The statistics on those suffering from post traumatic stress disorder highlight a current crisis in mental health. According to CBS, there were 6,256 suicides among those who’ve served in the armed forces. That’s 120 a week. According to the department of veteran’s affairs, there are nearly 1000 suicide attempts by veterans per month. Some veterans centers, such as the Worchester, MA Veteran’s Center have found that Yoga therapy has proven effective for combat veterans with post traumatic stress disorder in terms of mental, physical and emotional growth.
Additionally, the Philadelphia Inquirer reports that severe stress, brought on by prolonged, untreated post traumatic stress disorder can have lasting consequences, such as heart disease. Unfortunately, there is no evidence to show that medications have been effective in treating PTSD according to the Institute of Medicine. Treating PTSD requires access to a variety of methods that can be tailored to an individual’s needs. As the Vet Centers are coming to realize, Yoga can be among those therapies that can be tailored to a particular individual’s needs.
Yoga Asanas and the Chakras
Yoga means union, of body and mind and self with the larger community and a higher power. The practice of Yoga has been handed down for over two thousand years, and in general the study of Yoga follows an eightfold path which includes asanas or poses. In working with the asanas, some yogic texts also detail methods of harmonizing and controlling the flow of energy through the body, either through controlling prana, or life force, through breath work, or by focusing on the chakras.
The chakras have been defined as spheres of energy located in the energetic body, the sensing feeling self, which emanate out from the nerve endings in the spinal column through the body These chakras consist of seven major spheres and can be thought of as meeting points of the mind and body. These areas can become blocked or unbalanced by tension or low self esteem held so long it becomes “part of the body.”
Some authors note that the imbalances in the chakras can be temporary or chronic. Remember that chakras are essentially, “site where we receive, absorb, and distribute life energy,” chronic imbalances can originate from childhood experiences, past stress or strain or internalized cultural values. Others describe an imbalanced chakra as neither receiving appropriate energy nor easily manifesting that chakra’s energy in the world. In essence, being closed down in a part of the body and mind. This can manifest physically in the slumped curled shoulders of a depressed person, causing both physical and emotional pain, as such a posture does not invite others to engage with you, and throws weight improperly into the lower back.
The goal in working with the chakras is to deepen your awareness of your self and your energetic/emotional self. See Paul Catalfo, Reviewing Sins of the Spirit, Blessings of the Flesh by Matthew Fox in Yoga Journal. While precise definitions of chakras may be elusive, generally it is thought that the seven chakras compose seven major sites of energy flowing up and back down the spinal column. In this way, the chakras are the metaphysical shadow of the endocrine system.
Part of the blurred edges of the definition and study of the chakras is due to their prevalence in multiple cultures. Even wikipedia’s entry on chakra’s offers the following “In Chinese medicine, traditional chakra locations correspond to acupuncture points. IN some eastern thought, chakra’s are considered to be graduations of consciousness and reflect states of the soul… A mystic may deal with chakra as a model for their internal and external experience, and when talking about ‘energy centers’ may be talking about subtle forces which connect to the physical, emotional, mental, and spiritual aspects of a person.”
In working with the chakras – either as a visual tool for meditating or as centers of energy to be unlocked and provide movement and freedom in Yoga – it is essential to remember that they are the subtle body, and are interconnected. Just as sitting up straighter is done by focusing on the abdomen and solar plexus, lengthening that area out, in so doing the shoulders slump less and move towards opening, so too is it possible to have an open and free heart if you have a strong sense of self and knowledge of your individual nature.
The Seven Major Chakras
The Root Chakra – the first – which is also called the support chakra or in Sanskrit, Muladhara. It is located at the base of the spine (imagine the tailbone area). Sources state that its function is “survival and grounding.” Focusing or meditating on the first chakra helps invite a sense of inner stability and stillness into the body and mind. To meditate on this area, you can either visualize your tailbone lengthening, digging into the earth and growing down like a root, spreading its fingers or simply use the mantra “I am.” Balancing this chakra brings energy to the physical body, controls fear, increases overall health, and helps in grounding.
