“No intervention that takes power away from the survivor can possibly foster her recovery.” – Judith Herman, Trauma and Recovery
This article describes my greatest takeaways from a trauma-sensitive yoga training with Susan Lovett at Hands to Heart Center.
Susan Lovett, the founder of Hands to Heart Center: Yoga to the People, began our trauma-sensitive training with a short Trauma-Sensitive Trauma Center Yoga (TSTCY) practice. It sounded something like this:
“Maybe you reach your arms overhead. You might fold forward. Maybe you lengthen forward, and maybe you fold back down. In your own time, you can consider rising back up. You might pause with your hands at your heart.”
Clearly, sun salutations are quite different from studio or gym yoga classes when taught from a trauma-focus. The glaring difference between the two? The peppering of “maybes”, “mights”, and “considers” that qualify every action. Susan admitted that she wondered when she started teaching TSTCY if the smattering of qualifiers she was required to use was too much. However, she was once told by a participant that they could never be told too many times that they had choices.
TSTCY runs counter to traditional lineages of yoga, such as Iyengar and Ashtanga – lineages that are intensely strict to the point where students have accused their gurus of verbal, physical, and sexual abuse. Yes, these lineages may have caused trauma for some students, whereas others have left seemingly unscathed and blossomed into incredibly skilled teachers who have done much more good than harm.
TSTCY is likely not the only form of yoga that has been a lifeline for trauma survivors over the years. Yet it is the only yoga methodology that is objectively supported by research. The Trauma Center published its first randomized controlled trial supporting their yoga methodology as adjunctive treatment for post-traumatic stress disorder (PTSD) in 2014 in an article in the Journal of Clinical Psychiatry. This study randomly assigned 64 women with chronic, treatment-resistant PTSD to one hour of weekly women’s health education or trauma-sensitive yoga in an intervention that ran for 10 weeks.
Results of the Trauma Center’s study showed that yoga significantly reduced PTSD symptomology in 52% of the yoga group compared with 21% of the control group. As Susan explained during our training, trauma symptomology may include flooding or flashbacks, sleep disturbances, stomachaches, panic attacks, avoidance behavior, hypervigilance, agitation, and a general feeling of lacking safety in one’s own body.
Since the time of this study, the Trauma Center has published several other studies assessing trauma-sensitive yoga’s impact on trauma symptoms. In all of this research – from yoga’s impact on youth with complex trauma to yoga’s impact on domestic violence survivors – the Trauma Center has utilized and refined their TSTCY methodology. In our workshop, Susan filled us in on the five pillars of TSTCY: environment, language, choice, non-coercion, and interception.
Environment
Environment is the first impression that students have when they walk into a yoga space, and it’s often one that stays with them. In general, trauma-sensitive yoga environments should be welcoming, accepting, and predictable enough to foster a shared authentic experience between the teacher and students.
Aside from the obvious aspects that make yoga studios serene (e.g., dim but not totally dark lighting, simple yet aesthetically pleasing décor, and soft props – bolsters, blankets, and eye pillows), it is important to facilitate privacy. There can be shades on windows so students aren’t on display to passerby’s and a “Do Not Disturb” sign on the door. That being said, there should also be an open-door policy. Students should be made aware that there is no cutoff time for arrival, and they can always leave if they need to.
Additionally, teachers should give ample information about what to expect in class. Even if students have been to class before, it can be reassuring to hear the class norms and the plan for practice again. To make class predictable in TSTCY, sequencing is always similar and teachers stay on their mat, practicing on their own for the duration of the class. Susan says she even informs students if she’s going to walk across the room to adjust the temperature so that they can always know what to expect.
It is also important to consider specifics of the environment for certain populations. Teachers should always dress modestly in TSTCY to avoid offending cultural groups who find skin-tight Lululemon pants to be offensive. Furthermore, chairs should be available for seniors or individuals with limited mobility. Finally, individuals in wheelchairs should be able to access the teaching space (at the very least, organizations should provide clear information that their yoga space is NOT disability friendly if it’s located on the fifth floor of a building where stairs are the only way up).
