[This page follows from the work of Dr. Willoughby Britton, her research associates, the ongoing research at the The Clinical and Affective Neuroscience Laboratory, and the work of Cheetahhouse to support practitioners in distress. Many bows to these bodhisattvas!]

Many people don't have any adverse impacts from concentrative meditation practices, even when sitting demanding retreat schedules; this is uncontroversial. 

The concern here is for the people who have unrecognized adverse impacts. It is also for those who might develop adverse impacts as they increase their time in meditation. Open Mind Zen practitioners attending OMZL daily 7 am EST sits are asked to become at least glancingly familiar with these issues.

What are concentration practices? These are meditation techniques in which a practitioner is asked to focus on an object—and to return to that object, when their mind wanders. The object could be the breath, body-scanning, one's own flow of thoughts, and many other possibilities. 

Increasingly, practitioners come to Zen with prior exposure to concentration practices: meditation apps, Mindfulness trainings, and Insight Meditation/Vipassana. 

It's difficult for Buddhist students and teachers alike to connect the dots between concentration practices that seem effective and highly rewarding on the cushion... and increasing levels of insomnia, sensory sensitivity, spaciness, bodily pain, or reactivity in daily life. But from a scientific viewpoint, this possibility is easier to consider. Please begin with this article offering a quick overview. Meet Dr. Willoughby and hear about how her research began with this video. [Note: when she says "meditation" she is referring to mindfulness concentration practices.]

Practicing ten to twenty minutes three times a week, there seems to be little cause for concern in using concentration techniques, and some evidence of benefit. Sitting daily for an hour, however, moves students into the range where they might experience adverse impacts from concentration practices.

Anecdotally, I am not aware of any meditators with adverse impacts from a few minutes of concentration practice at the beginning of a longer sit. Many find a brief use of a focus helps to transition, to raise energy for practice, and re-orient to the cushion.*

Mindfulness (concentration) meditation techniques have been found to increase cortical arousal for all participants. Whether this is beneficial or not very much depends on how much, and on the individual practitioner. Too much cortical arousal leads to hyperarousal; beyond that it leads to dissociation. On the hyperarousal side, A student might experience symptoms such as irritability, a shortened fuse, anxiety, panic, insomnia, traumatic re-experiencing, and pain syndromes. On the dissociative side, one might experience a blunting of empathy and creativity, anhedonia, disidentification with the body and the senses, and a diminished sense of personal agency. [Meditation-induced hyperarousal, signs of dissociation, mechanisms of meditation-induced dissociation.] 

Here is the comprehensive symptom list from the Varieties of Contemplative Experience research study, by Drs. Lindahl and Britton. Please review the list and assess. 

If you have experience with any of the symptoms, you are not disqualified from meditating. You may wish to educate yourself, and use other meditation techniques. Some suggestions are found at the end of this page. 

Meditation Technique and Neurodiversity

My anecdotal experience is that neurodiverse people find concentration practices to be especially attractive and accessible. Paying intense attention to a focus is an internal experience that may be familiar, safer, productive, comforting, rewarding, or otherwise valued to people with experiences of ADHD or autism. There's a clear goal, which most folks appreciate. Anyone suffering unrelieved emotional pain would value increased personal control over internal experience. 

Meanwhile, neurodiverse people and others (all people!) seem to benefit from training for what I call un-concentration. This involves 1) relaxed, accepting, soft-focus, generalized awareness; 2) fluid, timely transitions between diffuse and focused attention, as is situationally appropriate to the moment, and 3) co-regulation with other practitioners ("refuge in sangha").

A skillful practice involves respecting and balancing our innate inclinations and well-developed capacities. As Buddha taught, it's about the middle way. As Dr. Willoughby explains, it's about the Inverted U-Shaped Curve [see above]. 

People might choose to use certain techniques for specific spiritual experiences. Meanwhile meditators might take up practices that never were intended for the long haul and the demands of daily life. A few weeks of insomnia on retreat can be acceptable as part of someone's spiritual search. A few years of insomnia, with no relief and deteriorating daily functioning, is a whole other level of suffering and consequences. All meditators should be informed about the potential impacts of the practices they take up, so they can adjust as their needs, goals and experiences evolve.

Regarding adverse impacts, lacking the quality peer-reviewed research on specific demographics of neurodiverse folks that I hope is to come... I'll resort to a parable of a hike with a rock in a shoe. 

