Effects of Singing Bowl Sound Meditation on Mood, Tension, and Well-being

Abstract

Poor mood and elevated anxiety are linked to increased incidence of disease. This study examined the effects of sound meditation, specifically Tibetan singing bowl meditation, on mood, anxiety, pain, and spiritual well-being. Sixty-two women and men (mean age 49.7 years) participated. As compared with pre-meditation, following the sound meditation participants reported significantly less tension, anger, fatigue, and depressed mood (all Ps <.001). Additionally, participants who were previously naïve to this type of meditation experienced a significantly greater reduction in tension compared with participants experienced in this meditation (P < .001). Feeling of spiritual well-being significantly increased across all participants (P < .001). Tibetan singing bowl meditation may be a feasible low-cost low technology intervention for reducing feelings of tension, anxiety, and depression, and increasing spiritual well-being. This meditation type may be especially useful in decreasing tension in individuals who have not previously practiced this form of meditation.

Full text

Original Article
Effects of Singing Bowl Sound Meditation
on Mood, Tension, and Well-being:
An Observational Study
Tamara L. Goldsby, PhD
1,2
, Michael E. Goldsby, PhD
1
,
Mary McWalters, BA
1
, and Paul J. Mills, PhD
1
Abstract
Poor mood and elevated anxiety are linked to increased incidence of disease. This study examined the effects of sound meditation,
specifically Tibetan singing bowl meditation, on mood, anxiety, pain, and spiritual well-being. Sixty-two women and men (mean age
49.7 years) participated. As compared with pre-meditation, following the sound meditation participants reported significantly less
tension, anger, fatigue, and depressed mood (all Ps <.001). Additionally, participants who were previously naı¨ve to this type of
meditation experienced a significantly greater reduction in tension compared with participants experienced in this meditation (P<
.001). Feeling of spiritual well-being significantly increased across all participants (P< .001). Tibetan singing bowl meditation may be
a feasible low-cost low technology intervention for reducing feelings of tension, anxiety, and depression, and increasing spiritual
well-being. This meditation type may be especially useful in decreasing tension in individuals who have not previously practiced this
form of meditation.
Keywords
Tibetan bowls, anxiety, depression, spiritual well-being
Received May 19, 2016. Received revised August 8, 2016. Accepted for publication August 15, 2016.
Heart disease, diabetes, addiction, and mental health issues
have all been linked to stress and tension.
1-6
Meditation,
including systems such as mindfulness-based meditations, has
shown promise in inducing the relaxation response and helping
alleviate anxiety and improve well-being.
7,8
The relaxation
response is the body’s physiological response in relaxation,
including lowered blood pressure to counter the fight-or-
flight response and activation of the parasympathetic nervous
system.
9-11
As promising as mindfulness and other meditation
systems may be, a common complaint is the time, patience, and
discipline required to learn meditation. Thus, a form of relaxa-
tion and stress relief that does not require a steep learning curve
or a great deal of discipline to utilize could potentially be a
huge benefit to human wellness and health.
The authors set out to examine the possibility that merely
lying down and listening to the high-intensity, low-frequency
combination of singing bowls, gongs, and bells in a sound
meditation could induce a deep relaxation response and posi-
tively affect mood and sense of well-being. Sound healing has
been used for centuries and been utilized in various forms by
cultures the world over, including native peoples. Australian
aboriginal tribes have used the didgeridoo as a sound healing
instrument for over 40 000 years.
12
Ancient instruments have
also been used for religious and spiritual ceremonies such as
Tibetan (also called ‘‘Himalayan’’) singing bowls.
13
Tibetan
singing bowls are metal bowls usually consisting of a combi-
nation of metal alloys and originally used by Tibetan monks for
spiritual ceremonies.
While sound healing is not a new concept, there is a paucity of
research in areas such as Tibetan or quartz crystal singing bowls.
The majority of singing bowl studies relate to the physics of these
musical instruments, including the sonic and wave properties, as
well as attempting to model the singing bowl’s acoustic charac-
teristics.
14-16
In one study, singing bowls were used for emotional
1
University of California, San Diego, La Jolla, CA, USA
2
California Institute for Human Science, Encinitas, CA, USA
Corresponding Author:
Tamara L. Goldsby, PhD, Department of Family Medicine and Public Health,
Center of Excellence for Research and Training in Integrative Health,
University of California, San Diego, 9500 Gilman Drive, La Jolla,
CA 92093, USA.
Email: tgoldsby@ucsd.edu
Journal of Evidence-Based
Complementary & Alternative Medicine
2017, Vol. 22(3) 401-406
ªThe Author(s) 2016
Reprints and permission:
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DOI: 10.1177/2156587216668109
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Creative Commons CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License
(http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further
permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

healing with high-risk youth as part of what was termed the best
self-visualization method.
17
Thebowlswereusedinapsy-
chotherapy model in combination with deep breathing, visuali-
zation, and a loving kindness meditation. The authors reported
that this combination of healing methods may be a catalyst for
emotional and psychological healing in counseling sessions.
The purpose of the present study was to further advance
research in this area by examining the possible effects of sing-
ing bowls and sound healing on mood, anxiety, physical pain,
and spiritual well-being, and to lay the foundation for a future
more formal randomized control trial.
Methods
Participants
A convenience sample of 62 individuals participated (age range, 21-77
years; mean age ¼49.7 years, SD ¼13.0; 9 males and 53 females).
The study was conducted at 3 locations: the Seaside Center for Spiri-
tual Living in Encinitas, California (17 participants), the Chopra Cen-
ter for Wellbeing in Carlsbad, California (39 participants), and the
California Institute for Human Science (CIHS) in Encinitas, California
(6 subjects). All participants provided written informed consent. The
study was approved by the University of California, San Diego Insti-
tutional Review Board (#160174). Demographic information is pre-
sented in Table 1.
Design
Participants completed standardized questionnaires prior to and fol-
lowing the meditation, including the short from of the Profile of Mood
States (POMS-SF)
18
to assess tension, anger and confusion, the Hos-
pital Anxiety and Depression Scale (HADS)
19
to assess depressed
mood and anxiety, and the 10-item Functional Assessment of Chronic
Illness Therapy–Spiritual Well-Being Scale (FACIT-SP)
20
to assess
spiritual well-being.
Additionally, prior to the meditation, participants completed a
demographic questionnaire which included questions regarding any
prior experience with meditation or singing bowls, substance use, med-
ications, and over-the-counter or herbal supplements. Additionally, the
form asked if they were currently experiencing any physical pain or
discomfort. If they were experiencing physical pain, they were asked
the type of pain, and to rate the pain on a scale of 1 to 5.
Following the meditation, participants completed a 2-item ques-
tionnaire that asked if they had fallen asleep and if they were currently
experiencing any physical pain. If they were experiencing pain at that
point, they were again asked to rate the pain level on a scale of 1 to 5.
Sound Meditation Protocol
Participants were instructed to bring yoga mats on which to lie down
and if desired, a pillow and/or blanket for the sound meditation. Par-
ticipants were asked to lie down in a half-circle or an oblong-shaped
configuration (depending on the size of the room and number of
participants) around the room with their heads pointed toward the
musical instruments, which were placed on the floor near their heads.
The musical instruments consisted of Tibetan singing bowls, crys-
tal singing bowls, gongs, Ting-shas (tiny cymbals), dorges (bells),
didgeridoos, and other small bells. The majority of the Tibetan singing
bowls (approximately 90%) consisted of large-sized Jambati bowls
(bells), which ranged in size from 9 to 12 inches and ranged in weight
from 3 to 5 lbs. Approximately 5%of singing bowls were very small
Thadobati bowls, approximately 4.5 inches in size and weighing
0.5 lbs. The remaining 5%of singing bowls were very large Jambati
bowls, ranging from 12 to 14 inches in size and weighing 6 to 8 lbs.
The singing bowls (bells) were the primary instrument played
during the meditations, played for approximately 95%of the time,
while the additional instruments were played for approximately 5%
of the meditation session. The major method of creating sound and
vibration from the singing bowls was by tapping or striking the bowls
with a mallet, which was utilized approximately 95%of the time.
Between 30 and 80 Tibetan bowls, 2 and 3 crystal bowls, and 2 and 6
gongs were used depending on the number of participants. Thus, parti-
cipants at CIHS and the Chopra Center listened to approximately 25
Tibetan bowls, 2 crystal bowls, and 2 gongs while participants at the
Seaside Center listened to approximately 80 Tibetan bowls, 6 crystal
bowls, and 6 gongs. Each participant had at least 2 Tibetan bowls near
his or her head. The bowls were struck with a cloth-covered wooden
mallet called a puja stick. The instruments were all played in a regular
sequence: tingshas, Tibetan bowls, bells, crystal bowls, gongs, and
more Tibetan bowls, then the sequence was repeated. The duration of
the sound meditation was approximately 60 minutes.
Additionally, Tibetan (metal) bowls were placed in the center (or
near-center) of the room and the bowls were in turn struck by the
mallet or rubbed along the rim of the bowls, creating a distinctive
sound, which was allowed to trail off. Additionally, several quartz
crystal bowls were placed near the center of the room and were played
by rubbing the rim with a felt cloth-covered mallet and the sound
trailed off after playing the bowl.
