“As you possess all the necessary resources needed to survive, you possess all the resources necessary to heal.”- Janina Fisher
This quote is a powerful lever that reflects the potential for recovery and healing for trauma survivors. Complex trauma is defined as the experience of chronic and repeated interpersonal trauma (abuse, neglect, violence) that affects the functioning of individuals1 with repercussions that usually persist into adulthood. The long-term consequences of complex trauma are major. They include2 :
- Symptoms of post-traumatic stress, such as feeling as if you are reliving certain events, avoiding stressful places, thoughts, or situations, and constantly being on high alert.
- Identity difficulties, which may include a chronic sense of inner emptiness, negative self-image, or difficulty identifying needs and goals.
- Difficulties in emotion regulation. For example, such difficulties could manifest as difficulty calming down after getting angry; having disproportionate reactions to situations; having panic attacks.
- Dissociation, i.e., a disconnection with thoughts, emotions, body sensations and actions. Dissociation often leaves a feeling of being in an unreal world or out of body.
- Sexual and relationship problems. This includes difficulties in engaging in intimate relationships (despite a desire to be in a relationship), more conflicts that can escalate into intimate partner violence, sexual dysfunction, insecure attachment, etc.
- Somatization, i.e., medically unexplained physiological symptoms, such as migraines or bone pain.
To alleviate these difficulties in the functioning of complex trauma survivors, the intervention Connecting to Our Strengths to Recover from Traumatic Experiences (Se relier à ses forces pour se relever d’expériences traumatisantes)* was created. The intervention is based on a trauma-sensitive mindfulness approach. Mindfulness is defined as the awareness that arises when we pay attention to the present moment, with acceptance and without judgment3 . Mindfulness can be mobilized in interventions for survivors of complex trauma to reduce stress, promote contact with painful experiences, reduce avoidance and increase acceptance4 . It can, however, worsen the situation for survivors5 , for example by causing feelings of panic, dissociation, or retraumatisation6 .
For mindfulness to be helpful and not harmful to survivors of complex trauma, factors derived from good practice were considered in the intervention Connecting with our Strengths to Recover from Traumatic Experiences. These factors help to achieve the objectives of reducing avoidance, improving acceptance, and supporting the resilience process. The factors considered, which we invite you to look for in the interventions offered to survivors of complex trauma, are:
- Ensure that the safety climate remains a primary concern. Some indications that safety is a priority are: respecting the pace and limits of the participants; offering exercises as invitations rather than directives; providing options when guiding mindfulness practices; avoiding asking participants to share details of their traumas.
- Identify the favorable qualities in practitioners who use mindfulness in their individual or group interventions. The preferred qualities are: compassion, caring, and authenticity.
- It is possible to adapt the mindfulness exercises to suit your needs and pace. Do not hesitate to shorten the duration of a practice, to open your eyes if you feel overwhelmed during a practice, to move when necessary, etc. Many practices can also be adapted to be trauma-sensitive.
- Seek reliable sources of information to understand your trauma and its consequences. Reliable sources of information do not promise instant and linear healing, are based on science, are nuanced, and do not generalize to all survivors who often have their own unique symptoms and characteristics.
- Question trauma-sensitivity. According to the trauma-sensitive approach7 , interventions for trauma survivors should a) Realize the impact of trauma, b) Recognize the signs of trauma, c) Respond to the needs of the survivor and d) Resist retraumatisation. Professionals working with trauma survivors should be able to offer services that fit into these four main principles. If you do not feel that these four main principles are reflected in an intervention, you should question how appropriate it is for you or other trauma survivors.
In conclusion
It is based on these reflections - and many others! - that the program Connecting to our Strengths to Recover from Traumatic Experiences was developed. With this program we want to put forward the idea that recovery from complex trauma, although difficult, is possible. These words from a program participant illustrate what survivors may gain from engaging in a mindfulness-based process of recovery and healing:
“I'm going to be able to get other tools to help me, but I'm not exaggerating, it gave me the taste to live like never before, to live as my true self”.
*Note on the program Connecting to our Strengths to Recover from Traumatic Experiences: The program includes 15 three-hour sessions and is currently being implemented with a fifth cohort of users from the public health system (CLSC). This means that the program is available to people who use CLSC services. The research team is currently evaluating the program to measure its effectiveness with participants. We hope that it will be offered to other clienteles in the future!
The individual and group services offered by Connecting to our Strengths to Recover from Traumatic Experiences is not available to everyone at this time. However, if you or a loved one is in a critical situation, do not hesitate to call on the following resources for help:
Info-Social or Info-Santé
Info-Santé (option 1) or Info-Social (option 2) 811 is a free and confidential telephone consultation service. If necessary, the counsellors can refer you to an appropriate resource in the health and social services network or to a community resource.
Emergency services 911
If you fear for your safety or that of a loved one, or if you are in need of immediate attention.
Suicide Prevention and Support Line 1-866-CALL (277-3553) If you are thinking about suicide or are concerned about a loved one.
National Institute for the Clinical Application of Behavioral Medicine (NICABM)
This website is a gold mine of information on trauma and mindfulness. It includes infographics, blog posts, professional training. There is also a repository of NICABM experts. https://www.nicabm.com
David Treleaven’s website
David Treleaven is a well-known trauma-sensitive mindfulness practitioner and teacher. His website offers free recorded webinars with guided trauma-sensitive mindfulness practices, podcast episodes, and professional training. https://davidtreleaven.com
Kristin Neff’s website
This site offers guided meditation on self-compassion. It also offers research and other resources related to self-compassion. https://self-compassion.org
The publication of this article was made possible thanks to our partner, the Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), and the Fonds de recherche du Québec.
- 1Milot, T., Collin-Vézina, D., & Godbout, N. (2018). Trauma complexe : Comprendre, évaluer et intervenir. Presses de l’Université du Québec. https://doi-org.proxy.bibliotheques.uqam.ca/10.2307/j.ctv28683g.5
- 2Godbout, N., Girard, M., Milot, T., Collin-Vézina, D., & Hébert, M. (2018). Répercussions liées aux traumas complexes. Dans T. Milot, N. Godbout, & D. Collin-Vézina (Éds), Le trauma complexe : Comprendre, évaluer et intervenir (pp. 57-90). Presses de l’Université du Québec.
- 3Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163–190. https://doi.org/10.1007/BF00845519
- 4Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: A review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience: JPN, 43(1), 7–25. https://doi.org/10.1503/jpn.170021
- 5Treleaven, D. (2018). Trauma-sensitive mindfulness: Practices for safe and transformative healing (First ed.). W.W Norton & Company.
- 6Britton, W. B., Lindahl, J. R., Cooper, D. J., Canby, N. K., & Palitsky, R. (2021). Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clinical Psychological Science, 9(6), 1185-1204. https://doi.org/10.1177/2167702621996340
- 7Substance Abuse and Mental Health Services Administration (SAMHSA, 2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Retrieved from https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf
