Up front: I have a lifetime membership with Calm, but no one has asked me to make this post and I'm not receiving anything for writing it.

Last year was a big year for the mindfulness service industry. People were stuck and home trying to make sense of an increasingly confusing and stressful world, and many experimented with applications on their phones to try to bring things back to normal. This has translated to lofty company valuations; Calm recently raised a round of funding at a valuation of $2 billion, and Headspace roughly doubled their number of subscribers last year. With this kind of success, the products must work, right?

The evidence is encouraging

There's some pretty good evidence that mindfulness practice has real, positive effects on people. I remember first hearing about medical applications of meditation back in 2012 or 2013: people with chronic pain were able to lead more normal lives by mentally separating the physical sensation pain from the emotions it brought on. While they were still in the same amount of physical pain as before, they were no longer burdened by the feeling of helplessness or and emotional fatigue. This effect was confirmed in a 2018 paper published in the American Journal of Psychiatry:

Studies demonstrated that there are neurological changes involved in differentiating between the sensory experience of pain [..] and the emotional response to pain [..]. Identifying these experiences as separate [..] via mindfulness techniques, allows one to distinguish between unpleasant sensations and secondary emotions in the context of pain, thus reducing the body's sensitivity to the unpleasant experience.

The alternative treatment for these patients is often some form of opioid. These painkillers are incredibly powerful but also incredibly addicting, and America is currently in the process of fighting an opioid epidemic. If mindfulness treatment is nearly as effective as high-powered drugs, that would be a huge step towards reducing the number of opioid addictions and overdoses!

There also seems to be a benefit to those who suffer from anxiety or depression. A 2013 study found that just one meditation session caused people to think more positively of themselves, and a 2019 study found that students who participated in an hourlong yoga and meditation session just once per week saw their self-reported stress and anxiety levels drop significantly.

Even some of the more suspect claims of mindfulness seem to bear fruit: the paper from the American Journal of Psychiatry above found that brain structure seemed to change in "expert meditators", causing changes in pain sensitivity. There are some open questions about whether those changes should be considered good or not, but it certainly appears that mindfulness practice physically effects the brain.

The less enthusiastic evidence

Just because a result is measurable does not mean it is significant! Unfortunately the word "significant" usually means something different in scientific literature than it does in everyday English. Statistical significance tells you whether something happened, but in regular conversation we talk about the importance of a thing that happened.

The 2013 paper cited above found that while meditation seemed to provide a benefit to people's anxiety levels, it didn't provide a statistically different primary outcome from their control group, which participated in stress management education. Even when there was a statistically significant difference in results, the impart of those results was muted: people's impression of their anxiety levels were statistically different but rounded to the same number.

This kind of result seems to be the norm: the Harvard Gazette  found that despite the encouraging headlines, real results generally weren't better than existing treatments:

There are a few applications where the evidence is believable. But the effects are by no means earth-shattering, [..] We’re talking about moderate effect size, on par with other treatments, not better. And then there’s a bunch of other things under study with preliminary evidence that is encouraging but by no means conclusive.
 - Gaëlle Desbordes

Conveying nuanced results to an audience that may only read the headline is a tricky thing, to be sure, and one that is particularly hard for people working in complex fields. Even those writing about "simple" things like cooking or music must be careful: Adam Ragusea became the "Mariah Carey chord guy" when Vox decided to make their headline catchier than it should have been.

But things get worse: a recent meta-analysis of meditation practices from Acta Psychiatra Scandinavia found that at least 8% of participants in meditation studies experienced some negative effects from their practice. While some of the side effects like increased anxiety or stress are expected, I found some of the reported effects shocking. People who experienced trauma may re-experience it, others lose their personality, and some even suffered from amnesia!

And there evens seems to be significant reason to believe that these studies are underreporting the number of negative outcomes in their samples. There is a shocking difference between the rate of adverse effects in experimental studies (~4%) and observational studies (~33%). They note that while this difference may be because "individuals in the observational studies are practicing meditation within uncontrolled settings," that's exactly what you would be doing with a mindfulness service! They even note that "observational studies might better reflect the present context of meditation practice, with many individuals practicing without face-to-face interaction, either using books or phone apps." Your meditation app seems like it has a 1 in 3 chance of hurting you!

The app itself

So you have carefully thought through the benefits and risks of meditation and other mindfulness activities and have decided you still want to give these apps a try. But which one to try? You need one on your phone; otherwise how will you calm down while you're on your flight?

These services make grand promises with very few specifics, and it can make it hard to figure out which one is best for you. Do you want to be "more resilient" (Headspace) or to "stress less" (Calm)? To "live better" or to be "happier"? These claims set off alarm bells in my head because there isn't a great way for me to know if the services are delivering on their promises. Still, if the underlying activity (meditation) is good for me, and the product helps me do the activity, the product must still be good for me, right?

Cost

These services aren't free and may actually be bad for your wallet. Calm will sell you a lifetime subscription for $400 up front, or you can choose to pay them $70 yearly. Headspace has the same yearly pricing, or you can pay them $13 monthly. While these costs aren't huge, they also aren't small. It's cheaper than Netflix, sure, but you also can't really binge meditation sessions like you can Schitt's Creek.

If you're getting one of these services for the health effects, you probably live in America where healthcare is incredibly expensive. In that case, $70/month may be a bargain! For the rest of the world, this may be well out of range.

Gamification

Maybe you've noticed, but most of the services we use online have tried to make things into a game. Email clients encourage you to reach "inbox zero" by showing you a beautiful new image or fun quote after clearing out your inbox and shopping sites shower your screen in confetti after you make a purchase. Gamification is everywhere.

