Mandala Process Palecek Alexander A Contemplative Approach To Trauma

Running head: MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH
A Contemplative Approach to Trauma Recovery:

The Mandala Process
by
Alexander M. Palecek
Master's Paper
Presented to the
Contemplative Psychotherapy Faculty
of
Naropa University
in partial fulfillment
of the requirements
for the degree of
Master of Arts: Psychology
Contemplative Psychotherapy
Naropa University
Boulder, CO
May 2013
MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

Abstract
Psychological trauma is widespread, and effective treatment requires specialized techniques.
Standard mindfulness-based interventions have the potential to exacerbate trauma symptoms, to
the detriment of psychotherapy clients and meditation practitioners. However, contemporary
trauma theory and Contemplative Psychotherapy principles can support effective trauma
recovery. Mandala Process is presented as a synthesis of somatic trauma sequencing protocols,
the Four-Step Process for working with conflicting emotions, and the Five Wisdom Families of
Buddhist psychology.
Keywords: trauma, sequencing, mindfulness, meditation, Contemplative Psychotherapy,
Buddhist psychology, mandala
Acknowledgments
This paper would not have been possible without the teachings and institutions of
Chgyam Trungpa, Rinpoche. To the crazy wisdom guru of the three times, I make this offering.
My practice has been sustained by many great teachers, including Longchenpa,
Khenchen Thrangu Rinpoche, Khenpo Tsltrim Gyatso Rinpoche, Khenpo Gangshar, Pema
Chdron, and the lineage of those who have tamed their own minds and awakened their hearts.
Thanks to my parents Mike and Diane Palecek, my brother Tim Palecek, and my late
grandmother Bev Palecek. The strength of your love has sustained me through extremely trying
times, and I have not always made it easy on you. Thanks for your patience and perseverance.
Many mentors helped me along the way. To Dale Asrael, Sandra DeWalt, Genevive
Dhanis, Keith Dowman, Anne Howland, Jaci Hull, Steve Jewell, J. Ryan Kennedy, Tania
Leontov, Roz Leppington, Valerie Lorig, Priscilla MacLean, Lodi Siefer, and Scott Woodley:
thanks for mixing wisdom with your lived experience, and feeding me that fresh-baked bread.
To special friends, some of whom have drifted out of my life altogether: Jordan Ganz,
Sue Guelke, Nat Kramer, Katherine LoPiccalo, Bryce Mathern, Erika Olson, Julia Pancoe, Chris
Rempel, Katja Schoerle, Valerie Secaur, Diana Smith, Nandi Townsend, Ben Walsh, Celso
Wilkinson. Thanks for hanging in there and sharing your beautiful, brilliant hearts with me.
My MACP 2013 class has been the best community I have ever experienced; thank you
all for helping me heal, soften, and relax with myself. I love you all dearly, and I hope our
connection can continue to grow and flourish, so that we can truly help the world.
Finally, I'd like to dedicate this paper to future generations of Contemplative
Psychotherapists, their clients, and meditators of the three times. May we heal the roots of
trauma that rob us of life and drive us to madness, and thus restore the natural dignity, strength,
and wisdom of our human being-ness and our world.
Table of Contents
Abstract............................................................................................................................................2
Acknowledgments............................................................................................................................3
Contemplative Trauma Treatment: A Synthesis of Eastern and Western Approaches....................5
Literature Review.................................................................................................................6
How I Became Interested in Mindfulness and Trauma........................................................7
Western Approaches and Contemporary Trauma Theory....................................................8
Trauma Symptoms and Complications..........................................................................9
Hyperarousal............................................................................................................9
Intrusion...................................................................................................................9
Constriction............................................................................................................10
The Genesis of Trauma................................................................................................10
Trauma Sequencing Models.........................................................................................12
A Five-State Model of Traumatic Arousal...................................................................12
Contemplative Psychotherapy Principles..........................................................................14
Brilliant Sanity.............................................................................................................15
Maitri............................................................................................................................15
Mindfulness..................................................................................................................15
Impermanence..............................................................................................................16
Body, Speech, and Mind..............................................................................................17
The Five Wisdom Families..........................................................................................17
The Four-Step Practice................................................................................................18
Mandala Process: The Five Wisdom Families as Trauma Intervention.............................18
Preparing the Ground...................................................................................................19
Components of a foundation for trauma therapy...................................................19
Mandala Process: The Main Practice...........................................................................20
Vajra: clarity and containment...............................................................................20
Ratna: resourcing and regulation...........................................................................23
Padma: titration and touch & go............................................................................24
Karma: sequencing and simply allowing...............................................................26
Buddha: integration and is-ness.............................................................................29
Concluding Practices...................................................................................................30
Case Examples...................................................................................................................31
Belle.............................................................................................................................31
John..............................................................................................................................33
Discussion..........................................................................................................................35
Dissociation..................................................................................................................36
The Truth of Suffering.................................................................................................36
Limitations...................................................................................................................36
Herman's Five Stages of Trauma Healing....................................................................38
The Need for Empirical Research................................................................................38
The Need for Further Training and Experience...........................................................39
Conclusion.........................................................................................................................39
References......................................................................................................................................40
Figure 1: Five-State Model of Trauma...........................................................................................44
Figure 2: Sequencing the Five States.............................................................................................45
Figure 3: Mandala Process.............................................................................................................46
Contemplative Trauma Treatment: A Synthesis of Eastern and Western Approaches

