Feasibility of a Telephone-Delivered Group Meditation Intervention for Chronically Ill Socially Isolated Older Adults.

OBJECTIVES: This pilot study assessed the feasibility of a group-based telephone-delivered meditation intervention to reduce social isolation in older adults. It included weekly training sessions and daily practices of loving-kindness meditation in small groups via telephone conferences for six weeks and an extended group meditation practice for another six weeks. METHODS: Community-living older adults (age 60+) with multiple chronic conditions and experiencing social isolation were recruited. Each participant was assessed at the pretest, posttest, and follow-up (6 and 12 weeks after pretest). Outcome measures included social interaction, loneliness, and depressive symptoms. Open-ended questions were asked in the posttest and follow-up. RESULTS: Sixteen individuals enrolled, and fourteen completed the program (87.5% retention). Completers showed high levels of adherence (95% attendance to training) and acceptability and a statistically significant increase in social interaction at follow-up. Qualitative data suggest that participants experienced changes in emotion regulation, motivation and confidence, and sense of belonging. CONCLUSIONS: A group-based telephone-delivered meditation intervention targeting chronically ill older adults who experience social isolation is technically feasible, very acceptable, and potentially beneficial to them. CLINICAL IMPLICATIONS: Older adults enjoy learning meditation. Telephone conferencing is a low-cost tool for engaging socially isolated older adults in social interactions and group meditation.

Meditation Quality Matters: Effects of Loving-Kindness and Compassion Meditations on Subjective Well-being are Associated with Meditation Quality.

Loving-kindness and compassion meditations (LKCM) are considered a promising practice for increasing long-term well-being. While previous studies have mainly focused on meditation practice quantity, the current study provides an initial exploration of the quality of meditation during multiweek LKCM training. Data were collected through offline (Study 1; N = 41) and online (Study 2; N = 243) LKCM interventions. Quality of meditation was measured using two kinds of difficulties experienced during LKCM each week/unit (i.e., difficulty in concentration and difficulty in generating prosocial attitudes). Subjective well-being (SWB) was assessed by life satisfaction before and after training as well as positive and negative emotions each week/unit. Two studies consistently suggested that meditation quality was significantly associated with changes in SWB. Study 1 even showed that quality had a stronger association with SWB than did meditation quantity. Moreover, both short-term (measured each week/unit) and long-term (measured across the entire training period) associations between the quality of meditation and SWB were significant. Focusing on meditation quality, our findings provide theoretical and methodological pathways for understanding the contribution of meditation practice to LKCM training, which is helpful for guiding future research and best practices. Supplementary Information: The online version contains supplementary material available at 10.1007/s10902-022-00582-7.

The Need, Feasibility and Willingness to Explore "Meditation on Twin Hearts" as a Self-administered Tool for Mental Health Management among Transgender Women: An Exploratory Survey.

Hijras are the transgender community and have been socio-economically marginalized and hence their mental healthcare needs to be addressed. This was a descriptive, qualitative study, conducted in Mysore, India to examine the mental health status of 33 transgender women (TGW) and their response to the "Meditation on Twin Hearts (MTH)" intervention. Assessment of anxiety, depression and suicidality was carried out before the meditative session followed by a single session of MTH. Their feedback on meditation experience was collected, coded, and transformed into quantitative data. Among total participants, 39.4% of TGW exhibited severe anxiety, 21.2% has severe depression and 75.8% of them were at suicidal risk. Depression was positively correlated with anxiety and suicidal behavior. Most participants reported MTH was useful with signs of improvements in mental state. Thus, a single session of MTH has shown good signs of improvement in mental state among TGW.

Boosting prosocial career aspirations: Loving-kindness meditation relates to higher communal career goals in youth.

Wanting to help others and benefit society in one's future career are examples of communal career goals. Raising these goals in youth should increase interest in HEED-occupations (Healthcare, Early Education, Domestic, and the Domestic fields) which are strongly gender-skewed and face labor shortage. Research has yet to find ways to increase communal career goals. In this study, we test the novel hypothesis that after listening to a brief loving-kindness meditation, participants will rate stronger communal career goals, as compared to controls. In three experimental studies, volunteering high-school students (Study 1 and 3) and university students (Study 2) listened to a 12-min recording of the meditation with the explicit purpose of investigating its effect on stress. They thereafter filled out an apparently unrelated career goal survey. We compared the results with a control group that just rated the career goals (Studies 1-3) and a control group that listened to calm music before filling out the survey (Study 2 and 3). The results showed that the high-school students rated higher communal career goals after listening to the meditation, as compared to controls. We did not replicate the result in the sample of university students, which could relate to adults having less flexible career goals than youth, or to a ceiling effect in communal goals. This is the first study that has demonstrated a method with the potential of increasing communal career goals in youth. In addition to increasing interest in HEED, raising communal goals could benefit society, since they are intrinsically prosocial.

