West - The Psychosomatics of Meditation

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THE PSYCHOSOM TICS OF MEDIT TION

MICH EL A. WEST

(Received 18 March 1980)

Abstract-Meditation is defined and its historical context is briefly described. Its use in the Western

world as a relaxation technique is discusred and the problems of carrying OUI research in this area are

delineated. Research results in four areas are reviewed: the psychophysiological correlates of meditation;

personality change associated with learning and regularly practising meditation; the use of meditation as

a therapy and the use of meditation in stress-related disorders. Finally, the dangers of meditation

practices and theoretical explanations for the effects of meditation are described.

INTRODUCTION

IT H S become a clichk to speak of the physiological and psychological stress

associated with a rapidly changing technological urban existence. The demands

made upon human resources by the rapid changes in the economic and social

structures of industrialised society can partially be measured by the incidence of

chronic psychosomatic and psychiatric disorders.

Over the last 20 yr there has been a trend toward rejecting the solutions to these

problems offered by Western science and even Western religion. Young people and

old people alike have experimented with new drugs, with new techniques and with

new religious philosophies. The influence of Eastern religion has been paramount.

At first, meditation was used by small groups attracted to new cults but increasingly

large numbers are using meditation as a way of improving the quality of their

everyday lives. Wide ranging claims are made for the usefulness of meditation

techniques in bringing people both relief from stress and a perception of the absolute

realities of existence.

What does meditation have to offer in the field of mental health? Does it represent

a solution to many of the problems of modern day life or is it merely another fad

or passing fancy which will be rejected in favour of some other new idea in the near

future? Before attempting to anb\ver these questions, however, it is important to

define meditation and to place it in both a historical and geographical contexl.

The historical context oftrteditution

Meditation is an exercise which usually involves the individual in turning attention

or awareness to dwell upon a single object, concept, sound or experience. So, for

example, religious symbols such as the Cross of Christianity are used as meditation

objects. It is also common for a particular word or sound called a mantra to be used

as the central object in meditation. Examples of these are the mantra chanted aloud

by the Hare Krishna movement in this country, or the mantra OM used by many

religious groups in the East.

Meditation may also involve physical movement where the central object or

experience of rneditation is repetitive movement. A simple example is the repetitive*Reque$th for reprints should be sent to klichael A. West, Ph. D., Social Psychology Research

Unit, University of Kent ar Canlerbury.

Social P\ycholog Rewarch Unit. The llnl\erGty of Kent at (I anterbury, Canterbury, Kent. U.K.



266 MIC HAE:L A WEST

touching of the tips of the four fingers individually with the thumb. Some prac-

titioners are trained to observe imagined inner body sounds, called ‘nadam’. These

vary from the sound of a waterfall to the hum of intoxicated bees.

To illustrate how widespread geographically meditation techniques are, it i$

possible to identify them in almost all cultures of the w:orld. In America, Indians

have practised a form of meditation remarkably similar to zazen. In Africa, in the

Kalahari desert, the people of the KungZhu/twasi practice a form of ritual dancing

(like the Sufis) which activates an energy (n/urn) like Kundalini and produces an

ecstasy experience. Many African people practise such ritual dancing, coupled with

chanting, to produce altered states of consciousness. Shamanism is widespread in

tribal religions in North and South America, Indonesia, Oceania, Africa, Siberia

and Japan. Each shaman uses a chant to induce a trance state-often going into

solitude to do so. Researchers have described how the Eskimoes would sit facing a

large soft stone, and using a small hand stone, would carve a circle in the large stone

continuously, for periods as long as 3 days, in order to product a trance state.These techniques are by no means confined to the religions of the East and of

primitive people. Meditation has long been used within the Christian religion. St.

Augustine wrote of a method of contemplation or recollection which he used to

“pass even beyond this power of mine which is called memory; yea I will pass

beyond it, that I might approach unto Thee, 0 sweet light”. The Prayer of the Heart

was used as a meditation object in Russian monasticism. The practice of this

prayer was used as a way of giving “Sure knowledge of God, the Incomprehensible”.

