Sunday, September 22, 2019

The dubious research claims of Transcendental Meditation, part 2: "peer review" doesn't always mean "quality" or "accuracy"

David Lynch, Sarina Grosswald,
and John Hagelin at a David Lynch
Foundation press conference,
December 2011.
Read this series from the beginning.

This series continues with Part 3, here.

The organizations that have promoted Transcendental Meditation (TM), including the David Lynch Foundation (DLF), have for decades repeated the insistence of TM’s founder, Maharishi Mahesh Yogi, that extensive scientific research supports their claims of TM’s validity. As I discussed previously, when their claim that “hundreds of published studies” is examined, it’s clear that an enormous proportion of those studies - 82% of the studies listed from the front page of the website - have been authored, or co-authored, by researchers with a documentable, institutional tie to a TM organization. That’s just the first of the issues that arise, when their various claims of independence, volume and quality are contrasted with an analysis of this set of studies. I think we can safely assume that a list on the primary TM website would contain the best studies they can come up with and that support their frequent claims of scientific validation of TM. The response of, “is that really all you’ve got to offer after fifty years of trying?” comes to mind when the contents of that list are carefully examined.  The methodology of many of these studies, versus the conclusions made, are the points at which the movement’s assertions don’t hold up under scrutiny.

There’s also the implied insistence among those offering TM, that when a study is published in a “peer-reviewed journal,” that that study has some magical stamp of approval and that everything in any such study, particularly conclusions favoring TM, are always absolutely and perpetually true. This is, unfortunately, often the way that scientific research is reported in the media, leaving a misimpression with the public that published studies in prestigious journals are some fixed statement of scientific reality. This is seldom true. Science is an ongoing process of discovery, and often the findings of studies, even those published in highly regarded, peer-reviewed journals, will conflict with one another, are found to be not all they were initially thought to be, and in a few rare cases, the researchers were found to have committed fraud in the course of producing a study which supported their predetermined conclusion.

This reliance on peer review as some absolute stamp of accuracy and legitimacy is actively exploited by TM apologists. David Orme-Johnson, longtime psychology department chairman at the TM movement’s university, Maharishi University of Management (MUM), writes about peer review on his “Truth About TM” website as if it would, in every case, notice and intercept every instance of shoddy science performed by a researcher, who’s also a meditator, working on a subsequently published study favoring TM:

Moreover, one purpose of the peer-reviewed process is to screen out studies that may have been biased by the orientation of the investigators. The numerous published studies on the Transcendental Meditation program have met the high standards of peer-review.

This is not quite how academic publishing works in the real world, where faults in research, missed by reviewers, are noted by other scientists after they’re appeared in those peer-reviewed journals, and those faults are later discussed. Those critiques, rebuttals and counter-rebuttals of TM research can sometimes be found in the pages of the same journals in which the original studies of TM have been published.

The list that purports to be “Hundreds of published research studies” linked from the front page of the website, contains only 160 entries, of which 123 refer to original research. On that list are two studies that show how there are serious issues with much of the TM research that is performed by, or with the participation of, long-time committed meditators. These studies are  uncritically reported on in the media, and are recirculated in TM promotional materials over years if not decades, despite the clear issues with the quality and veracity of the research. These two studies, published 30 years apart, have both been criticized for having similar problems.

When the current list of publications from the website is winnowed down and alphabetized, the first of these two studies comes up on top of the list. It can be found under the subheading list, “Insomnia.” Both authors were affiliated with the TM organization in 1978, the first of the two authors, Allen Abrams, was once an assistant professor of education at MIU, and has published research while affiliated with a TM organization as recently as 2015.

Abrams AI, Siegel LM. The Transcendental Meditation program and rehabilitation at Folsom State Prison: a cross-validation study. Criminal Justice and Behavior, 1978, 5(1):3-20.