A New Second-Generation Mindfulness-Based Intervention Focusing on Well-Being: A Randomized Control Trial of Mindfulness-Based Positive Psychology.

Second-generation mindfulness-based interventions (SG-MBIs) align well with positive psychology philosophy and practices, but trials of SG-MBIs have largely focused on ill-being. This study developed a mindfulness-based positive psychology (MBPP) intervention integrating positive psychology with an SG-MBI to enhance well-being. A randomized control trial was performed to compare MBPP with a waitlist condition among 138 Chinese participants. The results showed that MBPP significantly reduced negative emotions for subjective well-being and significantly improved environmental mastery for psychological well-being. Improvements in self-compassion and negative attitudes but not avoidance, mediated changes in well-being. Changes in positive emotions, positive relations, and awareness were associated with the amount of meditation practice. These findings showed that MBPP is promising for improving well-being and that the positive psychology components play important roles. Broadly, the study illustrated that positive psychology and SG-MBIs can be effectively integrated, and it supported the further application of SG-MBIs from the positive psychology perspective. Supplementary Information: The online version contains supplementary material available at 10.1007/s10902-022-00525-2.

Increasing Self-Compassion: Review of the Literature and Recommendations.

Depression is a common symptom among college students and is often accompanied by negative thoughts about oneself. Self-compassion is a technique students can use to combat those negative thoughts. Self-compassion is an emotion-regulation strategy in which the individual engages in self-kindness, particularly after a mistake, failure, and/or rejection. This paper reviews the concept of self-compassion, assessment of self-compassion, and interventions that have been shown to increase self-compassion. Self-compassion is associated with lower levels of psychopathology and higher levels of well-being. It is theorized to work by buffering against a self-critical ruminative process after a mistake, failure, and/or rejection. Self-compassion is most commonly assessed through a validated scale that measures overall self-compassion and its six subscales: self-kindness, common humanity, mindfulness, self-judgment, isolation, and over-identification. Multiple self-compassion interventions have been shown to increase self-compassion and improve psychological health. These interventions are varied and contain strategies such as mindfulness meditation, loving kindness meditation, and changing self-talk. Details of those interventions and practical strategies that individuals, students, and professors can use to increase self-compassion are described. Overall, self-compassion is a valuable tool that can help individuals cope with mistakes, failure, and/or rejection.

Imagination-Based Loving-Kindness and Compassion Meditation: A New Meditation Method Developed from Chinese Buddhism.

Many loving-kindness and compassion meditation methods used in psychological research are derived from Theravada and Tibetan Buddhism. Zhiyi (), a representative figure of Chinese Buddhism, proposed a different meditation method, namely, imagination-based loving-kindness and compassion meditation. The current article introduces the imagination-based loving-kindness and compassion meditation proposed by Zhiyi and compares it with meditation methods from Theravada and Tibetan Buddhism. Zhiyi's method limits the content of imagination during meditation, which can be an essential supplement to the free association method derived from Theravada Buddhism. Zhiyi's method of helping others entirely through imagination differs significantly from the tonglen method derived from Tibetan Buddhism and may be more suitable for participants without religious beliefs. Based on Zhiyi's source text and previous psychological studies, a mental-health training program for imagination-based loving-kindness and compassion meditation is proposed. The limitations of Zhiyi's method and the future directions for empirical research on Zhiyi's method are also discussed. The differences between Zhiyi's method and other methods in terms of effects and applicable populations need to be examined in future studies.

Integrative Approaches to Minimize Peri-operative Symptoms.

