Many clients with complex trauma will come to us convinced that they have already failed mindfulness and that they are about to fail EMDR.  Some of the approaches that I have seen to teaching mindfulness to clients assume a non-pervasively traumatized nervous system. Which is simply something we should not assume. Many approaches throw the client into the deep end of the present, the body, or noticing without much preparation or guidance almost as though they are running every client through the same mindfulness machine.  How we approach a client system with severe trauma needs to be different than how we approach a system that relatively healthy.  Our interventions should match the client we are working with. So, maybe the problem isn’t that many clients simply can’t do mindfulness. Maybe they can’t do it the way we have been teaching it.

Complex trauma is not a special case. It’s nearly the only case we see in community mental health contexts globally. A large percentage of pervasively traumatized clients struggle with even the most basic forms of mindfulness for reasons that we will explore, but also because of how we teach it. And, the easiest thing to change in this equation is how we teach it.  Even in EMDR Therapy, the assumption that “Ok, now we’re in Phase Two and I’m going to teach you these resources so that you can calm down when you get activated.”  This is true, but do you hear the therapist agenda in the way we may be introducing it?  As you will see, when we are working with clients with extreme trauma what we are looking for is information about the client’s nervous system and not necessarily the relaxation response.  I want to show you how to use that information that surfaces in the service of the client’s recovery.

What We are Asking Clients to Do in Mindfulness Feels Like it Goes Against Common Survival Strategies

The Present

Bodies

Noticing

The Mind is Taxed with Survival Tasks

There is Performance Anxiety in What they Know We’re about to Ask

Add to all of these things the performance anxiety of trying a skill focused on these places of discomfort and knowing that the therapist is going to ask them about their experience with it.  These are clients that are accustomed to being what other people need them to be and performance anxiety associated with “Is this working?” “Am I doing this right?”  “What does it mean that I don’t find this relaxing?”  Etc.

Step One of One Way to Do this Differently: Normalize the Difficulties

Normalize the difficulty using all of the information above and all of the information you have learned about the client’s survival. You know how to do that.  Do it.  “Of course mindfulness and the way we have been approaching it hasn’t worked well for you.  Would you be interested trying this differently?”

Step Two of One Way to Do this Differently: Appreciate the Role of Parts and Get Consent

Step Three of One Way to Do This Differently: “Dip Your Toe In” by Decreasing Exposure Time

Step Four of One Way to Do This Differently: We’re Not Necessarily Looking for Something that is Calming

Step Five of One Way to Do This Differently: Recalibrate what “Working for Me” Means—The Car Metaphor

Step Six of One Way to Do This Differently: Bridge Resources

Step Seven of One Way to Do This Differently: Send Clients Home to Practice at their Baseline, Not When Triggered

Putting It All Together

And while there are a lot of other ways to do the same types of things, what we don’t want to do is simply pronounce that the client isn’t ready.  We need to meet them where they are with modifications and accommodations.  Otherwise the client will die not ready.  We need to identify the difficulties, work on them every session and between sessions until they are prepared enough for trauma reprocessing.