Yoga Therapy for Trauma

 

1. Synopsis- Mitigating Rural Adolescent Trauma: Remote Delivery of a Trauma-Informed Yoga Intervention During COVID-19- Students at a small, rural high school in Montana volunteered to participate in a 6-week, twice-weekly trauma-informed yoga intervention for 45 minutes in their PE class. Survey measures, including the PHQ-A, GAD-7, and ACE-Q instruments, were utilized to measure mental health outcomes before and after the intervention. Salivary cortisol levels were also measured pre-, mid-, and post-intervention. Statistically significant declines in cortisol levels and improvements in sleep duration were noted when comparing experimental vs. control groups. Declines in depression and anxiety levels were also seen when comparing the treatment to control groups. Mental health benefits of reduced anxiety and depressive symptoms in rural adolescents resulted from a remotely delivered trauma-informed yoga intervention. trauma-informed yoga can calm the nervous system; rhythmic, self-soothing somatosensory input, which is fostered in a yoga practice, leads to physical senses of safety (which is key in healing trauma) and pleasure, leading to the release of “pleasure” hormones and regulation of stress-related neural systems

2. Synopsis- Yoga to Reduce Trauma-Related Distress and Emotional and Behavioral Difficulties Among Children Living in Orphanages in Haiti: A Pilot Study- This study measured trauma-related distress and evaluated the feasibility, acceptability, and preliminary efficacy of an 8-week yoga intervention in reducing trauma-related symptoms and emotional and behavioral difficulties (EBD) among children living in orphanages in Haiti. This study involved 76 children 7-17 for 8 weeks with Yoga asana, breathwork and meditation vs the control group of dance classes for 8 weeks. Children with trauma-related distress showed improvements in symptoms after participation in an 8-week yoga program compared to controls. Findings declared Yoga to be a feasible and acceptable activity with self-reported benefits to child mental and physical health.

3. Synopsis- The Influence of Trauma-Informed Yoga (TIY) on Emotion Regulation and Skilled Awareness in Sexual Assault Survivors- The study employed a traditional quantitative one-sample, pre- and posttest design. Survey items were drawn from two existing measures: (1) Five Facet Mindfulness Questionnaire and (2) Difficulties in Emotion Regulation Scale. The majority of the sample (n = 37) identified as White (67.6%), followed by Latina (13.5%), African American (8.1%), multiracial (5.4%), and other (2.7%). The mean age of participants was 29 years (standard deviation 8 years, range 18-56 years). All participants identified as female. Findings demonstrated statistically significant changes in participants' emotion regulation and skilled awareness, both of which have the potential to reduce PTSD symptomatology.

4. Synopsis- “Following the Breath”: A Trauma-Informed Intervention for Educator Wellness in Rural Montana- A seven week, two times a week study of High School aged students participating in trauma-informed yoga therapies of breathing, meditation and mindfulness. Participants experienced statistically significant reductions in anxiety and increases in Strengths and Difficulties overall scores and some subscales; noteworthy improvements were also present in depressive symptomatology, salivary cortisol levels, and sleep duration. Importantly, participant qualitative feedback indicated significant benefits in focus, relaxation, and overall well-being.

5. Synopsis- Application of yoga in residential treatment of traumatized youth- The Trauma Center at Justice Resource Institute adapted a form of Hatha yoga into a trauma-sensitive intervention for use with complexly traumatized individuals exhibiting chronic affective and somatic dysregulation and associated behavioral, functioning, and health complaints. This study consisted of traumatized youth ages 12-21 in residential treatment facilities. Anecdotal data and clinical observation underscore the promise of yoga as a viable approach to build self-regulatory capacity of traumatized youth.

6. Synopsis- Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunami- This study evaluated the effect of a yoga breath program alone and followed by a trauma reduction exposure technique on post-traumatic stress disorder and depression in survivors of the 2004 Asian tsunami. In this non-randomized study, 183 tsunami survivors who scored 50 or above on the Post-traumatic Checklist-17 (PCL-17) were assigned by camps to one of three groups: yoga breath intervention, yoga breath intervention followed by 3-8 h of trauma reduction exposure technique or 6-week wait list. Measures for post-traumatic stress disorder (PCL-17) and depression (BDI-21) were performed at baseline and at 6, 12 and 24 weeks. Conclusion, Yoga breath-based interventions may help relieve PTSD/psychological distress following mass disasters.

