Potential Psychological Dangers of Meditation – Especially Relevant for Those with PTSD

Categories: Exploring PTSD Healing

February 28, 2014

There are 84,000 Buddhist meditation techniques*, and there are many non-Buddhist meditation techniques as well. There are sitting meditation techniques that use the repetition of mantras and guided meditation techniques that use visualization and imagination. There are short meditations and extended meditation retreats in which one may meditate for 10 full days. Each kind of meditation has its own origins, philosophy, teachings, objectives and goals. (*reference)

I was surprised to discover that some meditation practices could potentially cause psychological challenges and even harm. People with PTSD are more psychologically vulnerable and may experience even worse difficulties than others with these types of meditation.

1. Dangers of Destabilizing Effects of Prolonged Meditation (Retreats, Long-term Daily Practice)

Can meditation, especially for very long periods, induce such profound altered states and psychological changes as to destabilize the person meditating? Can meditation open him or her up to a plethora of disorienting and confusing internal experiences and even in some cases lead to a mental breakdown or psychotic break of some kind?

Brown University neuroscience researcher Willougbhy Britton has been researching exactly this.

Quoting from the article BuddhistGeeks Podcast 232: The Dark Night Project (which I can no longer find but there is a different article here and the podcast here):

“We’re joined again this week by Brown University neuroscience researcher Willougbhy Britton. Willougbhy begins this episode by going into further depth into some of the typical experiences that have been reported during her research into the difficult stages of the contemplative path. She lists out typical changes in cognition, affect (emotion), perception, and other psychological material.“

Following is an outline of some of the main issues her research has uncovered. Serious contemplative practice can cause:

Heightened Sensory Sensitivity. “…increase in sensory clarity and sensory threshold.”
Perceptual changes. “…along with this faster sampling rate there also seems to be I don’t know if I would call them hallucinations but experiences in every sensory modality especially visual lights.”
Physical sensations. “…general musculoskeletal body pain, headaches, and very strange sensations” (long list including sensation of electricity and vibrations)
Changes in Sense of Self. “…change in the way people experience their sense of self” “…this can be (1) “an attenuation in self” or it can be (2) “a complete dropping away of a sense of self” (3) “a lack of a feeling like there’s anybody controlling” (like you are not in control but just acting) (4) “temporal disintegration. …So the sense of time can fall apart, along with that your sense of a narrative self over time. …don’t have that kind of sense of past and future …waking up in a new reality every several minutes”
Fear. “…one of the most common symptoms is fear. And the lost of the sense of self I think is very tied in with this fear. And people can have really phenomenal levels of fear. I mean really just existential primal fear… And then along with fear spectrum you also anxiety and agitation and panic and paranoia. “
Emotional ups and downs. “Your emotions can get really high in both direction both manic manifestations, euphoria, sometimes grandiosity and also the worst depression, meaninglessness, nihilism the other end of things can also happen.”
Numbness. “In addition to that, people can also just lose all affect all together.”
Roto-rooter, bringing things up to the surface. “…a de-repression of the psychological material.”

Willougbhy Britton is using her research to help individuals who have embarked on a journey of contemplative practice and are coming up against some experiences and phenomena that are causing confusion, fear, disorientation and even causing them to believe they are going crazy. Her work hopefully will help them through these phases so they can gain the benefits that are possible through the practices they have chosen.

Victoria Maxwell, a speaker who does presentations on topics related to living with mental illness (she has bipolar disorder), experienced a mental breakdown firsthand during a long meditation retreat.

“Things went from bad to worse when she signed up for a weekend meditation retreat. For 48 hours, she sat utterly still on a hard floor, repeating a silent mantra that could be expressed as “Who am I?” By Sunday night, Victoria felt she was experiencing a mystical and spiritual awakening that was later to be diagnosed as a psychotic break and the beginnings of her bipolar disorder. ‘I had auditory hallucinations, like 1930s warplanes were rumbling overhead,’ she says.” (article)

There are actually two issues going on here:

The first issue is the lack of education about the normal and expected psychological effects of long-term contemplative practice. Willougbhy explained that many of the unusual perceptions, sensations, and altered states are a normal result of meditation. Here is an article that goes into detail explaining how these experiences are part and parcel of the spiritual path of meditation: The Map: Understanding the States and Stages of Enlightenment, Part 4. The problem is that nobody has ever informed the meditators that this is what they are getting themselves into, and they become justifiably confused, frightened, and disoriented when they begin having these experiences. It is the responsibility of the meditation teacher to explain all of these phases and phenomena to the student and give them the tools to handle each one as it arises, and obviously teachers are not fulfilling this responsibility well at the moment.

