Journal of Behavioral Medicine

, Volume 31, Issue 4, pp 351–366 | Cite as

Migraines and meditation: does spirituality matter?

  • Amy B. WachholtzEmail author
  • Kenneth I. Pargament


Migraine headaches are associated with symptoms of depression and anxiety (Waldie and Poulton Journal of Neurology, Neurosurgery, and Psychiatry 72: 86–92, 2002) and feelings of low self-efficacy (French et al. Headache, 40: 647–656, 2000). Previous research suggests that spiritual meditation may ameliorate some of the negative traits associated with migraine headaches (Wachholtz and Pargament Journal of behavioral Medicine, 30: 311–318, 2005). This study examined two primary questions: (1) Is spiritual meditation more effective in enhancing pain tolerance and reducing migraine headache related symptoms than secular meditation and relaxation? and, (2) Does spiritual meditation create better mental, physical, and spiritual health outcomes than secular meditation and relaxation techniques? Eighty-three meditation naïve, frequent migraineurs were taught Spiritual Meditation, Internally Focused Secular Meditation, Externally Focused Secular Meditation, or Muscle Relaxation which participants practiced for 20 min a day for one month. Pre-post tests measured pain tolerance (with a cold pressor task), headache frequency, and mental and spiritual health variables. Compared to the other three groups, those who practiced spiritual meditation had greater decreases in the frequency of migraine headaches, anxiety, and negative affect, as well as greater increases in pain tolerance, headache-related self-efficacy, daily spiritual experiences, and existential well being.


