There is widespread agreement in the literature that meditation reduces sympathetic activation and increases parasympathetic activation of the ANS, that is, it reduces physiological arousal thereby triggering a characteristic spectrum of simultaneous physiological changes: reduced respiratory rate (RR), reduced heart rate (HR), reduced blood pressure (BP), reduced electrodermal activity (EDA) and increased skin temperature (ST). Many studies of non-meditative practices such as relaxation, listening to music and sitting quietly have demonstrated the same pattern, leading to the assumption that meditation can be defined merely as a method of rest or relaxation — no different to other methods.

The significance of my research is that it has challenged current thinking by demonstrating that Sahaja Yoga meditators manifest changes that in some part are opposite to that which one would expect to see in participants who simply undergo rest/relaxation. Specifically, while the “relaxation” explanatory paradigm for meditation predicts that meditators’ ST should increase, this study found that it decreases and that this decrease correlates with the degree of mental silence reported by the meditator. A review of the literature indicates that this pattern of changes is difficult to mimic consciously. The observations in this study correspond closely with other studies on Sahaja Yoga meditation reported in the “grey literature”. Taken together these findings suggest that the mental silence experience may be associated with a relatively unique pattern of physiological activity.

Dr Ramesh Manocha

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Reports such as those described previously call for a deeper examination of meditation’s potential adverse effects. Thorough, systematic surveys post marketing surveillance-style studies need to be conducted, For this to be done properly, meditation instructors and organisations may be required to cooperate by providing comprehensive lists of those who have learnt or who currently practice meditation. In practice this may be difficult to achieve given the commercial interests of some organisations, the somewhat anti-establishmentarian views of those who practice in or participate in these organisations as well restrictions arising from privacy laws.

When decisions about a new intervention are being made, the net clinical benefit needs to be carefully assessed by balancing reported benefits and side effects. The CONSORT check-list includes reporting of such adverse events as item 19 of the CONSORT statement. Only proper and systematic reporting of side effects will allow adequate assessment of the potential net benefit of any intervention.

Dr Ramesh Manocha

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The fact that the mental silence construct, more than any other factor my research, correlated positively with a wide range of health measures raises interesting implications in several areas of study. The findings emanating from my research imply that the notion of mental silence and its associated yogic philosophy, may be important in the ongoing development of our understanding of meditation and the various definitions and taxonomies that relate to it. It also provides some new clues for scholars interested in the “essential factors” of religiosity and the question as to why some forms of religiosity are beneficial and others not. Furthermore, it provides empirical data that may help to progress the ongoing debate about the theoretical differences between “religiousness” and “spirituality”. Perhaps most important of all they provide empirical evidence of a positive relationship between a well-defined state of consciousness and health and wellbeing. That, it is asserted, constitutes a significant contribution to the nascent field of consciousness research as well as our understandings of health. It implies a nexus between religiosity, consciousness and health that is accessible to measurement. The practical ramifications are that meditation may have a valuable role to play in the promotion of mental health and the prevention of mental illness primarily as a result of the beneficial impact of the mental silence experience.

Dr Ramesh Manocha

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The diversity, and apparent impotence, of many meditative practices makes the construction of sham meditation quite feasible since researchers can develop rationales to justify almost any method that approximates the expectations of trial participants.

For instance, Smith’s (1995) RCT compared TM to an imitation exercise designed to closely mimic the entire technique, except for the proprietary mantra. Forty four participants practiced one of the 2 techniques for 24 weeks, with the same instructions for frequency and duration only to find that no difference between the 2 methods was detectable. This study used well validated self-reporting measures shown in other studies to be quite sensitive to the effects of meditative practices.

Similarly Dua (1992) compared a form of meditation that he developed to a “negative thought reduction” method as well as to a “negative thought enhancement placebo” for the management of anger in a small RCT and found no differences between the practices in any of the outcome measures at the end of the treatment period.

On the other hand, Wolf (2003) compared a meditation based on a traditional Sanskrit mantra (the maha mantra) with a pseudo mantra and observed substantial differences in post treatment outcomes.

In smaller trials, Rai (1988, 1993) observed a number of significant differences when he compared Sahaja Yoga meditation to “mimicking exercises” in the treatment of asthma, hypertension and stress.

Dr Ramesh Manocha

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It may not be practically possible to devise and implement an ideal control method for meditation trials, nevertheless it is important to select a strategy that approximates that ideal. The bare minimum criteria for a control process in meditation research should therefore be:

• First, high face validity as a therapeutic/stress management intervention in its own right. It should actually appear to be a credible meditation technique if that is the expectation of participants.
• Second, a process that involves relaxation and reduction of somatic arousal since this is the nearest conventionally understood phenomenon that meditation resembles and from which it needs to be distinguished.

Given these considerations there are two ideal strategies: sham meditation and the head-to-head comparison.

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health of meditators vs general population and clergy

This graph shows a comparison of the health of a group of experienced mental silence (Sahaja Yoga) meditators and three other groups including a group of Presbyterian clergy from America, a group of non-mental silence meditators, and the general Australian population. Health was measured using the Short Form 36 survey. The mental silence meditators’ health profile is generally better then the other groups. These results demonstrate an association between the mental silence experience and positive 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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Examining randomised controlled trials exploring meditation in my review, control methods were presumptively categorized according to their face-validity into low, moderate or high face validity categories.

