Meditation sickness. Has something gone wrong in western dhamma practice?

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Research by academic psychologists is delving into the mental harms of meditation. Among Western dhamma students and teachers there have been concerning reports:

“phenomenology closely associated with mania and psychosis,
such as loss of sleep and appetite, exaggerated positive affect,
delusions, paranoia, and in some cases hallucinations and
disruptive behaviors.”
" suicidality … addressed by seeking … help, including hospitalization and medication."
Progress or Pathology? Differential Diagnosis and Intervention Criteria for Meditation-Related Challenges: Perspectives From Buddhist Meditation Teachers and Practitioners

In the Buddhas teaching career there were also casualties with the infamous mass suicide event from loathsomeness contemplation . SN 54.9:3.4

Does anyone know if:

  1. The Suttas relate any other dhamma or meditation adverse mental events ?
  2. If not, does it then imply something has gone wrong in the teaching of dhamma in the west?
  3. If so what do western dhamma teachers and students need to learn from the suttas regards skillful practice?

Thanks :anjal:

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When the Buddha introduced someone to his teaching, there is a standard list of topics he taught them in a gradual way, following the needs of his audience based on how their mind was growing in wholesome qualities.

That list begins with a talk on generosity, then virtue/morality, then on heaven. That is, he gave them a gradual talk on the benefits of good deeds and making merit.

Practicing generosity is the first way one can get a taste of how happiness can come from letting go and not having rather than from acquiring and obtaining things. It also teaches the mind the inner beauty and ease that comes from being concerned about others’ well-being, rather than being overtaken by a selfish stain of stinginess in the mind.

Generosity is such a simple but powerful practice. When you receive a genuine, warm-hearted gift from someone, it is so uplifting and inspiring for everyone involved. And later on, you can also recollect the good, generous deeds you have done or the good deeds of others which you have witnessed! Rather than getting stuck in rumination loops of regrets, worries, fears, or anxiety, what if people were caught in recollecting and uplifting their mind with all of the wonderful and amazing selfless acts they performed!

The Buddha was once criticized for going for alms in a town with a large group of monks. He was accused of demanding too much on the laypeople, essentially. To this he responded that though he could recollect so many eons of universes, never could he remember a family going without their requisites due to too much alms giving.

Imagine the overwhelming prosperity in many modern countries these days. People sometimes feel they cannot practice giving very much. But this is really a matter of priority and mental states. The bliss and happiness of being a truly generous person are much greater than excess material comforts. The benefits of generosity far outlast the fleeting benefits of sensual pleasures in this life. The stain of stinginess can be truly oppressing to many beings’ minds. It deludes us into feeling we cannot let go, when that is the real remedy we need.

Where meditation falls in this gradual talk is near the very end, towards the renunciation of sensual pleasures or even when the Buddha describes the four noble truths, including the fourth on the path of practice. So building a foundation in the earlier topics is a great place to start! :slight_smile:

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I believe that this is painfully obvious.

Right Samadhi can only come in the proper framework of the 8fold path, which includes wisdom !

If isolated from the teaching, wrong Samadhi will lead exactly to the described problems.

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Greetings @Jara ,
Something’s certainly been wrong with “western” psychiatric nosology since its inception. It’s been fraught with validity and reliability issues from the get go, and every attempt to improve has only created even more controversy. It came to a crisis point with the DSM-V, and if it wasn’t for Big Insurance, it probably wouldn’t even be used anymore.

The problems with this study, and dozens of others like it, as it authors readily admit, is not only that their methods and instruments are yet not refined enough to screen for those predisposed to psychopathy, but also that “western” psychology is itself predisposed to ethnocentrically psychopathologize traditional varieties of religious experience. The gradualism that @Vaddha speaks of, IMO, is a mitigatory factor for getting the person from where they’re at to the most appropriate practice available from the suttas and a responsible, wise teacher. Granted, even then, there are levels of psychopathy that no part of The Path, even generosity, can touch. In general, though, The Dhamma per se is rarely if ever the issue.
best,
~l

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I think the problem is that there has been an (ovr)emphasis on meditation without establishing the right foundation for meditation practise first as others have pointed out. This can create problems for some people if they go from their (usual very busy daily life) in a somewhat abrupt way to meditating hours on a retreat.
I don’t recall where I read this , maybe it was a sutta, it might have been one of Ajahn Chah’s advices but it boils down to that you wouldn’t advice somebody to live in seclusion (I think it was a forest) without having established a good basis of mindfulness first. Otherwise it’s just too much to handle for the untrained mind. You need some taming first.

So sense restraint and sila is one of the key factors for establishing mindfulness in daily life before plunging into (prolonged) meditation.

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That’s an interesting and reasonable proposition that its “wrong samadhi” that leads to serious illness in westerners doing meditation.

Please can you elaborate on wrong samadhi? Is it just the samadhi technique is isolated from dhamma teachings?

Or in addition are there some specific types of samadhi techniques that are dangerous no matter if right view is taught or not?

The research rather surprising, also implicates raw mindfulness as well as samadhi techniques in harms.

Research suggests there’s little discernable difference between mindfulness based and samadhi based meditation practice in frequency of adverse outcomes. However the research base is rather limited and may be underpowered to reveal a small differential effect . Prevalence of meditation-related adverse effects in a population-based sample in the United States

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Good points, Bhante!

Can you please provide the source for this? Thank you.

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My guess would be that people with mental health problems tend to self-select into meditation groups because meditation and spiritual practice is free (or near free) and fairly effective.

Therapy is often inaccessible and usually only effective if you’re able to build a good rapport with the therapist.

IMO a lot would be solved by having a less harsh society that focused on human thriving rather than The Economy or GDP or whatever :woman_shrugging:

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Well yes, just imagine somebody e.g. not adhering to the Sila against alcohol intoxication and then going into deep meditation. This can easily result in something like a “bad trip”.

Or imagine somebody experiencing certain phenomena in high stages of Samadhi as described by the Buddha in his enlightenment experience (recalling former existences, transcending the current universe etc.) without being able to see them in the proper framework of Panna, wouldn’t this have the potential to freak you out completely or trigger pre-existing mental conditions?

Also just being mindful of random things without the langer perspective, e.g. a dropping tap or the ticking of a clock, can have very adversive effects IMO.

(As for “wrong” Samadhi, that was just a manner of speaking.)

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Sadhu,Sadhu,Sadhu Bhante :pray: good points. :+1:

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At SN 42.9 :slight_smile:

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All happens during the process of awakening. As the saying often goes, trust the process.
The downs are the process of awakening’s realization of the necessity of finding what needs to fall away to support its continued advancement. Rebirth is a continual process happening in every single moment. There is no end.

Everything Is as It Was and All Is as It Will Be Throughout Eternity.

There are No Ends, only Beginnings.

There is No Separation.

The End is the Dream’s Nightmare That Only Our Thoughts of Separation Create.

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The medical practitioners, unless they are versed in Dhamma, do little to help the practitioners with psychological problems.

But I find myself walking with Buddha Spiritually on the Noble Eightfold Path, and I notice that the Bodhisattva Path I have chosen is full of difficulty, pitfalls, and is as difficult as walking the Razor’s Edge. Taking Refuge in the Triple Gem has helped protect me, and I have noticed that all Sentient Beings are Equal in Sunyata, and interconnected in Life.

What the Buddha, during many parts of His Journey, did, could have very quickly have gotten Him into a psychiatric diagnosis in a lock down ward, from not eating to not drinking, to simply giving up a rich family Palace life and going homeless.

Becoming Enlightened is to go against this world. Even to help His own friends Jesus was crucified, and His message was not well received. His first followers were harshly mistreated, sometimes worse than Him.

So don’t expect Meditation life to be easy. If you want something easy, go out for ice cream. :white_heart:

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Looking more widely at the psychology research on meditation shows the literature is overwhelming positive. Mindfulness has been one of the main newer psychotherapeutic options developed, with mostly very good outcomes. More recently self-compassion is also making impacts.

So the Buddhas teaching, even when extracted out of context, taught by therapists with limited training and used with individuals with serious illness can be healing.

On the other hand, research into negative outcomes for western meditators is in comparison tiny. Its also questionable in quality, as well as quantity. Often the study methodologies have high risks of sample bias with meditators with bad experiences perhaps more likely to sign up for studies thus skewing the results to be more negative. Still life changing bad events seem rare eg only 0.2% in one study.

This still raises the question: are westerners actually more accident prone doing meditation then back in Buddhas teaching days ?

I wonder if the Suttas reveal any other instances of “meditation sickness”, (apart from the infamous suicides from loathsomeness contemplation. SN 54.9:3.4)

I cant find any other Suttas despite doing numerous searches but I think others are more likely to know.

Can anyone remember other Sutta’s?
:anjal:

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I read the OP study and it didnt seem to come to any real conclusion due to the being an early study. What was concerning was that there were claims that meditation was possibly responsible for making some undividuals dysfunctional in everyday life. Even issues experienced such as anxiety and insomnia can hospitalise people eventually.
Dysfunction is arguably the main trigger for medico’s to feel more confident in prescribing antidepressants and anti-psychotics drugs. If you cant function you really do need help.

More needs to be done in carefully evaluating whether individuals have pre-existing tendencies towards mental health problems prior to commencing meditation practice. The more the medical fraternity recognizes just how powerfully meditation can affect the mind, the greater will be the demand for meditation teachers to be held responsible. As a precaution, I think this is a good reason for business and cash flow to be kept entirely separate from teaching others deep forms of samadhi and immersion into jhana. Meditation is just one of a whole with eight interlocked parts.

