The more I study psychological trauma, the more I become convinced. Basic training in the biology, anatomy and physiology of trauma phenomena should be a mandatory part of yoga teacher training and certification. Without an understanding of how the body itself is altered by trauma, yoga teachers may be unintentionally doing harm. Survivors of human trafficking can suffer from post traumatic stress disorder (PTSD) at what are likely very high rates, as writer, advocate, and human trafficking survivor Holly Austin Smith and I discussed recently. Soldiers, as most of us know, are also frequent victims of traumatic injury. But so many people who have been in car accidents, witnessed violence, been affected by national tragedy, or served or treated traumatized persons in helper roles such as medical and social workers, psychotherapists, crisis line workers, juvenile court personnel, victim advocates, police and EMS, and even parents whose children have been through traumatic events. Indeed, even the loss of a loved one can cause traumatic grief, which is different than ordinary grief.
The environment of the yoga class is particularly ripe for trauma triggering because of its inherently intimate nature, arising out of the integration of mind and body and the teacher's position as a leader and spiritual or physical authority, and the fact that trauma can be held in the body. And odds are that every yoga teacher has or will have persons with traumatic injuries in his or her classes. Talking with my sister and brother trauma survivors I've learned that my experience - that yoga classes can be retraumatizing when teachers are not trained in trauma-sensitive or -informed yoga - is far from unique.
When thinking of trauma, mind and body must be thought of as a whole. While the phenomenon is a very complex set of physiological and biological process, psychiatrist Jonathan Shay gives a good, concise definition in his outstanding book Odysseus In America: Combat Trauma and the Trials of Homecoming: "The symptoms caused by psychological injury that the American Psychiatric Association calls PTSD in its Diagnostic and Statistical Manual of Mental Disorders (DSM) can be understood in one clear and simple concept: persistence of valid adaptations to danger into a time of safety afterward" (149). Because that adaptation is physiological and biological, as well as psychological and emotional, cognitive reframing alone (shifting one's mind to think about it differently) does not make the trauma response go away. Intellectual understanding may help, but it doesn't cure. And each triggering incident is a retraumatization, as far as the body is concerned. In a triggered state, to the body (and thus to the whole person) the traumatic event is happening again.
It is important to understand that trauma "triggering" or activation is not about externalization, reframing, or learning to take responsibility for one's own reactions, etc. If someone makes those arguments they are illustrating the need for the type of training I'm calling for in this article -- they're demonstrating ignorance about the difference between cognition and neurophysiologicol action or response. Traumatic responses do not happen on a cognitive level. They happen in the sympathetic and parasympathetic nervous systems, and are therefore largely outside of conscious control. Of course we all need to practice those other things, and it may even be necessary to learn them in order to get stable enough to do some of this other work I'm discussing here, but doing so won't necessarily touch trauma activation responses. Those have to be gone at in other ways, through the body and the unconscious.
When yoga teachers neglect to inform themselves about trauma phenomena they can inadvertently create signals that, to the student who has suffered a traumatic injury, are processed as danger. When that happens, the student can become "triggered" -- thrown into a physiological response to that perceived danger, because his or her body has been conditioned to respond that way by the traumatic event(s). Triggering is not an issue of the need for cognitive reframing, or lack of understanding of what's "really" going on. Nor should a student's emotional affect resulting from the triggering be interpreted by yoga teacher as the presentation of an issue that needs "worked through." It's a physiological response that is outside the sufferer's control. And every time it happens the response itself is reinforced and, if you will, driven further into the body, increasing the likelihood that it will happen yet again. In order for healing to happen in yoga practice, yoga teachers need to know how to avoid accidentally hijacking students' processes by triggering them into activated states. This is not philosophical speculation. Brain imaging and blood measurements are allowing us to take the guess work out of studying of these processes. Researchers are really, truly beginning to understand how the central and peripheral nervous systems work, and applying those studies to trauma and yoga.
Here's the hope: there is evidence that over time and with the right treatment, traumatic responses can be lessened, and the nervous system perhaps literally healed. According to research conducted by Bessel van der Kolk, et al., yoga may in fact have the capability to reverse secondary brain/nervous system damage caused by trauma (2007, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society). Yoga certainly shows efficacy is lessening symptoms of PTSD, even more than talk therapy, in controlled studies. However, its effectiveness may also be very much dependent upon yoga teachers making specific adjustments to how class is taught, language, touch, and props are used, and each teacher's self-awareness regarding her or his responses to student reactions. Without those adjustments, even a very accomplished and well-intentioned yoga teacher can do more harm than good.
My thinking on this matter is informed on my ongoing trauma studies, my experience working with people who have suffered traumatic experiences, my nearly 20 years as a yoga student (and sometime teacher), and the work I've done in and out of yoga on my own traumatic injury.
Tune in for Part II of Margaret's multi-part series on yoga, trauma, and recovery.
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