Episode 128 :: Gert de Boer, Brennen McKenzie, Doug Smith :: Scientific Skepticism and Buddhism

| July 29, 2012 | 86 Comments

Gert de Boer, Brennen McKenzie, and Doug Smith join us to talk about scientific skepticism and Buddhism.

We’ve found that there is a wonderful alignment between scientific naturalism, and secular Buddhism. Attitudes about Gotama’s presence as a human and the constraints of that embodiment, the veracity of first person experiences, and how we value the mutual support of community are rich areas for mutual exploration between these two disciplines. To serve as an introduction to some of these ideas, we’re going to have a round table discussion with three active free thinkers and meditation practitioners.

Gert de Boer

Gert de Boer studied philosophy with physics and mathematics as subsidiary subjects at the State University of Utrecht in the Netherlands. He moved to Switzerland where he is working as a database programmer. Since 2000 he is a regular participant of Buddhist meditation retreats, mainly with Reb Anderson. He is engaging, (sometimes fanatically) in the discussion fora of CFI, pleading for tolerance and correct understanding of science, religion and values, trying to put them on the right place in the human universe.

Brennen McKenzie

Brennen McKenzie is a small animal veterinarian in California and an advocate for a skeptical, science-based approach to medicine. He is the author of the SkeptVet Blog, a contributor to the Science-Based Medicine blog, and president of the Evidence-Based Veterinary Medicine Association. Dr. McKenzie has also found Buddhist meditation practice personally helpful and enriching, and he has an interest in the pragmatic, naturalistic approach of Secular Buddhism. He has been known to play the mandolin and the Irish pennywhistle and to wear the kilt, though he does not claim to do any of these well.

Doug Smith

Doug Smith had his first real exposure to Buddhism in an intro course at Princeton University, where he practiced Zen meditation while getting his bachelor’s degree in philosophy. He continued on to a PhD in philosophy at the University of Wisconsin-Madison, undertaking a minor in South Asian studies, which included classes from a Tibetan Geshe and several semesters of Sanskrit. An inveterate skeptic and secularist, in 2006 Doug got involved in volunteering for the Center for Inquiry, an organization created “to foster a secular society based on science, reason, freedom of inquiry, and humanist values”. He was made lead administrator of their web forum in 2007, where he still hangs out, chatting about philosophy, religion, skepticism and helping stem the unending tide of spammers.

So, sit back, relax, and have a nice Lapsang Souchong, with thanks to our wonderful guests for the suggestion.

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Music for This Episode Courtesy of Rodrigo Rodriguez

 

The music heard in the middle of the podcast is from Rodrigo Rodriguez. The track used in this episode is “Cross of Light” from his CD, Shakuhachi Meditations.

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Category: The Secular Buddhist Podcast

Ted Meissner

About the Author ()

Ted Meissner is the Executive Director of the Secular Buddhist Association, host of the SBA's official podcast The Secular Buddhist, and is on the Advisory Board for the Spiritual Naturalist Society. His background is in the Zen and Theravada traditions, he is a regular speaker on interfaith panel discussions, and is interested in examining the evolution of contemplative practice in contemporary culture.

Comments (86)

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  1. Dana Nourie Dana Nourie says:

    Another great podcast, Ted! I really liked what they had to say about the concerns of scientific studies regarding meditation as a stress reliever, etc., and the discussion about Buddhist morality. All of it great stuff!

  2. Candol says:

    Alas my power came unplugged half way through so i’ll have to go back to the beginning.

    • Dana Nourie Dana Nourie says:

      Candol, I don’t understand why you have to go back to the beginning. I just drag the little handle thing back to where I was. I can do that on the player here, if I play it in windows media, or if I play it on either my iPad or iPod. Just drag it back to where you were.

  3. Tom Alan says:

    Assuming that we consider the small animal vet a scientist, it’s nice to have at least one scientist taking part in a discussion of scientific skepticism. It would be even better if the scientist had expert knowledge of the research he criticizes, but I wonder if the vet has that. Like the other panel members, he’a not happy with meditation studies. His opinion is that meditation is “about as good as a nap.” I wonder how he rates the therapeutic value of naps? Is he familiar with the studies of MBSR in which researchers conclude that, because of its effects on immune function, MBSR could be used as a treatment for breast cancer and prostate cancer in its early stages?

    We might also mention study of MBCT, in particular the study in which prevention of relapse after recovery from depression was shown to be as good as with conventional treatment with antidepressant.

    Granted, this won’t help dogs.

    • Ted Meissner Ted Meissner says:

      Since this was a discussion between friends, and skeptics at that, we would be the last to use the Appeal to Authority fallacy. We’re not claiming to be experts, either, just having a conversation and sharing our thoughts.

      Tom, as this seems important to you, what is your expertise? Thanks for sharing.

  4. Tom Alan says:

    If I made an appeal on the basis of my own authority, it might arouse skepticism, as I am unable to verify my authority, so I’d better stick with authorities like Journal of Oncology Nursing, which have published MBSR studies. Of course, I wouldn’t blame people for being skeptical. Skepticism is a good thing. Unlike ideology (e.g., naturalism), science encourages skepticism.

  5. Doug Smith Doug says:

    I am no expert in this field, but any careful skeptic will avoid taking single studies, or small groups of studes, out of context. Perhaps the gold standard of evaluation for medical therapies is the Cochrane Collaboration. I find two citations there for meditation therapy. For ADHD they say,

    “As a result of the small number of studies that we were able to include in this review and the limitations of those studies, we were unable to draw any conclusions regarding the effectiveness of meditation therapy for ADHD. No adverse effects of meditation in children have been reported. More trials are needed on meditation therapies for ADHD so that conclusions can be drawn regarding its effectiveness.”

    For anxiety disorders they say,

    “Although meditation therapy is widely used in many anxiety-related conditions there is still a lack of studies in anxiety disorder patients. The small number of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for anxiety disorders. Transcendental meditation is comparable with other kinds of relaxation therapies in reducing anxiety, and Kundalini Yoga did not show significant effectiveness in treating obsessive-compulsive disorders compared with Relaxation/Meditation. Drop out rates appear to be high, and adverse effects of meditation have not been reported. More trials are needed.”

    Neither of these mean that meditation is ineffective, only that the data as yet are not robust enough to establish effect. (This does not mean there are no isolated studies here and there demonstrating various effects). Since Cochrane has no further information on meditation, the prudent assumption would be that there are no further, more reliable therapies for which meditation is indicated. If and when the evidence is forthcoming, I am sure they will revise their opinions.

