The Hidden Risks of Meditation — Dr. Willoughby Britton | The Tim Ferriss Show

In this episode of The Tim Ferriss Show, Tim Ferriss interviews Dr. Willoughby Britton, a clinical psychologist and associate professor at Brown University, about the potential adverse effects of meditation. Dr. Britton discusses her research on how meditation can impact individuals differently, sometimes leading to negative experiences such as insomnia, dissociation, and emotional blunting. She highlights the importance of understanding personal risk factors and the need for proper guidance and support structures in meditation practices. The conversation also touches on similarities between meditation and psychedelic experiences, the significance of monitoring and off-ramps in retreats, and the role of Cheetah House, a nonprofit she founded to support meditators in distress.

• Willoughby Britton is a clinical psychologist, associate professor of psychiatry and human behavior at Brown University Medical School, and director of Brown's Clinical and Affective Neuroscience Laboratory.
• Her research focuses on the effects of contemplative practices like meditation on the brain and body, particularly in treating mood disorders, trauma, and other conditions.
• Britton is interested in identifying which meditation practices are best or worst suited for different people or conditions and why.
• She is known for her research on adverse effects of meditation, understanding why they occur, and how to mitigate them.
• Britton founded Cheetah House, a nonprofit providing evidence-based support for meditators in distress and offering meditation safety training.

"She's especially interested in which practices are best or worst suited for which types of people, or conditions, and why."

• Britton's work aims to tailor meditation practices to individual needs and conditions.

• Tim Ferriss shares his experience at a silent retreat where he encountered overwhelming traumatic memories.
• A mutual acquaintance suggested Ferriss and Britton discuss meditation-related adverse events and their similarities to psychedelic experiences.

"I had a flooding of traumatic memories...it was overwhelming, to an extent that I could not have imagined, and certainly had not been prepared for."

• Ferriss's personal experience highlights the potential for meditation to trigger unexpected emotional responses.

• Britton's interest in meditation began after a personal crisis when a childhood friend committed suicide, leading to PTSD.
• She turned to meditation as an alternative to medication, inspired by Jack Kornfield's book "A Path with Heart."
• Britton's academic journey included studying altered states of consciousness and near-death experiences.

"I had probably diagnosable PTSD at that point, and I really didn't want to take medication."

• Britton's personal crisis motivated her to explore meditation as a coping mechanism.

• Britton's dissertation focused on the effects of mindfulness training on sleep, revealing unexpected results.
• Contrary to expectations, meditation was associated with increased cortical arousal and insomnia.
• Britton faced a dilemma between her scientific findings and her advocacy for meditation.

"We actually found that no matter how you measured arousal, cortical arousal, brain arousal, meditation was associated with increasing it, not decreasing it."

• Meditation can increase brain arousal, potentially leading to insomnia, challenging the assumption of its universal calming effects.

• Britton's research revealed that meditation can lead to hyperarousal and adverse effects, particularly at higher doses.
• Meditation is often marketed as a relaxation technique, but it can have stimulant-like effects similar to caffeine or Ritalin.
• Britton emphasizes the importance of understanding the potential risks and tailoring meditation practices accordingly.

"If you think about meditation as one of those, I mean, think about what happens when you —"

• Meditation can act as an attention-enhancing product, with potential for hyperarousal and adverse effects.

• Ferriss combined fasting, meditation, and microdosing psychedelics during a silent retreat, leading to a traumatic experience.
• He experienced a flood of childhood trauma memories, resulting in insomnia and psychological distress.
• Jack Kornfield provided crucial support and guidance during this crisis.

"I had this flooding of memories of childhood abuse...it was a re-experiencing of these traumatic experiences from age two to four."

• Ferriss's experience underscores the potential risks of combining meditation with other intense practices without proper guidance.

• Britton discusses the difficulty of predicting who may experience adverse effects from meditation.
• Factors such as meditation intensity, personal history, and psychological predispositions can influence vulnerability.
• There is a need for better screening and understanding of individual differences in meditation suitability.

"Males 18 to 30 who think that combining every possible powerful tool, all at once, to break on through to the other side is a story that I see again over, and over, and over again."

