The Benefits of Yoga and Mindfulness on Post Traumatic Stress Disorder

Posttraumatic stress disorder, or PTSD, is a mental health disorder that is triggered from experiencing or witnessing a terrifying or traumatic event which results in a person needing treatment from not being able to recover or cope from the incident. Psychotherapy is the primary treatment for PTSD, though more recently researchers have conducted studies to determine whether or not the practice of mindful meditation and yoga are beneficial in treatment of symptoms compared to other methods, which often present significant challenges. Mindful meditation incorporated with hatha yoga combines mindfulness through the combination of relaxation, breathing exercises, and movements that have been shown to alleviate hyper-arousal, intrusion, and avoidance symptoms. To validate this theory, participants were interviewed to determine if they met the diagnostic criteria for PTSD using the Clinician Administered PTSD Scale (CAPS), which was then followed by a 10 week yoga intervention and post assessment or interview to evaluate the impact on symptom-reduction. The results clearly indicated that treatment through yoga greatly reduced dysfunctional coping, avoidance, and overall stress. This was evident through participants being able to cultivate awareness and regulate arousal, in addition to ones search for novelty. The results of the studies provide evidence that therapy based on mindful meditation and yoga are essential in providing treatment for those suffering from posttraumatic stress.

Keywords: mindfulness, yoga, posttraumatic stress disorder

Posttraumatic stress disorder, or PTSD, is a mental health disorder that is triggered from experiencing or witnessing a terrifying or traumatic event which results in a person needing treatment from not being able to recover or cope from the incident. PTSD can develop as a result from dangerous events such as combat, sexual assault, a car accident, and natural disasters. Though in some cases people have developed PTSD from experiences like an unexpected or sudden death of a loved one, or a friend. In order to be diagnosed with PTSD, he or she must experience one re-experiencing and avoidance symptom, two arousal-reactivity symptoms, and two cognition-mood symptoms for at least a month or more (Post-Traumatic Stress Disorder, 2016). Re-experiencing symptoms generally cause issues throughout ones day, for they derive from a persons own thoughts and feelings. Often those suffering from PTSD will experience flashbacks to the event, reliving the trauma over in their head, or have bad dreams that relate to the incident. For example, many people whom suffer from PTSD as related to combat are triggered by ceiling fans, thinking that they are helicopter blades. Avoidance symptoms are fairly self explanatory in the sense that those suffering simply avoid places, objects, and events that remind the of the incident. Avoidance symptoms impact the persons everyday life, for they change their routine in order to prevent being triggered, such as a women avoiding a certain street considering that was where she was sexually assaulted. Arousal-reactivity symptoms are when a person is consistently in a state of fear, or constantly being on edge, which result in angry outbursts and difficulty sleeping and eating. Lastly, there are cognition-mood symptoms that make the person alienated from friends and family due to the feelings of guilt and blame. Additionally those suffering often experience negative thoughts about themselves, often resulting in them relying on substances, or sinking into a depression.

Treating PTSD is often difficult, considering that everyone is different, and one form of treatment may not work for another. PTSD is usually treated through medication and psychotherapy, though the lack of integration between the self and the body expose issues in current methods of treatment. PTSD is a psychophysiological condition that warrants interventions that address both the physical and physiological symptoms of PTSD, and many treatments fail to direct attention to trauma that is held in the body and the mind (Johnston et al., 2015). Research has suggested that treatment for PTSD should focus on mindful meditation and yoga for it systematically approaches that incorporate both mental practices and physical poses to alleviate symptoms.

