deep research - dark side meditation - chatgpt

criado em:

• 25-04-2025
• 14:46

relacionados:

• notas:

1. deep research - dark side meditation - gemini
2. deep research - dark side meditation - perplexity

• tags: #DR #drchatgpt
• Fontes & Links:

Great. I’ll begin compiling a structured outline and annotated draft for a ~5,000-word academic analysis exploring the potential adverse effects of meditation. This will cover a comprehensive literature review, synthesize empirical and theoretical findings, and address the seven specified research questions with critical evaluation and interdisciplinary context.

I'll let you know when the draft is ready for your review.

Adverse Effects of Meditation: Outline and Draft

Introduction

Meditation and related contemplative practices (e.g. mindfulness, concentrative and insight techniques) are widely promoted for their physical and mental health benefits. Numerous clinical trials and meta-analyses document improvements in stress, anxiety, depression, pain, and cognitive functioning from structured programs like Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ). These positive findings have driven the dissemination of meditation in healthcare, education, and popular wellness settings. However, a growing body of evidence suggests that meditation can sometimes produce challenging or harmful experiences in a minority of individuals. Reports range from transient anxiety or physical discomfort to more severe outcomes such as panic reactions, dissociative states, or even psychosis in vulnerable people (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed) ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ). Despite these case reports and qualitative studies, mainstream discussion of meditation has largely downplayed any “dark side,” and few clinical trials systematically monitor adverse events ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) (Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PubMed). This gap raises ethical concerns: as Baer et al. (2019) note, “any intervention powerful enough to have substantial benefits might also cause harm” ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ), and preventing harm is a core duty in medicine and psychology. Thus there is an urgent need to characterize the nature, prevalence, and mechanisms of meditation-related adverse effects (MRAEs), identify who is at risk, and develop guidelines for safer practice.

This analysis synthesizes current knowledge on meditation-related adverse effects with reference to empirical studies, theoretical analyses, contemplative texts, and case reports. It is organized around seven key questions:

1. Typology and phenomenology of adverse effects: What kinds of negative experiences occur, and how are they described?

2. Vulnerability factors and risk assessment: Which individuals or practices are more likely to produce adverse outcomes?

3. Neurobiological and psychological mechanisms: What underlying processes could explain these effects?

4. Boundary between transformative challenges and harmful effects: How can we distinguish normal difficult experiences from pathology?

5. Ethical frameworks and responsibility distribution: What guidelines and duties should meditation teachers, clinicians, and institutions follow to manage risk?

6. Special populations and contextual considerations: How do factors like age, culture, mental health status, or practice setting influence risks?

7. Integration of scientific and contemplative knowledge: How can modern research and traditional wisdom inform each other on these issues?

In the Current State of Knowledge section, we review empirical estimates of prevalence and categories of MRAEs, theoretical discussions, and methodological issues. The Analysis of Research Questions section then addresses each of the above questions in turn, drawing on peer-reviewed studies, clinical reports, and traditional literature (with scholarly translation where appropriate). Throughout, we aim for balance and nuance: acknowledging that many difficult experiences may be growth-promoting for some, while avoiding minimization of harm or sensationalism. Our presentation will use precise scientific terminology, critically evaluate evidence quality, and highlight gaps in the literature. We also include taxonomies and comparative tables where helpful. The goal is a comprehensive foundation for understanding meditation-related risks as the basis for a full academic treatment.

Current State of Knowledge

Prevalence and Scope of Adverse Effects

Large-scale surveys and reviews indicate that meditation-related adverse experiences are not vanishingly rare. In a population-representative U.S. sample, over 50% of meditators reported at least one type of adverse experience, and about 10% described lasting effects causing functional impairment ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ). In an international cross-sectional sample of regular meditators (n≈1,370), 22% reported particularly unpleasant meditation-related experiences, with ~13% rated as adverse ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ) ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). A systematic review of meditation studies found that anxiety and depression were the most commonly reported adverse outcomes (33% and 27% of studies, respectively), followed by cognitive disturbances (25%) (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed). Clinical trial monitoring further shows that about 6–14% of participants in mindfulness-based programs report “lasting bad effects” (beyond transient discomfort) (Defining and measuring meditation-related adverse effects in mindfulness-based programs - PubMed).

Importantly, the prevalence estimates vary widely across studies, reflecting methodological differences. For example, in Farias et al.’s systematic review, the pooled prevalence of any reported adverse event was only ~8% in randomized trials, but much higher (~33%) in observational studies (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed). Goldberg et al. (2021) found 32% of meditators endorsed any adverse effect, with 10.4% lasting ≥1 month ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ). Schlosser et al. (2019) found 25.6% of Western meditators reported a particularly unpleasant experience (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). These discrepancies highlight that many trials and surveys do not actively solicit reports of adverse events, so spontaneous reporting underestimates true incidence (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Still, the available data converge on the conclusion that adverse experiences occur in a meaningful minority of meditators, warranting systematic attention.