Migraine Meditation Pain Spirituality Headache 


  1. Alexander, C. N., Rainforth, M. V., & Gelderloos, P. (1991). Transcendental meditation, self-actualization, and psychological health: A conceptual overview and statistical meta-analysis. Journal of Social Behavior and Personality, 6, 189–248.Google Scholar
  2. Alexander, C., Robinson, D., Orme-Johnson, R., Schneider, R., & Walton, K. (1994). The effects of transcendental meditation compared to other methods of relaxation and meditation reducing risk factors, morbidity, and mortality. Homeostasis, 35, 243–264.Google Scholar
  3. Alexander, C. N., Swanson, G. C., Rainforth, M. V., & Carlisle, T. W. (1989). Effects of the transcendental meditation program on stress reduction, health, and employee development. Anxiety, Stress, and Coping, 6, 245–262. doi: 10.1080/10615809308248383.CrossRefGoogle Scholar
  4. Arnstein P., Caudill M., Mandle C., Norris A., & Beasley R. (1999). Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80, 483–491. doi: 10.1016/S0304-3959(98)00220-6.PubMedCrossRefGoogle Scholar
  5. Astin, J. A. (1997). Stress reduction through mindfulness meditation: Effects on psychological symptomology, sense of control, and spiritual experiences. Psychotherapy and Psychosomatics, 66, 97–106.PubMedCrossRefGoogle Scholar
  6. Bigal, M. E., Bigal, J. M., Betti, M., Bordini, C. A., & Speciali, J. G. (2001). Evaluation of the impact of migraine and episodic tension type headache on the quality of life and performance of a university student population. Headache, 41, 710–719. doi: 10.1046/j.1526-4610.2001.041007710.x.PubMedCrossRefGoogle Scholar
  7. Blanchard, E. B., Applebaum, K. A., Radnitz, C. L., Morrill, B., Michultka, D., et al. (1990). A controlled evaluation of thermal biofeedback and thermal biofeedback combined with cognitive therapy in the treatment of vascular headache. Journal of Consulting and Clinical Psychology, 58, 216–224. doi: 10.1037/0022-006X.58.2.216.PubMedCrossRefGoogle Scholar
  8. Boivin, M. J., Kirby, A. L., Underwood, L. K., & Silva, H. (1999). Spiritual well-being scale (a review). In P. C. Hill & R. W. Hood (Eds.), Measures of Religiosity (pp. 382–385). Birmingham: Religious Education.Google Scholar
  9. Buenaver, L. F. (2003). Evaluating the role of religious coping in a self-reported headache population. Unpublished doctoral dissertation. Virginia Commonwealth University.Google Scholar
  10. Carlson, C. A., Bacaseta, P. E., & Simanton, D. A. (1988). A controlled evaluation of devotional meditation and progressive relaxation. Journal of Psychology and Theology, 16, 362–368.Google Scholar
  11. Elkins, D., Anchor, K. N., & Sandler, H. M. (1979). Relaxation training and prayer behavior as tension reduction techniques. Behavioral Engineering, 5, 81–87.Google Scholar
  12. Fan, A. Y., Gu, R. J., & Zhou, A. N. (1999). MMPI changes associated with therapeutic intervention: A migraine control study. Headache, 39, 581–585. doi: 10.1046/j.1526-4610.1999.3908581.x.PubMedCrossRefGoogle Scholar
  13. Fetzer Institute (1999). Multidimensional measurement of religiousness/spirituality for use in health research. Kalamazoo, MI: John E. Fetzer Institute.Google Scholar
  14. French, D. J., Holroyd, K. A., Pinell, C., Malinoski, P. T., O’Donnell, F., & Hill, K. R. (2000). Perceived self-efficacy and headache related disability. Headache, 40, 647–656. doi: 10.1046/j.1526-4610.2000.040008647.x.PubMedCrossRefGoogle Scholar
  15. Goadsby, P. J., Lipton, R. B., & Ferrari, M. D. (2002). Migraine-current understanding and treatment. New England Journal of Medicine, 346, 257–270. doi: 10.1056/NEJMra010917.PubMedCrossRefGoogle Scholar
  16. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health: A meta-analysis. Journal of Psychosomatic Research, 57, 35–43. doi: 10.1016/S0022-3999(03)00573-7.PubMedCrossRefGoogle Scholar
  17. Harris, A. H.S., Thoresen, C. E., McCullough, M. E., & Larson, D. B. (1999). Spiritually and religiously oriented health interventions. Journal of Health Psychology, 4, 413–433.CrossRefGoogle Scholar
