Mindfulness, Trauma and Suicide Ideation

Recent emerging research indicates a strong correlation between Adverse Childhood Events (ACE) and risk of suicide (see Links below)

Current mainstream interventions often focus on counselling to work through those childhood traumas using CBT (Cognitive Behaviour Therapies) .

However, there is increasing evidence that mindfulness programmes ( provided the practice is sustained after the initial training), is extremely effective in reducing suicide ideation in young people at risk. Part of its success is that mindfulness training reduces the risk of uninhibited (spontaneous) dangerous responses to new adverse events . Research has indicated that young people exposed to ACEs have reduced inhibition and higher anxiety, and are more likely to “wallow” in historical adverse circumstance, which in turn increases the likelihood of responding to further adverse events in a negative and immediate way, as well as increasing the likelihood of chronic alcohol and drug use to anaesthetise the psychological pain. Other researchers believe that specific traumatic responses to severe ACE experiences- eg violence and sexual abuse, and the consequent flashbacks and Post-Traumatic Stress Disorder symptoms that subsequently impact on the victim, are the primary causes for suicide ideation risk. Other research indicates that simply damaging and dysfunctional family dynamics are sufficient to result in brain changes in young children exposed to that trauma which can result in increased suicide risk in later life.

Note also that exposure to ACE decreases the capacity to interact in positive ways with peers because of fear of further negative social encounters, and also reduces the capacity to interact positively with people in positions of authority ( those who have been in positions of authority with the child in the past may have often been damaging to that young person’s physical or emotional wellbeing) . People exposed to ACE face a double whammy: increased social isolation combined with increased internal risks: (the extrinsic and intrinsic impacts).

Interventions that improve parenting skills, reduce bullying and sexual and physical abuse and family violence are therefore core preventive measures to reduce suicide ideation in not just our young people, but people of all ages.

However, mindfulness training offers an opportunity to significantly reduce the risks once negative experiences have occurred. The core component of mindfulness and meditation is extremely simple: a reduction in random thoughts by focusing on an external point. In the case of mindfulness, that might be focusssing on the breathing or doing a body scan or focussing on sounds or an image.

Meditation techniques tend to use words or phrases repeated repetitively to increase the “strength” of the mind to focus and also the capacity to easily move away from negative thoughts or patterns. Meditation may for instance use repetitive prayer, or a mantra or koan.

While the principle is simple , the challenge is to achieve that state of focus. Many people for instance say “I cant do mediation”, which is a bit like saying ” I cant exercise”. What is required is a commitment to continue the practice in a meaningful way- never forcing the focus but always returning (without blaming oneself for the lapse!)- to the focus when the mind inevitably wanders . Just like exercising the body, exercising the mind through mindfulness or meditation strengthens the mind to stay clear and focussed more and more frequently, with the added bonus that it becomes possible to “acquire” moments of simply being in the moment and experiencing that joy ( ‘wherever I go, that’s where I am’).

However moving from a state of anxiety to a state of bliss or even just a measure of occasional tranquility, will obviously be a harder and much longer journey , and require greater tenacity for one who has come from a childhood of trauma and anxiety than a person who has come from experiences of peaceful acceptance by those who love them.

There is also some preliminary evidence that mindulness practice substantially improves outcomes for people bereaved by suicide and other traumatic loss. The ATTEND mindfulness bereavement programme is one such model.

CBT and other similar therapies rely largely on an assumption that it is the persons thoughts (their cognition) that directly influences their emotions. Work through the cognitive processes say CBT, and you can change the persons emotions for the better. Mindfulness simply says, increase the capacity to focus on whatever the person wishes to focus on (rather than their negative mind chatter) and you immensely improve their mental wellbeing. A researcher recently quoted one of her research clients as saying ” I think therefore I feel” ( a little ‘play’ on Descarte’s spurious statement “cogito ergo sum” -“I think therefore I am”) . What she meant was; whatever I think about , my emotions follow after. And this is largely, but not completely true. Our bodies have for instance strongly imbedded physiological responses to threat . In humans (as with other primates), that imbedded threat response is strongly correlated to being alone. To be part of the group, is to be safe. To be part of the group we must therefore have a meaningful role in the group-otherwise we are an outsider and an outlaw who no-one cares to protect and keep safe.

However , while no-one has as yet established the percentage , my guess is that 80% at least of all of our emotional responses relate to the things we are thinking at that moment. And the things we think are entirely and directly related to what we have experienced in the past. Our sense of self is simply the accumulation of those experiences, and our interpretation of them based on earlier experiences!

Lastly ( being a Buddhist – but this is not about religion or theology – this is about the nature of our internal realities); I would like to relate a simple Zen metaphor….

Two Buddhist monks come to a river where a beautiful young woman stands, but cant get across the river safely . These monks have sworn never to ‘defile’ themselves with touching a woman; yet one of the monks simply picks up the woman in his arms and carries her across the river to safety on the other side and puts her down. Many many miles later the other monk finally says to the “pickup” monk – ‘you have defiled our monastery and our names with your actions today by touching that woman”-and the other monk turns to him and says ” are you still carrying that young woman?- I put her down 2 hours ago”.

Steady personal application of mindfulness and meditation will enable us all to leave aside all those memories and experiences that our thoughts tell us defile us.

In summary: thoughts trigger feelings, and feelings communicate vital information on how to best live your life to survive—and thrive. Developing a stronger mental focus allows you to build your awareness of what emotions and sensations you experience in response to certain thoughts, and you may develop a stronger understanding of the intimate connection between your words or thoughts (self-talk) and your emotions and physical sensations and your consequent actions.

Links

Suicide Prevention Links
http://www.changethatmind.com/suicide-prevention-links/

Childhood predictors of lifetime suicide attempts and non-suicidal self-
injury in depressed adults. http://vww.ncbi.nlm.nih.gov/pubmed/25999526

Childhood adversities and risk for suicidal ideation and attempts: a
longitudinal population-based study. http://www.ncbi.nlm.nih.gov/pubmed/16999880

Incidence and course of suicidal ideation and suicide attempts in the
general population. http://www.ncbi.nlm.nih.gov/pubmed/20047721

Association between childhood adversities and long-term suicidality
among South Africans from the results of the South African Stress and
Health study: a cross-sectional study. http://www.ncbi.nlm.nih.gov/pubmed/24919638

Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomised controlled trial in patients with residual depressive symptoms.
http://www.ncbi.nlm.nih.gov/pubmed/25218397

The Use of Mindfulness-Based Approaches for Suicidal Patients

http://oxfordmindfulness.org/wp-content/uploads/WilliamsSwales2004.pdf

Mindfulness tempers the impact of personality on suicidal ideation
http://www.sciencedirect.com/science/article/pii/S0191886914002827

Mindfulness-based Stress Reduction (MBSR) Reduces Anxiety, Depression, and Suicidal Ideation in Veterans
http://www.sciencedirect.com/science/article/pii/S0191886914002827

Between suicidality and self : effects of mindfulness on college students’ entrance into and progression along the continuum of suicidality
http://repositories.lib.utexas.edu/handle/2152/21614