Why meditation


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This is a report made by Dr. Ramesh Manocha, who have used Sahaja Yoga Meditation for the improvement of symptoms and treatment of asthma, headache, menopause and depression.

Have a look, and feedback and comments are appreciated.

More information at: sahajayoga.org or at sahajayoga.dk

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Why meditation

  1. 1. Why meditation?BACKGROUND While many general practitioners perceive meditation as an acceptable, evenmainstream, health care strategy, it is paradoxically a poorly understood discipline.OBJECTIVE To define meditation, outline the broad types of meditation and give an overview of theextent and validity of available evidence for its efficacy.DISCUSSION The basic question of what constitutes meditation and what separates it from relaxationtherapy has been an impediment to formulating quality studies in order to research meditationtechniques. Examining the literature using evidence based criteria reveals that, while meditation doesappear to have therapeutic potential, there is a great need for further research before definitiveconclusions can be made. Researchers have yet to systematically compare different techniques ofmeditation to compare their profiles.M e ditatio n is se e n by a numbe r of The need f or an evidenced based rese arche rs as po te ntially o ne o f the approach most effective forms of stress reduction.1 A recent survey of A ustralian general practition-While stress reduction techniques have been culti- ers showed that while GPs perceived meditation asvated and studied in the West for approximately an acceptable, even mainstream, health care strat- Ramesh M anocha70 years, the data indicates that they are not con- e gy, it is parado xically a po o rly unde rsto o dsistently effective.2 discipline. In view of this, the authors concluded Meditation however, has been developed in that we ll de signe d trials and e ducatio n areEastern cultures and has a documented history of urgently needed to inform GPs’ decision making.6more than several thousand years. Eastern medita- M editation vs relaxationtive techniques have been developed, trialed andrefined over hundreds of generations with the spe- Implicit in the fact that the term ‘meditation’ existscific intention of developing a method by which separately from that of ‘relaxation’ suggests thatthe layperson can regularly attain a state of mental there should be clear differences between the twopeace and tranquillity, ie. relief from stress. It is a phenomena. However, there is as yet insufficientstrategy that can easily be adapted to the needs of evidence to draw a clear distinction. Moreover,clinicians and their patients in the West. researchers have yet to systematically compare dif- Ramesh Manocha, A U S study for example, showed that a short fe re nt technique s o f me ditatio n to de te rmine MBBS, BSc, is Barry Wren Fellow, Royalcourse of behaviour modification strategies that whether or not these techniques use different or Hospital for Women,included meditation led to significantly fewer visits similar mechanisms or have differing effect profiles. New South Wales.to physicians during the six months that followed. Lack of quality researchThe savings we re e stimate d at ove r $200 pe rpatie nt.3 A study of insurance statistics showed Despite the breadth of information available on med-that the use of medical care was significantly less itation, a report of the US National Research Councilfor meditators compared to nonmeditators.4 (NRC) on meditation raised concerns about weak The growing emphasis on: methodology and poor definition of the process.7• quality of life outcomes Examining the literature using evidence based• concepts such as psychoneuroimmunology or criteria reveals that while meditation does appear mind–body medicine,5 and to have therapeutic po te ntial, the re is a gre at• reducing healthcare costs need for further research before definitive con-suggest that stress reduction and improving mental clusions can be made . The body of knowle dgehe alth are becoming incre asingly re le vant to currently suggests that not all meditation tech-healthcare. ni que s are the same ; mo st te chnique s are Australian Family Physician Vol. 29, No. 12, December 2000 • 1135