  18. Hu, X. H., Markson, L. E., Lipton, R. B., Steward, W. F., & Berger, M. L. (1999). Burden of migraine in the United States: Disability and economic costs. Archives of Internal Medicine, 159, 813–818. doi: 10.1001/archinte.159.8.813.PubMedCrossRefGoogle Scholar
  19. Huber, D., & Henrich, G. (2003). Personality traits and stress sensitivity in migraine patients. Behavioral Medicine, 29, 4–13.PubMedCrossRefGoogle Scholar
  20. International Headache Society (2004). The international classification of headache disorders, (2nd ed.). Cephalagia, 24(suppl 1), 1–160.Google Scholar
  21. Keefe, F. J., Affleck, G., Lefebvre, J., Underwood, L., Caldwell, D. S., et al. (2001). Living with rheumatoid arthritis: The role of daily religious and spiritual coping. Journal of Pain, 2, 101–110. doi: 10.1054/jpai.2001.19296.PubMedCrossRefGoogle Scholar
  22. Koenig, H. G., McCullough, M. E., & Larson, D. B. (2001). Handbook of religion and health. New York: Oxford University Press.Google Scholar
  23. Lateri-Minet, M., Auray, J., Hasnaoui, A., Dartigues, J., Duru, G., et al. (2003). Prevalence and description of chronic daily headache in the general population. Pain, 102, 1143–1149.Google Scholar
  24. Lecci, L., & Wirth, R. J. (2000). Investigating the effects of physical discomfort on laboratory-induced mood states. Journal of Behavioral Therapy and Experimental Psychiatry, 31, 231–247. doi: 10.1016/S0005-7916(01)00008-8.CrossRefGoogle Scholar
  25. Lipton, R. B., Dodick, D., Sadovsky, R., Kolodner, K., Endicott, J., et al. (2003). A self-administered screener for migraine in primary care. Neurology, 61, 375–382.PubMedGoogle Scholar
  26. Lipton, R. B., Scher, A. I., Kolodner, K., Liberman, J., Steiner, T. J, & Stewart, W. F. (2002). Migraine in the United States: Epidemiology and patterns of health care use. Neurology, 58, 885–894.PubMedGoogle Scholar
  27. Lipton, R. B., Stewart, W. F., & Simon, D. (1998). Medical consultation for migraine: Results from the American Migraine Study. Headache, 38, 87–96. doi: 10.1046/j.1526-4610.1998.3802087.x.PubMedCrossRefGoogle Scholar
  28. Main, A., Vlachonikolis, I., & Dowson, A. (2000). The wavelength of light causing photophobia in migraine and tension-type headache between attacks. Headache, 40, 194–199 doi: 10.1046/j.1526-4610.2000.00028.x.PubMedCrossRefGoogle Scholar
  29. McDowell, I. (1996). Measuring health: A guide to rating scales and questionnaires (pp 206–213). New York: Oxford University Press.Google Scholar
  30. O’Halloran, J. P., Jevning, R., Wilson, A. F., Skowsky, R., Walsh, R. N., & Alexander, C. (1985). Hormonal control in a state of decreased activation: Potentiation of arginine vasopressing secretion. Physiology and Behavior, 35, 591–595. doi: 10.1016/0031-9384(85)90146-5.PubMedCrossRefGoogle Scholar
  31. Orme-Johnson, D. (1987). Medical care utilization and the transcendental meditation program. Psychosomatic Medicine, 49, 493–507.PubMedGoogle Scholar
  32. Paloutzian, R. F., & Ellison, C. W. (1982). Loneliness, spiritual well-being and quality of life. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and theraphy (pp. 224–237). New York: Wiley Interscience.Google Scholar
  33. Pargament, K. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. New York: Guilford Press.Google Scholar
  34. Pargament, K. I., Magyar, G., & Murray, N. (2005). The sacred and the search for significance: Religion as a unique process. Journal of Social Issues, 61, 665–687. doi: 10.1111/j.1540-4560.2005.00426.x.CrossRefGoogle Scholar
  35. Penzien, D., Rains, J., & Andrasik, F. (2002). Behavioral management of recurrent headache: Three decades of experience and empiricism. Applied Psychophysiology and Biofeedback, 27, 163–181. doi: 10.1023/A:1016247811416.PubMedCrossRefGoogle Scholar
  36. Radloff, L. S. (1977). The CES-D: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–410. doi: 10.1177/014662167700100306.CrossRefGoogle Scholar
  37. Rippentrop, A. E. (2005). A review of the role of religion and spirituality in chronic pain populations. Rehabilitation Psychology, 50, 278–284. doi: 10.1037/0090-5550.50.3.278.CrossRefGoogle Scholar
