Can Meditation Go Wrong? Adverse Events in Meditation (Farias 2020)
The first systematic review of meditation adverse events: 8.3% overall prevalence, anxiety and depression most common — and what it does and does not say about Daoist sitting.
The question
Can meditation go wrong — and how often? For years the clinical literature on meditation reported benefits while noting, almost as an afterthought, that harms were poorly reported (see the Goyal 2014 page). The Farias review is the first systematic attempt to count the other side of the ledger.
The study
- Design: systematic review of 83 studies of meditation and meditation-based therapies.
- Scope: “meditation-related adverse events” — harmful or distressing experiences occurring during or after meditation, including psychological, cognitive, and somatic events.
- Key structural finding: 55 of the 83 studies (65%) included reports of at least one type of adverse event — meaning the phenomena are not exotic; most studies that looked for them found some.
Findings (as stated by the authors)
- Overall prevalence: 8.3% (95% CI 0.05–0.12) of practitioners experiencing at least one adverse event.
- Prevalence varies enormously by study design: 3.7% (95% CI 0.02–0.05) in experimental studies; 33.2% (95% CI 0.25–0.41) in observational studies — a tenfold spread that reflects how the question is asked as much as what actually happens.
- Most common events: anxiety (33%), depression (27%), cognitive anomalies (25%). Gastrointestinal problems and suicidal behaviours were the least frequent (11% each).
- The naive-safety assumption is falsified: adverse events occurred in individuals with no previous history of mental health problems — the review’s single most important sentence for practitioners.
What it does NOT say
- Nothing about zuowang, jingzuo, or any Daoist practice. The reviewed studies cover mindfulness, Transcendental-Meditation-style mantra practice, and similar modern programs. The traditional Daoist claim that quiet sitting is universally safe, and the community counter-worry about “going wrong” (走火入魔), both remain untested for this specific practice — this page records the absence, not an answer.
- Nothing about severity. The review counts events, not their depth; an episode of transient anxiety and a serious crisis are both “adverse events.”
- No causal map. The review documents occurrence, not mechanisms or risk factors — a practitioners’ guide to risk it is not.
Why this page exists
This site’s problems and questions pages hold the line that Daoist sitting has no dedicated safety literature. The Farias review is the closest adjacent evidence, and it changes what an honest answer can say: meditation in general is not risk-free, adverse events are not rare when asked about, and absence of prior mental health difficulty is not protection. The traditional counsel on the sitting protocol page — gentle posture, no forcing, stop when distressed — becomes, in this light, not ornament but substance.
State of the question: the general-meditation safety question is now empirically illuminated; the Daoist-sitting safety question remains open. See Is Daoist sitting safe without a teacher? — answerState: open, for exactly this reason.
Sources
- Farias, M., Maraldi, E., Wallenkampf, K. C., & Lucchetti, G. (2020). Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatrica Scandinavica, 142(5), 374–393. DOI: 10.1111/acps.13225