The path to yoga and PTSD

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The integration of yoga into mainstream treatment for posttraumatic stress disorder (PTSD) unearthed motley of opinions, not only about whether the practice is beneficial to those suffering from PTSD symptoms but also about the ancient practice itself.

Yoga literally means union or integration. Its root is from a Sanskrit word yuj, meaning to join or unite. The long existence of yoga has been debated over recent years due to emergence of interest in the Western world within the last decades. Yoga is a very ancient practice. Pre-philosophical speculations of yoga begin to emerge in the Indian texts of c 500-200 BCE. The mission of yoga has been diluted to meet Western standards. Yoga, as we know it, is the integration of mind, body and spirit of the individual. This blog will focus on the Western practice of yoga.

As more and more service members are seeking a holistic approach as conjunct therapy for PTSD, the VA has begun to step up the choice of programs available at their treatment centers. Some of these programs are camouflaged with names like, “military resiliency training”, which is a program that began in Germany and is headed by a retired Army Colonel. The program has taken momentum and was recently renamed as “Marine 360” and made its way into Camp Lejeune in December 2013. The goal of these programs is similar, less PowerPoint, more yoga.

I don’t think many people doubt the benefits of the physical aspect of yoga practice on the body, the question lies in the benefits on the mind, and who can benefit from it. PTSD is a debilitating condition that results from exposure to traumatic events. Sufferers re-experience the event just as it was happening when it first occurred. This creates a catalyst of other emotions and a visceral reaction ensues including anxiety, anger, fear, hyperarousal, disturbed sleep, and sadness. The key point here is that what the mind thinks or believes is happening, the body feels.

It stands to reason then that the integral part of yoga practice for PTSD patients is mindfulness. Mindfulness is only one facet of yoga that introduces strategies for focusing one’s attention on the present moment. Mindfulness is the awareness of all things around you and of the thoughts, feelings, and emotions inside you in such an organized way that judgment of such dissipates. To reach this level however, takes conscientious effort and a long-term commitment.

The published scientific studies available for the benefits of yoga and PTSD have generally used small samples and/or nonrandomized designs. The findings however, underscore the need for more in depth and long-term research investigating the impact of yoga, specifically mindfulness, on mental health symptoms. In a 2006 study by van der Kolk, women randomly assigned to eight sessions of yoga exercises or dialectical therapy, only the yoga group demonstrated significant reductions in symptoms of intrusions and hyperarousal. A 2007 study was suggestive that yoga practice may reduce stress responsiveness. The study consisting of 17 participants with major depression who practiced yoga for eight weeks were observed to experience reduced symptoms of depression, anxiety, anger, neurotic symptoms, and low-frequency heart rate variability (Shapiro et al., 2007).

It is becoming clear that the regular practice of yoga techniques, consisting of physical poses, breathing exercises, relaxation and meditation, could potentially have a positive impact on PTSD. Participants may learn to tolerate unpleasant feelings and decrease avoidance of traumatic memories. Ultimately the benefits of conjunct yoga treatment have to be measured on an individual basis. If the mind is willing, the body will follow.

On my next blog, we’ll explore how research has shown pathophysiological ways yoga is benefiting PTSD patients as well.

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