In 2000 Pirrotta et al. published the results of a widely publicised survey of family physicians in Australia. Remarkably it reported that almost 80% of respondents had recommended meditation to patients at some time in the course of their practice, yet less than 35% had any formal training or education in the field. This reflects, on the one hand, the growing legitimacy of what was once regarded as a fringe concept and on the other, a lack of quality education on the topic. The medical community’s manifest interest in meditation is often construed by consumers as tacit endorsement of the practice.

Meditation arose from an ancient spiritual tradition centred in India. It has achieved substantial popularity in Western societies as a therapeutic tool as well as a method of self development. In both the East and West it is widely perceived to have potent, specific effects on both the body and mind. In Australia, a survey of a randomly selected but representative sample drawn from the state of Western Australia (n = 1,033) found that 11% of respondents had practiced meditation at least once. This reflects trends in other countries. In the United States for instance, a survey administered to 31,000 representative adults, conducted in 2002 as part of the National Health Interview Survey (NHIS) of the Centers for Disease Control and Prevention (CDC), showed that 8% of respondents had practiced meditation at some time.

Dr Ramesh Manocha.

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Probably the most thorough and up to date review of meditation research was published in 2007 by a team led by Ospina, specifically contracted by the US Department of Health and Human Services to assess the evidence base. They included both randomised and non-randomised trials. In their assessment of more than 800 studies they concluded:

“Many uncertainties surround the practice of meditation. Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterised by poor methodological quality. Firm conclusions on the effects of meditation in healthcare cannot be drawn based on the available evidence.

Ospina’s review represented a massive effort by a large team of researchers. Its thorough and comprehensive nature ensures that its contribution to the field of meditation research will be of great value. There are a number of features in the review’s design however that would seem to prevent important questions about specific effects and related issues from being clearly answered, such as:

  1. The inclusion of a wide variety of comparative studies, not just randomised controlled trials.
  2. Techniques that may not be widely accepted as meditation, such as Yoga, Tai Chi and Qigong. These practices include meditation as a component of their practice but also include many other practices such as physical exercise, dietary modification and other lifestyle choices whose confounding and non-specific effects are difficult to separate from any effects of meditation.
  3. Effect size calculations did not seem to take into account the heterogeneity of control groups and their widely varying ability to confound outcomes since the control methods themselves elicit both non-specific and, in some cases, specific effects.

Dr Ramesh Manocha

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Dr Ramesh Manocha carried out a randomised controlled trial to assess the impact Sahaja Yoga meditation (SYM) has on attention deficit hyperactivity disorder (ADHD) symptoms.

The results of this trial program indicate that SYM has potential as an adjunctive therapy for children with ADHD when offered via a family treatment approach and in combination with existing medical treatment. Although results were limited by the small number of children for whom complete data was available, the consistency of the findings, which drew on different measures of child outcomes, different groups of children and both parent and child respondents, along with the significance of the results, points to the positive potential of this approach.

Core symptoms of ADHD were improved. Parent ratings on the Connors Parent-Teacher Questionnaire, which assesses attention, hyperactivity and impulsivity, were significantly reduced over the course of the program. Children also reported that they felt calmer, less panicky, and more relaxed. Parents reported that the children’s approach to school and homework had improved during the SYM program, while the children themselves said that they were more able to concentrate at school. Improved sleep was another positive outcome reported by parents and children.

Evidence for the effectiveness of the SYM intervention, over other possible contributors was provided by the group of “wait-list” children whose baseline ADHD scores remained the same over two pre-treatment assessment points. It consequently dropped significantly over the 6-week SYM program.

Dr Ramesh Manocha wrote an article “2001: A Cosmic Metaphor” in his old student magazine “Knowledge of Reality”. In the article Dr Manocha considers the metaphors the classic movie 2001: A Space Odyssey made regarding the ancient Eastern outlook on life, the universe and everything.

“Dave, in crossing the void of space (ignorance), surviving the maniacal Hal 9000 (the mind, source of most delusion), the even more terrifying expurgation of his own being (that psychedelic experience which was the process of purification) attained a direct connection (yoga) with the cosmic awareness (self realisation).”

The full article can be found at www.sol.com.au.

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Two cases are described in a report by Xu (1994). The first involved a 22 year-old man who sought treatment for lumbago and experienced the onset of adverse effects while undertaking self-teaching of the Wu Qin Xi form of Qigong. He experienced anxiety, physical pain, psychosis and suicidal thoughts. Some relief was experienced as a result of treatment by a Qigong master, but symptoms recurred. These included hearing the “voices of evil spirits”, uncontrollable behaviour and attempted suicide. Some months later he developed similar symptoms when his family would not allow him to do his Qigong exercises. He attempted suicide and was admitted to a psychiatric institution. After ECT treatment he was discharged and was subsequently stable. The second case involved a 44 year old male who developed delusional psychosis after practicing He Xiang Zhuang (a form of Qigong) for a cervical disorder.

