Mindfulness Isn’t Always the Answer
When to Pause Before Prescribing Presence
Kelly Anderson, PhD
As a psychologist, mindfulness is something I recommend to most clients. It’s often one of the first tools I include in therapy or list in an assessment report because it can offer real benefits. However, it’s not a silver bullet. Mindfulness isn’t a cure-all and it doesn’t help every person or every symptom. In fact, mindfulness can even make some conditions worse if not used with intention.
Like many evidence-based strategies, mindfulness has gained popularity for good reason. It can support emotional regulation, improve attention, and lower stress. But it’s not one-size-fits-all. For people with certain diagnoses or nervous system patterns, traditional mindfulness practices can feel overwhelming or even harmful.
That’s why I’m careful to introduce mindfulness in a way that’s responsive to each person’s needs. Mindfulness used carefully can be incredibly useful, but it can also be harmful if it’s not a good fit.
When Mindfulness Helps
Mindfulness can be especially helpful for clients who feel disconnected from their thoughts, emotions, bodily sensations or who tend to operate on autopilot. It can improve present-moment awareness, increase tolerance for discomfort, and enhance the ability to pause before reacting.
Clients with anxiety, mild to moderate depression, or chronic stress often find relief through simple mindfulness exercises. These might include noticing the breath, tracking physical sensations, or naming thoughts as they come and go. In many cases, mindfulness reduces rumination and helps people feel more grounded.
Research supports its use in treating conditions like:
Generalized Anxiety Disorder
Mild to moderate Depression
ADHD (particularly when combined with behavior-based strategies)
Insomnia
Stress-related physical symptoms
Anger Management
Some pain conditions
Mindfulness can also increase emotional insight and reduce emotional reactivity, making it a strong complement to therapies like CBT, DBT, and ACT.
When Mindfulness Can Backfire
In some cases, mindfulness isn’t the right starting point. Clients with significant trauma histories, especially those who experience dissociation or hypervigilance, may feel more dysregulated when asked to close their eyes, sit still, or focus inward.
For some, mindfulness can trigger flashbacks, intrusive thoughts, or physical anxiety. People with OCD may report that focusing inward heightens obsessive thoughts. Those with severe depression sometimes describe mindfulness as too passive or too still, making them feel more numb or stuck.
In particular, I use caution with:
Complex PTSD or active trauma symptoms
Severe dissociation
OCD, especially with intrusive thought patterns
Psychosis
Autism (especially when mindfulness is presented in rigid or overly internal ways)
It’s not that mindfulness is never helpful in these cases, but it needs to be carefully adapted and monitored. Clients should never be pushed into mindfulness because it’s trending or expected. Moreover, if a client has given mindfulness a fair try and feels that it isn’t helping, or even causing more distress, therapists should hear this and respond accordingly.
Adapting Mindfulness to Work for You
When mindfulness is too much, I often modify the approach rather than abandon it altogether.
Instead of formal meditation or breathwork, I recommend:
Mindful movement (walking, stretching, yoga)
Sensory-based grounding (touching textured objects, noticing five things in the environment)
Mindful activities (drawing, cooking, gardening with full attention)
Noticing the present moment while doing a task, without judgment
Shortening mindfulness to mindful moments (1-5 seconds of mindfulness)
Practicing mindfulness externally before learning to turn inward
For clients with trauma, pairing mindfulness with movement, nature, or connection to others often feels safer and more effective. Additionally, we work to find emotion regulation skills and tools that can be incorporated into mindfulness practice.
The key is not forcing presence, but rather creating a sense of safety in the body and mind. Mindfulness should be something that supports regulation, not something that activates distress.
Where This Leaves Us
Mindfulness is a tool I come back to often and love to recommend, but only when it matches what a client truly needs. It can be an effective tool when used thoughtfully, or frustrating when used too soon or without support.
If you’ve tried mindfulness and it didn’t work for you, you’re not doing it wrong. It may just not be the right fit right now. There are many ways to regulate the nervous system and build awareness. Mindfulness is one option, not the only one. Learning to find what works best for you will support growth much more than trying to fit into a preconceived notion of what growth might look like.