Lost on the road to enlightenment

9:08Richard Davidson:This teacher was kind of being like, meditation is not just about wellness. It's also about spiritual awakening. So if it's about awakening, maybe it's not surprising that it's not good for sleep.

9:22Pierce Salguero:And so that was a kind of slap in the face and also a wake-up call to be like, what kind of assumptions do we have as mental health professionals or even just people? We think that meditation is a kind of therapy. And, like, this teacher was like, that's not at all what it's for.

9:40Richard Davidson:By this point, Willoughby herself had trained as a meditation teacher. She'd studied with the legendary Jon Kabat-Zinn, who created something called mindfulness-based stress reduction, which has been enormously influential. Scientists tend to study it because it's standardized and secular, and it's also reached the masses. But it's just one particular version of a practice that's been around forever. What I realized was that there were other meditation worlds that thought that the one that I was in was short-sighted or naive or uninformed or just kind of like JV.

10:27Richard Davidson:Whether it was JV or not, Willoughby was all in on this, still studying clinical psychology. And near the end of her PhD, she did a residency at Brown University.

10:37Pierce Salguero:I was working in an inpatient psychiatric hospital. And that one year, there were two people who had come off retreat and they were both completely psychotic. And so I went back to that same...

10:51Richard Davidson:On meditation retreats who show up in the emergency room?

10:55Pierce Salguero:Well, at the psych hospital, yes.

10:57Richard Davidson:At the psych hospital, okay.

10:58Pierce Salguero:And they, like, they, yeah. So they were there, like, for many days or weeks. Like, not just an emergency room visit, but, like, an, you know, inpatient hospital.

11:09Richard Davidson:Two psychotic meditators in one year seemed like a lot. So Willoughby started asking around, kind of casually bringing it up at conferences or retreats.

11:19Pierce Salguero:And then people would come up to me and be like, that thing you said, that happened to me. There were people like everywhere. It was impossible not to find people.

11:28Richard Davidson:They told her about all kinds of experiences that didn't seem to line up with a story about meditation as this great therapeutic practice. Experiences that were painful or distressing or just weird. Willoughby was fascinated. So alongside her research on the benefits of meditation, she starts kind of like a secret little side gig.

11:52Pierce Salguero:Basically just going to meditation teachers, really well-known teachers that ran their own centers, that had been doing it for decades, and just ask them, you know, what types of meditation-related challenges have you seen? And what do you do about it? From there, a lot of the teachers would tell these stories about kind of like their worst case scenarios. And, you know, they'd be like, well, let me see if that person will talk to you.

12:26Richard Davidson:Willoughby ended up formalizing these conversations into a study. A way to start to map this part of the meditation terrain that psychologists seem to have barely charted. She and her team interviewed about 100 serious meditators and meditation teachers. All of them identified as Buddhist, or at least doing Buddhist practices. But they were largely practicing in a Western context, largely white. And Western meditators, that's who this study was about and really who it's for. The point was to formally interview these people about their self-reported meditation challenges, symptoms that they had after meditating that often went away if they stopped.

13:12Richard Davidson:A qualitative study like this, interview-based, it doesn't tell us anything about how frequent these problems are in the real world. It doesn't untangle all the possible confounding factors here. But it does begin to bring these unusual meditation experiences into the realm of science, where they can be looked at more closely.

13:33Pierce Salguero:There's so many different kinds of experiences. Sometimes people would just feel like they're having almost like convulsions, where they're just having kind of all-over-body tics.

13:47Richard Davidson:People reported visual symptoms.

13:50Pierce Salguero:You can start seeing lights that can look kind of like Christmas lights.

13:56Richard Davidson:Some people re-experienced past traumas or got intensely emotional, like panicking.

14:04Pierce Salguero:But we also see the opposite, where people lose all emotion.

14:09Richard Davidson:There were cognitive symptoms, like someone forgot what numbers were.

14:14Pierce Salguero:There was a number five on their house, like an address number. And they were like, what is that shape? What is that? Is that some kind of Sanskrit or something? Like, they just didn't remember that it was a five anymore.

14:32Richard Davidson:It took years for Willoughby and her team to document and categorize these experiences. And the entire process, it highlights how tricky it can be for scientists to study a religious practice. For one thing, it wasn't easy to call all of these experiences adverse effects. Many of these people had struggled with the question of whether these symptoms were actually an important part of the spiritual path. Like, if you stop being so goal-oriented, maybe that looks like losing motivation to live your life could be negative. Or maybe it's the whole point of your practice. Get out of the productivity rat race.

