Satisfaction With Mindfulness Training
The majority of participants completed the optional anonymous post-treatment satisfaction survey. Of the 168 veterans that have completed post-treatment satisfaction surveys after completing the ITP, 77 rated the mindfulness training as very helpful 27 as quite helpful 21 as moderately helpful 22 as slightly helpful and 18 veterans rated it as not at all helpful. Three veterans selected that they did not remember if the mindfulness training was helpful. Overall, the majority reported that they found mindfulness training to be moderately to very helpful.
Impact On Brain Function:
A recent study looking at the neural functional impact of mindfulness meditation on those with PTSD implicates the interaction of two opposing brain networks in mediating beneficial outcomes.
In this study, 23 male veterans who served in Afghanistan and Iraq were divided into different treatment groups, one of which included mindfulness-based exposure treatment .
Results indicated that while each treatment group showed promise, the men in the group receiving Mindfulness-Based Exposure Therapy experienced actual post-treatment brain changes that indicate mechanisms by which mindfulness could potentially help in the treatment of PTSD.
Functional magnetic resonance imaging indicated that at the start of the study, the veterans showed increased activity in regions associated with perceived external threats. After receiving MBET, fMRI showed increased activity in what is known as the brains default mode network . The DMN consists of interacting brain regions associated with internally focusedmeandering and wandering thought. Additionally, fMRI also showed that the DMN increased its connections with whats known as the Executive Network, associated with the purposeful shifting of attention.
Both these networks were working in sync, providing insight into how mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.
List Of Group Therapy Activities For Clients With Ptsd And Trauma
Group therapy activities can be an effective tool for treating clients with PTSD and trauma. Group activities can provide education and promote group engagement among group members. Below you can find a list of group therapy activities that can be used with clients in a PTSD or trauma group setting.
- P- Paying attention to our body, thoughts, and feelings
- A- Assessing what is activating our responses
- U- Understand the roots of our feelings
- S- Set boundaries, separate, and ensure safety
- E- Empathise with those involved
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How Traumatic Stress Affects The Brain
Acute and persistent traumas are also known to impact the structure and function of the brain and nervous system. Human and animal studies find that traumatic stress is associated with in the hippocampus, anterior cingulate cortex, and left amygdala brain regions that are highly sensitive to environmental threat.
The hippocampus, part of the brains emotion processing center , plays an important role in learning, memory, and emotion processing. It is particularly vulnerable to stress, and tends to be smaller in volume in those with PTSD.The anterior cingulate links the limbic system to the prefrontal cortexoften referred to as the brains thinking center. It plays an important role in emotional regulation and cognitive flexibility.
All told, these brain signaling anomalies may be related to greater difficulty regulating and coping with negative thoughts, feelings, and memories a hallmark of post-traumatic stress.
The amygdala, another hub for cognitive and emotional processing, has also been found to be smaller in those with a history of trauma, although there doesnt appear to be a connection between the size of the amygdala and the severity of PTSD symptoms. Researchers do believe that decreased regulation of the amygdala may be associated with an increased risk of developing post-traumatic symptoms or a diagnosis of PTSD.
Mindfulness And The Triple Network Model Of Psychopathology
Emerging work among veterans with PTSD who participated in an MBET group has identified potential neural markers of symptom change within the ICNs.35 Here, MBET was associated with increased DMN connectivity with the dlPFC, a main node of the CEN no such changes were reported in a PCGT comparison condition . Furthermore, the authors noted that increased DMNCEN connectivity was associated with reduced avoidant and hyperarousal symptoms, which the authors suggested may reflect an increased capacity for voluntary control of attention and the ability to shift attention from internal self-referential processing via the DMN to other forms of internal experiences, including interoception via the CEN, thus leading to greater emotional regulation abilities.35 Notably, the authors also reported increased DMNSN connectivity in the MBET group following treatment . The authors note that this finding may seem contradictory given previous work showing increased SNDMN connectivity among individuals with PTSD , which is thought to underlie increased sensitivity to threat.93,94,97,98 However, King and colleagues35 suggested that given the role of the dACC in attentional and executive control, increased DMNSN connectivity may reflect an increased capacity for attentional shifting from internal self-referential states to external stimuli, as is suggested in the case of increased DMNCEN connectivity.
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Potential Of Mindfulness In Treating Trauma Reactions
Vujanovic, Niles, Pietrefesa, Potter, & Schmertz
Mindfulness is most commonly conceptualized as involving attention to and awareness of the present moment, and nonjudgmental acceptance . Awareness of the present involves observing thoughts, feelings, and sensations by focusing one’s attention on the current moment . While attending to the present, mindfulness also entails a stance of acceptance, or willingness to experience an array of thoughts and emotions without judgment .
