Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing

228 Pages·2018·1.31 MB·English

by  David A. Treleaven

TRAUMA-SENSITIVE
MINDFULNESS
Practices for Safe and Transformative Healing
DAVID A. TRELEAVEN
Foreword by Willoughby Britton
W.W. NORTON & COMPANY
Independent Publishers Since 1923
New York • London
A Norton Professional Book
This book proposes that trauma-sensitive practice involves resourcing social
justice movements challenging systemic conditions that create and perpetuate
trauma.

In this spirit, 60% of the author’s proceeds from this book will be shared equally
between three organizations:
generative somatics
A national nonprofit organization based in Oakland, California, that combines
social analysis with trauma healing (generativesomatics.org).
The Healing Justice Program of Black Lives Matter
The Black Lives Matter Global Network is a chapter-based organization working
to end state-sanctioned violence and win immediate improvements in the lives of
Black people (blacklivesmatter.com).
The Sogorea Te’ Land Trust
An urban, Indigenous women-led community organization that facilitates the
return of Chochenyo and Karkin Ohlone lands in the San Francisco Bay Area to
Indigenous stewardship (sogoreate-landtrust.com).
CONTENTS
Foreword by Willoughby Britton
Introduction: Why Trauma-Sensitive Mindfulness?
PART I: FOUNDATIONS OF TRAUMA-SENSITIVE MINDFULNESS
1. The Ubiquity of Trauma: Visible and Invisible Forms
2. Meeting the Moment: Mindfulness and Traumatic Stress
3. Shaped by the Past: A Brief History of Mindfulness and Trauma
4. The Brain and Body in Trauma and Mindfulness
PART II: THE FIVE PRINCIPLES OF TRAUMA-SENSITIVE
MINDFULNESS
5. Stay Within the Window of Tolerance: The Role of Arousal
6. Shift Attention to Support Stability: Avoiding the Fear/Immobility Cycle
7. Keep the Body in Mind: Working with Dissociation
8. Practice in Relationship: Supporting Safety and Stability in Survivors
9. Understand Social Context: Working Effectively Across Difference
Conclusion: Transforming Trauma
Acknowledgments
References
Endnotes
Index
FOREWORD