The second chakra is the naval/sacral chakra – also called svadrsthana, and it is located in the reproductive organ area (imagine the cavity in between your hip bones). Sources state that its function is desire, sexuality, and pleasure, as it sits near the reproductive organs. Other sources view this location differently – instead of focusing on the passionate aspects of reproduction, they focus on the function – that is creation, life giving. This can be thought of as the generator/incubator of ideas and dreams, where you give birth to visions and allow the cord to attach them to you, tying them back to the physical world and allowing practicality to give them shape, structure and existence. To meditate on this area, visualize the color orange, like a flame flickering or repeat the mantra “I feel.”
The Third Chakra is the solar plexus, also called manipura, it is located above the naval area – right where the wind gets knocked out of you in sports or here you contract your tummy to “suck it in.” Its function is individual will, its state is laughter, joy, and anger. Balancing this chakra is associated with calming emotions, soothing frustrations, and helping to better use intuition (or trusting your body’s senses and mind’s judgments). Meditations include focusing on the strength of the core/abdomen and repeating “I do.”
The fourth chakra is the heart chakra, also called anahata. While it is called the heart chakra it actually is located in the center of the chest. Most often, when people feel tension in their shoulders and upper back, it is from curling the shoulders in to protect the heart. A sense of safety and continuity can help open this chakra, as sometimes the brain thinks emotional pain (e.g., heart break), will lead to a cessation of self. Stability and continuity – understanding that breaches of trust, stabbing in the back and other deeds people without peace visit upon us are temporal in nature. They don’t repeat and can be left in the past. Balancing this chakra assists the circulatory system, heart and thymus. To do so, its necessary to work to open the heart, so that energy can flow into and out of it. Such a balancing affects feelings of spiritual love and universal oneness. A useful mantra for this chakra is “I love.”
The fifth chakra is the throat chakra – located at the mid center of the neck. Also called visuddha, its function involves speech, communication and creativity. Its state of balance is the synthesis of ideas into symbols, symbols into words. Balancing this chakra is important for speech and communication, though sometimes a tightness or “lump” in the throat can happen when you swallow the words your self thinks you need to say, and they sit like rocks resting on your voicebox. Focusing on the yama of truthfulness and balancing that with ahimsa, non violence, can help bring balance, as does the mantra “I speak.”
The sixth chakra is the third eye, also called Ajna. The third eye is located between the eyes in the middle of the forehead. It is the center of intuition, knowledge and seeing with your higher self -.e.g. without the ego and attachment. The function of the sixth chakra is to see and unit. Balancing this chakra is important for perception without filters of “acceptable” or other community standards of involuntary judgments and preconceptions, as well as balancing the pineal gland. A useful mantra for opening the third eye is “I know.” Bringing balance into this chakra will promote thought and reflection, with a fresh or pure perspective.
The seventh chakra is the crown chakra, known as sahsvara. Located at the top of the head, the crown chakra’s function is sometimes referred to as understanding, and other times thought of as connection with the higher self/god/the universe. Balancing this chakra is said to give vitality to the cerebrum and affects psychic abilities. This could also be inuited as balancing and strengthening an everyday connection to a higher power, seeing the unity of self, body and the universe/higherpower. Meditating on the thought “I understand” or that sense of connectedness can achieve peace.
The chakras can be useful points of focus for practicing the asanas as well. In an article by Melissa Garvey in Yoga Journal, teachers describe how focusing on the third and fourth chakras (the solar plexus and heart) can help achieve a strong more aligned backbend. The chakras can be useful ways for students to focus on the sensations of the body. Teachers focused on the use of chakras in Yoga often find the best connection between students and the topic when focusing on the fourth chakra – the heart chakra. This may be because this is where physical movement can become easier as emotions such as fear and stress are relieved. Others find the third chakra – the solar plexus and the area that houses the sense of self – to be the best place of emphasis because it is through Yoga that we hope to transform the self.
Focusing on the chakras not only brings emotions to the surface, but it can also provide a base for fine tuning and making your Yoga practice individually your own.