When people walk a path in their own time in their own way with no particular agenda, they are free to do what they need to do. After experiencing the first ouch! something's in my shoe!, people might: look for a safe spot to pause, limp over to it, shake out their shoe, ditch the rock, re-shoe their foot, and continue on their way.

Some meditation teachings disrupt this ordinary and wholesome way of responding to pain. Some of us may be profoundly disrupted.

Imagine the rock-shoe scenario for someone with hypervigilance or hyperfocus or sensory overwhelm or difficulty and frustration in focusing on boring, repetitive tasks. Complicate this further with beliefs about the self, hopes and dreams about the spiritual search, concerns and anxieties about being good enough, fitting in, being welcome in community, being valued and seen as worthy. 

One person, experiencing pain, might take it as a test and a trial and part of the practice. Believing they are supposed to ignore or transcend or tolerate the discomfort, they do not remove the rock. 

Another, drinking in the surroundings or otherwise absorbed in compelling sensory or mind object experience, feels very little sensation coming from their feet. They do not remove the rock.  

Another one notes the ouch... but easily distracts themself from the discomfort by focusing on something entirely else; the pain is masked. They do not remove the rock.

One person stops to remove the rock... but doesn't have a chair available, or the support they need to stand on one leg safely and get that shoe off and on again, or the ability to get up from the ground if they go down. They would like to remove the rock, but they cannot. They do not remove the rock.

One person marches on under fierce internal or external pressure—a parade, a ceremony, a classroom. Inclement weather. Military or competitive conditions. The approval or disapproval of a valued authority. They do not remove the rock.

Another person experiences chronic pain. When the pain of the rock comes, it's just more of the same. They are used to it. They do not remove the rock.

All these practitioners are extra vulnerable to harm from an activity—walking—that is ordinarily considered safe and universally recommended for everyone. 

Burnout is one of the greatest risks and struggles of life with many kinds of neurodiversity. Burnout halts ordinary functioning, and it is slow and painful to heal. Hyperfocus is compelling and rewarding, but in excess it is also a contributor. We do not want to ask our neurodiverse brains to spend more time in hyperfocus.

Non-anecdotally, for people already struggling with PTSD flashbacks, rumination, or easily triggered trauma memories, mindfulness (concentration) practices are frankly contra-indicated. "Specifically, mindfulness-based approaches may increase distress or destabilize clients who are particularly prone to flashbacks, rumination, or easily triggered trauma memories, given that they reduce avoidance of trauma-related thoughts and emotions and may increase exposure to traumatic memories and emotional states." 

*What might I do in place of concentration practices?

Just sitting with no particular expectations, treating all moments as valuable and perfectly fine for awakening, seems to be a generally safer practice. It's also less accessible in the beginning. 

With experience, just sitting may become a cultivated space in which both ordinary processing and deep work for the sake of change and liberation are spontaneous and ordinary. Here are three suggestions on how to transition or settle into just sitting.

Some students can transition from concentration practices by using a hua-tou question, such as "who sits?" "Who hears?" "What is aware?" The hua-tou question is not a replacement object for fixed attention. It's also not particularly meaningful in itself, by design. Its function is to affirm and validate direct engagement with personal experience in the moment. The hua-tou might be raised briefly, once or multiple times throughout the sit—depending on the practitioner, the circumstances, and the length of the sit. It's never wrong for the practitioner to become curious and aware of whatever's happening in response to the question. When a line of investigation comes to a natural end and it feels like "nothing's happening,"  the practitioner might repeat the question. Most notice how the answer has already changed.

Koan practice can be an option. Narratives capture human attention effortlessly. We love stories about people, and puzzles, and we love to mull over choices and outcomes. When our mind wanders from a fascinating story, it's usually only in order to come back to that story from a different angle. Koans are made for this. Meanwhile as we mull a koan, we may settle deeply and from there go on to experience many different meditative states.

Per Willoughby Britton (when asked about safer meditation and retreat practices): integrating movement into sitting throughout the day seems to be protective.

Meanwhile, an attitude of zealotry emerged as a clear risk factor. Great determination to awaken is perhaps a quality that follows her law of the Inverted U-Shaped Curve: you need some, not too little. And definitely not too much.

Further reading

Cheetah House has a collection of practitioner stories—first-person accounts of adverse impacts from meditative practices.

If research papers are your thing, The Clinical and Affective Neuroscience Laboratory offers the "The Meditation Safety Toolbox" as a free download. 

/\ Angie Reed Garner, Assistant Teacher OMZL