David Emerson is the founder and director of yoga services for the Trauma Center at the Justice Resource Institute in Brookline, Massachusetts, where he coined the term “trauma-sensitive yoga,” and author of “Trauma-Sensitive Yoga in Therapy” . He is a leader in the field of utilizing yoga in mental health interventions and leads trainings for yoga teachers and mental health clinicians worldwide.
First of all, how do you define trauma in the context of trauma-sensitive yoga?
We are referring to the framework alternately called complex-PTSD, complex trauma, treatment resistant post-traumatic stress disorder (PTSD) or developmental trauma. Most explicitly, it is trauma that occurs in the context of relationships where the primary dynamics are chronic coercion or manipulation (physical, sexual and/or emotional abuse) or chronic abandonment (various levels of neglect).
Tell us a bit about how you got into the field of utilizing yoga for mental health and why you felt there was a need for it.
After college, I was a milieu worker in residential and day programs for traumatized youth, although in those days I did not hear the word “trauma” associated with the kids I worked with.
The best of the programs that I worked in had a physical component, called Project Adventure, where the kids had a chance to use their bodies in positive, productive ways.
After 10 years of this type of work, I decided the next step was to go to school to become a clinical social worker. I went to the Smith School for Social Work, but dropped out after a year because the program was so heavily psychodynamic and I just didn’t feel comfortable using talk to process what I was most interested in—which turned out to be trauma.
However, while at Smith, I was able to read two books that were very influential to me: “Trauma and Recovery” by Judith Herman and “Traumatic Stress” by Bessel van der Kolk. These books were articulating both a framework for trauma that I found very satisfying (more so than PTSD) and the idea that the body needed to be involved in the treatment process.
After dropping out of Smith and becoming a yoga teacher, I realized that bridging my desire to help people heal from trauma and my enjoyment of the physical yoga practice was the best way forward for me.
Finally, there turned out to be a need for smart, body-based interventions for trauma because people with complex trauma were just not healing through psychodynamic psychotherapy alone.
Many people believe that yoga is an all-around “good” practice. But is yoga inherently good for people who have experienced trauma? Or are there potential downfalls?
Our yoga model is called Trauma Center Trauma-Sensitive Yoga (TCTSY) and it is based very strongly in trauma theory and has very clear, testable methodology. We would definitely say that yoga, in general, is not recommended as a trauma treatment because most yoga is not organized to deal with the particular needs of traumatized people.
Some of the potential downfalls include the fact that yoga as it has been transmitted to the west is steeped in guru-culture, which means that the authority figure is externalized. This is the same dynamic that is at the core of complex trauma.
In TCTSY, we work to internalize the locus of control and this kind of practice requires total consistency with no room for telling people what to do or how to feel in a yoga form.
How does trauma-sensitive yoga differ from everyday run-of-the-mill yoga? What does it do for trauma survivors?
In a TCTSY class or session, all cues are presented as invitations, for example, “if you like, you might lift your right arm,” instead of “lift your right arm.”
Also, the facilitator is always located in one place, does not do physical assists and is almost always participating with the students rather than telling their students to do one thing but then doing something else.
Finally, in TCTSY, we are using yoga forms for the purpose of making choices about what to do with our body and to notice what we feel/sense in our body when we do a yoga form (this is called “interoception”).
As a therapeutic modality, trauma-informed yoga addresses areas that traditional talk therapy cannot. Can you give some examples?
First and foremost, TCTSY offers opportunities to have direct, unmitigated body experiences without the need to interpret them through the lens of trauma. This is very different from traditional, talk-based therapy.
In addition, we are focused on this dynamic called interoception, which starts with our direct observation of what we are feeling in our body.
Based on current neuroscience research, it appears that people who experience complex trauma have less reliable interoceptive experiences than people who have not. It is possible that a good deal of the suffering associated with complex trauma (for example, self-harm and self medication) may be associated with getting unreliable sensation signals from your body (pain, for example, is interoception).
We use TCTSY to practice having interoceptive experiences that are clear and direct. Our thinking is that by toning our interoceptive capacity, we can clear up our felt experience within our body and thereby reduce some of the core suffering. According to neuroscience, the only way to do this is to actually practice it, not think or talk about it.
What does the research look like thus far for trauma-sensitive yoga, and what are some of the areas for further investigation?
We received the first grant every given by NiH to study our yoga model for people with complex trauma. Our results were positive and published in a psychiatric journal in 2014.
At this point, other groups are attempting to use our model in a variety of randomized controlled trials, basic outcome measures, and qualitative tests.
Aside from enrolling in a training, what are some tips you might offer to yoga teachers who may wish to be more sensitive to trauma in students?
One thing we have learned that yoga teachers can do to make their classes more trauma-informed is to consider moving around the room less or, possibly, not at all. Trying to keep track of the whereabouts of a yoga teacher for 60 or 90 minutes can be exhausting and it takes away from a person’s ability to form a new relationship with their body experience, which requires turning attention inward.
Yoga teachers should also consider developing a referral network that includes local mental health care professionals. Even if you are not doing yoga specifically for trauma, you will very likely have students with trauma histories in your classes and one day it may be very helpful for you to be able to make a referral that you feel good about.
We also have a website where folks can get a whole bunch of our publicly available information.