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Mediatation with anxiety reduction. Effective way for a anxiety-free life.

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  • 0272%7358/85 $3.00 + .W Copyright 0 1985 Pergamon Press Ltd.

    MEDITATION AND ANXIETY REDUCTION: A LITERATURE REVIEW

    M. M. Delmonte

    Psychosomatic Unit

    St. James4 Hospital

    Dublin 8.

    ABSTRACT. Meditation is increasingly bring @u?icud as a therapeutic technique. The effects of pv-actirf on psychometrically assrssed unxipty leuel,s hazer been Pxtmsiuely researched.

    &-osfiPcti-i,u meditators tend to r+ort aboz,P allCrap ie-oek of anxiety. In gPnPv-al, high anxiety Gvels @dirt a subsequent low ,frequrncy of kracticp. Howczler, the e_ckLencu suggests that

    those who pa&P regularl? tend to .show significant drcreusrs in anxiety. Meditation does

    not appear to br more pfffctz-ilp than comparative intpnlmtions in reducing anxiety. There is

    ezlidence to suCgpt that hypnotizability and exppctuncy may both play a role in reported anxiety

    decrPmPnt.s. Cprtain indi-rJidua/.c, with a capacity to engage in uu~tonomous .selfabsorbed

    rrlaxation, may bmpfit vnost from meditation.

    Meditation is becoming more prevalent as a self-management and self-mastery technique, as well as an adjunct to psychotherapeutic intervention (Candelent & Candelent, 1975; Delmonte 8c Braidwood, 1980; Glueck 8c Stroebel, 1975). To date, there has been no extensive review of the research literature in relation to the effects of meditation on self-reported anxiety levels.

    TYPES OF MEDITATION

    For the most part, this review will be limited to those forms of meditation in which ones attention is focused (restricted), such as in Transcendental Meditation (TM) and Zen Meditation, as opposed to the various opening-up exercises. The former concentrative techniques are widely practiced in North America and Western Europe, whereas the latter mindfulness approach is less well known and has only occasionally been the subject of research in the West. In concentrative meditation ones attention can be focused on a variety of objects such as a sound (mantra), a candle tlame, ones breath, and so on. The above two types of meditation are not

    Requests for reprints should be addressed to Dr. M. M. Delmonte, St. Jamess Hospital, Psychosomatic Unit, Dublin 8. Ireland.

    91

  • ;~l~)ltite cate,gorics as fhcrc ia :I cc.t-lain ;ii~tot~ttl of ocedap (SW Orristein, 1972, toi

    ;I mow c~otnplrl~ disc-ttssiott).

    MODELS OF MEDITATION

    Mctlitalioti has Iwrn viewed frotii both psychoan:ilytic attd l~ehavioral perspectives.

    For csatriplc, tiiedilatiott is secti as adapti\e regi~essioti in the service of the ego

    (Shalii, 1973) ot as ;I wrt of. Ko)xl Koxl to the ttttconscious (Jung, 19.58, p. 508).

    (~olctnmt (197 I) buggc3tetl that tt~ecliratioti nt;i): be (3)ticeptualiad as SIOM self-paced s~sletnatic clesctisitil.~ttioti. Othrrs have tltwrtbrd meditation as 2 techttiqur that

    itiwlvcs t-cc-iprocal inhil)itiott 2nd cottnttr cotttlitiotiitig Iwtlittg lo tlesensitization

    of. atixit.ty rvokittg Ihoughta (Ue1-~4%k Lb OAel. 1973; Mikdis, I98 1; Shapiro & %iff~rhlatt. IW6). hledit~triott is also twcisagect as ;I r~lasatioti techtiique (C;r-ren- wootl SC Bensott, I977; Sltapiro &I Zifferl~Litt, 1976). Iti fact, (;rcettwood and ISenso~t

    ( 1977) h;tw at-gttetl that tneditati\~e relax;ttioti is ittore appropriate 1 hi abbreviared rclaxatiott traittitig as ;I t~eciprod itthil~iror itt systematic tlesetisitiz~ttiort. Koals

    (1!)7H) c-ontcticlrd that c-Ltssicdl contiitiotiitig elicit5 cltanges iii the direction of. re-

    Lixatiott when the. tttattlrii I~ecotncs ;t cotitlitiottetl id~txatiott ariniulus. Delniontc

    ( 197!I) provitlcd tGtl~ttc_r tltat ;I tiiiititm may hecome ;t contlitiotied stiniulus eliciting ;I condition;il relaxation respotisc in terms of frotitalis lCYl(;. lhe sane tionrtiedi-

    tatol-s had signifiwtt~ly lowt~ lChf(i leccls while tdtxittg \vith closrtl eyes than wldc suhvcally repeating ;I tn;tt1tr;1. .1lantr;t rcpetitiott had pt-eGottsly been pail-d with

    fl-ontalis Ehl(; biofcctllmck training dttring fi)tir sessiotta wet- four consecutive

    days. Finally, CLirpctiter- ( I977) sttygsted that tneditati\~c rxercises provide tht-eta therapeutic gains, ttamcly insight into repetitive self-defeating patterns of behavior

    and thinking (e.g., cravings), desensitization of painful thoughts, and condition- ing of the wtttt-al tierwus systcvti.

