PTSD & Veterans: How Mindfulness Can Help
By Ingeborg Monsen
Mindfulness is a practice that over the past decade has become increasingly popular in everyday cultural context. It has been recontextualised from ancient Eastern tradition into many forms, one of them being as a mainstream Western form of wellbeing. The practice can revolutionise how individuals approach their everyday life and is often cited to significantly improve many mental health concerns, with organizations such as the NHS and UK Mental Health Foundation praising its benefits. Even in the military, there has been an increase in awareness of the benefits of mindfulness, with figures such as former Col. Micheal Brumage working with well-respected mindfulness teacher Jon-Kabat Zinn in order to inspire the U.S. Army to incorporate mindfulness wide scale into the military, and the British military offering mindfulness training apps to all it’s service personnel. One of the key reasons behind the promotion of mindfulness within the military is to aid in the prevention and treatment of war-related post-traumatic stress (Senauke & Gates, 2014) as well as to bolster wellbeing within the troops.
Sometimes referred to as ‘exercise for the brain’, research has found that mindfulness can be especially supportive for individuals suffering from mental illness, such as depression, anxiety and PTSD (Costa et al., 2018). Although mindfulness meditation can have a cornucopia of other benefits including; improving sleep quality, heightening focus and bettering interpersonal relationships. Its foundation lies in training our present awareness, which can help us notice automatic reactions, thought patterns, and even habits that we otherwise do not notice or pay attention to. The founder of the Mindfulness-based Stress Reduction (MBSR) course Jon Kabat-Zinn defines mindfulness as “an awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally”.
Post-Traumatic Stress Disorder (PTSD) can often paint the affected individual’s mind with images of past traumatic events and uncontrollable disturbing thoughts and feelings; often as a reaction to otherwise salient external events (such as loud noises or unexpected touch).These reactions are linked with hyper-activation of the amygdala, the area of the brain primarily associated with emotional processes, resulting in PTSD symptoms such as emotional undermodulation (re-experiencing/hyperarousal) and overmodulation (e.g. derealization/emotional numbing).
So how could Mindfulness help? In everyday life, symptom reduction can be achieved just by noticing and consequently unhooking from rumination, leading to less anxious arousal. When anxious, we start to activate our fight or flight response, also known as the sympathetic nervous system. By bringing attention to ourselves and our surroundings, we can better conceptualise the reality of the moment; that we are not in danger. From there the parasympathetic nervous system (that has an opposite effect to the sympathetic nervous system) activates instead and we start to relax and become less anxious. A moment dedicated to sensing your body when such feelings arise and taking a moment to observe them, followed by coming back to the present moment can therefore be a powerful tool in letting anxiety pass you by. Studies that have imaged the brain suggest that mindfulness can help restore connectivity between brain areas related to emotional control, reducing inappropriate activation and therefore PTSD symptoms (Boyd et al., 2018). In addition to this, mindful awareness promotes a non-judgmental attitude, helping to increase willingness to approach fear-provoking stimuli, reducing avoidance.
A study of Veterans with PTSD identified six core aspects to the mindfulness as an intervention (Schure et al., 2018) (commented on here by participants of the study:
Dealing with the past: “There's a lot of introspection involved, and it's not necessarily fun sometimes, going back and opening those locked doors, but it helps.”
Staying in the present: “I'm taking one day at a time, I'm not going forward into tomorrow and I'm not going back.”
Acceptance of adversity: “I'm able to see it [pain] in a different light that pushing through and dragging on is not always the right answer, and you have to spend a little time thinking about your pain to be able to actually manage it.”
Breathing through stress: “The biggest thing is when I see something is building up inside of me,… I check in with myself..., and then I say, okay you [got to] take a deep breath.”
Relaxation: “You get so relaxed. I think that's what all of us really truly liked. I mean the body just relaxed, you collapsed, and the whole body gives in. It was wonderful.”
Openness to themselves and others: “I've learned how to be more gentle with bringing myself back and not being critical with the fact that I seem to overdo it. All of that has been very very helpful. I guess just being softer within. What I've learned about me is that the softer I am, the easier I am with others. The more critical I am of me, the more critical I am of others.”
