Yoga and the Trauma Survivor - Offering Choices

Relatively speaking, Posttraumatic Stress Disorder is still a diagnostic adolescent. Not officially recognized until 1980s in DSM III and driven by reactions to combat, we are still learning so much and yet so many questions remain. One thing that is clear, the prevalence of those who have experienced trauma is much higher than previously thought and affects more than just veterans. To complicate matters, like all mental health treatment, one size does not fit all. In recent years, research has been exploding on the integration of bodywork into or as an adjunct treatment to therapy.

As a Psychologist, I have been studying and integrating yoga and yoga theory into work with clients with many different diagnoses, including PTSD. Yoga is a benefit-packed practice that is receiving a significant amount of attention from the trauma world. The Trauma Center, in Brookline MA1, has created a new style of yoga called Trauma-Sensitive Yoga (TSY)2. This practice differs from your standard yoga class in many ways and emphasizes one very important piece of the puzzle: choice. Typically, yoga classes are prescriptive in that they direct yogis from pose to pose. Variations and modifications are usually offered but for the most part, all students do as they are told. The option of choice can be very powerful for a survivor of interpersonal violence as they typically have long histories of being told what to do, how to do it, and how to feel about it.

Standard treatment is also often instructive: “Take this medication to help your nightmares,” “Be sure to practice your deep breathing,” and “even though it’s difficult, it’s important to talk about what happened.” In our kindest and most competent effort, we tell our clients what they can do to feel better. This perspective is not meant to discredit any of the evidence-based practice used to treat trauma today as TSY is not considered a replacement. In fact, TSY requires participants to be involved in therapy. Again, TSY provides a choice for clients. I recently had a particularly intense session with a survivor and she opted to end with a brief TSY chair practice to “help her relax” (her words, not mine). As she sat in her chair, I sat in mine, going through the practice. At one point, she simply chose not to do any of the movements offered. At the end of the practice, she provided an unsolicited explanation saying she noticed that a particular movement caused pain in her back. She said she chose to just sit and breathe which ultimately relaxed her. This may seem so trivial but if we think of the therapy office as a micro chasm of the real world, what if this client could always choose not to do something that hurt her? What if she could dictate what she did with her body? What if she could feel safe in her own body? What if she saw an opportunity to break a pattern?

As therapists, we are mindful not to re-traumatize clients but merely taking away a choice, could have a negative impact. Some clients have become so disconnected from their bodies that just recognizing that their body needs something is a challenge. Trauma-Sensitive Yoga offers clients an opportunity to restore that connection and to be the one who chooses how to meet those needs.

Can “Regular” Yoga Help?

The simple answer is, yes. There is an abundance of research available on the use of yoga for anxiety, depression, and other medical and mental health issues. A “regular” yoga class still provides all of those benefits to someone with PTSD/Complex Trauma. However, it would not be considered “trauma-sensitive.” This may be a barrier for some.

The image of a “good yogi” is a petite, toned, young woman in skin tight clothing, effortlessly bending her body into precarious poses all while balancing on one toe. Now for a moment, imagine sending a client with PTSD to a yoga class filled with fitness models who are able to stand on their heads, look good