Abstract
Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease.
Despite its principle association with Eastern philosophies, meditation has become more widely popular in the last 4 decades-often as an adjunct to conventional medical therapies. Meditation is the practice of becoming aware, of paying attention, 1 or "the act of inward contemplation." 2 It is estimated that more than 2 million Americans have learned transcendental meditation (TM), a well-publicized form derived from Hinduism. 3 Mindfulness meditation is taught as the basis for more than 100 stress reduction programs sponsored by major medical centers around the United States. 4
Complementary and alternative medicine (CAM) defines a broad category of interventions (such as meditation) that are "not taught widely at US medical schools or generally available at US hospitals." 5 Yet in 1997 more than 42% of the adult population in the United States used CAM 6 to manage cancer 7 and other chronic diseases, and meditation is one of the most commonly used practices. 8
The rationale for using meditation as a complementary therapy for the treatment of chronic illnesses will be explored by reviewing literature in 3 areas: (1) the experience of chronic illness, (2) theories about meditation, and (3) the clinical effects of meditation practices. Theoretical and empirical works on these subjects will be analyzed, critiqued, and the state of the science summarized in this article.