Trauma Center Trauma Sensitive Yoga (TCTSY)
TCTSY is an empirically validated, adjunctive clinical treatment for complex trauma or chronic treatment-resistant PTSD. In 2017, TCTSY became the first dedicated yoga program in the world to be listed as an evidence-based program/practice for the treatment of psychological trauma.
Scroll down to learn more about TCTSY and how it connects with our philosophy at Calo Programs.
What is Trauma Center Trauma Sensitive Yoga?
For people impacted by trauma, finding a connection to and safety within their body can have beneficial therapeutic effects. TCTSY is an empirical or evidence-based adjunctive practice of using yoga along with other healing modalities to help individuals with complex trauma achieve this connection. With foundations in trauma theory, attachment theory and neuroscience, TCTSY provides a supportive and deeply trauma-informed atmosphere in which participants are invited to observe physical sensations and make choices using yoga forms as the vehicle.
Keri Sawyer, who leads the TCTSY programs for Calo Programs, suggests that it’s helpful to think of TCTSY as adjunctive therapy for complex trauma with PTSD first, and yoga second. People who have undergone trauma, she explains, can become disconnected from their bodies and unable to self-regulate or act within their own long-term best interest. In her work with kids enrolled at our New Vision Wilderness (NVW) programs, she has seen the inability to self-regulate manifest in multiple ways, such as program participants wearing tank tops and shorts in the cold and snow. TCTSY enables participants to become attuned to a sense of touch and feel while learning agency by making choices about their own bodies, which is a key component to learning self-regulation.
How is Trauma Center Trauma Sensitive Yoga incorporated into Calo Programs?
All of our programs are certified providers of TCTSY. All of our programs use the therapy as part of the program and NVW, specifically, includes weekly TCTSY for all students as part of their treatment process. At Calo Young Adults, we have a TCTSY facilitator on staff. Calo Programs is also the only organization outside of the Trauma Center itself which is certified to provide TCTSY to adolescents, teens and young adults.
Therapists at Calo Programs go through 12 hours of training with Keri Sawyer before having one-on-one sessions with students which are typically 10 minutes in length.
There are a number of ways in which TCTSY connects with Calo Programs’ primary mission of “profoundly changing lives and creating joy.” This includes achieving security in relationships by providing participants with a predictable and safe sense of self. This sense of safety is achieved in part by providing participants with greater choice in exploring the movements of their own bodies and determining what feels most secure, choosing for themselves what they feel comfortable doing as opposed to traditional yoga which focuses more on the assignment of specific positions and postures.
Who is David Emerson?
David Emerson is widely recognized as the founder and visionary behind TCTSY. He is a member of our Calo Programs Distinguished Council and the director of yoga services at the Trauma Center at Justice Resource Institute in Brookline, Massachusetts, where he coined the term “trauma-sensitive yoga.” He is also the co-author of Overcoming Trauma through Yoga and author of Trauma-Sensitive Yoga in Therapy.
In 2002, Emerson approached Dr. Bessel van der Kolk, a world renown clinical psychiatrist whose work integrates mind, brain, body, and social connections to understand and treat trauma, about the idea of using yoga in the treatment of trauma. At the time there was no existing model, so for the next three years, from 2003–2006, Dr. Kolk and Emerson collaborated to combine Kolk’s clinical insight with Emerson’s knowledge of yoga to develop and launch the first pilot studies, which were conducted through the Trauma Center in Brookline, MA.
Who is Dr. Bessel van der Kolk?
Bessel A. van der Kolk M.D. has been active as a clinician, researcher and teacher in the area of posttraumatic stress and related phenomena since the 1970s. His work integrates developmental, biological, psychodynamic and interpersonal aspects of trauma’s impact and treatment. His book Psychological Trauma was the first integrative text on the subject, painting the far ranging impact of trauma on the entire person and the range of therapeutic issues which need to be addressed for recovery.
Dr. van der Kolk and his collaborators have published extensively on the impact of trauma on development, such as dissociative problems, borderline personality disorders, self-mutilation, cognitive developmental issues, and the psychobiology of trauma. His collaboration with Emerson has provided a clinical basis for the integration and use of Yoga as an adjunctive therapy in the treatment of Trauma as an alternative to traditional talk therapy and prescriptions.
Dr. van der Kolk is former President of the International Society for Traumatic Stress Studies, Professor of Psychiatry at Boston University Medical School, and Medical Director of the Trauma Center at JRI in Brookline, Massachusetts. He has taught at universities and hospitals across the United States and around the world, including Europe, Africa, Russia, Australia, Israel, and China. His book, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society, co-edited with Alexander McFarlane and Lars Weisaeth, explores what we have learned in the past 20 years of re-discovering the role of trauma in psychiatric illness. In Dr. van der Kolk’s most recent 2014 book, The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma, he explains how traumatic stress literally rearranges the brain’s wiring—specifically areas dedicated to pleasure, engagement, control and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies
What differentiates Trauma Center Trauma Sensitive Yoga from other forms of Yoga?
Unlike traditional forms of centuries-old yoga practices such as Bikram or Ashtanga, TCTSY is ultimately more of an adjunctive therapy based on and rooted in yoga.
One of the areas where TCTSY differs most significantly from traditional yoga is in the emphasis on making students feel safe and giving them choices about how to execute their poses and even whether to attempt certain poses.
Other differences between TCTSY and other forms of yoga include the following:
- The teacher has experience and certification in Trauma-Sensitive Yoga practices.
- Classes are gender specific with no physical hands-on adjustment.