Now there’s quite a bit of irony surrounding the appearance here of this particular study, starting with the fact that the people who decide what goes on this website haven’t yet picked up on the fact that the second author, “Siegel LM” is actually Aryeh Siegel, the former TM teacher who recently wrote and published a book called “Transcendental Deception: Behind the TM curtain – bogus science, hidden agendas, and David Lynch’s campaign to push a million public school kids into Transcendental Meditation.” Siegel is quite explicit, as you might expect from the full title, about how he believes TM’s claims are based on “bogus science.” This forty year old study still regularly shows up on TM research lists published by the organization. Clearly, after half a century of trying, the scientific evidence in support of TM is still so thin, that every possible study is included on this list, including one that’s both decades old and co-authored by someone who’s currently one of its most high profile critics.

In “Transcendental Deception,” at page 26, Siegel describes his later misgivings about TM research and this study which he co-authored:

I also recognized that other aspects of TM were failing me. Importantly, my strong research background led to a troubling realization: nearly every study done by TM researchers was at least somewhat biased, and most were poorly designed. To be fair, I had to include the study that I co-authored at Folsom Prison in that assessment.

As it turns out, we don’t have to rely only on Siegel’s self-assessment of this study. The other ironic thing about the inclusion of this study on a current list on a TM website, is that the study itself is not online. If you Google the title, you’ll find the publisher’s page with an abstract of the study, which mentions reduction in insomnia, among other alleged benefits. But you can’t see the article unless you’re willing to spend 36 dollars, which the usual prospective meditator layperson without everyday access to such journals is probably not willing to spend to confirm the claim.

But what is available online for free download is another article, entitled “TM At Folsom Prison: A Critique of Abrams and Siegel,” written by a British Columbia forensic psychologist at a prison there, which the same journal published a year later. The abstract says it all in a few words:

The article by Abrams and Siegel, "The Transcendental Meditation Program at Folsom State Prison: A Cross Validation Study" is examined and found wanting in several respects. Abrams and Siegel are criticized for inadequate controls which seriously limit the conclusions to be drawn from their study. In addition, the authors have taken greater than normal liberties in interpreting their statistical results. It is suggested that if there are any rehabilitative effects from Transcendental Meditation, they are not documented by Abrams and Siegel’s paper.

What I find fascinating about this critique, is that the writer’s  “first point of contention” is very similar to that found in a critique of the subsequent study written thirty years later. Here is the kind of basic research methodology error, particularly regarding the use of controls, or not, that I think is common across so much TM research, and that I also think is almost completely unavoidable. This is because the multi-session method of teaching TM, taken as a whole, goes way beyond simply the assigning of a mantra and how to use it. It’s a process that’s full of coaching and expectation-setting that a certain sort of mental experience will occur, and that meditation practice will be followed by a great positive change in their lives and give them certain benefits, but only if the research subject meditates and meditates regularly. In the 1970’s, and still true to some extent today, it may also have been difficult to impossible to shield the research subjects from the ubiquitous media coverage of the claims for personal transformation through TM common at the time. All of these factors are difficult to control for, thus TM sympathetic researchers simply don’t bother trying.

The first point of contention results from the authors’ failure to use any form of placebo control or to shield the Ss [subjects] from the Es [experimenters’] main expectations. Basically, what Abrams and Siegel have done is to take two groups of people, tell one they will be given training which will radically alter its members lives, show them the way in which this alteration will be assessed (by the use of the same instruments in the pre- and posttests), and then ask them if they feel their lives have been altered. This group was then compared with a second group whose members were told they would not receive treatment until a later date and therefore to expect no change in their behavior.

The critic goes on to allege that the study’s authors made multiple errors, one sentence begins, “A more flagrant example of an attempt to distort the data…”  and the phrase “grossly misleading” also appears.

