Tuesday, June 4, 2013

Considering mindfulness in trauma recovery

In April of 2013 the psychology department of Trinity Christian College hosted it's annual conference. The conference, entitled Psychology Renewed, focused on the concept of mindfulness. The following post reflects one of the presentations at the conference. 

We live in a world that is plagued by violence, destruction and catastrophe. Unfortunately, it would seem that opportunities to experience trauma are all around us. From a Christian perspective this can be seen as a result of original sin entering into God’s perfect creation. Trauma is characterized as “a serious injury or emotional wound that creates substantial, lasting damage to the psychological development of a person” (www.thefreedictionary.com). In fact the word trauma comes from the Greek word for “wound”. Psychologically we use it to refer to experiences that overwhelm a person’s ability to function (Follette & Vijay, 2009). Psychologists have long recognized that the psychological effects of experiencing traumatic events can be significant and long-lasting. Individuals can develop maladaptive coping patterns, the extreme of which is Post Traumatic Stress Disorder. PTSD is characterized by re-experiencing the trauma through nightmares, flashbacks and physical reactions. Symptoms of PTSD often result in major impairments to an individual’s relationships and quality of life. Exposure to trauma does not always result in the development of maladaptive stress reactions, but when it does individuals experience a tremendous amount of pain and suffering.

Usually individuals with exposure to trauma attempt to cope with it by avoiding painful or provoking stimuli. However, paradoxically when we attempt to avoid thinking about something it actually increases its frequency. This leads to more exposure to the traumatic event instead of less. Experiential avoidance is characterized by a psychological unwillingness to remain present with particular emotions due to their difficulty or intensity (Follette, Palm, & Rasmussen Hall, 2004). Individuals who employ experiential avoidance as a primary coping strategy also tend to show cognitive inflexibility and increased symptoms of PTSD (Thompson, Arnkoff, & Glass 2011).

So what can help lead to healing?

As a psychologist I am interested in understanding what can help to heal the brokenness that often results from trauma. I wonder where is the hope for hurting people? This question comes from my belief that hope is crucial to growth and change.

Mindfulness practice offers an alternative to experiential avoidance. Mindfulness can be defined as the “moment to moment awareness of one’s experiences without judgment” (Davis & Hayes, 2012). Mindfulness stresses the importance of paying attention to the moment but also recognizing that the moment is transient. Its goal is to change one’s relationship to one’s thoughts. Instead of seeing difficult emotions such as pain and fear as permanent using mindfulness allows the possibility that thoughts and feelings can shift over time (Thompson et al., 2011). It is a unique way of thinking and attending to one’s thoughts that often results in greater calmness and stability (Follette, Palm, & Pearson, 2006). Mindfulness operates as a mechanism for sustaining a “moment to moment focused awareness and openness to one’s internal experience and immediate environment” (Briere, 2012). 

Survivors of trauma can benefit from attempts to notice and attend to painful feelings while also allowing them to transform into something new. Mindfulness encourages acceptance rather than avoidance as a primary coping strategy (Follette et al., 2009). Acceptance does not critique one’s experience of something painful, but rather notices it and offers an opportunity for it to pass.

Mindfulness also offers an opportunity for trauma survivors to relearn the ability to manage and process difficult emotions. By practicing mindfulness an individual is actively enlarging her capacity to review and notice emotions (Follette et al., 2006). This is crucial for the psychological health of trauma survivors because “emotion regulation skills are necessary for individuals to modulate the frequency and intensity of their emotions in order to safely and fully experience the wide range of trauma-related thoughts, feelings and memories they have been working diligently to avoid” (Follette et al., 2004, p. 202). It appears that by noticing one’s emotions in a non-judgmental manner there is increased ability to tolerate distressing and painful memories. This means that a trauma survivor can spend less time attempting to suppress difficult memories and more time engaging with the world around her (Follette et al., 2006).

Mindfulness practice results in fewer symptoms of trauma exposure and an increased ability to hold painful emotions (Follette et al., 2006). It actually changes our relationship to our thoughts, instead of seeing thoughts as fixed and impermeable we can shift to seeing our thoughts as momentary reflections of the present reality. As we increase our contact with the present moment through mindful thinking we decrease rumination on the past (Thompson et al., 2011). By attending to the present moment our minds are more in tune with the emotional content of the moment and less concerned with controlling or avoiding it. Practicing these skills results in a greater ability to regulate one’s emotions.

In addition to acceptance and emotional regulation developing increased psychological flexibility is associated with more adaptive engagement to the world. Psychological flexibility is the ability to contact the present moment as a conscious human being and make choices about behavior based on what the situation affords in line with one’s chosen values (Follette et al., 2009). More simply put it is the ability to recognize that our emotions can also be short-term in nature and it is critical to make decisions based on longer-term goals and objectives.

What are the implications?

Trauma reflects one of the most broken areas of humanity. It is in this overwhelming and tremendously difficult place that we can find opportunities to see God’s healing powers. While trauma is devastating finding hope can change our entire orientation to the world. As a psychologist who is of the reformed tradition of Christianity I look in both the psychological world as well as the religious to find paths of hope and change. Based on the possibilities it appears that mindfulness practice offers survivors of trauma an opportunity to develop a place of healing. For that I am grateful and encouraged. 


Briere, J. (2012). Working with trauma: Mindfulness and compassion. In C. Germer & R. Siegel (Eds.), Wisdom and Compassion in Psychotherapy: Deepening Mindfulness in Clinical Practice (pp. 265-279), Guilford Press.

Davis, D.M. & Hayes, J.A. (2012, July/August). What are the benefits of mindfulness? Monitor on Psychology, 64-70.

Follette, V., Palm, K.M. & Pearson, A.N. (2006). Mindfulness and trauma: Implications for treatment. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 24, 45-61.

Follette, V.M., Palm, K.M. & Rasmussen Hall, M.L. (2004). Acceptance, mindfulness, and trauma. In S. Hayes, V. Follette and M. Linehan, (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 192-208). Guilford Press.

Follette, V.M. & Vijay, A. (2009) Mindfulness for trauma and posttraumatic stress disorder. In F. Didonna, (Ed.), Clinical handbook of mindfulness (pp. 299-317), Springer Science and Business Media.

Thompson, R.W., Arnkoff, D.B., & Glass, C.R. (2011). Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma. Trauma, Violence, & Abuse, 12, 220-235. doi: 10.177/1524838011416375

Kara E. Wolff, PhD Assistant Professor of Psychology, Trinity Christian College