15:14Richard Davidson:But some people in the study reported becoming suicidal, which these experienced Buddhist meditation teachers pretty universally said was not a good sign. Also worrying, symptoms that lined up with psychosis. Teachers described getting psychological intervention in those cases. And even some of the more ambiguous effects could be things that people just didn't want. This time, Willoughby publishes the study. She is ready to put something out there that is very different from the standard meditation story within psychology, and that certainly goes against all the hype.

15:53Pierce Salguero:I would say that more than any other factor having any effect on my success, it's been meditation.

16:00Willoughby Britton:Man, it's so hard to crystallize into one thing how great meditation is. If pharmaceutical companies could bottle up even a quarter of those benefits, it would be the best drug in the world.

16:12Richard Davidson:Now, look, there is, of course, still a lot of evidence that meditation can be good for you. I talked to another researcher who has published a ton on the benefits of meditation. His name is Richie Davidson. And he was like, I got to remind you, for the vast majority of people, meditation is, in fact, safe.

16:31Willoughby Britton:I would say for the average person, the risk for psychosis of meditation is not greater than the risk of walking down the street and producing psychosis.

16:45Richard Davidson:As for why this happens to some people, scientifically, it's not clear. Willoughby has some ideas. She thinks some of the symptoms might be best described as side effects of concentration. You focus in so much on your breath that you almost put yourself in a sensory deprivation situation. But the brain likes a certain level of stimulation, so it ends up creating some of these strange symptoms. Richie was like, maybe, but there could be other things going on. We just don't have good evidence either way.

17:16Willoughby Britton:I think the kind of evidence you would need is hard to come by. And that would be having a sufficient number of cases where you can actually get recordings from them during these periods of decompensation. It's very challenging to do that kind of research.

17:37Richard Davidson:By that, do you mean someone would have to be in an MRI machine while they're becoming psychotic after meditating? Something like that? Yeah, something like that. So, like, difficult. But Richie is pretty convinced that the danger here is limited to a small group of people. Those with some kind of psychological risk factor, like a mental health disorder, and those involved in super intensive meditation practices. Obviously, there are many different kinds of meditation, and maybe you're more at risk if you're like going on long, silent meditation retreats. Willoughby agrees that those are risk factors, but she is adamant that they don't explain the entire phenomenon.

18:17Richard Davidson:She says there were people in the study who had like a squeaky clean psych history. And she has only gotten more convinced over time that the mental health world and the meditation world just really need to take all this more seriously.

18:32Pierce Salguero:I'm hearing the victim saying like, people didn't believe me. Like the teacher didn't believe me. The therapist like laughed in my face.

18:39Richard Davidson:After she published the study, she started hearing from a lot of struggling meditators who felt like, finally, maybe this researcher can give me some answers.

18:50Pierce Salguero:The lab phone rang and rang and rang to the point where we were collecting data for another study. We had to actually turn it off because it was like disrupting data collection. You had to unplug the phone. Yeah. And, you know, a university lab is not a hotline. That's not what we do. And so we basically had to create a hotline.

19:17Richard Davidson:The people calling in are like, okay, science can argue about who exactly this happens to and why, but it's happening to me or to my kid. I need to figure out what to do. Like, do I get therapy? Take medication? Read a thousand-year-old text about this? Uh, maybe? That is after the break.

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21:22Richard Davidson:So after Willoughby publishes her study, her lab phone starts ringing off the hook with meditators in distress who are feeling confused, blindsided. But another person hears about Willoughby's research and is not surprised at all.

21:39Willoughby Britton:The kinds of symptoms that they have been describing, to me, were immediately recognizable as having analogs in historical texts. Now, I thought to myself, isn't this interesting?

21:53Richard Davidson:Pierce Salgaro, professor of Asian history and health humanities at Penn State.

21:57Willoughby Britton:Of course, the language is completely different. They had their own medical paradigms that have to do with, you know, chi or with prana or with the four elements or with demons. But as a historian of medicine who specializes in looking at how ideas are transmitted and translated across cultures, that's what I do. Without sacrificing our appreciation for the nuance, I still think we can say there's a thing here that people are pointing at and describing in different ways.

