Research on meditation

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EEG technology has been used for meditation research

Since the 1950s hundreds of studies on meditation have been conducted, though many of the early studies were flawed and thus yielded unreliable results.[1][2] More recent reviews have pointed out many of these flaws with the hope of guiding current research into a more fruitful path.[3]

Research on the processes and effects of meditation is a growing subfield of neurological research.[4][5][6][7][8][9] Modern scientific techniques and instruments, such as fMRI and EEG, have been used to see what happens in the body of people when they meditate, and how their bodies and brain change after meditating regularly.[5][10][11][12][13]

Meditation remains a broad and poorly defined term. More reports assessed that further research needs to be directed towards the theoretical grounding and definition of meditation.[1][14]

Weaknesses in historic meditation research[edit]

A comparison of the effect of various meditation techniques on systolic blood pressure.[15]

In June, 2007 the United States National Center for Complementary and Alternative Medicine (NCCAM) published an independent, peer-reviewed, meta-analysis of the state of meditation research, conducted by researchers at the University of Alberta Evidence-based Practice Center. The report reviewed 813 studies involving five broad categories of meditation: mantra meditation, mindfulness meditation, yoga, T'ai chi, and Qigong, and included all studies on adults through September 2005, with a particular focus on research pertaining to hypertension, cardiovascular disease, and substance abuse.

The report concluded, "Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality. Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence. Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results." (p. 6) It noted that there is no theoretical explanation of health effects from meditation common to all meditation techniques.[1]

A version of this report subsequently published in the Journal of Alternative and Complementary Medicine stated that "Most clinical trials on meditation practices are generally characterized by poor methodological quality with significant threats to validity in every major quality domain assessed". This was the conclusion despite a statistically significant increase in quality of all reviewed meditation research, in general, over time between 1956 and 2005. Of the 400 clinical studies, 10% were found to be good quality. A call was made for rigorous study of meditation.[3] These authors also noted that this finding is not unique to the area of meditation research and that the quality of reporting is a frequent problem in other areas of complementary and alternative medicine (CAM) research and related therapy research domains.

Of more than 3,000 scientific studies that were found in a comprehensive search of 17 relevant databases, only about 4% had randomised controlled trials (RCTs), which are designed to exclude the placebo effect.[1]

A 2013 statement from the American Heart Association evaluated the evidence for the effectiveness of TM as a treatment for hypertension as "unknown/unclear/uncertain or not well-established", and stated: "Because of many negative studies or mixed results and a paucity of available trials... other meditation techniques are not recommended in clinical practice to lower BP at this time."[16]

Research by type of meditation[edit]

Mindfulness[edit]

A 2013 metastudy of mindfulness meditation found moderately improved anxiety and depression.[17] Another study showed higher mindfulness and reduced stress correlated with the number of days meditated per week.[18]

A 2003 meta-analysis found that Mindfulness-Based Stress Reduction (MBSR) may be broadly useful for individuals attempting to cope with clinical and nonclinical problems. Diagnoses for which MBSR was found to be helpful included chronic pain, fibromyalgia, cancer patients and coronary artery disease. Improvements were noted for both physical and mental health measures.[19]

Sahaja yoga and mental silence[edit]

Sahaja yoga meditation features a state called "mental silence" or "thoughtless awareness" (an aspect often not included in other meditation techniques). Users of this meditation have been shown to achieve clinically and statistically significant better levels of mental health, emotional health and general health when compared with the general population,[20][21] in work related stress, depressed feelings, and quality of life as compared to users of common stress management programs,[22][23] and to relaxing, listening to music or taking a short nap.[24][25] Sahaja meditation was also found, in comparison with a control, to have limited beneficial effects on the impact of asthma.[26]

Sahaja meditation has been shown to correlate with particular brain and brain wave activity.[27][28] Some studies have led to suggestions that Sahaja meditation involves 'switching off' irrelevant brain networks for the maintenance of focused internalized attention and inhibition of inappropriate information.[29]

A study comparing practitioners of Sahaja Yoga meditation with a group of non meditators doing a simple relaxation exercise, measured a drop in skin temperature in the meditators compared to a rise in skin temperature in the non meditators as they relaxed. The researchers noted that all other meditation studies that have observed skin temperature have recorded increases and none have recorded a decrease in skin temperature. This suggests that Sahaja Yoga meditation, being a mental silence approach, may differ both experientially and physiologically from simple relaxation.[30]

Kundalini yoga[edit]

Kundalini yoga meditation research has found that their "appears to produce structural as well as intensity changes in phenomenological experiences of consciousness", and that multiple regions of the brain are active.

