However, if a practitioner progresses beyond the initial levels of MEA, this will likely require that secular meditation teachers refer practitioners to well-qualified traditional contemplative teachers, depending on the contemplative preferences of the practitioner. For such referrals to be possible, establishing reliable and professional links between providers of secular meditation training and teachers across contemplative traditions will be needed. This will be necessary to accommodate a wide variety of contemplative backgrounds and preferences which practitioners bring to their secular meditation training. Development of such links will also require effort on the part of traditional contemplative teachers, so that they develop basic understanding of the principles and practices applied in secular meditation programmes and are able to build on this foundation in further contemplative training. There will also be a need for familiarity with basic concepts of contemplative science, particularly those relevant to the progression of MEA, to allow for informed exchanges about supporting existential insight and existential well-being of practitioners across contemplative traditions.
Another platform for supporting long-term meditation practitioners could arise within psychotherapy itself, provided by contemplative psychotherapists who aside from the necessary psychological training also have experiential understanding of MEA. The development of contemplative psychotherapy would also bring with it unique requirements regarding transparency about the contemplative tradition a particular contemplative psychotherapist follows and their qualifications in terms of experiential and intellectual understanding. Contemplative psychotherapy as an established approach could build on the common principles outlined in contemplative science theory in terms of MSRC, MEA and existential drive. These constructs would then be adapted within a particular contemplative context. In this way, contemplative science can provide the platform and focus needed for contemplative psychotherapy to establish itself as a rigorous and effective psychotherapeutic approach.
Contemplative neuroscience
Research in neuroscience of meditation attracted a lot of scientific and public attention over the last decade. It demonstrated that meditation practices reliably induce tangible changes in brain function and structure. However, this line of research has been also subject to the same limitations as psychological research on meditation, and in some regards even more so. These limitations include primary focus of neuroscience studies on short-term effects of meditation training and dispositional associations. No longitudinal neuroscience studies using fMRI or EEG have so far investigated effects of meditation beyond four months. While there are also interesting studies with advanced long-term meditators, these applied cross-sectional designs where we are not able to assess brain activity of practitioners before they started meditation. In cases of very advanced practitioners this may simply not be possible because their meditation training may span over 20 years. However, in other cases, particularly in studies which assess effects of secular meditation programmes from before to after the program, follow-ups of at least a year or a couple years would significantly enhance our understanding of longer-term effects.
Another drawback of neuroscientific, just like psychological, studies on meditation is their nearly exclusive focus on self-regulation abilities of practitioners. Indeed, most studies have so far investigated brain changes resulting from meditation training which are associated with attention or emotion processing. In contrast, our understanding of neural correlates linked to MEA is virtually absent. Only a couple of studies investigated brain activity modulations resulting from decentring and there are less than a dozen studies which examined more advanced MEA. In addition, most of these studies still focused on changes in attention and emotion processing as consequences of shifts in MEA, rather than on unique neural correlates of MEA as such (see examples in Dorjee, 2016).
The current lack of contemplative theory to guide research in contemplative neuroscience also results in difficulties when it comes to comparing and integrating findings from studies. This is because descriptions of meditation techniques, programmes or traditions often do not contain enough detail to allow for clear predictions of similarities and differences in expected brain patterns. In addition, researchers sometimes combine studies to make inferences about overarching patterns in ways which seem driven more by similarities in brain activation than similarities in practices and expertise of meditators. For example, a recent review combined findings from studies with participants in secular mindfulness courses with results of studies with Zen, Vipassana and Tibetan Buddhist meditators (Tang, Hölzel and Posner, 2015). Despite the differences in practices and levels of proficiency of practitioners, the authors attributed similarities in findings as indicative of neural correlates of mindfulness relevant to enhancements in self-regulation.
Building on the initial findings of neuroscientific studies on meditation, the next phase of research in contemplative neuroscience will need to be driven by stronger theoretical foundations and finer distinctions between meditation practices. Increasing numbers of studies now target more nuanced classifications of meditation types (e.g., Dahl, Lutz and Davidson, 2015) and more studies are trying to relate subtle phenomenological descriptions of MEA with associated neural correlates (e.g., Dor-Ziderman et al., 2016). The framework of contemplative science proposed in this book (and in Dorjee, 2016) suggests that conceptualizing contemplative neuroscience research in the terms of MSRC and MEA can further support development of comprehensive contemplative science theory. This is because this theory would allow for comparison of similarities and differences in modulations of the MSRC resulting from various contemplative practices and enable targeted investigation of neural correlates of shifts in MEA with long-term meditation training (rather than attention or emotion processes associated with it).
