Disconnection from Childhood Trauma: A Potential Determinant of Depression and Ill-Health

Johann Hari, in his book Lost Connections: Uncovering the Real Causes of Depression, identified seven social causes of depression including the loss of connection to other people.  One of the surprising findings in his discussions with researchers and his colleagues, was the link between obesity, childhood trauma and depression.  In the final analysis, collectively they established that in many instances unresolved childhood trauma was a determinant of obesity and depression. 

Obesity and depression

Johann drew on the ground-breaking research of Dr. Vincent Felitti, Founding Chairman of the Department of Preventative Medicine of Kaiser Permanente – a fully integrated medical provider offering not only health care plans but also services such as specialist medical practitioners, a dynamic medical school, mental health services and education and an affordable housing initiative.  Kaiser Permanente views a healthy life for all as a cause to pursue, and is a pioneer in offering seamless health services along with leading edge research into preventative methods and treatment approaches.

Kaiser Permanente commissioned Vincent to undertake research into obesity because it was becoming the major factor in the growth of its operational costs.  Vincent started out by using a specialised diet plan supported by vitamin supplements that was designed to help obese people lose weight.  This approach appeared highly successful on early indications, but Vincent noticed that the people most successful at losing weight were dropping out of the program and returning to their eating habits and becoming overweight again.  Additionally, they often experienced depression, suicidal thoughts, rage or panic. 

Research by way of interview of 286 participants dropping out of the obesity program established that most had been sexually abused or experienced some other form of childhood trauma.   Obesity was their way to deal with the aftereffects of childhood trauma, including fear of sexual assault and the desire to hide their shame.

Childhood trauma and depression

Vincent was surprised by the findings of the initial study and realised that research of childhood history as a determinant of adult ill health had been avoided previously because of shame, secrecy and the taboo nature of the topic.  Yet his early findings established that childhood trauma played out powerfully decades later in terms of emotional state, biomedical disease and life expectancy.  He found, for example, that 55% of participants in the obesity study had suffered childhood sexual abuse.

The link between obesity, depression and childhood trauma was not well received by the established medical profession.  The video, A Tribute to Dr. Vincent Felitti, highlights the scorn he experienced when first announcing his findings at a medical conference and demonstrates the resilience of a man who had the courage to back his research and the bravery to pursue his creativity.

Vincent was convinced that he had to undertake research with a larger and broader sample of people to establish the credibility of his findings.  Through Kaiser Permanente’s processes of capturing the medical history of patients he was able, in collaboration with Dr. Robert Anda of the Center for Disease Control (CDC), to add additional questions relating to life history.  The questions picked up on the 10 types of childhood trauma identified by participants in the earlier study. The 17,500 participants involved in the second study were representative of the broader population of California where the study was done.  They were middle class with an average age of 57 and were employed.

The research titled the Adverse Childhood Experience Study (ACE) highlighted even more surprising results.  Two thirds of the participants in the research program had experienced one or more traumatic events.  One in nine had experienced 5 or more adverse childhood events.  They also established that the higher the number of different adverse childhood events experienced by an individual (their ACE Score), the greater the likelihood of that person committing suicide.

Typical strategies adopted by individuals to cope with the impacts of childhood trauma only exacerbate the problem of ill health, e.g. smoking or over-eating.  Vincent maintained that the experience of chronic, unrelieved stress affects the nervous system and the brain and can produce “the release of pro-inflammatory chemicals in a person’s body”, leading to suppression of the immune system.

What can be done about childhood trauma?

I have previously discussed principles and guidelines for trauma-informed mindfulness practice.  Johann Hari, in the section of his book on reconnection strategies offered several strategies that could have a positive effect on the negative impacts of childhood trauma, such as obesity and depression.  His recommended reconnection strategies include social prescribing and reconnection with nature, meaningful work and meaningful values.

Vincent Felitti, too, was concerned that people who had experienced childhood trauma need some form of hope about their ability to redress its negative effects.  He decided to do further research involving medical practitioners who were treating patients through Kaiser Permanente.  He provided them with a few simple questions to ask patients that related to life history and covered childhood experiences, and asked them to express genuine empathy and respect for the patient. 

Vincent found that the participants showed “a significant reduction in illness” once a patient shared their story of childhood trauma with a doctor.  He thought that the explanation for this was twofold – (1) the person was sharing their story with another person for the first time and (2) the recipient of the disclosure was a trusted authority figure who treated them with kindness and respect.  He postulated that the intermediate effects related to the fact that the experience removed the shame and self-loathing associated with the adverse childhood event.  The association of the childhood trauma with the experience of humiliation was broken. Vincent acknowledged that this was an area for further research.

Vincent argued that the ultimate solution to childhood trauma lay in “primary prevention” and advocated for the integration of their research findings into primary care medical practice.  He also supported the development of a life experience questionnaire reporting on childhood trauma as a part of a patient’s medical record that could subsequently be viewed by the treating doctor.  A healing conversation could take place if the patient was willing and able to share their story.

David Treleaven warns, however, that when dealing with someone suffering from post-traumatic stress disorder (PTSD), it is imperative not to tackle the trauma experience head-on.  He advocates a trauma-sensitive mindfulness approach.  Sam Himelstein also cautions against the use of direct questioning and talking where a person is outside their window of tolerance

Reflection

As we grow in mindfulness through research, meditation and reflection, we can begin to recognise the impact of our own experience of childhood trauma and address the negative impacts it has on our own life and relationships. We can also become sensitised to the experience of others who have experienced adverse childhood events and take this into account when dealing with individuals and groups who are seeking to use a mindfulness approach to improve their quality of life.

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Image by Pete Linforth from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Understanding Trauma-Sensitive Mindfulness

David Treleaven, through his doctoral dissertation and subsequent book, has raised awareness globally about the need for trauma-sensitive mindfulness.  His book, Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing, identifies three myths about mindfulness and trauma, discusses research-based case studies and offers clear options for the way forward.  His work is so critical to the teaching of mindfulness that Brown University has sought to integrate his work and findings into their Mindfulness Based Stress Reduction (MBSR) Course and the Search Inside Yourself Leadership Institute is exploring integration of David’s approach into their Mindful Leadership program.

Trauma and mindfulness

Trauma is described as “the experience of severe psychological distress following any terrible or life-threatening event”.  Many organisations and trainers/consultants/psychologists offer services, strategies and programs for trauma sufferers. Beyond Blue, for example, offers coping strategies and ways that friends and relatives can help someone close to them who is suffering from a traumatic event.

Mindfulness has become acknowledged as an effective way to deal with trauma.  For example, Boyd, Lanius and McKinnon (2018) concluded from a review of the relevant literature that mindfulness-based therapeutic approaches are effective in reducing the symptoms of post-traumatic stress disorder (PTSD).   They suggested that reduction in shame and self-blame could be key explanations of the efficacy of mindfulness-based approaches to PTSD.

David, however, warns that there are potential difficulties in using a mindfulness approach if practitioners are not sensitive to the interplay between mindfulness practices, beliefs about the universal efficacy of mindfulness and related messaging.  He points out that most people will experience at least one traumatic event in their life. So, in any one room of meditation participants, there is likely to be one or more people who are experiencing trauma in their lives.

David dedicates his life to making people aware of the need for trauma-sensitive mindfulness through his book, videos, podcasts and workshops. He articulates his concerns about a lack of sensitivity to this issue amongst meditation teachers by identifying three “myths” about mindfulness and trauma that can potentially create harm for trauma sufferers.

Three myths about mindfulness and trauma

David’s research with trauma sufferers and practitioners in the field working with people who have experienced trauma, has led him to identify three “myths” (widely held false beliefs) that impede effective and safe use of mindfulness approaches. The myths are powerful determinants of the behaviour of mindfulness teachers:

  • Universality – David describes this myth as “one size fits all”.  However, David’s experience is that for some people who have experienced trauma, meditation can activate trauma stimuli so that the person re-experiences trauma.  As Peter Devine comments, “The nervous system can’t tell the difference between that [reliving the trauma] and the original trauma”.
  • Certainty – this myth relates to the assumption by meditation teachers that they will know when a person has experienced (or is currently experiencing) trauma.  David cites a case of a very experienced meditation teacher who failed to pick up the cues that some of his trainees were trauma sufferers.  He maintains that there are some very subtle non-verbal cues that can signal the existence of trauma, but it requires sensitised awareness to detect them.  He suggests that two major impediments that get in the road of someone openly disclosing their experience of trauma are (1) feelings of shame and (2) compliance (felt need to conform to an authority figure).
  • Neutrality – the myth that breath is always neutral, with no emotive content.  David recounts the experience of one person who was traumatised by a violent parent when a child.  Focusing on his breath “reconnected with the need to hide”, caused him to re-live his trauma and led to increased anxiety.  So, instead of being a calming anchor, mindful breathing acted as a trauma stimulus.

Trauma-Sensitive Mindfulness: some strategies

David provides considerable detail, explanation and case illustrations of these myths in his book on Trauma-Sensitive Mindfulness and in a video presentation on The Truth About Mindfulness and Trauma, which was a promotional webinar for his course for practitioners on recognising trauma, responding to trauma and preventing the re-living of trauma during mindfulness practice.

