Mindfulness in the Treatment of Trauma

Woman thinking at the parkPeople who have experienced traumatic events often experience stress, anxiety, and depression. These aftereffects can last for weeks, months, or years. The treatment of trauma in therapy can greatly reduce the duration of these symptoms.

Some common features of trauma are difficulty in concentrating, racing and intrusive thoughts, and flashbacks of the traumatic experience. My clients often express that these features cause them to experience magnified stress, anxiety, and/or depression. In the treatment of trauma, I have found it important to introduce stabilization skills from the beginning of treatment in order to address these “crisis” features of trauma. These stabilization skills can be helpful to clients between sessions, as the features of trauma can occur at any time.

One treatment component that I have found to be effective in stabilization for my clients is mindfulness. According to Cullen (2011), mindfulness-based interventions have become more commonly used to treat many mental health and medical issues, including (but not limited to) stress, anxiety, and depression. Mindfulness also has been found to be effective in treating these challenges (Cullen, 2011).

According to Jon Kabat-Zinn (1994), one definition of mindfulness is “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally. I have noticed in using mindfulness exercises with clients that focus improves, stress and anxiety decrease, and insight increases, which can help to reduce depression.

Sometimes a person’s thoughts can race, which can create a chain reaction of related thoughts and emotions. This process is not at all uncommon and can occur with anyone, not just someone who has been through a traumatic experience. For the traumatized individual, however, this process of racing thoughts and a chain reaction of distressed thinking and intense emotion can become more frequent than it was before the trauma and can in fact be more intense and longer lasting. If these thoughts are triggered by something related to the trauma, or if the thoughts by themselves are upsetting, the thought pattern can become negative and can create significant anxiety and depression if not addressed.

Mindfulness skills can help to bring a person back to the present moment. 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 is a way of grounding oneself to the present moment, which can redirect the thoughts that are producing negative emotion and help a person to address the accompanying anxiety, stress, and depression associated with the thoughts.

Mindfulness can be utilized in several different ways. One mindfulness exercise that I have found to be effective comes from McKay, et al. (2007): taking time to focus on a single object. To begin, I have the client select an object he or she has or an object in my office he or she would like to focus on. I have the person use his or her senses to explore the object, noticing different aspects of the object such as its form, color, and anything interesting about the object. I then have the client hold the object and notice the different textures, temperature, rigidity, shape, and weight of the object. I have him or her explore the object for a set period (usually five to 10 minutes). After the exercise, I discuss with the client what he or she experienced, if he or she noticed anything about the object that may not have been noticed before, and the thoughts he or she noticed while practicing the exercise.

I find it is important to emphasize to clients that they may still have thoughts during a mindfulness exercise. The task is not to eliminate thoughts, but to identify that thoughts are coming up and to then refocus attention on the object or anything else the person has chosen to focus on. I encourage clients to have a small object they can carry with them that they can practice this mindfulness exercise with between sessions, particularly when they begin to notice distressing thoughts, racing thoughts, stress, anxiety, depression, or any other symptom related to trauma.

This is only one of many mindfulness exercises. There is a wealth of information available to clinicians on mindfulness and specific interventions to use with clients. I have received feedback from clients dealing with trauma that it is one of the most useful tools in coping with the distressing aftereffects of trauma during the therapeutic process while they are working through and resolving their trauma, and even after they have completed therapy. I would encourage therapists to do their own research on mindfulness and the applications it may have for their clients.

References:

  1. Cullen, M. (2011). Mindfulness-Based Interventions: An Emerging Phenomenon.  Mindfulness, Vol. 2, #3, September, 2011.
  2. Kabat-Zinn, J. (1994). Wherever You Go, There You Are. New York: Hyperion.
  3. McKay, M., Wood, J.C., & Brantley, J. (2007). The Dialectical Behavior Therapy Skills Workbook: Practice DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, & Distress Tolerance. Oakland, CA: New Harbinger Publications, Inc.

© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Anastasia Pollock, LCMHC, therapist in Midvale, Utah

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Val

    Val

    June 26th, 2013 at 12:39 PM

    Practicing mindfulness could be beneficial in multiple situations. It can not only help you to manage the painful flashbacks form traumatic events, but it can also help to keep you grounded in the here and now. Too many times I think that we go back to the pain and wonder what if I had done one thing differently or wonder how this will affect the future. Those are the things that don’t matter. What matters is to take care of yourself today, which will help to heal the wounds of yesterday and to give you the strength to face the new challenges of tomorrow.

  • GR

    GR

    June 26th, 2013 at 10:34 PM

    How exactly does this effectively help? Does the concentration in the present help in getting over the traumatic event’s flashbacks? Because there is at least one thing that keeps haunting me from my childhood. I’d love to be able to put that to rest.

  • stephanie volgren

    stephanie volgren

    June 27th, 2013 at 3:59 AM

    The only downside that I coiuld ever see to this is that as a therapist I would have to worry that someone could takie being mindful of the presentt o the extreme, and that they would do so much to be aware of today that they could somehow try to suppress yeaterday.
    It is awesome when you start feeling so good about your life that you are able to walk away from the things that have happened to you in the past. But you can’t so that to the point of simply tucking those memories away. They have to be addressed and dealt with too.
    I would only hope that not only can someone find a way to confron those demons from the past but to say that they honestly don’t define them anymore and live in the moment as a way of appreciating so much the life that they still have in front of them.

  • Anastasia Pollock, LCMHC

    Anastasia Pollock, LCMHC

    June 27th, 2013 at 11:07 AM

    GR and Stephanie,

    Mindfulness helps one to bring their attention to the present moment which can reduce the anxiety, stress and depression associated with flashbacks. In my experience, mindfulness is very effective for the stabilization of symptoms related to trauma. In addition to mindfulness for stabilization I generally use Eye Movement Desensitization and Reprocessing (EMDR) to treat the actual trauma. As EMDR involves facing the past memories and current disturbance, which can bring up anxiety and stress, the mindfulness exercises are very useful in closing the session, helping the client to come to the here and now, and to help the client to feel stable when leaving a session. Using both mindfulness and EMDR has been very effective for my clients in their resolution of trauma. This is a topic I plan to write another article on in the near future.

    GR, I would recommend you look for a therapist in your area who is trained in trauma and more specifically EMDR.

    Thank you for your comments!

  • Megan Astley

    Megan Astley

    June 8th, 2014 at 12:00 PM

    My therapist used EMDR with me – it has been amazing. I have lived with anxiety all my life and finally I am able to confidently say I am no longer crippled daily by it. I am able to recognise any triggers, to let go, I don’t allow others comments and behaviour effect me and go into a spiral of self criticism. When I first went into therapy in May last year I said that I didn’t expect anyone to wave a magic wand, I just wanted to manage the flashbacks and intrusive memories. I didn’t say I wanted to get rid of my anxiety because to me that was normal.
    I feel now that a magic wand has been waved and since October can manage and deal with any negativity without allowing things to overwhelm me. EMDR has been an amazing journey for me.

  • Sienna

    Sienna

    June 28th, 2013 at 5:39 PM

    My old therapist would sit and stare at the carpet, sometimes falling asleep. This was her un-informed arrogant way of trying to practice mindfulness. She just said the word ‘mindfulness’ and it solves everything, and I’d sit there thinking why am I paying someone, I drive here to sit and watch her stare at the floor for 10-15 minutes until I distract (wake her up) and continue. It wasn’t guided meditation in the least. I just got up and walked out of this bs ‘therapy’ one day and never went back. Reading a quick article or book or attending a weekend class on mindfulness doesn’t mean a therapist knows what they are doing, especially if they are too lazy to guide the client or explain what they are doing. Hearing about her beachfront property and going on about her son was what she filled the rest of the time with. Nice to get paid for this. Wish I left sooner!

  • Natalie Desmarais

    Natalie Desmarais

    March 3rd, 2014 at 11:51 PM

    I was under the impression that focusing on an object and eliminating thoughts was Zen meditation, and mindfulness is simply taking a step back and seeing a situation as it actually is.

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