• Young males attempting to combine intense practices are at higher risk of adverse experiences.

• Meditation can have both positive and negative effects, depending on individual circumstances and practice intensity.
• Britton's work highlights the need for personalized meditation approaches and awareness of potential risks.
• Ferriss's experience serves as a cautionary tale for those considering intense meditation practices without adequate preparation or support.

"There should also be a letter to your future self, so you don't do the same thing again."

• Reflecting on past experiences can help prevent repeating mistakes and guide safer meditation practices.

• Meditation-related adverse effects can arise from various risk factors, including trauma history, psychiatric history, and belonging to minority groups.
• Screening people out from meditation based on these risk factors is not ideal, as most people have some exposure to stressors.
• Meditation is marketed for various mental health conditions, which complicates the idea of excluding certain groups from practice.

"Statistically speaking, there is an increased risk factor for a large range of variables that would be considered stressors, adversity."

• The presence of stressors and adversity increases the likelihood of experiencing adverse effects from meditation.

"More than 90 percent of people have exposure to a criterion A stressor, so that would be almost everyone gets ruled out, except for the extremely sheltered and privileged."

• Excluding people from meditation based on exposure to stressors would mean excluding nearly everyone, which is not the goal.

• Even experienced meditation teachers can experience adverse effects, indicating that correct practice does not guarantee safety.
• Meditation-related challenges are not limited to those with psychiatric or trauma histories.

"In our study, 60 percent of the people who had meditation-related challenges were themselves meditation teachers."

• Meditation teachers, despite their knowledge and experience, also face challenges, suggesting that adverse effects are not solely due to incorrect practice.

• The focus should be on monitoring and providing off-ramps rather than screening people out.
• Meditation is being marketed for conditions that are typically red-flagged, creating a dilemma for access.

"I'm not a big fan of screening people out. I think the other side of this is that there are a lot of people... meditation is being marketed for schizophrenia, for psychosis, for bipolar disorder."

• Excluding individuals based on mental health conditions contradicts the marketing of meditation as a beneficial practice for these conditions.

• Adverse effects from meditation are comparable to those from psychotherapy, with 6 to 14 percent experiencing lasting negative effects.
• The definition of adverse effects includes impairment in functioning, not just negative experiences during meditation.

"Of these people, six to 14 percent had lasting negative effects. So that's what I wanted to bring up, a number that closely mirrors the adverse effects of psychotherapy, five to 13 percent."

• The prevalence of adverse effects in meditation is similar to that in psychotherapy, highlighting the need for awareness and management strategies.

• Training instructors and monitoring practitioners are crucial for managing risks associated with meditation.
• Individual awareness of personal indicators of stress or discomfort can prevent adverse effects.

"We created a taxonomy of 59 categories of meditation-related challenges... I think that the best way to do it is to train each individual person to be like, how do you know when you're getting outside of your window of tolerance?"

• Understanding personal indicators of stress can help individuals manage their meditation practice safely.

• Identifying personal signs of stress or dysregulation is essential for safe meditation practice.
• Factors like overcaffeination, lack of sleep, and fasting can contribute to negative experiences.

"My mouth gets dry, is like an indication of sympathetic activation. I get really hot, and when I'm really about to, a strong stressor for me is when my visual field starts to get wonky."

• Recognizing early signs of stress, such as physical sensations, can help individuals adjust their practice to avoid adverse effects.

• Diet can significantly impact meditation experiences, with high-protein and high-fat foods potentially mitigating negative effects.
• Retreats often involve dietary changes that can affect practitioners' experiences.

"A lot of people found that to be a factor, and found that actually eating really high fat protein meat is a remedy for the problems."

• Dietary adjustments, such as increasing protein and fat intake, can help stabilize individuals during meditation retreats.

• Meditation can lead to emotional detachment or anhedonia, affecting both negative and positive emotions.
• This detachment can be seen as equanimity or a decrease in emotional intensity, depending on individual goals.

"Meditators also reported diminished emotions, both negative and positive. 'I had two young children,' another meditator said. 'I couldn't feel anything about them.'"

