Complementary Alternative Cardiovascular Medicine

Chapter 8 / Meditation and CVD 123
oxygen consumption, increased galvanic skin resistance, and decreased
heart rate, respiration rate, and blood pressure, associated with a state of
decreased sympathetic nervous system activity (8,9).
Meditative practice dates back centuries and its origin is in several
largely Eastern spiritual traditions. Regardless of its religious origin,
meditation’s primary goal is to achieve a state of consciousness described
as “restful alertness,” which in the various traditions is known as “jhana,”
“samadhi,” “nirvana,” or “enlightenment” (14,15). Although religious
in origin, the basic principles of meditative practice need not be practiced
in a spiritual context. Indeed, healthcare professionals who are
currently applying meditation as a mind–body intervention for their
patients are doing so independently of their spiritual or religious origins.
There are two general forms of meditation, and each has slightly
different methods and goals: concentration meditation, exemplified by
transcendental meditation (TM) and mindfulness meditation (MM).
Transcendental Meditation
TM is the principal approach for stress reduction and self-development
of the traditional comprehensive prevention-oriented natural system
of healing know as Maharishi Ayur-Veda. This approach was
initially introduced to the West by Maharishi Mahesh Yogi (14,16,17).
TM practice requires no changes in lifestyle, personal beliefs, philosophy,
diet, or physical activity (16). TM is typically taught either individually
or in a group by an instructor who has been trained by Maharishi
Mahesh Yogi. This approach focuses on one object: the sensation of
breath entering and leaving the body, or a mantra (a sound or phrase that
is repeated silently). This is known as the concentration, or “onepointed,”
method of meditation, which Buddhists call shamatha or
samadhi practices (14). Maharishi describes the nature of this narrowing
of attention and the process of TM as “turning the attention inward
toward the subtler levels of a thought until the mind transcends the
experience of the subtlest state of the thought and arrives at the source
of the thought” (18, p. 470).
Students are instructed to maintain a passive attitude throughout the
meditation practice. If distracting thoughts or images arise, they are to
be disregarded and the meditator’s attention should be redirected to the
mantra or the breath. The student is also instructed to sit in a comfortable
position to minimize the amount of muscular work required during
meditation. TM students are typically instructed to practice the technique
twice daily for 20-min periods. The overall results of this meditation
practice have been described as the development of a distinct
psychophysiological state of restful alertness (18,19).