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Copyright 0 1985 Pergamon Press Ltd.

MEDITATION AND ANXIETY REDUCTION:

A LITERATURE REVIEW

M. M. Delmonte
Psychosomatic Unit
St. James4 Hospital
Dublin 8.

ABSTRACT. Meditation is increasingly bring @u?icud as a therapeutic technique. The

effects of pv-actirf on psychometrically assrssed unxipty leuel,s hazer been Pxtmsiuely researched.
&-osfiPcti-i,umeditators tend to r+ort aboz,P allCrap ie-oek of anxiety. In gPnPv-al,high anxiety
Gvels @dirt a subsequent low ,frequrncy of kracticp. Howczler, the e_ckLencusuggests that
those who pa&P regularl? tend to .show significant drcreusrs in anxiety. Meditation does
not appear to br more pfffctz-ilp than comparative intpnlmtions in reducing anxiety. There is
ezlidence to suCgpt that hypnotizability and exppctuncy may both play a role in reported anxiety
decrPmPnt.s. Cprtain indi-rJidua/.c,with a capacity to engage in uu~tonomous .selfabsorbed
rrlaxation, may bmpfit vnostfrom meditation.

Meditation is becoming more prevalent as a self-management and self-mastery

technique, as well as an adjunct to psychotherapeutic intervention (Candelent &
Candelent, 1975; Delmonte 8c Braidwood, 1980; Glueck 8c Stroebel, 1975). To date,
there has been no extensive review of the research literature in relation to the
effects of meditation on self-reported anxiety levels.

TYPES OF MEDITATION

For the most part, this review will be limited to those forms of meditation in which
one’s attention is focused (restricted), such as in Transcendental Meditation (TM)
and Zen Meditation, as opposed to the various “opening-up” exercises. The former
“concentrative” techniques are widely practiced in North America and Western
Europe, whereas the latter “mindfulness” approach is less well known and has only
occasionally been the subject of research in the West. In concentrative meditation
one’s attention can be focused on a variety of objects such as a sound (mantra), a
candle tlame, one’s breath, and so on. The above two types of meditation are not

Requests for reprints should be addressed to Dr. M. M. Delmonte, St. James’s Hospital,
Psychosomatic Unit, Dublin 8. Ireland.

91
;~l~)ltite cate,gorics as fhcrc ia :I cc.t-lain ;ii~tot~ttl of ocedap (SW Orristein, 1972, toi
;I mow c~otnplrl~ disc-ttssiott).