  2. 2. ■ W h y m e d it a t io n ? pro bably e labo rate re laxation me tho ds while Meditatio n is popularly perceived to be any there are others that may well involve physiologi- activity in which the individual’s attention is pri- cal processes unique to meditation. marily focused on a repetitious cognitive activity. The Meditation Research Program (MRP) is This very broad definition is, in the opinion of the o ne o f the o ngo ing activitie s o f the N atural MRP, the main cause for much of the inconsistent Therapies U nit at the Royal Hospital for Women outcomes seen in meditation research. in Sydney. The MRP is committed to thorough sci- entific evaluation of meditation, its physiological ‘Thoughtless aw areness’ effects and its potential for healthcare. If one closely examines the authentic tradition of meditation it is apparent that meditation is a discrete What is m edit at ion? and well defined experience of a state called ‘thought- There are many forms of meditation, ranging in less awareness’. This is a state in which the excessive complexity from strict, regulated practices to general and stress producing activity of the mind is neutralised recommendations. If practised regularly, meditation without reducing alertness and effectiveness. is thought to help develop habitual, unconscious A uthentic meditation enables one to focus on microbehaviours that can potentially produce wide- the ‘present moment’ rathe r than dwe ll on the spread positive effects on physical and psychological unchangeable past or undetermined future. It is functioning. Meditation even for 15 minutes twice a this state of equipoise that is said to be therapeutic day has been shown to bring beneficial results.3 both psychologically and physically and which fun- damentally distinguishes meditation from simple How does meditation w ork? relaxation, physical rest or sleep. Parasym pathetic response Reducing ‘background m ental noise’ Most theories are based on the assumption that A cco rding to this pe rspe ctive , stre ss is the meditation is a sophisticated form of relaxation inevitable byproduct of an overactive mind. The involving a concept called the parasympathetic unsilenced mind is responsible for almost continu- response. Psychological stress is associated with o us ‘background me ntal no ise ’ the co nte nt o f activation of the sympathetic component of the which is mostly unnecessary and unproductive. Yet autonomic nervous system which, in its extreme, it is this ‘mental noise’ that impinges on our other- causes the ‘fight or flight response’. Meditation and wise natural te nde ncy toward psycho lo gical, any form of rest or relaxation acts to reduce sym- mental and spiritual health. pathetic activation by re ducing the re lease o f Quasi-meditation catecholamines and other stress hormones such as cortisol, and promoting increased parasympathetic Most commercialised meditation techniques do not activity which in turn slo ws the he art rate and reliably give the key experience of mental silence improves the flow of blood to the viscera and away or ‘thoughtless awareness’ hence they can more from the periphery. precisely be described as ‘quasi-meditative’. These include methods that use constant repetition of Other neurophysiological effects syllables (such as mantras), visualisations or other Other proponents claim that meditation involves thought forms. unique neurophysiological effects; however, this This does not mean they may not be useful as remains to be proven. Research at the MRP sug- they do encourage relaxation by reducing or simplify- gests the limbic system may be involved in Sahaja ing mental activity or focusing attention. However, yoga meditation (SYM) since significant effects well designed physiological and clinical trials have, on invo lving mo o d state have be e n co nsiste ntly the whole, shown little difference between these tech- observed. niques and physical rest or relaxation.8 Defining w hat w e mean by meditation Types of m edit at ion The most important issue that must be addressed in There are many meditation techniques available to this field of research is to clearly define meditation consumers. Three notable examples include trans- and then subject that definition to scientific testing. cendental meditation, mindfulness and Sahaja yoga.1136 • Australian Family Physician Vol. 29, No. 12, December 2000
