Effects of meditation

{{Short description|Surveys & evaluates various meditative practices & evidence of neurophysiological benefits}}

{{cs1 config|name-list-style=vanc}}

{{Use dmy dates|date=October 2020}}

File:EEG cap.jpg has been used for meditation research.]]

The psychological and physiological effects of meditation have been studied. In recent years, studies of meditation have increasingly involved the use of modern instruments, such as functional magnetic resonance imaging and electroencephalography, which are able to observe brain physiology and neural activity in living subjects, either during the act of meditation itself or before and after meditation. Correlations can thus be established between meditative practices and brain structure or function.{{cite journal |last=Rahimian |first=Sepehrdad |title=Commentary: Content-Free Awareness: EEG-fcMRI Correlates of Consciousness as Such in an Expert Meditator |date=2021-08-30 |journal=PsyArXiv |url=https://osf.io/6q5b2|doi=10.31234/osf.io/6q5b2|s2cid=242883247}}

Since the 1950s, hundreds of studies on meditation have been conducted, but many of the early studies were flawed and thus yielded unreliable results.{{cite journal | vauthors = Ospina MB, Bond K, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, Bialy L, Hooton N, Buscemi N, Dryden DM, Klassen TP | title = Meditation practices for health: state of the research | journal = Evidence Report/Technology Assessment | issue = 155 | pages = 1–263 | date = June 2007 | pmid = 17764203 | pmc = 4780968 | url = http://www.ahrq.gov/downloads/pub/evidence/pdf/meditation/medit.pdf | archive-url = https://web.archive.org/web/20090225175425/http://www.ahrq.gov/downloads/pub/evidence/pdf/meditation/medit.pdf| url-status = dead | archive-date = 25 February 2009 }}{{cite book |first1=Antoine |last1=Lutz |first2=John D. |last2=Dunne |first3=Richard J. |last3=Davidson |year=2007 |chapter=Meditation and the Neuroscience of Consciousness: An Introduction |pages=499–552 |editor1-first=Philip David |editor1-last=Zelazo |editor2-first=Morris |editor2-last=Moscovitch |editor3-first=Evan |editor3-last=Thompson |title=The Cambridge Handbook of Consciousness |series=Cambridge Handbooks in Psychology |publisher=Cambridge University Press |isbn=978-0-511-81678-9 |doi=10.1017/CBO9780511816789.020|s2cid=2635196 }} Another major review article also cautioned about possible misinformation and misinterpretation of data related to the subject.{{cite journal | vauthors = Van Dam NT, van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Kerr CE, Gorchov J, Fox KC, Field BA, Britton WB, Brefczynski-Lewis JA, Meyer DE | title = Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation | journal = Perspectives on Psychological Science | volume = 13 | issue = 1 | pages = 36–61 | date = January 2018 | pmid = 29016274 | pmc = 5758421 | doi = 10.1177/1745691617709589 }}{{cite journal | first = Bret | last = Stetka | date = October 2017 | title = Where's the Proof That Mindfulness Meditation Works? | url = https://www.scientificamerican.com/article/wheres-the-proof-that-mindfulness-meditation-works1/ | journal = Scientific American | volume = 29 | issue = 1 | page = 20 | doi = 10.1038/scientificamericanmind0118-20 }} Contemporary studies have attempted to address many of these flaws with the hope of guiding current research into a more fruitful path.{{cite journal|vauthors=Ospina MB, Bond K, Karkhaneh M, Buscemi N, Dryden DM, Barnes V, Carlson LE, Dusek JA, Shannahoff-Khalsa D|date=December 2008|title=Clinical trials of meditation practices in health care: characteristics and quality|journal=Journal of Alternative and Complementary Medicine|volume=14|issue=10|pages=1199–213|doi=10.1089/acm.2008.0307|pmid=19123875|s2cid=43745958}}

However, the question of meditation's place in mental health care is far from settled, and there is no general consensus among experts. Though meditation is generally deemed useful, recent meta-analyses show small-to-moderate effect sizes. This means that the effect of meditation is roughly comparable to that of the standard self-care measures like sleep, exercise, nutrition, and social intercourse. Importantly, it has a worse safety profile than these standard measures (see section on adverse effects).{{cite journal | last1= Fincham | first1=G. W. | last2= Strauss | first2=C. | last3= Montero-Marin | first3=J. | last4= Cavanagh | first4=K. | title= Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials | journal= Scientific Reports | volume=13 | issue=1 | year=2023 | pages=432 | pmid=36624160 |pmc= 9828383 |doi=10.1038/s41598-022-27247-y | bibcode=2023NatSR..13..432F }}{{cite journal | last1=Galante | first1=J. | last2= Friedrich | first2=C. | last3= Dalgleish | first3=T | last4=Jones | first4=P. B. | last5=White | first5=J. R. | title= Systematic review and individual participant data meta-analysis of randomized controlled trials assessing mindfulness-based programs for mental health promotion | journal= Nature Mental Health | volume=1 | year=2023 | issue=7 | pages=462–476 | doi=10.1038/s44220-023-00081-5 | pmid=37867573 | pmc=7615230 |url=https://doi.org/10.1038/s44220-023-00081-5}}{{cite journal | last1= Goldberg | first1=S. B. | last2= Riordan | first2=K. M. | last3= Sun | first3=S. | last4= Davidson | first4=R. J. | title= The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials | journal= Perspectives on Psychological Science | volume=17 | issue=1 | year=2022 | pages=108–130|pmid=33593124|pmc=8364929|doi= 10.1177/1745691620968771}}{{cite journal | vauthors = Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA | title = Meditation programs for psychological stress and well-being: a systematic review and meta-analysis | journal = JAMA Internal Medicine | volume = 174 | issue = 3 | pages = 357–68 | date = March 2014 | pmid = 24395196 | pmc = 4142584 | doi = 10.1001/jamainternmed.2013.13018 }}{{cite journal | last1= Kreplin | first1=U. | last2=Farias | first2=M. | last3=Brazil| first3=I. A. | title= The limited prosocial effects of meditation: A systematic review and meta-analysis | journal= Scientific Reports | volume=8 | issue=2403 | year=2018 | page=2403 |pmid=29402955 |pmc=5799363 |doi=10.1038/s41598-018-20299-z | bibcode=2018NatSR...8.2403K }} A recent meta-analysis also indicates that the increased mindfulness experienced by mental health patients may not be the result of explicit mindfulness interventions but more of an artefact of their mental health condition (e.g., depression, anxiety) as it is equally experienced by the participants that were placed in the control condition (e.g., active controls, waiting list). This raises further questions as to what exactly meditation does, if anything, that is significantly different from the heightened self-monitoring and self-care that follows in the wake of spontaneous recovery or from the positive effects of encouragement and care that are usually provided in ordinary healthcare settings (see the section on the difficulties studying meditation).{{cite journal | last1= Tran | first1=U. S. | last2= Birnbaum | first2=L. | last3= Burzler | first3=M. A. | last4=Hegewisch | first4= U. J. C. | last5= Ramazanova | first5=D. | last6= Voracek | first6=M. | title= Self-reported mindfulness accounts for the effects of mindfulness interventions and nonmindfulness controls on self-reported mental health: A preregistered systematic review and three-level meta-analysis of 146 randomized controlled trials | journal= British Journal of Health Psychology | volume=148 | issue=1–2 | year=2022 | pages=86–106 |doi=10.1037/bul0000359 |url= https://psycnet.apa.org/record/2022-61115-004 }} There also seems to be a critical moderation of the effects of meditation according to individual differences. In one meta-analysis from 2022, involving a total of 7782 participants, the researchers found that a higher baseline level of psychopathology (e.g., depression) was associated with deterioration in mental health after a meditation intervention and thus was contraindicated.{{cite journal | last1= Buric | first1=I. | last2= Farias | first2=M. | last3= Driessen | first3=J. M. A.| last4= Brazil | first4=I. A. | title= Individual differences in meditation interventions: A meta-analytic study | journal= British Journal of Health Psychology | volume=27 | issue=3 | year=2022 | pages=1043–1076 | pmid=35224829 | pmc= 9543193 |doi= 10.1111/bjhp.12589 }}

{{TOC limit|3}}

Effects of mindfulness meditation

A previous{{Clarify timeframe|date=March 2025}} study commissioned by the American Agency for Healthcare Research and Quality found that meditation interventions reduce multiple negative dimensions of psychological stress. Other systematic reviews and meta-analyses show that mindfulness meditation has mental health benefits, including reductions in depression symptoms,{{cite journal | vauthors = Strauss C, Cavanagh K, Oliver A, Pettman D | title = Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials | journal = PLOS ONE| volume = 9 | issue = 4 | pages = e96110 | date = Apr 2014 | pmid = 24763812 | pmc = 3999148 | doi = 10.1371/journal.pone.0096110 | bibcode = 2014PLoSO...996110S | doi-access = free }}{{cite journal | vauthors = Khoury B, Sharma M, Rush SE, Fournier C | title = Mindfulness-based stress reduction for healthy individuals: A meta-analysis | journal = Journal of Psychosomatic Research | volume = 78 | issue = 6 | pages = 519–28 | date = June 2015 | pmid = 25818837 | doi = 10.1016/j.jpsychores.2015.03.009 }}{{cite journal | vauthors = Jain FA, Walsh RN, Eisendrath SJ, Christensen S, Rael Cahn B | title = Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: a systematic review | journal = Psychosomatics | volume = 56 | issue = 2 | pages = 140–52 | date = 2014 | pmid = 25591492 | pmc = 4383597 | doi = 10.1016/j.psym.2014.10.007 | url = http://www.escholarship.org/uc/item/0372c9xp }} improvements in mood,{{Cite journal|last1=Walsh|first1=Kathleen Marie|last2=Saab|first2=Bechara J|last3=Farb|first3=Norman AS|date=2019-01-08|title=Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study|journal=JMIR Mental Health|language=en|volume=6|issue=1|pages=e10844|doi=10.2196/10844|issn=2368-7959|pmc=6329416|pmid=30622094 |doi-access=free }} strengthening of stress-resilience, and attentional control. Mindfulness interventions also appear promising for managing depression in youth.{{cite journal | vauthors = Simkin DR, Black NB | title = Meditation and mindfulness in clinical practice | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 23 | issue = 3 | pages = 487–534 | date = July 2014 | pmid = 24975623 | doi = 10.1016/j.chc.2014.03.002 }}{{cite journal |vauthors=Zoogman S, Goldberg SB, Hoyt WT |title= Mindfulness Interventions with Youth: A Meta-Analysis |journal= Mindfulness |date=Jan 2014 | doi=10.1093/sw/swu030 |pmid= 25365830 |volume=59 |issue= 4 |pages=297–302|s2cid= 14256504 }}

Mindfulness meditation is useful for managing stress,{{cite journal | vauthors = Sharma M, Rush SE | title = Mindfulness-based stress reduction as a stress management intervention for healthy individuals: a systematic review | journal = Journal of Evidence-Based Complementary & Alternative Medicine | volume = 19 | issue = 4 | pages = 271–86 | date = October 2014 | pmid = 25053754 | doi = 10.1177/2156587214543143 | doi-access = free }}{{cite journal | vauthors = Hofmann SG, Sawyer AT, Witt AA, Oh D | title = The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review | journal = Journal of Consulting and Clinical Psychology | volume = 78 | issue = 2 | pages = 169–83 | date = April 2010 | pmid = 20350028 | pmc = 2848393 | doi = 10.1037/a0018555 }} anxiety, and also appears to be effective in treating substance use disorders.{{cite journal | vauthors = Chiesa A, Serretti A | title = Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence | journal = Substance Use & Misuse | volume = 49 | issue = 5 | pages = 492–512 | date = April 2014 | pmid = 23461667 | doi = 10.3109/10826084.2013.770027 | s2cid = 34990668 }}{{cite journal | vauthors = Garland EL, Froeliger B, Howard MO | title = Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface | journal = Frontiers in Psychiatry | volume = 4 | issue = 173 | pages = 173 | date = January 2014 | pmid = 24454293 | pmc = 3887509 | doi = 10.3389/fpsyt.2013.00173 | doi-access = free }}{{cite journal | vauthors = Black DS | title = Mindfulness-based interventions: an antidote to suffering in the context of substance use, misuse, and addiction | journal = Substance Use & Misuse | volume = 49 | issue = 5 | pages = 487–91 | date = April 2014 | pmid = 24611846 | doi = 10.3109/10826084.2014.860749 | s2cid = 34770367 }}

In 2016, Hilton and colleagues published a meta-analysis of 30 randomized controlled trials, found high-quality evidence for improvement in depressive symptoms.{{cite journal | vauthors = Hilton L, Hempel S, Ewing BA, Apaydin E, Xenakis L, Newberry S, Colaiaco B, Maher AR, Shanman RM, Sorbero ME, Maglione MA | title = Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis | journal = Annals of Behavioral Medicine | volume = 51 | issue = 2 | pages = 199–213 | date = April 2017 | pmid = 27658913 | pmc = 5368208 | doi = 10.1007/s12160-016-9844-2 }}

Other reviews have concluded that mindfulness meditation can enhance the psychological functioning of breast cancer survivors, is effective for people with eating disorders{{cite journal | vauthors = Godfrey KM, Gallo LC, Afari N | title = Mindfulness-based interventions for binge eating: a systematic review and meta-analysis | journal = Journal of Behavioral Medicine | volume = 38 | issue = 2 | pages = 348–62 | date = April 2015 | pmid = 25417199 | doi = 10.1007/s10865-014-9610-5 | s2cid = 22953790 }}{{cite journal | vauthors = Olson KL, Emery CF | title = Mindfulness and weight loss: a systematic review | journal = Psychosomatic Medicine | volume = 77 | issue = 1 | pages = 59–67 | date = January 2015 | pmid = 25490697 | doi = 10.1097/PSY.0000000000000127 | s2cid = 32414780 }} and may also be effective in treating psychosis.{{cite journal | vauthors = Shonin E, Van Gordon W, Griffiths MD | title = Do mindfulness-based therapies have a role in the treatment of psychosis? | journal = The Australian and New Zealand Journal of Psychiatry | volume = 48 | issue = 2 | pages = 124–7 | date = February 2014 | pmid = 24220133 | doi = 10.1177/0004867413512688 | s2cid = 32414692 | url = http://irep.ntu.ac.uk/id/eprint/26548/1/PubSub3164_Griffiths.pdf }}{{cite journal | vauthors = Chadwick P | title = Mindfulness for psychosis | journal = The British Journal of Psychiatry | volume = 204 | issue = 5 | pages = 333–4 | date = May 2014 | pmid = 24785766 | doi = 10.1192/bjp.bp.113.136044 | doi-access = free }}{{cite journal | vauthors = Khoury B, Lecomte T, Gaudiano BA, Paquin K | title = Mindfulness interventions for psychosis: a meta-analysis | journal = Schizophrenia Research | volume = 150 | issue = 1 | pages = 176–84 | date = October 2013 | pmid = 23954146 | doi = 10.1016/j.schres.2013.07.055 | s2cid = 25506013 }}

