Control methods in meditation trials can be positioned on a spectrum based on their varying ability to elicit non-specific effects. At the low face validity end are those that are mostly passive and implausible (such as “waiting list”) and therefore unlikely to control for non-specific factors, while at the other extreme are those that are mostly active and, by virtue of their credibility and active content are high face validity and much more able effectively to elicit and therefore control for non-specific effects.
High face validity, active control strategies that elicit a respectable level of non-specific effect are however very resource intensive to devise and implement. Researchers with very limited resources therefore often opt for simpler, less demanding strategies with necessarily poorer control for non-specific effects.
Dr Ramesh Manocha.
Posted in complementary and alternative medicine, meditation, research, thesis excerpt | Tagged complimentary alternative medicine, control methods, meditation, mental silence, ramesh manocha, research, sahaja yoga, sahaja yoga meditation |
It seems obvious that the non-specific effect of any intervention is closely related to its credibility and plausibility as a therapeutic intervention i.e. its “face validity”.
Now, some of the effects associated with meditation must be non-specific, i.e. comprising a mixture of placebo, therapeutic contact, spontaneous improvement, and so on, whereas some, hopefully, are specific to meditation alone. One might even propose that different meditation techniques have varying proportions of specific and non-specific effects. Within the context of an RCT (randomised control test), the control strategy should ideally:
- elicit all the non-specific effects that meditation might have, but have none of meditation’s specific effects
- not have any specific effects of its own.
By fulfilling these criteria the control strategy makes the RCT methodology sensitive to any specific effects of meditation that might be detectable.
Dr Ramesh Manocha.
Posted in complementary and alternative medicine, meditation, research, thesis excerpt | Tagged complimentary alternative medicine, dr ramesh manocha, meditation, mental silence, ramesh manocha, research, sahaja yoga, sahaja yoga meditation, spirituality |
The design of RCTs ( randomized controlled trials) for meditation (or any behaviour-based therapy for that matter) involves a number of unique challenges compared with pharmacological trials.
While both categories of trial use an inactive placebo, the pharmaceutical trial uses an inert “sugar tablet” which appears similar to the medication being administered. The participant taking the “sugar tablet” is unable to ascertain whether or not they are taking the active or placebo treatment thus allowing the trial to control for confounding factors that may contribute to changes in the participants condition other than that caused by the treatment being studied.
The meditation trial however poses a unique challenge, since participants receiving the “inert” treatment must be involved in a placebo-like activity that nevertheless requires their active, conscious and conscientious involvement. They must also be sufficiently convinced of its authenticity to motivate them to participate at a level necessary to maintain the validity of the study.
Dr Ramesh Manocha.
Many considerations bring us back to the most important issue in the ongoing effort to reconcile the differing polemics from science, ancient tradition and pop culture. Which is not the question about whether meditation has any effect, because it clearly does have, but whether or not meditation has any specific effect.
Clearly the RCT (randomized controlled trials) evidence is the only segment of the literature that could possibly answer this question. Despite this there arecurrently no published reviews aimed at specifically and comprehensively appraising the RCT evidence nor have there been comprehensive reviews closely examining RCT methodology and its relationship to study outcomes.
Dr Ramesh Manocha
Can mental silence and its associated yogic philosophy provides a basis for a taxonomy of meditation that is practically useful in the delivery of healthcare?
This question is based on the wide range of applications in medicine, psychology and neuroscience on which Sahaja Yoga meditation (SYM) interventions have been shown to have a specific effect. Moreover, meditation is particularly relevant to the growing field of complementary medicine because it represents an entire genre of complementary and alternative medicine (CAM) modalities. It is contended that the apparent therapeutic effects of mental silence position this genre of CAM in a new category with practical relevance.
Dr Ramesh Manocha.
Posted in complementary and alternative medicine, medicine, meditation, research, thesis excerpt | Tagged complimentary alternative medicine, dr ramesh manocha, meditation, mental silence, methodological issues, research, sahaja yoga, sahaja yoga meditation |
Defining meditation has proved a difficult challenge for modern researchers. Conceptual definitions of meditation vary widely but generally lack empirical confirmation. The authoritative National Centre for Complementary and Alternative Medicine (a department of the National Institutes of Health) in the United States in 2006 defined meditation as “a conscious mental process that induces a set of integrated physiological changes termed the Relaxation ResponseRelaxation ResponseRelaxation Response” (NCCAM2004. Meditation for health purposes. D308 ed: National Institutes of Health, US department of Health and Human Services, 2004). Yet the most original and authentic traditional treatises on meditation define it as an experience of mental silence. For example in the Katha Upanishad, as follows: “When the five senses and the mind are still, and reason itself rests in silence, then begins the path supreme” (Mascaro J. Katha Upanishad. The Upanishads. London: Penguin classics, 1965). Such a conceptualization contrasts sharply with many of the contemporary understandings of meditation put forward in the West; probably the most pervasive of which is as a method of achieving reduced physiological arousal, or in another words relaxation.
