Mindfulness meditation, good or dangerous for your health?

It is credited with all the benefits, or on the contrary a cascade of undesirable effects. But what is it really? Inspired by the Buddhist meditative tradition, mindfulness meditation has developed in many forms, sometimes keeping its spiritual or religious dimension, sometimes losing it. It claims to improve physical and mental health, well-being and interpersonal relationships, even cognitive functions by using techniques aimed at controlling one’s attention, “being aware” of the present moment and “observing without judgment” its emotions and thoughts. If the popularity of applications like Petit Bambou, Namatata or Headspace testifies to its recent growth, its success dates back several decades.

Mindfulness is also of interest to the world of science, since since 2020, around 25,000 (!) scientific studies have been published on the subject. All are not equal. And sorting it out can be tricky. Nevertheless, on the occasion of an opinion on the interest of introducing mindfulness meditation at school, the Scientific Council for National Education (CSEN) proceeded to a review of the scientific literature.

Its experts have therefore selected the studies offering the most solid methodologies and presenting the highest level of evidence: meta-analyses (which compile the results of dozens of studies) and randomized controlled trials (which compare the results of a practice or drug with a control or placebo group). The measured conclusions of the CSEN – accessible online -, which sees no reason to ban mindfulness meditation at school while emphasizing its limited benefits and above all the possibility that other measures may be more effective, contrasts with the polarization of the debate around this practice.

One of the most studied aspects by science concerns the potential positive effects on psychological disorders, such as depression, addictions, anxiety or phobias. A meta-analysis published in 2018 in Clinical Psychology Review compiles, for example, 142 randomized controlled trials including a total of 12,000 participants. She compares mindfulness-based therapies – including Mindfulness Based Cognitive Therapy and the Mindfulness Based Stress Reduction – to other interventions, in order to measure their impact on the reduction of symptoms of various psychiatric disorders.

According to this work, mindfulness-based interventions are more effective than no intervention. They also do better than minimal interventions, based on advice and the usual follow-up – and are more effective than psychodynamic and psychoanalytical follow-ups, the benefits of which are not proven. In addition, “they have shown similar efficacy” to cognitive and behavioral therapies (CBT) which have the best level of evidence for mental disorders, according to the CSEN note. If this meta-analysis was deemed relevant, it should nevertheless be noted that it was funded by the Mind and Life Institute, an institute founded by the Dalai Lama which promotes this practice.

The effects on certain cognitive functions such as attention, working or long-term memory and executive functions (all the mental processes implemented to manage one’s behaviour, thoughts and emotions in a new situation ) have also been evaluated by science. A meta-analysis published in Clinical Psychology Review in 2021 focuses in particular on the results of 25 studies (1439 participants in all). The results suggest “globally insignificant” effects on attention and memory. And if potentially positive effects have been identified for executive functions, the absence of an active control group clearly tarnishes this conclusion.

A second meta-analysis published in Neuropsychol Rev in 2021 and involving 45 studies (2,238 participants), also finds positive effects on working memory, albeit modest, and mainly in older people. She considers that effects on attention and declarative memory are “not significant”. Here again, the absence of an active control group does not allow a high level of proof: its conclusions therefore offer little certainty. Finally, a third meta-analysis, published in 2021 in Mindfulness, this time compiles 87 studies and concludes with positive, but insignificant effects on attention, executive control and alertness. Moreover, these works include many studies of low methodological quality and seem to artificially tip the balance in favor of positive results.

Published in 2022 in the journal Evidence Based Mental-Health, a meta-analysis compiling 66 randomized controlled trials and bringing together 20,000 minors aged 4 to 18 looks at the effects of mindfulness meditation on the symptoms of depression and anxiety and stress, on attention, executive functions and disruptive behaviors. By retaining only the 36 studies which present an “active control group”, the CSEN notes very slight beneficial effects on the symptoms of anxiety and stress, but no conclusive effect on social behavior and well-being. By also retaining studies with a lower methodological level, slight positive effects are also observed on cognitive abilities and behavior. These results are similar to those observed in adults.

In summary, mindfulness meditation appears to provide benefits for psychological disorders, such as stress and anxiety. As for well-being, memory, etc., the current evidence suggests that this practice could possibly prove moderately beneficial, without proving any “game-breaking” effect, as some of these proponents sometimes try to make out. . However, this practice does not present any obvious risks, as its detractors like to think.

Certainly a meta-analysis published in 2020 in Acta Psychiatrica Scandinavica, takes a more negative look at the relationship between the practice of mindfulness and psychiatric disorders. Often cited by opponents of this practice, it compares the results of 55 studies and concludes that 8% of participants (1 out of 12) experienced adverse effects: panic attacks, worsening of depression or anxiety, or even onset these symptoms for the first time. But according to Franck Ramus, research director (CNRS), cognitive science researcher and main author of the CSEN note, this meta-analysis is not rigorous enough to provide a satisfactory level of proof. The studies she compiles are “too heterogeneous” and relate to different populations and different types of intervention (including extended retreats), sometimes without a control group. “We can’t conclude anything from it,” he sweeps.

Franck Ramus prefers to quote the meta-analysis published in 2018 in the journal Mindfulness, which measures the same adverse effects, but this time with control groups, and which finds no significant difference. “In other words, there are people who panic or fall into depression in a given period, neither more nor less among those who follow a mindfulness meditation intervention than among the others. In any case, that’s what the studies say. stronger than I could find”, explains the researcher.

Nevertheless, legitimate concerns persist. Because apart from certain codified protocols, such as the Mindfulness Based Cognitive Therapy and the Mindfulness Based Stress Reduction, there are almost as many mindfulness meditation practices as there are practitioners, and anyone can claim to teach them, without guarantee that their method corresponds to those that have been shown to be effective in the meta-analyses cited. The risk of exposure to adverse effects that are more numerous or more serious than those documented in practice therefore clearly exists.

Above all, the reports of the Interministerial Mission for vigilance and the fight against sectarian aberrations (Miviludes) devote entire chapters to mindfulness meditation and call for vigilance. “This practice can be exploited and constitute a gateway to other movements or groups which are deviant, even dangerous, and which are the subject of particular vigilance, indicates in particular the 2021 report. Indeed, those They use this technique as a loss leader and as a means of carrying out active proselytism in order to recruit followers.” The risks of enlistment in false beliefs, isolation and financial exploitation are therefore not to be excluded, just like in many other “well-being” practices, personal development and all alternative medicines.

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