    One thing to keep in mind is the so-called “file-drawer effect”, whereby negative outcome studies are filed away in the drawer instead of being published. This creates a hidden bias in favor of the effectiveness of any given therapy, since researchers tend to only be exposed to positive outcome studies.

    • Tom Alan says:

      Doug, thanks for sharing these findings. Here are some comments about your post.

      One thing to consider in medical research is that the value of effect strength depends on the intended purpose of the treatment. If study of a new treatment results in a calculated effect strength that is generally considered low, the treatment might still be recommended. We have to consider how serious the illness is, the availability and effectiveness of other treatments, the side effects and risks of the new treatment, and how expensive it would be. Use of MBSR in the treatment of breast cancer and prostate cancer provides an example of a low-risk treatment for an extremely serious illness. With respect to cost, research on self help is encouraging. Mindfulness-Based Cognitive Therapy is available as a computer program in the UK. (For studies that show the effectiveness of a self-help manual by David Burns as therapy for adults, elderly, and adolescents with mild to moderate depression, see Handbook of Self Help Therapies, 2008). A case study in which one of the schizophrenic participants showed reduction of negative symptoms may be considered significant if only in light of the absence of other therapies for negative symptoms.

      What follows is from the 2009 article by Ledesma and Kumano, “Mindfulness-based stress reduction and cancer: a meta-analysis.”

      OBJECTIVE:
      This meta-analysis was conducted to investigate the effects of mindfulness-based stress reduction (MBSR) on the mental and physical health status of various cancer patients.

      METHODS:
      Ten studies (randomized-controlled trials and observational studies) were found to be eligible for meta-analysis. Individual study results were categorized into mental and physical variables and Cohen’s effect size d was computed for each category.

      RESULTS:
      MBSR may indeed be helpful for the mental health of cancer patients (Cohen’s effect size d=0.48); however, more research is needed to show convincing evidence of the effect on physical health (Cohen’s effect size d=0.18).

      CONCLUSION:
      The results suggest that MBSR may improve cancer patients’ psychosocial adjustment to their disease.

      What follows is from the 2010 article by Hofmann and colleagues, “The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.”

      Objective:
      Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. Method: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions.

      Results:
      Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges’s g = 0.63) and mood symptoms (Hedges’s g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges’s g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up.

      Conclusions: These results suggest that mindfulness based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.

      With regard to the Cochrane reports you cited, there is no mention whatsoever of MBSR, mindfulness, or any of the evidence-based mindfulness therapies in their ADHD report. They use the word “mindfulness” in their anxiety report, but do not identify any particular program. Also, they put mindfulness meditation together with Transcendental Meditation in their anxiety report.

      • Tom Alan says:

        Re my previous post, the schizophrenia article I mentioned is concerned with what is called metta or loving kindness meditation.

        • mckenzievmd says:

          I agree that one must consider the balance of petential risks and benefits in evaluating the utility of any intervention, and one must consider the urgency of action. And since all of us involved in the interview have experienced positive subjective effects from meditation in our own lives, I don’t think any of us are inclined to argue that it’s not reasonable or plausible to consider teaching meditation to people with serious illness in an effort to offer them some comfort or coping skills.

          The problem remains, however, that the literature you cite involves evaluating the impact of a subjective experience (meditation) on a subjective experience (mood, anxiety, etc), and that it is very difficult to make definitive general conclusions about mechanism or reliable predictions about efficacy with these kinds of interventions and measures. People report improvements in subjective measures during clinical trials of every kind of intervention, and within robust, repeatable findings from high-quality and well-controlled trials, this doesn’t translate into a reliable generalization about the effectiveness of these interventions. Homeopathy, Bach flower essences, non-mindfulness-based meditation, psychotherapy, and even anti-depressant drugs have all shown positive results in some studies under some conditions despite wide variations in mechanism and plausibility. This speaks to our poor ability to isolate and identify objective criteria for a specific treatment effect on subjective variables.

          In any case, as I said, I’m very positive about the effects of meditation practice myself, I simply caution against making the claim that there is strong scientific evidence for the value of meditation on physical or mental health when applied as an intervention in people with illness, becasue I think the research in this area is problematic in a nmber of ways.

          • Tom Alan says:

            The literature of medicine uses the term “effect strength.” The effect strengths reported in the two meta-analyses I’ve cited indicate that MBSR may be recommended for some cases of cancer (if only for patients’ mental health but possibly for improvement of immune function as well) and for some cases of anxiety. I don’t know what you mean by “strong evidence.”

          • Tom Alan says:

            Please read the cancer study, which reports OBJECTIVE findings, not SUBJECTIVE findings on effects related to immune function.

  6. mckenzievmd says:

    Hi Tom,

    I thought I’d offer just a couple of responses to your comments.

    “Assuming that we consider the small animal vet a scientist…”
    I’m not sure what the purpose of the qualifier is here, other than perhaps to express some doubts about my qualifications to critique scientific studies of meditation. I’ve generally found that credentials don’t matter all that much since people tend to cite them as evidence that a person is right if that person says something they agree with (which is, as Ted points out, merely the fallacy of appeal to authority), and they tend to dismiss credentials if the person has positions they don’t agree with.

    In any case, apart from my veterinary degree, I do have an MA in Physiology and Behavior, I am currently studying for an MSc in Epidemiology, I have published in and peer-reviewed for scientific journals and spoken at scientific meetings, and I am president of the Evidence-Based Veterinary Medicine Association. Such credentials might suggest I am qualified to critically appraise research articles in general, though I certainly admit I am no expert in the scientific study of meditation.

    Then again, anyone who is an expert researcher in this area likely also has a strong belief that there is some therapeutic value in meditation or they would not devote their professional career to studying it, so this opens up the question of expertise versus bias. I’ve often been told I have no business criticising research on homeopathy since I am not a practicing homeopath, but such an argument would seem to insist that only foxes be allowed to guard the henhouse, eh? :-)

    Anyway, my opinions are, of course, merely my opinions.

    “he’a not happy with meditation studies. His opinion is that meditation is “about as good as a nap.” I wonder how he rates the therapeutic value of naps?”

    There’s a bit of a mixup here, I believe, since Doug (the Philosopher) made the comparison between meditations and naps (we have similar sounding voices). I wouldn’t say I am “not happy” with meditation studies. I have only looked at a couple in any detail, and they seem to suffer from some significant deficiencies in terms of clearly defined questions, interventions, and outcome measures, but again I am not expert in the field. I would be happy to look at any particular study you feel is compelling evidence for the therapeutic value of meditation for a specific complaint and evaluate it from the general perspective of level of evidence, quality, methodology, and the sorts of appraisal criteria that is my area of expertise. Overall, I’m somewhat interested in the therapeutic potential of meditation, but I do consider it a challenging subject to study in a rigorous scientific way given the inherent subjectivity of the intervention and many of the outcome measures often looked at.

