Vipassana Meditation: Systematic Review of Current Evidence

In the 1980-1990's Kabat-Zinn's Mindfulness-Based Stress Reduction (MBSR) and Linehan's Dialectical Behavior Therapy (DBT) helped kick off the recent wave of mindfulness research. Prior to that, there had been an accumulating body of research on the usefulness of Buddhist meditation in the 1970's and 80's, which had begun to trickle in as early as the 50's.

Although research of mindfulness-based treatments such as MBSR and DBT make up the majority of the currently published literature, there remains an interest in particular Buddhist meditative traditions. Dr. Chiesa of the University of Bologna, Italy, who also authored a review of neuroimaging studies of mindfulness meditation, recently reviewed research on Vipassana Meditation. Vipassana is a Pali word commonly translated as "insight" or "clear seeing." It is a mindfulness meditation, and is distinguished from meditative practices that emphasize concentration. The counterpart to Vipassana is Samatha ("calm abiding"in Pali), which is a way to calm the mind and develop one's ability to focus through concentrating on a particular object, often the breath.

Although I'm not a Buddhist scholar by any means, Chiesa's understanding of Vipassana appears to be a little shaky. Contrary to Chiesa's claim thar Vipassana is the "most ancient of Buddhist traditions," it is perhaps more accurate to say that Vipassana is a style of meditation attributed to the Buddha, which he is said to have developed after finding that concentration meditation failed to bring about lasting transformation and enlightenment. Concentrative practices such as Shamatha are believed to have been practiced thousands of years before the Buddha.

Vipassana is a general term and encompasses a number of traditions such as the Insight Meditation Society that inspired Kabat-Zinn and S.N. Goenka's promulgation of the tradition of U Ba Khin. It is Goenka's program that Chiesa focuses on in his review. Goenka has been hugely influential in creating a network of rigorously organized 10-day Vipassana retreats all over the world.

Chiesa uncovered 18 articles on Vipassana in his search but found only 7 met his inclusion criteria. Three of them came out of Dr. Marlatt's lab and were briefly mentioned in a previous post on Mindfulness-Based Relapse Prevention (Bowen et al., 2007, 2008; Simpson et al., 2007). One is by Dr. Lazar, whose work was also briefly discussed in a previous post, which looks at differences in cortical thickness in meditators (Lazar et al, 2005). Two were by Dr. Holzel (Holzel et al., 2007, 2008), and the remaining one I had never heard of (Emavardhana & Tori, 1997).

A problem I have with the way the review is the set-up: Dr. Chiesa links Vipassana to Goenka's organization in his introduction but does not mention other Vipassana traditions such as Insight Meditation. This would be fine if Dr. Chiesa only included studies of participants in Goenka's retreats (i.e., Bowen et al., 2006, 2007; Holzel et al., 2007, 2008; Simpson et al., 2007); however, he includes two studies with meditators that appear to be from Vipassana traditions other than Goenka's (Emavardhana & Tori, 1997; Lazar, 2005). One is through the Young Buddhist Association of Thailand (i.e., Emavardhana & Tori); the other appears to be of Insight Meditation meditators (i.e., Lazar). None of this is necessarily a problem, but it should have been made clearer in the introduction.

Chiesa makes the important point that these initial studies show great promise for continued research of Vipassana meditation, but that more higher quality studies are needed. Given that Goenka's retreats are donation only (i.e., you pay only what you want and can for the retreat), they offer a potentially untapped resource for people who cannot afford ongoing psychotherapy. (However, they do require an initial 10-day investment.) Chiesa also suggests that Vipassana meditation be compared against Transcendental Meditation (TM) for treatment of addiction. Unless things have changed, however, my understanding is that the TM organization is open to research but has more rigid requirements to allowing itself to be studied; for example, it rarely allows TM to be compared to another technique (See Rao, 1998).

Overall, this review is useful in drawing attention to the growing body of research on Vipassana meditation. Because it is so standardized, Goenka's program would be a great resource for continued research; however, from what I've heard from Dr. Marlatt's lab, they found it impossible to secure grant funding for continuing their inquiries. For now, research on Buddhist meditation remains much less cohesive than research on particular mindfulness and acceptance-based treatments. I would love to see continued exploration of the benefits of these forms of Buddhist practice, but it may take commitment of a researcher or group of researchers to develop a series of studies that build upon one another.

For the full citation:

Chiesa, A. (2010): Vipassana Meditation: Systematic Review of Current Evidence. Journal of Alternative and Complementary Medicine, 1(16), 37-46.

For those interested, I've tracked down downloadable files of some of the articles Dr. Chiesa's review discusses. Just click on the citation:

Bowen, S., Witkiewitz, K., Dillworth, T. M., Chawla, N., Simpson, T. L., Ostafin, B. D., Larimer, M. E., et al. (2006). Mindfulness Meditation and Substance Use in an Incarcerated Population. Psychology of Addictive Behaviors, 20(3), 343-347.

Bowen, S., Witkiewitz, K., Dillworth, T. M., & Marlatt, G. A. (2007). The Role of Thought Suppression in the Relation between Mindfulness Meditation and Alcohol Use. Addictive Behaviors, 32(10), 2324-2328.

Holzel, B. K., Ott, U., Gard, T., Hempel, H., Weygandt, M., et al. (2008). Investigation of Mindfulness Meditation Practitioners with Voxel-Based Morphometry. Social Cognitive and Affective Neuroscience, 3(1), 55-61.

Lazar S. W., Kerr, C., Wasserman R. H, Gray, J. R., Greve D., et al. (2005). Meditation Experience is Associated with Increased Cortical Thickness. NeuroReport, 16, 1893-1897.

Simpson, T. L., Kaysen, D., Bowen, S., MacPherson, L. M., Chawla, N., Blume, A., Marlatt, G. A., et al. (2007). PTSD Symptoms, Substance Use, and Vipassana Meditation Among Incarcerated Individuals. Journal of Traumatic Stress, 20(3), 239-249.