At the beginning of the sound healing meditation, the lead musi-
cian spoke to participants in a soothing tone. He instructed participants
to lie down and if they wished to fall asleep, they were allowed to do
so. He then told them to merely observe any sensations they felt in the
body during the meditation without judging them and to simply relax
and enjoy the meditation. Then the sound meditation began.
At the conclusion of the meditation, the lead musician instructed
participants to gently become aware of their surroundings.
Table 1. Participant Demographics.
Characteristic All (n ¼62) Males (15%) Females (85%)
Age in years, mean (SD) 49.7 (13.0) 42.0 (15.8) 51.0 (12.0)
Education, %
High school 4.8 11 4
Some college 31 33 30
BA/BS 34 33 34
Masters 24 11 26
PhD/MD 6.5 11 6
Marital status, %
Single 38 50 36
Partner 7 13 6
Married 33 25 34
Divorced 21 13 23
Widowed 2 0 2
Meditation experience, %
Yes 87 100 85
No 13 0 15
Bowl experience, %
Yes 59 56 60
No 41 44 40
402 Journal of Evidence-Based Complementary & Alternative Medicine 22(3)

Participants were also instructed to take their time in readjusting to
a state of awareness.
Data Analysis
Analyses included 2-way (group by time) repeated-measures analysis
of variance [(Statistical Program for the Social Sciences (SPSS Ver-
sion 22)]. Data were normally distributed.
Results
There were significant differences between pre- and posttreatment
for all subscale variables on the POMS, HADS, and FACIT mea-
sures (Table 2). Eta-squared revealed a large effect size for all
subscale variables, except the FACIT Faith subscale, which
demonstrated a moderate to large effect size. An effect for these
variables was also observed by age (see Table 3). Individuals in the
age group 20 to 39 years displayed the largest change in tension,
with a mean score of 1.6 at baseline and a mean of 0.2 posttreat-
ment, followed by those in the age group 40 to 59 years who had a
tension mean of 1.3 at baseline and 0.2 posttreatment (P<.05).
Additionally, effects for participants who had prior experi-
ence with singing bowl meditations (termed ‘‘Bowl Experi-
enced’’) versus those who had never experienced this type of
meditation previously (termed ‘‘Bowl Naı¨ve’’) were examined
(Table 4). Significant effects were observed for tension, anxi-
ety, and depressed mood (all Ps <.01).
In order to assess any potential effects of the sound medita-
tions on participants’ levels of physical pain, participants were
asked if they were experiencing pain prior to and following the
meditation. Twenty-nine participants reported experiencing
physical pain pre-meditation. If experiencing pain, they were
asked to rate their pain on a scale of 1 to 5 (1 representing ‘‘very
slight discomfort’’ and 5 representing ‘‘extremely painful’’) and
describe the pain and location on the body. Table 5 displays the
mean pain rating ofparticipants(by age group) who reported pain
at pre-meditation and their mean pain rating post-meditation.
Participants aged 40 to 59 years showed the most significant
effects from the meditation, with a reduction (or elimination)
of feelings of physical pain post-meditation, with a baseline mean
pain rating of 2.00 and a posttreatment mean pain rating of 0.79.
Additionally, physical pain pre- and posttreatment was
examined for Bowl Experienced and Bowl Naı¨ve participants
(see Table 6). Change (decrease) in reported pain was most
significant for participants who were previously naı¨ve to sing-
ing bowl meditations, with a mean score of 1.88 at baseline and
0.69 posttreatment.
Discussion
This was an observational study designed to examine the poten-
tial effects of a singing bowl meditation on mood, tension,
anxiety, physical pain, and spiritual well-being. A significant
difference was found in all endpoints examined in response to
the meditation.
The tension subscale in particular displayed highly signifi-
cant effects for participants post-meditation, thus providing
support to the hypothesis that a sound meditation would
increase feelings of relaxation and decrease feelings of stress.
Additionally, depressed mood and anxiety scores on the HADS
were significantly reduced post-meditation compared with pre-
meditation. Moreover, scores on the FACIT revealed increased
feelings of spiritual well-being, as well as faith, immediately
following the sound meditation. Thus, while less desirable
mood states such as tension, anger, and depression decreased
Table 2. Results on Measures at Pre- and Postmeditation.
