As you may recall from previous blogs, trauma causes a paradoxical effect, or a dialectical dilemma, in which we end up with both too much and too little of something. Each of the following blogs in this series will focus on a specific pair of extremes caused by trauma, as well as the middle path between those extremes.

For example, people who have been traumatized experience both too much awareness and not enough. The clinical term for excessive awareness is hypervigilance, while the technical term for diminished awareness is dissociation. Hypervigilance occurs when you and your senses are on high alert and you are poised to react at a moment’s notice. Dissociation, in contrast, happens when you completely check out and don’t even remember something significant taking place.

Often the trauma survivor will do some combination of both, in which you obsess over minor details (over-focus) while completely ignoring major issues (under-focus). While both hypervigilance and dissociation serve important functions in helping you to survive the original trauma, these reactions can cause gobs of issues with other aspects of your life.

For example, let’s assume you’re at your ten-year-old’s piano recital. The auditorium is packed with people. Your attention starts to focus on the large crowd. You remember a time when you were humiliated in front of a large group of people, with no escape. You start to scan the room for the closest exits. You notice that your heart beats faster and your hands get clammy. You start to panic…precisely about having a panic attack!

Your mind knows exactly what to do next: to avoid creating a scene, you completely check out. And in the process, you miss the entire piano recital. As a result of hypervigilance and dissociation, you were not mindfully present. Due to your trauma history, your mind over-focused on some details while under-focusing on everything else.

The middle path between these two extremes is a state of mind called mindfulness. The concept of mindfulness has been around for thousands of years. Mindfulness simply refers to paying attention for an intentional purpose, in the present, without judging.

Each of these components is essential to the definition of mindfulness. For example, you could pay attention to something randomly or by accident or obsessively—but that’s not mindfulness, since mindfulness, by definition, is intentional. Or you could intentionally focus your attention on something that already happened or something that may happen—but that’s still not mindfulness, since mindfulness, by definition, refers to awareness of the present. Or you could try really hard to concentrate on something happening right now in this moment (such as reading this blog), but instead end up focusing much more on your judgmental thoughts about the blog than on the blog itself (such as “this blog is too long” or “mindfulness is so boring.”) None of those scenarios would be mindfulness.

A great example of mindfulness is children playing. Healthy children (and especially children at play) are naturally mindful. In fact, they are mindfulness machines—and it’s contagious! Think of a group of children playing at recess. Are they worried about the test they will take after lunch? Are they fretting about the scuffle they had yesterday? Are they incessantly judging their quality of play? No, they are not! Without any external prompting, they are mindfully engaged in the present moment.

And even if there is a distraction or disruption (such as an annoying teacher with too many rules), what do they do? They get back in the game as quickly as possible! And that, my friend, is what mindfulness is all about.

Each of the components of mindfulness is critical for trauma recovery. Due to the polar processes of hypervigilance and dissociation, your brain has learned to focus on just about everything except the present moment. With hypervigilance, your brain—like a sniper—is acutely trained to scan the environment and zero in on any data point that resembles a prior danger, which your brain interprets as a present or potential threat. Your brain also focuses much more on your cognitive, emotional, and physical reactions to the situation than on the actual situation itself.

Therefore, hypervigilance is not uber-mindfulness…it is pseudo-mindfulness! Point for point, hypervigilance does not meet the criteria for true mindfulness. Hypervigilance is a reaction, and therefore not intentional. Hypervigilance focuses more on connecting the dots between prior and potential danger than on the present reality. In addition, hypervigilance focuses more on judgments (negative assessments or interpretations) of the situation than on the actual situation. Even worse, once dissociation gets triggered, mindfulness is completely out the window.

Therefore, mindfulness practice is critical for relearning a middle path between these two extremes. In Sanskrit, an ancient language, there were three separate words to describe what have all become clumped together into our current English word “mindfulness.” Each of these concepts is significant in its own right.

1. One of the original words for mindfulness referred to a concentrated focus; in other words, focusing your attention on just one thing at a time (for example, noticing your breathing)—even if only for a few moments.

2. Another word for mindfulness referred to sustained focus; in other words, learning to keep your focus going over a stretch of time (for example, intentionally noticing your breathing for a full five minutes).

3. A third word for mindfulness was used to denote yet another concept: awareness of the mind itself, including when the mind is able to focus, but also when the mind wanders.

Each of these components is critical for trauma recovery. In order to overcome the extremes of hypervigilance on one hand and dissociation on the other hand, a great starting point is learning to focus on just one thing at a time. With hypervigilance, your brain wants to focus on too many things at once; and with dissociation, your brain doesn’t want to focus on anything at all.

