Meditation Has Adverse Effects, and the People Most Likely to Meet Them Are the Ones Told It Cannot Hurt

The commonest categories were affective, at 16.3 percent, somatic at 13.4 percent and cognitive at 11.5 percent, followed by disturbances in the sense of self at 9.9 percent.

Who is most at risk

People with a pre-existing mental health condition had about 1.6 times the odds of reporting an unpleasant experience.

Which is the group most likely to be told to try meditation, and most likely to be told it is gentle, safe and suitable for everyone. That mismatch is the practical problem. Intensity is the other consistent factor: long silent retreats, many hours a day, and practices emphasising deconstruction of the sense of self carry more risk than ten minutes of guided breathing on an app.

How to hold this sensibly

The base rates deserve proportion. A large majority of people who meditate regularly report nothing worse than boredom, and the severe outcomes are rare in absolute terms. Nobody should be frightened away from sitting quietly for ten minutes.

What follows is more modest. Difficulty during practice is a known phenomenon rather than a sign of failure or of doing it wrong, which is what people are usually told and which keeps them pushing when they should stop. Increasing dose is not automatically better. A first long retreat is a significant undertaking and deserves the same caution as any other intensive intervention. If you have a history of psychosis, dissociation, severe trauma or an unstable mood disorder, this is worth discussing with a clinician rather than an app.

And a teacher who cannot describe what going wrong looks like should be treated the way you would treat a physiotherapist who has never heard of injury.

Spirituality, health and the trap of instrumentalising it

There is a body of epidemiological work associating religious and spiritual involvement with better health outcomes, and it is genuinely difficult to interpret. Communities provide social support, meaning and behavioural norms, all of which have well established health effects, and disentangling those from anything specific to belief has largely defeated the field. The honest summary is association, plausible mechanisms, weak causal evidence.

There is also something worth naming about the framing. Contemplative practices were not developed to lower blood pressure. They were developed to answer questions about meaning, death, attention and the self. Recruiting them as health interventions and then judging them on biomarkers is a strange transaction, and it tends to produce both bad science and thin practice.

You can meditate because it makes you calmer. You can meditate because the tradition it comes from is asking a question you find serious. The second reason is at least as defensible as the first, and it does not require a trial to justify it. The corresponding evidence for the physiological side, which is stronger and narrower than most claims made for meditation, is in today's piece on slow breathing.