Polyvagal Theory, Dissociation and Yoga: Healing Trauma Through Embodiment
Trauma is not merely stored in the mind, it can be stored in the body too – so embodiment practices like yoga and other forms of movement can be powerful
Fiona Agombar explains polyvagal theory and how working with this knowledge can help us overcome dissociation and PTSD
Talking therapy can also be transformative if you have experienced a traumatic event or chronic stress – find your therapist here
There is evidence to show yoga reduces stress chemicals in the body, thus down-regulating the fight-or-flight response. Consequently, yoga may be of great importance to those experiencing severe anxiety or post-traumatic stress disorder (PTSD). Until recently, a psychiatrist or psychologist would work with someone with these conditions using talking therapy. Experts in PTSD such as Dr Peter Levine and Dr Bessel Van Der Kolk have demonstrated adding a physical practice such as yoga to the mix may also benefit someone with a history of trauma.
Healing trauma with the body
Dr Peter Levine notes that if we have had any kind of trauma (including Adverse Childhood Experiences or ACEs), we may disassociate from the body, as it no longer feels a safe place to be. He describes trauma as being stuck in either high or low levels of arousal and dissociation, or swinging between these two states (Levine, 2008). Yoga for trauma consequently emphasises body connection, relaxation and mindfulness together with the importance of feeling grounded.
‘"n research supported by the National Institute of Health, my colleagues and I have shown that ten weeks of Yoga practice markedly reduced the PTSD symptoms of patients who had failed to respond to any medication or to any other treatment.’" Bessel Van Der Kolk- The Body Keeps the Score
The polyvagal theory and trauma
Research by Stephen Porges (2011), sees the nervous system as a network which continuously monitors our environment for danger, with the vagus nerve playing an important role. His polyvagal theory suggests that there are three responses to any experience in life:
1) The ventral vagal system (VVS). This keeps us centred, calm and connected. It’s involved with how we perceive ourselves as safe and joyful, how present we are and how able we are to engage successfully with others. This system affects facial expressions in a way that helps us to feel accepted and secure. VVS is known as the Compassionate Nerve as in this mode we can access feelings of empathy and solicitude. Chanting and yogic breathing help to bring the VVS online.
2) If we feel unsafe or under threat, the sympathetic nervous system (SNS) triggers the stress response.
3) If stress is prolonged or very traumatic there is a third response from the parasympathetic system: the dorsal vagal system (DVS) then dominates. This is a freeze reaction that occurs from life-threatening situations. It is a shut-down mechanism associated with being detached from the world. It’s a feeling of numbness and presents as lack of emotion or empathy. A person in this mode may experience fatigue, depression and helplessness and can feel isolated, trapped and hopeless. DVS dominance is a state that can continue long after the trauma has passed.
Most people who have experienced trauma swing between SNS and DVS. So they might be highly reactive and anxious or appear uninterested and disassociated from their current experience. The aim in yoga is to ease the client back to what is known as a ‘window of tolerance’ (VVS), so they can reconnect with their body and rediscover the joy of being present and relaxed.
How the body holds on to trauma
If we can’t discharge our stress physically after experiencing trauma, tension is held in the body at a cellular level. Our posture reflects this – you can see if someone feels strong and confident, or bowed down and tense. If we can’t release those stress hormones in some way, the energy of the experience gets ‘trapped’ in the tissues of the body and is played out again and again. This affects functioning at all levels.
Yoga and coming home to the body
In a yoga session, we want the client to feel comfortable with their physical sensations and not go into overwhelm, so we aim to discharge high-levels of activation in a manageable way. Someone with PTSD may feel that their body isn’t OK and that it has let them down, that it’s not part of them but is something that is slightly alien. Our aim is for our client to develop a safe relationship with their physical being so they can down-regulate their stress response and feel connected to both themselves and others. However, this process has to be done gradually as it is quite common for the client to experience fear or even pain as they start to become more embodied.
I have a history of trauma and when I tried my first yoga class in 1993 I hardly knew what was what. If my teacher said: ‘lift your left leg,’ I had difficulty in making sense of her instruction. In hindsight I realise I was in DVS dominance. As I connected with my body again, I noticed that I ached all over. Previously, I managed this pain through disassociation. It took me another five years to develop awareness around my mid-spine which was so numb that I couldn’t feel into what was causing my chronic back problems.
Yoga practice for trauma
Yoga tools that are helpful for PTSD include feeling the connection between the body and the floor in various postures to offer a sense of grounding and working on centring and safety together with an awareness of present-moment sensations. Setting up feelings of felt, acknowledged physical boundaries is also important. Learning to sense the skin as a safe container can be useful. Holding a strong standing posture can create a feeling of confidence, security and control since posture and emotions are closely connected: how we feel is reflected in how we hold ourselves and how we move.
Yoga can help us to ‘bear with’ an experience as we learn to relax into a pose and to accept sensations that arise as we breathe slowly. Working like this, the client learns how to tolerate their physical and emotional experience without going into overwhelm. We have to be very careful here however, because if someone has anxiety, holding such postures before they are ready may be counter-productive, especially for someone who feels unsafe. Therefore we always offer choice and invite the client to titrate. This means exploring moving in and out of body sensations slowly. Working on core stability by gently bringing the belly to the spine on the exhalation and encouraging the client to feel their centre as strong but flexible is also invaluable. This helps with self-regulation because holding correct alignment helps to release tension.
It is not uncommon for the client to have a big release as they begin to connect with their body again. This can take the form of crying, laughing, trembling or shaking – a letting go as tension is discharged. But it is also possible for someone to touch on a deeply buried fear, because yoga encourages us to drop our barriers as we relax. For this reason yoga teachers who want to work with trauma should always have training so they don’t push students too far or accidentally release an unsafe memory before the student is ready.
Slow, safe and supportive
Aiming to create a place of safety, yoga should be practised slowly with attention directed to body awareness in a supportive environment with the teacher giving plenty of choice and not referring to the trauma in case this bring up unsafe memories. In the context of PTSD, the student-teacher label may not helpful as it can disempower the client. The yoga teacher is rather a facilitator; someone who gently guides the client at their own pace back into present moment awareness. Clients should be able to work with their eyes open if they want and teachers should never use touch unless they have permission. Trigger postures should be avoided. For example I worked with a client who had been sexually abused. She became overwhelmed if we attempted hip-opening postures. I reassured her she didn’t have to do anything that made her feel uncomfortable. I also emphasised that she could go at her own rate and that she was in a safe space.
Meditation and trauma
To be silent with the mind may be too much for someone who is in a heightened state of anxiety with a tendency to ruminate. Just being relaxed can be stressful for someone with PTSD, since being hyper-vigilant may be their way of protecting themselves. Following the breath may also be too overwhelming. It’s more helpful to combine movement with breath, with the focus on the body. The most important thing is to be present for the client and to help them to find a resource that makes them feel secure. This might be a place, a pet, a person or a deity or even their felt-sense of the floor (for example). From this we can build more resources to help them feel protected and held. The aim is to engender a sense of safety, to provide authentic care and to help the client develop more resilience as they claim back agency and develop a healthier relationship with their body.
Fiona Agombar is the author of Yoga Therapy for Stress, Burnout and Chronic Fatigue Syndrome
Levine, P. (1997) Waking the Tiger: Healing Trauma – The Innate Capacity to Transform Overwhelming Experiences. Berkeley, CA: North Atlantic Books.
Levine, P. (2008) Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body. Boulder, CO: Sounds True.
Porges, S. (2011) The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. New York: WW Norton & Company.
Van Der Kolk, B. (2015) The Body Keeps the Score. London: Penguin, Random House.