#11: Unlocking Healing: Mindfulness in Trauma Recovery
NOVEMBER 21, 2024
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In this episode of Courage to Heal, we’re diving into the transformative role of mindfulness in trauma recovery. Mindfulness is more than just being present—it’s a powerful tool for managing emotional triggers, calming the nervous system, and fostering inner resilience.
We’ll explore how mindfulness practices can help trauma survivors feel grounded and safe in the moment, even during challenging times. Plus, I’ll guide you through a simple mindfulness exercise that you can use anytime to support your healing journey.
Tune in and discover how mindfulness can be a source of strength and peace as you reclaim your power.
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Transcript
Anna: Today, let's talk about the role of mindfulness in trauma recovery. I will talk briefly about what trauma is, and I will give you a clear definition of mindfulness. Then, explain why mindfulness can be a very powerful tool for healing the effects of trauma.
We will then take a look at mindfulness research and some specific techniques, and even try a mindfulness practice or two. If you have any kind of trauma history - and 83 percent of Americans do - then you want to stick around to learn more about how simple mindfulness can be a powerful tool on your healing journey.
If you listened to last week's episode, then you know exactly what trauma is. I went over it in great detail. If you missed it, not to worry. I will give you a brief definition of trauma.
Trauma is something that overwhelms your nervous system's ability to cope with, process, and integrate what's happening to you, thus creating a lasting nervous system injury. There are so called “big T” traumas, which are significant, overly distressing events like a violent assault or childhood abuse.
And then there are so called “little t” traumas, which are less obvious, like job loss or death of a pet. These traumas can be further divided into two categories, type 1 and type 2 trauma. Type 1 trauma is when you have a single distressing event happen to you, like let's say a car accident. And type 2 is when you have a series of distressing experiences over time, like domestic violence or childhood abuse.
Type 1 trauma can result in post traumatic stress disorder, or PTSD, while type 2 trauma can result in what's called complex PTSD. I covered both in detail in last week's episode.
As I mentioned, trauma causes an injury to the nervous system. When you undergo a traumatic event, your body reacts in one or more of the following ways, flight, fight, freeze, faint, or fawn. These reactions can get stuck in the body, making lasting changes to the nervous system and how it responds to its environment.
For example, let's say you have two people, one of them has not undergone the trauma of being in a car accident, and the other one has. And although not everyone who undergoes a distressing event develops issues, in this particular example, we will say that the car accident survivor does have PTSD from it.
So, imagine these two people in the same situation. They are walking down the street and they hear brakes squealing from a car that's on the road next to them. The person who has not been in an accident may be a bit startled by the noise, but that's about it. He continues on with his day. The car accident survivor, however, is showing what's called an exaggerated startle response.
He jumps out of his skin. His heart starts to beat extremely fast, and his breathing becomes shallow and ragged. He is sweating. His digestive system is getting ready to evacuate. In his mind, he has an intrusive image of the car accident that happened to him. In his bloodstream, he has an overabundance of adrenaline and cortisol.
His hands are shaking. He is terrified. That's what it looks like when someone has that nervous system injury from trauma. Same situation, two very different reactions.
So, how do we heal this injury? How do we return our nervous system to a state of equilibrium where the sound of squealing brakes or another trigger does not plunge us into terror? How do we recalibrate it back into normalcy?
Well, there isn't a single correct way of doing this. There are many pathways to healing, and one of these pathways uses mindfulness. So let's take a look at what mindfulness is.
Mindfulness is defined as the awareness that arises through non-judgmentally paying attention in the present moment. The awareness that arises through non-judgmentally paying attention in the present moment.
It's a way of relating to oneself and one's environment lovingly and with presence. When you're mindful, you can acknowledge your thoughts and emotions, but you're not being critical of them or stressing yourself out over them.
Being mindful also means paying attention to your breathing and the sensations in your body, as well as to what's happening in your external environment. You are totally living in the here and now.
In dialectical behavioral therapy or DBT, there's a concept of the wise mind. And that's when you're able to make choices based on your inner wisdom, your emotions, and the facts of the situation.