By Willoughby Britton
In 2012, I found myself sitting across from His Holiness the Dalai Lama at the
Mayo Clinic in Rochester, Minnesota. I was at the 24th Mind & Life dialogue—
an integration of science and contemplative practice—and was presenting my
1
research on mindfulness and meditation. As a clinical neuroscientist, I was used
to speaking in front of discerning audiences, but that day discovered that the
customary butterflies in my stomach felt more like pterodactyls. Looking at the
Dalai Lama’s curious face, I was worried how he might respond to my work.
I study the potentially adverse effects of meditation. While the majority of
my research over the last 20 years has focused on the clinical benefits of
meditative practices, I’ve expanded my work over the last decade to
investigating some of the more challenging aspects of contemplative practice. In
2007, I started a research study called “The Varieties of Contemplative
2
Experience” based in my lab at Brown University. The project involved
interviewing more than 100 meditators and meditation teachers about what, if
any, difficulties arose in their practice. Trauma emerged as a major theme, from
the graduate student who developed paralyzing flashbacks on a 10-day retreat to
the seasoned meditation teacher who, it turned out, had been experiencing
3
trauma-related dissociation in practice for years.
Through this research, the particular relationship between meditation and
trauma became a thorn in my side. When people who’d experienced meditation-
related difficulties associated with trauma approached me for help, I couldn’t do
much more than reassure them that they weren’t alone, and that what they were
experiencing wasn’t their fault. During this time, I’d always wanted to provide
them with something more—a comprehensive explanation of why this was
happening to them, and what to do about it.
Then, a month after my presentation at Mind & Life, I came across a grainy
video online of a Ph.D. dissertation defense on mindfulness meditation and
trauma. I had never heard of David Treleaven, but sat mesmerized as he
articulately provided the answers I had been seeking. For years, I’d been looking
for a clear framework that I could offer to the struggling meditators who came to
me—including those who were teaching them, and researchers who were
interested in meditation and mindfulness. Suddenly, I’d found it. The puzzle
pieces clicked into place one after another.
I ended up referring many people to David, and they’d often report back to
me that their work together and the framework he provided were lifechanging.
Their stories were so compelling—and their progress so palpable—that I decided
to embark on a multi year trauma training myself. I thought I had sufficient
training as a psychologist and neuroscientist, but through David’s insights I
realized that I needed to learn more about trauma to competently address the
issues I was encountering in my practice and research.
I stayed in touch with David, and when I read the first draft of the book
you’re holding, it felt like a gift. Based on my conversations with meditation
teachers, researchers, and mindfulness practitioners, I believe this book will be a
long-awaited resource for many people. With painstaking rigor, compassion, and
insight, it addresses some of the most common—but also most neglected—
issues that meditators who’ve experienced trauma can face.
As readers of this book will know, mindfulness has exploded in popularity. From
schools and clinics to prisons and businesses, mindfulness and meditation are
now practiced in a variety of settings—with research backing up their benefits.
Yet the notion that mindfulness and meditation can be a cure-all for countless
conditions and problems, including trauma, has had some unintended
consequences. We have all heard of the benefits of meditation, and for many
people who practice regularly those benefits become a reality. But I have learned
that people who do not have that experience, and who do not share this narrative
and trajectory, often feel deeply ashamed—particularly those who have
experienced trauma. They often feel that they failed meditation, did something
wrong, or are profoundly and irrevocably broken.
David’s book tackles the issue of shame head-on. It challenges the notion
that those who experience these difficulties are simply flawed or not good
meditators. Many of the meditators who contact me—often teachers themselves
—express humiliation around the inability to manage their symptoms with
meditation. David shows us the perils for trauma survivors practicing
mindfulness, explains why they exist, and introduces grounded practices that
support a safe and transformative trauma-sensitive practice. His work is
evidence based, rooted in clinical research, and receptive to modifications as
further research becomes available. As such, the book serves as a foundation for
a larger conversation.
This book also offers us a systemic view of trauma. Paralleling David’s own
journey, it extends mindfulness from the suffering of isolated meditators—and
their individual nervous systems—into the social, cultural, and political domains
that also play a role in creating and perpetuating trauma. While the idea of
interdependence—that we are all deeply interconnected and influencing each
other—is not new to the mindfulness community, it is often presented as a kind
of metaphysical salve of unity that inspires prosocial behavior but does not
require deep personal confrontation. Through his work with social justice
movements, David challenges us to question the water around us, to “critically
examine the frameworks we have been offered, and be increasingly informed
about our role.”
Trauma-Sensitive Mindfulness comes at a time when a more nuanced
conversation around mindfulness and meditation is desperately needed. I’ve
spent the majority of my academic career advocating for such dialogue, whether
in my classroom, at my lab, at academic conferences or Mindfulness-Based
Interventions teacher trainings, or with journalists searching for a catchy taglines
4
about the merits of mindfulness. Sometimes I’ve felt like a lone voice in this
pursuit, arguing that we need to be careful about the use of contemplative
5
practices and increase our awareness of the potential difficulties people face.
But recently, more and more of my colleagues are joining in. This year, 15
mindfulness researchers came together to write a consensus statement called
“Mind the Hype” that advocates for a more careful and nuanced presentation of
6
mindfulness that includes both its benefits and limits. These approaches aren’t
meant to discourage people from meditating; on the contrary, their purpose is to
make the practices more powerful and applicable to a contemporary audience.
With this book, I’m happy to say we’re taking a further step together in this
new direction. David has created a rigorous, accessible, empirically grounded
resource for those of us looking to teach and practice mindfulness in a trauma-
sensitive way. It’s a timely gift, and one that I hope helps you as much as it
helped me.
Willoughby Britton, Ph.D.
Brown University
NOTES
1. Britton Lab; Dalai Lama Presentation. See https://vimeo.com/69253042.
2. A summary of the Varieties of Contemplative Experience research project can be found on the Clinical
and Affective Neuroscience Laboratory website:
https://www.brown.edu/research/labs/britton/research/varieties-contemplative-experience
For an overview paper detailing the study methods and results, see Lindahl, J., Fisher, N., Cooper, D.,
Rosen, R., and Britton, W. (2017). The Varieties of Contemplative Experience: A Mixed-Methods Study
of Meditation-Related Challenges in Western Buddhists. PLOS ONE 12(5): e0176239.
The full text of this paper is available at: http://journals.plos.org/plosone/article?
id=10.1371/journal.pone.0176239.
3. Lindahl, J. R. (2017). “Somatic Energies and Emotional Traumas: A Qualitative Study of Practice-
Related Challenges Reported by Vajraya¯na Buddhists.” Religions 8(8): 153, doi: 10.3390/rel8080153.
The full text of this paper is available at: www.mdpi.com/2077-1444/8/8/153/pdf.
4. Britton, W. B. (2016). Scientific Literacy as a Foundational Competency for Teachers of Mindfulness-
Based Interventions. In McCown, D., Reibel, D., and Micozzi, M. S. (eds). Resources for Teaching
Mindfulness: An International Handbook. New York: Springer. Also see Britton, W. B. (2016). “Self-
Inquiry: Investigating Confirmation Bias.” In McCown, D., Reibel, D., and Micozzi, M. S. (eds).
Resources for Teaching Mindfulness: An International Handbook. New York: Springer.
5. As an example, see The Meditation Safety Toolbox, created by Dr. Britton by aggregating meditation
safety resources from different mindfulness centers and programs, including informed consent
documents, screening and monitoring tools, and management strategies.
https://www.brown.edu/research/labs/britton/resources/meditation-safety-toolbox.
6. Van Dam, N. T, van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C., Olendzki, A., Meissner, T.,
Lazar, S. W., Kerr, C., Gorchov, J., Field, B. A., Britton, W. B., Brefczynski-Lewis, J. A., and Meyer, D.
E. (2017). “Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Mindfulness and
Meditation Research.” Perspectives in Psychological Science. In press.
INTRODUCTION
Why Trauma-Sensitive Mindfulness?