The second issue is that for some people, the cumulative effect of all these normal results of meditation can be so overwhelming to their system it does cause a mental breakdown, or a psychotic break, or a kind of break from reality. This could happen to anyone, but it would be especially troublesome for someone with an undiagnosed (or diagnosed) mental illness. For example, if someone is already psychologically vulnerable all these bizarre experiences can open up or set off symptoms that were perhaps in the background or under tenuous control. This is likely why there are reports of people needing to be taken to a psychiatric hospital during or after a meditation retreat.

Someone with PTSD, for example, is already experiencing an overwhelming and confusing array of emotions, sensations, perceptual changes, issues with sleep and nightmares and flashbacks. Try to imagine what would happen if you were to add all the above altered states of consciousness to this person’s life. I can definitely see how an emotional and mental meltdown could occur and the person could end up in the hospital.

Also, with regards to the long meditation retreats, I’m thinking that is probably not the best kind of meditation for an individual with PTSD. First, it removes them from their regular routine. Now going out and doing new things is great, but in this case, the length of time away from home and the degree of how different the setting and schedule is from one’s normal routine could well be destabilizing and shocking to the system. The setting is probably also not set up to handle someone who may get triggered, have nightmares, insomnia, immobility, terrors, etc. It might well turn into a disaster. Actually now that I think of it I did attend a three day retreat with PTSD and it was definitely a mistake, but that whole thing is another blog post!

2. Dangers of Detachment and the Path of the Renunciate

Can meditation, in some cases, make us too detached from our emotions and the outside world, even causing us to lose skills needed to interact with people and take care of life?

Michael Eigen’s book The Psychoanalytic Mystic is referenced in an article for the Vancouver Sun (Meditation: The darker side of a good thing). The article also references writings and statements made by Ken Wilbur. Some common issues or pathologies that develop in meditators are:

Isolation, lack of human contact, especially putting up walls and not allowing people in. “Focusing on their inner lives, neither Owen nor Jessie allowed themselves to be ‘transformed’ by others. …he became insensitive to women and others. Eigen says Jesse really needed to control people, because they threatened him.”
Increased narcissistic and self-centered tendencies. “The meditator felt himself better than others, including his students, and often privately denigrated them. …Wilber believes many middle-aged baby-boomers who meditate bring to it an over-simplified commitment to pluralism and relativism and the notion that, ‘You do your thing and I’ll do mine.'”
Lack of integration of the “shadow” emotions and experiences of life.“The meditators did not integrate life’s inevitable suffering and limitations into their own being, says Eigen. ” ” Buddhism instructed him not to hold onto such idealized maternal feelings, but to “detach” from them”
They became too detached from themselves – their own viewpoints, opinions, convictions. “The Eastern teaching that people should have “no ego,” an idea espoused by Vancouver-based spiritual teacher Eckhart Tolle and many others, encourages meditators to try to be “empty,” to have no viewpoint, says Wilber. The trouble is many meditators believe that means having no viewpoints at all, even on important issues. As Wilber says, many meditators don’t believe in anything.”

This article further clarifies the problem with the teaching of “detachment.”

“Acclaimed Scottish poet John Burnside says, ‘To imagine that one can simply withdraw, and somehow achieve peace, or wisdom, or detachment, is a mistake. It is also, in most cases, inappropriate, selfish and even cowardly. With a few exceptions, the only valid withdrawal is a temporary one…'”

This misunderstanding about detachment is eloquently explained in an article by Lorin Roche about the two paths of contemplative practice, the Renunciate and the Householder. Only certain people were supposed to isolate themselves from the world; these were called Renunciates. If your life lessons are best met via interaction with the world you are a Householder, and your practice is meant to give meaning to a life completely immersed in the world. Indeed, “householders live in the world and evolve through working and playing with it.”

