Practice can produce both short- and long-term effects that can positively affect cognitive and affective functions

Meditation, described as a practice of self-regulation of body and mind, is characterized by a set of techniques that train the focusing of attention. Also known as mind training, this practice constitutes a technique capable of producing psychosomatic effects. This article presents a review of some evidence about the benefits of meditation and its role in clinical application. Numerous studies have shown its effectiveness, which is especially related to the reduction of symptoms related to stress and anxiety. In addition, research shows that this practice can produce both short- and long-term effects that can positively affect cognitive and affective functions. Aspects related to the definitions and particularities of each technique and the contexts to which it can be linked are discussed. Despite the growing accumulation of evidence on the relationship between meditation and physical and mental health, more research is still needed.

The effects of meditation in the light of scientific research in Psychology: literature review

Carolina Baptista Menezes*Débora Dalbosco DellAglio
Federal University of Rio Grande do Sul
Address for correspondence


SUMMARY

Meditation, described as a practice of self-regulation of body and mind, is characterized by a set of techniques that train the focusing of attention. Also known as mind training, this practice constitutes a technique capable of producing psychosomatic effects. This article presents a review of some evidence about the benefits of meditation and its role in clinical application. Numerous studies have shown its effectiveness, which is especially related to the reduction of symptoms related to stress and anxiety. In addition, research shows that this practice can produce both short- and long-term effects that can positively affect cognitive and affective functions. We discuss aspects related to the definitions and particularities of each technique and the contexts to which it can be linked. Despite the growing accumulation of evidence on the relationship between meditation and physical and mental health, more research is still needed.


ABSTRACT

Meditation, described as a practice of body and mind self-regulation, is characterized by a set of techniques that train the focalization of attention. Also known as a mental training, this practice characterizes a technique capable of producing psychosomatic effects. This paper presents a revision of some evidence on the benefits of meditation and its role for clinical application. A great deal of research has shown its efficacy, especially concerning its association with the reduction of symptoms related to stress and anxiety. Besides that, research has indicated that this practice can produce short and long term effects, positively affecting the cognitive and affective functions. We discuss the aspects related to the definitions and particularities of each technique and the contexts to which meditation can be linked to. Despite growing evidence on the relationship between meditation and physical and mental health, it is still necessary to carry out further investigation.


RESUMEN

Meditation, described as a practice of self-regulation of body and mind, is characterized by a set of techniques that strengthen the focus of attention. También conocida como entrenamiento mental, esa práctica constituye una técnica capaz de producir efectos psicosomáticos. This article presents a review of some evidence about the benefits of meditation and its role in clinical application. Numerous studies have shown its effectiveness, which is especially related to the reduction of stress and anxiety-related symptoms. Furthermore, research shows that this practice can produce short- and long-term effects that can positively affect cognitive and affective functions. Aspects related to the definitions and particularities of each technique and the contexts to which it can be linked are discussed. Despite the growing accumulation of evidence about the relationship between meditation and physical and mental health, further investigations are still necessary.


Meditation can be defined as a practice that encompasses a set of techniques that seek to train the focusing of attention (Shapiro, 1981). For this reason, it can be called a self-regulatory process of attention, in which through practice the control of attentional processes is developed (Davidson & Goleman, 1977; Goleman & Schwartz, 1976). In addition, meditation can be characterized as a practice that achieves similar goals to some cognitive psychotherapy techniques, although by different means. Both lead to a decrease in repetitive thinking and cognitive reorientation, developing skills to deal with automatic thoughts. The difference, however, is that in meditation practice, the contents that emerge to consciousness are not to be intentionally confronted or elaborated upon, only observed, so that the practice becomes a learning process of how not to let oneself be influenced by them and understand them as mental flows (Bishop et al., 2004; Miller, Fletcher, & Kabat-Zinn, 1995; Vandenbergue & Sousa, 2006).