The instructions for the prayer are identical to instructions for Eastern meditation

techniques.

“Sit down alone and in silence. Lower your head shut your eyes. breath? OUI gently and imagineyourself looking into your own heart. Carry you - mind and thoughts from your head to your heart.

As you breathe out say “Lord Jesus Christ have mercy on me”. Say it moving your lips gently or

\imply say it in your mind. Try to put all other thoughts aside. Be calm be patient and repeat the

process \ery frequently.”

It is also important therefore when defining meditation IO point out that historically,

the goal of meditation has been religious enlightenment. For example, if you close

your eyes and focus your attention on your breath at the point at which it enters

and leaves the nostrils. you would be practising a technique reportedly used by the

Buddha on the night that he reached Nirvana or achieved enlightenment.

Meditation in the Western worldThe traditionally religious or spiritual goal of meditation is therefore intrinsic to

any definition of meditation and this is important because increasingly today in the

West meditation is being used not as a religious exercise, but as a way of relieving

psychological stress, reducing anxiety, and increasing feelings of relaxation. The

average Westerner approaches meditation on a practical level. Ordinarily he or she

does not think of it as being a deep spiritual commitment, if it i\ thought of as being

spiritual at all. Usually it is learned to make life easier and more pleasant.

Some people would say that it is wrong to teach meditation as a kind of mental

prophylactic and that mediation is only valid within the particular religious or

philosophical context from which it derives. In a sense this may be true. It is probably

unlikely that the businessman who uses meditation a< way of reducing anxiety and

tension at the end of the day is going to reach a pure knowledge of the Absolute



The psychosomatics of meditation 267

as a result of his practice. Equally, the aims of the businessman in his meditation

must appear facile and futile to the devoted monk who has practised meditation and

abstinence for twenty years.

However, research has shown that the vast majority of people in this country who

take up meditation do so because they hope to get mental and physical benefits,

they hope to learn to relax, or to treat headaches, or because they are generally

nervous, or to be calm, or to relieve depression [l]. Only a small minority learn

meditation in order to get increases in such things as personal growth or awareness,

self-realisation, or to be at one with the world or to achieve changes in consciousness.

Subjective reports, however, are not sufficient evidence for the therapist who wishes

to use meditation techniques in practice.

Research problems

If meditation is going to be used as a way of helping those with mental health

problems or indeed improving mental health generally, we need to know whathappens during meditation, for whom is meditation best suited, and is following one

routine when practising meditation any better than following any other routine?

Can meditation be applied successfully to certain stress-related disorders and, if

so, for which patients and for which disorders? It is also important to find out how

meditation produces changes in the individual and it will then be easier to establish

for whom meditation is best-suited. Furthermore, if we are going to use meditation

in the mental health field we need to acknowledge the dangers that exist in its use.

The persistent public interest in meditation has been mirrored by the research

interest in elucidating the effects of the practice of meditation techniques. This

research has examined changes taking place both during and outside of meditationpractice on physiological and psychological measures and the results have suggested

that decreases in arousal occur during meditation practice and that decreases in

anxiety and neuroticism tend to occur when people first learn meditation and

practise regularly for a period of time.

A major problem for research work arises here because it may be that these

results are due primarily to the fact that people believe meditation will make them

feel better. The use of techniques like Transcendental Meditation in experimental

investigations has confounded these problems since these techniques are generally

taught in such a way that placebo and expectancy effects are maximised. In the case

of TM for example, people wanting to learn meditation are exposed to wide claimsfor the benefits of the technique. These claims are backed up by the results of not

always very scientific research and presentation of research results by the TM

organisation generally ignores neutral or negative findings. The individual is also

taken through a religious ceremony and is exposed to group pressure to conform

to the expectation that the technique works.

