Several years ago I got involved with a London charity, Ourmala, and started teaching yoga classes for them. Ourmala works with refugees and asylum seekers, offering practical help to people who, through no fault of their own, have suffered unthinkable trauma and cruelty.

After attending a short in-house training, I wanted to deepen my knowledge and signed up for a short course of ‘Yoga for PTSD (Post-Traumatic-Stress-Disorder)’ offered by the Minded Institute and the wonderful Heather Mason. Assuming that all refugees and asylum seekers suffered with PTSD, the course taught us the most effective techniques to use when working with people who have suffered trauma.

Those 2+ years which I spent working for Ourmala were very challenging but also extremely rewarding. My assistant and I would often find ourselves in situations we had never witnessed before and which required a quick assessment and appropriate action.

At this point some of you may be wondering why would anyone want to offer yoga classes to people who have suffered from terrible trauma. In fact, you may argue that surely there are other therapies which would be better suited to help these people.

It all started in March 2015 when I attended a conference held at SOAS in London,‘Yoga: a key to mental health? Psychological and physiological mechanisms for emotional regulation’.  Unlike others, this conference, organised by the ‘Minded Institute’, was open to yoga teachers alongside healthcare professionals such as psychiatrists and psychotherapists. We were all in the same room, listening to the evidence and attending the same workshops. In the keynote by Heather Mason, yoga was introduced as an integrative system which profoundly influences the mind-body connection, thus enhancing the capacity for emotional regulation and psychological resilience. During the weekend we explored how yoga influences physiological mechanisms which in turn lead to improved brain functioning and psychological health. There were keynotes by psychiatrists who had conducted research indicating that yoga was a powerful treatment for depression, for example. We were invited to choose from a variety of workshops such as experiential workshops which included gentle movements, breathing and relaxation practices to alleviate negative emotions and activate internal healing processes or how to use yoga to manage anxiety. The weekend also featured a workshop, which sadly I did not attend, on Yoga for Schizophrenia as an effective add-on therapy. One of the workshops which I did attend was ‘Yoga and Adolescent Mental Health’ by Lisa Kaley-Isley, a clinical psychologist and yoga therapist.

That workshop with Lisa Kaley-Isley was a catalyst for me and in 2018 I embarked on a 60-hour course in ‘Teen Yoga and Mindfulness’ by the Teen Yoga Foundation. Prior to the pandemic I used to teach a weekly yoga class for Teens & Tweens at my home yoga studio in North London.  Although I don’t offer this class at the moment, all my online yoga classes are open to children from the age of 12 with or without parental supervision. Having started practising yoga in my late teens I am very aware of the long-term benefits of introducing a body-mind practice during the formative years.

A year prior to the conference, in 2014, a revolutionary book was published, ‘The body keeps the score: Mind, Brain and Body in the Transformation of Trauma’ by Bessel Van Der Kolk, a psychiatrist, author, researcher and educator based in the US. His research had been in the area of post-traumatic stress and his book became a New York Times bestseller. Van Der Kolk explains how common trauma is: ‘One does not have to be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families and our neighbours.’

In a nutshell, what are the physical impacts of trauma? How can yoga help?

  • Brain – a shrinkage in prefrontal cortex (to do with cognitive functions) and hippocampus (to do with learning and memory) with an enlarged and more reactive amygdala. Furthermore, a dysregulation of brain waves can lead to anxiety and an inability to concentrate. Neural pathways are affected and a need to ‘rewire’ the brain. How can yoga help? Through mindful exercise conducted in a safe and nurturing environment. Yoga has been shown to increase neuroplasticity, which is the ability of the brain to form and reorganize neural connections, especially in response to learning or following injury. Interestingly, research has confirmed positive structural neuro plastic effects in the hippocampus in the elderly after 6 months of yoga practice.
  • Nervous system – in PTSD the sympathetic and parasympathetic nervous systems are out of sync, which explains why traumatized people are vulnerable to overresponding to relatively minor stresses. Van Der Kolk discovered that heart rate variability (HRV) which measures the balance between the sympathetic and parasympathetic nervous system, is poor in trauma sufferers, making people more susceptible to a variety of physical illnesses such as heart disease and cancer. This dysregulation of the nervous system will have a knock-on effect on the stress hormones like cortisol which in turn can damage the cells and other hormone glands. It is imperative to bring the nervous system into a more balanced and coherent state. The slow, mindful movements and the breathing practices which are used in yoga trigger a parasympathetic response. Research has confirmed that a regular yoga practice brings about a significant drop in cortisol levels. Yoga has also been found to improve rates of HRV

Understanding HRV (Heart Rate variability) – during inhalation the heart rate goes up and during exhalation the heart rate goes down. This is completely normal and it reflects an excellent physiological health. In a person with chronic PTSD the heart rate is slow and it’s out of sync with the breath.
  • Immune system – over a long term of dysregulation in the hormones can create inflammation which is the underlying cause of many diseases such as asthma and arthritis. The gentle movements and an emphasis in diaphragmatic breathing can help regulate the nervous system and the hormones.

Van Der Kolk sums it all up: ‘Mindfulness increases activation of the medial prefrontal cortex and decreases activation of structures like the amygdala that trigger our emotional responses. This increases our control over the emotional brain.’ It is important to note that mindfulness can be interpreted as mindful movement which is more accessible to the vast majority of people than just a seated mindfulness practice.

 

Mara currently teaches weekly yoga classes at a secure mental health hospital.