PURPOSE OF REVIEW: Cancer patients who require surgery often experience peri-operative symptoms, including nausea, anxiety, and pain, which can significantly impair quality of life. Here, we review the evidence for using integrative approaches to manage these peri-operative symptoms. RECENT FINDINGS: Conventional peri-operative pharmacologic interventions, such as opiates for pain control, can lead to adverse effects such as respiratory depression, prolonged hospital course, and long-term dependence. Integrative medicine, also known as complementary and alternative medicine (CAM), has been explored as way to reduce peri-operative symptoms. Acupuncture, guided imagery, and loving-kindness meditation have all shown potential efficacy in reducing both peri-operative pain and anxiety in retrospective studies and small randomized controlled trials. Integrative medicine techniques, such as acupuncture, are a promising approach to control peri-operative symptoms without the associated adverse effects of more conventional pharmacologic interventions.

Brief breath awareness training yields poorer working memory performance in the context of acute stress.

Mindfulness-based interventions that span multiple sessions over time appear to confer psychological benefits. However, the effects of brief periods of mindfulness meditation training are less clear, particularly on measures of cognitive functioning. This study assessed whether brief mindfulness practice (breath awareness) or training in two other contemplative practices - loving-kindness and gratitude - differentially impact working memory performance following acute physiological stress relative to an attentional control. Participants (n = 162) were randomly assigned to one of four training groups and completed the automated Operation Span (OSPAN) task pre-training and again after undergoing the cold pressor task. Three of the four groups improved in OSPAN performance, with loving-kindness, gratitude, and attentional control conditions showing increases in OSPAN relative to breath awareness. Changes in OSPAN were not correlated with changes in positive or negative affect. It appears that brief breath awareness training may not effectively buffer against acute stress in this predominantly meditation naïve sample and may in fact impair subsequent cognitive performance relative to a control or other contemplative practices. A granular approach is warranted to understand potentially distinct and contextually variable effects of different contemplative practices. Implications are discussed in light of the stress buffering hypothesis and Monitor and Acceptance Theory.Trial registration: ClinicalTrials.gov identifier: NCT02214264.

Acute effects of meditation training on the waking and sleeping brain: Is it all about homeostasis?

Our recent finding of a meditation-related increase in low-frequency NREM sleep EEG oscillatory activities peaking in the theta-alpha range (4-12 Hz) was not predicted. From a consolidated body of research on sleep homeostasis, we would expect a change peaking in slow wave activity (1-4 Hz) following an intense meditation session. Here we compared these changes in sleep with the post-meditation changes in waking rest scalp power to further characterize their functional significance. High-density EEG recordings were acquired from 27 long-term meditators (LTM) on three separate days at baseline and following two 8-hr sessions of either mindfulness or compassion-and-loving-kindness meditation. Thirty-one meditation-naïve participants (MNP) were recorded at the same time points. As a common effect of meditation practice, we found increases in low and fast waking EEG oscillations for LTM only, peaking at eight and 15 Hz respectively, over prefrontal, and left centro-parietal electrodes. Paralleling our previous findings in sleep, there was no significant difference between meditation styles in LTM as well as no difference between matched sessions in MNP. Meditation-related changes in wakefulness and NREM sleep were correlated across space and frequency. A significant correlation was found in the EEG low frequencies (<12 Hz). Since the peak of coupling was observed in the theta-alpha oscillatory range, sleep homeostatic response to meditation practice is not sufficient to explain our findings. Another likely phenomenon into play is a reverberation of meditation-related processes during subsequent sleep. Future studies should ascertain the interplay between these processes in promoting the beneficial effects of meditation practice.

Fostering Self-Compassion and Loving-Kindness in Patients With Borderline Personality Disorder: A Randomized Pilot Study.

The aim of this randomized pilot study is to investigate the effects of a short training programme in loving-kindness and compassion meditation (LKM/CM) in patients with borderline personality disorder. Patients were allocated to LKM/CM or mindfulness continuation training (control group). Patients in the LKM/CM group showed greater changes in Acceptance compared with the control group. Remarkable changes in borderline symptomatology, self-criticism and self-kindness were also observed in the LKM/CM group. Mechanistic explanations and therapeutic implications of the findings are discussed. HIGHLIGHTS: Three weeks of loving-kindness and compassion meditations increased acceptance of the present-moment experience in patients with borderline personality disorder. Significant improvements in the severity of borderline symptoms, self-criticism, mindfulness, acceptance and self-kindness were observed after the LKM/CM intervention. LKM/CM is a promising complementary strategy for inclusion in mindfulness-based interventions and Dialectical Behavioural Therapy for treating core symptoms in borderline personality disorder. Copyright © 2016 John Wiley & Sons, Ltd.