Psychological trauma is widespread, complex, and difficult to treat using mainstream
psychotherapeutic approaches. Contemporary trauma treatment provides skillful methods for
resolving trauma symptoms and recovering health, such as mindfulness and somatic sequencing.
However, the neuropsychological frame of contemporary trauma theory lacks a thorough
grounding in relational, existential, and transpersonal approaches. Contemplative Psychotherapy
provides a theoretical and practical background for bringing trauma treatment into the
therapeutic relationship, recognizing the wisdom of trauma symptoms, and addressing them with
mindfulness. Drawing on these traditions, this paper presents the Mandala Process, which is a
synthesis of contemporary trauma treatments and the mandala of the Five Wisdom Energies.
This paper is primarily intended for Contemplative Psychotherapists, meditation
practitioners, and meditation instructors. Psychotherapy clients might benefit from reading it,
but if they need these skills, it may be best to learn from a skilled therapist with a background in
mindfulness and trauma. (If therapists judge that a clear articulation of Mandala Process would
be helpful to clients, they are welcome to share this framework, and should provide guidance in
applying the techniques.) I created this model to address a perceived gap in my training, as a
Contemplative Psychotherapist, meditation practitioner, and meditation instructor, as well as to
articulate my understanding of trauma healing in my experience as a psychotherapy client.
For Contemplative Psychotherapists, a thorough grounding in trauma treatment is
missing from our training, due to the pressures of curriculum requirements and time limits. If
our psychotherapy training is not trauma-informed, we run the risk of retraumatizing clients,
misunderstanding their symptoms, and recapitulating prior traumas. Mainstream approaches to
psychotherapy may fail to address trauma, and our mindfulness-based practices of touching into
emotions and allowing space in the therapeutic relationship may fail to give clients the structure
and support they need to heal. Moreover, in any situation where we work with traumatized
individuals, we run the risk of experiencing vicarious traumatization (Siefer, 2009). At these
times, we need a way of working with our own experience (such as Mandala Process), so that we
can metabolize the traumatic affect we may have picked up from our clients.
Meditation practitioners may discover trauma states coming up in their mindfulness
practice, but standard techniques may actually make things worse: by plunging practitioners
repeatedly into trauma states, mindfulness practice becomes a traumatic recapitulation (Palecek,
2012a; Treleaven, 2012). Mandala Process can resolve trauma symptoms safely and effectively.
Finally, meditation instructors should give trauma-informed instructions to students who
need them, as students may be drawn to mindfulness practice as a way of dealing with trauma
symptoms (Palecek, 2012a). However, if trauma arises in meditation and the student continues
to work with standard techniques, mindfulness may actually be retraumatizing (Treleaven, 2012).
Instructors can help students navigate these obstacles by learning about trauma and appropriate
mindfulness techniques. This paper includes an introduction to trauma theory, and Mandala
Process is a set of meditation instructions specifically designed for working with trauma.
In this paper, I use the words client and traumatized person interchangeably.
Remarks pertaining to clients may also address meditators and psychotherapists working with
their own experience. Likewise, notes to therapists may apply to meditation instructors. Let us
turn now to the literature on trauma in Contemplative Psychotherapy and mindfulness practice.
Literature Review
A few papers in the Contemplative Psychotherapy literature address trauma. Dillon
(2012) joins contemporary trauma theory with the Mahayana Buddhist mind training slogans
(Trungpa, 1993). Whittaker (2012) integrates Contemplative Psychotherapy principles and
Herman's (1997) five-stage trauma treatment model. Collina (2008) connects the four noble
truths with Briere's (2006, as cited in Collina, 2008) trauma treatment approach. Flory (2005)
joins trauma treatment with the four noble truths and the noble eightfold path of Buddhism.
Each of these papers integrates neuropsychology, contemporary trauma theory, Contemplative
Psychotherapy principles, and clinical experience. None of these papers addresses somatic
sequencing, which (as I argue below) is a crucial component of successful trauma therapy.
For a thorough review of mindfulness and trauma treatment, see Treleaven (2012). In his
hermeneutic analysis of the Western Vipassana Movement and Somatic Experiencing, the author
explains how standard mindfulness practice can be retraumatizing, which raises crucial questions
for the future of mindfulness practice in the West. Treleaven (2012) recommends that all
meditation teachers have a basic training in recognizing trauma, and that trained psychotherapists
be available on meditation retreats to consult with students experiencing trauma symptoms.
How I Became Interested in Mindfulness and Trauma
My own interest in mindfulness and trauma began when I used meditation practice to
heal from bipolar disorder. Although much of my suffering resolved after a transformative
experience (Palecek, 2010), I continued to experience intrusive emotional states. After years of
research and healing work, I encountered contemporary trauma theory in my coursework at
Naropa University, and began work with a somatically oriented, trauma-informed Contemplative
Psychotherapist. This brought rapid and lasting relief of many of my trauma symptoms.
In my clinical internship, I have worked with several clients who experienced traumatic
life events, and who have suffered from symptoms of Post-Traumatic Stress Disorder (PTSD, as
defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., DSM-IVTR, American Psychiatric Association, 2000). Several of these clients also have a past diagnosis
of bipolar disorder, as defined in DSM-TR-IV (2000) 4th ed., text rev. Based on my own
experience recovering from bipolar disorder and trauma symptoms, I began to incorporate this
understanding into my clinical work (Palecek, 2012b), and my clients seemed to benefit.
During this time, I continued to experience trauma symptoms during meditation practice,
and for about six months, I discontinued mindfulness practice, because each session seemed
retraumatizing. Finally I approached Dale Asrael, a meditation teacher at Naropa University, and
received instructions for working effectively with these difficult states, much to my relief (Dale
Asrael, personal communication, October 22, 2012; Palecek, 2012a). Based on Asrael's
instructions, my study of trauma theory and somatic sequencing approaches, Contemplative
Psychotherapy principles, and my lived experience of meditation and trauma healing, I realized
that the Five Wisdom Families could be a template for the trauma healing process.
Next, let us consider the theoretical background of trauma in Western psychology.
Western Approaches and Contemporary Trauma Theory
Trauma was acknowledged at the beginning of Western psychotherapy. In Paris in 1887,
Charcot proposed that the hysterical symptoms of his patients at the Salptrire arose from
traumatic histories (van der Kolk, 2003, p. 174). Charcot's student Janet reported how
decontexualized triggers often induced trauma reactions in patients, and Freud completed two
clinical rotations at the Salptrire, after which he continued to study hysterical patients with
Breuer (van der Kolk, 2003, pp. 174-175). Freud asserted that these patients had experienced
paternal incest, but subsequently recanted due to social pressures (Herman, 1997, pp. 13-14).
Trauma was neglected by mainstream science for decades, gradually reemerging in response to
World War I and II combat traumas (shell shock), post-Vietnam war PTSD, and societal
acknowledgment of widespread systemic violence against women (Herman, 1997, pp. 20-28).
While trauma has been present since the beginning of Western psychology, it has often been
suppressed; Herman (1997) argues that this is a systemic social ill which perpetuates trauma.
Having reviewed the history of trauma theory, let us turn to the symptoms of trauma.
Trauma Symptoms and Complications

