Healing the Impacts of Adverse Childhood Experiences and Childhood Trauma

The classic study on Adverse Childhood Experience (ACE) conducted by CDC-Kaiser Permanente with more than 17,000 members of a health organisation found that two thirds had suffered at least one ACE and more than 20% reported suffering three or more adverse experiences in childhood.  Adverse childhood experiences cover the whole gamut of experiences resulting in immediate and long-term effects on a child – the experiences cover aspects such as physical, psychological or sexual abuse, violence in the home, mental illness of carers, separation from parents at an early age, divorce or suicide within the family.  ACEs occur irrespective of gender, culture, context or economic status – although, children in poverty situations are more likely to experience ACEs.  The range of adverse childhood experiences is extensive, their incidence is extremely high, and their impacts are long-lasting.

The impacts of adverse childhood experiences

This is an area that has been extensively researched and documented.  CDC (Centers for Disease Control and Prevention) summarises the long-terms effects of ACEs in terms of their physiological, mental, relationship and behavioural impacts.  The impacts are far-reaching and long-lasting.  Nadine Burke Harris found in her research that toxic stress arising from adverse childhood experiences changes a person’s biological and neurological make-up and can result in an over-active stress response.  

Nadine was inspired by the ACE study mentioned above and undertook extensive reading of research results and conducted her own research.  In a TED talk, she shared her conclusions that early childhood experiences and related trauma impacted every area of a developing mind and body:

High doses of adversity [in childhood] not only affect our brain structure and function, they affect the developing immune system, developing hormonal systems and even the way our DNA is read and transcribed.

Preventing and healing the impacts of adverse childhood experiences

Nadine has dedicated her life and work to redressing the impacts of adverse childhood experiences and related childhood trauma. In 2007, she founded, as medical director, the Bayview Child Health Center (BCHC) which is not only focused on individual child health and wellness but also activism, education and community development.

Also, as a founding member and CEO of the Center for Youth Wellness, Nadine has contributed substantially on a global basis to the development and implementation of strategies to prevent and heal the impacts of adverse childhood experiences in individuals, communities and society generally.  Some of the strategies developed by the Center and other activists in the area include:

  • Parental education in childhood development, sources of stress, the impacts of adverse childhood experiences and positive parenting
  • Multidisciplinary health care teams for children and youth
  • Screening for adverse childhood experiences by primary medical health practitioners and paediatricians
  • Community development to create social support systems and collaborative caring environments
  • Interventions in schools and political systems to raise awareness, support policies and action plans
  • Dissemination of the latest research into the nature and impacts of adverse childhood experiences.
  • Carer support centres
  • Early detection, intervention and home visitations for identified at-risk situations for children
  • Enabling reconnection with others through social prescribing and encouraging reconnection with nature
  • Adopting the guidelines and principles of trauma-informed mindfulness.

Nadine has documented her research and work in the area through her recent book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity.  Together with other concerned professionals, parents and community members from the Center for Youth Wellness, Nadine has contributed to the development of the Stress Health website designed to help carers and parents to develop the basic components of a child’s life that will protect them, or help to heal them, from toxic stress.  The website provides an ACE quiz based on the original ACE study to help you identify for yourself or your child the level of toxic stress experienced in childhood.  On completing the quiz, you are given access to several suggested strategies for stress reduction, including mindfulness.

Reflection

Many of us have experienced one or more adverse childhood events.  The care and concern of a loving friend or relative may have been instrumental in helping us to overcome or, at least, reduce the impacts of these experiences in our life, work and relationships.  Other formative experiences such as personal study, community engagement or personal development may have helped also.  As we grow in mindfulness, we can develop a deepened self-awareness and understanding of the impacts of adverse childhood experiences in our own lives, and increase our capacity for self-regulation to reduce those impacts.

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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.

Sound Meditation and the Power of Music

In previous posts I have discussed the role of music as a pathway to mindfulness focussing on the features that music and meditation have in common such as inner harmony, patience and deep listening.  Alexandre Tannous has researched the role of music in therapy, in different cultures and philosophical perspectives.  In a recent presentation for The Being & Doing Summit, he emphasised the power of music to heal, express emotion and deepen our awareness.  He provides a range of sound meditations through his album, Sound Submersion – Volume 1, which incorporates musical instruments, such as the Tibetan Singing Bowl, that produce overtones.