• Emotional detachment can result from meditation and may not align with everyone's goals, highlighting the importance of understanding personal objectives in practice.

• Meditation and psychedelics can both lead to similar adverse effects, such as dissociation or emotional numbness.
• Intense experiences from either practice can lead to a shutdown of the limbic system, resulting in anhedonia.

"With meditation, if you look at the neuroscience of meditation... you regulate all your anxiety and depression. But if you keep going, then you're going to see a downregulation of not just negative emotions, but also positive ones."

• Both meditation and psychedelics can downregulate emotional responses, leading to a state of emotional numbness or detachment.

• Matching retreat goals with individual needs is crucial for minimizing risks.
• Shorter, less intense retreats with movement practices and tailored feedback are generally safer.

"I think that a lot of it has to do with matching the goals to the person. So I don't want to necessarily rule out or recommend any particular retreat across the board."

• Aligning retreat goals with personal needs and preferences can help mitigate risks associated with intensive meditation practices.

• Meditation systems should allow flexibility for better outcomes.
• Some systems are rigid, not allowing participants to adjust practices as needed.
• Flexibility in meditation retreats can include dietary adjustments and practice modifications.

"If somebody knows, 'I need to be able to leave the meditation in the middle so that I'm not continuing to meditate,' and the meditation retreat manager is like, 'No, that won't be allowed. You have to stay. If you come, you have to stay for the whole thing,' that's not really allowing flexibility."

• This quote highlights the rigidity in some meditation systems and the need for flexibility to accommodate individual needs.

• The diet at meditation retreats often contradicts dietary approaches beneficial for certain mental health conditions.
• Metabolic psychiatry, such as ketogenic diets, can be beneficial for conditions like schizophrenia and borderline personality disorder.

"If you look though at the food served at these meditation retreats, uniformly effectively the exact polar opposite, which is kind of interesting."

• The quote points out the contradiction between typical retreat diets and those beneficial for certain mental conditions.

• Meditation practices can have implicit values and goals not suited for everyone.
• Personalizing meditation practices can lead to better outcomes.

"I've started to understand that there's a whole set of implicit values that I didn't necessarily choose."

• This quote reflects the realization of implicit values in traditional meditation practices and the importance of personalizing them.

• The study identified 59 categories of meditation-related challenges and adverse effects.
• These challenges were categorized into cognitive, perceptual, affective, somatic, conative, sense of self, and social domains.

"We came up with 59 categories of meditation-related challenges and adverse effects, and we categorize them into seven different domains."

• The quote summarizes the extensive research into meditation-related challenges, emphasizing the complexity and variety of experiences.

• There are significant overlaps between meditation-related and psychedelic-related adverse events.
• Both can lead to prolonged adverse effects, sometimes lasting years.

"You could take almost everything you just mentioned if not everything, and map it to adverse events related to psychedelic experiences."

• This quote highlights the similarities between adverse effects from meditation and psychedelic experiences.

• Scaffolding is a supportive approach for individuals recovering from meditation-related challenges.
• It involves building personalized practices based on individual resources and preferences.

"If I'm following you and just reflecting back to you what I'm seeing, that can be a little bit more palatable to people who — that's kind of what scaffolding is."

• The quote explains the scaffolding approach, emphasizing the importance of personalized support in recovery.

• Personal practices should align with individual needs and preferences for optimal well-being.
• Engaging with nature and physical activity can be more beneficial than traditional meditation for some individuals.

"If you wanted to paint a picture of what my daily practice looks like, imagine me putting on some Carhartt overalls and getting a weed whacker or chainsaw and going out and doing trail work."

• This quote illustrates how personal practices tailored to individual preferences can enhance well-being, contrasting with traditional meditation practices.

• Cheetah House offers resources and training for understanding and mitigating meditation-related adverse effects.
• The website provides information and courses for individuals and facilitators.

"The public-facing sort of service branch, info branch of my lab is at Cheetah House, so that's cheetah, like the animal, house, like a house, .org."

• The quote provides a resource for further information and training on meditation-related challenges.