Some would argue that effects due to beliefs or placebo effects are unimportant-

that such effects are only a problem for the researcher. This is certainly true for

some clinicians who are only concerned with whether or not a particular technique

works rather than with what the causal agents in any effect are. But in order to

counter the suggestion that meditation is ineffective in itself, placebo and expectancyeffects have to be partialled out from effects specific to meditation itself. This is a

problem in many different forms of treatment. Until effects attributed to the



treatment can be distinguished from the effects of merely treating (no matter what

the treatment) the answer to the research puzzle will not have been found.

There are also problems for the clinician who wishes to use meditation as a therapy.

He may be loath to delegate responsibility for treating his clients or patients to

cultic and evangelical organisations. These organisations often raise people’s

expectations too high and the non-fulfilment of these expectations can create

further difficulties.

Such problems for the clinician and the researcher are being partially overcome

by the development of non-cultic, non belief-based techniques of meditation for

the use of therapists and of individuals who wish to teach themselves meditation.

Probably the most carefully devised of these is a technique called CSM, or Clinically

Standardised Meditation [2, 31 which is available as a simple tape-recorded course

of instruction.

RESEARCH RESULTS

Psychophysiological correlates o meditation

Research on psychophysiological changes has suggested that decreases in arousal

occur during meditation practice:

EEG changes.

(1) On beginning meditation alpha amplitude increases and in some cases alpha

frequency slows by 1-3 counts/set.

(2) Later in meditation, trains of theta activity occur, often intermixed with alpha

(this is especially so when the subjects are relatively experienced in their practice

of meditation).(3) During deep meditation, experienced subjects sometimes exhibit bursts of high

frequency beta of 20-30 or 40 counts/set.

(4) At the end of meditation alpha sometimes persists even when meditators arc

sitting with their eyes open [4].

Other physiological changes. Other physiological changes during meditation

include decreases in:

Heart rate

Oxygen consumption

Carbon dioxide elimination

Respiratory rateSkin conductance

Arterial blood lactate

Muscle tonus [5].

The picture painted by these research results is one of meditation producing a

coherent and consistent pattern of decreases in arousal and this has led some

researchers to talk of meditation producing a fourth major state or consciousness

characterised as a unique wakeful hypometabolic physiologic state. However, research

on parameters other than the electroencephalogram (EEC;) has generally also shown

that decreases in arousal observed during meditation are not significantly different

from decreases in arousal observed during other relaxing practices. Fenwick et al. [6],for example, found that a control group who listened to music for 20 min exhibited a

decrease in oxygen consumption of similar magnitude to the oxygen consumption

decrease shown by a group who meditated for 20 min.




It may be that the reason very large changes are not found in physiological

arousal during meditation is because practitioners used in experiments are relatiw

novices. In the most meticulous study of respiration rate and energy metabolism in

meditation to date, Sugi and Akutsu [7J examined changes in these parameters in ten

experienced Zen Monks of the Zen Temple, Kasuisai, Japan. During Zazen (sitting

meditation) the monks decreased their respiration rate initially to 5-7 breaths per min,

then after 3 min to 335 breaths per min. In one or two cases the breath rate went as

low as 1.5-2 breaths per min. These lowered rates remained constant for the whole

duration of Zazen practice.

Oxygen consumption was also found to decrease by 20% during meditation and

a control experiment examining a forced decrease in respiration rate in control

subjects showed that this exercise produced an increase in oxygen consumption.

The monks, when sitting quietly and not practising Zazen consumed 2070 less

oxygen than the national Japanese average for their age groups. Bagchi and Wenger

[8] observed similar decreases in respiration rate in Indian Yogis during meditation

and they reported that respiration occasionally became so shallow that the rate was

uncountable.

So it does seem that it might be important in studies of meditation to distinguish

between those who are expert and those perhaps who merely use meditation in

order to relax. Expert practitioners appear to show different and more dramatic

patterns of physiological change during meditation than do novice Western

practitioners.

