section_path: "Challenging" and adverse effects/Contemplative traditions
section_name: Contemplative traditions
paragraph_text: Contemplative traditions
  
  Throughout East Asia the detrimental and undesirable effects of incorrect Meditation and Mindfulness practice are well documented due to the long varied history of cultivation in these fields. Many traditional herbal, intentional and manual treatments have been prescribed from the past to present day for what is diagnosed as Zouhuorumo (Chinese: 走火入魔).
  
  Meditation may induce "challenging" and "unwanted" experiences, and adverse effects to physical and mental health. Some of these experiences and effects are documented in the contemplative traditions, but can be quite perplexing and burdensome when the outcomes of meditation are expected to result in more advantageous and beneficial health outcomes than detrimental ones. By extension this problem is compounded with little or no support or explanatory framework publicly for novice or laity that is easily accessible for a practitioner to know when it is appropriate to self manage or when it is advisable to seek professional advice on the adverse symptomatology that may arise in this field of self-cultivation.
  
  According to Farias et al. (2020), the most common adverse effects are in people with a history of anxiety and depression. Other adverse psychological symptoms may include narcissistic, sociopathic behaviour and depersonalization or altered sense of self or the world, distorted emotions or thoughts, a mild form of psychosis including auditory and visual hallucinations. In extreme cases in patients with underlying undiagnosed or historical emotional conditions there have been instances of self-harm.
  
  According to Schlosser et al. (2019), "preliminary findings suggest that their occurrence is highly dependent on a complex interaction of contextual factors." For instance, meditation-related psychosis has been linked to sleep deprivation, preceding mental dispositions, and meditation without sufficient social support or any explanatory framework. However, according to Farias et al. (2020), "minor adverse effects have been observed in individuals with no previous history of mental health problems") Farias et al. (2020) further note that "it is also possible that participants predisposed to heightened levels of anxiety and depression are more likely to begin or maintain a meditation practice to manage their symptoms."
  
  According to Farias et al. (2020) there is a prevalence of 8.3% adverse effects, "similar to those reported for psychotherapy practice in general." Schlosser et al. (2019) reported that of 1,232 regular meditators with at least two months of meditation experience, about a quarter reported having had particularly unpleasant meditation-related experiences which they thought may have been caused by their meditation practice. Meditators with high levels of repetitive negative thinking and those who only engage in deconstructive meditation (vipassana/insight meditation) were more likely to report unpleasant side effects.
  
  The appraisal of the experiences may be determined by the framework used to interpret these experiences. Schlosser et al. "found strong evidence that religious participants have lower odds of having particularly unpleasant meditation-related experiences," and "found weak evidence that female participants were less likely to have unpleasant meditation-related experiences," and note the importance of "understanding when these experiences are constitutive elements of meditative practice rather than merely negative effects."
  
  Difficult experiences encountered in meditation are mentioned in traditional sources, and some may be considered to be an expected part of the process. According to Salguero,
  
  Problematic experiences such as strange sensations, unexplained pains, psychological instability, undesired hallucinations, sexual anomalies, uncontrollable behaviors, demonic possession, suicidality, and so forth seem to be quite well-known and well-documented across traditions.
  
  The Visuddhimagga mentions various unpleasant stages, and possible "unwholesome or frightening visions" are mentioned in Practical Insight Meditation: Basic and Progressive Stages, a practical manual on vipassanā meditation by Mahāsi Sayādaw. Classical sources mention makyō, Zen sickness (Chinese and Japanese: 禪病; pinyin: Chánbìng; rōmaji: Zenbyō) and related difficulties, such as zouhuorumo (走火入魔; ' fire possession '), and mojing (魔境; ' demonic states '). Traditional sources also precribe cures against these experiences, for example Hakuin Ekaku's treatment of Zen-sickness.