Treating trauma in the body: trauma informed yoga

It’s well documented that trauma, whether a single event or sustained complex trauma has an effect on the body. As Bessel Van Der Kolk pointed out, and astutely named his renowned book on trauma, ‘The Body Keeps The Score’. Yoga is a practice used by hundreds of thousands of people the world over, for wellness, both physical and mental: so what about for trauma?

Written by Bryony Porteous-Sebouhian

At the end of last year, I wrote an introductory blog to a ‘holistic complex trauma programme’ I had been enrolled onto by my GP practice, you can read full details of how that came about and some of the context around it here . This blog is part one of two focusing on trauma informed yoga, how the classes we took part in were structured and the learning I have taken from them.

As we moved onto trauma informed yoga from our psychoeducation sessions, we were reminded of the core tenants of the body focused approach connecting all of the interventions that we were going to take part in. Karl, our yoga teacher pointed out the two general trauma responses that most people experience:

• the hyper-response: fight or flight
• the hypo-response: freeze or collapse, sometimes called ‘flop’

He then went onto place this within the context of the yoga practice and space, saying that yoga can provide a safe environment in which to explore these two kinds of responses, as well as providing tools to develop resilience and tolerance.

Generally, the practice of yoga in a trauma-informed space can help us to better regulate our nervous system, something that becomes increasingly difficult when we are experiencing the daily effects of trauma.

I went into these sessions with an open mind, I practiced yoga daily for the majority of the first lockdown and found the structure of it helpful to bring a kind of schedule to my days and weeks. I also found it to be hugely beneficial to my general physiological pain that I experience day to day.

The only worries I had going into these sessions were that I feel quite uncomfortable being ‘embodied’ and exercising in any way around other people, some practices in yoga unfortunately are very similar to what I tend to autopilot to when I dissociate and finally, that it might bring up body memories from my trauma in session.

Week 1: trauma and breathing

For the first week we focused on one simple but highly effective thing: breath. We explored three breathing techniques that, when incorporated with yoga poses, can be utilised to regulate the nervous system, ground you when you are in fight, flight, freeze, fawn or flop and finally can be used to address the physical symptoms of anxiety and hypervigilance.

Diaphragmatic/Belly breathing: This simple breathing technique focuses on an inhale that results in the belly naturally ‘doming’ outwards, rather than being focused in the upper chest which often results in shallow, quicker breathing. The other key part of this breathing technique is that the exhale is elongated, giving the body a greater relaxation response.

Coherent breathing: This breathing technique is a little out of the ordinary for many of us. It relies on the practice of making your inhale and exhale last for equal amounts of time. Karl told us in session that the optimal time is a six second inhale, and a six second exhale. However, he did mention that at first this can be difficult and possibly triggering for trauma survivors. Any practice that encourages you to pay close attention to your breathing and body can be triggering, so it is important to take it steadily, possibly starting with a four second inhale and exhale.

Breath synchronised with movement: In yoga this breathing technique works as follows: practice a movement in which you can inhale on one part of the movement and exhale on another. For example, you could take a comfortable seated position, lift both arms above your head on an inhale, and exhale as you being both arms down and rest by your sides. The pairing of breathing and movement can be particularly helpful for dissociation and feeling connected to the present moment and your body.

During this first session we tried some of these breathing techniques with a few easy yoga poses such as, seated forward fold, mountain poses with arms lifting above the head and then lowering, a warrior pose, standing forward fold and a seated twist with coherent breathing.

Week 2: trauma, embodiment and interoception

For week 2, we focused on embodiment and interoception, meaning the ability to feel present in your body and to also name and identify internal sensations within the body such as tension, nausea, softness etc.

To start off this shift in focus we explored three embodiment techniques.

The first was noticing areas of the body that felt relaxed: here we found any comfortable position and tried to notice and name body parts or areas that felt relaxed, whilst trying out the belly breathing from the previous week.

The second was noticing areas of the body that felt tense: again, in a comfortable position we brought attention to areas of the body then felt tense whilst naming them, and again breathing deeply through the belly breathing.

The third technique was patting and naming body parts: whilst stood or seated we lightly patted over different areas of our bodies, at the same time in hour heads, or quietly out loud naming that body part. This is a simple way to bring yourself into your body, which might feel silly or odd at first.

Again, Karl was careful to reassure us that noticing our bodies, and becoming embodied can be triggering and that this is normal for those of us who have experienced trauma. The key is to go slowly and to listen to yourself; if things become overwhelming we can ground ourselves by looking around in our environment and naming things we can see.

During the second session we repeated some of the simple poses we learnt in week one, with an addition of down dog, chair and tree pose, during which were instructed to try and notice relaxed or tense body parts.

Week 3: trauma and the window of tolerance

In our third week Karl introduced us to a new concept to be embedded into our yoga practice. This concept is the window of tolerance. The basic principle is that each person has an optimal zone of arousal in which they can function in their day-to-day life.

If we are operating within this zone or ‘window’ we can function effectively when external stimuli comes at us, even if it’s distressing or alarming. Within this window of tolerance we are able to use our minds to think rationally about situations, stimuli and problems without becoming overwhelmed, which can lead to a lack of embodiment or dissociation.

The idea is that when we are in a constant state of arousal because of post-traumatic effects, aka: the hyper- or hypo-responses we are unable to function within this window of tolerance and even small everyday problems become extreme, flooded with emotion and can feel impossible to manage.

Karl taught us that being in constant hyperarousal due to trauma, actually shrinks this window of tolerance and so, even small uncontrollable stimuli can knock you out of it. The class shared an empathetic chuckle as he described an experience on the way to class, where a bus drove past him close to the pavement and made a loud noise as it passed, resulting in a loud exclamation of shock from Karl, something I’m certain everyone in that class had done many times themselves.

Within the yoga practice, Karl showed us how we can safely push out the boundaries of that window of tolerance, allowing ourselves to feel slightly uncomfortable or aroused but implementing breathing techniques or embodiment to ground ourselves and prevent that hyper- or hypo-response.

To do this we experimented with doing poses and beginning to think about the idea of ‘dosage’ and how we might reduce the intensity of a pose and then increase it whilst noticing how our bodies felt between each dosage.

We continued with the previous week’s poses with the addition of a seated side bend, shifting our body weight from side to side and back to front in mountain pose, and seeing how the low cobra pose felt. Karl pointed out that we would be continuing this focus on window of tolerance and dosage into the next week, where we would explore it further.

Some thoughts at the start of our six weeks of trauma informed yoga

Throughout these three weeks I experienced an interesting transition. In week one and two I felt as though there were things I ‘had’ to or ‘should’ do, to play the part of someone going to a yoga session in a way. However by week three I felt much more comfortable actually taking Karl’s very careful direction to only do something if it felt right, or to swap one pose for a slight variation etc.

I did continue to, as I predicted, struggle with dissociating during. However it was becoming easier to know when it was happening, and instead of allowing it to run it’s course, as I do when I am really triggered, to actively address it through movement, focusing on things in the room or utilising the belly breathing technique: something which has become a bit of a go to when I am struggling to sleep due to being hyper aroused or when I’m feeling particularly stressed.

Part two of this trauma informed yoga blog will be published later this week.