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Woman lying down on yoga mat with hands pressed together above her head.
When I experienced the worst thing that’s ever happened to me, I took it out on the gym. I spent night after night there in an attempt to sweat myself out of the maw of sadness that had taken hold. And then, over a matter of weeks, I was discovering a pattern: All of that physical exertion would inevitably lead to an emotional purge as soon as I left. I’d get in my car, put on my seatbelt, and let the ugly cry-fest begin. And it felt … GREAT! I likened it to a holy experience. I asked my trainer at the time about this phenomenon, and she told me it was my body’s way of releasing pent-up grief. It became one of the biggest and most effective coping tools for me as I navigated a new normal.
When The Body Keeps the Score was published in 2014, a seminal text exploring the physical manifestations of PTSD, it was a game changer for trauma recovery. Penned by renowned psychiatrist and researcher, Bessel van der Kolk, the book is centered in how the brain likes to package up and store away (aka, repress) traumatic events, but the body does not forget, which results in a “recalibration of the brain’s alarm system, an increase in stress hormones, an alteration in the system that filters relevant information from irrelevant.”
The book highlights the power of trauma sensitive yoga teachings—how movement isn’t just a physical matter. Inspired by these findings, Macarena Corral, PsyD, LP, E-CYT, attended a workshop for yoga teachers alongside van der Kolk himself and got certified in 2017. She is currently one of only a handful of trauma sensitive yoga facilitators in the state of Minnesota. Ahead, she talks about the science behind trauma sensitive yoga, its role in chilling out our fight-or-flight response, and how it can serve as an adjunct mental health treatment.
Give us a primer on trauma sensitive yoga. Who is it for? And how does it help?
For many people who have been traumatized, they are frequently highly anxious and/or hypervigilant—it can show up in the body in many ways including (but not limited to) feeling on edge, muscle tension, chest tightness, trouble sleeping, nightmares, memory issues, trouble focusing, and anxiety. As such, they need help learning ways to tolerate and regulate their emotions and behaviors. Trauma sensitive yoga can encourage positive emotions as well as increased parasympathetic activity, helping to calm the nervous system. More specifically, yoga can help activate the parasympathetic nervous system (PNS), the opposite of the fight, flight, or freeze response. When the PNS is activated, our heart rate, blood pressure, and breathing slows and we enter a state of relaxation. Learning these techniques can be useful for people when they are triggered into memories of the trauma, limiting the physical and emotional response that arises with the memory.
Tell me a little about your background. What led you to this line of work?
Courtesy of Center for Collaborative Health
Macarena Corral, PsyD, LP, E-CYT
While finishing my doctorate program in clinical psychology, I was introduced to hatha yoga which became my way of handling the immense stress that came along with juggling school and work responsibilities. From there, I jumped straight into a 200-hour yoga teacher training program and started teaching yoga a few months after. Throughout this time, I continued studying and learning about different trauma techniques, which led me to the work of Bessel van der Kolk [renowned psychologist and author of The Body Keeps the Score] and the Center for Trauma and Embodiment. In 2013, I attended a workshop on teaching trauma sensitive yoga at the Kripalu Center in Massachusetts, alongside van der Kolk himself, and that weekend was very impactful for me—it drastically changed how I practiced and taught yoga and how I viewed the needs of my students. It also became part of my vision for a mental health clinic that would utilize multiple interventions to treat the whole person by providing an integrative and empowering approach to healing and preventative care; a clinic that would later become the Center for Collaborative Health. After that initial training, I applied and was accepted into the formal certification program and became a Trauma Center Trauma-Sensitive Yoga Facilitator in 2017. Currently, at the Center for Collaborative Health, we provide structured trauma sensitive yoga sessions, in addition to incorporating aspects of yoga and breathing in individual therapy sessions as a conjunctive treatment for certain diagnoses.
Can trauma be actually physically held in our bones and muscles?
Research shows that trauma not only affects the mind—it affects the body. The body remembers the trauma, even if we are not consciously aware of it. Trauma is not stored in the muscles or bones; it's actually stored in the memory and emotional centers of the brain, and expressed as changes in the biological stress response (i.e., increased heart rate, increased blood pressure, upset stomach, changes in appetite or weight, sweating, chills, and restlessness). Intense emotions at the time of the trauma are stored in this way and we become conditioned to respond to reminders of the event in similar ways. This suggests that the body has a physical reaction whenever a situation reminds the person of the traumatic event. Evidence suggests that this causes your nervous system to stay on alert, always ready to face the next perceived threat or trigger.
How do you know if you're reaping the benefits of this practice? What do markers of improvement look like?
In general, people who are affected by trauma tend to feel unsafe in their bodies and in their relationships with others. Yoga can help build that trust again by helping a person to understand their body better, promote a more positive relationship with their body, and empower them to make the right choices for their body. However, regaining a sense of safety can take weeks, months, or even years, depending on the nature of the trauma. People who have experienced ongoing, chronic abuse may take longer to see the changes that they want (as “success” is defined by each person and what they are hoping to gain from their yoga practice). Overall, trauma sensitive yoga can help improve things such as concentration, focus, and attention; reduce anxiety, stress, and anger; provide emotional regulation techniques; and assist with relaxation, sleep, and mood. Treatment outcomes are particular to the person and their situation.
Walk us through how trauma sensitive yoga can help an overactive fight-or-flight response stay calm under pressure.
When a person has experienced a trauma, the amygdala, or the part of the brain that activates the fight, flight, or freeze response, becomes overactive. This can increase the level of stress hormones in the body, such as cortisol, leading to an underlying feeling of being “on edge” most of the time. Basically, the brain sends messages that we are not safe and that we need to be on high alert. The problem is that in addition to the amygdala being overactive, the parts of the brain that help with self-regulation and rational thought are not activated. In effect, we are only focused on survival and cannot be in the present moment. This is why sometimes talk therapy is not as useful if our bodies are dysregulated and we do not have the capacity to engage in therapy in a meaningful way.
Breathing and movement can help activate the parasympathetic nervous system, regulating physical reactions and bringing the body to a place of relaxation and safety. Trauma sensitive yoga can also help a person learn to recognize and tolerate physical sensations, thereby regaining a feeling of safety inside their body. By noticing sensations in the body, we begin to understand what we need to feel healthy and well. Trauma sensitive yoga facilitators can then empower people to make choices about how they move, and learn very specific ways to regulate themselves and be in control of their emotional distress.
Anything else you want others to know about this practice?
I think it is important to consider that trauma sensitive yoga, or any form of yoga, is not always the right treatment choice for anyone. People, and their stories, are all so unique and so it is important to work together with your provider(s) (e.g., therapist, medical provider, etc.) to determine what treatment strategy is best.
Dr. Corral practices out of the Center for Collaborative Health, and offers individual sessions (from $55 for 30 minutes to $110 for an 60 minutes) in addition to couples sessions ($180 for 60 minutes).
