Meditation – scientifically validated and with osteopathic references

Table of contents

What does meditation mean?

Meditation is an umbrella term for many different mental practices that have been practised for thousands of years in various religious traditions. Meditation is a central element, particularly in Buddhism, Hinduism and Christianity. Since the 20th century, meditation has also become increasingly popular in the “Western” world, and science and research have been exploring the field with growing interest. An essential element of all meditative techniques is the conscious direction of attention, with the aim of achieving a state of inner calm. This state can also be understood as thought-free awareness. The body scan is also a form of meditation; see the Body Scan article.

What meditation techniques are there?

Basically, two types of meditation are distinguished:

1. Passive meditation: focusing attention while sitting or lying down, without moving
2. Active meditation: this additionally involves physical exercises, e.g. in yoga or some martial arts styles. Chanting mantras or praying are also included.

There are now countless meditation techniques. What they all have in common is a focus on one’s inner world by gently directing attention inward, e.g. by concentrating on the breath. In a sense, you become a quiet observer of your own thoughts as well as feelings and emotions, without judging them. The art is to remain in the observing position and not be carried away by emerging distractions. This is particularly challenging for beginners, but it becomes easier with practice. Tip: drifting away from conscious perception and observation is completely normal. If, while meditating, you notice that your thoughts are everywhere except on your breath, acknowledge this and gently, without judgement, bring your attention back to your breath.  By the way, when meditating you can also focus on things other than your own breathing rhythm. Other objects could include physical sensations, emotions, smells, sounds, or an image in the mind’s eye.  

How do I meditate correctly, and how often should I meditate?

First of all, you should let go of expectations of immediately reaching a transcendental state and avoid putting pressure on yourself. You cannot really meditate “wrong”! However, especially at the beginning, it takes a little discipline to make meditation a regular practice. What “regular” means for you is for you to decide. At the start, it is worth trying out different meditation exercises—because not all techniques are equally suitable for every person.  

How can I learn to meditate?

There are various ways to learn meditation:

• In-person courses
• Exchange with other beginners and advanced practitioners
• Books on meditation & meditation exercises
• Online courses & numerous videos on guided meditations
• With apps

Meditation and osteopathy

When patients come for a consultation, their complaints and symptoms represent only the tip of an iceberg. Beneath that, usually relatively unnoticed, a multitude of longer- and shorter-lasting, more or less interacting influences, mutually reinforcing or mitigating risk factors, mechanisms of action and influences are at work, such as genetics, the course of pregnancy, pre-, peri- and postnatal factors, stress early in life, infections, accidents, top-down and bottom-up processes (for example belief systems, emotional experience, autonomic states, etc.), living circumstances (profession, partnership, finances, family situation, friendships, housing situation), lifestyle habits, and states of the metabolic, immune, hormonal, respiratory, cardiovascular and musculoskeletal systems. With osteopathic touch, we can also grasp certain parts of the invisible iceberg. However, this requires further specialist knowledge and perceptual tools, which is why I developed psychosomatic osteopathy (Liem, Neuhuber 2020a); see article. Patients can actively support their osteopathic treatment by training their mindfulness for the interactions that are constantly at work in their lives, thereby becoming better able not only to perceive them, but also to assume responsibility for themselves and their environment more effectively and appropriately.

Moreover, intensive training in meditation and mindfulness appears to improve osteopaths’ haptic threshold (Sange 2013).

Sange, S. Influence of mindfulness exercises and meditation on haptic perception. Manuelle Medizin. 2013; 51: 479–483.

