The Cutting Edge of Trauma Treatment: Healing Through the Body
by Nora Isaacs
The muscles elongate. The heart opens. The breath deepens. A yoga practice can help us feel more vibrant, agile, and connected. But for anyone who has experienced trauma, a body-based practice like yoga can also be a lifesaving healing technique. By releasing held tension, paying attention to the present, and regulating the nervous system, a somatic approach helps ease the feelings of helplessness, fear, arousal, and disconnection that can arise for trauma patients.
Traumatic experiences can take many forms—a car accident, a mugging, or abuse, to name a few. In the past, conventional wisdom led people to talk therapy for healing. But some experts say this isn’t enough.
“Trauma causes the body to be frozen in a state of fear, terror, and hypervigilance,” says Dr. Bessel A. van der Kolk, a clinical psychiatrist and founder of the Trauma Center in Brookline, Massachusetts and a leader in the field of posttraumatic stress. “So fundamentally, the effect of trauma is in relationship to one’s body. One’s body gives the signal that it’s not safe, and your body keeps fighting an existing enemy.”
Because trauma is so linked with the body, a growing number of people—led by van der Kolk—have been vocal advocates for incorporating body-based techniques into trauma recovery. And although yogis have understood the mind-body link for thousands of years, modern science is now catching up: cutting-edge brain scans have recently given neuroscientists the chance to more accurately understand the physiological effects of trauma on the body. With this knowledge, it’s clear that practices like yoga, Eye Movement Desensitization and Reprocessing (EMDR), and Somatic Experiencing can help unlock the body’s pattern of fear by allowing trauma survivors to become masters—rather than victims—of their own physiology.
Some of us toss around the word “trauma”” lightly: “That meeting was so traumatic!” But for those who’ve experienced it, there is nothing lighthearted about it. “Trauma is a condition under which your body continues to get triggered into living an old situation as if you were back there again,”” explains van der Kolk, who has worked with many types of trauma patients.
According to Kripalu-trained yoga teacher Dana Moore, trauma runs on a continuum. Dana is a founding member of the Trauma Center Yoga Program and a faculty member of the Trauma Center Professional Training Institute who uses yoga, mindfulness, and counseling to help people overcome stress and trauma. On one end lies “Big T” trauma. Big T traumas, such as child abuse, physical or sexual assault, or a life-threatening medical procedure or car accident, pose “a threat to life or bodily integrity,” Moore explains. They can be single events, or things that happen over and over, such as chronic abuse. These experiences overwhelm a person’s capacity to tolerate the experience as it’s happening, and it’s common to get numb or disassociate during a traumatic incident. “The psyche shuts down, which is the body’s natural way of dealing with overwhelming stress,” explains Moore. “Often the result of a Big T trauma is that a person lives in a hyperaware, hyper-sensitive state to ensure that an intense life-threatening experience doesn’t happen again.”
People who’ve experienced Big T trauma include the combat soldier returned from war who builds a bunker in the basement or a 9/11 survivor who sleeps with a gun on the night table.
On the other end of the spectrum lie “little T” traumas, which include the universal stresses in life such as a breakup, job loss, big move, or minor traffic accident. While most of us experience these at one time or another, in some people they can trigger a significant stress response in the body. Moore uses the example of a significant breakup: although it’s hard on everyone, one person might grieve and then move on, while for another person it might trigger intense feelings of abandonment left over from early childhood.
Van der Kolk doesn’t focus on the cause of trauma in his patients. Instead, he is concerned with the effects of trauma—feelings of numbness and disassociation or a hyperaroused state, among others. In his decades of working with posttraumatic stress, he’s observed that many people turn to medication, drugs, food, and alcohol to deal with these states of being. But, of course, these external substances don’t address the root cause. To do this, he says, he aims to “get people’s bodies to function again.”
The Effects of Trauma on the Body
In order to get the body functioning normally, it’s helpful to understand exactly what happens physically when we are under stress. When the body feels threatened, it shifts into the “fight or flight” response, the evolutionary reaction that gets us ready to fight the proverbial tiger at our backs. As the body goes on red alert for danger, the heart rate increases, blood pressure rises, and stress hormones like cortisol and adrenaline flood the body.
