Rates of Trauma and Addiction Are Skyrocketing. Yoga Can Help

As a mental health professional working in the Acute Rehabilitation Addiction Recovery Center at Hoag Hospital, the past 18 months have been some of the most challenging in my career. In this time, I’ve witnessed an alarming increase in trauma and suffering related to addiction.

I’ve seen firsthand the debilitating effects that the pandemic has had on people with mental health issues, a history of trauma, or who suffer from diseases of despair—those related to substance abuse, alcohol dependency, and suicidal thoughts and behaviors. I’ve also seen how yoga practices can help them heal.

The connection between trauma and addiction

The pandemic has caused many people to experience new mental health challenges, and worsened pre-existing issues in others. Many have turned to substance use to cope: In 2020, there was a 59 percent increase in alcohol use and the number of drug overdoses hit an all-time high. Accompanying this surge in dangerous behavior has been an exponential increase in people needing support for mental health and addiction.

Most people aren’t using substances to numb out of their “perfect” lives, says Ashly Fox, yoga therapist, clinical addiction counsellor, and founder of the Recovery Yoga Network. “They do it because they are living in a way that feels out of alignment with their personal values. They use because they are suffering.”

At least 75 percent of people who suffer from substance use disorders have experienced some form of trauma, says Fox. That might be childhood trauma (such as an injury or abuse), or triggered by recent events (say, a pandemic-inflicted job loss).

Trauma also shows up in the yoga and wellness industries in unique ways, says Sangeeta Vallabhan, a trauma-informed yoga teacher and founder of the nonprofit The Practice Coalition, an organization dedicated to supporting teachers of trauma-informed yoga. “We have seen instances of sexual abuse and manipulation, emotional and spiritual abuse, and taking advantage of unpaid labor and calling it seva,” she says.

How trauma-informed yoga can help

Regardless of the type of trauma, the impact is the same: Trauma can disrupt the nervous system and lead to a multitude of chronic health issues including anxiety, depression, cardiac issues, and immune dysfunction.

Trauma-informed yoga is a methodology designed to elicit a sense of safety. It meets people where they are and invites them to safely connect to themselves. Everything is an invitation. Nothing is forced. Trauma-informed teachers are trained in nervous system regulation techniques so that they can create a practice that supports healing and builds resilience.

Trauma-informed classes can help people struggling with substance use disorders by reducing impulsivity and increasing self-awareness, says Fox. When yoga is taught in a way that accommodates feelings of safety, it can facilitate healing and complement more traditional therapies, such as cognitive behavior therapy (CBT), where people verbally process their trauma.

What does trauma-informed yoga involve? 

A trauma-informed approach to yoga assumes that symptoms of trauma—like disassociation, depression, or hypervigilance—are the body’s attempt to regulate a dysregulated nervous system.

Yoga provides what we call a “bottom-up” approach to healing, says Fox. That means that you initially learn to cope with trauma at a sensory level. For example, a teacher might take you through an asana flow to get your heart rate elevated, then teach breathing techniques you can use to dial down your nervous system’s response and reach a state of calm. Over time, these self-regulating techniques help practitioners get to a place where they can talk about their trauma without getting overwhelmed. 

Practices to regulate the nervous system’s response to trauma

1. Langhana Ujjayi Breathing: This is powerful for centering and nervous system regulation because it almost instantly brings the heart rate down, redirects the mind to the present, and can help with insomnia.
2. 1/2 Sun Salutation: This breath-to-movement sequence increases prana in the body and redirects the mind, which can help you release stuck or stagnant emotions. Start in Tadasana (Mountain Pose). Inhale. As you exhale, fold over your legs. Inhale to lift halfway, then exhale as you fold again. Inhale back into Mountain Pose, exhaling your hands together at your heart. Repeat at least 5 times or as many as 10.
3. Virabhadrasana II (Warrior II Pose): This strengthening posture invites you to tap into your future by grounding into the earth and leave the past behind by gazing into the future. This is a metaphorical reminder to survivors: You are not what happened to you.
4. Legs-up-the-Wall (or on a chair) Pose: This inversion sends messages to the body that decrease sympathetic activation and increase the parasympathetic response. Spend at least 5 minutes in this pose any time you find yourself ruminating on a particular thought, your heart is racing, or your muscles are tense. These are all signs that your nervous system is in overdrive.
5. Balasana (Child’s Pose): This grounding posture allows you to return to yourself. In this posture, connect to the earth with your body and the palms of your hands to remind you of your connection to this planet and each other.
6. Yoga Nidra: The Veteran’s Administration and nontraditional spaces use this type of body scan meditation for PTSD and trauma recovery. It facilitates restful sleep and nervous system regulation.

