Meditation types

Meditation can be an effective form of stress reduction and has the potential to improve quality of life and decrease health care costs. Meditation involves achieving a state of ‘thoughtless awareness’ in which the excessive stress producing activity of the mind is neutralized without reducing alertness and effectiveness. Authentic meditation enables one to focus on the present moment rather than dwell on the unchangeable past or undetermined future.

There are many meditation types available to consumers. Three notable examples include Sahaja Yoga Meditation, Transcendental Meditation and Mindfulness.

Sahaja Yoga Meditation is the technique of choice in the Meditation Research Program (MRP). Sahaja Yoga Meditation aims to promote the experience of ‘thoughtless awareness’ based on the original meditative tradition. Meditators in the MRP consistently describe the ability to achieve this experience. They are encouraged to practice twice daily for approximately 15 minutes. Sahaja Yoga Meditation is well suited for the general population and for research, because it is easy to learn and is taught free of charge. Sahaja Yoga Meditation is currently used in three Sydney hospitals for patients, staff and public. Feedback from management teams and anecdotal reports from patients and carers are favourable. As yet no adverse effects have been reported in the MRP’s trials, clinics or in the literature.

The MRP has conducted a number of small and large trials on Sahaja Yoga Meditation which have generated promising results in Australian conditions. A randomized controlled trial of meditation for moderate to severe asthma compared Sahaja Yoga Meditation to a relaxation control. Sahaja Yoga Meditation was more effective in a number of objective and subjective endpoints.

A number of locally conducted pilot studies examining the effect of Sahaja Yoga Meditation suggest that it may have a beneficial role in menopausal hot flushes, severe migraine and psychological stress. Randomized controlled trials are underway in order to obtain definitive data. Studies in India suggest that Sahaja Yoga Meditation is more beneficial than mimicking exercises in the treatment of epilepsy and hypertension.[10]

Transcendental Meditation is the commonest form of mantra meditation. It aims to prevent distracting thoughts by use of a mantra. Students are instructed to be passive and, if thoughts other than the mantra come to mind, to notice them and return to the mantra. A Transcendental Meditation student is asked to practice for 20 minutes in the morning and again in
the evening.

Transcendental Meditation is said to be associated with clinical outcomes such as blood pressure reduction[1] and physiological changes such as lowered blood cortisol levels.[2]

Adverse effects
There are however, a number of case reports in the mainstream medical literature describing occasional adverse psychological[3] , [4] and physical effects[5] that appear to be causally related to the technique. These adverse events range from mild to severe and warrant further systematic investigation.[6]

Cost issues
The technique is taught using a commercial system in which one begins by purchasing a mantra. Further instruction entails an escalating system of fees that can be cost prohibitive. Moreover, the Transcendental Meditation organization has on occasion been implicated in unethical and cultic practices.[7] In light of this information, medical practitioners have no choice but to recommend caution with regard to this method.

Mindfulness is a general method that serves as a basis for techniques such as Vipassana meditation. It aims to use focused attention (often by using a physical sensation such as the breath) to cultivate mental calmness. Regular practice enables one to objectively observe one’s thoughts and therefore enhance one’s self understanding. Mindfulness approaches have been shown to be effective in certain clinical applications such as chronic pain.[8]

Vipassana is both a general term referring to a specialized form of mindfulness meditation and also a specific brand name. The following information refers to the latter. Vipassana is taught in Australia via a number of Vipassana retreats and centres. The retreats involve up to 10 days of intensive meditation, several hours per day, and other strict observances such not talking and encouragement to maintain strict postures for long periods of time. There is no fee for these retreats but ‘recommended donations’ are described. These retreats are unsuitable for the average person, particularly those unfamiliar with meditation, due to the extreme physical and psychological demands. Adverse events associated with Vipassana have been described although it is unclear as to which form these reports refer.[9]

Dr Ramesh Manocha
Meditation Research Program – Royal Hospital for Women, Sydney

[1] Schenider. In search of an optimal behavioral treatment for hypertension: a review and focus on transcendental meditation. In: Johnson E H, ed. Personality, elevated blood pressure and essential
hypertension. Washington DC: Hemisphere.
[2] Maclean C, Walton K. Effects of the Transcendental Meditation Program on adaptive mechanisms: Changes in hormone levels and responses to stress after four months of practice. Psychoneuroendocrinology. 1997; 22(4): 277–295.

[3] Heide F J, Borkovec T D. Relaxation induced anxiety: Mechanism and theoretical implications. Behav Res Ther 1984; 22:1–12.

[4] The various implications arising from the practice of transcendental meditation: an empirical analysis of pathogenic structures as an aid in counsel ling. Bensheim, Germany: (Insti tut fur Jugend und Gesellschaft, Ernst-Ludwig-Strasse 45, 6140); The Institute for Youth and Society, 1980.

[5] Persinger M A. Transcendental meditation and general meditation are associated with enhanced complex partial epileptic-like signs: evidence for cognitive kindling? Percept Mot Skills 1993; 76:80–82.
[6] Otis L S. Adverse effects of transcendental meditation. In: Shapiro D, Walsh R, eds. Meditation: classic and contemporary perspectives. New York: Alden, 1984.
[7] Skolnick A. Maharishi Ayur-Veda: Guru’s marketing scheme promises the world eternal perfect health! JAMA 1991; 266(10):1741–1750.
[8] Kabat-Zinn J, Lipworth L, Burney R, et al. The clinical use of mindfulness meditation for the self regulation of chronic pain. J Behav Med 1998; 8(163):190.
[9] Shapiro D, Deane H. Adverse effects of meditation: A preliminary investigation of long term meditators. Int J Psychosom 1992; 39:1–4; SI:62–67.
[10] Panjwani U, Selvamurthy W, Singh S H, Gupta H L, Thakur L, Rai U C. Effect of Sahaja yoga practice on seizure control & EEG changes in patients of epilepsy. Ind J Med Res 1996; 103(3):165–72.