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0272%7358/85 $3.00 + .W 0 1985 Pergamon Press Ltd.
MEDITATION AND ANXIETY REDUCTION: A LITERATURE REVIEW
M. M. Delmonte
Psychosomatic Unit St. James4 Hospital Dublin 8.
Meditation is increasingly bring @u?icud as a therapeutic technique. The effects of pv-actirf on psychometrically assrssed unxipty leuel,s hazer been Pxtmsiuely researched. &-osfiPcti-i,umeditators tend to r+ort aboz,P allCrap ie-oek of anxiety. In gPnPv-al,high anxiety
Gvels @dirt a subsequent low ,frequrncy of kracticp. Howczler, the e_ckLencusuggests that those who pa&P regularl? tend to .show significant drcreusrs in anxiety. Meditation does not appear to br more pfffctz-ilp than comparative intpnlmtions in reducing anxiety. There is ezlidence to suCgpt that hypnotizability and exppctuncy may both play a role in reported anxiety decrPmPnt.s. Cprtain indi-rJidua/.c, with a capacity to engage in uu~tonomous .selfabsorbed rrlaxation, may bmpfit vnostfrom meditation.
as a self-management
technique, as well as an adjunct to psychotherapeutic intervention (Candelent & Candelent, 1975; Delmonte 8c Braidwood, 1980; Glueck 8c Stroebel, 1975). To date, there has been no extensive review of the research literature in relation to the effects of meditation on self-reported anxiety levels. TYPES OF MEDITATION For the most part, this review will be limited to those forms of meditation in which one’s attention is focused (restricted), such as in Transcendental Meditation (TM) and Zen Meditation, as opposed to the various “opening-up” exercises. The former “concentrative” techniques are widely practiced in North America and Western Europe, whereas the latter “mindfulness” approach is less well known and has only occasionally been the subject of research in the West. In concentrative meditation one’s attention can be focused on a variety of objects such as a sound (mantra), a candle tlame, one’s breath, and so on. The above two types of meditation are not Requests for Psychosomatic
reprints should be addressed Unit, Dublin 8. Ireland. to Dr. M. M. Delmonte, St. James’s Hospital,
508). Smith (l!US).1.titit Ihat tneclitatioti practice is iwwfici. p. Finally. tttattlrii I~ecotncs .I tn. Iti fact. tatol-s had signif’iwtt~ly repeating lowt~ . ‘l‘he sane tionrtiedisuhvcally lChf(i leccls while tdtxittg \vith closrtl eyes than wldc . I le later produced Factors”). Othrrs have tltwrtbrd meditation as 2 techttiqur that itiwlvcs t-cc-iprocal inhil)itiott 2nd cottntt’r cotttlitiotiitig Iwtlittg lo tlesensitization of. ttamcly insight into repetitive self-defeating patterns of behavior and thinking (e.1lantr. ( 19. (~olctnmt (197 I) buggc3tetl that tt~ecliratioti nt.il relaxation respotisc in terms of frotitalis lCYl(. antI SchwatY/. biof’cctllmck training dttring fi)tir sessiotta wet. evidence to strppor( this cotttettlioti (see “Nott-Sprcif’ic TYPES OF ANXIETY/AROUSAL Handron psychiatric . however. I haI thr thci-apeittic ktiefits fbutitl could t)c the result of exlwctatioti of’ t-dief or of’ simply silting on .g. (. 1976).tl1! c\ery schoc~lof’~~s~~~~~ologic~. I977.~l~)ltite cate. “breaching the rcpressioti harti~r” and I he behavioral noCon of‘ ctesetisitizatioli.~ttioti.ty rvokittg Ihoughta (Ue1-~4%k Lb OAel.rcettwood and ISenso~t ( 1977) h.I wrt of.the ~tii~jor pot-lions ot‘ the vat~iancr iti anxiety qucstiorimire scores..ii~tot~ttl of ocedap (SW Orristein. I98 1.t1!.tt1tr. . atixit..ttid Asher. hledit~triott is also twcisagect as .gorics as fhcrc ia :I cc. (Iat-ringtott antI L’. IW6). Shapiro & %if‘f~rhlatt.r-renwootl SCBensott. Delniontc ( 197!I) provitlcd tGtl~ttc_r tltat . rather ~~. Mikdis.ing: the practice that rttistrcssing is .59) and Huss ( I96L’).tic. ..tl thought” has I)een invoked to supl)otA tItt> cl. For csatriplc.q (1975).ic-couttttd Sc~hallitig.I mow c~otnplrl~ disc-ttssiott).t~~~i~ concept of ioral tnotlelb of‘ twditarion.t-lain .phroti of catharsis by nicatts of which pwvious slJotit. and “conditioning” of’ the wtttt-al tierwus systcvti.ttioti is ittore appropriate 1hi abbreviared rclaxatiott traittitig as . having . hypothrsi/etl thar anxiety is made (197X).f’our consecutive days. 1973) ot as “.~ttti~ effects of niedi- ratiott. 1)): f’aclor att.il. lHe coticltrdctl. in mi vxtcttsivc review of‘ the ps~~hotliet-~iI.I tiiiititm may hecome . cravings). 1973.t rcpetitiott had pt-eGottsly been pail-d with fl-ontalis Ehl(.. tiiedilatiott is secti as adapti\e regi~essioti in the service of‘ the ego (Shalii. and <.ttiecdolal tqwr(s of“‘ttttstI-cssittg” triiittiiatic of meditation.58. .ttteottsl~.and the heha\:as it invokes hotlt rhc 1Js)~llo(lvtt.I r~lasatioti techtiique (C.iti~. LTnstrrssing (1075) suggest ~i~~ottt~). reLixatiott when the. Sltapiro &I Ziff’erl~Litt.tti.I condition. desensitization of painful thoughts.oleman (~rotiholnt. Koals (1!)7H) c-ontcticlrd that c-Ltssicdl contiitiotiitig elicit5 cltanges iii the direction of.t contlitiotied stiniulus eliciting .it~sirtionioirsl~.t cotitlitiottetl id~txatiott ariniulus. CLirpctiter( I977) sttygsted that tneditati\~c rxercises provide tht-eta therapeutic gains. 19.I fi)rni or stressf‘ul events are released is the littk hetwectt the tJs)“‘tio.I regular basis. ohtaincd two faclors (‘psychic’ and ‘somatic anxiety) which fbr.I t~eciprod itthil~iror itt systematic tlesetisitiz~ttiort. extctisicely reviewed the literattirt.i): be (3)ticeptualiad as SIOM’self-paced s~sletnatic clesctisitil. 1972.lltt3y arc fl-equettt . noted that “vit-~tt.tlyhg attxiety SC‘OI~~S obtained f’rotn patienls. toi MODELS OF MEDITATION Mctlitalioti has Iwrn viewed frotii both psychoan:ilytic attd l~ehavioral perspectives.tw at-gttetl that tneditati\~e relax. Ko)xl Koxl to the ttttconscious” (Jung. I)avidsoti.
It will not be possible to give detailed accounts of these studies.’ Similarly. Davidson and Schwartz postulated that somatic and cognitive components ( 197(i). Hence. they contend that specific suhcomporlents of anxiety may be differentially associated with relaxation techniques engaging primarily cognitive They offered some (poor) retrospective evidence that versus somatic subsystems. state. On the contrary. This review focuses primarily on the effects of meditation in terms of psychometric (i. ISSUES METHODOLOGICAL Anxiety can be evaluated in terms of several criteria (e. cross-sectional designs with various degrees of matching. and psychometric measures). they (i. In general. 1975. primarily cognitive versus mode vs.e. together with neuroticism. Schwartz et al. self-report) ratings of anxiety. However. the word ‘anxious’ will include ‘neurotic’ unless otherwise indicated... with theil of arousal would differentially respond to different forms of posited that the different relaxation techniques. Similarly. a general overview will be attempted. somatic) “will be more effective in reducing same (p. anxiety and/or neuroticism have been featured in numerous (i. Expectancy of relief should be considered in meditation research outcome (Delmonte. This is purely a pragmatic decision and does not imply any theoretical position. components.e. subjects practicing physical exercise reported relatively less somatic and more cognitive anxiety than meditators (the two groups were neither matched nor formed by random assignment). In other words. pre-post designs with prospective meditators as controls. who posit that the various relaxation techniques all elicit a general relaxation (trophotropic) response involving all systems in concert. . 426). with this design there still remains the problem that those assigned to the meditation and control conditions will have different expectations. The review commences with the weakest designs and finishes with the best studies (e.g. A major problem with the cross-sectional studies is that individuals attracted to meditation may differ in certain respects from those who are not so inclined. psychophysiological. trait. The studies reviewed in this paper range from the methotlologically weak to the sophisticated. cognitive. More precisely. 198 la. however.up of cognitive “multi-process” and somatic model. in approximately 40) studies on meditation. The above multi-process 1node1 is opposed by the 01de1 unitary relaxation response model of Benson. Smith. differences found between meditators and nonmeditators may not be attributable to practice per se. simple pre-post designs. and Carol (l974).. and so on). other mode anxiety” in favor of “differential effects of a somatic (physical exercise) and a cognitive (meditation) relaxation procedure” (p. LJnless otherwise specified. or by randomly assigning metlitation-naive subjects to meditation and control groups. 321). in pre-post research paradigms. will be collectively referred to as ‘anxiety.. Heal-y. and somatic anxiety. 1976).g. random assignment to meditation and control groups. This problem can be partly overcome 1~): using prospective meditators as controls. Physiological and biochemical outcome criteria have been reviewed elsewhere by the author. random assignment to meditation and comparison groups with control for credibility and expectancy. rather.. (1978) argued relaxation. behavioral. there has been a paucity of research on personality variables and their relationship to the practice of meditation.e.