Very little research has been carried out to assess the long term physiological

effects of the regular practice of meditation. In one experiment [9] designed to

examine long term physiological changes, 11 subjects were taught meditation andthey regularly practised the technique for a period of 6 months. Measures of

spontaneous skin conductance responses were taken prior to the subjects learning

meditation. These measures were repeated at 3 months and 6 months into their

practice. Spontaneous skin conductance responses are usually taken as one physio-

logical measure of arousability and anxiety. The greater the number of spontaneous

responses, the more aroused or anxious the individual is thought to be. A comparison

group also attended for testing on each occasion and the responses of both groups

were compared. The group practising meditation showed a statistically significant

decrease in spontaneous skin conductance responses over the 6-month period. The

comparison group, however, showed no change. Furthermore the experimentalgroup demonstrated progressively greater decreases in arousal during meditation

over the 6-month period. The results therefore suggested firstly, that meditation

was effective in producing relaxation outside of the meditation state itself and

secondly, that regular meditation practice leads to a greater efficiency in achieving

physiological stillness during meditation.

In another experiment carried out in the United States [lo], some support for

the results of this work can be found. A group of experienced meditators showed

far more rapid recovery after seeing stressful film incidents of accidents in a Canadian

logging camp than did a control group. This recovery was measured by examining

heart rate and spontaneous skin conductance responses.

Meditation and personality

Studies of the effect of meditation on personality scores also suggest that meditation

ix effective in producing decrease\ in anxiety and neuroticism.



Studies comparing mean personality scores of matched groups of novice meditators,

long-term meditators and non-meditators suggest that long-term meditators are

significantly less anxious than the other groups and that novice meditators exhibit

significant decreases on measures of anxiety subsequent to their learning meditation.

Williams er nl. [l l] found that over 6 months of meditation practice, subjects

showed significant decreases in neuroticism and those decreases correlated

significantly with regularity of meditation practice in their subjects.

In a number of studies, however, authors have reported that those attracted to

meditation are significantly more anxious and neurotic than the normal population

in the first place ]I I-131. In a survey of meditation practice [l] neuroticism scores

of a sample of all those who had learned meditation in one area of the country were

measured and these were found to be significantly higher than the average score

for the general population. Most of the subjects in this survey, including those who

had given up meditation, reported that psychological benefits such as calmness and

relief from tension, and physical benefits, such as relaxation and better sleep,

resulted from their practice of meditation.

There are therefore some indications that learning and practising meditation

produces decreases in measured anxiety and neuroticism and increases in subjective

feelings of relaxation and that those attracted to meditation are likely to be more

anxious and neurotic than the rest of the population. These indications, coupled

with findings from studies examining the psychophysiological correlates ot

meditation, have led some researchers to the hypothesis that meditation is effective

as therapy.

Meditation and therap_v

Meditation has become increasingly popular as a therapy over the last 20 yr withinpsychiatry but studies evaluating its effectiveness have failed to overcome the

methodological research problems which do research in this area. Vahia et al. [ 131.

however, rnanaged to overcome many of the problems (though not entirely all).

Ninety-five outpatients diagnosed as psychoneurotic acted as subjects in the study.

All had failed to show improvement as a result of previous treatments. Half of them

were taught yoga and meditation, and they practised these techniques for 1 hr every

day for 6 weeks. The other half of the sample was given a pseudo-treatment consisting

of exercises resembling yoga postures and were asked to write down all the thoughts

that came into their minds during treatment, as a control for the meditation.

Following treatment, the experimental group exhibited a significant mean decrease

in anxiety, measured on the Taylor Manifest Anxiety Scale. Overall, 74% of the

experimental group were judged to be clinically improved after treatment as against

only 43070 of the control group.

More recently Benson et al. [ 151 compared the usefulness of self hypnosis and

meditation as treatments for anxiety. Thirty-two patients practised their assigned

techniques daily for 8 weeks. Change in anxiety was determined by psychiatric

assessment, physiological testing and self assessment. There was essentially no

difference between the two techniques in therapeutic efficacy-overall improvement

occurred as a result of both techniques. The author concluded that meditation is

effective in the therapy of anxiety and is simple to use.

