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-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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Image by obBilder 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: 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.