In her classic (1997) work, Herman describes trauma symptoms in three primary
dimensions: hyperarousal, intrusion, and constriction (p. 35). These findings are echoed in van
der Kolk's discussion of PTSD symptom clusters (2003, p. 171).
Hyperarousal.
This constellation of symptoms is characterized by a chronic state of hypervigilance and
activation. The human system of self-preservation seems to go on permanent alert, as if the
danger might return at any moment (Herman, 1997, p. 35). Symptoms of hyperarousal can be
seen in PTSD diagnostic criteria in the DSM-IV-TR (2000) 4th ed., text rev.: difficulty sleeping,
extreme startle response, irritability, difficulty concentrating, and hypervigilance. Ongoing
agitation, fear, distrust, suspicion, paranoia, and attentiveness to minute interpersonal cues are
typical for traumatized individuals, who live as though the original threat is still present.
Intrusion.
In intrusion, fragments of implicit memory, in the form of body sensations, images, and
emotions from the original traumatic experience, intrude into normal waking consciousness.
Long after the danger is past, traumatized people relive the event as though it were continually
recurring in the present. (Herman, 2007, p. 37). These somatosensory and emotional intrusions
impinge upon everyday awareness, and mimic the original event (Ogden, Minton, & Pain, 2006,
p. 238). The implicit memories of the trauma return not as ordinary memories of what
happened, but as intense emotional reactions, nightmares, horrifying images, aggressive
behavior, physical pain, and bodily states (van der Kolk, 2002, p. 4). Because these experiences
have no clear cause in present-day biographical awareness, the intrusion can be experienced as
overwhelming, shame-producing, and disorienting by the traumatized person.
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Constriction.
Constriction and numbing involve avoiding stimuli which might trigger traumatic
intrusions, and inhibiting emotional activation altogether (Herman, 1997, p. 42). Constrictive
symptoms are enumerated in the DSM-IV-TR (2000) 4th ed., text rev. diagnostic criteria for
PTSD (p. 468): avoiding thoughts, feelings, activities, conversations, places, or people associated
with the trauma; partial amnesia of the traumatic event; reduced interest or participation in
significant activities; estrangement; and restricted range of affect. The traumatized person
attempts to control their experience by avoiding cues that might trigger trauma states, and by
continually suppressing emotional responses altogether.
In sum, the traumatized person lives in continual fear and hypervigilance; battles with
disorienting somatosensory intrusions; and avoids situations and experiences associated with the
traumatic experience, sometimes cutting off from social supports and resourcing activities
(Herman, 1997, pp. 46-47.) These symptoms are chronic, confusing, and debilitating.
Let us now turn to the origins of trauma, as explained by contemporary trauma theory.
The Genesis of Trauma
Trauma occurs in relation to an overwhelming threat, or one which is perceived as
overwhelming (Levine, 2005, p. 8). Kennedy (2003) lists several different types of trauma:
shock trauma, developmental trauma, fear-based trauma, vicarious trauma, and social trauma.
Thus, traumatic events are diverse; the key point is that they are perceived as a threat to survival.
Viewed through a neurophysiological lens, trauma arises from high sympathetic nervous system
(SNS) arousal, combined with parasympathetic nervous system (PNS) arousal (Wolterstorff,
2011). These trauma imprints remain in the nervous system as fragmented sensory and
emotional traces, but are continually suppressed by higher-level neocortical activities (van der
Kolk, 2007, pp. 6-7), preventing therapeutic release and integration of traumatic memories.
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Scaer (2007, pp. 16-19) explains in more detail. When animals are threatened, the SNS
fight-or-flight response engages, readying the organism for defensive action by increasing heart
rate, blood circulation, sensory attunement, etc. This begins when danger is first perceived, and
increases as the threat intensifies. When the threat cannot be escaped (for example, the animal is
captured by a predator), the PNS freeze response engages, causing immobilization and numbing.
Often the animal is killed and eaten at this point, but in some cases, playing dead works, and
the predator moves on. When the threat is past, the animal wakes up and shakes off SNS
activation in a process that Scaer calls freeze discharge (p. 19), and normal behavior resumes.
In humans, shaking off typically does not occur (Scaer, 2007, p. 20); rather, after an
overwhelming threat, people report a state of shock resembling dissociation (pp. 20-21). This
lack of discharge of autonomic energy. may represent a dangerous suppression of instinctual
behavior, resulting in the imprinting of the traumatic experience in unconscious memory and
arousal systems of the brain (Scaer, 2007, p. 21). Urban living may induce chronic low-level
helplessness in humans, and modern civilization may impose suppression of the freeze discharge,
resulting in a chronically traumatized and dissociated population (Scaer, 2007, p. 22).
Neuropsychologically speaking, our complex neocortex allows humans to suppress the
spontaneous freeze discharge, through using top-down processing to inhibit information from
lower brain structures, including unpleasant emotions and sensations (van der Kolk, 2002, p. 7).
For traumatized people who need to complete the freeze discharge and shake off activation,
learning to abstain from neocortical inhibition through mindfulness is a key intervention.
How do trauma symptoms fit into this neuropsychological model? In trauma, stored
autonomic nervous system (ANS) energy impinges on top-down neocortical processing, in the
form of unresolved SNS and PNS activation, and the neocortex attempts to inhibit these signals.
This matches neatly with hypervigilant, intrusive, and constrictive trauma symptoms. SNS fight-
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or-flight activation manifests as hypervigilance. Intrusions are SNS fight-or-flight activation and
PNS dissociative states impinging on the neocortical cohesive sense of self. Constriction is the
neocortical attempt to make experience cohesive and manageable, by avoiding trauma triggers.
Trauma Sequencing Models
In the clinical domain, several effective approaches to trauma treatment have arisen in the
last few decades, including Somatic Experiencing (Levine, 1997, 2005), Sensorimotor
Psychotherapy (Ogden et al, 2006), and Containment and Resolution (Wolterstorff, 2011). I
focus on somatic sequencing models, as I have found them to be the most helpful personally and
in my work with clients. These approaches are neuropsychologically informed, somatically
focused, and relationally driven. They all recognize the necessity of phased trauma treatment,
mindfulness of present experience, and the importance of the therapeutic relationship.
Trauma sequencing entails learning to invoke traumatic affect and allowing it to undergo
freeze discharge (Scaer, 2007). While an in-depth investigation of trauma sequencing models is
beyond the scope of this paper, the primary components of these approaches have been
abstracted and synthesized into the stages of containment, resourcing, titration, sequencing, and
integration, which are presented in the main topic of this paper, as the Mandala Process.
A Five-State Model of Traumatic Arousal
In the context of trauma sequencing, it is important to understand ANS arousal states.
Wolterstorff (2011) presents a five-state model in his Containment and Resolution approach.
This map explains experiences that may arise in sequencing, and how to navigate that process.
Wolterstorff (2011) outlines five states of nervous system arousal, as depicted in Figure 1.
Baseline levels of ANS arousal are indicated by the dotted horizontal line. SNS (fight-or-flight)
and PNS (freeze) arousal are depicted along the vertical axis. The diagram shows an arousal
curve with troughs and plateaus, in a spectrum running from ordinary waking consciousness
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(state 0), through stress states (mild stress at state 1, high stress at state 2), and trauma states
(trauma at state 3, and severe trauma at state 4). States 3 and 4 are characterized by simultaneous
SNS and PNS activation, and correspond to Scaer's (2007) freeze response.
When the organism perceives a threat, activation proceeds along the curve, from State 0
towards the right of Figure 1. Danger averted, regulatory functions move activation back
towards State 0. In normal animal functioning, the shaking off of the freeze discharge (Scaer,
2007) occurs as arousal moves from State 4 or 3 to State 0. Humans habitually suppress this
response (Scaer, 2007), and trauma sequencing therapies reengage the body's instinctual trauma
resolution process. Sequencing can arise as internal sensations, emotional responses, sensory
fragments, shaking, and other motor responses. Detailed recommendations for working with
implicit memory fragments are beyond the scope of this paper, but Ogden et al. (2006),
Wolterstorff (2011), Levine (1997, 2005), and Rothschild (2000) provide further depth.
Once a traumatic state is elicited and attended to mindfully, ANS activation and
subjective experience proceed leftwards through the arousal curve. Each of the five states is
characterized by different body sensations, as in Figure 2 (adapted from Wolterstorff, 2011).
State 4 severe trauma appears blank or dissociated. At State 3, cold symptoms like heaviness
and fatigue appear. As PNS arousal fades and latent SNS arousal emerges, intensely
uncomfortable hot body sensations arise (e.g. itching, tightness, burning) as the trauma
sequences to State 2. At State 1, body sensations are hot, but less intense. As the ANS
regulates, arousal reaches State 0, characterized by neutral body sensations. Note the top of the
curve, between States 3 and 2. During sequencing, traumatic states which have been dissociated
(State 4) or suppressed (State 3) will build in intensity, reach a crescendo of SNS activation, and
go over the hump to State 2. Experientially, things will seem to get worse before they get better.
When sequencing initially begins, it is best to train gradually (Wolterstorff, 2011), by
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starting with bringing State 1 activation to State 0. Then, one could work with State 2 activation,
and practice in bringing it to State 1, then State 0. Likewise, proceed to 3-2-1-0, and finally 4-32-1-0. In this way, the client's nervous system gradually learns to sequence ANS activation
states, and the client learns to tolerate these experiences while maintaining mindfulness.
To summarize, trauma arises from an overwhelming event, which leads to simultaneous
SNS and PNS activation. Animals appear to sequence this activation spontaneously, but humans
habitually suppress the freeze discharge (Scaer, 2007). This suppression leads to symptoms of
hyperarousal, intrusion, and constriction, which disrupt normal functioning and happiness. By
practicing mindfulness of body sensations, traumatized individuals can learn to sequence
traumatic affect. Somatic sequencing techniques are crucial, because they bypass neocortical
suppression and allow underlying ANS charge to resolve. Trauma sequencing proceeds through
predictable states of nervous system activation; therapists can help clients navigate this process.
Because the experience of trauma is frightening and overwhelming, it is especially
important to approach trauma healing with a gentle, open-minded, and relational therapeutic
orientation. The tenets of Contemplative Psychotherapy are ideally suited to trauma therapy.
Contemplative Psychotherapy Principles
Contemplative Psychotherapy is a discipline embracing Buddhist psychology, Western
psychotherapy, and contemplative methods for cultivating wisdom and compassion. According
to Chgyam Trungpa, the founder of this discipline, Contemplative Psychotherapy is based on
genuineness, simplicity, and communicating from one's personal experience (2005, p. 138). This
points to the importance of relationship, and being authentically oneself. In the M.A.:
Contemplative Psychotherapy program at Naropa University, the following principles are taught
experientially, as well as theoretically. On the basis of the therapist's personal experience, it
becomes possible to communicate to traumatized clients that healing is close at hand.
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Brilliant Sanity
In the view of Contemplative Psychotherapy, the basic state of human beings is health
and goodness. This innate wisdom may be obscured by confusion and emotional reactivity, but it
can never be lost. Brilliant sanity is non-conceptual, ungraspable, and beyond reference points.
It underlies all experience, like the sun shining whether or not it is covered by clouds.
Brilliant sanity is a potent antidote to trauma. Trauma symptoms have a sense of
impending doom, irrevocable brokenness, and irretrievable loss. Brilliant sanity cannot be
undone, and because it is uncreated and unconditional, it is constant. For clients who can
recognize the vast spaciousness, potent clear awareness, and limitless compassion of their minds
(Wegela, 2009, pp. 43-45), the experience of brilliant sanity can be profoundly healing. Clients
may regain trust in their state of mind, and realize that recovery from trauma is possible. The
therapist holding the view of brilliant sanity based on personal experience can open the way for
clients' healing (Trungpa, 2005, p. 142). By recognizing clients' brilliant sanity, therapists
promote a shift in allegiance (Podvoll, 1983), which is a crucially helpful trauma intervention.
Maitri
Maitri connotes fundamental openness and friendliness towards one's experience
(Wegela, 2009, pp. 72-74). Rather than judging, rejecting, or manipulating experience, we could
be with it as it is. By being open to experience, traumatized persons gain more power of choice,
and potential for skillful engagement with traumatic sequelae and life situations. By bringing
kindness and openness to themselves and their experience, traumatized persons gain an
important resource and the healing power of gentleness and kindness. People with trauma may
be used to toughing it out, and maitri is a gentle, potent antidote for self-aggression.
Mindfulness
Mindfulness is paying attention, on purpose, in the present moment, and
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nonjudgmentally (Kabat-Zinn, 1994, p. 4). Mindfulness practice enables one to gather the
mind, examine one's experience, and place the mind on what one wishes, rather than be ruled by
habit and impulse. Mindfulness cuts through habitual patterns, and enables one to make
informed, wise choices. With its emphasis on present-moment experience, mindfulness
establishes a greater allegiance with reality, and promotes holistic vision. While the breath is a
traditional focus of mindfulness practice, any object may be used. Sense perceptions, emotions,
visualizations, and everyday activities can all be supports for cultivating mindfulness.
Mindfulness is a root skill of trauma recovery. It helps traumatized individuals recover
choice and stabilize their experience. Mindfulness enables one to choose what to attend to, and
to expand one's awareness to include whatever else is happening. It soothes and calms the mind,
and embraces experience as it arises (thus cultivating maitri). It also opens the gateway to
noticing that awareness is constant and indestructible (thus discovering brilliant sanity).
In terms of neuropsychology and trauma, mindfulness enables the neocortex to attend to
experience as it arises and learn to tolerate it, counteracting intrusion and constriction. It
establishes self-regulatory patterns of mindfulness and awareness, enabling clients gracefully to
self-soothe and shift ANS activation into the optimal arousal zone (Ogden et al., 2006, p. 27),
counteracting hyperarousal and constriction. Finally, mindfulness creates choice and grounds
clients in the present moment, thus alleviating choiceless and timeless traumatic intrusions.
Impermanence
All phenomena are in constant flux, and all composite things will disintegrate and fade
away (Wegela, 2009, p. 14). Because everything is changing all the time, any attempt to grasp
onto things being a certain way will fail. Likewise, pleasure and pain are temporary.
Impermanence can liberate, because it means that trauma passes. Difficult feelings are not
actually timeless, and trauma symptoms are subject to change and dissolution. Simply by being
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in and opening to the present moment, we participate in the natural flow of change.
Body, Speech, and Mind
Body, speech, and mind are traditional ways of understanding experience in Buddhism
(Kalu, 1997, p. 103), and they are are part of the Contemplative Psychotherapy supervision
approach (Walker, 2008). By acknowledging the levels of behavior and physical form (body),
emotion, relationship, and energy (speech), and thought, belief, and space (mind), traumatized
persons and therapists are better able to bring mindful awareness to what comes up.
The Five Wisdom Families
The Five Wisdom Families or Five Buddha Families represent natural energies of the
mind, which manifest as either neurosis or wisdom (Wegela, 1996). By growing familiar with
these qualities and relaxing into the direct experience of conflicting emotion, individuals can
recognize wisdom and confusion as the play of the mind. The Five Wisdom Energies are the
primary template for the Mandala Process explained in this paper (see Figure 3).
Each family has a Sanskrit name, and each relates to a particular energy or style
(Trungpa, 2005, pp. 126-134). The Vajra family relates to clarity and mirror-like wisdom, and its
neurotic manifestation is anger and intellectualization. The wisdom of the Ratna family is
equanimity, and its confused aspect is pride on one hand, and poverty mentality on the other. In
the Padma family, wisdom is appreciation of details and discriminating awareness; the neurotic
aspect is grasping passion and inner emptiness. The Karma family is characterized by allaccomplishing wisdom, which spontaneously does what needs to be done, in contrast to the
confusion of competition and destructive goal-directedness, or being bound by circumstance.
Finally, the Buddha energy has the wisdom of accommodation and the basic hospitality of space,
and in confusion, this quality of mind evasively spaces out or constricts into tunnel vision.
These five styles of experience arise from the inherent potentiality of the mind, and
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understanding this can help traumatized individuals relinquish fixated defenses. By recognizing
the seed of wisdom in the neurotic states of the Five Buddha Families, it becomes possible to
transmute them into the open state, simply by relaxing with things as they are (Wegela, 1996).
The Four-Step Practice
The Four-Step Practice of transmuting emotions is a technique taught to Contemplative
Psychotherapy students as a way to transform emotional suffering through awareness, so that
inherent wisdom and health can shine through (Cashman, 2012). Each step correlates with one
of the Five Wisdom Families, and draws upon each energy to liberate conflicting emotions. In
this way, students grow familiar with the lived experience of their emotional energies.
The basic process is to bring awareness to the direct experience of the emotion (Vajra),
explore its textures and qualities (Ratna), cradle the experience with warmth and melt into it
(Padma), and open out into space, allowing the energy to self-liberate (Karma; Cashman, 2012).
The practice is really a five-step practice: the goal is not to change anything, but rather, to
awaken to what is (Buddha; Paul Cashman, lecture, January 16, 2012). (This is only a brief
sketch; interested persons should seek personal instruction from a qualified teacher.)
While this technique is initially presented to student therapists as a way to practice with
their own emotions, it can also be taught to clients (Paul Cashman, lecture, January 16, 2012)
and employed by therapists while in session with clients (Paul Cashman, lecture, January 22,
2012). This technique cultivates mindfulness and maitri, and reveals brilliant sanity.
Contemplative Psychotherapy principles embrace the full potential of healing, and grace
traumatized individuals with gentleness and liberating understanding. Let us turn to the Mandala
Process, which is an extension of the Four-Step Practice specifically modified for trauma.
Mandala Process: The Five Wisdom Families as Trauma Intervention
Mandala Process is an integrative trauma treatment model, which unites contemporary
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trauma treatment and Contemplative Psychotherapy. It is a template for the overarching journey
of trauma healing, as well as a process map for working with individual trauma states. After
preparing the ground, the main practice is Mandala Process, followed by concluding practices.
To clarify the presentation, each section is divided into body, speech, and mind.
Preparing the Ground
Before using Mandala Process, traumatized persons need a stable, safe life situation, with
sufficient resources to address trauma successfully. Because trauma entails feelings of threat and
annihilation, it is important to create a present-day situation which is non-threatening and
supportive. Otherwise, when traumatic affect comes up, the individual will be retraumatized.
The following outline draws on the work of Herman (1997) and Rothschild (2000, p. 99).
Components of a foundation for trauma therapy.
Body.
People need stable shelter, food, water, and sufficient finances to care for themselves and
access therapy. They need access to basic healthcare, and to be secure from physical threat.
Speech.
Individuals need supportive relationships, and the capacity to tolerate and name
emotions. Impulse control and emotion regulation skills should be in place, as well as sufficient
social skills to navigate daily life and build friendships. They must be able to establish safety
with their therapist (Herman, 1997, p.133) and in other relationships (Rothschild, 2000, p. 99).
Mind.
The client must be able to learn new skills, and to examine their experience. The most
important capacity is mindfulness, because it allows individuals to distinguish between the
experiencing self and the witnessing self (van der Kolk, McFarlane, and Weisaeth, 1996, as
quoted in Rothschild, 2000, p. 130). Thus, clients can experience traumatic affect arising, but
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remain grounded in present-moment awareness of safety and empathic relatedness (Ogden,