Since both hypervigilance and dissociation become deeply entrenched default settings, occasionally focusing on just one thing at a time will not be enough to reprogram your brain. Therefore, you will also need to practice focusing your attention on just one thing at a time and for extended periods of time. This will help establish another default setting for your brain: a middle path between the two extremes.

So does that mean once you have practiced training your brain to focus on just one thing at a time, and even for extended periods of time, that your brain will never, ever revert back to patterns of hypervigilance or dissociation? Of course not! The last component of mindfulness is probably the most important of the three. Remember, the third form refers to mindfulness of the mind itself. That means, over time and with lots of practice, you will better notice when your mind is staying on track but also when your mind is drifting over to one of the two extremes.

Mindfulness is not about always paying perfect attention at all times (since that is impossible, even for the Zen Buddhists of the world). On the contrary, mindfulness is much more about learning to observe the mind itself (both when it behaves and does not behave), and learning to gently bring the mind back to the middle path.

So far in this series, you’ve been introduced to DBT and trauma. Now let’s connect the dots and explain why trauma-focused DBT is a great starting point for trauma work. In the previous section, you learned how trauma affects the nervous system. This explanation is called the polyvagal theory, and it provides the theoretical basis for trauma-focused DBT.

To this day, many medical professionals do not fully understand or appreciate the physical impact of trauma on the nervous system (and therefore, the entire body). Since the nervous system interacts with all other body systems, many possible physical symptoms can result. These symptoms will be different for everyone, since we all have our own unique bodies with our own unique nervous systems.

Trauma affects every part of the body and every part of the brain. That’s a lot of turf. There is still much that even highly trained professionals do not understand about how trauma affects a person, both physically and emotionally. What follows is an introduction to the causes and effects of trauma.

Dialectical behavior therapy (DBT) was developed in the 1970s by Dr. Marsha Linehan to treat symptoms of what we call borderline personality disorder. A borderline personality is characterized by a fear of abandonment; chaotic relationships; chronic feelings of emptiness; reckless, impulsive, and self-injurious behaviors; and a constant roller coaster of emotions, including fits of rage.

So far you have been on quite the journey! Earlier, we learned that trauma has a way of throwing everything off balance, including our thoughts, our feelings, our behaviors, and our relationships. Since trauma by definition represents an extreme situation, trauma sends each of these areas of our lives into extreme positions.

So far, we have learned a lot of information about how to improve relationships. For example, you have learned to assert, to appreciate, and to apologize with the Adult Voice. You have also learned to listen, understand, and validate; to appear confident with poise, interest, and expressiveness; and to stay calm, aware, and respectful (even when the other person is anything but).

So far, we have learned some basic social skills to balance your relationships. For example, you have learned to be assertive, which is the middle path between passive and aggressive. You have also learned to use the Adult Voice, which is the middle path between the Parent Voice and Child Voice.

Congratulations! You have just learned how to be more assertive in four simple steps: Describe, Express, Assert, and Reinforce. Of course, healthy relationships involve much more than just walking around and asserting yourself all day!

Regardless of how you are wired as a person, and regardless of how someone else is wired as a person, there are three A’s which are indispensable for human interactions: Assert, Appreciate, Apologize. If you can get these three concepts down, you are well on your way to more effective communication…not to mention healthier relationships!

Before we learn specific strategies on how to improve our relationship skills, it will be helpful to first learn about the different relationship styles that people have in the first place.

In earlier blog posts, you learned that trauma has a way of throwing us off balance. Just about everything can get thrown off balance by trauma: our thoughts, our feelings, and our actions. And since trauma by definition represents an extreme situation, trauma tends to force our thoughts, feelings, and actions into extreme positions as well.

Would you ever plant a garden in the spring, and just abandon it till the end of the summer? Even if you planted the right seeds, what kind of outcome would you expect if you did absolutely nothing to maintain the garden? Well, the same concept applies to your emotions. Now that your emotional garden has been planted, we need to fertilize it! In the final lesson of your garden of emotions, you will learn the ABC’s of maintaining emotional stability (Linehan, 2015):

When it comes to the game of life, do you have trouble shooting? Or have you learned to shoot your troubles? Now I am not a violent person, but please work with my analogy: If we are going to protect our garden of emotions, we may have to shoot some predators! And life is full of them: work, deadlines, appointments, bills, illness…you get the point.

Did you ever notice that reacting to your emotions can actually make them worse? For example, let’s suppose that you are really ticked off. And when you get ticked off, you clench your fists and raise your voice. Have you noticed that the more you clench your fists and raise your voice, the angrier you get? Now let’s suppose you are feeling really sad, and you just want to sleep, isolate—and crawl in your bed and never come out.