    Thanks for the comment!

  7. Doug Smith Doug says:

    Yes, the “naps” comment was mine. I can’t precisely recall where I heard it, but I believe it was spoken by a couple of skeptics with scientific/medical backgrounds. (E.g., something like ‘there’s nothing wrong with meditation, but it’s basically not shown to be any different from taking a nap’). Clearly at some level I do not accept this appraisal since I regularly practice meditation instead of just taking naps, but I am attentive to what’s considered the best evidence so far.

    It is also quite possible that these skeptics were in error about the state of the art, or spoke before the release of some new evidence, if so, I am sure we would all be interested to know. :)

  8. Mark Knickelbine says:

    A very interesting podcast — and I got two commute rides out of it!

    In general, I felt the “meditation” on discussion here was a little bit two-dimensional. While all the speakers mentioned the importance of applying mindfulness skills in life, in a lot of the conversation I sensed a bit of the common assumption that meditation is something we do in order to have meditative experiences which are somehow good for us. Of course the question for a skeptic would be, how can we judge the benefit of such experiences objectively?

    The longer I practice, the less that common idea about meditation seems to apply. The work of meditation is fundamentally, I think, learning and internalizing a new perspective on our experience and skills that help us reform our habitual reactions to our experience. From this perspective, “how we know meditation works” is more straightforward — have I learned the skills? Am I applying them? Am I any less caught up in habitual reactions? Such things are much more concrete and even objectively observable.

    Secondly, the “sangha question” needs more discussion. Gotama’s great insight was that the same relational processes we use when we interact with others can be used to “tame the self.” He also emphasized the brahma viharas as keys to liberation, and these are all relational. As a result, all practice is relational, and being in a practice community helps make that relational quality vivid and explicit. While it is true that, in a larger sense, our real sangha is everyone we encounter, being together with people who are striving to be open and present for one another creates an “intersubjective resonance” that is powerfully nurturing. It’s the best lesson that true practice isn’t simply what happens between our ears while we sit on the cushion. Sangha is not optional, which is why it’s so important that we set up opportunities where people with secular world views can come together and feel supported in their practice.

  9. Doug Smith Doug says:

    Thanks for the reply, Mark. I think we tried to get at a bit of your point about meditation — maybe clumsily — by distinguishing subjective and objective approaches, or meditation done for one’s own interests versus meditation done with a medical model in mind.

    Anyhow I agree with your point: meditation isn’t necessarily about experiences in particular, or even about health and well being; indeed it’s not clear that meditation is about any one thing in particular. It’s a complex practice, with any number of aims. That said, the point of the podcast was to bring together a scientifically minded skepticism with Buddhist practice: and in that case, what’s most germane is the objective stuff, the ‘how is meditation supposed to be good for us’, question. Because that is something that does come up within at least a Western-modeled practice, and is the sort of thing that, if it is true, is the sort of thing that could be measured. Other, more subjective questions are in a sense less germane to the skeptical approach.

    Re. Sangha, I agree with you. It is very, very important to a healthy practice to have a like-minded group of ‘good friends’ in the Buddha’s terms. The problem we all have, as was mentioned in the podcast, is in finding this group.

    • Tom Alan says:

      Unfortunately, science is not all that friendly. It’s full of controversies and contention, especially medicine, psychology, and the social sciences. The friendliest pastime I can remember is community theater — real team spirit among the cast and crew, because everybody wanted a good show I’ve also had a lot of friendly experiences in volunteer work.

      • NaturalEntrust says:

        Tom that is something I’ve felt too.

        “The friendliest pastime I can remember is community theater — real team spirit among the cast and crew, because everybody wanted a good show I’ve also had a lot of friendly experiences in volunteer work.”

        But as soon as party politics enter then all hell break lose.

        Okay back to skepticism. There are James Randi type of skepticism.
        http://www.randi.org/site/
        and there are CSI type of skepticism.
        Skeptical Inquirer is the official journal of the Committee for Skeptical Inquiry.
        http://www.csicop.org/si/

        and there are Michael Shermer type of being Skeptical.
        http://www.skeptic.com/

        As a naturalistic atheist I can see merit on all these.
        what I fail to see merit in is the Sam Harris way of
        being skeptical to natural science. In his book
        The End of Faith by Sam Harris he made references
        to the radical skepticism that Rupert Sheldrake
        and Dean Radin show them being very accepting
        of paranormal research that all of the other skeptics
        see as “woo”.

        So Sam Harris seems to be a more Buddhist type
        of skeptic. Buddhist come through to me as very
        skeptic of natural science take on what matter is?

        One famous example has to be Erwin Schrödinger with his
        two small books What is Life and …

        http://en.wikipedia.org/wiki/What_Is_Life%3F
        Or maybe Erwin where into Hindu views?

        Anyway it is a kind of skepticism that to me looks anti-science.
        It may be very pro-science in that Dali Lama and others wants
        to engage with scientists and they say that they will change
        Buddhism is Science is right and Buddhism is wrong.

        But I get the feeling they rather wants the Scientists to say nice things about their particular school of Buddhism. But I am maybe too skeptical?

        • Tom Alan says:

          NaturalEntrust, I have been discussing evidence of the therapeutic value of mindfulness-based therapy on this thread. Have you any opinions on this subject?

          • NaturalEntrust says:

            Could you maybe help me to find that text?
            I only by accident found this comment.

            I am not good at using software.

            I don’t doubt that practicing mindfulness
            can have therapeuptic value.

            I agree with Sam Harris though on this

            http://www.samharris.org/site/full_text/killing-the-buddha/

            quote
            If the methodology of Buddhism (ethical precepts and meditation) uncovers genuine truths about the mind and the phenomenal world—truths like emptiness, selflessness, and impermanence—these truths are not in the least “Buddhist.” No doubt, most serious practitioners of meditation realize this, but most Buddhists do not. Consequently, even if a person is aware of the timeless and noncontingent nature of the meditative insights described in the Buddhist literature, his identity as a Buddhist will tend to confuse the matter for others.