The effects of meditation on body and mind – current state of research

1. Mindfulness meditation and the immune system – The results of a systematic review from 2017 suggest possible effects of mindfulness meditation on specific markers of inflammation, cell-mediated immunity and biological ageing. Mindfulness meditation may have salutogenic effects on immune system dynamics, but further work is required to investigate these effects in more detail (Black et Slavich 2017).
2. Meditation and brain organisation – An Italian meta-analysis used existing neuroimaging data to examine the effects of meditation on brain structure and function. The results show that meditation leads to activation in brain areas involved in processing self-relevant information, self-regulation, focused problem-solving, adaptive behaviour and interoception. Furthermore, in experienced meditators, meditation practice leads to functional and structural brain changes, particularly in areas involved in self-referential processes such as self-perception and self-regulation (Boccia et al 2015). Top-down therapies such as imagination or meditation initiate conscious and voluntary mental processes at the level of the cerebral cortex (Taylor et al 2010).   They bring about a shift in brain function, associated with a reorganisation of neuronal representations within the CNS and improved bidirectional communication between the cerebral cortex and the limbic system as well as brainstem structures that regulate autonomic, neuroendocrine and emotional behaviour (Liem, Neuhuber 2020b, Craig 2002, Critchley et al 2001, Saper 2002).
3. Meditation and gene expression – It is now considered established that our environment influences gene expression, and not only physical influences; psychological, social and cultural components also play a role in gene expression. The first studies on yogic and meditative practices suggest that these practices positively influence gene expression profiles in immune cells in the bloodstream. This shows that mindfulness training can benefit physiology at its most fundamental level. However, further studies and meta-analyses are necessary to evaluate the exact molecular networks (Saatcioglu 2013).
4. Mindfulness-based meditation and chronic pain – The therapeutic effectiveness of meditation for chronic pain has been well documented since the 1980s. In a 10-week study, mindfulness-based meditation was used for stress reduction, relaxation and self-regulation in 51 chronic pain patients. The meditation intervention was effective for back, neck, shoulder and headache pain, as well as facial pain, angina pectoris and non-coronary chest pain. As a mechanism of action, the study proposed the development of a mindful attitude towards proprioception (perception of one’s own body in terms of its position in space, the relative positions of head, trunk and limbs, and their changes as movements, together with the sense of heaviness, tension, force and speed). Detached observation of the pain experience appears to decouple the sensory dimension from the affective response and reduce the experience of suffering through cognitive processing (Kabat-Zinn 1982). More recent research is now using neuroimaging techniques to elucidate the neuronal mechanisms of cognitive strategies in pain processes. A high-quality review from 2018 concluded that cognitive and meditative therapies can alter the function of brain regions in an extensive network, including non-nociceptive regions. In patients with chronic pain, neuroimaging results showed increased activation of the prefrontal cortex and the limbic system, while in healthy individuals increased activation of the anterior cingulate cortex and anterior insular cortex and decreased activation of the thalamus were observed. Overall, cognitive and meditative therapies reduced affective pain experience. This systematic review therefore demonstrated that meditative techniques lead to morphological brain changes (Nascimento et al. 2018).
5. Meditation programmes for psychological stress and well-being – A large meta-analysis examined the effects of mindfulness meditation programmes on mental health and overall well-being. In total, 47 studies with 3,515 participants were included. The analysis found that meditation can make a significant contribution to reducing stress, anxiety and depressive moods. Based on these data, the research group concluded that meditation programmes contribute to reducing the negative dimensions of psychological stress (Vieten et al. 2018). Meditation can also reduce stress by activating the vagus nerve (Gerritsen et al 2018, Telles et al. 2013). For example, “loving-kindness meditation” increased positive emotions through improved perception of social relationships, which in turn led to an increase in vagal tone. However, this effect was achieved only in those individuals who actually felt increased joy and social connectedness (Kok et al 2013). It is assumed that vagal activation also occurs via deep breathing during meditation (Gerritsen et al 2018). Since, as in yoga, there are many different types of meditation, these variations could be taken into account in future studies. Mindfulness meditation also improves emotion regulation and reduces amygdala responses (Kober et al 2019).
6. Meditation and eating behaviour – Initial research findings suggest that mindfulness meditation could be an effective intervention for excessive eating (binge eating). A systematic review from 2014 provided the first evidence that mindfulness meditation can effectively reduce binge eating and emotional eating (Katterman et al. 2014). Mindfulness has also been associated with increased creativity (Lebuda et al. 2016), offsetting age-related cognitive decline (Gard et al. 2014), and improved attention in adolescents in educational settings (Felver et al. 2016, Shapiro et al. 2015). The positive effects of meditation on physical and mental health are well supported by scientific evidence. Nevertheless, it can sometimes be difficult to establish new behaviours in the long term. Therefore, below you will find helpful tips for integrating meditation into your everyday life over the long term:

• Create a dedicated meditation space
• Wear comfortable clothing when meditating
• Experiment with different postures (cross-legged, lying down, sitting on a cushion)
• Start with short sessions of max. 10 minutes
• Lower your expectations
• Do not rush after meditation

What risks should be considered?