22:31Richard Davidson:Piers started a whole project with like 25 colleagues to translate accounts about meditation difficulties. From ancient scriptural sources and medieval historical sources, from India, China, Tibet. He said descriptions of negative meditation side effects go all the way back to the beginning of Buddhism. There are even descriptions of meditation problems from the Buddha himself.

22:54Willoughby Britton:He describes kinds of headaches and other sorts of symptoms that he had from doing meditation, you know, either too much or incorrectly or too intensely. And essentially, you know, this idea that meditation can cause harm in some cases, I don't want to overstate it, but it seems like it can be found pretty much in all places in all times within the Asian Buddhist tradition. It's also really well known just in society more generally. So I don't think it would be surprising at all if you grew up in one of these historically Buddhist cultures. You might sort of have the understanding that meditation, when you pick up meditation, you're playing with fire.

23:37Richard Davidson:That is part of the point.

23:40Willoughby Britton:The original purpose of this practice was to radically destabilize your sense of self in order to produce what in Buddhism is being sought after, which is a transformation in your consciousness, a loss of your sense of separate selfhood, powerful mystical experiences that are going to transform your life permanently. And that these were being had by people in social contexts where they had left behind the world and gone off into monasteries or caves in order to do these practices. So if you're doing this practice because you expect to have a little stress reduction, and what happens is yourself gets destabilized and you start having, you know, weird mystical experiences, the practice is actually doing what it was intended to do.

24:35Richard Davidson:Obviously, many people who meditate today are not monks. I'm from Los Angeles, and it's like you can barely order a coffee without being offered a side of meditation. So I wanted to talk to people who had had these radically destabilizing meditation experiences in our modern context. And I found someone who first got into meditation through a very secular source.

24:58Willoughby Britton:I think it was a For Dummies book, like that series. Really? Yeah. And the first time I practiced meditation, it was quite a radical experience, I would say. And not everyone has that, you know, sometimes it happens later or, but I felt my mind become very still and very peaceful. I felt my body also deeply relax.

25:28Richard Davidson:Scott Lippitt started meditating when he was 15. And I really want to give him his due here. Like, he may have started with meditation for dummies, but after that, he got really into Buddhist teachings. He studied the spiritual side of the practice for years. He meditated regularly, 20 minutes in the morning, 20 minutes at night. And one evening, about five years in, he meditated in his college dorm on his special orange cushion.

25:53Willoughby Britton:I sat up and went to just do my bedtime routine, brushing my teeth. But when I looked in the mirror, I did not recognize myself necessarily. Like, it felt as though it was a photo of me or I logically knew it was me, but it didn't have the felt sense of, oh, that's me. It almost felt like my thoughts and my ability to perceive the nuances and detail of them was that dial was turning up. and I've often described it as if anyone has experienced marijuana, maybe too much marijuana, and they've felt almost like life is looking cartoony or almost started to feel like I was experiencing life frame by frame.

26:48Richard Davidson:Even when you weren't meditating?

26:50Willoughby Britton:Yes, definitely towards the back end of those 10 years. that meditative state became my reality day to day.

27:02Richard Davidson:He'd be in a work meeting at his environmental protection job and feel like, am I even really here? I actually felt out of my body at that point,

27:12Willoughby Britton:like almost as though I was a foot behind myself just watching everything happen. And there was a lot of anxiety with that because I knew that I had to be participating in this meeting. but I was having a borderline psychedelic experience at the same time.

27:30Richard Davidson:Not in a fun way.

27:32Willoughby Britton:No, yeah, not in a fun or not in an insightful way, just in a difficult and terrifying way, yeah.

27:43Richard Davidson:Now, Scott, he may not have been a monk, but he was also not unprepared for the idea that meditation could be radically destabilizing.

27:52Willoughby Britton:So much of my goal of meditation at that time was to free myself from the illusion of self. For some people that might lead to a liberation and like deep peace and all of that. But for me, it led to a really cold and empty reality where not only was I feeling terrible, but I have no agency either. And what's the point? I think that's where those kind of suicidal ideations came to play.

28:28Richard Davidson:Through all this, Scott just kept meditating harder. That's kind of the message he got when he asked spiritual teachers what to do.

28:37Willoughby Britton:They're just like, oh, yes, you're in the dark night of the soul. You need to do X, Y, and Z. But if I look at the data, it's been five years of immense and confusing suffering that was just leading me to be disconnected from family.

