est Outcome Study

Robert Ornstein, Ph.D.

Principal Investigator

Charles Swencionis
Project Director

Arthur Deikman, M.D.

Psychiatric Advisor

Ralph Morris, M.D.

Medical Advisor

March 15, 1976

To est graduates,

In early 1974, an exhaustive survey (680 items) was completed by 10.5% of the est
graduate population. The survey asked graduates to report their experience of health and well-
being after the est training and their experience of health and well-being the year before the
training.

The study is not, strictly speaking, an outcome study. There were no control groups of
nongraduates, and subjects were not surveyed both before and after taking the est training. The
study is a preliminary self-report, retrospective survey of est graduates, focusing on health and
well-being changes.

It was designed to identify those health and well-being changes most often reported after
taking the est training, in order to provide a basis for selecting those areas to be investigated by
further controlled study.

est demonstrated an unusual openness in its interest in being investigated by outside

researchers by inviting us, as independent investigators, to design a study to:

1. Look carefully for any evidence that est might harm anyone.

2. Look at the spectrum of possible health changes and find the areas of most apparent
change to indicate which further studies could be done.

3. Make a composite statement about what people report their experience with est and
health and well-being has been.
To accomplish this, the project took two years, involved over 200 volunteer workers, and
analyzed responses from 1,400 est graduates. Four methods were used:

1. Personal interviews;

2. A major questionnaire, asking 680 questions, mailed to 2,000 randomly

selected graduates;

3. A smaller, follow-up questionnaire mailed to people who had not responded to

the major questionnaire, in order to determine if the group of people which
responded initially was representative of the test population in general or
biased toward reporting better health subsequent to the training;

4. A series of phone interviews intensively pursuing a random subsample of

people who had not responded to the major questionnaire, to further determine
the degree of representativeness of the respondents to the major questionnaire.

Both subsamples were substantially consistent with the major questionnaire population,
lending weight to the assumption that the findings were representative of the population
of est graduates at large.

Respondents reported strong positive health and well-being changes since taking
the est Standard Training, especially in the areas of psychological health and well-being
and those illnesses with a large psychosomatic component. These are sufficiently strong
to justify controlled follow-up studies of particular physical and psychological variables.

Respondents reported most changes in: general physical health; mental health;
missing work due to illness, headache and migraine; hypertension; sleep difficulties; drug
usages including pain medication, sleeping medication, tranquilizers, psychoactive drugs,
and other prescription and nonprescription drugs; alcohol consumption; energy level;
satisfaction with work; relationship with significant others; meaningfulness of life;
allergies, acne, weight problems, colds, sore throats and sinus problems; dysmenorrheal;
gastrointestinal problems such as ulcers, colitis, indigestion, diarrhea, constipation and
gas; back pain, neck and shoulder pain; genitourinary complaints; cigarette and marijuana
smoking; nervous habits, memory problems; sexual difficulties; and fear of doctors.

Significantly more people than chance would allow reported improvements on

these questions than reported no changes or negative changes, and no question in the
whole survey had predominantly negative answers. On those variables which people
reported the most change, most people report positive changes and a few report negative
changes. In others words, the problems the test group reported most improvements on
were also the problems they reported the most negative changes on, with improvements
reported consistently more frequently than negative changes. Regarding the
questionnaire as a whole, few people (under 7% of the respondents to the questionnaire)
report negative changes in physical or mental health. The results support the view that
est is not harmful.

This study does not demonstrate that people’s health actually changes, but only
that they say it does. The reported changes are strongly positive and the findings are
powerful enough to warrant further research in any of the areas mentioned above.

We are confident of the reliability and representativeness of the data because our
response rates are high. Of 12,000 people who had taken est when we took our sample,
2,000 were randomly sampled, or 1/6; 1,895 of these people were deemed reachable by
mail, and 1,465 of them responded, or 77.31%.

People who responded to the shorter, later questionnaire and interview, as

compared to the longer, earlier questionnaire, reported predominantly positive change but
of slightly less magnitude than earlier respondents. They did not report more negative
change. This suggests that people who are less involved in and concerned about est are
receiving primarily positive effects but of somewhat lesser magnitude than those more
involved.

This study has not controlled possible effects of influences in people’s lives other
than est or changes that happen spontaneously to people who have not taken est. It
should be noted that people typically give “socially desirable” responses to
questionnaires; that is, they wish to present an attractive image to the world. The
retrospective nature of the questionnaire may increase this effect as memory is often
faulty. In addition, the “placebo” effect may also be influencing results; that is, merely
participating in a program like est may produce effects regardless of the contents of the
program. The expectation of the participants that they will change as a result of the
training could be sufficient to produce changes.

A controlled before and after study of est trainees would answer some of these
possible effects. We encourage further research by other independent investigators based
on the results of our study.

Sincerely,

Robert E. Ornstein, Ph.D.

Principal Investigator

Charles Swencionis
Project Director
APPENDIX

The following data generated by the survey is of general interest and is not mitigated by
the survey limitations described in the letter.

A. Demographics: Distribution of ages of est respondents.

16 – 24 Less than in general population.

25 – 34 More than in general population.
35 – 44 More than in general population.
45 & over Less than in general population.

The average age of the respondents is 35 years old.

B. Education levels of est respondents as compared to the general population.

General
est Population
Grades 1 – 12 12% 67%
Some college ( 1 – 3 years) 31% 16%
Completed College (4 years) 17%
Graduates or Professional school 40% 57% 17%
100% 100%

C. Divorced or Separated:
Divorced Separated

Year before est 6.2% 8.5%

After est 4.3% 7.7%

D. Average time since taking the training for respondents.

11 months

(NOTE: Demographic information about the “general population” in the Outcome Study
is taken from: 1970 Census; Population and Housing, issued April 1972, U.S Department
of Commerce. )