THE PSYCHOSOMATICS OF MEDITATION

MICHAEL 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 HAS 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 imagine
yourself 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 world
The 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 what
happens 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 meditation
practice 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 claims
for 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 expectancy
effects 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 peoples
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 of 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 rate
Skin 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.
The psychosomatics of meditation
269
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 and
they 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 experimental
group 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 within
psychiatry 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 disorder3
Not surprisingly, some attention ha\ also been focused on the effectiveness ol
The psychosomatics of meditation 271
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 many
hours 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 grounds
for 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 the
response 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 meditate
in 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! iIlOi:
<tillnrsr and warmth, ;.elaution he~ond thongbi id:np o1 \ uspel l \ i ol 1 I i , dwp f i 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_c reinforced. 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 tt~cc:l~ ,~i\oc~;i:ed M !!j~ Ineditatloli
practice, the untratJder? re~arch gr::i:i~ !Wli;;ril:\ C. \ i Ci l si i e. I T: . ! : ; 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,!lkl LiCire;ics:ij B!liii!t
The psychosomatics of meditation
273
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 remain
beneficial effects which can have practical applications in the field of mental
health.
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