Theoria[edit]

Fifteen Carmelite nuns came from the monastery to the laboratory to enter a fMRI machine whilst meditating, allowing scientists there to scan their brains using fMRI while they were in a state known as Unio Mystica (and also Theoria).[31] The results showed that far-flung parts of the brain were recruited in the sustaining of this mystical union with God.[31] The documentary film Mystical Brain by Isabelle Raynauld examined this study.[32]

Integrative body-mind training[edit]

A study involving the participation of a group of college students, who were asked to use a meditation technique called integrative body-mind training (IBMT involves body relaxation, mental imagery, and mindfulness training), concluded that "meditating may improve the integrity and efficiency of certain connections in the brain" through an increase in their number and robustness.[33] Brain scans showed strong white matter changes in the anterior cingulate cortex.[34]

Transcendental[edit]

The first Transcendental Meditation (TM) research studies were conducted at UCLA and Harvard University and published in Science and the American Journal of Physiology in 1970 and 1971.[35] However much research has been of poor quality,[36][37][38] including a high risk for bias due to the connection of researchers to the TM organization and the selection of subjects with a favorable opinion of TM.[39][40][41] Independent systematic reviews have not found health benefits for TM exceeding those of relaxation and health education.[36][42][43] A 2013 statement from the American Heart Association described the evidence supporting TM as a treatment for hypertension as Level IIB, meaning that TM "may be considered in clinical practice" but that its effectiveness is "unknown/unclear/uncertain or not well-established".

Research on unspecified or multiple types of meditation[edit]

Brain activity[edit]

The medial prefrontal and posterior cingulate cortices have been found to be relatively deactivated during meditation (experienced meditators using concentration, lovingkindness and choiceless awareness meditation). In addition experienced meditators were found to have stronger coupling between the posterior cingulate, dorsal anterior cingulate, and dorsolateral prefrontal cortices both when meditating and when not meditating.[44]

Another study (of Tibetan Buddhist, QiGong, Sahaja Yoga, Ananda Marga Yoga and Zen meditators) found reduced functional interdependence between brain regions in meditation.[45]

During meditation a modest increase in slow alpha or theta wave EEG activity has been observed.[46][47]

Perception[edit]

Studies have shown that meditation has both short-term and long-term effects on various perceptual faculties. In 1984 a study showed that meditators have a significantly lower detection threshold for light stimuli of short duration.[48] In 2000 a study of the perception of visual illusions by zen masters, novice meditators, and non-meditators showed statistically significant effects found for the Poggendorff Illusion but not for the Müller-Lyer Illusion. The zen masters experienced a statistically significant reduction in initial illusion (measured as error in millimeters) and a lower decrement in illusion for subsequent trials.[49] Tloczynski has described the theory of mechanism behind the changes in perception that accompany mindfulness meditation thus: "A person who meditates consequently perceives objects more as directly experienced stimuli and less as concepts… With the removal or minimization of cognitive stimuli and generally increasing awareness, meditation can therefore influence both the quality (accuracy) and quantity (detection) of perception."[49] Brown also points to this as a possible explanation of the phenomenon: "[the higher rate of detection of single light flashes] involves quieting some of the higher mental processes which normally obstruct the perception of subtle events." In other words, the practice may temporarily or permanently alter some of the top-down processing involved in filtering subtle events usually deemed noise by the perceptual filters.

Sleep need[edit]

Kaul et al. found that sleep duration in long-term experienced meditators was lower than in non-meditators and general population norms, with no apparent decrements in vigilance.[50]

Relaxation response[edit]

Herbert Benson, founder of the Mind-Body Medical Institute, which is affiliated with Harvard University and several Boston hospitals, reports that meditation induces a host of biochemical and physical changes in the body collectively referred to as the "relaxation response".[51] The relaxation response includes changes in metabolism, heart rate, respiration, blood pressure and brain chemistry. Benson and his team have also done clinical studies at Buddhist monasteries in the Himalayan Mountains.[52] Benson wrote The Relaxation Response to document the benefits of meditation, which in 1975 were not yet widely known.[53]

Calming effects[edit]

According to a March 2006 article in Psychological Bulletin, EEG activity begins to slow as a result of the practice of meditation.[54] The human nervous system is composed of a parasympathetic system, which works to regulate heart rate, breathing and other involuntary motor functions, and a sympathetic system, which arouses the body, preparing it for vigorous activity. The National Institutes of Health (NIH) has written, "It is thought that some types of meditation might work by reducing activity in the sympathetic nervous system and increasing activity in the parasympathetic nervous system," or equivalently, that meditation produces a reduction in arousal and increase in relaxation.