Limitations And Future Research
Mindfulness skills can significantly increase over the course of a 3-week ITP for PTSD, and veterans generally find daily mindfulness training acceptable. As such, the present findings suggest that daily mindfulness training can be incorporated into intensive PTSD treatment programs. Future research should involve dismantling ITPs to determine which treatment components contribute to increases in mindfulness skills. Given the highly polarized satisfaction ratings reported by the veterans in this study, future research should continue to address veterans feedback and examine whether there are certain types of individuals who may benefit from the addition of mindfulness programming, and for whom additional practice in acceptance skills or other skills to cope with difficult cognitions may be beneficial above and beyond trauma-focused psychotherapy. Lastly, future research should also assess the extent to which continued practice of mindfulness skills following program completion affects the overall treatment gains. Overall, daily mindfulness training has been shown to be possible and beneficial, and future research should evaluate the extent to which it improves treatment of PTSD and other comorbid psychological disorders.
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Final Thoughts On Selecting Group Therapy Activities For Your Clients With Past Trauma
Group therapy activities for PTSD provide counselors with an opportunity to have an engaging and educational group session. As an example, if you recognize that group members are struggling to cope with distress, establish or maintain healthy boundaries, or engage in self-care practices, you can tailor your group activities to focus on these topics.
For counselors who prefer to use handouts to guide their group activities, online resources such as our Trauma Worksheets can provide you with informational handouts that can support you while you facilitate your PTSD group therapy activities.
While individual therapy is commonly used for clients who struggle with PTSD, it can be beneficial for clients to engage in group therapy. Together, group members can establish a safe, supportive, and encouraging environment where they can grow together as they work towards living their best life.
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The Triple Network Model Of Psychopathology And Ptsd
Activity and connectivity of the CEN is also disrupted in individuals with PTSD, with meta-analytic findings pointing to reduced activity in the dlPFC.61 Interestingly, one study reported inappropriate activation of the DMN during a working memory task among patients with PTSD that contrasted with appropriate activation of the CEN among controls, suggesting an inability to recruit task-positive networks in individuals with PTSD.99 In addition, reduced resting state functional connectivity among frontoparietal regions of the CEN have been associated with PTSD symptoms and trauma history100 . Notably, increased connectivity between DMN nodes and the dlPFC has been associated with dissociative symptoms in patients with PTSD.98 In addition, increased connectivity within the CEN during supra- and subliminal threat processing was noted among women with PTSD+DS , suggesting hyperconnectivity of the CEN and potentially increased topdown inhibition of limbic regions.101
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Pay Attention To What Your Body Tells You
When asked to pay focused, sustained attention to their internal experience, trauma survivors can find themselves overwhelmed by flashbacks and heightened emotional arousal, writes Treleaven.
I find sitting still and focusing on my body to be distressing at times, as my body is where much of my trauma took place. Some of these experiences came from the outside world and some came from self-harmful behavior.
When I do a body scan, for example, the hyper-awareness of every sensation in my body can lead me to experience unpleasant symptoms, specifically dissociation.
Ive survived two overdoses in my lifetime, and the physical impacts were life-threatening and deeply traumatic.
When my body is too still, those traumas can sometimes resurface. I feel the excruciating twists in my stomach, the loss of muscle control, the blurred vision, and an inability to speak.
The pain and shame come back to me, and I feel overwhelmed and want to escape.
When we ask folks with a trauma history to be still, close their eyes, and pay close and continuous attention to an internal landscape thats painful and overwhelming without adequate support, its possible theyll feel an increase in emotional arousal and symptoms of traumatic stress including flashbacks and intrusive thoughts, says Alison James, a trauma-informed psychotherapist from Ontario, Canada.
Establish Stable Anchors Of Attention
To support your window of tolerance, you need to learn how to shift your focus away from traumatic stimuli during mindfulness practice.
This can be done by opening your eyes and paying attention to the surrounding environment
Shifting your attention can also be done by choosing a stable anchor of attention.
Its important to choose an anchor that is stabilizing for you. Some people connect the breath, for instance, to trauma. Its an area of the body that can hold tension related to trauma.
Instead of concentrating on the breath, you can choose anchors of attention that are more stabilizing for you, such as the feeling of your feet on the ground, or the sensations of your hands resting on your thighs.
Other stabilizing anchors might include another sense, such as hearing or sight. However, working with a sense thats less tactile can be distracting and make it harder to bring your attention back to your practice.