MODELS OF MEDITATION

Mctlitalioti has Iwrn viewed frotii both psychoan:ilytic attd l~ehavioral perspectives.
For csatriplc, tiiedilatiott is secti as adapti\e regi~essioti in the service of‘ the ego
(Shalii, 1973) ot as “;I wrt of. Ko)xl Koxl to the ttttconscious” (Jung, 19.58, p. 508).
(~olctnmt (197 I) buggc3tetl that tt~ecliratioti nt;i): be (3)ticeptualiad as SIOM’self-paced
s~sletnatic clesctisitil.~ttioti. Othrrs have tltwrtbrd meditation as 2 techttiqur that
itiwlvcs t-cc-iprocal inhil)itiott 2nd cottntt’r cotttlitiotiitig Iwtlittg lo tlesensitization
of. atixit.ty rvokittg Ihoughta (Ue1-~4%k Lb OAel. 1973; Mikdis, I98 1; Shapiro &
%if‘f~rhlatt. IW6). hledit~triott is also twcisagect as ;I r~lasatioti techtiique (C;r-ren-
wootl SCBensott, I977; Sltapiro &I Ziff’erl~Litt, 1976). Iti fact, (;rcettwood and ISenso~t
( 1977) h;tw at-gttetl that tneditati\~e relax;ttioti is ittore appropriate 1hi abbreviared
rclaxatiott traittitig as ;I t~eciprod itthil~iror itt systematic tlesetisitiz~ttiort. Koals
(1!)7H) c-ontcticlrd that c-Ltssicdl contiitiotiitig elicit5 cltanges iii the direction of. re-
Lixatiott when the. tttattlrii I~ecotncs ;t cotitlitiottetl id~txatiott ariniulus. Delniontc
( 197!I) provitlcd tGtl~ttc_r tltat ;I tiiiititm may hecome ;t contlitiotied stiniulus eliciting
;I condition;il relaxation respotisc in terms of frotitalis lCYl(;. ‘l‘he sane tionrtiedi-
tatol-s had signif’iwtt~ly lChf(i leccls while
lowt~ tdtxittg \vith closrtl eyes than wldc
suhvcally repeating ;I tn;tt1tr;1.
.1lantr;t rcpetitiott had pt-eGottsly been pail-d with
fl-ontalis Ehl(; biof’cctllmck training dttring fi)tir sessiotta wet- f’our consecutive
days. Finally, CLirpctiter- ( I977) sttygsted that tneditati\~c rxercises provide tht-eta
therapeutic gains, ttamcly insight into repetitive self-defeating patterns of behavior
and thinking (e.g., cravings), desensitization of painful thoughts, and “condition-
ing” of’ the wtttt-al tierwus systcvti.
.lltt3y arc fl-equettt ;ttiecdolal tqwr(s of“‘ttttstI-cssittg” ~i~~ottt~);iti~.ing: the practice
of meditation. (Iat-ringtott antI L’.phroti (1075) suggest that rttistrcssing is ;I fi)rni
of catharsis by nicatts of which pwvious triiittiiatic or stressf‘ul events are released
slJotit;ttteottsl~. LTnstrrssing
is the littk hetwectt the tJs)“‘tio;tti;t1!.tic- and the heha\:-
ioral tnotlelb of‘ twditarion, as it invokes hotlt rhc 1Js)~llo(lvtt;t~~~i~ concept of
“breaching the rcpressioti harti~r” and I he behavioral noCon of‘ ctesetisitizatioli.
Smith (l!US). in mi vxtcttsivc review of‘ the ps~~hotliet-~iI,~ttti~ effects of niedi-
ratiott. noted that “vit-~tt;tl1! c\ery schoc~lof’~~s~~~~~ologic~;tl thought” has I)een invoked
to supl)otA tItt> cl;titit Ihat tneclitatioti practice is iwwfici;il. lHe coticltrdctl, rather
~~;it~sirtionioirsl~, however, I haI thr thci-apeittic ktiefits fbutitl could t)c the result
of exlwctatioti of’ t-dief or of’ simply silting on ;I regular basis. I le later produced
evidence to strppor( this cotttettlioti (see “Nott-Sprcif’ic Factors”).

TYPES OF ANXIETY/AROUSAL

Handron ( 19.59) and Huss ( I96L’), 1)): f’aclor att;tlyhg attxiety SC‘OI~~S obtained f’rotn
psychiatric patienls, ohtaincd two faclors (‘psychic’ and ‘somatic anxiety) which
;ic-couttttd fbr- the ~tii~jor pot-lions ot‘ the vat~iancr iti anxiety qucstiorimire scores.
Sc~hallitig, (~rotiholnt. ;ttid Asher,q (1975). antI SchwatY/. I)avidsoti. and <;oleman
(197X), having extctisicely reviewed the literattirt., hypothrsi/etl thar anxiety is made
up of cognitive and somatic components. Davidson and Schwartz ( 197(i), with theil
“multi-process” model, postulated that somatic and cognitive components of arousal
would differentially respond to different forms of relaxation. More precisely, they
posited that the different relaxation techniques, (i.e., primarily cognitive versus
somatic) “will be more effective in reducing same mode vs. other mode anxiety”
(p. 426). Similarly, Schwartz et al. (1978) argued in favor of “differential effects
of a somatic (physical exercise) and a cognitive (meditation) relaxation procedure”
(p. 321). In other words, they contend that specific suhcomporlents of anxiety may
be differentially associated with relaxation techniques engaging primarily cognitive
versus somatic subsystems. They offered some (poor) retrospective evidence that
subjects practicing physical exercise reported relatively less somatic and more cog-
nitive anxiety than meditators (the two groups were neither matched nor formed
by random assignment). The above multi-process 1node1 is opposed by the 01de1
unitary relaxation response model of Benson, Heal-y. and Carol (l974), who posit
that the various relaxation techniques all elicit a general relaxation (trophotropic)
response involving all systems in concert.