The Self-Compassion Scale is Not Validated in a Buddhist Sample.

The concept of self-compassion originated from Buddhism, but very little is known about the utility and functions of this concept among Buddhists. Four hundred and eleven individuals (179 Buddhists and 232 non-Buddhists) completed the survey packages using the self-compassion scale (SCS; Neff in Self Identity 2(3):223-250, 2003a. doi: 10.1080/15298860309027 ). Confirmatory factor analysis showed that the original six dimensions of the SCS were not replicated by both samples, and further analysis of the intra-correlations within dimensions of SCS and relationships between SCS and other variables showed unexpected results specific to Buddhists. Among Buddhists, the dimensions of self-kindness and common humanity neither showed negative correlations with their opposite dimensions nor were associated with better emotional outcomes. In addition, these two dimensions were not predicted by the regular practice of loving-kindness meditation. This study argued that the ideas of self-compassion reflected in the SCS are theoretically different from the ideas of Buddhism, and further implications for measuring and clinically applying self-compassion were discussed.

A wait-list randomized controlled trial of loving-kindness meditation programme for self-criticism.

UNLABELLED: Self-criticism is a vulnerability risk factor for a number of psychological disorders, and it predicts poor response to psychological and pharmacological treatments. In the current study, we evaluated the efficacy of a loving-kindness meditation (LKM) programme designed to increase self-compassion in a sample of self-critical individuals. Thirty-eight individuals with high scores on the self-critical perfectionism subscale of the Dysfunctional Attitude Scale were randomized to an LKM condition (n = 19) or a wait-list (WL) condition (n = 19). Measures of self-criticism, self-compassion and psychological distress were administered before and immediately following the intervention (LKM or WL). WL participants received the intervention immediately after the waiting period. Both groups were assessed 3 months post-intervention. Intent-to-treat (n = 38) and per-protocol analyses (n = 32) showed significant reductions in self-criticism and depressive symptoms as well as significant increases in self-compassion and positive emotions in the LKM condition compared with the WL condition. A follow-up per-protocol analysis in both groups together (n = 20) showed that these gains were maintained 3 months after the intervention. These preliminary results suggest that LKM may be efficacious in alleviating self-criticism, increasing self-compassion and improving depressive symptoms among self-critical individuals. KEY PRACTITIONER MESSAGE: Self-criticism plays a major role in many psychological disorders and predicts poor response to brief psychological and pharmacological treatments for depression. The current study shows that loving-kindness meditation, designed to foster self-compassion, is efficacious in helping self-critical individuals become less self-critical and more self-compassionate. The study also suggests that practising loving-kindness may reduce depressive symptoms and increase positive emotions.

Training Emotion Cultivates Morality: How Loving-Kindness Meditation Hones Compassion and Increases Prosocial Behavior.

Traditional moral philosophy has long focused on rationality, principled thinking, and good old-fashioned willpower, but recent evidence strongly suggests that moral judgments and prosocial behavior are more heavily influenced by emotion and intuition. As the evidence mounts, rational traditions emphasizing deliberative analysis and conscious decision making are called into question. The first section highlights some compelling evidence supporting the primacy of affective states in motivating moral judgments and behavior. The real challenge is finding a way to align intuition with desired behavior. In cool reflective states, one may desire to be a kind and loving person. But when it is time to act, the moment is often accompanied by strong affect-laden intuitions. I argue that if affective states are the primary motivators of behavior, then moral sentiments must be trained through habituation in order to increase prosocial behavior. The second section provides empirical evidence linking emotional training with increased prosociality. To highlight this connection, focus is placed on the relationship between habitual meditation training, compassion, and prosocial behavior. Recent studies by Antoine Lutz, Richard Davidson, Susanne Leiberg, and others show that various meditation practices can dramatically affect the human person at various levels, i.e., increased physical health, neural restructuring, regulation and development of emotions, and increased helping behavior, to name a few. The current article focuses on the impact the habit of loving-kindness meditation (LKM) has on compassion and prosocial behavior. Recent studies strongly support the conclusion that LKM training hones compassion and ultimately leads to an increase in compassionate behavior.

The effects of loving-kindness interventions on positive and negative mental health outcomes: A systematic review and meta-analysis.