Typology of Adverse Experiences

Researchers have begun to classify the variety of meditation-related adverse effects. Broadly, categories include emotional, cognitive, perceptual, bodily, and self-related disturbances. For instance, the MedEx codebook (Britton et al., 2021) identified 44 specific categories across six domains ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ):

• Affective domain: Changes in emotions (e.g. anxiety, panic attacks, sudden anger, overwhelming guilt), mood blunting, suicidal thoughts, or re-experiencing of traumatic memories ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed).

• Cognitive domain: Disruptions in thinking (e.g. confusion, memory problems, racing thoughts, loss of concentration, or even transient delusions) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One).

• Perceptual domain: Altered sensory perceptions, such as derealization/depersonalization, hypersensitivity to sights/sounds, changes in time perception, or hallucination-like distortions ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One).

• Sense-of-self domain: Disturbances of identity or body (e.g. disembodiment, feeling the “self” dissolving, extreme merging with surroundings, loss of agency) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One).

• Somatic (bodily) domain: Physical symptoms such as headaches, pain, muscle twitches, nausea, sleep and appetite disturbances, and even autonomic episodes (e.g. fainting) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC ). The autonomic study by Qureshi and Perry (2024) found that novice meditators sometimes showed unexpected sympathetic arousal (e.g. increased heart rate variability) associated with nausea during focused meditation, contrary to the expected relaxation response ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC ).

• Social/occupational domain: Impairment in work or relationships, increased irritability or isolation, though these are reported less often.

Table 1 below summarizes these categories with examples. In practice, many adverse experiences span multiple domains (e.g. severe anxiety with racing thoughts and body tremors).

        Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC
    ](https://pmc.ncbi.nlm.nih.gov/articles/PMC8845498/#:~:text=the%20MBP,four%20categories)) |

| Cognitive | Confusion, disorientation; memory or attention deficits; obsessive or intrusive thoughts; derealizing confusion; delusional beliefs | Britton et al., 2021 ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ); Lindahl et al., 2017 (mixed-methods) | | Perceptual | Sensory distortions or hallucinations (visual/auditory flashes), derealization/depersonalization, altered time sense | Britton et al., 2021 ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ); Lindahl et al., 2017 | | Sense-of-self | Loss of self; ego-dissolution; feeling detached from body, identity; intense transcendence or merging with universe | Lindahl et al., 2017; Britton et al., 2021 ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) | | Somatic | Headache, dizziness, nausea, tremors; insomnia or hypersomnia; gastrointestinal distress | Britton et al., 2021 ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ); Qureshi & Perry, 2024 ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC ) | | Social/Occupational | Social withdrawal; conflict with friends/family; inability to work or perform tasks | Britton et al., 2021 ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ) |

Despite these efforts, phenomenology of MRAEs remains an under-studied area. Many existing reports are case studies or retrospective surveys that list symptoms but lack standardized criteria. Qualitative interviews (e.g. Lindahl et al., 2017) show that practitioners themselves often struggle to categorize their experiences – some label them as “spiritual crises” or “stuckness,” while others call them side-effects or illness (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One) ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ).

Quality of Evidence and Methodological Issues

Research on meditation harms is still nascent and methodologically uneven. Most randomized controlled trials of meditation do not include systematic adverse-event monitoring (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) (Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PubMed). Instead, many rely on passive reporting, leading to undercounting (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One). As a result, prevalence estimates vary. Schlosser et al. (2019) point out that terms like “side-effect,” “unpleasant experience,” and “adverse reaction” are often used inconsistently ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Some authors have proposed clear definitions: for example, Duggan et al. (in Baer et al., 2019) define harm as “sustained deterioration caused directly by the intervention,” whereas the WHO defines harm more broadly as any “subjectively unpleasant” outcome ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Britton et al. (2021) developed a structured interview (MedEx-I) to systematically capture MRAEs in MBCT trials, identifying both transient distress and lasting adverse impacts (Defining and measuring meditation-related adverse effects in mindfulness-based programs - PubMed) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ).

Nevertheless, critical gaps persist. Most epidemiological data are from self-selected samples (e.g. meditators attending retreats or surveys), often lacking control groups. Case reports provide anecdotal evidence but no denominators. Traditional contemplative literature offers rich descriptions (see Integrating Traditional Knowledge below) but differs in context and interpretation from secular clinical settings. There is a clear need for prospective studies with rigorous, standardized adverse-event assessments and appropriate comparison groups. Indeed, Van Dam et al. (2018) warn that the field’s youth means exciting positive findings may overshadow rigorous harm monitoring ( Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl - PMC ) ( Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl - PMC ).

In summary, the evidence to date establishes that a range of negative meditation-related experiences can occur. They appear relatively common (on the order of 20–50% of meditators reporting at least one unpleasant experience), though only a minority (≈5–15%) suffer enduring or functionally impairing effects ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ) (Defining and measuring meditation-related adverse effects in mindfulness-based programs - PubMed). Anxiety and cognitive/perceptual disturbances are among the most frequent categories (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed) ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ). However, most studies are cross-sectional or retrospective. Causal inferences and generalizations are limited by lack of long-term, controlled research. We now turn to analyze each research question in depth.

