Healing PTSD with Yoga
Yoga saved her life. Six months before her wedding she travelled to South America with her parents; without warning her mother had a heart attack and died in her arms. Coming home, she attempted to re-engage her life as she had known it. But the panic and depression were unbearable. She lost everything she cared about; her mother, her fiancé, her home. Knowing herself as an active, successful woman, she was unrecognizable to herself…
In this post we explore the healing benefits of yoga for trauma through the lens of one woman’s journey into and out of PTSD. When suffering the painful consequences of trauma it is imperative to know there is a healing path. You can reclaim your life from the effects of trauma and research has demonstrated that yoga is a valuable adjunctive treatment to psychotherapy. As a clinical psychologist with twenty years experience teaching yoga, I have not only experienced but also witnessed how cultivating a yoga practice can change lives.
“Every day you meet yourself on the mat where you are. In yoga we aim to explore our “edge” by breathing into sensation, tolerating discomfort, and finding ease. This deepening in your practice might be discovered during a longer hold in warrior pose or in the midst of the stillness of child’s pose. How does your body want to move today?”
-Dr. Arielle Schwartz
One Woman’s Healing Journey
Recently one of my yoga students shared with me her story about how yoga saved her life. Life was good. She had a job she loved, was soon to be married, and had recently moved into a new home with her fiancé. Six months before the wedding she travelled to South America with her parents and without warning her mother had a heart attack and died in her arms. In shock and in grief she came home. Upon her return she attempted to re-engage her life as she had known it. But the grief, anxiety, and panic became unbearable and began to interfere with her ability to live her life.
She went to her doctor who prescribed medications to manage her symptoms. Over the next several months her depression and panic worsened. She became unhitched emotionally; alternately crying uncontrollably and feeling unmanageable rage. Knowing herself as an active, successful woman she was unrecognizable to herself. She felt too tired to exercise and too wired to get the deep rest she so badly needed. Her relationship suffered from the stress. Sadly, within a year she lost her mother, her husband-to-be, and her home.
She began to feel that the medications were worsening her symptoms and after consulting her medical doctors decided to stop taking them. She began therapy and understood that she was suffering from Post Traumatic Stress Disorder (PTSD) but she still couldn’t see a way out of the emotional and physical pain. She contemplated ending her life. This was no way to live.
Then a friend invited her to attend a yoga class. Initially she was only able to do a small portion of the practice; however, she described a remarkable change after the class. Walking out of class she felt “like herself” for about 30 minutes; which during that time felt like a miracle. She was intrigued and went back. Again, she felt both focused and relaxed afterwards; a balance she had been seeking for many months. She began to practice yoga like her life depended upon it, and it did. She shared that the positive effect was amplified when she engaged in standing postures and that slowly reclaiming her physical strength and flexibility was key in her recovery. She discovered that over time the lingering positive feeling lasted longer and carried through into the next day.
Now, fifteen years have passed since her mother’s death and she continues her yoga practice to maintain her mental wellbeing. She proudly asserts that she has reclaimed her life from the costs of PTSD.
I share her story at her request in hopes that it may make a difference in the life of another.
Nervous System Regulation
Wired and tired. This combination of anxiety and depression is a noteworthy characteristic of PTSD; an alternation between two paradoxical autonomic nervous system states:
- Sympathetic nervous system activation and the experience of anxiety or panic
- Parasympathetic nervous system activation and the experience of depression and hopelessness
With PTSD we lose a sense of choice regarding our nervous system state. We can either feel stuck “on” or stuck “off”. Much of the literature on trauma recovery is focused on the regulation of our nervous system states. Psychotherapy focused on healing trauma, especially EMDR and Somatic Psychology, recognizes an individual’s capacity to successfully recover from the effects of trauma. While medications can sometimes be necessary, it is important to note that some medications interfere with recovery from PTSD, as was the case with my yoga student. Rather than managing symptoms, healing requires having an opportunity to process through the cognitive, emotional, and physiological reactions to the event. More recently, yoga has been recognized in psychology as a valuable adjunctive treatment when added to psychotherapy.
Yoga offers tools to work directly with imbalances in the nervous system resulting from PTSD including meditation practices, breathing practices, and movement practices. We have the opportunity to observe our mind; cultivating increased awareness about the relationship between our thoughts, emotions, and body. There are practices aimed towards relaxing or re-energizing ourselves depending upon what is needed to establish equilibrium.