Studies have also shown that rumination and worry contribute to mental illnesses such as depression and anxiety,{{cite journal | vauthors = Querstret D, Cropley M | title = Assessing treatments used to reduce rumination and/or worry: a systematic review | journal = Clinical Psychology Review | volume = 33 | issue = 8 | pages = 996–1009 | date = December 2013 | pmid = 24036088 | doi = 10.1016/j.cpr.2013.08.004 | url = http://epubs.surrey.ac.uk/805216/6/Querstret%26Cropley_2013.pdf | hdl = 2164/3892 | hdl-access = free }} and mindfulness-based interventions are effective in the reduction of worry.{{cite journal | vauthors = Gu J, Strauss C, Bond R, Cavanagh K | title = How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of meditation studies | journal = Clinical Psychology Review | volume = 37 | pages = 1–12 | date = April 2015 | pmid = 25689576 | doi = 10.1016/j.cpr.2015.01.006 | s2cid = 4117449 }} Some studies suggest that mindfulness meditation contributes to a more coherent and healthy sense of self and identity when considering aspects such as a sense of responsibility, authenticity, compassion, self-acceptance, and character.{{cite journal | vauthors = Crescentini C, Capurso V | title = Mindfulness meditation and explicit and implicit indicators of personality and self-concept changes | journal = Frontiers in Psychology | volume = 6 | pages = 44 | year = 2015 | pmid = 25688222 | pmc = 4310269 | doi = 10.3389/fpsyg.2015.00044 | doi-access = free }}{{cite journal | vauthors = Crescentini C, Matiz A, Fabbro F | title = Improving personality/character traits in individuals with alcohol dependence: the influence of mindfulness-oriented meditation | journal = Journal of Addictive Diseases | volume = 34 | issue = 1 | pages = 75–87 | year = 2015 | pmid = 25585050 | doi = 10.1080/10550887.2014.991657 | s2cid = 8250105 }}

=Brain mechanisms=

{{main|Mechanisms of mindfulness meditation}}

The analgesic effect of mindfulness meditation may involve multiple brain mechanisms, of which chronic pain is shown to have a slight decrease when performing meditation.{{Cite journal |last1=Hilton |first1=Lara |last2=Hempel |first2=Susanne |last3=Ewing |first3=Brett A. |last4=Apaydin |first4=Eric |last5=Xenakis |first5=Lea |last6=Newberry |first6=Sydne |last7=Colaiaco |first7=Ben |last8=Maher |first8=Alicia Ruelaz |last9=Shanman |first9=Roberta M. |last10=Sorbero |first10=Melony E. |last11=Maglione |first11=Margaret A. |date=April 2017 |title=Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis |journal=Annals of Behavioral Medicine |language=en |volume=51 |issue=2 |pages=199–213 |doi=10.1007/s12160-016-9844-2 |issn=0883-6612 |pmc=5368208 |pmid=27658913}} Current research demonstrates a lack of high-quality data to support a strong case for clinical prescription of meditation, however future research may further change our understanding of chronic pain treatment and mindfulness,{{Cite journal |last1=Bawa |first1=Fathima L Marikar |last2=Mercer |first2=Stewart W |last3=Atherton |first3=Rachel J |last4=Clague |first4=Fiona |last5=Keen |first5=Andrew |last6=Scott |first6=Neil W |last7=Bond |first7=Christine M |date=June 2015 |title=Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis |journal=British Journal of General Practice |language=en |volume=65 |issue=635 |pages=e387–e400 |doi=10.3399/bjgp15X685297 |issn=0960-1643 |pmc=4439829 |pmid=26009534}} but there are too few studies to allow conclusions about its effects on chronic pain.{{cite journal | vauthors = Jensen MP, Day MA, Miró J | title = Neuromodulatory treatments for chronic pain: efficacy and mechanisms | journal = Nature Reviews. Neurology | volume = 10 | issue = 3 | pages = 167–78 | date = March 2014 | pmid = 24535464 | pmc = 5652321 | doi = 10.1038/nrneurol.2014.12 }}

=Changes in the brain=

{{main|Brain activity and meditation}}

Mindfulness meditation alters the brain, leading to a heightened ability to improve emotions.{{Cite journal |last1=Gotink |first1=Rinske A. |last2=Meijboom |first2=Rozanna |last3=Vernooij |first3=Meike W. |last4=Smits |first4=Marion |last5=Hunink |first5=M.G. Myriam |date=October 2016 |title=8-week Mindfulness Based Stress Reduction induces brain changes similar to traditional long-term meditation practice – A systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S0278262616301312 |journal=Brain and Cognition |language=en |volume=108 |pages=32–41 |doi=10.1016/j.bandc.2016.07.001|pmid=27429096 |url-access=subscription }} In an 8-week mindfulness meditation study, Gotink et al. results showed activity in the amygdala, insula, cingulate cortex, and hippocampus to decrease. Short-term brain changes such as these are correlated to effects seen in people who have practiced mindfulness over longer periods such as months or years. Another meta-analysis found preliminary evidence for effects in the prefrontal cortex and other brain regions associated with body awareness.{{Cite journal |last1=Fox |first1=Kieran C. R. |last2=Nijeboer |first2=Savannah |last3=Dixon |first3=Matthew L. |last4=Floman |first4=James L. |last5=Ellamil |first5=Melissa |last6=Rumak |first6=Samuel P. |last7=Sedlmeier |first7=Peter |last8=Christoff |first8=Kalina |date=June 2014 |title=Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners |journal=Neuroscience and Biobehavioral Reviews |volume=43 |pages=48–73 |doi=10.1016/j.neubiorev.2014.03.016 |issn=1873-7528 |pmid=24705269 |s2cid=207090878}} However, these results should be interpreted with caution as funnel plots indicate that publication bias is an issue in meditation research.{{cite journal |vauthors=Fox KC, Nijeboer S, Dixon ML, Floman JL, Ellamil M, Rumak SP, Sedlmeier P, Christoff K |date=June 2014 |title=Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners |journal=Neuroscience and Biobehavioral Reviews |volume=43 |pages=48–73 |doi=10.1016/j.neubiorev.2014.03.016 |pmid=24705269 |s2cid=207090878}} A 2016 review using 78 functional neuroimaging studies suggests that different meditation styles result in different brain activity.{{cite journal |vauthors=Fox KC, Dixon ML, Nijeboer S, Girn M, Floman JL, Lifshitz M, Ellamil M, Sedlmeier P, Christoff K |date=June 2016 |title=Functional neuroanatomy of meditation: A review and meta-analysis of 78 functional neuroimaging investigations |journal=Neuroscience and Biobehavioral Reviews |volume=65 |pages=208–28 |arxiv=1603.06342 |bibcode=2016arXiv160306342F |doi=10.1016/j.neubiorev.2016.03.021 |pmid=27032724 |s2cid=9451371}} While other studies have found structural changes in the brain may occur, most studies have utilized weak methodology.

=Attention and mindfulness=

==Attention networks and mindfulness meditation==

Psychological and Buddhist conceptualizations of mindfulness both highlight awareness and attention training as key components in which levels of mindfulness can be cultivated with the practice of mindfulness meditation.{{Cite journal |last1=Tang |first1=Yi-Yuan |last2=Hölzel |first2=Britta K. |last3=Posner |first3=Michael I. |date=16 April 2015 |title=The neuroscience of mindfulness meditation |url=https://www.nature.com/articles/nrn3916 |journal=Nature Reviews Neuroscience |language=en |volume=16 |issue=4 |pages=213–225 |doi=10.1038/nrn3916 |pmid=25783612 |issn=1471-0048 |via=PubMed}}{{cite journal | vauthors = Kabat-Zinn J | year = 2003 | title = Mindfulness-based interventions in context: past, present, and future | journal = Clinical Psychology: Science and Practice | volume = 10 | issue = 2| pages = 144–156 | doi=10.1093/clipsy/bpg016}} Focused attention meditation (FAM) and open monitoring meditation (OMM) are distinct types of mindfulness meditation; FAM refers to the practice of intently maintaining focus on one object, whereas OMM is the progression of general awareness of one's surroundings while regulating thoughts.{{cite journal | vauthors = Lippelt DP, Hommel B, Colzato LS | title = Focused attention, open monitoring and loving kindness meditation: effects on attention, conflict monitoring, and creativity - A review | journal = Frontiers in Psychology | volume = 5 | pages = 1083 | date = 2014 | pmid = 25295025 | pmc = 4171985 | doi = 10.3389/fpsyg.2014.01083 | doi-access = free }}{{cite journal | vauthors = Lutz A, Slagter HA, Dunne JD, Davidson RJ | title = Attention regulation and monitoring in meditation | journal = Trends in Cognitive Sciences | volume = 12 | issue = 4 | pages = 163–9 | date = April 2008 | pmid = 18329323 | pmc = 2693206 | doi = 10.1016/j.tics.2008.01.005 }} Some forms of Buddhist mindfulness meditation may lead to greater cognitive flexibility.{{cite journal | vauthors = Moore A, Malinowski P | title = Meditation, mindfulness and cognitive flexibility | journal = Consciousness and Cognition | volume = 18 | issue = 1 | pages = 176–86 | date = March 2009 | pmid = 19181542 | doi = 10.1016/j.concog.2008.12.008 | s2cid = 9818458 }}

In an active randomized controlled study completed in 2019, participants who practiced mindfulness meditation demonstrated a greater improvement in awareness and attention than participants in the active control condition. Alpha wave neural oscillation power (which is usually associated with an alert resting state) has been shown to be increased by mindfulness in both healthy subjects and patients.{{cite journal|vauthors=Lomas T, Ivtzan I, Fu CH|date=October 2015|title=A systematic review of the neurophysiology of mindfulness on EEG oscillations|url=http://roar.uel.ac.uk/4509/1/A%20systematic%20review%20of%20the%20neurophysiology%20of.pdf|journal=Neuroscience & Biobehavioral Reviews|volume=57|pages=401–410|doi=10.1016/j.neubiorev.2015.09.018|pmid=26441373|s2cid=7276590}}

===Sustained attention===

Tasks of sustained attention relate to vigilance and the preparedness that aids in completing a particular task goal. Psychological research into the relationship between mindfulness meditation and the sustained attention network has revealed the following:

  • In a continuous performance task{{cite journal | vauthors =Schmertz SK, Anderson PL, Robins DL | year = 2009 | title = The relation between self-report mindfulness and performance on tasks of sustained attention | journal = Journal of Psychopathology and Behavioral Assessment | volume = 31 | issue = 1| pages = 60–66 | doi=10.1007/s10862-008-9086-0| s2cid = 143771349 }} an association was found between higher dispositional mindfulness and more stable maintenance of sustained attention.
  • In an electroencephalography study, the attentional blink effect was reduced, and P3b ERP amplitude decreased in a group of participants who completed a mindfulness retreat.{{cite journal | vauthors = Slagter HA, Lutz A, Greischar LL, Francis AD, Nieuwenhuis S, Davis JM, Davidson RJ | title = Mental training affects distribution of limited brain resources | journal = PLOS Biology | volume = 5 | issue = 6 | pages = e138 | date = June 2007 | pmid = 17488185 | pmc = 1865565 | doi = 10.1371/journal.pbio.0050138 | doi-access = free }} The incidence of reduced attentional blink effect relates to an increase in the detectability of a second target.
  • A greater degree of attentional resources may also be reflected in faster response times in task performance, as was found for participants with higher levels of mindfulness experience.{{cite journal | vauthors = Jha AP, Krompinger J, Baime MJ | title = Mindfulness training modifies subsystems of attention | journal = Cognitive, Affective, & Behavioral Neuroscience | volume = 7 | issue = 2 | pages = 109–19 | date = June 2007 | pmid = 17672382 | doi = 10.3758/cabn.7.2.109 | doi-access = free }}

===Selective attention===

  • Selective attention, linked with the orientation network, selects the relevant stimuli to attend to.
  • Performance in the ability to limit attention to potential sensory inputs (i.e., selective attention) was found to be higher following the completion of an eight-week MBSR course, compared to a one-month retreat and control group (with no mindfulness training). The ANT task is a general applicable task designed to test the three attention networks, in which participants are required to determine the direction of a central arrow on a computer screen.{{cite journal | vauthors = Fan J, McCandliss BD, Sommer T, Raz A, Posner MI | title = Testing the efficiency and independence of attentional networks | journal = Journal of Cognitive Neuroscience | volume = 14 | issue = 3 | pages = 340–7 | date = April 2002 | pmid = 11970796 | doi = 10.1162/089892902317361886 | citeseerx = 10.1.1.590.8796 | s2cid = 12681459 }} Efficiency in orienting that represent the capacity to attend to stimuli selectively was calculated by examining changes in the reaction time that accompanied cues indicating where the target occurred relative to the aid of no cues.
  • Meditation experience correlates negatively with reaction times on an Eriksen flanker task measuring responses to global and local figures. Similar findings have been observed for correlations between mindfulness experience and an orienting score of response times taken from Attention Network Task performance.{{cite journal | vauthors = van den Hurk PA, Giommi F, Gielen SC, Speckens AE, Barendregt HP | title = Greater efficiency in attentional processing related to mindfulness meditation | journal = Quarterly Journal of Experimental Psychology | volume = 63 | issue = 6 | pages = 1168–80 | date = June 2010 | pmid = 20509209 | doi = 10.1080/17470210903249365 | s2cid = 717916 }}
  • Participants who engaged in the Meditation Breath Attention Score exercise performed better on anagram tasks and reported greater focused attention on this task compared to those who did not undergo this exercise.{{Cite journal|last1=Green|first1=Joseph P.|last2=Black|first2=Katharine N.|date=2017|title=Meditation-focused attention with the MBAS and solving anagrams.|journal=Psychology of Consciousness: Theory, Research, and Practice|volume=4|issue=4|pages=348–366|doi=10.1037/cns0000113|s2cid=151764564|issn=2326-5531}}

===Executive control attention===

  • Executive control attention includes functions of inhibiting the conscious processing of distracting information. In the context of mindful meditation, distracting information relates to attention-grabbing mental events, such as thoughts related to the future or past.
  • More than one study has reported findings of a reduced Stroop effect following mindfulness meditation training.{{cite journal | vauthors = Chan D, Woollacott M | title = Effects of level of meditation experience on attentional focus: is the efficiency of executive or orientation networks improved? | journal = Journal of Alternative and Complementary Medicine | volume = 13 | issue = 6 | pages = 651–7 | year = 2007 | pmid = 17718648 | doi = 10.1089/acm.2007.7022 | s2cid = 26104244 }} The Stroop effect indexes interference created by having words printed in a color different from the read semantic meaning, e.g., green printed in red. However, the findings for this task are not consistently found.{{cite journal | vauthors = Anderson ND, Lau MA, Segal ZV, Bishop SR | year = 2007 | title = Mindfulness-based stress reduction and attentional control | journal = Clinical Psychology & Psychotherapy | volume = 14 | issue = 6| pages = 449–463 | doi=10.1002/cpp.544| doi-access = }}{{cite journal | vauthors = Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U | title = How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective | journal = Perspectives on Psychological Science | volume = 6 | issue = 6 | pages = 537–59 | date = November 2011 | pmid = 26168376 | doi = 10.1177/1745691611419671 | s2cid = 2218023 | url = https://semanticscholar.org/paper/73b8a5091dc9a8a7ea60b81641689bb5ccc5aea1 }} For instance the MBSR may differ to how mindful one becomes relative to a person who is already high in trait mindfulness.{{cite journal | vauthors = Malinowski P | title = Neural mechanisms of attentional control in mindfulness meditation | journal = Frontiers in Neuroscience | volume = 7 | pages = 8 | year = 2013 | pmid = 23382709 | pmc = 3563089 | doi = 10.3389/fnins.2013.00008 | doi-access = free }}
  • Using the Attention Network Task, a version of the Eriksen flanker task, it was found that error scores that indicate executive control performance were reduced in experienced meditators and following a brief five-session mindfulness training program.{{cite journal | vauthors = Tang YY, Ma Y, Wang J, Fan Y, Feng S, Lu Q, Yu Q, Sui D, Rothbart MK, Fan M, Posner MI | title = Short-term meditation training improves attention and self-regulation | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 104 | issue = 43 | pages = 17152–6 | date = October 2007 | pmid = 17940025 | pmc = 2040428 | doi = 10.1073/pnas.0707678104 | bibcode = 2007PNAS..10417152T | doi-access = free }}
  • A neuroimaging study supports behavioral research findings that higher levels of mindfulness are associated with greater proficiency in inhibiting distracting information. A greater activation of the rostral anterior cingulate cortex (ACC) was shown for mindfulness meditators than matched controls.{{Cite journal|last=Marchand|first=William R|date=2014-07-28|title=Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies|journal=World Journal of Radiology|volume=6|issue=7|pages=471–479|doi=10.4329/wjr.v6.i7.471|issn=1949-8470|pmc=4109098|pmid=25071887 |doi-access=free }}
  • Participants with at least 6 years of experience meditating performed better on the Stroop Test than participants without experience meditating.{{cite journal | vauthors = Fabio RA, Towey GE | title = Long-term meditation: the relationship between cognitive processes, thinking styles and mindfulness | journal = Cognitive Processing | volume = 19 | issue = 1 | pages = 73–85 | date = February 2018 | pmid = 29110263 | doi = 10.1007/s10339-017-0844-3 | s2cid = 3477655 }} The group of meditators also had lower reaction times during this test than the group of non-meditators.
  • Following a Stroop test, reduced amplitude of the P300 ERP component was found for a meditation group relative to control participants. This was taken to signify that mindfulness meditation improves executive control functions of attention. An increased amplitude in the N2 ERP component was also observed in the mindfulness meditation group, which was thought to reflect more efficient perceptual discrimination in earlier stages of perceptual processing.{{cite journal | vauthors = Moore A, Gruber T, Derose J, Malinowski P | title = Regular, brief mindfulness meditation practice improves electrophysiological markers of attentional control | journal = Frontiers in Human Neuroscience | volume = 6 | pages = 18 | date = 2012 | pmid = 22363278 | pmc = 3277272 | doi = 10.3389/fnhum.2012.00018 | doi-access = free }}

= Emotion regulation and mindfulness =

Research shows meditation practices lead to greater emotional regulation abilities. Mindfulness can help people become more aware of thoughts in the present moment, and this increased self-awareness leads to better processing and control over one's responses to surroundings or circumstances.{{cite encyclopedia |last1=Chawla|first1=Neharika |last2=Marlatt|first2=G. Alan |title=Mindlessness-Mindfulness|date=2010 |encyclopedia=The Corsini Encyclopedia of Psychology |pages=1–2 |publisher=American Cancer Society |doi=10.1002/9780470479216.corpsy0549 |isbn=978-0-470-47921-6 }}{{cite journal|last=Baer|first=Ruth A. |date=2003|title=Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review |journal=Clinical Psychology: Science and Practice |volume=10|issue=2|pages=125–143|doi=10.1093/clipsy.bpg015 }}

Positive effects of this heightened awareness include a greater sense of empathy for others, increased positive thinking patterns, and reduced anxiety. Reductions in rumination also have been found following mindfulness meditation practice, contributing to the development of positive thinking and emotional well-being.{{Cite journal|last=Wolkin|first=Jennifer R|date=2015-06-29|title=Cultivating multiple aspects of attention through mindfulness meditation accounts for psychological well-being through decreased rumination|journal=Psychology Research and Behavior Management|volume=8|pages=171–180|doi=10.2147/PRBM.S31458|issn=1179-1578|pmc=4492627|pmid=26170728 |doi-access=free }}

==Evidence of mindfulness and emotion regulation outcomes==

Emotional reactivity can be measured and reflected in brain regions related to the production of emotions.{{cite journal | vauthors = Ochsner KN, Gross JJ | title = The cognitive control of emotion | journal = Trends in Cognitive Sciences | volume = 9 | issue = 5 | pages = 242–9 | date = May 2005 | pmid = 15866151 | doi = 10.1016/j.tics.2005.03.010 | s2cid = 151594 }} It can also be reflected in tests of attentional performance, indexed in poorer performance in attention-related tasks. The regulation of emotional reactivity as initiated by attentional control capacities can be taxing to performance, as attentional resources are limited.{{cite journal | vauthors = Posner MI, Rothbart MK | title = Research on attention networks as a model for the integration of psychological science | journal = Annual Review of Psychology | volume = 58 | pages = 1–23 | year = 2007 | pmid = 17029565 | doi = 10.1146/annurev.psych.58.110405.085516 | s2cid = 8826493 }}

  • Patients with social anxiety disorder (SAD) exhibited reduced amygdala activation in response to negative self-beliefs following an MBSR intervention program that involves mindfulness meditation practice.{{cite journal | vauthors = Goldin PR, Gross JJ | title = Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder | journal = Emotion | volume = 10 | issue = 1 | pages = 83–91 | date = February 2010 | pmid = 20141305 | pmc = 4203918 | doi = 10.1037/a0018441 }}
  • The LPP ERP component indexes arousal and is larger in amplitude for emotionally salient stimuli relative to neutral.{{cite journal | vauthors = Cuthbert BN, Schupp HT, Bradley MM, Birbaumer N, Lang PJ | title = Brain potentials in affective picture processing: covariation with autonomic arousal and affective report | journal = Biological Psychology | volume = 52 | issue = 2 | pages = 95–111 | date = March 2000 | pmid = 10699350 | doi = 10.1016/s0301-0511(99)00044-7 | s2cid = 17202155 | url = https://kops.uni-konstanz.de/bitstreams/07fb2c65-fed1-4bc9-8c84-50fc2e96641d/download }}{{cite journal | vauthors = Schupp HT, Cuthbert BN, Bradley MM, Cacioppo JT, Ito T, Lang PJ | title = Affective picture processing: the late positive potential is modulated by motivational relevance | journal = Psychophysiology | volume = 37 | issue = 2 | pages = 257–61 | date = March 2000 | pmid = 10731776 | doi = 10.1111/1469-8986.3720257 | url = http://nbn-resolving.de/urn:nbn:de:bsz:352-opus-21050 }}{{cite journal | vauthors = Schupp HT, Junghöfer M, Weike AI, Hamm AO | title = Attention and emotion: an ERP analysis of facilitated emotional stimulus processing | journal = NeuroReport | volume = 14 | issue = 8 | pages = 1107–10 | date = June 2003 | pmid = 12821791 | doi = 10.1097/00001756-200306110-00002 | citeseerx = 10.1.1.521.5802 | s2cid = 14610024 }} Individuals higher in trait mindfulness showed lower LPP responses to high arousal unpleasant images. These findings suggest that individuals with higher trait mindfulness were better able to regulate emotional reactivity to emotionally evocative stimuli.{{cite journal | vauthors = Brown KW, Goodman RJ, Inzlicht M | title = Dispositional mindfulness and the attenuation of neural responses to emotional stimuli | journal = Social Cognitive and Affective Neuroscience | volume = 8 | issue = 1 | pages = 93–9 | date = January 2013 | pmid = 22253259 | pmc = 3541486 | doi = 10.1093/scan/nss004 }}
  • Participants who completed a seven-week mindfulness training program demonstrated a reduction in a measure of emotional interference (measured as slower response times following the presentation of emotion relative to neutral pictures). This suggests a reduction in emotional interference.{{cite journal | vauthors = Ortner CN, Kilner SJ, Zelazo PD | year = 2007 | title = Mindfulness meditation and reduced emotional interference on a cognitive task | journal = Motivation and Emotion | volume = 31 | issue = 4| pages = 271–283 | doi=10.1007/s11031-007-9076-7| s2cid = 3114372 }}
  • Following an MBSR intervention, decreases in social anxiety symptom severity and increases in bilateral parietal cortex neural correlates were found. This is thought to reflect the increased employment of inhibitory attentional control capacities to regulate emotions.{{cite journal | vauthors = Goldin P, Ziv M, Jazaieri H, Hahn K, Gross JJ | title = MBSR vs aerobic exercise in social anxiety: fMRI of emotion regulation of negative self-beliefs | journal = Social Cognitive and Affective Neuroscience | volume = 8 | issue = 1 | pages = 65–72 | date = January 2013 | pmid = 22586252 | pmc = 3541489 | doi = 10.1093/scan/nss054 }}{{cite journal | vauthors = Farb NA, Segal ZV, Mayberg H, Bean J, McKeon D, Fatima Z, Anderson AK | title = Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference | journal = Social Cognitive and Affective Neuroscience | volume = 2 | issue = 4 | pages = 313–22 | date = December 2007 | pmid = 18985137 | pmc = 2566754 | doi = 10.1093/scan/nsm030 }}
  • Participants who engaged in emotion-focus meditation and breathing meditation exhibited a delayed emotional response to negatively valenced film stimuli compared to participants who did not engage in any type of meditation.{{cite journal | vauthors = Beblo T, Pelster S, Schilling C, Kleinke K, Iffland B, Driessen M, Fernando S | title = Breath Versus Emotions: The Impact of Different Foci of Attention During Mindfulness Meditation on the Experience of Negative and Positive Emotions | journal = Behavior Therapy | volume = 49 | issue = 5 | pages = 702–714 | date = September 2018 | pmid = 30146138 | doi = 10.1016/j.beth.2017.12.006 | s2cid = 52092402 }}

==Controversies in mindful emotion regulation==

It is debated as to whether top-down executive control regions such as the dorsolateral prefrontal cortex (DLPFC),{{cite journal | vauthors = Quirk GJ, Beer JS | title = Prefrontal involvement in the regulation of emotion: convergence of rat and human studies | journal = Current Opinion in Neurobiology | volume = 16 | issue = 6 | pages = 723–7 | date = December 2006 | pmid = 17084617 | doi = 10.1016/j.conb.2006.07.004 | s2cid = 17157089 }} are required or not to inhibit reactivity of the amygdala activation related to the production of evoked emotional responses. Arguably, an initial increase in activation of executive control regions developed during mindfulness training may lessen with increasing mindfulness expertise.{{cite journal | vauthors = Chiesa A, Calati R, Serretti A | title = Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings | journal = Clinical Psychology Review | volume = 31 | issue = 3 | pages = 449–64 | date = April 2011 | pmid = 21183265 | doi = 10.1016/j.cpr.2010.11.003 | s2cid = 33953894 }}

Furthermore, current research data is inconclusive and incomplete in linking the positive effects of mindful meditation with a variety of reported positive effects. Additional high-fidelity studies are needed before a complete understanding of the full effects of mindfulness can be reached.

=Stress reduction=

Research has shown stress reduction benefits from mindfulness.{{cite journal|vauthors=Sevinc G, Hölzel BK, Hashmi J, Greenberg J, McCallister A, Treadway M, Schneider ML, Dusek JA, Carmody J, Lazar SW|date=June 2018|title=Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs|journal=Psychosomatic Medicine|volume=80|issue=5|pages=439–451|doi=10.1097/PSY.0000000000000590|pmc=5976535|pmid=29642115}}{{Cite web|url=https://www.laboratoryequipment.com/news/2018/06/mindfulness-meditation-relaxation-response-have-different-effects-brain-function|title=Mindfulness, Meditation, Relaxation Response Have Different Effects on Brain Function|work=Laboratory Equipment |date=2018-06-13}}{{Cite journal|last1=Bostock|first1=Sophie|last2=Crosswell|first2=Alexandra D.|last3=Prather|first3=Aric A.|last4=Steptoe|first4=Andrew|date=2019|title=Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being.|journal=Journal of Occupational Health Psychology|language=en|volume=24|issue=1|pages=127–138|doi=10.1037/ocp0000118|issn=1939-1307|pmc=6215525|pmid=29723001}} A 2019 study tested the effects of meditation on the psychological well-being, work stress, and blood pressure of employees working in the United Kingdom. One group of participants was instructed to meditate once a day using a smartphone mindfulness app, while the control group did not engage in meditation. Measurements of well-being, stress, and perceived workplace support were taken for both groups before the intervention and then again after four months. Based on self-report questionnaires, the participants who engaged in meditation showed a significant increase in psychological well-being and perceived workplace support. The meditators also reported a significant decrease in anxiety and stress levels.

Another study conducted to understand the association between mindfulness, perceived stress, and work engagement indicated that mindfulness was associated with lower perceived stress and higher work engagement.{{Cite journal |last1=Bartlett |first1=Larissa |last2=Buscot |first2=Marie-Jeanne |last3=Bindoff |first3=Aidan |last4=Chambers |first4=Richard |last5=Hassed |first5=Craig |date=2021 |title=Mindfulness Is Associated With Lower Stress and Higher Work Engagement in a Large Sample of MOOC Participants |journal=Frontiers in Psychology |volume=12 |page=724126 |doi=10.3389/fpsyg.2021.724126 |pmid=34566805 |pmc=8461060 |issn=1664-1078|doi-access=free }}

An additional study from 2021 looking at the effect of centering meditation intervention on stress levels of college students saw a statistically significant improvement in stress and mindfulness levels over time. Inclusive of this was the finding that it helped reduce stress and the variance of that stress on a participant-to-participant basis.{{Cite journal |last1=Dorais |first1=Stephanie |last2=Gutierrez |first2=Daniel |date=2021-10-21 |title=The Effectiveness of a Centering Meditation Intervention on College Stress and Mindfulness: A Randomized Controlled Trial |journal=Frontiers in Psychology |language=English |volume=12 |doi=10.3389/fpsyg.2021.720824 |doi-access=free |issn=1664-1078 |pmc=8567013 |pmid=34744885}}

Other research shows decreased stress levels in people who engage in meditation after shorter periods of time as well. Evidence of significant stress reduction was found after only three weeks of meditation intervention. Brief, daily meditation sessions can alter one's behavioral response to stressors, improving coping mechanisms and decreasing the adverse impact caused by stress.{{Cite journal|last1=Basso|first1=Julia C.|last2=McHale|first2=Alexandra|last3=Ende|first3=Victoria|last4=Oberlin|first4=Douglas J.|last5=Suzuki|first5=Wendy A.|date=2019|title=Brief, daily meditation enhances attention, memory, mood, and emotional regulation in non-experienced meditators|journal=Behavioural Brain Research|volume=356|pages=208–220|doi=10.1016/j.bbr.2018.08.023|pmid=30153464|issn=0166-4328|doi-access=}}{{Cite journal|last1=Surinrut|first1=Piyawan|last2=Auamnoy|first2=Titinun|last3=Sangwatanaroj|first3=Somkiat|date=2016|title=Enhanced happiness and stress alleviation upon insight meditation retreat: mindfulness, a part of traditional Buddhist meditation|journal=Mental Health, Religion & Culture|volume=19|issue=7|pages=648–659|doi=10.1080/13674676.2016.1207618|s2cid=152177044|issn=1367-4676}} A study from 2016 examined anxiety and emotional states of naive meditators before and after a seven-day meditation retreat in Thailand. Results displayed a significant reduction in perceived stress after this traditional Buddhist meditation retreat.