Also called mind-body technique (Hankey, 2006; Kabat-Zinn, 2003), behavioral technique (Cardoso, 2005; Vandenbergue & Sousa, 2006), and relaxation response (Campagne, 2004; Galvin, Benson, Deckro, Fricchione, & Dusek, 2006), meditation is described as a mental training, capable of producing greater integration between mind, body, and external world (Brefczynski-Lewis, Lutz, Schaeffer, Levinson, & Davidson, 2007; Slagter et al., 2007).

Meditation is a very ancient practice, originating in Eastern traditions, and is especially related to the philosophies of yoga and Buddhism (Levine, 2000). However, this term is also used to designate some practices cultivated by certain religions, such as Christianity, Judaism, Islam, Taoism, and Shamanism, among others, through the displacement of consciousness from the external world to the internal one (Naranjo, 2005). With regard to scientific investigations, although the potential of meditation has been discussed since 1936 (Smith, 1975), it was only around the 1960s that meditation began to be the subject of more rigorous studies (Goleman, 1988; Shapiro, 1981). Doing a search on the descriptor meditation in the PsycINFO database, it was found that of the 1588 abstracts listed in peer reviewed journals, the oldest dates back to 1956. Moreover, their design has different emphases. While in the East meditation is synonymous with spiritual search, in the West, especially in scientific research, the word meditation has been used to describe self-regulatory practices of body and mind. Scientific research on meditation starts from the premise that, although there are several techniques, they all have a common fundamental characteristic: the control of attention (Cahn & Polich, 2006; Goleman, 1988).

Depending on how the attentional process is directed, meditative techniques can be classified into two or three main types, in the Western view. In general, two basic styles are mentioned: mindfulness and concentrative (Cahn & Polich, 2006; Davidson & Goleman, 1977). Mindfulness type, or insight meditation, is described as a practice of openness, in which there is an awareness of stimuli, such as thoughts, feelings, and/or sensations, although the specific attention held is a free observation that does not judge or analyze them. Some Eastern techniques that fall into this type are Zen meditation, vipassana, and the Western adaptation mindfulness itself. Concentrative meditation techniques are characterized by the restriction of attention to a single object, internal or external. You ignore any stimulus from the environment, focusing on a specific mental or sensory activity, for example, the repetition of a sound, an image, or breathing. This type includes some meditations originating from yoga, such as transcendental meditation and Buddhist samatha meditation (Cahn & Polich, 2006). Some authors argue that there is a third type, called contemplative, which is an integration of the other two types, since it requires both the ability to focus and the ability to be open. Some examples are Jewish meditation and certain prayers (Shapiro, 1981; Shapiro, Schwartz, & Santerre, 2005).

In practice, these basic types may interact, constituting facets of a single process (Goleman, 1988) or a continuum along which various techniques with their subtypes are found (Cahn & Polich, 2006; Naranjo, 2005). Often it is necessary to train concentration first, only then to be able to open oneself to judgment-free observation of mental contents, as proposed by the mindfulness type (Goleman, 1988). In scientific research, studies have investigated the effects of the different types in isolation. It is believed that each technique has certain specificities that impact the development of particular skills (Hankey, 2006; Newberg et al., 2001). Bishop et al. (2004), for example, have proposed a specific operational definition for mindfulness-type meditation, which can be understood and measured through two key components: self-regulation of attention and an attitude of openness and acceptance of the present moment.

Besides the specifics of each technique, other variables such as genetic predispositions, personality traits, particular experiences of each person, expectations, motivations, and values can also mediate the type and quality of response that meditation practice will produce (Davidson & Goleman, 1977; Smith, 1978; Takahashi et al., 2005). Therefore, the study of meditation and its effects must consider the characteristics of the subject before practice, the states that occur during or shortly after meditation, and, finally, the lasting changes resulting from continued practice (Davidson & Goleman, 1977). It is agreed that this is best done through longitudinal studies (Brefczynski-Lewis et al., 2007; Davidson & Goleman, 1977; Hankey, 2006; Lazar et al., 2005; Slagter et al., 2007).

