Meditation and Emotional Regulation of Female Trauma Survivors of Interpersonal Violence with Co-Occurring Disorders

Background and Purpose: Female trauma survivors of interpersonal violence with substance use issues often experience difficulty with effectively regulating their emotional states, which can contribute to lingering trauma symptoms, relational problems, and co-morbid post-traumatic stress and substance use disorders. Emotions and memories can also be suppressed outside of conscious awareness, complicating attempts to regulate emotions through cognitive techniques. Meditation training may help these women achieve better regulation of their emotions through mind-body awareness, mental discipline, and processing previously suppressed emotions. Growing literature supports the use of mindfulness meditation for a wide variety of problem areas, but other types of meditation—such as compassion and lovingkindness meditation—have received less research attention. This study investigates the perspectives of women with trauma and substance use concerns who participated in a six-week meditation curriculum, and explores their changing experiences with emotion over the course of the intervention.

Methods: This qualitative study used an emergent design based on the constant comparative method to the explore the process through which meditation practice impacts emotional regulation in female survivors of interpersonal trauma. The study took place alongside a clinical trial of the effect of the meditation intervention on mental health and trauma symptoms in women with co-occurring trauma and substance use disorders. The participants for the trial were recruited from a substance abuse treatment program for homeless women, and the 31 participants for this qualitative study were those women randomly assigned to receive the meditation intervention. The interviews included questions about their meditation practice progress over the course of the project, including the challenges they faced, their feelings toward meditation, and the impact it had on their daily lives. Data analysis for this study used “emotional regulation” as a sensitizing concept. Three research team members participated in open coding and discussed codes and themes until consensus was reached. The process of identifying and consolidating themes progressed until saturation was reached.

Results: Participant narratives expressed a process through which meditation helped them to understand and accept their emotions and led to greater emotional control and positive emotional experiences. Interestingly, several participants noted that at first meditation brought up more negative emotions and even resurfaced painful memories of past trauma. However, participants also expressed that meditation opened up space for them to work through these memories and emotions and ultimately accept them and let them go. The major themes in this process included emotional awareness, emotional understanding, non-judgmental acceptance, and letting go of negative (and suppressed) emotions, which led participants to experience greater emotional control and more positive emotions. By releasing memories and emotions related to past trauma, and accepting difficult emotions and allowing them to pass, participants could refocus on their life in the present moment.

Conclusions and Implications: The findings point to a meta-cognitive process of understanding and nonjudgmentally accepting emotions as a path to emotional regulation through meditation. Incorporating compassion and lovingkindness meditation in addition to mindfulness may further promote emotional regulation among female survivors of interpersonal violence with co-occurring trauma and substance use concerns.