METHODOLOGICAL ISSUES

Anxiety can be evaluated in terms of several criteria (e.g., behavioral, psychophys-

iological, and psychometric measures). This review focuses primarily on the effects
of meditation in terms of psychometric (i.e., self-report) ratings of anxiety. Phys-
iological and biochemical outcome criteria have been reviewed elsewhere by the
author. The studies reviewed in this paper range from the methotlologically weak
to the sophisticated. The review commences with the weakest designs and finishes
with the best studies (e.g., cross-sectional designs with various degrees of matching,
simple pre-post designs, pre-post designs with prospective meditators as controls,
random assignment to meditation and control groups, random assignment to med-
itation and comparison groups with control for credibility and expectancy, and so
on).
A major problem with the cross-sectional studies is that individuals attracted to
meditation may differ in certain respects from those who are not so inclined. Hence,
differences found between meditators and nonmeditators may not be attributable
to practice per se. This problem can be partly overcome 1~): using prospective
meditators as controls, or by randomly assigning metlitation-naive subjects to med-
itation and control groups, in pre-post research paradigms. However, with this
design there still remains the problem that those assigned to the meditation and
control conditions will have different expectations. Expectancy of relief should be
considered in meditation research outcome (Delmonte, 198 la; Smith, 1975, 1976).
In general, there has been a paucity of research on personality variables and
their relationship to the practice of meditation. On the contrary, however, anxiety
and/or neuroticism have been featured in numerous (i.e., in approximately 40)
studies on meditation. It will not be possible to give detailed accounts of these
studies; rather, a general overview will be attempted. LJnless otherwise specified,
state, trait, cognitive, and somatic anxiety, together with neuroticism, will be col-
lectively referred to as ‘anxiety.’ Similarly, the word ‘anxious’ will include ‘neurotic’
unless otherwise indicated. This is purely a pragmatic decision and does not imply
any theoretical position.
 94

STUDIES WITH CROSS-SECTIONAL DESIGNS

Some authors report that experienced meditatoi-s are significatttl) less atisious than
comparison groups of‘ controls ((;otetnan 82 Sctiwart~. 1076; IIjrllC. l%~l: vat1 den
Berg 8c Mulder, t!)f(i). In all the abo\,th stu(lies the control iubjccta were eithei
prospective meditators (i.e., Hjelle, tC)7G; \:att tlrn Bet-g & hlultlet-, 1!176) or ‘in-
terested’ in meditation (Goleman & Schwartz, 1976). In this respect these studies
controlled for predisposition to meditatioti. Ho~~e\.er. thev did not cotitrol for setf’-
selection, as attrition from nieditation practice. ma\ accoutit f’or the rxpet‘ienced
meditators being different from thc cotttrol subjc.c.ts. .I‘ttesc stutties do not provide
evidence that meditation practicr actualI\ dccrcasrs attsiet),.
There is considerable evidence 10 suggest ttiat prospcctt\ c’ meditators arc sig-
nificantly more anxious than l~uf~lislird l~ol~ulatioti tiorms or 1ti;iti c.otitr01 groups
(l)etnionte, l#O; Ferguson X- (knva~i. IW~i: Katias & Iloro\vit/, tC177; Otis, t!G3:
Rogers 8c Livingston, I Cj77; West, 1!MO; Witli;tms, Fratic-is, & l)urtiatri, 1076).

