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. 

References

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

Free will, the Holy Spirit, and the best predictor of future behavior

When I assign a compare/contrast essay to my Introduction to Psychology students I usually get certain responses. I ask the students to pick a perspective that has influenced the field of psychology (e.g. biological, behaviorist, cognitivist, humanist) and compare it to a Christian perspective. Students will often choose the behaviorist or biological perspective and rightly point out that these perspectives are very deterministic in nature while a Christian perspective supports the existence of human free will. Some students will also insightfully note that materialist worldviews like behaviorism ignore the possibility of the Holy Spirit acting in people’s lives to instigate change. 

My students are right, but sometimes I worry about them. As Christians we hear stories of dramatic conversions. We hear of people who were addicted to drugs and lived on the streets but who have turned their life around through Christ’s power. We talk about Chuck Colson who became a Christian and completely changed his life after being involved in the Watergate scandal. We read of the apostle Paul who went from persecuting Christians to preaching the gospel. These are powerful stories. They show that hearts can change, that God is mighty, and that no one’s future is determined by nature or nurture. However, there is a reason we treasure these miraculous events. It is because they are extraordinary. Extra-ordinary. Not ordinary. Usually change is very, very difficult. 

This is where my concern for my students comes in. It is somewhat of a psychological truism that the best predictor of future behavior is past behavior. If I want to predict if a man will smoke a cigarette tomorrow the most important information I can get is not his age, not his attitude toward cigarettes, not even his faith in God, but whether or not he smoked a cigarette today. If I want to predict a woman’s attendance to a particular class session the most valuable information I can get is not her attitude toward class, not her Meyers-Briggs personality type, but her prior attendance record. 

While it is true that people can change, and that the Holy Spirit works in the hearts of mankind, it would be unwise for us to ignore all of the useful insights that psychologists have gained while working under biological and behaviorist perspectives. Just because we reject the worldview of materialist perspectives like behaviorism we should not reject the research that came out of those perspectives. There is a lot to learn by studying brains, genes, learned behaviors, and early childhood experiences. We must not ignore the effects of neurotransmitters, the influence of inherited traits, or the power of learned behaviors. 

If we fail to take to heart the lessons learned from these perspectives through the over-emphasis of free will and change we run the risk of making bad decisions. As my dedicated students work hard to reject the anti-Christian ideas in some psychological theories I can’t help but fast-forward in my imagination to their futures. What if student X finds herself in an abusive relationship? Will she stick with him and believe that with enough love he will change? Or will she remember that nature, nurture, and learned behaviors are strong forces, highly resistant to change? What if student Y bends to the temptation to view internet pornography a handful of times? Will he remind himself of human free will and tell himself he can stop at any time? Or will he understand that such images are acting as powerful reinforcers and he is leading himself into a habit that has all the hallmarks of an addictive behavior?

God can change hearts and He can change minds and He can do these things in radical ways, but sometimes God allows us to struggle through the character-building life-lessons of slow and difficult change. As we struggle we can use the information God gave us through studies in psychological science. I always hope my students are enabled to do just that. 

Jessica Clevering, PhD., Assistant Professor of Psychology, Trinity Christian College

Psychology, Christianity, and Gender

Megan Regalado currently works in a residential program as an Eating Disorder Counselor in Southern California. She graduated from Trinity Christian College in December ’12 with a Bachelor of Arts, in Psychology and a minor in Sociology. She hopes to attend graduate school in the Fall in order to obtain her Masters of Science in Counseling, and become a Marriage and Family Therapist. She plans on spending her career focusing on working with teens struggling with addictions.

Psychology, Christianity, and Gender

Differences in gender can be seen through social dominance, aggression, and sexuality, but as Christians we should understand the topic of gender differences as differences that are created in order to demonstrate the need for one another in a fallen world.

Social dominance can affect an individual’s view of a person’s social rank, and can overall affect the hierarchy pattern in which males are most often viewed as possessing more social dominance. Psychology examines reasons that the need for dominance is apparent in society.  Ainsworth and Maner (2012) suggest that males have an underlying need for dominance among one another as well as among females. Some psychologists suggest the role of men has been to be more socially dominant than women and to express this dominance through positions of authority.

Men and women differ in their styles of aggression, where men are viewed by psychologists as being more aggressive. Aggression then spills over into relationships among men and women. Ross’s (2012) findings suggested that physical, sexual, and psychological abuse tended to co-occur in the relationships of women with highly violent or controlling partners. Aggression and social dominance are often spoken of in the same breath when psychologists discuss the need for a male to obtain a mate for reproduction. This negative view of the aggression of men is discussed in terms of a man’s sexuality.