Minton, and Pain, 2006, pp. 165-200). Mindfulness can be fostered through formal practice,
mindfulness of daily activities, and through body-mind synchronization (Wegela, 1996, p.190).
For some clients, therapy may focus on establishing basic resources; others may begin
with many of these in place. These foundations must be maintained throughout treatment.
Mandala Process: The Main Practice
The main practice consists of five stages of trauma resolution, based in the Five Wisdom
Families: Clarity and Containment (Vajra), Resourcing and Relaxing (Ratna), Titration and
Touch & Go (Padma), Sequencing and Simply Allowing (Karma), and Integration and Is-ness
(Buddha). Figure 3 shows the flow of treatment, organized in a mandala pattern.
Each stage is explained in detail below, and each builds upon prior stages. At any point,
it may be necessary to use skills from a prior stage. Therapist experience, clinical judgment, and
the client's capacity to tolerate ANS stimulation without dissociating (Rothschild, 2000, pp. 109115) are good guides for which skill to use, based on what is happening in the client's experience.
Each stage presents increasingly complex ANS regulation and trauma sequencing skills, and
treatment will be most effective as clients integrate these skills into everyday life experience.
Vajra: clarity and containment.
The Vajra family is characterized by clarity, and the capacity to distinguish this from that
(Trungpa, 2005, pp. 127-128). Traumatized persons need to learn to recognize traumatic affect,
and use trauma healing skills when needed. They also need to contain traumatic feelings when
they arise in non-supportive contexts, to avoid overwhelm and retraumatization. This is like
putting difficult feelings in a jar, closing the lid, and putting the jar on the shelf; and being able to
take the jar down and open it as needed. By understanding trauma and creating a safe container
within their experience, clients gain control and present-day safety, which lays the groundwork
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for future stages. Clarity and containment apply at the levels of body, speech, and mind.
Body.
Because traumatic affect involves experiences of somatic fragmentation, clients need to
learn that their bodies are intact, and have an inside and an outside. By paying attention during
showers, touching and tapping their body, and exploring physical boundaries (Levine, 2005),
traumatized individuals can build a sense of the body as a physically secure container.
Through mindfulness of present-moment body sensations, clients learn to maintain
present awareness during traumatic intrusion. Greater awareness of internal states and their
meaning helps to avoid triggers and choose adaptive coping strategies. Some clients regularly
dissociate from the body, thus losing a valuable source of information. By reestablishing body
awareness, clients reclaim the body, and are empowered to make choices about where and when
to engage with traumatic affect. Rothschild suggests some helpful exercises (2000, p. 100).
This stage is a good time to inquire into clients' habits around exercise, drugs and alcohol,
and diet. Therapists may need to help clients cultivate body disciplines that support healing.
Speech.
Trauma healing is supported by an expanded emotional vocabulary. Once clients learn to
recognize, name, and understand emotions, they can make informed decisions. Otherwise, they
may feel overwhelmed by inexplicable sensations and impulses. Emotion regulation skills
(Linehan, 1993, pp. 84-95; 135-164) can help clients safely manage their experience.
Emotion regulation skills lead to a capacity to choose activities that reduce suffering. A
distressed person can observe their experience, investigate it to understand their feelings, and act
accordingly. If tired, they could sleep; if hungry, they could eat; and if lonely, they could seek
out friends. Through understanding emotions, clients are empowered to care for themselves.
Emotional awareness also helps to establish safe boundaries. By investigating feelings,
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clients increase their capacity to negotiate interpersonal situations (Linehan, 1993, pp. 70-83).
This also helps traumatized people differentiate present-moment reality and trauma-linked
emotional reality, and negotiate the needs of each (Rothschild, 2000, pp. 130-132).
The therapeutic relationship needs clear boundaries, to create safety and prevent
retraumatization. These should be established at the outset, and revisited as necessary.
Mind.
Traumatic experience may arise as thoughts, beliefs, memories, and stories related to the
trauma. Stories may be clearly linked to traumatic events, or may unconsciously recapitulate
traumatic situations. Getting stuck in the story can reinforce maladaptive beliefs and stir up
greater turmoil. Previously, trauma treatment focused on memory retrieval, but this is misplaced;
rather, the goal of working with memory is resolution of the trauma (Ogden et al., 2006, p. 240).
Clients may benefit from learning about psychological trauma, its symptoms and causes,
and hearing an outline for the course of treatment. Psychoeducation can normalize peoples'
experience, reduce shame, promote empowerment, and enhance treatment adherence. Rothschild
writes of a client whose suffering was greatly reduced after just one session of psychoeducation
(2000, pp. 97-98). Psychoeducation can contextualize suffering and build resilience.
By using mindfulness to choose what to attend to, clients can learn to tolerate distress
(Linehan, 1993, p. 168). Deliberately focusing on non-triggering experience can give clients
confidence, power, and safety. Clients can also study their experience in order to understand
triggers and learn to manage their lives more skillfully (Rothschild, 2000, pp. 116-117).
Therapists can use a clear understanding of trauma theory (Rothschild, 2000, p. 96) to
guide therapy and maintain a safe container. Through visual cues and client reports (Rothschild,
p. 109-115), therapists can help contain clients within the window of tolerance (Ogden, Minton,
and Pain, 2006, p. 32), by guiding them to be mindful of neutral or resourcing experiences. This
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avoids retraumatization, and implicitly teaches containment skills to clients.

