Abstract
Emotional dysregulation poses significant challenges for women who have experienced trauma and can contribute to problems with substance use in an attempt to manage intense emotions and arousal. Various forms of meditation have shown benefits for improved awareness and management of emotions and offer a promising complementary treatment for women in residential substance use treatment who have histories of interpersonal traumas. This qualitative study explored lived experiences with meditation practice and emotional regulation among female trauma survivors with co-occurring substance use and mental disorders. Thirty-two trauma survivors participated in a six-week curriculum at their residential treatment program that included mindfulness, compassion, and loving-kindness meditations. Using an emergent design based on the constant comparative method, the study analyzed qualitative data from individual interviews and focus groups and identified common themes. The findings indicated a perceived pathway through which meditation promoted emotional regulation. This pathway started with increased awareness of their emotions, involved the ability to then accept and let go of their emotions, and ended with emotional growth and improved self-regulation. Though participants portrayed meditation as beneficial, several participants also described suppressed emotions and traumatic memories resurfacing during meditation and described the importance of support from program staff outside of group to help them process and cope. The participants’ perspectives support the appropriateness of meditation as an empowering complementary intervention for female trauma survivors with co-occurring disorders, but also indicate the importance of supervision and support at the start of meditation practice in case negative experiences arise.
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Arch, J. J., Ayers, C. R., Baker, A., Almklov, E., Dean, D. J., & Craske, M. G. (2013). Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders. Behaviour Research and Therapy, 51, 185–196. https://doi.org/10.1016/j.brat.2013.01.003
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143. https://doi.org/10.1093/clipsy.bpg015
Bailey, K., Trevillion, K., & Gilchrist, G. (2020). “We have to put the fire out first before we start rebuilding the house”: Practitioners’ experiences of supporting women with histories of substance use, interpersonal abuse and symptoms of post-traumatic stress disorder. Addiction Research & Theory, 28(4), 289–297. https://doi.org/10.1080/16066359.2019.1644323
Berking, M., & Wupperman, P. (2012). Emotion regulation and mental health: Recent findings, current challenges, and future directions. Current Opinion in Psychiatry, 25(2), 128–134. https://doi.org/10.1097/YCO.0b013e3283503669
Bieling, P. J., Hawley, L. L., Bloch, R. T., Corcoran, K. M., Levitan, R. D., Young, L. T., MacQueen, G. M., & Segal, Z. V. (2012). Treatment-specific changes in decentering following mindfulness-based cognitive therapy versus antidepressant medication or placebo for prevention of depressive relapse. Journal of Consulting and Clinical Psychology, 80, 365–372. https://doi.org/10.1037/a0027483
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Velting, D., & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science Practice, 11, 230–241. https://doi.org/10.1093/clipsy.bph077
Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., Clifasefi, S., Garner, M., Douglass, A., Larimer, M. E., & Marlatt, A. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse, 30, 295–305. https://doi.org/10.1080/08897070903250084
Briere, J. (2002). Treating adult survivors of severe childhood abuse and neglect: Further development of an integrative model. In J. D. B. Myers, L. Berliner, J. Briere, C. T. Hendrix, T. Reid, & C. Jenny (Eds.), The APSAC handbook on child maltreatment (2nd ed., pp. 1–26). Sage.
Broman, C. L., Wright, M. K., Broman, M. J., & Bista, S. (2020). Self-medication -and substance use: A test of the hypothesis. Journal of Child and Adolescent Substance Abuse, 28(6), 1–11. https://doi.org/10.1080/1067828X.2020.1789526
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clinical Psychology Review, 29, 560–572. https://doi.org/10.1016/j.cpr.2009.06.005
Cooper, D., Yap, K., & Batalha, L. (2018). Mindfulness-based interventions and their effects on emotional clarity: A systematic review and meta-analysis. Journal of Affective Disorders, 235(April), 265–276. https://doi.org/10.1016/j.jad.2018.04.018
Corbin, J., & Strauss, A. (2008). Basics of qualitative research. Sage.