  3. 3. W h y m e d it a t io n ? ■Transcendental meditation time. There is no fee for these retreats but ‘recom-Transcendental meditation (TM) is the commonest mended donations’ are described. These retreatsform of mantra meditation. It aims to prevent dis- are unsuitable for the average person, particularlytracting thoughts by use of a mantra. Students are tho se unfamiliar with me ditatio n, due to theinstructed to be passive and, if thoughts other than e xtre me physical and psycho logical de mands.the mantra come to mind, to notice the m and A dverse events associated with Vipassana havereturn to the mantra. A TM student is asked to been described although it is unclear as to whichpractise for 20 minutes in the morning and again in form these reports refer.17the evening. Sahaja yoga meditation Transcendental meditation is said to be associ-ated with clinical outcomes such as blood pressure Sahaja yoga meditation (SYM) is the technique ofre d u c t i o n9 and physiolo gical change s such as choice in the MRP. Sahaja yoga meditation aims tolowered blood cortisol levels.10 promote the experience of ‘thoughtless awareness’ base d o n the o riginal me ditative tradition.Adverse effects Meditators in the MRP consistently describe theThere are however, a number of case reports in the ability to achieve this experience. They are encour-mainstream medical literature describing occasional aged to practise twice daily for approximately 15adverse psychological11,12 and physical effects13 that minutes. Sahaja yoga meditation is well suited forappe ar to be causally re late d to the te chnique. the general population and for research, because itThese adverse events range from mild to severe and is easy to learn and is taught free of charge. Sahajawarrant further systematic investigation.14 yoga meditation is currently used in three Sydney hospitals for patients, staff and public. FeedbackCost issues from management teams and anecdotal reportsThe technique is taught using a commercial system from patients and carers are favourable. A s yet noin which o ne be gins by purchasing a mantra. adverse effects have been reported in the MRP’sFurther instruction entails an escalating system of trials, clinics or in the literature.fees that can be cost prohibitive. Moreover, the TM The MRP has conducted a number of small andorganisation has on occasion been implicated in large trials on SYM which have generated promis-unethical and cultic practices.15 In light of this infor- ing results in A ustralian conditions. A randomisedmation, medical practitioners have no choice but to co ntro lle d trial o f me ditatio n for mo derate torecommend caution with regard to this method. se ve re asthma compare d SYM to a re laxatio n control. SYM was more effective in a number ofM indfulness and Vipassana meditation objective and subjective endpoints.Mindfulness is a general method that serves as a A number of locally conducted pilot studiesbasis for techniques such as Vipassana meditation. examining the effect of SYM suggest that it mayIt aims to use focused attention (often by using a have a beneficial role in menopausal hot flushes,physical sensation such as the breath) to cultivate se ve re migraine and psycho lo gical stre ss.mental calmness. Regular practice enables one to Randomised controlled trials are underway in orderobjectively observe one’s thoughts and therefore to obtain definitive data. Studies in India suggestenhance one’s self unde rstanding. Mindfulne ss that SYM is more beneficial than mimicking exer-approaches have be en shown to be effective in cises in the treatment of epilepsy and hypertension.18certain clinical applications such as chronic pain.16 Vipassana is both a general term referring to a Recom m ending m edit at ionspecialised form of mindfulness meditation and t echniques t o pat ient salso a specific brand name. The following informa- General practitioners must exercise commonsensetion re fers to the latter. Vipassana is taught in and discrimination when recommending medita-A ustralia via a number of Vipassana retreats and tion to their patients as they have a duty of care tocentres. The retreats involve up to 10 days of inten- ensure the safe ty of their patients’ he alth andsive meditation, several hours per day, and other finances. Meditation is contraindicated in thosestrict observances such not talking and encourage- suffe ring fro m psycho sis and sho uld o nly bement to maintain strict postures for long periods of applied with great caution in those with severe psy- Australian Family Physician Vol. 29, No. 12, December 2000 • 1137
