Trauma Recovery Report

Mind-Body Therapies for Trauma Healing

Prepared by: Allison Fischman, MPH Candidate

Vibrational Medicine

 Vibrational medicine practices tap into the flow of energy within the body. Cells throughout the body are in communication with each other and with the brain. Practices emerging from ancient Chinese medicine and ancient Indian Ayurveda, like acupuncture, acupressure, and yoga, can help reconnect the body and mind to facilitate healing.

Yoga

The ancient practice of yoga combines breathing work with postures to center the mind and body. Dr. van der Kolk notes that yoga helps you inhabit your body again. It also can provide valuable stress relief through breathing and physical activity. Clinical trials have shown that yoga can reduce inflammation, improving overall health. Some studies have also shown yoga’s benefits during cancer recovery and for mental health issues. Yoga and meditation-based lifestyle intervention also has been shown to reduce the rate of cellular aging. Chronic and traumatic stress, PTSD, and depression are associated with cellular aging, so yogic practices can help to combat the rate at which this process occurs. While these studies are still relatively new, there is promise for significant physiological benefits to practicing yoga.

 Movement in yoga, whether a physically demanding form or something more sedentary and slower like chair yoga or yin yoga, also helps connect you to your body. Movement is fundamental to the embodied mind – while moving in a particular environment, the brain senses and perceives how the body moves in space. The combination of movement and contemplative practices like meditation is known as movement-based embodied contemplative practices. Combining yoga postures with meditation, breathing exercises, repeating mantras or self-affirmations, or other contemplative practices can help reinforce the body-mind connection. This may not be easy. Certain postures may bring up memories of traumatic experiences or otherwise trigger stress responses. However, moving slowly and focusing on breathing can help center the body and mind in the present by focusing on what you are sensing (seeing, hearing, feeling, etc.). van der Kolk explains that it is important to recognize how you feel and take things slowly. Don’t be discouraged if you experience setbacks or healing does not move as quickly as you would like. Self-awareness and body connection fostered through yoga develop through a non-linear, imperfect, and slow process.

 Mudras are another type of yoga practice that can help connect the mind and body. Essentially yoga postures for your hands, mudras often utilize pressure points to activate brain-body connections. They can help with focus or induce certain states of mind in conjunction with breathing exercises or affirmations/mantras.

Acupuncture/Acupressure

 Like mudras, acupuncture and acupressure tap into certain points of the body to activate connections between the brain and the body. In ancient Chinese medicine, the insertion of acupuncture needles along certain energy points is used to improve and balance Qi, or the life force and energy circulating through the body. One study reported that acupuncture increased levels of endorphins and serotonin, hormones that lower pain perception and increase feelings of well-being. Acupuncture has also been shown to reduce PTSD severity and improve depression, pain, and other aspects of physical and mental health function. Acupressure targets points on the body without the use of needles.

Chromotherapy

Chromotherapy utilizes the vibrations of light energy to connect the mind and body. While there is less definitive research on the health benefits of chromotherapy compared to yoga and acupuncture, emerging research shows that certain colors may have calming, energizing, or other effects on the body, impacting mood. Additionally, sunlight and vitamin D exposure are vital for body system function and mood regulation.

Emerging Trauma Healing Therapies

 In addition to ancient vibrational medicine practices to heal trauma, new modalities are being developed through research and practice that also aim to reconnect body and mind for recovery. Two types of newer trauma healing therapies are discussed below.

Somatic Experiencing

 Somatic experiencing is a new therapeutic system that can be considered a movement-based embodied contemplative practice. The theory is based on observations of how animals recover from trauma in the wild. The primary method is paying attention to a variety of bodily sensations (tactile (touch), spatial (in space), kinesthetic (position and movement of muscles and joints), proprioceptive (awareness of the position of the body), and interoceptive (gut and other internal organ responses)). A practitioner leads the client verbally into internal and external movement to rebalance the autonomic nervous system. Attention is paid to how bodily sensations are experienced and how they may change. First, the client is told to focus on positive sensations only, and then in a following phase, they focus on the balance between positive or pleasant and negative or unpleasant bodily sensations. This inner attention can resolve symptoms of traumatic and chronic stress.

Somatic experiencing works through invoking biological self-protective and defensive responses and the regulation of excess autonomic arousal (i.e., stress responses). As previously explored, trauma interrupts the proper function of the autonomic nervous system and can lead to inappropriate reactions to stimuli and chronic stress responses that have detrimental health impacts. Somatic experiencing aims to retrain these systems to regain normal, healthy function and combat chronic stress. Somatic experiencing can be a therapeutic supplement to cognitive and exposure therapies, offering similar benefits to meditation and other mind-body practices.