From the literature review, it can be seen that many results found from different techniques are quite similar. Based on this perception and on the fact that different techniques have common essential characteristics (Goleman, 1988), some Brazilian researchers concluded that it would be important to create a general operational definition about meditation that would encompass such characteristics and allow a standardization of its use for health research purposes (Cardoso, Souza, Camano, & Leite, 2004). Thus, also under the prerogative of self-regulation, they describe meditation practice as the use of some specific and clearly defined technique, with which some muscular and mental relaxation is achieved during the process, being an exclusively self-induced state through the use of a focus (anchor).

Although this operationalization is an important step towards systematizing and standardizing the study of meditation, certainly its field of investigation is still developing. Therefore, research is still needed to clarify some points that remain without consensus by the scientific community, such as the specifics of each technique and their respective effects, the degree to which they differ, and the impact that such difference may have on the final result of long-term practice. However, to date, what is noticeable is a large body of research that, even unintentionally, suggests some uniformity among the effects of meditation practices. Thus, it seems correct to conclude, as Cardoso et al. (2004) propose, that there are some common and essential factors in the different meditative techniques that make them equally effective and that, in some way, characterize what meditation is.

Neurophysiological correlates of meditation

The first studies on meditation were aimed at explaining the mechanisms underlying this practice and its repercussions on the practitioner’s life. Through thorough and rigorous measurements, a series of patterns of reactions associated with meditation practice have been identified, which characterize it as a particular state of consciousness, different from those traditionally known, such as wakefulness, sleep, and dreaming (Wallace, 1970). These reactions are also called psychophysiological or neurophysiological responses, because they reflect changes in the central and autonomic nervous system (Aftanas & Golocheikine, 2001; Danucalov & Simoes, 2006).

Changes in the autonomic nervous system, as found by experimental and meta-analysis studies, include a reduction in oxygen consumption, carbon dioxide elimination, and respiration rate, indicating a decreased rate of metabolism. In addition, meditation is also associated with an increase in skin resistance and a reduction in plasma lactate, the high concentration of which is associated with high levels of anxiety (Dillbeck & Orme-Johnson, 1987; Travis & Wallace, 1999; Wallace, 1970; Wallace & Benson, 1972; Wallace, Benson, & Wilson, 1971). With respect to heart rate, some studies observed no difference (Dillbeck & Orme- Johnson, 1987; Travis & Wallace, 1999), while others found a significant decrease (Maura et al., 2006; Wallace, 1970; Wallace & Benson, 1972; Wallace et al., 1971). Although it has been discussed that the results on the effects of meditation are not conclusive (Canter, 2003; Holmes, 1984), in the literature, there is a growing body of research corroborating the physiological correlates of this practice (MacLean et al., 1997; Goleman & Schwartz, 1976; Takahashi et al., 2005; Travis & Wallace, 1999).

In general, observation of these reactions has led to the conclusion that through meditation it is possible to achieve a state of basal hypometabolism while keeping the mind alert and that the one who meditates therefore develops the ability to control certain involuntary physiological functions (Wallace et al., 1971). It is based on this idea, that is, the ability to gain some degree of control over autonomic psychobiological processes, that meditation can be considered an effective biofeedback technique, constituting one of the oldest techniques of self-regulation (Cahn & Polich, 2006; Davidson & Goleman, 1977).

In addition to autonomic changes, since the 1970s, research into the brain effects of meditation has also gained prominence, under the premise that mental states can alter physiological functions (Wallace et al., 1971). It was then found that some characteristics traditionally associated with meditation, such as low anxiety and positive affect, could be explained by changes in neuroelectric activity. Through Electroencephalogram (EEG) Examination, increased production of alpha waves in frontal regions and, to a lesser extent, theta waves, has been observed in both beginners and advanced meditators (Aftanas & Golocheikine, 2001; Hankey, 2006; Takahashi et al., 2005; Wallace & Benson, 1972), with theta wave observation being more common in more experienced meditators (Cahn & Polich, 2006).

