Yoga and Trauma
The benefits of a yoga practice include building flexibility, strength, agility, balance, and concentration. However, a regular yoga practice can help anyone dealing with the stress of facing military deployment, being homeless, being in prison or recovering from alcohol and substance abuse.
The commitment of yoga teachers and therapists for their work bringing trauma-sensitive yoga and meditation to veterans, prisoners, persons with eating disorders, and those in recovery from addictions — with powerful results — is deep and impressive. It is tempting for me to write a book about each of these worthy people. Instead, over the past four years, I’ve interviewed many of them for a Huffington Post blog series called “Yoga, How We Serve.”
In their interviews, these women and men shared the unique needs of survivors of trauma, lessons learned in doing this work and how existing resources and treatments generally do not adequately address the needs of these populations. Here is just one of many extraordinary comments from a Vietnam War veteran in a program called Mindful Yoga Therapy:
“As I started to practice daily, I noticed several things happening. First, I began to sleep better. Next, I was getting to know myself, for the first time ever. Slowly I came off all of my psych meds. That was big! For the first time in over 40 years, I was medication free. Over the years, I’ve been on over 23 different kinds of medications, from Ativan to Xanax! Yoga is now my therapy.”
Vietnam War Veteran
This veteran went on to say he hopes that yoga will someday be offered to all veterans, and offered to our troops during basic training.
I very much share this hope, because the costs of treating trauma—whether it occurred 40 years ago or in the past decade, have become a major concern in our society. According to the Centers for Disease Control and Prevention, the economic burden of trauma is more than $585 billion annually in the U.S., including both health care costs and lost productivity.
The CDC also measures “Life Years Lost,” used to account for the age at which deaths occur, which gives greater weight to deaths occurring at younger ages and lower weights to deaths that occur at older ages. It turns out that the impact on life-years lost from trauma is equal to the life-years lost from cancer, heart disease, and HIV combined.
Statistics can’t say much about the personal burdens of individuals and families, of how individual sufferers are impacted, but it’s still instructive to mention one or two more here. For instance, there is an average of 293,066 victims of sexual assault or rape each year in the US, with someone in the United States being sexually assaulted every 107 seconds. And roughly 22 veterans commit suicide every day from the effects of PTS symptoms, one every 65 minutes.
What is Trauma?
The word “trauma” comes from the Greek, and means “a wound” resulting from an emotional or psychological injury or experience that causes someone to have mental or emotional problems, usually for a long time. According to Bessel van der Kolk, “Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds…The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their lives.”
Yoga for Recovery
The lives of many trauma survivors revolve around coping with the constant sense of danger they feel in their bodies. It is typically difficult for them to feel completely relaxed and physically safe in their bodies. As Yoga of 12-Step Recovery (Y12SR) founder Nikki Myers puts it, “Sustainable addiction recovery is about more than the mind…the issues live in our tissues.” Y12SR is a rich framework for integrating the wisdom of yoga and the practical tools of 12-step programs, with Y12SR meetings available nationwide, and the curriculum quickly becoming a feature of addiction recovery treatment centers across the United States.
Yoga helps one reconnect with the body, giving the opportunity to discharge accumulated stress and anxiety, and restoring the human organism to safety. Sabrina Seronello’s story paints this picture: she was on active duty in the Air Force from March 2000-March 2006, working as a medic in the emergency department of a Level 1 trauma center at Wilford Hall Medical Center, Lackland AFB. Sabrina deployed to Iraq in January 2005 to the Air Force Theater Hospital, a Level III (injured patients and emergency operations) trauma center. Given what she saw and experienced taking care of the wounded in Iraq, and being a victim of sexual assault while in active duty, she had been suffering anxiety and panic attacks. Upon returning from Iraq she was introduced to yoga and saw how it helped her deal with post-traumatic stress, anxiety and depression. In 2013 she started teaching a regular weekly yoga class to incarcerated veterans at San Quentin State Prison in CA under the Prison Yoga Project.
Trauma-sensitive yoga programs are becoming more available at domestic violence shelters, and universities are offering them for survivors of sexual assault. Caitlin Lanier was sexually assaulted during her freshman year of college. This assault led to issues with anorexia, cutting and otherwise trying to numb her uncomfortable feelings. According to Caitlin, “those were just outward manifestations. Inside, I felt broken, ugly, lost, like I couldn’t trust anyone, and so sad.” Caitlin has recently pioneered several trauma-sensitive yoga programs in the Boise, Idaho, area, including at a domestic violence shelter, and at Boise State and the College of Idaho. She also trains local yoga teachers on the neuroscience of trauma and how to integrate trauma-sensitive practices into their teaching. She has woven breathing techniques and mindfulness into a weekly support group for survivors of domestic violence that she co-leads with a licensed clinical social worker.
People with post-traumatic stress (PTS) who practice yoga report better sleep, improved focus and concentration, less anger and irritability, and exhibit an overall greater ability to enjoy life in the present moment. The Mindful Yoga Therapy has been found to be especially helpful for veterans who are also participating in evidence-based psychotherapy for PTS. “Yoga is like a gyro that brings me back into equilibrium when dealing with the effects of my disorder,” says Paul, a Vietnam War veteran.