1. Typology and Phenomenology of Adverse Effects

Meditation-related adverse effects span psychological, physiological, and interpersonal phenomena. Building on the categories above, we can further subdivide and refine the typology:

• Emotional/Affective: Anxiety/panic is widely reported, especially during initial stages of practice or in those with high neuroticism (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed) (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). Individuals may experience sudden panic attacks, intense fear, or persistent dread that seems to “surface” during meditation. Depression or dysphoria can also be exacerbated or newly triggered, though evidence is mixed (some studies show meditation helps depression, others note rare cases of sadness) (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed). Emotional lability (rapid mood swings) and reactivation of traumatic emotions or memories has been observed, particularly in trauma survivors (see Section 6). In extreme cases, suicidal ideation has occurred; Baer et al. (2019) cite suicidality as an example of an adverse outcome warranting concern, though systematic data on this is scant ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ).

• Cognitive: Confusion or “mental fog” may arise, especially in intensive or unsupervised practice. Practitioners sometimes report feeling unable to think clearly, or having racing thoughts that they cannot still ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ). Unwanted intrusive thoughts (often negative self-judgments) may initially worsen for some meditators. Some have experienced transient dissociative symptoms (feelings of unreality) that blur thinking. Rarely, individuals have developed delusion-like ideas during meditation retreats (e.g. believing oneself to have special powers); classic examples include precipitating psychotic episodes in those with vulnerability ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ) ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ).

• Perceptual: Some meditators report alterations of sensory perception. Common reports include visual auras or distortions, unusual sounds, or feeling that the environment is unreal or muffled. Temporal distortions (“time slowing or speeding up”) also occur. Intense derealization/depersonalization (feeling detached from the world or one’s body) can be profoundly distressing and has been documented among retreat participants (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ). Sensory hypersensitivity (e.g. noises seeming unbearably loud) has also been noted.

• Somatic (Bodily): Headaches, neck or back pain, or eye discomfort often accompany prolonged sitting. Farias et al. (2020) included gastrointestinal symptoms (e.g. nausea, indigestion) as one class of AEs, though these are less emphasized than psychological effects (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed). Sudden autonomic responses are possible: an observational study of Samadhi meditation found that most novices showed increased parasympathetic tone, but a subset (those who vomited) paradoxically had sympathetic arousal (decreased heart-rate variability) ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC ). This suggests that intense focus can trigger a fight-or-flight response in some individuals, manifesting as nausea or even fainting. Other reports include muscle spasms, trembling, chills, or sudden release of tension (sometimes interpreted spiritually as “energies”).

• Sense-of-self/Identity: Meditation can produce experiences of self-dissolution. While an expanded sense of connection is often a positive goal, some practitioners are frightened by ego-loss. Descriptions include “losing sense of personal boundaries,” feeling “merged” with objects or cosmos, or conversely, feeling alarmingly empty. The Pāli and Sanskrit traditions describe these as “rupa- and arupa-nimittas” (signs) that can mislead novices if not well understood (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One). In modern terms, these states resemble transient psychosis or dissociation. Importantly, whether such states are harmful depends on context: when integrated properly they may be enlightening, but unmoored they can destabilize one’s sense of reality.

• Behavioral and Social: Although less frequently studied, behavioral changes have been noted. For example, persistently elevated arousal or paranoia can strain relationships or work. Isolation is common during intensive retreats; upon returning to daily life, conflicts sometimes arise due to changed perspective. One MBP study found about 2% of participants reported impaired functioning (e.g. avoiding friends or quitting job due to meditation-induced distress) ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ).

In summary, phenomenology of adverse effects is highly heterogeneous. It ranges from mild (e.g. transient anxiety or muscle soreness) to severe (e.g. full-blown psychosis). The key themes are: distress (fear, grief, anger surfacing unexpectedly), dysregulation (loss of cognitive/emotional control), and physiological arousal (autonomic responses). Table 2 (below) provides illustrative examples from case reports and surveys. Traditional Buddhist texts anticipate many of these (see Section 7).

Table 2: Illustrative Meditation-Related Adverse Effects (Cases & Examples)

• Intense anxiety/panic: e.g. a meditator on retreat suddenly becomes terrified, heart racing, convinced she is “going insane” (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC ).

• Depersonalization: e.g. practitioner feels she is “floating above her body” during koan practice, frightened by loss of self (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One).

• Re-emergence of trauma: e.g. childhood memories of abuse vividly re-experienced during a body-scan meditation, leading to severe panic attacks ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ).

• Psychotic break: e.g. an experienced meditator with prior schizophrenia history develops paranoid delusions and hears voices after prolonged silent retreat ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ).

• Psychic “emptiness” or depression: e.g. a student reports deep emptiness and despair during meditation, akin to a depressive episode ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ).

