Meditation, is that what you need? Part 1: What Does the Science Say?

For those of you with limited time/non uber-geeks, here’s the gist of the article:

Summary

Meditation and Mindfulness are becoming very popular practices within the health/fitness/well-being/self-improvement world, indeed, I have been trying it myself on and off for the last 5 or so years.

Analyse the available body of research however, and there’s actually very little evidence to show that it “works”.

Proponents claim that it can improve concentration and memory, reduce anxiety, stress and physical pain, and boost empathy and compassion, whilst reducing aggression and prejudice.

Unfortunately the truth is that the evidence for the above is at best very weak, at worst completely lacking.

This is not to say that meditation definitely does not work. Possibly it does. But the science required to find out for sure would require a lot of time and money, which currently it seems no one wants to spend.

Below is a detailed review of the current state of the research, should you be interested. If not, come back for part 2 where I’ll be talking more about my personal experiences with meditation, and whether I’ll be continuing based on the finding I made while researching this article.

Full Article: [est_time] estimated total reading time

I have been “practising mindfulness meditation” on and off for several years now.

Regular readers of this blog will know that when it comes to evaluating claims for interventions/practices that promise to improve health and well-being, I am highly sceptical, and always try to let the science inform my choices.

Both Steven Novella, and the Science-Based Medicine website, are sources of information in which I place a high degree of trust, so it caught my attention when I saw the articles by Steven Novella Is Mindfulness Meditation Science-Based? and Mindfulness No Better than Watching TV.

Mindfulness and Meditation are very popular at the moment, and there are no shortage of books, articles and websites claiming that there is an every growing mountain of scientific evidence to back up its efficacy.

But, as I have written about many times before on this blog, neither of the above factors are actually any kind of indication that there is really any scientific evidence to back up a claim. Mountains of evidence often turn out to be mole hills of at best, very weak studies, at worst potentially fraudulent ones.

In this post, I want to put forward my take on the Novella articles, plus do my own review of the current literature on mindfulness meditation to see if I come to the same conclusions.

Meditation no Better than Watching TV?

I must say, I’m very disappointed in Mr Novella for his use of this title on his blog.

I’m not sure if it’s written as click bait, or whether it was written out of a genuine “belief” that meditation is worthless pseudoscience. Either way, it shows a lack of respect for the topic and the audience in my opinion, and is certainly not conducive to opening productive conversation on the topic.

A better title could have been “Meditation MAY BE no Better than Watching TV FOR ALTERING PROSOCIAL BEHAVIOUR” but I guess that’s just not catchy enough.

The article goes on to dismiss meditation and mindfulness on the basis of a systematic review and meta-analysis that looked at the effect of meditation on prosocial behaviours such as compassion, empathy, aggression, connectedness and prejudice.

The Science Based Medicine article is much more tempered, I can only imagine his articles here are subject to editing and moderation, resulting in a more objective article.

Again, the article is based on the results of a systematic review/meta study: Mind The Hype (Full Text PDF Download)

Despite the fact that Novella seems to have already made up his mind that mindfulness and meditation are woo woo nonsense (“I find these results entirely unsurprising”), I must say that I do actually agree with most of what is said in the articles. Namely, that many claims for meditation are not supported by strong evidence, more research is needed, and that the terms mindfulness and meditation aren’t clearly defined and could in fact refer to multiple diverse practices (This is basically the conclusion of the Mind the Hype review).

Having said that, I’m not sure I agree with his use of the acupuncture comparison. I don’t think anyone is calling for more acupuncture research. It’s been pretty conclusively shown to be nothing more than placebo. I don’t think that this is the case for meditation.

He is perhaps closer to what I believe when he says “I think the best current summary is to consider mindfulness like yoga, or a specific form of exercise. There is evidence that doing yoga has specific health benefits. However, those benefits are likely not specific to yoga and are universal to exercise. It is therefore more accurate to say that exercise has many health benefits, and yoga is a form of exercise”.