The low face-validity controls used strategies that were:
Passive and unstructured: Participants were involved in minimal or no activity relating to the trial and had no interaction with researchers as a result of being allocated to the control group (e.g. waiting list, no treatment, self-directed reading, or referral to community resources). This kind of comparator controls for minor non-specific effects, such as regression to the mean, the natural history of disease states and environmental factors common to all participants. It does not however, control for any non-specific effects that may be elicited by behaviour therapies.

The moderate face-validity controls use strategies:
Passive and structured. These involved some sort of regular and structured interaction with personnel associated with the experiment (e.g. regular lectures, specific reading, structured educational sessions on unrelated topics, regular blood pressure checks). This controls for the same confounders as Category 1 in addition to the effects of therapeutic contact and sense of active involvement.
• That were active in nature and generated some expectation of benefit but did not have effects or credibility as either a method of relaxation or meditation e.g. support groups, education about health factors measured in the study, or lectures on stress and lifestyle management. This controls for the same as Categories 2 and 3 in addition to the effects of social support, improved lifestyle, etc. Social support has been repeatedly demonstrated to be effective in improving mood and quality of life and reducing the severity of disease symptoms. “Standard treatment” was included in this category.

High face-validity controls use strategies that were:
• That were active in nature but not designed to generate significant expectation of therapeutic benefit (e.g. exercise). This controls for the same as Category 2 in addition to the effects of regular physical activity. Regular physical exercise has been shown to improve mood.
Active in nature, generated some expectation of benefit and elicited the simple physiological effects on rest but did not have specific credibility as a meditative method (e.g. progressive muscle relaxation, other relaxation methods, hypnosis, biofeedback, psychotherapy).
• The same as above but also had credibility as a meditative method (e.g. meditation techniques, strategies designed to convincingly mimic meditation) or constituted a legitimate form of psychotherapy (e.g. desensitisation, cognitive behaviour therapy, counselling).

Dr Ramesh Manocha

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The observations of previous randomised controlled trials assessing meditation could lead to three possible conclusions:

1. Meditation is in fact no more effective than other approaches to rest and relaxation. Yet meditative traditions have existed for thousands of years and at least in India, are widely perceived to have specific and unique features. In other words history and culture do not agree with the idea that meditation is simply a method of mundane relaxation. While this “test of history” does not provide proof of efficacy, it does encourage the undertaking of a thorough examination of the phenomenon before it is discarded as mere folklore and superstition.

2. The measures which have so far been used to assess the effects of meditation are not sensitive to the specific effects of meditation. The wide variety of outcome measures used means that if the specific effects of meditation are not detectable, then the effects are either too small or too esoteric for mundane study. Yet classical descriptions of meditation suggest that despite the metaphysical basis of meditation, its effects do manifest themselves in mundane dimensions such as health and behaviour, implying that at least some of the many measures available to researchers should be able to detect a differential effect. Again, while this might be satisfactorily applied to the genre as a whole, there appear to be isolated exceptions which suggests that certain as yet undetermined categories may be able to generate specific effects. Yet our analysis of the aggregated data has not yet yielded a pattern with sufficient clarity to identify the features of that category.

3. The methods that have been labelled as “meditation” in the trials do not consistently reflect the true nature of meditation. This is the most interesting and important issue and therefore merits considerable discussion. The functional and conceptual definition determines the nature of the intervention, which in turn influences the choice of the control method that ought to be used and therefore the validity and generality of the findings. Yet defining meditation has proven to be a difficult challenge for modern researchers. While early empirical reports seemed to show that measurable distinctions between meditation and rest or simple relaxation existed, rigorous trials did not support these perceptions. As a result, much of the research work on meditation has been based on the assumption that meditation techniques are much the same despite minor external and superficial differences. Indeed Western researchers have proposed that most meditative processes are physiologically similar to simple rest and relaxation and the high quality physiological trial data seems to support this. These perceptions have thus given rise to an assumption of “psycho-physiological uniformity”.

This last idea is the key to the problem because in fact both Western meditation enthusiasts and Western scientists, despite their opposing views, have failed to apprehend a key factor that underlies the ancient tradition of meditation: The idea that meditation necessarily involves the experience of mental silence.

Dr Ramesh Manocha

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long term meditators frequency of achieving mental silence
The graph represents the results of a survey conducted on long term Sahaja Yoga meditators. They were asked the question “how often do you achieve thoughtless awareness/ mental silence for a few minutes or more?” Almost half of those surveyed responded that they achieved mental silence “several times per day or more”.

Dr Ramesh Manocha

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In view of the seriousness of some of the reactions described above it is questionable whether all forms of meditation can be viewed as “generally safe for general consumption”. Moreover, given that recent reviews of meditation have clearly demonstrated a lack of convincing evidence for a specific effect, the importance of developing a comprehensive understanding of meditation’s adverse effects, and the risk to both healthy and unwell populations is of considerable importance. I propose that a more cautious set of clinical recommendation guidelines be considered until more thorough, independent studies are done.

A simple guideline may be that candidates should be recommended to experienced instructors with health professional backgrounds and that referring clinicians should screen for history/susceptibility to serious mental illness. It may be also appropriate to avoid recommending methods in which commercialisation or similar considerations may lead to a conflict of interest. There are many meditation techniques that can be accessed on a low fee/non-commercial or free of charge basis and these ought to be recommended over expensive, commercialised methods. Should negative experiences occur, novices should be advised to cease practising the techniques immediately.

Dr Ramesh Manocha

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