Transforming Trauma With Lifestyle Medicine

Abstract

A common misconception is that trauma—“injury” to the mind, body, and spirit—comes only to those individuals who have experienced threats of death, sexual violence, or serious injury. The SARS-CoV-2 (COVID-19) and the widespread disruption, anxiety, and stress it has left in its wake have shown us that this is not the case; trauma is universal. Left unaddressed, trauma can have long-term physical and psychological consequences. It appears that the consequences of trauma can also be transmitted from generation to generation through modifications in the DNA of the exposed individual that alter the function of one or more genes. Meditation and other practical, evidence-based mind-body skills can reverse what has been damaged by traumatic events and long-term stress. The Center for Mind-Body Medicine (CMBM), established in 1991, has developed a comprehensive, innovative, and evidence-based model that has been used by diverse populations to heal psychological trauma and promote resilience. Comprehensive, easily available programs of self-care and group support, such as The CMBM’s Mind-Body Skills Group Model, can ensure that children and adults everywhere have the psychological skills they need to address the trauma of the COVID-19 pandemic.

‘Meditation and other practical, evidence-based mind-body skills can reverse what has been damaged by traumatic events and long-term stress.’

A common misconception is that trauma—“injury” to the mind, body, and spirit—comes only to those individuals who have experienced threats of death, sexual violence, or serious injury. ¹ Population studies show us that over their lifetime, virtually all adults have been exposed to at least 1 traumatic event. ²

The SARS-CoV-2 (COVID-19) and the widespread disruption, anxiety, and stress it has left in its wake have shown us that trauma is universal. According to the National Pandemic Impact Report, 90% of US adults are experiencing at least 1 of the following: insomnia, anxiety, loneliness, and/or depression. ³ More US adults and adolescents than ever before are reporting frequent thoughts of suicide and self-harm. ⁴

Frontline health care workers have experienced even higher levels of anxiety and depression. They are likely, as well, to suffer long-term physical and psychological consequences. ⁵ Studies from the 2011 SARS epidemic show that frontline health care workers experienced significant increases in anxiety, depression, posttraumatic stress, and rates of suicide up to 3 years after the epidemic. ⁶

Over the past 30 years, studies on adverse childhood experiences (ACEs) have shown us the long-term damage that trauma can do. ⁷ The CDC-Kaiser ACE Study revealed that 61% of US adults had experienced 1 or more types of significant abuse and/or neglect (ACEs) during their childhood and that the number of ACE exposures correlates with increased incidence of adult chronic illness. ⁷ In another study, US adults who had experienced 4 or more categories of ACEs were found to have 12 times the rate of posttraumatic stress disorder (PTSD), alcoholism, drug abuse, depression, and suicide than was observed among members of the general US population. ⁸

It appears that the consequences of traumatic events can be transmitted from generation to generation through modifications in the DNA of the exposed individual that alter the function of one or more genes.^9,10 Yehuda et al ¹¹ examined this epigenetic effect (epi is the Greek prefix for above and indicates that the changes are happening in the structure of the DNA) in Holocaust survivors. Both maternal and paternal survivors transmitted epigenetic alterations to their children and grandchildren and with them a vulnerability to PTSD. Subsequently published data revealed that both the exposed and offspring cohorts showed methylation alterations in the FK506-binding protein 51 (FKBP5) gene, an important modulator of glucocorticoids and the hypothalamic-pituitary-adrenal axis.^12,13 The bottom line is that the trauma passed from generation to generation made offspring less able to deal with the stress they experienced.

Meditation and other practical, evidence-based mind-body skills can reverse what has been damaged by traumatic events and long-term stress.^14,15 Mind-body skills are an antidote to persistent and overwhelming stress and enable us to restore psychological and physical balance after we have been traumatized or, indeed, while we are dealing with significant stress. ¹⁶

Since its founding in 1991, The Center for Mind-Body Medicine’s (CMBM) evidence-based Mind-Body Skills Group Model has become the gold standard in population-wide psychological trauma relief. Our comprehensive model includes 15 self-care techniques, all of which can play an important role in lifestyle medicine. Each is grounded in science and a number, including various forms of meditation, guided imagery, exercise, and nutrition, and self-expression in words, drawings, and movement, have repeatedly been shown to enhance neuroplasticity and encourage neurogenesis.^17-19

CMBM’s Mind-Body Skills Groups usually include 8 to 10 participants and take place for 2 hours, once a week. ²⁰ During each group, participants practice a mind-body skill and share their experience with others in a confidential group environment. One technique, “soft-belly breathing,” enables the restoration of the physiological and psychological balance that has been disrupted by chronic stress and trauma. This slow, deep breathing, in through the nose and out through the mouth, with the belly soft and relaxed, is technically a “concentrative meditation”—directing focus to the breath, to the words soft and belly, and the feeling of relaxation in the abdomen. Soft belly breathing is easily learned and taught.

CMBM’s comprehensive, practical approach has been used effectively to reverse psychological trauma and promote resilience during and after wars and with war-traumatized US veterans. ¹⁶ It has been used to relieve stress and enhance professional performance among health professionals and medical students and with US populations devastated by climate-related disasters, the opioid epidemic, and school shootings. ²¹ It has become central to the treatment and prevention of chronic illness in VISN-8, the largest division of the US Veteran’s Administration, and is being implemented in health care systems across the country.

More than 7000 frontline health care professionals, workers, students, parents, and others affected by the COVID-19 pandemic have participated in CMBM’s Mind-Body Skills Groups, which have been featured in The New York Times. ²² Peer-reviewed studies have repeatedly demonstrated that participation in these groups has reduced the numbers of those qualifying for the diagnosis of PTSD by 80% or more. ¹⁵ Adults and children from the age of 3 years and older who participate in these groups grow less anxious and angry, sleep better, have enhanced quality of life, and are more hopeful.^20,23-25

The newly authorized COVID-19 vaccines offer us hope for a future without COVID-19. There is, however, no vaccine for the psychological, social, and spiritual effects of the pandemic. That does not mean that there is no remedy. Properly understood, the trauma we have all experienced can open the door to a process of individual and collective healing that modern psychologists call “posttraumatic growth.” ²⁶ Comprehensive, easily available programs of self-care and group support, such as CMBM’s Mind-Body Skills Group Model, can ensure that children and adults everywhere have the psychological skills they need to address the trauma of the COVID-19 pandemic.