Vipassana for Depression, Anxiety, Trauma, and Addictions
The integration of Vipassana meditation with various forms of therapy has for many years been a standard of treatment worldwide and in Vermont, 
especially when impulse control and emotion regulations issues are included. Buddhist Psychology offers clear explanations why this intervention may be helpful for so many suffering people. The four most common clinical conditions of depression, anxiety, trauma, and addictions are strongly and positively influenced by regular practice of this form of meditation. Below I have noted in a very basic manner how Vipassana’s effects may be explained via Buddhist Psychology and the dharma.
- Impermanence is a focal aspect of Buddhist Psychology, meditation practice, and dharma. This constant of change may be explained best as the rising and falling of all humanly perceived phenomena. Although arising and falling away in conscious awareness include all phenomena, some clarity is needed regarding use of it in clinical practice. Sense impressions, mental events, sensations/feelings/emotions, impulsive behavior, and compulsive cognitions all relate to the clinical conditions noted here. Therefore, any intervention that brings important insight may be useful.
- Humans suffer from habitual behaviors and reactions. It is best recognized in attachment to positive sense objects or experiences and aversion to negative ones. Sensory impressions and mental events about them lead to active roles on the hedonic treadmill. When we use sensory information and experience awareness of something that we evaluate as pleasant, neutral, or unpleasant we behave according to samsara – we crave for more or desire aversion from such phenomena. We may not at all realize that our attachment/desire to continue the pleasant – as well as the aversion to continue the unpleasant – is our major cause of unhappiness, pain, and suffering. Likewise the lack off this awareness or insight has the same unpleasant effects – we suffer. We become stuck wanting what we want but cannot always get, and hoping to avoid unpleasant experiences that may be unavoidable in human life. We tell ourselves only if I had…then I would be happy. General dissatisfaction, unfortunate as it is, is the human norm.
- The information and processes noted above do NOT include a separate, long-lasting, independently arising entity called the Self. We do need to recognize that I am NOT my depression, anxiety, trauma, or addictions. I am simply aware or conscious of the fact that “I” am experiencing or feeling depression, anxiety, trauma, or addictions. It is only in more advanced Buddhist practices that we work seriously on the “no-self” reality. There are significant consequences in over-identification with either pleasant or painful experiences. Believing that it is “my self” that is trapped disempowers us in many important ways. The Four Noble Truths and The Eight Fold Path can help us.
- In very unique ways Vipassana meditation can help us in all of the above. Here are some skills recommended by S. N. Goenka (now deceased). First, anchoring the breath by paying attention to the upper lip and the nostrils as you breathe in and out. In anapana sati we
simply pay undivided attention to the feelings/sensations as we breathe in and out. Moment-to-moment bare attention is practiced for at least 30 minutes. To be successful, you must practice letting go of thoughts, emotions, and memories of past suffering. When they arise simply note that it/they have come up, and pay no attention to it/them – hold a non-evlautaive stance and stay with your breath. It will require significant practice before you can do this well. Awareness may then be expanded to the throat and chest areas – just feeling sensations of awareness as you breathe in and out. Second move into about 30 minutes of loving kindness meditation. Third, complete a body scan with attention only from head to toes and back again for about 30 minutes. Just pay attention to the awareness of sensations and feelings as you are guided slowly down and up the body. When distractions come, simply return attention back to the part of your body you are working with now. - Vipassana (Pali for “seeing things as they actually are”) allows us to learn all there is to know in items 1-3 above, and how to benefit significantly from such understandings. Long-term Vipassana practice may eventually bring you to a more stable self-existence, fully focused on your state of meditative awareness without strong reactivity in life. At some point you will become aware of interoception, the ability to feel sensations in your body before they bloom into emotions and behaviors. In the clinical conditions noted, such a skills can be live-saving.
For more information refer to Follette, V. M. and Briere, J. et.al. (2015). Mindfulness-Oriented Interventions for Trauma…New York: Guilford Press, pp. 273-283, 329-342. See also Ariele and Manahemi (1997). Doing Time, Doing Vipassana (Film); and, www.prisondhamma.org.
Anthony R. Quintiliani, PhD., LADC
From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton Sangha
Author of Mindful Happiness
In line with the thousands of studies now available supporting the use of mindfulness-based interventions in depression, anxiety, chronic pain and addictions (via emotion regulation and interoception), this post will review recommended mindfulness interventions for trauma and PTSD. The post will note information from two recent books on this topic. Also recognize that meta-analytic research in 2004, 2010, and 2014 have found that mindfulness-based interventions improve depression, anxiety, chronic pain, and emotion regulation. These are common conditions co-occurring with addictions and trauma. Such interventions may be carried out as part of various Western therapies: cognitive, behavioral, cognitive-behavioral, dialectical-behavioral, and even psychodynamic.
the best of object relations therapy, mindfulness therapy (MBSR, ACT), and cognitive-behavioral therapy. Here is the listing of therapeutic functions and interventions.
requires an exceptional therapeutic alliance (psychodynamic therapy), modifications in automatic negative thoughts (cognitive therapy), changes in unhelpful behaviors, like self-medication of pain (behavior therapy, and combinations like very well executed cognitive-behavioral therapy), commonly long-term healing outcomes have been somewhat disappointing. Perhaps an experienced and skilled therapist able to develop a high quality psychodynamic clinical alliance as well as highly effective cognitive-behavioral interventions may achieve admirable outcomes; however, that specific combination of skills is not common. I am suggesting that a high quality helping alliance and successful interventions in thinking and behavior problems may be helpful for people suffering from serious trauma. However, most of these approaches (other than informed and skilled DBT) miss the mark when it comes to integrated positive impact on the mind-body system. Even in DBT (and CBT), it is common for it to be used as a form of cognitive therapy – leaving the important behavioral and body-based areas out all together. To take a new look at the traumatized mind-body, witness current successes in trauma-informed yoga and meditation for PTSD. Recent meta-analytical reviews have noted that meditation (and yoga to a lesser degree) do improve depression, anxiety, physical pain (emotional pain?), and emotion regulation. Therefore, such body-based approaches improve three (depression, anxiety, self-medication) of the common clinical conditions associated with serious trauma.
mindfulness-based interventions in trauma, the best therapists are also practitioners in these practices. Limbic and prefrontal interventions, NOT psychodynamic and cognitive interventions, may be highly helpful in effective trauma-informed psychotherapy.