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Clinical Utility Of Mindfulness For Treatment Following Trauma
The potential clinical utility of integrating mindfulness-based exercises in extant PTSD treatments has yet to be examined empirically . However, given the beneficial effects of mindfulness practice on enhancing emotion regulation as well as decreasing anxiety and depressive symptoms , mindfulness has been increasingly discussed in the context of PTSD and its treatment . The relevant theoretical and empirical literature suggests that mindfulness may serve clinically meaningful functions in alleviating PTSD symptoms.
Regular mindfulness practice can lead to a greater present-centered awareness and nonjudgmental acceptance of potentially distressing cognitive and emotional states as well as trauma-related internal and external triggers . Awareness and acceptance of trauma-related thoughts and feelings may serve as an indirect mechanism of cognitive-affective exposure. This may be especially useful for individuals with PTSD, as it may help decrease experiential avoidance, reduce arousal, and foster emotion regulation. For instance, among trauma-exposed individuals evaluated at a single time point, greater levels of acting with awareness and accepting without judgment were associated with lower levels of posttraumatic stress symptoms . Regular mindfulness practice has also been shown to decrease physiological arousal .
In This Article
Mindfulness Practice In The Treatment Of Traumatic Stress
Mindfulness means noticing and paying attention to what is going on in the present moment. It also means not making judgment. Learn how mindfulness might help you cope with stress or difficult emotions.
Reading time: minutes
It’s because I meditate I have a different way of understanding how I’ve been affected.
David Edgar
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Mindfulness Skills For Trauma And Ptsd: Practices For Recovery And Resilience
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Meditate Only In Places Where You Feel Safe
When I first had flashbacks during meditation, it was with my meditation group on my university’s campus. Guess what else was on campus? My rapist. In hindsight, it seems obvious, but a part of the reason I experienced flashbacks during meditation was because I didnât feel safe there. While I didnât feel like I was in immediate danger, my subconscious felt unsettled and uncomfortable. In the comfort of my own home, however, I felt different. I was free of all obvious triggers, and that helped keep the intrusive thoughts at bay.
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Mindfulness Skills For Trauma And Ptsd
Reviewed by Kevin Jeffrey Goldwater, New York University
So appropriately stated on the back cover of Mindfulness skills for trauma and PTSD is by working skillfully with our challenges, we can each reduce suffering and build lasting strengths. It is exactly this that author Rachel Goldsmith Turow preaches in her newly published book, full of resources to combat daily challenges faced by survivors of trauma and PTSD. With detail and patience, Turow guides her reader towards cultivating a better self after trauma.
One of the most notable aspects of Turows book is her inclusion of research and in their own words features littered throughout the book. These portions from researchers, colleagues and friends of Turows provides support of and strengthens the presence of the skills, giving evidence of the value of the skills described in the book. Turows approach to teaching has a voice of kindness and patience, creating a guidebook that is a not a bulleted instruction piece but rather a comforting resource. Turows book also clarifies the purpose of the skills is not simply fixing the problem rather healing and moving forward , constantly promoting the forward thinking mindset. While each chapter has an independent theme, they each rely on the first chapter of basic skill sets. Without these, Turow would lose the reader and confusion would ensue.
Studies On Mindfulness And Ptsd
As is the case with many “therapies” such as mindfulness, research has only begun to explore the benefits for people with anxiety disorders such as post-traumatic stress syndrome. That said, the research done thus far implies that there is a significant benefit to these practices.
Mindfulness has been shown to be an effective stress reduction practice in general, but there may be other ways it works for people with PTSD as well. Recent research suggests that mindfulness may help to mitigate the relationship between maladaptive thinking and posttraumatic distress.
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Limitations And Future Directions
Although the studies reviewed here provide promising initial evidence for the utility of mindfulness-based approaches in reducing symptoms of PTSD among military and other trauma-exposed populations, additional work is needed before these treatments can be considered as potential first-line interventions. Indeed, just 1 study has compared the usefulness of mindfulness-based approaches as a first-line, evidence-based treatment for PTSD,145 and no studies have compared these approaches to CPT or PE however, as reviewed, mindfulness-based treatments appear to have similar effect sizes , suggesting similar efficacy. Moreover, initial findings are promising, with Catani and colleagues145 reporting equivalent symptom reductions following either a meditationrelaxation intervention or narrative exposure therapy among children with symptoms of PTSD.
Importantly, no work to date has investigated whether dissociative symptoms associated with PTSD can be ameliorated through mindfulness-based interventions despite theoretical models suggesting that mindfulness is opposed to dissociative states and may improve pathological dissociative symptoms .53,54 This is a crucial avenue to explore, as alternative treatment approaches may be particularly indicated among individuals with PTSD+DS in light of potentially reduced treatment response18,19 and increased disease severity.23