• Roman Palitsky is exploring the intersection of spiritual, existential, religious, and theological issues within the context of psychedelic-assisted therapies.
• Palitsky published an article in JAMA on this topic, offering new insights and perspectives that are being unpacked for audiences.

"He just published an article in JAMA about that topic and he'll be unpacking it for people."

• This quote highlights Palitsky's recent contribution to the academic discussion on psychedelics, emphasizing the significance of his work in a reputable medical journal.

• Adverse events can occur in both psychotherapy and meditation practices, often due to the practitioner's lack of empathy or competence.
• Tim Ferriss shares a personal experience with a well-known psychotherapist who caused significant damage due to his ego and lack of empathy.

"This guy was one of the most narcissistic, unbelievably unempathetic people I'd ever met in my life. And he did a tremendous amount of damage."

• Ferriss's quote underscores the potential harm that can arise from engaging with professionals who lack empathy and the importance of choosing practitioners carefully.

• Practitioners dealing with mind-altering modalities need to be skilled, empathetic, and have experience handling adverse events.
• Ferriss emphasizes the need for practitioners to have a proven track record and competency in managing challenging cases.

"It's to me, really important that you assess practitioners in advance to ensure that they have in fact handled these cases and feel very capable, and have demonstrated competency in handling these things calmly."

• This quote stresses the importance of vetting practitioners to ensure they are equipped to handle adverse events with empathy and skill.

• Institutional betrayal occurs when helping professions cause harm instead of providing support, leading to a lack of trust in these institutions.
• Cheetah House employs a peer support model where individuals with shared experiences offer empathy and validation, fostering a supportive community.

"This is called institutional betrayal, when the people who are supposed to be helping you are actually the cause of harm."

• The quote highlights the concept of institutional betrayal and the importance of alternative support systems like peer support models.

• Ferriss advises that individuals should have extensive personal experience with psychedelics before serving them to others, suggesting a minimum of 30 to 50 high-dose experiences.
• Volunteering with harm reduction organizations like Zendo can provide valuable experience in handling crisis situations.

"If you have not had at least 30 to 50 high-dose psychedelic experiences, you should not be serving psychedelics to anyone."

• This quote emphasizes the need for personal experience and proper training to ensure safe administration of psychedelics.

• Willoughby Britton discusses her research on the connection between near-death experiences and temporal lobe epilepsy.
• NDEs often have similar elements, such as tunnels, lights, and life reviews, making them ideal for study.

"Near-death experiences are actually one of the few types of spiritual experiences that are actually kind of similar."

• Britton's quote points out the consistent features of NDEs, which make them a valuable subject for research.

• Britton's research found distinct brain activity in individuals who had NDEs, leading to varied interpretations by skeptics and believers.
• The study results were met with contrasting reactions, illustrating the polarizing nature of NDE research.

"This group has a different, it has a sort of distinct brain activity compared to non-experiencers."

• This quote summarizes the key finding of Britton's research, indicating a difference in brain activity among those who have had NDEs.

• Researchers often face polarized interpretations of their findings, with both skeptics and believers projecting their beliefs onto the results.
• Britton shares how her findings were misinterpreted by both camps, highlighting the challenges researchers face in charged topics.

"Thank you for finally proving that these people are all nuts."

• This quote reflects the extreme and often misguided interpretations researchers encounter from the public.

• Meditation can lead to adverse experiences, and the Dalai Lama's response to these findings was seen as dismissive by some.
• Britton presented her research to the Dalai Lama, who attributed meditation challenges to a lack of Buddhist training.

"The Dalai Lama was basically saying, that this happened to people because they didn't have enough Buddhist training."

• This quote illustrates the Dalai Lama's perspective on meditation challenges, suggesting a need for deeper training.

• Ferriss and Britton emphasize the importance of awareness and preparation when engaging with meditation and psychedelics.
• They advocate for informed decision-making and the establishment of support structures to mitigate potential risks.

"I hope that will help people to think about this in a sort of risk-informed way, not so that they can say, 'I'm never going to meditate,' but simply to know this is a possibility."

• Ferriss's quote encourages a balanced approach to meditation and psychedelics, promoting awareness and preparedness.