Willoughby Britton, PhD.

David Treleaven , Ph.D.

Jared Lindahl, PhD.

Day 2: Foundational Knowledge and Skills

Day 2 focuses more on concrete steps to ensure safety for your program, and includes four modules: informed consent, screening, monitoring, and mechanism, which are described below. 

This module is accompanied by access to the Meditation Safety Toolbox, which includes official curricula and implementation guidelines, informed consent, screening instruments from the UMASS, Oxford and Bangor mindfulness centers, as well as a folder of research and other resources. The Toolbox is updated monthly to stay current on new developments. Links to recommended readings are listed with each module.

Learning Objectives for Day 2:

• Describe MBI standards of practice and teacher competencies, with particular emphasis on four competency domains: 1) Informed Consent,Informed Consent, 2) Screening, 3) Monitoring and 4) Mechanisms

• Demonstrate the importance of establishing community agreements regarding confidentiality and consent

• Consider and reflect upon how different experiences are understood from the perspective of different traditions

• Identify the range of possible experiences that can arise from meditation practice in the context of MBIs

• Understand why meditation practices may be experienced as challenging, distressing, or impairing

• Learn how to properly and proactively screen participants and monitor for meditation-related difficulties instead of relying only on passive or spontaneous reporting

• Understand the psychological and/or neurobiological mechanisms by which meditation practices or instructions can produce different types of experiences

• Outline and discuss the responsibilities of MBI instructors to assess their own scope of competence, provide adequate mentalhealth referrals, and commit to ongoing personal development

• Learn how to recognize symptoms of dysregulated arousal, including dissociation, in MBI environments, respond to them utilizing specific trauma-informed modifications, and develop curricula and interventions that actively prevent re-traumatization

Informed Consent, Screening and Differential Diagnosis

Informed Consent: This module reviews the informed consent process, and is legal implications. Here we review advertising brochures, and other statement of benefits vs limitations and risks. Examples of informed consent documents, and advertisements from mindfulness programs are provided.

Screening: The screening module provides training in how to screen participants who are interested in taking an MBI program, and includes review of inclusion/exclusion criteria and decision trees for participation, and screening instruments.

Differential Diagnosis in Cultural Context: How do you know if an experience is harmful or part of the path? What criteria would you use to decide? This module explains how different contexts appraise experiences in different ways. Meditation teachers are encouraged to reflect on their context and those that they teach.

Safety Monitoring in MBIs :

The monitoring module teaches facilitators how to adequately monitor or track potential adverse reactions in their mindfulness clients. Expecting the students to spontaneously report difficulties to the facilitator, a process known as “passive monitoring” is not adequate. Proper monitoring, must be active, ask specific questions, and be anonymous and non-penalizing. This module focuses on the meditation-related difficulties that are most likely to occur with MBI interventions, such as anxiety/panic, traumatic re-experiencing and dissociation.

Recommended Reading:

●       Baer, R., Crane, C., Miller, E., & Kuyken, W. (2019). Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clinical Psychology Review. doi:10.1016/j.cpr.2019.01.001

Mechanisms part 1: Mechanisms of meditation-induced hyperarousal

Meditation can cause symptoms of hyperarousal (anxiety, panic, traumatic-re-experiencing, perceptual hypersensivity) through multiple pathways, including sensitization, somatosensory amplification, dual process theory, and relaxation-induced panic.

Introduction to Trauma-Sensitive Mindfulness

David’ Treleaven draws from his book Trauma-Sensitive Mindfulness, explains the window of tolerance

Recommended Reading:

Treleaven, D. (2018) Trauma-sensitive Mindfulness. Norton.

Appraisals of and Remedies for Changes in Sense of Self (Lindahl)

What types of changes in sense of self can be expected from meditation. How is this related to Buddhist doctrine of no-self (anatta) and/or dissociation? Can you tell the difference?

Mechanisms Part 2: Mechanisms of Meditation-induced Dissociation (Britton)

How does meditation induced changes in sense of self and/or dissociation? What is dissociation?

Recommended Reading:

• Lindahl, J.L. and Britton, W.B. (2019) “I Have This Feeling of Not Really Being Here”: Buddhist Meditation and Changes in Sense of Self. Journal of Consciousness Studies, 26 (7-8), 157-183.

• Lindahl, J.R., Cooper, D.J., Fisher, N.E., Kirmayer, L.J., Britton, W.B. (2020). Progress or Pathology? Differential Diagnosis and Intervention Criteria for Meditation-Related Challenges: Perspectives from Buddhist Meditation Teachers and Practitioners. Frontiers in Psychology: Cultural Psychology. doi: 10.3389/fpsyg.2020.01905

Working with the Body and Dissociation in Contemplative Practice (Treleaven)

Intense body focus can be contraindicated for people with a history of trauma. Meditation often includes focusing on the body. How can someone with a trauma history practice safely?

Towards a Person-Centered Approach (Lindahl & Britton)

How to teach meditation in a way that honors the meditator’s values, objectives and goals? What are the biggest complaints that meditators have about their teachers? The answers might surprise you.

Recommended Reading:

• Lindahl., J.R., Britton, W.B., Cooper, D., Kirmayer, L.J., (2019) Challenging and Adverse Meditation Experiences: Toward A Person-Centered Approach. In Farias, M., Brazier, D., and Laljee, M., Eds). The Oxford Handbook of Meditation. Oxford University Press. DOI: 10.1093/oxfordhb/9780198808640.013.51

Systemic Trauma (Treleaven)

Trauma is not evenly distributed, but instead affects certain groups more than others in predicable ways. Social marginalization, racism, ablism, sexism, homophobia, poverty, immigration. These are all forms of systemic trauma, and can affect the nervous system just as severely as other forms of trauma. To teach meditation in a trauma informed way, we must understand systemic forms of trauma that we may not be aware of. or maybe even unintentionally part of.

Recommended Readings:

·         Bryant-Davis, T., & Ocampo, C. (2005). The trauma of racism: Implications for counseling, research, and education. The Counseling Psychologist, 33(4), 574-578.

·         [BOOK] Menakem, R. (2017). My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies. Central Recovery Press.

·         Franklin, A. J., Boyd-Franklin, N., & Kelly, S. (2006). Racism and invisibility: Race-related stress, emotional abuse and psychological trauma for people of color. Journal of Emotional Abuse, 6(2-3), 9-30.

·         [BOOK] King, R. (2018). Mindful of race: Transforming racism from the inside out. Sounds True

·         [BOOK] Williams, A. K., Owens, R., & Syedullah, J. (2017). Radical Dharma: Talking race, love, and liberation. North Atlantic.