The Hippies Were Right: Healing Trauma With Yoga

Tuesday, September 27, 2016 by Meg   •   Filed under Treatment Techniques

Post-traumatic stress disorder can come with difficult symptoms, many of them physical. Some people with a history of trauma have a constant heaviness in the chest, some have muscle tension or pain. Others experience continuous feelings of helplessness, hopelessness or flashbacks. Most have some difficulty regulating their emotions and may suffer from distorted body image or difficulties in personal relationships. Still others numb emotions with substances , rely on distractions like high-risk behaviors or use self injury to ward off the internal pain with an external distraction (read more on the symptoms of trauma in The Evolution of PTSD).

But some feel far less due to self protection in the form of dissociation or disconnection, some detaching so cleanly that they may have to look at their arm to know it’s moving at all. But this disconnection from body and emotion is usually imperfect, with individuals experiencing breakthrough symptoms at unexpected times, suddenly panicking at a particular noise or freezing mid conversation. Childhood trauma in particular often hides until a later date when the individual is more able to handle the discomfort, leading some to wonder, “I didn’t feel this bad then! Why is this happening now?” 

Congratulations, you’re healing. It feels shitty but it means your brain and your body are finally dealing with what happened. You are no longer fully disconnected. And you now have a chance to take back your body.

But how? 

Physical treatments may exist to foster acceptance, bodily connection, and listening to the self as well as allowing individuals to practice the element of choice after experiences where this choice was removed. And because of the nature of the practice, yoga may be the perfect medium. 

Wait…like all that hippie stretching mixed with half-naked people chanting, “Ohm”? You want me to use that to treat trauma? What the hell? 

Seriously, it has some merit, guys. Every once in awhile, outside the box is where the answer is. 

Fight, Flight, Freeze or Submit

Most are familiar with the fight/flight response, or the body’s reaction to a threatening situation. We are programmed to respond to a threat with increased heart rate and respiration, ready to flee a danger or fight the same. We also come equipped with a freeze response, where the body shuts down and collapses in order to make a predator less interested or to save us from pain during an attack. 

Trauma may occur when the fight flight and freeze defenses are aborted and submission takes precedence1. In this state we are helpless despite our best efforts. In Overcoming Trauma Through Yoga, Emmerson and Hopper break down that freeze response into two categories, a hyper-vigilant stage of not being able to move but actively taking in information to determine the best course of action for escape, and submission, defeat or playing dead. In submission or defeat, the activation of the parasympathetic nervous system triggers lowered blood pressure, releases opiods which allows us to feel less pain, and leads to dissociation with its characteristic alterations in time, space and reality1

This dissociation can cause a body-brain disconnect that persists long after the initial trauma is over because some of the changes that occur during trauma are physical. While other areas in the brain may be involved in self awareness as well2, the insula—an area that transmits bodily sensations into conscious awareness—has been shown to function differently in those with trauma3,4,5 as do other parts of the brain related to self awareness and other functions5. There are also structural differences, such as decreased volume in the hippocampus (an area related to memory and depression) and alterations in frontal limbic structures in the brains of trauma survivors6

So trauma probably alters some of those memory functions, and changes our awareness of self (and thus pain) for protection. But many are still aware of the helplessness, or perhaps an underlying feeling that their bodies betrayed them. It is hard to understand why emergency systems that were supposed to protect us failed to do so. It’s as if our bodies are ineffective to combat outside forces. We cannot trust ourselves at our most basic level. We no longer feel safe.

Because of this lack of relative safety, people become prone to overreaction. Even in cases of dissociation (where you might not be aware of what your body is doing) you may remain physically hyperaroused (on the verge of fight/flight), ready to respond with barely a trigger, and without thought necessary. Likewise, you may also experience under-reaction, a better way to conserve energy, as each new situation is probably hopeless anyway. 

Most go back and forth between the two. This chronic over or under activation of the body may cause oscillation between numb and easily triggered, disconnected or highly sensitized.

And those fluctuations can be seen in physical systems, not purely in emotional reports. 

The Heart Rate Variability Model (HRV) and Trauma

Heart Rate Variability (HRV) serves as a measure of the brain’s arousal systems. Those with good HRV have inhalations and exhalations that produce expected fluctuations in heart rate1. Good HRV indicates strong connection between systems. Those with higher HRV also tend to have more ability to control their impulses and emotional responses, in contrast to those with lower HRV who tend to have more trouble maintaining balance1,8.

Researchers note that those with traumatic histories have especially low HRV 1,7,8. And Emmerson and Hopper believe that yoga may create rhythms to combat low HRV and encourage reconnection with the body1. But whether improvements with yoga are due to the HRV model, the ability of exercise to assist the endocrine system and the HPA axis or the way yoga tends to increase mindfulness, numerous studies show that yoga is a viable treatment for reducing the symptoms of post-traumatic stress1,9,10,11

Treatment Options For PTSD: CBT, Writing and Yoga

Some therapeutic interventions such as cognitive behavioral therapy, visualization, psychosexual somatics and physical exercise are discussed here in PTSD and Treatment Alternatives. At this time, variations of cognitive behavioral therapy that include elements of exposure therapy and writing or storytelling remain the most popular treatment alternatives. I also like the techniques described in Trauma and the Body: A Sensorimotor Approach to Psychotherapy, where authors encourage a combination of a number of practices including cognitive techniques, bodily processing, affect regulation, altering meanings of events and fostering attachment repair12.

But no matter which path you take here, yoga is generally a safe and effective way to begin the process towards reconnection and healing. 

