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

This page is the result of years of practicing and teaching meditaiton.

I have contemplated suicide from failed meditation sessions. I know others who have also contemplated suicide from failed meditaiton sessions.

First, Do No Harm

I think meditation is not intended to harm us.

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

Risks

Big Risks

  • Suicide
  • Suicidal ideation
  • Self-harm

Medium Risks

  • Dissocation
  • Flashbacks

The Unavoidables

  • Changes in behavior (sometimes good, sometimes bad)

Mechanics of Meditation and Trauma

Our brains have an organ called the medial prefrontal cortext (mPFC). It's basically the spot on our brows between our eyeballs. It's also the seat of mindfulness.

Developed mindfulness leads to an altered state of consiounsess as distict and different as being awake is to being asleep.

Our psyches know this ability is there ... trying to reach for it, and failing can be traumatic in-and-of-itself.

This altered state is meant to be learned under supervision from someone else with experience, a lot like how a child how to act via an adult shaping their behavior.

In our culture of self-reliance, mindfulness is seen as another activity, like watching TV, or going for a walk. It isn't.

I strongly recommend listening to guided meditations, for years if required. It's OK to need support in this area.

Ariadne's Stopping Points

These are the "do not continue" feelings

Emotions associated with self-harm
  • Hopelessness
  • Helplessness
  • Despair
  • Flashbacks
  • Chest pain

In Others

Sensing a stoping point in someone else being guided is much harder.

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  • Withdrawn?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

Groups are at risk for meditation harm

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

Self-loathing

Self-hate prevents mindfulness.

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

Difficulty meditating is not a moral failing.

Traumatized

Quiet introspection can lead to flashbacks.

Dissociative

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

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

Low Dopamine - ADHD

Failure to sit still, and/or pay attention.

Religious texts group this under "restlessness." Western medicine knows it as a dopamine shortfall. Meditation is easier with movement, music, interesting sensory objects, medication, and/or caffeine.

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

  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
  • Fatigued
  • Despair
  • Heartbreak
Shame
  • Self-conscious
  • Embarassment
  • Humiliation
  • Awkward
  • Chagrin

Specific feelings that can lead to suicidal ideation

When two specific feelings combine, they lead directly to suicidal ideation

  • Hopeless
  • Despair

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?

v2.2 - Last edit 21-Jan-2025

This work dedicated to the Public Domain via CC0 1.0