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


Dr Ramesh Manocha explains why strong controls are necessary when researching the real-world relevance of meditation in this excerpt from his thesis:

“Some might argue that controlling for non-specific effects is an academic exercise with little real-world relevance. This is supposedly because factors such as the placebo effect, expectancy of relief and demand characteristics are a critical component of most health interventions when administered to patients in the field. Thus trials directed at assessing the ecological (“real-world”) relevance and validity of an intervention have no need to control for factors which will be operating in conjunction with the intervention effect anyway. Authors of such reports add that studies with these kinds of controls reflect real-world scenarios since study participants offered either meditation or the “usual care” (i.e. usually nothing) reflect the reality of their environment. This line of argument assumes that the only value of proper controls is its ability to help answer theoretical questions about meditation, but that such controls fail to allow meditation to demonstrate its “practical relevance”.

“Yet commercial purveyors of meditation frequently claim that their often expensive proprietary techniques are uniquely effective in order to justify expensive fees. Moreover, many meditation techniques can be arduous and culturally challenging. It is important to determine whether it is justifiable to demand these significant costs and efforts or whether the same effects might be elicited by simpler strategies that are similarly rich in non-specific effects but possibly cheaper and easier to implement. By controlling for non-specific effects, it is possible not only to provide important theoretical information about whether meditation has any unique effects, but also whether it is an economically justifiable option, whether it offers any more of an advantage over accepted strategies and whether the claims of meditation enthusiasts have any basis.”

More information about Dr Manocha’s research can be found at his website.