Yoga has proven to be beneficial in reducing symptoms of PTSD through the combination of physical movement, breathing exercises, and relaxation. Over time research has shown that yoga has the ability to reduce musculoskeletal and mental tension, in addition to increasing both body and cognitive awareness all while helping people become more physically flexible. Breathing exercises taught and practiced in the studio aim to reduce stress and increase mindfulness through psychological and physiological change that modifies respiratory frequency. People with PTSD are low in inhibitory neurotransmitter gamma amino butyric acid (GABA), and coincidently GABA has been shown to increase in PTSD patients while practicing yoga (Johnston et al., 2015). Incorporated into yogic practice is mindful meditation, which has been shown to help people manage stressful situations by fully embracing their current life situation and help increase overall awareness. Qualities of mindfulness that benefit those struggling with PTSD include: acceptance, patience, trust, openness, and letting go (Snyder, Lopez & Pedrotti, 2011). Practicing mindfulness and mindful meditation helps alleviate dysfunctional coping and avoidance symptoms with those diagnosed with PTSD, and provides individuals with the ability to manage their triggers and symptoms.

The benefits of yoga and mindful meditation have been tested on people diagnosed with posttraumatic stress disorder to see whether or not the practices relieve symptoms. In 2015, Johnston et al. staged a yoga intervention to help service men and women participants suffering from PTSD increase awareness, release chronic tension and decrease maladaptive automatic reactions while inducing a state of relaxation to manage and diminish symptoms. The study was benchmarked against other interventions used on men and women in the service to see whether or not yoga has more positive results. Participants were recruited through flyers and advertisements, who would undergo a phone screening to see whether or not they were eligible for the study. Participants were then interviewed in person to ensure inclusion criteria was met, in which they would then undergo a Clinician Administered PTSD Scale (CAPS) assessment. The study consisted of a 10-week yoga intervention that included poses, breathing strategies, and mindful meditation, along with 15-min a day at home yoga practice. Instructors focused on cultivating mindful awareness in each poses to insure relaxation and responsiveness to the environment, rather then the participants displaying hyper-arousal and avoidance. When the study concluded participants were asked to complete self-report questionnaires and once again underwent a CAPS assessment. Results supported that yoga was a practical and successful intervention for PTSD as a result of a decrease in CAPS scores. Unfortunately, there were no significant findings on mindfulness likely due to a small sample size, and individual variation among participants (Johnston et al., 2015).

Similarly, in 2017 West, Liang, and Spinazzola conducted a qualitative study to address treatment of PTSD following participation in a 10-week yoga program that focused primarily on trauma sensitive yoga. Participants were recruited through involvement in a previous study related to their PTSD. As previously stated the participants all mer the diagnostic criteria of PTSD, which was originally discovered through the CAPS assessment. Unlike the previous study mentioned, participants were required to also participate in psychotherapy to investigate whether yoga could target symptoms left untreated despite ongoing psychotherapy. In the interview prior to the yoga program participants were asked to describe their level of functioning. The program focused on the key elements practice in yoga; breathing and mindful silence and meditation. Additionally the program emphasized a sense of awareness, ownership, and befriending of ones own body. At the conclusion of the program, participants were interviewed using symptoms of PTSD and Organismic Valuing Theory (OVT) to describe the their experiences in treatment, in which they reflected on changes they observed in themselves. Researchers found that yoga and mindful meditation did in fact diminish participants symptoms of PTSD, in addition to learning how to control their stress and anxiety. A common theme researchers found through the interviews of the participants was that each displayed gratitude and compassion, relatedness, acceptance, centeredness, and empowerment. One of the authors Jennifer West coined the acronym G.R.A.C.E to explain the five themes. For example, centeredness was expressed by the participants having a new found ability to quiet their mind, be less reactive, and feel more positive; or acceptance which participants expressed in being able to accept their disorder and their lives and feel at peace. (West, Liang, & Spinazzola, 2017).

Treatment for PTSD should focus on mindful meditation and yoga for it systematically approaches that incorporate both mental practices and physical poses to alleviate symptoms. Future research should gather assessments from therapists on their clients change and growth throughout the 10-week yoga interventions. Further research is needed in order to clarify the role yoga and mindful meditation play in helping those whom suffer from PTSD recover. Moreover, research in yoga as it relates to PTSD is essential to positive psychology for its correlation to positive cognitive states and processes. Overall yoga and mindful meditation help elevate ones well-being and ultimate goal to achieve happiness.

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