Contemplative neuroscience research possibly also offers further, largely unexplored opportunities to investigate some of the most persistent questions of science. One of these is the mind–body problem, which asks how an immaterial mind and a material body interact. Perhaps this is where meditation research has further untapped potential to make a contribution. Meditation training, unlike any other type of mental training, aims to further enhance our ability to be aware of processes and states of our mind, and of the ‘what it is like’ phenomenological aspects of experience. Such training makes meditators experts at distinguishing subtle shifts in their minds and knowledge of these can then guide researchers in linking these more closely to the associated brain changes (Lutz, 2002; Lutz and Thompson, 2003; Ricard, 2003; Wallace and Hodel, 2009). Hence, research into long-term effects of meditation is likely an instrumental next step in furthering our knowledge of how phenomenological shifts in the mind relate to brain activity.
Contemplative science in healthcare
If self-regulation and existential well-being can be considered the core pillars of human well-being, the research in contemplative psychology, contemplative psychotherapy and contemplative neuroscience has direct implications for healthcare. Aside from psychotherapeutic applications, which we have discussed in one of the preceding sections, contemplative approaches have a significant potential to contribute to prevention of illness and enhancement of well-being and resilience more broadly. This is because previous studies outside of meditation research documented clear links between improvements in self-regulation and better health, and initial research shows that meditation training can enhance attention (Jha, Krompinger and Baime, 2007) and emotion regulation skills (e.g., Goldin and Gross, 2010). In addition, meditation-based approaches have largely untapped potential in supporting existential well-being, which is another factor associated with resilience and better coping skills (Maselko, Gilman and Buka, 2009).
However, to fully harness the potential of meditation-based approaches in public health, more rigorous long-term investigations of their effects across the life-span are needed. The number of studies on possible protective effects of meditation is limited and the effects reported a
re relatively short-term. Future research needs to assess the impact of long-term meditation training on illness prevention. Such research also needs to go hand in hand with an expansion of the repertoire of meditation techniques investigated since majority of previous studies examined only the effects of mindfulness-based approaches. Meditation-based programmes developing compassion, loving kindness and existential insight which build on the foundations of self-regulation developed through mindfulness-based approaches may have particularly strong impact on enhancing both self-regulation and existential well-being. In addition, access to continuous support in developing and sustaining long-term meditation practice, both in formal and informal formats, will most likely be instrumental in maintaining and further enhancing the initial gains. Finally, further research is needed regarding tailoring of meditation-based training to particular dispositions of course participants to reduce dropout rates and increase the likelihood of practitioners developing long-term meditation practice. For example, very preliminary evidence suggests that participants with high rumination levels may benefit more from mindfulness training than loving kindness meditation whereas those with low rumination may benefit more from loving kindness practices (Barnhofer et al., 2010).
Another underexplored area of contemplative science application is in palliative care. Initial research highlights the potential of mindfulness-based approaches in reducing symptoms of anxiety and depression in those faced with life-threatening diagnosis (Piet, Würtzen and Zachariae, 2012). However, very few studies examined the effects of meditation-based approaches on existential well-being with initial research providing some encouraging results (Labelle et al., 2015). However, this research particularly looked at the effects of mindfulness-based approaches, and in the palliative context meditation techniques targeting more closely the development of MEA might be of most relevance. This includes compassion and loving kindness meditations, visualization-based practices and existential insight practices. Here the evidence of effects is particularly limited, together with the lack of research on long-term effects of meditation for existential well-being at the end of life. Furthermore, meditation-based approaches have virtually untapped potential in informing care during the process of dying, since they provide very detailed accounts of associated changes in the mind and ways of supporting practitioners during this process (Dalai Lama, 2004).
Aside from the potential role of contemplative practices in prevention and treatment of illness, contemplative science can also make a significant contribution to the support of care staff. A compassionate approach to patients is together with competent care the main expectation of professional healthcare. Yet, care staff typically does not receive training in experiential aspects of compassion, which would give authentic grounding to compassionate relating to others, even though they are expected to behave compassionately. Initial research on empathy and compassion suggests that we can respond to others’ suffering either with empathic distress linked to negative affect or with compassion associated with positive affect (Singer and Klimecki, 2014). Thus, being able to compassionately relate to others seems to be not only an expected part of caring, but can also have protective effects on the carer’s own well-being. With the high rates of burnout in healthcare professions (e.g., Glasberg, Eriksson and Norberg, 2007) meditation-based training, particularly programmes cultivating compassion, has the potential in both improving the care provided by and well-being of care staff. This, together with possible preventive effects of meditation-based approaches, points to a powerful potential of contemplative science in meaningfully contributing to healthcare.