Articulating one's theoretical orientation may offer clients views that support healing and
growth. Explaining brilliant sanity, maitri, and mindfulness, and using meditation exercises to
provide experiential access to these, may help clients relax into their innate healing resources.
Ratna: resourcing and regulation.
The Ratna phase involves accumulating a wealth of soothing and regulating experiences
that clients can use to cushion traumatic experience, and return to a state of well-being.
Resourcing also involves building up self-regulatory capacities, as well as pleasant behaviors,
emotions, and thoughts that clients can rely on. Enriching the field of experience helps people
learn that the trauma is over, and the present moment is safe. This learning needs to occur at the
level of implicit (somatosensory and emotional) memory, as well as behaviorally and cognitively.
Ogden et al. explain resourcing and regulation in depth (2006, pp. 206-233).
Body.
By engaging in pleasant behaviors, traumatized people learn how to enjoy life and take
care of themselves. Rothschild (2000, pp. 92-93) writes of oases (activities that provide stability
and needed breaks) and anchors (concrete resources that bring relief). By expanding their
resources, clients enrich themselves with feelings of safety and ANS regulation. A helpful
resource in this regard is Linehan's Adult Pleasant Events Schedule (1993, pp. 157-159).
Clients can learn to care for their body through balanced exercise, healthy cooking, and
relaxation. Taking up a hobby that builds self-reliance, capability, and safety can help clients
orient towards trauma healing as a process that may take time and effort, but is within their
reach. Thus, clients can accumulate experiences of competence, resiliency, and capacity.
Speech.
Clients can use resourcing to create soothing somatic memories (Rothschild, pp. 118-
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119), body-mind states suffused with safety and relaxed awareness. By evoking pleasant
experiences, clients can give rise to resourced somatic states, and allow these feelings to pervade
their awareness. This is a balm for intrusion and hyperarousal. Meditation techniques such as
metta or loving-kindness may also be helpful. Clients can imagine caring for a loved one, or
petting a kitten or puppy, to arouse feelings of kindness, gentleness, and well-being. Therapists
may suggest that clients extend such feelings toward their own experience. Positive emotional
states can be implicitly learned, and evoked at any time. Individuals should build a great
reservoir of such states, and use them; these are a crucial resource throughout treatment.
Mind.
This phase includes building mindfulness, through whatever means. By increasing
familiarity with mindfulness, maitri, and brilliant sanity, clients uncover their innate resources.
Clients might research practices, ideas, and views that support their healing. Religion
and spirituality, healing systems, art, and literature may be enriching. By building resources of
heart and spirit, clients nourish themselves. It's important that clients cultivate generosity
towards themselves, without the extremes of poverty mentality, hoarding, or overindulgence.
Padma: titration and touch & go.
In this phase of treatment, clients learn to invoke traumatic affect and titrate it with their
wealth of resources and awareness. Titration involves identifying traumatic affect, containing it
so as not to be overwhelmed, touching into it just a little, and then coming back to resources.
This technique is common to contemporary trauma treatments: Ogden, Minton & Pain deem it
oscillation (2006, pp. 217-218), and Levine calls it pendulation (2005, pp. 197-199).
One approach to this process is a modified version of the touch & go meditation
technique (Trungpa, 2005, pp. 27-31). In the touch phase, the client brings awareness to
traumatic affect, and feels into the somatic texture of direct experience (i.e. the somatosensory
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and energetic dimensions) with an attitude of gentle non-judgment. After touch comes go:
the individual focuses on a resource, such as a feeling of present-moment safety, a body memory
of goodness and strength, or an image or visualization that is calming and stabilizing.
The touch may last a brief moment, or longer, but should not overwhelm the client.
The go should last as long as it takes to stabilize arousal within the window of tolerance, and
provide feelings of safety, comfort, and support. Over time, the client's window of tolerance may
broaden, and titration may become an internalized habit of self-soothing and ANS regulation.
In the standard touch & go technique, one goes to the breath. However, the breath is
too subtle for working with trauma states, and such attempts may be retraumatizing (Palecek,
2012a.) Thus the need to go to a resource which is substantial enough to meet the trauma.
Clients can practice titration on their own between sessions. As clients internalize the
touch & go skill, they learn to maintain optimal arousal (Ogden, Minton & Pain, 2006, p. 32),
and trauma integration continues on its own. By allowing traumatic affect to arise in the present
and mix with resourcing experiences, these fragments of past terror are allowed to reassociate
with a regulated ANS and resourced body-mind, and meld with the ongoing flow of awareness.
To reiterate, body, speech, and mind are always co-occurring. A client's traumatic
experience may include racing thoughts, turbulent emotions, and intense body sensations.
Resourcing experiences may include comforting thoughts, feelings, and sensations. During
titration, if the individual feels blocked or overwhelmed in one domain of body, speech, and
mind, it may be helpful to resource in another, more accessible domain. For instance, after
touching into a trauma state with overwhelming negative thoughts (the level of mind), it may
be helpful to go to a resource of emotional soothing (speech) or physical well-being (body).
Body.
Activities, sensations, body parts, postures, and movement tags can all elicit traumatic
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affect to touch into. Others can be used as resources to go to. Clients may benefit from somatic
and motor metaphors for touch & go, e.g. moving the right hand between the left fist (signifying
the trauma) and the right knee (standing for the resource), or whatever is appropriate.
Speech.
Words, songs, emotions, relationships, expressive movement, and energetic experiences
can be supports for the touch and go phases, as either traumatic or resourcing touchstones.
Clients may benefit from developing a connoisseurship of the emotional textures of their
experience, by learning to mindfully experience feelings in all their subtle nuance.
Mind.
Thoughts, memories, and beliefs can be used to evoke trauma and resources for touch
and go, and experiences of mindfulness and spacious awareness can be resources for the go
phase. Clear explanations of how titration works, and how staying within a zone of optimal
arousal (Ogden, Minton & Pain, p. 32) enhances integration, may be helpful. Emphasis should
be put on letting go of the storyline, without rejecting or pushing away, and without clinging to
thoughts or memory. Titration can be likened to tasting blue cheese: one tries a little bit at a time
to savor the experience, rather than eating it by the handful (Steve Jewell, personal
communication, January 17, 2005). The experience of building mindfulness, confidence, and
mastery can become an ongoing resource and lived worldview for traumatized persons.
Karma: sequencing and simply allowing.
The sequencing phase of treatment involves eliciting traumatic experience in the present
moment, and allowing frozen ANS states to thaw, sequence, and rejoin the present-day flow of
experience. Client and therapist work together to anchor the client in the present moment, and
the client observes fragmented aspects of traumatic experience arise and constellate on the levels
of body, speech, and mind. These fragments are held within the larger container of the client's
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mindfulness, and are allowed to sequence through and achieve resolution. In the therapy room,
the freeze discharge response (Scaer, 2007, p. 19) arises and resolves in a present-moment
experience of safety. By bringing mindfulness to traumatic affect, staying with it, and allowing
arousal to peak and naturally decrease, therapist and client can fully sequence traumatic states.
This is what Rothschild calls dual awareness (2000, p. 129): experiencing traumatic
sensations, motor impulses, relational gestalts, emotional states, and thoughts as they arise, while
maintaining present-moment awareness of internal states and empathic relatedness with the
therapist. The therapist helps the client stay with the experience, letting it unfurl, all while
monitoring client ANS arousal and helping the client stay within the window of arousal (Ogden
et al., 2006, p. 32). Sequencing is often followed by a period of collapse and relaxation. When
this occurs, it is important to provide resourcing, comfort, and safety.
This technique involves simply allowing, because sequencing is not necessarily orderly
or predictable. Traumatic affect needs to arise in experience, be held in mindful awareness, and
be allowed to pursue its own course in sequencing. If ANS activation drifts outside the optimal
zone, use resourcing, titration, and containment to make the situation safe and manageable again.
If the therapist or client understand that additional support is needed, for example, verbal
coaching or somatic contact, interventions that arise out of the needs of the moment and the
clinical experience of therapist and client are appropriate. It's important to take it slow, not
overwhelm the nervous system, and allow comfort and ease to pervade the sequencing process.
Trauma sequencing is a complex therapeutic issue, and this is only a brief discussion.
Therapists should do in-depth study and training in sequencing before attempting it with clients.
Body.
On the body level, sequencing involves allowing frozen ANS responses (in the form of
sensations, sensory fragments, and motor impulses) to thaw and sequence through. Sensations,
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motor impulses, and somatic arousal states are allowed to arise, manifest, and complete.
In sequencing, the client may experience internal body sensations, such as burning,
itching, cold, emptiness, bodylessness; feelings of being crushed, torn, rent, pulled, pushed, etc.
Motor impulses may include collapse, defensive movements, flight movements, shaking, and
heavy breathing. The client may experience sensory fragments, such as visual memory, sounds,
etc. These may be the same phenomena that the client previously experienced as intrusions.
Scaer (2007) explains that motor impulses of the freeze discharge response often mimic
the movements that would have occurred in fight-or-flight activation (p. 19). While movements
that were suppressed during the original traumatic event may arise during sequencing, deliberate
attempts to recreate these may be countertherapeutic: it is best to allow body sensations and
motor impulses to arise on their own (Ogden et al., 2006, p. 258).
Speech.
Emotions, words, relational gestalts, and energy phenomena may arise in the course of
sequencing. Clients may benefit from emotional attunement and empathic relatedness with the
therapist, and the therapist may offer reassurance and coaching, or provide missing information
and guidance. Present-moment empathic relatedness also helps ground the client in a sense of
safety and capability, especially in the case of relational trauma. Transference-related emotions
may arise towards the therapist, as well as misattunement, rupture, and the need for repair.
Working with these skillfully can be a powerful intervention (Rothschild, 2000, pp. 82-87).
Mind.
Cognitive processes such as meaning-making, interpretation, and crafting a narrative are
