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

none

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

none

Practitioners of sahaja yoga meditaiton (SYM) consistently report that the state of mental silence is characteristically associated with other subjective phenomena such as a natural focusing of attention and a sense of wellbeing which somehow leads to improved physical health. A number of SYM practitioners do describe occasional transcendent experiences, with concomitant benefits to physical and mental health, that in many ways reflect traditional descriptions of mystical experiences and states such as Sahaja yogic tradition, as well as modern SYM practitioners ascribe these experiences to a unique, spontaneous and more or less involuntary psycho-physiological process that occurs during meditation. The process is said to involve a system of yogic energy centres (chakras), interconnecting channels (nadis) and activating energy (kundalini). Modern proponents of the yogic tradition put this “psychic anatomy” forward as a kind of psychosomatic theory of health.

Ramesh Manocha.

none

The mechanism of action provoked by meditation is thought primarily to involve its ability to reduce stress. There are two main theories about how this happens. First, that it reduces somatic-arousal thereby reducing the reactivity of the individual to environmental stressors and, second, that it alters the individual’s cognitive appraisal of and perceived self-efficacy with regard to stressors. By eliminating background mental noise, the meditator probably increases internal and external awareness and therefore somehow achieves more veridical perception, reduced negative affect and improved vitality and coping capacity.

Ramesh Manocha

none

archives