Meditation and stress-relarrd disorder3Not surprisingly, some attention ha\ also been focused on the effectiveness ol




meditation in the treatment of stress-related disorders such as insomnia, hypertension

and headaches.

In a study of the effectiveness of meditation as a treatment for insomnia Woolfolk

et al [16] recruited 24 chronic insomniacs on the basis that there was considerable

evidence that mere belief in a treatment is ineffective in the treatment of severe

insomnia. Meditation was compared with progressive relaxation and a waiting list as

treatments for insomnia and analysis of the data showed both meditation and

progressive relaxation to be superior to no treatment in reducing time taken to get to

sleep. The meditation and progressive relaxation treatments did not differ in

effectiveness. In a follow-up study carried out 6 months later, both the groups still

showed significant improvement over pre-treatment levels.

So again, in this study, patients with a disorder often associated with anxiety

responded well to the treatment of meditation, suggesting that meditation can be

a very useful therapy in the field of mental health.

The application of meditation as a treatment for high blood pressure has also

been carefully investigated. Of the 7 studies published to date, all show a significant

effect of meditation in reducing elevated blood pressure, though two of these

demonstrated only a short term improvement in symptoms. In both of these latter

studies, significant decreases in blood pressure levels over a 3-month period of

meditation practice were observed, but the decreases were not significant by the

end of 6 months. One possible explanation for this finding is that the initial decreases

are a result of belief or placebo effects showing diminishing returns over time.

Alternatively, it is possible that the motivation to practise meditation regularly,

evoked by the experimenters in their patients, and individual differences in response

to meditation could have been responsible for the differing results.Overall, though, the picture is encouraging. Meditation does seem to be a useful

way of treating elevated blood pressure though it also seems to be important to

make sure that patients are sufficiently strongly motivated to practise meditation

regularly and consistently.

The dangers of meditation have been referred to by a number of authors. Otis

[17] reported that five of his patients suffered a re-occurrence of serious psycho-

somatic symptoms after commencing meditation, and Lazarus [18] reports cases of

attempted suicide, severe depression and schizophrenic breakdown following TM

instruction. It appears likely that such cases are the result of over-meditation initially.

This belief is supported by the reported findings that over-meditation of manyhours a day, month after month, may induce symptoms that range in severity from

insomnia to psychotic manifestation often with hallucinatory behaviour [2]. Such

over-meditation appears to be very unusual however.

This therefore constitutes a very brief review of what is now a large body of

scientific research into meditation. There is some evidence from psychophysiological

and personality studies that meditation practice is associated with decreases in

anxiety and neuroticism and that it seems possible that those who meditate regularly

and consistently are less susceptible to stress, and recover more quickly after stressful

incidents. Furthermore, the work examining the usefulness of meditation in

psychiatry and in the treatment of stress-related disorders provides us with groundsfor cautious optimism.



01scuss10r:

The problem of how to explain results associated with meditation still remains if

placebo effects are assumed to be only a partial cxpianation. l-low does meditation

magically produce lower arousal during and outside of meditation? I5 it the secret

psychophysical properties of the religious sound the practitioner repeats or is it theresponse of some divine force to the magical invocation of its name, as some would

have us believe? I propose that there is a more rcasonablc, if more turg~tl and

colourless explanation.

The meditation state is characterised by decreased arousal. This decrease in

arousal is produced at least partially by four contributing factors. The repetition of

a simple stimulus is known to produce habituation of the orienting reaction and to

produce sleep onset. Meditation often involves the repetition of a single simple

stimulus such as a mantra. Secondly, during meditation the eyes are usiially closed

and $0 exernal stimulation is reduced and this is likely to produce decreascc in

arousal. Thirdly, practitioners of meditation often report that they prefer to meditatein warm, dimly-lit, comfortable, quiet rooms where they are unlikely to be

disturbed [l]. Such an environment is also likely to produce relaxation. Finally,

there are the expectations of the meditator that meditarion in\-ol\,ej deep rclasation

and states of peace. The combination of these factors makes it ikcly therefore that

decreases in arousal will occur during meditation.

