Is Mindfulness Safe for Trauma Survivors?

by David Treleaven

 

David Treleaven

Over the past decade, I’ve researched the relationship between mindfulness meditation and trauma. Placed beside one another, mindfulness and trauma can seem like natural, even inevitable, allies. Both are concerned with the nature of suffering. Both are grounded in sensory experience. And while trauma creates stress, mindfulness has been shown to reduce it. In theory it seems that anyone who has experienced trauma could benefit from practicing mindfulness meditation. What could go wrong?

Plenty, it turns out. For people who’ve experienced trauma, mindfulness meditation can actually end up exacerbating symptoms of traumatic stress. When asked to pay focused, sustained attention to their internal experience, trauma survivors can find themselves overwhelmed by flashbacks and heightened emotional arousal. I’ve met survivors who, despite their best intentions, have ended up feeling disoriented, distressed and humiliated for somehow making things worse. The power of meditation thrusts survivors directly into the heart of wounds that often require more than mindful awareness to heal.

Yet mindfulness is also a valuable asset for trauma survivors. Mindfulness can enhance present-moment awareness, increase self-compassion, and strengthen a person’s ability to self-regulate—all important skills that support trauma recovery. The question for those of us who teach and utilize mindfulness is thus how we can help minimize the potential dangers of meditation to trauma survivors while simultaneously leveraging its potential benefits.

To be “trauma-sensitive” means having a basic understanding of trauma in the context of one’s work.

The answer I came to in my own work was a trauma-informed approach to mindfulness meditation. Mindfulness doesn’t cause trauma—rather, it may uncover it—but the practice by which mindfulness is pursued can land trauma survivors in difficulty. To be “trauma-sensitive” means having a basic understanding of trauma in the context of one’s work. A trauma-informed physician will ask for permission before touching a patient, for example; and a trauma-informed school counselor might ask a student whether they want the door open or closed during a session, and inquire about a comfortable sitting distance. With trauma-informed mindfulness, we apply this concept to mindfulness instruction. We can give people options about how they practice mindfulness, encouraging breaks and utilizing various anchors of attention. We can ensure we’re trained in recognizing trauma symptoms, responding to them skillfully, and taking preemptive steps to ensure that people aren’t re-traumatizing themselves under our guidance.

The potential risks of meditation, including for trauma survivors, have become increasingly well-known. At Brown University, a clinical neuroscientist by the name of Willoughby Britton started a project named the “The Varieties of Contemplative Experience” (https://www.brown.edu/research/labs/britton/research/varieties-contemplative-experience), which, over several years, has examined the range of challenging experiences that can arise in the context of Buddhist meditation—experiences that can resemble psychological dissociation, depersonalization, and the re-experiencing of traumatic memories (Lindahl, Fisher, Cooper, Rosen, & Britton, 2017).

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Many who suffer under the weight of traumatic stress respond favorably to mindfulness meditation. But others may have a different experience, where the practice unintentionally lands them in more pain. Mindfulness practice doesn’t need to work for everyone, but I’ve become convinced that certain modifications to meditation can support survivors, at the very least ensuring that they are not re-traumatizing themselves in practice. Mindfulness meditation isn’t bad: it’s powerful. And those of us offering it to others benefit when we continue exploring its risks and rewards.

Ultimately, the need for trauma-sensitive mindfulness is a reflection of both odds and statistics. As many readers will know, the practice of mindfulness has exploded in popularity over the past decade and is now encouraged in a wide range of secular environments, including elementary and high schools, businesses, and hospitals. Yet, at the same time, the prevalence of trauma is extraordinarily high. The majority of us will be exposed to at least some type of traumatic event in our lifetime, and some of us will develop debilitating symptoms in its aftermath. What this means is that in any environment where mindfulness is being practiced, there’s a high likelihood that someone will be struggling with traumatic stress.

Many who suffer under the weight of traumatic stress respond favorably to mindfulness meditation. But others may have a different experience, where the practice unintentionally lands them in more pain. Mindfulness practice doesn’t need to work for everyone, but I’ve become convinced that certain modifications to meditation can support survivors, at the very least ensuring that they are not re-traumatizing themselves in practice. Mindfulness meditation isn’t bad: it’s powerful. And those of us offering it to others benefit when we continue exploring its risks and rewards.

 

Reference

Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLoS One, 12(5), e0176239. doi:10.1371/journal.pone.0176239

David A. Treleaven, PhD, is an educator and psychotherapist whose work focuses on the intersection of trauma, mindfulness, and social justice. Trained in Counseling Psychology at the University of British Columbia, he received his Doctorate in Psychology from the California Institute of Integral Studies. He has been studying mindfulness for twenty years, has a private practice in the San Francisco Bay area, and is the author of Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing (in press, W. W. Norton & Co).

 

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