Cancer diagnosis and treatment often comes with psychological complications; as an example, rates of psychological distress in breast cancer patients in China was a staggering 49%. {{Cite journal |last1=Tang |first1=Wen-Zhen |last2=Mangantig |first2=Ernest |last3=Iskandar |first3=Yulita Hanum P. |last4=Cheng |first4=Shi-Li |last5=Yusuf |first5=Azlina |last6=Jia |first6=Kui |date=2024-09-26 |title=Prevalence and associated factors of psychological distress among patients with breast cancer: a systematic review and meta-analysis |journal=BMJ Open |volume=14 |issue=9 |pages=e077067 |doi=10.1136/bmjopen-2023-077067 |issn=2044-6055 |pmc=11429273 |pmid=39327054}} A meta-analysis of 869 studies saw that Mindfulness-based stress reduction resulted in significant decreases of anxiety and depression levels in cancer patients. {{Cite journal |last1=Lin |first1=Li-Ying |last2=Lin |first2=Li-Hua |last3=Tzeng |first3=Ghao-Ling |last4=Huang |first4=Ya-Hui |last5=Tai |first5=Jui-Fen |last6=Chen |first6=Yu-Ling |last7=Wu |first7=Chia-Jung |last8=Chen |first8=Pin-Hsi |last9=Lin |first9=Pei-Chin |last10=Hung |first10=Pi-Lien |date=2022-06-01 |title=Effects of Mindfulness-Based Therapy for Cancer Patients: A Systematic Review and Meta-analysis |url=https://link.springer.com/article/10.1007/s10880-022-09862-z |journal=Journal of Clinical Psychology in Medical Settings |language=en |volume=29 |issue=2 |pages=432–445 |doi=10.1007/s10880-022-09862-z |pmid=35249176 |issn=1573-3572}}

=Insomnia and sleep=

Chronic insomnia is often associated with anxious hyperarousal and frustration over the inability to sleep.{{cite journal | vauthors= Ong JC, Moore C | title = What do we really know about mindfulness and sleep health? | journal = Current Opinion in Psychology | volume = 34 | pages=18–22 | year = 2020 | doi = 10.1016/j.copsyc.2019.08.020 | pmid=31539830| s2cid = 202248995 }} Mindfulness has been shown to reduce insomnia and improve sleep quality, although self-reported measures show larger effects than objective measures.{{cite journal | vauthors= Wang X, Li P, Yunlong Deng Y | title = The Effect of Mind-Body Therapies on Insomnia: A Systematic Review and Meta-Analysis | journal = Evidence-Based Complementary and Alternative Medicine | volume = 13 | pages=9359807 | year = 2019 | doi = 10.1155/2019/9359807 | pmc=6393899 | pmid=30894878| doi-access = free }}

A 2008 study looked at the combination of meditation and cognitive behavioral therapy in treating those meeting the diagnostic criteria for psychophysiological insomnia. Results after the 6-week intervention showed statistically significant improvements in pre-sleep arousal, sleep-related distress, and insomnia.{{Cite journal |last1=Ong |first1=Jason C. |last2=Shapiro |first2=Shauna L. |last3=Manber |first3=Rachel |date=2008-06-01 |title=Combining Mindfulness Meditation with Cognitive-Behavior Therapy for Insomnia: A Treatment-Development Study |journal=Behavior Therapy |volume=39 |issue=2 |pages=171–182 |doi=10.1016/j.beth.2007.07.002 |pmid=18502250 |pmc=3052789 |issn=0005-7894}}

Sleep disturbance is a common symptom of cancer that many patients face, with incidence rates ranging anywhere from 30 - 90%. {{Cite journal |last1=Han |first1=Jing |last2=Cheng |first2=Hui-Lin |last3=Bi |first3=Liu-Na |last4=Molasiotis |first4=Alex |date=August 2023 |title=Mind-body therapies for sleep disturbance among patients with cancer: A systematic review and meta-analysis |url=https://pubmed.ncbi.nlm.nih.gov/37244384 |journal=Complementary Therapies in Medicine |volume=75 |pages=102954 |doi=10.1016/j.ctim.2023.102954 |issn=1873-6963 |pmid=37244384|hdl=10397/108416 |hdl-access=free }} A 2023 meta-analysis looking at the relationship between meditation and cancer-related sleep disturbance saw significant immediate effects in patients on self-reported sleep disturbance levels.

= Meditation And Cancer =

Cancer itself and the treatment patients go through often comes with varying side effects including fatigue, nausea, sleep disturbance, pain, and others. {{Cite journal |last1=Devlin |first1=Elise J. |last2=Denson |first2=Linley A. |last3=Whitford |first3=Hayley S. |date=2017-08-01 |title=Cancer Treatment Side Effects: A Meta-analysis of the Relationship Between Response Expectancies and Experience |url=https://linkinghub.elsevier.com/retrieve/pii/S0885392417301860 |journal=Journal of Pain and Symptom Management |language=English |volume=54 |issue=2 |pages=245–258.e2 |doi=10.1016/j.jpainsymman.2017.03.017 |issn=0885-3924 |pmid=28533160}} Over the past few decades, the connection between meditation and its effect on cancer has been a topic of interest for researchers. Mindfulness meditation, in particular, has been shown to influence health outcomes associated with cancer diagnosis and treatment, including pain, mental health and sleep disturbance, which have susceptibility to play off of one another.

====Pain====

Pain is a common side effect of cancer patients, with 30-50% of patients experiencing moderate to severe levels. {{Cite journal |last1=Ngamkham |first1=Srisuda |last2=Holden |first2=Janean E. |last3=Smith |first3=Ellen Lavoie |date=2019 |title=A Systematic Review: Mindfulness Intervention for Cancer-Related Pain |journal=Asia-Pacific Journal of Oncology Nursing |volume=6 |issue=2 |pages=161–169 |doi=10.4103/apjon.apjon_67_18 |doi-access=free |issn=2347-5625 |pmc=6371675 |pmid=30931361}} Mindfulness-based cognitive therapy was found to garner statistically significant effects in regards to self-reported pain levels in cancer patients after 8 weeks. {{Cite journal |last1=Mehta |first1=Ria |last2=Sharma |first2=Kirti |last3=Potters |first3=Louis |last4=Wernicke |first4=A. Gabriella |last5=Parashar |first5=Bhupesh |last6=Mehta |first6=Ria |last7=Sharma |first7=Kirti |last8=Potters |first8=Louis |last9=Wernicke |first9=A. Gabriella |last10=Parashar |first10=Bhupesh |date=2019-05-09 |title=Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques |journal=Cureus |language=en |volume=11 |issue=5 |pages=e4629 |doi=10.7759/cureus.4629 |doi-access=free |issn=2168-8184 |pmc=6623989 |pmid=31312555}} Inclusive of this was another finding that pain severity may be lowered through mindfulness-based interventions. {{Cite journal |last1=Ngamkham |first1=Srisuda |last2=Holden |first2=Janean E |last3=Smith |first3=Ellen L |date=April 2019 |title=A Systematic Review: Mindfulness Intervention for Cancer-Related Pain |journal=Asia-Pacific Journal of Oncology Nursing |language=en |volume=6 |issue=2 |pages=161–169 |doi=10.4103/apjon.apjon_67_18 |doi-access=free |pmc=6371675 |pmid=30931361}} Research saw that mindfulness meditation may additionally be effective in pain management as the patient's report of the pain can be lessened through diverting their attention away from the symptoms, thus increasing pain tolerance. Though studies have brought about significant evidence of meditation's effect on pain management, scholars believe that it should not be used as a mainstay treatment for cancer pain without further research.

== Mental Health ==

Cancer diagnosis and treatment often comes with psychological complications; as an example, rates of psychological distress in breast cancer patients in China was a staggering 49%. {{Cite journal |last1=Tang |first1=Wen-Zhen |last2=Mangantig |first2=Ernest |last3=Iskandar |first3=Yulita Hanum P. |last4=Cheng |first4=Shi-Li |last5=Yusuf |first5=Azlina |last6=Jia |first6=Kui |date=2024-09-26 |title=Prevalence and associated factors of psychological distress among patients with breast cancer: a systematic review and meta-analysis |journal=BMJ Open |volume=14 |issue=9 |pages=e077067 |doi=10.1136/bmjopen-2023-077067 |issn=2044-6055 |pmc=11429273 |pmid=39327054}} Armed with this information, researchers began to look into interventions to help alleviate the mental suffering of patients, including meditation. When regarding cancer-related effects on mental health, a meta-analysis of 869 studies saw that Mindfulness-based stress reduction resulted in lower anxiety and depression levels in cancer patients as well as improvement in physical functioning. {{Cite journal |last1=Lin |first1=Li-Ying |last2=Lin |first2=Li-Hua |last3=Tzeng |first3=Ghao-Ling |last4=Huang |first4=Ya-Hui |last5=Tai |first5=Jui-Fen |last6=Chen |first6=Yu-Ling |last7=Wu |first7=Chia-Jung |last8=Chen |first8=Pin-Hsi |last9=Lin |first9=Pei-Chin |last10=Hung |first10=Pi-Lien |date=2022-06-01 |title=Effects of Mindfulness-Based Therapy for Cancer Patients: A Systematic Review and Meta-analysis |url=https://link.springer.com/article/10.1007/s10880-022-09862-z |journal=Journal of Clinical Psychology in Medical Settings |language=en |volume=29 |issue=2 |pages=432–445 |doi=10.1007/s10880-022-09862-z |pmid=35249176 |issn=1573-3572}} In a review of 29 randomized controlled trials looking into nonpharmacological mediations for impairment of cognition relating to cancer, meditation was found to be the best option when compared to other interventions including yoga, acupuncture, and cognitive training. {{Cite journal |last1=Zeng |first1=Yingchun |last2=Dong |first2=Juntao |last3=Huang |first3=Meiling |last4=Zhang |first4=Jun-e |last5=Zhang |first5=Xiaoming |last6=Xie |first6=Man |last7=Wefel |first7=Jeffrey S. |date=2020-04-01 |title=Nonpharmacological interventions for cancer-related cognitive impairment in adult cancer patients: A network meta-analysis |url=https://linkinghub.elsevier.com/retrieve/pii/S0020748919303219 |journal=International Journal of Nursing Studies |volume=104 |pages=103514 |doi=10.1016/j.ijnurstu.2019.103514 |pmid=32004776 |issn=0020-7489}}

== Sleep Disturbance ==

Sleep disturbance is a common symptom of cancer that many patients face, with incidence rates ranging anywhere from 30 - 90%. {{Cite journal |last1=Han |first1=Jing |last2=Cheng |first2=Hui-Lin |last3=Bi |first3=Liu-Na |last4=Molasiotis |first4=Alex |date=August 2023 |title=Mind-body therapies for sleep disturbance among patients with cancer: A systematic review and meta-analysis |url=https://pubmed.ncbi.nlm.nih.gov/37244384 |journal=Complementary Therapies in Medicine |volume=75 |pages=102954 |doi=10.1016/j.ctim.2023.102954 |issn=1873-6963 |pmid=37244384|hdl=10397/108416 |hdl-access=free }} Disturbances in sleep have been found to result in other consequences such as stress, fatigue, and cognitive impairment. Research has been conducted on the connection between meditation and sleep disturbance to see if it is deemed effective as an intervention. A meta analysis of 56 studies saw mindfulness to result in significant immediate effects on sleep disturbance. Additional results yielded statistically significant short-term effects on sleep in patients when compared to education and breath control. Sleep disturbance was found to be relieved in patients who underwent mindfulness-based intervention. {{Cite journal |last1=Yang |first1=Bei |last2=Nie |first2=Qiao |last3=Yang |first3=Yi |date=2021-07-01 |title=The effects of mindfulness-based intervention on sleep disturbance and benzodiazepine hypnotics use in patients hospitalized with cancer: A systematic review and meta-analysis |url=https://www.sciencedirect.com/science/article/abs/pii/S0022399921001288 |journal=Journal of Psychosomatic Research |volume=146 |pages=110483 |doi=10.1016/j.jpsychores.2021.110483 |pmid=33895429 |issn=0022-3999}} When accounting for longevity, a meta-analysis found the effects of mindfulness on sleep to last around 6 months.

=Future directions=

A large part of mindfulness research is dependent on technology. As new technology develops, new imaging techniques will become helpful in this field. Real-time fMRI might give immediate feedback and guide participants through the programs. It could also be used to train and evaluate mental states more easily during meditation itself.{{cite journal |vauthors=Tang YY, Posner MI |date=January 2013 |title=Tools of the trade: theory and method in mindfulness neuroscience |journal=Social Cognitive and Affective Neuroscience |volume=8 |issue=1 |pages=118–20 |doi=10.1093/scan/nss112 |pmc=3541497 |pmid=23081977}}

Effects of other types of meditation

=Insight (Vipassana) meditation=

{{Advert|section|promotional language|date=October 2024}}

thumb

Vipassana or "insight" meditation is a form of mindfulness meditation attributed within the Buddhist tradition to the Buddha Gautama. The practice aims to increase a sense of awareness of the present moment. The practitioner becomes a quiet observer of their thoughts, emotions, and sensations; allowing them to come and go without passing judgement.{{Citation |title=Becoming "pure Buddhist" (Part 2): vipassana meditation and the Theravada care of the self |date=2016-08-05 |work=The Buddhist Art of Living in Nepal |pages=161–187 |url=http://dx.doi.org/10.4324/9781315651064-10 |access-date=2024-02-03 |publisher=Routledge|doi=10.4324/9781315651064-10 |doi-broken-date=1 November 2024 |isbn=978-1-315-65106-4 }}{{Citation |last=Chavan |first=Dhananjay V. |chapter=Vipassana: The Buddha's tool to probe mind and body |title=Models of Brain and Mind - Physical, Computational and Psychological Approaches |date=2007 |series=Progress in Brain Research |volume=168 |pages=247–253 |url=http://dx.doi.org/10.1016/s0079-6123(07)68019-4 |access-date=2024-02-03 |publisher=Elsevier|doi=10.1016/s0079-6123(07)68019-4 |pmid=18166399 |isbn=978-0-444-53050-9 }} A plethora of evidence now exists to suggest that vipassana meditation does indeed lead to increased mindfulness, but the benefits of the practice do not stop there. It has also been found to reduce stress and increase both self-kindness and overall well-being.{{Cite journal |last1=Szekeres |first1=Roberta A. |last2=Wertheim |first2=Eleanor H. |date=December 2015 |title=Evaluation of Vipassana Meditation Course Effects on Subjective Stress, Well-being, Self-kindness and Mindfulness in a Community Sample: Post-course and 6-month Outcomes |url=https://onlinelibrary.wiley.com/doi/10.1002/smi.2562 |journal=Stress and Health |language=en |volume=31 |issue=5 |pages=373–381 |doi=10.1002/smi.2562 |pmid=24515781 |issn=1532-3005}}

