

I’m myself an off-again-on-again meditator, and I do believe there is great value to it. But we shouldn’t expect it to be a panacea for all the modern world’s ills, or even appropriate to any situation. I don’t think there’s anything that’s universally beneficient, so one shouldn’t really be surprised that it can have negative consequences. Whatever has (real) effects, is going to have side effects.

But perhaps the real issue isn’t with meditation as such, but with its use as a means to an end. Well, in a certain sense, it’s of course that—the cessation of suffering, of dukkha, being that sort of end. But it’s not a self-help technique; it’s not geared towards improving the functioning of people. Shoehorning it into that role, while cutting it off from its original transformative goal, may be part of what’s going wrong.

17

That some people experience adverse effects from meditation has been known, and doesn’t undo the positive effects many experience. Standard of care at the psych hospital units I’ve worked on has included the modification of keeping one’s eyes open, for example, or for some patients, focus on breathing and here-and-now sensations rather than guided imagery. For a patient with PTSD, I might have them sit where they can see the door or remain seated rather than lying down.

I work with all of my clients on breathing, autonomic relaxation, and here-and-now sensory data, or recommend walking meditation (possibly with a friend). None of my individual clients have reported adverse effects.

One person did present for a first meeting with a history of deep meditation practice during which they had a frightening and vivid experience of dissolution of a body part, which was horrifying to them. I don’t know what caused this response, and they found it too difficult to discuss and didn’t return, but my guess from the intake is that this person probably had some ongoing psychotic process already, or had mixed cannabis, mushrooms, or LSD with their meditation, but I didn’t have enough relationship with them yet to ask.