Yoga has a rich history that goes back nearly 5000 years in Indian texts and is now recognized as an integrative therapy to support mental health and enhance overall well-being. Research shows that practicing yoga can help improve conditions such as anxiety, depression, chronic pain, sleep issues, and post-traumatic stress disorder (PTSD). By incorporating mindful movements, yoga can assist in regulating the autonomic nervous system (ANS) during times of stress, particularly for those who have faced complex trauma and PTSD. Trauma center trauma-sensitive yoga (TCTSY) serves as a body-centered approach to aid in treatment and healing from complex trauma and PTSD.
Trauma
Complex trauma refers to the repeated traumatic experiences that some people face during childhood or adolescence, which can manifest as a more intricate version of PTSD. This type of trauma often involves threats of physical harm or death, and while it may also involve serious emotional or physical injuries, such as unwanted sexual contact, the specifics can vary greatly. Complex trauma is recognized as a diagnosable condition under the eleventh revision of the International Classification of Diseases (ICD-11), although this hasn’t yet been incorporated into clinical practice guidelines.
Identifying complex trauma may be difficult because it’s often more of a subjective diagnosis than PTSD, which has clear definitions and parameters in the diagnostic and statistical manual (DSM-5). To receive a PTSD diagnosis, an individual over the age of six needs to meet specific criteria for more than one month, as outlined in the DSM-5 TR.
- Exposure to actual or threatened death, serious injury, or sexual violence results in at least one intrusive symptom: distressing memories, dreams, dissociative reactions, intense or prolonged psychological distress, or a significant physiological response to internal or external cues that remind the individual of the traumatic event.
- The individual actively avoids reminders of the traumatic event and experiences negative thoughts or moods due to heightened reactivity of the sympathetic nervous system (SNS).
- The traumatic event causes negative thoughts or emotions, such as gaps in memory related to the trauma, exaggerated negative beliefs or expectations about oneself, distorted thinking that leads to self-blame, a persistent negative emotional state, decreased interest and participation in meaningful activities, feelings of detachment or estrangement from others, and the inability to experience positive emotions.
- The individual experiences heightened arousal and reactivity that begins or worsens following the traumatic event, as evidenced by irritability, unprovoked anger, reckless or self-destructive behavior, hypervigilance, an exaggerated startle response, difficulty concentrating, or sleep disturbances.
Researchers suggest that complex PTSD includes the symptoms of PTSD as outlined in the DSM-5, along with challenges in self-organization, which can be seen through emotional changes, negative self-image, and struggles in building relationships with others. While about two-thirds of people who face a traumatic event do not experience lasting psychological or physiological effects, the remaining one-third might experience chronic complex PTSD symptoms and may benefit from therapeutic interventions.
Yoga Roots
The word yoga is derived from Sanskrit root “yuj” meaning to yoke, unite, or join—in essence, it is the union of mind, body, and spirit. Ashtanga yoga, otherwise known as the eight limbs of yoga, is the philosophical underpinnings of yoga practice. The eight limbs of yoga encompass the Yamas (moral/ethical/social conduct), Niyamas (personal conduct), Asana (physical postures), Pranayama (breathing practices), Pratyahara (withdrawal of senses), Dharana (contemplation), Dhyana (meditation), and Samadhi (self-realization or union with the divine).
The Yamas incorporate the five ethical and moral social constructs of the following:
- Ahimsa: compassion towards self and others
- Satya: dedication to truthfulness and integrity
- Astheya: honesty and generosity
- Brahmacharya: moderation and balancing of vital life force energy
- Aparigraha: abundance and fulfillment
The five Niyamas include the following personal ethical guidelines:
- Saucha: simplicity and purity
- Santosha: peace and contentment
- Tapas: purification
- Swadhaya: the study of the divine and self
- Iswara Pranidhana: devotion/faith
Yoga is an ancient practice with a fascinating history. It continues to gain popularity as a health and fitness practice for people around the world. This interest has encouraged researchers to look closely at how it benefits our mental, physical, and spiritual well-being. Practices like yoga can be wonderful in helping us lower stress and build resilience when facing tough times. It’s important to remember that we all respond to stressful or traumatic experiences differently. Our unique reactions can be shaped by various factors, including our stress levels, genetic makeup, early connections with caregivers, and the specific circumstances of the event itself.
Please see our next issue, coming in July 2025, for Part 2 of this article, which will take a more in-depth look at the relationships between therapeutic yoga, trauma, and nervous system processes.
Nanci Kaczegowicz, MSN, APRN, FNP-C, PMHNP-BC, APHN- BC, is an advanced practice registered nurse with over twenty-seven years of experience. She is nationally certified as both a family and psychiatric mental health nurse practitioner. Her additional training in holistic nursing and yoga helps her to promote spiritual, mental, emotional, and physical well-being. She is passionate about helping teens and adults experiencing depression, anxiety, insomnia, and chronic stress understand the root cause of psychological distress impacting their lives. Services may include medication, psychotherapy, therapeutic yoga, mindfulness, stress reduction, and relaxation techniques.
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