Sound therapy

Sound therapy uses sonar frequencies to reignite and re-balance the energy frequency in the body.  It can lead to healing and deep calm by enabling people to use the body’s natural healing powers to promote health and inner harmony.  The applications of sound therapy are numerous, including its use with dementia and Alzheimer patients to stimulate memory recall.  A social worker, Dan Cohen, discovered the power of music, aligned to personal preference, to help Alzheimer patients to access memories that have been locked away and normally inaccessible to them.  The story of this amazing research was captured in the film, Alive Inside: A Story of Music and Memory.  Sound therapy has also been used very effectively with seriously wounded veterans who can recapture or learn the skill of playing a musical instrument and discover a way to express their thoughts and feelings through music.

As an ethnomusicologist, Alexandre has travelled to over 40 countries to study music in different cultural and social settings.  While he acknowledges that sound therapy has had a major resurgence in recent times, he maintains that it is an ancient practice, especially in Eastern philosophies.  Alexandre explains that sound therapy often involves overtones, sound freqencies over and above a fundamental frequency, that we rarely hear because we are unaware of them and because the fundamental frequency is so strong that it dominates our hearing.  Alexandre’s music compositions focus on “overtone-emitting” musical instruments such as the Thai Gong employed in Thai and Burmese temples.

Sound and mindfulness

Alexandra’s audio recordings provide the basis for sound meditations using different instruments. He identifies multiple benefits of sound meditation based on his extensive research over many years.  Among the benefits are the development of inner harmony and equanimity, “ability to access and release trauma“, capacity to break habituated behaviour patterns that are unproductive, enhancement of self-awareness, development of higher levels of consciousness and stimulation of empathy and compassionate action.  In the final analysis, sound therapy builds our awareness muscle through enhancing our concentration, listening and focusing skills.

As with other forms of meditation, there will always be intrusive thoughts. Alexandre suggests that we just let them pass, not entertain them and return to our focus on the music.  Sound is truly transformative and if we adopt a deep listening posture during our sound meditation, it can improve our mental health and overall well-being.

Reflection

We often overlook the power of sound to deepen our consciousness and heal our mind and body.  As we grow in mindfulness through sound meditation, we can enrich our lives in multiple ways, not the least of these is enhancing our self-awareness and awareness of others.  Through sound meditation, we can build the capacity to deal with the waves of life – the ups and downs of everyday existence.

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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.

Trauma-Sensitive Mindfulness: Providing A Choice of Anchors

David Treleaven recently published a book on Trauma-Sensitive Mindfulness. The book enables mindfulness trainers to recognise a trauma-affected individual, provide appropriate modifications to their mindfulness processes and avoid aggravating the individual’s trauma experience.

David argues that two factors are foundational to trauma-sensitive mindfulness, (1) choice and (2) anchors.  He observes that people who are trauma-affected have experienced an unwanted negative event that endangered them, a total loss of control over the situation and a lack of agency (capacity to influence the outcomes).  Providing choice, especially in relation to anchors, is critical for the welfare of the trauma-affected individual – it avoids reactivating the sense of helplessness associated with the traumatic event and reduces the likelihood of triggering a painful “body memory”.

Providing a choice of anchors – internal sensations

An anchor enables an individual to become grounded in the present moment despite being buffeted by distractions, negative self-stories or endless thoughts.  The choice of an anchor is a very personal aspect of mindfulness – it relates to an individual’s preferences, physical capacity and emotional state.  An anchor enables a person to experience ease and emotional stability.

Jessica Morey, an experienced teacher of trauma-sensitive meditation, begins a meditation training session by offering participants a choice of three internally-focused anchors – a bodily sensation, attention to sound within their immediate environment (e.g. the “room tone”) or a breath sensation (air moving through the nostrils, abdomen rising and falling or movement of the chest).

Participants are given the opportunity to try out these different anchors over a five-minute period and to make a choice of an anchor for practice over a further period.  Providing this choice of anchors avoids locking individuals into a mindfulness process that can act as a trigger for reexperiencing trauma, e.g. sustained focus on breathing.

