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

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

Mindfulness and the Aloha Response
http://scholarspace.manoa.hawaii.edu/bitstream/handle/10125/33336/v3i1-03le.pdf?sequence=1

Selah: A Mindfulness Guide Through Grief
https://books.google.co.nz/books?id=q82pyGrilkEC&pg=PA19&lpg=PA19&dq=mindfulness+and+support+for+bereaved+by+suicide+attend&source=bl&ots=Di32bATRQW&sig=fUF1PN_sZ0MOGj4EzR2YUYL123Y&hl=en&sa=X&ei=2deEVbmrE8a2mQX_5Z3ABw&ved=0CDgQ6AEwAQ#v=onepage&q=mindfulness%20and%20support%20for%20bereaved%20by%20suicide%20attend&f=false

ATTEND: toward a mindfulness-based bereavement care model
http://www.ncbi.nlm.nih.gov/pubmed/24567995

Suicide: Finding Hope/ Mindfulness
http://www.suicidefindinghope.com/content/mindfulness

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