Can meditation apps improve mental wellbeing? What the science says

2022 is lining up to be an exciting year for Medito in terms of scientific research. We have several projects in the pipeline to help us to further our understanding of the benefits of mindfulness and meditation and to measure the efficacy of the Medito app.

This article will explore some of the existing scientific literature around the effects of meditation and mindfulness on mental wellbeing before reviewing research on the effectiveness of mobile apps for teaching mindfulness. The learnings from this research will help us to shape developments in the Medito app and future research projects.

The benefits of mindfulness for mental wellbeing

Many studies have shown that mindfulness can have a positive impact on mental wellbeing. One study, by Pepping et al. (2013), found that mindfulness contributes greatly to psychological wellbeing. They found that self-esteem can be increased through mindfulness, which is a significant finding, as high self-esteem can lead to improved wellbeing in other areas such as health, relationships and work.

A more recent study by Strohmaier et al. (2021) found that both longer and shorter sessions significantly improved depression, anxiety and stress. Bellosta-Batalla et al. (2020) came to a similar conclusion, with brief mindfulness sessions resulting in a significant reduction in anxiety, along with an increase in salivary oxytocin.

It has also been shown that mindfulness can literally change the structure of the brain. A study by Hölzel et al. in 2011 found that mindfulness practice can lead to increased grey matter concentration in the brain, which is associated with improved learning, memory and emotion regulation.

Another way that mindfulness could lead to improved wellbeing is by helping people to get better sleep. In his book Why We Sleep, Matthew Walker explains that getting consistently good quality sleep has been shown to enhance memory, increase creativity, lower food cravings and protect against cancer, dementia, flu, heart attack, stroke and diabetes.

Studies, such as Rusch et al. (2019) and Shallcross et al. (2019) have found that mindfulness meditation may be effective in treating sleep disturbance. So, considering the benefits of good quality sleep listed above, mindfulness could be extremely beneficial to wellbeing.

However, there is some evidence of adverse effects of practicing mindfulness. Lindahl et al. (2017) claim that negative experiences of meditation are underreported. A study by Britton et al. (2021) found that mindfulness meditation can be ‘associated with both transient distress and enduring negative impacts on life and functioning at similar rates to other psychological treatments’.

So, it seems there is a need for continued research into the adverse effects of meditation, and in the meantime, we should provide mindfulness practitioners with resources to mitigate the risk of adverse effects, and support for those who might find themselves in distress.

Are mobile apps a suitable channel for teaching mindfulness?

Considering the potential benefits of mindfulness meditation for mental wellbeing, plus the need to provide adequate support to meditators who might have negative experiences, are mobile apps a suitable channel for teaching mindfulness?

There have been several studies that show that mindfulness apps are effective for improving mental wellbeing, for example:

1. Chittaro and Vianello (2016) found that inexperienced meditators significantly increased their level of mindfulness after using a meditation app.
2. Van Emmerik et al. (2018) found that after eight weeks, participants benefited from large decreases of general psychiatric symptoms and moderate increases of psychological, social and environmental quality of life.
3. Flett et al. (2019) carried out a randomized controlled trial involving university students using two mindfulness apps. They found that app users experienced improved depressive symptoms, college adjustment, resilience and mindfulness.
4. Flett et al (2020) examined students’ use of a well-known meditation app and found that there were small improvements in distress and college adjustment.

Three out of the four studies mentioned above lacked any kind of placebo control, but Flett et al. (2019) did use one, so it is promising to see positive results even when this is accounted for.

Another issue to consider when evaluating whether mobile apps are appropriate for mindfulness teaching is whether they stand up to face-to-face mindfulness teaching.

Mindfulness apps vs. face-to-face teaching

Flett et al. (2019) discussed the benefits of face-to-face teaching as well as the benefits of mobile apps. They said ‘face-to-face delivery of mindfulness instruction likely provides a superior social environment for new mindfulness practitioners.’ However, they also pointed out that ‘apps provide wide reach, immediate access, superior scalability, and generally are available at lower cost’.

Cavanagh et al. (2014) also recognised the high resource required for face-to-face teaching in comparison to ‘self-help’ options such as mobile apps. The main benefits that they list are around ease of accessibility to up-to-date information, plus reduction in stigma of accessing mental health support and increase in self-efficacy. The disadvantages that they put forward are around lack of a group context and absence of a responsive teacher.

Overall, their research showed a positive result for self-help mindfulness practice. Their meta-analysis found that it resulted in a significantly higher level of mindfulness/acceptance skills and significantly lower levels of anxiety and depressive symptoms than control conditions.

