By Rose Hahn

In this article, I’m exploring the intersection between two big wellness topics making the rounds in newsrooms, social media, and mental health outlets today: yoga and trauma. It might seem these topics have little to do with each other. But the truth is, they’re being tied together in yoga rooms and research studies around the world. And there’s good reason for this.

To understand the connection, we’ll need to dig into two basic, but important questions. The very same questions researchers are peering into. One, can yoga actually support trauma recovery? And two, if it can, how exactly does it work? 

But first, let’s start with some groundwork.

What’s Driving This Interest in Trauma and Yoga?

Experiencing a traumatic event can result in lasting difficulties that interfere with, and sometimes debilitate, our capacity to cope with life. Even at times when life isn’t especially stressful. The government’s addiction and mental health agency, SAMHSA-HRSA, states that “In the United States, 61 percent of men and 51 percent of women report exposure to at least one-lifetime traumatic event, and 90 percent of clients in public behavioral health care settings have experienced trauma.” Those are some sobering statistics. It’s why there’s so much effort being focused on how to best treat PTSD and other trauma-related mental health issues right now. 

Trauma awareness is on the rise today. Unless you’ve been living under a rock, you’ve probably seen at least one or two headlines talking about trauma or Post-Traumatic Stress Disorder (PTSD). Often, it comes up in connection with veterans and the challenges they face upon returning home from deployment. But, it’s also surfacing in discussions about the underlying causes of conditions like anxiety and depression. Additionally, as a culture, we’re stepping up to address the hard truths about both the prevalence and the lasting impacts of childhood trauma, domestic partner abuse, and sexual assault. We’re overall becoming a more trauma-aware society.

Included in all this awareness is a growing interest in how body-based modalities, like yoga, can provide powerful supports for trauma recovery.

Brief Overview of Trauma

To understand if and how yoga might support trauma recovery, it’s helpful to know a little bit about what trauma is in the first place. I myself am a trauma survivor. But before I learned about the underlying mechanisms of trauma, I didn’t fully grasp how it had impacted me, and in turn, how my yoga practice could help me. I’d been doing yoga for years. It was indeed making me more emotionally stable, calmer, and resilient to life’s stresses. However, it wasn’t until I did a LOT of trauma-informed work in my yoga therapy training that I made dramatic progress and saw how beneficial this body-based work could be for healing trauma.

According to SAMHSA-HRSA, trauma occurs when someone experiences, or witnesses, an event they perceive as emotionally or physically harmful or life-threatening. This experience results in adverse effects that impact life functioning and one’s mental, emotional, physical, or spiritual well-being.

Trauma can occur after exposure to a single, extremely disturbing event. It can also arise in response to repetitive exposure to threatening occurrences, such as ongoing emotional, sexual or physical abuse. In all instances, the person goes into survival or self-protection mode. They’re forced either to take action (fight or flight) or to dissociate (freeze). These are instinctual reactions that arise from rapid responses in the body and brain that trigger releases of different neuro-hormones, such as cortisol, epinephrine, norepinephrine, and others. This acute stress response is quite complex and still isn’t completely understood, but if you’d like to learn more about the trauma response, you can read about it in detail here.

What’s key to know is that, in general, when we experience trauma, an important part of our brain shuts down. It’s the part that normally processes our experiences analytically. The part that produces an integrated narrative about life events that makes them feel manageable to us. During trauma, we’re catapulted into emergency mode. Everything gets processed and filed away as emotional and sensory data, with little or no logical or problem-solving framework. This is why, oftentimes, people can experience memory-loss around the traumatizing event.

As a result, we’re left with unresolved, free-floating sensory and emotional memories of the event that we essentially don’t know what to do with. Over time, this unprocessed material interferes with how we relate to present-time stressors and sensory triggers that remind us of the traumatic event or trigger our trauma response. In the case of PTSD, long-term changes in the brain and neurochemistry can result.

