Is mindfulness the right treatment for everyone?

– By Dr Miguel Farias and Catherine Wikholm

The benefits of mindfulness have hit the news yet again. This time the reports stated that a study found mindfulness-based cognitive therapy (MBCT) to be as effective as anti-depressants in preventing the relapse of recurrent depression. While the authors of that paper interpreted their results in a slightly less positive light than the media, stating that (contrary to their hypothesis) mindfulness was no more effective than medication, the meaning inferred by many is that mindfulness is superior to medication. In fact, media reports would have us believe it is a panacea for the modern-age — a cure-all for common human problems, from stress, to anxiety, to depression. By taking this ‘natural pill’ every day, we open ourselves up to the potential for myriad benefits and no ill-effects — unlike synthetic pills, such as anti-depressants, whose potential for negative side-effects we are all aware of.

Mindfulness has been sold to us and we are buying it. After all, thousands of studies suggest that meditation produces various kinds of measurable psychobiological effects. However, despite what is commonly propagated in the media, the idea that science has unequivocally shown how meditation can change us is a myth. After examining the literature from the last 45 years on the science of meditation, we were astonished to find out that that we’re no closer to finding out how meditation works or who benefits the most or the least from it.

The few available meta-analyses report moderate evidence that meditation affects us in various ways, such as reducing anxiety and increasing positive emotions. However, it is less clear how powerful and long-lasting these changes are — does it work better than physical relaxation, for example? Or than a placebo? The evidence is contradictory and inconclusive. We need better studies, as well as convincing models as to HOW meditation works. For example, with mindfulness-based cognitive therapy (MBCT), we still can’t be sure about what is actually the ‘active’ ingredient in this ‘Buddha pill’ for recurrent depression. Is it the meditation itself that causes the positive effects, or is it more to do with learning to step back and become aware of our thoughts and feelings in a supportive group environment?


The Side Effects of Mindfulness

Mindfulness is presented as a technique that will have myriad positive effects – and only positive effects. It is easy to see why this myth is so widespread. After all, sitting in silence, focusing on your breathing or being aware of the flow of thoughts and feelings would seem like a fairly innocuous activity with little potential for harm. But when we consider that for many of us sitting alone with our thoughts is something we rarely do, it isn’t hard to see how this might lead to difficult thoughts and emotions rising to the surface – which we may, or may not, be equipped to deal with. Yet the potential for emotional and psychological disturbance – what we refer to in our book as the ‘dark side of meditation’ – is rarely talked about by mindfulness researchers, the media, or mentioned in MBCT training courses.

And here we come to an important point. Buddhist meditation was designed not to make us happier, but to radically change our sense of self and perception of the world. Given this, it is perhaps not surprising that many will experience other effects such as dissociation, detachment, depression… However, like the small print on boxes of medication, these ‘side-effects’ that happen to some individuals are not what the creators of this pill are concerned with promoting; when trying to sell a product, one will of course tend to promote only its benefits. Yet this does not mean there is not a downside. For some, penicillin is life saving; for others, it induces a harmful reaction. Just because your friend or family member responds to a pill a certain way, does not mean you will respond the same; the same is also true with this ‘Buddha pill’; for some, it may be very effective, for some, it may not work at all, for others, there may be harmful effects.

Mindfulness has become a ‘brand name’ product for an ancient technique that has been carefully marketed to appeal to consumers who are over-worked, stressed, anxious, depressed, or simply seeking some relief. That we could gain this naturally is of course appealing – who wouldn’t want to take a natural pill over a synthetic one? Yet here we must also consider: mindfulness as we know has been separated from its roots, stripped of its ethical and spiritual connotations, and sold to us as a therapeutic tool. While this may not deny its power as a technique to change our state of consciousness and with implications for mental health, it arguably limits its ‘naturalness’, as well as its potential – at least as originally intended. Many Buddhists are critical of the use of meditation for purposes which are very different from the radical shift in perception they aim for — the realisation of ‘emptiness’ and liberation from all attachments. Instead, some claim, this technique has been turned into a McMindfulness which only reinforces one’s egocentric drives.

Our aim is not to dissuade individuals from trying out mindfulness or to suggest that pharmacological approaches to mental health are better than psychotherapy-based ones. The idea that each of us is unique is a cornerstone of individual-based therapy. But with mindfulness-based therapy approaches there is little space for one’s individuality, in part because it’s a group practice, but also because there has been no serious attempt to address how individuals react differently to this technique. So if you go into it – as with taking any other kind of pill – keep your eyes open. Don’t consume mindfulness blindly.

Miguel Farias leads the Brain, Belief and Behaviour group at Coventry University and Catherine Wikholm is finishing a doctorate in Clinical Psychology at the University of Surrey. They have written “The Buddha Pill: Can Meditation Change You?” (Watkins, 2015)

Disclosure Statement: Miguel Farias receives funding from the John Templeton Foundation and the Bial Foundation.

Vicky Hartley is the Marketing Director and Head of Digital for Watkins Publishing Limited (including Duncan Baird Publishers)