7. Synopsis- A Rapid Review Exploring the Role of Yoga in Healing Psychological Trauma- This article gathered data from identified relative studies about yoga and trauma healing and compiled the data to show the common findings. The evidence based findings show the role of yoga in healing psychological trauma. The participants in the various studies performed trauma sensitive yoga, Kundalini or Astanga yoga. The following main impacts of yoga on participants were identified: feeling an increased sense of self-compassion; feeling more centered; developing their coping skills; having a better mind–body relationship; and improving their relationships with others. 

Summary of my conclusions based on my review and synopsis of the literature. Evidence would suggest that a healing prescription for trauma might include yoga therapies. Pranayama, Asana and meditation are all modalities used that have been proven effective in mitigating psychological distress from traumatic experiences. Trauma can shift the autonomic nervous state, disrupting neurophysiological regulation (such as sleep, digestion, etc).  This shift caused by stressors in the autonomic nervous system can release hormones, including the corticotropin releasing factor (CRF), which triggers the release of cortisol, a stress hormone; the release of CRF can cause a permanent upregulation of the autonomic nervous system, which can lead to autoimmune diseases, depression, stress, and anxiety. A cultivation of a yoga practice is one way to reconnect with one’s physical and emotional sensations to foster a sense of self-awareness and emotional regulation which also assist with processing complex trauma; this awareness leads to improved interoception, or discovering the body’s internal rhythms while simultaneously benefiting one’s proprioception, or awareness of connection to one’s self, others, and their environment. Studies of yoga therapies have indicated its use as a therapeutic intervention benefits the participants with positive mental health outcomes in measures of resilience, anger, anxiety, stress, depression and fatigue as well as physical health improvements such as flexibility, strength, and weight loss. The suggested prescription for trauma might involve a combination of pranayama, asana and meditation for 6-8 weeks two times per week to gain the desired outcome. 

Reference List:​​

1. Davis L, Aylward A. Mitigating Rural Adolescent Trauma: Remote Delivery of a Trauma-Informed Yoga Intervention During COVID-19. J Child Adolesc Trauma. 2022 Dec 1:1-14. doi: 10.1007/s40653-022-00496-9. Epub ahead of print. PMID: 36471891; PMCID: PMC9713729.

2. Culver KA, Whetten K, Boyd DL, O'Donnell K. Yoga to Reduce Trauma-Related Distress and Emotional and Behavioral Difficulties Among Children Living in Orphanages in Haiti: A Pilot Study. J Altern Complement Med. 2015 Sep;21(9):539-45. doi: 10.1089/acm.2015.0017. Epub 2015 Jun 19. PMID: 26090580.

3. Nicotera N, Connolly MM. The Influence of Trauma-Informed Yoga (TIY) on Emotion Regulation and Skilled Awareness in Sexual Assault Survivors. Int J Yoga Therap. 2020 Jan 1;30(1):19-31. doi: 10.17761/2020-D-18-00031. PMID: 32160072.

4. Lauren Davis, Alexandra Aylward, Brandon G. Scott, Jonathan Jacobs. (2023) “Following the Breath”: A Trauma-Informed Intervention for Educator Wellness in Rural Montana. Education Sciences 13:1, pages 23.

5. Spinazzola J, Rhodes AM, Emerson D, Earle E, Monroe K. Application of yoga in residential treatment of traumatized youth. J Am Psychiatr Nurses Assoc. 2011 Nov-Dec;17(6):431-44. doi: 10.1177/1078390311418359. Epub 2011 Aug 25. PMID: 21868714.

6. Descilo T, Vedamurtachar A, Gerbarg PL, Nagaraja D, Gangadhar BN, Damodaran B, Adelson B, Braslow LH, Marcus S, Brown RP. Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunami. Acta Psychiatr Scand. 2010 Apr;121(4):289-300. doi: 10.1111/j.1600-0447.2009.01466.x. Epub 2009 Aug 19. PMID: 19694633.

7. English A, McKibben E, Sivaramakrishnan D, Hart N, Richards J, Kelly P. A Rapid Review Exploring the Role of Yoga in Healing Psychological Trauma. Int J Environ Res Public Health. 2022 Dec 3;19(23):16180. doi: 10.3390/ijerph192316180. PMID: 36498254; PMCID: PMC9741324.