Yoga for Prisoners
Breath work, three extended exhales, is part and parcel of the Prison Yoga Project protocol for addressing symptoms of un-discharged traumatic stress, according to James Fox, Founder and Director. He says “the extended exhale serves as the body’s built-in release valve to discharge stress and anxiety.” This is confirmed from current and former prisoners at San Quentin State Prison who have been part of the yoga program. “It was mainly because of the inner peace and trust that I have developed and nurtured through my yoga practice that I was able to respond to a confrontational situation with calm.”—B.B. Or “I’m able to stay grounded by getting into my breathing which takes my focus off stressful, traumatic events such as flashbacks. It keeps me mindful mentally and physically and enhances my self control.” –D.B.
Yoga & Eating Disorders
Finally, yoga can become a game-changer in combating eating disorders. An estimated 24 million Americans suffer from an eating disorder (anorexia, bulimia, or binge eating). Chelsea Roff took her first yoga class at the suggestion of a therapist just a few months after getting out of the hospital for eating disorder treatment. “The short story is that yoga brought me to a place in my recovery that no form of talk therapy or medical treatment ever had before. Downward dog certainly didn’t cure my eating disorder, but the practice did teach me how to relate to my body in a more compassionate way. And more importantly, perhaps, going to yoga introduced me to community–to the people I soon came to consider family–and I suppose that’s exactly what I needed to fully step into recovery,“ she says.
Health Care Costs
What if the over one-half of teenage girls and nearly one-third of teenage boys who use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives, were offered regular yoga classes? Regular trauma-sensitive yoga classes for victims of trauma can help reduce our nation’s health care costs on a larger scale, as they address cognitive, emotional, and physiological symptoms associated with trauma. But a cultural change is required to make this happen. The current system is broken, because it overly relies on medical therapy and cognitive behavioral therapy, both of which are very costly without commensurate relief from symptoms.
According to Kantar Media, the heath care industry spent $14 billion on advertising alone in 2014, enough to fund over 215,000 trauma sensitive yoga classes. Especially for PTS, mainstream therapies have resulted in patients remaining significantly symptomatic after treatment, with additional problems including addiction, difficulties maintaining work, and homelessness.
The results are adding up to a national calamity that leaves human lives in ruins, particularly for men and women who have risked their lives to serve our country and need our help. According the Congressional Budget Office’s report on PTSD and Traumatic Brain Injury among recent combat veterans, the average cost of treatment in the first year is $8,300 per patient and $4,100 in the following years. The average cost of treating an eating disorder is $1,250 per day, and only 1 in 10 sufferers ever receive treatment. Eating disorders have the highest mortality rate of any mental illness. Such treatment is expensive not only for patients, but for insurance companies, and society at large.
The evidence base for the effectiveness of yoga in addressing trauma is extensive. Here are some resources for further reading: the textbook on trauma and body-mind practices by Bessel van der Kolk, MD, The Body Keeps The Score: Memory and Psychobiology of Post Traumatic Stress; Overcoming Trauma Through Yoga by David Emerson and Elizabeth Hopper; The Trauma Toolkit: Healing PTSD From The Inside Out by Susan Pease Banitt; and Intelligence In The Flesh by Guy Claxton.
Learn more about Give Back Yoga Foundation and how you can get involved.
Addiction Recovery Through Yoga
With all the images online of toned women in tights pulling themselves into pretzel-like poses, it’s easy to focus on the physical side of yoga, thinking of it as an exercise class that ends with a mini nap. But the ancient practice of yoga can also help with drug and alcohol addiction, diseases that affect millions of us in this fast-paced, modern world.
While yoga can be a powerful tool for personal transformation and recovery, many people write it off before even stepping onto a mat, saying they’re not flexible enough or they can’t afford the classes. Yet the mind-body connection, stress relief and personal growth that can occur through the regular practice of yoga can be just what a recovering addict needs. Yoga encourages a person to reconnect to their breath, body, mind and heart. Here are just a few ways yoga can help release the mind and body from the grips of drug and alcohol addiction.
Yoga Eases Stress
“It was such a crazy/stressful/hectic day… I need a drink” is such a common phrase in our culture, it’s easy to forget that there are healthy ways to cope with stress. Many addicts have become so dependent on their substance of choice, they’ve forgotten that movement or even just a few deep breaths can bring a real sense of calm to the day. And that moment of calm can lead to healthier choices as you move toward a sober life.
The benefits of mindful movement and breathing, which are at the center of many yoga classes, have been proven to increase overall health.
According to the American Institute of Stress, 20 to 30 minutes of deep breathing has been shown to help the body kick into a relaxation response, where stress levels drop and blood pressure decreases. “Deep breathing increases the supply of oxygen to your brain and stimulates the parasympathetic nervous system, which promotes a state of calmness,” according to an article on the organization’s website. “Breathing techniques help you feel connected to your body—it brings your awareness away from the worries in your head and quiets your mind.”