- Our TCTSY is performed one-on-one, which removes some of the group dynamics that cause adolescents, teens and young adults to focus more on others than on themselves.
- The focus is on managing symptoms including anxiety, complex trauma, acute stress and PTSD while increasing the capacity for healing, self-regulation and agency.
- The goal is to offer students the opportunity to reconnect with themselves and feel safe within their bodies.
- Some classes integrate play therapy, chair massage therapy and the use of essential oils to safely engage the body and activate sensory responses.
- A great degree of attention is paid to potential feelings of vulnerability in certain postures.
- Participants are offered options rather than instructions, allowing them to make their own choices and opt in or out of motions or positions at any time.
Whereas most of the TCTSY students involved with the Trauma Center have been adults, Calo Programs focuses exclusively on preteens, teens and young adults. Consequently, given the maturity level of the student (rather than the actual age), TCTSY may incorporate more aspects of play therapy for less mature students, and may more closely resemble traditional yoga class for more mature students.
One of the important differences is having a one-on-one setting. Given the age and maturity levels of our TCTSY students, being in a group setting can shift the focus from looking within oneself to looking outward at the group dynamic, with focus on acceptance, fear of ridicule and related aspects. Hence one-on-one sessions remove those potential distractions and allow the student to focus on their own bodies, movements and breathing.
Also, because trauma is expressed differently in each individual, the option for more movement is incorporated for students with ADHD and difficulty staying still. On the other end of the spectrum, a slower pace with less movement can be utilized for those that feel more comfortable being still.
What is the goal or objective of Trauma Center Trauma Sensitive Yoga?
Clinically speaking, the primary aims of TCTSY are to restore interoception, agency and the capacity for effective inter and intra-relational action. What this means, essentially, is providing participants with the ability to feel safe within their own bodies through a better connection to their own physicality, choice and control (or self-regulation).
In one of his recent books, Bessel van der Kolk states that the goal of any PTSD to trauma-related treatment “is to help people live in the present, without feeling or behaving according to irrelevant demands to the past.”
What is interoception?
Interoception is a form of sensory processing. Unlike our five senses, there are two others that make up the interoception senses, the vestibular system (which involves the apparatus of the inner ear involved in balance) and the proprioceptive system, (which determines our muscular response). Interoception refers to our perception of what’s happening to our bodies internally. It is interoception which produces feelings of pain, exhaustion, hunger, thirst, temperature, itching and related sensations. At the most basic level, interoception enables us to answer the question, “am I okay?”
Children, adolescents and other survivors of trauma may experience both hypersensitivity (increased) and hyposensitivity (diminished) to interoceptive input. Researchers have suggested that mindfulness and yoga are helpful in enabling these individuals in regards to self-regulation.
What is agency?
Agency is the sense that some actions are self-generated. Scientist Benjamin Libet was the first to study self-agency. He discovered that brain activity predicts the action before one even has conscious awareness of his or her intention to act. The most influential psychologist in the topic of self-agency was Daniel Wegner, who created the three criteria of self-agency: priority, exclusivity, and consistency.
According to Wegner, priority means that an action must be planned. Another criterion for self-agency is exclusivity, which means cause and effect is due to the intentional action and not some other cause and effect. The last criteria Wegner suggested was consistency. Consistency is the criteria that the one’s planned action must occur as planned.
Internal motor cues are also an indicator in deciding whether an action was used with self-agency and can be measured by the generation of movement. If the predicted sensory state matches the actual sensory state, then self-agency has likely occurred.
When we talk about agency in the context of TCTSY, what we mean is a sense of control. And by this, we mean more than just being in control of the external environment, but having a subjective awareness of intentionally planning, executing and consistently controlling one’s actions of their own volition or choosing.
What is the importance of choice in Trauma Center Trauma Sensitive Yoga?
Choice is related to the sensitivity techniques used in TCTSY. Participants are invited to notice and feel sensations within their body throughout the practice. Following this, they are encouraged to make choices about what they do and how they move with their body based on what they sense. This allows participants to investigate what choice feels supportive for them, taking cues from their own individual experience. No physical adjustments or assists are provided. This less rigid adherence to specific positions differs from other forms and practices of yoga.
For many individuals, trauma is about an extreme lack of choice in terms of both physical and inter-relational power. Trauma generally entails having no choice within the context your body, either what may have been done or what was withheld (such as sensitivity, responsiveness and predictability). Hence, TCTSY aims to restore the ability and safety in making choices regarding one’s body and movement, thereby giving the control back to the student. In addition to being able to ask, “what do I want to do” rather than what am I being instructed to do, participants begin to assume agency, which is foundational in achieving joy and positive relationships in the world. This is why physical assists that are a common part of more traditional classroom yoga are not used in TCTSY, including seemingly simple instructions as coming alongside of someone and suggesting that they straiten their arms or back.
Can traditional yoga do more harm than good?
In some cases, the practice of more traditional yoga can cause students to re-experience their trauma. Trainers point to multiple cases in which they have been told that the command-like language and physical feel of certain poses produce a range of negative reactions ranging from discomfort to tears and outbursts.
Having a bad experience with yoga can produced increased shame and insecurity related to one’s body as well as guilt of letting down the instructor or others.
Additional resources on TCTSY
You can find additional information on TCTSY through the resources below.
Books and Publications:
- Trauma-Sensitive Yoga in Therapy by David Emerson
- Overcoming Trauma through Yoga by David Emerson and Elizabeth Hoppe
- Trauma and Recovery by Judith Herman
- The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk
- Overcoming Trauma Through Yoga: Reclaiming Your Body by Bessel van der Kolk