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I propose that one of the main reasons for the paucity of convincing evidence with regard to meditation is because Western scientists have failed to apprehend the key idea that underlies the meditation tradition: meditation is traditionally defined in Eastern cultures as the experience of mental silence. Modern Western understandings of meditation vary, but probably the most common understanding is that it is a method for eliciting reduction in physiological arousal. The notion that meditation involves a state of consciousness “beyond thought” seems all but absent from modern Western scientific literature on meditation.

Dr Ramesh Manocha.

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Summarising the basic features of Sahaja Yoga meditation, it is:

1. Relatively simple to learn and practice.
2. Appears to have a specific, positive effect on health.
3. Can be made available on a low-cost/zero-cost model.
4. Can be taught via mass media vehicles such as radio, television, Internet.
5. Evidence to date suggests a low side effect profile.

These features make mental silence orientated techniques such as SYM ideally suited as strategies to promote and preserve health as well as prevent disease and mental disorders.

For discussion on the future directions of research for Sahaja Yoga meditation, check Dr Ramesh Manocha’s blog.

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A head-to-head comparison is where two different approaches to meditation are compared. They are easier to conduct then sham meditation comparisons since elaborate deception strategies are not required, they have inherent authenticity and ethical problems are much less likely. Head-to-head trials are important and valuable because they allow comparison of different definitions, paradigms and approaches to meditation. They are especially useful given that there is no consensus even on what exactly meditation is. A disadvantage of such comparisons is that they may not necessarily allow for a clear distinction between meditation-specific and non-specific effects.

a head-to-head comparison where two different approaches to meditation are compared. They are easier to conduct since elaborate deception strategies are not required, have inherent authenticity and ethical problems are much less likely. Head-to-head trials are important and valuable in the current context because they allow comparison of different definitions, paradigms and approaches to meditation. They are especially useful given that there is no consensus even on what exactly meditation is. A disadvantage of such comparisons is that they may not necessarily allow for a clear distinction between meditation-specific and non-specific effects.
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It is necessary to point out from the start of these observations that the basis of all perceptions of ‘reality,’ and what it means is ‘experience’. By experience I refer to that central act of consciousness by which we cognise existence. All understandings and philosophies concerning the nature of reality are interpretations of experience.

‘To experience’ suggests ‘to be conscious’. In practise this means ‘to be conscious of’. As soon as consciousness is described in this way an object of experience is implicit, and correspondingly an experiencer is also implied. This is the basis of the ‘subject/object’ relationship, while the perception of this distinction resides entirely within the cognition of the experiencer.

When we think of ‘reality’ usually in western culture the term is used with a strong emphasis on the ‘objective’ aspect of this relationship for practical and functional reasons, with the implicit and largely unconscious assumption that ‘reality’ exists independently of the experiencer. This briefly is the central underlying philosophic assumption of the western approach to knowledge.

Viewed from this perspective the experiencer is also regarded as an object of perception rather than the source of perception.

This emphasis on the object aspect of experience, while important and practical, is one-sided and leads to a fundamentally erroneous understanding of ‘reality’. It seems crucial to understand that the essence of reality is experience, not objectivity per se, and that experience is both object and subject. In exploring truth, or reality, it may be that there are two cardinal sins. One is the well known ‘subjectivity’ while the other, much less recognised in our culture, is ‘objectivity’, which as I have suggested has become erroneously identified with reality and placed on a pedestal. It may be worth removing it from its pedestal and standing it on the ground.

It would seem that an understanding of reality requires equal recognition of both aspects of experience, and not just intellectually, within a conceptual model, which necessarily falls into the objective domain, but at a more fundamental level prior to the exercise of the faculty of conception in the cognitive process.

Can this be done? Yes, it is possible to establish awareness at earlier stages of cognition and thereby place the attention much more in touch with reality, that is, experience unprocessed by conceptual interpretation. Correct practice of meditation can achieve this though it should be introduced and guided by an experienced practitioner. The cultures from which the practice originates have long experience of this and their deep traditions embody important practical knowledge in this respect, regarding the relationship between those established in ‘reality’ and those aspiring.

After all anyone can claim expertise but not all such people actually know what they are doing and a guide can’t take you if he doesn’t know the way, regardless of what they may say. There are signs that help but for the most part these reside in the discrimination of the aspirant who must use them and trust them, to recognise truth in his/her search.

Written by Mark Callaghan.

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There are a large number of reviews on the topic of meditation in the peer reviewed journal literature. Their conclusions are remarkably diverse, ranging from overwhelmingly positive to considerably negative. These disparities are explainable by factors such as the methodological standards set by the reviewers, whether or not the researchers were interested in differentiating between specific and non-specific effects and the researcher’s own affiliations. Generally speaking, the more rigorous the standards set by the reviewers, the less likely they were to express enthusiasm for meditation.

For more detail on how the meditation research can be sorted and analysed, check Dr Ramesh Manocha’s blog.

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Meditation research to date has been plagued by conceptual and methodological problems. One of the most significant difficulties involves developing control strategies involving interventions which blinded participants might consider plausible, that have no specific therapeutic effects. Randomisation and management of other sources of bias is another area of concern; a large number of controlled trials have used non-randomised, dissimilar cohorts.

Dr Ramesh Manocha further discusses the specific problems of defining meditation at his blog.

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