Can Mindfulness Be Dangerous?

This is a fair question given that mindfulness is now so well established in many people’s minds as something entirely positive. What could be the harm in practicing mindfulness meditation? It is my belief as a trained Mindfulness Based Stress Reduction (MBSR) teacher that mindfulness can be a source of good for a very large number of people among the general public. Having said that, there may be situations where mindfulness meditation, if not handled correctly, has the potential to cause harm where an individual might be particularly vulnerable.

What risks are associated with mindfulness practice?

For people who have experienced a significant episode of trauma or series of traumatic events, certain mindfulness practices have the potential to trigger old trauma in the individual and there is a danger of re-traumatization. For some people, systematically exploring sensations in the body which is typical of a mindfulness practice known as the Body Scan, could trigger a traumatic reaction where the individual has experienced physical or sexual abuse. It may also happen that for some people who commonly experience anxiety, sitting still while paying attention to the breath, instead of having a calming effect, could actually increase the sense of anxiety. Another mindfulness practice which encourages the individual to develop a sense of loving kindness for themselves could occasionally trigger the opposite, a sense of self-loathing or a sadness about not having felt loved before.

How can the risk factors of taking a mindfulness course be reduced?

In the case of an MBSR or MBCT (Mindfulness Based Cognitive Therapy) course, the mindfulness teacher is obligated to screen potential participants to assess for risk and see what can be done to provide the optimal level of support for participants who might be stressed or feeling vulnerable. In some cases the teacher may advise the potential participant to not attend the course especially in the following cases:

where there has been a recent bereavement
the break-up of a marriage or long term relationship
the individual has a drug or alcohol dependency
the individual is going through a significant life crisis
the individual lacks the resources to adequately take care of themselves or seek the support of others

What can a mindfulness teacher do to reduce the risk of causing harm?

There is a whole range of things a mindfulness teacher can do to promote safety for the individual coming to learn mindfulness. Some of these include:

Actively promote a warm , friendly, non-judgemental atmosphere in the learning environment.
Always remind participants that if a mindfulness practice doesn’t feel right for them that they may opt out or make adjustments to the practice that works best for them.
Provide choice so that participants don’t have to follow guidance exactly as it has been given. For example, it is common practice to do mindfulness with eyes closed but this can be potentially triggering for a small number of people, and so the option to keep them open should be provided.
Provide choice in the posture adopted for a particular meditation or practice. Many practices involve sitting up straight while sitting on the floor on a meditation cushion or stool. However, for a variety of reasons this may not be recommended for some people, so the choice to sit on a chair or to lie down or to stand should always be given.
Mindfulness teachers can regulate their voices in such a way that the tone and the pacing of the meditation can support in the minds of participants a sense of gentleness, acceptance and ease.
In MBSR and MBCT classes, some meditations can take as long as 40 minutes. This might be too long for some people and they should have the freedom to meditate for a shorter period. There is evidence that longer practices are more beneficial but there is also a greater risk associated with these. Where necessary, short practices can be extended to longer practices when people feel ready for them.
A mindfulness teacher should never assume that a participant is feeling a particular way during a meditation or as a result of finishing a meditation. Nor should they suggest how a participant should feel. Participants feel safer when their experience is acknowledged and validated.
Sometimes a meditation involving mindful walking or some kind of mindful movement may be gentler and less triggering for someone who might have a history of trauma.
On occasion, teachers will encourage participants to gently explore a difficulty in their lives using mindful awareness. This can be very helpful as we all need to deal with situations that we find challenging. However, in undertaking this meditation it is wise not to take on anything that might cause overwhelm or increase distress. Participants should always have choice and control over what mindfulness practise they engage in.
Mindfulness teachers should make themselves available between classes in case participants wish to contact them about any concerns they have about their experience of doing mindfulness either at home or in class.
There can be an added risk of trauma activation where participants are attending a silent residential intensive mindfulness retreat which might involve several hours of daily mindfulness practice. Organisers need to provide additional support for individuals who may need to talk through their experiences or who might need to follow a less intensive programme.

Once mindfulness teachers observe good practice guidelines as set out by their profession and once individuals practicing without a teacher, practice in moderation and only as they feel comfortable, the risk of adverse reactions to mindfulness are greatly reduced.