Alternative anchors – external sensing

David notes that the five senses offer further choices of anchors – in addition to the internally focused anchors suggested by Jessica.  The senses enable a participant in meditation training to focus on some aspect of their external environment:

  • Hearing – tuning in to the external sounds such as birds singing, the wind blowing or traffic flowing past.  The downside of this approach is that it may trigger our innate tendency to interpret sounds and this may lead to focusing on a particular sound – trying to identify it and its potential source. So, this may serve as a distraction pulling us away from experiencing (the “being” mode) to explaining (the “thinking” mode).  The aim here is to pay attention to the experience of hearing, not to focus on a single sound. Sam Himelstein has found that listening to music can be a very effective anchor for a person who is in a highly traumatised state – choosing music that aligns with the individual’s musical preferences can serve as a powerful anchor.
  • Touch – a trauma-affected person could have an object, e.g. a crystal or a stone, that provides comfort and reassurance and enables them to become grounded in the present moment through the sensation of touch.
  • Seeing – taking in the natural surroundings, e.g. by observing closely the foliage of a tree – its colours, shape and texture or observing the patterns in the clouds.

Other options include sensations of smell or taste.  However, in my view, these tend to be less neutral in character and can re-traumatise a trauma-affected person.

David Treleaven offers a wide range of resources to help meditation trainers build their awareness, skills and options in the area of trauma-sensitive mindfulness (TSM).  These include an online training course, interview podcasts, a TSM Starter Kit (incorporating an introductory video and a comprehensive “TSM Solutions Checklist”) and a live meetup of the TSM Community (registered members of a community of TSM-aware practitioners).

Reflection

As we grow in mindfulness through meditation, research and reflection, we can become more flexible about how we offer mindfulness training.  A trauma-sensitive approach to mindfulness requires an awareness of the manifestations of trauma and post-traumatic stress disorder (PTSD), identification of different sources of anchors and the willingness and capacity to offer participants the choice of an anchor and an approach to mindfulness.  This means that we need to move beyond our own fixation with “meditation logistics” and be flexible enough to offer trauma-informed mindfulness practices.

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Image – Trees on the foreshore, Wynnum, Brisbane

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.

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.

Trauma-Informed Mindfulness: Relationship Building through Music

Sam Himelstein has developed several basic principles and a series of guidelines to assist mindfulness teachers to sensitively work with people who are impacted by trauma. While these principles have been developed over more than a decade working with trauma-impacted teens, the principles and guidelines are also relevant to anyone working with adults who have experienced trauma. 

Relationship building through music

In his podcast interview with David Treleaven, Sam discussed a particular case that was a primary catalyst to the development of his principles and guidelines.  He provides a more detailed discussion of the case in his blog post, Trauma-Informed Mindfulness with Teenagers – 9 Guidelines.  The case involved a 17-year-old high school student, Jeanette, who had experienced a traumatic childhood with many categories of traumatic events in her life, including drug addiction of her father.  She had approached Sam, a registered psychologist, for help with her trauma-related issues.

During initial psychotherapy treatment, Sam was helping her to locate her estranged father so she could establish a connection with him.  However, before this reconnection happened, the young woman learned that her father had died from a drug overdose.  This intensified her trauma and when she presented at Sam’s clinic after the death of her father, she was unable to talk about her father, follow a line of discussion or formulate coherent sentences.  Sam described this in terms of “her brain down regulating”.

Sam’s first principle – “do no harm” – came into play as he realised that getting her to talk would take her outside her window of tolerance.  As he knew about her interest in music and her favourite genre, he intuitively realised that listening to music that she liked would enable her to establish some degree of equanimity, build trust and reinforce the relationship through a shared pleasant experience. 

As they listened to the music together, she slowly began to move her head in line with the beat and rhythm of the music.  Then, she began to talk.  Sam described the effect on Jeanette of listening to the music as regulating her central nervous system, bringing her back within the window of tolerance and enabling her to access her language ability so that she could express her emotions such as anger, grief and sadness.

Sam had realised that while Jeanette was positive about the utility of mindfulness in the context of therapy, “conventional talk therapy or mindfulness meditation wasn’t going to work”.  This music intervention was in line with what he described as practising an INCRA, an “inherently non-clinical relational activity” that is not a therapy technique in itself but effectively builds the relationship.  Sam discusses case studies where he has used INCRA in a clinical setting with teens in his forthcoming book, Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.

