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

none

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

none

In light of the number of studies reporting adverse effects from meditation broad based surveys need to be conducted, and given that studies such as Kaldor’s (2002) suggest that up to 10% of the population may have tried meditation at some time, a direct-to-public cross sectional survey may be sufficiently effective in quantifying adverse effect rates. Also important are controlled observational studies with a specific focus on detecting, characterising and quantifying adverse reactions. Moreover, meditation should not be the only modality assessed but instead, the opportunity should be taken to assess the effects of all related quasi therapeutic practices including hypnosis, faith healing and Qigong, Reiki and other new age practices. Combining the outcomes from these different data gathering strategies on a wide variety of contemplative and new age practices will not only help us understand adverse effects associated with meditation but also provide a perspective with regard to related practices. Such information will hopefully help to explain why a practice traditionally described as beneficial seems to be associated with a consistent reporting rate of adverse events.

Dr Ramesh Manocha

none

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.

none

Although many of meditations adverse effects reported in literature are anecdotal cases studies, incidental findings or unexpected outcomes it is clear that meditation is not a universally benign intervention and that it can be associated with both serious and non-serious adverse reactions. Some studies, such as those of Otis (1984) and Persinger (1993, 1992), suggest a dose response relationship whereas others, such as that of Xu (1994), suggest an unpredictable idiosyncratic effect.

For more information regarding future research that needs to investigate the adverse effects of meditation, check Dr Ramesh Manocha’s blog.

none

Kennedy (1976) described 2 cases in which de-personalisation appeared to be triggered by meditation. The first case developed after the subject used breathing and meditation exercises described in a book on self-development. The experience continued for at least 16 months. The second case involved the use of meditation techniques recommended by the Arica Institute. While at first pleased with the experiences, the subject soon found he was unable to maintain a job and needed professional help.

More information about Kennedy’s study and the adverse effects of meditation can be found at Dr Ramesh Manocha’s blog.

none

Shapiro (1992) observed the effects of vipassana meditation on a small group of meditators and found that while most participants experienced positive results, a small number of meditators experienced distinctly negative states.

Glueck (1984) studied 110 participants and reported that the practice of transcendental meditation (TM) appeared to release repressed subconscious impressions. A small proportion of participants reacted adversely to this experience. Heide (1983, 1984) found that 54% of anxiety prone participants demonstrated increased anxiety during mantra meditation modelled on TM. Otis (1974) observed a cohort of 62 novices who tried TM and concluded that it was not suitable for those with serious emotional problems.

Read more about the research into the adverse effects of meditation here.

Ramesh Manocha.

none

Lazarus (1976, 1984) described several cases in which psychiatric problems such as depression, agitation and schizophrenic de-compensation were observed. These included a 34 year old woman who became suicidal and a 24 year old woman who experienced severe de-personalisation, apparently as a result of transcendental meditation (TM). He also suggested that participants who failed to experience the benefits of meditation might experience a sense of failure and anxiety rather than the enhanced self-understanding that they perhaps were looking for.

Ramesh Manocha.

none

A study commissioned by the German government (1980) to assess the effects of TM on youth created controversy when it reported that the majority of participants observed during the trial experienced psychological problems, worsening concentration and variety of physical complaints. Publication of the study was unsuccessfully contested by the TM organization in the German courts.

More information on the adverse effects of meditation can be read at Dr Ramesh Manocha’s blog.


A study commissioned by the German
government to assess the effects of TM on youth created controversy when it
reported that the majority of participants observed during the trial experienced
psychological problems, worsening concentration and variety of physical
complaints
557. Publication of the study was unsuccessfully contested by the TM
organization in the German courts.

none

archives