These certainly aren’t the kind of things that one would normally think would be associated with a study, that an organization would put forward on a rather sparse list of scientific evidence in support of its products. But that’s what’s happened here, and evidently it’s not unusual. Few people ever scratch the surface of these lists or spend time examining, in detail, these claims, even while they’ve been sitting out in plain view for a long time. In this case, it’s certainly been easy enough to find in recent years, as these documents eventually become accessible online.

Fast-forward to 30 years later, to 2008. I think it’s reasonable to think that, if the study of TM were a robust field of research, a lot of these obvious problems would have been resolved, subsequent researchers would have learned from the mistakes of their predecessors, and there would be studies that would move beyond the realm of “exploratory research” - that is, preliminary research of questions that aren’t fully defined, where hypotheses are being proposed, and where research design is being refined. 

The reality is that, after fifty years of trying, most if not all TM research is still exploratory and in its initial stages. That never seems to stop this research from making its way into the media as some definitive proof that TM is effective and is every bit as important and valuable as its proponents say it is. These studies, at best, provide nothing more than tenuous suggestions for more research and are not solid evidence in support of all the claims made for TM. But a rather effective promotional effort aimed at the media, where celebrity endorsements are woven together with claims of scientific legitimacy, results in media coverage, that along with the studies themselves are perpetually recycled by the TM organization and the David Lynch Foundation. 

The second study, published in 2008, received a considerable amount of media attention at the time. It’s listed in the “Stress and Anxiety” research section on the website.

Current Issues in Education is an online journal that’s edited by graduate students at Arizona State University. If the impression is to be maintained that TM research generally appears in highly regarded and influential journals, this is not one of those examples. For example, the SCImago Journal Rank, for 2008, of this journal is 626, out of 828 publications worldwide. This ranking is a measure of the scientific influence of journals, as measured by how often articles are cited by other researchers; this one is not particularly influential.

Once again, as with so much research concerning TM, there is the issue of the institutional connections of the investigators, with TM promoting organizations. Out of the 4 authors of the study, three are obviously meditators and they can be directly connected to TM institutions.

  • Sarina J. Grosswald was an owner of a medical education consulting firm and was formerly employed by the American College of Obstetricians and Gynecologists. Ms. Grosswald, a TM teacher, died in 2015. She was a candidate for the United States House of Representatives, from Arlington, Virginia, in 1996 and 2000, with the Natural Law Party, which was the TM movement’s since-defunct political party. She also served in various roles with the David Lynch Foundation, including  Executive Director, Office of ADHD and Learning Differences, was reportedly the DLF’s “director of research,” and was the director of the Arlington, Virginia Transcendental Meditation center, in the Washington DC area. Her name appears in seven studies listed on the website. 

  • Fred Travis learned TM in 1972 and became a TM teacher shortly afterward, according to his 1974 letter to the editor of the Ithaca Journal. He’s a 1976 graduate of Cornell University, his senior thesis was a study of 35 Cornell undergraduates who practiced TM. He received both his  MA and PhD from Maharishi International University (now MUM) between 1984 and 1988, and has directed the Brain Center there since 1990. Twenty-eight of the 123 original studies on the website were authored or co-authored by Travis.

  • Mark A. Bateh was a University of Phoenix faculty member, which is the affiliation that appears on this study. He’s a statistician and data analyst with his own consulting firm, and has been an adjunct faculty member at the University of North Florida and Florida State College at Jacksonville. No evidence of a direct connection to TM institutions, or his status as a meditator, could be confirmed, nor is he known to have authored or co-authored any other study on TM.

The authors of this study share some demographic quirks. Of the three who are clearly closely associated with TM, all of them were all born within a year of 1950 or 1951, and it's likely they all would have been undergraduate students between 1970 and 1974, during the period when Transcendental Meditation was being heavily promoted on college campuses. These traits match those that can be frequently seen among many of the published researchers associated with TM: most often, they learned TM as undergraduate students before 1975, sometimes almost immediately becoming TM teachers, and they have continued to be enthusiastic meditators for, at this point, forty years or more. Many of them moved to the movement’s base at Fairfield, Iowa, becoming staff or faculty at their university there and living and working almost exclusively among other meditators. They are outliers relative to most people who started TM at some point in their lives, and who stopped meditating some months or years afterward. In this case, two of these individuals lived and worked in the Washington DC area, where a large number of meditators settled in the early 1980’s and where an active community of meditators, and a prominent TM facility, still exist today, along with an office of the David Lynch Foundation.

