We sought to, first, better understand the role of emotional responding, and specifically shame and guilt, in trauma recovery among asylum-seekers following forced displacement; and, second, to explore whether therapeutic effects of a mindfulness-and compassion-based intervention on trauma recovery among asylum-seekers are mediated by therapeutic effects of the intervention on shame and guilt. Study aims were tested through a randomized waitlist-controlled trial of a 9-week Mindfulness-Based Trauma Recovery for Refugees program among a community sample of 158 Eritrean asylum-seekers (55.7% female) residing in an unstable high-risk urban postdisplacement setting in the Middle East (Israel). First, in a cross-product test of parallel mediation, we found that shame, but not guilt, mediated the preintervention associations between traumatic stress exposure history, as well as current postmigration living difficulties, and current posttraumatic stress (ab Shame = .035, 95% CI [.024, .048], ab Shame = .183, 95% CI [.122, .249]) and depression (ab Shame = .384, 95% CI [.234, .55], ab Shame = .405, 95% CI [1.117, 2.693]) symptom severity. Second, in a linear mixed effects model of mediation, we found that reduced shame from pre-to postintervention, mediated the effect of MBTR-R, relative to waitlist control, on improved posttraumatic stress (ACME Shame = À.18, BCa 95% CI [À.34, À.04]) and depression (ACME Shame = À1.78, BCa 95% CI [À3.29, À.29]) symptom severity outcomes. Findings provide insight into the potential role of shame in trauma-and stress-related recovery among FDPs (forcibly displaced people). Findings indicate that mindfulness-and compassion-based training promotes trauma recovery, in part, through reducing feelings of shame postdisplacement.

Objective: We sought to address a growing debate regarding the adverse and salutary impact of unusual, extraordinary, or intense subjective experiences during mindfulness interventions. To do so, we empirically characterized such peak experiences during an intensive mindfulness meditation intervention and their impact post-intervention. Method: We conducted a preregistered prospective intervention study among 96 adults who registered to a six-day mindfulness meditation retreat and 47 matched-controls. Controls were selected from a pool of 487 people recruited from the same community of meditators as retreat participants and systematically matched to retreat group on age and lifetime meditation experience. Measures included the Peak Meditative Experience Scale (PMES) and the Impact of PMES (I-PMES). Results: Seventeen peak experiences that were predominantly pleasant (e.g., deep and unusual peace, aha! moment) occurred more frequently among retreat participants than among matched-controls in daily living (ps < .05; mean φ = .33). In contrast, 14 peak experiences that were mostly unpleasant (e.g., flashbacks, overwhelming sadness) occurred at similar rates in both groups (ps > .05). At two-week follow-up, the perceived impact of all pleasant and most unpleasant peak experiences was more salutary than adverse (ps ≤ .015; M Cohen’s d = 1.61). Conclusions: Peak experiences that resulted from intensive mindfulness meditation training were primarily pleasant and had a large salutary impact post-retreat. Inconsistent with conclusions from uncontrolled studies, findings document that intensive mindfulness meditation training may not contribute to unpleasant peak experiences, and even when they occurred their impact was typically more salutary than adverse.