It is now known that in addition to these functional changes, meditation can also produce structural changes, acting on brain plasticity. Research comparing the cortex thickness of experienced meditators with a control group found a significant difference in the regions related to sustaining attention, where the thickness was greater in the experienced practitioners (Lazar et al., 2005). This study supports the idea that regularity and continuity of practice influence the intensity of responses, and that meditation can therefore produce lasting changes. Several research studies have observed that, even in baseline situations, more experienced meditators produced significantly different responses than those measured in controls (Cahn & Polich, 2006; Dillbeck & Orme- Johnson, 1987; Easterlin & Cardeña, 1998; Goleman & Schwartz, 1976; Lutz, Greischar, Rawlings, Ricard, & Davidson, 2004).

Mindfulness is one of the cognitive functions that seems to be particularly involved in the changes that meditation practice can generate. As early as the 1970s, it was demonstrated through some neuropsychological tests that the longer one practiced meditation, the greater the capacity for attentional absorption, and this was associated with decreased anxiety (Davidson, Goleman, & Schwartz, 1976). More recent research has confirmed this idea through cognitive and neural measures. By Single Photon Emission Computed Tomography Examination (SPECT) (Newberg et al., 2001) and by gamma wave measurement (Lutz et al., 2004), these two studies found that experienced Buddhist meditators had brain responses that indicated significantly greater power of concentration compared to the control group.

Two studies investigating practitioners of concentrative meditation also observed significant differences in attentional ability (Brefczynski-Lewis et al., 2007; Carter et al., 2005). Furthermore, the study by Brefczynski-Lewis et al. corroborated one of the central ideas of concentrative meditation, that the longer the practice time, the less effort required to maintain greater focus. The authors found that practitioners with more hours showed less activation of the regions involved in the meditative process, suggesting that the technique can act on the distribution of cognitive resources, which idea had already been demonstrated in another study using the mindfulness technique.

Through the attentional blink task, it was found that people who participated in a three-month intensive meditation training mindfulness had a reduced allocation of brain resources to the first stimulus of the task, with a consequent increase in the ability to detect the second stimulus presented, without any impairment in the ability to perceive the first (Slagter et al., 2007). The authors concluded that the ability to process two significant and temporally very close stimuli depends on the efficiency with which mental resources are employed in perceiving the first stimulus, and meditation is a way to increase control over the allocation of these resources.

Although using different techniques, these researches show complementary results, indicating that through meditation it is possible to train cognitive skills, such as attention. Other studies have been concerned with comparing the differences in cognitive patterns and neural activity between different types of meditation. Carter et al. (2005) found that half of the meditators who practiced the concentrative type were able to maintain significantly prolonged perceptual stability on the test used, compared to practitioners of Buddhist compassion meditation (Carter et al., 2005). Another study, when comparing four subtypes of Buddhist meditation, found that gamma frequency activity (25-42 Hz) did not have an equal distribution among the different techniques (Lehmann et al., 2001).

From these results, it can be inferred that there are some distinctions in the mechanisms underlying different techniques, even if the results are not yet conclusive. However, it is also possible to notice that different techniques seem to be capable of acting on attention, corroborating the idea that, even though there are specificities in each practice, they all have the self-regulation of attention as a common basic process.

Meditation, physical health and mental health

Stress symptoms, in particular, have shown quite significant results after the use of meditation with clinical and non-clinical populations, as pointed out by measures of distress (distress) psychological and biological markers (Cruess, Antoni, Kumar, & Schneiderman, 2000; Goleman & Schwartz, 1976; Oman, Hedberg, & Thoresen, 2006; Ostafin et al., 2006). Furthermore, according to a meta-analysis in which a consistently high effect size of meditation on various clinical conditions was observed, it is through stress reduction that meditation may be beneficial for various health conditions (Grossman, Niemannb, Schmidtc, & Walachc, 2004).

Follow-up studies have found that meditation aids in stress management and stress reduction, and that this effect extends over time (Miller et al., 1995; Oman et al., 2006; Ostafin et al., 2006). Although Ostafin et al. (2006) found no significant positive correlation between frequency of practice and decreased psychological distress, Oman et al. (2006) found that adherence to meditation practice over four months had a direct effect on reduced stress after that time.

