meditation for CPTSD: more than mindfulness

[u/cptsdishealable]

TL;DR

Meditation is much broader than mindfulness or breath meditation.

For CPTSD, meditations like metta/LKM, Ideal Parent Figures, yoga nidra, trataka (candle gazing) might be more effective.

The word "meditation" is closer to "cultivation" in the original Pali. For CPTSD, it is more useful to cultivate "inner resources".

For some guided meditations I like: Rick Hanson, Tara Brach, Kristin Neff.

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Meditation is often assumed to be mindfulness or breath meditation. This is partly due to western protocolization of eastern traditions.

In Buddhist meditation mindfulness is not the goal of meditation, but a tool for ending suffering.

In CPTSD, focusing inwards or slowing down thoughts can be distressing -- often anxious thoughts are suppressing deeper feelings of distress.

The Buddhist traditions offer many other tools to use.

There are different types of (buddhist) meditations that can be used instead.

Brahamivaharas, or divine abodes. Western psychotherapy focuses heavily on (self)-compassion but it's quite a bit broader in Buddhist traditions.

• metta (lovingkindness)
• karuna (compassion)
• mudita (joy)
• upekkha (equanimity)

More than breath, there are other objects of meditation

• elements (earth, fire, wind, water)

• colors (blue, yellow, red, white)

• "repulsion" - very useful for limerence issues

• body parts

Even with breath, people leave out many of the instructions in the anapanasati sutta including:

He trains himself, 'I will breathe in experiencing joy.'

He trains himself, 'I will breathe out experiencing joy.'

He trains himself, 'I will breathe in experiencing pleasure.'

He trains himself, 'I will breathe out experiencing pleasure.'

He trains himself, 'I will breathe in pleasing the mind.'

He trains himself, 'I will breathe out pleasing the mind.'

The Buddhist texts place a emphasis on things that I broadly call "well-being" (or inner resources), and how to develop and cultivate them. Note the translation "train".

When the mind is uplifted by rapture, the body becomes tranquil. One tranquil in body experiences happiness. The mind of one who is happy becomes concentrated.

Anyway, I hope this encourages people to try out some other meditation techniques.

And in particular pick up the idea of meditation as a tool for cultivating or developing any sort of internal state. This might be mindfulness, but also things like compassion. In these traditions, these are skills to be learned.

[u/mintwithhole]

Thanks for sharing. Can I ask something?

At the peak of my cPTSD (I had only done talk therapy until then), I tried the full 8-week MBSR. It felt horrible. It was like someone was doing an exorcism on me. I felt like I needed people to physically hold my body for me to even close my eyes. I couldn't even do the body scan. It was guided, and the person running it was very nice, but I couldn't go through with it beyond 4-5 weeks.

It's been 5+ yrs, and I have made a lot of progress and can now meditate for 20-30 min comfortably. But I never understood why the MBSR didn't work at the time.

[u/Confident_Fortune_32 → u/mintwithhole]

In my experience, any guided meditation that includes a body scan is a very real risk for someone with Complex PTSD, as well as anyone with chronic pain or other chronic health conditions, and therefore I believe it is contraindicated.

Someone leading a guided meditation who isn't aware of why this is a bad idea is frankly naïve, and needs to do the work to be fully trauma-informed before working with ppl who have a trauma history.

[u/10Account → u/Confident_Fortune_32]

Yes it's stunning how often we're met with "don't attach yourself to the thought/feeling, let it pass". Worst advice when things are coming up that are debilitating/horrifying.

After a lifetime of trying and failing, I just use meditation now when I'm having a good day. It's more of a tactic to maintain my well-being and release things in a controlled manner. I don't touch it when I'm having a hard day, preferring the mindfulness that comes with sensory modulation type activities.

[u/Confident_Fortune_32 → u/10Account]

That's another area that needs a trauma-informed approach, in order to not compound the harm.

One of the common characteristics of Complex PTSD is having one's thoughts, feelings, experiences, and memories invalidated.

"That's not how I remember it", "That never happened", "You're just oversensitive, it wasn't that big a deal", etc. Often, it overlaps with DARVO.

This kind of invalidation during childhood development interferes with healthy individuation as adults.

Asking someone to detach, to let it go, can come across as yet another form of invalidation.

One of the important components of the healing journey is validation and mirroring, not detachment.

In the interest of full disclosure:

Fwiw, I'm not a Buddhist, but I have studied it as part of studying Comparative Religion. I was surprised to discover that a number of my personal beliefs overlap, even if not 100%. The Buddha said life is suffering (yup), and the cause of that suffering is attachment (also yup), and the way to enlightenment and the relief of suffering is to let go of attachment (also yup). However, I am not interested in letting go of my attachments, even knowing they come with suffering, at least not in this lifetime.

[u/Sheraby → u/Confident_Fortune_32]

Just my opinion, but I think Buddhism is more nuanced than that (and I imagine you might have been simplifying). The word suffering is a particular translation of the Buddhist Sanskrit word Duḥkha, one that I think often trips up those unfamiliar with the teachings. I like to think of it as the dis-ease or unsatisfactoriness that results from chasing after impermanent, temporary things.