Work stress[edit]

A study of GPs attending a meditation workshop found subsequent falls in their Kessler Psychological Distress Scale - 10 (K10) readings.[55]

Western therapeutic use[edit]

Meditation has entered the mainstream of health care as a method of stress and pain reduction. As a method of stress reduction, meditation has been used in hospitals in cases of chronic or terminal illness to reduce complications associated with increased stress that include depressed immune systems. There is growing agreement in the medical community that mental factors such as stress significantly contribute to a lack of physical health, and there is a growing movement in mainstream science to fund research in this area. There are now several mainstream health care programs which aid those, both sick and healthy, in promoting their inner well-being, especially mindfulness-based programs such as Mindfulness-Based Stress Reduction (MBSR).

Flow[edit]

Mindfulness meditation, mindfulness of the breath, and related techniques, are intended to train attention for the sake of provoking insight. A wider, more flexible attention span makes it easier to be aware of a situation, easier to be objective in emotionally or morally difficult situations, and easier to achieve a state of responsive, creative awareness or "flow".[56]

Potential adverse effects and limits of meditation[edit]

The following is an official statement from the US government-run National Center for Complementary and Alternative Medicine:

"Meditation is considered to be safe for healthy people. There have been rare reports that meditation could cause or worsen symptoms in people who have certain psychiatric problems, but this question has not been fully researched. People with physical limitations may not be able to participate in certain meditative practices involving physical movement. Individuals with existing mental or physical health conditions should speak with their health care providers prior to starting a meditative practice and make their meditation instructor aware of their condition."[57]

Adverse effects have been reported,[58][59] and may, in some cases, be the result of "improper use of meditation".[60]The NIH advises prospective meditators to "ask about the training and experience of the meditation instructor... [they] are considering."[57]

As with any practice, meditation may also be used to avoid facing ongoing problems or emerging crises in the meditator's life. In such situations, it may instead be helpful to apply mindful attitudes acquired in meditation while actively engaging with current problems.[61] According to the NIH, meditation should not be used as a replacement for conventional health care or as a reason to postpone seeing a doctor.[57]


See also[edit]

References[edit]

