Meditation

In both religious and nonreligious contexts, people have practiced a variety of forms of meditation for thousands of years. The shifting of mental focus and awareness is a common theme shared across types of meditation that otherwise differ in procedures and psychological objectives. These procedures and psychological objectives are highly influenced by cultural outlook. In this entry, Western and Eastern philosophical views of meditation are discussed, followed by a survey of research. To illustrate how meditation defies a singular definition, the entry leads off with a brief presentation of some differing perspectives on this phenomenon. The entry closes with a call for the integration of Eastern and Western perspectives as a means of shedding light on meditation and its effects.

What Is Meditation?

Meditation has been characterized, for example, as (1) one of the many procedures that elicit a salubrious state of restorative relaxation (namely, relaxation response), (2) a means to gain enhanced self-awareness through inner reflection, (3) a method of ritualized prayer or reciting of holy verses designed to unify the practitioner with God, or (4) a means of unifying with the true way of nature through disciplined mental exercises designed to unfetter the mind of illusory conceptions of reality. That is, objectives range from the spiritual unity with God characteristic of Judeo-Christian and Islamic practices; to the development of a higher, cosmic consciousness associated with yogic-based practices (e.g., Transcendental Meditation, TM); to the Zen cultivation of pure seeing or perception as a way of coping with universal suffering; to the induction of the relaxation response to reduce the damaging effects of the stress of modern living that is characteristic of the Western tradition. In short, the characterization and objectives of meditation vary as a function of cultural and sociological developmental milieus.

Amelioration of Stress: The Western Interest in Meditation

With advances in industrialization and technology (e.g., improved sanitation, housing, and medical care), diseases of lifestyle (e.g., heart disease, high blood pressure, diabetes, and some cancers) have replaced the chief causes of death prior to 1900 (namely, infectious diseases and trauma). Unhealthy aspects of the modern Western lifestyle include a chronic sense of (1) “hurry-worry” triggered by the demands of a fast-paced, competitive society, (2) poor nutrition, (3) increased substance abuse, (4) pollution, (5) lack of exercise, and (6) loss of social support. Our modern ways appear linked to behavioral and psychological processes that are discordant with the Stone Age biology we inherited through evolution. For decades researchers have posited and reported evidence supporting the notion that a frequent and excessive induction of the fight-or-flight response contributes to stress-related diseases.

Briefly, our body is constantly working at striking a balance between energy conservation (rest and restoration) and energy expenditure (physiological adaptations for exercise, or for attack or defensive maneuvers). Rest and restoration are the domain of the parasympathetic nervous system (PSNS), whereas adaptation to states of physical exertion, threat, and emergency are the domain of the sympathetic nervous system (SNS), which is linked to the fight-or-flight response. The brains registering of threatening or crisis situations triggers the SNS and reduces PSNS activity and also sets in motion a cascade of events inducing the release of stress hormones (bodily created substances that are released into the blood stream for regulation of the body’s responses). The relaxation response, with its decreased respiration, muscle tension, and cardiovascular activation characteristic of PSNS dominance, has been conceptualized as a “hypometabolic state” associated with a quieting and calming of both the mind and the body and, thus, rest and restoration.

Given these considerations, Western researchers have focused on examining the attenuation of fight-or-flight-induced arousal as a means of investigating the psychological and physical benefits of meditation.

Anxiety Distress

Anxiety, or the experience of worry, tension, and/or bodily arousal (e.g., cold, sweaty hands), is though to reflect high levels of arousal. Meditators have been reported to self-report lower anxiety and depressed mood levels than nonmeditators. Studies randomly assigning persons without prior meditation experience to either a meditation group or a nonmeditation control group showed that the greatest decreases in anxiety occurred for those taught meditation. The effects of meditation on the frequent and across-situation experience of anxiety (trait anxiety) was examined using meta-analysis, which combines statistics testing differences between groups (e.g., meditators vs. nonmeditators) across studies to yield an average statistic showing the strength of the treatment effect. The meta-analysis showed that TM displayed the strongest effect of all the relaxation techniques. Moreover, concentration meditation (i.e., focusing on an external object like a vase) showed the weakest effect. However, studies exist showing no effects of meditation on levels of anxiety, and that the effects of meditation do not necessarily generalize to behavioral or physiological markers of anxiety. Furthermore, it has been reported that prospective meditators high in trait anxiety appear more likely to not complete the study and to benefit less from the intervention. Finally, studies of short duration (i.e., less than 3 months) often did not reveal meditation effects.

