The Journey to Heal: Understanding Trauma-Sensitive Yoga

2 Comments

This is an article by two of our practitioners with The Breathe Network, Alexis Marbach and Zabie Khorakiwala who share their experiences and insights gained from attending the  Justice Resource Institute’s Trauma Center’s trauma-sensitive yoga teacher training.

kripalu

100 people. Five different continents. One mission: Transforming the lives of trauma victims through the practice of yoga.

Kripalu Center for Yoga and Health. A beautiful sanctuary to rest, restore, relax, and explore what it means to “live your yoga.”  This was an ideal setting to immerse ourselves in understanding the framework for teaching trauma-sensitive yoga. Various professional backgrounds were represented including: psychotherapists, social workers, police officers, victim advocates, rape crisis counselors, etc. There is something incredibly transformational about guiding trauma victims through their yoga practice and empowering them to move fluidly in skin that has been so violated. The energy of that space transcended all words.

As yoga instructors, our first job is to attend to the needs of our students. Students with carpal tunnel? Offer modifications where there is limited pressure on the wrists and forearms. Disc degeneration in the cervical spine? Steer clear of inversions. But what about the needs we can’t see?

Trauma can create both an emotional and physical imprint on the body. As Bessel Van Der Kolk explains, unresolved emotional trauma creates “issues in our tissues”, manifesting as physical symptoms such as migraines, nervous ticks, clenched shoulders/neck/jaw, a sunken chest, and a heavy heart. Trauma survivors often display physical characteristics as a result of a somatic reaction to emotional distress, dysregulation, and hypo- or hyper-arousal. Students may find that their throat constricts, their shoulders move up, their range of motion becomes limited, all as a result of experiencing trauma. At some point, a trauma survivor must find a coping mechanism (healthy or unhealthy), because as Van Der Kolk states, “gut wrenching feelings are incompatible with being alive”. The physical body slowly becomes the enemy. Core functions of sleep, digestion, breathing, and chemical balance become disrupted. Traumatized individuals may also feel shame or become self-consciousness as they over-react to physical or emotional cues from the world around them.

The moment that a person experiences trauma, the body automatically makes a decision to protect itself. This decision could result in a fight, flight, or freeze reaction. It is easy to become trapped by a sympathetic nervous system reaction. The adaptive response can become prime and paramount, creating new chronic states of being.

Our brains change. Trauma can damage the insula, a part of your brain that registers what is happening with the body. Insula damage translates as the inability to experience joy, love, happiness, and to experience the very sensations of what our bodies are physically doing. Additionally, trauma damages the prefrontal cortex, which assists us in self-regulation. After experiencing trauma, an individual may feel lost feel as though it cannot rely on itself to become reoriented. But this feeling must come from within.

Enter: yoga.

While the experience of trauma and its aftermath can feel isolating, yoga provides an opportunity to be physically in sync with others. Moving in unison with fellow classmates or with an instructor can help re-establish interpersonal (and intrapersonal) rhythms.

A trauma-sensitive yoga practice can increase connection with the breath, enabling the brain to become less aroused, and relaxation to begin. A trauma sensitive practice can rebuild connections with both the insula and prefrontal cortex, strengthening the mind-body connection. The practice can help a student to regain their sense of control and ownership over their own body and their own experience.

The training offered a wealth of information for yoga instructors who are interested in teaching from a trauma-informed perspective. We hope to share lessons and groundbreaking strategies with the Breathe Network practitioners who are looking to enhance their existing approach to best meet the unique needs of survivors of sexual violence.  We are highlighting a few key concepts to shed light on this incredible movement. If you have ever considered attending the trauma-sensitive yoga teacher training, we invite you to live your intention.

Language of Inquiry: The cues that you give in a trauma-sensitive yoga class should be invitational and focus on empowering the student to explore forms that feel comfortable and safe in their body. Inviting students to notice what is happening in the body and cueing language of inquiry can allow the survivor to actually feel themselves regaining power and control. A few key words to utilize include: explore, experiment, and investigate. Other effective cues include:

“This is an opportunity to practice meeting where your body is today.”
“This form is not better than the other, just another option for you to experiment with.”
“As you’re ready, I invite you to come into child’s pose”
“If you would like, allow your breath to flow here.”
“You can always modify to suit your experience.”

It may take time to incorporate constant use of invitational language into your classes. However students enrolled in trauma-sensitive yoga classes have said that they cannot be reminded enough that they have choices.

Options for breath. A trauma informed practice does not pay unique and special attention to the breath in the sense that students are encouraged to, at first, breathe in whatever way feels natural and comfortable. Trauma survivors may experience shallow breath or breath body linkages that promote oppositional breath patterns, i.e. drawing the belly in and up when inhaling, and letting the belly expand on the exhale. Breath retention practices can elicit a sense of panic, as can kapalabati breathing. As an instructor you can use cues that encourage people to be aware of what is happening in their body in the present moment. “Notice the breath… is it shallow? Is it deep? How does it feel to breathe? Are you feeling more comfortable breathing in and out of your mouth or nose?” may prove to be more safe and stable for a trauma survivor than guiding a practice based solely on breath counts (such as sun salutations guided by breath). As you work with students over a longer period of time, you may find it appropriate to introduce pranayama breathing techniques but start small, start with awareness, noticing, and being in the present moment.