Electroencephalography studies on Vipassana meditators seemed to indicate significant increase in parieto-occipital gamma rhythms in experienced meditators (35–45 Hz).{{cite journal |last1=Cahn |first1=BR |last2=Delorme |first2=A |last3=Polich |first3=J |title=Occipital gamma activation during Vipassana meditation. |journal=Cognitive Processing |date=February 2010 |volume=11 |issue=1 |pages=39–56 |doi=10.1007/s10339-009-0352-1 |pmid=20013298|pmc=2812711 }}

In another study conducted by NIMHANS on Vipassana meditators, researchers found readings associated with improved cognitive processing after a session of meditation, with distinct and graded difference in the readings between novice meditators and experienced meditators.{{cite book |last1=Kakumanu |first1=Ratna Jyothi |last2=Nair |first2=Ajay Kumar |last3=Sasidharan |first3=Arun |last4=John |first4=John P. |last5=Mehrotra |first5=Seema |last6=Panth |first6=Ravindra |last7=Kutty |first7=Bindu M. |title=Meditation |chapter=State-trait influences of Vipassana meditation practice on P3 EEG dynamics |series=Progress in Brain Research |date=2019 |volume=244 |pages=115–136 |doi=10.1016/bs.pbr.2018.10.027|pmid=30732834 |isbn=978-0-444-64227-1 |s2cid=73417633 }}

Khoury and colleagues (2017) conducted a meta-analysis including a total of 21 studies and 2,912 participants. The study aimed to evaluate the effects of traditional vipassana meditation retreats in various populations including advanced meditators, novice meditators, and incarcerated individuals. More specifically, it explored the psychological outcomes including anxiety symptoms, depressive symptoms, and stress following the retreats, evaluated the impacts of the retreats on levels of mindfulness, and explored variables moderating the effectiveness of traditional retreats. Results suggested that traditional vipassana meditation retreats were moderately effective at improving psychological outcomes, with novice meditators and members of the general population experiencing particularly large reductions in anxiety, depression, and stress when compared to both experienced meditators and incarcerated individuals. Moreover, the results suggested an increased capacity for emotional regulation, acceptance, compassion, and mindfulness as well as higher quality of life scores following the retreats across all populations. These results held steady even at follow-up.{{Cite journal |last1=Khoury |first1=Bassam |last2=Knäuper |first2=Bärbel |last3=Schlosser |first3=Marco |last4=Carrière |first4=Kimberly |last5=Chiesa |first5=Alberto |date=January 2017 |title=Effectiveness of traditional meditation retreats: A systematic review and meta-analysis |url=http://dx.doi.org/10.1016/j.jpsychores.2016.11.006 |journal=Journal of Psychosomatic Research |volume=92 |pages=16–25 |doi=10.1016/j.jpsychores.2016.11.006 |pmid=27998508 |issn=0022-3999}}

An essential component to the Vipassana mediation approach is the focus on awareness, referring to bodily sensations and psychological status. In a study conducted by Zeng et al. (2013), awareness was described as the acknowledgement of consciousness which is monitoring all aspects of the environment.{{Cite journal|last1=Zeng|first1=Xianglong|last2=Oei|first2=Tian P. S.|last3=Liu|first3=Xiangping|date=December 2014|title=Monitoring Emotion Through Body Sensation: A Review of Awareness in Goenka's Vipassana|journal=Journal of Religion and Health|language=en|volume=53|issue=6|pages=1693–1705|doi=10.1007/s10943-013-9754-6|pmid=23846450|s2cid=10485156|issn=0022-4197}} This definition differentiates the concept of awareness from mindfulness. The emphasis on awareness, and the way it assists in monitoring emotion, is unique to this meditative practice.

=Kundalini yoga=

Kundalini yoga has proved to increase the prevention of cognitive decline and evaluate the response of biomarkers to treatment, thereby shedding light on the underlying mechanisms of the link between Kundalini Yoga and cognitive impairment. For the study, 81 participants aged 55 and older who had subjective memory complaints and met criteria for mild cognitive impairment, indicated by a total score of 0.5 on the Clinical Dementia Rating Scale. The results showed that at 12 weeks, both the yoga group showed significant improvements in recall memory and visual memory and showed a significant sustained improvement in memory up to the 24-week follow-up, the yoga group showed significant improvement in verbal fluency and sustained significant improvements in executive functioning at week 24. In addition, the yoga cohort showed significant improvement in depressive symptoms, apathy, and resilience from emotional stress. This research was provided by Helen Lavretsky, M.D. and colleagues.{{cite journal |last1=Watts |first1=Vabren |title=Kundalini Yoga Found to Enhance Cognitive Functioning in Older Adults |journal=Psychiatric News |volume=51 |issue=9 |year=2016 |pages=1 |doi=10.1176/appi.pn.2016.4b11 }} In another study, Kundalini Yoga did not show significant effectiveness in treating obsessive-compulsive disorders compared with Relaxation/Meditation.{{cite journal | vauthors = Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M | title = Meditation therapy for anxiety disorders | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD004998 | date = January 2006 | pmid = 16437509 | doi = 10.1002/14651858.CD004998.pub2 }}

=Sahaja yoga and mental silence=

Sahaja yoga meditation is regarded as a mental silence meditation, and has been shown to correlate with particular brain{{cite journal | vauthors = Hernández SE, Suero J, Rubia K, González-Mora JL | title = Monitoring the neural activity of the state of mental silence while practicing Sahaja yoga meditation | journal = Journal of Alternative and Complementary Medicine | volume = 21 | issue = 3 | pages = 175–9 | date = March 2015 | pmid = 25671603 | doi = 10.1089/acm.2013.0450 }}{{cite journal | vauthors = Hernández SE, Barros-Loscertales A, Xiao Y, González-Mora JL, Rubia K | title = Gray Matter and Functional Connectivity in Anterior Cingulate Cortex are Associated with the State of Mental Silence During Sahaja Yoga Meditation | journal = Neuroscience | volume = 371 | pages = 395–406 | date = February 2018 | pmid = 29275207 | doi = 10.1016/j.neuroscience.2017.12.017 | hdl = 10234/175002 | doi-access = free | hdl-access = free }} and brain wave{{cite journal | vauthors = Aftanas LI, Golocheikine SA | title = Human anterior and frontal midline theta and lower alpha reflect emotionally positive state and internalized attention: high-resolution EEG investigation of meditation | journal = Neuroscience Letters | volume = 310 | issue = 1 | pages = 57–60 | date = September 2001 | pmid = 11524157 | doi = 10.1016/S0304-3940(01)02094-8 | s2cid = 26624762 }}{{cite journal | vauthors = Aftanas L, Golosheykin S | title = Impact of regular meditation practice on EEG activity at rest and during evoked negative emotions | journal = The International Journal of Neuroscience | volume = 115 | issue = 6 | pages = 893–909 | date = June 2005 | pmid = 16019582 | doi = 10.1080/00207450590897969 | s2cid = 23303346 }}{{cite journal |last1=Manocha |first1=Ramesh |last2=Black |first2=Deborah |last3=Spiro |first3=David |last4=Ryan |first4=Jake |last5=Stough |first5=Con |date=March 2010 |title=Changing Definitions of Meditation – Is there a Physiological Corollary? Skin temperature changes of a mental silence orientated form of meditation compared to rest |journal=Journal of the International Society of Life Sciences |volume=28 |issue=1 |pages=23–31 |url=http://www.researchingmeditation.org/meditation_research/skintemp.pdf |access-date=17 October 2014 |archive-date=1 November 2019 |archive-url=https://web.archive.org/web/20191101071526/http://www.researchingmeditation.org/meditation_research/skintemp.pdf |url-status=dead }} characteristics. One study has led to suggestions that Sahaja meditation involves 'switching off' irrelevant brain networks for the maintenance of focused internalized attention and inhibition of inappropriate information.{{cite journal | vauthors = Aftanas LI, Golocheikine SA | title = Non-linear dynamic complexity of the human EEG during meditation | journal = Neuroscience Letters | volume = 330 | issue = 2 | pages = 143–6 | date = September 2002 | pmid = 12231432 | doi = 10.1016/S0304-3940(02)00745-0 | s2cid = 2515889 }} Sahaja meditators appear to benefit from lower depression{{cite journal | vauthors = Hendriks T | title = The effects of Sahaja Yoga meditation on mental health: a systematic review | journal = Journal of Complementary and Integrative Medicine| volume = 15 | issue = 3 | date = May 2018 | pmid = 29847314 | doi = 10.1515/jcim-2016-0163 | s2cid = 44076116 }} and scored above control group for emotional well-being and mental health measures on SF-36 ratings.{{cite journal | vauthors = Manocha R, Black D, Wilson L | title = Quality of life and functional health status of long-term meditators | journal = Evidence-Based Complementary and Alternative Medicine | volume = 2012 | pages = 1–9 | year = 2012 | pmid = 22611427 | pmc = 3352577 | doi = 10.1155/2012/350674 | doi-access = free }}{{cite journal |doi=10.1111/j.1601-5215.2010.00519.x |title=Meditation, mindfulness and mind-emptiness |journal=Acta Neuropsychiatrica |volume=23 |pages=46–7 |year=2014 |last1=Manocha |first1=Ramesh |s2cid=144683760 }}{{cite thesis | first = Adam | last = Morgon | degree = Doctor of Clinical Psychology | title = Sahaja Yoga: an Ancient Path to Modern Mental Health? | publisher = University of Plymouth | url = https://pearl.plymouth.ac.uk/handle/10026.1/1969 }}

A study comparing practitioners of Sahaja Yoga meditation with a group of non-meditators doing a simple relaxation exercise, measured a drop in skin temperature in the meditators compared to a rise in skin temperature in the non-meditators as they relaxed. The researchers noted that all other meditation studies that have observed skin temperature have recorded increases and none have recorded a decrease in skin temperature. This suggests that Sahaja Yoga meditation, being a mental silence approach, may differ both experientially and physiologically from simple relaxation.

=Transcendental Meditation=

In a 2006 review, Transcendental Meditation proved comparable with other kinds of relaxation therapies in reducing anxiety. In another 2006 review, study participants demonstrated a one Hertz reduction in electroencephalography alpha wave frequency relative to controls.{{cite journal | vauthors= Cahn BR, Polich J | title = Meditation states and traits: EEG, ERP, and neuroimaging studies | journal = Psychological Bulletin | volume = 132 | issue=2 | pages=180–211 | year = 2006 | doi = 10.1037/0033-2909.132.2.180 | pmid=16536641| s2cid = 2151810 }}

A 2012 meta-analysis published in Psychological Bulletin, which reviewed 163 individual studies, found that Transcendental Meditation performed no better overall than other meditation techniques in improving psychological variables.{{Cite journal |first1=Peter |last1=Sedlmeier |last2=Eberth |first2=Juliane |last3=Schwarz|last4=Zimmerman|last5=Haarig|last6=Jaeger|last7=Kunze|first3=Marcus|first4=Doreen|first5=Frederik|first6=Sonia|first7=Sonja|date=May 2012 |title=The Psychological Effects of Meditation: A Meta-Analysis |quote=The global analysis yielded quite comparable effects for TM, mindfulness meditation, and the other meditation procedures...So, it seems that the three categories we identified for the sake of comparison, TM, mindfulness meditation, and the heterogeneous category we termed other meditation techniques, do not differ in their overall effects.|journal=Psychological Bulletin|doi=10.1037/a0028168 |pmid=22582738 |display-authors=etal |volume=138 |issue=6 |pages=1139–1171}}

A 2013 statement from the American Heart Association said that Transcendental Meditation could be considered as a treatment for hypertension, although other interventions such as exercise and device-guided breathing were more effective and better supported by clinical evidence.{{cite journal |vauthors=Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ, Fuchs FD, Hughes JW, Lackland DT, Staffileno BA, Townsend RR, Rajagopalan S |title=Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association |journal=Hypertension |volume=61 |issue=6 |pages=1360–83 |year=2013 |pmid=23608661 |doi=10.1161/HYP.0b013e318293645f |doi-access=free }}

A 2014 review found moderate evidence for improvement in anxiety, depression and pain with low evidence for improvement in stress and mental health-related quality of life.{{cite journal |vauthors=Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA |title=Meditation programs for psychological stress and well-being: a systematic review and meta-analysis |journal=JAMA Intern Med |volume=174 |issue=3 |pages=357–68 |year=2014 |pmid=24395196 |doi=10.1001/jamainternmed.2013.13018 | quote = ... we found low evidence of no effect or insufficient evidence that mantra meditation programs had an effect on any of the psychological stress and well-being outcomes we examined. |pmc=4142584}}{{cite book | publisher = Agency for Healthcare Research and Quality |vauthors=Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA | year = 2014 | title = Meditation Programs for Psychological Stress and Well-Being |series=AHRQ Comparative Effectiveness Reviews |pmid=24501780 | url = https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0063263/| quote = Our review finds that the mantra meditation programs do not appear to improve any of the psychological stress and well-being outcomes we examined, but the strength of this evidence varies from low to insufficient.}}

Transcendental Meditation may reduce blood pressure, according to a 2015 review that compared it to control groups. A trend over time indicated that practicing Transcendental Meditation may lower blood pressure. Such effects are comparable to other lifestyle interventions. Conflicting findings across reviews and a potential risk of bias indicated the necessity of further evidence.{{cite journal |last1=Bai |first1=Z |last2=Chang |first2=J |last3=Chen |first3=C |last4=Li |first4=P |last5=Yang |first5=K |last6=Chi |first6=I |date=February 2015 |title=Investigating the effect of transcendental meditation on blood pressure: a systematic review and meta-analysis |journal=Journal of Human Hypertension |publisher=Nature Publishing Group |volume=29 |issue=11 |pages=653–662 |doi=10.1038/jhh.2015.6 |issn=1476-5527 |pmid=25673114 |s2cid=22261}}{{cite journal |last1=Ooi |first1=Soo Liang |last2=Giovino |first2=Melisa |last3=Pak |first3=Sok Chean |date=October 2017 |title=Transcendental meditation for lowering blood pressure: An overview of systematic reviews and meta-analyses |journal=Complementary Therapies in Medicine |publisher=Elsevier |volume=34 |pages=26–34 |doi=10.1016/j.ctim.2017.07.008 |issn=1873-6963 |pmid=28917372 |s2cid=4963470}}

= Effects of loving, kindness, and compassion =

Several meta-analyses have examined the effects of mindful meditation on one’s loving, kindness, and compassionate disposition and behaviors. Significant increases in self-reported self-compassion. Compassion, and well-being were reported alongside decreases in depression and anxiety.{{Cite journal |last1=Kirby |first1=James N. |last2=Tellegen |first2=Cassandra L. |last3=Steindl |first3=Stanley R. |date=November 2017 |title=A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions |url=https://linkinghub.elsevier.com/retrieve/pii/S0005789417300667 |journal=Behavior Therapy |language=en |volume=48 |issue=6 |pages=778–792 |doi=10.1016/j.beth.2017.06.003|pmid=29029675 }} Another study indicated an increase in positive emotions.{{Cite journal |last1=Galante |first1=Julieta |last2=Galante |first2=Ignacio |last3=Bekkers |first3=Marie-Jet |last4=Gallacher |first4=John |date=December 2014 |title=Effect of kindness-based meditation on health and well-being: A systematic review and meta-analysis. |url=https://doi.apa.org/doi/10.1037/a0037249 |journal=Journal of Consulting and Clinical Psychology |language=en |volume=82 |issue=6 |pages=1101–1114 |doi=10.1037/a0037249 |pmid=24979314 |issn=1939-2117}}{{Cite journal |last1=Luberto |first1=Christina M. |last2=Shinday |first2=Nina |last3=Song |first3=Rhayun |last4=Philpotts |first4=Lisa L. |last5=Park |first5=Elyse R. |last6=Fricchione |first6=Gregory L. |last7=Yeh |first7=Gloria Y. |date=June 2018 |title=A Systematic Review and Meta-analysis of the Effects of Meditation on Empathy, Compassion, and Prosocial Behaviors |journal=Mindfulness |language=en |volume=9 |issue=3 |pages=708–724 |doi=10.1007/s12671-017-0841-8 |issn=1868-8527 |pmc=6081743 |pmid=30100929}} There may be further benefits that are yet to be discovered, with only preliminary data on mindfulness and mediation. Further studies and explorations into the effects of mindful meditation on the self are needed to draw further conclusions.