Yoga for Trauma
Recently, research by Bessel van der Kolk and colleagues at the Justice Resource Center in Brookline, Massachusetts demonstrated the importance of yoga in the treatment of PTSD. The effects of yoga practices are being shown to balance autonomic sympathetic activation, reduce blood pressure, improve neuroendocrine and hormonal activity, and decrease reported symptoms of PTSD. Their treatment model includes attending a trauma-sensitive yoga class as an adjunctive treatment alongside psychotherapy for PTSD. Creating a class environment that feels emotionally and physically safe is of primary importance given the vulnerability associated with healing from trauma. This may include soft lighting, minimizing use of mirrors, and setting a tone of gentleness and non-judgment.
Unfortunately, trauma-sensitive yoga classes are not available in all areas. In such cases, focus on finding a yoga class in your community that feels nurturing and safe. Attending a yoga class has added benefits of developing community and reducing the isolation associated with PTSD. There are a wide range of yoga styles including Kripalu, Ashtanga, and Kundalini to name just a few. If you are new to yoga, I recommend trying out several types of classes until you find one that fits your needs.
If you are feeling too vulnerable to attend a public class or cannot find the right class in your area it may be necessary to develop a home-based practice. Luckily, in our digital age, the internet can help you access many of the world’s best teachers from the comfort of your living room. Here are several considerations when cultivating your personal practice of yoga for trauma:
- Work in tandem: Healing from PTSD with yoga is recommended in conjunction with good trauma-informed psychotherapy. Discuss your health care goals with your psychotherapist and medical providers and consult them regarding any concerns about starting a yoga practice.
- Create a safe place: Take a moment to reflect on a place in your home where you would like to practice. Ideally this will be a quiet space; free from distractions and interruptions. Attend to the space you have chosen by placing items that feel nourishing and positive. Perhaps place a flower, a candle, or a photograph in your space that you can turn towards as a resource in times when you feel ungrounded.
- Open your mind: Yoga is a mindfulness practice and is grounded in a foundation of present-centered awareness, a mindset of non-judgment, awareness of your bodily felt sense, and awareness of your breathing patterns. Yoga is a form of self-study and involves being curious about your moment-to-moment experience and noticing the connections between your thoughts, body, and emotions.
- Move your body: Yoga asana, or the physical practice of yoga, offers opportunities to explore strength building through standing postures such as warrior pose or downward dog. Releasing tension is the complementary action to strength building and involves the art of letting go. Most important in the practice is your ability to listen to your body. Every day you meet yourself on the mat where you are. In yoga we aim to meet our “edge” by breathing into sensation, tolerating discomfort, and finding ease. However, such deepening in your practice might be discovered during a longer hold in warrior pose or in the midst of the stillness of child’s pose. How does your body want to move today?
- Welcome your emotions: It is common to experience difficult emotions such as anger, fear, or grief after a traumatic event. Central to healing trauma with yoga is having an environment where emotions are welcome. Sometimes being alone with big emotions can increase feelings of isolation or fear. It is equally important to know that you have choice about when to feel and when to contain your feelings to bring back forward in the presence of your therapist.
- Explore your breath: Working with pranayama, or conscious breathing, provides direct connection to the autonomic nervous system allowing you to work with your physiology. Our inhale allows the sympathetic nervous system to be dominant and the parasympathetic relaxation response is paramount on the exhale. We can vary the rhythm and length of our inhales and exhales as one tool to reintroduce flexibility of our stress response systems. For example, cultivating deep belly breaths can slow down and calm the nervous system when you feel anxious. In contrast, rapid breathing patterns such as breath of fire or kapalbhati pranayama can energize you when you feel depressed or sluggish.
- Keep a journal: When healing from trauma it is typical to feel “all over the place” emotionally making it difficult to notice patterns and connections between your thoughts, emotions, and body. Keeping a journal as part of your yoga healing journey can be a valuable part of your process. Take note of your moods and your thoughts. Keep a log of the postures and breath practices that helped and those that brought up uncomfortable feelings. If memories or big feelings come up during your practice your journal can be a place to reflect upon these moments and a way to bring them back to therapy.
You can reclaim your life from the effects of PTSD, one breath at a time.
About Dr. Arielle Schwartz
Dr. Arielle Schwartz is a licensed clinical psychologist, wife, and mother in Boulder, CO. She offers trainings for therapists, maintains a private practice, and has passions for the outdoors, yoga, and writing.