How yoga can help ease PTSD symptoms
Groundbreaking studies have revealed that yoga practice actually changes core physiology related to PTSD and C-PTSD and can clinically decrease the symptoms by syncing awareness of movement with breath. This has a profound impact on training our nervous systems and can help people with PTSD or C-PTSD reconnect with their bodies.
Typically consisting of ‘pranayama’ (breathing exercises), ‘asanas’ (stretching and posture work), and meditation, yoga teaches individuals how to befriend their bodies, and therefore be better equipped to navigate the complexities of trauma and its physiological effects.
This article will answer why and how yoga can help minimise the symptoms of PTSD and C-PTSD, what specific symptoms yoga can help with, and the particular yoga practices that can help.
In ‘The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma’ Dr. Bessel Van Der Kolk writes: ‘We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body.’ For people affected by PTSD and C-PTSD to truly relearn how to inhabit their bodies, Van Der Kolk emphasises the importance of becoming familiar with bodily sensations: ‘For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present… Yoga became a major cornerstone in our understanding that it is imperative to befriend one’s bodily sensations in order to overcome the imprint of trauma.” Yoga is an excellent way to learn to confront internal sensations and to learn that it is safe to have these feelings and sensations.
Why does yoga help people with PTSD and C-PTSD?
People with PTSD and C-PTSD often experience alexithymia, a technical term for not being able to identify what is going on in your body. Yoga is a vital practice that can help those with PTSD or C-PTSD reconnect their mind and brain to their body, and regain a sense of themselves in the world.
As Van Der Kolk also writes, those with PTSD and C-PTSD often find it challenging to control emotions and impulses, as the relationship between the regulating systems of the amygdala and the medial prefrontal cortex in the brain are typically off-balance in a traumatised body. Van Der Kolk identifies two ways of navigating this imbalance – either through top-down or bottom-up regulation. Top-down regulation involves strengthening the capacity of the medial prefrontal cortex to monitor bodily sensations. Yoga and meditative practice can help with this, equipping individuals with a better capacity to self-regulate and gain control of their own bodies.
Breathing practices help to centre individuals in their own body – even steps as simple as noticing the speed, duration, and placement of breath can be a significant achievement in improving your relationship with your body.
When practising different postures, it’s helpful to take time to notice which muscles are activated in the stretch – this will, in turn, reconnect you to your body. As Van Der Kolk writes: ‘Simply noticing what you feel fosters emotional regulation, and it helps you to stop trying to ignore what is going on inside you.’
What symptoms can yoga ease?
Regular yoga has been shown to reduce physiological arousal in those with PTSD and C-PTSD, helping the autonomic nervous system (ANS) to adapt better to triggers and stimuli. In other words, yoga helps minimise the risk of the body experiencing intrusive memories and other physical symptoms of PTSD and C-PTSD. This can, in turn, reduce emotional arousal and consequent distress.
Regular mindfulness and meditation can also make positive changes to neural functioning – for example, helping the learning and memory processes, emotional regulation, and perspective-taking – as well as reducing the size of the amygdala.
Regular yoga – in particular hatha yoga – stabilises heart rates and reduces blood pressure, as well as improving hormonal activity.
Yoga is equally great for easing tense muscles and improving the confidence of those with PTSD or C-PTSD to go about daily life, secure in the knowledge that they are less likely to experience triggering episodes.
The benefits of specific yoga practice
Hatha yoga is particularly effective at helping with heart rate variation (HRV), a measurement of the balance between the sympathetic and the parasympathetic nervous systems. Having a balanced HRV is vital to emotional self-regulation: it equips us with the ability to calm ourselves down. Typically, those with PTSD and C-PTSD have low HRV; hatha yoga is noted for helping to stabilise HRV, as well as helping to reduce intrusive thoughts and anxiety, and is therefore a particularly beneficial yoga practice.
Hatha Yoga is also particularly suitable for trauma survivors, thanks in part to the breath work and compassionate observation of the internal and physical experience. “Eventually, this skill translates into un-attaching from intense emotional and physical waves of trauma symptoms so that you witness the experience rather than feel fear or shame. Both physical and emotional trauma can leave survivors so disconnected from their bodies that not feeling becomes normal. That’s why asana is so important: Moving through poses allows you to explore a pathway to connection that may have been disrupted and learn to both feel and trust physical sensations such as natural limits within a particular pose.”
Kundalini yoga has also been found to be effective in minimising the symptoms of PTSD and C-PTSD – in particular, perceived stress and anxiety, resilience, and sleep. Studies looking at Kundalini yoga and PTSD found that those who participated in Kundalini yoga experienced a significant improvement in their PTSD symptoms, a greater change in their ability to sleep, in how they perceived anxiety and stress, and in their resilience to everyday life. Afterwards, the participants also saw improvements in their mental clarity, a higher self-esteem and a greater ability to self-reflect.
One of the main symptoms that people who have PTSD or C-PTSD experience is feeling frightened or stressed even when they’re not in danger. Their nervous system remains in a heightened sense of activity and can lead to them either feeling hyper-aroused or disassociated.
Through Kundalini yoga, people can safely start to move out of these states of being and can start to find a sense of relative safety. They can then also start to explore how their body is feeling, accept some of the problems they have been dealing with, and finding the ability to be ‘present’ in their body. This is crucial for starting the journey towards recovery. The yoga is performed at the speed and progression that suits each individual, with a pause after each action to ensure people have time to feel what changes each move has brought about.
It isn’t just about slowing the body down though – yoga can actually have a positive physical impact on the brain as well. For those living with PTSD or C-PTSD, they typically have an over-responsive amygdala and a physically smaller hippocampus.
However, research published in the International Journal of Yoga in 2011 found that when people chanted ‘OM’ in an MRI machine, it significantly deactivated the amygdala. Additionally, a separate study published in Psychiatry Research in 2011 found that an 8-week mindfulness meditation programme also helped to increase the size of the hippocampus. Yoga is a great source of mindfulness.
It is generally agreed that more research is needed into the link between yoga and the reduction of PTSD and C-PTSD symptoms. Nonetheless, yoga is an effective practice by which to make a tangible, non-medical intervention, and has been proven to have significant positive effects on PTSD and C-PTSD symptoms, as reconnecting the mind and brain with the body is a vital way of navigating trauma.
How do I get started with yoga to help PTSD or C-PTSD?
There are many yoga classes around the UK and even some amazing ones online. It’s worth mentioning your PTSD or C-PTSD diagnosis to your yoga teacher so thy can help guide you where needed too. But there are also a number of specific trauma trained yoga teachers in the UK, and you can find some of them here.
It’s important to note, that while choosing your PTSD or C-PTSD recovery path you need to address both the symptoms and the underlying condition. NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).
Please remember, these aren’t meant to be medical recommendations, but they’re tactics that have worked for others and might work for you, too. Be sure to work with a professional to find the best methods for you.
- Gallegos, A. M., Crean, H. F., Pigeon, W. R., & Heffner, K. L. (2017). Meditation and yoga for posttraumatic stress disorder: A meta-analytic review of randomized controlled trials. Clinical psychology review, 58, 115–124. https://doi.org/10.1016/j.cpr.2017.10.004
- Kim SH, Schneider SM, Kravitz L, Mermier C, Burge MR. Mind-body practices for posttraumatic stress disorder. J Investig Med. 2013 Jun;61(5):827-34. doi: 10.2310/JIM.0b013e3182906862. PMID: 23609463; PMCID: PMC3668544.
- Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012 May;78(5):571-9. doi: 10.1016/j.mehy.2012.01.021. Epub 2012 Feb 24. PMID: 22365651.
- Hölzel, B. K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S. M., Gard, T., & Lazar, S. W. (2011). Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry research, 191(1), 36–43. https://doi.org/10.1016/j.pscychresns.2010.08.006
- Matthew Tyler Boden, Amit Bernstein, Robyn D. Walser, Leena Bui, Jennifer Alvarez, Marcel O. Bonn-Miller, Changes in facets of mindfulness and posttraumatic stress disorder treatment outcome, Psychiatry Research, Volume 200, Issues 2–3, 2012, Pages 609-613, ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2012.07.011.
- Seppälä EM, Nitschke JB, Tudorascu DL, Hayes A, Goldstein MR, Nguyen DT, Perlman D, Davidson RJ. Breathing-based meditation decreases posttraumatic stress disorder symptoms in U.S. military veterans: a randomized controlled longitudinal study. J Trauma Stress. 2014 Aug;27(4):397-405. doi: 10.1002/jts.21936. PMID: 25158633; PMCID: PMC4309518.
- Jindani, F., Turner, N., & Khalsa, S. B. (2015). A Yoga Intervention for Posttraumatic Stress: A Preliminary Randomized Control Trial. Evidence-based complementary and alternative medicine : eCAM, 2015, 351746. https://doi.org/10.1155/2015/351746
- The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma (Penguin Books: 2014), Dr. Bessel Van Der Kolk
- Kundalini House
- Yoga and PTSD
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It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).
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