It’s quite a long, and good, article, so I will just quote some paragraphs here and if interested you can hop on over there and read the entire thing.

“When householders practice meditations designed for renunciates, they inadvertently damage the psychic and energetic structures they need to make their way in the material world. Meditation works, and it works on you on a deep level. If you go into meditation with the idea that you have to detach from the world, you may get more than you bargained for – you may find yourself gradually getting dissociated, removed, alienated, and depersonalized. It is always easier to destroy than to create, and detachment means to cut off or separate. It can take years to rebuild connections that you have severed through mistakenly practicing detachment.”

“The recluse path that nuns and monks take is as magical in its way as that of Knights, Princes and Elves. So what if it necessitates maintaining some anti-life or antibiotic attitudes. It is as if recluses continually take antibiotics to cure them of the disease of having desires and individuality. This is the sacrifice, a sublimated blood sacrifice. Any desire other than the desire to bow down and obey has to be suppressed. The only good nun is a docile, compliant nun. All this murder of impulses is healthy for recluses, part of their way of being. They call it detachment, and it is a primary attitude of the recluse. Detachment is necessary and healthy for recluses. When it works, we get these radiant, loving, fearless people who are great servants of humanity. By giving up their personal life, they become universal.”

“People who have families, jobs, pay rent or mortgages, and live in the real world, have very different needs in meditation. Recluses call us householders. Householders do not need to constantly kill off their natural impulses. As a matter of fact, the last thing they need is to weaken their desires, instincts and intuition. The path of the householder involves working with attachment. It is very daring to be attached. Tolerating the experience of attachment takes courage. Personal bonds are attachments. Loving someone is an attachment. Householders, when they meditate, should savor every sexual impulse, cherish every desire, honor and listen to all their instincts, and cultivate their general enthusiasm for life.”

“When householders practice meditation in the style of a recluse, and practice detaching from their desires, they often find that over time their instincts become weaker, their intuition becomes flawed, they become confused about their desires, and they start looking for an external authority to dominate them and tell them what to do.”

“What happens to people in ashrams and spiritual groups often recapitulates the best and worst aspects of early childhood. The best aspects include the fantasy of being around an all-knowing, all-loving, all-wise father figure/guru. The worst aspects are scapegoating and sexual abuse.”

“Over the past 40 years, I have met innumerable meditators who have been drained and devitalized by the anti-life attitudes they have internalized and practiced. … There are people all across the United States who were involved with meditation in the past, and now find that their training is interfering with their ability to bond with a mate, stay in love, find their life’s work, make money, and express their individuality.”

“The problem we have in the West, currently, as of 2004, is that almost all meditation teachers active in the field have been trained by recluses or have been deeply influenced by them. The language everyone uses is polluted by recluse terminology. ”

“Out of the ten million or so people in the United States who are practicing meditation, an unknown percentage of them are internalizing negative attitudes and damaging their ego structure and instincts. Some of these people become prey for dominating, authoritarian personalities who pretend to be enlightened and demand to be worshipped.”

“For a householder, practicing detachment is indistinguishable from practicing depression. The symptoms defining depression include: loss of interest in most or all activities, significant change in weight or appetite, sleep disturbance, slowed behavior, loss of energy, feelings of worthlessness, and suicidal thoughts.“

Here is a list of all damages that can occur if a householder tries to practice renunciate practices and follow renunciate life philosophies:

unhealthy level of isolation and lack of human contact; unhealthy detachment from relationships with friends, family and intimate partners
promotion of narcissism
lack of integration of the “shadow”
people become too detached from themselves, their viewpoint, opinion, position, independent thought, emotions; damages personal desires and personal will; produces confusion in relation personal desires
develop symptoms of dissociation and depersonalization.
damage their ego structure
damage to one’s sense of personal boundaries
devaluation of the individual will can make people act cowardly towards life
damages the psychic and energetic structures they need to make their way in the material world; lack of ability to function and perform basic life tasks (can include not developing skills as well as regression, loss of previously developed skills).
their instincts become weaker; damage can occur to natural human instincts
intuition becomes flawed
being internally confused and unstable, they start looking for an external authority to dominate them and tell them what to do
they can become drained and devitalized by the anti-life attitudes they have internalized and practiced
in householders heavy involvement in detachment can promotes the symptoms of depression: loss of interest in most or all activities, significant change in weight or appetite, sleep disturbance, slowed behavior, loss of energy, feelings of worthlessness, and suicidal thoughts.