Dakwar, E., & Levin, F. R. (2009). The emerging role of meditation in addressing psychiatric illness, with a focus on substance use disorders. Harvard Review of Psychiatry, 17, 254–267. https://doi.org/10.1080/10673220903149135
Dingle, G. A., da Neves, D. C., Alhadad, S. S. J., & Hides, L. (2018). Individual and interpersonal emotion regulation among adults with substance use disorders and matched controls. British Journal of Clinical Psychology, 57(2), 186–202. https://doi.org/10.1111/bjc.12168
Dube, S., Anda, R. F., Felitti, V. J., Edwards, V. J., & Croft, J. B. (2002). Adverse childhood experiences and personal alcohol abuse as an adult. Addictive Behaviors, 27, 713–725. https://doi.org/10.1016/S0306-4603(01)00204-0
Ehring, T., & Quack, D. (2010). Emotion regulation difficulties in trauma survivors: The role of trauma type and PTSD symptom severity. Behavior Therapy, 41(4), 587–598. https://doi.org/10.1016/j.beth.2010.04.004
Follingstad, D. R. (2009). The impact of psychological aggression on women’s mental health and behavior: The status of the field. Trauma, Violence, & Abuse, 10, 271–289. https://doi.org/10.1177/1524838009334453
Falsetti, S. A., Resnick, H. S., Resick, P. A., & Kilpatrick, D. G. (1993). The Modified PTSD Symptom Scale: A brief self-report measure of posttraumatic stress disorder. The Behavior Therapist, 16, 161–162.
Frewen, P., & Lanius, R. (2015). Healing the traumatized self: Consciousness, neuroscience, treatment. Norton.
Germer, C. K. (2005). Mindfulness: What is it? What does it matter? In C. K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), Mindfulness and Psychotherapy (pp. 3–27). Guildford Press.
Geshe Kalsang Damdul, Lee, M. Y., Zaharlick, A., & Akers, D. (2013). A meditation curriculum for trauma survivors of interpersonal violence. Unpublished Manual.
Glaser, B. (1978). Theoretical sensitivity. The Sociology Press.
Gregory, J., Caspi, Y., Kamnierer, N., Mazelis, R., Jackson, E. W., Russell, L., Clark, C., Liebschutz, J., & Kimerling, R. (2005). The assessment of trauma history in women with co-occurring substance abuse and mental disorders and a history of interpersonal violence. The Journal of Behavioral Health Services & Research, 32(2), 113–127. https://doi.org/10.1007/BF02287261
Gross, J. J. (2015). The extended process model of emotion regulation: Elaborations, applications, and future directions. Psychological Inquiry, 26(1), 130–137. https://doi.org/10.1080/1047840X.2015.989751
Hawn, S. E., Bountress, K. E., Sheerin, C. M., Dick, D. M., & Amstadter, A. B. (2020a). Trauma-related drinking to cope: A novel approach to the self-medication model. Psychology of Addictive Behaviors, 34(3), 465–476. https://doi.org/10.1037/adb0000552
Hawn, S. E., Cusack, S. E., & Amstadter, A. B. (2020b). A systematic review of the self-medication hypothesis in the context of posttraumatic stress disorder and comorbid problematic alcohol use. Journal of Traumatic Stress, 33(5), 699–708. https://doi.org/10.1002/jts.22521
Jacobsen, L. K., Southwick, S. M., & Kosten, T. R. (2001). Substance use disorders in patients with posttraumatic stress disorder: A review of the literature. American Journal of Psychiatry, 158, 1184–1190. https://doi.org/10.1176/appi.ajp.158.8.1184
Jones, T. M. (2018). The effects of mindfulness meditation on emotion regulation, cognition and social skills. European Scientific Journal, ESJ, 14(14), 18–32. https://doi.org/10.19044/esj.2018.v14n14p18
Kabat-Zinn, J. (2012). Mindfulness for Beginners: Reclaiming the Present Moment and Your Life. Sounds True, Inc.