In the video mentioned above, David suggests a range of strategies that address the limitations and potential damaging effects of the three myths:

  • Develop awareness about possible difficulties for people during mindfulness practices
  • Increase knowledge of, and sensitivity to, the signs of trauma
  • Provide space for people to experience different aspects of mindfulness practice and be ready to make modifications after asking, “What would work for you?”
  • Acknowledge at the outset that some people may have a very different experience to the calming effects of mindfulness meditation
  • Offer the opportunity for participants to approach you privately to have a conversation about their experience
  • Don’t reinforce the “shoulds” of mindfulness experience, e.g. avoid saying, “you should experience calm and peace”
  • Avoid “close and sustained attention to breath” as this may be a stimulus for re-experiencing trauma
  • Offer a range of options for people to practice mindfulness so that they can choose their own anchor for paying attention, e.g. breath, sounds, the sensation of the feet on the floor, feeling of the body on the chair or fingers touching each other.  According to David, Paula Ramirez, a Director of Breathe International, maintains that this choice of options gives participants a sense of agency (the opposite of a loss of control).

As we grow in mindfulness through our own meditation, research and reflection, we can become more sensitive to the needs of people who have suffered (or are suffering) trauma; be better able to respond to their needs; and also learn to adopt strategies that avoid re-traumatising participants in mindfulness training groups.

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Image by Anemone123 from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Becoming Healed by Nature

In the previous post, I discussed the stress-reduction effects of trees.  Florence Williams takes this discussion and research focus further when she explores the healing power of nature. Florence, a journalist and writer, is the author of The Nature Fix: Why Nature Makes Us Happier, Healthier and More Creative. She draws on the latest science, proven practices from around the world and individual case studies to promote the healing power of nature.

Experiencing “nature-deficit disorder”

In a TED Talk given in 2016, Florence described the effects of her own nature-deficit disorder resulting from moving home from the openness of the wilderness environment of Boulder, Colorado to the dense, built environment of Washington D.C. She explained that her sense of wellbeing declined rapidly – she experienced depression, anxiety, irritability and a “sluggish brain”. She was hyper-sensitive to the sounds of planes and noise pollution that surrounded her. However, her saving experience was to be assigned to write for Outside Magazine about the Japanese practice of “forest bathing” (Shinrin-yoku) – absorbing nature through your senses
(sights, sounds, smell, touch, taste). This, in turn, stimulated her interest in the power of nature to make us happier, healthier and more creative.

Global trend to use the power of nature to heal

Following on from the research and writing project in Japan, Florence undertook a global project on behalf of National Geographic. In researching practices involving the use of nature for healing, she discovered different practices in a range of countries. Besides Japan’s “forest therapy trails”, Korea has established “healing forests” along with “forest healing rangers” to take children on programs designed to overcome everything from digital addiction to bullying. Based on their experience and scientific research, Finland has recommended that people spend at least 5 hours a month in nature – a minimum that reflects how nature-deprived we are in the cities of the world. where so much time is spent indoors and on digital devices.

Florence describes the research and practices she uncovered in her global project in a video presentation titled, Your Brain on Nature. This video summarises her book on the power of nature to heal. She gives examples from across the world where nature has been used to help troubled teenagers, people suffering from depression, adults who have experienced trauma or post-traumatic stress disorder (PTSD) and people working in jobs that create a lot of stress such as the role of firefighters.

In her introductory chapter, Florence points to Wordsworth and Beethoven as creative people who drew their inspiration from nature, thus serving as forerunners to modern day neuroscience research which is exploring the impact of nature on our brains – and on our health, happiness and creativity. She points out that the research from the Mappiness app (daily mood monitoring by thousands of people over an extended period) concluded that people are much happier outdoors in nature than they are in urban environments devoid of natural features. She notes the research by Elisabeth Nisbit and John Zelenski that suggests that because of our habitual “disconnection from nature” we tend to “underestimate the psychological benefits of nature”. Their research highlighted that even green spaces in urban environments can elevate mood and generate happiness.

Science shows us how we can be healed by nature

In a landmark article on the impact of time in nature on our wellbeing, Kevin Loria advances 12 science-based reasons we should spend more time outside:

  1. improves short-term memory
  2. helps us to de-stress
  3. can reduce inflammation
  4. reduces fatigue by restoring energy
  5. helps overcome depression and anxiety
  6. my have a protective impact on vision (e.g. reduced rate of myopia)
  7. improves capacity to focus
  8. enhances creativity
  9. improves the immune system
  10. lowers blood pressure
  11. promotes the production of anti-cancer proteins
  12. lowers the risk of an early death.

