Mindfulness can have harmful effects – and people need to know

Mindfulness can be practised at home without cost, so it is often presented as an ideal remedy for stress and mental health difficulties.

A Buddhist-derived form of meditation, mindfulness involves paying attention to what you are sensing, thinking and feeling in the present moment.

The earliest documented evidence of such practice comes from India and dates back more than 1,500 years. Written by a Buddhist community, the Dharmatrāta Meditation Scripture sets out several practices and records accounts of depression and anxiety symptoms that may arise following meditation.

It also describes cognitive irregularities linked to psychosis, dissociation and depersonalisation episodes, in which people experience the world as “unreal”.

Mindfulness research and adverse effects

Scientific interest in this subject has increased sharply over the past eight years. This research indicates that harmful effects are not uncommon.

A 2022 study of 953 regular meditators in the US found that more than 10 percent of participants had experienced adverse effects that substantially affected daily life and persisted for at least one month.

A review published in 2020, covering more than 40 years of research, identified anxiety and depression as the most frequent adverse effects. They were followed by psychotic or delusional symptoms, dissociation or depersonalisation, and fear or terror.

Studies have also shown that adverse effects may affect people with no prior mental health difficulties, as well as those with only moderate exposure to meditation, and that symptoms can endure over the long term.

Evidence of these effects has been available in the western world for many years, too.

In 1976, Arnold Lazarus, an influential figure in the cognitive-behavioural science movement, warned that indiscriminate use of meditation could cause “serious psychiatric problems such as depression, agitation, and even schizophrenic decompensation”.

There is evidence that mindfulness may support people’s wellbeing. Yet mindfulness coaches, videos, apps and books seldom alert people to the possible adverse effects.

In his 2023 book McMindfulness, management professor and ordained Buddhist teacher Ronald Purser argued that mindfulness had become a form of “capitalist spirituality”.

Meditation is worth US$2.2 billion (£1.7 billion) in the US alone. Senior figures in the mindfulness industry should also be aware of meditation’s potential problems.

Jon Kabat-Zinn, a prominent figure in the mindfulness movement, acknowledged in a 2017 interview with the Guardian that “90 percent of the research [into the positive impacts] is subpar”.

In the foreword to the 2015 UK Mindfulness All-Party Parliamentary Report, Kabat-Zinn wrote that mindfulness meditation could ultimately transform “who we are as human beings and individual citizens, as communities and societies, as nations, and as a species”.

This near-religious confidence that mindfulness can alter not only individuals but humanity’s wider direction is widespread among supporters. Many atheist and agnostic mindfulness practitioners likewise believe the practice can foster greater peace and compassion around the world.

Media coverage of mindfulness

Media treatment of mindfulness has been somewhat uneven as well.

My 2015 book with clinical psychologist Catherine Wikholm, Buddha Pill, contained a chapter reviewing research into meditation’s adverse effects. The book received wide media attention, including coverage in New Scientist and a BBC Radio 4 documentary.

However, the most costly study in meditation science history received little media attention in 2022, despite more than US$8 million in funding from the research charity Wellcome Trust.

Conducted between 2016 and 2018, the study involved more than 8,000 children aged 11–14 at 84 UK schools. It found that mindfulness did not improve children’s mental wellbeing compared with a control group, and may even have harmed those already at risk of mental health problems.

Ethical implications

Can mindfulness apps be sold, meditation classes taught, or mindfulness used in clinical settings without disclosing potential adverse effects? In light of the evidence showing both how common and varied these effects can be, the answer ought to be no.

Nevertheless, many meditation and mindfulness teachers assume these practices can only be beneficial and are unaware that adverse effects are possible.

The most frequent account I hear from people harmed by meditation is that their teachers do not believe them. They are commonly told simply to continue meditating and that the problem will pass.

Research into safer meditation practice has only recently started, so clear guidance for people is not yet available. A broader difficulty is that meditation involves unusual states of consciousness, while psychology lacks theories of mind that can help explain them.

People can, however, use resources to understand these adverse effects. These include websites created by meditators who have experienced severe adverse effects, as well as academic handbooks with sections dedicated to the subject.

In the US, a mindfulness researcher leads a clinical service specifically for people who have experienced acute and long-term problems.

For the time being, if meditation is used as a wellbeing or therapeutic tool, the public must be told about its potential harms.

Miguel Farias, Associate Professor in Experimental Psychology, Coventry University

This article is republished from The Conversation under a Creative Commons licence. Read the original article.

An earlier version of this article was published in July 2024.