Loving-kindness meditations involve sending feelings of kindness and care to a series of people including oneself, loved ones, strangers, and all beings. Loving-kindness interventions (LKIs), which include knowledge and/or practice related to loving-kindness, have been gaining attention as a potential intervention for improving mental health in adults. This meta-analysis synthesized the effects of LKIs on both positive (i.e., mindfulness, compassion, positive affect) and negative (i.e., negative affect, psychological symptoms) indices of mental health across comparison types (i.e., passive control, active control, alternative treatment) and general sample types (i.e., community, university), and explored characteristics of LKIs that may impact their effectiveness (i.e., intervention format, intervention length, presence/absence of a live facilitator). Following a systematic review of six databases in November 2023, 23 randomized controlled studies met eligibility criteria and were included in the review. Relative to passive control groups, LKIs had positive effects on mindfulness, compassion, positive affect, negative affect, and psychological symptoms; these effects were non-significant relative to active control groups and alternative therapeutic treatments. Notably, the effects of LKIs did not differ as a function of sample type, intervention format, intervention length, or the presence/absence of a live facilitator. Findings provide support for the effectiveness of LKIs relative to passive control conditions, as well as their potential comparability to alternative evidence-based therapeutic treatments, and provide insight into resource-effective approaches to the delivery of effective LKIs. However, additional studies are needed to confirm the impacts of LKIs relative to other interventions in the field.

Understanding the Implementation of Informal Meditation Practice in a Smartphone-Based Intervention: A Qualitative Analysis.

Objectives: Informal practice (i.e., brief meditation practices incorporated spontaneously into daily activities) may be important for increasing the efficacy and accessibility of meditation-based interventions (MedBIs). However, the facilitators and barriers to engaging in informal practice are largely unknown. The current study aimed to investigate factors associated with the implementation of informal practice. Method: Participants were drawn from a randomized trial testing the effects of 5- versus 15-min daily meditation practice in a 4-week smartphone-delivered meditation training. Qualitative interviews on informal practice were conducted with 17 participants (mean age: 37.12 years; 82.35% female; 52.94% non-Latinx White) following the intervention. Given that prior knowledge on this topic is limited, inductive content analysis was utilized to characterize participants' experiences in relation to implementing informal practice. Results: Four overarching categories emerged from the data, namely (a) reported benefits of informal practice, (b) integration of informal practice, (c) perceived barriers to informal practice, and (d) recommended facilitators of informal practice. Conclusion: This study underscores the importance of addressing barriers and facilitators (e.g., providing personalized app features, reminders, social support, and repeating intervention content) to encourage individuals' informal practice. Findings provide suggestions for methods to increase engagement in informal practice, which may, in turn, increase the accessibility and effectiveness of MedBIs. Preregistration: The larger trial from which the qualitative interview participants were drawn was preregistered through clinicaltrials.gov (NCT05229406) and the Open Science Framework (https://osf.io/fszvj/?view_only=039b14ccbf8848bd99808c983070b635). The qualitative analyses reported here were not preregistered.

The effects of loving-kindness meditation on doctors' communication anxiety, trust, calling and defensive medicine practice.

OBJECTIVE: The study investigated the effects of loving-kindness meditation (LKM) on doctors' communication anxiety, trust, calling, and defensive medicine practice. METHODS: This study recruited 94 doctors from a hospital in China, randomized them to an LKM group (n = 47), and waited for the control group (n = 47). The experimental group accepted an 8-week LKM interference while the waiting for the control group underwent no interference. Researchers measured four major variable factors (communication anxiety, trust, calling, and defensive medicine practice) before and after the LKM intervention. RESULTS: In the experimental group, trust, and calling were significantly higher, and communication anxiety, and defensive medicine practice were significantly lower than in the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test. CONCLUSIONS: The results of this study demonstrate that LKM may help to improve trust, and calling, and reduce communication anxiety and defensive medicine practice. The finding of LKM's effect extends the understanding of the integrative effects of positive psychology on the decrease of defensive medicine practice. TRIAL REGISTRATION: ChiCTR2300074568. Registered in Chinese Clinical Trial Registry (ChiCTR), 9 August, 2023.

Is informal practice associated with outcomes in loving-kindness and compassion training? Evidence from pre-post and daily diary assessments.