The science in support of the benefits of nature on health, happiness and creativity is building rapidly as scientists and medical professionals become increasingly aware of the negative impacts of “nature-deficit disorder”.

As we grow in mindfulness through mindful immersion in nature and growing awareness of nature’s healing powers, we can begin to enjoy the benefits of improved health, happiness and creativity. In turn, we can deepen our awe of nature – its energy, beauty and majesty.

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Image by Sven Lachmann from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Accessing Our Inner Resources to Cope With Trauma

Mindfulness through “resourcing meditation” can help us to cope with trauma.  It does not replace the need for therapeutic assistance but complements therapy and facilitates the process of dealing with deeply held fear or grief.

The causes of trauma

Trauma can be experienced by anyone at any stage of life.  The associated experience of profound psychological distress can result from a natural disaster such as a cyclone or earthquake; a personal life event such as the death of a parent. life partner or a child; being involved in a serious car or transport accident; the experience of going to war or being a prisoner of war; experiencing a vicious relationship break-up; being a person displaced by war; experiencing a toxic work environment over an extended period; being a refugee attacked by pirates when trying to flee a war-torn country by boat (the experience of Anh Do).

People in helping professions can experience vicarious trauma by virtue of supporting others who have had a traumatic experience. So midwives in a hospital can experience trauma when a mother and/or baby dies; professionals providing access to legal aid can be overcome by constant exposure to the recounting of traumatic experiences by clients; police, ambulance drivers and paramedics can experience vicarious trauma as a result of the work they do with victims of crime or serious car accidents; and police and their life partners, too, can experience trauma vicariously as a result of the death of a colleague through violence.

The effects of trauma

Just as the causes of trauma can be many and varied, so too are the effects experienced by people who have been traumatised.  Some people experience Post Traumatic Stress Disorder (PTSD).  This usually occurs when a person experiences an event that is personally life-threatening to themselves or others and is more likely in situations where a pre-existing mental illness is present, and/or a series of traumatic events are involved, such as sexual abuse.  People who have PTSD will experience “feelings of intense fear, helplessness or horror” and tend to replay the traumatic event(s) over and over, so that their intense anxiety condition becomes locked in.

The spectrum of responses to the experience of trauma is very wide – from numbness and inertia to aggression and violence.  People who experience trauma can become withdrawn and avoid interactions; experience de-sensitisation to the people and situations they have to deal with; experience on-going depression; become cynical or distrustful in their interactions; or experience a profound and enduring sadness.  They may question their self-worth and accomplishments; experience difficulty in relaxing and sleeping; or be overcome by a deep sense of grief (where someone significant to them has died).

Accessing our internal resources

In a previous post, I wrote about how to use the R.A.I.N. meditation process to deal with fear and anxiety.  However, in cases of trauma and intense grief, we may not be able to plumb the depths of our feelings because the experience would be too painful and/or cause flashbacks to the traumatic event(s).

Tara Brach, in the course on the Power of Awareness, described how to access internal resources to cope initially with the psychological pain experienced with trauma.  Drawing on her own experience with trauma victims and sound research in the area, she suggests a number of ways to resource ourselves:

  • Physical grounding – this involves getting in touch with the feeling of our feet on the ground and our buttocks on the chair.  The physical sensation of contact with the ground or chair is important because it enables us to link the sense of safety and security through sitting or standing with our psychological experience.
  • Breathing deeply and slowly – this could begin with lengthening our in-breath and out-breath and move to mindful breathing, which includes paying attention to the space between.
  • Touch – touching our heart or stomach with some loving gesture that brings warmth to relax our body.
  • Talking to ourselves – we can use comforting and supportive words while engaged in conversation with ourselves.
  • Envisaging our allies – there may be relatives or friends in our life who provide very strong emotional support and constant affirmation of our self-worth.  There are others such as members of a support group for a chronic illness or for loss of a child or loved one.  Bringing these people to mind together with the feelings of kindness and encouragement they engender, can build our inner resources to cope with trauma.
  • Revisiting a place of peace or relaxation – we can do this physically or just by visioning what it was like to be in our favourite place.  It could be by the bay or at the seaside, in the mountains or on the deck in our home-anywhere that gives us strength, renews our spirit and intensifies our feelings of security.

Whatever process we use for inner resourcing, it is important to get in touch with what positive effects we are feeling in our body, as well as in our minds.  Tara Brach, in the Power of Awareness course, encourages us to use resourcing meditations based on the above listed pathways to tap into, and strengthen, our inner resources.   She argues that these meditations are a true refuge, unlike the false refuges of drugs or alcohol.

