Effects of Meditation: Psychological Literature.
While literature on beneficial effects of meditation involves much research data (Shapiro 1982; West, 1987), literature on adverse effects is largely anecdotal, and no one has factored out effects of other variables such as the aloneness, silence, and reduced food and sleep that often accompany intensive meditation. Spontaneous muscular-skeletal movement, proprioceptive sensations, and intense emotional states (known as “unstressing” in TM literature) often occur and can take extreme forms during extended meditation sessions. These may relate to release of past physiological and emotional stresses stored in the mind and body (Coleman, 1971). Severe anxiety, depression, depersonalization, derealization, panic, and emergence of overwhelming repressed material sometimes occur, especially in people with traumatic backgrounds and longstanding emotional problems (Carrington, 1977; Epstein & Lieff, 1986). Extreme dysfunction, such as psychosis, is rare, but does happen, especially during intensive meditation in people who have a history of psychosis (“A forum,” 1988; Kornfield, 1989; Walsh & Roche, 1979). A reoccurrence of psychosis may be part of practice because what one fears most tends to emerge in practice (Kornfield, 1989). Also, serious pathology may emerge when the will for practice is so strong that it overrides usual defense mechanisms (“A Forum,” 1988). This idea is supported by Glueck and Stroebel (1975), who assessed the effect of TM on psychiatric inpatients and found that psychotic episodes were precipitated in Dire ho, against instructions, meditated more than twice a day for longer periods than the usual 20 minutes. Also, Sangharak****a (1980) notes that a Burmese method of respiration-mindfulness led to “extreme nervous tension and a schizoid state” in a number of people and hospitalization for some (p. xv). (This method may resemble the Sunlun practice, which involves intense effort, heavy breathing, concentration on pain, and sitting motionless for 2-3 hours. See Kornfield (1977) for a description of this practice.)
While extremely dysfunctional states are rare, ASC are common (Kornfield, 1979) and “primary process” thinking tends to increase in beginning phases of meditation (Brown & Engler, 1986; From, 1977). This cognitive mode involves more images, “drive” (sexual/aggressive) content, and preverbal and nonverbal processes than does “secondary process’ thinking, which is verbal and oriented to reality testing, goals, logic, and abstraction. Brown and Engler (1986) suggest that many Westerners may do a form of self-exploratory therapy when they become aware of the contents of their mind and consequently fail to develop the concentration and mindfulness necessary for formal meditation. Kornfield (1979) found chat many Westerners in. initial stages of intensive Vipassana meditation experienced unusual mental and physical phenomena, such as spontaneous movement, altered body-image perceptions, altered visual perceptions, powerful imagery, vivid dreams, intense feelings, and mood swings. These phenomena were uncommon in control subjects who received the instructions and teaching of the experimental group, but who meditated much less (1-2 hours/day vs. 12-15) and were not in a disciplined, silent retreat milieu. Concentration appeared to be a major factor in increasing the frequency and duration of these altered states.
Kornfield (1979) notes that traditional Western psychology considers these phenomena pathological rather than normal responses to meditation in predominantly healthy individuals. Respect for such phenomena as spiritual experiences may be growing, however (Chandler, Holden, & Kolander, 1992). Sourcebooks, such as Bragdon’s (1988), and support networks, such as the Spiritual Emergence Network, have been developed to aid people in “spiritual emergence.” The Grofs (1986, 1990) and Lukoff (1985) highlight the need to differentiate pathology from spiritual experiences and crises that can be transformative. They offer schemata of differential diagnosis and propose treatment alternatives to medication when certain criteria are met, such as lack of organicity, adequate pre-episode functioning, and abilities to relate, cooperate, work intrapsychically, maintain physical health, and refrain from acting upon impulses. This spiritual emergence movement has impacted diagnostic criteria in the forthcoming DSM—IV, the main diagnostic manual used by mental health professionals (“Diagnosing,” 1992).
Differentiation of spiritual and psychotic! psychosis proneness.
If phenomena are similar in spiritual-mystical and psychotic states, what makes these states different and who is prone to psychosis? Chapman and Chapman (1980) take an empirical approach to these questions. They suggest that these experiences fall on a continuum as to degree of deviancy. Factors that make for less deviancy are: incomplete belief in the experience; presence of cultural support for the experience; brevity; facilitation by hypnogogic or hypnopompic states; the subject talking about past rather than present experience; other factors that make the experience seem closer to normal. They recognize that fairly well-functioning people can have occasional psychotic or psychotic-like experiences, so factors such as level of stress and functioning are also considered in assessing someone’s stability. As to the issue of proneness, Chapman, Chapman, and Raulin (1976, 1978) and Eckbad and Chapman (1983) developed paper-and-pencil tests to measure several variables that purportedly are precursors of schizophrenia such as magical ideation, anhedonia (defect in experience of pleasure) and perceptual aberration (distortion in perception of body and other objects). Research on these tests’ validity has mostly involved undergraduates (Lenzenweger & Loranger, 1989). L. Chapman (personal communication, August 13, 1993) believes that the Perceptual Aberration and Magical Ideation scales could be useful screening tests for meditators if they are answered in terms of non- meditative states of consciousness.
A more theoretical approach has been taken by a number of authors who are familiar with Buddhism as well as psychodynamic, developmental, and transpersonal psychology. Wilber (1986) proposes a hierarchical “spectrum” model of development that involves “prepersonal,” “personal,” and “transpersonal” stages. These stages involve different kinds of personality organization and pathology. The prepersonal stages involve psychotic, borderline (between psychotic and neurotic), and neurotic organization and pathology. Wilber (1986) and Engler (1986; Nisker, 1988) suggest that “uncovering” therapy and meditation can be harmful to people with psychotic or borderline organization. The recommended intervention for psychotic organization, which may involve schizophrenia and bipolar (manic—depressive) diagnoses, is medication, external structure, and supportive therapy. The borderline level includes characterological or personality disorders, including the narcissistic and borderline disorders, which supposedly stem from arrest in developing a separated-individuated “self” due to constitutional factors and failures in parental empathy and responsiveness to needs. They can involve psychosis at times of stress and require ego and self “structure-building” rather than uncovering therapy or meditation. To undergo “derepressive” meditation practices, such people need a healthier sense of self and more “ego strength,” including abilities to observe self, tolerate intense emotional states, and experience feelings without acting on them. For people with neurotic organization, however, meditation can be helpful because its derepressive effect enables “regression in service of the ego.” In other words, neurotic repression is overcome and unconscious material can be made conscious and integrated.
Epstein (1986, 1998, 1989, 1990), in contrast to the above authors, believes that meditation can help transform borderline and narcissistic pathology. At deeper levels of practice, concentration and insight practices enable knowledge of the insubstantiality of selfhood and balances that knowledge with calmness.. Thereby, a transcendence of narcissism is promoted. He does not recommend advanced insight practice for people at a borderline level of organization, however, because it involves relinquishing fundamental beliefs about self and world and experiencing terrifying upsurges of regressive material. For such people, he recommends preliminary concentrative and mindfulness practices that promote ego development through stabilizing emotions and gaining an observing stance and more cohesive sense of experience. Epstein (1993) also recommends that people continue taking prescribed medication while meditating. (See also Epstein & Lieff, 1986.)
http://downthecrookedpath-meditation-gurus.blogspot.com/2012/03/meditation-related-psychosis-from.html
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