            There is a reason that we don’t talk about “Christian physics” or “Muslim algebra,” though the Christians invented physics as we know it, and the Muslims invented algebra. Today, anyone who emphasizes the Christian roots of physics or the Muslim roots of algebra would stand convicted of not understanding these disciplines at all. In the same way, once we develop a scientific account of the contemplative path, it will utterly transcend its religious associations. Once such a conceptual revolution has taken place, speaking of “Buddhist” meditation will be synonymous with a failure to assimilate the changes that have occurred in our understanding of the human mind.
            /quote

            My take is either that being mindful in standard English
            is not same as practicing mindfulness as a Buddhist do it.

            I think that practicing mindfulness as a Buddhist do it
            could be based on something that has a very precise
            Buddhist reference to a text in Pali and that it almost
            impossible to translate that Pali word and that
            being mindful in the ordinary meaning of the word is something else.

            Unless the usage of practicing mindfulness as a Buddhist has
            had so big impact that the directors of Dictionaries has adopted
            the meaning of practicing mindfulness as a Buddhist do it as the
            now current way to understand the word being mindful.

            example from one Dictionary.

            mindful
            attentive, aware, or careful
            (usually followed by of):
            mindful of one’s responsibilities.

            That is the standard usage of being mindful.

            Maybe the “Mind the gap” on the refuge?
            of a UnderGround is an example?

            One is responsible to not go too close to the train.
            One have to be mindful of the danger of standing
            too close to the train coming into the Station.

            I fail to see that practicing mindfulness is on that level?
            But I know too little. How do I find that text of yours?

          • Tom Alan says:

            N,

            I have posted the abstracts of two articles here, a meta-analysis of studies on the use of a mindfulness-based therapy, MBSR, for cancer and a meta-analysis of studies on the use of MBSR for anxiety and depression. These abstracts summarize objectives, methods, results, and conclusions of the meta-analyses.

            The cancer article: “The results suggest that MBSR may improve cancer patients’ psychosocial adjustment to their disease”

            The anxiety and depression article: “These results suggest that mindfulness based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.”

            I discussed the implications of these studies in my post.

            If you do a Google search with the article and authors names, you can find these abstracts and download the articles.

    • mufi says:

      Good discussion.

      I guess that my only lingering concern here is that the panel was overly dismissive of subjective criteria. If we go so far in that direction, then what basis is there for our concepts of mental health, subjective well-being, or happiness? How do we know if, say, an anti-depressant drug really works unless the subjects report improved mood or positive affect (over some period of time)? And how can we study consciousness without subjects reporting their first-person experiences, while neuroscientists try to correlate those with (technology-enhanced) third-person phenomena (a.k.a. neurophenomenology)?

      Sure, I get that subjective reporting is not as objective as, say, a blood pressure measurement. But sometimes (depending on the hypothesis) that’s just the best and/or only evidence available.

      So let’s not knock it. :-)

      • Ted Meissner Ted Meissner says:

        Hi, Mufi. I think that’s fair, it’s early in the development of scientific rigor around this kind of research. Happily, we all do share the expectation based on our experience with meditation at least being helpful to us, so we’re all on board that it’s Good Stuff :-)

        • mufi says:

          Glad we agree, Ted.

          By the way, I recently came across this interesting paper, Exercise, Yoga, and Meditation for Depressive and Anxiety Disorders, in which meditation appears to be less effective (compared with exercise and yoga) than I might have expected in treating these disorders. So my point was a more general, methodological one re: subjective vs. objective data.

          Off to my yoga class (in which my instructor’s usual Hindu woo will no doubt do wonders for my Secular Buddhist identity)… :-)

          • Ted Meissner Ted Meissner says:

            They do wonder, those yoga teachers!

            Ah, yes — you know it was Philippe Goldin who shared this kind of study at the MA symposium a few months ago. He and Richie Davidson both quoted several of the critics of studies, and said that the research can benefit from having tighter controls. Goldin was very open about the results of a study, not sure if it was this one you mentioned, that also had results that might be considered “disappointing” rather than simply giving good information. He was pretty clear that we need to avoid the file drawer effect that was mentioned earlier.

            So, good news all around, leaders in the community are recognizing that this is a great area for research, we may turn up things that surprise us, but we need to be honest about that because we’re learning what works.

  10. Tom Alan says:

    The potential harm of therapeutic mindfulness and other healthy lifestyle therapies is not side-effect risk but prejudice against conventional medicine. Stephen Ilardi, a clinical psychologist and researcher who treats depression and studies it at the University of Kansas, has said that some depressed people who take antidepressants would do better with lifestyle change. We should consider that he has NOT said this about all patients who take antidepressants, which is what extreme advocates of alternative medicine would say.. They denigrate medical science and promote unproven treatments.

    In its report “Anxiety” (available as PDF), the National Institute for Clinical Excellence (UK) recommends cognitive-behavioral therapy (CBT), medication, and CBT self help, depending on the individual patient.
    Some patients respond to CBT better than others. We would say the same for mindfulness-based therapy.

  11. Tom Alan says:

    Mufi, with regard to criteria, nine studies have shown the mindfulness-based treatment Dialectical Behavior Therapy to be the best treatment for borderline personality disorder, a mental illness characterized by what is called parasuicidal behaviors. The term is given to reckless actions such as DUI and suicide attempts that are not carried out completely. These studies used behaviors that could be verified as criteria, i.e. police reports and hospital admissions, in addition to participants reports of behaviors, such as binge drinking.

    The research is reviewed in Mindfulness-and Acceptance-Based Therapies in Practice by Elizabeth Roemer and Susan Orsilo of the Univ. of Mass.

    • Tom Alan says:

      Re my previous post, the following is a summary of findings in the 2007 study by Marsha Linehan and colleagues. Women with borderline personality disorder and past suicidal behavior participated. Number of participants: 101. Results with DBT were compared with control group results.

      From Roemer and Orsillo, p. 15:

      “Greater reductions in suicide attempts, medical risks associated with suicide attempts and self-injury, psychiatric hospitalizations, and emergency room visits in DBT vs. [control] across treatment and 12-month follow-up.

      Improvements in depression and suicidal behaviors in both conditions

      Fewer dropouts or change in therapists in DBT vs. [control].

      More group contact in DBT vs. [control].

      – from “Two-year randomized controlled trial and follow-up of Dialectical Behavior Therapy vs. therapy by experts for suicidal behaviors and borderline personality disorder.” Archives of General Psychiatry, 63, 757-766.