  4. 4. ■ W h y m e d it a t io n ? chological problems. The medicolegal implications contemporary perspectives. New York: Alden, 1984. 15. Skolnick A. Maharishi Ayur-Veda: Guru’s marketing of re commending a te chnique that leads to an scheme promises the world eternal perfect health! adverse event have not been explored. JAMA 1991; 266(10):1741–1750. A simple and e ffe ctive rule o f thumb when 16. Kabat-Zinn J, Lipworth L, Burney R, et al. The clinical use of mindfulness meditation for the self regulation of choosing or recommending a meditation technique is chronic pain. J Behav Med 1998; 8(163):190. to assume that ‘the best things in life are free’. 17. Shapiro D, Deane H. Adverse effects of meditation: A Organisations involved in the commercialisation and preliminary investigation of long term meditators. Int J Psychosom 1992; 39:1–4; SI:62–67. marketing of often costly ‘meditation’ techniques, 18. Panjwani U, Selvamurthy W, Singh S H, Gupta H L, courses and ‘master classes’ are least likely to be Thakur L, Rai U C. Effect of Sahaja yoga practice on selling an authentic method. Unfortunately in these seizure control & EEG changes in patients of epilepsy. situations the welfare of the individual and the com- Ind J Med Res 1996; 103(3):165–72. munity usually become secondary to profit or fame. References 1. Hassed C. Meditation in general practice. Aust Fam S UM M AR Y OF Physician 1996; 25(8):1257–1260. I M P OR T A N T P OI N T S 2. West M (ed). The psychology of meditation. Oxford: Clarendon Press, 1987. 3. Achterberg J. Mind body interventions, meditation. In: • Meditation can be an effective form of Berman B. Alternative medicine, expanding medical stress reduction and has the potential to horizons. Washington DC: Office of Alternative improve quality of life and decrease Medicine, National Institute of Health, 1992. healthcare costs. 4. McSherry. Medical economics. In: Wedding D, ed. Medicine and behaviour. St Louis: Mosby and Co, • Although meditation differs from relaxation 1990:463–484. techniques, the components which 5. Sommer S. Mind body medicine and holistic constitute this difference have not yet been approaches: The scientific evidence. Aust Fam clearly defined. Physician 1996; 25(8)1233–1242. • Meditation involves achieving a state of 6. Pirotta M V, Cohen M M, Kotsirilos V, Farish S J. ‘thoughtless awareness’ in which the Complementary therapies: Have they become accepted excessive stress producing activity of the in general practice? Med J Aust 2000; 172:105–109. mind is neutralised without reducing 7. Druckman D, Bjork R A, eds. In the mind’s eye: enhancing human performance. Washington DC: alertness and effectiveness. National Academy Press, 1991. • Authentic meditation enables one to focus on 8. Fenwick P B, Donaldson S, Gillis L, et al. Metabolic the present moment rather than dwell on the and EEG changes during transcendental meditation: an unchangeable past or undetermined future. explanation. Biol Psychol 1977; 5(2):101–118. • There is little quality evidence comparing 9. Schenider. In search of an optimal behavioural treat- one meditation technique with another or ment for hypertension: a review and focus on transcendental meditation. In: Johnson E H, ed. meditation with relaxation techniques. Personality, elevated blood pressure and essential • The theoretical explanation for the effects of hypertension. Washington DC: Hemisphere. meditation and relaxation techniques is that 10. Maclean C, Walton K. Effects of the Transcendental the release of catecholamines and other Meditation Program on adaptive mechanisms: Changes in stress hormones are reduced and hormone levels and responses to stress after four months of parasympathetic activity is increased. practice. Psychoneuroendocrinology. 1997; 22(4): 277–295. • Whether meditation involves other unique 11. Heide F J, Borkovec T D. Relaxation induced anxiety: neurophysiological effects remains to Mechanism and theoretical implications. Behav Res be proven. Ther 1984; 22:1–12. 12. The various implications arising from the practice of transcendental meditation: an empirical analysis of pathogenic structures as an aid in counselling. Bensheim, Germany: (Institut fur Jugend und REPRI NT REQUESTS Gesellschaft, Ernst-Ludwig-Strasse 45, 6140); The Institute for Youth and Society, 1980. Dr Ramesh Manocha 13. Persinger M A. Transcendental meditation and general Natural Therapies Unit meditation are associated with enhanced complex Royal Hospital for Women partial epileptic-like signs: evidence for cognitive kin- Locked Bag 2000 dling? Percept Mot Skills 1993; 76:80–82. 14. Otis L S. Adverse effects of transcendental meditation. Randwick, NSW 2031 In: Shapiro D, Walsh R, eds. Meditation: classic and Email: R.Manocha@ unsw.edu.au1138 • Australian Family Physician Vol. 29, No. 12, December 2000