gives a sensible, researched view of the effects of meditation. However surprisingly enough they have found one form of meditation to actually be effective unlike all the others: "Sahaja Yoga" as taught by the "World Saviour": Shri Mataji Nirmala Devi (see http://www.sahajayoga.org/shrimataji/default.asp)

I suspect that this finding might have grounds in a researcher being a follower of said guru as the TM researchers find TM to be incredibly effective and as DLM doctors (or was there only one?) found Knowledge to be effective in all ways until after 20 years of non-effectiveness Prem Rawat had to announce that Knowledge will not help your mental state, health or social life in any way and definitely won't make you a better person.

Making sense of meditation
13 August 2004

Dr Ramesh Manocha considers the effectiveness of meditation as a treatment.

MEDITATION is becoming increasingly popular with Western consumers. A recent survey of Australian GPs found that almost 80% had recommended meditation at least once,1 and a survey of Australian consumers found that about 10% of the population had tried or were currently practising it.2

Within scientific literature, meditation is a poorly defined and heterogenous collection of methods aimed at achieving states of relaxation and better well-being by using structured exercises to focus attention and modify thinking activity.

Consumers perceive meditation to be uniquely effective, and researchers have investigated meditation to determine whether these specific effects exist.

MEDITATION RESEARCH
The Natural Therapies Research Unit (NTU) at the Royal Hospital for Women in Sydney recently completed a systematic review of the scientific evidence for meditation.

Of more than 3200 articles on meditation in peer-reviewed literature, less than 100 (about 3%) were randomised controlled trials (RCTs).

While the majority of these RCTs reported positive effects of meditation, more than two-thirds failed to properly address the placebo effect – the most important confounder in medical research.

People are understood to respond similarly to almost any behaviour therapy, even sham therapies, simply because the therapies involve non-specific effects such as regular contact with a therapist, the simple effects of rest and relaxation, and the natural tendency to get better, not to mention pressure from researchers to report improvements. All of these factors contribute to the placebo effect.

MEDITATION EFFECTIVENESS
A statistically significant pattern emerged when the RCTs were rated according to the credibility of control method.

While almost all trials using inactive and non-credible controls reported positive effects, those using more credible and active controls reported considerably less favourable outcomes.

In fact, most trials that compared genuine meditation techniques with elaborately designed and executed sham procedures did not report any significant differences.

However, some trials have shown exceptions.

SAHAJA YOGA
Sahaja yoga is noted as a promising technique, with positive results demonstrated in pilot studies in India.

Recently, the NTU conducted an RCT that compared sahaja yoga with a credible stress management program for people with moderate to severe asthma on prestabilised treatment, but who remained symptomatic.

Both groups experienced similar improvements in a number of outcome measures, but the yoga group demonstrated significantly greater improvements in key measures of emotional health and quality of life.

Most importantly, the meditation approach generated significant changes in airway hyper-responsiveness, suggesting that this technique may actually impact on pathophysiological processes.4

Further, the NTU has just concluded a large, independently funded RCT in which sahaja yoga was compared with a generic form of meditation for stress and anxiety.

Sahaja yoga was found to be significantly more effective than the generic approach in reducing stress, anxiety and depressive symptoms.

The critical difference between the approaches is thought to be the ability of the sahaja technique to elicit a specific state of 'mental silence' in which the meditator is fully alert and aware but does not experience unnecessary mental activity.

Brain imaging studies have shown that this approach to meditation is associated with reproducible patterns of brain activity that correlate with subjective experience of mental silence.5,6

INDICATIONS
Meditation is indicated in any scenario when stress and anxiety may be contributing factors.

It is ideally suited to conditions that cause subobtimal quality of life and well-being, such as work stress, primary insomnia and mild anxiety. Also, it is useful as an adjunct in the management of severe, chronic or terminal illness.

CONTRAINDICATIONS AND SIDE-EFFECTS
Meditation is contraindicated in patients with severe mental illness, particular if there is a risk of psychosis, and should be supervised closely if used by anyone with mild to moderate mental illness.

There is evidence of adverse effect, mostly associated with commercialised methods.7

CONCLUSION
If faced with a choice between user-pays meditation lessons and regular time out to sit quietly in a comfortable chair or to enjoy a pastime, scientific evidence suggests the latter is equally efficacious, cheaper and more accessible.

However, if a patient is keen to try meditation, recommend a technique that has genuine evidence of efficacy, and is learned easily, such as sahaja yoga.

REFERENCES
1. Pirotta MV. Cohen MM. Kotsirilos V. Farish SJ. Complementary therapies: have they become accepted in general practice? Medical Journal of Australia. 172(3):105-9, 2000 Feb 7.
2. Kaldor P, Francis L J, Fisher J W. Personality and spirituality: Christian prayer and Eastern meditation are not the same. Pastoral Psychology. Vol 50(3) Jan 2002, 165-172
4. Minocha R, Marks GB, Kenchington P, Peters D, Salome CM. Sahaja yoga in the management of moderate to severe asthma: a randomized controlled trial. Thorax. 57(2): 110-5, 2002 Feb
5. Aftanas LI, Golocheikine SA. Human anterior and frontal midline theta and lower alpha reflect emotionally positive state and internalized attention: high resolution EEG investigation of meditation. Neuroscience Letters. 310(1): 57-60, 2001 Sept 7
6. Aftanas LI, Golocheikine SA. Non-linear dynamic complexity of the human EEG during meditation. Neuroscience Letters. 330(2): 143-6, 2002 Sept 20
7. Murphy M, Donovan S. Chapter 4: Subjective Reports, Negative Effects, in The physical and Psychological Effects of Meditation, Institute of Noetic Sciences, California,