      • Tom Alan says:

        Mufi, I don’t know why you didn’t relate everything the article that compares yoga with meditation says about meditation. This sentence says it all —

        “Meditation had no clear treatment effects on depression or anxiety disorders,[23],[39] although it is effective for preventing relapse in patients with three or more episodes of depression. [25], [26]”

        As I have said on this thread, study of Mindfulness-Based Cognitive Therapy in which the program is compared with antidepressant shows that MBCT is effective in preventing relapse.

        • mufi says:

          Tom, I provided a link so that anyone who’s interested can read the entire paper – some of which does indeed report a positive effect from meditation (not to mention that it only addresses depression and anxiety, not other disorders). As I interpreted the paper, exercise and yoga have more clearly positive effects [e.g. "Several studies of exercise and yoga have demonstrated therapeutic effectiveness superior to no-activity controls and comparable with established depression and anxiety treatments (e.g., cognitive behavior therapy, sertraline, imipramine)."]. I certainly didn’t mean to suggest that meditation is thereby worthless in this regard.

  12. Doug Smith Doug says:

    Mufti, I think all scientific skeptics are rightly leery of subjective criteria for objective endpoints like physical health, because we’ve seen it all before. Every potential therapy, no matter how ineffective, produces subjective reports of improvement. (This is known as the placebo effect). So when it comes to a ‘medical model’ of therapy, that is, a therapy that is supposed to treat disease, we want evidence for something more than just positive self-reporting.

    The point I think we were at pains to make in the podcast is that one should not only look at meditation with the medical model in mind. Meditation may indeed, in the fullness of time, be shown to have beneficial effects on disease. It also, frankly, may not. But even so, meditation provides subjective benefits to those willing to put the time and effort into regular practice: it may, for example, help one gain insight into one’s own mental processes.

    • Tom Alan says:

      Doug, I refer you to the objective findings of Linehan and colleagues that I have cited, e.g., “medical risks associated with suicide attempts and self-injury, psychiatric hospitalizations, and emergency room visits.”

    • mufi says:

      Doug: To simplify matters, let’s just take depression as an example (even though I think that other examples – like the neurophenomenology project that I referred to – are equally important).

      According to the PubMed Health site:

      Symptoms of depression can include:

      Agitation, restlessness, and irritability

      Becoming withdrawn or isolated

      Difficulty concentrating

      Dramatic change in appetite, often with weight gain or loss

      Fatigue and lack of energy

      Feelings of hopelessness and helplessness

      Feelings of worthlessness, self-hate, and guilt

      Loss of interest or pleasure in activities that were once enjoyed

      Thoughts of death or suicide

      Trouble sleeping or too much sleeping

      How does a health care provider arrive at a diagnosis of depression without reliance upon subjective reports (e.g. “I’ve been feeling agitated and irritable lately”, “I’ve been contemplating suicide”, etc.)?

      Once the diagnosis is made and a treatment program has begun, how does one know if a treatment is effective without reliance upon subjective reports (e.g. “I’ve been feeling less agitated and irritable lately”, “I no longer contemplate suicide”, etc.)?

      Perhaps you’ll respond: “Well, yes, that’s because depression is a mental disorder, whereas our discussion was more focused on classic physical ailments, like cancer and infectious disease.” If so, then fair enough.

      But, given that many sources of suffering (like depression) are subjective in nature, and given that Buddhist meditation is traditionally focused on suffering (in general), that seems like an awfully narrow scope for a discussion about the therapeutic merits of Buddhist meditation.

      • mufi says:

        PS: Just to clarify my last comment, I’m not denying the possibility of objective criteria for diagnosis and treatment evaluation for depression (e.g. based on certain physiological readings). But then how do we even arrive at those objective criteria without correlating them with the subjective criteria listed above? In other words, the dual-criteria methods of neurophenomenology seem indispensable here, as well.

  13. Gert de Boer says:

    Mufi, I understand your concern. But there is of course quite a difference between researching the effectiveness of anti-depressants and meditation. One can give a patient a placebo in a double blind study instead of the real thing. With meditation this is difficult. In both the subjective reports are of the utmost importance, that is what it is all about: the subjective improvement of well being. But we want to know of both that they, well , objectively , work.

    For meditation one has only the subjective reports, and then in my view there are only two ways of objectively evaluating them: statistics (how do meditators do compared to none meditators), with all its problems if the correlation that might be found is a causal relation; or what you mentioned: try to find changes in the brain of meditators compared to none meditators. However, in a naturalistic world view, changes in subjective feelings are always correlated with changes in the brain. So we are rather stuck here, at least methodologically.

    • mufi says:

      Thanks, Gert.

      I hope that my reply to Doug above conveys my agreement with you that “we are rather stuck here, at least methodologically”, although I’m still less concerned about that than I am about the (radically skeptical) conclusion that any reliance upon subjective data is therefore of no scientific value.

      • Gert de Boer says:

        Sorry, maybe I was not clear. The problem arises when we only have subjective data. In the case of depression the subjective data can be used, because we can correlate them with the objective data if the person got anti-depressants or not. So yes, subjective data have scientific value, but they should be treated differently from objective data.

        Even more, when you are looking for the cause of subjective well being, then of course it is impossible to do without subjective data.

        But for me it is not quite clear how we can use this for evaluating the effect of meditating. It is just not easy to compare randomised persons, where one group meditates, and the other doesn’t. Of course that can be done, but I think you would get a complete other picture when persons are self motivated to meditate. But then surely you have no randomised groups anymore.

        And just as a note: I do not believe in positive effects of mediation in general. As remarked elsewhere, the psychological effects on health are limited, and so will be the effect of meditation.

        So personally, for me it is enough that I think I experience positive effects on my well-being. I don’t think a scientific conclusion that says ‘Meditation does not improve mental health’ will have any influence on me. If I enjoy the silence, and feel more balanced during daily life, I am happy with it.

        • mufi says:

          Gert, I don’t claim that one study (let alone one with a small sample) is conclusive, but your comment reminded me of a report that I read a while back about a study of the effect of meditation on cognition. This part in particular seems relevant:

          The experiment involved 63 student volunteers, 49 of whom completed the experiment. Participants were randomly assigned in approximately equivalent numbers to one of two groups, one of which received the meditation training while the other group listened for equivalent periods of time to a book (J.R.R. Tolkein’s The Hobbit) being read aloud.

          So we can now agree that, not only is an RCT possible here, but it’s already been done.

          Now imagine, ten or twenty years from now, a Cochrane systematic review is conducted, which concludes that meditation training significantly improves performance on such-and-such tasks. Would that still not be a valid test of meditation’s effects?

