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Complementary & Alternative Medicine
Index Of Alternative Therapies And Modalities
When deciding to begin a complementary therapy or to see a complementary practitioner, first speak with your primary health care provider.
Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.
Different types of meditation have been practiced for thousands of years across the world. Many types have roots in Eastern religions.
Meditation can generally be defined as the self-regulation of attention to suspend the normal stream of consciousness. A common goal of meditation is to reach a state of "thoughtless awareness," during which a person is passively aware of sensations at the present moment. It is this goal that distinguishes meditation from relaxation. Various types of meditation may use different techniques. Techniques that include constant repetition of sounds or images without striving for a state of thoughtless awareness are sometimes called "quasi-meditative."
- Mindfulness This involves focusing on a physical sensation. When thoughts intrude, the meditating individual returns to the focus. Key elements of mindfulness meditation have been used in cognitive therapy, pain control, and stress reduction programs. Mindfulness-based stress reduction (MBSR) is a structured, standardized group program originally developed for chronic pain patients.
- Breath mediation This involves focusing on the process of breathing. Breathing exercises taught in childbirth classes are based on this technique. Counting while breathing may provide a meditative focus.
- Visualization This involves focusing on specific places or situations.
- Analytical meditation This involves an attempt to comprehend the deeper meaning of an object of focus. Analytical meditation differs from other forms in that the practitioner does not repeat a word over and over, but rather strives to comprehend the deeper meaning of the object of focus.
- Guided meditation Guided meditation or guided imagery is a technique that directs the imagination towards a conscious goal. Yoga nidra or yogic "sleep" is considered to be a form of guided meditation.
- Walking meditation This Zen Buddhist form of meditation called kinhin involves focusing on the sensation of the feet against the ground. Sitting meditation is similarly practiced.
- Transcendental Meditationฎ (TMฎ) This involves focusing on a mantra (a sound, word or phrase that is repeated over and over, either aloud, as a chant or silently). Maharishi Mahesh Yogi introduced TM to the West in the late 1950s, and this practice was well publicized because of its famous followers such as the Beatles. A goal of TM is to reach a state of relaxed awareness. Intruding thoughts may be noticed passively before returning to the mantra. The claimed health benefits are controversial, such as improved IQ and reduced violent tendencies. It has been debated as to whether TM should be classified as a religion, because some people assert that TM constitutes a cult or a religious sect. TMฎ is a registered trademark with centralized administration of training at Program Centers worldwide.
Meditation is usually practiced in a quiet environment and in a comfortable position. Sessions vary in length and frequency. It is often recommended that meditation be practiced at the same time each day.
There is no broadly recognized certification or licensure for meditation instructors, although some organized religions and professional organizations have specific requirements for formal training and credentialing of new teachers.
There are a number of theories about how meditation works and its potential health benefits. One hypothesis is that it reduces activity of the sympathetic nervous system (responsible for the fight-or-flight response), leading to a slower heart rate, lower blood pressure, slower breathing and muscle relaxation.
Several preliminary studies of transcendental meditation have noted these types of effects, although the research techniques were of poor quality, and the results cannot be considered conclusive. Changes in hormone levels, lactic acid levels, blood flow to the brain and brain wave patterns have been reported in some studies that were of poor quality. Better research is necessary to make a firm conclusion.
Scientists have studied meditation for the following health problems:
There are several studies of the effects of mindfulness, transcendental meditation or "meditation-based stress reduction programs" on anxiety (including in patients with chronic or fatal illnesses, such as cancer). This research is not well designed, and although some benefits are reported, the results cannot be considered conclusive.
Because of weaknesses in research design, it remains unclear if any form of meditation is beneficial in people with asthma.
Because of weaknesses in research design, it remains unclear if any form of meditation is beneficial in people with fibromyalgia.
High blood pressure
There are reports that transcendental meditation may lower blood pressure over short periods of time and that its long-term effects may improve mortality. However, because of weaknesses in research design, a firm conclusion cannot be reached.
Atherosclerosis (clogged arteries)
Transcendental meditation, along with other therapies, has been reported to help attenuate atherosclerosis in older people, particularly in those with apparent cardiovascular heart disease. Further research is needed to confirm any potential benefits from meditation alone.
Quality of life in breast cancer
Preliminary research suggests no added benefits of transcendental meditation techniques over support groups alone to improve quality of life in women with breast cancer. Additional research would be necessary to form a more firm conclusion in this area.
Research suggests that there may be increased antibody response after meditation. Further study is needed to confirm these findings.
Meditation may help to improve cognitive function and blood pressure in the elderly, which may in turn promote overall health and longevity. More research is needed to identify the specific effects of meditation on aging. However, based on the available evidence, meditation can be recommended as a health-promoting activity for the elderly.
Hypertension (high blood pressure)
In general, it appears that regular practice of meditation may promote relaxation and reduce blood pressure. More research is needed before recommendations can be made. However, meditation can be recommended, in addition to healthy diet and exercise, for the benefit of preventing hypertension.
