The Pandemic and Narrowing of the Window of Tolerance

David Treleaven and Liz Stanley discussed the current pandemic In their interview podcast on Widening the Window of Tolerance.  They both asserted that COVID-19 had effectively narrowed the window of tolerance of many people.  There are many people who are becoming increasingly stressed and traumatised by unfolding events, whether because of the death of relatives and friends, loss of a job, dislocation from their normal place of work (and way of working) and/or stringent “lockdowns”.

Narrowing the window of tolerance

In these very challenging times, people are becoming controlled by their “survival brain” – resorting to a fight, flight or freeze response.  Their window of tolerance is becoming narrowed, both in terms of their inner tolerance of challenges and external tolerance of differences.  Everything has been “thrown up in the air” so that they have lost their grounding in accurate perception and balanced body sensations. 

Polarisation , racism, and hate thrive in this disrupted state as people seek refuge in their “own tribe” (flight) and attack others who are different from themselves (fight).  Liz suggested that many people are “uncomfortable in their own skin” so that lockdowns and movement restrictions , creating disconnection, exacerbate the tendency to dysregulation (inability to control emotions).   The sense of hopelessness and helplessness in facing continuous and growing uncertainty adds to the incidence of anxiety and depression.

A compounding factor is that social media becomes what Liz calls an “echo chamber” – it gives unregulated voice to “dysregulated communications” that increase the tendency towards polarisation.  People retreat to social media and television only to find that these media are increasingly disorientating and disturbing.    

Further compounding the issues for individuals is the fact that we tend to make a “bargain” with ourselves – e.g. we can put up with lockdown for three weeks by adding some new routines such as working different hours, taking more regular breaks and expanding project timelines.  However, when other people blatantly and inconsiderately breach lockdown regulations or social distancing requirements leading to further lockdowns, conforming people can feel betrayed – intensifying a sense of hopelessness and helplessness.

Hope and widening the window of tolerance

In the previous post I discussed trauma-sensitive mindfulness and widening the window of tolerance.    Liz provides several strategies in her book, Widen the Window: Training Your Brain and Body to Thrive During Stress and Recover from Trauma.  In the interview podcast she shared some of her own strategies for becoming grounded during the current health and economic crisis – mindfulness meditation, gardening, walking and playing with the dog, and focusing on connectedness to others.

Liz’s Mindfulness-based Mind Fitness Training (MMFT)® provides detailed strategies and tools to navigate effectively through times of trauma and stress.  She makes the point that whenever we are controlled by our “survival brain”, we are disconnected from our “thinking brain” and shut off from the opportunity to access our creativity and ingenuity. In discussing “hope” in the current challenging times, David noted that the tendency to “hyperfocus on what is not working” (as he has done at times) tends to narrow the window of tolerance and our capacity to cope.  He suggests that accessing stories of successful transition can help to widen our window of tolerance, e.g. successful career changes by people who have lost their jobs. Another strategy that he suggests is to effectively reframe what is happening.  By way of example, he draws on the comments of Adrienne Maree Brown in her article on living through the unveiling:

Things are not getting worse, they are getting uncovered, we must hold each other tight and continue to pull back the veil.

Liz reinforces this view when she suggests that it is really only in times of turbulence when everything seems to be “thrown up in the air”, that genuine and sustainable change can happen.

Reflection

As David suggests, we can choose to stay in the fog bank by continuing to absorb negative messages, both external and internal, or we can free ourselves from this befuddled state by growing in mindfulness and developing our own strategies to build resilience and stay grounded.

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Image by My pictures are CC0. When doing composings: 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-Sensitive Mindfulness and the Window of Tolerance

In the previous blog post I discussed several resources on the topic of trauma-sensitive mindfulness.  One of these was David Treleaven’s Trauma-Sensitive Mindfulness Podcast which includes interviews with people who have expertise in the area or a related area.   In a recent podcast, David  had a conversation with Liz Stanley who not only experienced very considerable trauma, the impact of mindfulness meditation on her traumatic experience but also has developed her own resources and training for people, both civilians and military personnel, who have experienced trauma.  The conversation with Liz on the topic of Widening the Window of Tolerance draws on her personal experiences, study and training and incorporates ideas from her training program and her book, Widen the Window: Training Your Brain and Body to Thrive During Stress and Recover from Trauma.

The Window of Tolerance

The concept of the Window of Tolerance has been attributed to Dan Siegel, clinical psychologist and founding co-director of the Mindful Awareness Research Centre (MARC), UCLA.  Dan is the author many books, including Aware: The science and practice of presence.  Many people, including David Treleaven and Liz Stanley, have applied the concept of the Window of Tolerance in their research and training in relation to trauma-sensitive mindfulness.

