Meditation In Mental Health

LESSON 7
Integrating Meditation into Therapy

Mental Disorders

I have used meditation in my clinical work as a psychologist at Camarillo State Hospital, UCLA Neuropsychiatric Institute, and the San Francisco VA with serious conditions such as schizophrenia, depression, PTSD, and chronic pain. I have taught meditation to patients as a mind calming technique for over 20 years. As mentioned earlier, I developed a multimodal holistic health program for schizophrenic patients at a state psychiatric hospital which incorporated meditation without any adverse effects. ABSTRACT
Lukoff D, Wallace CJ, Liberman RP, Burke K.
A holistic program for chronic schizophrenic patients. Schizophr Bull. 1986;12(2):274-82.

Actually what I used at Camarillo State Hospital with schizophrenic patients was music by Steven Halpern,PhD, a who has researched and recorded non-melodic, non-rhythmic music that induces a relaxed state. I found that this music enabled patients to achieve a meditative sense of calm amidst voices and paranoid delusions that many were experiencing.

EXERCISE: Listen to audio files of meditative music from Spectrum Suite by Steven Halpern. Two brief excerpts are linked on this page about 2/3 of the way down.

I have also conducted walking meditation sessions with patients at the San Francisco VA Day Treatment Program where I worked as a psychologist for 14 years.

The practice is based on the work of Vietnamese Buddhist monk Thich Nhat Hahn. The patients enjoyed walking in silence quite a bit and several asked to do this again.

I also have used a breath meditation on a CD by Andrew Weil,MD in groups at an outpatient VA clinic for patients with pain management and chronic illness issues. This meditation proved effective in helping many cope better with their medical conditions even though many also had diagnoses of PTSD as well. This simple meditation did not exacerbate dissociative symptoms (which a more intensive practice might run the risk of doing).
The Art of Breathing

Substance Abuse

In mental health applications, meditation has been used both with and without its religious/spiritual heritage. For example, Transcendental Meditation (TM), which does draw upon its roots in Hinduism, has been used in the treatment of substance abuse, and the results have generally shown positive outcomes. A review of 24 studies concluded that TM simultaneously addressed several factors underlying substance abuse, and provided both immediate relief from distress (such as urges) and also long term improvements in well-being, self-esteem, personal empowerment, and other areas of psychophysiological health.
Gelderloos P, Walton KG, Orme-Johnson DW, Alexander CN. Effectiveness of the Transcendental Meditation program in preventing and treating substance misuse: a review. Int J Addict 1991 Mar; 26(3):293-325)

Psychotherapy

In his review of meditation and psychotherapy, Greg Bogart, Ph.D. concludes that meditation has clinical applications beyond its well documented capacity to induce physiological relaxation and to alleviate stress, anxiety, and other physical symptoms:

Meditation brings about cognitive shifts that can be applied to behavioral self-observation and management, and to understanding limiting or self-destructive cognitive patterns.

Meditation may also permit deepened access to the unconscious. However, meditation by itself may not be an effective means of reflecting upon and giving meaning to the previously submerged material that may come to consciousness. Here the interpretive approaches developed by psychoanalytic, Jungian, and other psychodynamic theorists may prove more useful. Conversely, meditation techniques like Vipassana focus attention on the manner in which unconscious conflicts are being processed and recreated in the mind on a moment-to-moment basis. Thus, vipassana offers the possibility of not just understanding such conflicts conceptually, but of actually penetrating and gradually dismantling them through meditative insight.

An additional benefit has been observed by Herbert Benson,MD. Even using his spiritually sanitized version of meditation, he found one result that surprised him:

Not only did my research -- and that of my colleagues -- reveal that 25% of people feel more spiritual as the result of the Relaxation Response, but it showed that those same people have fewer medical symptoms than do those who reported no increase in spirituality. It became clear that a person's religious convictions or life philosophy enhanced the average effects of the Relaxation Response in three ways: (1) People who chose an appropriate focus, that which drew upon their deepest philosophic or religious convictions, were more apt to adhere to the Relaxation Response routine, looking forward to it and enjoying it; (2) affirmative beliefs of any kind brought forth remembered wellness, reviving top down, nerve cell firing patterns in the brain that were associated with wellness; (3) when present, faith in an eternal or life transcending force seemed to make the fullest use of remembered wellness because it is a supremely soothing belief, disconnecting unhealthy logic and worries.
Examining the Faith Factor

Others, such as Arthur Deikman, MD, have offered a contrary position and questioned the integration of spiritual practices such as meditation into psychotherapy:

Another question that arises frequently is whether techniques from the domain of spiritual practice should be introduced into the psychotherapy situation. My own view is that they should not - unless the psychotherapist is also qualified as a spiritual teacher. Although a variety of procedures such as meditation, chanting, and visualization can be used to provide calmness and relaxation, the mystical literature indicates that such benefits are secondary. The sages who invented these techniques emphasized that they should be used as part of an integrated, individualized teaching system requiring the supervision of a teacher whose own perceptual capacity has been developed and who thus knows how to prescribe them according to the specific spiritual needs of the student. To use such techniques for lesser purposes may decrease their effectiveness for spiritual development. Since locating a competent therapist can take some searching, and locating a competent spiritual teacher can take even more, locating someone who is adequately skilled in both is a difficult undertaking indeed. I do not regard myself as such a person, nor do I know of anyone else who is.
Spirituality Expands a Therapist's Horizons

Some groups, such as the Jehovah's Witnesses, have criticized even the secular forms of meditation:

Dr. Benson's formula is not neutral but religious; it derives from Eastern Religions, Mysticism and Gnosticism...Dr. Benson's formula is incompatible with Christianity, and dangerous.
Jehovah's Witness Web Site

Yet Buddhist practitioners emphasize, and Benson has actually found the opposite, namely that meditation often strengthens individuals religious beliefs.

Many Jewish rabbis and Catholic priests and nuns meditate--even regularly practicing Buddhist meditation--without changing their religious affiliation. Moreover, there are various kinds and styles of meditation that have developed with Buddhism. Some involve visualizing and invoking Buddhist deities (archetypal representations of the highest spiritual qualities within us), while others have virtually no Buddhist content. Buddhism is not intent upon converting anyone, and there is no conversion ceremony in Buddhism. Meditation, in short, is a an excellent example of a spiritual practice that transcends "isms" and schisms. It's post-denominational and can deepen any religious quest. (In addition to Buddhist meditation, there are Jewish, Muslim, Hindu, Sikh, Jain, Christian, Taoist, and other forms of meditation, by the way.) Meditation helps awaken and enlighten us, grounding us more in the present moment, the holy now.
Surya Das, an American-born Tibetan lama, I Sit, Therefore I Am...a Buddhist?

And research has clearly established that meditation can be a valuable adjunctive technique in psychotherapy, pain management, and other situations where cultivating a relaxed body and calm mind would benefit an individual. It is still rare to see mind-body-spirit techniques being taught on psychiatric inpatient units, but there is growing support for interventions which actively utilize patients' religious and spiritual beliefs and values as part of therapy. This can range from using religious or spiritual practices in the treatment sessions (e.g., conducting a loving kindness meditation from Buddhist practice) to adoption of Christian imagery in cognitive-behavioral interventions.

Meditation has become acceptably "mainstream" with many perceived benefits, which the therapist
can use to motivate the patient to try the technique and develop a regular practice of meditating.

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