In the Calm app (the only one I have any real experience with), you get badges for completing meditations. It keeps track of the number of consecutive days your meditated with a "streak" counter, and you can track your progress by looking at your history. Meditations come in all shapes and sizes, and you can get alerts for a mini-meditation "check in" or sleep story to make sure you take some time to use the app. All of these things make your mindfulness experience into a kind of game, where you get points for using the application.

You may think this is impure, and I would tend to agree. But gamification works both ways: it can help us choose the "right" actions by making them more fun than the "wrong" actions, and making meditation fun may be the best way for a person to form the habit. The problem comes when trying to decide if using your meditation app is actually the correct thing to do, and really only you can answer that.

Find your motivation

I hope I've made it clear that there are real downsides to these services, despite some decent evidence that they can cause positive effects in people. The problem is that you can't know ahead of time whether meditation will cause a positive, negative, or completely neutral change in you, or if will do anything at all. Regardless of what I or anyone else writes, you'll still be going in with very little information. If you've made it this far and are still thinking about signing up for one of these services, take a quick look inside yourself and figure out why you think you need this in your life.

Health

Whether mental or physical, your primary motivation may be your health. That's great! Hopefully the information above (and anything else you find involving the scientific method) help you make this choice. As mentioned above, it seems like a service like this is an excellent addition to the life of any person who suffers from chronic pain.

But other people should really take a better look at their life if they believe 15 minutes of meditation is going to cause that much of a difference. What if there is no magic pill, and you just have to put in the effort to make your life better? Consider your life more broadly: are you eating healthy, exercising regularly, and interacting with other people? If you're always stressed, ask yourself if you'll really take those 15 minutes a day or if it'll just be another thing to stress about. Realistically, the time spent meditating won't make or break your life, but what you do with the rest of your day does.

Spirituality

Perhaps a quarter of the USA denies the existence of any deity, but that doesn't mean there isn't a place for spirituality in your life. Many still seek to feel a "oneness" with the wonders of the world around them, and meditation provides a good outlet to that feeling without the requirement for deities or other supernatural beings. This interaction can be very difficult to find, but activities like yoga and meditation have had such an effect on me in the past.

If you're struggling to find your place in the cosmos, and you've already tried going for walks, planting a garden, and doing yoga, a mindfulness app may be right up your alley.

Unplugging

Maybe you just want a way to unplug from your digital life and get back to basics. You need to get away from those awful, addictive services like Facebook and YouTube. Meditation should help you separate yourself from those services and help you get back to where you were before.

Have you... considered going for a walk? Trying to distance yourself from your phone by putting more things on your phone is a terrible idea and an easy way to fail in your goal. If your goal is truly to unplug, you need to actually unplug.

Productivity

2019 and 2020 saw the explosion of what I call ProductivityTube, where YouTubers (and others) collectively monetize the world of online productivity. Self help books have been a staple of modern life for a long time, but now we have those books in video form online. The casual observer might only see a video about their favorite internet personality's morning routine or digital organization strategies, but in there are many, many advertisements for products in those videos. Most of the morning routine videos I've watched in last year included some section about meditating and mentioned a specific application, and videos in the style of Matt D'Avella's I meditated 1 hour every day for 30 days gained mainstream appeal.

This kind of advertising is incredibly powerful, even if it's well intentioned. We see people doing things that we want to do, and we see them using things while they do that. With time, we learn to think about those tools as parts of that lifestyle, and you'll regularly find yourself looking to the same products that your favorite streamers or vloggers or bloggers use. I myself noticed that I saw so many Apple AirPods in 2018 and 2019 on my commute that I considered getting them, even though I really enjoyed the headphones I was using. I was living the same lifestyle as they were, but the social pressure was immense.

And this isn't to mention the in-person pressure. While it decreased significantly in 2020, mindfulness apps were everywhere in Silicon Valley by 2018. I saw people opening Headspace and Calm with me on my commute. More companies started offering subscriptions to these services, and places like Joyable popped up offering even shorter meditation sessions. If you were a company in Silicon Valley, you had to offer some perk for improving your employees' focus or mental health and these services provided an easy way for them to do that. If you were an employee, you'd hear about the new perk and want to take advantage of it. It was almost impossible to avoid.

This was all an aside from the topic: can your increase your productivity by meditating? Probably, but you need to be sure that you're not doing it for the social pressure, and even then you shouldn't expect enormous leaps. You won't become a productivity guru like Ali Abdaal or Thomas Frank just because you started meditating. You'll get there by making small, intentional progress over time. But they won't sell you on that, and when it comes time to sell ads, neither will I.

So, should you get it?

If you're comfortable with possible negative health effects mentioned, feel like the price is within budget, and have confirmed you're thinking about this for all the right reasons, then this should be a resounding yes! If you were hesitant for any of the sections above, it's worth considering a broader look at your life to see where you can make improvements that lead to similar effects.

As I mentioned, I do have a lifetime membership with Calm. I don't use it every day anymore, but at one point I was meditating at least once per day on my commute into work, and often once more on the way back. At some point I decided I could do without the normal functions of the application and instead focused on truly unplugging, leading to a pretty significant boost in my happiness and heart health. In retrospect, I may have even been dealing with some disassociation, as I found it hard to stay in that feeling of zen with any other emotions around.

But then why keep the subscription? Because when I can't sleep, or when I'm having a moment of anxiousness, or I'm in the throes of my yearly migraine, it's nice to have a relaxing voice walk you through a body scan. When I traveled (remember that activity?), a morning meditation felt like it helped me better cope with the jet lag.