Employing Yoga in Treatment of Trauma

As a long time student of yoga, I have personally experienced the short and long term benefits of yoga for the mind and body. However, it was not until I introduced yoga to a client with post-traumatic stress disorder (PTSD) that I fully understood the depth of healing that a yoga practice could provide.  

One definition of trauma is described as an experience that overwhelms our ability to cope that often results in debilitating physical and mental symptoms (Emerson and Hopper, 2011). Whether a single trauma, like a devastating wild fire, or complex trauma, such as repeated child abuse, the effects of trauma on the mind and body can render an individual helpless, unable to cope with the most benign life stressors.  The effects of trauma on the brain can be extensive and complex.  Dr. Bessel van der Kolk discusses the damage of trauma on the structures of the brain in his book The Body Keeps Score.  He touches on the physical changes in the structures of the brain responsible for our interoception, including the medial prefrontal cortex and other structures within what he calls our “mohawk of self-awareness.” He compares the brain scan images of non-traumatized adults with brain images of adults diagnosed with PTSD, highlighting the brain activity in the structures that generate our sense of self awareness. Alarmingly, the brain images of those with PTSD had little or no activity in this area of the brain when under stress. He further describes how the impairment of these brain structures inhibit our ability to determine threat vs. non-threat, or screen stimuli that is relevant vs. irrelevant. It is not until these structures are activated that the brain is “re-wired” and an individual can recover and move past the traumatic experience. Yoga is one avenue to accomplish this. 

It is common knowledge amongst yoga practitioners that yoga has been practiced for thousands of years for its benefits to the mind, body and spirit that lead to a life of peace and contentment. It wasn’t until the last decade that research was conducted to prove yoga as an evidence-based therapeutic practice for individuals suffering the effects of trauma. In a 2014 research study, 64 adult women with treatment un-responsive PTSD were randomly assigned to a group receiving 10 weeks of trauma-informed yoga or a health educational control group. Findings showed 52% of women in the yoga treatment group no longer met the criteria of PTSD compared to 21% in the control group. (Van der Kolk et al., 2014).  Through the practice of asanas, pranayama, and meditation, yoga increases interoception, stimulating activity in the medial pre-frontal cortex, and our “mohawk of self awareness.”  In addition, these practices stimulate the production of GABA in the brain, a pain-blocking neurotransmitter responsible for reducing nerve activity and calming the nervous system. Yoga practice can teach self-regulation, reduce emotional distress, and increases quality of life in yoga students.

Unlike psychotherapies such as Cognitive Behavioral Therapy which uses “top-down strategies” (Gard et al, 2014) that rely on frontal lobe functioning to understand situations based on accumulated knowledge and understanding of emotions, yoga uses both “top-down and bottom-up strategies” (Ogden, 2010, 2015; Van der Kolk, 2014).  Bottom- down strategies are initiated from the body and communicated with the brain stem and limbic system to self-regulate emotions.  By practicing asanas and pranayama an individual self regulates from the bottom-up. Through the practice of meditation self-regulation comes from top-down.  In individuals with PTSD, frontal lobe impairment makes top-down self-regulation difficult or impossible. Yoga teaches self-regulation from both perspectives. 

In addition, the benefits of yoga include improving heart rate variability (HRV), a measurement now used as an indicator human health and resilience.  A robust HRV indicates a healthy fluctuation in heart rate and is a good indication of physical and emotional health. Conversely, a poor HRV indicates a lack of coherence in breathing and heart rate making an individual more susceptible to both physical and mental health problems. Yoga improves the balance of the autonomic nervous system demonstrated through increasing HRV, which ultimately, improves one’s ability to manage their response to stimuli and self regulate. (Van der Kolk, 2015)

In summary, yoga is an effective and now evidence-based treatment for individuals suffering from the effects of trauma which can include anxiety and depression.  Just a few of the many benefits of practicing yoga include an increase in self- awareness, self-regulation and overall improved physical health. Interestingly, yoga has been a practice great sages have used for centuries to improve and sustain a mind, body and spiritual sense of wellbeing. Although we in the West are only now giving yoga practice the credit of healing the damage of trauma; violence, destruction and other forms of traumatic events that have occurred in yoga-practicing cultures long before western medicine took an interest. One can only surmise that these great sages have been using yoga to heal and cope with trauma and suffering as long as it has existed.