Perhaps a better comparison than acupuncture, though I’d say that it’s more likely the reverse. That is to say that mindfulness and meditation practice is like “exercise”. Exercise itself is a pretty nebulous term that can have a wide range of effects. I think the realm of fitness, exercise and training is not one with which Novella is particularly familiar, but those of us who are, I don’t think we’d expect to see “universal results” regardless of the modality employed. You wouldn’t randomly assign subjects to practice either yoga, power lifting or marathon running and expect to see the same outcomes. Or at least no decent coach I know would!

I’ll return to this analogy between meditation and exercise in a second, but before I do, I also have to comment that it’s interesting Novella A) Neglects to mention the potential negative effects of meditation cited in the Mind the Hype Study, and B) Has chosen to comment upon 2 systematic reviews that show little to no benefit, whilst ignoring others which have shown benefits, such as a 2014 meta-analysis of 47 placebo controlled studies which found that mindfulness meditation resulted in moderate improvements in anxiety, depression and pain.

One has to consider that there is some selection bias going on here – Are the potential negative effects ignored because to acknowledge them is to acknowledge effects in general? Is the meta-analysis which finds positive results ignored because it doesn’t fit Novella’s belief that meditation is worthless?

Before moving on to look in more detail at the 3 systematic reviews and going deeper into the exercise/meditation analogy, I think it’s worth pointing out a couple of comments below Novella’s blog post, one from Novella himself where he kind of tries to make amends for the title (but doesn’t change it) and clarify some points, and another by Ted Meissner, author of the Mind the Hype review who makes some excellent points.

Exersise for the Mind?

I’m going to begin by looking at the 3 aforementioned meta-studies, to see what we can glean from them.

Meta Study 1 – Prosocial Behaviour

The limited prosocial effects of meditation: A systematic review and meta-analysis.

Using the exercise analogy, this study is IMHO akin to conducting a meta-analysis into the effect of “Going to the Gym” on achieving a 2.5 x Bodyweight Deadlift.

Why do I say this?

The goal of a 2.5kg Deadlift, like the goals of bringing about positive changes in compassion, empathy, aggression, connectedness and prejudice is pretty hefty, to say the least. I’d like to think that they are all goals which could be achieved by anyone, given the right opportunities, environment and motivation, as would be a 2.5 x BW deadlift, but it’s no mean feat.

I say “Going to the Gym”, as the different interventions assessed, are all different, not necessarily targeted to these specific outcomes, and perhaps most importantly all for either short, or very short, durations.

Over 1/3 of the studies involve interventions of less than 15 minutes, most of these just 5-7 minutes!

Would we look at a meta-study into exercise that looked at the effects of people performing single workouts of 15 minutes or less, and then conclude exercise as ineffective as there was no improvement in strength or endurance? I think not.

The majority of the studies are periods of 6-8 weeks. One could certainly expect to see some improvements from a targeted exercise program in this amount of time, particularly in untrained individuals, but again, I don’t think that that’s what we’re looking at here.

The groups being studied in most of the cases are either US undergraduate students or healthy US adults. The other 4 are healthy Swedish, Dutch and Japanese adults and UK undergraduate students. In other words, they’re all WEIRD. One would think (hope?) that when it comes to compassion, empathy, aggression, connectedness and prejudice, all these groups would already rate pretty highly. Do unsympathetic, intolerant, aggressive, disconnected bigots regularly sign up for university based psychology studies?

When it comes to prosocial behaviour, these individuals are more like highly trained athletes. One would not expect to see significant changes in an already fit and strong individual in such as short space of time. I’m pretty sure that if you were to compare the effect of 5 mins to 8 weeks of various different training protocols in already trained athletes on max deadlift, you’d probably find little benefit over watching power lifting on TV.

Basically, this meta-study is completely worthless. At best, it tells us that 5 mins of meditation won’t make you Gandhi, but I’m pretty sure no one was claiming that in the first place.

Meta Study 2 – Mind the Hype

Mind The Hype (Full Text PDF Download)

This is a very interesting read. One of the lead authors, Ted Meissner, is a professional meditation teacher so one has to take into account the potential for bias. (Check out his comment on the Neurologica blog if you didn’t already).

