Boston-based psychiatrist Bessel van der Kolk has researched the area of post-traumatic stress and neurobiology extensively since the 1970s, and sheds new light on what helps with recovery from trauma.
In his book, “The Body Keeps the Score” he reviews two important studies of trauma treatment research programs.
- In the first, the traumatised person and their brain is compared with their state before the trauma (find our more about what it means to be traumatised, here).
- In the second, a researcher compares the traumatised with the non-traumatised brain via neuro-imaging studies.
Via these two evidence bases, van der Kolk demonstrates the human brain’s natural balance state, most recently termed the Default State Network or DSN. This DSN is found now to be vital, as it can moderate all those hypervigilant systems to achieve a ’Calm Brain’ mode.
For 99% of us, our Default State Network runs down the midline of the brain (van der Kolk’s “Mohawk of Self Awareness”).
The Calm Brain
Researchers have found that a lightly active DSN is a condition of a healthy resting (calm) brain.
However for it to be at optimum, it has to be in a Goldilocks state – that is, not too active and not too dulled. It seems to achieve this when it thinks of nothing in particular and just allows things to be, in the present moment.
Most people move into this state whenever they pause, deep breathe, recline or otherwise relax. Not surprisingly, this is what ancient traditions similarly describe as meditation, or benefits of meditative practice.
What amazed van der Kolk is that in a series of neuro-imaging studies, it was found that those with long term post-event trauma (mainly PTSD or childhood trauma), when asked to think of nothing, failed to activate their Default Network State. The DSN regions of the brain remained dimmed on scan results.
The Effect of Trauma on the Brain
This is relevant to trauma recovery and healing, as Dr van der Kolk noticed many of his post trauma patients (when not in flight, fight or flee mode) were going through their days numbed out, that is, devoid of purpose and feeling. Van der Kolk surmised that when the DSN goes dead, so does our sense of self – leading the person to no longer be both purposeful and emotionally balanced.
Sure enough, when his patients were examined they also had more than their share of darkened areas.
Researchers discovered the DSN is also the processing relay switchboard that integrates our many bodily sensations (touch, sight, smell, sound, taste, etc) and tells us where we are located spatially. People with a deadened DSN have a deadened sense of sensation, and are often ‘just surviving’ in a somber amotivational state. Dr van der Kolk noted this zombie-like behaviour was common in his chronic PTSD patients.
“If we want to change posttraumatic reactions, we have to access the emotional brain and do “limbic system therapy” [ie] repairing faulty alarm systems and restoring the emotional brain to its ordinary job of being a quiet background presence that takes care of the housekeeping of the body, ensuring that you eat, sleep, connect with intimate partners, protect your children and defend against danger. - World Expert on Trauma, Dr Bessel van der Kolk, in The Body Keeps the Score.
Thus we are looking at a two-pronged approach to recovery from trauma. First the alarm system (limbic system) must be reset so it doesn’t sound off randomly or inappropriately.
Secondly, the traumatised individual has to learn to calm the brain even if the alarm system is correctly reset. The calming of the brain is where meditation comes in. Apparently, in its most structured and studied form (Mindfulness Based Stress Reduction), it is probably the single best intervention that can be used for recovery from trauma.
Evidence in van der Kolk’s book strongly suggests that if you are traumatised, you will likely benefit from the OPPOSITE of what most therapists attempt (which is talk-based therapy, whether CBT, or Solution Focussed or IPT or whatever).
Instead he urges therapists to use non talk therapies. He and many other leaders in stress and trauma research have credited Mindfulness Based (ie structured) meditation (also called Mindfulness Based Stress Reduction or MBSR) as THE premier method to promote recovery from trauma and traumatic stress conditions.
Such structured meditation for stress reduction is a topic that has been well researched now for about 45 years, at leading research institutions around the world.
In addition, with the arrival of advanced neuro-imaging, study design and EEG signal processing, we can now see conclusive proof of the recovery capabilities of structured meditation.
How Mindfulness and Meditation can help with Trauma Recovery
Below is just a subset of findings, relayed recently in both van der Kolk as well as Forbes Magazine. These directly relate to the use of structured meditation in trauma recovery. (Other modes ofintervention can also be found to work, but MBSR includes meditation as well as a host of the other interventions).
Meditation Practice can Lead to Volume Changes in Key Areas of the Brain related to Stress (Forbes)
A researcher at Harvard Medical School, Sara Lazar, PhD, ran a series of studies each using eight weeks of the above Mindfulness Based Stress Reduction (MBSR).
To many researchers’ surprise MBSR was found to increase cortical thickness in the hippocampus, which governs learning and memory. It also impacts positively the ‘Mohawk of Self-Awareness’ (mentioned above) which provides stability in emotional self-regulation and self-referential processing (awareness and sense of Self).