    .lltt3y arc fl-equettt ;ttiecdolal tqwr(s ofttttstI-cssittg ~i~~ottt~);iti~.ing: the practice

    of meditation. (Iat-ringtott antI L.phroti (1075) suggest that rttistrcssing is ;I fi)rni of catharsis by nicatts of which pwvious triiittiiatic or stressful events are released

    slJotit;ttteottsl~. LTnstrrssing is the littk hetwectt the tJs)tio;tti;t1!.tic- and the heha\:-

    ioral tnotlelb of twditarion, as it invokes hotlt rhc 1Js)~llo(lvtt;t~~~i~ concept of

    breaching the rcpressioti harti~r and I he behavioral noCon of ctesetisitizatioli. Smith (l!US). in mi vxtcttsivc review of the ps~~hotliet-~iI,~ttti~ effects of niedi-

    ratiott. noted that vit-~tt;tl1! c\ery schoc~l of~~s~~~~~ologic~;tl thought has I)een invoked to supl)otA tItt> cl;titit Ihat tneclitatioti practice is iwwfici;il. lHe coticltrdctl, rather

    ~~;it~sirtionioirsl~, however, I haI thr thci-apeittic ktiefits fbutitl could t)c the result

    of exlwctatioti of t-dief or of simply silting on ;I regular basis. I le later produced evidence to strppor( this cotttettlioti (see Nott-Sprcific Factors).

    TYPES OF ANXIETY/AROUSAL

    Handron ( 19.59) and Huss ( I96L), 1)): faclor att;tlyhg attxiety SCOI~~S obtained frotn psychiatric patienls, ohtaincd two faclors (psychic and somatic anxiety) which

    ;ic-couttttd fbr- the ~tii~jor pot-lions ot the vat~iancr iti anxiety qucstiorimire scores. Sc~hallitig, (~rotiholnt. ;ttid Asher,q (1975). antI SchwatY/. I)avidsoti. and

  • up of cognitive and somatic components. Davidson and Schwartz ( 197(i), with theil multi-process model, postulated that somatic and cognitive components of arousal would differentially respond to different forms of relaxation. More precisely, they posited that the different relaxation techniques, (i.e., primarily cognitive versus somatic) will be more effective in reducing same mode vs. other mode anxiety (p. 426). Similarly, Schwartz et al. (1978) argued in favor of differential effects of a somatic (physical exercise) and a cognitive (meditation) relaxation procedure (p. 321). In other words, they contend that specific suhcomporlents of anxiety may be differentially associated with relaxation techniques engaging primarily cognitive versus somatic subsystems. They offered some (poor) retrospective evidence that subjects practicing physical exercise reported relatively less somatic and more cog- nitive anxiety than meditators (the two groups were neither matched nor formed by random assignment). The above multi-process 1node1 is opposed by the 01de1 unitary relaxation response model of Benson, Heal-y. and Carol (l974), who posit that the various relaxation techniques all elicit a general relaxation (trophotropic) response involving all systems in concert.

    METHODOLOGICAL ISSUES

    Anxiety can be evaluated in terms of several criteria (e.g., behavioral, psychophys- iological, and psychometric measures). This review focuses primarily on the effects of meditation in terms of psychometric (i.e., self-report) ratings of anxiety. Phys- iological and biochemical outcome criteria have been reviewed elsewhere by the author. The studies reviewed in this paper range from the methotlologically weak to the sophisticated. The review commences with the weakest designs and finishes with the best studies (e.g., cross-sectional designs with various degrees of matching, simple pre-post designs, pre-post designs with prospective meditators as controls, random assignment to meditation and control groups, random assignment to med- itation and comparison groups with control for credibility and expectancy, and so on).

    A major problem with the cross-sectional studies is that individuals attracted to meditation may differ in certain respects from those who are not so inclined. Hence, differences found between meditators and nonmeditators may not be attributable to practice per se. This problem can be partly overcome 1~): using prospective meditators as controls, or by randomly assigning metlitation-naive subjects to med- itation and control groups, in pre-post research paradigms. However, with this design there still remains the problem that those assigned to the meditation and control conditions will have different expectations. Expectancy of relief should be considered in meditation research outcome (Delmonte, 198 la; Smith, 1975, 1976).

    In general, there has been a paucity of research on personality variables and their relationship to the practice of meditation. On the contrary, however, anxiety and/or neuroticism have been featured in numerous (i.e., in approximately 40) studies on meditation. It will not be possible to give detailed accounts of these studies; rather, a general overview will be attempted. LJnless otherwise specified, state, trait, cognitive, and somatic anxiety, together with neuroticism, will be col- lectively referred to as anxiety. Similarly, the word anxious will include neurotic unless otherwise indicated. This is purely a pragmatic decision and does not imply any theoretical position.

  • 94

    STUDIES WITH CROSS-SECTIONAL DESIGNS

    Some authors report that experienced meditatoi-s are significatttl) less atisious than

    comparison groups of controls ((;otetnan 82 Sctiwart~. 1076; IIjrllC. l%~l: vat1 den

    Berg 8c Mulder, t!)f(i). In all the abo\,th stu(lies the control iubjccta were eithei

    prospective meditators (i.e., Hjelle, tC)7G; \:att tlrn B

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