What are the downsides of mindfulness meditation?

0:04 This is Crappita Happy and I am your host, Cas Dunn. I'm a clinical and coaching psychologist. I'm mindfulness meditation teacher and of course author of the Crappita Happy books. In this show, I bring you conversations with interesting, inspiring, intelligent people who are experts in their field and who have something of value to share that will help you feel less crappy and more happy. Hello and welcome to another solo episode of the Crappita Happy Podcast. Today, I want to talk about mindfulness meditation. But before you switch channels because you don't want to hear about mindfulness meditation, what I want to talk today about is when is mindfulness meditation perhaps not the answer? When is it not good for you? And what are some of the circumstances in which it might be really helpful to consider what some of those adverse effects might be. Anybody who knows me knows that I'm a big fan of mindfulness meditation. And somebody asked me last week if I could share with her some resources demonstrating the benefits of mindfulness meditation. She asked me because she was trying to convince somebody else who was skeptical about the practice of mindfulness and meditation, And of course my first response was, of course, there's so much research. How could anybody be skeptical because I've

1:34 been practicing and teaching it for so long, and I am really a huge fan and very familiar with what some of the studies are that have proven the benefits of mindfulness for physical and mental health and improving overall wellbeing. I'm obviously a huge fan. Just from the perspective of any kind of behavior change as a therapist and as a coach, I think if we want to make changes to our patterns of thinking and behavior, the ways that we kind of undo ourselves and sabotage ourselves, and the old patterns that we repeatedly fall into in our lives, I think we have to start with a level of mindful awareness, that is, being able to observe ourselves in the moment, to see what we're doing, to watch what's happening as it's happening with no judgment, to bring that element of curiosity to ourselves in order to be able to pause and choose a different response, to be able to recognize a pattern of behavior is unhelpful, and to be able to then choose a more wise response and to be able to do that with kindness and compassion.

2:38 So even as a coach, I feel like having that base level, that foundation of mindfulness, that mindful awareness, the capacity to be able to observe ourselves and what's happening around us and within us without judgment is just key. And then when you add to that all of the reported benefits to your wellbeing, reducing relapse rates, depression, helping you manage stress, anxiety, improved communication in relationships, physical benefits, improved experience of pain, lengthening of telomeres like reducing signs of aging and illness, thicker gray matter, and your brain. I could go on and on and on. To me, it seems like a no brainer. Of course mindfulness meditation is good for you. But when I was asked this question, I thought, well, in the spirit of me being mindful, noticing my own automatic response the path that I go down, wanting to just say, of course, mindfulness is great, why wouldn't everybody be practicing mindfulness meditation, I thought, well, maybe I need to pause and check myself and have a look into what are some of the times or situations when maybe mindfulness meditation is not the right thing. What are potentially some of the adverse experiences that people have when they try to practice mindfulness meditation? And I think this also came about. I felt this was important because when I was supporting a friend of mine a while ago who was delivering a mindfulness teacher training, I was

4:09 asked the question, what about if a student, for example, has experienced trauma, like, how do we be aware of people's trauma when my teaching mindfulness meditation? Bearing in mind that these people who were taking this teacher training are not mental health professionals, and so my response in that situation had been, I think we need to treat everything as trauma informed. We need to practice trauma informed everything. By that, I mean a significant proportion of the population has experienced some trauma. So my view is classrooms, workplaces, courses, classes, anybody we interact with, I believe we should all be practicing trauma informed behaviors. And so I guess my response was, there are certain things that you can do in a class, and the way that you manage a classroom situation if you're teaching a group of students and you don't know what they're history, is that you would do things in such a way as to be mindful that some people may have a traumatic background, empower people to make their own decisions about what they're comfortable with, what they're not, give people permission to participate, to not participate, et cetera, et cetera. But then afterwards I thought, well, maybe that wasn't really a full response, and maybe it is worth and I do believe now it is worth equipping people, particularly people teaching mindfulness and people who are practicing mindfulness, for them to have some awareness of what might happen when you're practicing mindfulness meditation if you have a history of trauma. And so that's what I mean also by a potential adverse experience or an adverse reaction to a

5:41 mindfulness meditation. So with that little bit of context, I thought today I would just like to spend a bit of time explaining what some of the research has been because I did dig up some research which is looking at what the adverse reported effects potentially can be from mine meditation, and also just cover a little bit of this trauma stuff. So if you are looking at initiating a mindfulness meditation practice, if you're looking at taking a class learning mindfulness, if you are teaching mindfulness meditation, then what are some of the things that we all need to probably be a little bit more aware of, Because in my experience as a student for many years of mindfulness meditation, typically if you are not comfortable, if you're not having a good experience, if you're struggling with meditation, the answer always seems to be, sit with it, take it back to the cushion, observe, be curious, allow All feelings are welcome. All experience is a welcome observe without judgment.

6:41 But sometimes that can be really difficult for people if the experience that they're having is deeply, deeply distressing because of a personal history, for example, of trauma. So let's just start with I hopped online and I started to look has there been research done into the adverse effects of mindfulness meditation, And recently there have been some analysis done meta analysis looking at a whole big bunch of mindfulness research studies and looking at what the adverse experiences were that were reported. By and large, the summary, like the net result of all of these studies was that mindfulness meditation does improve people's experience of depression, anxiety, stress, and improves the overall well being. That's a fact. Some of the analysis found that mindfulness didn't necessarily improve people's experience any more so than, for example, physical exercise or some other sort of mental health intervention. I think that's fair enough. I think you know, we already know that mindfulness can be as effective, for example, as CBT, So it's not like and different people respond differently to different kind of interventions. So I'm not sure that we're necessarily saying it is the one thing that is going to help improve your mental health. But it certainly is a thing and intervention a practice that is going to improve your mental health. The interesting thing was that many of these studies didn't actually measure adverse experiences. Obviously, when you do a research study, you're looking at, okay, well, I'm

8:12 testing to see if this is going to be beneficial for people, you know, if it's going to improve their scores on depression scales or anxiety scales, improve their experience of mood, their wellbeing overall, et cetera, et cetera. But many of the studies were not actually looking for adverse experiences. They weren't asking people to report adverse experiences. So I guess that's an issue we probably need to be spending more time asking people to report adverse experiences. There have been some studies though, that show that people's scores on for example, a depression inventory are higher after they have completed a mindfulness intervention. So when I say mindfulness intervention, I'm talking about like when they do these studies, they will put people through like a four week course or an eight week course, where you go to class every week and you'll learn some mindfulness meditation skills, do some meditation in class, and then you go home and you practice each day and you get some instruction. So definitely, there have been some studies that have shown that people's scores are higher. There have been some other reports of people actually experiencing psychosis. So I read one particular case study of a man who had no mental health history who attended a the Passiona meditation program. Now this is a different thing. This is quite an intensive meditating all day, every day for a period of time. The partial courses are typically a ten day program. I've done one myself many years ago, but you can go for twenty days, thirty days, and this individual had attended two separate the

9:44 Pasiona courses nine years apart, and after both of those experiences, the time that he spent in that intensive meditation, when he returned home, he had really paranoid delusions, thought his wife was having an affair, for people trying to kill him, thought his wife was trying to poison his food, stopped going to work, you know, really serious kind of psychotic episode. Needed to be medicated, and in the second instance, needed to be hospitalized. It's kind of a really different thing than what we're talking about with a brief mindfulness intervention, like an eight week course like I mentioned before. Those VI PASIONA programs are, like I said, intense. You're meditating from for example, four in the morning sometimes through until late at night. There is no contact with the outside world.