In addition, the Harvard team found a reduction in brain cell volume in the amygdala, the earlier mentioned ‘red alert’ centre. Lazar stated: “The brain changes matched the participants’ self-reports of their stress levels, indicating that meditation not only changes the brain, but it changes our subjective perception and feelings as well.”
Positive Meditation Effects Carry Over into Daily Moods
Lazar’s team found that after meditation training (up to 4 months later), changes which occurred in the above- mentioned brain areas were linked to participants’ later reports of their psychological wellbeing. So the meditation induced changes rippled out into their daily lives as well. They improved in mood and subjective wellbeing.
Meditation Reduces Anxiety — and Social Anxiety
While many people start meditating for its benefits in stress reduction, research has also shown that structured meditation, in contrast to attending to the breath only, can reduce generalised anxiety (called GAD) and sometimes specific anxieties.
For example mindfulness meditation has demonstrated healing powers for experiences of social anxiety disorder, which is often found in sufferers of trauma.
Forbes Magazine also reported on a Stanford University team which found that structured meditation (the main part of MBSR) brought about changes in brain regions involved in attention, as well as relief from symptoms of social anxiety.
MBSR (Meditation) Effects Rival Those of Antidepressants for Depression & Anxiety
Both Forbes and Van der Kolk report that the efficacy for MBSR Structured Meditation rivals that of antidepressants.
While many researchers’ articles and monographs describe findings on relative efficacies of meditation vs antidepressants, they still often end with “further research is needed” (science being innately biased to be cautious and often swayed by other agendas, those of investors, pharmaceutical companies and other institutions.)
However in my clinical opinion, the vast weight of the evidence now clearly indicates that structured meditation is a safe and effective alternative to pharmaceuticals.
I started to use MBSR in therapy five years ago, and find it very rewarding as a practitioner when clients return with positive feedback about structured meditation, and how it has helped them to better handle memories of trauma.
Meditation Reduces Activity in the Brain’s “Me Centre”
Forbes reports that structured meditation helps expand the idea of ‘me’ (the ‘ego’) to the greater world, which expansion in itself seems to confer health benefits.
As reporter Alice Walton put it, “Since mind-wandering is typically associated with being less happy, ruminating, and worrying about the past and future, it’s the goal for many people to dial it down. Several studies have shown that meditation, through its quieting effect on the DSN, appears to do just this.”
This is highly useful for trauma recovery because as mentioned above, when previously traumatised individuals retrain their brains (their DSNs) to that ‘sweet spot of Calm Mind’ they then find they live and breathe easier on a moment to moment, daily basis.
Post training, trauma sufferers find they have more tolerance for themselves, for delays and setbacks, and for the people around them.
Most relevant to this article, they become less susceptible to the upwelling of vivid memory images, emotions and beliefs that often plague the traumatised. The fight-flight switches start working properly.
In addition they are de-conditioning the centrality of their ego-based me, and as this happens they begin to see themselves as connected to a greater (safer) world. And as a follow on from this (or maybe just a corollary), they start to find purpose and can move toward connecting with people.
Other benefits of structured meditation mentioned by both Forbes and Van der Kolk mention include maintaining healthy brain functioning as it gets older (thus retarding or preventing dementia type diseases); and with only a few days of good training, improvements in concentration and attention can be mentioned.
These findings apply to the majority of us, with or without previous trauma.
World trauma expert Dr Bessel Van der Kolk has summarised the case for going beyond talk-based therapy with the use of meditation, body movement and mindfulness based therapies. Structured meditation and in particular MBSR have been shown to speed the pace of recovery, and even promote better quality of life for traumatised individuals.
My experience and those of a growing number of therapists indicates it is time to break free of the dominance of talk-based therapies, and start employing structured meditation and mindfulness based therapies as not just adjuncts, but first lines of intervention, in our work with traumatised individuals.
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- Van der Kolk, B. The Body Keeps the Score: Brain Mind and Body in the Healing of Trauma. Viking Press, 2014.
- Kabat-Zinn, J. Mindfulness Meditation: Cultivating the Wisdom of Your Body and Mind (CD-rom). Simon & Schuster Audio. www.SimonSaysAudio.com
- Walton, Alice (contributing Writer), Forbes Magazine, 7 Ways Meditation Can Actually Change The Brain. Section:Pharma and Healtcare, 9 Feb 2015.
- Fadel Zeidan; Katherine T Martucci; Robert A Kraft; John G McHaffie; Robert C Coghill. Neural correlates of mindfulness meditation-related anxiety relief. Social Cognitive and Affective Neuroscience, Volume 9, Issue 6, 1 June 2014, Pages 751–759, https://doi.org/10.1093/scan/nst041