Sexuality is another area where men and women differ in terms of emotional involvement and arousal. “Men’s sexuality revolves around physical factors, in which nature is predominant and the social and cultural dimension is secondary. For women, social and cultural factors play a much greater role, and the role of physical processes and biological nature is relatively smaller” (Baumeister, 2000, p. 368). Baumeister (2000) also suggests that women are more creatures of meaning while men are relatively creatures of nature. The evolutionary psychology view about the sexuality of men describes their motivation for sex as being driven by their need to pass on their genes.

From a Christian standpoint, God is the creator of man and woman. Differences in social dominance and sexuality can be seen through the initial creation of man and woman, but is affected by the sin that they fell into while in the garden. “Eve was in no way inferior to her husband, but she was nonetheless given a role that was subordinate to his leadership…The relationships within the Trinity illustrate perfectly how headship and submission can function within a relationship of absolute equals” (Macarthur, 2005, p. 7). Adam and Eve were created to produce offspring and those offspring were to fill the earth. They were naked in the garden together as man and wife, and were not ashamed. Upon sin entering creation through Adam and Eve, they saw themselves merely as individuals who were naked and ashamed, emphasizing their own knowledge of their bodies and how different they were from one another by attempting to cover themselves. The relationship between man and woman is affected by sin, but that also allows us to see how man and woman complement each other with their different qualities. Man and woman are created in order to demonstrate the need for one another in a fallen world and to glorify God through their interactions and relations with one another.

References

Ainsworth, S.E., & Maner, J.K. (2012). Sex begets violence: Mating motives, social dominance, and physical aggression in men. Journal of Personality and Social Psychology, 103, 819-829. 

Baumeister, R. F. (2000). Gender differences in erotic plasticity: The female sex drive as socially flexible and responsive. Psychological Bulletin, 126, 347-374.

Macaruther, J. (2005). Twelve Extraordinary Women: How God Shaped Women of the Bible and What he Wants to do With You.  Nashville, TN: Thomas Nelson.

Ross, J. M. (2012).  Self-reported fear in partner violent relationships: Findings on gender differences from two samples. Psychology of Violence, 2, 58-74. 

Research shows: Christians should take a pass on tackle football

Oftentimes clinical psychologists and mental health counselors like myself shy away from political issues and public advocacy.  We often define our work as a-political and even sometimes as morally non-judgmental especially in relation to political controversy.  Phillip Rieff, in his influential and insightful work, The Triumph of the Therapeutic suggested that it was Freud who introduced to the modern world the basic ideals of a therapeutic culture that avoids moral judgment, is largely anti-institutional, and retreats from public life.  Rieff suggests that Freud’s pessimism about social progress and his emphasis upon exploring the intra-psychic life appeals to modern persons who seek to retreat from the larger questions of social and political life and prefer to enjoy an expansion of their personal freedom and private interests. The fact is, in addition to functioning as therapists, psychologists are also citizens, parents, consumers and some are even church-going believers.  To avoid the issues arising from these roles is quite impossible—to remain silent and seek to remain merely private in one’s work and cultural life is itself a political stance.  Of course many psychotherapists have recognized the social and cultural origins of the mental health problems afflicting the client they see in their practice.  However the largely individualistic approach remains the dominant model for psychotherapy.  Public approaches to mental health do not focus on social or cultural change.  Mental health institutions manage individuals largely through medication and confinement of persons who pose a danger to themselves or others. 

 

Due to the widespread acceptance of the non-political, non judgmental, individualistic focus of psychotherapy it is difficult and sometimes awkward for psychologists and counselors to take public positions on social and political issues.  It seems inappropriate to one’s professional identity and doing so may be detrimental to one’s ability to attract clients. In this post, I am crossing the threshold into the public domain at the risk of stirring up a part of American culture that increasingly has taken on a religious aura.  I am talking about the sport of tackle football.  The Superbowl games of recent years have taken on the character of a “holy day” or holiday for many Americans.  Football games in many college and universities are festivals and grand events attended by hundreds of thousands each year.  Football is played in high school and can begin as early as elementary school for some.  Football has become America’s game displacing baseball.  While baseball may be America’s pastime, football has become its passion. 