Keep in mind, we’re looking at a paper co-authored by longtime meditators, one of whom was doing research on TM thirty years before working on this study, a few years after the Folsom prison experiment was skewered by at least one critic. If there was progress being made in this field, why would we see the same issues with this study, performed by a few people in a position to be fully aware of what’s come before?

But the first thing that captures my attention, reading through the paper, is this passage which is something of a diatribe against the use of drugs to treat children with ADHD. There’s a substantial amount of propaganda produced by the TM organization which centers on the fear of “side effects” of medicine, both with respect to TM, as in this context, and with its efforts to revive their version of Indian folk medicine, Ayurveda, as a commercial product under its own “Maharishi” brand name. While it may not be apparent to the reader unfamiliar with the culture around TM and the fear of medicine and science that it sometimes fosters, these few sentences, which start on the study’s first page, sounds a familiar refrain among meditators and TM critics:

Side effects of the ADHD medication can further compound the problem by causing or  exacerbating emotional disorders. Consequently many children on ADHD medication are taking multiple drugs that include treatment for anxiety or other mood disorders, though most of  those drugs are not FDA approved for use with children. The long-term health effects of ADHD medications are not fully known; however, evidence suggests risks of cardiac disorders and sudden death, liver damage, and psychiatric events.

To fan the flames of fear of the use of drugs, and to provide support for the TM organization’s products, including Ayurvedic remedies, here they are falsely implying that the off-label use of drugs, or their use outside specific FDA approval, is life threatening, by immediately raising in the next sentence,  the specter of “sudden death” as a consequence of any drug-based therapy. This also matches the more general attitude among TM insiders, that TM is a solution to all problems, including those of mental health. 

Such attitudes against conventional, authentically evidence-based, medicine and science are clearly present among TM leaders, teachers and many meditators. Vaccination rates at the movement’s primary school in Fairfield, Iowa, have been among the lowest in that state, resulting in an outbreak of measles cases there in 2004. In India, where the movement and its founder have at times been much more explicit about their intentions, a book published by Maharishi Mahesh Yogi contains a declaration that all medicine and medical practices must be banned, that do not conform to his concept of Ayurveda, which are largely folk medicine practices unsupported by modern science.

The authors continue:

In light of the growing concerns about the safety of ADHD medication, their actual effectiveness,  and potential long-term health risks, the need to find effective non-drug interventions is becoming paramount.

Again, what’s oozing out around the edges of this paper is the assumption that TM is a fix for everything. The disregarding of the benefits of medicine, and instead, emphasizing those scientific studies that, they say, showed that modern medicine caused side effects and thus should be avoided, could be seen on TM websites produced around that time. To drive home that point to students at MUM, a display in the lobby of the Dreier Building there, once held a clear plastic-enclosed stack of paper, piled almost to the ceiling, representing 7,000 studies that they say showed the “hazards of modern medicine.” A similar graphic appears with one such page on the “Global Country of World Peace” website, one of numerous global TM organizations.

So the report of this study is rather remarkable in that it leads off with one of the underlying assumptions of the TM movement’s self-importance and world-transforming agenda, in plain view. The sentiment that the world and everything in it is horribly flawed, that a need to do something different is “paramount” to avert imminent disaster, and that the TM movement and all its products will bring about “Heaven on Earth” as well as personal and social benefit, colors everything that TM researchers do, and that’s reflected in the poor quality of what they produce. It is also a set of expressions of an unusual religious faith, that also asserts that its premises will invariably be verified by way of modern science.

