Soldiers in a war zone experience more trauma in a week than many others experience in their lives . . .
. . . but it still feels like our tools for treating trauma aren’t quite sufficient.
Mindfulness meditation could be a powerful healing intervention – but does it work with soldiers?
The early research is promising. It’s still very young. . . but it’s promising. That’s why I thought this study was so interesting.
Anthony King, PhD, research professor in the University of Michigan department of psychiatry, led a team to investigate whether mindfulness-based cognitive therapy (MBCT) could help veterans with PTSD.
They gathered 37 PTSD patients seeking treatment at a local VA outpatient clinic, and randomly assigned them into two groups.
One group received an 8-week MBCT course, while the other received psychoeducation as usual to serve as a control.
The veterans in the MBCT group participated in short classes, which included mindful movement exercises, mindful eating, meditation, and body scans. They were also instructed to practice mindfulness during their daily lives.
Meanwhile, the treatment-as-usual group received psychoeducation about PTSD symptoms, anger, emotion, and group discussions. Their treatment involved roughly the same number of hours as the mindfulness group.
Researchers took measurements of all patients with a semi-structured interview before the treatments began. The veterans completed a PTSD self-diagnostic test, along with a short survey measuring negative posttraumatic cognitions.
Once treatment was completed, the veterans took the test again . . .
. . . and the results were remarkable.
73 percent of veterans in the MBCT group showed significant improvement, while only 33 percent of the psychoeducation group of patients showed the same. They improved in many categories, but one of the most remarkable was avoidance symptoms. The MBCT group showed an improved ability to sustain their focus on even unpleasant thoughts and memories, which is a key tenet of mindfulness practice. The MBCT patients also showed a decrease in feelings of self-blame and perceived the world as less dangerous.
Of course, it’s important to note that this study was conducted with veterans in particular, so we have to be cautious about generalizing to the population at large.
But it’s still promising, especially if you’re interested in finding ways to help veterans heal from trauma.
If you’re interested in reading the full study, you can find it online in Depression and Anxiety.
For more about the treatment of trauma, take a look at our courses on trauma. They combine innovative theory with powerful practical applications to give you the tools you need to help your clients heal.
If you’ve ever worked with veterans, you know how difficult PTSD can be. What strategies do you find effective? Please share your thoughts in the comments below.
Mindfulness Therapy and especially Mindfulness-based Exposure Therapy can be extremely effective at helping people reprocess traumatic memories, especially when the focus is on changing structure of the traumatic imagery itself (Mindfulness-based Image Reprocessing). See: Online Mindfulness Therapy for PTSD
I agree mindfullness will help each and evey person in their lifetime, specilly war veterens are living with their trumatic memories of what they had experienced in the battle feild, MBCT help them be at present moment. and to enjoy their life with healthy mind.
Mindfulness therapy provides one of the most effective approaches for the treatment of PTSD and for trauma recovery because it teaches you how to break free from the habitual reactions, emotional and cognitive, that feed the trauma and cause you to relive the trauma. I have a particular interest in teaching people how to use mindfulness meditation for trauma recovery.
Boulder Center for Online Mindfulness Therapy
Hi. We welcome the oponituprty to tell you about our non-profit organization, Horses4Heroes, Inc., that is changing lives for veterans .. and their families one horseback ride at a time!Thanks. Sydney KnottPresident/Executive Director
As a veteran myself I wonder at what point in counseling MCBT would be good to bring into the counseling session?
Also many veterans I have talked with understand they have PTSD, sometimes mTBI or TBI and are very reluctant to go any where near some of the issues they live with. Others realize that in order to get better they may actually get worse while exposing issues and how they are dealing with them, how they affect their daily life and most importantly how it affects them as part of a family unit, be it as a husband/wife, son/daughter, parent, and lastly how they are seen by the others in their family unit, community, church, etc.
I like the results that this information has presented but wonder if a much larger group is going to be tried and determine if this is a good tool to put in one’s counseling tool box.
thanks for your response
Currently developing a PTSD, trauma program for the federal forces in Mexico. They have been in combat for the last seven years without assistance. So I’m very interested in this article or any other article that references treatment for PTSD of veterans.