important parts of the sequencing process (Ogden et al., 2006, p. 166). This may include
understanding what happened during the traumatic event, insight into how trauma has shaped
one's life, and shifting the image of the core self in response to trauma healing. Meaning-making
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is most likely to be helpful when it follows the simply allowing tenet of sequencing.
Obsession, fascination, dramatization, and agonizing over the veracity of the story are clues that
the meaning-making process is being forced. The key here is to slow down, emphasize maitri
and mindfulness of present experience, and allow meaning to emerge organically.
Core beliefs, memories, and thoughts may come up in the course of sequencing. Many of
the client's unconscious beliefs about reality, relationships, and themselves may result from the
traumatic experience itself, and these beliefs may come up explicitly during trauma sequencing,
making them available to awareness. However, it is important not to let therapy get bogged
down in storyline and interlocking patterns of belief, nor to focus on memory retrieval and
narrative construction as ends in themselves. According to Ogden, Minton & Pain (2006),
successful treatment of traumatic memory [entails] the resolution of the effects of the traumatic
past on the client's current organization of experience, rather than as the formulation of a
narrative (p. 235). Thus, helping clients reclaim, reconnect, and create meaning in order to put
intrusive memory fragments to rest is the activity of the domain of mind in the sequencing phase.
It is important to explain to clients in advance how sequencing works, so they have a
framework for understanding what may otherwise be a confusing and overwhelming experience.
Providing people with a cognitive framework can help them relax and allow sequencing to occur.
Buddha: integration and is-ness.
Having sequenced traumatic material, clients can allow it to integrate into an ongoing
sense of being. A sense of basic is-ness, free from panic, dawns. This is brilliant sanity
(Trungpa, 2005) or basic goodness (Trungpa, 1984), which becomes increasingly accessible and
reliable, as a present-moment lived experience of health, safety, and wholesomeness.
From the point of view of arousal states, this means bringing a traumatic fragment that
was stuck somewhere in the arousal curve, to resolution at State 0 (see Figures 1 and 2). What
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was once a separate fragment of painful experience, has been accommodated and experienced
within mindfulness and maitri, has sequenced through and been released, and now merges with
the ongoing sense of being. Clients recover a natural sense of is-ness and peace, which had been
covered by the trauma symptoms of constriction, hyperarousal, and intrusion (Herman, 1996).
Viewed through a neuropsychological lens, the ANS has developed more self-regulatory
pathways, so the triune brain is better able to organize and cohere (Siegel, 2007), and neocortical
processes are in harmonious relationship with lower brain structures (van der Kolk, 2002).
Trauma sequencing and integration results in capacities for greater well-being and happiness:
Clients discover a new sense of self that is more flexible, adaptive, and capable of pleasure
and positive affect (Siegel, 2006, as quoted in Ogden et al., 2006, p. 299).
The task of the integration phase is simply to relax with what is, and allow responses to
arise naturally. Throughout the Mandala Process, clients have trained in and internalized the
capacities of each phase. The activities of prior phases are natural ANS self-regulatory
capacities, which have been neocortically suppressed due to traumatic experience or
socialization. Once clients have learned these trauma healing skills, they can use them as the
need arises. These healthy patterns arise spontaneously, and the person's innate body-mind
wisdom continues to integrate and heal. In addition to the trauma healing skills of Mandala
Process, myriad experiences of body, speech, and mind may arise during the integration phase.
The basic approach of integration and is-ness is to pay attention and relax. This brings a sense of
peace, and greater trust in oneself, one's state of mind, others, and the world.
Concluding Practices
Having healed from trauma, clients are empowered to live their lives fully, no longer prey
to traumatic sequelae. The strength, creativity, trust, and power they gained in the trauma
healing process remains available to them throughout life. As an expected gift of the trauma
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healing experience, individuals may find new purpose, inspiration, and meaning.
Herman (1997) describes later phases of recovery, when clients reconnect with others
(pp.196-236). Connecting with community, reaching out and offering their gifts to the world,
and helping others who suffer may be rewarding experiences for trauma survivors.
After trauma resolution, Mandala Process can be used with non-traumatic emotional
experiences, as the Four-Step Practice (Cashman, 2012). Here, the emphasis shifts away from
trauma states, and towards mindful awareness of emotions and present-moment experience.
Case Examples
These two clinical examples illustrate how the Mandala Process can be used as a general
template for trauma treatment. These clients see me for individual therapy at a counseling center.
Belle
Belle is a woman of Asian descent in her mid-thirties, who began services in 2012 after a
car accident. Her background includes adoption in early childhood, and subsequently moving to
the U.S. Belle reported that her mother was punitive and withholding, and made Belle's
childhood very difficult. In her early twenties, Belle was diagnosed with bipolar I disorder, and
received psychiatric treatment and hospitalization, including two courses of electroconvulsive
therapy (ECT). After that, Belle lived rent-free in a property owned by a family member, until
deciding to move out on her own, supported by a meager Social Security Disability income.
Shortly thereafter, Belle was referred to me by her outgoing therapist at the same clinic.
Initially, treatment focused upon building a therapeutic relationship and establishing a
foundation of trust in therapy. The first few sessions, I mostly listened, as Belle recounted her
story, which included many agonizing details about minor decision-making and anxiety around
that. Over time, I began to make more interventions, asking specific questions about Belle's
history and current life situation. During this time, our relationship deepened.
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Initially, Belle presented the stresses of her daily life in the context of heavily medicated
post-ECT bipolar I disorder. When she recounted the details of her childhood, I began to see
how attachment trauma had dogged her from an early age. (This is a Vajra point: identifying
traumatic affect as such.) As I observed Belle's tendency to alternate between collapse
(describing days when she would lay in bed doing nothing, not even eating) and hyperarousal
(keeping a detailed to-do list, forcing herself to accomplish it, and ruminating energetically in
session), I began to conceptualize her situation as one of interrupted trauma sequencing. At that
point, I understood the need for containment and mindfulness.
I began to ask Belle about her ability to contain her feelings of collapse, and to identify
precipitating factors (both Vajra interventions). Among risk factors we identified were poor
eating habits, erratic sleep, social isolation, and rumination (a Vajra clarification of missing
foundations). Belle adopted routine sleep, healthy meal plans, and regular socialization to create
supportive structures in her life. We also began using mindfulness exercises in session.
As treatment continued, I realized that Belle needed strong resourcing (Ratna phase) to
provide alternatives to traumatic overwhelm, and to serve as an anchor (Rothschild, 2000,
p. 93) for Vajra containment practices. One such resource we identified was a calming image of
a natural site that Belle loved to visit, which for her symbolized spirituality, stability, and peace.
We used mindfulness practices in session to visit this place, and to allow feelings of calm, clarity,
and stability to pervade Belle's experience. She also used this visualization as needed between
sessions. This mindfulness practice contributed to a reservoir of somatic resourcing states, as did
other enriching activities which added to Belle's collection of pleasant experiences.
Another crucial resource that developed over the course of therapy is Belle's sense of
maitri or loving-kindness towards herself. With my coaching, Belle became more self-accepting
and less self-aggressive. This may have reduced a great deal of Belle's suffering.
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Several months into therapy, Belle's mother passed away of a terminal illness. Belle
chose to move back in with her family, and to return to a web of relationships (Padma). This
shift in the family system has reduced Belle's general level of distress, and has stabilized and
grounding her in meaning and mutual support. Belle appears to be regulating in harmony with
her family members. She reports a capacity to grieve her mother's death without feeling
overwhelmed (Padma touch & go), and her intrusive experiences have attenuated. Therapy
continues, and it appears that Vajra clarity and containment, Ratna resourcing and regulation, and
Padma titration and touch & go have had a positive impact for Belle.
John
John is a Caucasian male in his late twenties, who was referred for therapy due to acute
suicidality, including a clear timetable, firm intent, heavy drinking, and a pistol. He spent the
last year in chronic pain due to complications arising from a genetic bone disorder, which caused
his bones to erode and grind against each other, leading to excruciating pain while walking, or
even raising a limb in bed. He was uninsured, in too much pain to work, and had been unable to
access social services to address his medical issues. After years of drinking heavily to escape the
pain, he got sober, but things seemed to get worse. John no longer wished to live in chronic pain
with a progressively deteriorating body, and suicide seemed a valid response.
In addition to his overwhelming physical pain, John's bone disorder resulted in a body
shape that is visibly and unmistakably different from the norm. Since childhood, he has been
physically different, weaker than others his age, and suffered scorn, mockery, and exclusion.
Thus, John also suffers from a trauma of difference, and its emotional and social repercussions.
Therapy began with a frank and unflinching discussion of suicide, and the deep pain John
was in. I remember his eyes boring into me, and how I understood and acknowledged the depths
of his pain and the seriousness of his threat. I believe that this intervention of Vajra clarity
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opened the way for the rest of therapy. In that session, we completed a safety contract, wherein
John agreed not to kill himself for eight weeks. This created a clear container for therapy.
We proceeded by investigating John's resources (Ratna), including housing and skills. I
referred him to a skills training group (Linehan, 1993), thus enriching his capacities and
providing him with needed self-regulation tools. We also began to collect resourcing activities,
images, and ideas. One example is John's car, which he repaired and modified for himself, and
which was a symbol of pride, confidence, and capability for him. With my encouragement, John
used the image of his car, and the felt experience of driving around in it, as a metaphor for how
therapy could work, and as a touchstone of resourcing somatic memory.
We began to investigate the textures of John's pain, and the direct experience of his
