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Mindfulness research: separating the hype from the science

Mindfulness research: separating the hype from the science
REUTERS/Edgard Garrido
The study found no evidence “that meditation programs were better than any active treatment” like exercise.

Is all the recent hype about the health benefits of mindfulness meditation justified?

That’s the question Timothy Caulfield, a health law and policy researcher at the University of Alberta (and author of the new book “Is Gwyneth Paltrow Wrong About Everything? When Celebrity Culture and Science Clash”), thoughtfully explores in a recent online commentary for the journal Policy Options, which is published by the Canadian Institute for Research on Public Policy.

“Is mindfulness a science-based approach to health and wellbeing or a philosophy about how we should live?” he asks. “If the former, what does the good science actually say about the benefits? If the latter, does it matter what the science says, and what, then, is its place in an (allegedly) evidence-based health care system? And, perhaps most challenging, can it be both?”

‘No firm conclusions’

Caulfield notes that, despite the fact that celebrities, sports stars and business leaders have enthusiastically endorsed claims for the physical and mental benefits of mindfulness meditation, the scientific evidence “is far less definitive.”

He explains:

A rigorous 2014 systematic review of available evidence on the impact of meditation on stress and well-being, published in JAMA Internal Medicine, reviewed over 18,000 citations and found 47 randomized clinical trials worthy of consideration. Using only these high-quality studies, it concluded there is moderate evidence to support the benefits associated with anxiety and depression and either insufficient evidence or evidence of no effect “on positive mood, attention, substance use, eating habits, sleep, and weight.”

More importantly, the study also found no evidence “that meditation programs were better than any active treatment.” Mindfulness was not better than, for example, exercise. In part, this may be because many of the studies on mindfulness and meditation are, from a methodological perspective, less than ideal.

A 2007 review done for the US Department of Health and Human Services by the University of Alberta Evidence-based Practice Center came to a similar conclusion, finding that most studies on meditation were “of a poor methodological quality” and that no “firm conclusions on the effects of meditation practices” can be made.

“These are pretty underwhelming conclusions for an approach that has received so much attention,” Caulfield concludes. 

Big business

Still, Caulfield stresses that he’s not out to “bash meditation.” The observed benefits for some conditions, particularly anxiety and depression, are “significant and measurable” and worth further study, he points out.

Timothy Caulfield
Timothy Caulfield

But we must conduct and interpret those studies with our eyes wide open. Caulfield warns that mindfulness and meditation research is often tainted by “white hat bias” — bias that leads to a “distortion of information in the service of what might be perceived to be righteous ends.”

He also notes that mindfulness has become a multibillion-dollar business. That means “that the potential for profit will, inevitably, further twist what we hear about the value of the practice ” — just as it does with other products and services offered by various corners of the health-related industry, both alternative and mainstream.

So, suggests Caulfield, “let’s tone down the hype and study mindfulness in a rigorous manner, looking at both benefits and possible harms. We should strive to do it in the same critical and dispassionate manner that good science demands for all areas of research.”

“If we want to use science to justify the use of mindfulness,” he adds, “we must play by the rules of science.”

You can read Caulfield’s article on the Policy Options website.

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Comments (6)

They're

just sheeple.

Chaotic methodology = meaningless results

This article interchangeably uses the terms "mindfulness", "mindfulness meditation", and "meditation". These are all different things. Mindfulness can be employed to a variety of practices, meditation being one of them, and there are a huge number of meditation methodologies.

The general problem with these "oh no the new age woo doesn't work" "skeptic" pieces is the general incoherence of the critiques and faulty analogies. One wouldn't conduct a clinical trial of a drug, for example, giving people random doses of it. The same goes for meditation practices - some people are very good at it, some people are not.

To top it off, a lot of these arguments are strawmen - looking to show that these practices don't "cure" X, Y, or Z when they're not intended to cure X, Y, or Z, or only some people make these claims.

Mediation and mindfulness, practiced regularly, will make a person more clear-minded. Clear-minded people make better decisions. So how exactly is one going to measure the effects of that in totality? Meditation and mindfulness aren't pharmaceuticals and shouldn't be compared to them - the analogy and framework are absurd.

Some of the work being done at UW-Madison by Dr. Richard Davidson is more helpful, since it tends to focus on people who have well-developed skills in meditative disciplines.

I'd suggest you read the reference given

by the author of this excellent article.

Meditation Programs for Psychological Stress and Well-being
A Systematic Review and Meta-analysis
link: http://archinte.jamanetwork.com/article.aspx?articleid=1809754

The article is free and quite good. I believe that it answers most of the questions you have raised, for example:

"Meditative techniques are categorized as emphasizing mindfulness, concentration, and automatic self-transcendence. Popular techniques, such as transcendental meditation, emphasize the use of a mantra in such a way that it transcends one to an effortless state where focused attention is absent.3- 5 Other popular techniques, such as mindfulness-based stress reduction, emphasize training in present-focused awareness or mindfulness. Uncertainty remains about what these distinctions mean and the extent to which these distinctions actually influence psychosocial stress outcomes.5,6"

Attempting to discredit the research by quibbles such as:

This article interchangeably uses the terms "mindfulness", "mindfulness meditation", and "meditation". These are all different things.

