When Chris Brown used a laser to create repeated pin-pricks of pain in the arms of volunteers, he made a curious discovery. Half the men and women felt the pain was less unpleasant than did the others. And scans of their brains showed that areas that are involved in anticipation were far less active.
The two groups of people were identical, except that those for whom the pain sensation was less unpleasant were all men and women who practised meditation. And the longer they had practised, the lower the sensation.
The research by Dr Brown and pain specialists at Manchester University gives fresh insight into the way that meditation may work to ease symptoms in conditions as diverse as chronic pain, rheumatoid arthritis, depression, anxiety, insomnia, and irritable bowel syndrome.
“It seems to work by reducing the anticipation of pain and reducing the negative view of pain, rather than distracting attention away from pain sensation itself,” he says. “When people meditate they focus on their breathing or on other body sensations, and learn how to experience these sensations with attitudes of acceptance, openness and curiosity. This appears to reduce negative thinking about sensations such as pain.”
Meditation’s origins date back thousands of years, and there are many different types, including Samatha, mantra, Zen Buddhist, yoga, Sahaj Marg, and the two that are more widely used in the west, transcendental and mindfulness meditation.
Many of the origins of mindfulness meditation are in Buddhism, and in one of the most widely used forms, users are taught to focus on the sensation of breathing in and out. They are taught to focus attention on what is being experienced in the present, rather than the future or the past. In this way, it’s suggested, meditators learn to experience thoughts and emotions in their everyday life with greater balance and acceptance.
Transcendental meditation has its roots in Hindu traditions, and uses a mantra – words repeated silently – to block distracting thoughts. Its goal is to achieve a state of relaxed awareness.
Hundreds of studies have looked at the effects of meditation on health, and many have found benefits. But it is difficult to carry out gold-standard placebo-controlled trials for meditation therapies. Many studies have simply compared the outcomes in those who had meditation with those who did not, but it is difficult to design trials that control for everything that might contribute to a placebo effect, which is likely to be high in this kind of therapy.
Another way to help validate the effectiveness of the therapy would be to tease out the mechanisms by which it could work, and many researchers are looking at just that. At the Human Pain Research Group, University of Manchester, researchers carried out pain perception tests on 27 men and women, half of whom practised meditation. The volunteers were exposed to flashes of pain from a laser over a five-minute period.
“We found from brain scans that the meditators had less activity in the areas of the brain associated with anticipation. They also had a reduction in the sensation of pain compared to the other people,” says Dr Brown. “We believe that in meditation, focusing attention on breathing, for example, anchors the individual in the present and not the past or the future. When the individual experiences pain, they do not block it out, |but deal with it in a less negative way. In this way, meditation should reduce the emotional evaluation of pain or other stressful events by withdrawing attention away from anticipating their unpleasantness.”
It has also been suggested that meditation might work by affecting the autonomic or involuntary nervous system, which regulates many organs and muscles, controlling functions such as heartbeat, sweating, breathing and digestion. It consists of the sympathetic nervous system, which prepares the body for action and the “fight-or-flight response”, where heart and breathing rates increase and blood vessels narrow, restricting the flow; and the parasympathetic nervous system, which causes the heart and breathing rates to slow, and blood vessels to widen, improving, blood flow. It is thought that meditation may reduce activity in the sympathetic nervous system and increase activity in the para-sympathetic system. More than 50 clinical trials are under way looking at the effects of meditation in various conditions, or at how it may work.
Mindfulness meditation may rival medication at preventing relapse in people with depression, according to a report in the Harvard Mental Health Letter of a study involving 160 adults who had experienced at least two episodes of major depression. In the first phase of the study, the patients took antidepressants, and after eight months, 53 per cent were in remission and went on the second phase where they either continued with antidepressants at a lower dose, had a placebo pill, or had mindfulness-based therapy. During this period 38 per cent of patients having mindfulness therapy relapsed, compared with 46 per cent on medication, and 60 per cent on placebo.
Irritable bowel syndrome
A study at the State University of New York showed meditation reduced symptoms. Significant reductions were noted for abdominal pain, diarrhoea, flatulence, bloating and pain. “It appears continued use of meditation is particularly effective in reducing the symptoms of pain and bloating; and it is a beneficial treatment for IBS in both the short and the long term,” say researchers.
Mindful meditation may help in |losing weight, according to a study at Oregon Research Institute, which involved six weeks of training, focusing on mindfulness meditation, mindful eating, body awareness and triggers to overeating. Results show the obese people had significant decreases in weight, binge eating, depression and stress. “This study provides preliminary evidence that an eating-focused, mindfulness-based intervention can result in significant changes in weight, eating behaviour and psychological distress,” say researchers.
Mindfulness-based stress reduction could work for social anxiety disorder, according to a study at Stanford University. Brain scanning showed that during breath-focused work there were changes in brain activity. “These changes might facilitate reduction |in social anxiety behaviour, clinical symptoms and emotional reactions to negative self-beliefs,” say researchers.
Just four days of mindfulness meditation training can reduce pain intensity. In a US study at Wake Forest University School of Medicine, men and women were exposed to experimental pain. Results show that meditating reduced pain unpleasantness by 57 per cent, and pain intensity by 40 per cent.
Symptoms in a number of chronic conditions can be improved with mindfulness-based stress reduction. Researchers at La Trobe University in Australia analysed results from 15 studies, which looked at the mental and physical health, wellbeing, and quality of life of people with conditions including fibromyalgia, chronic pain, rheumatoid arthritis, type 2 diabetes, chronic fatigue syndrome and cardiovascular conditions. “Participation [in meditation] is likely to result in coping better with symptoms, improved overall wellbeing and quality of life, and enhanced health outcomes,” they say.
Chronic insomnia can be helped by mindful meditation, according to a study at the University of Minnesota. Patients were given mindfulness training over three months. Results show it reduced the time taken to get to sleep by an average of 8.9 minutes and provided evidence for meditation as a viable treatment for chronic insomnia.
Mind-body therapies can reduce menopausal symptoms, according |to a review of research at the West Virginia University School of Medicine. Eight of the nine studies of yoga, tai chi, and meditation-based programmes showed improvements in overall menopausal symptoms, including hot flushes and night sweats. |Results also show that breath-based and other relaxation therapies may be effective for alleviating menopausal symptoms, say the researchers.
Quality of life, and symptoms of depression and fatigue improve after mindfulness training, according to a trial at the University Hospital Basel with 150 patients. Results show that those who had the training – an eight-week programme – saw improvements that were still evident six months later.