Trauma-Sensitive Yoga

Sabine: Mr. Pfahl, you have been researching the topic of trauma for many years. At the same time, you have cared for patients in a number of different environments and backgrounds including barracks and prisons. Can you start by explaining how trauma takes place and how this experience of trauma affects the lives of trauma survivors? 

Joachim Pfahl: It's not easy to explain in a couple of sentences, because there is so much to be said about what trauma is. In general, you can say that a person is traumatized by experiencing an event or situation that is life-threatening, and have occurred once or multiple times. The person will often experience a split where they no longer sense or feel the body. This instinctive reaction was originally used as a protection mechanism which is useful in the midst of the traumatic experience. The problem is when this reaction occurs in future situations where there are no signs of danger present. Possible effects of being traumatized are disassociation, or the disconnect among thought, action and behavior, panic attacks, anxiety and depression. These are commonly associated with Post Traumatic Stress Disorder (PTSD). 

Sabine: So you are talking about a disconnect between the body and mind that needs to somehow be restored. How is it possible to reestablish this? Is it possible to achieve this through rational faculties, or does it need to be addressed through different channels? 

Joachim Pfahl: Yes, it does in fact require different channels. Through a variety of approaches, we attempt to restore the person's fundamental ability to inhabit their body or to want to feel connected with their physical body. It also means rediscovering the body as a safe place. Interoception is the ability for a person to perceive and sense their body from the inside out and is the central goal when working with Trauma-Sensitive Yoga (TSY). 

Sabine: So what you are describing suggests that trauma therapy must be adapted accordingly. My first assumption would be that traditional therapy may not suffice, as it doesn't really hit the core of the problem entirely. Would you agree? 

Joachim Pfahl:  There is a growing understanding that a physical approach should be integrated to compliment traditional therapy because trauma is stored in the body and is anchored in the body's memory. Peter Levine, Bessel van der Kolk and others have long pointed out this key element in their scientific findings. (Studies on NCBI:   PMC4316402 und PMC3181584 )

Sabine: You yourself apply yoga practices in your therapy sessions. And for you, do they support traditional therapy approaches, or is yoga more an integral part of the treatment as a whole? 

Joachim Pfahl: Both, actually. Yoga itself can be a therapy when it is done under the guidelines of TSY, or Trauma-Sensitive Yoga (TSY ingradual^®). We have developed a TSY ingradual^® program with the goal of bringing healing for trauma survivors through a careful, sensitive form of yoga. Through relaxation, which is an integral part of yoga, as well as strengthening and stretching, old wounds which present themselves as everyday stress for example, can be opened up and dissolved. The concept of addressing the body's stored memory of experiences and events is what led to the need for a special form of yoga, one that is sensitive to the body's trauma. In this practice, one can reawaken parts of the body injured through trauma, sensing them once again and slowly integrating these parts back into the whole. When practicing in this way, it is very clearly an independent form of therapy. It can also be used to inform and accompany the know how of yoga teachers or trauma yoga therapists who work together with psychologists or phsychotherapists. 

Sabine: What kind of reactions do you get when people hear you are offering yoga as a form of therapy? I could imagine that especially in environments such as barracks or prisons that at least in the beginning that many would be rather unwilling to give the class a try because of the stigma attached to yoga as effeminate or only for softies.   

Joachim Pfahl: This can definitely be true, especially at the beginning.  But word gets around fast in such closed populations like in barracks or prisons. If one soldier can sleep again or his panic attacks disappear, labels such as 'girly gymnastics' are dropped and people start to respect the practice naturally. At least, that is my experience with it. 

Sabine: As yoga teachers we are coming into contact with people who may have survived trauma and working in a very close and personal way with people. How, or where can we learn the tools to help us to use yoga appropriately to best serve our students?

Joachim Pfahl: We have seen that the various pioneers in the field of yoga and meditation for trauma survivors all come to very similar conclusions and outcomes through their experiences. More and more we are seeing a wide array of specifically outlined guidelines for offering Trauma-Sensitive Yoga, a term that was actually coined in the United States. There are continuing education courses available for Trauma-Sensitive Yoga as well as for Trauma Yoga Therapists. There are also trainings taking into consideration that some teachers work with the general public and do not know who may or may not have survived trauma in the room. 

Sabine: Thanks to the growing popularity of yoga, it is no longer only classified as an esoteric practice. As there is more awareness of the effects of yoga and its ability to help people to find inner balance, there is probably a growing number of people who are coming to classes in search of this harmony. It is highly possible that a person comes to one of my classes who has survived trauma and I would never know it. Can this be problematic, specifically at the end of the lesson when we take constructive rest? Is there a way to recognize the red flags? And if so, what can I do to accommodate all of my students regardless of whether or not they have a trauma history?    

Joachim Pfahl: As a yoga teacher's awareness grows on the subject, they are able to sense and identify possible triggers in their yoga classes. Now this is not about offering a substitution for therapy, we are talking about learning how to deal with a triggering situation and how to best respond to it. I can't offer a lot of information on this because it requires looking at a lot of factors and there is no single recipe for dealing with this type of situation. However, there is a principle approach that can be learned and then implemented in a meaningful way in order to best support the students in your classes. 

Sabine: Thank you for sharing your insights on the topic of trauma sensitive yoga and how it can support trauma therapy. I am looking forward to learning about new developments and research in the area and hope that we can soon report more about the topic in the near future. 

More information about trauma sensitive yoga (TSY ingradual^®) teacher trainings can be found here:
http://www.traumasensiblesyoga.de