{"id":2529,"date":"2022-12-23T07:41:16","date_gmt":"2022-12-23T07:41:16","guid":{"rendered":"https:\/\/www.meditationmag.com\/blog\/?p=2529"},"modified":"2023-01-01T20:36:55","modified_gmt":"2023-01-01T20:36:55","slug":"trauma-sensitive-meditation-treleaven","status":"publish","type":"post","link":"https:\/\/www.meditationmag.com\/blog\/trauma-sensitive-meditation-treleaven\/","title":{"rendered":"Healing Trauma Through Meditation: A Conversation With Dr. David Treleaven"},"content":{"rendered":"\n

Healing Trauma Through Meditation: A Conversation With Dr. David Treleaven<\/strong><\/p>\n\n\n\n

<\/p>\n\n\n\n

In the long history of psychology & healthcare, Trauma-Informed Care<\/em> (or TIC<\/em>) is a relatively new concept. <\/p>\n\n\n\n

First proposed by \u200b\u200bMaxine Harris and Roger Fallot in 2001, TIC aims to recognize the unique needs of trauma-survivors, and adapt our healthcare systems to better serve those who are experiencing the lingering effects of trauma.<\/p>\n\n\n\n

Newer still is the application of TIC to the world of mindfulness & meditation. While meditation itself dates back into prehistory (well before Gautama sat under the Bodhi tree 2,500 years ago), the first mention of Trauma-Informed Mindfulness (TI-Mindfulness) in the scientific literature dates back to 2014 (less than ten years ago), when Amber R. Kelly proposed (in her doctoral dissertation) \u201cTrauma-Informed Mindfulness-Based Stress Reduction\u201d as a new model for working with people who have survived interpersonal trauma.<\/p>\n\n\n\n

In 2018, Dr. David Treleaven (who has been specializing in mindfulness and trauma for over a decade) published his groundbreaking book, Trauma-Sensitive Mindfulness<\/em>, which demonstrates an empathic, compassionate, balanced approach for mindfulness instructors to work more sensitively and skillfully with trauma survivors.<\/p>\n\n\n\n

As with any new field of study, TI-Mindfulness has met with some skepticism from \u201ctraditionalists\u201d within the fields of mindfulness & meditation.<\/p>\n\n\n\n

Traditional meditation practices (especially the techniques from the mindfulness\/Buddhist traditions) encourage us to observe, accept, and befriend our most difficult thoughts, sensations, and emotions, rather than running away from them. In many traditions, the willingness to face our deepest fears is one of the most important aspects of the practice. <\/p>\n\n\n\n

We are currently living in a time when meditation & mindfulness are being touted by mainstream media and modern McMindfulness mavens as \u201crelaxation techniques\u201d \u2013 emphasizing relaxation and calmness, while brushing off the (often difficult) work of sitting equanimously through the raging storms inside. Traditional meditation teachers tend to view this trend toward meditation-as-relaxation as problematic, because it provides new meditators with an incomplete, watered-down \u201cmeditation\u201d practice, and causes them to miss out on some of meditation\u2019s most important and powerful components.<\/p>\n\n\n\n

Much of the guidance in TI-Mindfulness centers around the avoidance of bringing up traumatic memories in the mind & body of the trauma survivor. There are recommendations to avoid using words in meditation that might \u201ctrigger\u201d or \u201cactivate\u201d the survivor. There are suggestions on how to calm survivors down, pull them out of traumatic memories, and prevent them from going into states of fear, panic, and hyperarousal.<\/p>\n\n\n\n

Meanwhile, modern science has consistently corroborated the ancient wisdom that avoiding<\/em> traumatic memories is actually one of the worst things that survivors can do\u2026 and that, in fact, mindfulness & acceptance are the path toward healing. To quote one major literature review on mindfulness & trauma:<\/p>\n\n\n\n

\u201cMindfulness and acceptance are associated with greater psychological adjustment following exposure to trauma, while experiential avoidance, persistent dissociation, and coping strategies involving emotional disengagement are associated with greater PTSD symptom severity.\u201d<\/p>\n\n\n\n