10:30 These are the rules with these strict kind of a passion of courses. You don't have access to your phone, you're not supposed to speak to anybody, make eye contact with anybody. And for some people, and my understanding is that for the second program that he did, it was like a twenty day program, and it was by about day eighteen that they sent him home because he was getting aggressive and getting really paranoid, and so he had experienced sleep deprivation, that was fasting, he was only eating one meal a day. So I guess in that case, when you if you hear reports of that kind of adverse experience, that's quite a different scenario than what would be a typical mindfulness meditation course that the average person would would do to develop skills in mindfulness meditation. It is still really interesting and noteworthy, but I think what I have read is that they're not really sure did meditation cause psychosis or did were the other factors the fasting, the sleep deprivation, the sensory deprivation, And also is it that the meditation practice is putting stress on the individual which ultimately kind of induces this kind of a breakdown, this mental breakdown that happens in both cases. That guy, you know, he was hospitalized the second time around, he was medicated, and he made a full recovery by all accounts, And I guess the result of that that the upshot of all of that, the conclusion was that people are teaching mindfulness, they probably need to be more aware of potential adverse experienceperiences, and that mindfulness teachers need to be

12:03 trained to be able to manage trained in mental health issues in case some of this comes up. But as a counter argument, I just wanted to make the point that it's really important to be clear about what you define as an adverse experience with mindfulness meditation, because if somebody reports that they feel more depressed, for example, if somebody reports that they feel more anxious, it could be argued that what mindfulness meditation is. The point of mindfulness meditation is to be more present with what is happening as it's happening, as opposed to distracting ourselves or engaging in unhelpful coping strategies. Unhelpful coping strategies are things that we do to manage feelings of discomfort, for example, drinking, online shopping, Facebook scrolling, compulsive busyness, just avoidance of anything that is particularly distressing or uncomfortable for us. Most of us spend a lot of our lives in avoidance, and the point of mindfulness meditation is to get present with what is actually happening in your life and in your world, in your emotional world, what is actually happening, and being able to sit with that. So, if somebody reports that they feel more depressed after they have practiced mindfulness meditation.

13:28 It could well be that all mindfulness has done is remove the distraction, bring to their attention something that they've been very busy avoiding, which is not a bad thing. Like the point, once you're truthful, once you're honest, and once you can confront what is actually happening in your life, your unpleasant thoughts and feelings, well, then you take back the power to be able to make different decisions and make some choices about how you manage that that do not involve unhelpful, unhealthy hoping strategies that you might otherwise be engaging in. If somebody is talking about psychosis, we have to look at what else is going on. What are the circumstances in which this is occurring. Because practicing and sitting for fifteen minutes in meditation fifteen to thirty minutes and focusing on your breath, the idea that would trigger a psychotic episode is difficult to fathom, to be honest, unless there is something dormant that is there that is being uncovered. All I would say is that I think if we're going to look at adverse experiences, then we need to really be thinking about what are we classes an adverse experience, because if somebody just says I felt more stressed or more uncomfortable because I was practicing mindfulness meditation, it could well be that somebody's perception of mindfulness was that it's relaxing, calming thing. I'm just going to close my eyes and chill out and go to my happy place.

14:51 And what they've actually discovered is that mindfulness is about actually getting very present with what is going on within you and not hiding from it anymore. That is a much healthier path towards healing. I did interestingly read one article which looked at mindless meditation and people's willingness to make reparation to somebody that they had wronged. So basically the premise of this paper was that mindfulness meditation reduces people's negative emotions. You know, over time, this is what it does. It helps you to feel more calm, it helps you to be more accepting of both pleasant and unpleasant experiences, and just by being more accepting and more curious and kind to yourself, it can reduce the intensity of negative emotions. This is a good thing. So this premise of this paper was that sometimes a negative emotion, like something that's a difficult uncomfortable emotion is a good thing because what it does is it encourages activity. Like there is this thought action repertoire where an uncomfortable emotion prompts you to take action to do something that is in your best interests. So if you feel angry, for example, then that you feel compelled to maybe go and have a fight with somebody, and so that maybe managing your anger so that you don't do something silly or irrational is a good thing. But the experience of guilt if you have done something wrong, can actually be a useful emotion to feel if it prompts you to take action

16:21 to make amends or to repair a wrong that you have done. And these people did this study where they got people to think of somebody that they had done wrong by they evoked feelings of guilt. They had them do a fifteen minute mindfulness meditation, and then they gave them the option to make amends, to do something to repair the damage that they had done in that relationship. And there were different kinds of conditions that they might have had. They were given one hundred dollars and they could either spend it on themselves or they could give it to the person that they had done wrong, or they could split it whatever way. Anyway, the result was that people who practice mindfulness meditation were less likely to make amends, to make reparation towards somebody that they had done wrong by. And so, you know, their conclusion was that mindfulness meditation is not always a good thing because sometimes by reducing the discomfort of the negative emotion, it's actually it's not very good for relationships necessarily because it's reducing the motivation to actually make amends and take steps to you know, to do something good. And I guess that's interesting and that's worth considering. I would also add that they found that people who practiced loving kindness meditation were more likely to want to make amends. You're familiar with the loving kindness meditation because I taught it to you in a recent episode of The Crapit a Happy Podcast.

17:47 It might have been in three Mindful minutes. I'm not too sure, but I'll link it in the show notes in case you're interested, because it's a good one. So that's interesting. The loving kindness meditation actually prompted people that were more likely to make amends. But I guess, and maybe this is my bias coming in. I was thinking, okay, so a fifteen minute mindfulness meditation and then they're measuring people's behavior, of people's choices immediately after that, Practicing mindfulness and adopting an attitude of mindfulness and being more mindful in your life is not achieved after a fifteen minute meditation. The whole point of mindfulness meditation is not to sit for fifteen minutes and then make a decision about what you're going to do next. It is cultivating a skill, and it is cultivating an attitude of acceptance and curiosity and kindness, and it's a willingness to be present with what's happening. And it is couched in a whole lot of other philosophy and intention and it is about connecting with values, and it is about emotional regulation for sure, but it's also about being intentional in the choices that we make and how we live our lives, and ultimately the attitude that we choose to bring to any situation and any relationship. And it's so much more than a fifteen minute meditation. So I guess I feel a little bit like inducing an emotional response, like encouraging an emotional response,

19:18 doing a fifteen minute meditation and then seeing what people do after it. It's interesting, for sure. I'm not saying that the results weren't interesting and really and valid, But I'm not sure that that should be a reflection on somebody learning and practicing mindfulness as a whole, like engaging in a process, like even doing a course, for example, working step by step through the theory and the practice and what the point of the whole thing is, and you know how it applies to life more broadly beyond just this fifteen minutes of sitting and meditating and feeling better in yourself. And if you sit for fifteen minutes and you feel better in yourself, well then that's great. But it's so much more than that. I came on here to talk about the adverse experiences or the adverse effects of mindfulness meditation, and I think I keep bringing the counter argument and sticking with my original position, which is that it's good for you and that you should do it. But let's talk about trauma, because certainly some people who have had a history of trauma are going to find it very uncomfortable to sit in MINDFULSS meditation.

20:32 If somebody has a history of trauma, and for example, maybe they have PTSD, maybe they have experiences that make it very uncomfortable for them to close their eyes and connect with their inner world. Maybe sitting in mindfuless meditation means that they're going to experience really distressing, intrusive thoughts, images, really distressing, uncomfortable sensations in their body, and it feels unbearable to sit with that mindfuless. Metaal instructs you to sit and observe and be curious and stay with your experience. But we can't ignore the fact that for some people, in some circumstances, that is potentially really distressing and not a good thing. And I guess historically mindfulness meditation, if you're having difficulty, if you have if you're uncomfortable with something, or you're struggling with the meditation, and you go and talk to the teacher, that the advice always is just take it back to the map, Just take it back to the cushion, just observe, you know, just basically go back and do more of the same, go back and continue to practice your meditation. And I think that we know now, I think we are aware enough now that that is not always good advice for people that for some people, there needs to be a different approach for some people sitting and being present to what is happening.

21:57 It's too much. It's too much, and we have to be aware of that. And what can happen is if somebody has, for example, been referred to mindfulness meditation because they're experiencing anxiety or they're having difficulty, they're struggling, and there is this history of trauma, and somebody with the best of intention, even a GP for example, or a psychologist, has said mindfulness meditation could be helpful. When that person doesn't benefit from that, or when they people already come to mindfulness meditation and feel like they're not doing it right or it's not going to work for them or whatever, and when they have that difficult experience or that adverse experience, and the teacher's response is just stay on the mat, and that can really undermine people's sense of confidence in themselves, their faith in the practice. For people who have already been disempowered, it can just feel even more disempowering. What we want to be doing is empowering people to be able to use this tool and engage in this practice in a way that is healing and a way that feels safe. So for some people it does not feel safe to close your eyes, focus on your breath, focus on your body, and anything that makes people feel unsafe is you know, this is not the outcome that we're looking for. So I guess the point of this, without going into loads of detail, is that if you have

23:28 experienced that, then there are ways, There is a way to get to the positive outcomes, the positive benefits that are available with the practice of mindfulness meditation. But sometimes it does require a different approach, and it will require the support of somebody who has some experience of trauma and who at least has the awareness of what this might look and feel like and what some of the dangers might be, or not the dangers, but what the risks might be for some who has a history of trauma and who is therefore skilled in a way to be able to guide you through a process so that you are able to stay in a zone where you feel safe. You've heard me talk about the window of tolerance before. If you haven't, you can go back and find that the window of tolerance talks about how we're able to stay in our zone of optimal arousal. So when we stay in a zone of emotional regulation nervous system regulation, where we feel safe, calm, open, we do feel like we're in control of our experience. As soon as we start going out of the window of tolerance, we start going into hyper arousal, which is anxious, racy, panicky, overwhelmed, can't think, racing thoughts. Or then we dip into crashing, into collapse basically and lethargic, no energy, almost depressed. And people with the history of trauma sometimes like swing between these two states hyper arousal. So if that's what's happening,

25:00 can't make any change. There's no benefit to be gained by swinging between those two states. So the first thing you have to do is to be able to find your way into that window of tolerance, into that zone of optimal arousal, and be able to sense within yourself when you're slipping out of it, And so you know when you start to go towards the edge of your window of tolerance, how to have practices and processes and strategies to be able to bring yourself back into the window before you go on to the next step or choose what to do next. So you know at the very least. I think that people teaching mindfulenss meditation should have some training in this, some awareness of this, about the window of tolerance, about the zone of optimal arousal, about how trauma may impact people's experience of meditation, and to be able to therefore, at least, even if you're not a therapist or a trauma specialist, to at least have enough understanding that you can assure people that this is not that doesn't mean there's something wrong with them, and it also doesn't mean there's something wrong with a practic, but to be able to help them to feel comfortable, and to be able to provide a safe, supportive space for people rather than just directing them to continually take it back to the mat and just to stay with it and breathe through it and sit with it, and all of those things that often are what we're told when we are first learning to practice mindfulness meditation. I have to say that having gone down this path and investigated all of this a little further, and with my experience as a psychologist and as a practitioner and a

26:31 teacher of mindfulness meditation, it has occurred to me that it might be useful for me to put together a mindfulness teacher training that covers some of this that really helps budding mindfulness meditation teachers. And I'm not talking about NBCT, which is what I'm trained in, you know, mindfulness based cognitive therapy and those very therapeutic kinds of mindfulness. I am talking about just the everyday mindfulness meditation. Maybe I should put together a teacher training myself which includes all of this stuff about mental health, psychology, trauma informed aspects of mindfulness, what to be on the lookout for, so that emerging mindfulness teachers, aspiring mindfulness teachers have this awareness and have this training. If that's something that you might be interested in, maybe email me casstcastone dot com and let me know, because that could be something that I could add to my list of offerings. I do feel very passionately about mindfulness meditation, and I do feel like teachers need to be properly trained and you know, across all of the mental health aspects. So maybe that's something to think about. I hope you found this interesting if you have had a difficult experience with mindfulness meditation, I hope that has helped you understand a little bit of what you might be experiencing, and again hit me up if you have any other questions or anything specific that you've experienced that you would like my input into always Here to Answer question, hit me up on the DMS, on Instagram cast, on Underscore XO, email me like I said,

28:05 and I can't wait to catch you on the next episode of Crappy to Happy