In meditation, there is a risk of absolutising one’s own inner experience. However, the contents of one’s awareness are one thing; the psychological individual and collective structures against whose background contents of consciousness are first “seen” and interpreted are another. These structures are largely inaccessible to a purely phenomenological practice (Liem 2008).  A merely subjective inward gaze—even if pursued with the utmost sincerity and devotion—cannot recognise them. Through a “monological” inward gaze, we can indeed study the phenomena of our individual consciousness ever more closely, but neither psychodynamic aspects nor developmental structures can be noticed and identified in this way. These become possible only through an understanding of the respective individual and historical-cultural contexts, for which a dialogical and hermeneutic practice is indispensable (Liem 2011).  Not infrequently, it is precisely here that an extraordinary reluctance prevails “among certain meditators”, encouraged by the fact that seductive monopolistic models, with their promises and not infrequently demands, easily tempt us to surrender our autonomy at the outset. This results in absurd, sometimes dangerous, blind adoption of Indian, Tibetan or Japanese meditation techniques and systems in Western meditation courses. Fundamentalist traits (under no circumstances deviating from the original system), especially in combination with rigid personality structures and ignorance of Western reflective achievements, make one blind to such insights. The problem also lies in the fact that the explanatory models of the respective meditation—their theoretical models and traditions based on metaphysics—may have been coherent at the time of their emergence, but are no longer so today. Not only because their explanatory attempts do not withstand contemporary discourse, but also, for example, because at that time they were simply not able to take intersubjective, i.e. cultural, influences into account and instead attributed absolute validity to subjective experiences.  Furthermore, the respective meditations are often embedded in metaphysical religious explanatory models because, a few thousand years ago or several centuries ago, they simply could not be explained otherwise, since it has only been possible for a few decades to research the neurophysiological and neuroanatomical correlates of meditative experiences. Fields of knowledge so significant for human consciousness as psychoanalysis and developmental structuralism are only about 100 years old, whereas the practice of introspection has been handed down for millennia, which is why one finds little of the former in the traditions—and cannot find much (Liem 2008). By unreflectively following these old models, modern practitioners of introspection are unreflectively also given the archaic, magical and mythical contents of the traditions as “timelessly valid” truths. The problem is that today’s “meditator” cannot recognise this infection of consciousness by the early intersubjective contents of the teaching, no matter how much introspection is practised. Indeed, one of the major weaknesses of the old teachings is that they could not yet understand that meditators’ subjective experiences are not truths per se, but are largely determined by collective intersubjective and individual psychodynamic contents. This can, in the “meditator”, partly give rise to deep inner experiences with no longer appropriate frames of reference, with the risk of reductionist, narrowing attitudes that unfortunately hinder the “meditator” in many of their other developmental lines rather than supporting them. What is usually needed here is not a major change in the respective meditation practices, but rather a supplementation of the old teachings, a relativisation of the monopolistic frames of reference of the old traditions, and integration into the more differentiated, more integrated, more comprehensive—i.e. more developed—frameworks of postmodernity (Liem 2011).  Incidentally, something similar also applies to the unreflective adoption of perspectives from the early days of osteopathy, especially when cultural, social and scientific-historical conditions in the development process of osteopathy are not taken into account. ReferencesBlack DS, Slavich GM. Mindfulness Meditation and the immune system. Physiol Behav. 2017;176(3):139-148Boccia M, Piccardi L, Guariglia P. The meditative mind: A comprehensive meta-Analysis of mri studies. Biomed Res Int. 2015;2015Craig AD. How do you feel? interoception: the sense of the physiological condition of the body. 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