emotions. These were overwhelming at first, and we used the Padma titration skill to modulate
arousal by going to resources, which included the present-moment therapeutic relationship. We
also investigated his lived experience of helplessness, and of having no control over his life or
body. John reported benefiting from touching into these feelings, and being able to come back
out, which resourced him with feelings of competence and present-moment safety.
Soon after, John learned that his application for social services was denied, and he went
into a tailspin. Fearing for his safety after he missed an appointment, I broke confidentiality and
called his emergency contact. This person stated that John had been hospitalized for suicidality.
John spent two weeks in the hospital, and was discharged into my care. He reported that
while he was in hospital, he underwent a breakdown, and cracked the shell of a lot of his
underlying issues. He also was able to advocate for himself within the public health system, and
with a caseworker's help, gained access to a badly needed surgery to relieve his chronic pain, and
a more vigorous pain management plan. In sum, John reported that his hospitalization was a
success, intrapsychically as well as in accessing needed services.
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Therapy has continued for a few months since then, and we have mostly focused on
keeping John stable and happy while awaiting surgery. We have been working with John's
tendency to overdo it pushing himself to complete tasks, which results in more physical pain.
We have also been working with noticing how John's experience shifts in relation to his
upcoming surgery. This is a simply allowing Karma intervention: mindfully experiencing
trauma states (hyperarousal, constriction, and intrusion, Herman, 1997) in the here-and-now.
John's first surgery was a success, and he enthusiastically returned to therapy only a week
afterward. While my internship is drawing to a close, I feel confident that John will consolidate
his gains in therapy, and continue to practice these trauma recovery skills in the future.
I hope these two vignettes, discussing my work with Belle and John, illustrate how
Mandala Process can used to support clients with diverse histories and presenting issues.
Discussion
The case examples illustrate how Mandala Process can be used in different situations to
support clients in integrating traumatic affect without feeling overwhelmed or retraumatized.
Trauma healing can be a long process. Even if clients do not experience all the steps of the
Mandala Process, they can still benefit from earlier phases of treatment.
Mandala Process can be viewed as a map for the entire arc of trauma treatment, and it can
also be used for each iteration of traumatic affect arising. When a trauma response arises in the
person's experience, Mandala Process can help in navigating that experience by bringing the
traumatic fragment through each stage of the mandala. Alternatively, when one is thoroughly
familiar with the technique, one can call upon whichever skill is needed; this is the spontaneous
wisdom of the Buddha stage of integration and is-ness.
This approach requires an experiential learning process. For clients to be able to use
Mandala Process effectively, they need to practice it in their daily lives, rather than just thinking
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about it or doing it only in session. The actual experience of using the stages of the process
retrains ANS self-regulatory functions, and implicitly teaches trauma states that present-moment
experience is safe, stable, and resourced. From an interpersonal neurobiology (Siegel, 2007)
perspective, skillful mindfulness of trauma states may foster a secure internal attachment style,
promote neural integration, and create lasting healthy changes in the brain. Through intentional
training in these skills, the body-mind can regain its innate trauma healing powers.
Dissociation
Clients who dissociate may have difficulty giving rise to traumatic affect in the Padma
titration and touch & go phase. It may be helpful to start working with any strong affect that can
be elicited in session, for instance, by thinking about a recent situation that was emotionally
disturbing and produced a State 1 or 2 response (see Figure 1). In this way, clients can grow
familiar with the basics of Mandala Process, and their ANS will be prepared to handle more
intense affect when it arises. See Wolterstorff (2011), Rothschild (2000), and Ogden, Minton,
and Pain (2006) for more ways to contact, sequence, and integrate dissociated traumatic affect.
The Truth of Suffering
Mandala Process is not a panacea, and even if we resolve trauma completely, we will still
experience inescapable existential givens (such as impermanence, suffering, and egolessness,
Wegela, 1996, pp. 88-90). To heal from trauma is to trade one set of problems for another, and at
a certain point, it is important to communicate this to clients. Hopefully, the new problems allow
for more creativity and freedom, beyond the confusion and instability of traumatic affect.
Limitations
Mandala Process has limitations, some of which are inherent to trauma treatment. Clients
need to have a stable life situation, to be able to afford psychotherapy services, to attend
treatment, and to practice skills on their own in a safe place. Unfortunately, for many
37
traumatized individuals, trauma symptoms are so debilitating that they cannot establish these
basic foundations in their lives. Mandala Process might not be effective for such clients.
The emphasis on mindfulness in Mandala Process requires that clients be able to cultivate
mindfulness and a witnessing presence. For some clients, such as those with complex PTSD
(Herman, 1997) or severe dissociative symptoms, this may be an insuperable obstacle.
Dissociation is in some sense the opposite of mindfulness, and if clients have been using
dissociation to manage their experience for a long time, it may take long training and ongoing
attention to reverse dissociative habits and train in mindfulness skills.
Mandala Process requires that clients be able to tolerate traumatic affect without
decompensating or using destructive coping techniques. Thus, it may be inappropriate for use
with psychotic clients, clients with borderline features, or clients with active addictions. Dual
diagnosis cases are complex, and while trauma may be the root of addiction, it remains to be
seen if Mandala Process is an appropriate intervention for people with active addictions.
Clients need to distinguish safety and overwhelm, and communicate that to the therapist.
Particularly during titration and sequencing, clients need to have control over the flow of the
session, in order to avoid affective flooding and retraumatization. In this sense, clients need to
be able to say no to the therapist, to set limits and feel safe in doing so. Depending on clients'
attachment style, relationship to authority, ego strength, and relational trauma history, they may
have difficulty doing this. Thus, therapists may need to help clients gain these capacities.
Otherwise, clients may experience therapy as retraumatizing, and drop out precipitously.
Clients need to be able to gauge degrees of arousal, to report their experience to the
therapist, and to modulate contact with traumatic affect (through touch & go, resourcing, and
containment). This capacity extends to the trauma recovery process altogether, because clients
need to participate in normal activities unrelated to trauma healing in order to stabilize their
38
lives. Clients need to find the sweet spot of trauma recovery, without erring into either
excessive focus on trauma (leading to overwhelm) or avoidance (which perpetuates symptoms).
One of the strengths of the sensorimotor psychotherapy (Ogden, Minton, and Pain, 2006)
and Containment and Resolution (Wolterstorff, 2011) approaches is their emphasis on client
reports of present-moment experience. This verbalization of somatosensory and relational data
can help guide therapy, and avoid retraumatization and recapitulation of prior relational traumas.
These verbal techniques could be incorporated into the Mandala Process in psychotherapy.
Herman's Five Stages of Trauma Healing
Herman's (1997) guide to trauma therapy outlines five stages of recovery: a healing
relationship, safety, remembrance and mourning, reconnection, and commonality. These stages
complement Mandala Process, and frame it in time and social context. Trauma therapists are
advised to read this classic work, and use its valuable insights in their practice.
The Need for Empirical Research
There is a paucity of empirical research into the effectiveness of somatic trauma
sequencing models. While there is a wealth of anecdotal evidence from clients and therapists,
more outcome research is needed, in order to establish trauma sequencing in the wider field of
psychotherapy. Empirical trials are a double-edged sword, in that they provide institutional
support and societal approval, but they risk flattening subjective experience, and opening
intrapsychic and interpersonal processes to colonization by scientific materialism and
reductionism (Wilber, 2007). These latter efffects are antithetical to a client-centered trauma
therapy, and may recapitulate social and institutional traumas, entrenching the wounds inflicted
upon the subjective and intersubjective dimensions of experience by scientific materialism,
consumerism (Marcuse, 1964/1991), and the mass media (DeBord,1967/1992). However,
outcome trials supporting therapeutic gains over time, combined with rigorous professional
39
certification and training requirements, may prevent such therapies from being diluted and
commodified into manualized brief therapy protocols, quick-fix approaches, or self-help pablum.
The Need for Further Training and Experience
Before attempting somatic trauma sequencing with clients, Contemplative
Psychotherapists need in-depth study and training in somatic sequencing. Otherwise, they risk
harming clients by attempting to treat issues outside their scope of practice. Similarly, if
therapists wish to use those phases of Mandala Process leading up to the sequencing phase, they
should practice those skills personally, before using them with clients. One should not purport to
guide someone up a steep mountain path if one has not already made the journey oneself, for to
do so would be unethical and risky for both parties. Therapists need to practice these skills and
train in trauma sequencing before bringing Mandala Process into their work with clients.
Conclusion
Mandala Process is a novel synthesis of Contemplative Psychotherapy approaches and
contemporary trauma treatment. As such, it owes an enormous debt to the pioneers of both of
these disciplines, as well as to many generations of psychotherapy clients and meditation
practitioners. Mindfulness and trauma therapy is a burgeoning field, and there will doubtless be
many promising developments in the years and decades to come. I hope this paper has
contributed something valuable to the literature, and that Contemplative Psychotherapists,
trauma therapists, meditation instructors, meditators, and psychotherapy clients will derive some
benefit from it. Psychological trauma is widespread and debilitating, and by addressing it
skillfully, brilliant sanity, healing, and effective social transformation can manifest. I hope this
paper, distilled from my struggles with mindfulness and trauma, will be a seed for personal and
social liberation, healing, and peace. Mandala Process is the fruit of a decade of trauma healing,
intensive study, and meditation practice. I dedicate the merit of this work to the benefit of all.
40
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44
Figure 1: Five-State Model of Trauma
Five-State Model of Trauma
Sympathetic activation
Combined activation
Parasympathetic activation
baseline
p
base state
stress states
trauma states
e
Activation levels of each state:
p
q
w
e
r
Easy Pleasant, relaxed awareness