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(4), 220\u2013235.<\/em><\/p>\n\n\n\n

For these reasons, some traditional meditation teachers have viewed TI-Mindfulness with skepticism, worrying that it promotes the avoidance of difficult thoughts, sensations, and emotions, in favor of short-term experiences of relaxation & calm.<\/p>\n\n\n\n

But diving into Dr. Treleaven\u2019s book, Trauma-Sensitive Mindfulness<\/em>, we can find a balanced, nuanced, and sophisticated approach to working with trauma. Dr. Treleaven often explains that the aim of TI-Mindfulness is not to avoid thoughts, sensations, and emotions, but rather to work more skillfully with them, moderate them as needed, and access them at a pace that is healthy and manageable for each individual meditator.<\/p>\n\n\n\n

TI-Mindfulness is still an emerging field of study. Its insights will need to be fleshed out more fully, so that we can integrate them skillfully into our meditation teaching (and personal) practices. <\/p>\n\n\n\n

<\/p>\n\n\n\n

Reflections on Trauma-Informed Mindfulness<\/h1>\n\n\n\n

A Q&A with Dr. David Treleaven<\/p>\n\n\n\n

Introduction & Questions by Kevin Ellerton. Answers by Dr. Treleaven<\/p>\n\n\n\n

Hi Dr. Treleaven!<\/p>\n\n\n\n

In my interviews with meditators, gurus & spiritual teachers around the world, I\u2019ve observed two basic approaches to working with pain and suffering. These methods cannot be implemented simultaneously, so people generally lean toward one or the other. For simplicity, let\u2019s call these two approaches \u201cThe Relief Approach\u201d vs \u201cThe Acceptance Approach.\u201d<\/p>\n\n\n\n

The Relief Approach<\/h3>\n\n\n\n

In The Relief Approach, when we encounter pain and suffering, in ourselves or others, our goal is to relieve<\/em> it. We aim to change, improve, transform, or get rid of something that we find to be problematic, painful, or uncomfortable, and to shift into more \u201cpositive\u201d states, like calm, relaxation, peace, and happiness. The Relief Approach tends to be the \u201cdefault\u201d paradigm for western medicine.<\/p>\n\n\n\n

The Acceptance Approach<\/h3>\n\n\n\n

In The Acceptance Approach, when we encounter pain and suffering, our goal is to stop trying to relieve it<\/em>. Instead of trying to get rid of<\/em> pain or change<\/em> our experience, we accept<\/em> it, befriend<\/em> it, and even love<\/em> it. When we (truly, consciously and unconsciously) accept pain and suffering, and stop trying to relieve them, we let go of the idea that they are \u201cnegative\u201d or \u201cproblematic.\u201d We realize that while pain and suffering may still be arising, our relationship<\/em> with those experiences can be peaceful, friendly, and even loving. The Acceptance Approach tends to be less intuitive to us in the west, as it goes against our evolutionary drive to \u201cmake things better.\u201d Acceptance of pain & suffering is fundamental to many of the eastern spiritual\/contemplative traditions. Indeed, one of Buddha\u2019s core teachings is that dukkha is inevitable, and equanimity (non-judgmental awareness) is the path to ultimate freedom from suffering.<\/p>\n\n\n\n

Pros & cons of each approach<\/h3>\n\n\n\n

Each of these approaches has pros and cons. With The Relief Approach, we can completely \u201cfeel better\u201d and \u201cget rid of the pain.\u201d In the short term, Relief seems like \u201cThe Solution\u201d to pain. But when the next moment of pain inevitably comes along, we find ourselves suffering again, in an endless struggle to \u201cmake it stop.\u201d With The Acceptance Approach, we are literally giving up on the idea of pain relief, which some may view as capitulation. But the advantage of this approach becomes apparent in the long term. When the next moment of pain comes along, the attitude of acceptance is already in place, and so the pain does not become a \u201cproblem.\u201d We live in a state of lifelong \u201chappiness,\u201d rather than going up and down on a roller coaster of pleasure and pain.<\/p>\n\n\n\n

Finding balance between the two approaches<\/h2>\n\n\n\n

We can use different approaches in different situations. We may aim for Relief in some situations, while practicing Acceptance in others. This balancing act is encapsulated in the famous prayer: \u201cGod, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.\u201d<\/p>\n\n\n\n

But we can\u2019t apply both approaches at the same time. The Relief Approach is founded on the idea that \u201cpain is a problem that needs to be fixed.\u201d In order to motivate ourselves to take action to relieve the pain, we must hold this \u201cproblem\u201d idea in our minds, until it is \u201cfixed.\u201d The Acceptance Approach, on the other hand, is founded on completely letting go of that idea<\/em> \u2014 that \u201cpain is a problem that needs to be fixed\u201d \u2014 which is precisely the thing that prevents us from accepting pain in the first place. We cannot hold an idea in mind, and<\/em> let it go at the same time. Therefore, we are unable to work toward relieving pain while at the same time (fully) accepting it\u2026 and we are unable to truly accept pain without giving up the goal of relieving it.<\/p>\n\n\n\n

Ideally, we can select the appropriate approach for each situation. I\u2019ve observed that many traditional meditation teachers (monks and gurus in monasteries and ashrams, for example) tend to favor The Acceptance Approach in nearly all situations \u2014 even for those involving extreme pain (grief after tragedy, intense physical pain, etc). They switch over to The Relief Approach only when Acceptance can cause long-lasting damage (for example, if you are damaging the tendons in your knees by sitting in a certain meditation posture, the instruction is to adjust to a more comfortable position). Western medical professionals, on the other hand, tend to favor Relief over Acceptance, and only \u201cgive in\u201d to Acceptance when The Relief Approach fails.<\/p>\n\n\n\n

Where does Trauma-Informed Mindfulness <\/em>fit in?<\/h3>\n\n\n\n

The TI-Mindfulness Movement is a child of two very different parents. The \u201cTrauma Informed\u201d perspective is born out of the western medical paradigm of Relief, while the \u201cMindfulness\u201d is rooted in eastern spiritual traditions of acceptance. This places TI-Mindfulness in a tricky spot: do we approach trauma with the goal of Relief \u2014 avoiding activating traumatic memories, cultivating states of calm and relaxation, staying within the window of tolerance, etc? Or do we approach trauma with the goal of Acceptance \u2014 allowing traumatic memories to arise, allowing states of calm\/relaxation and anxiety\/tension to come and go, allowing ourselves to flow in and out of our window of tolerance, etc?<\/p>\n\n\n\n

<\/p>\n\n\n\n

Q&A WITH DR. TRELEAVEN<\/strong><\/h2>\n\n\n\n
    \n
  1. Can The Acceptance Approach ever be appropriate for working with trauma survivors, or should we always lean toward Relief?<\/strong><\/li>\n<\/ol>\n\n\n\n

    Yes, the Acceptance Approach is very appropriate for work around trauma. In fact, it\u2019s essential! <\/p>\n\n\n\n

    What I point to in my work is that it needs to be a blend between what you call \u201cacceptance\u201d and \u201crelief.\u201d Trauma survivors can learn to \u201caccept\u201d traumatic sensations, for example, but there are also times to back off in the service of healing. More is not always better with Acceptance, and we need to employ a wide range of tools in practice.<\/p>\n\n\n\n

      \n
    1. In your book, Trauma-Sensitive Mindfulness, you mention the possibility that trauma survivors may \u201cre-traumatize\u201d themselves in mindfulness practice, and thereby incur lasting damage in their attempts to practice mindfulness. What would re-traumatization look like? Have you ever seen it in practice, or in scientific studies? Could re-traumatization be avoidable by approaching the practice with a goal of equanimity and Acceptance (rather than Relief), as described above? <\/strong><\/li>\n<\/ol>\n\n\n\n

