Yoga for PTSD
Yoga and Post Traumatic Stress Disorder
by Amy Bernard
“Recent Research has unveiled the fact that our bodies have great capacity, when it comes to storing bad memories. The body processes some of these memories and the rest is passed onto our nervous system where it rests on our spine untreated for several years to come, until one takes a conscious step to get rid of it” – Christopher Jacoby
In this article, we will be looking at an alternative approach to treating symptoms of post traumatic stress disorder. Many people throughout the world are afflicted with PTSD and most people are unaware of the steps that they can take in order to treat themselves. Throughout this article we will explore the body’s capability to store trauma and how we can treat their symptoms by practicing components of the sacred science of Yoga.
Post Traumatic Stress Disorder (PTSD) is a severe anxiety disorder that can develop after exposure to any event resulting in psychological trauma. Such events are usually those that lead the victim to feel that his or her life is in danger. Common traumatic events leading to a diagnosis of post traumatic stress disorder can be; rape or other forms of sexual assault, war/combat, physical abuse, abandonment early on in life, natural disasters, major accidents, and the death of a loved one.
According to the National Center for PTSD, in the United States, 70% of adults have experienced some sort of trauma in their lifetime with 20% going on to develop PTSD. That means that as many as 31.3 million people in the US suffer from PTSD. It is also estimated that 5% of Americans suffer from PTSD at any given time, that’s 11.2 million people. In the past year alone, the rate of diagnosed veterans has gone up by 50% with 1 in 5 soldiers returning from Iraq and Afghanistan having a diagnosis of PTSD.
There are many symptoms for those who suffer from PTSD and not all victims suffer from all symptoms. The symptoms include:
Disassociation – When people experience high levels of fear or anxiety associated with a traumatic situation, one of the mind’s natural defence mechanism to an overwhelming traumatic experience is to separate itself from the experience in order to survive. People have reported, “feeling numb” or, disassociating. This can lead to a person who suffers from PTSD to lack the feeling of connectedness and feeling grounded.
Depression: Most sufferers of PTSD report feeling a sense of worthlessness, a lack of interest in daily activities, sadness, hopelessness and helplessness and overall symptoms of depression.
Panic attacks: These can occur in a victim if they experience similar stimuli to the initial trauma. The breath can quicken and become shallower, the victim can suffer from brief feelings of intense fear, heart palpitations, and nausea.
Flash-backs: These can also occur in a victim if they experience similar stimuli to the initial trauma. Vivid memories of the initial trauma come into the victim’s mind, causing them to feel as if the trauma is taking place at that present moment.
Disturbed sleep patterns: When people suffer from PTSD, they can have racing thoughts, particularly at night time when the mind tries to rest. It may be difficult for the victim to fall asleep and nightmares associated with the trauma may interfere with the victim’s ability to stay asleep.
Feelings of powerlessness: Feeling powerless is very common in those afflicted with PTSD. Since the victim was unable stop the traumatic experience from occurring, especially if it occurred repetitively, the victim is left feeling that he is unable to control anything in his life since he was unable to do so during the event.
Trauma can very easily be stored in both the brain and the body. When a situation is life threatening, often times the victim holds their breath. During this hold, the energetic imprint of the scenario; sight, smell, sound are energetically recorded in the Body. The body and brain then mobilise a great amount of energy to prepare to fight or escape. The brain sends a signal from the heart to the adrenal glands to release the stress hormones adrenaline and cortisol in ordewr to stimulate the cells in preparation for the flight or fight response. If it is impossible for a person to remedy their situation through the fight or flight response, the mind then kicks into survival mode. Instead of fighting or fleeing, the mind and body may freeze and disassociate from emotional and physical sensations, as such sensations are beyond a person’s capacity to process. If these stress hormones are not properly released through some kind of action, the body and mind can get stuck in this state of high of alertness, and fear and toxins that are created in abundance during the trauma get stored in the body. (Levine)
During the initial trauma, the sympathetic nervous system is overstimulated and very easily becomes accustomed to responding to similar situations in the same way later on. If the sympathetic nervous system continues to over-activate in this manner, neural cell degeneration can occur which can result in disturbed sleep patterns, nightmares, problems with attention, and increased startle responses. Respiratory patterns can be thrown off balance as well resulting in the breath becoming shallower. This decrease in oxygen to the brain can cause anxiety attacks. People that suffer from PTSD typically live in a state of heightened arousal, as their sympathetic nervous system is continuously activated and cortisol and adrenaline is constantly being generated.
How Yoga Can Help
So how can yoga help with symptoms of PTSD? There has been a lot of research conducted about the calming effects of breath work, meditation, and physical exercise, all of which are components of Yoga.
Yoga means union, union of the body, mind, and spirit. When one suffers from a traumatic event, the body and mind often become separated as a survival mechanism. Through yoga, those afflicted with PTSD can bring those components of the Self back together. Yoga helps the practitioner to stay in the moment through focus in the asana and focus during meditation. Yoga inspires the practitioner to bring awareness to how their body is feeling and how they can create quiet and calm in the body through the breath.