Long-Term Effects of Trauma

Trauma can lead to full-blown PTSD, with symptoms that may include: flashbacks, nightmares, avoidance of things that remind you of the trauma, hyperarousal (high alert), sleep problems, lack of trust, feeling the world is a dangerous place, being easily startled, and more. It has also been tied to anxiety and depression, as an underlying cause. There are a number of physical ailments that have been connected to trauma responses as well. These include fatigue, muscle aches, chronic pain, digestion issues, and heart disease, among others.

When a traumatic event(s) has not been integrated, you continue to have intense responses to reminders of the event even when there is no imminent danger. This can occur even after many years have passed. And, it occurs at a physical level (i.e. blood pressure, heart rate, skin conductance). In other words, it’s not all in your head.

You can have heightened responses to intense but otherwise neutral stimuli, such as loud noises. During these trauma-response episodes, some people can’t put into words precisely what they’re feeling, because the symptoms occur at a sensory and emotional level only. There’s little or no analytical, narrative process to accompany it. They’re in emergency mode, just like when the traumatic event originally occurred.

Given all this complexity, you might be wondering, can yoga possibly help? Well, studies have shown that yes, in fact, it can.

Research Shows Yoga Can Help With Trauma-Related Mental Health Issues

More and more, yoga is being both researched and recommended as an adjunct therapeutic approach for trauma-related mental health issues. The reason is simple. Studies keep finding it works to reduce the symptoms.

This review of 185 studies published in the Sage Journal finds a wealth of evidence for yoga’s effectiveness in working with trauma-related issues, including PTSD, depression, and anxiety. They caution that the rigor of some of the studies could be improved. Also, that yoga has only been recommended as an additional support to other established treatment methods (i.e. medication and therapy). But overall, they conclude, “Given that the current evidence suggests that yoga may be a promising ancillary or complementary intervention and unlikely to cause harm, providers should be prepared to discuss yoga with their clients, if not recommend and/or implement yoga in their own service delivery practices.”

Given the prevalence for PTSD among veterans, Veterans Affairs programs are increasingly offering yoga interventions as an adjunctive treatment option. This study, conducted on veterans suffering from PTSD, found significant decreases in symptoms in all three PTSD symptom-clusters: hyper-arousal (i.e. startling, high alert), re-experiencing (i.e. flashbacks and nightmares), and avoidance of stimuli that reminded patients of their traumatic events. Increases in mindfulness and decreases in anxiety, depression, and insomnia were also noted.

What Is It About Yoga That Makes It So Beneficial For Trauma?

This is where the gap now lies in research. Studies have shown yoga helps with trauma-related mental health issues, but no one has been able to prove exactly how it works. Or, what specific yoga practices should be recommended and in what doses. There’s progress being made in this arena, though, with some guidelines for effective, trauma-informed yoga teaching methods emerging.

The Trauma Center Trauma Sensitive Yoga program has conducted several studies regarding the effectiveness of yoga for trauma and have delivered recommendations for facilitating trauma-sensitive yoga sessions. Their findings emphasize the importance of body awareness and emotional regulation in trauma recovery and point to yoga’s capacity to support these goals. Unlike cognitive or talk-based modalities, yoga works directly with the body using physical postures, breathing techniques, and mindful awareness of present moment sensations. According to the study linked above, this helps participants “notice, tolerate, manage, and reinterpret visceral sensations [that] may substantially promote affect tolerance.” 

It goes on to suggest, “yoga poses are likely to help individuals to observe and tolerate physical sensations and to use this tolerance to disconnect their physical feelings from the emotional reactions to assaults in the past.”

While the study’s report delves into much detail about the neurophysiological processes at play in trauma responses, it can be summarized briefly like this. The body and brain are automatically reacting to present-time, non-threatening situations as if there were, in fact, a present danger. Yoga helps trauma survivors rewire how their body and brain respond to stimuli so that their response is more connected to their safe, present-moment reality.