Before suggesting how to get started with mindfulness, I’d like to quickly note that when practicing mindfulness for anxiety and specifically post-traumatic anxiety, it can in some cases have some adverse effects too. As a consequence of coming face to face with trauma through being with your thoughts and bodily sensations, and it can sometimes be overwhelming. Please do listen to your body when practicing mindfulness, and if you feel this is something you could find challenging, I encourage you to seek support from a mindfulness community dedicated to trauma survivors or perhaps seek alternative tools to help you manage.
If you are looking to incorporate mindfulness into your life remember that maintaining the practise is required to really see the benefits. You might feel relaxed after one practise, but making mindfulness a habit in your life will create lasting changes. Plus, as you acquaint yourself with the practise, it can be an incredibly useful tool in times of stress to calm yourself. If you are looking to start your own mindfulness practise, or even if you are a little sceptical, you can look at it as an experiment. As a suggestion you could commit to two months of daily 5 or 10-minute meditations and examine the changes you’ve noticed at the end. If you haven’t given it time to properly settle in your life, how can you know if it’s working or not?
Here are some ideas to get you started:
Try this 6-minute Face Relaxation meditation
Download the app Insight Timer for more free meditations.
Set a daily alarm as a reminder on your phone to practice mindfulness.
Hang post-it notes around your house: “Check in with yourself”, “How does your feet on the ground feel?” etc.
Books: “The Science of Meditation: How to Change Your Brain, Mind and Body” by Daniel Goleman and Richard Davidson, and “The Miracle of Mindfulness” by Thich Nhat Hanh.
Join a scheduled 6- or 8-week course such as the a well established MBCT or MBSR course.
In conclusion, individuals with PTSD or PTSD-like symptoms can find that mindfulness functions as a powerful tool in lessening the automatic, anxious reactions the disorder often causes. Including such a practice into your everyday life can be a powerful tool to take back some control and ownership of your body and mind. Mindfulness can help you to live a more grounded existence rooted in acceptance of the present moment.
“What does it mean to be mindful? Being here, not there, with whatever is arising, and doing so with kindness.” Shirley Kessel
Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. Journal of psychiatry & neuroscience : JPN, 43(1), 7–25. https://doi.org/10.1503/jpn.170021
Britton, W. B., Lindahl, J. R., Cooper, D. J., Canby, N. K., & Palitsky, R. (2021). Defining and Measuring Meditation-Related Adverse Effects in Mindfulness-Based Programs. Clinical Psychological Science, 9(6), 1185–1204. https://doi.org/10.1177/2167702621996340
Marchand, W. R., Sandoval, K., Lackner, R., Parker, S. C., Herrmann, T.,Yabko, B., Velasquez, T., Lewis, L., & Butler, J. (2021). Mindfulness-based interventions for military veterans: A systematic review and analysis of the literature. Complementary Therapies in Clinical Practice, 42. https://doi.org/10.1016/j.ctcp.2020.101274.
Patel, R., Spreng, R. N., Shin, L. M., & Girard, T. A. (2012). Neurocircuitry models of posttraumatic stress disorder and beyond: a meta-analysis of functional neuroimaging studies. Neuroscience and biobehavioral reviews, 36(9), 2130–2142. https://doi.org/10.1016/j.neubiorev.2012.06.003
Schure, M. B., Simpson, T. L., Martinez, M., Sayre, G., & Kearney, D. J. (2018). Mindfulness-Based Processes of Healing for Veterans with Post-Traumatic Stress Disorder. Journal of alternative and complementary medicine (New York, N.Y.), 24(11), 1063–1068. https://doi.org/10.1089/acm.2017.0404
Senauke, A., & Gates, B. (2014). Interview with Jon Kabat-Zinn: The Thousand-Year View. Inquiring Mind. Retrieved February 28, 2022, from https://www.inquiringmind.com/article/3002_14_kabat-zinn-interview-with-jon-kabat-zinn-the- thousand-year-view/