Edward T Lacy
As a conventially trained psychiatrist of 40+ years training and experience AND a practicing Buddhist who currently assists in the management of the Service-related trauma of a considerable number of veterans, it has long appeared wise to be circumspect in introducing meditative techniques and practice. It is also appropriate to note the the terms “meditation” and “mindfulness” are widely used without necessarily clearly defining what is meant!
You are so right. Mindfulness and mindfulness meditation need to be defined much more closely. For eg, many think that mindfulness meditation means following the breath. This is a popular interpretation, but fundamentally misses the point of meditation, which is to bring about healing and freedom from emotional suffering. This happens when we learn to meditate on the mind, which means meditating on our thoughts, emotions and memories themselves as the primary objects of meditation. We learn to develop a conscious and friendly non-reactive relationship with our emotions and traumatic memories. This is the focus of meditation (as I teach it) and I would say that this has to be done if a person is to recover from PTSD or emotional trauma.
PS – – it is also important to point out that while it is true 73% of patients in the in the MBCT showed “clinically meaningful” improvement in PTSD symptoms (and yes, we are happy about that!!) remember that this is standard term from psychotherapy research usually defined as a 10-point or greater drop on the CAPS (a standardized instrument)
In our brief group, the average decrease in CAPS was about 16 points in completers (vs an average of no decrease in symptoms in the brief “treatment as usual” groups…) – – this IS meaningful, but i need to point out that more intensive and longer forms of individual, trauma-focused psychotherapy (like prolonged exposure or EMDR) typically can show a 30 or sometimes even a 50 point drop in CAPS scores…
what was important to us about our work it that is was an example of a non-trauma focused, less intensive, brief, group intervention (which some people may prefer – – especially as a “first step”) that was able to lead to some meaningful improvements in symptoms and people’s lives.
Dear Ruth, B Grace, and all,
Thank you all for this very kind discussion. I was the lead author of the paper, and your article is extremely kind and complimentary! But i hope it is OK if i point out a couple of small but important inaccuracies and other “caveats”.. A minor issue (to some, but not to my Dept, i am sure!) is that I am an *Assistant* Research Professor. More importantly, we must clarify that the pilot project was NOT randomized, but did involve recruitment of similar vets from the same clinic over similar time period into different brief group therapy treatments; however we recruited for groups one at a time and did not assign vets to one group or the other based upon their preferences, etc. This is a pilot study!
I agree with and very much appreciate B Grace’s points that there are a number of “Mind-Body” approaches and they are not all the same, etc. and should not be thought of as interchangeable, etc. And that this is preliminary work….
And most importantly, I would not recommend people struggling with PTSD to immediately start “meditating”, particularly not without a (kind and competent) guide or instructor and a supportive group and safe environment…
I actually rarely if ever even use the word “meditation” to describe the activities we did in the the PTSD group, rather preferring terms like “practicing mindfulness”, “grounding”, “being mindful”, “being in the present”, “checking in” “noticing”, etc. Many meditation teachers and traditions would not necessarily call what we do in these groups as “meditation”… it is more some basic psychological work…
Meditation is not an easy thing, even for people who are not struggling with PTSD or other problems, and i also completely agree with the statement that for persons with PTSD, sitting quietly for even 5 min can lead to the arising of intrusive (and distressing) traumatic memories and feelings… this did happen in our group, and this was used as a therapeutic “tool” (sometimes called “exposure” to “experiential avoidance” etc.). It is important to recognize that this work was done in the context of a PTSD therapy group, with an experienced PTSD psychotherapist in each group, as well as a mindfulness instructor…
I strongly appreciate Emily’s and Elke’s points, and i completely agree that “jumping into meditation” for a person with PTSD while sometimes can be helpful be providing “grounding” to the present moment, sometimes relaxation, etc.for many, it can also be associated with an increase in trauma memories, rather than a state of peacefulness. We saw this in our groups, in fact… but this was used therapeutically and we talked about this / ‘processed’ this in the groups.