Those attracted to meditation arc \lgnificantly more anxious and nciirotic than

the normal population. Such individuals have been shown to hake significantly

higher levels of autonomic and cortical arousal. Now, it may well be that the

decreased arousal associated with meditation is more pleasurable and recvarding for

subjects cvith normally high levels of arousal. Indeed, subjective reports of meditation[l] suggest that the meditation state is perceived as pleasantly relaxing--~dcscrirti(~ns

include phrases such as:

“Freling\ of quiet; calmnes: peace; pleasant fcling\. warm iorlteniciitic\\, le.c rr f o i’IlOi:

<tillnrsr and warmth, ;.elaution he~ond thongbi id:np o1‘\ uspel l \ i ol 1 Ii ,dwp fi srnl rh."

Such perceptions may be subJecti\ely more pleasant and re\\drding for those wh..

normally display high levels of arousai. Thus the subjecti\,e experience of meditatio:l

is a pleasant one and continued meditation practice i_creinforced. l-he dccreahe ii)

arousal associated with meditation might then reasonably be ::upposed 10 generalist

with regular practice to other behaviour if relaxation ha\ been learned and found

to be pleasant.Other theoretical explanations which have been adcanced in the past have ~ggc~ed

that meditation ii a form of desensitization. It has been proposed that Jurins IIIC

low arousal meditation state unfinished psychic material, pre\,erbal elitotional

trauma and lift conflicts are dealr with. A number cjf authors, have referred to :hc

‘deautomatiration’ which is supposed to result from meditation practice. They see

meditation as a way of learning to experience without either categorizing or

experiencing in any predetermined way likely io result irom habit. Finally it i>

possible to see meditation as a technique which produces >ignificant changes in the

perception of the ‘self’. 1191.

Whatever the theoretical explanation for the t‘t‘~cc:l~ ~i\oc~;i:ed M j~ Ineditatlolipractice, the untratJder? re~arch gr::i:i~’ Wli;;ril:\ C. \ iCi l si i e. IT: . : i l c [)o>5ibliilv lh,lt LI

technique exists \i ~ c i ii al~~.~ciated L I i: Iiiriz; :.?d : 2;.i”,;lliOil ,.i, lklLiCire;ics:ij B liii’ ‘t




is one which deserves very careful study. With the advent of all wonder cures like

meditation and biofeedback, initial enthusiasm can produce a great many hopes,

claims and expectations which are later washed away by the results of careful

research.

It does appear however that as research into meditation continues, there remainbeneficial effects which can have practical applications in the field of mental

health.

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SERAFINOWICZ H. Metabolic and EEG changes during transcendental meditation. Biol. Psychol. 5,101 (1977).

Sucr Y. and AKUTSU K. Studies on resoiration and enerev metabolism during sitting in Zazen.

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ROGERS C. A. and LIVINGSTON D. D. Accumulative effects of periodic relaxation. Percept. Mot.

Skills. 44, 690 (1977).FEHR T. A longitudinal study of the effect of the TM program on changes in personality. In ScientificResearch on the Transcendental Meditation Program, Collected Papers (Edited by ORME-JOHNSON

D., DOMASH L. and FARROW J.). MIU Press, West Germany (1976).

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experience with the therapy based upon concepts of patanjali in the treatment of psychiatric

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P. E., CRASSWELLERK. D., GREENWOOD M. H., KOTCH J. B., ARNS P. A. and ROSNER B. Treatment

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Psychother. Psychosom. 30,229 1978).WOOLFOLK R. L., CARR-KAFFASHAN L. and MCNULTY T. Meditation training as a treatment for

insomnia. Behav. Ther. 7,359 1976).

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LAZARUS A. Psychiatric problems precipitated by transcendental meditation. Psycho/. Rep. 39, 601

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West - The Psychosomatics of Meditation