While research on somatic experiencing is still very new, a randomized controlled study of the therapy for PTSD treatment found that it can be a promising treatment option. Another study found there was not a significant difference in outcomes between physiotherapy alone and physiotherapy with somatic experiencing, but research is still developing.

Accelerated Resolution Therapy (ART)

 ART is a new evidence-based psychotherapy where a provider uses a directive protocol to guide the patient through the therapeutic process without getting significantly involved. The provider instructs the patient to visualize a distressing event or a metaphor and helps them process somatic sensations experienced through recalling the memory. The patient does not have to narrate memory, in contrast to other trauma-focused therapies, which can increase feelings of safety and control. Next, the provider directs the patient to rescript the visual memory but leave the facts and explicit memory unchanged. This process helps resolve memory fragments, which is common in people with trauma.

ART moves quickly, ensuring that patients do not have to experience distressing memories for long periods of time. Furthermore, each session involves a sense of closure to help prevent feelings of vulnerability and lingering unprocessed emotions between ART sessions. Though ART is very new, therapists have reported significant improvement in patients with PTSD, addictions, anxiety, depression, grief, phobias, and obsessive-compulsive disorder (OCD).

Concluding Thoughts

 Many people think that those who have experienced trauma must live with their trauma and its detrimental consequences for the rest of their lives. Though trauma never goes away, and it is not helpful to push these memories aside, there is hope for healing and living a fuller life. Dr. van der Kolk asserts that all traumas can be resolved eventually, except for dissociation resulting from traumatic experiences. However, through anecdotal evidence from a number of trauma survivors, consistent practice of mind-body therapies can eventually resolve even dissociation. As previously mentioned, healing from trauma is not a straightforward process and is bound to have setbacks and bumps in the road along the way. I hope, however, that this collection of evidence-based trauma healing resources can be a starting point for healing. Remember to be kind to yourself and know that there is hope.

References:

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (2015) by Bessel van der Kolk M.D.

“The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system” (2009) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108032/

“The embodied mind: A review on functional genomic and neurological correlates of mind-body therapies” (2016) https://www.sciencedirect.com/science/article/abs/pii/S0149763416303256

“Somatic experiencing: using interoception and proprioception as core elements of trauma therapy” (2015) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316402/

“Randomized Effectiveness Trial of a Brief Course of Acupuncture for Posttraumatic Stress Disorder” (2014) https://journals.lww.com/lww-medicalcare/fulltext/2014/12001/randomized_effectiveness_trial_of_a_brief_course.13.aspx

“A critical analysis of chromotherapy and its scientific evolution” (2005) https://pubmed.ncbi.nlm.nih.gov/16322805/

“A future perspective for regenerative medicine: understanding the concept of vibrational medicine” (2018) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859346/

“Classification of Electrophotonic Images of Yogic Practice of Mudra through Neural Networks” (2018) https://pubmed.ncbi.nlm.nih.gov/29755225/

“Somatic Experiencing for Posttraumatic Stress Disorder: A Randomized Controlled Outcome Study” (2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518443/

“Somatic Experiencing® for patients with low back pain and comorbid posttraumatic stress symptoms – a randomized controlled trial” (2020) https://pubmed.ncbi.nlm.nih.gov/30466429/

“Movement-based embodied contemplative practices: definitions and paradigms” (2014) https://www.frontiersin.org/articles/10.3389/fnhum.2014.00205/full

“Accelerated Resolution Therapy (ART): a Review and Research to Date” (2017) https://pubmed.ncbi.nlm.nih.gov/28290061/

While trauma and mental health impacts, like post-traumatic stress disorder (PTSD), were historically viewed as purely psychological, research over the last decade or so has shown that traumatic experiences have profound impacts not just on mental health, but on physical health, as well. Toxic stress in childhood, or the experience of prolonged trauma, adversity, abuse, or mistreatment, contributes to high allostatic loads. Allostatic load is cumulative “wear and tear” on the body’s neurological and endocrine (hormone) systems that disrupts normal functioning. Over time, chronic stressors interfere with the body’s ability to regulate its systems, including stress, immune, and other responses.

With his landmark 2015 book The Body Keeps the Score, Dr. Bessel van der Kolk changed the landscape of trauma healing. He asserted that the brain and body are connected, and when trauma occurs, not only do physical symptoms result, but the connection between mind and body is disrupted. Trauma interferes with one’s ability to be in the present. However, neuroplasticity, or the ability of the brain to “re-wire” and change its activity in response to stimuli, allows for neural pathways formed by traumatic experiences to be overridden. Trauma healing methods can retrain the brain to form new connections to heal trauma.

