The understudied risks of mindfulness

Seeking inner peace? Brown researchers warn that mindfulness meditation isn’t as harmless as you may think.

Meditation has been around for thousands of years, but it’s only in the past few years that a modern form has found mainstream popularity. No longer primarily a religious practice of monastics, mindfulness and other meditation-based programs are sprouting up in hospitals, businesses, schools, and prisons. Need wellbeing on the go? Now, there’s an app—or rather, hundreds of apps—for that.

While these programs have promise, popular enthusiasm and a widespread application have proceeded without much assessment of safety. Brown researchers worry this puts vulnerable people at risk from overstated claims of benefit and understated harms.

Finding clarity

There’s an assumption that meditation is free of risks or side effects. But ancient meditation manuals, scientific reports, and mindfulness program guidelines have documented the potential risks of meditation including hypersensitivities, insomnia, anxiety, dissociation, re-experiencing of traumatic memories, and psychosis.

Drs. Willoughby Britton and Jared Lindahl, co-directors of Brown’s Clinical and Affective Neuroscience Laboratory (CLANlab), conducted the largest study to date on the risks and challenges of meditation. Entitled “The Varieties of Contemplative Experience,” the study took more than a decade to complete. Interviews with more than 100 Buddhist meditation teachers and meditators yielded 59 categories of meditation-related challenges and 26 influencing factors that impact whether these experiences are mild and fleeting or long-lasting and debilitating.

Drs. Willoughby Britton (left) and Jared Lindahl (right)
Drs. Willoughby Britton (left) and Jared Lindal (right), co-directors of Brown's Clinical and Affective Neuroscience Laboratory (CLANlab)

Meditation practitioners described in detail the types of challenges they faced as practitioners and how they responded to them. Some practitioners reported challenges that were transient and that fit in with their expectations about how meditation worked, whereas others reported long-term and debilitating experiences that often required seeking alternative means of support. 

The causes of meditation-related challenges, their duration and impact, and how they are appraised depends upon multiple social, individual, and cultural variables. Britton and Lindahl’s ongoing research in the CLANlab has been focused on addressing these issues in the context of mindfulness-based programs—one of the fastest-growing delivery systems for meditation, and one in which meditation-related challenges have remained understudied. 

The fact that I am receiving calls from meditators-in-distress indicates that they are not receiving adequate support from wherever they learned to meditate.

Dr. Willoughby Britton Co-director of Brown's Clinical and Affective Neuroscience Laboratory

“Current research at the CLANlab investigates which meditation practices are best or worst suited for which types of people or conditions and why,” says Britton. “The lab also creates guidelines for properly measuring and monitoring meditation-related adverse effects in clinical trials, since less than a quarter of meditation studies actively assess adverse effects.”

In addition to ongoing research, Britton and Lindahl seek to close the “science-to-service gap” between research and end-users, including meditators and meditation teachers. “Usually it takes 17 years for a scientific discovery to reach its end-users,” says Britton, “but in the case of meditation risks, that’s far too long. People need to have this information to make informed decisions about meditation now.”

“First, Do No Harm”

At the request of mindfulness and meditation organizations worldwide, Britton and Lindahl have been providing training for meditation teachers and mindfulness providers called “First, Do No Harm.” The three-day training includes a detailed overview of meditation-related challenges; best practices for informed consent, screening and monitoring; trauma-informed management strategies; and strategies for context-specific decision making. The training is supplemented by a free, online “Meditation Safety Toolbox” of guidelines, research articles, and other resources. In the meantime, Britton still receives several calls a week from meditators-in-distress. She runs a weekly online support group that spans nine time zones.

“The fact that I am receiving calls from meditators-in-distress indicates that they are not receiving adequate support from wherever they learned to meditate,” says Britton. “Whether it's mindfulness centers, apps, or school programs, these programs should be taking responsibility for the effects of the practice they are teaching—both positive and negative. In the meantime, we just need to keep trying to raise awareness.”

 

Willoughby Britton, PhD is the director of the Clinical and Affective Neuroscience Laboratory and assistant professor (research) in the Department of Psychiatry and Human Behavior at the Warren Alpert Medical School at Brown University. Jared Lindahl, PhD is a visiting assistant professor in Brown’s Department of Religious Studies and director of the humanities research track in the Clinical and Affective Neuroscience Lab.

Top photo by Dingzeyu Li