Dr Ramesh Manocha.
A general reading of the total literature makes it obvious that method validity is the major challenge to meditation research. More specifically, the main problems are: first, the use of appropriate control strategies to exclude non-specific effects (more widely known as the “placebo effect”), second, the need for randomization and other strategies to eliminate bias and third and most importantly, a consistent and meaningful definition of meditation.
Dr Ramesh Manocha.
The characteristic features of attention deficit hyperactivity disorder (ADHD), such as hyperkinesis, poor attention and impulsiveness, are seem to be more or less the opposite of those qualities that meditators wish to cultivate. Meditation, in many ways seemed like an ideally designed antidote.
Treatment program
The intervention was conducted over a 6 week period and consisted of twice-weekly 90 minute clinics, held in large meetings rooms at Prince of Wales Hospital, Sydney. For the first 3 weeks, the clinic consisted of guided meditation sessions, with parents attending one group and the children another. The sessions were conducted by meditation instructors experienced in Sahaja Yoga Meditation (SYM) techniques. The meditation process involved practising techniques which helped participants to achieve a state of “thoughtless awareness”. Instructors directed participants to become aware of this state within themselves by becoming silent and focusing their attention inwardly. Parents were also asked to conduct shorter meditation sessions at home twice a day.
Psycho-stimulant medication
The SYM treatment program did not ask or advise parents to reduce their child’s pharmacological treatment for ADHD, but it was clear from comments made by a number of parents at recruitment that they were looking for alternatives to medication. At the middle and endpoints of the program, parents were asked: “Have you been able to reduce your child’s level of medication and still maintain an acceptable level of behaviour?” If medication had been reduced, parents were asked to report the proportion.
ADHD is characterized by a symptom triad of inattention, hyperactivity and poor impulse control. Meditation is precisely directed at developing the opposite features, that is, stable attention, calm and measured behaviour and the ability to contain one’s impulses.
The use of complementary and alternative medicines and other non-pharmacological strategies as a treatment for children diagnosed with ADHD is widespread, but little is known on the effectiveness of many such therapies. This study investigated Sahaja Yoga Meditation (SYM) as a family treatment method for children with ADHD. Parents and children participated in a six-week program of twice-weekly clinic sessions and regular meditation at home. Pre- and post-treatment assessments included parent ratings of children’s ADHD symptoms (a mean reduction of 35%), self-esteem and child–parent relationship quality.
Results showed improvements in children’s ADHD behaviour in both respects. Children described benefits at home such as better sleep patterns and diminished feelings of anxiety and also at school, reporting that they felt more able to concentrate and experienced less conflict with peers and teachers. Parents reported feeling happier, less stressed and more able to manage their child’s behaviour. Indications from this preliminary investigation are that SYM may offer families an effective management tool for family-oriented treatment of childhood ADHD.
Posted in ADHD, complementary and alternative medicine, in the news, research, thesis excerpt | Tagged ADHD, complimentary alternative medicine, dr ramesh manocha, mental silence, ramesh manocha, research, sahaja yoga meditation |
In his study of 1,599 members of the baby-boomer generation conducted in the US in the early 1990s, the American researcher Roof (1993) demonstrated that there had been major defections from organized religion in the 1960s and 1970s, coupled with an increase in New Age type movements which emphasized the superiority of direct spiritual experience over institutional religion. Roof found that one well-educated segment (“highly active seekers”) of this group, was specifically focused on developing a highly individualized spirituality that rejected religious orthodoxy and instead favoured mystical experience and New Age ideas. They characterized themselves as “spiritual” but not “religious”*.
It is this generation that appears to have driven the rising legitimacy of meditation in the West. The perspective of these highly active seekers is now reflected in wider social attitudes and perceptions of religion.
*Roof W. A generation of seekers: the spiritual journeys of the baby boom generation. San Francisco: Harper, 2003.
Posted in meditation, research, thesis excerpt | Tagged dr ramesh manocha, history of meditation, meditation, mental silence, ramesh manocha, research, sahaja yoga meditation, spirituality, yoga |