Part of me wished I hadn’t seen the e-mail. It was well past midnight, and I’d
impulsively checked my inbox one last time before bed. “Please Help . . .” the
subject line read, “Crisis with Meditation.” I leaned back in my chair, reading
on. It was the third such e-mail I’d received that month.
The message was from Nicholas, a high school teacher in Vermont who’d
1
come across an article I’d written on adverse responses to mindfulness. He’d
started practicing mindfulness meditation to help manage his anxiety, and the
benefits of his practice had been immediately clear: enhanced clarity, sharper
recall, and a more persistent sense of ease. But more recently, Nicholas had also
begun to experience an unnerving symptom: when his timer signaled the end of
his brief meditation, he’d struggle to reach for the alarm on his phone—his body
seemingly paralyzed by fear. It felt to him as if he were being restrained.
The more Nicholas practiced, the more intense and unsettling these
experiences became. The moment he closed his eyes, images began flooding his
vision—shattered glass, an open sky, smoke. His sleep had become fraught with
nightmares, routine tasks produced panic, and the chatter in his mind was
becoming untenable. The tranquility he’d sought in meditation was being met by
its opposite—an underlying terror and dread that haunted him throughout the
day and night.
Nicholas and I met a week later on a video call, and I could immediately see
the concern and confusion in his eyes. When I asked whether the images he’d
encountered in meditation held any significance for him, he nodded. A few years
earlier, he’d been in a serious car accident—helplessly pinned down in his car
for an hour until he was rescued. But it wasn’t the accident that perplexed him. It
was his bewilderment about mindfulness meditation. How could a practice that
had been so constructive and positive now leave him feeling panicked and
unhinged?
I was no stranger to this question. As a psychotherapist and researcher, I’d