Reflection

As we grow in mindfulness through meditation and reflection, we can better access our intuition when working with or training people who have suffered trauma.   Being present to the person needing help will enable us to let go of conventional, trained responses and be open to activities that are non-clinical in nature but develop the relationship – the foundation for all helping.  Trauma-informed mindfulness, then, involves not only sensitivity to trauma-impacted people but also the flexibility to depart from habituated responses or processes.  Mindfulness helps us to tap into our innate curiosity and creativity.

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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.

Trauma-Informed Mindfulness: Guidelines for Effective Helping

Sam Himelstein, in a podcast interview with David Treleaven, discussed the principles for teaching mindfulness that he has developed over more than 12 years working with teens impacted by trauma.  His principles and related guidelines have relevance for anyone using mindfulness to help people who have experienced trauma. 

Besides his discussion in the interview mentioned above, Sam provided a blog post that addresses the guidelines explicitly.  The principles and guidelines (together with examples from real cases, teaching material and  practical exercises) are explained in depth in his forthcoming book,  Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.

Guidelines for effective helping of people impacted by trauma

The guidelines developed by Sam Himelstein provide clear and consistent actions that can be taken by anyone helping people impacted by trauma:

  • Do no harm – this is a fundamental guideline informing the others.  Through research, study and practice of trauma-informed mindfulness practice, we can be more aware of potential harm and have the tools to do the best we can to avoid further harming the person suffering from trauma.  Sam mentions two resources that he draws on, The Meditation Safety Toolbox and Chris Willard’s Guidelines for Ethical Teaching of Mindfulness.
  • Avoid prescription about “meditation logistics” – people who are impacted by trauma are often unable or unwilling to start with formal meditation.  Sam urges us to avoid being inflexible through insisting on a set posture or closed eyes when initiating our helping interaction.  This requires letting go of the structural prescriptions of our own meditation training.  It is important to recognise that the people we are helping will be in a “different space” but can still develop mindfulness (inner and outer awareness) with processes other than formal meditation.  We need to acknowledge that mindfulness is more than just meditating.
  • Establish safety – it is critical that the person we are helping feels safe.  If they do not feel safe, they may experience re-traumatisation.  In addition to physical safety, this involves relationship and emotional safety through developing trust, being authentic and being prepared to modify our approach to suit where the person is at.  A more involved aspect of safety is what Sam calls cultural safety developed through “intersectional awareness”.  This requires an awareness of our implicit biases when dealing with people who have characteristics different to our own, e.g. gender, ethnicity, religion, age, sexual preference, disability or “class”.
  • Employ somatic practices first – this involves recognising the role of body memory in trauma and being cognisant that cognitive approaches commenced too early in the intervention can exacerbate the situation for the trauma-affected person.  Sam indicated that he often uses deep breathing exercises and basic somatic meditations.
  • Understand the “window of tolerance” – relates to a personal zone within which a person is able to effectively employ their cognition to “receive, process and integrate information”.  If a person is outside their window of tolerance than are unable to engage effectively in talking, telling stories or undertaking meditation practices.  Sam suggests that a sign of this “intolerance” is the person’s inability to use language, e.g. unable to formulate complete sentences or follow a line of discussion.  He recommends the book Trauma and the Body, as a resource for understanding the “window of tolerance” and learning about somatic approaches to trauma healing.

Reflection

As we grow in mindfulness through meditation practices, research and reflection, we can develop our awareness and understanding of the sensitivity of trauma-impacted people to formal meditation.  This requires that we become more aware of the “window of tolerance” and develop our capacity to pay attention to the signs that someone we are working with is not coping with our processes.  Associated with this, is the need to build the relationship through establishing safety and trust.  Employing somatic approaches will be more effective if we have experienced their utility ourselves as part of our own mindfulness practice and experience.   The more mindful we become, the better we will be able to help people impacted by trauma – for one thing, we will be able to let go of our assumptions and become more aware of our biases.

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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.

Trauma-Informed Mindfulness: Principles for Effective Helping

Sam Himelstein has specialised for more than 12 years in using mindfulness to help teenagers impacted by trauma.   In a podcast interview with David Treleaven, Sam explained in depth his approach to teaching mindfulness to teens affected by trauma, as well as the evolving principles that shape his practice. While his focus is primarily on teens and educating others to work with teens, his approach and principles have relevance to anyone who is using mindfulness to assist people impacted by trauma (or anyone who is teaching mindfulness where a participant is a trauma sufferer).  He has developed his principles through ongoing reflection on practice.