As this point is clearly recognized by the authors of the cited article.

It is time for us to be mindful in separating science from hype. One of the big mindfulness pushers, Dr. Oz, has been lately taking it on the chin for "disdain for science and for evidence-based medicine."

I'd suggest you stop assuming I didn't read it

Thank you for the unwarranted condescension, though.

To reference the section you quoted:
"Uncertainty remains about what these distinctions mean and the extent to which these distinctions actually influence psychosocial stress outcomes."

What that means in, contrary to how you interpret and portray it, is that uncertainty exists about the distinctions between the different forms of techniques that are all lumped together in the meta-study and the MinnPost coverage of it. Meaning, they don't understand the differences and perhaps investigate exactly what they are before writing yet another hackneyed "quackery" article.

"It is time for us to be mindful in separating science from hype."

I agree entirely. That won't be achieved by sloppy reasoning and unwarranted condescension.

"One of the big mindfulness pushers, Dr. Oz, has been lately taking it on the chin for "disdain for science and for evidence-based medicine.""

Oh, I see. Cute. Since some popsci celebrity has specific opinions and behaviors, that discredits entire fields of endeavor. How logical. So if a specific doctor is a clueless nitwit and prescribes treatment regimens that are wrong, does that discredit all of western medicine?

People lecturing others about evidence, reason, and clear thinking should try demonstrating it first.

I see you are a master of the straw man argument ...

"does that discredit all of western medicine?"

Where did I say it did?

Putting words in someone else's mouth is what one does when they have a weak argument.

Logical fallacies: ad hominem and appeal to authority

ad hominem
* "Is Gwyneth Paltrow Wrong About Everything?"
* "celebrities, sports stars and business leaders have enthusiastically endorsed claims for the physical and mental benefits of mindfulness meditation"
* "mindfulness and meditation research is often tainted by 'white hat bias' — bias that leads to a 'distortion of information in the service of what might be perceived to be righteous ends.'"
* "He also notes that mindfulness has become a multibillion-dollar business."
* "I'd suggest you read the reference given"
* "One of the big mindfulness pushers, Dr. Oz, has been lately taking it on the chin for 'disdain for science and for evidence-based medicine.'"
* "I see you are a master of the straw man argument"
* "Putting words in someone else's mouth is what one does when they have a weak argument."

appeal to authority
* "Timothy Caulfield, a health law and policy researcher at the University of Alberta"
* "author of the new book 'Is Gwyneth Paltrow Wrong About Everything? When Celebrity Culture and Science Clash'"
* "the journal Policy Options, which is published by the Canadian Institute for Research on Public Policy"

As for the strawman fallacy:
"The Straw Man fallacy is committed when a person simply ignores a person's actual position and substitutes a distorted, exaggerated or misrepresented version of that position."

The original interrogative:
"So if a specific doctor is a clueless nitwit and prescribes treatment regimens that are wrong, does that discredit all of western medicine?"

This is not saying someone made this argument (which would be a strawman), it is applying the fallacious ad hominem argument being contested by demonstrating how illogical it is when applied to a realm the author of the fallacious argument finds of value.

The original objection to this piece was the author using the terms "mindfulness", "meditation", and "mindfulness meditation" interchangeably, which does nothing to clarify the issue. Mindfulness is a state of being, meditation is a practice with thousands of forms, and mindfulness meditation is one general form of meditation which has a variety of different subforms (sitting, walking, doing dishes, etc). Lumping them all together is sloppy and therefore of no intellectual value.

Mr. Caulfield is a lawyer who openly admits he has no personal familiarity with mindfulness, meditation, or mindfulness meditation. So not only is appeal to authority generally fallacious, Mr. Caulfield isn't even an authority - on medicine, science, mindfulness, meditation, or mindfulness meditation. But, hey, he has strong opinions and bashes dumb celebrities. "Logic". "Science".

He seems quite opportunistic (in his words, employing "hype"), looking to sell his books etc, by latching onto celebrities: Paltrow, Winfrey, Bryant, Jobs, et al. Then publishing his "medical" insights in a policy journal article. He then exposes his biases by linking (mindfulness) meditation to naturopathy. This is the general problem with almost all of these bashing pieces - lumping things together incoherently.

In fact he openly admits, per the JAMA piece, that "many of the studies on mindfulness and meditation are, from a methodological perspective, less than ideal". It's not the fault of something being studied that it's not being studied well.

Like I said, this is all incoherent and of no intellectual value. He, this piece's author, and the vitriolic commenters should all aim for the precision of the scientific method they're supposedly espousing. Otherwise, it's just noisy bashing.