The prevalence of traumatic events among adults in the United States range from 40-90%. The highest prevalence is seen in veterans or current individuals in the armed forces. Exposure to traumatic events, such as being in war, can lead to the development of mental health problems such as posttraumatic stress disorder (PTSD), major depressive disorder, substance use disorders, anxiety disorders, and suicidal ideation. Gaining knowledge of potential mediators of the link between trauma exposure and mental health outcomes help enrich treatment and the development of more targeted clinical interventions.
Mindfulness is a clinical intervention that has become part of a component package for treatment of experiencing a traumatic event. Mindfulness is paying attention to the present moment in a nonjudgmental way and cultivating awareness of one’s mental state; and shifting attention from ruminative thought patterns to the present moment (Kachadourian et al., 2021). This allows a person to respond with flexibility when in a situation that has previously evoked distress caused by the traumatic event(s). The individual will be more likely to engage in adaptive behaviors by increasing acceptance of trauma-related experiences and decreasing the impact of trauma related stimuli.
Interventions to help bolster mindfulness may further help alleviate the negative mental health impact that aggregate traumas on individuals, particularly for U.S. military veterans. Other mindfulness factors that should be further researched include observing (i.e., ability to notice or attend to internal and external experiences), describing (i.e., ability to label internal experiences with words), nonjudging of inner experience (i.e., taking a nonevaluative stance toward thoughts and feelings), and nonreactivity to inner experience (i.e., tendency to allow thoughts and feelings to come and go). These may help with differential associations between trauma exposure and mental health.
Kachadourian, L. K., Harpaz-Rotem, I., Tsai, J., Southwick, S., & Pietrzak, R. H. (2021). Mindfulness as a mediator between trauma exposure and mental health outcomes: Results from the National Health and Resilience in Veterans Study. Psychological Trauma: Theory, Research, Practice, and Policy, 13(2), 223–230. https://doi-org.ruby.uhv.edu/10.1037/tra0000995
According to Google Trends, “Mindfulness” has become an increasingly popular search term over the past decade, and a variety of resources are available to date, including books, blogs, videos, and courses. In addition to its popularity, mindfulness has been studied empirically and become an evidence-based treatment for common problems such as anxiety and depression. Generally speaking, mindfulness involves bringing intentional focus to the present moment and observing the things you are experiencing at that moment for what they are, without judgment. Your observations may involve noticing thoughts, feelings, or bodily sensations. Mindfulness interventions are commonly carried out in person, but this form of intervention is difficult for people who live in rural areas and has become particularly challenging due to the COVID-19 pandemic which has restricted social interactions. Fortunately, a group of researchers found that the positive effects of mindfulness could also be achieved via an online platform.
In 2013, Krusche and colleagues evaluated the effects of a web-based mindfulness course for stress, anxiety, and depression with 273 participants. The authors developed 10 online interactive sessions led by mindfulness instructors, and participants participated for at least 4 weeks, but the course was designed to follow the same sequence as an 8-week mindfulness course. Participants were also given audio and video clips for guided meditation and assigned work to complete outside of sessions, including informal practice of mindfulness (i.e., being present while doing an everyday task such as washing the dishes). After the course had ended, results showed significant decreases in scores related to stress, anxiety, and depression, and these effects maintained at a 1-month follow up. The results of this study are promising and suggest that many people experiencing emotional challenges during this time might benefit from online interventions such as telehealth and video-based mindfulness instruction and guide practice.
Krusche, A., Cyhlarova, E., & Williams, J. M. G. (2013). Mindfulness online: An evaluation of the feasibility of a web-based mindfulness course for stress, anxiety and depression. BMJ Open Science. doi:10.1136/bmjopen-2013-003498
Mindfulness as a part of therapy is often used to help clients hone their ability to attend to their experience in a different way. As a part of “ACT” Acceptance and Commitment Therapy you may be asked by your therapist to practice mindfulness in the therapy room or between sessions. Much like exposure practices, skill develops from repeated practice rather than doing an exercise once.
Below, we’ve added a favorite ACT exercise “Leaves on a Stream” with thanks to Therapy in a Nutshell.