Trauma-sensitive yoga involves three main components:

  1. Simple, direct language is used, without metaphors. This helps participants remain in present-moment body awareness, without attaching additional meaning or context to the experience.
  2. Participants are encouraged to notice their bodily experience with a sense of curiosity and acceptance, using words such as “notice”, “allow”, and “when you are ready.”
  3. Participants are given the power to choose what’s happening to their bodies. For example, how long to stay in a posture. Or, doing a modified version of the posture. 

All of this supports a sense of safety, control over one’s experience, and an openness to exploring and tolerating a variety of sensations in the body.

Additional Recommendations for Yoga and Trauma Recovery

The Sage Journal review of 185 studies (linked earlier) also offers some guidelines for using yoga to work with trauma-related mental health issues. Their findings indicate the meditative aspects of yoga appear to produce the best results for depression symptoms. Thus, they recommend yoga practices that include a strong meditation component. They also encourage health care providers to recommend the following protocols for management of trauma-related anxiety symptoms:

  1. “participate in yoga for a significant period (e.g., at least 2–3 months)
  2. include meditation as a component of their yoga practice
  3. attend a formal class by a trained yoga instructor rather than do yoga at home independently on their own direction”

My Personal Experience Using Yoga to Work with Trauma

During the course of my yoga therapy training, a 900-hour certification that extended over a nine-month period, I was required to do a lot of reading about how emotions and trauma show up in the body. Additionally, I engaged in regular yoga practice with a focus on self-inquiry and curiosity around my body’s responses to different postures. Perhaps most importantly, I was instructed on how to hold space for myself during this self-inquiry process.

What I gained from this experience was a deep understanding of how my body responds to stimuli, both on and off the mat. I developed an expanded capacity for sitting with uncomfortable states. I learned how to witness the arc of experience that occurs with uncomfortable sensations and emotions – from rising, to peaking, to dissipating. And by witness, I mean being able to tolerate discomfort without having to act on it. I could observe the process as it unfolded, and increasingly trust that I was safe and capable of taking care of myself in each moment.

I gained awareness of, and respect for, my edges. Both physical and emotional. The edge is that point where I know I’m really feeling something. The point where the intensity of that feeling is noticeably heightened but still acceptable. I can sit with it safely, even though it might feel uncomfortable, and see what happens. How I might grow from the experience, whether that be through greater tolerance, increased emotional or physical regulation, or simply learning to trust myself more. Or, how my edge might shift. Maybe it’s no longer edgy, and I can relax into the experience. Conversely, maybe it’s no longer tolerable, and I need to take action to change my experience. I learned that sometimes, honoring my edge means removing myself from a pose or a situation. That taking a break to tend to my needs is healthy and okay. 

It’s this deeply enhanced self-awareness that yoga offers through the physical postures, breathing techniques, meditation practices, and mindfulness that supported my growth beyond trauma responses. When automatic responses arose, I was better able to identify them, explore them with curiosity, and hold space in which new response patterns could emerge. For me, this process is what answers the question of how yoga can help with trauma-related issues.

Closing Thoughts…

Not all yoga classes focus on creating this sort of safe container for self-inquiry. But, there are many that do. It might just take a few tries to find the right fit of class and teacher to support your trauma recovery. And, of course, processing what happens on your mat with a therapist or other health professional who’s familiar with trauma and body-based approaches can propel even greater progress.

The bottom line is, yoga can be a powerful intervention for trauma-related mental health issues. If you’re struggling with resolving a traumatic experience or with PTSD, anxiety, or depression, it’s worth investigating this modality as an adjunct to your other treatment approaches. 

I wish you all the best in your journey of healing and self-discovery. 
-Rose

About the Author:
Rose Hahn’s passion for inspiring intentional wellness has evolved over the past 20 years from a personal practice, to working as a yoga teacher and yoga therapist, to founding the first neuroscience and mindfulness-based addiction treatment center in Texas with her husband. Currently, her energy is focused on her wellness blog, an upcoming book, and her yoga/music/arts event production company. RoseHahn.com