Other research has indicated that meditation can provide better adaptation to stress. Through an aversive stimulus, it was found that the more experienced group recovered faster from autonomic arousal, i.e., the experienced meditators, after the stressor ended, had their heart rate and skin conductance response decrease faster, indicating a faster ability to habituate to stress (Goleman & Schwartz, 1976). In this same direction, one study found that even when beginners and advanced practitioners reported lower acceptance under stressful conditions, the less experienced group showed significantly less acceptance (Easterlin & Cardeña, 1998).

These results are supported by studies that have measured the relationship between meditation and cortisol and have observed a decrease in this hormone in HIV patients (Cruess et al., 2000) with prostate and breast cancer (Carlson, Speca, Patel, & Goodey, 2004) and non-clinical practitioners (MacLean et al., 1997) compared to controls. Moreover, this reduction was always associated with a decrease in symptoms of psychological distress. It was also found that the diurnal variance of adrenocorticotropic (ACTH) and ß-endorphin secretion was significantly lower in meditators compared to a control group, and that therefore this technique may have a neuroendocrine modulating effect on the hypothalamic-pituitary-adrenal axis (Infante et al., 1998).

Meditation practice is also associated with decreased anxiety (Brown & Ryan, 2003; Davidson et al., 2003; Galvin et al., 2006; Schwartz, Davidson, & Goleman, 1978; Grossman et al., 2004), and the effects of an eight-week meditation intervention on reducing symptoms of generalized anxiety disorder and panic disorder, with and without agoraphobia, were sustained for three years (Miller et al., 1995). In addition, people with binge eating disorder who underwent an intervention using meditation had the frequency and intensity of their episodes decreased due to reduced anxiety and depression (Baer, Fischer, & Huss, 2005; Kristeller & Hallett, 1999).

Meditation is also capable of stimulating healthy aspects, and is very much associated with mental health (Goleman, 1988; Hankey, 2006). One research study found that meditation practice was associated with activation of the left prefrontal cortex (Davidson et al., 2003), which is related to positive affect and greater resilience (Davidson, 2004). Furthermore, theta waves produced by meditation also showed a positive correlation with the report of positive emotional experience during practice in experienced meditators, in contrast to beginners (Aftanas & Golocheikine, 2001).

Subjective measures and with self-report instruments have also indicated that meditation is able to generate positive affect (Brazier, Mulkins, & Verhoef, 2006; Easterlin & Cardeña, 1998; Jain et al., 2007), improve mood (Cruess et al, 2000), improve quality of life (Carlson et al., 2004), and psychological well-being (Brazier et al., 2006; Wallace, 1970), and the longer the practice, the greater the reported positive emotional experience (Aftanas & Golocheikine, 2001; Brown & Ryan, 2003). Furthermore, research that compared positive affect between experienced meditators and a control group revealed that, even at baseline levels, meditators had significantly higher levels of positive affect (Goleman & Schwartz, 1976), supporting the assumption of Eastern philosophies that meditation can bring about effects that override the state condition.

Thus, through continued practice, it is possible to transform states into traits, which even act on the personality. Compared to a control group, experienced meditators showed less neuroticism (Goleman & Schwartz, 1976; Leung & Singhal, 2004), and the longer the time of practice, the lower the prevalence of this trait (Leung & Singhal, 2004). Another study found that more experienced meditators were more adapted, joyful, mature, self-confident, and had better self-image. It was also observed that these practitioners, compared to the control group, were more emotionally stable, aware, confident, relaxed, and self-reliant (Sridevi & Krisha Rao, 1998).

According to Jain et al. (2007), meditation can provide the development of positive psychological characteristics by reducing ruminative and distracting thoughts. In comparing the effects of meditation and body relaxation, Jain et al. found that while both techniques produced a reduction in psychological distress and an increase in positive affect, meditation had a greater effect on increasing positive affect. In addition, it was the only technique with an effect on reducing ruminative thoughts and behaviors.

For Bishop et al. (2004), non-ruminative awareness develops through a meta-cognitive process characteristic of meditation, since it fundamentally works on self-observation of mental processes. This idea is consistent with results showing an increase in self-awareness associated with meditation practice (Brown & Ryan, 2003; Easterlin & Cardeña, 1998). Furthermore, they confirm the assumption that important levels of insight can be achieved through this activity (Goleman, 1988).