You can combine logical reasoning with emotional reasoning and make the best decision for yourself. And I guess one could say that being mindful is like being present in your wise mind.
And we know that mindfulness is associated with many mental health benefits, such as reduced anxiety and depression, and other positive attributes, such as self-esteem and self-acceptance. It has even been found to improve your immune function and heart health as well as your sleep.
And mindfulness is something you can practice both formally and informally. For example, you can sit down for a formal mindfulness meditation session and spend 10 minutes paying attention to your external and internal environment.
Or you can do it informally, as in engaging in mindful eating, mindful walking, or mindful conversation. Even washing your hands and brushing your teeth can be a mindful activity. It just means you are paying attention to every little bit of sensory information your brain and body are receiving.
And since I mentioned meditation, let me clarify something. Many people confuse mindfulness and meditation. Meditation can be defined as a practice where you use mindfulness or focusing the mind on a particular object, thought, or activity to train your attention and awareness and achieve a mentally clear and emotionally stable state. So meditation is a formal practice meant to alter or enhance one's state of mind.
It is a tool used to cultivate mindfulness. Mindfulness is just one aspect of meditation and meditation is just one way to practice mindfulness. Meditation also usually focuses on concentration and attention control. And there are many kinds of meditation out there. For example, you can focus on the flame of a candle, which is called Trataka meditation, or you can chant mantras to yourself, which is called Japa meditation.
I would argue that meditation always involves some degree of mindfulness. But mindfulness does not always involve meditation.
As far as benefits go, we know that mindfulness practices lead to improvements in mental health and chronic pain. People who use mindful practices actually show structural differences in their brains.
Specifically, the prefrontal cortex, which controls all of your executive functioning; the cingulate cortex, which contributes to emotional processing; and the hippocampus, which is involved in memory recall, all show increased activity after mindfulness. And the amygdala, which is responsible for threat detection, shows decreased activity.
What this means is mindfulness improves our emotional regulation and makes us feel safer in the present moment. And I think the amygdala is worth a specific mention. It's an almond shaped structure in our midbrain that plays a key role in processing emotions, especially fear, anxiety, and rage. You can also think of it as a smoke alarm that sounds when danger is detected.
An overactive amygdala is seen in trauma survivors. The amygdala basically becomes hijacked and starts sounding the alarm over situations that are normally safe. Like remember that example with two people hearing the brakes squealing? There was no danger to either person, but the person who was in a car accident reacted as if they were in danger.
That's the result of a hyperactive or overactive amygdala. So I'm sure you're starting to see how mindfulness is helpful to trauma survivors if it calms down that region of the brain. It helps us decrease the activity in the amygdala. It can help us with increasing feelings of safety and with regulating emotions like anxiety and fear, thus aiding in trauma recovery.
So let's talk further about how mindfulness is an amazing and important tool for trauma recovery. Mindfulness helps create a safe space to observe thoughts and emotions without judgment. which is very helpful for trauma survivors who tend to feel overwhelmed by their emotions, and getting overwhelmed is easy for them because of that overactive amygdala.
Being judgmental towards oneself is also a common result of trauma because many survivors tend to blame themselves for what happened to them despite not being at fault. Practicing non-judgment is an important step towards healing.
Mindfulness also helps with grounding and bringing someone back to the present moment, which reduces flashbacks. I'm sure you're familiar with the term when it comes to trauma, it's when somebody basically flashes back to the trauma that happened to them. So imagine that car accident survivor again, completely immersed in the accident that happened to him after hearing those brakes squealing.
He is not living in the present moment. He is living in the past. Mindfulness can help break that connection to the past and bring the survivor back to the present. What this does is it helps form a new association between the trigger, the sound of the brakes squealing, and the environment, which in this case is now safe.
So mindfulness helps break the association that causes flashbacks in the first place. And finally, mindfulness is a way to notice triggers without reacting impulsively. thus breaking the trauma cycle. It gets you out of survival mode. Staying present and calm after encountering a trigger is crucial in healing the impact of trauma and healing that injury to the nervous system.