Post Traumatic Stress Disorder is a Somatic/Mental Break
Post traumatic stress disorder involves both mentally and physically re-experiencing past trauma. That is why there are somatic aspects to this disorder. Rothschild, xiii. Among the diagnostic criteria for PTSD are that an individual physically feels the toll of the traumatic events. Rothschild, 5. For PTSD sufferers, the trauma intrudes on visual, auditory, and somatic realities. Rothschild, 6. “Individuals with PTSD suffer inundation of images, sensations, and behavioral impulses disconnected from context, concepts and understanding.” Rothschild, p. 37.
The very definition of PTSD is that it “disrupts the functioning of those afflicted by it, interfering with their abilities to meet daily needs and perform the most basic tasks.” Rothschild, 6. The current diagnostic criteria for the disorder, as listed in the psychological diagnostic manual – the DSM-IV – is that it generates from combat, sexual and physical assault, being held hostage, terrorism, torture, disasters, accidents, and the diagnosis of a life threatening illness. The DSM-IV notes “the disorder may be especially severe or long lasting when the stress is of human orgin (e.g. torture or rape).” See Rothschild. Symptoms include: re-experiencing the event or having flashbacks, avoiding reminders of the trauma, chronic hyperarousal in the autonomic nervous system, or essentially being stuck in the fight or flight mode of survival, leading to a high startle response or “jumpiness.”
While its normal to experience some of these symptoms directly after a stressful event, where they last for more than a month or cause someone to lose functioning in a job or relationship they’ve moved from normal stress to PTSD. IN approximately 20 % of people who live through a trauma are afflicted by PTSD, in rape survivors that number climbs to 70%, and for veterans who have done more than three tours in Iraq, the approximate percentage rate is between 60 and 80%. That means these individuals struggle on nearly daily basis to function an live their lives, being productive members of society.
The chronic autonomic nervous system arousal leads to physical effects – sleep disturbances, loss of appetite, sexual dysfunction, panic, anxiety, weakness, exhaustion, muscle stiffness. Rothschild, p. 7. Biochemically, those with PTSD do not release enough cortisol, a hormone that shuts off the body’s fight or flight response, thus locking the person in a constant survival mode. One trait among PTSD sufferers is a phenomenon of freezing or playing dead, like a mouse would do when being battered around by a cat. Rotshchild, 9. The body does this automatically to feel less pain. This freezing mechanism is related to dissociation, here you literally split your consciousness. Rothschild, 13. Dissociation is an instinctive response to save the self.
We can gather that flashbacks and reexeperiencing – both the fight/flight response or the playing dead dissociation, are the hallmarks of PTSD. The flashbacks arise from a trigger or sensation that brings individual memories so intense that the sufferer is unable to distinguish reality from the past. This can be from “sensory messages from muscles and connective tissue that remembers a particular position, action or inaction.” Rothschild, 45. The flashbacks can be triggered by different stimuli – events that are familiar or stressful, a feeling that is similar or being out of breath for someone who might have been held down or strangled while the traumatic event occurred.
It is also possible that a physical sensation such as increased heart rate can be triggered by body positioning. Therefore, asking someone to reconstruct their body position before and during the trauma can bring these details into awareness. Rothschild, p. 36.
Treating PTSD requires unifying the body with the mind to put the trauma in the past and stop reliving it. Because “PTSD is not just a psychological condition, but a disorder with important somatic components,” treatment models vary. Currently, they are either verbal (talk therapy) or body oriented. Babette Rothschild, in The Body Remembers: The Psycho-Physiology of Trauma Treatment, states that there is a growing body of research legitimizing a mind body connection. She argues that “Integrated trauma therapy must consider, consist of and utilize tools for identifying, understanding and treating trauma’s effects on both body and mind.” P. xiii. In plain English, therapy for PTSD needs to involve helping people stay in their bodies.
Just as earthquake drills can prevent panic through rehearsal – e.g., building pathways in the brain’s message center, so do traumatic responses build a rehearsal aspect. Rothschild, p. 54. This means anticipation and awareness are elements of treatment.
However, some PTSD sufferers can’t tolerate memory–oriented treatment, but will still benefit from therapy geared towards coping skills, relieving symptoms, and improving functionality. P. 79, 83. Part of the therapy needs to involve “braking” or giving an individual an ability to step back from processing the event when they get overwhelmed. Rothschild, 79. These can be functional, physical, psychological, interpersonal, and spiritual. Rothschild, 88. Physical resources involve training the body. Rothschild, 89. “The potential benefits of being able to use the body as a resource in the treatment of trauma and PTSD, regardless of treatment model, cannot be overemphasized.” Rothschild, 100. Among the potential therapies is building body awareness, p. 13o, relaxation and muscle tensing, p. 137.
