For part one go here

Use of yoga in recovering from above symptoms of PTS

Prashant S. Iyingar observes that:

“With regular practice, yoga teaches us how to develop a greater awareness of both our physical and psychological states, which in turn increases our ability to cope with everyday stresses and situations, enabling us to step back and assess our reactions and coping mechanisms.”

Let me illustrate: When we are in traumatic situations, or in abusive relationships which lead to traumatic experiences (threats to life and limb, or to our loved one’s), where we must be hyper-aware of our surroundings then the above symptoms make sense, they keep us safe. A quick startle response makes sense to a soldier who could, at any moment, be attacked and killed. Hyper-arousal, being observant and on edge, makes sense for the child who must use their keen sense of observation to predict and attempt to avoid being abused.

In addition, reliving the traumatic situation in our mind is way for us to look at the circumstances and see if there is another course of action that we could have taken to change the situation (not that we could have changed the situation, abuse is about the abuser’s need for control, they will abuse because that’s what abusers do). As Herman reveals,

Adaptation to this climate of constant danger requires a state of constant alertness. Children in abusive environment develop extraordinary abilities to scan for warning signs of attack. They become minutely attuned to their abuser’s inner states. They learn to recognize subtle changes in facial expression, voice, and body language as signals of anger, sexual arousal, intoxication, or dissociation. (99)

Being in tune with these subtle changes within the abuser or environment can help to keep victims safe, alert them to the possibility that abuse is coming. However, when one has escaped the terror these coping mechanisms can become maladaptive and begin to interfere with the survivor’s ability to function in a safe environment. And yet these coping mechanisms can also be the source of strengths, when used consciously. Survivors are often highly aware of the emotional states of those around them. This attunement can lead to greater empathy and insight, when engaged in consciously.

Yoga and mindfulness techniques, learning to observe the thoughts without attachment to them, can help the survivor become aware of when they have been triggered by a stimulus that brings back memories of the trauma. Once the survivor has become aware (via mindfulness) that they have been triggered the use of yogic breathing techniques and asana can change the physiological responses to the stimulus.

Yogic breath techniques work because the autonomic nervous system (ANS) has two sub-systems; the sympathetic nervous system, which is responsible for triggering the flight-or-fight response and the parasympathetic nervous system, which is responsible for returning the system to a relaxed state after the danger has been averted or survived.

If the stimulus of the initial trauma is extreme, to the degree that the survivor perceives a real threat to his or her life or the life of a loved one, or if the terror is prolonged (as in the case of childhood abuse, domestic abuse, and survivors of war), the baseline for the sympathetic nervous system may be elevated (hyper-arousal) and the system may not be able to reach the same state of relaxation that was available before the trauma.

However, if the trauma was such that the individual could not escape the threat, if the fight or flight response was not enough to prevent or escape attack, the individual will most likely experience a freeze response., The freeze response is associated with dissociation. In the text The Trauma Spectrum- Hidden Wounds and Human Resiliency Robert Scaer M.D. cites Freud and Pavlov stating, “Both Freud and Pavlov commented on this immobility response as a self-protective behavior in certain animals and likened it to the state of sleep and hypnotism.” (44) Scarer goes on to elucidate on the freeze response stating:

“Because the freeze response follows a life thereat, one would expect that blood pressure and pulse would be elevated as a result of release of large amounts of adrenaline associated with heightened arousal. Indeed, (they may) … However this is only part of the autonomic response. More prominently, the pulse also periodically falls to extremely low levels, the blood pressure drops and blood vessels dialate, indicative of activity of the parasympathetic, or vegetative nervous system.” (45)

Therefore often trauma survivors, especially those whom attempts at self-preservation via fight or flight have been thwarted and thus were propelled into a freeze response, experience vacillation between extreme states of hypo and hyper arousal. In states of hypo arousal they are experiencing parasympathetic responses of the freeze state, and in hyper arousal they are experiencing sympathetic nervous system response related to the fight or flight responses.

Yoga and pranayama can be of great support to people experiencing these varied states because of all the functions of the autonomic nervous system (ANS), breath is the only one over which we have conscious control. When we control the breath, slowing it down and breathing, via the nostrils, into the whole lung, the para-sympathetic nervous system is stimulated, which can help calm one who is experiencing hyper arousal, (This information is taken from notes I took at a Yoga Journal presentation on yoga for stress, by Dr. Timothy McCall). Or as the authors of Trauma Sensitive Yoga: Principles, Practice, and Research state:

“…pranayama (yogic breath) techniques… have been shown to reduce sympathetic nervous system activity and shift the autonomic balance toward parasympathetic dominance.”

In the same article the authors cite eleven different research studies which show:

“yoga practices, including meditation, relaxation, and physical postures, can reduce autonomic sympathetic activation, muscle tension, and blood pressure, improve neuroendocrine and hormonal activity, decrease physical symptoms and emotional distress, and increase quality of life” (124).

Conversely, if someone is experiencing hypo arousal; characterized by spacing out, lethargy, depression, and the like; there are other pranayama techniques that can help to invigorate the nervous system, returning the system to a functioning level.

Bibliography:

Scaer, Robert (2005). The Trauma Spectrum: Hidden Wounds and Human Resiliency. WW Norton, NY, NY.

Herman, Judith M.D. (1992). Trauma and Recovery: The Aftermath of Violence- from domestic abuse to political terror. Basic Books. NY, NY.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition. Washington, DC.

Emerson, Sharma (PhD), Chaudhry & Turner. Trauma-Sensitive Yoga: Principles, Practice, and Research. International Journal of Yoga Therapy; 2009;19,123-141.