Quality of life (cancer)
There is good evidence that various types of meditation may help improve quality of life for cancer patients. Studies have shown benefits for mood, sleep quality and the stresses of treatment. The specific effects of meditation are not fully understood. However, meditation can be recommended as a form of support for cancer patients.
The evidence indicates that meditation may help healthy people reduce the effects of stress. More studies are needed to further examine the dynamics of stress and meditation, but meditation can be recommended as a general health-promotion activity.
Meditation may offer general stress-reducing effects for treating or preventing alcohol abuse. However, more studies are needed before recommendations can be made for or against meditation for alcoholism treatment or prevention.
Studies suggest that meditation may offer some benefits for anger management. However, more studies are needed to recommend meditation as a form of behavioral intervention for anger.
Meditation (in the form of Tai Chi or Qigong) may help to improve balance in healthy elderly people. More research is needed to understand the specific effects of meditation on balance.
Meditation may offer general benefits for mood and stress, which are likely to aid in cardiac care. However, more studies are needed to recommend meditation as a specific treatment during cardiac rehabilitation.
There is good evidence that meditation may help cancer patients improve quality of life during cancer treatment. However, not enough research has shown meditation to help in the prevention of cancer. More studies are needed.
There is not enough evidence that meditation has any clinical effects in cardiovascular disease. More studies are needed to determine whether meditation may have benefits in cardiovascular disease, and whether specific techniques might be more effective than others.
Chronic fatigue syndrome
Mindfulness meditation with Qigong may contribute to improved overall health. However, not enough studies have examined the specific effects of meditation on chronic fatigue syndrome. More studies are needed before meditation can be recommended as a treatment for chronic fatigue syndrome.
Meditation, yoga, and other stress management techniques may help to relieve chronic pain. However, since meditation is often used with many other treatments and therapies, the specific benefits of meditation are not clear. More studies are needed that examine the specific effects of meditation as a treatment for chronic pain.
Meditation may not be as effective as other therapies for preventing relapse in recovering cocaine addicts. More studies are needed before meditation can be recommended as a treatment for cocaine dependence.
Some forms of meditation may have positive effects on cognitive function. However, there is not enough clear evidence that any specific form of meditation can support or enhance cognitive function.
Congestive heart failure
Meditation may improve quality of life in elderly patients, and may even potentially reduce the risk for congestive heart failure. However, there is not enough evidence to make recommendations for meditation in congestive heart failure, and more studies are needed.
Some forms of meditation may prevent relapse in patients who have had bouts of major depression. However, more studies are needed to confirm that meditation may be used as part of treatment for depression.
Yoga meditation may help prevent seizures in epileptics, although higher-quality studies are needed to make a firm recommendation.
It has been suggested that mindfulness meditation may help improve symptoms in patients with fibromyalgia. Better-quality research is necessary before a conclusion can be formed.
Research suggests that meditation may help improve quality of life in patients with HIV/AIDS. Meditation may even affect immune function, though the studies have been inconclusive. More studies are needed to establish how meditation may be useful as an adjunctive therapy in HIV/AIDS patients.
Irritable bowel syndrome (IBS)
Some forms of meditation may help to ease the symptoms of IBS. However, more research is needed before recommendations can be made.
Low back pain (chronic)
Patients suffering from chronic low back pain may improve with breath therapy. Further research is needed to confirm these results.
Metabolic syndrome (coronary heart disease)
Use of transcendental meditationฎ (TM) in coronary heart disease patients may improve some aspects of metabolic syndrome. More studies are needed before a recommendation can be made.
For healthy subjects, there is not enough scientific evidence that meditation can improve mood. More studies are needed to determine whether meditation has any specific effects on mood.
It is suggested that meditation may help to improve quality of life in organ transplant patients. However, more research is needed before recommendations can be made.
Post-traumatic stress disorder (PTSD)
There is some evidence that certain meditative techniques may improve symptoms in people with PTSD. However, more studies are needed to examine the specific benefits of meditation before it is recommended for use in patients with PTSD.
Some evidence suggests that meditation may help to reduce complications in pregnancy or childbirth. However, more studies are needed to recommend meditation for specific benefits during pregnancy.
Meditation has been suggested to improve the healing of psoriasis, when used in combination with standard treatments. More studies are needed to investigate the specific effects of meditation on psoriasis.
When used in combination with standard psychiatric treatment, meditation may improve treatment outcome in patients with various psychological conditions. However, more research is needed before meditation is recommended to use along with psychotherapy.
The ability of meditation to improve sleep has been suggested in patients being treated for drug abuse, as well as patients with breast cancer. However, there is currently not enough evidence that meditation improves sleep in patients or in healthy subjects.
The research thus far does not indicate whether meditation can help people to quit smoking. More studies are needed to examine the possibility that meditation help in smoking cessation.
Meditation has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using meditation for any use.