In a study conducted in 2005, survivors of the 2004 tsunami in the Andaman Islands were assessed before and after participation in a one week Yoga program. The assessment included polygraph tests of heart rate and breath rate, EKG testing, and self reporting of anxiety, fear and sadness. Over 8 days, 47 survivors participated in 60 minutes of Vivekananda Yoga daily. The regimen included 10 minutes of warm-ups, 20 minutes of asanas, 15 minutes of pranayama, and 15 minutes of guided relaxation.
After completing the final assessment, the polygraph findings showed an overall decrease in heart and breath rate while the overall reports of fear, sadness and anxiety were also less.
More and more trauma centres throughout the United States are introducing Yoga programs into their milieu. Yoga Warriors is a Yoga program offered to war veterans through a trauma centre in Massachusetts. Many veterans suffer from PTSD, having vivid flashbacks that come about due to various triggers. Participants of Yoga Warriors have noted the calming effects of yoga, reporting feeling more present and grounded, experiencing fewer flashbacks, and feeling peace in their minds.
Trauma at the energetic level
Chakras, or energy centers, are found throughout the body and are connected with energy channels called Nadis. There are 7 primary chakras that run along the sushumna nadi (throughout the spine). These energy centers govern different emotions and hold the energy of events that occur throughout one’s life. For the purpose of holding trauma, we will just talk about the first 5 chakras and the effects of trauma on them.
- Muladhara Chakra is a located at the base of the spine and is the root chakra. It governs all things related to survival. This chakra is influenced by early relationships and how one feels in their environment. The feeling of groundedness comes from this energetic center so if one holds trauma, the root chakra governs the symptoms of disassociating, feeling unsafe, and feeling unbalanced.
- Swadisthana Chakra is located an inch or two below the navel and is the pleasure center. It governs people’s sense of self worth, attitude toward sex, and is one of the emotional centers. If one holds trauma in the body, swadisthana governs the symptoms of fear, being self negating and overly sensitive. People who suffer from PTSD as a result of rape or other forms of sexual abuse could suffer from an overactive or deficient swadisthana chakra.
- Manipura Chakra is located above the navel and is the center of personal power. It is influenced by self esteem. People tend to hold their traumas in the Manipura chakra. Those suffering from PTSD often feel like they have no power, no strength in decision making and who they are and these symptoms are governed by this energy center.
- Anahata Chakra is the located at the heart center and governs compassion, unconditional love, and grief. It is said to be the most vulnerable of all energy centers. Those who suffer from PTSD as a result of not receiving unconditional love early on in life or from losing a loved one will build walls around their Anahata chakra and suffer symptoms governed by this chakra.
- Vishudha Chakra is located at the throat and governs self expression. Those who suffer from PTSD as a result of emotional abuse often have blockages in their Vishudha Chakra, causing fear around speaking, self expression, and perhaps could be related to a sufferer having a hard time seeking out help.
Knowledge of the chakras can aid the process of treating symptoms of PTSD. Different asanas can be prescribed for balancing and toning the chakras. For example, asanas like Tadasana can be prescribed for balancing the Muladhara chakra, giving the practitioner a sense of balance and becoming grounded. Meditation can also be focused on opening the chakras. Each chakra has its own seed sound, or mantra that can be chanted to stimulate the chakra. They also each have a colour associated with them that can also be visualised when picturing the chakra during a chakra meditation.
Knowledge of Pranayama can also aid the process of treating symptoms of PTSD. Pranayama is a yogic practice of breath work that helps to clear energy channels in the body so that life force energy can flow freely without blockages. Pranayama practice has great effects on the nervous system. Inhalations tend to stimulate the sympathetic nervous system while exhalations tend to stimulate the parasympathetic nervous system. If the symptoms of PTSD are anxiety and fear, those who practice pranayama will want to focus on deep, prolonged exhalations. For example, the practice of Nadi Sodhana can be used for reducing stress and anxiety. The purpose of practicing this technique is to clear the way for energy to flow more freely. The technique involves breathing through alternate nostrils, one nostril at a time, bringing a sense of calm to the body and mind.
Yoga Class for PTSD
There are many things to be considered if one is going to lead a yoga program for those who suffer from PTSD. Teachers should not do physical adjustments on the students under any circumstances. If the student is putting their body in danger due to misalignment, the teacher should give verbal cues or instruct the student to come out of the pose all together. The space in which the classes are to be conducted should promote feelings of safety and comfort. Teachers should perhaps consider the use of calming colours, aromas, and music in their space as well. It may be a good idea to have chakra themed classes over a 5 week program with one chakra being the focus of the meditation and asana portion of the class.
The following is a suggested outline for a class to be taught to those who suffer from PTSD:
Centering: The students should start in a comfortable seated position and teachers can begin by emphasizing the importance of being present while on the mat. They can begin by visualizing a safe place-maybe somewhere that they go when feeling unsafe, or maybe just a place where they feel loved. With this in mind they should scan throughout the body from head to toe to find out if there invite the student to set an intention of respecting their bodies and the body’s limitations. A talk about respect and compassion for the Self may be introduced.