Because of this relationship between meditation and positive psychological aspects, many authors conceive of it as a useful technique for psychotherapeutic treatments (Hayward & Varela, 2001; Martin, 1997; Naranjo, 2005). Meditation, like psychotherapy, seeks the elimination of ego-barriers in order for human potentialities to manifest (Martin, 1997; Naranjo, 2005). By focusing attention, meditation can be interpreted as an attempt to undo the mind’s conditioning and programming (Goleman, 2003); moreover, the development of an attention free of elaboration can enable the emergence of contents previously inaccessible to consciousness (Bishop et al, 2004); therefore, some authors believe that meditation is close to the guiding assumptions of several theoretical lines of psychology (Naranjo, 2005; Vandenberghe & Sousa, 2006), and can be described as a state of psychological freedom (Martin, 1997).

Applications

Besides its relationship with psychotherapy, meditation has also become a clinical intervention used as a tool for adjunctive treatments, becoming the main focus of certain health programs. O Mindfulness-Based Stress Reduction (MBSR – Stress Based Stress Reduction Program mindfulness), for example, is a program developed by Kabat-Zinn, situated in a stress reduction clinic for non-hospitalized patients at the University of Massachusetts Medical Center, whose goal is to provide relief from physical and psychological suffering (Kabat-Zinn, 2003). The program consists of eight weekly meetings, of two and a half hours, in which the techniques of yoga postures and meditation are trained, to be practiced the rest of the days during the eight weeks, for one hour, at home. In addition, a seven-hour silent retreat is held in the sixth week. Numerous positive health outcomes, such as improved psoriasis (Kabat-Zinn et al., 1998), anxiety disorders (Miller, et al., 1995), and reduced stress in both non-clinical (Grossman et al., 2004; Jain et al., 2007) and clinical patients (Carlson et al., 2004; Speca, Carlson, Goodey, & Angen, 2000), have been associated with the program, suggesting its effectiveness.

The MBSR also gave rise to another similar program, but focused on the treatment of depression, within a context linked to cognitive-behavioral psychotherapy. This program, called Mindfulness-Based Cognitive Therapy (MBCT), aims to follow up depressive patients who have had successful cognitive psychotherapy in order to prevent their relapse. Like the MBSR, the MBCT includes eight weekly meetings, although with smaller groups, and the participant cannot be depressed at the time of the training. This program differs from cognitive-behavioral therapy in that it does not emphasize changing the content of thoughts, but rather transforming the patient’s awareness of thoughts and how he or she relates to them. The program has been shown to be effective for patients who have had at least three episodes of depression by increasing access to meta-cognition, in which patients experience negative thoughts and feelings as mere mental states rather than as an immutable condition of the self (Teasdale et al., 2002).

Another well-known program at Harvard’s Mind Body Medical institute was developed in the late 1960s by cardiologist Herbert Benson, and is called the relaxation response (Casey & Benson, 2004). Benson coined the term relaxation response to designate the set of techniques used, such as meditation and progressive relaxation, in the adjunctive treatment of various conditions, seeking to provide greater health and well-being to patients. The author describes the relaxation response as a set of biological and emotional reactions opposite to those generated by the fight-or-flight response characteristic of stress. A number of clinical applications of the program have shown significant results, such as less somatization (Nakao et al., 2001), better management of chronic and acute pain (Schaffer & Yucha, 2004), improvement of stress-related conditions (Esch, Fricchione, & Stefano, 2003), among others.

Meditation and other Eastern and relaxation techniques have also been used in health care systems in some countries, such as New Zealand (Duke, 2005), Canada (Andrewsa & Boonb, 2005), Australia (McCabe, 2005), the United Kingdom (Ernst, Schmidt, & Wider, 2005), and the United States (Spiegel, Stroud, & Fyfe, 1998), under the designation of complementary alternative medicine (CAM). In Brazil, the Ministry of Health, through Ordinance No. 971, based on a World Health Organization document, approves the use of complementary practices of Chinese Medicine, such as acupuncture, homeopathy, and meditation (Ministério da Saúde, 2006). However, there are still no scientific publications depicting the use of meditation in the health care system, although it is certainly used in public and private clinical practice. In Brazilian universities, there is also a lack of research on the subject. There are two research groups working in the area, one focused on research, at the Department of Psychobiology at the Federal University of São Paulo (UNIFESP), and the other more focused on the practice and insertion of the technique in the mental health field, at the School Clinic of Psychology at the University of Fortaleza (UNIFOR), where a free therapeutic service is offered to the population.

