Leading the Way in Trauma Therapy

Trauma Institute & Child Trauma Institute

Mindfulness is rightly enjoying considerable popularity lately. Mindfulness is a practice of non-judgmental awareness of thoughts and feelings as they arise in moment-to-moment experience. Mindful awareness is correlated with increased activity in the prefrontal cortex – the thinking, reasoning part of the brain – as well as decreased activity in the amygdyla – the emotional, survival-instinct part of the brain (Creswell et al, 2007). This translates to decreased feelings of emotional or somatic overwhelm, and increased feelings of rationality. In short, mindfulness helps people to be calmer, less reactive, and more able to behave as they would like to.

This does not mean that mindfulness can reliably heal trauma. While mindfulness practice can be helpful for some traumatized individuals, it can also be risky (Compson, 2014; Lustyk et al, 2009). Trauma-related thoughts, sensations, or emotions can be overwhelming. Drawing attention to and exploring post-traumatic stress symptoms and intense emotional states, without adequate tools for integrating them, can make people feel worse, potentially leading to dissociation, psychosis, depression, or other symptoms (Lustyk et al, 2009).

In our treatment center, we rely on EMDR and PC – proven-effective, efficient, well-tolerated methods – to guide the client through trauma healing. These are both dual-focus methods, meaning that the client is guided to access and activate the trauma memory while also focusing on something else at the same time – such as the therapist’s moving fingers (EMDR), or the therapist’s counting aloud (PC). It is possible that mindfulness contributes to the treatment effect of the dual focus trauma healing methods. However, this is not stand-alone mindfulness. Within the structures of EMDR or PC, the therapist will work to ensure that the client is within their individual "window of tolerance" – the zone of emotional activation in which individuals are able to productively interact with challenging feeling states, rather than being flung into chaos and overwhelm, or shutting down and numbing out.

After trauma healing, most people report feeling much less dysregulated and more able to manage the difficulties of daily life. However, for some people, their trauma-related dysregulation has become autonomous, and persists to some extent even after the trauma healing has been completed. Then mindfulness practice can be incorporated as a follow-up/adjunct treatment, so the client can re-train their brain to become better regulated.

Numerous variants of mindfulness practice are available. For example, the easy-to-remember acronym RAIN is a simple mindfulness tool that can promote ongoing development of self-awareness and self-soothing (Brach, 2012).

  • Recognize -- Notice the unpleasant sensation or emotion, track where it is located in the body, notice what is happening inside.
  • Allow -- Allow the experience to be there, just as it is, without needing to change it, fix it, or make it go away.
  • Investigate -- With curiosity and compassion, investigate what's going on. What was happening just before I started to feel this way? When have I felt this way in the past? What might I be believing about myself that is contributing to this feeling?
  • Nurture --  Offer self-compassion in the form of kind words, provide reassurance, engage in a nurturing activity, reach out for connection to a safe person or animal, etc.

Trauma healing methods such as EMDR and PC often get the job done, but not always. Mindfulness practice may enable therapy clients to consolidate trauma treatment gains and feel even more equipped to manage the inevitable stresses and challenges of everyday life.

References

Brach, T. (2012). True refuge: Finding peace and freedom in your own awakened heart. NY: Bantam.

Compson, J. (2014). Meditation, trauma and suffering in silence: Raising questions about how meditation is taught and practiced in Western contexts in the light of a contemporary trauma resiliency model. Contemporary Buddhism, 15, 274-297.

Creswell, J. D., Way, B. M., Eisenberger, N. I., & Lieberman, M. D. (2007). Neural correlates of dispositional mindfulness during affect labeling. Psychosomatic medicine, 69, 560-565.

Lustyk, M. K. B., Chawla, N., Nolan, R. S., & Marlatt, G. A. (2009). Mindfulness meditation research: issues of participant screening, Safety procedures, and researcher training. Advances, 24, 20-30.

Note: This post was authored by Margot Reilly, LCSW, and Ricky Greenwald, PsyD

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