• Somatic surge: e.g. meditator experiences tremors and vomiting during a breathing practice, with confusion and fear ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC ).

Some of these effects may be time-limited (resolving with time or adjustment), while others can persist or worsen without intervention. For example, Britton et al. found that 6–14% of MBCT participants had adverse effects that lasted >1 month (Defining and measuring meditation-related adverse effects in mindfulness-based programs - PubMed). Lindahl et al. (2017) also documented chronic cases requiring clinical treatment (e.g. hospitalization). Importantly, even when experiences were painful, many meditators did not regret the practice and still reported being “glad” for having practiced ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ). This underscores that some difficulties are interpreted as part of growth by practitioners (see Question 4).

2. Vulnerability Factors and Risk Assessment

Not everyone who meditates will encounter severe difficulties. Research suggests several participant-related factors that influence susceptibility:

• Psychiatric History: A past or present diagnosis (e.g. anxiety disorder, depression, PTSD, or psychotic spectrum) appears to increase risk. In Pauly et al.’s large international survey, individuals with any current mental disorder were more likely to report adverse experiences ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Similarly, Lindahl et al. (2017) found that the vast majority of experienced Buddhist teachers interviewed viewed a history of mental illness or trauma as a risk factor ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ). This is consistent with clinical wisdom: for example, Walsh & Roche (1979) famously reported meditation precipitating relapse in schizophrenic patients, and subsequent case reports (Joshi & Manandhar, 2021) document relapse of psychosis after intensive meditation ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ). However, caution is needed: some evidence from MBCT trials suggests people with depression or high vulnerability may actually gain more benefit than harm from guided mindfulness ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ). These findings are mixed and often lack systematic harm assessments, but the consensus is that screening for severe mental illness (especially untreated psychosis or bipolar mania) is prudent before high-dose practice.

• Personality and Traits: High neuroticism or a tendency to ruminate/negative thinking has been linked to more unpleasant meditation experiences (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One) ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Schlosser et al. (2019) found that meditators scoring high on repetitive negative thought reported more frequent adverse experiences (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). Conversely, higher dispositional mindfulness seems protective; Pauly et al. (2021) found that being more “mindful” (aware and non-reactive) was associated with fewer negative effects ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Traits like extreme perfectionism or trauma sensitivity might also predispose individuals to distress if unresolved issues surface during meditation.

• Practice Experience and Intensity: Beginners may lack coping skills, but even experienced practitioners can be vulnerable when practice is intense. Two factors stand out:

  • Retreat vs. Daily Practice: Consistently, studies report that attending a long silent retreat (often 5–10 days) is associated with more reports of adverse experiences ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ) ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ). For example, Schlosser et al. hypothesized and found that retreat participants had higher severity of unpleasant experiences ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ) ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ). Lindahl et al. noted that 75% of difficulties in their sample occurred during or after retreats (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). In a sense, intensive retreats accelerate practice (many hours/day, isolation, silence), magnifying risks.

  • Meditation Style: Dahl et al. (2015) classify techniques as attentional, constructive, or deconstructive (insight) practices ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Insight practices (e.g. Vipassanā, Dzogchen) directly challenge habitual self-concepts. In line with this, Schlosser et al. found that “deconstructive” practice types (insight-oriented) were linked to more unpleasant experiences ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Practices involving confrontation with difficult emotions (“working with difficulties”) may trigger overwhelming affect. In contrast, “loving-kindness” or breathing-focused practices may carry less risk, though systematic comparisons are lacking.

• Contextual Factors: The environment and guidance quality matter. Meditating in a supportive group with an experienced teacher is generally safer than solitary practice. Factors such as sleep deprivation, sensory deprivation, and physical strain (as in extreme retreats) can exacerbate risk ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ). For instance, the psychosis case report noted that the subject’s intensive regimen (18 hours/day, 4–5 hours sleep, one meal/day) likely contributed to the outcome ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ) ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ). Thus, general medical or psychiatric vulnerability becomes accentuated under extreme meditation conditions.

• Cultural/Conceptual Framework: How a practitioner interprets sensations influences risk. In Buddhaghosa’s terms, upakkilesa (impurities or disturbances) are expected in progress, whereas a Westerner might interpret them as illness. Limited prior knowledge (e.g. a novice expecting only relaxation) may make normal phenomena seem alarming. Lack of preparation/training (e.g. someone self-teaching from an app without guidance) can increase vulnerability.

In practice, risk assessment should take a holistic view. As Britton (2019) emphasizes, potential harm arises from “participant, program, and teacher factors” ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ). Clinically, one might screen for red flags: active psychosis, untreated bipolar, recent trauma, or severe personality disorders. Questionnaires (e.g. the Meditation-related Adverse Effects Survey used by Goldberg et al.) and open-ended interviews can be incorporated into intake. Some have proposed structured tools to capture a range of possible experiences (e.g. the MedEx-I protocol) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ). But no standardized “risk score” exists yet. A practical approach is the precautionary principle: mediate in graduated steps, ensure medical oversight if high risk, and educate practitioners about possible difficulties.