Measures n
Premeditation Postmeditation
Change PZ
a
Mean SD Mean SD
Tension
(POMS)
62 1.26 1.03 0.14 0.57 1.12 .000 .51
Anger
(POMS)
60 0.85 0.98 0.05 0.19 0.80 .000 .42
Confusion
(POMS)
60 1.10 0.87 0.30 0.56 0.80 .000 .54
Fatigue
(POMS)
60 1.65 1.12 0.42 0.75 1.23 .000 .46
Vigor
(POMS)
59 1.97 1.19 1.48 1.05 0.49 .002 .15
Anxiety
(HADS)
58 1.11 0.66 0.44 0.49 0.67 .000 .49
Depression
(HADS)
57 0.62 0.51 0.42 0.36 0.20 .002 .16
Faith
b
(FACIT)
62 3.18 1.10 3.46 0.96 0.28 .005 .12
Spirituality
b
(FACIT)
57 2.85 0.94 3.64 0.46 0.79 .000 .49
Abbreviations: POMS, Profile of Mood States; HADS, Hospital Anxiety and
Depression Scale; FACIT, Functional Assessment of Chronic Illness
Therapy–Spiritual Well-Being Scale (FACIT-SP).
a
Effect size (Z): .01 ¼small, .06 ¼moderate, .14 ¼large effect.
b
Faith and Spirituality scores displayed a positive direction rather than a
negative direction postmeditation.
Table 3. Mean Change in Tension, Anxiety, and Depressed Mood by
Age Group From Pre- to Postmeditation.
Age Group
(Years) n
Premeditation Postmeditation
Change PZMean SD Mean SD
Tension (POMS)
20-39 15 1.56 0.88 0.21 0.31 1.35 .000 .71
40-59 33 1.29 1.15 0.20 0.68 1.09 .000 .47
60-79 14 0.88 0.78 0.26 0.43 0.62 .038 .29
Anxiety (HADS)
20-39 15 1.43 0.61 0.67 0.62 0.76 .000 .70
40-59 33 1.03 0.70 0.27 0.52 0.76 .000 .54
60-79 14 0.74 0.46 0.29 0.47 0.45 .019 .35
Depressed mood (HADS)
20-39 15 0.63 0.37 0.48 0.32 0.15 .207 .11
40-59 33 0.66 0.66 0.38 0.39 0.27 .012 .18
60-79 14 0.55 0.43 0.35 0.32 0.20 .051 .26
Abbreviations: POMS, Profile of Mood States; HADS, Hospital Anxiety and
Depression Scale.
Goldsby et al 403

following the meditation, potentially desirable variables such
as a sense of spiritual well-being increased.
Interestingly, previous experience with singing bowl med-
itations (or lack thereof) also appearedtobeafactorinthe
effects of the meditations. Participants who were previously
naı¨ve to this meditation demonstrated larger effects than those
who were experienced in these meditations. An unexpected
effect was discovered in the significant mean change in the
tension subscale from baseline to posttreatment for partici-
pants in the age group 40 to 59 years. Those participants in
this age group who were previously naı¨ve to singing bowl
meditations (‘‘Bowl Naı¨ve’’) had a significant reduction in
mean tension from baseline to posttreatment, indicating a
dramatic effect of the meditation. On the other hand, Bowl
Experienced participants in the age group 20 to 39 years
reported a significant reduction in the tension subscale
posttreatment.
Participants aged 40 to 59 years appeared to especially ben-
efit from the sound meditation. This age group demonstrated
the largest reduction in physical pain and a strong reduction in
tension, especially for those who were previously naı¨ve to this
type of meditation. Thus, a follow-up sound meditation study
might examine this age group in more depth.
The reason(s) for the beneficial effects of singing bowls is
unclear; however, various theories have been proposed. One
theory includes the potential effects of binaural beats in which
the brain entrains to the hertz difference between tones played
in each ear, propelling the brain into brainwave states of deep
relaxation, such as beta waves or even meditative or trance-like
brainwave states in theta waves.
21-23
In addition, potentially the
action of sound waves on the purported biofield or energy field
of the body could be a factor.
24
Such theories may begin to
characterize the potential effects on mood as well as physiolo-
gical changes associated with singing bowls. Physical healing
was the goal of a study that utilized blood pressure data in
relation to a singing bowl. This study attempted to quantify the
sonification of blood pressure through 3-dimensional imprint-
ing, designing, and fabricating of a singing bowl using blood
pressure data.
25
Allen and Shealy
26
examined the use of a
single quartz crystal singing bowl on participants’ electroder-
mal responses (the body’s electric responses) to toning and
playing the crystal bowl. The authors recorded electrodermal
responses of forty acupuncture meridian points on participants’
left hands and right feet, which demonstrated increases and
decreases, respectively, in electrical responses to playing the
crystal bowl. Another study examined the potential effects of
quartz crystal bowl playing on perception of pain and revealed
mixed results.