Stress Moderate activation, alert and ready
Intense Stress High activation, adrenaline rush

Trauma Overwhelm, shutdown, depersonalization
Severe Trauma Dissociation, blanking out
FIgure 1. Diagram displaying the interplay of sympathetic and parasympathetic nervous

system activation, trauma states as simultaneous SNS and PNS activation, and clinically
significant plateaus of activation and traumatic experience. Adapted from Love and Trauma:
Healing trauma and its effects on ourselves and our relationships, A self-help and clinical
manual for psychotherapists and their clients, Circulating draft excerpt, by E. Wolterstorff,
2011, p. 32, fig. 14c. Retrieved from http://www.loveandtrauma.com/wp-content/
Uploads/2011/11/Love-and-Trauma-Book-Chapters-13-and-14.pdf.
45
Figure 2: Sequencing the Five States
Sympathetic activation
Sequencing the Five States
Parasympathetic activation
baseline
When the nervous system

and body function naturally,
sequencing spontaneously
occurs, and the trauma and
stress states are processed
and released automatically.
CNS activation gradually
passes through the states in
descending order, finishing
up at the base state (0).
The body sensations of each

state are felt fully, and
released.
Typical sensations during sequencing:

p Pleasant, relaxed awareness
q
w
e
r
Discomfort, tightness, itching
Intense discomfort, intense tightness, heat

Heaviness, fatigue, cool or cold sensations
Blankness, numbness, lack of sensation
Figure 2. Diagram displaying sequencing of stress and trauma states, and body sensations
typical of each state. Adapted from Love and Trauma: Healing trauma and its effects on
ourselves and our relationships, A self-help and clinical manual for psychotherapists and their
clients, Circulating draft excerpt by E. Wolterstorff, 2011, p. 32, figs. 14c and 14d. Retrieved
from http://www.loveandtrauma.com/wp-content/ Uploads/2011/11/Love-and-Trauma-BookChapters-13-and-14.pdf.

Figure 3: Mandala Process
Mandala Process
Padma:
Titration and
Touch & Go
Ratna:
Resourcing and
Regulation
Buddha:
Integration and
Is-ness
Karma:
Sequencing and
Simply Allowing
Vajra:
Clarity and
Containment
Figure 3. Diagram displaying the stages of the Mandala Process, arranged in the traditional
mandala configuration (Karen Kissel Wegela, lecture, September 4, 2012). The phases of
trauma treatment are depicted linearly, but each phase is available to client and therapist as
needed. For clients who are so inclined, incorporating this diagram and Buddhist iconography
could help frame trauma recovery as a journey of spiritual healing. However, it is not at all
necessary to embed the process within a religious or spiritual framework. These phases are
simply ordinary aspects of human experience and trauma recovery.
46

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Running head: MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

A Contemplative Approach to Trauma Recovery:

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

Contemplative Trauma Treatment: A Synthesis of Eastern and Western Approaches

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

Trauma Symptoms and Complications

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

remain grounded in present-moment awareness of safety and empathic relatedness (Ogden,

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

avoids retraumatization, and implicitly teaches containment skills to clients.

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

Treleaven, D. (2012). Meditation and trauma: A hermeneutic study of western Vipassana

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

Figure 1: Five-State Model of Trauma

Five-State Model of Trauma

Easy Pleasant, relaxed awareness

Intense Stress High activation, adrenaline rush

FIgure 1. Diagram displaying the interplay of sympathetic and parasympathetic nervous

MANDALA PROCESS: A CONTEMPLATIVE TRAUMA APPROACH

Figure 2: Sequencing the Five States

Sequencing the Five States

When the nervous system

The body sensations of each

Typical sensations during sequencing:

Discomfort, tightness, itching

Intense discomfort, intense tightness, heat