Markers of Physical Health

One randomized study of older African Americans with mildly elevated blood pressure showed TM to be more effective at lowering blood pressure than either progressive muscle relaxation or education only. In a study of people at high risk for cardiovascular disease (high blood pressure, high cholesterol, and/or tobacco use), persons randomized to meditation/relaxation plus health education, relative to those randomized to a health education only group, showed lower blood pressure and cholesterol levels, thereby suggesting reduced risk for heart disease; the blood pressure results were maintained 4 years postintervention, and the cholesterol differences were present at 8 months postintervention. Similarly, for a group of adolescents with blood pressure elevated for their age and gender, those randomly assigned to TM, relative to those randomly assigned to a health education control group, showed decreases in resting systolic blood pressure and reduced cardiovascular reactivity to psychological stress. Relative to patients randomized into a control group, a meditation/mindfulness group (i.e., passive nonjudgmental awareness of thoughts, feelings, breathing, and bodily sensations) showed a more rapid response to the medical treatment for psoriasis (skin disorder). In a longitudinal study of elderly participants, those randomly assigned to a TM condition showed improved memory function, lower systolic blood pressure, and greater longevity than persons not taught TM. Other studies report meditation to reduce stress hormones (chemical messengers activating bodily responses via the blood stream; e.g., Cortisol) and foster adjustment to chronic pain.

Summary and Conclusions

Even though a corpus of evidence indicates that meditation positively affects the affective, psychological, and physical functioning of practitioners, our current state of knowledge is still quite limited, despite decades of research. Studies typically deploy small samples. Moreover, there is a paucity of randomized group studies examining the impact of factors such as (1) expectancy and demand characteristics (e.g., placebo effects or rituals designed to cultivate a positive expectation of change), (2) duration of treatment, (3) amount of meditation (how many times per day and how much time per meditation), (4) type of meditation (e.g., sitting with eyes open while counting breaths vs. eyes closed while silently repeating a mantra), (5) the critical elements of meditation (e.g., focusing and refocusing attention on a single object vs. allowing attention to flow, in a nonjudgmental manner, with the changing contents of consciousness), (6) amount of time as a practitioner, (7) religious- versus non-religious-affiliated meditation (e.g., Sufi meditation practices vs. Benson’s secular approach), and (8) the mechanisms distinguishing different types of meditation from each other as well as from other types of relaxation procedures. Although comparing meditators to nonmeditators (i.e., case-control studies) have yielded some differences (e.g., trait anxiety, blood pressure, and pulse rate), these differences can result from the drawing of samples from two different groups (those who chose to meditate versus those who did not). Recall that persons who meditate tend to manifest a profile of low reported psychological symptoms, and highly anxious people tend to drop out of meditation training. These studies of anxiety are consistent with the notion that case—control studies cannot separate preexisting group differences involving a myriad of psychological, biological, demographic, and lifestyle factors from the effects of meditation.

Whether the effects of meditation are unique or simply represent a general relaxation response or states of simple rest has been debated. For example, it has been reported that the peripheral changes associated with increased PSNS (e.g., reductions in respiration, heart rate, or sweat glands) are equivalent to simply resting. Studies incorporating brain waves (electroencephalogram) and behavior (slow, rolling eye movements or gross bodily jerks) indicated that experienced meditators lapsed into sleep episodes or hovered between drowsiness and wakefulness; some argue that, like the studies of peripheral responses, this shows meditation is merely a state of rest or low arousal, whereas others argue that such hovering reflects the ability to shift attention to maintain a state between sleep and wakefulness. Again, most of the evidence relates to case-control studies or studies of a handful of meditators (e.g., five persons of the Sufism), making it difficult to separate the effects of the meditation from the characteristics of the persons meditating.

In sum, there is a body of evidence indicating the salubrious effects of meditation. However, methodological shortcomings obfuscate the mechanisms of how meditation affects physical and psychological well-being. Likewise, failure to obtain clear results may result from the disconnection of the Western, behavioral methods from the objectives of mediation practices developed in non-Western cultures. For example, some Zen practices are oriented to a nonjudgmental awareness of the ebb and flow of thoughts, emotions, bodily sensations, and images to develop perceptions less biased by emotional needs. How is a measure of trait anxiety or heart rate on one or more occasions going to address this phenomenon? For research in this area to progress substantially, it is important to recognize that conceptual views of meditation vary widely, and to work at developing methods and procedures that reflect these views and objectives rather than attempting to make the phenomenon fit our available and convenient Western methods. It is time to go beyond viewing meditation as primarily a tool for reducing stress-induced arousal, particularly because it is known that patterns of arousal vary among people (e.g., some people may primarily react through the cardiovascular system, others through the gastrointestinal system). In other words, it is time to undertake a biopsychosocial integrative approach, in which cognitive measures of attention and memory, measures of brain function, patterns of SNS and PSNS responding, markers of freedom from disturbing cognition (e.g., use of palm-held computers to record occurrence of disturbing ruminations versus the occurrence of feeling joy over feeling connected to surrounding events and people), measures of individual differences (e.g., openness to experience or optimism), lifestyle (nutrition and substance use), and social functioning (e.g., healthy assertion versus hostile, agonistic behavior) are integrated into a multidimensional profile of the successful meditators. Additional randomized, prospective studies are essential to examine the direct effects of meditation.