27
In a recent randomized crossover study, play-
ing a single Tibetan (or Himalayan) singing bowl was found to
decrease blood pressure and heart rate more than silence alone
when conducted immediately prior to a guided visualization.
28
Participants who listened to the singing bowl also had lowered
scores on the Positive and Negative Affect Schedule (PANAS),
a measure of affect and mood
29
than meditation alone but had
comparable PANAS scores to the silence-only group.
There were limitations with the present study. The most
notable limitation was that this was a nonrandomized observa-
tional study without a control group. The study does, however,
provide the groundwork for future research regarding the
effects of singing bowl meditations on assessments of stress
Table 4. Mean Changes in Tension, Anxiety and Depressed Mood for ‘Bowl Naı¨ve’ and ‘Bowl Experienced’ Participants from Pre- to
Post-Meditation.
Measures n
Premeditation Postmeditation
Change
ANOVA
Mean SD Mean SD PZ
Bowl naı¨ve
Tension (POMS) 26 1.61 1.13 0.32 0.80 1.29 .000 .500
Anxiety (HADS) 26 1.30 0.69 0.41 0.51 0.89 .000 .590
Depressed mood (HADS) 26 0.80 0.61 0.41 0.41 0.39 .003 .298
Bowl experienced
Tension (POMS) 36 1.01 0.88 0.15 0.26 0.86 .000 .500
Anxiety (HADS) 36 0.89 0.61 0.47 0.43 0.42 .000 .400
Depressed mood (HADS) 36 0.51 0.47 0.39 0.30 0.12 .100 .075
Abbreviations: ANOVA, analysis of variance; POMS, Profile of Mood States; HADS, Hospital Anxiety and Depression Scale.
Table 5. Mean Change in Physical Pain Ratings by Age Group From
Pre- to Post-meditation.
Age Group
(Years) n
Mean Pain
Change SDPremeditation Postmeditation
20-39 8 1.63 0.75 0.88 1.17
40-59 14 2.00 0.79 1.21 1.21
60-79 7 1.57 1.00 0.57 0.9
Table 6. Mean Change in Physical Pain Ratings for ‘‘Bowl Experi-
enced’’ and ‘‘Bowl Naı¨ve’’ Participants From Pre- to Postmeditation.
Bowl Naı¨ve or
Experienced n
Mean Pain Mean
Change SDPremeditation Postmeditation
Experienced 13 1.69 1.00 0.69 0.91
Naı¨ve 16 1.88 0.69 1.19 1.29
404 Journal of Evidence-Based Complementary & Alternative Medicine 22(3)

and well-being. As discovered by Landry,
28
this low-tech form
of meditation may have the capacity to lower blood pressure
and heart rate, thus there are potential benefits to cardiovascu-
lar health yet to be further explored. The results provide prom-
ise for a form of stress reduction that does not require the
individual to learn a disciplined form of meditation. In fact,
the participant may even fall asleep if desired. At the very least,
participants generally express feelings of deep relaxation and
inner peace following the sound meditation.
Moreover, those in health professions such as nurses and
counselors could easily provide these meditations to patients.
While it may require a very minimal amount of practice, exten-
sive training is not necessary to learn to play the singing bowls
and other instruments; one merely taps or rubs the bowls gently
with a mallet. Thus, this type of meditation could be taught to
health and counseling professionals and provided in an almost
unlimited number of settings to induce the relaxation response,
reduce stress, and potentially stress-related disease in the body.
In summary, this observational study found significant ben-
eficial effects of Tibetan singing bowl meditations on a number
of markers related to well-being. Future randomized control
trials are warranted to further examine the effects of these
meditations on mood, well-being, and physical pain. In addi-
tion, future research could explore the meditation’s effects on
various age groups in more depth.
Acknowledgments
The authors are grateful to Deep Deoja, the Nepalese musician who
conducted the Singing Bowl Sound Meditations.
Author Contributions
TLG conceived of and designed the study and MEG provided ideas on
initial design. PJM provided design help and selection of assessment
tools. TLG and MMcW conducted the bulk of the study, with assis-
tance from MEG. TLG and MEG conducted the majority of the data
analyses with guidance from PJM. TLG and MEG provided the initial
draft of the manuscript, of which PJM provided further writing and
editing.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the
research, authorship, and/or publication of this article: The work was
supported by the University of California, San Diego Center of Excel-
lence for Research and Training in Integrative Health.
Ethical Approval
The study was approved by the University of California, San Diego
Institutional Review Board. All participants provided written
informed consent.
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