An estimated 90% of the population has been exposed to a traumatic event, and 8-20% of these people will develop posttraumatic stress disorder, or PTSD. - David Treleaven
Medical issues impact our Central Nervous System (CNS). Illness, injury, medications - each of these plays a role in whether and how we attend to stimuli, and also how much bandwidth we have to regulate our responses to those stimuli.
Put another way, when medical events occur, it will be more difficult to be mindful and calm.
As David Treleaven writes in his book, Trauma-Sensitive Mindfulness, survivors of traumatic events can struggle in their mindfulness practice. Mindfulness, or the "practice of cultivating nonjudgmental awareness in day-to-day life (Stahl & Goldstein, 2010)," may mean coming into contact with inner experiences that are challenging and painful. The formal practice of mindfulness through meditation also involves harnessing and guiding our attention, continuously redirecting it towards a central focal point. For individuals who have been through tragedy in its many forms, both of these aspects of mindfulness may be deeply confronting. A trauma-informed approach to mindfulness and meditation involves awareness of the manner in which our diverse lived experiences (gender, race, class, ability status, religious background, sexual identity, etc.) impact how we engage with these practices.
We call mindfulness practice a practice for a reason. By engaging in the process of sitting with and tending to what is present for us again and again, we gradually increase our capacity to hold ourselves and others with thought and care - even when in the midst of hardship. The ability to stay well-regulated during stress will not manifest itself overnight, however. It takes time, patience, and willingness to build a relationship with a practice that does not produce immediate results.
As I was learning Acceptance and Commitment Therapy (ACT), an evidence-based treatment developed by Steven C. Hayes, I was introduced to the idea of "Doom and Gloom Radio." Imagine for a moment that you have a radio with several nobs. The first nob is the on/off switch. Unfortunately, it is broken. We can't turn the radio off, and it keeps playing this Doom and Gloom station.
The second nob controls the volume for the radio. It is also broken. So, the radio plays loudly sometimes, and softly other times. We can't control the volume at all.
The third nob changes the channel. Guess what? Also broken. (Why do we even have this radio?) This radio will play its "Doom and Gloom" station no matter what we do.
For individuals working with chronic stressors like pain or medical problems, long-term caregiving, or repeated exposure to trauma through their work as medical professionals, this resonates. There are times when we cannot change the channel on our lives. There are experiences in which there is no quick fix for what we face.
So, let's look at this radio one more time. Over in the corner, kind of camouflaged - we see another button. We almost don't push it, because none of the other buttons have worked (see this related post on learned helplessness). But - something tells us to try.
This is the "willingness" button, and - it moves.
When in the midst of hardship, we may not be able to control our environments, our stressors, our illnesses or our emotions. What we can shift is our willingness to have these experiences. Rather than getting angry at the radio, or ashamed because we have this radio, or scared because of the messages it sends us - we can simply say, "Oh. I hear that radio station again. Yep - there it goes."
This is where mindfulness practice can help. Humans are narrative creatures, and we make stories out of our experiences. The situations we face are hard enough without the added burden of the negative stories we tell ourselves about them. Fear of an illness is hard enough, without adding the story that we should be ashamed that we are afraid. Physical pain is difficult enough, without spiraling into what it has taken from us. Mindfulness can help us notice the stories we tell ourselves so that we can gently and compassionately figure out how much we want to engage with them. The practice helps us to both be with and work with what is hard. It takes awareness that we are listening to a gloomy radio station before we can begin to figure out how to unhook from its messaging. It takes awareness that we are carrying around a broken radio before we can figure out how to put it down. If our stories are causing us suffering, mindfulness helps us to become aware of that suffering, to be with it and soothe through it. It also provides a framework for letting it go.
And, my friends, that awareness-building takes willingness. It takes practice. Chances are, when we put down that broken radio for the first time, it will feel strange. We may feel like we have forgotten something. We might pick it up again out of habit. Other people may not see that we've put down the radio, and still treat us like we're listening to it, so we may ask ourselves: what's the point? We may even pick up another radio that plays a different, but no less harmful, station.
That is okay.
This is part of what it means to be human. We are in relationship with our mindfulness practice, because we are in relationship with the world. The world is full of broken radios, that keep us shamed and suffering. It is also full of beautiful music. By continuing to be in relationship with our mindfulness practice, allowing it to move and shift, allowing ourselves to attune to ourselves and what we need - we have a better chance of finding, singing, and even creating soul songs for the world.
There are different ways to practice mindfulness, and one key piece of the puzzle is to do so in a way that honors and acknowledges the traumatic experiences we have been through. In the Medical Trauma Support podcast, I had the chance to talk with Sarah Stasica about some of what a trauma-informed approach to mindfulness work with medical populations can look like. We also talked about what it is like for medical providers to regulate their central nervous systems, and how we handle grief. Check it out below!
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