      Re-traumatization in practice can look like extreme dissociation, or reliving traumatic events in a dysregulating way. This has been documented in the Varieties of Contemplative Experience<\/em> study1<\/sup>, which is the largest qualitative study on meditation-related difficulties ever held. <\/p>\n\n\n\n

      Re-traumatization can absolutely be avoided by employing a mix of \u201crelief\u201d and \u201cacceptance\u201d practices, where it\u2019s okay to back off of traumatic memories or sensations when it\u2019s overwhelming. <\/p>\n\n\n\n

      This isn\u2019t to say the point of meditation is to be comfortable \u2013 on the contrary, we\u2019re practicing so that we\u2019re able to stay with difficult experiences. But traumatized people need more than just basic acceptance and mindfulness-based practices to work skillfully and safely with trauma.   <\/p>\n\n\n\n

      1. Lindahl, J., Fisher, N., Cooper, D., Rosen, R., and Britton, W. (2017). \u201cThe Varieties of Contemplative Experience: A Mixed-Methods Study of Meditation-Related Challenges in Western Buddhists.\u201d PLOS ONE 12(5): e0176239 <\/em><\/p>\n\n\n\n

        \n
      1. Are you aware of any scientific studies that have compared the effectiveness of The Relief Approach vs The Acceptance Approach (or TI-Mindfulness vs traditional equanimity-oriented instructions) in the general population, or in PTSD sufferers?<\/strong><\/li>\n<\/ol>\n\n\n\n

        No this is still a new area, I\u2019m not aware of any such studies.<\/p>\n\n\n\n

          \n
        1. In your book, Trauma-Sensitive Mindfulness, you talk about the \u201cWindow of Tolerance\u201d \u2014 the \u201csafe\u201d zone between hypo-arousal and hyper-arousal. The implication is that when we are inside our Window, we are able to self-regulate, grow, and heal\u2026 but when we are outside our Window, we are unable to grow or heal through mindfulness & equanimity. However, in some contemplative traditions, practitioners intentionally put themselves into states of hypo or hyper-arousal as a way to practice equanimity, expand their Windows of Tolerance, and bring Acceptance into every aspect of life. As an extreme example, the Aghoris of India meditate with corpses in graveyards, ingest high doses of mind-altering drugs, and generally spin dizzily, chaotically, and euphorically through the ups and downs of life. It occurs to me that this type of Radical-Acceptance approach could be a possible alternative for working with dysregulating thoughts, sensations, and emotions, like those that arise in the minds and bodies of trauma survivors. What is your take on this?<\/strong><\/li>\n<\/ol>\n\n\n\n

          There are absolutely times to push our edges in practice. These experiences can create life-changing breakthroughs. With trauma, things are a bit more complicated. Trauma survivors often need to confront their trauma, but if they do so with too much intensity, they can overwhelm their nervous system. <\/p>\n\n\n\n

          In Trauma-Sensitive Mindfulness, the work is to help people learn how to self-regulate when they\u2019re feeling overwhelmed. The goal isn\u2019t to avoid trauma, or always stay in a window of tolerance. It\u2019s to empower trauma survivors with tools to help them work skillfully with their own experience. <\/p>\n\n\n\n

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          Healing Trauma Through Meditation: A Conversation With Dr. David Treleaven In the long history of psychology & healthcare, Trauma-Informed Care (or TIC) is a relatively new concept.  First proposed by \u200b\u200bMaxine Harris and Roger Fallot in 2001, TIC aims to recognize the unique needs of trauma-survivors, and adapt our healthcare systems to better serve those […]<\/p>\n","protected":false},"author":4,"featured_media":2535,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[116],"tags":[],"class_list":["post-2529","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-interviews"],"yoast_head":"\nHealing Trauma Through Meditation: A Conversation With Dr. David Treleaven - Meditation Magazine<\/title>\n<meta name=\"description\" content=\"Trauma-Sensitive Mindfulness. 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