Trauma

What Is Trauma, and Can Mindfulness Help Treat It?

How do mindfulness and trauma relate? Here's what you need to know.

Posted Sep 19, 2019

The word trauma comes from the Latin word meaning "wound." In medicine, professionals use the word "trauma" to refer to physical damage to body parts. By contrast, psychological or emotional trauma, loosely defined, also refers to another type of wound: any past event that creates significant hardship and impairment in the present, at least one month after it occurred.

Many equivocally think trauma is about what happened to the person when in reality, it's more about how the mind and body register what happened. Let me clarify from early on, however, that healing is very possible, doesn’t need to take a lot of time (many trauma therapies such as EMDR therapy are short-term and highly effective), and doesn’t mean what the perpetrator(s) did was okay.

Unfortunately, much of the lay public doesn't see it this way or understand how or why psychological trauma can have a lasting negative impact on someone. Trauma treatment is still younger than 40 years old. In fact, it wasn't officially recognized as a significant emotional difficulty until 1980! 

This is why there has been a movement toward "trauma-informed care" in all mental health fields recently. All this means is a sensitivity and awareness of how what happened to someone in the past affects them in the present. The ground-breaking ACE (Adverse Child Experiences) study is an example of this: children who endure adverse events such as physical abuse and neglect had higher rates of virtually any health problem later in life. In this sense, the ultimate goal of trauma-focused psychotherapy is getting past your past. Trauma psychotherapy, especially EMDR therapy, can be thought of as emotional surgery.

Those who experience traumatic events often develop post-traumatic stress disorder (PTSD) symptoms, such as stress, anxiety, and depression, although many don't. The criteria for PTSD are primarily hyper-arousal (the mind and body stay in a crisis-like state of tension and exhaustion, ready for danger), hyper-vigilance (the body and mind are constantly scanning for any signs of danger, and unfortunately often reacting to false-positives), and intrusive thoughts about the traumatic event replaying ceaselessly and uncontrollably in one’s mind.

These aftereffects can last for weeks, months, and even years. Trauma also can cause difficulty focusing, racing and intrusive thoughts, and flashbacks of the traumatic experiences. It can wreak havoc on sufferers’ relationships and quality of life. It can also affect sleep patterns, the immune system, diet, and other physiological processes significantly. 

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Contemporarily, more are affected by trauma than ever before (Herman, 2015). The literature demarcates two central umbrella categories regarding trauma: large "T" and small "t" events (Shapiro & Forest, 2016).

Large "T" traumas are indisputably distressing, often necessitating a PTSD diagnosis. Examples are war combat, physical abuse, automobile accidents, loss of a loved one, terminal illness, or natural disasters, all of which can result in PTSD for many.

By contrast, small "t" traumas are those less conspicuous, quotidian events in which we are left feeling unloved, unsafe, or helpless. Small “t” traumas comprise failures, humiliations, and losses of many types. Examples are being a victim of bullying, falling off a skateboard, experiencing infidelity in your relationship(s), or being chosen last on a sport's team. Small "t" events can appear on the surface to be of little importance, yet can have a significant, enduring impact.

There's a catch, however. In a recent interview, Dr. Peter Levine, a trauma expert and creator of the breakthrough trauma therapy called Somatic Experiencing, shared a finding from an intriguing study. After successful trauma treatment, when therapists asked clients if they prefer to have never had gone through the trauma, or have gone and worked through it, most clients stated preferring having the trauma and working through it, instead of it never happening. 

While this does not apply to everyone who has experienced significant trauma, trauma can clearly be a powerful catalyst for growth, wisdom, strength, meaning, and purpose. In therapy, the traumatized client often advances through treatment by starting as a victim, then feeling like a survivor, and ultimately, toward the end of therapy, a thriver. 

Trauma can also wake us up. One way of working with and through trauma is mindfulness meditation. That said, practicing mindfulness can be triggering for many trauma survivors. Mindfulness practices aren't likely to cause trauma, but can reveal it. 

I’m an EMDR therapist, which can be considered a mindfulness-based therapy. Mindfulness practices and research also have a lot to offer trauma sufferers and survivors. The essence of trauma is not emotionally and psychologically situated in the here-and-now. In other words, trauma keeps you stuck in the past or constantly and helplessly fearing the future.

By practicing mindfulness, sufferers can shift the pendulum back to their presence in the here-and-now. Trauma and presence (or mindfulness) cannot coexist. Thus, mindfulness practices can help bring trauma victims back to the present and heal from disturbing past events. 

Mindfulness practices can greatly decrease the frequency, intensity, and duration (what I refer to by the acronym "FID" when measuring treatment goals with clients) of these trauma symptoms. In doing EMDR therapy with clients, I have found it important to introduce mindfulness and stabilization skills (training the mind and body to rest in a calm, peaceful, and safe state mindfully in the here-and-now) from the beginning of treatment in order to mitigate these symptoms before proceeding with the emotional surgery of EMDR.

These stabilization skills can be helpful to clients between sessions, as the features of trauma can occur at any time. Mindfulness is central to these stabilization skills and to a successful outcome in EMDR therapy. 

Dr. Jon Kabat-Zinn (1994) is largely responsible for bringing mindfulness to the Western world. He defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” In using mindfulness exercises with clients, I've noticed that their focus improves, stress and anxiety decrease, and personal insight increases, which can all help to reduce trauma-related symptoms.

A traumatized brain is perhaps the opposite of a mindful brain. Whereas trauma symptoms pull you into the past, mindfulness can help to bring you to the present moment, the only place you can feel joy, calm, and peace. Often, when thoughts are racing in this manner, they are thoughts about what happened in the past or what will happen in the future. Mindfulness can be utilized in several different ways.

One of my favorite ways is with sound. Sound as an object of awareness articulates the ungovernability of experience and the open, spacious quality of consciousness quite well. It's often a safer way to start experimenting with meditation for trauma survivors, as opposed to the breath, which can be triggering or uncomfortable, especially if the person had trouble breathing during the traumatic event(s), for example.  

I find it is important to emphasize to clients that they will still have thoughts during a mindfulness exercise. The task is not to eliminate thoughts, but to identify what thoughts are coming up and to then gently refocus attention on the chosen object of attention (whatever it is) in the here-and-now. It helps clients learn to rest their minds on sounds or other suitable objects of attention to between sessions, particularly when they begin to notice disturbing, racing, or ruminative thoughts, stress, anxiety, depression, or any other symptom.

Beware, however, as mentioned, that while mindfulness doesn’t cause re-traumatization or stress in itself, it can increase a client’s awareness of it. In other words, it can reveal what’s already there and needing to be healed.

This post is for educational purposes and should not substitute for psychotherapy with a qualified professional. Copyright Jason Linder, LMFT

References

Shapiro, F., & Forest, M. S. (2016). EMDR: The breakthrough therapy for overcoming anxiety, stress, and trauma. New York, NY: Basic Books.

Herman, J. L. (2015). Trauma and recovery: The aftermath of violence--from domestic abuse to political terror. Hachette UK.

Kabat-Zinn, J. (1994). Wherever you go, there you are: mindfulness meditation in everyday. Hyperion.