Summary of Vulnerability Factors:

• Pre-existing conditions: Mental illness (especially psychotic/trauma spectrum), past trauma.

• Psychological traits: High anxiety/rumination, low baseline mindfulness.

• Practice parameters: Intensive retreats; insight-oriented techniques.

• Context: Isolation, sleep/food deprivation, inexperienced teacher.

These factors should guide instructors and clinicians in tailoring meditation recommendations and monitoring for adverse signs.

3. Neurobiological and Psychological Mechanisms

Why would meditation, typically considered calming, induce adverse responses? A variety of tentative mechanisms – psychological and neurobiological – have been proposed, though evidence is limited and largely speculative.

On the neurobiological side, one hypothesis is that meditation induces atypical arousal states. While meditation is often linked to increased parasympathetic (rest-and-digest) tone, Qureshi & Perry (2024) found that some individuals show paradoxical sympathetic activation during intense focus, as evidenced by heart-rate variability changes accompanying nausea ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC ). This suggests heterogeneity: perhaps those who experience distressing effects have a stress-response that fails to down-regulate. Research on neurotransmitters provides hints: surges in dopamine, serotonin, or acetylcholine during extended practice may underlie mood changes or hallucination-like phenomena ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ). Indeed, Joshi & Manandhar (2021) cite literature reporting increased dopamine and cortical blood flow in meditation, overlapping with brain regions implicated in psychosis ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ). However, direct causal data are lacking. Studies of meditation’s acute brain effects generally show shifts in default-mode network and limbic activity, but it is unknown how these might tip into maladaptive patterns in some people.

Psychologically, a leading explanation is that meditation exposes latent material. By quieting mental chatter and sensory distractions, suppressed emotions or memories (e.g. trauma) can flood consciousness (an “exposure” effect). This can be akin to what happens in prolonged exposure therapy but without a therapist present. Similarly, meditation’s emphasis on non-judgmental awareness can paradoxically amplify ruminative cycles for those prone to them, if one fixates on distressing thoughts. In other words, rather than achieving mindfulness, the novice may become fixated on negative content that rises up (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One).

Cognitive factors may also play a role. Metacognitive beliefs that one must feel bliss or that difficult thoughts should go away can lead to frustration and distress when practice doesn’t meet expectations (a kind of self-generated anxiety). This is compounded by cultural messages that meditation is always beneficial (the “mindfulness hype” criticized by some scholars ( Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl - PMC )); when reality contradicts expectation, cognitive dissonance results.

Another model views some adverse effects as a form of stress response. Intensive meditation (especially long breath holds or deep concentration) could trigger the hypothalamic-pituitary-adrenal (HPA) axis, similarly to hyperventilation or deprivation experiences. The Vipassana retreat case illustrates multiple stressors (fasting, solitude) that might have synergized to provoke psychosis in a vulnerable brain ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC ). In fact, parallels with sensory deprivation and high-altitude phenomena have been drawn. Under this view, meditation can be thought of as a controlled stressor that, if misapplied, overwhelms coping capacity.

Conversely, some adverse effects may emerge from neural plasticity. Long-term practice is known to thicken the insula, increase prefrontal control connectivity, and reduce amygdala reactivity (beneficial changes). But if these brain systems change too rapidly or imbalanced with other systems, dysphoria or mania might result (though this is speculative). For example, increased default-mode network decoupling may foster a temporary loss of ego-boundaries (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One), experienced as terrifying by some.

Finally, cultural/interpretive mechanisms matter. The meaning ascribed to an experience determines whether it is seen as pathology. A sudden vision might be a spiritual insight in one context and a hallucination in another. This intersects with psychological projection and the meditation group’s “nocebo” expectations. Therefore, what researchers label an “adverse effect” may partly reflect extraneous context rather than a fixed neurobiological syndrome.

In summary, no single mechanism is established. Likely a confluence of factors – heightened arousal, cognitive de-focusing, emotional exposure, and neurotransmitter fluctuations – interact. Figure 1 (below) conceptually diagrams possible pathways. Future neuroimaging and physiological studies (including stress markers) are needed to identify how meditation produces contrasting states of deep calm in most versus hyperarousal/dysphoria in a few.

4. Boundary Between Transformative Challenges and Harmful Effects

A central conceptual issue is distinguishing expected “spiritual emergencies” from genuine harm. Traditional contemplative paths have long recognized that profound inner work often comes with crisis. Buddhist texts warn meditators not to mistake illusory joys for enlightenment (the “50 mental impurities” in the Śūraṅgama Sūtra) (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One). Theravāda teachers describe the vipassanā-upakkilesā (“corruptions of insight”) – transient periods of confusion or strong emotion – as normal in insight practice (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One). The “dark night of the soul” is a Jungian term for a kind of mystic crisis often associated with advanced practice. Many meditators report initial turmoil followed by transformation. For example, a common pattern is that a meditator struggles with restlessness or dullness, eventually leading to a breakthrough. From this viewpoint, some discomfort is not only expected but necessary.