Developmental contemplative science
Possible applications of meditation-based programmes in education have over the last decade attracted a lot of attention from educators, policy makers and researchers primarily because of the potential of meditation training in enhancing self-regulation of children and adolescents (Davidson et al., 2012; Roeser and Zelazo, 2012). This could have longer-term protective effects given that self-regulation in childhood predicts health, levels of education and even income in adulthood (Moffitt et al., 2011). The initial evidence in support of enhancements in self-regulation is encouraging even though limited by the weak methodological quality of the available studies. Nevertheless, recent meta-analyses suggest that cumulative evidence on the effects of mindfulness-based approaches shows improvements in cognitive performance and reductions in stress in children and adolescents (Zenner, Herrnleben-Kurz and Walach, 2014).
Most of the available studies on the effects of meditation training on self-regulation and well-being of children and adolescents did not include follow-ups longer than three months. So it is currently not clear whether exposure to meditation-based practices in young age can have protective effects later on. Nevertheless, there have been arguments made that teaching meditation-based techniques to children may have long-term protective effects on their health and well-being. This is particularly pertinent given the increasing rates of mental health problems in children, adolescents and young adults. There is no evidence currently available which would support such claims, but these arguments highlight the need for both long-term follow-ups and for supporting children in cultivating long-term meditation practice. This may require development of programmes for children and adolescents which follow the developmental trajectory and gradually build a progression of meditation training. Such training will most likely need to include a variety of meditation practices which may also provide a broader repertoire for children to choose from based on their preferences and propensities.
No studies so far investigated possible impact of meditation training with children and adolescents on their spiritual development. Such investigations could target assessments of MEA, particularly with adolescents who are more able to provide introspective reports because of more advanced meta-awareness than children. Given that decentring is the most investigated MEA and seems to be the central mechanism underlying therapeutic effects of mindfulness-based training on anxiety in adults (Hoge et al., 2015), examining shifts in MEA with meditation training in adolescents seems particularly relevant to the possible impact of these methods on the well-being of young people. In addition, no studies so far investigated possible links between changes in self-regulation and shifts in MEA from the developmental perspective; these investigations could provide valuable understanding of developmental mechanisms of meditation practice. Such knowledge from a long-term developmental perspective would be particularly helpful in guiding decisions of educators and policy makers about introducing meditation-based techniques into education.
Contemplative science and society
Aside from possible applications of meditation-based techniques in psychotherapy, healthcare and education, there has been growing interest in introducing meditation-based programmes in the context of the work-place, in prisons, in developing sustainable behaviour and across sectors more broadly. In the workplace context these programmes are considered as ways to support well-being of employees which in turn could also enhance their productivity. Meditation-based programmes also have potential to contribute to the well-being and rehabilitation of offenders who have very high rates of mental health problems. In the sustainability context, meditation-based techniques may have the potential for supporting behaviour change because of their emphasis on the meta-awareness of mental processes, which may result in the lessening of non-sustainable reactive and automatic behaviour.
However, these wide applications of meditation-based techniques, particularly mindfulness, have also attracted a lot of criticism. For example, there is the concern that in the workplace context these methods could primarily become the means of increasing productivity without employers looking at actual causes of productivity decline such as long hours or unrealistic demands. There isn’t sufficient research to support or reject these concerns yet, but the obvious temporary solution might be to apply these techniques in contexts such as the workplace with the intention of both supporting th
e well-being of employees while at the same time also trying to address work conditions which could negatively impact their well-being. Nevertheless, the criticism of applying meditation techniques in the workplace is perhaps particularly rooted in a deeper concern about these methods being introduced as a means to a goal which isn’t consistent with the intention behind these practices in the traditional contemplative systems. In these, meditation techniques are practiced with the goal of progressing towards increasingly higher levels of existential insight whereas secular applications of meditation have been separated from this intention.
This is again where contemplative science may provide a platform for the development of a long-term view of meditation practice which is grounded in exploration of motivational/intentional factors for engaging in meditation training and also involves exploration of ways we express our existential drive in our work and everyday activities. Are our responses from the broader perspective and purpose and meaning in our life adaptive or maladaptive? Are meditation practices in whatever context we are training improving our existential well-being? Are we by our actions supporting others in developing their existential balance? If we start perceiving meditation training not only as a means to a short-term superficial goal but also focus on the development of long-term meditation practice, these existential explorations may become natural. They may possibly lead to authentic transformation in our thinking and behaviour, which may facilitate wider societal change towards a sustainable and pro-social way of living.
Neuroscience and Psychology of Meditation in Everyday Life Page 25