STUDIES WITH SIMPLE PRE-POST DESIGNS

Several researchers reported that arixiety decreased in a group ot tiieditators from

pre-initiation to ~otlo~~-ill,-rI_atiging front 1 to I(i monttts later (Blackwelt et al.,
1976; Tjoa, 1975; Williams et al., lC)76). Ho\vever. none of‘ these stud& included
;I cotiCr01 group.
It appears that those subjects who drop out (betwceti 30%-.3JC~8 af’tet- 1 year)
tend to be significantly more anxious than those \vtro cotttittur (l)eltnont~, 1X30;
Otis, 1973; Smith, 107X; West. ICMO; M~iltiants ct. at., 1076). ‘l‘hesc findings at-e
consistent with reports that those who drop-out of‘ tneditatiott score significantly
higher on measures of‘ psychopat hology (Nystul & (Garde, I W9: Sttiit tt, 1(_)76, t<)iH)
and lower on self-esteem (Rivers & Spanos, 1% I ).
The question now remains, cm the prc/post c-tratigc iii ;ittsict\, t)e totally x-
counted for by this self’-selection process, or dora the tqutar l~ractic-e of mcditatioti
per se mediate ;I reduction in such scores? Otis (15173) stated that “the peopfr in
each of‘ these groups (i.e., ‘regulars, ‘irregulars ’ mttl ‘drop-outs’) may tt;iw dif‘ferrd
f‘rom each other in those particular attributes I)ef’orc starting ‘l‘hl” (1). i).
In an attempt to address this question, bottt nietfit;itot~a and c.otitrots wcrc pre-
tested and followed up for periods rattging f‘rom 6 to IO \vcc’E; ( Fct-guson & (knvm,
tY76; Rogers 8c Li\~ingston, lC177; Van dtvt Het-g &c hlulder. 15)7(i). Itt these studies
anxiety was significantly reduced f’or meditatot3 only. IIow~\~et; subjects had not
been randomly assigned to conditiotts. ‘I‘herc was thus thy l~rot~teti~ ot votutiteet
status and predisposition to meditation. Vati tlr~t Berg and ?rlttltlct- tat-gel\, ovc‘rc;mte
this problem by using prospective mrditators as c.ontrol subjects.

PRE-POST DESIGNS WITH RANDOM ASSIGNMENT TO GROUPS

Several authors improved on the above ~xpet-imrntal design b! ratttlomly assigning

subjects to either nieclitatioti ot~coml~~irisoti procetturc5. On fi)tto\V-up (lvliich varied
from I to 12 months later) only the meditators stto~vrd sigttific-atttty pt-e- to posttest
reductions in anxiety (Bali, 1979); Carrington ct at., I!#(); Leht-er. Schoickec. C:ar--
rington, 8c WootfiAk, 1MO; l’uryear. Caycc. kk ‘I‘tiurstott. I Wfi: Zut-of‘f’ ti ScliM.arz,
197X). This finding is particutarly interesting in the c.asc’ of‘ttt? %urot‘tattd 5chwat.z
(1978) and the Lehrer et al. ( 1980) reports, because, as well as control groups, these
studies also employed parallel progressive relaxation groups which showed no
significant changes in anxiety.
Several authors who had also allocated subjects, at random, to either meditation
or other forms of intervention found significant reductions in anxiety for both med-
itation and comparison conditions, including the following: :10 minutes of rest-
the dependent measure being state anxiety in this case (Bahrke 8c Morgan, 197X;
Michaels, Parra, McCann, SC Vander, 1979), 2 to 5 weeks of progressive relaxation
(Boswell & Murray, 1979; Busby 8c DeKoninck, 1980; Parker, Gilbert, 8c Thoreson,
1978), 6 weeks of muscle biofeedback (Raskin, Bali, SC Van Peeke, 1980), 3
weeks of rest using alcoholics as subjects (Parker, et al., 1978) and from 1 week
to 6 months of highly credible “anti-meditation” or “mock-meditation” (Boswell &
Murray, 1979; Goldman, Domitor, & Murray, 1979; Smith, 1976). Thus, although
the meditators demonstrated significant decreases in anxiety, these decreases were
not greater than those found with established relaxation techniques, or with physical
exercise (Bahrke 8c Morgan, 1978) or with highly credible control procedures. This
finding contradicts other, :ilreacIy quoted, reports that the practice of meditation,
unlike that of progressive relaxation, is associated with significant decrements in
anxiety.
Other studies, in which random assignment \vas used, showed not only that
meditation experience-ranging from 1 to 1 X weeks-was associated with signif-
icant reductions in anxiety, but also that this reduction was significantly greater
than that observed in a parallel control group which engaged in eyes-closed rest
practice over 2 weeks (Dillbeck, 1977) or which formed a no-treatment comparison
group (Heide, Wadlington, & Lundy, 1080; Linden, 1973). The Linden study also
included 18 weeks of counselling as a comparison condition. Meditation was also
significantly superior to this condition in reducing (test) anxiety.