So these are the three main ways in which mindfulness can be a tool for recovery from trauma. Absorbing emotions without judgment, grounding in the present moment, and stay in calm when triggers are present, which ultimately forms a new association between the trigger and the now safe environment, essentially erasing the effects of trauma.
And like I already said, there are many ways to practice mindfulness. When you are consciously bringing your wandering mind back to the present moment, you are developing mindfulness. When you do one thing at a time and engage fully in that activity as it's happening, you are developing mindfulness.
You can eat a piece of food mindfully. You can hug your partner mindfully. You can pet your dog mindfully. You can even do the dishes mindfully. It's all about being present and not getting caught up in your thoughts. And if you do get caught up in your thoughts, noticing that, then gently returning your attention to the task at hand without judging yourself. That's mindfulness.
Even right now, you can practice mindfulness while listening to me speak. If you are multitasking and looking at other things while listening, that's not mindful. But if you put everything away, and focus on my voice. On what thoughts come up for you, but without getting caught up in them. On what emotions come up for you, but without judging them. On what your senses are sensing right now. That's being mindful. That's an informal mindfulness practice.
But I also want to show you some more formal mindfulness practices. First, there is breath tracking. So why don't we go ahead and try that together right now? I want to show you the difference it can make when you simply focus on your breath. So for just a moment, put away all distractions and let's just try it together.
You can do this seated or lying down. Just please don't do this if you're driving right now. Okay, so settle in, and first, I want you to pay attention to how you are feeling in this moment. Just take stock of your emotional state and what that feels like in your body.
Notice if there's any anxiety or maybe you have a restless mind.
Just notice that.
Now place one hand on your chest and the other on your belly if that's accessible to you.
Feel free to close your eyes or leave them open.
Start to notice your breathing, but don't change it in any way. Just track the air. As it goes into your nose, into your throat, into your chest and lungs and belly.
And then track it as it goes out of your belly, out of your chest, into the throat, and out of the nose.
In and down, and up and out.
Notice which one of your hands is moving more. The one on the chest or the one on the belly.
Just notice.
Notice how the air is cool when it enters your nostrils. and warm when it exits. Follow
the air all the way from the tip of your nose to the depths of your belly and all the way out.
In and down and up and out.
Now take your breathing a bit deeper into your stomach so that the hand on your belly goes up and down more than the one on your chest.
Notice how that changes your breathing.
Simply notice.
In and down and up and out.
Keep noticing your in-breath and out-breath.
Now, take stock of your emotional state once again. Just notice what's still the same and what's different, without judgment, without analysis.
Well done. You've just engaged in some mindful breath tracking. Simply paying attention to your breathing can be a formal mindfulness practice and you don't need to do anything special to do that. No fancy tools, just your attention.
Now because I really want to show you just how versatile mindfulness can be, we are going to do another practice. This one is a simple grounding technique called 5-4-3-2-1.
You may be familiar with it already, but let's do it together anyway. For this one, you can be seated or lying down, but with your eyes open. So the breath tracking we just did kind of works really well with eyes closed, but this one you have to keep your eyes open and that's where the versatility comes in.
First thing I want you to do is look around the space you are in and notice five things you can see, and when you notice them, be specific about their size or color or shape.
For example, I see a white bookshelf, a silver laptop, a black microphone, a rainbow basket with yarn, and the tall black lamp. So look around your space and mindfully notice five things, saying their names and descriptions out loud or to yourself.
Now notice four things you can touch and actually touch those things. paying attention to their texture and temperature. I will give you a chance to notice and touch your four things now.
The next step is to notice three things you can hear. Focus on the up-close sounds and distant sounds. I can hear the hum of my laptop, the sound of the cars passing by my house, And the sound of the fan from the other room. Now do your three things.
Now we are going to notice two things we can smell. Pay attention to every scent around you. Do that now.
