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.

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

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

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

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

The conceptualisation of meditation as involving mental silence is virtually absent in Western scientific discussion. Why has this important notion been ignored? How did contemporary, popular notions of meditation become almost diametrically opposed to the ancient Indian ideas which form their source? Some explanations are examined below.

When René Descartes made the philosophical statement “cogito ergo sum” (I think therefore I am) in his Principles of Philosophy he laid down a foundation element of Western philosophy. The “cogito ergo sum argument” essentially states that “I am thinking therefore I exist”. The metaphysical implications of Descartes’ phrase, which equate thinking activity with self identity contrast sharply with the Eastern metaphysical idea that existential reality can be perceived only when one is not thinking, which might be stated in Latin as “sum cogito ergo” — I am, therefore I think!

The influence of Descartes’ “cogito” on Western thought is widely acknowledged and cannot be overstated. It offers some explanation as to why the idea of mental silence has failed to find currency in the Western scientific literature on meditation. For example, Wright (2001), in an attempt to dispel myths and misconceptions about meditation (as he, a Western scientist, sees it) completely contradicts the Indian tradition when he states:

When we close our eyes to meditate our mind does not go completely blank, void of thoughts at one with the universe, because just as hearts are meant to beat and lungs to breath, brains are meant to think and will never be completely devoid of thought, perhaps until they are dead.

Wright’s comments in many ways are a reflection of Descartes’ cogito argument. It suggests that Western scholars having been brought up in the milieu of a Western philosophy built on the notion of “I think therefore I am”, might have difficulty acknowledging the possibility that a state of consciousness which is devoid of thought might be possible.

Dr Ramesh Manocha

Sahaja is one of a number of terms that have been used to describe the trans-mind condition. Sahaja is derived from the Sanskrit saha, meaning “together” and ja, meaning “born” and can be translated to mean “innate”. It is a term that has long been associated with Indian mystical thought and practice, although its popularity has fluctuated as different Indian spiritual movements encouraged, revised or ignored it. Davidson provides seven contexts in which sahaja has been used over the recorded history of Indian, especially Buddhist, spiritual thought. The most pertinent to this discussion include the assertion that sahaja is:

“[A] fundamental, irreducible condition, decidedly a noun. It is roughly equivalent to svabh¯ava or svar ¯upa, and is used to described the inherent and inalienable attributes that exist irrespective of accidental circumstances.”

And,

“The present moment when one thing occurs with another, a temporal value differentiated from the prior and subsequent moments, when the two items were not associated.” (Davidson, 2002)

Synonymous terms and ideas include jivan mukta, “Buddha state” and “liberation”. Modern Western equivalent descriptions might include, but are not restricted to, “unitive state”, “self-realisation”, “self-actualisation”, “peak experience”, “sainthood” and “state of grace”.

Sahaja signifies one’s natural or spontaneous self, divested of all external influences and the mental conditioning produced by them. This natural state is demonstrated by young children, for example, who are free of the complex adult mind and its attendant pretences, “hang-ups” and neuroses. The sahaja state flows naturally to the one who has attained the depths of meditation and is therefore a logical consequence of the mental silence or “trans-mind” principle — a kind of renascent freedom. It can be described as the optimal state in which the body, the psyche and the soul find a synergistic integration to realise the potentiality that exists within each human being.

Dr Ramesh Manocha

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

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

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