How could there be a placebo for meditation? A placebo has to replicate the experience of going through the 'real' treatment being trialled. How could you create the experience of meditation without the subject actually meditating? The claim being tested is simply that the experience of meditation is beneficial, so I don't know what form a placebo could take.
It would be OK to do a trial where one group is instructed to meditate and the other is not given any instructions, and you check back with each group in a couple of weeks and ask them how they feel. If there's a difference in the meditation group, that proves there is value in meditating. Placebo doesn't come into it, because no one is claiming there is any benefit to meditation that doesn't come from simply experiencing it.
For comparison, I once heard of a way of testing acupuncture against a placebo – someone invented needles that look and feel the same but don't actually penetrate the skin. So they could compare the reported benefits of 'fake acupuncture' with real acupuncture, and see if there's any health benefit to the physical intervention, or if it's all just theatre. And if it is all just theatre, that's OK – it doesn't negate the health benefits of acupuncture, it just helps us understand that it's all about the experience of having someone slowly and dramatically stick pins in you, which is interesting. It's not the same as saying that acupuncture doesn't work.
There are a mountain of studies that have been done on meditation. Among those that are controlled, there a few different strategies.
The best strategy is an "active control" group which receives some combination of education, attention from instructors, group therapy and the like which is matched with the meditation group for time and attention. This has subsets of "specific active control" in which the control is a known procedure (like exercise or progressive muscle relaxation) or "non-specific active control" in which the control procedure is not a known effective procedure and so is expected not to have any effect.
The other main control group used is a "wait list" or "usual care" control, in which the participants don't receive any treatment or only receive the treatment you would usually get for the condition under study, which isn't matched with the meditation group for time and attention.
A control group that does not do anything and does not receive anything is not using a placebo.
A placebo is very specifically a substitute for whatever you want to measure the effect of.
You can have both a control group and a group using a placebo and get substantially different results for them, and that's exactly why placebos are used: People report substantial effects from sugar pills and the like when they believe there should be an effect.
Your source does not support your claim that research has not shown that meditation beats a placebo.
Apart from pointing out that "meditation" is a wide ranging concept that includes a vast number of different, often contradictory, practices, and that a lot of the research is of poor quality (given the number of "research" papers coming out of TM affiliated sources alone - see blow -, that should not be a surprise), it relates a claim in a report from 2007 that amongst others claim "Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence". Without looking at what was covered in the papers that report looked at, this is not enough to support your claim.
The closest the article comes to dealing with the issue of placebo explicitly, is in referring to another article focusing on TM. TM is a cult-like money-grabbing business promoting one very specific form of meditation, and hardly representative of all forms of meditation practices. They're also one of the groups doing a lot of work to assist in churning out pseudo-science research papers to support their business, and as such did a lot to damage the overall quality of meditation research.
It might be possible to do a double-blind study on meditation, but you would have to be incredibly strict about the procedure for achieving a meditative state, and you would have to select people who know nothing about "meditation" as a practice both to administer bouts of meditation and to participate in the study. Then your part in the study would be to teach the controls the "placebo" practice and to teach the non-controls the strictly-defined meditative practice, and to convince all of the participants that they're meditating either way.
Unless you're testing Zen meditation in which case the placebo group and the real group may not (should not?) be distinguishable from one another.
It's often taught as "just sitting" so by the time you get the control group to sit down, shut up and hold still for half an hour every day they're doing the practice. Heck, they may be doing it better than the Zen meditators because they won't have anything extra attached to it at all :)
However, study of emotional response can be part of the scientific process. In fact, that's the basis of the advertising industry.
If I have tested meditation and found it predictably alters my moods (and similar examinations have been done for friends/family), is it fair to claim that is not science?
It is not science, but in the context of the original "start meditating" quip on this thread, it is what matters: If it works, it solves the original problem, whether or not it works because o the placebo effect or something else.
Research has not shown that meditation beats a placebo
Isn't that sort of irrelevant here? I think the OP's point is that it helps, not that it helps better than something else (wahtever that may be, even a placebo)?
A placebo often helps substantially. That is why we tend to test with a placebo rather than nothing at all, in order to measure the effect of what we want to test rather than the ability of our mind to influence our body.
And the effect is not merely psychological. Often placebo produces measurable responses.
Still though, the idea behind placebos is that they 're the most convenient thing to do compared to the alternative. It doesn't justify the suggestion to "meditate to increase T" more than "take a sugar pill to increase T"
The idea of placebos is to attempt to introduce a "noise floor" of sorts that lets you get an idea for how much of the measured effect is actually caused by what is being measured.
