A systematic review of 27 randomized controlled trials found that mindfulness skills, decentering, and attitudes such as self-compassion are significant indirect pathways through which mindfulness-based programs improve mental health and well-being. Only four studies examined mechanisms within specific mindfulness practices. The evidence for alternative mechanisms like attention and awareness remains limited, especially regarding well-being outcomes, mental health promotion, and comparisons with active controls. The authors call for high-quality trials with powered multivariate mediation analyses to address these knowledge gaps and guide future interventions.
Intense meditation-related experiences (IMREs) can suddenly alter a person's sense of self, worldview, and emotions, but their meaning often shifts as meditators reflect and interpret them over time within their social and cultural context. Through in-depth interviews with 13 participants, four themes emerged: watching the self and world transform; emotional explosions leading to insight; deciding whether to share the experience or remain silent; and developing new perspectives and agency. Most participants found that the meaning of their IMREs became clearer through conversation with others, using concepts from science and meditation traditions. These experiences were transformative, offering new ways of perceiving and acting in the world.