However, I do believe mindfulness training can be helpful for persons with PTSD in the context of a supportive group (and there are as well 3 other (very well performed…) scientific studies of MBSR with traumatized persons by my friend Lisa Kimbrough (sadly, deceased) and Trish Magyari, and by David Kearney at Puget Sound VA which were published before our little pilot study. Especially it appears, doing this kind of work with an experienced and empathic instructor(s), and with a supportive, respectful group of people who are working with similar issues and creating a ‘safe vessel” and a therapeutic “community” while doing this work together – is so important… please remember this was done in the context of a therapy group.
Warmly, and with respect and best regards, Tony
Mindful living and meditation are powerful methods for improving your life and making you more aware. It is possible to leave the world for a few minutes and maybe touch onto the truth of who you really are. Good Stuff!!
Ruth, thank you for accurately representing the findings of this study – specifically pointing out that the research is preliminary and that it is important not to generalize the findings to the general population. It is important to recognize that meditation is not a one-size-fits-all proposition. In my role as the Editor in Chief of the International Journal of Yoga Therapy (a PubMed, Medline indexed research journal), I often find that authors use terms like yoga, yoga therapy, meditation and mindfulness interchangeably. This creates confusion among practitioners, clients, students and researchers who take study results to mean that any form of mindfulness or mind-body practice will yield results.
In the case of the article that you cited, researchers were using MBCT. This is a very specific intervention model. Again, meditation, mindfulness and mindful movement are not interchangeable concepts. So please, when considering using meditation, mindfulness practices, yoga, or similar strategies in your work with clients, please bear in mind that there are specific techniques and strategies for specific purposes, and that it is important to be a wise consumer of the research literature, particularly in the case of working with individuals whose nervous systems are compromised as a function of trauma. It is great to see so many practitioners considering alternative forms of treatment. Be well.
B Grace, can you point me to more information on this?
Meditation in groups, a good tip! Also, I found meditating with sounds/music that orient to the different brain waves that signify deep meditative states, to be quite helpfull. At first I was sceptical, but it works! Especially, when the risk of flash backs is a real possibility, this might help.
That is all well and good. But You are not a group. Meditation literally means ‘to connect to the center’. What is the center? You are the center.
Who are
You? How do you connect you to you? You need an expert. If you are open to this most profound undertaking, I can humbly recommend this engaging introduction.
Thank you.
I agree with Emily that for the beginner or the traumatised person, meditation works best in a group setting with an experienced person guiding the participants through the meditation.
More and more people in the medical profession are advising their patients to start meditating. However, the typical western mind is untrained in the art of meditation and without guidance, it simply becomes one more stress and creates performance anxiety instead of the inner peace the person is seeking.
My anecdotal evidence bears this out. For example, a participant recently told me that she had been trying for 30 years to meditate and had countless ‘How to…’ books to no avail. Already in the first meditation class she experienced a depth of meditation she had never thought possible.
The energy that is created by a group of people that has come together for a similar purpose is quite remarkable. The experience is also very empowering and does much for self-confidence.
While I am aware anecdotally that jumping too quickly into meditation for someone with severe PTSD may lead to flashbacks that are difficult to manage, my personal experience is that I have known several people through the years who have found meditation to be extremely helpful in recovering from and/or managing trauma. It may be relevant that these people did a large amount (if not most or all) of their meditation in groups. The safe presence of other humans may have been a big part of making the experience easier to manage–and the benefits therefore easier to access. This includes soldiers from different wars, as well as survivors of sexual abuse. I have known someone who was adamant for years that she could not meditate due to PTSD and who now has a dedicated practice with good results. I hope that meditation for trauma survivors continues to be studied so that more and more people will have access to meditation at a pace which is perceived to be, and is, safe for them. I feel that many of the tools offered in Somatic Experiencing would be helpful in restoring resilience and self-awareness that will in turn help clients to maximally benefit from meditation techniques.
Mindfulness meditation therapy involved developing a safe and non-reactive conscious relationship with traumatic memories and associated emotions. This is an essential part of successful therapy for PTSD – to overcome the habitual tendency to react to and feed emotional trauma. In Mindfulness Therapy we learn to meditate on the memories and emotional reactions themselves to develop this.