Meditation and psychosis. A trigger or a cure?

Abstract

SummaryThis is a review of studies concerning the use of meditation techniques in psychiatry and psychotherapy. A brief history and characteristics of meditation are presented, with an emphasis on mindfulness meditation, which is a type most widely used as a health intervention. Potential adverse effects of meditational practices are also brought to attention. We focus mostly on the links of meditation to psychosis, describing both conditions in which meditation may cause decompensation, as well as presenting research on the effects of the implementation of modified meditation techniques in psychotic patients. In order to better understand the phenomena described we interpret the effects of meditation using psychodynamic and cognitive theories. The studies presented here suggest that in certain circumstances meditation may trigger psychosis, but they also show that interventions based on mindfulness may play an important clinical role in the alleviation of symptoms during psychotic episodes. meditation / mindfulness / psychosis / schizophrenia / psychotherapy

Is mindfulness for psychosis harmful? Deconstructing a myth

“…Historical concerns about use of mindfulness in psychosis can perhaps be linked to the over-reliance on early uncontrolled case study evidence which suggested that people developed psychotic episodes after taking part in meditation retreats. 1 For example, Walsh & Roche 4 report three cases of apparent psychotic relapse in people diagnosed with schizophrenia who had taken part in intensive meditation retreats. The retreats were described as involving ‘many hours each day of sitting and walking meditation and total silence, without communication of any kind (even eye contact)’ and up to ‘18 hours of meditation a day’ over the course of a 2-week retreat.…”

“…Similarly, although mindfulness-based cognitive therapy (MBCT) is now recommended in the National Institute for Health and Care Excellence (NICE) guidelines for the prevention of relapse in depression (www.nice.org.uk/guidance), concerns from clinicians that mindfulness is harmful for people with psychosis or can trigger psychotic episodes in vulnerable individuals are common. 1 What do we know about harm in mindfulness-based interventions?…”

Mindfulness-Based Interventions for In-Patients With Schizophrenia Spectrum Disorders—A Qualitative Approach

“…Various circumstances of adapted meditation practices, such as several hours of intensive meditation, sleep deprivation through meditation, or concentrative forms of meditation, have been reported to be potentially safe for patients with SSDs. However, these findings are based mainly on uncontrolled case studies (59)(60)(61). Consequently, research and clinical trials have deliberately focused on careful adaptations and changes in the implementation of MBIs for patients with SSDs.…”

Mindfulness and Divergent Thinking: The Value of Heart Rate Variability as an Objective Manipulation Check

“…Having an objective manipulation check is important because: (a) when there are no effects on the dependent variable (in this case, creativity), the researcher knows it is not due merely to manipulation failure; (b) one can increase sensitivity to detect MF effects by eliminating non-adhering or resistant participants; (c) when MF effects are found, one can then further show that it is strongest in the responders (i.e., a stronger 'dose' leads to a larger effect). More generally, the existing survey measures of the degree of MF are very subjective and somewhat controversial [16]. So, having an objective measure of MF might pave the way to a better understanding of MF and how it affects the nervous system.…”