It’s fair to say that therapists of many stripes have integrated mindfulness meditation, either through the use of well-developed protocols, such as MBCT, or the integration of specific practices, such as the 3-Minute Breathing Space, into their clinical practices. But do we know, as is the case for pharmaceutical treatments, whether there are problematic side effects associated with its use? 

Mindfulness, like any practice that invites proximity to difficult mind and body states as a way of developing a new relationship to them, may indeed lead to distress in the short term as these skills consolidate. But you can say the same thing for other important self-care activities, such as exercise.

What is needed is more precise information about the nature of the risk or costs associated with mindfulness practice, so that these can be weighed against its benefits. Clients could then make a more informed choice at the outset about embarking on this particular approach to emotional well-being. In this way, mindfulness is not alone; we need this information about all forms of psychotherapy too. 

Anecdotal reports raise important questions, but they do not provide answers. For example, reports of silent meditation retreats bringing on episodes of depression or anxiety do appear from time to time and garner some attention in the press, but these reports are problematic. How well do retreats exclude vulnerable participants? How similar are retreat experiences to the structured class setting found in MBCT or individual psychotherapy? These are important distinctions when considering the relevance of these reports to mindfulness in psychotherapy settings.   

We need systematic approaches that address this question of safety. The one source I found was a side note in the recent MBCT meta-analysis, which canvassed 9 studies for adverse events reported by patients who received MBCT. None were reported. This type of safety monitoring is a step in the right direction, but more needs to be done going forward to fully address this question.