CLINICAL STUDIES

There have also been several reports of decreased anxiety following meditation
practice in a clinical context. (Benson et al., 1978; Candelent 8c Candelent, 1975;
Daniels, 1975; Glueck 8c Stroebel, 1975; Kirsch & Hem-y, 1979; Shapiro, 1976).
Some of the above studies were poorly designed and were more like case histories.
However, there were exceptions as in four studies both random assignment and
longitudinal design were used. Benson et al. (1978), f ound that meclitation relax-
ation and self-hypnosis were equally ef-fective over 8 weeks in reducing anxiety in
patients with anxiety neurosis. Patients who had moderate-high hypnotic respon-
sivity, independent of the technique used, significantly improved. Kirsch and Henry
(1979) found that meditation, systematic desensitization, and systematic desensi-
tization with meditation replacing progressive relaxation did not differ in their
efficacy in reducing anxiety. Smith (1976) found that meditation, although effective
in reducing anxiety in “anxious college students,” was no more so than highly
credible procedures which were designed to control for expectation of relief and
for the ritual of sitting twice daily. Raskin et al. (1980) reported that, although
meditation was effective in reducing chronic anxiety, it was not superior to muscle
biofeedback in this respect. ‘l-here are, therefore, at least four longitudinal studies,
with random assignment of high anxious subjects, in which substantial decrements
in anxiety were reported following meditation practice. It thus appears that med-
itation is as ef‘fectiw as some other clinical iii~erventions in reducing ele\ated levels
of anxiety, Ijut that expec‘tmcy a~itl ritual may acco~~nt for these findings-in part,
at least.

In ;I stud!; without co~i~rol subjects, (;irodo (1974) used ;I sinirilatecl ‘I‘M technique
with nine patients diagnosed as anxiety 1ieurotic. md, afier 4 months, five patients
improved significantly and the rcnwining four showed no appreciable decline in
aixiety. Girodo stated rliat his mialvsis showed that meditation tended to be ben-
eficial for those patie11ts with ;I shol’t history of illness (;LI = .I‘= 14.2 months) and
not f’or those four subjects with ;I long history (A1 = sPl.2 nlonths). Kaskin et al.
(1980) argued that the rf’f&:tiwness of‘ nleditation in the tre;1tnlent of chronic
anxiety is limited i11 that onI) 40% of‘ liis sul’Jects sl~owecl “marked clinical i1n-
proven~ent.” I fowcv~r Kaskin et al. ( I9XO), urlhkr (;irodo, (lid not investigate the
role of. chronicity iti intervention outcome.