  1. ^ a b c d Ospina MB, Bond TK, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, Bialy L, Hooton N, Buscemi N, Dryden DM, Klassen TP (June 2007). "Meditation Practices for Health: State of the Research. Evidence Report/Technology Assessment No. 155". Agency for Healthcare Research and Quality. Retrieved 2012-01-27. 
  2. ^ "Empirical research on meditation started in the 1950s, and as much as 1,000 publications on meditation already exist. Despite such a high number of scientific reports and inspiring theoretical proposals (Austin, 19 9 8; Shapiro & Walsh,1984; Varela, Thompson, & Rosch, 19 9 1;Wallace, 2 0 0 3 ; West, 1987), one still needsto admit that little is known about the neurophysiological processes involved in meditation and about its possible long-term impact on the brain. The lack of statistical evidencecontrol populations and rigor of many of the early studies; the heterogeneity of the studied meditative states;and the difficulty in controlling the degree of expertise of practitioners can in part account for the limited contributions made by neuroscience-oriented research on meditation." – "Meditation and the Neuroscience of Consciousness: An Introduction" by Lutz, Dunne and Davidson
  3. ^ a b Ospina MB, Bond K, Karkhaneh M, et al. (December 2008). "Clinical trials of meditation practices in health care: characteristics and quality". J Altern Complement Med 14 (10): 1199–213. doi:10.1089/acm.2008.0307. PMID 19123875. 
  4. ^ There has been a dramatic increase in the past 10 or 15 years or so of studies on the impact of meditation upon one's health. Translator for The Dalai Lama, interviewed in a video here
  5. ^ a b http://www.investigatingthemind.org/ "...the power of our non-invasive technologies have made it possible to investigate the nature of cognition and emotion in the brain as never before..." Mind and Life Institute summary of Investigating the Mind 2005 meetings between The Dalai Lama and scientists
  6. ^ Venkatesh S, Raju TR, Shivani Y, Tompkins G, Meti BL (April 1997). "A study of structure of phenomenology of consciousness in meditative and non-meditative states". Indian J. Physiol. Pharmacol. 41 (2): 149–53. PMID 9142560. 
  7. ^ Peng CK, Mietus JE, Liu Y, et al. (July 1999). "Exaggerated heart rate oscillations during two meditation techniques". Int. J. Cardiol. 70 (2): 101–7. doi:10.1016/s0167-5273(99)00066-2. PMID 10454297. 
  8. ^ Lazar SW, Bush G, Gollub RL, Fricchione GL, Khalsa G, Benson H (May 2000). "Functional brain mapping of the relaxation response and meditation". NeuroReport 11 (7): 1581–5. doi:10.1097/00001756-200005150-00041. PMID 10841380. 
  9. ^ Carlson LE, Ursuliak Z, Goodey E, Angen M, Speca M (March 2001). "The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up". Support Care Cancer 9 (2): 112–23. doi:10.1007/s005200000206. PMID 11305069. 
  10. ^ mindandlife.org
  11. ^ Davidson, Richard J.; Kabat-Zinn, J.; Schumacher, J.; Rosenkranz, M.; Muller, D.; Santorelli, S.F.; Urbanowski, F.; Harrington, A.; Bonus, K.; Sheridan, J.F. (July–August 2003). "Alterations in brain and immune function produced by mindfulness meditation". Psychosomatic Medicine 65 (4): 564–570. doi:10.1097/01.PSY.0000077505.67574.E3. PMID 12883106. 
  12. ^ Physiological Effects of Transcendental Meditation by Wallace @ http://www.sciencemag.org/cgi/content/abstract/167/3926/1751 published in 1970!
  13. ^ Kabat-Zinn, Jon; Lipworth, L.; Burney, R. (1985). "The clinical use of mindfulness meditation for the self-regulation of chronic pain". Journal of Behavioral Medicine 8 (2): 163–190. doi:10.1007/BF00845519. PMID 3897551. 
  14. ^ Awasthi, B (Dec 2012). "Issues and perspectives in meditation research: In search for a definition". Front. Psychology.: 3:613. 
  15. ^ Ospina p.130
  16. ^ Brook, Robert D.; Appel, Lawrence J.; Rubenfire, Melvyn; Ogedegbe, Gbenga; Bisognano, John D.; Elliott, William J.; Fuchs, Flavio D.; Hughes, Joel W.; Lackland, Daniel T.; Staffileno, Beth A.; Townsend, Raymond R.; Rajagopalan, Sanjay (April 22, 2013). "Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure : A Scientific Statement From the American Heart Association". Hypertension 61 (6): 1360–83. doi:10.1161/HYP.0b013e318293645f. PMID 23608661. 
  17. ^ http://www.ncbi.nlm.nih.gov/pubmed/24395196
  18. ^ "Mindfulness and psychologic well-bei... [J Altern Complement Med. 2011] - PubMed - NCBI". ncbi.nlm.nih.gov. Retrieved 2014-05-27. 
  19. ^ Grossman, P.; Niemann, L.; Schmidt, S.; Walach, H. (2004). "Mindfulness-based stress reduction and health benefitsA meta-analysis" (pdf). Journal of Psychosomatic Research 57 (1): 35–43. doi:10.1016/S0022-3999(03)00573-7. PMID 15256293. Retrieved 2010-07-07.  edit