  38. Rojahn, J., & Gerhards, F. (1986). Subjective stress sensitivity and physiological responses to an aversive auditory stimulus in migraine and control subjects. Journal of Behavioral Medicine, 9, 203–212. doi: 10.1007/BF00848478.PubMedCrossRefGoogle Scholar
  39. Scott, B., & Melin, L. (1998). Psychometric properties and standardized data for questionnaires measuring negative affect, dispositional style and daily hassles. A nation-wide sample. Scandinavian Journal of Psychology, 39, 301–307. doi: 10.1111/1467-9450.00088.CrossRefGoogle Scholar
  40. Smith, T. B., McCullough, M. E., & Poll, J. (2003). Religiousness and depression: Evidence for a main effect and the moderating influence on stressful life events. Psychological Bulletin, 129, 614–636. doi: 10.1037/0033-2909.129.4.614.PubMedCrossRefGoogle Scholar
  41. Spielberger, C. D. (1983). Manual for the state-trait anxiety inventory STAI. Palo Alto, CA: Mind Garden.Google Scholar
  42. SPSS (2004). Statistical package for the social sciences, 13.0. New York: Prentice Hall.Google Scholar
  43. Stewart, A. L., & Ware, J. E. (1991). Measuring function and well-being: The medical outcomes study approach. Durham, NC: Duke University Press.Google Scholar
  44. Stewart, W., & Lipton, R. (2002). Need for care and perceptions of MIDAS among headache sufferers study. CNS Drugs, 16S, 5–11. doi: 10.2165/00023210-200216001-00002.CrossRefGoogle Scholar
  45. Stewart, W. F., Lipton, R. B., Celentanto, D. D., & Reed, M. L. (1992). Prevalence of migraine headache in the United States. Relation to age, income, race, and other socio-demographic factors. Journal of the American Medical Association, 267, 64–69. doi: 10.1001/jama.267.1.64.PubMedCrossRefGoogle Scholar
  46. Underwood, L. G., & Teresi, J. A. (2002). The daily spiritual experiences scale: Development, theoretical description, reliability, exploratory factor analysis, preliminary construct validity using health-related data. Annals of Behavioral Medicine, 24, 22–33 doi: 10.1207/S15324796ABM2401_04.PubMedCrossRefGoogle Scholar
  47. Wachholtz, A. B. (Speaker) (2007). Progressive muscle relaxation. Guided self-awareness [CD]. Durham: Duke University Diet and Fitness Center.Google Scholar
  48. Wachholtz, A. B., & Pargament, K. I. (2005). Is spirituality a critical ingredient of meditation? Comparing the effects of spiritual meditation, secular meditation, and relaxation on spiritual, psychological, cardiac, and pain outcomes. Journal of Behavioral Medicine, 28, 369–384 doi: 10.1007/s10865-005-9008-5.PubMedCrossRefGoogle Scholar
  49. Wachholtz, A. B., Pearce, M., & Koenig, H. (2007). Exploring the relationship between spirituality, coping, and pain. Journal of Behavioral Medicine, 30, 311–318 doi: 10.1007/s10865-007-9114-7.PubMedCrossRefGoogle Scholar
  50. Wagner, T. H., Patrick, D. L., Galer, B. S., & Berson, R. A. (1996). A new instrument to assess the long-term quality of life effects from migraine: Development and psychometric testing of the MSQOL. Headache, 36, 484–492 doi: 10.1046/j.1526-4610.1996.3608484.x.PubMedCrossRefGoogle Scholar
  51. Waldie, K. E., & Poulton, R. (2002). Physical and psychological correlates of primary headache in young adulthood: A 26—year longitudinal study. Journal of Neurology, Neurosurgery, and Psychiatry, 72, 86–92 doi: 10.1136/jnnp.72.1.86.PubMedCrossRefGoogle Scholar
  52. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070 doi: 10.1037/0022-3514.54.6.1063.PubMedCrossRefGoogle Scholar
  53. Wenneberg, S., Schneider, R., Walton, K., Maclean, C., Levitsky, D., et al. (1997). A controlled study of the effects of the Transcendental Meditation program on cardiovascular reactivity in ambulatory blood pressure. International Journal of Neuroscience, 89, 15–28. doi: 10.3109/00207459708988461.PubMedCrossRefGoogle Scholar
  54. Zwart, J. A., Dyb, G., Hagen, K., Odegard, K. J., Dahl, A. A., Bovim, G., & Stovner, L. J. (2003). Depression and anxiety disorders associated with headache frequency: The Nord-Trondelag Health Study. European Journal of Neurology, 10, 147–152.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of Mass Medical CenterWorcesterUSA
  2. 2.Bowling Green State UniversityBowling GreenUSA

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