Detachment and PTSD. This teaching of detachment could harm just about any normal human being, but it could be particularly damaging to someone with PTSD. If you consider that some major hurdles people with PTSD have to overcome are: avoidance of people, places and things; emotional numbness; tendencies to go into immobility and “play dead” internally and experiencing apathy, energy drain, and all the symptoms of depression listed above, the last thing someone recovering from PTSD needs is a practice that reinforces and increases all these symptoms!

Danger of Escapism and Addiction. Detachment, because it is a kind of avoidance, could actually be very tempting for someone with PTSD. PTSD is like a frozen lake over an unseen volcano of turmoil. People who have some emotional trauma inside might think they are doing something spiritual by doing meditation, but really may be finding another way to escape feeling all the messages the body and emotions have to convey. Spiritual practice of detachment could even be used in ways similar to drugs or other addictions, to escape from the frightening and troubling emotions of PTSD, which would prevent actually healing the PTSD.

Actually there are 31 Topics (!) under “Dangers of Meditation” on Lorin Roche’s website. This is a must-read for anyone trying to decide which kind of meditation to practice. He has an interesting synopsis of the main dangers:

“The Dangers of Meditation Itself
The challenge of finding the right kind of meditation.
The challenge of learning to face every thought and emotion.
Dangers of doing the wrong type of meditation for your body and personality.
Dangers of over-meditating.
Predictable crises in the life of a meditator.
Dangers of abandoning meditation because you are in a crisis.
Dangers of opening the chakras.
Enchantments and beguilements from opening the senses.
Dangers of stress release.”

And I would just add to this: Dangers of succumbing to various kinds of manipulation on the part of the teacher, Danger of it being a cult, Danger of there being psychologically damaging elements of the philosophical aspects of the teaching.

3. Dangers of Attention & The Prerequisite of Self-regulation

I mentioned this issue in the article summarizing the light and dark sides of Byron Katie. #12 in harmful results of The Work states, “for PTSD, inquiry should only be done after all the trauma-related issues have been processed to a level such that the person is able to reach and maintain inner stability reliably.” (aka self-regulation)

Basically, there are a lot of different spiritual practices that pretty much require one to be able to self-regulate one’s own emotions BEFORE embarking on the practice.

Byron Katie’s “Inquiry” can be destabilizing because someone is asking repetitive questions, emotions that arise are not being dealt with by the technique itself and are just ignored, and it could cause dissociation, emotional repression, or emotional triggering.

With regards to mindfulness, placing focused unwavering awareness on one’s body could amplify physical pain and placing focused unwavering awareness on one’s inner world could amplify certain painful emotions. And this is a danger for someone with PTSD, because PTSD renders an individual very vulnerable and unstable and this amplification can be overwhelming and unsettling.

Jim Hopper explains this in detail on the Mindfulness section of his website:

Scroll down to the Caution: Mindfulness Includes Pain, and Requires Readiness section. Again, a long article, so I will quote his main points here:

1. Attention Magnifies Pain. “We’ve all learned that ignoring (or attempting to ignore) pain can reduce our experience of it, and that focusing on experiences of pain can amplify them.”

2. Thoughts Increase Emotional Pain. “An important difference between emotional and physical pain makes emotional pain more capable of being altered by attention: emotional pain usually involves an interweaving of feelings and thoughts…And like attention, thoughts can increase emotional pain. ”

3. Attention Plus Certain Kinds of Thoughts Cause The Greatest Amplification in Human Suffering. “The greatest amplification of suffering comes from focusing one’s attention on the pain while thinking thoughts that escalate the pain. Such thoughts can take many forms, including interpretations, judgments, and memories. ”

4. Mindfulness Practice Benefits Come from Clear Observation. “…mindfulness can help, by allowing you to catch these cycles of suffering early on,… The present-focused, non-judgmental attention of mindfulness allows one to directly observe the separateness of feelings and thoughts, to attend to feelings without running off into associated memories, stories, etc.”