Being able to deal with trauma through the R.A.I.N. meditation process (plumbing the depths of our fear or grief) may take months of resourcing ourselves before we can confront the depths of our emotions, but Tara’s own counselling experience with people who have suffered trauma (including PTSD) confirms that it is possible to emerge from the depths to live a balanced and happy life.

As we grow in mindfulness through resourcing meditations, we strengthen our inner resources to cope with the profound psychological effects of a trauma and build up our capacity to deal with the resultant debilitating emotions.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of Maialisa on Pixabay

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Facing the Fear Within

We have explored the R.A.I.N. meditation process in a preliminary manner.  Now we will look at how R.A.I.N. can help us deal with those deep-seated fears that take control of us, reduce our capacity to live life fully and prevent us from showing others loving kindness.

The disabling effects of fear and anxiety

Jaak Panksepp, author of Affective Neuroscience, discovered that young rats who had played and frolicked together became totally inhibited when a piece of cat’s hair was introduced into their cage – creating an immediate fear response and disabling anxiety.  Jaak believed that in-depth insight into the behaviour of animals helped us to better understand human emotions.

Anna Steinhenge explored whether fear and the associated anxiety induced a similar inhibiting effect in humans.  She found that in competitive situations where people viewed the outcome with positive anticipation, they were readily able to access clear thinking and creativity; in contrast, where people were anxious about the outcome, their creativity and critical faculties were impeded, and they tended to engage in cheating or unethical behaviour to win.  One only has to look at the behaviour of the leadership group in the Australian Cricket team during the third test in South Africa to confirm this perspective – they were anxious that they could not win the third test, when the score was tied at one test each, so they engaged in ball tampering.

Using the R.A.I.N. meditation process to face and conquer the fear within
Recognise the fear

The first step is to recognise the fear for what it is – to face it fully, understand how it impacts our body and impedes our mind.  Avoiding facing the fear only makes it stronger and weakens our capacity to manage the fear and its disabling effects.

Kayakers, for example, have shown that when caught up in a whirlpool that is sucking them deeper into the water, they need to relax and go with the direction of the sucking force, rather than fighting the whirlpool which only saps their strength.  They need to go to the bottom of the whirlpool to survive.  So too with fear, we need to access the depths of the fear itself before we can be freed from its inhibiting effects.

Accepting the existence of fear

We need to accept that the fear is part of our life but learn how to gradually disassociate from it so that we are not identified with it.  Tara Brach tells the story of a woman suffering from PTSD who, while sitting on a park bench, envisaged her fear beside her while she continued to explore her connectedness to nature – to the birds, flowers and trees surrounding her.

Investigating our fear

Tara suggests that we explore the nature of our fear and even question what it is like, where it lies within us, how deep and dense it is.  She suggests that we explore our relationship with fear and determine what fear is expecting of us and how we want to relate to our fear.  We could question where fear resides in our body and how it manifests itself through pain and physical disturbance – headaches, muscle soreness, cramps, twitching or shaking.

Nurturing ourselves through fear

Trying to discount fear by purely rational processes will not remove the fear but only make it go underground, away from our consciousness.  We need to see the fear for what it is in all its manifestations but treat ourselves with kindness.  This may mean pulling away temporarily from facing our fear and its intensity to rebuild our resources and strengthen our resolve.  This is a gentle way to treat ourselves if we become overwhelmed when facing the depth of our fear.  After rebuilding our resources, we can resume the P.A.I.N. meditation process by again grounding our body and mind through mindful breathing.

Plumbing the depths

Tara Brach suggests that the P.A.I.N. meditation process can be employed to handle any deeply-felt, negative emotion such as grief, anguish or self-disgust, as well as fear.  In the course on the Power of Awareness, Tara discussed Leaning into Fear and highlighted the process of facing fear by quoting David Whyte’s poem, The Well of Grief, which also uses the analogy of “plumbing the depths”:

Those who will not slip beneath
the still surface on the well of grief,

turning down through its black water
to the place we cannot breathe,

will never know the source from which we drink,
the secret water, cold and clear,

nor find in the darkness glimmering,

     the small round coins,
thrown by those who wished for something else.

As we grow in mindfulness through the P.A.I.N. meditation process, we develop the courage to plumb the depths of our fear and enable ourselves to be free of its inhibitions and disabling effects.  This process of inner exploration will gradually unearth the depths of our internal resources and capacity to handle deeply-felt emotions such as fear and grief.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of AdinaVoicu on Pixabay

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.