          That said, I agree that “it is enough that I think I experience positive effects on my well-being.” After all, I have no scientific support for my belief that, say, visiting an art museum is somehow good for me, yet I do it, anyway (and zealously so). It just feels right to me.

          • Gert de Boer says:

            Now imagine, ten or twenty years from now, a Cochrane systematic review is conducted, which concludes that meditation training significantly improves performance on such-and-such tasks. Would that still not be a valid test of meditation’s effects?
            Yes, of course. I said it is not easy, not impossible.

            Still, I think we miss something when we have a clear purpose for meditating. To promote meditation in the way ‘Meditation is good for you!’ seems somehow not fitting. It reduces meditation to some mental exercise, instead of means to get insight. When somebody is actively meditating, gets more concentrated on his work, and his work is weapon trading, I think he missed what (at least Buddhist) meditation is about.

          • mufi says:

            It reduces meditation to some mental exercise, instead of means to get insight.

            Gert: I emphasize the “means” in your statement above because I think it’s still the language of instrumentalism (or means-end rationality) – even though it substitutes insight for other (arguably, better defined) end (e.g. enhanced cognitive function).

            Whether such thinking is driven by human nature, Western culture, or a combination of both, it seems hard to get away from. Even if we try to do so, that itself appears like another example of it.

          • Gert de Boer says:

            Hah! You got me there…

            It is very difficult to express, think, and feel in a non-instrumentalist way. So let me rephrase a little, and say that somebody starts a Buddhist practice as a means to reach for lasting happiness and insight. That one of the results might be that seeing that one of the roots of the problem is seeing the world in instrumentalist terms is written in a next chapter…

          • mufi says:

            Gert: I’m in no position to confirm the potential long-term results. I just know that, here and now, I rely upon incentives to keep me motivated in my (semi-)daily practice. Some of those incentives are more emotional or “spiritual” in nature, like the sorts of quiet pleasures that you alluded to (e.g. “If I enjoy the silence, and feel more balanced during daily life…”), and some are more intellectual in nature (e.g. based on the encouraging, albeit provisional, results of relevant empirical research). Given the multitude of emotionally satisfying ways to spend one’s short time on this earth, the latter kind of incentive helps me to narrow down the options – e.g. to those that might actually do better than provide short-term feel-good effects.

  14. Doug Smith Doug says:

    Tom, to repeat what I said above, no careful skeptic will take single studies, or small groups of studies, out of context. There are studies purporting to show the effectiveness of homeopathy (viz., water and sugar pills) for a variety of illnesses, which homeopaths like to trot out in fora such as this one. To know that these are fallacious, one has to know the context; how the studies were done, what other, negative studies are out there or might have been ‘file drawered’. As I say, I am not an expert in the field of meditation as a medical treatment. The Cochrane folks are as close as I know to such experts, and they — as of today — claim to have found nothing. Perhaps they are behind the times, but if so, I am sure that their information will eventually be updated.

    As regards the issue of cancer and mental health, which wasn’t really the subject of our podcast but has come up in this thread, I note an interesting post out today on the Science Based Medicine blog HERE by James Coyne, Professor of Psychology and Director of Behavioral Oncology Research at the Abramson Cancer Center.

    • Tom Alan says:

      Doug, what do you mean? I have shown you two articles — a meta-analysis of MBSR cancer studies and a meta-analysis of MBSR mood disorder studies? What does this have to do with “single studies or small groups of studies out of context” ?

      Do you know what the word meta-analysis means?

      • Tom Alan says:

        Re my previous post, this is what is I quoted from the 2010 article by Hofmann and colleagues, “The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.”

        Objective:
        Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. Method: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions.

        Results:
        Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges’s g = 0.63) and mood symptoms (Hedges’s g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges’s g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up.

        Conclusions: These results suggest that mindfulness based therapy is a promising intervention for treating anxiety and mood problems in clinical population

  15. Doug Smith Doug says:

    BTW, sorry not to respond to the proper person in the proper place, but for some reason that function isn’t working on my iPad …

  16. Tom Alan says:

    As I’ve said, studies have shown that self help has been shown to be effective in treating mild to moderate depression. However, certain questions remain. It’s unclear as yet who benefits from self help. Belief in its efficacy would seem to be an obvious consideration.

    The report “Anxiety” (available as a PDF) from the National Institute for Clinical Excellence (UK) lists the following recommendations: cognitive-behavioral therapy (CBT), medication, and CBT self help — depending on the individual patient.

    When we say that MBSR may be recommended as a low cost/ low risk treatment for anxiety based on an acceptable effect strength, shown in the meta-analysis I’ve cited, the recommendation should depend on the individual. As with CBT, some people are better off with pills.

    Mindfulness can be regarded as part of a patient’s healthy lifestyle. There are different lifestyle preferences. Stephen Ilardi has pointed out that the best exercise regimen is one the patient enjoys. If you enjoy tai chi, you will stay with it. Ilardi prefers team sports because of the social activity. Meditation is not for everybody. Healthy lifestyle, however, is for everybody. According to a recent poll, many mental health professionals overlook the importance of lifestyle.

    In the case of DBT, this is clearly the best treatment for borderline personality disorder.

    • mufi says:

      On a personal note, one of the paths to mindfulness practice that I followed was through a self-help manual, called Mind and Emotions: A Universal Treatment for Emotional Disorders, which is based on techniques derived from CBT, DBT, and ACT.

      Mindfulness happens to be a component that’s shared by all three of those therapies and (according to the manual) is an effective treatment for specific “transdiagnostic factors” (or TDF’s, which are “dysfunctional coping strategies that start out as attempts to manage stress but backfire and end up creating severe emotional pain”). In particular, mindfulness practice (i.e. the exercises in the chapter, Mindfulness and Emotion Awareness) specifically targets rumination and experiential avoidance. (Other chapters and exercises target the other five TDF’s given, although there is some overlap between them.)

      That said, I don’t have direct access to the research on which these prescriptions are based (indeed, most of the references are guides for clinicians), so it’s fair to say that I put my trust in the expertise of the authors (Matthew McKay, PhD, Patrick Fanning, and Patricia Zurita Ona, PsyD). And, since the manual claims that mindfulness treats only two out of the seven given TDF’s, I never expected that mindfulness practice alone would be an effective treatment for multi-factorial emotional disorders, like depression and anxiety.

      • Tom Alan says:

        Mufi,

        This is a quotation from Roemer and Orsillo, the authors of the book on mindfulness therapies I mentioned. It’s from the article they wrote on generalized anxiety disorder.

