Trauma Informed Mindfulness

A New Understanding to Inform and Advance Your Practice

Mindfulness can generally be defined as any meditative practice that emphasizes an acceptance of experience in the present moment. The intention is to allow any and all thoughts, feelings, and bodily sensations to exist without judgment or attachment. It is about learning to be present with inner experiences-all inner experiences, the pleasant and the unpleasant; to learn to sit with discomfort or fear and recognize that it is transient and does not last.  It is a practice of learning to observe and intentionally respond to the inner workings of the mind/body rather than reacting automatically and defensively. For trauma survivors, this can be an opportunity to orient to their experience of the present moment in ways that can create a sense of security or safety; that the events from the past or fears for the future are not happening now, and that there are ways to manage emotional and physical flooding. This process can facilitate increased self-awareness and empowerment, recognizing the connection between thoughts and feelings, and discovering the ways that the mind has been conditioned by overwhelming experiences to generate repeated additional distress.

In these ways, mindfulness can be used as a powerful counterbalance to many of the common after-effects of trauma, including avoidance of inner experiences, anxiety, reliving, numbing, and feeling easily triggered. Over time, these practices can even change or “heal” the brain, decreasing the size of the amygdala, and increasing the ability of the frontal lobes to do their job.  While there is strong scientific evidence to support the use of mindfulness for emotional and psychological healing, it is also important to recognize how these practices can lead to increased distress. For those with unresolved trauma, the practice of mindfulness can be approached carefully and thoughtfully to minimize the likelihood of negative outcomes.

Mindfulness as a Trigger

For some, intentionally engaging in the experience of “being present” with thoughts, feelings, and bodily sensations can lead to a resurfacing of unresolved, or even undiscovered, issues and feelings. By itself this is not necessarily a bad thing, but for someone that is unprepared, does not have an appropriate level of support, and/or experiences the resurfacing as overwhelming, this experience can trigger feelings of panic, spontaneous abreaction, or flashbacks…in essence, re-traumatizing the survivor to a lesser or greater extent.  At times, being mindful can leave a survivor feeling like they are trapped or helpless again.

Trauma Informed Mindfulness

This obviously presents a serious dilemma. Mindfulness is potentially a useful and important skill for trauma survivors, but how do we know when to use these skills without creating unnecessary distress? The short answer is that there is no definitive test. There is no foolproof way to know if practicing Mindfulness will be “too much” for a particular person at a particular time. The survivor is the expert of their own experience.  However, it we take a trauma informed approach, there are a few guidelines and modifications that can help make these practices more approachable.

Titration

It is generally better to begin with shorter, well-structured meditations, with permission to interrupt the process at any point. If things begin to feel overwhelming during a mindfulness practice, it is OK to take a break. In fact, it is recommended. In these situations, intentionally step out of the practice, perhaps engage in some grounding exercises or other support until you are ready to return. This is similar to the idea of “working at your edge.” This practice can help increase self-awareness, the ability to trust feelings, and encourage self-care and self-compassion. The video below provides some additional considerations to guide your trauma informed approach to mindfulness.

Modifications & Support

If someone becomes overwhelmed with emotions, sensations, or images during a mindfulness practice, consider some of the following modifications and grounding skills:

• Open the eyes and look around the room

• If lying down, sit up. If sitting, consider standing

• Use calming self-talk to orient to the here and now

• Move in place (stretch arms, adjust seated position, press palms together, etc.)

• Get up and quietly walk around the room

• Leave the room and return when grounded.

While seemingly simple, these modifications and supports are powerful in the ways they change the practice of mindfulness for survivors of trauma. In our center, we have found that most people would never consider these modifications on their own because they want to “follow the rules.” There is a particular culture associated with meditation that leaves many people feeling that they must simply sit with pain and discomfort. This is only beneficial to a point, becoming counter-productive and potentially damaging for the individual. In fact, many trauma survivors give up their meditation practice shortly after beginning due to the level of psychological discomfort experienced. With a trauma-informed lens and a few relatively straightforward modifications, these practices can be much more accessible and effective.