No Such Thing as a Free Lunch: Even Mindfulness Has A Downside

I’ve spent a lot of time the past few weeks thinking about the limitations of mindfulness and the potential benefits of non-mindful activities like mind-wandering. I have done this deliberately, not to make myself feel better about a dry period in my own meditation practice, but to address a blind spot in my thinking.

I am a fan of the neurodiversity perspective on psychological “disorders”, and my own research is currently heavily biased on the costs and benefits of different approaches to a task, and yet I like most others saw only the good that might come from mindfulness and meditation. It brings you into the present moment! It promotes loving-kindness! It can treat depression as well as drugs! It improves your cognitive function!  Aside from the effort required, I came across not one mention of a downside of either mindfulness or meditation in the first four years of my own flirtations with mindfulness.

I owe my wake-up call to Dr. Willoughy Britton, of Brown University’s Contemplative Studies Initiative, who came to give a talk at the ACMHE’s Summer Session in Contemplative Pedagogy, about her research into the psychological disturbances meditators may suffer.

In many ways, this should not be new ground. Classic Buddhist texts see meditation as anything but a  linear path; there are “stages of insight” on the path to enlightenment that include both the positive experiences everyone thinks about but also negative ones that arise from taking a hard look at the nature of suffering and the fact that everything is impermanent. These negative moments seem to have been left behind as mindful meditation reached the mainstream; possibly, because suffering and impermanence are the heart of Buddhist philosophy, and the Western take on meditation is quite secular. I can easily imagine anyone looking at the distress mentioned as accompanying some of these stages of insight, and dismissing them because their meditation is secular, focused on being present and aware, and not a heavy contemplation of suffering.

There is compelling evidence that there is some risk to meditation even when it is stripped of Buddhist trappings. The DSM, which defines all psychological disorders from autism to pica, has a little-known section on “culture-bound syndromes” (which even this Psychology Ph.D. learned about from that online magazine), or disorders that only impact certain cultures or countries. One of these is associated with qi gong, a contemplative practice that shares features with meditation and yoga often promoted as a natural health care approach. Qi gong is more focused on channeling energy than on existential questions of suffering and impermanence, but in China at least it is known to contribute to psychiatric disturbances called “qi gong deviation syndrome” featuring anxiety, delusions, impaired functioning, and a risk for suicide. The cause is so-called “imperfect” practice, and for those of us picking up meditation and other holistic practices from a book or a quick course, I have no doubt that we have some imperfections in there somewhere.

Moving from qi gong to meditation, Dr. Britton found some compelling evidence that meditation has similar risks for psychological disturbance. This kind of research is incredibly difficult to conduct; a psychological reaction to meditation is not something you can or should produce in someone on demand, and in the normal course of events it’s difficult to tell whether someone’s reaction stems directly from meditation (for example, if they’re meditating to help with depression, no one can really tell if a depressive episode is the disease returning or a result of meditation). As a first step into this research, Dr. Britton followed referrals from a number of devoted meditation teachers and contact meditators who reported some kind of difficulty that they connected to their meditation.

There is a lot researchers still cannot say about these disturbances. Practitioners have reported many symptoms, from impaired functioning to distorted perceptions, anxiety, physical symptoms like nightmares and fast heart rate, and a loss of the sense of self, but there isn’t enough information to decide which symptoms are common, let alone necessary for the disturbance to be considered clinical. What they can say is that some assumptions people might make to dismiss concerns about negative meditation experiences are not founded. People reporting difficulties crossed many lines: both male and female; both with a history of trauma and with a clean psychological slate, both participating in an intense meditation retreat and just going about their daily meditation practice.

Most critical to me is that people did not have to be experienced meditators trying to push their meditation to a deeper level to experience problems. Although the average time practicing meditation before these difficulties arose was about 10 years, there was at least one person (out of 25 total) who experienced these problems after just 1 month. I’d like to think this is the person whose symptoms resolved after only 2 days (instead of the average 4.5 years), but even that positive spin can’t hide the fact that even new students in a traditional MBSR course might be at risk. I remember several people dropping out of the MBSR course I took during graduate school; I have the impression that they mostly just found it too much work and not particularly helpful, but the possibility remains that they found it actually created problems instead of just failing to solve them.

As thought-provoking as this research is, I cannot emphasize enough that it is all preliminary; although a peer-review journal article is planned in the next few years, I’m working off of notes from a research presentation and a handout from a poster at an unspecified conference. These are reasonable sources of information and a critical way for researchers to share their findings (because the road to peer-reviewed papers is a very slow one; I myself have several findings that have been presented at conferences that will get published, once I navigate rounds of reviewing and revising), but they don’t have the weight of an official publication, and they don’t have the detail that allows for really fine analyses of what’s going on and why.

Personally, I am still going to try to develop my meditation practice, and will still have my students take a few minutes of mindfulness at the start of class. But I have accepted the reality check the mindfulness is one way to approach the world, and that we need to be aware of both what we can gain from it and what we might risk by practicing it. It’s not a panacea, not a miracle cure, not the single best way to approach life; but it is a potentially helpful tool. Right now I believe the positives outweigh the negatives, and I don’t anticipate that changing – the rates of these difficulties are higher than you might expect, but they aren’t catastrophic – but I have been reminded that there are negatives, and I should keep myself aware of what I might not like as well as what I love to hear.

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3 thoughts on “No Such Thing as a Free Lunch: Even Mindfulness Has A Downside

  1. Golden rule seems to stand, everything to be tested, tested, tested – and never blindly accepted on some authority…. I am am bit worried seeing today meditation teachers treated as celebrities and have their theories accepted on faith. Thank you for bringing this out!

  2. I had a bad experience on a recent MBSR course, and left the course. I became severely depressed doing one of the home exercises, but when I said this at class the teacher carried on as if I had said it was a nice day. Because of her response, I no longer felt safe at the course, so I left – after which my depression dissipated. (I wondered if her mindful practice allowed her to be oblivious to the fact that what I said something to be dealt with, not just a thought floating by). I raised the issue with her, but her sole response was that this was not a psychotherapy course. In fact, it was probably a simple case that I was going into the exercise too deeply, but she did not give me a chance to explore this at class. I have since been told by a counsellor that a considerably number of people run into issues at Mindfulness classes because the teacher does not listen to the students. I am now researching negative reports on mindfulness, but they are incredibly hard to find. I do not believe I am the only one to have this experience, or similar. I see benefits of limited meditation and awareness of the present moment to stop my mind going all over the place, but I am more cynical about the buzz word that is Mindfulness (and big business).

    • This is one of the risks of the current attitude toward a lot of mindfulness and meditation; seeing it as wholly positive with no possible downsides mean teachers are unprepared and dismissive if someone does have a bad experience. It makes mindfulness seem more like a cult and less like a careful philosophy with benefits that (usually) outweigh the risks.

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