Generally you want a placebo that makes the test subject unable to tell which is the placebo. That will not be the case with just handing people a sugar pill and being honest about what it is. To have an effect of a sugar pill in such a setting you would have to tell people there is a chance the pill is some form of medication intended to produce similar effects.
The problem with that is that if the effects of meditation are just placebo, what you end up measuring is the strength of peoples beliefs about the efficacy of meditation vs. the efficacy of drugs - you're not comparing like with like, and can't rule out additive effects of combining the two (whether or not they're both caused by the placebo effect) either.
And even if it is all placebo, that does not mean it may not be justified to suggest to meditate. In fact, it is a long standing debate of medical ethics whether - and if so when - it might sometimes be justified to utilize placebos as medical treatment, because it can often have real, measurable physical effects on peoples health.
The issue with that is that you'd be lying to a patient, and it might undermine peoples trust in the medical profession. That is not an issue with an off the cuff suggestion to people to meditate from someone not claiming to be a doctor.
Also, I haven't seen anyone here suggest meditating to increase T, but giving an off the cuff remark suggesting meditating to address "psychological worries" people might have 10-20% of the time. Serious psychological issues needs professional treatment, but I took his comment, given the context, the term "worries", and the implication they'd only be there 10-20% of the time to mean general stress and light performance anxieties, in which case meditation either works for you or it doesn't.
If it does, it does not matter if it works because of the placebo effect or not. If it doesn't, then no harm done and you can consider TRT.
The point of his comment seemed to be that most people do not need TRT, but fall in the normal range and should consider other factors first. I'm saying that as someone who will seriously consider TRT when I'm older (I'm turning 40 this year)
Wordplay? If it helps just as much (which technically is also 'not more'), it could still help since a placebo might help. Hell, even if it would help 'less' than a placebo it might still be helping since I didn't quantify exactly how much :P
Yeah again, if you only want to go after research, you might run in circles. Meditation has helped me and a lot of people I know, a lot. Whether it will work for you in your circumstances is a different question. But then: The study won't be much help, because you might have different variables in your life.
The question is not if Placebo is an efficient method. We know for sure that it is. The question is if training and practicing meditation is better than doing nothing.
If you don't beat the placebo, it could mean that there's nothing to train and practice.
It is meaningless to speculate on this without a concrete paper doing a concrete comparison of a specific concrete form of meditation vs. a concrete form of placebo, and without knowing whether or not the placebo was compared to a control group doing nothing.
You're right, it could mean there's nothing to train and practice. It also could mean there'd be a substantial placebo effect and a big gap from "doing nothing" to either the placebo or meditation, in which case, even if meditation were to turn out to be 100% placebo effect it would still be worthwhile to train and practice unless said researchers were to come up with a placebo that works just as well with less time spent.
What I know is that meditation has substantial subjective benefits for me. I don't care if that's 100% placebo effect and/or if I'm just tricking myself in other ways.
Because you know what? It doesn't matter.
Meditation makes me feel relaxed. It makes me feel as if I get insights into my mind and thought processes. It makes me feel like I have more energy. It make me feel more in control and in touch of my emotions and the world in general.
No matter the actual biochemical and psychological reasons for those feelings, they're still just as worthwhile outcomes to me.
That's easy to lose sight of.
Beating a placebo is an important measure when looking at drugs, because they pretty much all have potential risks and downsides (including the downside of cost). Showing provable effects is also important if considering prescribing meditation practice for psychological disorders, for example, because it could mean avoiding other treatment.
It is also worthwhile in order to learn more about the processes involved, and see what effects can be proven.
But it is largely uninteresting when considering casual meditation for someone who expects only subjective effects on mental state. In that case, what matters is mainly whether the perceived effects are sufficiently positive for someone to find it worthwhile to continue.
If it's all a trick of the mind, then fine. It still feels great.
Great answer, and I agree with you. As a practicer it doesn't really matters as long as you get your dose of well-beingness.
I was more thinking of all the "train yourself to meditate" thing which can end with more frustration than relaxation for some, relatively of the scientific measure of this training (which is imperfect as we just saw).
On a side-note, I practice relaxation on the evening and I don't see such huge effects on my mind but "only" a greater sleep (which is already great). Could you share some of your practices ?
I only practice mindfulness meditation with varying frequency, sitting anything from about 5 minutes to 30 minutes, rarely longer.
Typically mindfulness meditation starts with basic breath meditation: Sit in a stable, comfortable position, focus on your breath and notice it going in and out. If thoughts appear, try to keep focus on the breath but don't force the thoughts away, just try to let them dissipate without continuing them.
