Study of Effect of Vipassana on Anxiety and Depression

Th is study employed pretestposttest experimental group design to study the impact of vipassana at Nepal Vipassana center(NVC) on anxiety and depression of students taking the course for the first time. Th irty one subjects (students) were studied. Vipassana is found to be effective to reduce the severity of depressive symptoms significantly (p=0.001). Vipassana could be the option for treating depression along or coupled with other methods.


Introduction
Vipassana is a form o f meditation, which was d iscovered twenty-five centuries ago by Gautam Buddha. Vipassana means "insight" in the ancient pali language of India, the language that Buddha spoke. It teaches to see things as they are. Although Vipassana contains the core of what later has been called Buddism, it is not an organized relig ion, requires no conversion, and is open to students of any faith, nationality, color or background [1]. It is the ethical and social path that derives fro m an explo ration of nature within the framework of one's own mind and body. Vipassana's goals are liberation fro m suffering, and spiritual transcendence [2]. According to Hart, healing-not disease cure, but the essential healing of hu man suffering-is the purpose of Vipassana.
Among the various types of meditation in the world today, the Vipassana method taught by S. N. Goenka is unique. This technique is simp le, logical way to achieve real peace of mind and to lead a happy, useful life [2]. Mr. Goenka learned the technique of vipassana fro m a master vipassana teacher called Sayagyi U Ba Khim fro m Burma (now called Myanmar). Through the work of Mr. Goenka and his assistant teachers in the past decade, vipassana has spread world wide.
Vipassana is taught as ten -day residential courses that require students (practionars are called students) to live in silence and full time meditation. Each course is taught in an ambiance that duplicates and facilit ates the goals of the practice. No conversation, reading, writ ing, rad ios, telephone calls, or other distractions are permitted. Students begin their course with vows to adhere to high moral conduct i.e. sila for the ten days. These are; to refrain fro m taking any life, to refrain fro m any into xicants or sexual act ivit ies, to avoid lying or stealing [3]. The students then progress for three and half days through a preliminary, concentrative meditation which focuses on breath. It is called "anapana" (i.e. awareness of respiration). This involves continuous observation of the natural flo w of inco ming and outgoing breath. Gradually mind gets concentrated on this natural activity and the person can exercise greater control over the mind [4]. Fro m that they proceed to vipassana proper, the third step which involves insight into the nature of entire mind and body phenomenon. This step is called development of "pana" (i.e. wisdom). Co mplete salience is observed for the first nine days. On the tenth day, students resume speaking, making the transition back to a more extroverted way of life [5]. The course closes on the morning of eleventh day with the practice of mitta-vhavana (i.e. good will towards other).
The ethical, restrained at mosphere and the concentrative background make six and half days of silent practice of vipassana in noble silence and intense, profound, often lifetransforming experience [1]. Vipassana focuses on absolute interconnection between mind and body. During a ten-day med itation course, the unbroken atmosphere of hard work coupled to a supportive ambiance enables a flood of personal memo ries, hopes, and reveries to enter the students' consciousness for the first time. A long with awareness of this liberated flood of mental life, vipassana also raise into consciousness awareness of an equally compelling stream of bodily sensations that constitute the physical level of life Vipassana is particularly related to either somat ically or physically oriented healers [5]. The practice of vipassana has corrective influence of psychic disturbances [4].
Vipassana has been taught in Nepal by Nepal Vipassana Centre (NVC) at Dharmashringa, Budhanilakantha , Kathmandu. To part icipate the course one has to register the name at NVC . No fees are charged fo r participation.
The present study was designed to study the impact of vipassana on negative thoughts, anxiety, and depression on students taking vipassana for the first time at NVC. It simp ly measured the change in severity of an xiety and depression according to some well established scales. Such symptoms are present in general population at various degrees irrespective of the presence of mental disorders. Study has shown vipassana to be effective in reducing feelings of hostility and help lessness of prisoners [4]. Also, vipassana was found to reduce the symptoms of an xiety, and depression of respectively diagnosed inmates in the same study. Studying the impact of vipassana on students from general population who came fo r the course for the first time was the interest of present design. Reduction in severity of anxiety and depression as impact of vipassana course on the students was expected.

Methods
The present study imp lied pretest-posttest experimental group design taking 40 consecutive students registered at NVC for Ju ly 10 th session, 2005 after their consent. Two instruments were used to measure the severity of anxiety and depression .Nepali adaptation of Beck An xiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) by Kohrt et al [6] were used to measure anxiety and depression respectively. The instruments were applied to the subjects at first one day before they start learning vipassana .Post test was taken from the students on the day of completion of 10 days vipassana course. Among 40, only 31 students filled the scales completely on posttest. So result of total (N) 31 subjects is fed into SPSS and data were analyzed accordingly.

Result
There were total (N) 31 subjects, among which 17 were females and 14 were males. F-test gave no significant (p=0.05) difference in the frequency of female and male subjects. Ages of the subjects were in between 18-51 years old. Mean age of the sample was 23 years old. Mean age of female subjects was 23.5 years old where as mean age of male subjects was 22.5 years old. T-test of equality of age of male and female subjects gave no significant difference (p<0.0005). A ll subjects, except six, had comp leted their university graduation. Out of six, four had co mpleted intermediate university degree and remaining two were junior high school passed. Table 1 below has summarized the result.  Table 1 shows that mean posttest score in BDI-II is significantly s maller than mean pretest score (p=0.001) in the same. Whereas, there is no significant different (p=0.439) in pretest and posttest mean score of BAI scale. The different in mean scores can be seen from figure 1.

Discussion and Conclusions
Most of the previous vipassana researches were carried in prisons [4]. Those researchers lacked control over the social environment and non-meditators were found discouraging the subjects from maintain ing the continuity of practice. Also, observation about compliance non-compliance with instructions during the course was not made. Since this study was carried on subjects from general population in general setting at NVC, greater control over social environ ment was attempted. All individuals inside the centre were either students taking the course, volunteers to help the students, or teacher who conducted the course.
Practice/non-practice of vipassana was also observed. Five among 40 init ial subjects were found not follo wing the instructions as reported by the teacher, so they were excluded fro m the study. Result of the study has shown vipassana to be effective in reducing the severity of depressive symptoms significantly (p=0.001). The result is consistent with previous studies on depressed jail in mates. This also accepts our assumption made in this study regarding depression. Though mean score in an xiety scale is reduced at posttest in comparison to pretest, but the difference is not significant (p=0.343). It cannot be concluded that vipassana course at NVC is effect ive in reducing severity of symptoms of anxiety on subjects. This rejects our assumption regarding the effectiveness of vipassana at NVC on an xiety. Subjects were taking the course for the first time sitting in new social and physical environment, which may be the reason to maintain the anxiety. So me subjects reported being more anxious then they used to be before they took the course. Differences in the result on anxiety fro m p revious studies are may also be due to the differences in efficiency of teachers to conduct vipassana at NVC and in prev ious studies. The value system fostered by vipassana has therapeutic ingredients. According to Chandiramani [4], understanding every experience as impermanent can serve as a powerful antidote to all the negativities of mind (i.e. an xiety, depression, fear etc).
The abstention from killing any sentient being, stealing, sexual misconduct, lying and taking any intoxicants could be one of the best possible approaches to mental hygiene. The practice of anapana for greater control over mind is helpful in handling harmful impulses and wishes. From the study it can be concluded that Vipassana reduces the severity of depressive symptoms of the individuals practicing even for first time. It could be used for therapeutic use in treating depression.
In this study, only experimental group design was applied which is the limitation of the present study paradigm. Further study with control group on both general and clinically diagnosed depressive patients is recommended.