Buddhist literature and autobiographical reports contain warnings about challenging periods on the road to enlightenment via meditation. The Tibetans call it nyams which encompasses a great many of what they euphemistically call “meditation experiences” which are code for the scientific term used here in the West: adverse effects (AE). These can range from ecstatic joy and holy visions to physical pain, psychological disorientation, paranoia, mood disorder, and the like. The road is quite tricky as what may be a psychological crisis in one person may be a desired result in another. Certain nyams are viewed as signs of spiritual progress which others are dismissed as obstacles. In Zen Buddhist traditions, the term makyō encompasses a group of symptoms, or what the Buddhist masters called “side-effects” or “disturbing conditions,” that may appear during meditation. They interpreted some of these as being indications of spiritual development (Lindhal et al., 22017). In my early studies of existentialism, I found references to “Zen sickness”[1] being a kind of deep existential despair. But there are other kinds of sicknesses as well. The Śūraṅgama Sūtra of Mahāyāna Buddhism gives 50 delusional experiences that may come up during meditation. Some of these experiences can be quite wonderful and so these are viewed as being especially dangerous in their seductiveness. Progress in the Theravāda Buddhist tradition is expected to eventually lead to disturbing experiences which they call “corrruptions of insight” (vipassanā-upakkilesā) (Lindahl et al., 2017).
Are these good or bad? Again, it all depends.
And so, just to be fair and objective as we end this series on the health effects of meditation, it must be acknowledged that meditation does have some potential risks. Studies of therapeutic interventions based on meditation and mind-body practices typically highlight the positive health benefits of meditation while the negative effects go mostly unreported (Tayor et al., 2022). Good news about meditation—and deservedly so—have dominated the research literature for more than 40 years, but now a small but growing voice about some of its hidden dangers is now making itself heard—also deservedly so.
In Eastern religious traditions, difficulties associated with meditation are acknowledged—although perhaps rather quietly–and are usually rationalized as being just milestones on the path to enlightenment, problems from improper practice, or from the meditator’s own psyche. More troubling is that Western culture has secularized meditation as a kind of “Swiss Army Knife” technique while overlooking its possible negative side effects. Westerners have converted meditation from a practice of spiritual enlightenment to a utilitarian tool for psychological development and personal transformation. This leads to the view that meditation is just plain good for everybody (Lutkajtis, 2018).
Unfortunately, this is not the case at all. Let us now consider the findings of several research studies aimed at finding out more about the AEs of meditation.
The Varieties of Contemplative Experience study conducted qualitative interviews with meditation practitioners in the Theravāda, Zen, and Tibetan styles. Meditators had to have practiced for at least 18 years and had no history of psychological disturbance prior to beginning to meditate. Meditation experts were also included in the group (N=60). Meditators were located in the US, Canada, Europe, and Mexico. Interview questions centered on meditation experiences and a follow-up survey provided quantitative assessments of the experiences. Data analysis yielded the categorization of 59 meditation-related experiences across seven areas: cognitive, perceptual, affective, somatic, conative, sense of self, and social. The following chart gives a good overview of the range of positive and negative experiences to be had over time in meditation and would be a valuable aid regarding informed consent or just as a standard teaching tool when entering any meditation training program.
Next is a meta-analytic study of 1,826 research articles on AEs from meditation. AEs fell into two types: somatic and mental problems. Almost all of the studies found some kind of mental distress while fewer studies found somatic disturbances. Data analysis confirmed that AEs are more prevalent when the primary intervention technique used (Taylor et al., 2022).
A third study using a specialized meditation questionnaire survey form found that AEs were commonly experienced in subjects attending an eight-week mindfulness meditation program (n = 96). More than half of the subjects–eighty-three percent—had at least one AE. Meditation related AEs occurred in 59 percent with negative emotions and 37 percent with negative feelings. Lasting bad effects occurred in six to 14 percent and were associated with signs hyper-agitation or dissociation) (Britton et al., 2021).
Closing Thoughts
The problem here as I see it—and please know that I’m not an expert at all in this area—is multi-sided. First, meditation may be a catalyst that invokes a psychological crisis in a mentally healthy person. In other words, it’s pretty much up to chance if any AEs occur at all.
Second, there are many people who are in poor mental health, possibly just on the edge of crisis, and they turn to meditation for a cure or to self-medicate. In some areas, Buddhist meditation is augmenting and even replacing conventional psychiatry. This is termed “mindfulness-based interventions” and have been applied to addiction recovery, chronic pain, mood disorder, chronic medical conditions, and PTSD (Lindahl et al., 2017). Unfortunately, some people’s psychic structures are too vulnerable and so the meditation precipitates a collapse. I have practiced meditation in the past in groups for brief periods of time and on one occasion—at a weekend workshop on Sudarshan Kriya Breathing—one young man became unruly and had to be asked to leave. We found out later that he had a psychotic break that evening.
Third, there is the problem of “spiritual crisis” as pioneered by Christina Grof (1941-2014) and her finding of the “spiritual emergency” which is defined as a spontaneous and overwhelming release of kundalini energy (Grof & Grof,1989).
A related problem is that meditation teachers apparently are not trained in how to screen for basic mental instability and, most likely, many of them sincerely believe that meditation is THE UNIVERSAL ANSWER. This does not make for a discriminatory recruitment attitude.
Next, there is the distinctly American attitude that if something is good, then a whole lot it must be great. I don’t think this applies to meditation and have heard stories of people meditating too much and experiencing disorientation, depression, and even hallucinations.
Another problem is an unquestioning attitude. It is generally assumed that just sitting quietly and focusing your mind is a simple, harmless task. It’s just thinking, isn’t it? How could this possibly be harmful? Yet, as was discussed in Part 1 of this series, even a little bit of meditation can go a long way in affecting brain activity. Meditation is far more powerful than most people can ever imagine.
Lastly, there is the historical consideration that meditation was originally taught within a controlled environment—monastery or religious community—by teachers who understood the psychological pitfalls. Meditation here in the West is an unregulated stew of various schools, styles, and teachers and most, if any, are not trained in identifying or managing spiritual crises.
I follow the observations of Binda, Greco, & Marone (2022) that meditation will often stir up disturbing emotions, memories, and feelings and this should be expected so as to be effectively managed. More severe AEs such as disabling anxiety, psychosis, or mania are multi-determined and also need to be guarded against, but their presence will most likely require a combination of spiritual counseling and psychiatric supprt.
References
Binda, D., Greco, C., & Morone, N. (2022). What are adverse events in mindfulness meditation? Global Advances in Health and Medicine 11, p. 1-3.
Britton, W., Lindahl, J., Cooper, D., Canby, N., & Palitsky, R. (2021). Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clinical Psychological Science 9(6), p. 1185-1204.
Grof, S. & Grof, C. (1989). Spiritual Emergency: When Personal Transformation Becomes a Crisis. New York, NY: Tarcher.
Lindahl, J., Fisher, N., Cooper, D., Rosen, R., & Britton, W. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLoS ONE 12(5): e0176239. https://doi. org/10.1371/journal.pone.0176239.
Lutkajtis, A. (2018). The dark side of dharma: Why have adverse effects of meditation been ignored in contemporary Western secular contexts? JASR 31(2), p. 192-217.
Nelson, Lawrence (2012). Chan (Zen) Sickness and the Master’s Role in its diagnosis, treatment, and prevention. Unpublished doctoral dissertation, California Institute of Integral Studies, San Francisco, CA.
Taylor, G., Vasquez, T., Kastrinos, A., Fisher, C., Puig, A., & Bylund, C. (2022). The adverse effects of meditation-interventions and mind-body practices: A systematic review. Mindfulness 13, p. 1839-1856.
[1] Known in Eastern religious teachings as Chan Sickness (Nelson, 2012).