Each year, about eight million adults around the world experience PTSD. And approximately seven to eight percent of the global population will develop PTSD at some point in their lives—about ten percent of women, and four percent of men.
One in eight soldiers returning from active combat suffers from PTSD, while less than half of them seek help.
One in five women and one in 71 men have been raped at some point in their lives. One in four girls and one in six boys will be sexually traumatized before the age of 18. (Sexual trauma is defined as any lingering physical, emotional, or psychological symptoms resulting from physical assault of a sexual nature or battery of a sexual nature).
In addition, 2.9 million cases of child abuse are reported each year in the United States alone.
After researching and writing the figures above, I had to look hard again at these statistics. The word “sobering” simply does not describe adequately their effect on me.
PTSD varies in spectrum and quality, with a wide array of symptoms that range from emotional distance and social avoidance, to violent or self-destructive outbursts, loss of memory, and flashbacks.
As yoga teachers, our classes are not generally populated with tranquil, meditative cave dwellers or those who have danced through life unscathed. We don’t know the backstories of our students, and they may never tell us. It is our job to develop an appropriate degree of awareness and sensitivity to emotional triggers in the yoga classroom.
First, it is not within the scope of practice of a classroom yoga instructor to rout out the source of a student’s trauma on the mat or in guided meditations. Unless one has the credentials and training to counsel, there is the potential of doing more harm than good. The same is true when offering advice with respect to treatment, and especially medications.
Second, permission to touch is to be granted by each individual. A well-intended adjustment can be a strong trigger for those in recovery from abuse. If you are touching students in a classroom, ask at the beginning of class for an okay in the form of a head nod. Consent cards or a coin at the top of each mat is another method, with tails indicating a student’s preference for no adjustment. We also must not assume that because someone was fine with touch in prior classes, they’re fine with it now.
My tenets on touch in yoga class have changed over the years. I have known students who were physically or emotionally injured by a casual physical adjustment from “master teachers.” The truth is that no teacher can know why your knee is slightly bent, or how far your body will move in a side bend. And when you add a history of physical trauma into the mix, there is a decided need for communication between student and teacher that a public class does not afford. Slow-paced verbal skills can go far in maintaining safety. (Rescuing a student from potential injury with gesture or touch if they aren’t responding to verbal cues may be an exception.)
When I began working in addiction recovery, where the incidence of associated abuse and trauma were much higher, there was little training in trauma-sensitive yoga available. I saw firsthand what could cause non-participation, tears, or anger, and often when I least expected it. In these classes I learned to begin with breath-centered movement, rather than stillness (since being asked to be quiet and lie still could have links to past traumatic events). Poses like downward facing dog, tabletop, and happy baby were often met with intentionally crass wisecracks in the group: “That’s what my old man liked,” or “This is how I got pregnant—again.” The class would laugh nervously, and I’d have to remind myself that I wasn’t in studio etiquette-land anymore.
To avoid all of these basic postures may not be possible. But I found that sequencing them later in the practice, when some degree of trust has been established, helps students tolerate them better.
There may be a reason for an individual choosing to practice toward the back of the classroom. If a student is concerned about having others see them from behind, I try to respect that. Those who might not agree to a downward dog or a forward fold at the front of a class are often fine near a wall.
Straps can be a trigger for both rape and abuse victims who have been bound or beaten, as well as IV drug users who may associate them with tourniquets. While they are common in most yoga studios and gyms, it may be a good idea to keep them out of view unless in use. When straps are used, I’ve found it to be less threatening to demonstrate clearly what we’re going to do with straps, and then give students the option of whether or not to use them.
Consider suggesting that students have the option of closing the eyes, rather than speaking of it as a requirement (especially for final relaxation). Hypervigilance—maintaining abnormal awareness of environmental stimuli—is typical for a person suffering from PTSD. Such an individual may have heightened startle responses or flashbacks, and being forced to keep their eyes closed can trigger these anxiety responses. The cues “Calm the eyes,” or “Leave the eyes softly open, if needed,“ can give students the comfort of choice.
For teachers who have taught yoga for some time, words like anus, genitals, and buttocks may sound no more loaded than “elbow joint " or "thoracic spine.” But I found out the hard way that students can be emotionally re-injured by our over-familiarity with these terms when giving descriptions of practices like (root lock).
A teacher-training student of mine nearly quit training when he was asked to do a report on a senior teacher’s video involving an introspective practice that described all of the musculature of the pelvis. “My childhood sexual abuse came back. I felt probed and assaulted,” he explained. We can’t always avoid discussions in the classroom of bandhas or practices like (which involve contraction of the floor of the pelvis and abdomen), but we can be mindful of our words. Terms like “pelvic floor,” “root engagement,” or "drawing upward from our root” can be less inflammatory and still convey meaning. Just being aware that everyone isn’t on the same page as far as comfort with anatomical terms is concerned helps us proceed with more sensitivity.
There is a lot of research on the benefits of cross-patterning and its therapeutic benefits for trauma. Cross-patterning is when the limbs cross the midline of the body, often making connection to the opposite side of the torso (think eagle pose or sage twist, as well as many kundalini kriyas involving swinging or crossover movements). Cross-patterning can also involve “brain gym” games like rolling one arm or shoulder forward while the other rolls back. Incorporating more of this type of movement in class helps all yoga students with their neurological processing and coordination—but when processing trauma, the results can be quite remarkable.
Margaret Howard, a St. Louis-based trauma therapist and advocate for survivors of human trafficking, recommends additional training for yoga teachers:
"The more I study psychological trauma, the more I become convinced. Basic training in the biology, anatomy, and physiology of trauma phenomena should be a mandatory part of yoga teacher training and certification. Without an understanding of how the body itself is altered by trauma, yoga teachers may be unintentionally doing harm."
But not all teachers have the resources, either because of time or finances, to do another complete training. Therapist and yoga practitioner Jamie Marich, PhD, speaks about the need for trauma sensitivity in classroom yoga:
"A yoga teacher once challenged me for being too worried about the 'trauma issue,' too sensitive to matters of trauma because of my perspective as a counselor. She offered, ‘Not everyone has been traumatized.’ Point taken. Not everyone has HIV or blood-borne illness either, yet in healthcare settings we take universal precautions to prevent transmission because there is enough of a risk. The same reasoning applies here—trauma is enough of an issue in the general population and simple precautions can be taken to assure optimal safety for most."
Other recommendations from trauma therapists include speaking in each class about safety protocols, limiting breathing practices to shorter periods, being available to students after a class, keeping imagery clear and in the present, and avoiding assumptions about how a pose feels and affects students. More important than anything else, however, are choices—choices about touch, positioning in the class, range of motion, oils and fragrances, after-class hugs, exiting the classroom when needed, or taking water and bathroom breaks. Choices matter.
And while we cannot offer the perfect class for every student, it is part of our growth as teachers and sensitive human beings to become more aware of how our words and our actions affect those in our care. Simply remembering the trauma statistics can help keep us mindful. We are not there to pity or heal students, nor to assume authority over their individual practice. We are there as human beings who have also known suffering, to keep open the space that will help our students find their soul’s way.
“Our human compassion binds us the one to the other—not in pity or patronizingly, but as human beings who have learnt how to turn our common suffering into hope for the future.”