Modern commentators emphasize context and interpretation. Lindahl et al. (2019) note that whether an experience is “adverse” depends on subjective appraisal. In Schlosser et al.’s words, a key question is “when [an unpleasant experience] is constitutive of practice rather than merely a negative effect” (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). An emotional catharsis might be painful yet ultimately healing. Mindfulness teacher Saki Santorelli, for example, observes that some students experience “buying the farm” in meditation (confronting one’s deepest fears) which ultimately leads to insight, not pathology. Similarly, participants in MBCT trials sometimes report that initially disturbing memories surfaced but were resolved over time. Goldberg et al. (2021) found that meditators with adverse experiences were no less “glad” to have practiced than those without ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ), implying many view even hard experiences as acceptable costs for benefit.

On the other hand, some experiences clearly cross into harm. The consensus definitions matter: Duggan’s idea of harm (“sustained deterioration caused by the intervention” ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC )) suggests a key criterion is duration and functional impairment. A panic attack that resolves in minutes might be unpleasant but not “harm.” In contrast, a month-long psychotic state or chronic depression triggered by practice likely qualifies as harmful. Ethical guidelines (cf. Baer et al., 2019) emphasize monitoring for effects that are not just intense, but dysfunctional.

Table 3 below summarizes a proposed continuum:

Crucially, the intent and context matter. Mindful guidance says difficult feelings are to be observed non-judgmentally, but only if the practitioner is prepared; without such framing, the same feeling may be interpreted catastrophically. The distinction is not clear-cut, and current research has no validated “safety algorithm.” Lindahl et al. warn against prematurely pathologizing experiences that tradition considers normal, and vice versa (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ). Thus, assessments must consider duration, attribution (was it caused by meditation?), severity, and effect on functioning.

5. Ethical Frameworks and Responsibility Distribution

Given the evidence of potential risks, ethical practice dictates “do no harm” as a primary obligation. This duty falls on multiple stakeholders:

• Meditation Teachers/Facilitators: They bear responsibility to screen participants (e.g. medical/psych history), provide informed consent about possible challenges, and offer guidance. Standardized training programs (e.g. MBSR teacher training) now emphasize ethical considerations including discussing potential difficulties. Teachers should be alert during courses: for example, many instructors shorten home practice or adjust exercises for highly anxious participants. If severe issues arise, teachers should have referral networks (e.g. to mental health professionals). Importantly, as one mindfulness clinician notes, encouraging someone with acute trauma to meditate “when they should be in psychotherapy” can be dangerous (The Dangers of Improper Guidance by Meditation Teachers – The Mindfulness Centre). Thus, ethical teaching involves humility about limits and knowing when not to proceed.

• Program Designers and Clinicians: For clinical MBIs, Institutional Review Boards and ethics committees should require adverse events tracking, as is done for drug trials ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ). Manuals and protocols may incorporate safety measures (see Britton et al., 2021, for a checklist). There are nascent efforts to create ethical codes for meditation instructors, analogous to counseling codes, but no universally accepted guidelines yet. In healthcare settings, meditation might be treated like any therapy: practitioners should be certified, and programs should have clear policies on crisis management. Additionally, large-scale dissemination (apps, school programs) raises questions about oversight; organizations must decide how much responsibility the app or curriculum bears for user harm.

• Participants/Consumers: Individuals should ideally be aware that meditation is not risk-free. Ethical frameworks imply giving patients adequate information (informed consent). For example, some MBCT programs include a meditation agreement form acknowledging known side effects. However, data suggest many novice users (especially those using apps or unguided methods) are unaware of potential issues. Outreach and education (through articles, workshops) could help set realistic expectations.

• Researchers: Scientists have an ethical duty to report harms as well as benefits. To date, very few meditation RCTs report negative findings in detail. As Van Dam et al. (2018) point out, mindfulness research has lagged behind psychotherapy in monitoring harm ( Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl - PMC ). Future studies must systematically assess and publish adverse outcomes to inform the field. Journals and funders could mandate standardized harm reporting, similar to CONSORT guidelines in medicine.

• Society/Media: Popular media often hype mindfulness as a panacea, which can mislead people about risks. Ethically, media and influencers should present a balanced view, highlighting that meditation is generally safe for many but not a guaranteed cure-all (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One). Over-promotion without caveats borders on negligent.

In sum, responsibility is shared. A framework for ethical practice might include: pre-screening individuals for risk factors; obtaining informed consent; using qualified instructors; tailoring intensity to the individual; monitoring during practice (e.g. check-ins in classes); providing resources for psychological support; and tracking outcomes. The therapist’s rule “it’s not what you do, but how you do it and for whom” applies: even “good” meditation can harm if misapplied.