Clay Jones, a pediatrician who’s written under the handle “skepticpedi,” today writes for the Science Based Medicine website. In early 2009, around the time this study was getting plenty of uncritical, credulous coverage in the media, he wrote an article at the blog of the Houston Skeptic Society, “How to Design a Positive Study: Meditation for Childhood ADHD.” As with the critique of the Folsom Prison study thirty years earlier, the lack of controls is mentioned in the second sentence, and then there’s much more.

The flaws in this study are numerous. The number of subjects is too small, there is no control group and it isn’t blinded. The study reveals that some of the children are on medication but it does not take into account the possibility of recent changes in medical therapy, or improved compliance while on the study. It is based purely on self-report and subjective questionairres and there is very high liklihood that a placebo effect could have been the sole responsible factor in the subjects’ apparent improvements. 

He takes note of Sarina Grosswald’s obvious connections to the TM program, pointing out this particular quote in a Reuters Health report on this study:

“The effect was much greater than we expected,” lead researcher Sarina J. Grosswald, a cognitive learning specialist in Arlington, Virginia, said in a written statement.

As Jones points out, and as can easily be confirmed through numerous sources, Grosswald is “a hardcore believer in TM,” and so are two of her three co-authors. This expectation is what many meditators express, it’s what’s learned through the process of being instructed in TM, which is much more than just being handed a mantra and being told how to use it. There is constant reinforcement of the idea that regular and correct practice of TM must in every case bring about positive results.  If not, you must not be doing it right and it’s your own damn fault, and they think you should submit to having your meditation “checked,” which is more reinforcement aimed toward continued practice of TM. 

There’s more, and this concerns the fact that the children, who are the subjects of this research study, may have been coached in various ways. If they learned TM in ways similar to how most people learned TM - through multiple sessions, during which new meditators are told several times over how practice of TM provides benefits, and will change the world - they have been influenced in ways that go far beyond being taught to meditate. Such influences would, under the usual circumstances, invalidate any attempt to call this a valid research study; they aren’t disclosed or being in any way controlled for. (In this case, there were no actual controls, only “self-controls” through before and after questioning of the ten students.)

A more concerning red flag, and one which was also discovered in the talk given by Grosswald, is the fact that the 10 children involved in the study may have been coached. In the last few minutes of the presentation, Grosswald presents clips of the children meeting with the TM proponents prior to the initiation of the study, where it appears that they are told what the expected outcome of the trial is, that their symptoms will improve with TM. 

Not only are these kids aged 11 to 14 being told what the expected outcome of the study is by study investigators, the headmaster of the school, Linda Handy, can be seen at the very end of the video discussing how amazing the technique is and how it will change the students’ futures for the better. I am forced to question whether the teachers, whose evaluations of the study subjects’ behavior and performance are an integral component of the study conclusions of positive effect, might have been hesitant to give a negative evaluation when their boss is clearly also a true believer.

Jones noted the involvement of the Abramson Family Foundation in financing this study, a foundation created by a Washington DC developer and meditator, Jeffrey Abramson. Its since-defunct website listed an advisory board that includes most of the current advisory board of the DLF, and that included co-authors Grosswald and Stixrud, along with school headmaster Linda Handy.

In the acknowledgments section, The authors thank the Abramson Family Foundation for funding and the Institute for Community Enrichment for support. The Abramson Family Foundation is an organization which believes that TM can help students achieve the full potential of their brain… Of note, Grosswald sits on the Board of Advisors for the foundation. Joining her on the Board is none other than the school headmaster Linda Handy. Whatever doubt I had in my lack of enthusiasm for this study fell by the wayside upon that discovery.

