Lee, Zaharlick, & Akers | Meditation and Treatment of Female Trauma Survivors of Interpersonal Abuses: Utilizing Clients’ Strengths 41 Families in Society: The Journal of Contemporary Social Services | www.FamiliesinSociety.org DOI: 10.1606/1044-3894.4053 | ©2011 Alliance for Children and Families CLINICAL METHODS UTILIZING CLIENT STRENGTHS Meditation and Treatment of Female Trauma Survivors of Interpersonal Abuses: Utilizing Clients’ Strengths Mo Yee Lee, Amy Zaharlick, & Deborah Akers Clinical challenges encountered by trauma survivors revolve primarily around (a) recognizing and differentiating current emotional experiences and physical cues from trauma-based responses and (b) learning how to regulate emotions and behaviors that allow beneficial fulfillment of needs and goals as defined by current life context and not past trauma. Meditation provides a different and complementary “technology” for conceptualizing and providing treatment to trauma survivors. By training clients to attend to the present, enhancing their ability to stay physi- ologically calm, and increasing positive emotions, meditation practice allows clients to manifest their internal resources to address the problems of trauma. This article discusses meditation practice for treating trauma survivors and describes the meditation experience of two clients to illustrate the potential benefits of meditation in their recovery process. IMPLICATIONS FOR PRACTICE • Trauma survivors may experience meditation as an empowering com- plimentary behavioral treatment because of the way it helps build and strengthen self-resources and capacities. • Meditation is a low-cost, nonintrusive, and empowering intervention because clients can practice meditation on a regular basis at their own pace anytime and anywhere once they learn how to do it. T rauma has pervasive and devastating impacts on individuals. Based on data of the National Comorbidity Survey (NCS), more than half of all U.S. adults (50% female and 60% males) are exposed to traumatic stress during the course of their lifetimes. The estimated prevalence of lifetime posttraumatic stress disorder (PTSD) was 7.8% of the general adult population, with women (10.4%) twice as likely as men (5%) to have PTSD at some point in their lives (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). The most recent NCS Report, published in 2005 on a newer sample, estimated lifetime prevalence of PTSD among adult Americans at 6.8%. Trauma survi- vors, especially those with prolonged histories of interpersonal abuse, often suffer from comorbid conditions, including substance abuse problems, mood disorders (e.g., depression and manic-depressive dis- orders), and dissociative identity disorder (Mueser et al., 1998). The NCS conducted by Kessler and associates (1995) reported that 80% of clients with PTSD suffered from lifetime depression, anxiety disor- ders, or chemical abuse/dependency, and were almost eight times as likely to have three or more psychiatric disorders. PTSD clients also have unusually high utilization rates of psychiatric services. Patients with a PTSD diagnosis spent 10 times as much time in the hospital as patients with a diagnosis of depression only (Macy, 2002). Conventional treatment eforts involve mostly cognitive-behavior- al therapies, which have received the greatest research attention and support for their eicacy (Resick, Monson, & Gutner, 2007). Existing clinical practice guidelines for PTSD identify cognitive-behavioral therapies as the treatment of choice (e.g., American Psychiatric Asso- ciation [APA], 2004; Foa, Keane, & Friedman, 2000). Evidence-based cognitive-behavioral interventions for PTSD include prolonged expo- sure treatment (Cooper & Clum, 1989; Foa & Rothbaum, 1998), cog- nitive therapy (Ehlers & Clark, 2000), cognitive processing therapy (Resick & Schnicke, 1993), and stress inoculation training (Veronen & Kilpatrick, 1983). While cognitive-behavioral approaches have contributed signiicantly to the advancement of trauma treatment, helping professionals continue to further reine evidence-based PTSD treatments (Resick et al.). Meta-analysis of psychotherapy for PTSD shows that 50% of clients in these eicacy studies on cognitive-behav- ioral interventions did not beneit from the treatment and still met the diagnostic criteria for PTSD at the end of treatment and at follow-up periods (Bradley, Greene, Russ, Dutra, & Westen, 2005). In addition, those who had a history of childhood trauma; physical violence or injuries within the traumatic event (Hembree, Street, Riggs, & Foa, 2004); comorbidity conditions of pain, depression, or anxiety (Tay- lor et al., 2001); greater severity of PTSD at pretreatment (van Min- ner, Arntz, & Keijsers, 2002); or greater anxiety at the beginning of treatment (van Minner & Hagenaars, 2002) had signiicantly poorer treatment outcomes. here are also indings suggesting that clients with prolonged histories of interpersonal abuse responded adversely to prolonged exposure and cognitive restructuring treatments. Pro- longed exposure was related to increased severity in PTSD symptoms in some clients primarily because of psychophysiological reactivity of clients to trauma memory (McDonagh-Coyle et al., 2001). Research shows that the efect of trauma is psychological and neurological (Southwick, Vythilingham, & Charney, 2005). Trauma disrupts the stress-hormone system, inluences the entire nervous system, impairs functioning of the prefrontal cortex, and prevents individuals from processing and integrating trauma memories into their conscious mental frameworks (Southwick et al., 2005). Because of these complex neurological processes, traumatic memories stay in the brain’s “nether regions,” which are the nonverbal, nonconscious, subcortical regions (the amygdala, thalamus, hippocampus, hypo- thalamus, and brain stem), where they are not accessible to the frontal lobes, which are the understanding, thinking, and reasoning parts of the brain (van der Kolk, 1994). In treatment, when clients are encour- aged to reexperience the trauma for the purpose of integrating the traumatic experience (e.g., a routine procedure for prolonged expo- sure), they may become so overwhelmed by intense negative emotions that they no longer consciously process the trauma in a beneicial way (van der Kolk, 2002). his outcome echoes the notion of “self before