The effects of meditation on anxiety and stress are comparable to effect sizes described in conventional meta-analyses of psychotherapy field studies. For example Mattick’s (1990) review of psychotherapy for neurotic patients reported a mean effect size of 0.74 for verbal psychotherapy and 0.97 for behavioural psychotherapy vis-a-vis a mean effect size of 0.55 for placebo. My review of meditation on the other hand found a mean effect size of 0.90. It should be noted however that the meditation studies focused on participants with non-pathological anxiety states, raising the possibility that the potential impact of meditation may be limited by a “ceiling effect” due the recruited sample’s relatively mild symptomatology and hence minimal scope for clinical improvement.

Dr Ramesh Manocha

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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

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Meditation is widely perceived in the West as an effective method of reducing stress, and enhancing wellbeing. In Australia, a survey conducted by Kaldor (2002) of a randomly selected but representative sample drawn from the state of Western Australia (n=1,033) found that 11% of respondents had practiced meditation at least once. The Australian Community Survey (ACS), conducted by the National Church Life Survey (2004) found that 1.5 million Australians had tried meditation within 12 months of the time of the survey and that while 29% of those surveyed found prayer to be a source of peace and wellbeing, 24% had used meditation to achieve the same effect! Only 21% reported church attendance as a source of peace or wellbeing. In fact the ACS reports that although only about 20% of Australians attend church monthly or more often “around 33% of Australians pray or meditate at least weekly”.

This situation in Australia reflects trends in other Western countries. In 2002 a National Health Interview Survey (NHIS), undertaken by the Centers [sic] for Disease Control and Prevention (CDC) in the United States administered to 31,000 representative adults, demonstrated that 8% of respondents had practiced meditation at some time. That biomedically trained physicians in Australia were also advising patients about the therapeutic effects of meditation, was demonstrated when Pirrotta conducted a survey of Australian GPs in 2000.

Dr Ramesh Manocha

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The direct impact of negative thoughts and emotions on immunological function seems to be reasonably well documented and, since many Psychoneuroimmunology (PNI) phenomena seem to be mediated by negative affect, rather than situational “stress”, strategies that directly modify this factor may manifest greater benefits. While relaxation orientated meditation most likely acts to reduce the impact of stress that are mediated by neuroendocrine mechanisms such as the sympathoadrenal and hypothalamicpituitary axes, so too do other strategies that reduce physiological arousal. It might be argued that since mental silence approaches to meditation aim to not only reduce physiological arousal but also mitigate negative rumination and affect this may be one reason why it seems to be associated with a specific effect.

For more information on the effect a negative mood can have on the immune system, check out Dr Ramesh Manocha’s article on Psychoneuroimmunology.

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