6. Special Populations and Contextual Considerations

Certain groups warrant special attention when considering meditation risks:

• Clinical Populations: Patients with existing psychiatric disorders (e.g. borderline personality, PTSD, addiction) may experience different effects. Mindfulness-Based Relapse Prevention (for addiction) and MBCT (for bipolar depression) have been studied, generally showing benefits (Can Meditation Help with Bipolar Disorder Symptoms? - Psych Central). But observationally, people with PTSD often report reactivation of trauma memories during body-focused practices (e.g. long body scans can trigger flashbacks) (Change despite obstacles: A mixed-methods pilot study of a trauma …). Some therapists advocate “trauma-sensitive mindfulness” (shorter practices, grounding techniques, optional movement) to mitigate this. Similarly, MBCT for bipolar disorder has occasionally been linked to mania, though evidence is sparse (Can Meditation Help with Bipolar Disorder Symptoms? - Psych Central). Caution is advised: screening and possibly augmenting meditation with more structured therapy (e.g. CBT techniques) is common practice.

• Children and Adolescents: Research on meditation in youth is growing (some schools teach mindfulness to kids). However, developmental differences in the brain and emotion regulation mean that intense practices might be destabilizing. On the other hand, age-appropriate mindfulness has shown benefit in childhood anxiety/depression (Clinical effects of mindfulness-based interventions for adults with a …). No large studies focus on adverse events in youth; ethical practice suggests starting with brief, guided exercises (e.g. 3–5 min) and monitoring reactions, rather than recommending long silent sits.

• Elderly: Older adults often practice meditation for healthy aging. Physical comfort and cognitive change are considerations. For example, a frail person might fall asleep or develop low blood pressure during long sessions. No major risk patterns have been identified specifically for elders; one should ensure practices are adapted to mobility and sensory needs.

• Pregnant Women and Perinatal: Pregnancy is a time of hormonal shifts and mood vulnerability. MBSR has been beneficial for perinatal stress, but anecdotal reports suggest some women experience increased anxiety or unusual dreams. Modifying techniques (e.g. shorter practices, gentle movement-based mindfulness like walking) is prudent.

• Medical Conditions: Chronic pain patients use meditation to cope, but intense focus on bodily sensations could magnify awareness of pain, leading to frustration or catastrophizing in some cases. Certain conditions (e.g. epilepsy) have isolated case reports where deep meditation was thought to trigger seizures, but evidence is anecdotal. Again, tailor practice to comfort level.

• Prisoners and Highly Traumatized Groups: Mindfulness in prisons has become common. Participants with histories of violence or institutionalization may have difficulty trusting or attending to internal states; rigorous support and group norms are important. There’s no systematic data on adverse events in such contexts, but even more vigilance (e.g. combining mindfulness with psychotherapy) may be needed.

• Religious/Cultural Context: In cultures where meditation is traditional, there may be community support (e.g. temple sangha) for discussing difficulties. In secular settings (e.g. Western clinics), individuals may lack a conceptual framework to interpret strange experiences. This affects both reporting and coping.

Finally, practice context modulates risk: solitary at-home practice versus supervised group class versus intensive retreat. As noted, retreats have higher incidence of intense experiences ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ) (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). Similarly, apps that lead users rapidly into long meditations without preparation could increase risk. Structured programs with gradual progression and check-ins are generally safer for novices, while experienced meditators may tolerate more autonomy.

7. Integration of Scientific and Contemplative Knowledge

A promising direction is bridging modern science with insights from traditional contemplative teachings. Several recent authors have called for dialogue between Buddhist frameworks and clinical research (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One) ( Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl - PMC ). Buddhist scriptures have long discussed meditation pitfalls. For example, the Śūraṅgama Sūtra warns of fifty illusory experiences during deep concentration (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One). The Vipassanā-ñāṇa texts outline stages of insight that include crises of doubt and identity. Traditional meditation masters often view these as part of the path, prescribing specific antidotes (like external focus or skilled teacher intervention).

Western science can benefit from this knowledge by understanding that many reported adverse phenomena are not purely “pathological,” but can be contextually understood as “insight knowledges” or transitional states (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One). Conversely, contemplatives can learn from scientific rigor: standardized assessment of harms, neurobiological models, and clinical risk management. Combining both, some researchers propose culturally sensitive frameworks: for instance, classifying experiences on dimensions of valence (pleasant–unpleasant) and impact (helpful–hindering) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC ). This aligns with Tibetan approaches that view disturbances along a spectrum that can be navigated skillfully or can lead to suffering.

Contemporary collaborative projects like the Varieties of Meditation Experience group (involving psychologists and Buddhists) are mapping terminology differences and similarities (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). Such integration suggests that a unified taxonomy is possible – one that respects spiritual interpretations while applying objective criteria of risk. For example, a “Meditation Adverse Event” could be defined in research as any unwanted emotional or cognitive change attributed to practice and resulting in impairment, while traditional idioms (e.g. nyams) can be acknowledged as overlapping.

