Journal of Behavioral Medicine, Vol. 28, No. 4, August 2005 ( C© 2005)
DOI: 10.1007/s10865-005-9008-5
Is Spirituality a Critical Ingredient of Meditation?
Comparing the Effects of Spiritual Meditation, Secular
Meditation, and Relaxation on Spiritual, Psychological,
Cardiac, and Pain Outcomes
Amy B. Wachholtz1,2 and Kenneth I. Pargament1
Accepted for publication: October 26, 2004
This study compared secular and spiritual forms of meditation to assess the benefits of a spir-
itual intervention. Participants were taught a meditation or relaxation technique to practice
for 20 min a day for two weeks. After two weeks, participants returned to the lab, practiced
their technique for 20 min, and placed their hand in a cold-water bath of 2◦C for as long as
they could endure it. The length of time that individuals kept their hand in the water bath
was measured. Pain, anxiety, mood, and the spiritual health were assessed following the two-
week intervention. Significant interactions occurred (time × group); the Spiritual Meditation
group had greater decreases in anxiety and more positive mood, spiritual health, and spiritual
experiences than the other two groups. They also tolerated pain almost twice as long as the
other two groups.
KEY WORDS: meditation; pain; anxiety; depression; spirituality.
Stress causes a variety of physiological changes
in the body, including increased cortisol levels, in-
creased anaerobic cellular activity, increased heart
rate and blood pressure (Rabin, 1999). Over time,
these repeated actions produce permanent nega-
tive consequences on health. Acute reaction to
stress has been shown to be a good predictor
of future hypertension and mental health diffi-
culties (Carroll et al., 2001; Kasagi et al., 1995;
Weidner and Messina, 1998). Research indicates
that meditation can suppress these stress reactions
and, perhaps, even reverse some of the negative
consequences caused by prolonged exposure to a
stressor, such as chronic pain (Alexander et al.,
1991; Astin, 1997; Dillbeck and Orme-Johnson,
1987).
1Bowling Green State University Bowling Green OH 43403.
2To whom correspondence should be addressed at Department
of Psychology, Bowling Green State University, Bowling Green
OH 43403; e-mail: amywach@bgnet.bgsu.edu.
Previous research offers substantial evidence
that one form of spiritual meditation, transcenden-
tal meditation (TM), can reduce heart rate, lower
blood pressure, and improve mental health. Further,
in a meta-analysis comparing various meditation and
relaxation protocols, these effects were found more
often after the use of TM than secular meditation
techniques (Alexander et al., 1991). While TM in-
structors state that TM is not a religious practice,
they do suggest that it is the spiritual dimension of
TM that leads to more positive results than those
yielded by secularly focused relaxation techniques
(Dillbeck and Orme-Johnson, 1987; Alexander et al.,
1994). Theoretically, the spiritual nature of TM shifts
the mind away from physical and mundane concerns
to a focus on the larger universe and the individ-
ual’s place within it. While this study does not repli-
cate TM techniques, given the limited research on
non-TM forms of spiritual meditation, TM provides a
model on which to base spiritual meditation research.
As yet, few studies have directly compared the ef-
fects of (non-TM) spiritual and secular meditation
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370 Wachholtz and Pargament
techniques. The question remains whether spiritual
meditation has advantages over secular meditation.
BENEFITS AND HARM OF RELIGIOUS AND
SPIRITUAL PRACTICES
Although a number of studies have shown posi-
tive correlations between religion, and health (Hixon
et al., 1998; Levin and Vanderpool, 1989; Moore,
1996; Pargament, 1997), mental stability (Koenig
et al., 2001; Payne et al., 1992), and longevity (Koenig
et al., 2001), there have been few studies utilizing a
treatment-outcome design to compare religious or
spiritual interventions with their secular counterparts
(Harris et al., 1999). While religion and spiritual-
ity could prove to be a powerful source of strength
and comfort to assist therapy clients in achieving
their goals, without further research, it is impos-
sible to state what role, if any, religious therapies
play in improving treatment outcomes. McCullough
(1999) emphasizes the point in his meta-analysis;
he notes that research is lacking about the rela-
tive levels of treatment satisfaction, spiritual well-
being/improvements, or relapse prevention in secular
and religious forms of counseling.
In their 10-year literature review published in
Worthington et al. (1996) found that the role of spiri-
tuality in therapy had not been adequately addressed
in the research literature. The authors reported only
two studies published since 1984 that utilized a re-
ligious meditation technique, and one of these was
limited solely to the use of TM. Thus, only one study
attempted to compare a religious devotional or med-
itative practice with a secular practice.
In Harris et al. (1999) reviewed the available lit-
erature on spiritual and religious interventions. The
authors specifically identify two categories of reli-
gious or spiritual interventions. The first are those
methods, theories, or models that added religious or
spiritual content to secular approaches in order to
improve clients’ responsiveness. The second major
area includes those interventions that implicitly or
explicitly originated from a religious tradition. The
authors state that spiritually based therapies and in-
terventions offer modest improvements in the effi-
cacy of health care. However, they call for more re-
search and point specifically to the issues this study
addresses. Future research, they suggest, “should fo-
cus in on comparing explicitly religious or spiritually
oriented meditation interventions with more secular-
ized versions. . .” (Harris et al., 1999, p. 420).
RELIGIOUS MEDITATION AND HEALTH
Meditation has a long history of association with
spiritual and religious practices. Cultures around the
world integrate meditative practices into their reli-
gious and spiritual disciplines. Many of these forms of
meditation use meditative phrases to focus the mind
on spiritual concepts.
Spiritual meditation has been utilized to lower
heart rate, blood pressure (O’Halloran et al., 1985;
Wenneberg et al., 1997); metabolism (Elias et al.,
2000; Titlebaum, 1998); galvanic skin response, res-
piration rate and alter EEG readings (Dillbeck and
Orme-Johnson, 1987); enhanced autonomic stability
during stress (Alexander et al., 1991); and altered
endocrine responses to stress (Infante et al., 1998).
Additionally, participants report improved health
and greater relaxation after religious/spiritual med-
itation (Elkins et al., 1979; McKinney and McKinney,
1999). It has been suggested that spirituality can also
affect pain tolerance. Among advanced oncology pa-
tients, religious beliefs correlate with general happi-
ness and life satisfaction as well as with decreased re-
ports of pain (showing increased tolerance) and less
perceived pain (Yates et al., 1991).
Spiritual and religious meditation may have an
impact on stress reactivity, pain perception, and
pain tolerance through several possible pathways.
Meditation correlates with feelings of spiritual ex-
periences/support and may moderate mood which,
in turn, correlates to strengthened impulse control
(Tice and Bratslavsky, 2000). Additionally, spiritual
meditation may affect stress reactivity through the
pathways of spiritual connection (McKinney and
McKinney, 1999), peace, calm, and reduced anxi-
ety (Alexander et al., 1991; Carlson et al., 1988), in-
creased self-efficacy (Keefe et al., 2001) and result in
an improvement of mood (Bush et al., 1999), greater
internal loci of control (Ferguson, 1980), and de-
creased focus on the body (Alexander et al., 1994).
Thus, spiritual meditation may exert its effects on
stress reactivity through a number of possible path-
ways.
Meditation Intervention Studies
Despite the inclusion of spiritual meditation in
most major world religions, Transcendental Medi-
tation (TM) remains one of the few well-studied
forms of this technique. Spiritually based TM con-
sistently yields more positive effects than secular