Trauma Sensitive Yoga as a Complementary Treatment for Posttraumatic Stress Disorder: A Qualitative Descriptive Analysis
Authors: Jennifer West, Belle Liang, and Joseph Spinazzola
Date: July 4, 2016
Journal: International Journal of Stress Management
Traditional treatment modalities for Posttraumatic Stress Disorder (PTSD), which are conventionally top-down approaches such as cognitive processing therapy (CPT) and exposure treatments, often prove to be ineffective in addressing the multitude of symptoms displayed by trauma patients. This is especially true when PTSD results from childhood traumatic experiences, for which treatment is less effective than for adult-onset trauma.
Previous studies have shown that the physical benefits of yoga such as relief in muscular tension and pain may address somatic symptoms of PTSD and biochemical and physiological changes can reduce stress, and have positive impact on affect dysregulation, and distress tolerance. The psychological benefits of yoga including increased mindfulness can help in body-mind integration.
Massachusetts-based researchers West, Liang, and Spinazzola analysed a 2014 study that aimed to address gaps in previous research by investigating the effectiveness of Hatha Yoga as a complementary treatment for adult women with chronic PTSD related to chronic childhood trauma. The authors of the current study performed a qualitative analysis of the parent study to address its qualitative research gap.
The study being analysed by West et al. consisted of a randomised controlled trial (RCT) and subsequent interviews. The study involved 31 adult women who had PTSD arising from chronic ongoing or childhood emotional, physical, and/or sexual abuse. The women participated in a 10-week Trauma-Sensitive Yoga (TSY) course that supplemented psychotherapy. West et al. analysed the interviews conducted after the TSY course within a qualitative descriptive framework.
Upon analysing the interviews, West et al. identified five major themes that reflected the participants’ perceptions of their experience with TSY, acronymised G.R.A.C.E - grace and compassion, relatedness, acceptance, centeredness, and empowerment. TSY was found to have impacted the participants’ personal development and PTSD symptoms (both somatic and psychological) positively, but stirred a multitude of difficult emotions. The participants reported feeling more empowered after the course as TSY enabled them to confront their emotions and communicate more effectively, while relieving stress.
Findings indicate that TSY has positive impacts on both physical and psychological symptoms and promotes personal growth. It’s emphasis on mindfulness, self-acceptance, and building interoceptive awareness helps to reduce stress, anxiety, and dysfunctional coping mechanisms. Heightened self-awareness can help the patient overcome avoidance to enable action based on recognising internal cues.
The authors recommend a multi-stage approach to trauma treatment that combines body-based interventions such as TSY with talk therapy. More research is needed to provide more insight in the utility of a collaborative approach between the patient, therapist, and yoga instructor to build a comprehensive treatment plan. Since TSY is accommodative of the patient’s physical and psychological needs and limitations, it can be modified to be incorporated into therapy sessions.
Research on the use of yoga in the treatment of PTSD involving chronic childhood trauma is limited. Since the study was limited to the extent of the use of TSY, more research is needed into the effectiveness of other forms of yoga and their use in childhood-trauma-resultant PTSD.
Notes and References
van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola,
J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized
controlled trial. The Journal of Clinical Psychiatry, 75, e559–e565. http://dx.doi.org/10.4088/JCP.13m08561
Note on difficult emotions: Many of the participants reported feelings of great sadness when, through the mindfulness programme, they realised the extent to which their traumatic experiences had affected them. They also had trouble gaining awareness of previously suppressed emotions. By becoming more attuned to their emotions and having gained the ability to deal with difficult emotions, they were able to communicate about difficult experiences more effectively in psychotherapy.
Multifarious forms of yoga exist, differing in their practise. Some forms of yoga focus more on physical poses (asanas), such as hatha yoga, and some more on meditation or breathing exercises (pranayama). Most types of yoga such as Ashtanga yoga use an amalgamation of all these factors and focus on integrating the mind and the body. Some of the most common types of yoga practice include Hatha yoga, Sudarshan Kriya yoga, Kundalini yoga, etc.