In educational contexts, this integration means teaching trainees both the scientific findings on harms and the traditional “mindset.” An evidence-based manual might list common difficulties (e.g. “charnel ground” practice in Vajrayana) alongside empirical data on who is most likely affected. The aim is not to pit science against spirituality, but to let each inform safer practice.

Finally, research is needed to test traditional strategies for mitigating adverse effects, such as mental preparation, post-retreat integration rituals, or the “Four Reminders” meditation approach. Empirical studies comparing such methods could validate age-old wisdom or suggest adaptations for secular settings.

Future Research Directions (Integration)

• Standardized Harm Reporting: Develop consensus on definitions (e.g., “meditation-related adverse events”) and incorporate in all meditation trials, analogous to pharmaceutical trials.

• Prospective Cohort Studies: Longitudinal tracking of new meditators with psychological and physiological measures, to identify predictors of negative trajectories.

• Experimental Mechanisms: Use neuroimaging, autonomic and endocrine measures during meditation to compare individuals who do vs. do not report adverse symptoms, testing hypotheses about arousal or neurotransmitters.

• Comparative Studies: Examine differences among traditions (e.g. Theravāda vs. Zen vs. Tibetan) to see if certain practices systematically yield more difficulties, controlling for intensity.

• Intervention Trials: Test mitigation strategies (e.g. trauma-sensitive modifications, preparatory sessions) to see if they reduce incidence of adverse outcomes in high-risk groups.

• Case Registries: Create anonymized databases of meditation-related adverse events (similar to pharmacovigilance) to aggregate rare but serious cases.

Conclusion

Meditation is a powerful practice with well-established benefits, but it is not devoid of risk. This analysis has cataloged a spectrum of potential adverse effects – from common transient anxiety to rare but serious psychotic breaks – and identified factors that increase vulnerability. Key findings include that up to half of meditators may encounter some unpleasant experiences, especially under intensive or insight-oriented practices ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ) (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One). Pre-existing mental illness and trauma history are prominent risk factors ( Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PMC ). Neurobiological and psychological theories (though still preliminary) suggest that meditation can induce atypical arousal and expose latent material, among other mechanisms. Crucially, there is a nuanced boundary between difficult spiritual challenges and genuine harm, often hinging on context and duration.

Ethically, these insights compel the field to “do no harm” by improving screening, education, and monitoring, and by integrating guidance from both science and tradition. Meditation teachers and clinicians share responsibility for participant safety, which may involve informed consent and referral pathways. Special populations (e.g. trauma survivors, adolescents) demand tailored approaches.

In sum, a balanced perspective acknowledges that while the majority of practitioners experience no lasting harm, a significant minority do. Continued research – both empirical and contemplative-informed – is needed to refine our understanding, mitigate risks, and ensure that meditation’s benefits are accessible without unintended costs.

References (APA)

Baer, R. A., Crane, C., Miller, E., & Kuyken, W. (2019). Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clinical Psychology Review, 71, 101–114. (Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings - PubMed)

Britton, W. B., Lindahl, J. R., Cooper, D. J., Canby, N. K., & Palitsky, R. (2021). Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clinical Psychological Science, 9(6), 1185–1204. (Defining and measuring meditation-related adverse effects in mindfulness-based programs - PubMed)

Farias, M., Maraldi, E., Wallenkampf, K. C., & Lucchetti, G. (2020). Adverse events in meditation practices and meditation-based therapies: A systematic review. Acta Psychiatrica Scandinavica, 142(4), 310–322. (Adverse events in meditation practices and meditation-based therapies: a systematic review - PubMed)

Goldberg, S. B., Monahan, D. J., Truman, P. G., & King, M. W. (2021). Prevalence of meditation-related adverse effects in a population-based sample in the United States. Psychotherapy Research, 32(3), 291–305. ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC ) ( Prevalence of meditation-related adverse effects in a population-based sample in the United States - PMC )

Joshi, S., & Manandhar, A. (2021). Meditation-induced psychosis: Trigger and recurrence. Case Reports in Psychiatry, 2021, Article 6615451. ( Meditation-Induced Psychosis: Trigger and Recurrence - PMC )

Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLOS ONE, 12(5), e0176239. (The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists | PLOS One) ( Defining and measuring meditation-related adverse effects in mindfulness-based programs - PMC )

Pauly, L., Bergmann, N., Hahne, I., Pux, S., Hahn, E., Tam Ta, T. M., Rapp, M., & Böge, K. (2021). Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: International cross-sectional study. BJPsych Open, 7(1), e11. ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC ) ( Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study - PMC )

Schlosser, M., Sparby, T., Vörös, S., Jones, R., & Marchant, N. L. (2019). Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations. PLoS ONE, 14(5), e0216643. (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One) (Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations | PLOS One)

Qureshi, A. F., & Perry, A. (2024). Adverse effects of meditation: Autonomic nervous system activation and individual nauseous responses during Samadhi meditation in the Czech Republic. Frontiers in Human Neuroscience, 17, 11576787. ( Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic - PMC )