NON-SPECIFIC FACTORS

Smith (1978) f’ound that those who 111ai11tain nleditation practice and who display
the greatest reduction in trait anxiety scored high on the 16 PF Factors of‘Sizothymia
and Autia. Simthymic i1itlividuals tend to he “i~eservrd,” “detached,” “~~loof‘,” and
so on, W~KI-ras Autia descriks ;I tentlenc~~ to IX “iniag-iriatively eiitliralled by inner
actions.” “ char1r~ed by works of‘ thv iniaginatioti, ” “completely ;ibsot~bed” and to
dernonstr;ite ;I capacity to dissoc-iate and ctigage in “it1ito1io1iio1is, self-absorbed
relaxation.” ‘I‘his report is co1isistc11t with relial~lc f‘indirigs that subjects high on
hypnotic- responsivit) are more likel) to show substatltial decwments in anxiet)
(Renson et al., 107X; Heide t’t al., 19X0). It is also relevant to note that suggestibility
increasc~s during the practice of‘ meditation per se (IMmonte, 198 1b). Both cred-
ibility and expectancy are positively related to improved self’-reports. Highly cred-
ible control procedures were ,just as effective as meditation (Smith. 1076). In an
ingenious double-blind study, Smith randomly assigned subjects to meditation or
to a placelm condition (designed to match the form, complexity and expectation
f’osrering aspects of TI\/I,” but which incorporated an exercise that involved sitting
twice daily rather than meditation. 1~0th groups were equ;illy eftecrive in reducing
trait anxiety, striated ni11scle tension. ad skill cond~~ctance reactivity. Smith also
coInpared two other groiips which iweived similar fostering of expectations. &gain
he fi,und no significant tlif‘fbw~cw hetwrcrl thv groups on the above outcome
1neiisures even tho~igli one‘ groiip incorporated ;1 “‘I‘Mlike nwclitation exercise”
and rhe other “an exercise designed to he the near mltithesis of‘awditation (p. 630).
I~elrnonte (198 1a) found that expectancy of‘ Iwnefit fi~oni nieditatio11 practice as-
sessed prior to initiation is related both to the f’requency of‘ practice and to the
reported benefits of‘ such piwticc. Sin~il;irl~, Kirsch a11tl Henr! ( 1979) reported
that high rationale credibility of 1neditatio11 was significantly related to reduced
anxiety. It coiild, tlierefiwe, he AI-guecl that the reductions in anxiety reflect a
pl~~l~o cf’ftct. Only Zui-off and Schwarz ( 197X) f’ound that expec.tations of benefit
were not significantly carrelated bith such rcductio1is. ~I‘liis inconsistent finding
could be cl~le to the relatively I,ro;id and general assessment ot‘cxpec‘tancy eniployed
by Zuwf‘f’ mid Schwirz. In conclusioii, ;t strong case can be ~nade tar taking “non-
specific” Lictors into accourit in any corlcef,tu~tli/ation of. the therapeutic- ett‘ects of
nieditatiotr.
 97

AN EVOKED STRESS-RESPONSE STUDY

Goleman and Schwartz (1976) found that meditators, compared with controls,
reported significantly less state anxiety, both before seeing a stressful film and again
after exposure. However, as the meditators also scored significantly lower than the
controls on both trait anxiety and neuroticism, the above finding could represent
a sampling effect, as there were no pre-initiation scores available. However, the
finding that meditators showed lower state anxiety after stressor exposure is con-
sistent with reports that meditators show more rapid post-stressor recovery in
physiological responsivity (see Delmonte, in press-b). Unfortunately, this area has
received little empirical attention.

ANXIETY REDUCTION AND FREQUENCY OF MEDITATION PRACTICE

Decreases in anxiety were found to be positively related to frequency of practice

(Fling, Thomas, 8c Gallagher, 1981; Tjoa, 1975; Williams, et al., 1976). However,
Zuroff and Schwarz (1978) did not find such a relationship. Delmonte (1981), as
with anxiety, found that an improved “present-self” was correlated with frequency
of practice. It is possible that, although practice frequency is in general related to
the benefits claimed, there may, nevertheless, be a “ceiling effect” above which little
further improvement is reported. For example, Peters, Benson, and Porter (1977)
found that less than three practice periods per week produced little change, whereas
two daily sessions appeared to be more practice than was necessary for many
individuals to achieve positive changes. Similarly, Carrington et al. (1980) reported
that “frequent” and “occasional” practitioners did not differ in terms of improve-
ment.