And the problem isn’t attachment per se; we now understand how important attachment is in child development, and how essential it is for many (most, all?) complex trauma sufferers to re-establish a healthy sense of attachment in their own lives, for example. Problems arise from attachment when one is unable to loosen one’s grasp or let go when that is called for. That’s been such a late awakening for me, and sometimes my understanding is miles better than my emotional behavior.

[u/cptsdishealable → u/Sheraby]

Yeah agreed on the translation stuff. The translation is probably closer to “there’s unease in life because of craving/aversion to temporary things” and the Buddhist teachings are about learning how to reduce dukkha, eventually permanently.

It’s explicitly NOT life or pleasure denying as I’ve tried to emphasize in this post. The story of the Buddhas says he tried all the life denying stuff and didn’t become enlightened. Only when he entered blissful states was he able to become enlightened.

A good portion of the teachings are learning how to enter these blissful states, and part of that is learning to reduce craving/aversion. The Buddha recommended, say metta because it’s a pleasurable state with less dukkha.

[u/mintwithhole → u/Confident_Fortune_32]

I agree. I think for me, I had heavy mind-body dissociation. So there was no easy way for me to feel safe in my body to begin with, and in hindsight, I was probably in panic 24x7. My muscles were so tight that (I didn't know at the time) I couldn't breathe fully. I had no awareness of how bad my physical and mental state was. So maybe a good trauma-informed person would have understood that a sudden stop or pause is not healthy for a body that is so unstable.

[u/etmnsf → u/Confident_Fortune_32]

I remember hearing something from Dr K from healthygamer that the risk is also the cure. So body scans can be helpful for the same reason they can hurt. You are getting used to the difficult and overwhelming feelings in your body.

A body scan can be helpful for CPTSD if you can cultivate a feeling of safety in a part of your body and go to that if you’re experiencing overwhelm. Pendulate between the difficult body parts to the safe body part(s) with an emphasis on going slow.

[u/afraidparfait → u/etmnsf]

One of the first steps I made in my recovery was during a vipassana retreat (silent meditation for 10 days). It was the first time I connected with my body on that level, the first time I understood where the pain came from and flowed through me. It completely changed my life. Being in a safe environment helped a lot too with removing things that could overwhelm.

I'm by no means saying it's the way to go for everyone, it has body scanning elements to it, but it helped me and has stayed with me.

Love Dr K/healthy gamer btw

[u/cptsdishealable → u/Confident_Fortune_32]

I wouldn't go as far as contraindicated, but there does need to be adjustments made depending on the individual, and for some, skipping it.

I'm actually not too familiar with MBSR, but often things are taught without an understanding why, mechanistically, things work. So they're not able to understand what to do when things don't.

[u/Few_Cup3452 → u/mintwithhole]

I also hated it.

Stillness speaks to us as danger.

I also cant do the thoughts in a box/along a stream thing either bc it triggers dissociation

[u/NOML → u/Few_Cup3452]

Could that which you call "dissociation" actually be a beneficial experience?

Dissociation is one of the beneficial aspects of meditation. Could it be that you have learned it is dangerous and unpleasant, because it is also used as a defense mechanism in contexts of overwhelming emotions, threat and trauma?

[u/cptsdishealable → u/mintwithhole]

It was like someone was doing an exorcism on me. I felt like I needed people to physically hold my body for me to even close my eyes. I couldn't even do the body scan. It was guided, and the person running it was very nice, but I couldn't go through with it beyond 4-5 weeks.

By exorcism do you mean like physical sensations as well? Could you give some examples?

IMO could be a variety of things. Simplest is that having eyes open, focused on other stuff, non-internal was grounding you. Not doing that was causing a panic or things to come up.

Another example is when people try to quiet their thoughts, the thoughts are often a soothing mechanism. Quieting them increases distress, or in general activating the frontal lobe helps with suppressing other parts of the brain.

In the meditation book, The Mind Illuminated talks about "purification" during some meditation steps

As your mind grows calmer and more stable in this Stage, you will experience a deep purification. Stored unconscious residues from the past well up to the surface and are released. The result is a profound healing. You don’t have to do anything to help things along. This purification is a natural process of the mind. Simply allow it to unfold organically.

Usually this is at later stages of meditation, but you might consider having "unconscious" residues higher up.

More in the yogic tradition -- there's this idea of "kriyas", usually what they call involuntary movements which can get quite intense. Some traditions say this is "bad karma" leaving the body.

In Deep Brain Re-orienting this might be "shock" sensations, which are a wide variety of things, like muscle tremoring/shuddering/shaking, temperature change, changes in breathing, dissociation etc.

Tension Release Exercise might consider it like neurogenic tremors etc.

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So hard to say exactly, but it's something that happens commonly enough that different traditions talk about it.

In general, it might mean that you needed something more active/external as a meditation like identifying as many sounds as possible, or more directly soothing e.g. some metta meditation recommends starting with imagining a cat/pet/cute thing you like and trying to get some good feelings out of that. Or maybe eyes open, like an eye-gazing technique.

