Trauma and Mindfulness

Gerry Kopelow/span>
Published in the Winnipeg Free Press, February, 2008

“In this fathom-long body, subject though it is to death and decay, I will show you the beginning and end of the universe.” With these words the Buddha introduced “The Four Foundations of Mindfulness”, a comprehensive method for the investigation of reality that has flourished for some three thousand years. Spiritual seekers rely on the Buddha’s contemplative techniques to probe the inner realities of human existence in the same way that physicists use mathematics and electron microscopes to investigate the hidden realities of the physical world.

Mindfulness is a form of meditation defined as “non-judgmental awareness of the present moment.” Trauma is defined as “a serious injury or wound to the body and/or mind”. To most people, the conjoining of these two conditions would be extremely unpleasant, something to actively avoid or repress.

Some months back I was hit by an out-of-control car near Steinbach, Manitoba, and suffered extreme damage to both lower legs. At the outset it was not at all clear if my legs could be saved, but several sessions of very skillful surgery put me back together, and fourteen weeks after the accident I walked out of the Rehabilitation Hospital on crutches, two months ahead of schedule, according to my doctors.

I attribute my rapid comeback to the compassionate care of an army of healthcare professionals and to the involvement of family and friends, but also to a positive mental attitude that promoted healing. This attitude was sustained by maintaining ‘mindfulness’, as best I could, from the moment I was struck down, right through all the surgeries and subsequent medical procedures and on into the rehabilitation process leading up to my early exit from the hospital.

When I was hit by the car my body was seriously damaged. I understood immediately that my life had changed dramatically and that my complicated plans for the next few months were simply not going to happen. And since it was obvious that I was completely helpless, I recognized that my survival was entirely in the hands of complete strangers. I was lucky in that initially I felt no pain. My mind was clear, though I lay on the ground unable to move. The thought arose that the only sensible thing for me to do was to completely relax and let events unfold as they would.

At that moment two paramedics appeared. I greatly appreciated their professional concentration as they assessed my situation. Recognizing their competence and compassionate intentions, I surrendered to the process of being ‘taken care of’.  With the help of two firemen I was lifted into an ambulance and transported to Steinbach Hospital where I was assessed again, then transferred to a second ambulance bound for the Heath Sciences Centre in Winnipeg. I lost consciousness on the trip to Winnipeg, and awoke the next day in the Intensive Care Ward, still in possession of both my legs after two heroic surgical interventions. At this point I felt a lot of pain, and my commitment to ‘mindfulness’ was about to be tested.

If mindfulness is complete attention to the present moment, then logically there are only two alternate modes of experience: One is reflection on the past, and the other is speculation about the future.

For most of us reflection on the past is fraught with regret, if not real grief, especially if this reflection is triggered by physical trauma. Thoughts of ‘if only’ and ‘why me?’ and the automatic, constant replay of the traumatic events are natural. Similarly, speculation about the future is often extremely unpleasant as well: We fear for a multitude of possible negative outcomes subsequent to the initial trauma.

I am a teacher of Buddhist meditation techniques and have been learning how to be ‘mindful’ for some thirty-five years. This work allows me a measure of control of my mental processes, and so I decided to ‘mindfully’ compare the three experiential modes with a view to determining which felt better.

Clearly, lying in a hospital bed in pain and unable to move was, to say the least, unpleasant. But, due to the modern patient-centred approach to pain management, I had access to narcotics that moderated the physical discomfort. I also had the continuous company of a caring family and supportive friends, and I was the focus of intense medical attention as well. All this existed in the present moment.

If I allowed my mind to slip into reflection on the past I re-experienced the accident and the events that led up to it again and again. I experienced continuous regret and grief – metaphorically speaking, the non-stop wringing of hands and the gnashing of teeth. These thoughts and feelings spontaneously triggered a river of speculations about the future: Anxiety about future physical suffering, the possibility of infection and the loss of my legs, worry about work and money and my family’s future security, etc., etc. And these scenarios were also replayed repeatedly.

I did not spend much time on this experiment because it was clear that the present moment, however difficult it might be, was always less unpleasant than the multitude of griefs and anxieties my own mind was capable of generating. So I implemented, as best I could, the mental techniques that helped keep my awareness focused on the now because the ‘now’, always felt better.

The question arises, then, how does feeling better in this way facilitate healing? The answer lies in the nature of mind. We humans are born helpless. Our great evolutionary advantage is not strength or speed, but adaptability, the ability of the mind to assess present circumstances and imagine and remember coping strategies that promote survival. We are creative entities. This creativity requires a big, complicated brain. Indeed the human brain, with its billions of neural interconnections, is the most complicated device in the entire universe, as far as we know. Such a complex device is a big consumer of energy so the fabrication of past and future alternate universes – populated with life-like people, landscapes, buildings, even weather – is a resource-intensive endeavour. Rather than engaging in fruitless imaginings, it is better to hold the mind in the present and free up its creative power for more productive activities. In the case of the trauma victim, the most obvious use for this energy is healing.

The human body is the repository of four billion years of accumulated biological wisdom, all of which is dedicated to maintaining the living form as long as possible. Left to its own devices and unburdened by the energy drain associated with grief and anxiety, the body spontaneously sets to work repairing itself. In this way, mindfulness is not just the least unpleasant way to experience trauma, but the also the most biologically efficient. And because healing is beautiful to witness, mindfulness practice increases joy at the same time as it diminishes grief and anxiety. Our physical fragility is sobering to contemplate, but the resilience and intelligence of the body is exhilarating to experience directly.