Sam is a psychologist and youth worker and the author of A Mindfulness-Based Approach to Working with High-Risk Adolescents and the forthcoming book, Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.  He is also the founder of the Center for Adolescent Studies.

Principles for trauma-informed mindfulness practice

In discussing his approach to working with teens impacted by trauma, including incarcerated youth, Sam identified several principles that guide his practice:

  • Avoid “adultism” – the assumption that as an adult you are superior to teens and have a lot to teach youth and they have very little in the way of wisdom to offer.  Associated with this false belief, is the assumption that you know best what is good for them – implying that they should learn from your teachings (that you try to impose on them).  This also involves recognising the wisdom they gained in their transition to a teenager. [You can also test your assumptions when working with adults – do you assume that they have no insights into the nature and practice of mindfulness?]
  • Work from where they are at – do not begin with formal meditation as they are unlikely to be ready for this.
  • Focus on relationship-building – consciously build trust in every aspect of your interaction, as their level of trusting others will have been severely damaged by their trauma experience(s). 
  • Assist teens to become comfortable with “sitting with themselves” and exploring “inner awareness”.
  • Be genuinely curious about what is happening for them and what they are doing to cope – bring an open mind to the interaction.  It can be helpful to identify and test your own assumptions before interacting.
  • Develop your own mindfulness continuously – your inner and outer awareness – and learn to let go of “ego” and the need to control the process.

Reflection

When teaching mindfulness to adults and youth, we need to be aware of the possibility that they may have been impacted by trauma(s) in their life.  Being conscious of the principles employed by Sam will help us to demonstrate sensitivity, build trust and relationships, and work at their pace – rather than to a pre-ordained progress schedule.  It will be imperative for us to grow in mindfulness – becoming fully aware of the assumptions we bring to the teaching/interaction, letting go of ego and the need for control, and genuinely engaging with curiosity, humility and openness.

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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 and Post-Traumatic Stress

In the previous post, I addressed the need for trauma-sensitive mindfulness.  One of the observations of David Treleaven mentioned in the post, was the need for meditation teachers to develop an awareness of, and sensitivity to, the presence of people who are experiencing, or have experienced, trauma.  Failure to do this could lead to mindfulness activity that generates trauma stimuli leading to re-traumitisation.  Being trauma-sensitive means understanding the signs of post-traumatic stress as well as having the presence of mind to modify mindfulness practices to take account of people’s needs in this condition.

Recognising the signs of post-traumatic stress

Trauma results where a person experiences an overwhelming amount of stress that exceeds their ability to cope and deal with the emotional fallout from that experience.  The effects vary with each individual and the nature of the traumatic event. Traumatic events can include the loss of a sibling or parent through death, separation from a parent at a young age, a life-threatening car accident or terrorist event, separation and divorce, a house fire, physical or sexual abuse or a natural disaster.

This variability in the nature and impact of traumatic events, and the individual’s reluctance to disclose through shame or the need to comply with an authority figure, means that it is often very difficult to ascertain whether a person has suffered from trauma and is experiencing post-traumatic stress disorder (PTSD).  According to several reports, up to 20% of people who experience a traumatic event together will experience post-traumatic stress disorder.

Trauma can impact a person’s thoughts, emotions, perceptions, level of arousal/reactivity and mood.  It can be reflected in behavioural change such as avoidance of a person or location, inability to sleep or sleeping too much, reliving the trauma through nightmares or flashbacks or withdrawal from social contacts or work colleagues.  The attendant emotions could be depression, anxiety and feeling unsafe.  Thoughts of suicide can also be one of the signs of post-traumatic stress disorder.

The role of memory and embodiment

Peter Levine, in an interview with Serge Prengel, discussed the role of memory in trauma and post-traumatic stress disorder.  Peter is the author of the book, Trauma and Memory: Brain and Body in Search of the Past – A Practical Guide for Working With Traumatic Memory.  His book is ground-breaking in that he highlighted the role of “implicit memory” and showed how to treat trauma sufferers by accessing the “complex interplay of past and present, mind and body”.  He termed his methodology, “somatic experiencing”.

In the interview, Peter stressed that we have several different forms of memory and the ones that are particularly relevant to trauma are episodic or autobiographical memories, emotional memories and procedural or body memories.  Episodic memory, also termed “defining moments” by Serge the interviewer, though low in emotive content are nonetheless impactful. For example, Peter describes a teacher who acted as a mentor to him and instead of blaming him for poor judgement encouraged him to learn and explore his curiosity.  Other mentors in his life as he progressed through his studies modelled similar behaviour.  This, in turn, led him to a career choice as a professional mentor – so the episodic memory acted as a “trajectory” for his progress in life. 