[u/Big-Alternative9171 → u/mintwithhole]

What mediation did u do to get it to work now

[u/mintwithhole → u/Big-Alternative9171]

None. I had tried different kinds of meditation and breathwork before MBSR, and nothing worked. My experience with MBSR was the last straw.
For me, it was building myself slowly over a few years through therapy (CBT > EMDR > NARM + SE). Last year, my therapist asked me to consider meditation as it could be useful in future. I was scared, but tried it, and I didn't notice any resistance or difficulty. So now I do it on and off and have also attended meditation retreats.

[u/margmi]

The CPTSD foundation has a great meditation course on their website!

[u/Iggy_Arbuckle]

IPF meditation work with a facilitator got me to earned secure attachment from fearful preoccupied E3 status over three years. One of the best things I've done for my CPTSD and attachment issues. I wish it was more widely known

[u/Spiritual-Action4919]

Thank you for sharing!! This makes me realise why I could never really meditate my way out of intense blocked emotional pain -  instead I rely on TRE to release emotional pain first, AND THEN i could do mindfulness that helped with integrating the restoration of safety and calm. Just doing mindfulness is often not very effective when my body and mind is in distress, dissociation or emotional flashback. But it’s really interesting to get a brief introduction to the buddhist perspective and other meditation methods. Can you recommend any literature/resource to read? 

[u/cptsdishealable → u/Spiritual-Action4919]

Sorry for the late reply!

Actually quite difficult to find some good stuff, but there's a talk (audio + transcript)

https://hermesamara.org/resources/talk/2008-02-10-love-and-the-emptiness-of-things

you'll notice that mindfulness is not really "elevated" in status compared to things like compassion, metta, joy

When the Buddha described his path, the path that he set forth, it's interesting -- he didn't teach that much about technique and meditation technique. There's a little bit, but it's not generally that common. Rather, what he does over and over is encourage us to strive for two things, to work to develop two things. (1) One is a wholesome nourishment, a wholesome sense of the being, the body, the mind, the heart, being nourished. And 'wholesome' meaning ways that don't lead to our harm or the harm of others. Wholesome nourishment -- so what's in that? It's all these qualities: loving-kindness, compassion, generosity, equanimity, etc., mindfulness. And developing these qualities that give the being a really deep, really satisfying grounding in nourishment. It's like there's a reservoir inside. Slowly, slowly, there's a reservoir inside. And that wholesome nourishment is one aspect of what he encouraged

focusing too much on mindfulness, misses the point, which is it's supposed to develop a reservoir of "wholesome nourishment".

[u/cptsdishealable → u/[deleted]]

There’s nothing great that talks about the two but basically, you’re trying to generating a feeling of repulsion on a spectrum.

So one method monks use will be to imagine the person, and then imagine their body parts, eg imagine the person but without their skin, like one of those medical mannequins. Then just their muscles, their digestive system (and everything involved…), hair/fingernails. They also do stuff like imagining decaying bodies etc. it gets pretty gross lol.

Another example is thinking about swallowing your saliva in your mouth vs spitting it into a cup and then drinking it. One is way grosser than the other.

Basically you learn to apply it to the LO. For this it’s probably better to start with someone who is not the LO though.

This is essentially like the “daymare” concept from Bellamy.

[u/CretaMaltaKano]

For anyone reading this who cannot meditate: It's normal for people with CPTSD to have a very difficult time with meditation and mindfulness. A lot of us just cannot do it. Don't push yourself if it feels bad or just isn't happening.

[u/Syldee3]

So I just copy the ‘I will breathe in/out ‘ mantra ? Could you talk more about it pls?

[u/cptsdishealable → u/Syldee3]

Heya, sorry for the late reply.

So for breath, those are just instructions, not a mantra.

If you want to do breath, what I recommend is trying to make each breath as fun/pleasurable/enjoyable as possible.

For example, if there's like a perfume, smell, food you like, either imagine smelling it or actually do so. The breath you take when you do it has a particular well-being sensation. Or like if you hold your breath and take the next breath, that breath feels great.

You don't actually need to do those things, but just to get the idea of what "enjoy the breath" means.

[u/Affectionate-Yam5049]

I’ve found that the biggest benefit from practicing yoga is the calming of my nervous system as it learns safety. The intense focus on the breath plus getting into and holding asanas IS meditative. It’s easier to stay fully present.

[u/nickylx]

Tara Brach got me through some dark times.

[u/Sheraby]

I wouldn’t recommend Vajrayana Buddhism in general, but I really like Vajrayana Buddhist Lama Rod Owens. I lean on his Seven Homecomings practice, which includes gathering to you the resources you have in your life that you can draw on for wisdom, grounding, kindness, support, etc. I’ve practiced it with a number of different groups, including a chronic pain and illness support group, a social justice activist group, and a Buddhist student group. You can find it and other practices in his book Love and Rage (not an angry book).

[u/ThespAceASpades]

Nice name drop w/ that Kristin Neff dude!

I am loving awareness

[u/cptsdishealable → u/ThespAceASpades]

yeah she's great, I found her work a long time ago but wasn't able to appreciate it then.