  20. ^ http://www.hindawi.com/journals/ecam/2012/350674/
  21. ^ http://www.beyondthemind.com/research/data-slides/
  22. ^ http://lancashirecarelibraryblog.com/2011/02/12/meditation-mindfulness-and-mind-emptiness/
  23. ^ Manocha, Ramesh (2011-01-05). "Meditation, mindfulness and mind-emptiness" (etext). Acta Neuropsychiatrica (subscription required). doi:10.1111/j.1601-5215.2010.00519.x. Retrieved 2011-07-26. 
  24. ^ http://www.ncbi.nlm.nih.gov/pubmed/22611427
  25. ^ http://www.beyondthemind.com/wp-content/uploads/2013/01/Dr-Ramesh-Manocha%E2%80%99s-Doctoral-Thesis.pdf
  26. ^ http://www.ncbi.nlm.nih.gov/pubmed/11828038
  27. ^ http://www.ncbi.nlm.nih.gov/pubmed/11524157
  28. ^ http://www.ncbi.nlm.nih.gov/pubmed/16019582
  29. ^ http://www.ncbi.nlm.nih.gov/pubmed/12231432
  30. ^ Manocha R, Black D, Ryan J, Stough C, Spiro D, [1] "This study demonstrates a skin temperature reduction on the palms of the hands during the experience of mental silence, arising as a result of a single 10 minute session of Sahaja yoga meditation." [Changing Definitions of Meditation: Physiological Corollorary, Journal of the International Society of Life Sciences, Vol 28 (1), Mar 2010]
  31. ^ a b M. Beauregard & V. Paquette (2006). "Neural correlates of a mystical experience in Carmelite nuns". Neuroscience Letters (Elsevier) 405 (3): 186–90. doi:10.1016/j.neulet.2006.06.060. ISSN 0304-3940. PMID 16872743. 
  32. ^ Mystical Brain
  33. ^ "Meditation boosts part of brain where ADD, addictions reside". Ars Technica. Retrieved 2010-08-22. 
  34. ^ "Integrative body-mind training (IBMT) meditation found to boost brain connectivity". ScienceDaily. Retrieved 2010-08-22. 
  35. ^ Lyn Freeman, Mosby’s Complementary & Alternative Medicine: A Research-Based Approach, Mosby Elsevier, 2009, p. 163
  36. ^ a b Krisanaprakornkit, T.; Krisanaprakornkit, W.; Piyavhatkul, N.; Laopaiboon, M. (2006). "Meditation therapy for anxiety disorders". In Krisanaprakornkit, Thawatchai. Cochrane Database of Systematic Reviews (1): CD004998. doi:10.1002/14651858.CD004998.pub2. PMID 16437509. "The small number of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for anxiety disorders. Transcendental meditation is comparable with other kinds of relaxation therapies in reducing anxiety" 
  37. ^ Ospina MB, Bond K, Karkhaneh M, et al. (June 2007). "Meditation practices for health: state of the research". Evid Rep Technol Assess (Full Rep) (155): 1–263. PMID 17764203. "Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality. Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence." 
  38. ^ Ernst E (2011). "Chapter 51: Complementary and Alternative Approaches to Management of Patients with Heart Disease". In Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine (9th ed.) (Saunders). ISBN 978-1-4377-2708-1. "A systematic review of six RCTs of transcendental meditation failed to generate convincing evidence that meditation is an effective treatment for hypertension"  (References the same 2004 systematic review by Canter and Ernst on TM and hypertension that is separately referenced in this article)
  39. ^ Canter PH, Ernst E (November 2004). "Insufficient evidence to conclude whether or not Transcendental Meditation decreases blood pressure: results of a systematic review of randomized clinical trials". Journal of Hypertension 22 (11): 2049–54. doi:10.1097/00004872-200411000-00002. PMID 15480084. "All the randomized clinical trials of TM for the control of blood pressure published to date have important methodological weaknesses and are potentially biased by the affiliation of authors to the TM organization." 
  40. ^ Krisanaprakornkit T, Ngamjarus C, Witoonchart C, Piyavhatkul N (2010). "Meditation therapies for attention-deficit/hyperactivity disorder (ADHD)". In Krisanaprakornkit, Thawatchai. Cochrane Database Syst Rev 6 (6): CD006507. doi:10.1002/14651858.CD006507.pub2. PMID 20556767. "As a result of the limited number of included studies, the small sample sizes and the high risk of bias" 
  41. ^ Canter PH, Ernst E (November 2003). "The cumulative effects of Transcendental Meditation on cognitive function--a systematic review of randomised controlled trials". Wien. Klin. Wochenschr. 115 (21–22): 758–66. doi:10.1007/BF03040500. PMID 14743579. "All 4 positive trials recruited subjects from among people favourably predisposed towards TM, and used passive control procedures … The association observed between positive outcome, subject selection procedure and control procedure suggests that the large positive effects reported in 4 trials result from an expectation effect. The claim that TM has a specific and cumulative effect on cognitive function is not supported by the evidence from randomized controlled trials." 
