We were lucky to catch up with Kathleen Lisson recently and have shared our conversation below.

Kathleen, looking forward to hearing all of your stories today. Have you ever experienced a times when your entire field felt like it was taking a U-Turn?
Mindfulness – not a one size fits all stress reduction practice

There is a shadow to the popular belief that meditation and mindfulness practices are easy, inexpensive ways to reduce stress with no negative side effects. Nothing could be simpler than sitting comfortably, closing our eyes and taking a few relaxing deep breaths, right?

For some people – nothing could be harder.

Let’s look at the evolution of ‘mindfulness’ – it’s not just for California granola-crunching hippies anymore. In the article ‘Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation,’ van dam et al. state that “during the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and ‘key to building more resilient soldiers’” (van dam et al., 2018a). The reasons mindfulness is practiced have also changed over the last few decades, as “historically, many such practices arose in religious and spiritual contexts where the motivations and goals for what could and would be achieved through meditation differed greatly from secular Western notions of health, well-being, and flourishing” (van dam et al., 2018b).

The practice of mindfulness has potential benefits and drawbacks. Much like someone starting an exercise program, a new meditator should be aware of the potential for both improved health and the risk for injury. This insight that there may be a dark side to mindfulness may be surprising for those that are newer to the practice of secular mindfulness, but it’s well known in traditional, nonsecular forms of mindfulness.

In the landmark paper ‘The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhist,’ Lindahl et al. state that “that “the mindfulness movement draws heavily from Buddhist texts and teachings.” Researchers found that “Zen traditions have also long acknowledged the possibility for certain practice approaches to lead to a prolonged illness-like condition known as “Zen sickness” and “Buddhist traditions also acknowledge periods of challenge or difficulty associated with the practice of meditation” (Lindahl et al., 2017).

What are these difficulties?

The researchers interviewed meditation practitioners about their experience with meditation and found that “82% of practitioners experienced “fear, anxiety, panic, or paranoia” and 43% of practitioners had encountered “re-experiencing of traumatic memories” (Lindahl et al., 2017). I myself experienced waves of anger during my first week-long silent retreat and anguish during a subsequent silent retreat.

When do these experiences occur? The researchers found that “more than a quarter (29%) of practitioners first encountered challenges within their first year of practice.” This is one reason why it’s helpful to begin a meditation practice with support from a meditation teacher and community. Lindahl et al. found that “relationships within meditation communities and especially relationships to teachers were reported as being both risk factors for difficulties when teachers and communities were absent, unhelpful, or not sympathetic, as well as being remedies if teachers and communities were supportive, helpful and understanding” (Lindahl et al., 2017).

How are meditation teachers being unhelpful? The old way of advising meditators who report these issues was to tell them to ‘take it back to the cushion’ – as if they could meditate themselves out of the negative side effects of meditation. This ‘no mud, no lotus’ attitude may be a path forward for religious meditators but it is often unhelpful in secular meditation.

Does this mean that we should not teach mindfulness? Of course not. Mindfulness practices have been linked to a host of beneficial effects on the body, including stress reduction. But how we teach mindfulness is important, as “substance use, depression, rumination, worry, and blood pressure have all been shown to be lower in participants who endorse high levels of present-moment awareness, but only if the awareness is nonjudgmental or nonreactive” (Baer et al., 2019).

Marketing meditation as ‘quick and easy’ and offering little more guidance than ‘close your eyes and breathe’ or ‘download an app’ is not serving our clients’ best interest. What we need to do as meditation teachers and experts is become informed, spread awareness about the possible side effects of mindfulness and give our students useful tools and strategies.

Key points include understanding that mindfulness is not about feeling calm and happy. Researchers have found that:

“Distress and discomfort are likely to arise as participants learn new skills and practice applying them to the difficulties for which they sought help” (Baer et al., 2019)

“Participants’ awareness of their maladaptive coping habits could feel temporarily overwhelming” (Baer et al., 2019)

“Present-moment awareness was occasionally frightening” (Baer et al., 2019)

“Mistaken expectations that mindfulness should rid the mind of all depressive thoughts led to self-devaluation when this did not happen” (Baer et al., 2019)

“Sometimes breathwork or meditation can be overwhelming. For clients with trauma and toxic stress – traditional meditation and mindfulness techniques may not be beneficial.” (Treleaven, 2018)

Understanding the way we practice mindfulness is important:

“Increased present-moment awareness will not be helpful, and may even be harmful, unless ‘friendliness and compassion can be brought to those elements of present-moment experience to which we attend’“ (Baer et al., 2019)

“Self-focused attention (defined as awareness of thoughts, emotions, and sensations) is adaptive when it is nonjudgmental and experiential but maladaptive when it is judgmental and ruminative” (Baer et al., 2019)

“Among participants with low self-esteem, those who repeated a positive self-statement (“I’m a lovable person”) or who focused on how that statement was true felt worse than those who did not repeat the statement or who focused on how it was both true and not true’” (Wood et al. 2009).