Research on unspecified or multiple types of meditation

=Brain activity=

{{Main|Brain activity and meditation}}

The medial prefrontal and posterior cingulate cortices have been found to be relatively deactivated during meditation by experienced meditators using concentration, loving-kindness, and choiceless awareness meditation.{{Cite journal|last1=Brewer|first1=J. A.|last2=Worhunsky|first2=P. D.|last3=Gray|first3=J. R.|last4=Tang|first4=Y.-Y.|last5=Weber|first5=J.|last6=Kober|first6=H.|date=2011-11-23|title=Meditation experience is associated with differences in default mode network activity and connectivity|journal=Proceedings of the National Academy of Sciences|volume=108|issue=50|pages=20254–20259|doi=10.1073/pnas.1112029108|pmid=22114193|pmc=3250176|bibcode=2011PNAS..10820254B |issn=0027-8424|doi-access=free}} In addition experienced meditators were found to have stronger coupling between the posterior cingulate, dorsal anterior cingulate, and dorsolateral prefrontal cortices both when meditating and when not meditating.{{cite journal | vauthors = Brewer JA, Worhunsky PD, Gray JR, Tang YY, Weber J, Kober H | title = Meditation experience is associated with differences in default mode network activity and connectivity | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 108 | issue = 50 | pages = 20254–9 | date = December 2011 | pmid = 22114193 | pmc = 3250176 | doi = 10.1073/pnas.1112029108 | bibcode = 2011PNAS..10820254B | jstor = 23060108 | doi-access = free }} Over time meditation can actually increase the integrity of both gray and white matter. The added amount of gray matter found in the brain stem after meditation improves communication between the cortex and all other areas within the brain.{{Cite book|last=Baer|first=Ruth|url=https://books.google.com/books?id=DlnH-qadA08C&q=meditation+and+neuroplasticity&pg=PA185|title=Assessing Mindfulness and Acceptance Processes in Clients: Illuminating the Theory and Practice of Change|date=2010-05-01|publisher=New Harbinger Publications|isbn=978-1-60882-263-8|language=en}}{{Cite journal|last1=Chambers|first1=Richard|last2=Lo|first2=Barbara Chuen Yee|last3=Allen|first3=Nicholas B.|date=2008-06-01|title=The Impact of Intensive Mindfulness Training on Attentional Control, Cognitive Style, and Affect|journal=Cognitive Therapy and Research|language=en|volume=32|issue=3|pages=303–322|doi=10.1007/s10608-007-9119-0|s2cid=3329869|issn=1573-2819}} Meditation often stimulates a large network of cortical regions including the frontal and parietal regions, lateral occipital lobe, the insular cortex, thalamic nuclei, basal ganglia, and the cerebellum region in the brain. These parts of the brain are connected with attention and the default network of the brain which is associated to day dreaming.{{Cite journal|last1=Brefczynski-Lewis|first1=J. A.|last2=Lutz|first2=A.|last3=Schaefer|first3=H. S.|last4=Levinson|first4=D. B.|last5=Davidson|first5=R. J.|date=2007-07-03|title=Neural correlates of attentional expertise in long-term meditation practitioners|journal=Proceedings of the National Academy of Sciences|language=en|volume=104|issue=27|pages=11483–11488|doi=10.1073/pnas.0606552104|issn=0027-8424|pmid=17596341|pmc=1903340|bibcode=2007PNAS..10411483B|doi-access=free}}

File:Caudate nucleus.gif

In addition, both meditation and yoga have been found to have impacts on the brain, specifically the caudate.{{Cite journal|last1=Gard|first1=Tim|last2=Taquet|first2=Maxime|last3=Dixit|first3=Rohan|last4=Hölzel|first4=Britta K.|last5=Dickerson|first5=Bradford C.|last6=Lazar|first6=Sara W.|date=2015|title=Greater widespread functional connectivity of the caudate in older adults who practice kripalu yoga and vipassana meditation than in controls|journal=Frontiers in Human Neuroscience|volume=9|page=137|language=English|doi=10.3389/fnhum.2015.00137|pmid=25852521|pmc=4360708|issn=1662-5161|doi-access=free}} Strengthening of the caudate has been shown in meditators as well as yogis. The increased connectedness of the caudate has potential to be responsible for the improved well-being that is associated with yoga and meditation.{{Cite journal|last1=Gard|first1=Tim|last2=Taquet|first2=Maxime|last3=Dixit|first3=Rohan|last4=Hölzel|first4=Britta K.|last5=Dickerson|first5=Bradford C.|last6=Lazar|first6=Sara W.|date=2015-03-16|title=Greater widespread functional connectivity of the caudate in older adults who practice kripalu yoga and vipassana meditation than in controls|journal=Frontiers in Human Neuroscience|volume=9|pages=137|doi=10.3389/fnhum.2015.00137|issn=1662-5161|pmc=4360708|pmid=25852521|doi-access=free}}

=Changes in the brain=

Meditation is under preliminary research to assess possible changes in grey matter concentrations.

Published research suggests that meditation can facilitate neuroplasticity and connectivity in brain regions specifically related to emotion regulation and attention.{{cite journal |last1=Vago |first1=David R. |last2=Silbersweig |first2=David A. |title=Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness |journal=Frontiers in Human Neuroscience |date=2012 |volume=6 |page=296 |doi=10.3389/fnhum.2012.00296 |pmid=23112770 |pmc=3480633 |doi-access=free }}{{cite journal |last1=Hölzel |first1=Britta K. |last2=Lazar |first2=Sara W. |last3=Gard |first3=Tim |last4=Schuman-Olivier |first4=Zev |last5=Vago |first5=David R. |last6=Ott |first6=Ulrich |title=How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective |journal=Perspectives on Psychological Science |date=November 2011 |volume=6 |issue=6 |pages=537–559 |doi=10.1177/1745691611419671|pmid=26168376 |s2cid=2218023 }}

= Attention and mind wandering =

Non-directive forms of meditation where the meditator lets their mind wander freely can actually produce higher levels of activity in the default mode network when compared to a resting state or having the brain in a neutral place.{{Cite journal |last1=Mrazek |first1=Michael D. |last2=Franklin |first2=Michael S. |last3=Phillips |first3=Dawa Tarchin |last4=Baird |first4=Benjamin |last5=Schooler |first5=Jonathan W. |date=2013-03-28 |title=Mindfulness Training Improves Working Memory Capacity and GRE Performance While Reducing Mind Wandering |journal=Psychological Science |language=en-US |volume=24 |issue=5 |pages=776–781 |doi=10.1177/0956797612459659 |issn=0956-7976 |pmid=23538911 |s2cid=17754950}}{{Cite journal|last1=Xu|first1=Jian|last2=Vik|first2=Alexandra|last3=Groote|first3=Inge Rasmus|last4=Lagopoulos|first4=Jim|last5=Holen|first5=Are|last6=Ellingsen|first6=Øyvind|last7=Davanger|first7=Svend|date=2014|title=Nondirective meditation activates default mode network and areas associated with memory retrieval and emotional processing|journal=Frontiers in Human Neuroscience|language=English|volume=8|pages=86|doi=10.3389/fnhum.2014.00086|pmid=24616684|pmc=3935386|issn=1662-5161|doi-access=free}} These Non directive forms of meditation allows the meditators to have better control over thoughts during everyday activities or when focusing on specific task due to a reduced frustration at the brains mind wandering process. When given a specific task, meditation can allow quicker response to changing environmental stimuli. Meditation can allow the brain to decrease attention to unwanted responses of irrelevant environmental stimuli and a reduces the Stroop effect. Those who meditate have regularly demonstrated more control on what they focus their attention on while maintaining a mindful awareness on what is around them.{{Cite journal|last=Semple|first=Randye J.|date=2010-06-01|title=Does Mindfulness Meditation Enhance Attention? A Randomized Controlled Trial|journal=Mindfulness|language=en|volume=1|issue=2|pages=121–130|doi=10.1007/s12671-010-0017-2|s2cid=28567382|issn=1868-8535}}  Experienced meditators have been shown to have an increased ability when it comes to conflict monitoring and find it easier to switch between competing stimuli.{{Cite book|last1=Brown|first1=Kirk Warren|url=https://books.google.com/books?id=ZF-uCgAAQBAJ&q=meditation+and+episodic+memory&pg=PA190|title=Handbook of Mindfulness: Theory, Research, and Practice|last2=Creswell|first2=J. David|last3=Ryan|first3=Richard M.|date=2015-11-17|publisher=Guilford Publications|isbn=978-1-4625-2593-5|language=en}} Those who practice meditation experience an increase of attentional resources in the brain and steady meditation practice can lead to the reduction of the attentional blink due to a decreased mental exertion when identifying important stimuli.

=Perception=

Studies have shown that meditation has both short-term and long-term effects on various perceptual faculties. In 1984 a study showed that meditators have a significantly lower detection threshold for light stimuli of short duration.{{cite journal | vauthors = Brown D, Forte M, Dysart M | title = Differences in visual sensitivity among mindfulness meditators and non-meditators | journal = Perceptual and Motor Skills | volume = 58 | issue = 3 | pages = 727–33 | date = June 1984 | pmid = 6382144 | doi = 10.2466/pms.1984.58.3.727 | s2cid = 38007120 }} In 2000 a study of the perception of visual illusions by zen masters, novice meditators, and non-meditators showed statistically significant effects found for the Poggendorff Illusion but not for the Müller-Lyer Illusion. The zen masters experienced a statistically significant reduction in initial illusion (measured as error in millimeters) and a lower decrement in illusion for subsequent trials.{{cite journal | vauthors = Tloczynski J, Santucci A, Astor-Stetson E | title = Perception of visual illusions by novice and longer-term meditators | journal = Perceptual and Motor Skills | volume = 91 | issue = 3 Pt 1 | pages = 1021–6 | date = December 2000 | pmid = 11153836 | doi = 10.2466/pms.2000.91.3.1021 | s2cid = 31828795 }} Tloczynski has described the theory of mechanism behind the changes in perception that accompany mindfulness meditation thus: "A person who meditates consequently perceives objects more as directly experienced stimuli and less as concepts… With the removal or minimization of cognitive stimuli and generally increasing awareness, meditation can therefore influence both the quality (accuracy) and quantity (detection) of perception." Brown points to this as a possible explanation of the phenomenon: "[the higher rate of detection of single light flashes] involves quieting some of the higher mental processes which normally obstruct the perception of subtle events."{{Cite journal|last1=Brown|first1=Daniel|last2=Forte|first2=Michael|last3=Dysart|first3=Michael|date=June 1984|title=Visual Sensitivity and Mindfulness Meditation|url=http://dx.doi.org/10.2466/pms.1984.58.3.775|journal=Perceptual and Motor Skills|volume=58|issue=3|pages=775–784|doi=10.2466/pms.1984.58.3.775|pmid=6382145|s2cid=39549396|issn=0031-5125|url-access=subscription}} In other words, the practice may temporarily or permanently alter some of the top-down processing involved in filtering subtle events usually deemed noise by the perceptual filters.

= Memory =

Meditation enhances memory capacity specifically in the working memory and increases executive functioning by helping participants better understand what is happening moment for moment.{{Cite journal|date=2016-02-01|title=Mindfulness meditation practice and executive functioning: Breaking down the benefit|url=https://www.sciencedirect.com/science/article/abs/pii/S1053810016300058|journal=Consciousness and Cognition|language=en|volume=40|pages=116–130|doi=10.1016/j.concog.2016.01.005|issn=1053-8100|last1=Gallant|first1=Sara N.|pmid=26784917|s2cid=10182245|url-access=subscription}}{{Cite journal|last1=Bailey|first1=N. W.|last2=Freedman|first2=G.|last3=Raj|first3=K.|last4=Spierings|first4=K. N.|last5=Piccoli|first5=L. R.|last6=Sullivan|first6=C. M.|last7=Chung|first7=S. W.|last8=Hill|first8=A. T.|last9=Rogasch|first9=N. C.|last10=Fitzgerald|first10=P. B.|date=2019-10-16|title=Mindfulness meditators show enhanced working memory performance concurrent with different brain region engagement patterns during recall|url=https://www.biorxiv.org/content/10.1101/801746v1|journal=bioRxiv|language=en|pages=801746|doi=10.1101/801746|s2cid=208590582}} Those who meditate regularly have demonstrated the ability to better process and distinguish important information from the working memory and store it into long-term memory with more accuracy than those who do not practice meditation techniques. Meditation may be able to expand the amount of information that can be held within working memory and by so doing is able to improve IQ scores and increase individual intelligence. The encoding process for both audio and visual information has been shown to be more accurate and detailed when meditation is used. Though there are limited studies on meditation's effects on long-term memory, because of meditations ability to increase attentional awareness, episodic long-term memory is believed to be more vivid and accurate for those who meditate regularly. Meditation has also shown to decrease memory complaints from those with Alzheimer's disease which also suggests the benefits meditation could have on episodic long-term memory which is linked to Alzheimer's.{{Cite journal|last=Thompson|first=Lynn C.|year=2004|title=A Pilot Study of a Yoga and Meditation Intervention for Dementia Caregiver Stress|journal=Journal of Clinical Psychology|volume=60|issue=6|pages=677–687|doi=10.1002/jclp.10259|pmid=15141399}}