        “The monitoring found in all cognitive therapy programs may be considered a form of mindfulness exercise.”
        – in Clinical Psychology: Science and Practice, March, 2002

        Certain things go together because of their similarity. The similarity of mindfulness and what’s called monitoring or cognitive hygiene is like lemon and lime. MBCT uses mindfulness as a medium for cognitive hygiene and reduction of rumination. See MBCT.com

        After reading Handbook of Self Help Therapies, I am reluctant to recommend a self help book unless I know something about it. The Mindful Way Through Depression was written by the founders of MBCT. That and its popularity are encouraging. The Handbook warns that many books by experts fail to show results. So far as I know, the only book with demonstrated effectiveness in treating mild to moderate depression is Feeling Good by Burns.

        • mufi says:

          Just for clarity’s sake, I don’t necessarily recommend Mind and Emotions as a self-help guide. I don’t follow it that closely myself. It interested me (when I stumbled across it at the library) because of its claim to combine proven techniques from CBT, DBT, and ACT into a single therapy. I only mentioned it here because of its relevance to the topic of mindfulness (although, interestingly, it doesn’t mention Buddhism even once).

        • mufi says:

          Oh, yes, and I guess I also brought up that book because of its modest take on the therapeutic value of mindfulness practice; i.e. not as a total treatment for depression or anxiety, but specifically as healthier alternatives to the “dysfunctional coping strategies” of rumination and experiential avoidance – the descriptions of which would, I suspect, be familiar to most Buddhist practitioners as the kinds of habits that mindfulness practice (e.g. meditation on one’s breath) tends to counteract.

  17. Doug Smith Doug says:

    Tom, I think we can do without the snark. I am quite aware of what the word ‘meta analysis’ means. There are several meta analyses claiming to show the effectiveness of homeopathic treatment as well. But the clue here is ‘garbage in, garbage out’. The quality of any meta analysis depends upon the quality of the studies included in the meta analysis. Re. the number of participants, that is one key variable but hardly the only one.

    To reiterate, my point here is not to claim that these studies you cite are erroneous. I don’t know enough about them to make that determination. It is simply to say that one has to look at the full range of studies available to know effectiveness. Perhaps the most famous group tasked with this sort of aim is Cochrane, which as I say, claims to have found nothing.

    • mufi says:

      I get that Cochrane has a good reputation among scientific skeptics (e.g. one of my favorite books, Trick or Treatment, relies heavily on Cochrane), but other systematic reviews have been cited in this thread (some of which cover Cochrane, as well). Are they all worthless? or just sub-gold-standard?

      • Tom Alan says:

        On the other hand, the meta-analyses I’ve cited might be erroneous, likewise the nine DBT studies. I think you should read them, them get back to us bout them.

        • Tom Alan says:

          When you do, I would like another thought on your napping comparison. When you consider these findings that I’ve quoted from Linehan 2007, do you think Dialectical Behavior Therapy is a better treatment for borderline personality disorder than napping?

          “Greater reductions in suicide attempts, medical risks associated with suicide attempts and self-injury, psychiatric hospitalizations, and emergency room visits in DBT vs. [control] across treatment and 12-month follow-up.

          Improvements in depression and suicidal behaviors in both conditions

          Fewer dropouts or change in therapists in DBT vs. [control].

          More group contact in DBT vs. [control].

          – from “Two-year randomized controlled trial and follow-up of Dialectical Behavior Therapy vs. therapy by experts for suicidal behaviors and borderline personality disorder.” Archives of General Psychiatry, 63, 757-766.

          • Tom Alan says:

            Re “snark,” Urban Dictionary defines this as “sarcasm.” You have said that you are not an expert. I have no reason to contradict you. I was not being sarcastic.

        • mufi says:

          Tom, I assume that these two comments (i.e. this and this) directed at Doug. Correct? I ask because they show up in the thread as replies to me.

          • Tom Alan says:

            That is correct. There’s a lot of traffic on this threat. I don’t see how we can delete these.

          • Tom Alan says:

            PLEASE NOTE

            Messages intended for Doug were posted under Mufi , beginning at Aug. 3, 12.30 PM

  18. Doug Smith Doug says:

    Re. the issue of meditiation on depression, there are some objective endpoints one can look at, as Gert notes. E.g., if a patient continues needing anti-depressant medication, if they are sleeping well, if they regain a normal weight, etc. But of course, any diagnosis of depression will depend as well on subjective reporting, which makes determining causal effectiveness of claimed treatments like meditation all the more complex and difficult.

    This sort of problem bedevils a lot of mental health treatments, as opposed to more objectively manifest illnesses like cancer, virus or a broken leg. And I certainly understand the professional who might be obliged to go with what seems best, given limited information.

    • mufi says:

      Doug: I grant that a provider can measure a patient’s weight in a relatively objective way. But weight loss (or gain) is only one diagnostic criterion out of many. To determine if a patient needs anti-depressant medication, by and large the provider must ask the patient how she feels. In other words, the role of objective criteria in diagnosis and treatment of depression seems small, at best.

      • Candol says:

        There are also visual clues to depression and if someone is seriously depressed, the visual clues are pretty obvious in many cases if not all.

        • mufi says:

          Candol, that’s true, although in my experience (as the parent of a child who was diagnosed with depression, among other things), the diagnosis seemed to depend more on stories related by oneself and one’s family – via private talk sessions and questionnaires (a.k.a. subjective data) – and less on direct behavioral observation.

          What’s more, our daughter usually behaves very differently in session than she does outside “in the field” (she “hates therapy” is the reason she gives us), so the therapist naturally draws all sorts of inferences from that limited exposure, which seems prone to error.

  19. Doug Smith Doug says:

    Mufti, the only ‘gold standard’ in science is consensus. There are various ways to determine such consensus, such as opinions publicly stated by major scientific bodies (e.g., stating the reality of anthropogenic global warming), or by looking at impartial bodies tasked with researching such things, like Cochrane.

    Absent those, the only other option is to find credible researchers with deep knowledge of the state of the art, and use them to try to find out if consensus has been reached.

    And yes, as I said, we are in agreement that mental health endpoints are more subjective and hence easier to mistake and harder to demonstrate.

    The other problem, which we mentioned on the podcast and has come up here as well, is determining precisely what counts as ‘meditation’ or even ‘mindfulness meditation’. If there is any variability in technique, that calls into question whether and to what extent studies are really after the same phenomenon.

  20. Doug Smith Doug says:

    … sorry, my iPad keeps changing ‘mufi’ to ‘mufti’.