  42. ^ Ospina, MB.; Bond, K.; Karkhaneh, M.; Tjosvold, L.; Vandermeer, B.; Liang, Y.; Bialy, L.; Hooton, N. et al. (June 2007). "Meditation practices for health: state of the research". Evid Rep Technol Assess (Full Rep) (155): 1–263 [4]. PMID 17764203. "A few studies of overall poor methodological quality were available for each comparison in the meta-analyses, most of which reported nonsignificant results. TM had no advantage over health education to improve measures of systolic blood pressure and diastolic blood pressure, body weight, heart rate, stress, anger, self-efficacy, cholesterol, dietary intake, and level of physical activity in hypertensive patients" 
  43. ^ Krisanaprakornkit, T.; Ngamjarus, C.; Witoonchart, C.; Piyavhatkul, N. (2010). "Meditation therapies for attention-deficit/hyperactivity disorder (ADHD)". In Krisanaprakornkit, Thawatchai. Cochrane Database Syst Rev 6 (6): CD006507. doi:10.1002/14651858.CD006507.pub2. PMID 20556767. "As a result of the limited number of included studies, the small sample sizes and the high risk of bias, we are unable to draw any conclusions regarding the effectiveness of meditation therapy for ADHD." 
  44. ^ "Meditation experience is associated with differences in default mode network activity and connectivity". pnas.org. Retrieved 2014-05-27. 
  45. ^ http://www.ncbi.nlm.nih.gov/pubmed/22266174
  46. ^ Lutz, Antoine. "Breakthrough study on EEG of meditation". Retrieved 2006-08-14. 
  47. ^ Bhattathiry, M.P. "Neurophysiology of Meditation". Retrieved 2006-08-14. 
  48. ^ Brown, Daniel, et al. "Differences in Visual Sensitivity Among Mindfulness Meditators and Non-Meditators". Perceptual and Motor Skills 1984: 727–733.
  49. ^ a b Tloczynski, Joseph, et al., "Perception of Visual Illusions by Novice and Longer-Term Meditators". Perceptual and Motor Skills 2000: 1021–1027.
  50. ^ Meditation acutely improves psychomotor vigilance, and may decrease sleep need. Prashant Kaul, Jason Passafiume, R C Sargent and Bruce F O'Hara. Behavioral and Brain Functions 2010, 6:47 http://www.behavioralandbrainfunctions.com/content/6/1/47
  51. ^ Benson H (Dec 1997). "The relaxation response: therapeutic effect". Science 278 (5344): 1694–5. PMID 9411784. 
  52. ^ Cromie, William J. (18 April 2002). "Meditation changes temperatures: Mind controls body in extreme experiments". Harvard University Gazette (President and Fellows of Harvard College via Internet Archive). Retrieved 2011-12-11. 
  53. ^ Benson, Herbert, 1975 (2001). The Relaxation Response. HarperCollins. pp. 61–63. ISBN 0-380-81595-8. 
  54. ^ Cahn, Rael; Polich, John (March 2006). "Meditation states and traits: EEG, ERP, and neuroimaging studies". Psychological Bulletin 132 (2): 180–211. doi:10.1037/0033-2909.132.2.180. PMID 16536641. Retrieved 2012-03-03. 
  55. ^ http://www.ncbi.nlm.nih.gov/pubmed/19530378?dopt=Abstract
  56. ^ Commentary: In the Zone: A Biobehavioral Theory of the Flow Experience
  57. ^ a b c Meditation: An Introduction on the National Center for Complementary and Alternative Medicine's webpage, NCAAM is a subdivision of NIH. http://nccam.nih.gov/health/meditation/overview.htm#meditation
  58. ^ From a clinical study of twenty-seven long term meditators, Shapiro found that subjects reported significantly more positive effects than negative from meditation. However, of the twenty-seven subjects, seventeen (62.9%) reported at least one adverse effect, and two (7.4%) suffered profound adverse effects. Among these we find: relaxation-induced anxiety and panic; paradoxical increases in tension; less motivation in life; boredom; pain; impaired reality testing; confusion and disorientation; feeling 'spaced out'; depression; increased negativity; being more judgmental; and, ironically, feeling addicted to meditation Shapiro 1992, cited in Perez-De-Albeniz, Alberto and Holmes, Jeremy. Meditation: concepts, effects and uses in therapy. International Journal of Psychotherapy, Mar 2000, Vol. 5 Issue 1, p49, 10p
  59. ^ http://www.theatlantic.com/health/archive/2014/06/the-dark-knight-of-the-souls/372766/?single_page=true
  60. ^ Turner, Robert P.; Lukoff, David; Barnhouse, Ruth Tiffany & Lu, Francis G. Religious or Spiritual Problem. A Culturally Sensitive Diagnostic Category in the DSM-IV. Journal of Nervous and Mental Disease, 1995; Vol.183, No. 7 435–444. Page 440.
  61. ^ Hayes, 1999, chap. 3; Metzner, 2005

External links[edit]