I’ve been reflecting on trauma with my patients as of late. It’s occurred to me more and more that what is often diagnosed with depression, anxiety, and even conditions like Irritable Bowel Syndrome is really just masked trauma.
When I say trauma, I do mean all the things we usually consider trauma like physical violence and rape. But I also tend to define trauma more broadly than most. To paraphrase, Buddhist psychotherapist Mark Epstein, just living means to be traumatized. Or as the Buddha said long ago, Life is suffering. We all accumulate little paper cuts throughout our lives that hurt us. These pains inevitably lead to the many walls and defenses that do not allow us to experience life fully or presently.
Of course, some traumas are worse than others. Victims of violence or horrifying accidents or soldiers in wars can come down with intense post-traumatic stress (PTSD). The recovery from PTSD is long, hard, and bleak.
So how does a clinician help from a Buddhist perspective? We start with the first principle of modern Buddhism: mindfulness. At our core, all of us need to learn how to be watchful and have some distance over our thoughts and feelings. When we have too much trauma and pain, one of our go-to defenses is disassociation or fleeing from experience. People with trauma run away often by overusing drugs, screens, or video games. They tend to shy away from their feelings because their feelings are too painful to face. Through meditation practice, however, one can learn to watch one’s feelings with some distance and not get too caught up in the vicissitudes of living. Over time, our amygdalas adjust. People with traumas, often suffer from hypervigilance. Through mindfulness, however, hypervigilance tends to reduce. We can feel safer in the present moment with some practice and patience.