Conclusions

It is suggested that meditation can be understood and experienced from two perspectives, which can complement each other. The practice can be the reflection of a religious-spiritual context, through which the teachings transmitted by the philosophical precepts characteristic of tradition are cultivated and/or meditation can be an activity inserted in the health field, as a technique capable of producing certain benefits, promoting greater physical and mental health. It seems prudent to infer that one need not exclude the other, nor does one necessarily need the other.

Although meditation comes from Eastern philosophies, which characterize a particular way of perceiving and behaving in the world, including ethical values, the results discussed here reflect another aspect of the practice, indicating its potential as a psychosomatic technique with important repercussions for the health field in general. The technique itself is capable of generating a range of physical and psychological responses that can assist in the prevention of numerous conditions, especially those resulting from the deleterious effects of stress, in the management of established health problems, as well as in the promotion of mental health. Thus, meditation is an activity that can be used in a therapeutic context, as long as the conditions and peculiarities of the situation being treated are respected.

One study found that people who used spiritual meditation had greater reductions in anxiety, greater reports of positive affect, and greater pain tolerance compared to the group who used secular meditation (Wachholtz & Pargament, 2005). In addition, some authors maintain that meditation performed outside of its original context is not as facilitative of characteristics traditionally tied to the practice, such as deeper levels of purpose in life and self-actualization (Shapiro et al., 2005). However, it is proposed that meditation should be conceived as a multifactorial process, in which many aspects are interrelated, mediating its effects, such as genetics and personality traits, motivations and values, both pre-existing and acquired through one’s own practice and individual experiences, and the type of technique. Although spirituality can have a positive impact on well-being and physical and mental health (Guimarães & Avezum, 2007; Peres, Simão, & Nasello, 2007), there is a limit that refers to people who do not want to lead a life grounded in spirituality and should not be prevented from meditating or having access to meditation practice. Furthermore, more studies are needed comparing the different types as to their underlying mechanisms and as to a possible distinction in the impact of each.

Besides the specificities of each type, it should be noted that studies on meditation still elicit divergent opinions as to the acceptance of its applicability and effectiveness in the health field. Some authors caution that research with more rigorous methodologies are still needed to ensure that meditation is indeed responsible for the observed effects (Baer, 2003; Bishop, 2002; Canter & Ernst, 2004). Among the main arguments are the non-randomization of many samples, the small number of participants, the affiliation of the researchers to organizations linked to the investigated technique and, until 2004, the lack of an objective operational definition was argued (Bishop et al., 2004; Cardoso et al., 2004).

On the other hand, a large number of studies with positive results suggest that meditation can be effective with regard to psychosomatic reactions and especially subjective experiences, such as a sense of well-being and personal growth. Regarding the time required for such effects to occur, there is no precision. Although research shows that after a few months a significant difference can already be observed in certain states, there are also studies indicating that the longer the time of practice, the greater the intensity and permanence of the responses produced. Therefore, the regularity of the practice constitutes yet another variable that mediates the effects of meditation, and possibly a differential in that such reactions become more lasting and stable aspects of the personality.

Considering the relevance of the scientific study of meditation and its many facets, it is suggested that this is a field to be explored in research centers in Brazil. The still developing stage of meditation studies provides fertile ground for research, and as the results become more conclusive, it is possible to insert and disseminate them in clinical practice. In addition, it is recommended that those professionals who already use it in their therapeutic practices report their cases with the necessary scientific rigor for a Brazilian movement to begin to validate the use of meditation as a tool to promote quality of life in its various dimensions.

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Carolina Baptista Menezes
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