In my systematic review of 120 randomised controlled trials, twenty eight trials used a “multimodal” approach in which meditation was used as part of a “blunderbuss” of interventions woven into a single coordinated program. Most of these programs involved other practices aimed at reducing stress such as yoga postures, exercise, breathing techniques, or group support. Such approaches may be more clinically effective but the adjunctive use of non-meditative techniques obscures any effect that may be specifically attributed to the meditation component. They are therefore not useful in trying to understand the nature of meditation per se. Similarly, examining the 16 trials that were more or less based on Kabat Zinn’s Mind Body Stress Reduction Program (MBSR) clearly indicates that this interventions is only one component of a larger collection of practices including hatha yoga, simple cognitive therapy and breathing exercises. Therefore, although the MBSR is frequently equated with Mindfulness, for scientific purposes it would be more appropriately relegated to the multi-modal category.

Dr Ramesh Manocha

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Follow-up data, data obtained some time after the trial, is important as it gives an indication of how durable the effects of meditation might be. Unlike modern Western therapeutic thinking however, meditation was not originally designed to be used as a course of treatment so much as to be part of an ongoing lifestyle thus implying that the benefits of meditation are likely to persist in the follow-up phase only so long as the person chooses to meditate regularly. Meditation instructional programs are usually relatively intense and it is therefore worthwhile determining whether changes brought on by the instructional program can be maintained when participants are left to continue unsupervised with whatever skills they have acquired in the more formal phase of their training. Given that consistent evidence for a specific effect is lacking even within the intervention phase of the 120 randomised controlled trials my review, it is even more unlikely that evidence for an effect will be detectable in the follow-up phases. Of the entire sample of 120 studies in my review, 76 studies did not include any follow-up assessment strategies.

It might also be argued that, since researchers tend to be hampered by lack of resources, the primary question as to whether meditation has any specific effects ought to take priority over questions about the durability of its effects, if there are any. It is therefore understandable that many trials have not included follow-up assessments in their design. For this reason, it was decided that more in depth analysis of follow up data would be of little value to the primary questions set out in my review.

Dr Ramesh Manocha

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Skin Temp over time - Sahaja yoga meditation verses generic meditation

The graph displays a key difference between mental silence based meditation and other types of meditation.

Previous definitions of meditation have not differentiated between meditation and relaxation. A key feature of relaxation is that skin temperature increases with the reduced physiological arousal.

This graph shows data from a heuristic physiological study where mental silence meditators manifested reductions in skin temperature during meditation thereby contradicting the “reduced physiological arousal” conceptualisation of meditation.

Dr Ramesh Manocha

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In order to effectively tease out the effects of mental silence as opposed to the effects of other aspects of Sahaja Yoga meditation it was obviously necessary to use randomised controlled trial methodology. Having refined the practical approach in previous clinics it became possible to develop a standardised, instructional strategy whose structure could also be mirrored in control strategies in order to optimise the exclusion of non-specific effects.

The first attempt at this was a well-designed RCT involving 59 participants in which SYM was compared to a standard stress management programme for sufferers of moderate to severe asthma (on pre-stabilised, optimised treatment but who remained symptomatic). This trial was designed to compare two similarly active and credible interventions in which the main critical difference was the use of mental silence in the SYM group. While both groups experienced similar improvements in a number of outcome measures, the SYM group demonstrated significantly greater improvements in clinically important subjective measures such as aspects of asthma specific quality of life, mood state and, notably, an objective measure of disease severity known as airway hyper-responsiveness. The outcomes suggest: first, that mental silence does appear to have a specific effect on mood as well as some aspects of quality of life; second, that mental silence also has some effect on pathophysiology itself. Although well designed the sample size was small and drop out rates were somewhat higher than expected thereby raising the possibility that important effects were not detectable because of type 2 errors in the statistical analysis. A larger sample size was needed to overcome this possibility. Moreover, although mental silence had been compared to stress management, it would be more informative to determine its effect in comparison to an intervention that more closely resembled a non-mental silence approach to meditation.

Taking these considerations into account, a second, larger RCT of mental silence orientated meditation is reported. SYM, as an example of the mental silence approach, was compared to a “non-mental silence” approach to meditation. SYM was, on average, twice as effective as the comparator in reducing work related stress, general depressive symptoms and anxiety.

Thus in two well-designed RCTs in which the mental silence approach to meditation was compared to highly credible and active controls, substantial differences in therapeutic effects were observed, clearly suggesting that a specific effect is associated with mental silence orientated meditation techniques.

