The Benefits of Different Meditation Techniques
What Is The Effectiveness Cognitive Behavioral Therapy?
In recent years, it has been observed that there is increase in the literature related to meditation therapy. In comparison to the other relaxation techniques, meditation proved to be more beneficial in different conditions like anxiety, depression, blood pressure, cardiovascular heart disease, cognition and other psychology issues. Origin of meditation was found in the Buddhist teaching. Though, origin of meditation was found in the spiritual context, recently clinicians and researchers exhibited interest in the topic. Hence, numerous clinical studies were initiated to establish worldwide acceptance of meditation therapy. In this essay meditation intervention is being discussed with focus on the critical analysis of it.
Mindfulness or mind body wellness is a common term used for different practices, processes and characteristics improving attention, memory, awareness and acceptance. Though this terminology has historical base, in recent past it got attention from various discipline like psychology, psychiatry, medicine and neuroscience. Scientists, clinicians, and scholars studied it through modern techniques. Meditation got considerable attention from all the classes of people in the society; however, there is lack of methodological research for it. It has been considered as one of the most prominent practice in schools and corporate world. However, it is not accurately studied to whom it helps the most and whether it affects the mind and brain. Accurate methodology need to be implemented in actual practice because it can potentially lead to, people being harmed, cheated, disappointed, and/or disaffected. This misunderstanding about the research can lead negative implication about the meditation; hence it can affect potential utility of it. Its research in the potential area might be halted because people tired of hearing valid scientifically proved outcome of the research on meditation (Orme-Johnson et al., 2008).
Currently, it is a major subject of study for subdisciplines of psychology like social, personality, industrial/organisational, experimental, clinical, cognitive, health and educational. It has got tremendous popularity because most of the scientific literature and media got saturated by writing about meditation. However, most of the top media also failed to report accurate scientific research about it. Hence, it resulted in the exaggerated representation of the outcome of it. Meditation proved be useful in improving in both physical and psychological well-being of the person. However, it has been considered as the universal solution for most of the human deficiencies and ailments (Godfrin and van Heeringen. 2010).
Impact of Meditation on Cognitive-Attentional Processes
Empirical results need to be properly validated based on the type of meditation. Meditation for five minutes and meditation for 3 months are both being considered as mindfulness. Hence, there should be clear distinction between these two types of meditation practices. It can be resolved by establishing significant relationship between the clinical and practical outcome. It can be helpful in communicating accurate scientific aspects to the general public. Proper definition need to be established for meditation (Barker, 2014).
There are numerous studies are available for the effects of meditation on the concentrative and mindfulness-based techniques. Physical relaxation can be achieved through stress management effects of meditation. However, it has been found that there is robust correlation between meditation and cognitive-attentional processes. Understanding of these processes like physical relaxation and cognitive-attentional processes can be helpful in understanding different stages at the time of actual practice of meditation (Manicavasgar et al., 2012). Mindfulness meditation can be helpful in the moment-to-moment and non-judgemental awareness of self’s existing experience. It has not been proved whether this awareness is narrow or broad. Mindfulness meditation can be helpful in firm awareness of self’s internal and external experience. Internal experience includes cognitive-affective-sensory awareness and external experience include social-environmental awareness. Hence, it can be argued that meditation can be helpful in creating stable attention and unbiased awareness. It can produce different effects like physical relaxation, emotional balance and behavioural regulation. However, meditation is not being used widely for social and environmental awareness. All the changes in occurring during meditation can lead to stress management. There is less evidence available for the effects of meditation on physical and physiological processes (Ratanasiripong, 2015).
There are varied meditation techniques are available like Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT)), or broad categories of meditation or mindfulness techniques, such as focused attention and open monitoring, or with and without movement (MacCoon et al., 2012). All these techniques provide small to moderate improvement in the depression and anxiety including in patients with other comorbid conditions. It is difficult to identify efficacious component of the meditation therapy because most of the studies demonstrated confounding results due to following reasons : there is no detailed comparison is available for the praxis elements of each meditative therapy; hence it is difficult to identify common elements in meditative techniques in different studies. Different techniques used for the meditation can stimulate different neuronal substrates. Hence, different meditation techniques can impact different biological substrates for different psychological symptoms (Sedlmeier et al., 2012). It has not been proved whether all the meditation techniques are based on the mindfulness-based therapy. It can be likely that neural mechanisms related to cognitive component involved in the MBCT might not be involved in the MBSR. In both MBCT and MBSR, cognitive components are involved; however, in MBCT is related to cognition and MBSR is related to the stress management (Manicavasgar et al., 2013).
Physical Relaxation and Stress Management through Meditation
Treatments for the clinical depression can be provided in the distinct phases like acute, continuation, and maintenance phases, and relapse prevention in the acute or continuation phase. It is necessary to decide upon in which phase of depression can be more beneficial. It is evident that meditation exhibit different outcome in different phases (Williams et al., 2014). Meditation can exhibit effects like remission, partial benefit and total cure. Hence, it is most likely that efficacy of depression can be overestimated or underestimated if it doesn’t implement during exact phase of depression. Patients with acute severe major depressive episodes might be with low concentration necessary for meditation as compared to the partial remission. Hence, meditation effect might be more in partial remission phase of meditation. Meditation can not demonstrate potential benefit in patients with subacute depressive illness due to improvement in the patient (van Aalderen et al., 2012). Hence, it is necessary to asses the severity and phase of depression before implementing meditation therapy. MBCT proved beneficial in the considering the different phases of the depression. MBCT proved beneficial in reducing relapse rate in patients with major depressive disorders. However, therapy which mimic MBCT can’t exhibit effect similar to MBCT for relapse in patients with major depressive disorders (Omidi et al., 2013; Barnhofer et al., 2009).
Numerous studies are available for usefulness of meditation therapies for alleviating undesirable mental and physical conditions. Meditation therapies proved useful in conditions like pain, stress, anxiety, depression, obesity and addiction. However, clinical utility of meditation in most of these issues have not been established in the clinical trials. Most of the clinical studies were initiated for the meditation; however, these were not completed. Approximately 30 % studies didn’t reach beyond phase 1, 20 % studies were conducted in phase 2a, 9 % studies were conducted in phase 2b and only 1 % studies were conducted in phase 3. Meditation interventions were mainly differed in types of practice, methods of training and duration of intervention. Meditation has been advocated in multiple conditions like attention, positive mood, substance abuse, eating habits, sleep, and weight control. However, there is no proper evidence available for effectiveness of meditation in these conditions. Hence, prior to implementation of meditation in these conditions clinical validity need to be proved. It is evident that there is no improvement in the rigour of the medication therapies since many years. Clinical studies usually advance to next stage, if there is improvement in the efficacy of the intervention studied in that particular study. In case of meditation intervention, it has been observed that most of the studies are not advanced beyond stage 2A. From this, it is difficult to establish whether meditation interventions exhibited required efficacy in the prior studies. More research need to be carried to establish validity and to prove robust efficacy of the meditation intervention (Awasthi, 2012). It has been advocated that meditation intervention can be useful for both physical and mental disorders. However, there is no demarcation among different meditation interventions about its specific utility in either mental or physical disorders. Since, both physical and mental disorders need to be evaluated; multiple professionals form different disciplines need to be incorporated in the clinical studies of meditation intervention.
Different Phases of Depression and the Usefulness of Meditation Intervention
Most of the meditation interventions not used one pointed focus of attention; however, these interventions used varied attentional foci and techniques (Lutz et al., 2008). There are varied meditation techniques are available and all these techniques are different in its procedure and these techniques have different components. Most widely used meditation techniques include MBCT, Tai Chi studies, Sudarshan Kriya Yoga and Patanjali Yoga. In Sahaj Yoga, meditative component is present both in un-aerobic movement exercise and stationary posture and in Tai Chi technique meditative component is present during movement (Yeung, 2012; Lavretsky et al., 2011). Hence, single meditation technique can not be implemented to all the people. Moreover, similar outcome cannot be expected form the all the meditation techniques. Comparative assessment of all these techniques need to be carried out in randomised clinical trial to rank their superiority on one another and make decision on the specificity of the technique based on the person. Comparison of all these techniques can be effectively carried out by assessing same psychometric and neurophysiological measures (Chiesa and Serretti, 2010). It can be helpful in assessing the extent of benefit of these techniques. However, this kind of assessment is difficult because outcome of the meditation is mainly based on the aspects like behaviour, emotion, cognition and stress. It is difficult to recruit people with same baseline characteristics of behaviour, emotion, cognition and stress (Bohlmeijer et al., 2010).