Pranayama: The teacher can then ask the students to bring awareness to the breath. Nadi Sodhana can be taught here. The teacher can explain to the students the technique of practicing alternate nostril breathing and the benefits of balancing the nadis. The practice should be on 1:1:2 ration with a count of 5 on the inhalation, a count of 5 on the retention, and a count of 10 on the exhalation. After 5 rounds of Nadi Sodhana, the teacher may ask the students to take a few moments in silence and in regular breath to notice if there are any differences in the body and mind after practicing. Ask them to take note of their state of mind before entering the room and now that their practice is complete.
Meditation: A specific chakra can be the focus of a meditation. It may even be a good idea to have a 5 week program with each week having the focus of meditation and asana be a specific chakra. For example, if the theme of the class is to balance the Manipura chakra, the student can start by visualising in their mind’s eye a spinning disc of yellow. They can mentally chant the seed letter, “Ram”. After doing this for a period of time, the teacher can then ask the students to cultivate feelings of personal power and love for themselves.
Warm-Ups: For a safe asana practice, the students should be led through a brief series of warming up the joints. The teacher can introduce the practice of matching movement with breath at this time, again reminding the student how breathing can keep the mind calm while practicing various activities. This should be emphasised throughout the entire practice.
Suggested Asanas: Teachers should keep in mind that people that have been exposed to high degrees of violence, like war veterans hold a different kind of trauma than those who have experienced trauma through sexual abuse. Someone that has experienced the latter may have a more difficult time in postures such as ustrasana or “happy baby” pose due to their vulnerable physical position. The teacher can start the asana portion of the class by cueing Tadasana, or the mountain pose. This pose draws the students focus to their foundation, rooting them into the earth, where they can feel a sense of support, grounding, and a connection to the universe through their feet. So many people feel disconnected from others and the world when they suffer from PTSD and such postures can assist with this. This posture balances the Muladhara (root) Chakra. Other standing postures, such as Vrksasana can be introduced for grounding. During Vrksasana, or the tree pose, the teacher can ask the students to visualize that they have roots coming out of their standing leg, connecting them with the earth and that they are growing up and out of those roots.
Strong asana poses such as Virabhadrasana can be introduced to give the student a sense of power and inner strength. It may be beneficial for the teacher to tell the students about how the name of the pose, warrior, came about. This may further inspire the student to feel empowered and strong while practicing this pose. Balancing postures such as Bakasana and Garudasana can be prescribed as they demand concentration and calm, smooth breath work to hold the pose. Achievement of such postures can also bring about a sense of accomplishment, which does not come easy for those who suffer from PTSD. Students can also make the connection that when faced with a strenuous task, they can get through it with calm and steady breath, concentration, and awareness.
Twisting postures can be introduced as they help to eliminate toxins from the organs, toxins that can be generated from the body’s stress response. Spinal twists also help to balance the Manipura chakra. Pravrita Trikonasana can be introduced here. Forward folds can be introduced to balance the swadisthana chakra. Although the student may not be able to feel the effects of this, the benefits can still be described while practicing the asana. Sarvangasana can be introduced as this posture has so many physical and mental benefits. While the student is in their shoulder stand, the teacher can explain how the inversion is giving rest to the heart while pumping nutrient rich blood to the thyroid gland, calming the nervous system, benefitting sleep patterns, assisting with anxiety, and giving relief to headaches. This posture also stimulates the Vishudha Chakra. The counter position, Matsyasana can be prescribed after as a heart opening asana.
Throughout the asana portion, the teacher should continuously bring the student’s awareness to their breathing. Bringing attention to the fact that holding the breath causes students to easily become unbalanced or panic in their mind therefore talking themselves out of the pose. The teacher should also continue to remind the student about their initial intention to respect and care for their bodies and to treat themselves with love and compassion.
Deep Relaxation: The teacher can end the class with the students in Savasana position. They can be given the option of having their eyes open or closed. The teacher can guide the students through another body scan to release any tension leftover in the body.
There is no evidence that suggests that Yoga alone can cure a person from suffering from PTSD. In fact, this may be a controversial issue to those who believe that only traditional clinical therapy alone will benefit those who suffer from PTSD. The truth is, not everyone is cut out for traditional clinical therapy. But it is clear through my research that Yoga can have great benefits to people suffering from PTSD. It is seen that the practices of Yoga acts directly on the body’s parasympathetic nervous system, the very system that will sooth the nervous system by balancing out the over activity of the sympathetic nervous system. As an added benefit, Yoga is available to everyone. Some people are afraid to talk about things that have happened to them due to feelings of shame and guilt. Others are unable to seek the help of professional clinicians due to finances or health insurance. Perhaps by introducing yoga to those individuals, they can come to a place where they have a little more respect for themselves, understand that they deserve to be well, and find the power to move forward in seeking out further assistance with their issues.
By Amy Bernard – Himalaya Yoga Valley Graduate
1. Jacoby, Christopher. Releasing Trauma. The mind, Body, Spirit Connection. www.healthguidance.org
2. Levine, Peter. How Trauma Affects the Body
3. Telles, Shirley. Yoga Reduces Symptoms of Distress in Tsunami Survivors in the Andaman Islands.