We investigated whether informal meditation practice (i.e., self-reported application of meditative techniques outside a period of formal meditation) was associated with outcomes in smartphone-based loving-kindness and compassion training. Meditation-naïve participants (n = 351) with clinically elevated symptoms completed measures of psychological distress, loneliness, empathy, and prosociality at baseline and following a two-week intervention. Informal practice, psychological distress, and loneliness were also assessed daily. Steeper increases in informal practice had small associations with pre-post improvements in distress (r = -.18, p = .008) and loneliness (r = -.19, p = .009) but not empathy or prosociality. Using a currently recommended approach for establishing cross-lagged effects in longitudinal data (latent curve model with structured residuals), higher current-day informal practice was associated with decreased next-day distress with a very small effect size (ßs = -.06 to -.04, p = .018) but not decreased next-day loneliness. No cross-lagged associations emerged from distress or loneliness to informal practice. Findings suggest that further investigation into a potential causal role of informal practice is warranted. Future studies experimentally manipulating informal practice are needed.

The Impacts of Background Music on the Effects of Loving-Kindness Meditation on Positive Emotions.

Loving-kindness meditation (LKM) has been widely used in promoting mental health, with positive emotions as an important mechanism. The current study explored the impact of background music on the effects and difficulties of LKM practice. Two hundred participants were randomly divided into six groups, wherein LKM plus music with harmony only, LKM plus music with harmony and melody, and LKM without music were presented in a different order during the intermediate three days of a five-day LKM intervention. Participants reported three types of positive emotions (pro-social, low-arousal, and medium-arousal positive emotions) and the difficulties during meditation (lack of concentration and lack of pro-social attitudes) after each of three sessions. The results of MANOVA indicated that compared to the session without music, incorporating music could evoke more low-arousal positive emotions and pro-social positive emotions without altering the difficulties. However, the results did not reveal significant differences in the effects of music with harmony and music with harmony and melody on both emotions and difficulties. Additionally, practice effects may have influenced the generation of medium-arousal positive emotions and the difficulty of concentration, but the results were inconsistent across groups. Our findings suggest potential benefits for practitioners of LKM in incorporating music during the meditation process, and the directions for future research were further discussed.

Effects of meditation on health promoting protective factors of persons with cardiovascular disease-a quasi-experimental pilot study with pre-post comparison.

Background: The aim of this pilot study is to determine, in the context of a controlled intervention study, whether the health-promoting personal protective factors of sense of coherence, resilience, and self-compassion are strengthened by the practice of Metta meditation in individuals with cardiovascular disease. The interactions between mind and body play a pivotal role in health and mortality. Lifestyle factors and especially stress also play a decisive role in the development and progression of cardiovascular diseases. With health-promoting personal protective factors, which can be actively formed over the entire lifespan, stressors can be managed more adequately. Methods: Data collection will be conducted as part of a controlled nonrandomized longitudinal pilot intervention study that will enrol individuals with cardiovascular disease (n=29). After the first interview, a 12-week Metta meditation course will start for the intervention group (IG) (n=9), while the control group (CG) (n=20) will receive no intervention. The Minnesota Living with Heart Failure® Questionnaire (MLHFQ), the 13-item Sense of Coherence Scale (SOC-13), the Resilience Scale, the Self-Compassion Scale short form (SCS-sf) German version, the German version of the 10-item Perceived Stress Scale (PSS-10), and the Stress Coping subscale of the Stress and Coping Inventory (SCI) are used at both measurement time (MT) points. In addition, blood pressure parameters are collected. Furthermore, selected literature will be consulted to integrate the evaluated data into existing research findings. Results: The health-promoting personal competencies of sense of coherence, resilience, and self-compassion were not strengthened by the practice of Metta meditation in individuals with cardiovascular disease. However, there was a significant reduction in perceived stress {F[1, 27] =4.351, P=0.047, f=0.402} and improved stress coping skills {F[1, 26] =6.790, P=0.02, f=0.511} in the IG. Furthermore, the frequency of rehospitalization {F[1, 27] =5.607, P=0.03, f=0.456} differed significantly in the pre-post comparison. Conclusions: Due to the insufficient size of the sample, the results are only exploratory in nature and should therefore only be considered preliminary. Also, the correlations between the significant changes in the parameters and Metta meditation cannot be finally assessed. For this purpose, further studies with larger samples are needed.