Language
Language is an important pillar of trauma-sensitive yoga, and it’s one that’s especially evident when attending a TSTCY class. The most important piece of language in TSTCY is to be as inclusive as possible while inviting students into their own experience of the present moment. Being inclusive means avoiding words that may be triggering or that may lead them to think that their physical form is inadequate. This means using the words “shape” or “form” instead of “pose” or “posture.” In TSTCY, this also translates to avoiding naming frequently sexualized body parts, such as “hips”, “thighs”, and “belly.”
Additionally, TSTCY uses direct language to bring students into their experience of the moment. Instead of the classic yogic command to “raise THE left hand”, TSTCY invites you to “raise YOUR left hand” (although TSTCY says “either hand” to provide students with more choices for movement). Moreover, a TSTCY rule that would be particularly challenging for me is to avoid using metaphors, which the Trauma Center theorizes takes students away from present-moment reality. Okay, okay, I see the purpose of refraining from calling our arms sharp knives, but I really can’t ask students to feel their feet grow roots?
Finally, TSTCY says that our language can reflect our unassuming view of our students’ experience. Instead of saying “comfortable seat”, we could say “a seat you can sustain for X amount of time” to avoid assuming that students can find ease sitting with crossed legs unsupported on the mat. And instead of saying “do what feels good”, we can simply ask students to notice what they feel in their bodies to avoid assuming that they have ever genuinely “felt good” in their bodies.
The major caveat to the word-dense trauma-sensitive language is that it should be modified when working with individuals who don’t speak English as their first language or who struggle with auditory learning. In these contexts, the precise meaning of the words we use become somewhat less important than demoing postures while speaking in clear, concise language.
Choice
Providing ample choices for moving, breathing, thinking, and being during class is essential in trauma-sensitive yoga classes. Choice is empowering, and thus, creating a culture where students feel free to safely explore sensations in their bodies – or not – is imperative. Choice should be given throughout the class: teachers can recognize that watching or modifying our breath may be agitating and can therefore offer that students may opt out of breath awareness if they choose; teachers can recognize that yoga shapes are not one-size-fits-all and can offer a few different options for shapes (without offering them as a hierarchy of “beginner”, “intermediate”, and “advanced” shapes… and without giving so many options for shapes that it’s overwhelming); and teachers can recognize that the silence and stillness of Savasana can be extremely triggering to some students and can thus invite students to take rest in any physical form.
Non-coercion
Non-coercion means not using threats or force to achieve compliance. This essentially means that as teachers, we must check our egos out when we step on our mats to teach trauma-sensitive yoga. Rather than expect results from the class (e.g., students to like us, us to make a difference in students’ lives, students to become healthier/happier/more flexible, students to achieve a peak pose, or students to even show up), we can embrace the objective experience as it unfolds moment-to-moment. It also means that we make space for a shared authentic experience with students rather than assessing or manipulating students into postures.
Assisting – or should I say, not assisting – is also a big part of TSTCY. Touch can be healing when it’s done in a non-coercive context. For example, TIMBO makes simple, healing touch a pillar of its trauma-informed teaching. Yet touch is not always wanted, and it’s not always safe to assume that students can say “no” to assists when there are power differentials between the student and teacher are at play. Thus, in TSTCY, there are defined mutual physical boundaries between the teacher and the student.
Interoception
Interoception is arguably the most important principle of trauma-sensitive yoga. Interoception refers to the conscious awareness of the internal state of the body. This awareness is often disrupted or distorted for trauma survivors, often because of a feeling of unsafety in the body. By providing students space to become aware of sensations in the body as they arrive, develop, and pass, yoga can provide safe grounds for students to reconnect with their internal landscape. Thus, “notice that” is a key phrase that is repeated throughout trauma-sensitive yoga classes.
After presenting these five principles and the myriad rules that fell under each broad category, Susan reassured us that if we don’t remember every single rule, it’s okay. Trauma survivors are strong. They have coping mechanisms that they use every day to navigate life, and they won’t automatically leave them at the door when they step into our yoga spaces. They may be triggered, they may become angry at us, they may leave class, but we won’t break them.