To assist or not assist? The Trauma Center considers physical assists to be a clinical issue and they recommend that trauma-sensitive classes do not offer them. In the research they conducted, they found that in classes that offered physical assists, 50% of students did not return. Students may feel like they are doing something wrong or that they have to demonstrate the form in the way that the teacher prefers. Many trauma victims are not ready to be seen and assists distract from their own personal practice. As an alternative, instructors can offer verbal assists or demonstration.

Qualities of a trauma-sensitive yoga instructor. Be open to feedback, be safe, be predictable, and be consistent. Give students the opportunity to challenge themselves when they are ready and to navigate the forms in their own way and in their own time. Don’t worry about developing fancy flows. Focus on creating consistency in your sequence each week. This develops a space of trust and safety; the students know exactly what to expect each week.

Know that you will inevitably trigger a student, despite your best intentions. Be prepared to stay even keeled, calm, and present with the entire class. Allow each student to have his or her own experience feeling the trigger as well as regaining control and coming back into the present moment. Your role is not to attend to each emotion, but to allow students to be safe in feeling their body and emotions in the present moment.

Qualities of your practice space. Consider the space where you will conduct your class. The Trauma Center recommends practicing in a well-lit space that is free of mirrors. If there are large windows, cover them, even with a translucent curtain so that students will not feel exposed to all of the people potentially passing by. If you are restricted to a public space like a club room or cafeteria, do what you can to make the space inviting and yoga appropriate. You might consider sweeping the floor and laying out the mats so that each student has space to practice and is oriented in the same direction (reducing student concerns about setting up ‘correctly’ or being too close to another student). You might need to talk to others who share building space with you to ask for their sensitivity during your class time. For example, if you are using a conference room at a local rape crisis center to conduct your class, you could ask staff members at the center to be quiet when passing the room or refrain from having loud conversations outside of the conference room doors.

Considerations for participation. It is important to have a screening process for students who are taking part in your trauma-sensitive yoga classes. Students who have had recent hospitalizations, active drug and alcohol abuse, and psychosis are not eligible to participate. This is where collaborating with an established organization to teach classes can be quite effective. Having documentation such as a yoga note when working in conjunction with a student’s therapist can create powerful opportunities for healing. The yoga note includes questions such as, “What is one thing he/she noticed?” and ‘What is one thing that changed?.” One woman was a survivor of chronic childhood sexual abuse and struggled throughout her life making choices and exercising assertiveness. When she was in camel pose in class she realized she could not breathe well and she made a conscious choice to get out of the pose. That was a defining moment for her because it served as a catalyst for her to make choices and decisions in her everyday life.

The power of collaboration. Working with an already established agency such as a rape crisis center or university can be easier than trying to navigate the process on your own. The benefits include:

  • An already established intake process
  • Liability and insurance are covered
  • Therapeutic implications are clear
  • Available space for class
  • Embedded structure to conduct research
  • Financial structure is already established
  • Adds legitimacy to yoga as a component of trauma treatment

Assess your program. A randomized control study conducted by the Trauma Center at the Restorative Justice Institute has yielded overwhelmingly positive results. Participants who qualified for the study had met the clinical diagnosis of Post-Traumatic Stress Disorder, had been treatment unresponsive, spent more than 3 years in therapy and had experienced the index trauma at least 12 years prior to entering the study. When compared with an attention control group, participants in the yoga class series had a clinically significant reduction in PTSD. Additionally, participants reported experiencing:

  • patience
  • self-care, self-love and appreciation
  • pride and accomplishment
  • increase in relatability (with themselves and the outside world)
  • peace with their daily experience and present moment
  • less rumination, sense of calm and presence

If you have the opportunity to conduct research on your program, it can help people understand the benefits and present opportunities for future funding. If you are facilitating your program in a university setting, this would be an excellent opportunity for graduate students.

Benefits of yoga. The benefits of this work are unlike any type of trauma treatment. In addition to benefits such as self-care and reduction of anxiety, I have had students communicate that yoga allowed them to sleep without any medication, to be intimate again, to stop binge eating in order to take care of self, to report what had happened to them to the police because they felt open and supported, to seek other methods of healing, and the list goes on. Often times the impact that yoga has on the healing process is not something that can even be communicated through words. You are undoubtedly providing survivors with the tools to transform their lives.

Take care of you. Doing yoga as a tool of trauma therapy work can be incredibly rewarding. On the other hand, it can be very draining if you as the teacher neglect your self care. There is a lot to balance as a teacher, especially when students may be triggered or emotionally dysregulated during class. In order to remain present, consistent, and authentic, it is important to nurture your own yoga practice and to find community with other service providers, yoga teachers, and supportive friends and family. Our fellow practitioners in The Breathe Network are also fabulous resources.

This information is a re-cap of the training offered at the Trauma Center at the Justice Resource Institute. For more information on how to train with them, please visit: http://www.traumacenter.org/.

If you are interested in connecting directly with Alexis or Zabie, feel free to contact them and visit their websites below:

Alexis MarbachAlexis Marbach
E-mail: alexismarbach@gmail.com
Website: www.alexismarbach.com

zabieZabie Khorakiwala
E-mail: zkhoraki@gmail.com
Website: https://www.facebook.com/ZabieKhorakiwalaYoga

Comment: