Our science staff is trying to lead a more scientific life in 2018. Throughout the week, we’ve been questioning whether some of our habits and hobbies are based on junk science or real evidence. Here’s the fourth entry, on the merits of mindfulness.
Sometime around, oh, my 60th panic attack last year,1 I figured it was time to see a therapist. On top of weekly cognitive-behavioral therapy, she mentioned that I should really try this mindfulness thing people keep talking about. It sounded simple — you sit, you concentrate on your breathing, and you try to find some solace in the modern world. My therapist told me that meditation could make me feel better and that it had been shown to change the physiology of the brain.
Hmmmm, I thought.
Skepticism is a FiveThirtyEight staffer’s currency. The only mantras we chant around the office are: Wait for the evidence; wonder if the evidence has something wrong with it; trust the good evidence only until better evidence comes along.2 I was especially distrustful because mindfulness and meditation have been having a moment — meditation apps occupy some of the top spots on the App Store’s rankings of most popular health and fitness apps; Anderson Cooper has profiled the merits of mindfulness on “60 Minutes”; mindfulness is being used in schools as a way to help manage classrooms. Given the hype and this publication’s natural aversion to health trends, I figured I was safe disregarding my therapist’s big claims.
But as FiveThirtyEight’s science team assembled the junk science we wanted to shed in 2018, I started to wonder whether mindfulness really was bunk. So I dove into the scientific literature and discovered I was wrong: There is some limited evidence to suggest that meditation might help with some ailments and may produce measurable changes in the brain. It’s no miracle cure, and there’s still a lot of science left to do, especially about the kind of casual meditation people may fit into a busy day. But in my rush to doubt my therapist’s advice, I forgot that skepticism can sometimes be as flawed as the science it seeks to temper.
Western researchers have been thinking empirically about the efficacy of meditation only for a few decades, and they largely study it in two ways: how subjects say meditation makes them feel and how it might shape the brain. Importantly, meditation can be any of a number of things — a focus on breath, a silent chanting of a mantra, a focus on feelings of love and kindness — and it’s still unclear whether some types of meditation are more effective than others.
That creates a problem for the science, since it’s difficult to draw broad conclusions if different trials all test for the effects of “mindfulness” but don’t treat “mindfulness” as the same thing. “It’s this loose enough definition that it allows for anyone to say what they’re doing is mindfulness,” said Nicholas Van Dam, a research fellow at the University of Melbourne and one of the authors of a new paper about the limitations of mindfulness science. What’s more, the mindfulness regimens that researchers study are likely very different from what you’d casually do at home. Apps like Headspace, which offers as little as three minutes a day of directed meditation, are a far cry from the eight-week, 20-plus-hour mindfulness training that is used in the best studies.
With all those caveats on the record, let’s look at what we do know.
In 2014, a team of researchers led by Madhav Goyal, a professor of medicine at Johns Hopkins University, put together a meta-analysis of 47 trials featuring 3,515 participants and examined whether meditation consistently helped various ailments. The meta-analysis, which was published in the journal JAMA Internal Medicine, mostly came up empty — there wasn’t sufficient evidence in the scientific literature to say for sure that meditation had an effect on, say, sleep problems, substance abuse or inattentiveness.
Still, a few benefits did emerge. Subjects in several studies reported being less anxious, feeling less depressed and suffering through less physical pain than before they began a mindfulness-based stress reduction program, compared with participants who received no structured therapy. The effect wasn’t huge, but it was there.
For the anxious, depressed or pained among us — so, all of us? — that seems like promising news. But it’s important to note that there was not evidence that mindfulness was superior to other treatments, such as cognitive-behavioral group therapy or progressive muscle relaxation.
Meditation’s effect on the brain is similarly promising but preliminary. Studies show a consistent trend that meditation can alter brain structure. A 2016 meta-analysis of 30 studies in the journal Brain and Cognition showed that mindfulness-based stress reduction techniques stimulated development in areas of the brain related to regulating attention and keeping perspective on a situation. It also found changes in the participants’ amygdalae indicative of an improved ability to regulate emotions. In 2014, a different meta-analysis published in the journal Neuroscience & Biobehavioral Reviews also found structural changes in participants’ brains after they meditated.
Still, scientists urge caution when interpreting the results. The 2014 meta-analysis was careful to note that “any firm claims about whether meditation truly causes differences in brain structure are still premature.” Mindfulness research is also easily misrepresented. In 2005, Sara Lazar, a professor at Harvard and researcher at Massachusetts General Hospital, and others published a study that found differences in the brains of people who practice mindfulness, compared with those who don’t. But that’s all it showed — not that mindfulness caused differences in brain chemistry. Since then, Lazar said, the science has reached the point where we can show that meditation has a direct effect. But her experience is a reminder that mindfulness science can fall victim to the media hype cycle.
So where does all this leave a skeptic like me? I’ve tried mindfulness, and I think it has plenty to teach me about how to fight life’s undertow and come up for air. Still, I’m unlikely to fold mindfulness into my own routine. Cognitive-behavioral therapy has made my panic attacks almost nonexistent, and the science doesn’t suggest that mindfulness as a dedicated practice is necessarily better than talk therapy anyway. Plus, it’s not clear that the brief, app-led mindfulness I’d do at home would replicate the longer, more integrated mindfulness that most studies have tested.
But after looking at the research, I’ve come to realize that my dismissal of mindfulness was premature — and likely informed by my own biases against any number of things: science fads, non-Western medicine, things that could actually make me stop having panic attacks, etc.
And so I’m also taking away another lesson: that one can overcommit to skepticism, just as one can overcommit to certainty. In my research for this article, I came across an interview with Catherine Kerr, a neuroscience researcher who died in 2016: “The mistake is investing 100-percent certainty in a result and not holding a probabilistic view of scientific truth or risk and benefit. When people are making decisions for their own well-being, they need to hold that uncertainty in mind.” The same goes for investing 0-percent certainty in something. When I took a breath and stepped outside my normal thought process, I gained a different perspective. Mindfulness really can have its merits.