Finally, notice one thing you can taste. It can be just a taste that's already in your mouth, or you can grab something specific to taste. Just notice what it tastes like with your very Roll it around your tongue. Taste the essence of it.
Now take a deep breath. In and out.
Well done. You've completed the 5-4-3-2-1 exercise. You should feel a bit more grounded and in touch with your senses. This exercise is often recommended to trauma survivors because of how accessible and effective it is. You can do it anywhere at any time and it brings you right back from the past and into the present.
It lets you connect to the environment around you mindfully. So thank you for practicing it with me.
If you want to try a more formal mindfulness practice, I have just the thing for you. It's a guided mindfulness meditation that walks you through some breath tracking, noticing the sensations in your body, noticing your thoughts, emotions, and your environment. It really plunges you into the here and now, helping you experience the beauty of the moment.
I will put the link to download it in the show notes. It's completely free.
Now time to share something personal. I will share with you that mindfulness and meditation have played a key role in helping me feel less anxious and less angry. It is a noticeable shift both in my emotional baseline, meaning how I feel on an average day, and in moments of extreme stress.
I notice that I am a lot calmer and more level-headed, and even if I do lose control of my emotions, I recover much quicker. The thoughts that may be upsetting don't have as much pull on me. I am able to remain an outside observer to them, and if I do get pulled in, I return back to this observer role faster and feel grounded sooner.
I also notice that I'm a lot more self-compassionate. I don't judge myself as much, which is a result of that non-judgmental part of mindfulness. And I'm proud to say that so far, I have meditated every single day this year, and it feels great to be able to say that. Meditation is my preferred way of cultivating mindfulness.
Sometimes all I have time for is a short five-minute meditation. Sometimes I will meditate for much longer. And I also try to use mindfulness daily, whether it's during eating or having a conversation with my son or husband, or even just petting my dog. It's all about being present, noticing how it feels, and using all of my senses during the experience.
And I will also say that mindfulness is huge for my clients when it comes to trauma recovery. It's especially a game changer for people who get easily triggered and start to exist in the past where their trauma happened. Simply orienting yourself to the environment, kind of like what we did with the 5-4-3-2-1 exercise, can break you back out of that trauma memory and into the present moment, letting you know you are safe, and the bad thing is not happening anymore.
Now, I wanted to talk a little bit about research on mindfulness and specific programs that are available to those of you who want the more formal introduction to mindfulness.
Massachusetts General Hospital has this meditation research program in collaboration with Harvard Medical School. And just so you know, Massachusetts General Hospital is home to the largest hospital-based research program in the world and uses some of the world's most advanced neuroscience research technologies.
So they did several studies on meditation, and they found that participating in an eight week mindfulness meditation program makes those measurable changes in brain regions associated with memory, sense of self, empathy, and stress. The name of the specific program they used is Mindfulness Based Stress Reduction.
Meditation group participants reported spending an average of 27 minutes each day practicing those mindfulness exercises. And then their responses to a mindfulness questionnaire showed significant improvements in their emotional state. And MRI images found increased gray matter density in the hippocampus, which as you remember is known to be important for learning and memory, and in other brain structures associated with self-awareness, compassion, and introspection.
And like I said earlier, they show decreased gray matter density in the amygdala, which as you already know, plays an important role in fear, anxiety, and stress. Isn't that amazing? Spending just half an hour being mindful every day for eight weeks actually made visible changes to the brain. I find that fascinating.
Another piece of research I will mention is that studies show that mindfulness meditation reduces the activity in our brain's default mode network. Default mode network is a part of your brain that's active when you're not actively thinking about anything. That's why it's called default mode. So it's active when the rest of your brain is resting.
It consists of multiple regions in the brain, that's why it's called a network, and it includes the hippocampus and a few parts of the brain cortex. This default mode network is closely connected to our feelings and self-perception, and plays a role in our overall happiness. And by the way, studies show that trauma causes significant damage to this network in multiple ways.