Emotional memories, on the other hand, “though further out of the realm of awareness” are “very powerful and compelling” and shape how we behave in our life.  Some interaction from the past is encoded with a very strong emotion such as sadness, anger or fear.   The emotional memory can interfere with a current relationship when something or somebody acts as a reminder of the past interaction so that we can be overwhelmed with either a very strong negative or positive emotion. 

While emotional memories operate at a deep level, body memories are deeper still.  At one level, they have to do with the acquisition of motor learning and skills, e.g. riding a bike.  At another level, they are determinants of our approach or avoidance behaviour.  Peter gives the illustration of coming across a former classmate more than 30 years after their schooling and finding that he had a strong desire to approach and reconnect with him.  The classmate had been his protector at school when other children tried to bully him – hence his approach behaviour.  An example of avoidance behaviour conditioned by body memory is when someone who has previously experienced sexual abuse actually freezes when touched by a loving partner.

David Treleaven reinforced the relationship between trauma and body memory when he stated in his video presentation that “the respiratory system is intimately connected to our sympathetic nervous system which is totally tied to traumatic stress”.  He pointed to two books by Babette Rothschild that highlighted the close connection between trauma and body memory, The Body Remembers and Revolutionizing Trauma Treatment.   David also explained further why meditation exercises such as mindful breathing can activate trauma stimuli.  He drew on the differentiation between exteroception (body’s perception of external stimuli received through the senses) and interoception (sensing conditions within the body such as deep breathing or tightness of the chest).  Normally exteroceptors and interoceptors integrate (e.g. the external sensation of viewing a sunrise is matched with the internal sensation of a warm feeling in your chest and a sense of looseness in your hands and legs); with trauma sufferers, “the relationship between interoceptors and exteroceptors can go awry”.

Peter Levine emphasised the need to recognise that we have a “fluid identity” – while our identity is shaped by the past, and the interplay of multiple events and interactions, it is possible to gently, but surely, release the embodied memories and progressively unearth the richness, power and sense of connection of an identity not locked into painful memories.  He has dedicated his lifework to training individuals and professionals in understanding the role of the different memories and in learning to use his trauma treatment methodology, somatic experiencing.  Other professionals, through an understanding of the mind-body connection, employ somatic meditation to assist trauma sufferers.

Reflection

We can grow in mindfulness as we develop an awareness of the role that memory plays in our own thoughts, emotions, moods and behaviour and learn to recognise the signs of post-traumatic stress in others.  As we develop this heightened awareness, we can make appropriate modifications to our meditation teaching and deepen our own meditation practice and reflection.

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Image – Sunrise over the water, Wynnum, Brisbane

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.

Being Vulnerable: How to Improve Our Relationships and Contribution

In the previous post I discussed Tara Brach’s presentation on vulnerability and intimacy and ways to overcome our defence mechanisms. In this blog post, I want to focus on becoming vulnerable to improve two aspects of our lives – our contribution and our relationships.

Vulnerability is universal

Vulnerability is “part and parcel” of being human. When you think about it most people you encounter in life will have experienced at least one trauma – a significant frightening or disturbing event – in their life at one time or another. A traumatic event may take many forms and people will react differently to varying events such as the death of a child, partner, parent, sibling or friend; the break-up of parents through divorce; a major car or workplace accident; loss of a job; experience of chronic illness and/or pain; severe financial difficulties resulting in the loss of a home; break-up of an intimate relationship; a period of mental illness; addiction to drugs or alcohol; or any manner of distressing events.

Tara makes the point that “the more wounding there has been, the greater are the defences”. We each have been wounded at some time through various events, traumatic or otherwise, that have intensified our sense of being vulnerable and precipitated our defence mechanisms designed to protect us from such vulnerability. Ian MacLaren recognised that everyone experiences vulnerability when he wrote, “Be kind, for everyone you meet is fighting a hard battle”.

Because of our past experiences, we may feel afraid to speak up, to take part in a group activity, to perform publicly, to engage in conversation or to give positive feedback to another person. We may feel that we will be rejected, laughed at, or cut out of a group. We might be concerned about experiencing embarrassment, lack of control or overt emotions expressed as tears.