You may be able to find a trauma-based yoga class in your area (ask master Google). But if you can’t, you can always go to a standard yoga class and see if it fits your needs. If you happen to be susceptible to shame you may not want to hit the most advanced one. Likewise if you are someone who has issues with touch you want to make sure you attend a class where the teacher doesn’t physically adjust postures (though you can clearly speak to them ahead of time to ensure they don’t touch you). 

You can also start with yoga videos. My favorite DVD for this is A Yoga Practice For Healing Emotional Trauma. There are also books that detail yoga practices such as Yoga for Emotional Trauma: Meditations and Practices for Healing Pain and Suffering. And as an overview of postures you might like The Practical Encyclopedia of Astanga Yoga & Meditation (one of my favorite yoga books). 

For now, let me tell you about some of the practices detailed in Overcoming Trauma Through Yoga, combined with my personal favorites. Through all of these practices, you might benefit from matching your breath to your movements to foster additional connection.

Using Yoga To Treat Trauma: A Brief Overview of Postures and When To Use Them

  • Feeling frozen or rigid: Try standing and folding forward at the waist, letting the arms and head hang loosely. Rotate the neck if it feels right. 
  • Anxiety or tension: Try neck rolls, or belly breathing (discussed more here in Deep Breathing Techniques)
  • Feeling Isolated: Try a group yoga practice
  • Defensiveness or intimacy avoidance: Try a centering technique. Sit on the floor or in a chair, spine straight, palms open but facing down. Raise the hands as you inhale, lower them as you exhale, allowing yourself to connect with your body.
  • Feeling off balance or conflicted: Try a seated twist, triangle or other balancing postures. I like tree pose where you balance on one foot and bring the other to your middle thigh, hands and arms stretched above you. You can also try mountain pose, or standing with both feet on the floor, palms together stretching towards the ceiling. Boat pose, sitting on hip bones with legs and back off the matt (think making your body like a wide V) may also improve core strength and improve actual and emotional balance in the long run.
  • Overwhelmed or vulnerable: These feelings may mean a good child’s pose is in order. Kneel and sit back on your ankles. Lean forward with your forehead on the floor and stretch your arms in front of you.
  • Feeling stuck or having trouble making decisions: Any movement-based posture may help (this is where the above ashtanga book comes in handy).
  • Feeling numb: Mindfulness practices may be beneficial here to foster reconnection and self awareness (discussed more here in Mindfulness and Self Compassion). You can also try reading The Mindfulness Solution: Everyday Practices for Everyday Problems. For an audio-guided practice, check out The Guided Mindfulness Meditation Series 
  • Reenactments/flashbacks: Try any pose where you can practice sensing your body, say by feeling where your body comes in contact with the floor, as a way to remain in the present moment. You may also like experimenting with creating physical boundaries, say with pillows, blankets, etc. around your position.
  • Helplessness: Try poses that make you feel tall, such as mountain pose, or other standing poses that lengthen the spine (I like warrior poses for this one).
  • If you feel shut down or have low energy try breathing exercises that wake you up or postures that physically move you forward, such as moving from a chair (or seated) pose into a standing position with hands above your head.

With any of these practices, the critical element is to feel your body and learn to trust it again. Understand where your limits are and only go as far as is comfortable for you. Practice pushing yourself if it feels right, or slow down if it doesn’t. 

Yoga is essentially about choice, about being present. It is a personal practice; only you can feel what is right for you. And as long as you are listening to your body, to your limits, to your inner voice, you are already doing it right. Because while this practice won’t be right for everyone, it is just another tool in the toolkit to combat the symptoms of PTSD. And the more options we have to treat it, the better our chances of finding the best combination of tools for each individual. 

Find what works for you. You have control of your body. You’ve got this. 

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Citations
  1. http://www.amazon.com/Overcoming-Trauma-through-Yoga-Reclaiming/dp/1556439695
  2. http://www.biomedsearch.com/nih/Preserved-Self-Awareness-following-Extensive/22927899.html
  3. http://humanrights.ucdavis.edu/resources/library/documents-and-reports/imaging_the_trauma.pdf
  4. http://www.ncbi.nlm.nih.gov/pubmed/19501653
  5. http://www.ncbi.nlm.nih.gov/pubmed/23021615
  6. http://www.ncbi.nlm.nih.gov/pubmed/16730374
  7. http://www.ncbi.nlm.nih.gov/pubmed/20680439
  8. https://www.ima.org.il/FilesUpload/IMAJ/0/61/30924.pdf
  9. http://www.ncbi.nlm.nih.gov/pubmed/23929045
  10. http://www.ncbi.nlm.nih.gov/pubmed/22398342
  11. http://www.ncbi.nlm.nih.gov/pubmed/21868714
  12. http://www.amazon.com/Trauma-Body-Sensorimotor-Psychotherapy-Interpersonal/dp/0393704572  



Topic-Relevant Resources

Mindset: The New Psychology of Success
Can the way we think about learning create more successful people? Researchers say, "Yes." This book walks you through how to use that to your advantage.

Overcoming Trauma through Yoga: Reclaiming Your Body
Deep breathing and yoga poses designed to assist with healing through the body-mind connections common in PTSD.

Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy
Self help techniques using Eye Movement Desensitization and Reprocessing (EMDR) a therapy especially helpful in trauma and anxiety cases.

Trauma and the Body: A Sensorimotor Approach to Psychotherapy (Norton Series on Interpersonal Neurobiology)
Filled with creative, multidisciplinary approaches to heal trauma, this book is a must read for those suffering.

Waking the Tiger: Healing Trauma: The Innate Capacity to Transform Overwhelming Experiences
Dr. Peter Levine discusses the evolved processes that make us more susceptible to traumatic experiences and offers paths toward healing.



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