Procedures and outcomes of different meditation techniques cannot be generalized because limited commonality among these techniques. From the clinical studies also, it is evident that at the same stage of depression different meditation techniques were implemented (Shahar et al., 2010). However, comparison of these studies for relative usefulness of these techniques is not possible because in different studies people with different baseline characteristics were being recruited. There is one common aspect evident among all the meditation techniques. This aspect is that all these techniques exhibit efficacy due to certain specific element and not due to non-specific element of the technique. However, these common elements of different techniques are not similar. Hence, all these techniques cannot be implemented for the same person. Most of the studies of meditation therapy were being carried out on the small number of participants and none of the studies were not being carried out at different locations. Generalizability and validity of any therapy can be decided based on the number of participants recruited in the study and outcome of the study at different locations. Hence, generalizability of these studies is questionable. These limitations of meditation therapy studies might be due to purpose and drive for the conduction of the study. Most of meditation therapy studies were being conducted based on the cultural, spiritual and social aspects and not on the medical aspects. Sustained or long-term effect of any intervention can be evaluated by following-up the study. However, there is very less data available for follow-up in case of meditation technique intervention. Sham group is very important for assessing the effectiveness of therapy. However, in most of the studies related to meditation, sham group was not incorporated. Hence, it was difficult to assess the improvement from the baseline characteristics due to implementation of meditation intervention. Due to these limitations in the study design of these studies, these studies cannot be used as evidence-based studies for implementation in the clinical setting. Medications can produce significant impact on the outcome of the meditation intervention. Moreover, associated co-morbid conditions also can have significant impact on the outcome of the meditation intervention (Sohn et al., 2018). Hence, studies need to designed for the specific population with purpose of assessing impact of medications and co-morbid conditions.
Establishing Clinical Validity and Efficacy of Meditation in Various Mental and Physical Disorders
Existing studies of meditation therapy didn’t describe complete data related to the participants like adverse reaction and drop out rate, didn’t explained complete procedure to participants and didn’t considered their expectations. Hence, it is difficult to assess risk-benefit ration of particular meditation technique. It limits its application in the wider population (Schneider et al., 2012). Clinical validity of any intervention can be improved by its wider application. Studies related to meditation interventions were not being published due to unexpected outcome. Hence, these meditation clinical trials need to be registered. Psychoeducation along with meditation intervention can be more useful as compared to the meditation intervention alone. However, less evidence is available for such type of studies. Meditation is a practice and each meditation technique require its own skills. However, people of different healthcare status might not be able to follow the accurate technique of meditation. Hence, these meditation techniques cannot be implemented in vulnerable population. Studies can be designed in such a way that, these studies consist of all the components like meditation, active comparator and optimum psychoeducation (Segal et al., 2010). By incorporating all these elements in the meditation intervention, complete output from the study can be obtained with more clinical significance. Interaction of meditation intervention with psychotherapy and lifestyle changes need to be assessed. Psychotherapy and lifestyle changes can significantly influence outcome of the meditation. Large scale studies need to be carried out to provide clinical utility of the integrated effect of meditation, psychotherapy and lifestyle changes. Interaction among all these therapies might be additive, synergistic, antagonistic and partially active. Hence, it is important to assess this interaction to avoid overestimation or underestimation of the outcome. It can also be helpful to fit meditation technique in the usual therapeutic regimen of cognitive and depressive disorders (Hamidian et al., 2013).
Conclusion:
Meditation therapies are being increasingly advocated; however clinical utility of these medication therapies has not been fully established. Existing RCTs, for the meditation therapies proved positive in improving cognitive and depressive symptoms; however, these outcomes are not being generalized for the wider population due to limitations of these studies. Limitations of these studies include recruitment of participants without matching baseline data, lack of comparator group, lack of large number of participants and lack of follow-up of the studies. Meditation therapies are being used as first-line therapy and adjuvant therapies for cognitive and depressive symptoms; however, its clinical validity in the diverse population has not been established. Further studies need to be carried out to evaluate efficacy of meditation therapies in the co-morbid conditions. Interactions among medication therapy, psychotherapy and lifestyle changes need to be carried out for optimum utilization of the meditation therapies.
References:
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