  21. Dana Nourie Dana Nourie says:

    If you meditate just to relax, then my vote is for a nap. Naps are highly under-rated. I indulge in them frequently.

    If you want to learn how your mind and body work, how processes arise and fade away, how you create your own suffering, then Buddhist meditation is the way to go, and it may be anything BUT relaxing. It can be relaxing of course, but I view meditation as the tool to develop mindfulness, concentration, inner skepticism, and how the mind/body are one through a variety of processes.

    If I want to relax, what to fill myself with joy and warm fuzzies, I curl up with my go and watch TV or go to sleep. Chocolate works well too:-)

    • Gert de Boer says:

      Well, watching TV does not work for me. Reading books does.

      Naps are great. But if you were more balanced, you might not need them, because you live relaxed. And meditation might help with that.

      It is so to speak the difference between relaxing on the short term or the long term. Or to give another parallel: the momentary happiness because you enjoy your momentary activity, or the long-lasting happiness that even continues when you are in more difficult situations.

  22. Doug Smith Doug says:

    I’m sorry to say, Tom, I’m not in a position to go through studies for you. They really should be sent to organizations like Cochrane that can review the m objectively, in the context of other like studies. That said, neither conclusion from the meta analyses was very robust. Viz.:

    ————————————-
    CONCLUSION:
    The results suggest that MBSR may improve cancer patients’ psychosocial adjustment to their disease.

    And:

    Results:
    Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges’s g = 0.63) and mood symptoms (Hedges’s g = 0.59) from pre- to posttreatment in the overall sample. …

    Conclusions: These results suggest that mindfulness based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.
    —————————–

    Words like “suggest” and “promising” highlight that the matter is still unsettled.

    I think we have to be aware that as skeptics we are supposed to see the evidence from a disengaged point of view; to see it as a disinterested observer would see it, one who is not a meditation practitioner nor someone involved in establishing its validity. Personally, I view the results as plausible. But objectively, I have to await more complete and fuller evidence. That is, I have to await something approaching consensus.

  23. Tom Alan says:

    So we would be wary of MBSR if it were an expensive treatment or if it had high side-effect risks.

    At no time in this discussion have I made exaggerated claims. You have been dismissive.

    Please tell me what you think of the DBT studies.

    • Tom Alan says:

      Re my previous post,

      With regard to expense, I refer you to my comments on self help – MBCT is a computer program in the UK. The researchers have written a popular book

      MBCT – I refer you to the article mufi links us to comparing yoga with mindfulness. The article admits that MBCT is effective as a depression preventative

  24. NaturalEntrust says:

    Tom, I hope you can forgive me
    if I come through or my following
    comment get seen as questionable???

    But when I read your exchanges with
    Doug then I get reminded of something
    Buddhists tells me. That I cling to life.

    And I tell them that if I don’t cling to life
    then I lose life. I tell them that my body
    is not like their bodies. They can let go
    and still keep life.

    I may be very wrong and off base and
    totally biased and whatever but the way
    your defend these published papers come
    through to me as a kind of clinging.

    Maybe they give you hope. A kind of
    science assurance that mindfulness
    is approved of by Science.

    That mindfulness is evidence based treatment.

    Why is it so important to establish that now?

    I agree with Doug and others that it is way too early.

    We don’t know that now. Those studies that have
    been done does not have that weight to make us
    able to assert such thing. Too early.

    Our ability to feel good by any kind of attention
    or being part of a program of any sort makes all
    such research very prone to bias of each individual.

    I have supported “behavioral therapies” since the days
    of Skinner. Beck with CBT got even better result so
    I did put a lot of hope on CBT and defended that one
    and then Steven Hayes with ACT and then Linehan with DBT

    My take is that we simply don’t know enough now to
    make such assertions.

    When I say that from my point of view that it
    looks like you cling to that it has to be science
    supported already now that that is to cling then
    I don’t mean that as some debasing or dismissing
    looking down upon you or on mindfulness at all.

    I just mean that we have to me mindful enough
    to realize that if we don’t have reliable result
    then we need better research and not assertions.

    Thnk of the poor guy that came up with plate tectonics
    very unfortunate because very few could show results
    that confirmed it at that point. it was too early.

    Now there is consensus on that we do have plates that move.

    Maybe mindfulness is such and we only have to find the tools
    that can show it to be that effective but we don’t know this now?

  25. Ted Meissner Ted Meissner says:

    Gentlemen, let’s simply and companionably as fellow meditators agree that this is a beneficial practice, studies are promising, and more will be found with coming research.

    And then let’s move on.

  26. Tom Alan says:

    Doug, I really wish you would answer my question about the DBT studies. Don’t you think they provide objective evidence?

    • Doug Smith Doug says:

      Tom again, to know the quality of evidence I would have to do a thorough search for all published material on dialectical behavior therapy. There are hundreds of citations for it on PubMed. In particular, I would have to gauge the quality of the studies that were positive: sample size, control, effect, as well as corroboration from other studies. I don’t have time to do that. What I see right now would lead me to conclude it is “promising”.

      Have no fear though: if you are right, I am sure there will be high-quality follow up studies confirming the effectiveness of DBT, and eventually organizations like Cochrane will cite it as effective.

    • Doug Smith Doug says:

      Another issue that we touched on a little in the podcast is what counts as ‘meditation’. From the little I know of it, DBT isn’t simply ‘meditation’; there are other strategies involved. As such, even demonstrating that DBT has some beneficial effect doesn’t show that meditation alone has that same effect. One has to control all relevant variables.

  27. Tom Alan says:

    DBT is not “promising.” It’s a widely-accepted treatment, as these sources show. They refer to the treatment of borderline personality disorder, which DBT was originally designed for.

    National Institute of Mental Health:

    http://www.nimh.nih.gov/health/publications/borderline-personality-disorder/how-is-borderline-personality-disorder-treated.shtml

    SANE Factsheet, Australia

    http://www.sane.org/information/factsheets-podcasts/160-borderline-personality-disorder

    You offer no facts in support of your opinion..

  28. Tom Alan says:

    Doug, in response to your comment at 2:44 pm, Sept. 2, DBT is one of the mindfulness-based therapies.

  29. mufi says:

    It appears that there is also a Cochrane review in this case, and the results are indeed positive for DBT, as Tom suggests:

    Psychological therapies for borderline personality disorder

    That said, I also see Doug’s point, given the context.

    I guess it depends on the goal. If all we’re looking to establish is a contribution from Buddhism (i.e. its concepts and meditative techniques) to well-being – one with sound research to support it – then it appears that we have an example right here (albeit, a very limited one).

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