Like I said, mindfulness meditation is an effective way to reduce default mode network activity, which means it helps refocus the brain and keep the mind from wandering into stressful territory, like reliving traumatic events from the past or anxieties about the future. I'm sure you can see how that's really important in trauma recovery.
Once again, mindfulness brings us back from the past where trauma lives, or back from the future where anxiety lives, and takes us into the present moment. All of this research really highlights how incredible simple mindfulness practices can be, and what they can do for our health.
One common comment I get is, I can't calm my thoughts down when I try to be mindful and it seems futile, so I just give up. Here you have to remember that the point of mindfulness is not to sit there with your head completely devoid of thoughts.
That's a misconception. You will always have thoughts in your head. The key is to watch them come and go without going down the rabbit hole, as if you are an outside observer. You can literally tell yourself; I'm noticing I'm having the thought of what I need to do for work. I'm noticing I'm having the thought of what to make for dinner, as you practice mindfulness.
The key is to not go down that rabbit hole of actually thinking the thought of what to make for dinner and to not judge yourself when you catch yourself doing so. Remember, mindfulness is loving and non-judgmental. Just gently return to that role of outside observer. And also, there is a reason why it's called mindfulness practice.
You are never perfect. You are always practicing. That's the whole point.
Another common comment I get is it seems like mindfulness makes my trauma worse. As soon as I try to quiet down my mind, intrusive flashbacks start pouring in. And to that I say, yes, at first this is a completely normal reaction. You are slowing down, which is something your nervous system is not used to.
As soon as you give it some space, it's going to try to keep you safe by giving you reminders of the trauma. It's as if it's playing a videotape in your head saying, remember how this happened? We need to make sure it never happens again. So let me remind you how bad it was and how you need to avoid it.
So I want to validate that it's really hard at first to be mindful as a trauma survivor. But if you ground yourself in your senses and really scan your environment mindfully for cues of safety, you will feel better. It's a slow process, but we know from research that it works, that trauma recovery is greatly aided by mindfulness.
So please don't give up just because it doesn't feel good at first. With practice, it will get better, much better.
And finally, I get the question of what programs or therapies are out there focusing on mindfulness. So remember I mentioned Mindfulness Based Stress Reduction or MBSR. That's an eight-week program and you can find online courses teaching it.
As a matter of fact, the University of Massachusetts teaches the original program that the Massachusetts General Hospital used in that research I mentioned. They have a new cohort starting in winter of 2025. I will put the link in the show notes in case you are interested.
Another thing to check out is called Mindfulness Based Cognitive Therapy or MBCT. Mindfulness based cognitive therapy can help reduce the symptoms of PTSD, including avoidance, hypervigilance, emotional numbing, and negative emotions. MBCT also reduces rates of relapse by 50 percent among people who suffer from recurring depression and was found to be just as effective as medication for depression.
MBCT sessions cover a bunch of approaches, including mindfulness meditation, yoga, discussion about stress and coping, weekly mindfulness practices. So you can look for a therapist that specializes in mindfulness based cognitive therapy. And in general, you can just ask your potential therapist if they use mindfulness a lot in their practice. Some do, some don't.
So today we talked about trauma and its impacts, including big T and little t traumas. We talked about how trauma can be single incident or chronic and how both of those trauma types can cause an injury to our nervous system, especially a structure in the brain called the amygdala.
Then we talked about mindfulness and how it's the art of being present in your environment without judgment. We distinguished between mindfulness and meditation and talked about how mindfulness is so useful in trauma recovery because it creates a safe non-judgmental space, it helps with grounding during flashbacks, and it helps us stay calm after being exposed to triggers.
We even did two mindfulness practices, breath tracking and the 5-4-3-2-1 exercise. Next week, I will be talking about coping with seasonal depression, and I will give you practical tips on managing seasonal affective disorder and preparing for winter months.
Thank you all for joining today and for spending this time with me. I hope you leave feeling a little lighter and more empowered on your journey. Remember, healing takes time and you're exactly where you need to be. Take care of yourselves and until we meet again, be kind to your heart.