Teaching trauma-informed yoga

Vallabhan believes that all yoga teachers should attend a trauma-informed yoga training. “It’s an important lens to have, to look at all students with a more empathetic view, no matter what style you are teaching,” says Vallabhan. “When working with people, connecting to each other’s humanity should be foundational.”

Teaching trauma-informed yoga requires an added layer of knowledge and ability to hold space for people with traumatic experiences.

One note: Yoga, like any somatic practice, can be harmful to a trauma survivor. People who have experienced trauma can become triggered during a practice and not have the proper outlet to process their emotions, which can disrupt the healing process. If you are feeling triggered and are at a public place, stop the practice and leave the space. If you are on your own at home, stop the practice. Sit against a wall or lay down and take 10–20 deep breaths.

While the below tips can’t replace trauma-informed training, they can help you to develop a trauma-informed lens, says Vallabhan:

• Always start with simple movement. This helps clients become oriented with what you are offering them. Simple is best because it allows the students to start to develop awareness of sensations in their body.
• Think: Less is more. Trauma-informed yoga practices don’t need to be difficult or fancy. Making the movement simple enables the clients to use (resource) them later, when they actually need them. It also helps them feel successful, which can be empowering.
• Make sure there isn’t too much silence. Too much silence can be triggering for a trauma survivor. Find the balance of guiding the practice and not offering too many words or too much silence.
• Slowly build to more challenging poses. As the students feel comfortable with you as the teacher, slowly make the class more physically challenging, as it is appropriate to what trauma is in the room. Think more about gentle, appropriate challenges for your students, not necessarily pushing them out of their comfort zone. 
• Cultivate compassionate connection. The most important part of a trauma survivor’s healing journey is the trusting relationship between a student and their teacher. Walk in with your humanity. You are there to guide them in a practice to help them self regulate. Have the humility to know when you may not be the right person for a certain person or group.

Trauma for BIPOC communities in yoga

Being knowledgable about trauma-informed practices is especially important if you have BIPOC students in your class. Addiction and trauma can be compounded within BIPOC communities due to systemic racism, health inequalities, and less access to care.

Racial trauma can also show up as lack of representation or tokenism, or as cultural appropriation. Yoga can empower students and increase self awareness, but because of how yoga is typically marketed and where studios are established, BIPOC communities are often left out.

If you are a member of the BIPOC community, you may want to consider practicing trauma-informed yoga in conjunction with taking the steps below, says Vallabhan.

1. 1. Find a support network. This can be as small as one person, but only needs to be a small handful of people who understand your struggles, and they don’t put pressure on you or give you a timeline to recover.
   2. Set boundaries. Take yourself out of any social networks that cause harm or that are re-traumatizing you. For example, if you had a traumatizing experience at a yoga studio, you may want to avoid yoga studios for a while, as you could be triggered easily. Instead, go to the gym, yoga in the park or practice at home. 
   3. Get counseling. You could look for someone who specializes in trauma or a BIPOC counselor, if that is important to you. If you can’t afford counseling, look for support groups that may be free.
   4. Move your body. Talk therapy is great, but moving your body is also key to getting the trauma out of your body. Yoga is great to help regain autonomy after a traumatic experience, but other kinds of exercise are beneficial too.
   5. Re-prioritize your own well-being within safe relationships. These tips from psychologist Sophia Burke are a great place to start.