BIOCHEMICAL, MOTORIC, AND PHYSIOLOGICAL

MEASURES OF ANXIETY/AROUSAL

‘rhis review has primarily focused on changes in self-reported anxiety. It is worth

noting that reductions in self-reported anxiety, following meditation practice, are
not always accompanied by decrements in behavioral or physiological measures of
anxiety. For example, Raskin et al. (1980) found that, although meditation, relax-
ation and muscle biofeedback were all associated with reductions in clinically as-
sessed chronic anxiety, these reductions were not related to changes in EMC;. Kirsch
and Henry (1979) randomly assigned speech anxious subjects to (a) meditation; (b)
desensitization with meditation replacing progressive relaxation (as suggested by
Greenwood & Benson, 1977); (c) systematic desensitization, or (d) no treatment,
and found that all three treatments were equally effective in reducing self-reported
anxiety and produced a greater reduction in self-reported anxiety than found in
the untreated subjects. However, there were no concomitant improvements in be-
havioral measures of anxiety, and reliable changes in physiological (heart rate)
manifestations of anxiety were found only in subjects who rated the treatment
rationale as highly credible. Zuroff and Schwarz (1978) randomly assigned subjects
to Transcendental Meditation, muscle relaxation training, or no treatment. Whereas
all three groups improved on a behavioral measure of trait anxiety, only the med-
itation group showed significant decreases in a self-report measure of anxiety.
‘l‘hese last three studies show that riieclitators readily show ciec-rtmes in self-report
~neasures of‘ anxitTy hut that these decrenients may, 01‘ may not, receive convergent
validity in terms of behavioral and physiological nleasures. If‘ the effects of Ined-
itation are Inode specific, iib proposed by Schwartz et al. (1978) with their multi-
process niotlel, thtm it may indeed he that the ef’fects ot‘metlitation are more readily
apparent with self-report (predominantly cognitive?) as opposed to behavioral or
psychological, measures of‘ arixiety. There is also the more parsimonious interpre-
tation that it is easier to “f’bke good” with self-report, than with either behavioral
or physiological markers of‘ anxiety. Hounw-, the outcome of the Zurof’f and
Schwarz study, in which only the meditation group reported significant reductions
in both self-report arid Iwhavioral nieasurc’s of‘ anxiety, is not consistent with the
latter iriter~,retatioIi.
Most investigations of’biochernical nwrkers of’ rel~txation-arousal, associated with
the practice 01‘ meditation. were in tertns of state cfftcts, as in those immediate
responses precipitated duririg nietlitation per se. The outconie of ;I recent review
(IIelmonte, in press-a) is that meditation is only marginally superior (at most) to
eyes closed rest in terms of‘biochemic~il indices of activation. ‘I‘he reported decreases
in lactate, cortisol, dof’iltiiine-t)et;l-h~clr-oxl~tse, rcnin, alclosterone and cholesterol,
and the reported increases in phenylalanine and prolactin, although of‘ interest,
do not attribute special state ef‘fects to Ineclitation. ‘Ilie niost strongly supported
long-twrri (i.e., trait) effect of’ Ineditation is ;i reductioIl in seruni cholesterol levels.
This findirlg is in acco~-tl with the rather comp~lfing evidence that the practice of
meditation is associated with long-term reductioms in Mood pressure (see Delmonte,
in press-b For review). No significant effects were obtained using testosterone,
growth hormones and catechol~~mines as indices of charlge.
‘Ilie outcome ofanother extensive review-this time ofstudies with physiological
markers of’ a~~o~~s;~l-will I)e xunlnlari/rtl hew, as it also offers cross validational
rvitlenc-e on nneditation as an intervention strategy (see Delnionte, in press-b).
Mfdit;ttiori practice is associated with lowered acti\wion in ternis of state (i.e., in
situ) ef‘f’~cts-~~~~~-tic.ul~~~-l~~ with I-egartl to f’rontalis EhlG mcl respiratory indices
(such as oxygen consumption, carbon dioxide eliniination , aritl respiration rate)-
and in terrris of’ trait (i.e., lonp-tcrui) effects-es~,eci;lll~ with I-egxd to Mood pres-
sure reduction. llowever, thew effects are not ot estal~lished superiority to those
of‘ other relaxation pro~td~~res.
‘I‘hc outconic of‘ these two reviews is consistent with Be~ison’s relaxation response
model. Benson et al. ( 1974) postulated that ;i unitary relaxation response c;m be
precipitated by one of‘several rrlaxation procctlures (including meditation) meeting
certain niinirnal criteri;l such as closed eies, 1ow riir~scle tonus, ;I “mental device,”
;I passive attitude, and ;I quiet en\ironnient. Fiowever, as already mentioned, self-
report reductions in anxiety do not alwaj,s recei1.e convergent validity in terms of
behavioral or physiologic~;il mdices of ac.tivdtioIl. ‘l‘liis may suggest that the effects
of meditation are largely mode specific, in that somatic. componrtits of anxiety (as
~iie;~su~-t~l by physiological 2nd betia\~ior:il indices) may be less responsive to ;I
“mental” technique than the cognitive components of’ arousal as assessed by self’-
reports. If‘ f’urther evitlt7ice suhstantiatrs this \Gzw then tlierc will be increased
support for the S&wart/ et al. ( 197X) multi-process model. ‘Ii) rrcapitulate, Schwartz
ct al. predicted that meditation woulcl be more rf‘fbctivc in reducing cognitive than
somatic sul,coIrlf>on~Ilts of‘ anxiety. ‘I‘aking ;I glotd view of‘ anxiety, that is. inte-
grating the findings of‘ studirs usilig sdf-report. physiologic-al, biochemical mid
 Meditation and Anxirly Reduction 99