The National Institute for the Clinical Application of Behavioral Medicine (nicabm) provides an infographic that illustrates the concept in a very clear and easy-to-understand way.  They explain that the window of tolerance is about our capacity to deal with the challenges and stresses of the moment and take wise action to deal with them.  When stress takes us outside our window of tolerance we can experience hyperarousal (related to the fight/flight response) which manifests in uncontrolled anger, emotional overwhelm, or extreme anxiety; or, alternatively, experience hypoarousal (related to the freeze response) which manifests in the body trying to shut down resulting in numbness, “zoning out” or “spacing out”.  

The Attachment and Trauma Treatment Centre for Healing (ATTCH), drawing on the work of Dan Siegel and colleagues, provides a more detailed explanation of the concept in an article titled, Understanding and Working with the Window of Tolerance.  Pooky Knightsmith, on the other hand, provides a simple explanation in her short video on the window of tolerance and how to apply it to managing our emotions in everyday life (for those who are not experiencing trauma or trauma stimuli).

Trauma and narrowing of the window of tolerance

In her podcast interview. Liz reinforced the view that trauma causes a narrowing of a person’s window of tolerance.  She explained that she is a living example of someone who has experienced multiple traumatic events and who tried to cope in the only way she knew how, conditioned as she was by familial and social determinants.  Liz suffered an incredible range of traumatic experiences – active military duty in Asia and Europe, PTSD,  a near-death experience (NDE), rape, and whistle-blower harassment as a result of formally complaining about sexual harassment by her senior officers.

Liz described her response in terms of the compulsivity that comes with hyperarousal (which can occur when a person is outside their window of tolerance).  Instead of dealing with her traumatic stress, she intensified her activities, completing two undergraduate degrees simultaneously.  She explained that like a lot of people, she “compartmentalised” the stress, suppressed it and just kept going harder than ever, managing on two hours sleep each night – she “soldiered on”, both literally and metaphorically.

Liz had to make changes when she temporarily lost her eyesight – something she described as “cosmic coping pain” when her body which had “borne the brunt” of her hyperactivity decided “enough was enough”.  It was then that she explored mindfulness and researched trauma and trauma healing.

Liz explained “trauma” as impacting “neuroception” – “how neural circuits distinguish whether situations or people are safe, dangerous or life threatening”.  In effect, trauma can distort our neuroception and effectively narrow our window of tolerance.  She explains the effect in terms of our “thinking brain” and our “survival brain”.

Our thinking brain enables us to analyse, make decisions, accurately perceive stimuli, and take wise action; our “survival brain” responds to perceived threats with the fight/flight/freeze response.  With trauma, the connection between the two is “compromised” so that, for example, seemingly harmless stimuli can be perceived as a threat and engender an inappropriate response negatively impacting a person’s health, relationships and capacity to undertake their work.   When we perceive a situation as hopeless or ourselves as powerless, our survival brain and nervous system can become flooded with heightened “emotional arousal”.

Liz explains, however, that when the thinking brain and survival brain are in harmony and working together, we have a wider window of tolerance – e.g. better tolerance of ambiguity and uncertainty and the ability to identify and make effective choices, build sustainable connections, and perform optimally. 

Experience of mindfulness for dealing with trauma

Liz turned to mindfulness meditation to help her cope with her traumas which had deep-seated antecedents in the post-traumatic stress disorder (PTSD) experienced by her father and grandfather (along with all the distorted coping mechanisms and fractured relationships that this entailed). Her initial experience with mindfulness was one of helping her to achieve some degree of self-awareness and associated self-regulation.  However, over time, she found that her “survival brain” took over as it began to “peel back deeper layers” – deep emotional scars hidden behind her hyperactivity (just as the happy-go-lucky “joker” or “larrikin” can hide the deep emotional pain of depression).

As some mindfulness practices acted as “trauma stimuli” she experienced panic and shallow breathing in-the-moment and flashbacks, nausea, claustrophobia, and inability to sleep for days afterwards.  Liz explained that a potential problem with mindfulness done in isolation and without appropriate modifications can lead to such heightened emotional awareness and arousal that the traumatised person can lose their ability to regulate their emotions and their unhealthy condition can be exacerbated rather than diminished, both mentally and physically.

Developing a trauma-sensitive approach to mindfulness training

Liz explained that she spoke to scientists and neuroscientists, explored multiple skills and techniques, and wrote a book about her experiences and her journey out of trauma disablement.  She found that the myths surrounding mindfulness could make matters worse unless the mindfulness trainer recognised the impact of traumatic experience on a person’s window of tolerance.