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That’s interesting. It leaves me curious. I wonder if you might write some more please?

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Thanks very much for bringing this topic up. @Jara
I was with a Ch’an group for some years and our Taiwanese teacher sometimes warned about “meditation sickness,” including a couple of horror stories about beginning meditators who went at it too hard and/or organised intensive retreats on their own. Kind of “don’t-try-this-at-home” cautionary stories.

Apparently meditation sickness is a phenomenon that has generated no small amount of discussion over the centuries in Chinese Buddhism. This has also led to a number of suggested methods for treating the negative effects some experience from meditation. So I don’t think these difficulties are due to some error on the part of Western practitioners, other than, as has been mentioned, placing perhaps too much emphasis on meditation or seeing meditation alone (w/o precepts etc) as some sort of panacea.

Below is a paper by a historian of Asian Studies and Health Humanities, C. Pierce Salguero, about meditation sickness and its remedies in Medieval China which ends with a sensible recommendation that modern Western health professionals familiarise themselves to some degree with these practices as well as working with Buddhist meditators who have relevant experience themselves:
Meditation Sickness - Salguero.pdf (372.5 KB)

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Thanks for your very interesting post and also the direct link to that excellent article.

Its good to hear of a Chan teachers openness and sophistication in warning students of the risks of extremism. Did it put anyone off doing meditation? A kind of adverse effect to adverse effect warnings :slight_smile:

In contrast to your Chan teacher, in Japan and the west some Zen sesshin have had hardcore practice attitudes. This, despite the warning of Hakuin Zenji: Zen Sickness, by Zen Master Hakuin.

It appears Hakuin was saved from his Zen sicknessed by Taoist /Traditional Chinese Medicine informed practice. So the cultural background can be protective in offering understanding and remedy.

In the West it has been be quite different. Heres a tale that is published and more illustrative (with apologies for my cuts - any misleading editing is my fault alone):

Am I going mad?
Mary:
[At first] I started seeing lights in my practice … and having
very interesting shifts in my consciousness … [I had] shifts in my sense of self too: I didn’t recognize myself
in pictures or in the mirror … [Then later] I had a complete
dissolution of everything. My sense of self, my body … … I was incapacitated. The first year I couldn’t even leave my house. The second two [years] … I didn’t have any sense of self. …
It was an awful time … I went to many teachers and got a
whole bunch of advice … [But] the supposed experts didn’t
know what was going on … I spoke with [a well-known and
well-respected meditation teacher]. He said it was a sign of my mind becoming more concentrated and that I should do some serious retreat time …

Its a worry when a “well-respected teacher” encourages exactly the most harmful thing.

Note how insight dhamma teachers could get confused with “Mary’s” initial reports of dissolution of ego sounding like some of the abhidhamma insight stages. like Knowledge of Dissolution

Clearly meditation teachers need to learn a sophisticated differentiation of insight vs harmful experiences; so early warnings can be recognized and serious harms averted. However, its a hard skill to learn when most students have wonderful or at least undemanding experiences and its so rare for the serious adverse outcomes to happen.

Im still left wondering if the Suttas shine any light on meditation sickness, apart from the Buddha teaching metta? Clearly things went wrong even in the Buddhas time, let alone a millennium late in the East and now another millennium on in the West.

Does anyone remember any informative suttas or early sources with teachings on preventing meditation sickness?

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Most Western researchers view mindfulness as an intervention method for managing stress, anxiety, and other psychological challenges—similar to physical activity or specific therapeutic approaches. While extensive research supports mindfulness as an effective tool for reducing stress, etc., its role within the Buddhist tradition extends far beyond stress relief. In this context, mindfulness is an integral part of a broader framework aimed at cultivating deep insight into the nature of human experience—ultimately fostering wisdom.

For instance, Buddhist teachings emphasize understanding how all phenomena, including thoughts and emotions, continuously arise and cease due to various causes and conditions. From this perspective, experiences such as physical discomfort from prolonged meditation or anxiety during practice are not merely adverse effects to be flagged or reported; rather, they are seen as natural occurrences—hindrances to be understood, observed, and transcended. Through meditation techniques like Chittanupassana, practitioners learn to witness the transient nature of these mental states, recognizing that they are not constant. By doing so, they gradually cultivate the ability to let go and move beyond such obstacles, deepening their practice and insight.

In a recent article (titled ‘The Dangers of Mindfulness: Another Myth?), Venerable Analayo states that talking about ‘adverse effects’ appear to have become a current ‘hype’, and also that there appears to be an apparent lack of acquaintance of some scholars with Buddhist doctrine. Here’s a link to that article: https://www.dharma.org/wp-content/uploads/DangersMindfulness-1.pdf

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