Dr Ramesh Manocha

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A national survey of Sahaja Yoga meditation practitioners using standardised measures revealed that meditators experienced significantly better levels of quality of life and mental health as compared to population data drawn from national health surveys using the same instruments. Similar surveys of populations practising Western forms of religiosity also reported better health than the general population but the meditators appeared to experience substantially greater advantages. Remarkably, analysis revealed a robust and consistent relationship between reported frequency of mental silence experience and health scores, especially mental health, thereby providing support for my central hypothesis that is that the experiential mental silence aspect of meditation is associated with health benefits. An association however does not prove causality and so it became necessary to conduct observational experiments to determine if meditation, and more specifically, mental silence, was specifically responsible for the health benefits observed in the health survey.

Dr Ramesh Manocha

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relationship between mental silence and health

This graph shows the mental health of people sorted by how frequently they meditate with the mental silence based Sahaja Yoga. The graph depicts a correlation between the frequency of meditation for people who meditate and their mental health score. Mental health was measured by the mental health subscale of the Short Form 36 questionnaire.

The correlation was analysed and found to have a correlation coefficient of +0.36 with p<0.001.

Dr Ramesh Manocha

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Meditation is widely perceived in the West as an effective method of reducing stress, and enhancing wellbeing. In Australia, a survey conducted by Kaldor (2002) 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. The Australian Community Survey (ACS), conducted by the National Church Life Survey (2004) found that 1.5 million Australians had tried meditation within 12 months of the time of the survey and that while 29% of those surveyed found prayer to be a source of peace and wellbeing, 24% had used meditation to achieve the same effect! Only 21% reported church attendance as a source of peace or wellbeing. In fact the ACS reports that although only about 20% of Australians attend church monthly or more often “around 33% of Australians pray or meditate at least weekly”.

This situation in Australia reflects trends in other Western countries. In 2002 a National Health Interview Survey (NHIS), undertaken by the Centers [sic] for Disease Control and Prevention (CDC) in the United States administered to 31,000 representative adults, demonstrated that 8% of respondents had practiced meditation at some time. That biomedically trained physicians in Australia were also advising patients about the therapeutic effects of meditation, was demonstrated when Pirrotta conducted a survey of Australian GPs in 2000.

Dr Ramesh Manocha

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While the strong metaphysical linkage between Eastern religiosity, its psycho-spiritual practices, and health may offer important new perspectives on the relationship between religiosity and health, there are a number of practical difficulties associated with studying the epidemiology of non-Western forms of spirituality. These include:

  • differing criteria of religiosity
  • new confounding variables relating to language, culture, ethnicity, diet and environment
  • an absence of validated and reliable measures
  • accurate data regarding the background population may be unavailable.

Given these considerable limitations, the study of a Western sub-population that has adopted a well-defined aspect of Eastern religiosity may be particularly useful as it allows comparison with well-developed, validated databases and commentary while avoiding a number of the confounders mentioned above. Studies such as this may provide important conceptual bridges by which researchers can extend their understandings of the relationship between religiosity and health in non-Western groups using a common set of empirical scientific tools.

Dr Ramesh Manocha

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Sahaja Yoga meditators health statistics

This graph shows a comparison between a group of Sahaja Yoga meditators and a sample of the general population of Australia on a number of health outcomes. The meditator group performed significantly better on a number of key health outcomes including general health and mental health.

From Manocha R and German E. Meditation, Health and Quality of Life: A Census of a Meditating Population.

Dr Ramesh Manocha

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Within the yoga tradition, meditation is defined as an experiential state of awareness specifically involving control over all aspects of mental activity. Feuerstein (2006) explains that “the initial purpose of meditation is to intercept the flux of ordinary mental activity.” He translates Patanjali’s explanation from the Yoga Sutras (aphorism 1.2) as follows: “Yoga is the control of the fluctuations of the mind” (p98).

In this paradigm the highly developed meditator is not only less stressed and more relaxed but also experiences beneficial effects on health and psyche, having activated a previously latent potential for positive psychology and optimized wellbeing.

The mental complexities with which one gradually becomes encumbered as one progresses through life can be loosely termed as “mind” and they increase in strength as one becomes more involved in the mundane. Yogic systems in fact identify the mind as not only the source of “illusion” that prevents perception of reality, but also as the ultimate source of disease. According to the yogic tradition the true aim of life is to resolve these complexities and therefore progress toward a more profound understanding of one’s self. Feuerstein translates the passage of the Yoga Bhishya (1.1) in which the five fundamental behaviour patterns of the mind are described as follows:

  1. mudha – dullness;
  2. kshipta – restlessness;
  3. vikshipta – being intermittently distracted;
  4. ekagra – being focused
  5. niruddha – a state of control.

The order in which these states are cited is important; indicating a hierarchy in which the controlled mind is the most preferable. The Guru is traditionally seen as someone who, having mastered his own mind and soul, sets out to help others do the same.

Dr Ramesh Manocha

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