 

Leaving the religious elements of football aside, the dark side of the game in terms of its dangers and long-term destructive effects upon the players has become a growing public issue.  Once just a quiet whisper confined to training rooms, the players themselves have finally begun to speak up and take action.  In several high-profile cases their voices has come from the barrel of a gun while others have turned to the courts.  Some 3,500 former NFL players are suing the league for damages resulting from football injuries.  It has taken suicides and lawsuits for the public to begin to reflect on the nature of the game itself.  What sport, other than boxing, is essentially focused on aggressive contact with opponents?  The sport is brutal and glorifies violence.  The New Orleans Saints were recently punished by the NFL when it became apparent that players were being encouraged and rewarded for intentionally injuring other players.  While the “Saints” behavior was extreme it exposed a mentality that has been part of the league and part of the culture of football for many decades.  Football players “put the hurt” on their opponents and the more aggressive, the better.   If this approach merely resulted in busted knees and broken ankles it would be perhaps tolerable, but recent research has given clear evidence of significant short-term and long term cognitive and emotional dysfunction resulting from playing tackle football.  The cognitive deficits appear not only when concussive injuries occur, but increasingly evidence points toward negative cognitive effects upon players from just one football season in which no apparent concussive injuries were reported.  The long-term effects are even more devastating resulting in higher incidence of Parkinson’s disease, major depression, dementia and Alzheimer’s among football players.   These medical effects are often associated with other psychological and interpersonal dysfunction—domestic violence, alcoholism and other forms of violent behavior.  Efforts to respond these issues from the NFL all the way down to high school football have included greater attention to concussions, lighter practices, penalties for grossly intentional and dangerous tackling, etc. along with well-funded public relations advertising highlighting how concerned the football establishment is about protecting players.  However, the fact remains that the risks now evident from playing football are endemic to the game itself and unavoidable given the nature of tackle football.  It is what makes the game what it is--attractive and exciting to play and to watch.

 

Because of this evidence I have begun to publically call for a ban upon tackle football.  Given what we now know, I counsel any parent concerned about the health of their children to boycott football for their kids and at their schools.   Based upon the research, I believe it to be a public responsibility for colleges and universities to terminate their tackle football programs.  And because I am a Christian psychologist I especially call on Christian institutions of higher learning to cease participation in a sport that poses such great risk to their students and offers up a set of values so contrary to a life of peace and good sportsmanship.

 Michael DeVries, Ph.D., Professor of Psychology, Trinity Christian College

Navigating a way through

Psychology is a large and varied discipline and as a result holds many longstanding questions and areas of research. My particular home is in counseling psychology, and my perspective comes out of that discipline. Counseling psychology is grounded in a focus on normative development, counseling process and supervision, and an emphasis on multiculturalism.

Counseling psychologists are particularly interested in normative human development, which refers to how we grow and change over time. One issue that arises from this topic is that of prevention. For example, how do we prevent clinical depression? Or, what can we do to encourage resilience in adolescents? There is some agreement within the field that preventing a problem results in better long-term outcomes than treating it after it has already occurred. However, the question remains, how do we prevent mental health problems in the first place? My Reformed faith tradition has taught me to view people holistically, and therefore when thinking about prevention I seek to engage individuals on several levels: mentally, physically, emotionally and spiritually. To me prevention work can only be effective if it deals with all of these aspects of a person. Additionally, my faith reminds me that pain and suffering are not in complete opposition to health. There are times when enduing life’s trials can bring about great insight and personal development. I therefore seek to balance the benefits of preventing harm while also acknowledging the growth that can come from pain.

Further, on the topic of the counseling process, a question that arises is that of how change happens. What creates, motivates and ultimately spurs for us a new way of operating in the world? Scholars and clinicians have been trying to answer this question for some time with either a common-factors or critical-factors approach. Ultimately, however, it appears that psychologists have a variety of explanations for “why and how” change happens. As a person shaped by the Reformed tradition I use the framework of God’s sovereignty to explore this question. I have often wondered throughout my clinical work, what is the “right” thing to do? However, when I reflect on clients I’ve worked with there is unquestionably a sense of mystery to whether the treatment is effective. Sometimes clients make incredible progress, and in other instances treatment seems to have no effect. Even while I pursue academic answers to this mystery, I often remind myself that there is more “to the story” than I can see with my own eyes. For example, sometimes the process of therapy is a means of sustaining personal growth and development, but at other times it may not be the mode of change most useful. My faith encourages me to seek answers but also allows me to accept the unknown, as God is in all things and above all things and may often work in ways I do not understand.

As a counseling psychologist one of the most captivating issues in my profession is that of multiculturalism, especially questions regarding race and racism. For example, why does this divisive way of thinking, believing and acting continue to exist and morph into different iterations throughout history? How is it that in this country Whiteness continues to operate as a powerful privilege? I have personally spent many years wrestling with such questions, and I continue to realize that it is more important to be on the journey than to find a definitive answer. This journey involves what I see as the kingdom work of seeking reconciliation and changing the social order around the issues of race that still so often divide us. Even though such politically sensitive issues are difficult and messy, my faith and desire to understand humanity compels me to be a part of God’s pull and encourage others to be a part as well.

With that introduction to Psychology Renewed, I now invite you to join the conversation. How do you situate yourself in terms of worldview and professional identity? What helps you to navigate that path?

Dr Kara E Wolff, Assistant Professor of Psychology, Trinity Christian College