There is considerable evidence 10 suggest ttiat prospcctt\ c’ meditators arc significantly more anxious than l~uf~lislird l~ol~ulatioti tiorms or 1ti. 1(_)76. Caycc.. IW~i: Katias & Iloro\vit/.iti c. 1076). l%~l: vat1 den Berg 8c Mulder. Otis.e.ontrol subjects.. 8c WootfiAk. thev did not cotitrol for setf’selection.I‘ttesc stutties do not provide evidence that meditation practicr actualI\ dccrcasrs attsiet). I!#(). bottt nietfit. \:att tlrn Bet-g & hlultlet-. Williams et al.(knva~i. ( Fct-guson & (knvm. subjects had not ‘I‘herc was thus thy l~rot~teti~ ot votutiteet been randomly assigned to conditiotts. ‘irregulars f‘rom each other in those particular attributes I)ef’orc starting ‘l‘hl” (1). IIow~\~et..z .. 1076. Ho~~e\. 1X30.asc’ of‘ttt? %urot‘tattd 5chwat. tC)7G.1 year) tend to be significantly more anxious than those \vtro cotttittur (l)eltnont~.mte this problem by using prospective mrditators as c. 107X. 1975. 1973. Tjoa. IIjrllC.otitrots wcrc preIn an attempt to address this question. ICMO. lC177. West. Hjelle.th stu(lies the control iubjccta were eithei prospective meditators (i. 1976. In all the abo\.. tested and followed up for periods rattging f‘rom 6 to IO \vcc’E.94 STUDIES WITH CROSS-SECTIONAL DESIGNS Some authors report that experienced meditatoi-s are significatttl) less atisious than comparison groups of‘ controls ((.ittsict\. Smith. PRE-POST DESIGNS WITH RANDOM ASSIGNMENT TO GROUPS Several authors improved on the above ~xpet-imrntal design b! ratttlomly assigning subjects to either nieclitatioti ot~coml~~irisoti procetturc5. C:ar-kk ‘I‘tiurstott. & l)urtiatri. West. STUDIES WITH SIMPLE PRE-POST DESIGNS Several researchers reported that arixiety decreased in a group ot tiieditators from pre-initiation to ~otlo~~-ill.. t<)iH) and lower on self-esteem (Rivers & Spanos. 1!176) or ‘interested’ in meditation (Goleman & Schwartz. counted for by this self’-selection process. Carrington ct at.arz. 1% I ).otitr01 groups (l)etnionte. In this respect these studies controlled for predisposition to meditatioti. 1979). 1!MO. Itt these studies tY76. ‘l‘hesc findings at-e consistent with reports that those who drop-out of‘ tneditatiott score significantly higher on measures of‘ psychopat hology (Nystul & (Garde.to posttest reductions in anxiety (Bali. status and predisposition to meditation.tat-gel\. Leht-er. ma\ accoutit f’or the rxpet‘ienced meditators being different from thc cotttrol subjc.tms. I W9: Sttiit tt.I reduction in such scores? Otis (15173) stated that “the peopfr in ’ mttl ‘drop-outs’) may tt. .otetnan 82 Sctiwart~. Rogers 8c Li\~ingston.itot~a and c.er.ts. or dora the tqutar l~ractic-e of mcditatioti per se mediate . Ferguson X. l#O. Schoickec. t)e totally xThe question now remains. 1MO. 1076). Fratic-is.3JC~8 af’tet. I Wfi: Zut-of‘f’ ti ScliM. 15)7(i). On fi)tto\V-up (lvliich varied from I to 12 months later) only the meditators stto~vrd sigttific-atttty pt-e. Vati tlr~t Berg and ?rlttltlct. ‘regulars. Van dtvt Het-g &c hlulder. I Cj77. t!)f(i). as attrition from nieditation practice.c. 1976). ovc‘rc. 197X).iw dif‘ferrd each of‘ these groups (i. Witli. anxiety was significantly reduced f’or meditatot3 only. tC177.-rI_atiging front 1 to I(i monttts later (Blackwelt et al.I cotiCr01 group. at. i). cm the prc/post c-tratigc iii . rington. none of‘ these stud& included .. lC)76). M~iltiants ct. Ho\vever. Otis. It appears that those subjects who drop out (betwceti 30%-. l’uryear.e. This finding is particutarly interesting in the c. t!G3: Rogers 8c Livingston.