28:53Richard Davidson:Scott eventually got treatment for depression, which helped. But he said a key thing that he had to do to get his life back was to stop meditating. And eventually, the symptoms lifted.

29:06Willoughby Britton:I now view them as induced states. It'd be like someone taking a strong psychedelic every day and complaining about not feeling themselves or struggling with work, but saying like, yeah, but I'm going to see the truth and then everything will work. It's like, or you could stop taking a strong psychedelic every day, you know?

29:30Richard Davidson:I talked to about five meditators who'd gotten into some kind of trouble, ranging from I had bouts of anxiety and maniacal laughing, to my experience of time got extremely weird, to I went to a meditation retreat, then landed in the hospital with psychosis. And several of them did what Scott did. When the going got weird, they meditated more. I asked Pierce what the historical texts would say about that.

29:58Willoughby Britton:So I think one of the ways that people get into trouble is this kind of like hardcore practicing, you know, having challenges and then meeting those challenges with even more intensive meditation because it must be working. So these texts do warn explicitly against that kind of logic. And there's one of the kind of common refrains within these texts too is about not taking too seriously any particular spiritual experience that happens. And particularly not taking it as an indication of your attainment of some high level of enlightenment.

30:43Richard Davidson:If we've lost the cultural sense that meditation can be radically destabilizing, maybe we've also lost the sense for when that goes too far. Piers told me different cultures draw the line in different places, but consistently there is a line.

31:00Willoughby Britton:They say, you know, these are kind of like the normal expected kinds of challenges and here's how to deal with them. And then here's something that's beyond the line where we can really classify this as a medical condition that needs specific medical interventions.

31:19Richard Davidson:Some texts call it meditation sickness. Symptoms can line up with things will be found.

31:25Willoughby Britton:Things like depersonalization, depression, anxiety, psychosis. These would be the labels that psychiatrists and contemporary medical practitioners would put on these conditions. I think it's important to underscore, though, that the Buddhist texts are suggesting that these kinds of symptoms may come and go within a meditation practice that can be managed in a certain way. You can pivot in your practice and the symptoms can be resolved. So it has more to do with your relationship to meditation, maybe not having proper balance in that relationship, rather than any inherent characteristic of you, yourself, or of meditation itself.

32:10Willoughby Britton:It has more to do with the relationship between the two.

32:14Richard Davidson:So yeah, maybe our cultural relationship to meditation has gotten a little shallow. We think of it as relaxing when actually it can be quite grueling. And for a practice that's often happening alone, in silence, we do really talk about it a lot. But recently, I've also found myself thinking about this whole other phenomenon. It's called the zeal of the convert. The idea is that people who convert to a new faith or discover a new practice, they tend to be way more fervent, way more intense than people who grew up in it. Which makes sense. You see it all the time. That person telling everyone about the cute new little diner they discovered, they probably don't live next door.

33:02Richard Davidson:I think a lot of people who discover meditation today practice it with a sense of zeal. Sometimes they become evangelists. They go all in. But when it comes to meditation, that fervor can lead to trouble. If you have some intense experience and then double down. The advice from the historical texts seems to be something more like, oh yeah, that, that's a thing. Don't get caught up in it. Just shift your focus. Do some other kind of practice for a while. Take a breath.

33:55Richard Davidson:This episode was reported and produced by me, Sally Helm. Editing from Jorge Just with help from Joanna Solitaroff. Mixing and sound design from Christian Ayala. Music from Noam Hassenfeld and fact-checking from Melissa Hirsch. Meredith Hodnot runs the show. Amy Padula is determined not to catch a cold. Julia Longoria is our editorial director. And Bert Pinkerton turned toward the doctopus, who was barely conscious. And the doctopus let out a whisper. There's no time. You need to find the platypus, the one they call Platy Smith.

34:36Richard Davidson:Thanks as always to Brian Resnick for co-creating the show along with Byrd and Noam. And if you have any thoughts about the show, please send us an email. We are at unexplainable at vox.com. You can also leave us a review or a rating wherever you listen. That really helps us out. And if you are into supporting the show and all of Vox in general, join our membership program. You can go to vox.com slash members to sign up. Unexplainable is part of the Vox Media Podcast Network. And we'll see you next time.

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