An Embodied Model of Trauma Recovery: Examining Internal Regulatory Processes and Racial Stress in PTSD Among Black Americans

Abstract

Black adults in the United States navigate profound and often invisible stressors at the intersection of racism and trauma. The burden of chronic racial stress functions as an embodied form of oppression that may increase the risk and intensity of post-traumatic stress disorder (PTSD) symptoms and undermine psychological strengths such as mindfulness and self-compassion for healing, recovery, and well-being. These disruptions may also limit the effectiveness of mind-body interventions, such as mindfulness-based cognitive therapy (MBCT), a transdiagnostic intervention which addresses PTSD and depressive symptoms through the cultivation of mindfulness and self-compassion practices. Although prior work highlights MBCT’s feasibility and acceptability for trauma-exposed Black adults, there is a critical gap in the literature examining how racial stress shapes treatment responses and outcomes. Thus, the present study addressed this gap through secondary data analysis of a prior MBCT feasibility and outcomes trial conducted with trauma-exposed Black adults (N=80), focusing specifically on the n=43 participants randomized to the MBCT treatment condition. Using standardized measures of PTSD symptoms, racial stress, mindfulness, and self-compassion, the current study tested three research aims: 1) Examine mindfulness and self-compassion as mediators of 1-month follow-up (FU) PTSD symptom severity, 2) Examine baseline racial stress as a moderator of MBCT treatment outcomes (1-month follow-up PTSD and post-intervention mindfulness and self-compassion), 3) Examine baseline racial stress’ potentially moderating indirect effect of baseline PTSD on 1-month FU PTSD severity through self-compassion and mindfulness. Results from the analyses suggested that both post-intervention mindfulness and self-compassion are important components of PTSD treatment outcomes and that it is important to consider the culturally salient components of racial stress within trauma treatment for Black Americans. This study sought to fully honor and recognize Black Americans’ stories of healing that center and prioritize their experiences of racial and interpersonal trauma and meaning making. By conceptualizing racial stress as embodied oppression, and mindfulness and self-compassion as embodied healing mechanisms, this study offers preliminary insights for clinicians and researchers working at the intersection of racial trauma and culturally comprehensive intervention development.