Somewhere along the way, meditation stopped being a practice and became a prescription. Anxious? Meditate. Can't sleep? Meditate. Struggling at work, in your marriage, in your own skin? Learn to meditate.
On this week's Got Therapy?, Dr. Dan Rose and I discussed a recent article in The Atlantic arguing that meditation can be harmful. I want to take the argument one step further than we did on air: clinicians should stop recommending meditation as if it were universally benign.
The case is not that meditation is bad. Dan meditates every day. The case is that it is not one size fits all, and our field talks as though it were.
Consider who the conversation identified as at risk. People with high anxiety, for whom turning attention inward can raise anxiety rather than settle it. People with severe trauma or PTSD, for whom closing their eyes and relaxing in front of others can feel like surrendering control — or like being manipulated. People who practice to excess, hours a day or at week-long silent retreats, some of whom report panic. The Buddhist tradition itself has a name for these adverse experiences. We should know it too.
Dan's recommendation was measured and right: for people with high anxiety or a traumatic history, meditation "is at best something they need to ease into." And for those who try and struggle, the message should not be try harder but don't get upset at yourself — it isn't a panacea.
There is a second problem, subtler than the first. When meditation is sold as a productivity tool — meditate to focus, to perform, to earn — it risks training people to observe their lives rather than live them. Dan invoked Bion's two-headed arrow: health means moving between self-reflection and absorption in what we feel. Stay on one side too long and, in his words, "your emotional life is going to become deadened." A sunset won't make you bank. It may still matter.
What should replace the blanket prescription? Three things the conversation supports.
Attunement before technique
Dan placed empathic attunement at the base of the therapeutic pyramid — "regardless of the theoretical model." A technique offered before the relationship can bear it is not neutral. Move too quickly and people feel blamed.
Listening before eliminating
The best case for meditation is not calm. It is information. Feelings are trying to tell us something, and a practice that helps a person notice a feeling, pick it up, and — Dan's phrase — "invite it in for tea" is doing clinical work. A practice that only teaches a person to let every feeling drift past may be doing the opposite.
Starting small, and screening honestly
Thirty seconds of noticing the breath. Counting the steps into your building. These are low-cost, low-risk entry points. Hours a day, recommended to a highly anxious client in a first session, is neither.
None of this is anti-meditation. It is pro-client. The measure of a good intervention is not how fashionable it is but how well it fits the person in front of us. On that measure, "learn to meditate" is not advice. It's a slogan.
Our profession can do better than slogans.
MIC LEDGER is an independent editorial voice for the mental health professions. This editorial draws on Got Therapy? Episode 86 with Dan Rose Psy.D.