Linda Handy was not just an advisor to the Abramson and Lynch foundations. According to a recent biography on the website of the school where she is now “Director of Guidance & Counseling,” the Woods School, Handy herself is a meditator, as we might expect from anyone with any significant role with the DLF. As I mentioned earlier, many other meditators with various roles with the TM organization share  the history of having been an undergraduate student in the 1970-1974 period, which is also true of Handy.  Her direct association with the DLF on that biography is not evident, instead, she claims to be on the advisory board of the “Montgomery County Committee for Stress Free Schools.” No evidence could be found that an actual organization with that name exists. The “Committee for Stress Free Schools” was, according to its now-defunct website, established “in partnership with” the DLF in 2005, and Handy is listed among its “education advisors.” Since 2015, the web address for what was the Committee’s website has forwarded to the website of the DLF.

There’s also another peculiarity involving Handy, and this is in her bio on the DLF’s current website. She is listed as being the “principal of the Waldorf School in Silver Spring, Maryland,” and she’s been described that way on the DLF websites since at least 2006 through to the present. But there isn’t, and hasn’t been, a school called the “Waldorf School” in Silver Spring, and Waldorf schools generally don’t have principals. Her current employer, the Woods School, is a private Catholic school in the Washington DC suburb of Bethesda, Maryland, and other than the fact that a co-author of this study, William Stixrud, has given a lecture or workshop there, I haven’t located any public association between the Woods School and Transcendental Meditation. 

The conclusion of Jones’ assessment is actually rather depressing, given that science and health reporting is often unable to question or filter out advocacy based on marginal-to-invalid research of this nature, and his prediction has certainly held true in the subsequent decade since this was written. 

It wasn’t difficult to look at this study and see that the claims being made by TM supporters aren’t valid. It wasn’t even that hard to uncover the connections between the investigators, the school where the study was conducted and pro-TM organizations. Yet I was unable to find one news report that displayed even the slightest amount of critical thinking, instead reading like press releases from TM believers. The current state of science and health reporting is rather depressing, and I don’t see things improving any time soon as more and more dedicated science writers are falling prey to the poor economy.

Having seen this phenomenon over and over, across decades, it should be clear that research on Transcendental Meditation, when it’s performed by MUM faculty or other allied, long-term meditators and TM teachers, is meant to serve as an inducement to get more people to practice TM, and thus fulfill their expectations of global transformation or even “utopia” via the so-called “Maharishi Effect” if only enough people would meditate. TM isn’t just a meditation method,  it comes with an enormous amount of dogma that dictates that TM is effective, that its model of human consciousness based on some completely unsubstantiated connection to the “unified field” is valid, and that scientists simply need to catch up to what they already believe is true. Many of these basic assumptions about TM can be heard at an introductory lecture, and they are repeated frequently as a meditator becomes involved with other aspects of the program. As a result, meditators are, in my view, uniquely predisposed to assume that TM is effective in everything they do. 

This is what I consistently notice when exploring the research that's been offered in support of TM for decades now: whether they are fully aware of it or not, meditating researchers bend basic hypotheses, research design, and data analysis in the direction of favoring TM. Frequently, what they are calling “hypotheses” are actually restatements of basic points of doctrine that come from Maharishi’s particular interpretations of Vedic scripture, taught to TM teachers as part of their training, and to meditators in advanced courses.

It then comes as no surprise, among those of us who are longtime critics of Transcendental Meditation, that this is what the research looks like when it’s carefully examined. These studies always suggest that the bullseye is being drawn around the arrow; the arrow is the underlying anti-scientific, religion-based absolutism that they call “Vedic Science,” and the bullseye is what they think should result when science is placed into service for their own fundamentalist ends. Using science in this way is unlikely to work out very well for those with these obvious agendas, as scientists who aren’t among the very few who’ve been doing TM for 40 years or more, and who aren’t predisposed to favorable findings for TM, will very seldom reach the same conclusions.

Corrected, 2021-02-25: There are actually 10 papers tagged as referring to 'Insomnia' on the research list, not 2.

This series continues with Part 3, here.

Read this series from the beginning.

Photo: Cropped frame from David Lynch Foundation video at YouTube.

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