=Calming and relaxation=

Electroencephalography activity slows as a result of meditation.{{cite journal | vauthors = Cahn BR, Polich J | title = Meditation states and traits: EEG, ERP, and neuroimaging studies | journal = Psychological Bulletin | volume = 132 | issue = 2 | pages = 180–211 | date = March 2006 | pmid = 16536641 | doi = 10.1037/0033-2909.132.2.180 | s2cid = 2151810 }} Some types of meditation may lead to a calming effect by reducing sympathetic nervous system activity while increasing parasympathetic nervous system activity. Or, equivalently, that meditation produces a reduction in arousal and increase in relaxation.{{cite book |last1=Flanagan |first1=Steven R. |last2=Zaretsky |first2=Dr. Herb |last3=Moroz |first3=Alex |title=Medical Aspects of Disability, Fourth Edition |date=2011 |publisher=Springer |isbn=978-0-8261-2784-6 |page=596 |edition=Fourth |url=https://books.google.com/books?id=azCbzY2q0_kC |quote=It is thought that some types of meditation might work by reducing activity in the sympathetic nervous system and increasing activity in the parasympathetic nervous system}}

Herbert Benson, founder of the Mind-Body Medical Institute, which is affiliated with Harvard University and several Boston hospitals, reports that meditation induces a host of biochemical and physical changes in the body collectively referred to as the "relaxation response".{{cite journal|vauthors=Benson H|date=December 1997|title=The relaxation response: therapeutic effect|journal=Science|volume=278|issue=5344|pages=1694–5|bibcode=1997Sci...278.1693B|doi=10.1126/science.278.5344.1693b|pmid=9411784}} The relaxation response includes changes in metabolism, heart rate, respiration, blood pressure and brain chemistry. Benson and his team have also done clinical studies at Buddhist monasteries in the Himalayan Mountains.{{cite news|url=http://news.harvard.edu/gazette/2002/04.18/09-tummo.html|title=Meditation changes temperatures: Mind controls body in extreme experiments|last1=Cromie|first1=William J.|date=18 April 2002|work=Harvard University Gazette|archive-url=https://web.archive.org/web/20070524212421/http://www.hno.harvard.edu/gazette/2002/04.18/09-tummo.html|archive-date=24 May 2007}} Benson wrote The Relaxation Response to document the benefits of meditation, which in 1975 were not yet widely known.{{cite book|title=The Relaxation Response|last=Benson|first=Herbert|publisher=HarperCollins|year=2001|isbn=978-0-380-81595-1|pages=[https://archive.org/details/relaxationrespon00bens_0/page/61 61–3]|url-access=registration|url=https://archive.org/details/relaxationrespon00bens_0/page/61}}{{primary source inline|date=October 2014}}

=Aging=

There is no good evidence to indicate that meditation affects the brain in aging.{{cite journal | last1=Luders | first1=Eileen | last2=Cherbuin | first2=Nicolas | title=Searching for the philosopher's stone: promising links between meditation and brain preservation | journal=Annals of the New York Academy of Sciences| volume=1373 | issue=1 | date=2016-05-17 | issn=0077-8923 | doi=10.1111/nyas.13082 | pages=38–44| pmid=27187107 | bibcode=2016NYASA1373...38L | s2cid=5043942 }}

=Happiness and emotional well-being=

Studies have shown meditators may have higher happiness than control groups, although this may be due to non-specific factors such as meditators having better general self-care.{{cite journal |doi=10.1016/j.paid.2015.08.040 |title=Meditation and happiness: Mindfulness and self-compassion may mediate the meditation–happiness relationship |journal=Personality and Individual Differences |volume=93 |pages=80–85 |year=2016 |last1=Campos |first1=Daniel |last2=Cebolla |first2=Ausiàs |last3=Quero |first3=Soledad |last4=Bretón-López |first4=Juana |last5=Botella |first5=Cristina |last6=Soler |first6=Joaquim |last7=García-Campayo |first7=Javier |last8=Demarzo |first8=Marcelo |last9=Baños |first9=Rosa María |hdl=10234/157867 |hdl-access=free }}

Preliminary research indicates a possible relationship between the volume of gray matter in the right precuneus area of the brain and both meditation and the subject's subjective happiness score.{{cite journal | vauthors = Sato W, Kochiyama T, Uono S, Kubota Y, Sawada R, Yoshimura S, Toichi M | title = The structural neural substrate of subjective happiness | journal = Scientific Reports | volume = 5 | pages = 16891 | date = November 2015 | pmid = 26586449 | pmc = 4653620 | doi = 10.1038/srep16891 | bibcode = 2015NatSR...516891S }} A recent study found that participants who engaged in a body-scan meditation for about 20 minutes self-reported higher levels of happiness and decrease in anxiety compared to participants who just rested during the 20-minute time span. These results suggest that an increase in awareness of one's body through meditation causes a state of selflessness and a feeling of connectedness. This result then leads to reports of positive emotions.{{cite journal | vauthors = Dambrun M | title = When the dissolution of perceived body boundaries elicits happiness: The effect of selflessness induced by a body scan meditation | journal = Consciousness and Cognition | volume = 46 | pages = 89–98 | date = November 2016 | pmid = 27684609 | doi = 10.1016/j.concog.2016.09.013 | s2cid = 23099927 }}

=Pain=

{{See also|Meditation and pain|Mindfulness-based pain management}}

Meditation has been shown to reduce pain perception.{{cite journal | vauthors = Nakata H, Sakamoto K, Kakigi R | title = Meditation reduces pain-related neural activity in the anterior cingulate cortex, insula, secondary somatosensory cortex, and thalamus | journal = Frontiers in Psychology | volume = 5 | pages = 1489 | year = 2014 | pmid = 25566158 | pmc = 4267182 | doi = 10.3389/fpsyg.2014.01489 | doi-access = free }} An intervention known as mindfulness-based pain management (MBPM) has been subject to a range of studies demonstrating its effectiveness.{{Cite journal|vauthors=Mehan S, Morris J|date=2018|title=A literature review of Breathworks and mindfulness intervention|journal=British Journal of Healthcare Management|volume=24|issue=5|pages=235–241|doi=10.12968/bjhc.2018.24.5.235}}{{cite journal|vauthors=Brown CA, Jones AK|date=March 2013|title=Psychobiological correlates of improved mental health in patients with musculoskeletal pain after a mindfulness-based pain management program|journal=The Clinical Journal of Pain|volume=29|issue=3|pages=233–44|doi=10.1097/AJP.0b013e31824c5d9f|pmid=22874090|s2cid=33688569}}

Adverse effects and limits of meditation and mindfulness

{{see also|Meditation#"Challenging" and adverse effects}}

Meditation and mindfulness have also been correlated with unpleasant experiences, but the potential for adverse effects from meditation has received limited attention in scientific articles{{sfnp|Farias|Maraldi|Wallenkampf|Lucchetti|2020}}{{sfnp|Perez-De-Albeniz|Holmes|2000}}{{sfnp|Shapiro Jr|1992}} and the popular press. One in-depth investigation was produced by the Financial Times, and published in 2024 as a five-part podcast, entitled "Untold: The Retreat". In the podcast, the FT's special investigations editor Madison Marriage looks at claims of harm from people who had attended Goenka Vipassana retreats.{{cite web

|url=https://www.ft.com/content/1b93be65-3aaa-4f31-bbf1-a3ded4e15574

|title=Dear Madison: Can intensive meditation cause psychological distress?

|date=24 January 2024

|author=Madison Marriage

|publisher=Financial Times

|access-date=7 January 2025}}{{cite web

|url=https://www.ft.com/content/50d62b57-c780-4f00-8ab8-23613bb28a4b

|title=Ten Long Days: Madison hears from others who claim they suffered after going on meditation retreats

|author=Madison Marriage

|date=31 January 2024

|publisher=Financial Times

|access-date=7 January 2025}}{{cite web

|url=https://www.ft.com/content/e0555260-3f9e-4e22-850c-203100f54cfb

|title=Jaqui's Story: Could a meditation retreat have led to a young woman's death?

|date=7 February 2024

|author=Madison Marriage

|publisher=Financial Times

|access-date=7 January 2025}}{{cite web

|url=https://www.ft.com/content/b90ef7dc-d078-4e64-a9e0-63d8457bac09

|title=Another Death: Is the Goenka network aware of potential risks of meditation?

|date=14 February 2024

|author=Madison Marriage

|publisher=Financial Times

|access-date=7 January 2025}}{{cite web

|url=https://www.ft.com/content/ad5c47d8-f9a6-468a-b524-be21c167d423

|title=The Insiders

|date=26 June 2024

|author=Madison Marriage

|publisher=Financial Times

|access-date=7 January 2025}}

=Contemplative traditions=

According to Farias et al. (2020) the most common adverse effects of meditation are anxiety and depression.{{sfnp|Farias|Maraldi|Wallenkampf|Lucchetti|2020}} Other adverse affects may include depersonalization{{sfnp|Farias|Maraldi|Wallenkampf|Lucchetti|2020}} or altered sense of self or the world,{{sfnp|Schlosser|Sparby|Vörös|Jones|2019}} distorted emotions or thoughts, and, in a few cases, visual and auditory psychosis, and with pre-existing historical factors suicide.{{sfnp|Farias|Maraldi|Wallenkampf|Lucchetti|2020}}{{cite journal | last1=Goud | first1=S. S. | title=A Double-Edged Sword-A Case Report of Psychosis Associated with Excessive Unguided Meditation. | journal= Case Reports in Psychiatry | volume=2022 | issue=2661824 | year=2022 | pmid=36316997 | pmc= 9617715 | doi=10.1155/2022/2661824 | doi-access=free }}{{cite journal | last1= Yadav | first1=J. | last2= Bhardwaj | first2=A. | last3= Jangid | first3=P.| last4= Singh | first4=P. | last5= Gupta | first5=R. | title= Meditation-A Slippery Slope for Psychosis: A Case Series With Review of Evidence | journal= The Journal of Nervous and Mental Disease | volume=211 | issue=8 | year=2023 | pages=634–638 | pmid=37505896 |doi= 10.1097/NMD.0000000000001656 |url=https://journals.lww.com/jonmd/abstract/2023/08000/meditation_a_slippery_slope_for_psychosis__a_case.12.aspx}}{{cite journal | last1=Chan-Ob | first1=T | last2=Boonyanaruthee | first2=V | title=Meditation in association with psychosis | journal=Journal of the Medical Association of Thailand = Chotmaihet Thangphaet | volume=82 | issue=9 | year=1999 | issn=0125-2208 | pmid=10561951 | pages=925–30 |url=https://www.researchgate.net/publication/12739139}}

Schlosser et al. (2019) reported that, of 1,232 regular meditators with at least two months of meditation experience, about a quarter reported having had particularly unpleasant meditation-related experiences (such as anxiety, fear, distorted emotions or thoughts, altered sense of self or the world), which they thought may have been caused by their meditation practice. Meditators with high levels of repetitive negative thinking and those who only engage in deconstructive meditation were more likely to report unpleasant side effects. Adverse effects were less frequently reported in women and religious meditators.{{Cite journal |title=Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations |journal=PLOS ONE |volume=14 |issue=5 |pages=e0216643 |date=2019 |doi=10.1371/journal.pone.0216643 |pmid=31071152 |pmc=6508707 |last1=Schlosser |first1=Marco |last2=Sparby |first2=Terje |last3=Vörös |first3=Sebastjan |last4=Jones |first4=Rebecca |last5=Marchant |first5=Natalie L. |bibcode=2019PLoSO..1416643S |doi-access=free }}

Meditation also has an addictive potential as it both offers biochemical rewards and socially acceptable avenues for escapism (like internet use, social media, substance abuse).{{cite journal | last1= Jaseja | first1=H. | title= Is meditation associated with a potential risk of addiction? Warranting a greater insight | journal=Epilepsy and Behaviour | volume=14 | issue=4 | year=2018 | pages=709 | pmid=19236955 |doi=10.1016/j.yebeh.2009.02.017 |url=https://www.epilepsybehavior.com/article/S1525-5050(09)00074-2/abstract }}{{cite book | last = Metzner | first = Ralph | year = 2005 | chapter = Psychedelic, Psychoactive and Addictive Drugs and States of Consciousness | editor-last = Earlywine | editor-first = Mitch | title = Mind-Altering Drugs | publisher = Oxford University Press | location = Oxford | pages = 25–48 | isbn = 978-0-19-516531-9 | doi = 10.1093/acprof:oso/9780195165319.003.0002 }} Using spiritual ideas and practices "to sidestep or avoid facing unresolved emotional issues, psychological wounds, and unfinished developmental tasks"{{sfn|Fossella|Welwood|2011}} is known as Spiritual bypass, a term introduced in the mid 1980s by John Welwood, a Buddhist teacher and psychotherapist.{{sfn|Fossella|Welwood|2011}}

"Zen sickness", exhaustion caused by prolonged intense practice and self-neglect is described by Hakuin{{cite book| title = Wild Ivy: The Spiritual Autobiography of Zen Master Hakuin| translator = Norman Waddell| author = Hakuin| year = 2010| publisher=Shambhala Publications}} and Bankei.

=Mindfulness=

In recent years both the soundness of the scientific foundations and the desirability of the societal effects of mindfulness have been questioned.{{cite journal | last1=Farias | first1=M | last2=Wikholm | first2=C | title=Has the science of mindfulness lost its mind? | journal=BJPsych Bulletin| volume=40 | issue=6 | year=2016 | pmid=28377813 | pages=329–332 | doi=10.1192/pb.bp.116.053686 | pmc=5353526 |url=https://doi.org/10.1192/pb.bp.116.053686}}The Buddha Pill: Can Meditation Change You? by M. Farias and C. Wikholm, 2019 {{ISBN|9781780287188}}Mindlessness: The Corruption of Mindfulness in a Culture of Narcissism by T. Joiner, 2017 {{ISBN|0190200626}}McMindfulness: How Mindfulness Became the New Capitalist Spirituality by R. Purser, 2019 {{ISBN|191224831X}}

Britton et al. (2019), in a study on the effects of mindfulness-based programs (MBPs), found negative side-effects in 37% of the sample while lasting bad effects in 6–14% of the sample.{{cite journal |last1=Britton |first1=W. B. |last2=Lindahl |first2=J. R. |last3=Cooper |first3=D. J. |last4=Canby |first4=N. K. |last5=Palitsky |first5=R |title= Defining and measuring meditation-related adverse effects in mindfulness-based programs |journal= Clinical Psychological Science |volume=9 |issue=6 |year=2021 |pmid=35174010 | pages=1185–1204 |pmc=8845498 |doi= 10.1177/2167702621996340}} Most of the side effects were related to signs of dysregulated arousal (i.e., hyperarousal and dissociation). The majority of these adverse events occurred as a result of regular practice at home or during class something that challenges the notion that it is only intense practice that can give rise to negative experiences; as it turns out intense all-day retreats or working with difficulty practice accounts for only 6% of adverse effects. The symptoms most readily recognized as negative were those of hyperarousal (e.g., anxiety and insomnia). On the other hand, while dissociation symptoms (e.g., emotional blunting, derealization, and self-disturbance) were both less frequent and less likely to be appraised as negative, they were still associated with more than 5–10 times greater risk for lasting bad effects… This means that re-appraisal of dissociative symptoms via non-judgmental acceptance is not sufficient to prevent impairment in functioning and should not constitute the only response. Instead, training in how to recognize dissociative symptoms as potential indicators of the need for intervention, which have recently been added to some mindfulness teacher training programs may be important.{{cite journal |last1=Britton |first1=W. B. |last2=Lindahl |first2=J. R. |last3=Cooper |first3=D. J. |last4=Canby |first4=N. K. |last5=Palitsky |first5=R |title= Defining and measuring meditation-related adverse effects in mindfulness-based programs |journal= Clinical Psychological Science |volume=9 |issue=6 |year=2021 |pages=1185–1204 |pmid=35174010 |doi= 10.1177/2167702621996340 |pmc=8845498}}