The big difference for me with unstructured relaxation was that it was hard at first to focus on the breath. My mind produced all kinds of objections to sitting there and paying attention.
Sitting for 5 minutes like that caused my mind to practically rebel. Then I went through a period with dream-like states (one of the most memorable effects, which I've only had a few times, was like seeing a dream unfold around me, but while dreams always feel "fuzzy" and unclear for me this was as if I was standing in the middle of a theatre set, seeing everything clearly, yet knowing it was not real).
Then I had a period of what is something referred to as "monkey mind" - all kinds of distractions piled on. Then I went through a period where I would suddenly get an intensely strong belief that I'd forgotten to set my alarm and was going to be late. I knew I'd set my alarm, but the feeling would become unbearable until I looked at my (set) alarm. I had to solve that by triple check the alarm before I started, and telling myself it was set, and telling myself it didn't matter because I had lots of time free after it was set to go off, and then it stopped happening (and I don't triple check my alarm any more).
These distractions were not constant, and I could sit longer and longer before they'd set in. After a few weeks of daily practice they were weakened enough that I started feeling I was getting somewhere.
Once I'd gotten past those distractions, it changed nature very strongly. Now I slowly sink into more and more relaxed states depending on how long I sit. At about 20 minutes I will generally start feeling as if I am noticing the pulsing of blood in my eye lids and pressure on my eyes (I have no idea if those are real physical sensations or not - doesn't matter to me) and see patterns similar to what you might see if you squeeze your eyes firmly shut and feel a sense of blissful calm that makes it tempting to just stay like that.
If I sit longer and focus, those feelings dissipates as I get calmer and more concentrated and I can best describe it as if my mind is "emptying" and clearing of whatever feelings the sense of bliss brought, and it feels more steady and crisp. It's very hard to relate the sensations of it with words.
If I sit to the "bliss" state or past, I will feel an immense feeling of calm once I finish that will often last for hours afterwards.
I'd recommend the frequently recommended Mindfulness in Plain English (available for free online, or from Amazon etc.) or Introduction to Mindfulness (free podcasts) by Gil Fronsdal. Both are no-nonsense secular introductions and very simple, basic practice to try out and see if you like the effects.
If someone is stressed (from work, relationships, etc) we accept that it can and does have negative effects on our physical being. I would have thought that meditation would easily fall into the category of doing the opposite. Seems pretty obvious to me.
"Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior."
This directly contradicts the GP's claim that meditation is ineffective, and supports the OP's claim that meditation is a good way to deal with "psychological worries".
More information to satisfy the complaints of my critics regarding the date, definitions, forms of meditation, etc:
A systematic study on the efficacy of various forms of meditation programs (inc mantra, transcendental, and mindfulness meditation), commissioned by the US Agency for Healthcare Research and Quality, was published in 2014.[67] After a review of 17,801 citations, the study based its conclusions on 41 randomized controlled trials with an active control, involving 2,993 participants.
The assessment found "no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight."
Amazingly, you have cherry-picked the part of your source that agrees with you.
This is the full quote, including the bits you left you:
"Mindfulness meditation programs had moderate evidence of improved anxiety... depression... and pain... and low evidence of improved stress/distress and mental health–related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight."
The same source goes on to conclude,
"Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress"
You should be aware that the "CSM Mantra" (?) and "TM" meditation are very fringe forms. When most people say "start meditating" they're generally not referring to those. I personally consider TM to be neutral-to-harmful and I've never heard of this CSM Mantra until just now.
Mindfulness meditation, which is the only form tied to the 2,500 years of Buddhist meditation tradition, did ok.
Interesting is the graph of the results where you see the mindfulness meditation fared better than the "mantra" meditations pretty much across the board (even though most of it wasn't statistically significant.)
It would be OK to do a trial where one group is instructed to meditate and the other is not given any instructions, and you check back with each group in a couple of weeks and ask them how they feel. If there's a difference in the meditation group, that proves there is value in meditating. Placebo doesn't come into it, because no one is claiming there is any benefit to meditation that doesn't come from simply experiencing it.
For comparison, I once heard of a way of testing acupuncture against a placebo – someone invented needles that look and feel the same but don't actually penetrate the skin. So they could compare the reported benefits of 'fake acupuncture' with real acupuncture, and see if there's any health benefit to the physical intervention, or if it's all just theatre. And if it is all just theatre, that's OK – it doesn't negate the health benefits of acupuncture, it just helps us understand that it's all about the experience of having someone slowly and dramatically stick pins in you, which is interesting. It's not the same as saying that acupuncture doesn't work.