Q: I’m trying to get my clients to meditate, but it isn’t working. Any suggestions for working with especially vulnerable clients?

A: Clinicians often make a variety of mistakes while trying to introduce mindfulness, and in my 30 years of trying to figure it out, I’ve made all of them. So let me share some of my bloopers with you in the hopes that you can avoid them. After all, meditation teachers often say, “This practice is simple, but it isn’t easy.”

Myth 1: Always Start with the Breath

I know this is what they teach in meditation classes, but with a clinical population this isn’t always a wise place to start. Let me tell you about my experience with Kayla many years ago, before we knew much about mindfulness meditation or trauma. She was a new patient and was anxious about an upcoming job interview. I thought some deep breathing would help her relax, so I asked her to take a number of deep breaths. After a few minutes, she began to hyperventilate and became angry with me. I was confused. How could a simple relaxation practice go south so quickly? It turned out she had a trauma history that she hadn’t disclosed and was in the middle of a flashback of being suffocated by her father. Starting with the breath had triggered her memory of struggling to breathe. So please make sure you take a thorough history before attempting to introduce mindfulness to your clients. It’s often best to start with a…