motoric measures, leads to the conclusion that, although meditation is associated

with decrements in both subjective and objective indices of anxiety, there is no
compelling evidence that these reductions are of established superiority to those
elicited by other interventions.

SYNOPSIS

In summary, it appears that prospective meditators tend to show higher anxiety

scores than equivalent population norms. The regular practice of meditation ap-
pears to facilitate a reduction in anxiety for subjects with high or average level of
anxiety provided they meditate regularly. However, there appears to be a “ceiling
effect” at the higher practice frequencies. Meditation is probably less effective in
cases where subjects have a relatively long history of anxiety neurosis. There is
evidence that the anxiety scores of prospective meditators could be used to predict
their response to meditation, the drop-outs tending to score the highest, and the
regulars the lowest, on pre-initiation scores. Meditation does not appear to be more
effective than comparitive interventions in reducing anxiety-with the possible
exception of progressive relaxation. Nevertheless, meditation does seem to be ef-
fective, for many subjects, in reducing clinically elevated levels of anxiety. Those
who benefit most appear to demonstrate a capacity for autonomous self-absorbed
relaxation and/or to be relatively hypnotizable. Intervention credibility and ex-
pectancy also appear to play a role in outcome. It thus appears that cognitive set
is central to the effects of meditation and that neither the psychodynamic nor the
behavioral models of meditation suffice in this respect. Smith (1978) may have
been correct when he wrote that “meditation is quite likely a heterogeneous phe-
nomenon, producing effects ranging from sleep to enlightenment, and incorpo-
rating such diverse processes as insight, desensitization, and suggestion” (p. 278).
As none of the above reviewed studies-and many of them were well designed-
failed to report significant decrements in anxiety, it must tentatively be concluded
that meditation practice is associated with anxiety reduction. However, prospective
meditators tend to report elevated anxiety. Although practice is associated with
decrements in anxiety to a level comparable with that of the norm, there is insuf-
ficient evidence to suggest that the scores obtained are significantly lower than
those of the norm. Reductions in anxiety associated with the practice of meditation
do not always receive convergent validity in terms of behavioral or physiological
measures. This finding may suggest that the effects of meditation are mode specific,
and is thus in accord with the multi-process model. As there is no compelling
evidence that meditation is of significant superiority to other relaxation procedures
in terms of anxiety reduction, the case for unique (state or trait) effects is not
supported. Unfortunately, almost all the self-report measures were of trait anxiety
and as such no comment on the relative effectiveness of meditation on state versus
trait anxiety can be made. This might be an interesting area for future research.

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