Muscle tensing helps survivors feel strong, gives body awareness and helps an individual stay anchored in the present. But to work it must be done with body awareness and mindfulness. Rothschild, 137.
Whichever model of therapy is chosen, “ultimately the goal of trauma therapy is to relegate the trauma to its rightful place in the client’s past.” Rothschild, 155. In review, muscle tensing, relaxation, breathing methods and awareness are all useful tools in assisting a PTSD sufferer in overcoming trauma to “stay present.” Yoga encompasses each element of this trauma therapy and can be a useful mechanism for therapy. Additionally, those who teach should be aware of the potential for flashbacks in their students.
Yoga and PTSD as Integration
As discussed above, Yoga incorporates the elements of successful body therapy for PTSD sufferers. A traditional class involving body awareness, concentration on breath, discrete and deliberate movements, and focused relaxation and opportunity for short meditation seem to fit with the body focused therapy described by Rothschild.
One step further into the benefits of Yoga for PTSD sufferers is to focus the Yoga class on specifically providing these opportunities for healing. For example, a Yoga teacher could choose to work on strength building poses for those who were overpowered and feel weak by using the warrior series, plank and fierce/chair pose. Another teacher could choose to work on calming poses for those with panic attacks such as forward bend, legs up the wall pose, and child’s pose. Or a teacher could work with the rehearsal aspects of trauma therapy by asking the student to work on counting the lengths of their inhalation and exhalation while working on crow pose or scorpion, poses where the effort is intense and the fear of falling is a factor.
It may be easiest, however, to begin simply with focusing on the chakras. Each chakra is involved in PTSD therapy – the sense of connectedness or rootedness can be vital for those who dissociate or are particularly disturbed by flashbacks and wish to stay present. Additionally, working on the second chakra of passion or creativity, is in essence working on the manifestation of ideas and thoughts, on experiencing feelings, again essential for those overcoming dissociation or who are skittish about the depths of their fears. Similarly, a strong sense of self, and self confidence that you have the tools to access the therapy you need to heal yourself, since each experience with PTSD can differ so greatly, is vital, and therefore focusing on the third chakra can be very helpful. The heart chakra should be somewhat more obviously involved, as those who’ve lived through human generated trauma may have to work harder to open their hearts. The throat chakra as mentioned before, is involved with turning ideas and images into words, a useful mechanism for placing an event in a time, placing a feeling not as continuing but as part of a series of events – thus assisting in putting the trauma in the past. The third eye and the crown chakra can be helpful to those who seek to begin trusting others by first trusting their own instincts, then trusting in a higher power/god/the universe or fate.
There are other aspects of the eight fold path that are often incorporated into a Yoga class that can be hepful as well. As noted by Rothschild, focusing on breathing – both awareness of shallow or rapid breathing and learning to control breathing, can be a helpful. In Yoga working with the breath as a means of controlling the prana or life force energy is called Pranayama. Prana meaning life force and yama being study, master, observe or control. Pranayama exercises can be as simple as working to extend the length of an inhalation to a count of 20 and working on making the inhale as long as the exhale. Another step in the eight fold path that can be of assistance to those suffering from extreme hyperarousal – such as those with PTSD is Pratyahara. Pratyahara is the controlled withdrawal from the world of the senses. This sounds like dissociation as described above, but the difference being a controlled withdrawal. In pratyahara, the goal is to register the sounds or sensory experiences occurring around you but choose what occupies your attention. This can be done by selecting one sound to listen to, such as a bird singing, when sitting outside, and choose not to listen to the cars driving by or a neighbor’s lawnmower. In short, the practice of Yoga, to integrate body and mind, so that the yogi is better able to focus the mind and attain unity with the higher self, is a useful therapy for those suffering from a split between the body and mind, and in the mind between the then and the now.
Source: Written by Margaret Juliano for Sprout Yoga