In her book on widening the window, she draws on her own experiences and stories from people she has trained in a areas such as healthcare facilities and the armed forces.  Liz maintains that you can build resilience even in stressful jobs or when healing from traumatic experience(s).  She provides strategies involving paying attention in certain ways to increase the capacity to access choice and creativity and to make courageous decisions while effectively connecting with others through curiosity, openness, and compassion.

Liz’s Mindfulness-based Mind Fitness Training (MMFT)® which was developed in 2008 and evaluated on four occasions by neuroscientists and stress experts is now available online through Sounds True.  The comprehensive course includes video training and live sessions on topics such as resilience, stress and trauma recovery, effective decision making and relationship building along with “new tools for successfully navigating the interpersonal aspects of stress, trauma, emotions, and conflict”.

Reflection

When you first hear about the potential harmful effects of mindfulness meditation training for trauma sufferers, you can understandably become concerned about conducting mindfulness training for any group.  Alternatively, you might initially dismiss the trauma-sensitive mindfulness movement as a movement to counter the growing global popularity of mindfulness.  However, the evidence to support the trauma-sensitive approach is growing and cannot be ignored.

On the other hand, both Liz and David strongly encourage practitioners not to be put off from training others in mindfulness by this new information nor to behave as if they are “walking on eggshells”.  They strongly encourage mindfulness trainers to persist, especially in these challenging times when mindfulness and resilience is needed by some many people.  They do, however, suggest to proceed with “some discernment”, develop increased awareness of trauma and its impacts, learn about new tools available for trauma-sensitive mindfulness training and intensify their own efforts to grow in mindfulness so that they can train with increasing awareness, insight and sensitivity.

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Image by skeeze 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.

Resources for Trauma-Sensitive Mindfulness

The core resource that I have used to understand and practise trauma-sensitive mindfulness is the work of David Treleaven.  David experienced trauma as a child and was a committed to mindfulness meditation practice which he found to be essential for healing trauma, but of itself insufficient.  His own clinical practice as a psychotherapist working with trauma sufferers confirmed this view of the essential nature of mindfulness meditation but its insufficiency in healing trauma sufferers.  David has dedicated his life’s work to researching and educating others about the relationship between mindfulness meditation and trauma.  This has culminated in his book, Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing and a website with additional resources. 

The potential for harm to trauma sufferers during mindfulness meditation

In his book and a free webinar on The Truth About Mindfulness and Trauma, David explains that a lack of understanding by mindfulness trainers of the relationship between trauma and mindfulness meditation can result in overwhelm for a current or former trauma sufferer.  This overwhelm can be manifested in heightened anxiety, dissociation, or emotional dysregulation – the inability to control emotions elicited by a trauma stimulus.  Harm to the trauma sufferer by a meditation teacher can be exacerbated by a lack of understanding of trauma and perpetuation of the myths surrounding mindfulness meditation.  Typical responses that show this lack of understanding and sensitivity are statements like, “Stick with it” (by implication, “if you persist, your trauma response will go away”) or “Most people find this meditation relaxing and calming” (by implication, “there must be something wrong with you”).

The difficulty is compounded by the incidence of trauma and related adverse childhood experiences (ACE).   One study of 17,000 members of an integrated health fund found that two thirds had experienced an adverse childhood experience and 20% had experienced more than three such events.  There is now an ACE instrument whereby people can identify the number and type of ACE’s they have experienced in a lifetime.  David mentions other research that indicates that everyone will have at least one traumatic experience in their lifetime.  He goes on to say that the implication of this is that in any room of people practising mindfulness meditation, there will more likely be at least one person suffering trauma.  Johann Hari, author of Lost Connections, identifies disconnection from childhood trauma as one of the seven social causes of the pervasiveness of depression in society today.

The three myths about mindfulness meditation and trauma

In the 60-minute webinar on his website, David identifies three myths about mindfulness meditation that have been perpetuated in the popular press and in mindfulness training.  The three myths are as follows

  1. The Panacea Myth – the belief that mindfulness meditation will heal all kinds of stress, even stress generated by trauma.  David’s own experience and his clinical experience working with trauma sufferers reinforces the fact that mindfulness meditation alone will not heal trauma – mindfulness meditation processes need to be modified and, in some cases, supplemented by other methodologies such as professional psychological support.
  2. The Breath Myth – the belief that breathing is emotionally neutral.  David explains that because the respiratory system is biologically proximate to the sympathetic nervous system (responsible for excitation of our “flight/ flight/freeze” response) “close and sustained focus on the breath” can re-traumatise an individual for whom “breath” is a trauma stimulus. He states categorically and importantly that “people have different relationships to breath at different moments”.  He encourages the listener to experiment with this throughout the day to confirm that our breathing can be relaxed, tense or emotionally neutral at any point in a day.
  3. The Sufficiency myth – the belief that mindfulness meditation alone is sufficient to heal trauma.  David draws on case examples to illustrate the need for modifications to mindfulness meditation practice and the introduction of additional “self-regulation” tools to enable a person to heal from trauma.