During a traumatic experience, the body goes through even more profound changes. These changes have become clearer over the past five to seven years because of breakthroughs in brain scans like functional magnetic resonance imaging (fMRI), which enables scientists to look at how the brain functions in real time, rather than just taking a still photograph. “Only now are we getting a really deep understanding of how trauma impacts the body,” says Moore.
A key finding from these brain scans is that during traumatic stress, the speech center shuts down—one reason why many people cannot completely put what happened to them in words. ”This is why talk therapy is limited in helping someone recover from or heal from overwhelming stress,” says Moore.
Scans also show that the part of the brain responsible for experiencing what happens in the present moment—the medial prefrontal cortex—shuts down during stress. (On the other hand, Moore cites research conducted at Harvard on mindfulness meditation, where the medial prefrontal cortex lights up.) Yet another enlightening finding from scans shows that people who’ve experienced trauma have more difficulty processing information than those who haven’t. All of this information is helping the trauma community better understand—and help—those in need.
How Yoga Can Help
Because trauma has so many physical effects, it’s clear to van der Kolk why it’s important to move beyond simply talking: “It’s great to be able to put your feelings into words,” says van der Kolk, “and feeling that somebody understands your suffering is enormously comforting. But it doesn’t make your body know that you are safe. The real method is resetting your physiology.”
Van der Kolk says that yoga is an ideal method to do this. “Yoga really attends to the body and the breath, attends to stillness. It allows you to feel everything you feel, to tolerate every sensation, and to live and move with it.”
To this end, he recommends yoga in conjunction with working with a person who has special training in trauma therapy. “None of my patients have been able to tolerate a yoga program if they weren’t in therapy at the same time. Too much painful stuff comes up.”
Because a common outcome of trauma is hyperarousal—the gun by the bed, the bunker in the basement or, in less extreme cases, an intense reaction to a loud noise like a car backfiring—a gentle, trauma-sensitive yoga practice offers the opportunity to experience a change in mental states. “They can shift from hyperaroused to feeling relaxed, and that is very profound for them, even more so than the average population,” says Moore, who teaches yoga to trauma patients. “They can feel what it’s like to be ‘normal’ again.” He adds: “Then after yoga practice, they are able to say, ‘This is how I want to feel all of the time.’” Because yoga is nonverbal, it can help those people who experience the shutting down of their speech center. Even though they don’t talk about it, they can use their body as a means of self-expression.
And the simple act of moving the body can create a major sense of accomplishment for people whose bodies have been frozen or numbed by their experiences. Many people who’ve been through an overwhelming experience like a car wreck feel like victims of circumstances. “When they can move the body in a purposeful way, they cultivate an internal locus of power,” says Moore. “They can say, ‘I can act in my own best interest,’ or ‘I can determine the kind of experiences I have.’”
Overall, van der Kolk says that a somatic approach can radically alter the body’s physiology: “It can rewire your brain stem, and change the fear system in your brain. It can regulate the balance between the sympathetic and the parasympathetic nervous systems and activate the cranial nerves so your body doesn’t respond to everything as if it’s getting hurt.”
A New Frontier
Of course, yoga isn’t the only body-based therapy for releasing past trauma. “Overcoming trauma is learning how to regulate your own psychological system, and there are many ways to do that,” says van der Kolk. Other somatic techniques helpful for trauma include Somatic Experiencing, Sensory Motor Therapy, Hakomi Method, EMDR, and Internal Family Systems (IFS) Therapy. As more research is done on trauma, somatic therapies like these just might move to the forefront of trauma recovery.
Whether a person chooses yoga or another method, it’s important to find a skilled practitioner to work with, to move slowly, and to stick with it. What we know now that we didn’t know 40 or 50 years ago is that healing from trauma is possible. And for many the secret lies in accessing that healing through the body. “To feel what you feel and know what you know in your body, can go a long way toward healing,” says van der Kolk.
Nora Isaacs, a former senior editor at Yoga Journal, is a San Francisco-based journalist who writes about health and spirituality and is the author of Women in Overdrive: Find Balance and Overcome Burnout at Any Age.
© Kripalu Center for Yoga & Health. All rights reserved. Originally published in the Summer 2009 issue of the Kripalu catalog. To request permission to reprint, please e-mail firstname.lastname@example.org.