The report is pretty damning of the current state of meditation research, and the overstatement of claims made for meditation, both of which I’d be inclined to agree with. Note however, the report is critical of the research, not of meditation itself.

The report also acknowledges the difficulties of studying meditation.

WARNING – Big Waffle Here, non uber-geeks feel free to skip ahead!

Science is difficult and expensive. I’ve talked before about why the science of nutrition is so difficult, as is studying the effects of training and exercise.

Again, to use the exercise/training comparison, which I think is pretty close, one major problem comes from the vagueness of the terms meditation and mindfulness.

Just as with physical exercise and training, there are many different meditation techniques, with different objectives. Then of course there are questions of frequency and duration.

Scientists have been studying hypertrophy training for the last 50+ years, and we still don’t really have any consensus on the best way to do it, other than it’s necessary to lift weights. Whether there’s an optimum training frequency, volume, intensity, rest periods, tempo, etc, is still under hot debate.

Comparatively speaking however, resistance training is so much easier to study than meditation. One can measure muscle gain easily with some scales and calipers. Measuring changes in psychology, emotional state, and behaviour is much more difficult.

It’s not just outcomes that are difficult to measure either. In a resistance training study, one can count a participant’s sets and repetitions. Even if a meditation study is done under supervision, it’s hard to know if the participants are actually meditating or not.

As I’ll get to later, meditation is not easy. Not only could it be difficult for researchers to identify whether a participant is actually meditating (or at least trying to), it can be difficult for the participants themselves to know!

In this way, studying meditation is rather like low-budget diet studies where people are given diet list to follow, and then the researchers have to trust that they follow it. There are generally 3 types of participant:

1. Those that follow it to the letter
2. Those that try to follow the diet, and very probably believe they have, but have unconsciously or unwittingly cheated
3. Those who just want the pay cheque for signing up to the study and eat whatever the hell they want.

Type 2 aren’t necessarily a problem, as this kind of adherence is going to be a reality, so it’s important to take into account (Though it’s useful to be able to differentiate their results from those of type 1). Type 3 are the real fly in the ointment.

With a weight-loss study, the recruited participants will be overweight, and therefore, one would imagine, most will have some level of motivation to try to follow the prescribed diet.

It’s easy to imagine, however, that an undergraduate student recruited onto a meditation study for a few extra pennies as long as they promise to practice meditation for the next 8 weeks in order to improve their empathy, actually just ends up spending their time and extra pennies in the pub.

The alternative however, is recruiting participants that are already practicing meditation, or at least have an interest in it, which brings its own confounding factors such as increased risk of placebo, reporting bias, can’t measure change from baseline, etc.

Add to all these difficulties, that there is very little money in meditation, and we begin to see why we know so little! Yes, meditation retreats can be expensive, and now there are a proliferation of paid apps, books, online courses etc, but these pale in comparison to the behemoth that is the diet and fitness industry.

WAFFLE OVER. FOR NOW. ISH

Before I move onto the 3rd meta review, Mind the Hype also talks about the potential “adverse or side effects” of meditation, referencing 20 published reports of potential psychological trauma experienced by practitioners of meditation.

The possibility of adverse effects from meditation I’d come across before in an article in the Atlantic – The Dark Night of the Soul, and is one that I think deserves attention.

Unfortunately, we are in the same boat with the adverse effects as we are with the beneficial effects.

There are numerous anecdotes and case studies of individuals who have suffered severe breakdowns after practicing meditation, typically after intensive 10 day retreats.

Without further research, however, it’s impossible to know whether these breakdowns were actually caused by the meditation, or whether they just happened to occur in close temporal proximity by chance.

There are numerous possibilities:

1. Pure coincidence

It’s estimated that between 8-10% of US adults either meditate regularly, or have tried it at some time. It’s entirely possible, that purely by coincidence, some of these people may suffer breakdowns shortly after trying meditation. I’ve talked many times before about how we humans are programmed to see patterns of correlation, when often it’s really just coincidence.

2. Selection Bias/Confounding Factors

It’s highly possible, that people choose to take up meditation because they are suffering some kind of emotional distress. Quite possibly they were already heading for a breakdown. It’s even possible that meditation slowed the onset or reduced its intensity.

It is also possible that there are other confounding factors linked to “the type of person likely to take up meditation“. Are they more likely to smoke marijuana or other drugs that can increase risk of psychosis and breakdowns for example?

3. Exacerbation of Pre-Existing Conditions

Perhaps meditation really does have adverse effects in those with pre-existing conditions. It could well be that for people suffering from severe depression, anxiety, paranoia, schizophrenia and so on, a 10 day silent retreat with lots of introspection could send one off the precipice.

Exercise is great for the vast majority of people, but for a small percentage of the population who have pre-existing conditions (perhaps undiagnosed), such as congenital heart defects or blocked blood vessels, something as innocuous as a gentle jog could prove fatal.

4. Genuine Risk of Adverse Effects in All Populations

The final possibility is that meditation really does have inherent risks, for anyone that might try it, even those who have happy and healthy minds before starting.

Could mindfulness meditation be the mental equivalent of CrossFit, where rapid gains are accompanied by high risk of (psychic) injury?

Or perhaps meditation is like any other form of physical training. Done sensibly and safely under the right supervision the risk is almost zero, but done badly, you can really hurt yourself. The aforementioned deadlift is a perfect example. Done with good technique and a reasonable weight, it’s a fantastic exercise for developing strength, muscle, and coordination. Bad technique, too much weight and/or too many reps and you can seriously injure yourself.

Any of the above 4 scenarios are possible. Unfortunately, at the moment, we have no idea which! My guess would be that the reported breakdowns have probably been some combination – individuals with pre-existing mental health issues have jumped in at the deep end with a 10 day meditation retreat, and irresponsible/ill-equipped meditation teachers (true believers for whom meditation is a panacea) have not been able to give the necessary coaching/warning. But that is pure supposition.

Meta Study 3 – Psychological Stress and Well-Being

Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis

This meta-analysis looked at the effect of various different meditation practices of varying duration on Anxiety, Depression, Pain, Mood, Attention, Sleep, Substance Abuse and Weight.

Only RCTs were included with active controls.

Further to this, they refined the studies into those with nonspecific or specific active controls.

Nonspecific controls were activities “similar” in nature to meditation – i.e. education, attention training etc – non physical activities that require concentration, and only then, providing the nonspecific active control group was matched in time and attention to that of the active arm. This is akin to comparing the effect of a new drug to a placebo sugar pill.

Specific controls were active therapies that had been shown to be effective in treating the condition being studied – these varied from medications, exercise, muscle relaxation techniques, etc. This is akin to comparing a new drug to an established drug, already proven to work and on the market.

The meta-study did not find any strong evidence for benefits of meditation on Mood, Attention, Sleep, Substance Abuse or Weight.

The study did, however, find moderate evidence for meditation for the treatment of anxiety, depression and pain.

Doesn’t sound like anything to get overly excited about does it?

Before dismissing the idea altogether, however, take into consideration that the study also found meditation to be of roughly equivalent efficacy as the specific active controls it was compared against.

I.e. When it came to treating depression, anxiety and pain, meditation was as effective as exercise, anti-depressant drugs or whatever other already tried and tested therapy was used as the control.

I think this definitely indicates that more research is warranted. Particularly as meditation could also be used in addition to other therapies, particularly as it’s free and can be done anywhere any time.

Final thing I’ll mention regarding this report, is that it does highlight that one high quality study found that meditation was very effective in the reduction of pain in the suffers of IBS. IBS is something I’ve suffered from and N=1 experimented on myself using mindfulness meditation as part of my treatment, so perhaps it really did help?

So Where’s the Evidence?

There’s definitely strong evidence that mindfulness meditation is more popular than ever, both within the media, and as a topic of scientific study. Here’s a graph showing the increase in media coverage and published studies on meditation between 1975 and 2015:

Meditation’s increase in popularity, both with the public, and as a new item, is no doubt at least in part, if not predominantly, due to its “Scientific Backing”.

Let’s look at some of the claims for meditation as science based.

Andy Puddicombe and his Mindfulness Meditation App Headspace are no doubt responsible for introducing many people to the practice of daily meditation. Indeed, it was after watching his hugely popular TED talk that I first came across the idea, and my first dabble was the free 10 day trial with the Headspace app.

Michael Taft is the author of The Mindful Geek: Mindfulness Meditation for Secular Skeptics – Sounded the perfect book for me, being a Skeptical Geek Aethiest interested in Meditation – (Actually, I have to say, I looked to many sources, apps, online, audio guided meditations, and various books, and this was by far the best in terms of practical advice on how to meditate).

Both teach meditation, and promote it as backed by the science. They each have pages on their websites listing multiple scientific studies which purport to evidence meditation’s benefits for a wide range of areas:

https://www.headspace.com/science
https://themindfulgeek.com/benefits-of-mindfulness/

Did you visit the pages? That’s a lot of studies isn’t. And we all know that lots of links to studies to means lots of rock solid scientific evidence don’t we, great!

Oh wait, no hang on. Links to lots of studies is actually often an alarm bell for pseudoscientific BS :-/

Now I must confess, I haven’t read every single study in full detail. I randomly checked out around 1/2 of them, several of which I could only access the abstract (Never just go by the abstract!).

Of the studies that I randomly selected, and managed to find and read the full text, how many would you guestimate actually made me think, wow, that’s pretty impressive evidence that meditation definitely has profound effects?

I’ll give you a clue, it starts with Z. Z E R O!

Headspace was definitely the worse of the two with regards to listing either really bad studies, or studies that don’t even nearly support what they are claiming. The quoting of the sleep and breast cancer studies are particularly alarming as neither remotely seem to show benefits for meditation!

Taft’s links aren’t quite so bad, but they are still all unremarkable.

Of the studies I looked at there were either:

• Studies with waitlist controls showing improvements in subjective measures such as self reported levels of anxiety, stress, pain, etc

A study with waitlist control, to clarify, is one where they test group A and group B before the intervention, group A then meditates for X amount of time, group B do nothing. At the end of the study, they test both groups again and compare differences.

Unfortunately, this does not control for the placebo effect. Indeed, as noted by Novella, it is exactly this kind of study that proponents of acupuncture use to claim its efficacy.

It’s entirely possible that if group B were given some kind of placebo intervention which they were told would reduce their anxiety/stress/pain, (watching nature documentaries or sham acupuncture?), that they too would have reported a reduction in their symptoms.

• Studies measuring changes in biochemical markers or MRI scans.

There are studies out there showing increases in grey matter, changes in immune responses, differences in brain function in an MRI scanner.

Again, all these things are very interesting, but they don’t actually tell us whether meditation has any practical effects when it comes to health, well-being or mental function.

There have been many studies into diet and nutrition which have shown changes in metabolic markers over the short-term – protein synthesis, insulin secretion, lipoprotein levels and so on – but which later don’t translate into improved health, performance or well-being.

• Studies comparing differences between experienced meditators and the general population.

Numerous studies have highlighted impressive differences between experienced meditators and the general public – Resilience to stress, high levels of concentration and focus, high levels of empathy, the ability to levitate…

All very interesting, but unfortunately, it doesn’t tell us whether taking up meditation will bring about improvements in these areas for anyone who tries it. It’s equally possible that it is individuals who already have these attributes that are attracted to meditation in the first place, and/or have the ability to stick to it. There’s a high risk the traits we see in long-term meditators is simply an effect of survivorship bias.

Go to any gym, and you’ll see the weights room full of guys (and girls) with bulging muscles, and the yoga studio packed with super flexible bendy types. Stands to reason that if you want to be muscle-bound you go to the weights room, if you want to be bendy to the yoga class. What you don’t see however, is all the skinny bendy people who tried the weights briefly, then gave up and went to yoga, and all the bulky stiff folks that did the reverse with yoga.

Now, I’m not saying that resistance and flexibility training doesn’t work for everyone. What I am saying however, is that they don’t work for everyone equally.

Everyone can get stronger and more flexible than they are now, but not everyone can become a hulking beast or a contortionist. Naturally people tend to gravitate to what they are already good at and stick with that, hence the average experienced person found in the weight room, yoga studio, and perhaps meditation hall are not necessarily accurate reflections of what the average person would become after practicing those disciplines for prolonged periods, even if they were compelled to.

Or perhaps there are other confounding factors such as meditators are more likely to be educated, middles class, practice Buddhism?



What Would the Perfect Meditation Experiment Look Like?

OK, so I’ve spent enough time criticising the existing literature into meditation. What’s wrong with these damn scientists you might ask, why don’t they just do a rigorous study once and for all and be done with it?

As we’ll see, it’s not quite that easy.

Good science is A) Hard, and probably more importantly B) Bloody Expensive!

What we’d need to see would be:

• Large Sample Size

Most of the studies out there just don’t have enough participants to produce statistically meaningful results. Obviously, however, the more participants, the more costly the study.

• Single Blind

The participants can’t be blinded, as they have to do the meditating, but whoever is doing the assessment should be in order to protect against bias.

• An Active Control

As discussed, a waitlist control doesn’t adequately protect against misleading results due to the placebo effect. An active control that is similar in nature to mediation – perhaps daily contemplative journaling, some form of CBT, or other type of established psychotherapy?

• An Element of Randomization

This is where things get more tricky. I talked earlier about the trade-off between randomly selecting people to take part in a meditation study, or having people who’ve expressed a personal interest volunteering. With the former you’re likely to have high attrition rates, and there’s the potential risk they won’t even really meditate. Useful when it comes to deciding whether doctors and workplaces should try to encourage Joe Blogs to meditate or just give them the DVD box set of Planet Earth, but not so useful to those of us who have an interest and motivation to really try it. The second group however also comes with its own set of problems such as selection bias and increased risk of the placebo effect, but at least there’s a greater chance they’ll actually follow the instructions and stick to the program.

The only solution I could see would be to recruit from two sources – Group A with adverts for a “psychology study”, the applicants have no idea it’s for meditation, and group B with adverts explicitly stating they want people interested in meditation.

You’d then randomize Group A between meditation and the active control. The ideal I suppose would also be to randomize Group B too. Not sure on the ethics or practicalities of assigning those interested in meditation to the active control group would be. I suppose that would depend upon the length of the trial.

• Long Follow Up

How long do we need to follow-up? There are those that claim (and have studied, albeit poorly) beneficial effects of just 5 minutes of meditation. I think realistically though, we need to stretch that out a bit to see significant changes (should there be any). I’d say minimum 3-6 months, though longer follow ups would be great.

Ideally, the follow-up would be on everyone who was first enrolled in the study, to track both any changes in health, well-being and mental performance, and also attrition rates.

• Clear Statement of Outcomes to be Measured

There appeared to be quite a bit of “data-mining” going on in many of the meditation studies I looked at. For example the initial study might be to find the effects of mindfulness meditation on the completion of a concentration based task. The results show no difference in the participants performance, but after closer analysis of the data it is found that those that meditated found the test less stressful.

This is a classic technique used in order to find a positive result from an otherwise negative study. If you have a large dataset, search hard enough, and you will find some kind of pattern. This doesn’t mean it’s a real effect though, it could well just be random chance.

As you can see, determining whether A meditation intervention is actually effective is a pretty epic. I put A in italics, because even after doing all this, it would still only give us answers as to the effectiveness of the specific technique used, for the duration and frequency tested.

Perhaps 10 minutes a day of mantra meditation for 6 weeks is ineffective, but what about 20 minutes a day for 3 months? How about focusing on the breath for 30 minutes twice a week? What about a 10 day vipassana retreat?

So basically, there is no single perfect meditation experiment. There are just too many independent variables.

It may sound like I’ve been very critical of the science conducted so far, but in reality, these small-scale studies are necessary in order to try to give clues as to which variables are going to be worth dedicating more time and money into studying.