Despite the widespread popularity of Dr. van der Kolk’s work, several disconnects remain. Western medicine has yet to embrace the sort of alternative therapeutic modalities that The Body Keeps the Score and other similar work maintain are crucial to trauma healing. This may be due, in part, to a failure to recognize that alternative healing methods are not new and unproven. Mind-body therapies have been used in traditional medicine and practices in China, India, Tibet, and other countries and cultures for thousands of years. Research on trauma is just starting to test the effects of these traditional healing practices on physiological systems. In this overview, I will briefly explore how trauma interacts with body and mind, then outline several promising modalities for mind-body trauma healing identified through current academic research on trauma and chronic stress.

Trauma Pathways

   Dr. van der Kolk explains that trauma treatment must engage the entire person, body, mind, and brain to be successful. This approach is underlined by the knowledge that the effects of trauma are not singular, and our brains are not disconnected from our bodies. Trauma causes the brain to trigger fight/flight responses long after the threat or event has passed. The brain floods the body with stress hormones as if there was a present threat. The brain circuits that fire these stress responses become the default setting.

Trauma interacts with the most fundamental parts of our brain. The brain stem, what van der Kolk calls the “reptilian brain,” develops in the womb and governs basic life-sustaining functions. It is highly responsive to threat. The limbic system, which is organized through about age 6, controls behavioral and emotional responses, especially regarding survival, i.e. fight or flight responses. The prefrontal cortex develops later and governs executive function. It is the region of the brain most susceptible to detrimental effects of chronic exposure to stressors. Trauma can cause difficulty filtering out irrelevant information and can leave this part of the brain vulnerable to shutting down in response to threat.

Additionally worth considering in understanding how trauma interacts with the brain is the polyvagal theory. This theory explains that the evolution of the autonomic nervous system (which controls basic body functions like heartrate and breathing) provides the neurophysiological basis for adaptive behavioral strategies. These subsystems are linked to social communication (listening, vocalization, facial expressions), mobilization (fight or flight responses), and immobilization (behavior shutdown). The polyvagal theory can help explain psychiatric and behavioral disorders involving issues regulating social, emotional, and communication behavior. Trauma can affect these neurophysiological systems, particularly if trauma occurs in the early stages of development during childhood. If trauma interferes with the development of these systems, then a person may have maladaptive responses to safe, dangerous, and life-threatening contexts.

The concept of the “embodied mind” also helps us understand the connection between brain and body in the wake of trauma. Mental functions like cognition, motivation, and perception cannot be understood without the context of the physical body and the environment in which they are experienced. The body, mind, and environment all interact with one another. While these neurological systems are complicated, the important takeaway is that brains affected by trauma process sensory information differently. Many who have undergone trauma experience dissociation and flashbacks due to encountering reminders of their trauma that trigger stress responses in the body. Traumatized brain and body systems have trouble appropriately recognizing and responding to threats. The primary objective in healing trauma is to reconnect mind and body. As van der Kolk writes, "The fundamental issue in resolving traumatic stress is to restore the proper balance between the rational and emotional part of the brain."

Healing Trauma

   Recovering from trauma is not simple or easy. However, with dedication, practice, self-love, and compassion, people who have experienced trauma can heal and live a fuller life. Critical to healing from trauma is relying on others for support. This may be difficult for those who have experienced trauma, but if there are people with whom you can be in community, perhaps others who have experienced trauma or a trusted healthcare provider, social connection is key. Dr. van der Kolk reviews steps for trauma recovery. These steps include finding ways to become calm, learning to maintain that calm in the face of stressors and triggers, finding ways to live life fully, be in the present, and engage with others, and being authentic and truthful with yourself (not keeping secrets, including how you have managed to survive trauma). These steps overlap and do not occur in a particular order. van der Kolk also discusses the importance of talking openly about trauma, learning to inhabit your body, and self-leadership to reconnect fragmented parts of yourself. To move through these steps and heal, ancient medicine and healing practices provide us with a wealth of knowledge.

Mind-Body Therapies

   Mind-body therapies include practices such as yoga, meditation, mindfulness, qi gong, and types of controlled breathing. Many studies have shown that mind-body therapies can modulate the immune system/inflammatory responses and brain function related to attention, emotion regulation, and learning. Mind-body therapies facilitate stress reduction, which can improve health outcomes by lessening allostatic load, reducing harmful effects to the immune and nervous systems. Mind-body therapies, over time, can combat the effects of chronic stressors. The image below illustrates the neurophysiological systems impacted by mind-body therapies.

While it would be impossible to cover every type of mind-body therapy that can promote trauma healing, I will discuss some key practices and overarching themes.