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Meditation Is Not a Zero Risk Activity

Practicing, guiding, teaching, and/or suggesting meditation involves risk.

The big risks are: suicide, suicidal ideation, self-harm, flashbacks, dissociation, changes in behavior, changes in relationships, changes at work … all kinds of human behavior. It is difficult to predict what a practice can uncover or reveal.

Meditation can arouse difficult feelings, memories, and awareness. In our culture of self-reliance, the things brought to the surface can deeply hurt us, without the support of others.

This is one of the reasons a teacher is frequently recommended: to identify when support is needed, and provide it.

First, Do No Harm

I think meditation is best when it doesn’t add to our existing pain.

A framework of First, Do No Harm will have clear boundaries around when to stop a session.

Ariadne’s Stopping Points

  • Emotions associated with self-harm.
    • Hopelessness, helplessness, despair1
  • Dissociation2
  • Flashbacks
  • Chest pain

Guiding our own practice, I recommend erring on the side of caution. Can a practice be made gentler?

Guiding others practices … is there enough mindfulness and attentiveness to understand how others are doing? Can you tell if someone is dissociating? Do you know them well enough to sense a change in their behavior?

In Ourselves

  • Emotions
    • Positive? Negative? Helpful? Hurtful?3
  • Pain
    • Around the head? Chest?
  • Thoughts
    • Memories? Tasks? Arguments?

In Others

  • Posture
    • Turned in? Guarded? Withdrawn? Excited? Animated?
  • Energy
    • More? Less?
  • Speech
    • Nonverbal? Quiet? Reserved?
  • Breathing
    • Labored? Missing? Breath-holding?
  • Skin
    • Flushed? Pale? Goose-bumps?

These groups are at risk for harm

I’ve seen these groups struggle most. It is by no means definitive.

Self-loathing4

Inability to meditate is frequently tied to moral agency, and seen as a personal failing.

Traumatized

Quiet introspection can lead to flashbacks.

Dissociative5

Difficult emotions, unfamiliar tasks, and pressures can lead to dissociation.

Low Dopamine - ADHD6

Failure to sit still, and/or pay attention.

Metta is Especially Dangerous

This is a well-intentioned and bright practice. I’m familiar with it from Buddhism, where it has prerequisites for safety:

  • Stable loving community
  • Secure attachment
  • Easy call up of the feelings of love and compassion.

Those without the above prerequisites are in danger.

A Typical Metta failure:7

  1. Someone is told to direct their attention towards feelings of love and kindness.
  2. They cannot.
  3. As they continuously fail to arouse these feelings, much darker feelings are aroused.

Categories of feelings they might feel instead (an incomplete list!):

  • Anger
    • Self-hatred.
  • Disgust
    • Contempt
  • Fear
    • Helpless, insecure, anxious, vulnerable.
  • Surprise
    • Shock, overwhelm, confusion
  • Sadness
    • Depressed, hopeless, miserable, despair, heartbroken
  • Shame
    • Self-conscious, chagrin8, humiliation.

Specific feelings that can lead to suicidal ideation:

  • Fear - helpless, vulnerability
  • Sadness - hopelessness, despair9

Recommended Materials

Books

Trauma Sensitive Mindfulness - David Treleaven

Mindfulness Oriented Interventions for Trauma - A Routledge Press book. Interventions for clinicians.

Other Sites

Trauma Sensitive Mindfulness - Courses, Zoom meetups.

Meditation Safety Toolbox - Resources for clinicians, 73 files covering: MBSR/MBCT Guidelines, Informed Consent, Screening, Monitoring, Mechanism, Management.

Cheetah House - Help for meditators in distress

Online Courses.

First Do No Harm: Foundational Competencies for Working Skillfully with Meditation-Related Challenges - 3-Day Meditation Safety Training for MBSR/CT teachers

Dissociation Treatment Targets

What is Mindfulness?

redirect: sitwithariadne.com/meditation-is-not-zero-risk
v1.1 - Last edit 8-July-2024
This work dedicated to the Public Domain via CC0 1.0

  1. When I have these emotions I’m in either distress or crisis. See the below charts.
    DBT Crisis Skills
    DBT Reality Acceptance ↩︎

  2. It’s hard to define dissociation, it’s easier to define it as the opposite of mindfulness.
    What is Mindfulness ↩︎

  3. It took some practice, but I stop at self-loathing, and self-criticism. I do something else, like go for a walk, do some art, sleep. ↩︎

  4. Can lead to shame-anger-rage spirals. ↩︎

  5. Especially insidious because it can look like meditation. People who dissociate tend to be very quiet (nonverbal). To communicate to someone dissociative, ask if people would like to write down their thoughts and feelings. ↩︎

  6. The texts call this restlessness. I call it a dopamine shortfall. Meditation is easier with movement, music, interesting sensory objects, medication, and/or caffeine. ↩︎

  7. Metta is one of my favorite targets, but also the most fickle for me. I have a trauma and dissociative background, I had to learn this stuff to sort dissociation from meditation. ↩︎

  8. This is the feeling felt when someone said “I feel like a failure.” That’s chagrin. ↩︎

  9. I have felt everything on this list first-hand. I have contemplated suicide from failed Metta sessions. I know others who have also contemplated suicide from failed Metta sessions. ↩︎