Angina (chest pain)
Attention deficit hyperactivity disorder (ADHD)
Breast milk abnormalities
Cancer (including prevention)
Cardiac syndrome X
Coping with chronic illness
Coping with pain
Coronary artery disease (including prevention)
Fatigue in cancer patients
Fear of open spaces
Gag reflex abnormalities
Generalized anxiety disorder
Headache (including that related to smoking cessation)
Heart attack prevention
Heart rate reduction
Heart rhythm abnormalities
Immune system stimulation
| Improved mental clarity|
Irritability caused by smoking cessation
Irritable bowel syndrome
Low blood cortisol levels
Metastatic breast cancer
Peripheral neuropathy in HIV
Peripheral vascular disease
Post-traumatic stress disorder
Quality of life
Reduced oxygen consumption
Slowing the heart rate
Most types of meditation are believed to be safe in healthy individuals. However, the safety of meditation is not well studied.
People with underlying psychiatric disorders should speak with a mental health provider before beginning meditation because there have been rare reports of mania or worsening of other symptoms. Some publications warn that intensive meditation can cause anxiety, depression or confusion, although this is not well studied.
Meditation should be used with caution in patients with underlying psychiatric conditions such as mood disorders, personality disorders, seizures, or psychotic conditions.
The use of meditation should not delay the time it takes to see a health care provider for diagnosis or treatment with more proven techniques or therapies. Meditation should not be used as the sole approach to illness.
Meditation is an ancient technique with many modern variations. Meditation has been suggested as a way to improve many health conditions. However, well-designed research is lacking, and the scientific evidence remains inconclusive. People with psychiatric disorders should speak with a mental health provider before beginning meditation. Meditation should not be used as the sole approach to illness.
The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.
- Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
- National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research
Selected Scientific Studies: Meditation
Some of the more recent studies are listed below:
- Barnhofer T, Duggan D, Crane C, et al. Effects of meditation on frontal alpha-asymmetry in previously suicidal individuals. Neuroreport 2007;May 7, 18(7):709-712.
- Barnes VA, Treiber FA, Davis H. Impact of transcendental meditation on cardiovascular function at rest and during acute stress in adolescents with high normal blood pressure. J Psychosom Res 2001;51(4):597-605.
- Carlson LE, Ursuliak Z, Goodey E, et al. The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Support Care Cancer 2001;9(2):112-123.
- Davidson RJ, Kabat-Zinn J, Schumacher J, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med 2003;65(4):564-570.
- Fields JZ, Walton KG, Schneider RH, et al. Effect of a multimodality natural medicine program on carotid atherosclerosis in older subjects: a pilot trial of Maharishi Vedic Medicine. Am J Cardiol 2002;Apr 15, 89(8):952-958.
- Gaffney L, Smith CA. Use of complementary therapies in pregnancy: the perceptions of obstetricians and midwives in South Australia. Aust N Z J Obstet Gynaecol 2003;44(1):24-29.
- Keefer L, Blanchard EB. A one-year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome. Behav Res Ther 2002;40(5):541-546.
- King MS, Carr T, D'Cruz C. Transcendental meditation, hypertension and heart disease. Aust Fam Physician 2002;31(2):164-168.
- Larkin M. Meditation may reduce heart attack and stroke risk. Lancet 2000;355(9206):812.
- Lee SH, Ahn SC, Lee YJ, et al. Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder. J Psychosom Res 2007;Feb, 62(2):189-195.
- Manocha R, Marks GB, Kenchington P, et al. Sahaja yoga in the management of moderate to severe asthma: a randomized controlled trial. Thorax 2002;Feb, 57(2):110-115. Comment in: Thorax 2003;Sep, 58(9):825-826.
- Mason O, Hargreaves I. A qualitative study of mindfulness-based cognitive therapy for depression. Br J Med Psychol 2001;74(Pt 2):197-212.
- Mills N, Allen J. Mindfulness of movement as a coping strategy in multiple sclerosis: a pilot study. Gen Hosp Psychiatry 2000;22(6):425-431.
- Morone NE, Greco CM. Mind-body interventions for chronic pain in older adults: a structured review. Pain Med 2007;May-Jun, 8(4):359-375. Review.
- Schneider RH, Alexander CN, Staggers F, et al. Long-term effects of stress reduction on mortality in persons > or = 55 years of age with systemic hypertension. Am J Cardiol 2005;95(9):1060-1064.
- Speca M, Carlson LE, Goodey E, et al. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med 2000;62(5):613-622.
- Tacon AM, McComb J, Caldera Y, Randolph P. Mindfulness meditation, anxiety reduction, and heart disease: a pilot study. Fam Community Health 2003;Jan-Mar, 26(1):25-33.
- Targ EF, Levine EG. The efficacy of a mind-body-spirit group for women with breast cancer: a randomized controlled trial. Gen Hosp Psychiatry 2002;Jul-Aug, 24(4):238-248.
- Wenk-Sormaz H. Meditation can reduce habitual responding. Altern Ther Health Med 2005;11(2):42-58.
- Williams KA, Kolar MM, Reger BE, et al. Evaluation of a wellness-based mindfulness stress reduction intervention: a controlled trial. Am J Health Promot 2001;15(6):422-432.
- Yorston GA. Mania precipitated by meditation: a case report and literature review. Mental Health Relig Culture 2001;4(2):209-213.
Last updated May 06, 2008
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