Overall strategies to develop trauma-sensitive mindfulness training practices

David and other authors, practitioners, and researchers provide a range of strategies to “do no harm” when educating others in mindfulness meditation.  Here are some key strategies:

  • Understand trauma – First and foremost, understand trauma and its components on a biological, psychological, and social level.  Without this understanding, it is difficult to develop the sensitivity and flexibility required to do no harm when facilitating a mindfulness meditation session.  Associated with this, is the need to understand trauma-sensitive mindfulness and different strategies that can be adopted by mindfulness trainers and educators.
  • Provide choice re participation – this can be as basic as the freedom not to participate in any or all mindfulness practices on a particular occasion.  It can be the freedom to choose to close your eyes or leave them open (downcast or in wide-ranging exploration) and/or the option to sit, stand, walk  or lie down during meditation practice.  David points out that choice reinforces a sense of agency and is an important and healing aspect of mental health.  He also warns about the potential of offering too much choice in one session which can result in stress for participants, particularly those who already experiencing anxiety (David learned this by making this mistake himself in his zeal to provide agency).
  • Provide choice of anchors – this is a key area of choice that not only recognises that some anchors can be trauma stimuli for some individuals but also that anchors in meditation are an area of personal preference (what works for one person does not work for another).  Anchors enable meditators to restore their focus when they have been diverted by a distracting thought and/or emotion.
  • Adopt modifications to mindfulness meditation practices when needed – In the webinar mentioned about, David provides examples of how he has been able to offer modifications to mindfulness meditation practices for particular individuals when working one-to-one, including  allowing brief breaks to walk around, suggesting a shift in posture and encouraging the use of deep breathing at different intervals or at appropriate moments.  Sam Himelstein, who works with traumatised teenagers, has found, for example, that where a teenager cannot talk about, or focus on their feelings about, their traumatic experience, listening to appropriate music together can be relationship building and enable progress to be made in healing teenage trauma.
  • Develop awareness of principles, guidelines and practices for trauma-sensitive mindfulness – David provides a comprehensive, two-part, online program for training mindfulness practitioners in trauma-sensitive mindfulness.  He also provides a free Trauma-Sensitive Mindfulness Podcast featuring  people such as Liz Stanley on Widening the Window of Tolerance and Sharon Salzberg on Loving-Kindness Meditation.   Sam Himelstein, author of Trauma-Informed Mindfulness With Teens, offers both guidelines and principles to enable mindfulness trainers and educators to develop the awareness and sensitivity to work with people who have experienced trauma.

Reflection

Reading about the research on Adverse Childhood Experiences and trauma-sensitive mindfulness made me realise that I had suffered multiple traumas as a child and that my five-years’ experience in daily mindfulness meditation and Gregorian chant as a contemplative monk in the late 1960’s had helped me to heal from these traumas. 

Recently, I had two participants out of a group of 20 in a management training program who openly stated at the beginning of the program that they suffered from chronic anxiety – one of whom experienced trauma as a result of their manager shouting at them and abusing them in public.  This facilitation experience confirmed the need to modify the training program and also led me to further explore anxiety through Scott Stossel’s book, My Age of Anxiety: Fear, Hope and Dread and the Search for Peace of Mind.  This book helped me to become more aware of the pervasiveness of trauma-induced anxiety across the world, intensified by the global pandemic, and how such anxiety can pervade every aspect of an individual’s life.

I have also witnessed two situations of emotional dysregulation during training courses when individuals have experienced a trauma stimulus – one during a singing course when a person experienced acoustic trauma and another where someone experienced re-traumatisation during observation of a success posture exercise being undertaken by another individual with the guidance of a workshop facilitator.

As we grow in mindfulness through meditation, reflection and research, we can become more self-aware, develop insight and sensitivity to work with people who are experiencing trauma and anxiety and build the flexibility and confidence to adopt mindfulness practices and approaches that are more trauma-sensitive.

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Image by Maria Karysheva 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-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.

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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Image by enriquelopezgarre 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: 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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Image by Lubos Houska 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 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.