“Mindfulness practitioners who are self-critical may find it difficult to practice mindfulness consistently until they engage their inner critics. Therefore, self-critical people might benefit from starting with self-compassion practice before taking mindfulness training” (Germer & Neff, 2019).

Mindfulness instructors can also benefit from understanding and sharing strategies that offer alternatives to ‘cookie cutter’ mindfulness practices:

The concept of the Zone of Arousal and Window of Tolerance to help meditators keep track of their body’s stress response

Grounding resources for inviting participants back into their bodies

Offering choices and invitations instead of a ‘one-size-fits-all’ guided meditation practice

I am a meditation teacher and Certified Lymphedema Therapist and present information about mindfulness to people with chronic illnesses including lymphedema. When I share information about the effects of chronic stress on the body, many feel comfortable enough to open up about their own trauma history. They do not have to go through life feeling like they are ‘just not good at meditation’ if we give them tools to make the practice more comfortable and less stressful. Everyone should have the chance to experience the health benefits of mindfulness.

Resources:

Baer R, Crane C, Miller E, Kuyken W. Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clin Psychol Rev. 2019 Jul;71:101-114. doi: 10.1016/j.cpr.2019.01.001. Epub 2019 Jan 7. PMID: 30638824; PMCID: PMC6575147.

Germer, C. K., & Neff, K. (2019). Teaching the mindful self-compassion program: A guide for professionals. The Guilford Press.

Lindahl JR, Fisher NE, Cooper DJ, Rosen RK, Britton WB (2017) The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLoS ONE 12(5): e0176239. https://doi.org/10.1371/journal.pone.0176239

Treleaven, D. A. (2018). Trauma-sensitive mindfulness: Practices for safe and transformative healing. W.W Norton & Company.

Van Dam, N. T., van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A., Meissner, T., Lazar, S. W., Kerr, C. E., Gorchov, J., Fox, K., Field, B. A., Britton, W. B., Brefczynski-Lewis, J. A., & Meyer, D. E. (2018a). Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation. Perspectives on psychological science : a journal of the Association for Psychological Science, 13(1), 36–61. https://doi.org/10.1177/1745691617709589

van Dam, N. T., van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A., Meissner, T., Lazar, S. W., Gorchov, J., Fox, K., Field, B. A., Britton, W. B., Brefczynski-Lewis, J. A., & Meyer, D. E. (2018b). Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl. Perspectives on psychological science : a journal of the Association for Psychological Science, 13(1), 66–69. https://doi.org/10.1177/1745691617727529

van Rosmalen, L., van der Veer, R., & van der Horst, F. C. (2020). The nature of love: Harlow, Bowlby and Bettelheim on affectionless mothers. History of psychiatry, 31(2), 227–231. https://doi.org/10.1177/0957154X19898997

Wood JV, Perunovic WQ, Lee JW. Positive self-statements: power for some, peril for others. Psychol Sci. 2009 Jul;20(7):860-6. doi: 10.1111/j.1467-9280.2009.02370.x. Epub 2009 May 21. PMID: 19493324. Retrieved from: https://www.uni-muenster.de/imperia/md/content/psyifp/aeechterhoff/wintersemester2011-12/seminarthemenfelderdersozialpsychologie/04_wood_etal_selfstatements_psychscience2009.pdf

Kathleen, love having you share your insights with us. Before we ask you more questions, maybe you can take a moment to introduce yourself to our readers who might have missed our earlier conversations?
I went back to school in my 40s, after a career in public relations., to earn my Bachelors of Applied Science degree in Massage Therapy. I am board certified in therapeutic massage and bodywork and a Certified Lymphedema Therapist.

I am also an ACE certified health coach and MMI certified meditation teacher. I have spoken at the American Venous and Lymphatic Society (AVLS), Fat Disorders Resource Society (FDRS), MLD UK, and National Lymphedema Network (NLN) conferences. I am a coauthor of the Standard of Care for Lipedema in the United States document, published in the December 2021 issue of Phlebology.

I am interested in mindfulness interventions for adults with Adverse Childhood Experiences. My training as a health coach showed me the link between stress and chronic illness. My meditation teacher training showed me the positive benefits of meditation as a powerful way to reduce the impact of stressors on our bodies.

What’s a lesson you had to unlearn and what’s the backstory?
Learning more about the meditation-related challenges experienced by meditators with a trauma history has shown me that the usual verbal commands in many guided meditations are ineffective for many meditators. Simple instructions like: “close your eyes and focus on your breathing” are not calming for many people. The solution is not to be disappointed in those who don’t want to close their eyes, ‘can’t sit still’ or ‘can’t stop thinking,’ it’s to meet them where they are and offer options to get them to where they want to go without retraumatizing them.

Training and knowledge matter of course, but beyond that what do you think matters most in terms of succeeding in your field?
Listening. Truly listening to the stories and difficulties of your clients will give you insight into how to give them the experience that they really need.

Contact Info:

• Website: https://solacesandiego.wixsite.com/website
• Instagram: https://www.instagram.com/mindfulcoachkathleen
• Linkedin: https://www.linkedin.com/in/kathleenlisson/
• Twitter: https://twitter.com/kathleenlisson