There is also mounting evidence that mindfulness can disturb various prosocial behaviors. By blunting emotions, in particular the social emotions of guilt and shame, it may produce deficits in the feelings of empathy and remorse thus creating calm but callous practitioners. Hafenbrack et al. (2022), in a study on mindfulness with 1400 participants, found that focused-breathing meditation can dampen the relationship between transgressions and the desire to engage in reparative prosocial behaviors.{{cite journal | last1=Hafenbrack | first1= A. C. | last2=LaPalme | first2=M. L. | last3=Solal | first3=I. | title=Mindfulness meditation reduces guilt and prosocial reparation | journal= Journal of Personality and Social Psychology | volume=123 | issue=1 | year=2022 | pmid=34941333 | pages=28–54 | doi=10.1037/pspa0000298 |url= https://psycnet.apa.org/doiLanding?doi=10.1037%2Fpspa0000298 }} Poullin et al. (2021) found that mindfulness can increase the trait of selfishness. The study, consisting of two interrelated parts and totaling 691 participants, found that a mindfulness induction, compared to a control condition, led to decreased prosocial behavior. This effect was moderated by self-construals such that people with relatively independent self-construals became less prosocial while people with relatively interdependent self-construals became more so. In the western world where independent self-construals generally predominate meditation may thus have potentially detrimental effects.{{cite journal | last1=Poulin | first1=M. J. | last2=Ministero | first2=L. M. | last3=Gabriel | first3=S. | last4=Morrison | first4=C. D. | last5=Naidu | first5=E. | title= Minding Your Own Business? Mindfulness Decreases Prosocial Behavior for People With Independent Self-Construals | journal= Psychological Science | volume=32 | issue=11 | year=2021 | pmid= 34705576 | pages=1699–1708 | doi= 10.1177/09567976211015184 |url=https://journals.sagepub.com/doi/10.1177/09567976211015184}}

These new findings about mindfulness' socially problematic effects imply that it can be contraindicated to use mindfulness as a tool to handle acute personal conflicts or relational difficulties; in the words of Andrew Hafenbrack, one of the authors of the study, “If we 'artificially' reduce our guilt by meditating it away, we may end up with worse relationships, or even fewer relationships”.{{cite web |url=https://www.bbc.com/worklife/article/20220302-how-mindfulness-can-make-you-a-darker-person |title=How mindfulness can make you a darker person |website=bbc.com |date=2022-03-03 |access-date=2024-07-09 }} In line with this, a meta-analysis by Kreplin et al. (2018) concluded that meditation only has a limited effect in increasing prosocial behaviours (e.g., empathy, compassion).

Mindfulness is not helpful if it used to avoid facing ongoing problems or emerging crises in the meditator's life, in which case it will function as just another form of experiential avoidance and potentially exacerbate the crisis. In such situations, it may instead be helpful to apply mindful attitudes while actively engaging with current problems.{{cite book |last1=Hayes |first1=Steven C. |last2=Strosahl |first2=Kirk D. |last3=Wilson |first3=Kelly G. |title=Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change |date=1999 |publisher=Guilford |location=New York |isbn=978-1-57230-481-9 | chapter = 3 }}{{page needed|date=July 2024}} According to the NIH, meditation and mindfulness should not be used as a replacement for conventional health care or as a reason to postpone seeing a doctor.{{cite web |title=Meditation and Mindfulness: What You Need To Know |publisher=National Center for Complementary and Integrative Health |url=http://nccih.nih.gov/health/meditation/overview.htm |date=June 2022}}

=Support=

Organizations such as [https://www.cheetahhouse.org Cheetah House] and [https://meditatinginsafety.org.uk/ Meditating in Safety] document research on problems arising in meditation, and offer help for meditators in distress or those recovering from meditation-related health problems. In some cases, adverse effects may be attributed to "improper use of meditation"{{cite journal | vauthors = Turner RP, Lukoff D, Barnhouse RT, Lu FG | title = Religious or spiritual problem. A culturally sensitive diagnostic category in the DSM-IV | journal = The Journal of Nervous and Mental Disease | volume = 183 | issue = 7 | pages = 435–44 | date = July 1995 | pmid = 7623015 | doi = 10.1097/00005053-199507000-00003 }} or the aggravation of a preexisting condition; however, developing research in this area suggests the need for deeper engagement with the causes of severe distress, which previous "meditation teachers have perhaps too quickly and rather insensitively dismissed as pre-existing or unrelated psychopathology".{{cite journal| title=Delineating the 'dark night' in Buddhist postmodernism| author=Lutkajtis, Anna

| journal=Literature & Aesthetics| volume=29| number=2|year=2019}} Where meditation is prescribed or offered as a treatment,

{{blockquote|principles of informed consent require that treatment choice be based in part on the balance of benefits to harms, and therefore can only be made if harms are adequately measured and known.

{{cite journal| title=Defining and measuring meditation-related adverse effects in mindfulness-based programs|author1=Britton, Willoughby B |author2=Lindahl, Jared R |author3=Cooper, David J |author4=Canby, Nicholas K |author5=Palitsky, Roman | journal=Clinical Psychological Science| volume=9| number=6| pages=1185–1204| year=2021| publisher=SAGE Publications Sage CA: Los Angeles, CA

| doi=10.1177/2167702621996340| pmid=35174010| pmc=8845498}}}}

Difficulties in the scientific study of meditation

=Weaknesses in historic meditation and mindfulness research=

File:Meditation&BP.jpg]]

In June 2007, the United States National Center for Complementary and Integrative Health published an independent, peer-reviewed, meta-analysis of the state of meditation research, conducted by researchers at the University of Alberta Evidence-based Practice Center. The report reviewed 813 studies involving five broad categories of meditation: mantra meditation, mindfulness meditation, yoga, tai chi, and qigong, and included all studies on adults through September 2005, with a particular focus on research pertaining to hypertension, cardiovascular disease, and substance abuse. The report concluded:

{{blockquote|Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality. Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results. (p. 6)}}

It noted that there is no theoretical explanation of health effects from meditation common to all meditation techniques.

A version of this report subsequently published in the Journal of Alternative and Complementary Medicine in 2008 stated: "Most clinical trials on meditation practices are generally characterized by poor methodological quality with significant threats to validity in every major quality domain assessed." This was despite a statistically significant increase in quality of all reviewed meditation research, in general, over time between 1956 and 2005. Of the 400 clinical studies, 10% were found to be good quality. A call was made for rigorous study of meditation. These authors also noted that this finding is not unique to the area of meditation research and that the quality of reporting is a frequent problem in other areas of complementary and alternative medicine (CAM) research and related therapy research domains.

Of more than 3,000 scientific studies that were found in a comprehensive search of 17 relevant databases, only about 4% had randomised controlled trials (RCTs), which are designed to exclude the placebo effect.

In a 2013 meta-analysis, Awasthi argued that meditation is defined poorly and despite the research studies showing clinical efficacy, exact mechanisms of action remain unclear.{{cite journal|author=Awasthi B|year=2013|title=Issues and perspectives in meditation research: in search for a definition|journal=Frontiers in Psychology|volume=3|pages=613|doi=10.3389/fpsyg.2012.00613|pmc=3541715|pmid=23335908|doi-access=free}}

A 2017 commentary was similarly mixed, with concerns including the particular characteristics of individuals who tend to participate in mindfulness and meditation research.{{cite journal|vauthors=Van Dam NT, van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Gorchov J, Fox KC, Field BA, Britton WB, Brefczynski-Lewis JA, Meyer DE|date=January 2018|title=Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl|journal=Perspectives on Psychological Science|volume=13|issue=1|pages=66–69|doi=10.1177/1745691617727529|pmc=5817993|pmid=29016240}}

=Position statements=

A 2013 statement from the American Heart Association evaluated the evidence for the effectiveness of Transcendental Meditation as a treatment for hypertension as "unknown/unclear/uncertain or not well-established", and stated: "Because of many negative studies or mixed results and a paucity of available trials... other meditation techniques are not recommended in clinical practice to lower BP at this time."{{cite journal|vauthors=Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ, Fuchs FD, Hughes JW, Lackland DT, Staffileno BA, Townsend RR, Rajagopalan S|date=June 2013|title=Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure: A Scientific Statement from the American Heart Association|journal=Hypertension|volume=61|issue=6|pages=1360–83|doi=10.1161/HYP.0b013e318293645f|pmid=23608661|doi-access=free}} According to the American Heart Association, while there are promising results about the impact of meditation in reducing blood pressure and managing insomnia, depression and anxiety, it is not a replacement for healthy lifestyle changes and is not a substitute for effective medication.{{Cite web|title=Meditation to Boost Health and Well-Being|url=https://www.heart.org/en/healthy-living/healthy-lifestyle/mental-health-and-wellbeing/meditation-to-boost-health-and-wellbeing}}

=Methodological obstacles=

The term meditation encompasses a wide range of practices and interventions rooted in different traditions, but research literature has sometimes failed to adequately specify the nature of the particular meditation practice(s) being studied.{{cite journal|last1=Davidson|first1=Richard J.|last2=Kaszniak|first2=Alfred W.|date=October 2015|title=Conceptual and Methodological Issues in Research on Mindfulness and Meditation|journal=American Psychologist|volume=70|issue=7|pages=581–592|doi=10.1037/a0039512|pmc=4627495|pmid=26436310|authorlink1=Richard Davidson}} Different forms of meditation practice may yield different results depending on the factors being studied.

The presence of a number of intertwined factors including the effects of meditation, the theoretical orientation of how meditation practices are taught, the cultural background of meditators, and generic group effects complicates the task of isolating the effects of meditation:

{{blockquote|Numerous studies have demonstrated the beneficial effects of a variety of meditation practices. It has been unclear to what extent these practices share neural correlates. Interestingly, a recent study compared electroencephalogram activity during a focused-attention and open monitoring meditation practice from practitioners of two Buddhist traditions. The researchers found that the differences between the two meditation traditions were more pronounced than the differences between the two types of meditation. These data are consistent with our findings that theoretical orientation of how a practice is taught strongly influences neural activity during these practices. However, the study used long-term practitioners from different cultures, which may have confounded the results.{{Cite journal|last1=Deolindo|first1=Camila Sardeto|last2=Ribeiro|first2=Mauricio Watanabe|last3=Aratanha|first3=Maria Adelia|last4=Afonso|first4=Rui Ferreira|last5=Irrmischer|first5=Mona|last6=Kozasa|first6=Elisa Harumi|date=2020-08-07|title=A Critical Analysis on Characterizing the Meditation Experience Through the Electroencephalogram|journal=Frontiers in Systems Neuroscience|volume=14|page=53|doi=10.3389/fnsys.2020.00053|pmid=32848645|pmc=7427581|issn=1662-5137|doi-access=free}}}}

{{Clear}}

See also

References

{{Reflist}}

Sources

;Printed sources

{{refbegin}}

  • {{cite journal | last1= Farias | first1=M. | last2= Maraldi | first2=E. | last3= Wallenkampf | first3=K. C.| last4= Lucchetti | first4=G. | title= Adverse events in meditation practices and meditation-based therapies: a systematic review. | journal= Acta Psychiatrica Scandinavica | volume=142 | issue=5 | year=2020 | pages=374–393 | pmid=32820538 |doi= 10.1111/acps.13225 |url= https://onlinelibrary.wiley.com/doi/10.1111/acps.13225}}
  • {{cite journal |last1=Fossella |first1=Tina |last2=Welwood |first2=John |authorlink2=John Welwood |date=Spring 2011 |title=Human nature, buddha nature: an interview with John Welwood |journal=Tricycle: The Buddhist Review |volume=20 |issue=3 |url=http://www.johnwelwood.com/articles/TRIC_interview_uncut.pdf}}

  • {{cite journal |first1=Alberto |last1=Perez-De-Albeniz |first2=Jeremy |last2=Holmes |year=2000 |title=Meditation: Concepts, effects and uses in therapy |journal=International Journal of Psychotherapy |volume=5 |issue=1 |pages=49–58 |doi=10.1080/13569080050020263}}

  • {{cite journal| last =Shapiro Jr | first =Deane H|year=1992|title=Adverse Effects of Meditation: A Preliminary Investigation of Long-Term Meditators|journal=International Journal of Psychosomatics|volume=39|number=1–4|pages=63|pmid=1428622|url=http://deanehshapirojr.org/wp-content/uploads/2016/10/Adverse-Effect-of-Meditation.pdf}}

{{refend}}

;Web-sources

{{reflist|group=web|refs=

{{cite web |url=http://www.bbc.co.uk/programmes/articles/2nB1psRz3JFQpzDh6J2Z6xl/is-mindfulness-meditation-dangerous |title=Seriously... – Seriously... – Is Mindfulness Meditation Dangerous? |website=BBC Radio 4 |access-date=2018-05-07 |archive-date=2018-07-01 |archive-url=https://web.archive.org/web/20180701142238/http://www.bbc.co.uk/programmes/articles/2nB1psRz3JFQpzDh6J2Z6xl/is-mindfulness-meditation-dangerous |url-status=live }}

{{cite news |url=https://www.independent.co.uk/life-style/health-and-families/features/meditation-is-touted-as-a-cure-for-mental-instability-but-can-it-actually-be-bad-for-you-10268291.html?amp |title=Meditation is touted as a cure for mental instability but can it actually be bad for you? |date=2015 |website=www.independent.co.uk |access-date=2018-05-08 |archive-date=2018-05-08 |archive-url=https://web.archive.org/web/20180508185621/https://www.independent.co.uk/life-style/health-and-families/features/meditation-is-touted-as-a-cure-for-mental-instability-but-can-it-actually-be-bad-for-you-10268291.html?amp |url-status=live }}

{{cite web |url=https://www.nhs.uk/news/lifestyle-and-exercise/does-meditation-carry-a-risk-of-harmful-side-effects/ |title=Does meditation carry a risk of harmful side effects? |website=nhs.uk |date=2017-05-26 |access-date=2018-05-07 |archive-date=2021-01-03 |archive-url=https://web.archive.org/web/20210103073652/https://www.nhs.uk/news/lifestyle-and-exercise/does-meditation-carry-a-risk-of-harmful-side-effects/ |url-status=dead }}

{{cite web |url=https://www.psychologytoday.com/us/blog/mindfulness-wellbeing/201603/dangers-meditation |title=Dangers of Meditation |date=2016 |website=Psychology Today |access-date=2018-05-07 |archive-date=2023-03-17 |archive-url=https://web.archive.org/web/20230317095215/https://www.psychologytoday.com/us/blog/mindfulness-wellbeing/201603/dangers-meditation |url-status=live }}

{{cite web |url=https://www.theatlantic.com/health/archive/2014/06/the-dark-knight-of-the-souls/372766/?single_page=true |title=The Dark Knight of the Soul |first=Tomas |last=Rocha |date=25 June 2014 |website=The Atlantic}}

}}