What I am critical of is the over (or out right misinterpretation) of the results of these studies, when really the only intellectually honest response is “More research needed”.

Is there a Future for Meditation Research?

So the question is, what happens next?

Currently, I’d have to agree with Mr Novella that there is no strong scientific evidence that meditation has any clear benefits.

While I do still think that it’s an area that warrants further research, as there are various indications that it might be beneficial, to claim that “mediation has scientifically proven benefits”, is simply not true.

So more research is badly needed, but the question now is, who is going to pay for this research?



The Government/Tax Payer?

I think there is a possibility that meditation could help individuals reduce stress and anxiety, reduce suffering from chronic pain, and improve focus and cognitive function. I also think that perhaps, it could even help society as a whole by helping people to be less reactive and judgemental, improve empathy and reduce aggression.

I don’t think, however, that meditation research should be a focus of government funds however. I think that currently the money would be better spent on looking into solutions for a href=”https://nickbostrom.com/existential/risks.html” rel=”noopener” target=”_blank”>more pressing matters.

Big Mindfulness?

Though it may not be as large as the diet and fitness industry, there is still plenty of money being made from selling mindfulness meditation training, whether that be in the form of retreats, books, online courses or mobile apps.

Currently there is little motivation to reinvest into research however. If you are already able to sell your product as science based, why reduce your profit margin by paying for more studies? (Especially if that science risks undermining your claims, says the cynic in me).

Stricter regulations regarding claims for therapies would be a good start. If companies could be fined for making claims that aren’t supported by rigorous studies, we might see them more inclined to help fund some rigorous studies. One would think it would be harder to market your meditation program if you had to have a large disclaimer saying “There is no evidence that there are any benefits to health or well-being from following this program, and there maybe severe side effects of which we are not aware”. (Of course this hasn’t stopped the supplement or alternative medicine industries).

Though those likely to profit from an investment in the research may be the most feasible source, it is not without problems. This is why the pharmaceutical industry’s obligatory but self-funded scientific research is so rife with bias and fraud.

Big Data/Citizen Science?

Perhaps the best chance we have for finding answers to complex questions come from our increased capabilities (and tendencies) to both track, store, share, and analyse, large quantities of data.

Though I regularly sing the praises of Randomised Controlled Trials, they are always going to be limited in terms of size and duration.

Prospective Longitudinal Cohort studies are another type of investigation, which take a huge sample of people from a certain demographic (perhaps people born between certain dates, or within a geographical region, or who share the same profession for example), takes base line measurements from all participants, and then follow them over many years, even their entire lives, regularly reassessing the participants results on the tests and then searching for correlations. Perhaps the most famous example being The Framingham Heart Study which among other things helped show the links between smoking and cancer, exercise and reduced heart attack risk, obesity and increased heart attack risk.

Traditionally, these studies have also, understandably, been very expensive to conduct, and of course the number of outcomes being measured, and variables being tracked limited.

It’s not impossible to imagine a future however, where the potential cohort is anyone with a smartphone willing to track their health and well-being and consent to the anonymous sharing of their data.

Though correlation can never prove causation, the vast quantities of data would at least give very strong indications of where and how to focus resources on very high quality RCTs in order to get definitive answers.

In the Meantime…

Thanks for sticking with me through my (hopefully) thorough, and certainly lengthy analysis of the current state of research into mindfulness meditation.

As I mentioned at the start of this article, I’ve been meditating on and off for several years now.

I’ve talked before on this blog about how anecdotal evidence should be taken with a pinch of salt, been highly critical of claims for therapies without sufficient evidence, and warned against the potential dangers of N=1 experimentation.

Do I still think that this daily practice is worthwhile? Could I be putting those 10-20 minutes a day to better use, or at least with a higher probability of a decent ROI? If it is worth the risk (of wasted time, effort, or potential adverse effects) despite the lack of evidence, is there one technique that holds more promise than others, or a likely minimum or maximum dose?

All these questions I’ll attempt to answer in Part 2!

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