This final post in the mindfulness and trauma series explores the topic of prevention and solution to trauma based on an understanding of trauma, the central nervous system, and adverse childhood experiences. Using a neuropsychological lens we propose that mindfulness is one of the most viable and effective solutions available for trauma.
If you are not already familiar with mindfulness, you may want to refer to Mindfulness 101 for a crash course on what exactly we mean by the word mindfulness. We refer here to Jon Kabat-Zinn’s definition of mindfulness: “paying attention, on purpose, in the present moment, and non-judgmentally.”
Remember the zebra we talked about earlier? The zebra does not experience PTSD because it’s attention, and thus it’s nervous system response, is focused only on the present moment. In other words, the zebra exists in a state of complete mindfulness.
As leading trauma expert Dr. Bessel van der Kolk states it,
“Trauma is not remembered, it is relived…we tend to think of trauma as an illness of the past, but trauma is not an illness of the past. Trauma is an illness of not being fully alive in the present moment.”
The implication here is that supporting someone in being more fully alive and engaged in the present moment will reduce the symptoms of trauma. Dr. van der Kolk’s own research and recommended treatments support this conclusion. Here is what he describes as the components of effective trauma treatment:
- Finding a way to be calm and present
- Learning to maintain calm in response to images, thoughts, sounds, or physical sensations that remind you of the past
- Finding a way to be fully alive in the present and engaged with the people around you
- Not having to keep secrets from yourself, including secrets about the ways in which you have managed to survive
These components bear a striking resemblance to our definition of mindfulness: paying attention, on purpose, in the present moment, and non-judgmentally. Some of the techniques that Dr. van der Kolk and other trauma therapists use to support trauma treatment and recovery include somatic (body-based) therapies such as EMDR and somatic experiencing; however, non-therapeutic interventions such as yoga, martial arts, tai-chi, dance, acupuncture, massage, and even Shakespearean theater have been shown to be effective supports for victims of trauma. Since trauma creates a disconnect between mind and body, anything that helps someone feel safe in their body and connected to their self in the present moment can support healing of trauma.
Mindfulness, as it turns out, is a free tool that can be used at any time to accomplish just this. This wisdom is not new - many cultures around the world and throughout history have incorporated ceremony, dance, rites of passage, ritual and other practices designed to reinforce the mind-body connection into their core cultural traditions.
What is new is that this ancient wisdom is now supported by neuroscience. Researchers examining how trauma impacts the brain found several key regions of the brain that were consistently affected by trauma.
Regions that were inhibited by traumatic experiences included:
- The pre-frontal cortex: executive functions like planning, empathy, self-observation, identity/personality, impulse control and emotional mastery.
- The anterior cingulate: identifies what is relevant; the brain’s “filtering” mechanism
Regions that showed higher activation included:
- The amygdala: associated with threat response and intense emotions like anger/fear (the brain’s “alarm system”)
- The precuneus: associated with self-consciousness, anxiety, and worry.
In a separate study examining the effects of mindfulness on the brain, researchers found that mindfulness had almost precisely the opposite effects on the brain. Participants in an 8-week mindfulness training program demonstrated increased density of gray matter (using fMRI imaging) in the following regions of the brain:
- The pre-frontal cortex
- The anterior cingulate
- The hippocampus (associated with learning and memory)
Regions that showed decreased activation after mindfulness training included:
- The amygdala
- The “default mode network” (A network of brain structures, including the precuneus, thought to be activated by ‘default’ when the brain is not otherwise engaged in a task; associated with daydreaming and “mind-wandering” - active when thinking about self/others, remembering the past, and planning for the future).
So, is mindfulness the silver bullet we’ve been waiting for to cure all of our woes? Well, no - sorry to disappoint. It is, however, one of the most cost-effective, scalable, replicable and evidence-based interventions we can readily incorporate into every level of health care - from prevention in elementary schools to trauma and addiction treatment in hospitals.
The simple practice of turning your attention to the present moment - your breath, the sounds you hear, the sensations you feel - can actually physically change the structure of your brain and counteract the effects of stress and trauma in less than 8 weeks. Studies are now revealing that mindfulness-based therapy is more effective than anti-depressants and cognitive behavioral therapy combined in treating PTSD. Even better, the results are permanent as long as participants continue to practice mindfulness in their daily lives.
Two caveats to consider: someone must be physically and emotionally safe in order to begin practicing mindfulness and/or treating trauma. Mental illnesses, especially PTSD, function as natural defensive mechanisms in response to overwhelming and unsafe environments. Thus, increasing self-awareness (mindfulness) in an unsafe situation would only serve to further destabilize an individual. Second, as Dr. van der Kolk states, mindfulness is only useful when accompanied by a sense of self-love and self-compassion. Mindfulness requires the ability to non-judgmentally notice all sensation, thought and emotion in the present moment - including self-critical thoughts, difficult emotions, and painful sensations. If we increase awareness without a sense of compassion for these difficult experiences we are also more likely to cause more harm than good.
So, while we cannot look to mindfulness as a panacea, the benefits of mindfulness for treating a wide variety of mental and physical health issues has been well documented. If trauma is an illness of not being fully alive and present in the moment, then mindfulness presents a clear path for practicing engagement with the present moment. The beauty of mindfulness is that these benefits can be experienced directly - the number of apps, courses, books and podcasts now available make it a highly accessible practice. Simply find a way that works for you and begin to notice the benefits you receive in your daily life.