So, it seems that mindfulness apps do have their part to play in making mindfulness more easily accessible and affordable, which is exactly the aim of Medito Foundation. Face-to-face teaching could then be added alongside the use of a mobile app when and if it becomes available, depending on the meditator’s circumstances.

Combining mobile app teaching with group sessions

We could also consider expanding Medito’s offering to include more online forums or group video calls. This could potentially combine the accessibility and affordability of a mobile app with a community element.

But just how important is the community element to mindfulness practice? Matiz et al. (2018) assessed whether there were any differences in outcomes between people who practiced mindfulness meditation by themselves or in groups. They concluded that mindfulness meditation may have health benefits both when performed in group settings and in individual settings and that group meetings may not be the most important element. They also didn’t find any difference in drop-out rates between individual and group meditation.

However, another study by Allexandre et al. (2016) found that group support did improve participation and engagement. El Morr et al. (2019)carried out an analysis to inform the design of a mindfulness virtual community for students and found that students perceived several advantages for such a community, including anonymity when discussing mental health concerns, convenience and a sense of togetherness.

There were also some perceived disadvantages, including the lack of personal encounters and the worry of cyber bullying, but the consensus was that the overall experience could be positive if there was good moderation.

So, if Medito were to provide a moderated group community, it could possibly provide extra support for people’s mental wellbeing. It could also help people to maintain a more consistent practice and avoid the high drop-off rates that are common in ‘e-health’ as identified by van Emmerik (2018).

Avoiding McMindfulness

Another thing that we should aim to avoid when developing Medito, is falling into the bracket of ‘McMindfulness’. Miles Neale coined this term in 2010 and described it as ‘compartmentalized, secularized, watered-down version of mindfulness’, arguing that without other elements of Buddhism, mindfulness isn’t as valuable.

This view was also suggested by Maex (2011), who said that by removing the Buddhist context from mindfulness, it might lose the richness of valuable insights and practices. Ronald E. Purser’s goes a step further in his book entitled McMindfulness, as he suggests that secular mindfulness, as promoted by Jon Kabat-Zinn, encourages people to ‘bask in the glow of the present moment’ without judgement, instead of fighting against political and social injustices.

Anālayo (2020) argues against Purser’s view of McMindfulness. She points out that (i) stimulating political activism isn’t in line with Buddhist teaching; (ii) there is evidence of the promotion of mindfulness for mental health purposes in ancient India; (iii) mindful awareness doesn’t disable critical thinking, so it isn’t necessarily mutually exclusive with taking action. It could even make us more acutely socially aware.

Based on the above, for Medito to avoid McMindfulness, we should continue to recognize and refer to Buddhist roots and to build on existing elements such as mindful compassion, gratitude, insight, empowerment, anti-racism and activism.

Another element of McMindfulness is the commodification of mindfulness and its sale for profit. Kabat-Zinn (2015) referred to this when he said ‘that for certain opportunistic elements, mindfulness has become a business that can only disappoint the vulnerable consumers who look to it as a panacea’. Hyland (2017) argues that Kabat-Zinn underestimates the opportunistic elements and that the commercialization of mindfulness constitutes misuse of the practice and is at odds with ‘foundational mindfulness values such as right livelihood, loving kindness, compassion and non-materialism’. This is summed up well by Prof. David Forbes, who said:

‘…as more and more people make money off of mindfulness, I think it corrupts the spirit of the tradition and practice. I think it becomes more and more a product like any other in our society, and I think it becomes more an individualistic pursuit.’

Unlike many other meditation apps, Medito is 100% free, nonprofit and open source, so in this sense at the very least, we can avoid McMindfulness. We should continue to speak out against the commodification of mindfulness, and continue in our mission to reach as many people with accessible and free resources.

Conclusion

There is evidence to show that mindfulness may be beneficial for mental health and further evidence to show that mobile apps could be a suitable channel for teaching mindfulness.

However, there are limitations to the studies around mindfulness apps, so when Medito Foundation partners with researchers, our studies should be based on tracked usage rather than self-report and also include a placebo control.

When developing the Medito app, there are several key takeaways from this research that we will take into consideration:

1. Incorporate links to resources for meditators in distress, to ensure users have easy access to support when and if they need it.
2. Develop an online moderated community to support people’s mental wellbeing and to encourage consistent meditation practice.
3. Consider other options to help people to maintain a consistent practice, such as reminders. Also review app usage to identify behavior trends that lead to prolonged usage.
4. In order to avoid McMindfulness, we should continue to acknowledge Buddhist roots, and possibly consider adding additional Buddhist teachings. We should also further develop existing content topics such as mindful compassion, gratitude, insight, empowerment, anti-racism and activism. We should continue to speak out against the commodification of mindfulness and keep Medito nonprofit, free and open source.