Transcending Trauma:
How Yoga Heals

Initial study results revealed that participation in trauma-informed gentle yoga leads to a significant reduction in symptoms of post-traumatic stress.

“Elaine” is a survivor of childhood trauma, and her inability to control her emotions, trust her body, or form meaningful and loving relationships is a common cluster of side effects associated with complex post-traumatic stress disorder (complex PTSD), according to Judith Herman, professor of clinical psychiatry at Harvard and author of Trauma and Recovery, who coined the term. This particularly insidious form of PTSD affects those who suffer from chronic childhood abuse.

While we often think of PTSD as the intense and unexplained symptoms military men and women experience coming home from battle, this anxiety disorder can take many forms and touch a much wider population. Being raped, getting hit by a car, witnessing a violent crime, being in a war zone, losing your best friend to cancer, or even being scared of the possibility of something bad happening can all contribute to PTSD. How you deal with how you feel in the aftermath of such events determines the level of trauma that gets lodged in your cells.

Yoga's ability to touch us on every level of our being—physical mental, emotional, and spiritual—makes it a powerful and effective modality for trauma victims.

Yoga can make a big difference for trauma survivors like Elaine, and we are beginning to see more research that backs up her experience. A three-year NIH-funded yoga and trauma study conducted at the Trauma Center at Justice Resource Institute in Brookline, Massachusetts, with women who have treatment-resistant complex PTSD, has shown promising results. Bessel Van Der Kolk, MD, the study’s principal investigator, and his colleagues presented preliminary findings at the 2010 International Society for Traumatic Stress Studies conference in Montreal last November. Initial study results revealed that participation in trauma-informed gentle yoga leads to a significant reduction (over 30 percent) in symptoms of post-traumatic stress, including fewer intrusive thoughts and less dissociation from the body. By the end of the study (after only 10 weeks of yoga) several women in the yoga group no longer met diagnostic criteria for PTSD.

Other smaller studies show yoga increases heart rate variability (HRV), a measure of how robust the brain’s arousal systems are. It appears that traumatized people have unusually low HRV, says van der Kolk—who is also founder and medical director of the Trauma Center—which could explain why they are “so reactive to minor stresses and so prone to develop a variety of physical illnesses.” Yoga’s ability to touch us on every level of our being—physical, mental, emotional, and spiritual—makes it a powerful and effective means for trauma victims to reinhabit their bodies safely, calm their minds, experience emotions directly, and begin to feel a sense of strength and control.

All Talked Out
Most experts agree that trauma’s effects live in the body—and that’s why yoga works. Evidence suggests that people like Elaine respond best to body-based therapies, coupled with psychotherapy, because traditional “talk” therapy alone can dredge up old memories and reignite the pain all over again. And, while the mind may spend countless hours reliving the event and retelling the tale, it cannot undo the effects of what happened—the terror, rage, helplessness, and depression that then manifest in the body.
Most experts agree that trauma's effects live in the body—and that's why yoga works. 

According to Van Der Kolk, trauma is not the story we tell about the violence we endured or the horrible accident we witnessed; it’s not even the event itself. Instead it’s the stuff we can’t let go of—what van der Kolk calls the “residue of imprints” (and yogis call samskaras) that gets left behind in our neurophysiology (our sensory and hormonal systems). Van der Kolk, the author of numerous articles and studies on how trauma affects the brain, says that traumatized people are “terrified of the sensations in their own bodies,” so it’s imperative that they get some sort of body-based therapy to feel safe again, he says, and learn to care for themselves.
Unresolved “issues in our tissues” manifest physically as migraines, nervous tics, clenched muscles in the neck, shoulders, and jaw, a sunken chest, or a heavy heart. Left unresolved, they can exact an even heavier toll in the form of heart disease, diabetes, panic attacks, ADHD in children, fibromyalgia, irritable bowel syndrome, and a host of autoimmune disorders.
On a Physical Plane

Before a trauma survivor like Elaine can let go of any residue or feel any physical sensations, she needs to spend time getting to know her body—a little bit at a time. Dana Moore, a Santa Fe-based psychotherapist and Kripalu Yoga teacher who specializes in trauma therapy, told me adults who were neglected or abused as children “probably had no healthy way of learning about their bodies.” Most of them have neither a strong sense of self nor a keen sense of the connection between the internal and the external. In his sessions, Moore likes to invite students to pendulate between movement and rest, between interoception (sensations in the body) and exteroception (stimuli outside the body). For example, he might guide trauma victims through an exploration of the left hand, noticing every muscle and movement, and then ask them to stop, rest, and feel. And then ask them to bring their attention to their ears, noticing any sounds they hear. An exercise like this reminds them that they can feel something deeply and shift the focus, coming out of discomfort, anytime they want.

Moving from one asana to another, slowly and deliberately, encourages students to stay with sensation and notice what’s happening in their bodies, and to approach each movement with a sense of curiosity. The simplest of poses (standing or sitting in a chair) can produce profound results. Just feeling his feet on the floor for the very first time gave one agitated survivor a sense of balance, stability, and safety. For Elaine, who dissociated from her body and felt numb, doing gentle supported backbends began to wake up her body and get the blood flowing. Building a strong, capable body goes a long way toward developing a strong, centered mind.
No matter what poses survivors choose to do—or how much they experiment with the breathing exercises—they benefit from knowing that each exercise comes to an end, that they won’t get stuck in emotional overwhelm. A pose might feel uncomfortable, a round of pranayama might bring up feelings they would much rather stuff back down, but the sensations are temporary, only around until the next posture or the next exhalation.

According to Van Der Kolk, Western medicine doesn’t give us many tools to “master our own physiology,” so too many times trauma survivors end up self-medicating with drugs and alcohol as well as prescription drugs. Pranayama can have an energizing or calming effect on the nervous system, he says, and quiet the brain. Soltes adds that the breath can keep survivors in the body. Gentle pranayama that emphasizes the exhalation, she says, works well for those who chronically hold their breath or feel agitated. Alternately, focusing on the inhalation can help those collapsed in depression or dissociation, especially when paired with movements like modified sun salutations.