5. But Mindfulness Will Not Work Without a Foundation of Self-Regulation. “Only a solid foundation of self-regulation skills, and disciplined practice, will enable one to attend to emotional pain with a sustained mindfulness that does not bring escalation – as opposed to having one’s attention grabbed, dragged, and swept away in escalating cycles of suffering.”

6. He lists 4 Signs that Indicate an Individual may not be Ready:

“Tendencies to become overwhelmed and “flooded” by painful feelings and memories”
“Tendencies to “dissociate””
“Tendencies to get “lost in your own world” and withdraw from relating to others”
“Tendencies to hear voices in one’s head that sound like those of real other people, or to become convinced of ideas that are extremely unlikely or clearly untrue to other people.” (I think this one is referring to people who are at risk of disconnecting from reality due to the impact of their traumatic experiences, which is completely understandable, but they should be treated and stabilized before a mindfulness practice is attempted)

About Attention, Pain and PTSD. A person with PTSD may perceive physical pain sensations differently after PTSD than before. For me, it’s difficult to analyze amidst all the confusion but I believe I experience an amplification of some perceptions of pain and a total numbing out of others. Pain that happens to be a trigger related to a past trauma can overwhelm the system with fear, because it’s like a signal that the body is under a much greater threat than the body is actually under.

Remember the body and reptilian brain speak in “symbols” not in English. A pain that is a reminder of pain when one believed one was dying may act like a symbol of a legitimate death threat. This is what I refer to as problems with the “Danger Scale.” If the True Danger is a 5, a person with PTSD might think its a 90 on a scale of 100. The pain may seem exaggerated because the threat is exaggerated and everything seems exaggerated.

At the same time, some pain may be totally numbed out due to the “numbing” aspect of PTSD. I have a very high pain tolerance. I never get anesthetic even if getting a crown done at the dentist’s office. Which is strange because the slightest thing that triggers a memory of a trauma can cause a full on emotional meltdown, even with no pain at all. Could it be that, having endured so much physical pain in my life, as long as the pain is not a trigger I have learned how to use my mind to “go somewhere else” and escape pain? It’s pretty easy for me to do when I’m calm, so I think that is just part of the “numbing” part of PTSD.

With the kind of dysregulation and confusion happening in the system that results from PTSD, using the power of our attention may backfire. As Hopper said, attention is very powerful. The cultivated attention of mindfulness practice can be the doorway into an overwhelming state of immobility and terror, or a liberation from repetitive cycles of thought and emotion. The difference is in whether or not the individual has taken the time to develop the skill of self-regulation.

Self-regulation is a pre-requisite to many things in life, not just mindfulness meditation. Any moment in which one is triggered, it’s self-regulation that is the key to calming oneself down and returning to the normal state of consciousness referred to as “calm alert.” Thus, the first priority is to put some effort into learning self-regulation and restoring stability, balance, and calmness to the body and overall nervous system and slowly building a sense of self-confidence around being able to handle one’s self if one is going off the deep end. All of Peter Levine’s exercises build self-regulation; pretty much any one of his trauma books can help one develop self-regulation and I highly recommend them.

Conclusion…

Certain types of mindfulness training can help people overcome PTSD, but unfortunately it appears some kinds of meditation can cause serious harm. If you have PTSD, it is important to pick the right kind of meditation to experiment with and to pick the right time in your recovery to try it out. Long retreats, intense long-term meditation, meditation that is part of a philosophy of detachment or the path of the “renunciate”, and the use of strong focusing of attention all have potential pitfalls for people with PTSD. If at all possible, try to figure out if the mindfulness meditation can be used reliably as another way to build self-regulation. If the technique is having the effect inside you of increasing your symptoms, making you feel dizzy, unstable, dissociated, confused, falling apart, or bringing up intense emotions that you can’t process, stop the practice and choose another one.

References

A generous PTSD support group leader named Anne brought all the following resources to my attention making this article possible. I want to thank Anne very much for her contribution to our understanding. Links from Anne:

Dangers of Meditation

Two Paths

Caution: Mindfulness Includes Pain, and Requires Readiness

UPDATE: Can meditation be dangerous to your mental health?

The Map: Understanding the States and Stages of Enlightenment, Part 4

Resource Site dedicated to this issue:

Meditating in Safety – Raising awareness of mental health issues in relation to meditation practice