Can mindfulness meditation have negative side effects?

We have two copies of Dr. Miguel Farias' "The Buddha Pill: Can Meditation Change You?" book to give away. For a chance to win one, please email us <day6@cbc.ca>, with your full mailing address and put the word "Buddha" in the title. We'll select two entries at random. 

Adherents of meditation say it clears the mind and equips people to handle stress. A recent UBC study of grade four and five students in Coquitlam, B.C. says kids were calmer, more optimistic, and their math skills improved after being instructed in mindfulness. In 2010, a study from Toronto's Centre for Addiction and Mental Health concluded that mindfulness is just as effective as medication in preventing a relapse into major depression. But Dr. Miguel Farias of Coventry University argues that meditation can be connected to serious negative effects in some people and that the scientific research into the practice has been overwhelmingly uncritical. Farias is the co-author of the new book, The Buddha Pill: Can Meditation Change You? 

This interview has been edited for clarity and length.     

Your interest in the negative effects of meditation began with a student of yours, Louise. What happened to her?

She had been in a meditation retreat over the weekend and she was a yoga teacher. So she was used to meditating but this time things didn't go quite how she had planned. She started feeling very detached from her body. And to start with she felt, "Oh, perhaps this is a good sign that I'm moving spiritually somewhere," but she started getting more and more anxious as she felt that she couldn't get back to herself. She went back home and it kept deteriorating, so that she had to go to a psychiatric hospital and she was in treatment for most of ten years. 

You said that she thought this might be a good thing. What did she think was happening to her?
I've heard this from other people who have gone through similar experiences. Because you're doing something to get to a deeper spiritual place, if something comes up that is somewhat disturbing what you usually hear from the teacher is, "Just keep on doing it and it will eventually disappear. It's just part of the process." So she thought it was just part of the process. But in this case it just turned out to be a very severe psychosis. 

So how do you know that this is connected to meditation? Couldn't Louise have had a pre-existing psychological condition that might have been triggered by any number of things?
Yes, she herself comes up with that kind of explanation, that perhaps she did have some kind of vulnerability. However there's new research coming out from Brown University by Willoughby Britton, in which she's analyzing a large sample of long-term meditators. And she's arriving at the conclusion that you don't need to be particularly vulnerable. This can happen to anyone.

Is Louise's experience, which was a profound psychosis and went on for a long time and required long term treatment, is that typical for the people who have problems with meditation? 

So one study suggests that these very severe bad experiences can happen in up to 7% of the people. However, most long-term meditators will have experienced at least one difficult experience - not a severe as this, but they will have experienced something like unexpected deep anger or anxiety. Let me quote something by a meditation teacher from the Hindu tradition who we interviewed for our book. She was a Swami. She said that her Indian spiritual teacher told her, "Meditation was very much like cooking lentils. The scum rises to the surface when you are doing this." And with meditation, it's very much like that. So within Buddhism and Hinduism actually in the first and intermediate stages, it's not supposed to make you feel better or less stressed. It's actually supposed to shake you up. Something else which I should point out is that the longer you meditate for, the more likely you are to get to deeper levels, but also to unleash difficult material.

So some of the people that you've observed, and this is the case with Louise, these effects came after intensive periods of meditation, not somebody who was routinely meditating for a 15-minute period every day?

Yes, it was after a two-day intensive meditation retreat. However, there is some evidence that even a three-day short intervention of mindfulness, so where you just meditate for 15-minutes twice a day can actually lead to increased levels of biological stress. 

So let's look at that seven percent figure that you cited. If seven percent of the people who meditate may have problems, that still 93 per cent of people who will benefit. There are potential problems connected to antidepressants as well. So why do you think that 7% number is significant?

There is the 7% of people who may suffer severely from meditation, but then there's quite a lot of people for whom meditation does nothing. So there's been quite a lot of talk about meditation helping with recurrent depression, with mindfulness in particular. The most rigorous study done on mindfulness-based cognitive therapy for recurrent depression actually show that it didn't help. It didn't help more doing meditation than just being in the control group. There was nothing about it in the news. 

But that same study did not show that 7% of the people that were undertaking it went into deep psychosis. There have been thousands of scientific studies about meditation. Why aren't more of them coming to the same conclusions as you?

Well, one reason may be that very, very few studies, particularly on mindfulness, are actually asking participants if they have suffered any negative effects from meditating. So we are not asking participants this information. And because there is this whole hyped belief that meditation is always good for you, as a researcher what I think we're dealing with is a massive lack of information. People are not simply coming forward and saying, "Actually, I felt rather bad at a certain stage." They're either not saying anything or dropping out of the studies. 

What do you think is happening in the process of meditation that's leading people into a possible psychosis?
Meditation has always been a self-exploration technique. We need to have a holistic understanding of who we are. We have lots of hidden room within ourselves. So we have a great propensity towards being good and compassionate, but there's also within us the propensity for aggression and violence. And for a very good reason: survival. So when we start shaking up the deeper structures of who we are exploring ourselves, it's perfectly normal that we find out something unexpected about ourselves. And sometimes we're not at the stage at which we're ready to deal with this material, which is probably what is happening to the people who have suffered most severely from meditating. However, there are some psychiatrists who would claim that within this crisis there is the possibility of spiritual growth. I don't know. I sit on the fence here. What I'm dealing with right now is the necessity to address that there are these potentially very harmful psychological effects coming out of meditation techniques whether they are transcendental meditation or mindfulness. And we need to be aware of this.

But you're saying that medication could potentially be dangerous. So what advice do you have for someone who's thinking of taking up meditation?

Be aware that all sorts of things can come up. Find a meditation teacher who is aware of the individual differences - that people react differently to meditation. It will work wonderfully for some. It will do nothing for others. And it may be harmful for a few others. So check with your meditation teacher that he or she knows about this.