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. https://doi.org/10.3109/10673229709030550
Kjaer, T. W., Bertelsen, C., Piccini, P., Brooks, D., Alving, J., & Lou, H. C. (2002). Increased dopamine tone during meditation-induced change of consciousness. Cognitive Brain Research, 13(2), 255–259. https://doi.org/10.1016/S0926-6410(01)00106-9
Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71, 692–700. https://doi.org/10.1037/0022-006X.71.4.692
Kilpatrick, L. A., Suyenobu, B. Y., Smith, S. R., Bueller, J. A., Goodman, T., Creswell, J. D., Tillisch, K., Mayer, E. A., & Naliboff, B. D. (2011). Impact of mindfulness-based stress reduction training on intrinsic brain connectivity. NeuroImage, 56(1), 290–298. https://doi.org/10.1016/j.neuroimage.2011.02.034
Lazar, S. W., Bush, G., Gollub, R. L., Fricchione, G. L., Khalsa, G., & Benson, H. (2000). Functional brain mapping of the relaxation response and meditation. NeuroReport, 11(7), 1581–1585.
Lee, M. Y., Zaharlick, A., & Akers, D. (2011). Meditation and treatment of female trauma survivors of interpersonal abuses: Utilizing clients’ strengths. Families in Society, 92(1), 41–49. https://doi.org/10.1606/1044-3894.4053
Lee, M. Y., Zaharlick, A., & Arkers, D. (2015). Impact of meditation on mental health outcomes of female trauma survivors of interpersonal violence with co-occurring disorders: A randomized controlled trial. Journal of Interpersonal Violence, 32, 2139–2165. https://doi.org/10.1177/0886260515591277
Lee, M. Y., Chan, C. H. Y., Chan, C. L. W., Ng, S. M., & Leung, P. (2018). Integrative body-mind-spirit social work: An empirically based approach to assessment and treatment (2nd ed.). The Oxford University Press.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage.
Linehan, M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
López-Castro, T., Hu, M., Papini, S., Ruglass, L. M., & Hien, D. A. (2015). Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders. Drug and Alcohol Review, 34, 242–251. https://doi.org/10.1111/dar.12230
Marlatt, G. L. (2002). Buddhist philosophy and the treatment of addictive behavior. Cognitive and Behavioral Practice, 9(1), 44–50. https://doi.org/10.1016/S1077-7229(02)80039-6
Meyers, J. L., Sartor, C. E., Werner, K. B., Koenen, K. C., Grant, B. F., & Hasin, D. (2018). Childhood interpersonal violence and adult alcohol, cannabis, and tobacco use disorders: Variation by race/ethnicity? Pscyhological Medicine, 48, 1540–1550. https://doi.org/10.1017/S0033291717003208
Padgett, D. (2008). Qualitative methods in social work research (2nd ed.). Sage.
Raudales, A. M., Short, N. A., & Schmidt, N. B. (2019). Emotion dysregulation mediates the relationship between trauma type and PTSD symptoms in a diverse trauma-exposed clinical sample. Personality and Individual Differences, 139(November 2018), 28–33. https://doi.org/10.1016/j.paid.2018.10.033
Sauer, S. E., & Baer, R. A. (2012). Ruminative and mindful self-focused attention in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 3, 433–441. https://doi.org/10.1037/a0025465
Schlosser, M., Sparby, T., Vörös, S., Jones, R., & Marchant, N. L. (2019). Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations. PLoS ONE, 14(5), 1–18. https://doi.org/10.1371/journal.pone.0216643
Schmidt, S. (2004). Mindfulness and healing intention: Concepts, practice, and research evaluation. Journal of Alternative and Complementary Medicine, 10, S7–S14. https://doi.org/10.1089/acm.2004.10.S-7
Segal, Z.V., Williams, J.M.G., & Teasdale, J.D., (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. Guilford Press.
Seligowski, A. V., Lee, D. J., Bardeen, J. R., & Orcutt, H. K. (2015). Emotion regulation and posttraumatic stress symptoms: A meta-analysis. Cognitive Behaviour Therapy, 44(2), 87–102. https://doi.org/10.1080/16506073.2014.980753
Short, E. B., Kose, S., Mu, Q., Borckardt, J., Newberg, A., George, M. S., & Kozel, F. A. (2007). Regional brain activation during meditation shows time and practice effects: An exploratory fMRI study. Evidence-Based Complementary and Alternative Medicine, 7, 121–127. https://doi.org/10.1093/ecam/nem163
Sirotina, U., & Shchebetenko, S. (2020). Loving-kindness meditation and compassion meditation: Do they affect emotions in a different way? Mindfulness, 11, 2519–2530. https://doi.org/10.1007/s12671-020-01465-9
Sudsuang, R., Chentanez, V., & Veluvan, K. (1991). Effect of Buddhist meditation on salivary cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time. Physiology and Behavior, 50(3), 543–548. https://doi.org/10.1016/0031-9384(91)90543-w
Taylor, J., Mclean, L., Korner, A., Stratton, E., & Glozier, N. (2020). Mindfulness and yoga for psychological trauma: Systematic review and meta-analysis. Journal of Trauma & Dissociation, 21(5), 536–573. https://doi.org/10.1080/15299732.2020.1760167
Teasdale, J. D., Segal, Z., & Williams, J. M. (2003). Mindfulness training and problem formulation. Clinical Psychology, Science and Practice, 10, 157–160. https://doi.org/10.1093/clipsy.bpg017
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18. https://doi.org/10.1207/s15327965pli1501_01
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042
van der Kolk, B. A. (2002). The assessment and treatment of complex PTSD. In R. Yehuda (Ed.), Treating trauma survivors with PTSD (pp. 127–156). American Psychiatric Press.
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin.
van der Kolk, B. A., & van der Hart, O. (1989). Pierre Janet and the breakdown of adaptation in psychological trauma. American Journal of Psychiatry, 146(12), 1530–1540. https://doi.org/10.1176/ajp.146.12.1530
Vujanovic, A. A., Niles, B., Pietrefesa, A., Schmertz, S. K., & Potter, C. M. (2011). Mindfulness in the treatment of posttraumatic stress disorder among military veterans. Professional Psychology: Research and Practice, 42(1), 24–31. https://doi.org/10.1037/a0022272
Walton, K. G., Fields, J. Z., Levitsky, D. K., Harris, D. A., Pugh, N. D., & Schneider, R. H. (2004). Lowering cortisol and CVD risk in postmenopausal women: A pilot study using the Transcendental Meditation program. Annals of the New York Academy of Sciences, 1032(1), 211–215. https://doi.org/10.1196/annals.1314.023
Zeng, X., Chan, V. Y. L., Liu, X., Oei, T. P. S., & Leung, F. Y. K. (2017). The four immeasurables meditations: Differential effects of appreciative joy and compassion meditations on emotions. Mindfulness, 8(4), 949–959. https://doi.org/10.1007/s12671-016-0671-0
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This research is supported by the Ohio Department of Mental Health (currently renamed Ohio Department of Mental Health & Addiction Services, OhioMHAS), Grant# 60012277
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Lee, M.Y., Eads, R. & Hoffman, J. “I Felt It and I Let It Go”: Perspectives on Meditation and Emotional Regulation among Female Survivors of Interpersonal Trauma with Co-occurring Disorders. J Fam Viol 37, 629–641 (2022). https://doi.org/10.1007/s10896-021-00329-7
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DOI: https://doi.org/10.1007/s10896-021-00329-7