Nearly all yoga classes encourage students to consciously inhale and exhale, which brings peace to the mind and body, even as we move through a practice. If you commit even further, and regularly practice at home or at a studio, you might find yourself using deep breathing or a short yoga sequence to help you stay strong through a moment of temptation or stress.
This is especially important for addicts, as many suffer from post-acute withdrawal symptoms, or PAWS, in the early stages of recovery. These symptoms often include anxiety and mood swings. One study has shown that yoga directly helps to increase GABA, a neurotransmitter that aids in relaxing the nervous system, therefore improving your mood and decreasing anxiety.
Yoga Increases Self-Awareness
Addicts are often accused by their loved ones of being selfish. But devoting regular time to the kind of reflection that comes with yoga can be beneficial to those in recovery. More meditative types of the practice, like Yin Yoga, where there is little movement and just a few poses done in a single class, can create a meaningful space for really checking in with ourselves. While the questions that come to mind might not always be pleasant, these classes are set up as safe spaces for students to release emotions, and teachers are aware that their students might be struggling with all kinds of personal issues while in their studio. This type of contemplative yoga can help with anxiety, depression and even sleep issues. By dealing with some of the other factors that might be causing stress and unhappiness in your life, you might have more resolve or energy to commit to a recovery plan or time in a rehabilitation center.
Addressing the Roots of Addiction
Yoga is not superior in dealing with one addiction over another. Yoga begins to address the roots of a problem rather than the symptoms, making it a common tool among recovery from many addictions. If someone struggling with alcohol or drug addiction gets sober only to find him- or herself struggling with another addiction, such as food or gambling, yoga practices can be implemented to support in recovery from both addictions.
Yoga for General Wellbeing
Yoga can also be used as a tool to support general wellbeing regardless of addiction. For example, long deep breathing, or “yogic breathing,” has been shown to reduce levels of the stress hormone cortisol and increase stress resilience. Yoga can also be used to assist in dealing with trauma. According to Dr. Bessel van der Kolk, an expert in the field of trauma treatment, yoga may be more effective than many medications in treating PTSD. “Medication can be quite nice to sort of dampen some of the symptoms,” he states. “But in the end, people need to own their bodies, they need to own their physical experiences. And, in order to overcome your trauma, it needs to be safe to go inside and to experience yourself.”
Yoga asks you to show up for yourself. Although deep breathing can help relieve stress at any moment during the day, a physical yoga practice requires regularly carving out time for yourself. Even if you are just going to spend a few minutes stretching in your living room, you still must make the time to practice. As with any other type of physical exercise, you’ll see more benefits if you practice regularly. Yoga, for example, has been proven to ease chronic back pain and joint pain. Some studies have found that it can also help with mental health issues.
German researchers, for example, studied a small group of women who described themselves as “emotionally distressed.” Over a three-month period, they took two 90-minute yoga classes a week. At the end of the study, their stress, anxiety and overall health all improved. Similar studies have also shown the one-off benefits of even attending a single yoga class. The uniting factor in all of these cases? The participants showed up for themselves and attended a class. They might have had stressful days or felt anxiety about trying yoga or were plagued by depression, but they put all of that aside and spent the hour (or more) bending, breathing and stretching.
It’s easy to put off a yoga practice: to buy a mat or a DVD and let it go dusty. Or to attend a single class, but never step foot in the studio again. But the more you commit to yourself, and a regular mind-body practice, the more overall benefits you’ll begin to see and feel. A single healthy decision, like deciding to roll out your yoga mat, can change your focus for the day and encourage another healthy decision. Over time, those mindful moments will add up, perhaps leading to an overall more positive outlook and healthier lifestyle.
The Art of Surrender
Yoga requires us to surrender. The first of the 12 steps in Alcoholics Anonymous is “We admitted we were powerless over alcohol, that our lives had become unmanageable.” In a similar vein, yoga asks again and again that we drop everything that is not necessary in our lives. Most teachers will begin the class with a mind-clearing exercise and a short moment to set an intention. This helps us focus on the moment, and release all the other stresses in life. Similarly, some poses require surrender, as well.
Maybe there’s a complicated pose in class that you simply cannot twist your body into. That doesn’t mean you have to flop down on your mat or write the pose off for good. It simply means that accepting that today, that pose is not happening.
The same idea is true during some of the more “relaxing” poses. While your body might be still in a seated position, you may feel your mind racing. Again, yoga teaches us to simply surrender and to be present with who we are, where we are, right now. By engaging in a regular practice, we learn that acceptance comes with not being able to control the world around us but by allowing the world around us to exist as it is. By doing so we learn the art and gift of peaceful surrender.
In terms of learning to let go of expectations and limitations, yoga can be a boon for those who are recovering from addiction. In AA, the moment of surrender becomes “the firm bedrock upon which a happy and purposeful life is built.” The same is true in yoga: When we accept that a pose is out of our reach or that our minds cannot be quieted, we might finally find a moment of true freedom.