progressive because. 197X. Parra. Domitor. 1975. (Benson et al.” was no more so than highly credible procedures which were designed to control for expectation of relief and for the ritual of sitting twice daily. f ound that meclitation relaxation and self-hypnosis were equally ef-fective over 8 weeks in reducing anxiety in patients with anxiety neurosis. Shapiro. 1975. 3 weeks of rest using alcoholics as subjects (Parker. SC Van Peeke. is associated with significant decrements in anxiety. including the following: :10 minutes of restthe dependent measure being state anxiety in this case (Bahrke 8c Morgan. Glueck 8c Stroebel. (1978). 1979. 1978) or with highly credible control procedures. relaxation showed Several authors who had also allocated subjects.. 1980). 1979.. reports that the practice of meditation. independent of the technique used. 1080. Goldman. Bali. Kirsch and Henry (1979) found that meditation. at least four longitudinal studies. although meditation was effective in reducing chronic anxiety. ( 1980) reports. This finding contradicts other. Some of the above studies were poorly designed and were more like case histories. :ilreacIy quoted. Kirsch & Hem-y. Wadlington. Benson et al. Thus. Smith. 1979. 1979). it was not superior to muscle biofeedback in this respect. McCann. 1978) and from 1 week to 6 months of highly credible “anti-meditation” or “mock-meditation” (Boswell & Murray. although the meditators demonstrated significant decreases in anxiety. meditation experience-ranging from 1 to 1 X weeks-was showed not only that associated with signif- icant reductions in anxiety. Parker. therefore. at random. 1978. Gilbert. to either meditation or other forms of intervention found significant reductions in anxiety for both meditation and comparison conditions. Linden. 6 weeks of muscle biofeedback (Raskin. in which random assignment \vas used. However. and systematic desensitization with meditation replacing progressive relaxation did not differ in their efficacy in reducing anxiety. these decreases were not greater than those found with established relaxation techniques. Raskin et al. unlike that of progressive relaxation.(1978) and the Lehrer et al. & Murray. CLINICAL STUDIES There have also been several reports of decreased anxiety following meditation practice in a clinical context. Smith (1976) found that meditation. Other studies. although effective in reducing anxiety in “anxious college students. significantly improved. but also that this reduction was significantly greater than that observed in a parallel control group which engaged in eyes-closed rest practice over 2 weeks (Dillbeck. It thus appears that med- . 1976). these no studies also employed parallel significant changes in anxiety. 1973). Daniels. systematic desensitization. et al. in which substantial decrements in anxiety were reported following meditation practice. 1978). as well as control groups which groups. 8c Thoreson. 1977) or which formed a no-treatment comparison group (Heide. 1979. or with physical exercise (Bahrke 8c Morgan. Candelent 8c Candelent. & Lundy. (1980) reported that. there were exceptions as in four studies both random assignment and longitudinal design were used. with random assignment of high anxious subjects. The Linden study also included 18 weeks of counselling as a comparison condition. 1980. Meditation was also significantly superior to this condition in reducing (test) anxiety. 2 to 5 weeks of progressive relaxation Busby 8c DeKoninck. 1975. Michaels. Patients who had moderate-high hypnotic responsivity. 1976). SC Vander. (Boswell & Murray. ‘l-here are.
pl~~l~o cf’ftct.tu~tli/ation of. 107X. self-absorbed ‘I‘his report is co1isistc11t with relial~lc f‘indirigs that subjects high on relaxation. Girodo stated rliat his mialvsis showed that meditation tended to be beneficial for those patie11ts with .” “ char1r~ed by works of‘ thv iniaginatioti. (.itation is as ef‘fectiw as some other clinical of anxiety. Smith randomly assigned subjects to meditation or to a placelm condition (designed to match the form. 19X0).I‘= 14.1 “‘I‘Mlike nwclitation exercise” and rhe other “an exercise designed to he the near mltithesis of‘awditation (p. striated ni11scle tension. coInpared two other groiips which iweived similar fostering of expectations.just as effective as meditation (Smith.irodo (1974) used . &gain he fi. chronicity iti intervention outcome. Only Zui-off and Schwarz ( 197X) f’ound that expec. afier 4 months.t strong case can be ~nade tar taking “non- f’osrering aspects of TI\/I. Sin~il. i1nthe of chronic anxiety is limited i11 that onI) 40% of‘ liis sul’Jects sl~owecl “marked clinical proven~ent.I capacity to dissoc-iate and ctigage in “it1ito1io1iio1is. md. 1~0th groups specific” Lictors nieditatiotr.ro. complexity and expectation an exercise that involved sitting were equ. Smith also trait anxiety. Kirsch a11tl Henr! ( 1979) reported that high rationale credibility of 1neditatio11 was significantly related to reduced he AI-guecl that the reductions in anxiety reflect a anxiety. 630).und no significant tlif‘fbw~cw hetwrcrl thv groups on the above outcome 1neiisures even tho~igli one‘ groiip incorporated .I sinirilatecl ‘I‘M technique with nine patients diagnosed as anxiety 1ieurotic. ~I‘liis inconsistent finding could be cl~le to the relatively I. urlhkr (. I~elrnonte (198 1a) found that expectancy of‘ Iwnefit fi~oni nieditatio11 practice assessed prior to initiation is related both to the f’requency of‘ practice and to the reported benefits of‘ such piwticc. 1076).” and so on.irl~.id and general assessment ot‘cxpec‘tancy eniployed by Zuwf‘f’ mid Schwirz.1tnlent Kaskin et al.2 nlonths).I shol’t history of illness (. W~KI-ras Autia descriks . .I long history (A1 = sPl. Highly credible control procedures were .irodo. ” “completely . five patients improved significantly and the rcnwining four showed no appreciable decline in aixiety. Ijut that expec‘tmcy a~itl ritual at least. 198 1b).. NON-SPECIFIC FACTORS Smith (1978) f’ound that those who 111ai11tain nleditation practice and who display the greatest reduction in trait anxiety scored high on the 16 PF Factors of‘Sizothymia and Autia. without co~i~rol subjects. into accourit in any corlcef.” “detached..I tentlenc~~ to IX “iniag-iriatively eiitliralled by inner actions. the rf’f&:tiwness of‘ nleditation in the tre. In . In an ingenious double-blind study. ( I9XO).” are more likel) to show substatltial decwments in anxiet) hypnoticresponsivit) (Renson et al.2 months) and not f’or those (1980) argued four that subjects with . the therapeutic- ett‘ects of . Both credibility and expectancy are positively related to improved self’-reports.” but which incorporated twice daily rather than meditation.ite . In conclusioii.illy eftecrive in reducing ad skill cond~~ctance reactivity. tlierefiwe.LI = .ibsot~bed” and to dernonstr. (lid not investigate role of.I stud!. iii~erventions may acco~~nt for in reducing ele\ated these findings-in levels part. Simthymic i1itlividuals tend to he “i~eservrd. It coiild.” “~~loof‘. Heide t’t al.tations of benefit were not significantly carrelated bith such rcductio1is. It is also relevant to note that suggestibility increasc~s during the practice of‘ meditation per se (IMmonte.” I fowcv~r Kaskin et al.
as there were no pre-initiation scores available. It is possible that. For example. compared reported significantly less state anxiety. Delmonte (1981). et al. 1976). there may. Raskin et al. Zuroff and Schwarz (1978) randomly assigned subjects to Transcendental Meditation. However. only the meditation group showed significant decreases in a self-report measure of anxiety. MOTORIC. little empirical ANXIETY REDUCTION AND FREQUENCY OF MEDITATION PRACTICE Decreases in anxiety were found to be positively related to frequency of practice (Fling. Williams. 1981. It is worth noting that reductions in self-reported anxiety. Similarly. these reductions were not related to changes in EMC. muscle relaxation training. both before seeing a stressful after exposure. Unfortunately. 8c Gallagher. as with anxiety. relaxation and muscle biofeedback were all associated with reductions in clinically assessed chronic anxiety. this area has attention. be a “ceiling effect” above which little further improvement is reported. Carrington et al. the above finding could represent effect.. . and Porter (1977) found that less than three practice periods per week produced little change. as the meditators also scored significantly controls on a sampling finding that sistent with physiological received with controls. AND PHYSIOLOGICAL MEASURES OF ANXIETY/AROUSAL ‘rhis review has primarily focused on changes in self-reported anxiety. (c) systematic desensitization. BIOCHEMICAL. Benson. 1977). or (d) no treatment. although meditation. (1980) reported that “frequent” and “occasional” practitioners did not differ in terms of improvement. However. are not always accompanied by decrements in behavioral or physiological measures of anxiety. For example. found that an improved “present-self” was correlated with frequency of practice. Zuroff and Schwarz (1978) did not find such a relationship. nevertheless. and found that all three treatments were equally effective in reducing self-reported anxiety and produced a greater reduction in self-reported anxiety than found in the untreated subjects. film and again lower than the both trait anxiety and neuroticism. whereas two daily sessions appeared to be more practice than was necessary for many individuals to achieve positive changes. Tjoa. 1975. in press-b). Thomas.97 AN EVOKED STRESS-RESPONSE STUDY Goleman and Schwartz (1976) found that meditators.. and reliable changes in physiological (heart rate) manifestations of anxiety were found only in subjects who rated the treatment rationale as highly credible. or no treatment. Peters. although practice frequency is in general related to the benefits claimed. there were no concomitant improvements in behavioral measures of anxiety. However. Kirsch and Henry (1979) randomly assigned speech anxious subjects to (a) meditation. following meditation practice. the meditators showed lower state anxiety after stressor exposure is conreports that meditators show more rapid post-stressor recovery in responsivity (see Delmonte. (b) desensitization with meditation replacing progressive relaxation (as suggested by Greenwood & Benson. (1980) found that. However. Whereas all three groups improved on a behavioral measure of trait anxiety.
selfreport reductions in anxiety do not alwaj. dof’iltiiine-t)et. There is also the more parsimonious interpretation that it is easier to “f’bke good” with self-report. ‘I‘aking .I passive attitude. If‘ f’urther evitlt7ice suhstantiatrs this \Gzw then tlierc will be increased support for the S&wart/ et al.~l-will I)e xunlnlari/rtl hew. integrating the findings of‘ studirs usilig sdf-report.l such as closed eies.I recent review (IIelmonte. ‘Ilie niost strongly supported long-twrri (i. ( 197X) multi-process model. growth hormones and catechol~~mines as indices of charlge. cortisol. Benson et al. .I “mental” technique than the cognitive components of’ arousal as assessed by self’reports. and .ttiori practice is associated situ) ef‘f’~cts-~~~~~-tic. If‘ the effects of Inediib proposed by Schwartz et al. carbon dioxide eliniination . measures of‘ arixiety. lonp-tcrui) effects-es~.. llowever.i unitary relaxation response c.e. associated with the practice 01‘ meditation.I “mental device.coIrlf>on~Ilts of‘ anxiety. biochemical mid .lll~ with I-egxd to Mood pressure reduction.tivdtioIl.e.” . Hounw-.‘l‘hese last three studies show that riieclitators readily show ciec-rtmes in self-report ~neasures of‘ anxitTy hut that these decrenients may. receive convergent validity in terms of behavioral and physiological nleasures. The outconie of ..~su~-t~l by physiological 2nd betia\~ior:il indices) may be less responsive to . is not consistent with the process latter iriter~.m be rvitlenc-e on nneditation as an Mfdit. aritl respiration rate)and in terrris of’ trait (i. than with either behavioral or physiological markers of‘ anxiety. ‘Ii) rrcapitulate. in that somatic.. ‘l‘liis may suggest that the effects of meditation are largely mode specific. although of‘ interest.i reductioIl in seruni cholesterol levels.I quiet en\ironnient. ‘I‘he reported decreases in lactate. in I-egartl to f’rontalis EhlG mcl respiratory indices (such as oxygen consumption. predicted that meditation woulcl be more rf‘fbctivc in reducing cognitive than somatic sul. that is. thew effects are not ot estal~lished superiority to those of‘ other relaxation pro~td~~res. physiologic-al.s recei1. Most investigations of’biochernical nwrkers of’ rel~txation-arousal. comp~lfing evidence that the practice of meditation is associated with long-term reductioms in Mood pressure (see Delmonte. 01‘ may not. ‘Ilie outcome ofanother extensive review-this time ofstudies with physiological markers of’ a~~o~~s.l-h~clr-oxl~tse. 1ow riir~scle tonus. in which only the meditation group reported significant reductions in both self-report arid Iwhavioral nieasurc’s of‘ anxiety. (1978) with their multiitation are Inode specific.ul~~~-l~~ with precipitated by one of‘several rrlaxation procctlures (including meditation) meeting certain niinirnal criteri. componrtits of anxiety (as ~iie. the outcome of the Zurof’f and Schwarz study.e. were in tertns of state cfftcts. in press-b For review). do not attribute special state ef‘fects to Ineclitation. alclosterone and cholesterol. Fiowever. as in those immediate responses precipitated duririg nietlitation per se. Schwartz ct al. thtm it may indeed he that the ef’fects ot‘metlitation are more readily apparent with self-report (predominantly cognitive?) as opposed to behavioral or psychological.I glotd view of‘ anxiety. ‘I‘hc outconic of‘ these two reviews is consistent with Be~ison’s relaxation response model. with lowered acti\wion in ternis of state (i. in press-a) is that meditation is only marginally superior (at most) to eyes closed rest in terms of‘biochemic~il indices of activation.retatioIi.il mdices of ac. trait) effect of’ Ineditation This findirlg is in acco~-tl with the rather is . rcnin. as already mentioned. ( 1974) postulated that . in press-b).e convergent validity in terms of behavioral or physiologic~.eci. as it also offers cross validational intervention strategy (see Delnionte. No significant effects were obtained using testosterone. and the reported increases in phenylalanine and prolactin. niotlel.
and incorporating such diverse processes as insight. meditation does seem to be effective. Smith (1978) may have been correct when he wrote that “meditation is quite likely a heterogeneous phenomenon. there is insufficient evidence to suggest that the scores obtained are significantly lower than those of the norm. for many subjects. 637-646. REFERENCES Bahrke. it appears that prospective meditators tend to show higher anxiety scores than equivalent population norms. L. 278). and is thus in accord with the multi-process model. on pre-initiation scores. Unfortunately. (197X). There is evidence that the anxiety scores of prospective meditators could be used to predict their response to meditation. Although practice is associated with decrements in anxiety to a level comparable with that of the norm. Intervention credibility and expectancy also appear to play a role in outcome. M. prospective meditators tend to report elevated anxiety. essential hypertensive males: A controlled study. leads to the conclusion that. As none of the above reviewed studies-and many of them were well designedfailed to report significant decrements in anxiety.. & Morgan. there appears to be a “ceiling effect” at the higher practice frequencies. (1979). 41. Anxiety reduction tollowing exercise and meditation. almost all the self-report measures were of trait anxiety and as such no comment on the relative effectiveness of meditation on state versus trait anxiety can be made. Meditation does not appear to be more effective than comparitive interventions in reducing anxiety-with the possible exception of progressive relaxation. Reductions in anxiety associated with the practice of meditation do not always receive convergent validity in terms of behavioral or physiological measures. However. it must tentatively be concluded that meditation practice is associated with anxiety reduction. and suggestion” (p. It thus appears that cognitive set is central to the effects of meditation and that neither the psychodynamic nor the behavioral models of meditation suffice in this respect. Nevertheless. l&Ii. 323-333. This finding may suggest that the effects of meditation are mode specific. although meditation is associated with decrements in both subjective and objective indices of anxiety. 2. The regular practice of meditation appears to facilitate a reduction in anxiety for subjects with high or average level of anxiety provided they meditate regularly. producing effects ranging from sleep to enlightenment. R. This might be an interesting area for future research. . reductions are of established superiority to those SYNOPSIS In summary. Meditation is probably less effective in cases where subjects have a relatively long history of anxiety neurosis.Meditation and Anxirly Reduction 99 motoric measures. desensitization. in reducing clinically elevated levels of anxiety. Those who benefit most appear to demonstrate a capacity for autonomous self-absorbed relaxation and/or to be relatively hypnotizable. the drop-outs tending to score the highest. Long-term effects 01 relaxation on blood pressure and anxiety levels of. there is no compelling evidence that these elicited by other interventions. Cognitive Therapy and Hutrarch. the case for unique (state or trait) effects is not supported. However. and the regulars the lowest. W. As there is no compelling evidence that meditation is of significant superiority to other relaxation procedures in terms of anxiety reduction. PsychosomaticMedicine.
cor”...d. ‘.([ ‘1...\’ 001 .
2).. Imtitloti: . alld aldostuwne 31. (1971)../oumcr/ of hf~diccll 32. Kanas. of~rI-.. 40. (1977). evaluation v ill the I’crsonal of C.rt-allstrntlc-nt~tl 1X. 67 3946-953. Irrlrrrutiu~nnl Journnl o/ ~~11wrnl cmd Expr-rmrntcd psychologic fl~pnom.p.tn?iict\. for an alternative assessment competiti\r of anxiety R. <:ronholm.olema~~. P\+lqp A cognitive I.2lotor to 17). Meditation and Thrrcz~y.-\PA M. (1974). & ~Bndcr. New Schwartz. (1979). A. anxiety.14:Qi. Kenill. Bali. Schoicket.- c-ot-tisol. ttotr-mctlitators of public and In R. 690. M.anxiety: of meditation cxcrcisc. Shafti.&man. (Ed. Archr7w D. N.. and I~. ts of lwrirxiic 01 wlte !“rrrvp/w~/ anxirty C. & I. New Yol-k: Panthron 34. Lehrer.ttivc M. (1978).-r2al PuMc of with nteditation: 1 lome A ffmlth Puryear. and Mditmtiow Sow pv~ldogml hrrr~~~~ Paper (197X)..malyti( self-cotltt-ol and ~u~wnn/tor& of Jourd o/ P. dwpottt ps)c-hology. (1959). SkA. Pi-es..o. participation I-elaxation. Xc Thorewn. D..tl hlc(:antr. Nystul.. 54.ttion.tt)lvs at~d ‘I‘r. (1967). r-c+w~~ (Vol. applied Y2 l-328. I lylmotic and rcsponsi\ity a\ a ptwlictor 28. attrition ctnd S..r/a/r~ behavior R. population. 43.c R. Davidson.).. Mikulas. L. (197. Ornstein o/ (:anad. t’\$wlo. practicing 7’hua/~\‘. Perke. program. The efficac) as an intervention relaxation t-elxation rating. Greenwood. of mcdiratic~n~l~v r-eating ctiiltl1-cn ac-liievellient..P..aurvnl in and t’\~~c. Psychological a& commentary Reaction% on the ‘I‘ibctan book great and (Trans.r/faw Rlcdttation: controlled 37. and I). Mote. L.‘2i%5:) Arrrrri~cll2. measures of health.modelI 1’ot. 7<). Accumul. prcwnted in altoholics: meditators. S. & ‘l‘hurston. attti 0~ //w p\t/w/o.ivingston. (1977).\/.s~~t/w/o~~.. <. 15. anxiety.31. In L. 8s Porter. ego: I’svcho. (1980). independence. art Clinical M. of the and Patret-ning vc~sus in the self-regulation of.tl al health. 35X-366. ~]ouranl of co7uulli7z~ 11.<. Otis. Gilbert. 8c Garde. 8s Van t 1. ( 1973). A cons46. Transcendental Meditation. X Asberg. Raskin. l’~.. S. s( ho01 W.tl and mrditatiott of (~rnrl-r~l p\vhiotvp. C. Zen meditation 1:)4(1976). (bmpollrnts Thrir as related personality Emoluac: purametmmd nwasurrrrwnt (pp. (1975). implic-ations New hIcdit. responses D. films: Kirsch. 8c Spanos. ( IW))..rsattotl . E. Slusc Ir tt-wtnwnt vat-i. Daily tion ol autonomic arousal J. W. D. 29X -X09. and trait /‘\sc-tdqynl Kf~por/\. behavior. 103. E. (1976).\‘~ho. mctfitatiori I). I’. (195X).-lrcrl S<wbetiir A.rh P.yclrol.. in su+ts and ( IWO). B.11 Zen to a (xc gerl- I’.1nrrr_uc!n !‘cy- & Ziffbrblatt.5-X0 1. of P. (1981). I).. In C.md Icvel\ clinically ot field stander-dixd depc~idcncv reduction Self-actu. I: Effects on self-reported Cayce. 43 1 -443. & Henry.tli7atior.I. uv wu/ dnrgrc. ‘1‘ranswndent. 50-55. .~ytwlogi~~..rmdy. The HI-//~\/. S. of regula.. I’crc/u~/qrw/ I~rrortf. .. 1:39+ 143. 01 the Hooks. of relaxation II. E flu11 t(l stt-ess speaking c ogniriw 39. M. C. . R. :iS during modification. 41. (1977). 44. associated ill a working I’\pcholo~p. Rivers. 4. Parra. (1976).~~t~ll . voluntary . lot. and Raven arousal. and Hamilton. .l. libetation.. I-342. 14:s 1 . a meditation N.unsc-crldent.4. A. H.h~siological meditation. Naranjo L.ctic processes C. desensitization Hrhnrvor Rocn. Hcnson.llotrw Skill\. in stress reactivity. of C:ou\ul!zrr~ otu/ C~/f~r/cor(/‘~~~~/rolo.. 6~4 -6 of cogniti\r stud) stI-ategics Iwh.t\~iotxl and som.$w/op. C. of efficac L. 51!)&532. study. 19. Levi. . k Woolfolk. riorrtneclitators. Mearrs. & Horowitz.\. eralized Shapiro. Hjelle..G). (Eds. W. M. 337-343.rr.. Parker.i%b54 R.). Convention. Shapiro.. Jung. H&de. II. Silence R.qCIIIC/ (:IIIIUX/ twpottsr and btraks well-being. and R.trrcft~~~.)..Journul of Cor~~u//in..~~yrtlonrol!y. Practicing test anxiety fi Pw 1.q ad to stressful Brha&ur stimuli Krsrcrrch and (lrnrccd t’~uttdqy. M. II. Meditation 44. 623 -62X. of outcome meditation. Schalling. 18. of l. R./ou. (1981). Michaels. . .q I5- their- of mrd/tcrfrou.. 50-54. f’rytrowncrticMrtlu~rra. Buddhism bf~~~!wiu~.lllsc-rlltlt. f J. 41. (1979). M. r-elasaticm performance Anxiety 1. Barrington. at the . . & Benson. X.. Peters. 93G97. 47. SkzlL\. from Rogers.k: \‘ikitlg.x -466. 49. (1973)..q~?. Ornstein. E. Sleditatot-s Pmw/dud mrd . (1977).. X (. Wadlington..Xf.rogrcsGvc respotlr~ptt~r states h) in systematic t-esponse.7~~11 ‘l‘hc techniclurh R./olr.Redut tu hniclws.. o! tneditatioll. (1979). 1 XX. ctlologi\r. ‘I‘hc self-concepts of mcdit.ttora. meditation self-c-ontr-ol. pr-ogr-cwive P.tnd their . . & Schwartz. (1076). in a proposal M. prison X7%886. Eftects in the service D. PI-es York: I). in the 1 rcl. Linden. 7%~ P\~~hohu~/q Montreal. awl reduction bioftictllxtck ot c hw)ni( pwdic cflrc ting Prroqtucrl M. stucly. /orrrwtl (I/ (:~~r~\rrl/~~r.
Psychother. K. 75.. treatments. 44. Xs Muldcr. Meditation. on (1W(i).J. I). 4.]our-tlcll Ihffrrrucrs.tperttic sitting. Francis .lournnl .54.Skill\. P~yrholo. of contt-01 abuse.Effects locus of ‘l‘ransc endental and drug matad~ustment. (htrrlting nd Cliuic-01 P. technique Meditation. 1 t’rrsotrality nnci . 7‘rjfklwlft Prrwrurlit?ccd /~fnd~/ and meditation. the rffccts of the ww Transcendental P\y-I~olo. (t980). t 3% f’r. A f‘ottow-up. anxiety. 142. Psychological OII a numberpersonality of./ownnl of’l‘l-anst hleditation outcome 46. l(c Schwat-r. Personality . Williams. 5. IX.. Berg. A. Cklrcy. ?‘ijd. (107X). of continuation crud Cluucnl intelligence: and and in meditation 272-279. C. (:. C. daily of C~or~~.-r+furt/ and of muscle I’.. 82Durham. relaxation on 43. (1978). Smith. (:.~c. (1975). I-cscarch va1-iablcs.J.82. Meditation as psychotherapy: ef’fects A review endrntal of the literature. Smith. 167Van den 2OfiG2 West. personality and arousal.q. A. for expectation and erect sitting of relief control 3. and J.\rrltzngnud C:linuc~l f’cp~lzology. W. .. 182. . <:. 46. 2(i4&27 . I‘joa.J.Smith. Zuroff’.. 9~54-9. trait Meditation M. Pvychologzral with contwls Hull&t. (1976). tSOL637. correlates of (21rt\ul/1ng neuroticism H. hleditation . (1976).crhri// voor Pyhologi~. (I 975).\ythology.58~564. Grdrc~g.bfofol.