How we hide our fear of being vulnerable

There are many ways that we can camouflage our fear of being vulnerable such as:

  1. excessive criticism of others, constant judging (people never measure up to our expectations)
  2. projection of our own fears or anxiety onto others (“they are too fearful or lack courage”)
  3. aggressive emotions such as anger, blame (fight behaviour)
  4. withdrawal through depression (flight behaviour)
  5. inertia (freeze behaviour)
  6. overcontrolling others
  7. overconsuming – food, social media, goods and services, drugs
  8. hiding behind a mask/role – being the boss, the helper or the victim

The problem is that these ways of hiding our feelings of vulnerability are often subtle, elaborate, sub-conscious and developed over long periods of time. It takes a concerted effort and continuous training to be able to identify our defence mechanisms and overcome them through sustained, focused attention in meditation.

Being vulnerable to improve our contribution

Tara at one stage in her presentation tells the story of how a disturbed teenager’s life turned around when he heard a monk sing a song both loudly and off-key in front of an audience. He was taken with the courage required by the monk to do that and make a “fool” of himself. The monk showed bravery by placing himself in a potentially embarrassing situation.

I previously recounted a similar story of coach Mo Cheeks (who could not sing in tune) getting up in front of thousands of people at a NBA playoff and helping a 13 year old girl complete the national anthem after she was overcome with nerves.

Both these stories illustrate the power of being vulnerable (overcoming our natural defence mechanisms) to make a contribution to others and the community generally. Mo’s action, for instance, has been a source of inspiration for more than half a million people who have viewed the video of his compassionate intervention.

Improving a relationship by being vulnerable

Tara tells another story of a mother who was feeling very vulnerable because her daughter had become addicted to heroin and was continuously in and out of treatment centres for her addiction. The mother hid her sense of powerlessness and being vulnerable by her angry, blaming and controlling behaviour towards her daughter. Through psychotherapy the mother was able to let go of her defences and need for control and provide compassionate support for her daughter – to be with her daughter in her struggle, trusting in her daughter’s own wisdom to break free of the addiction.

The daughter did succeed and overcame her addiction and the mother and daughter built a deep relationship through this mutual experience of vulnerability. The mother was able to overcome her defence mechanisms to provide constructive support that enabled her daughter and the relationship to move forward.

A meditation on vulnerability

In her presentation (at the 35.45-minute mark), Tara provides a basis for reflection on your own sense of vulnerability and how it is impacting your relationships. She suggests you focus first on a relationship that you want to improve in terms of closeness or one that is bogged down in a pattern of behaviour that is not constructive. The focal relationship can be with anyone – life partner, friend, child, sibling or work colleague.

The reflection then revolves around exploring the ways that you are creating separation through your own thoughts and actions. Tara provides some questions to explore how your vulnerability is impacting the relationship:

  1. in what ways are you protecting yourself in these interactions?
  2. are you judging the other person?
  3. are you projecting on the other person some expectation of how they should be?
  4. are you withholding yourself and pretending to be who you are not?
  5. are you trying to impress the other person by constantly explaining how good you are at some endeavour or how much better your trip or experience was?
  6. are you operating from a low level of trust of people generally?

Once you have addressed these questions, the process then involves getting in touch with how you feel in your body when you are defending yourself – are you uptight?; does your face reflect your intensity?; are you physically rigid?; or are you looking distracted (as you search for a self-protective response)?

You next ask yourself how would you manage if you let go of one or more of your defences in your interactions with this person – how will you need to feel differently? A visioning question can be helpful here – “What if I reduce my armour, what will our interaction be like and how will I cope with being seen to be flawed or being rejected or looking foolish”? You can ask yourself, “How likely is it that these outcomes I fear will actually occur?”

The final step is to face your fear and sense of being vulnerable, acknowledge it and use your breathing to bring it under control. You can adopt a mindful breathing approach, deepen your in-breath and out-breath or envisage the fear as you breathe in and envisage its release as you breathe out.

As we grow in mindfulness through noticing and managing our vulnerability through meditation practice, we can open ourselves up to more creative contributions to our community and to deeper and more meaningful relationships. As the defence barriers we construct begin to come down or weaken, we are able to free up our creative abilities and let people into our life.

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

Image source: courtesy of geralt 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.