Scholarship and clinical practice in psychotherapy and cognitive science have produced many new insights into the nature of human development, trauma, and healing from PTSD. In this essay I will discuss how trauma relates to the anatomy and physiology of the nervous system and how yoga nidra may provide healing from trauma. Therapy that utilizes yoga nidra is considered from the perspective of Integral and transpersonal psychotherapies.
Trauma and the Central Nervous System
The somatic nervous system (SNS) “receives, interprets, and responds to information related to both our inner functioning and our outer environment” (Olsen, 119). The autonomic nervous system (ANS) is a part of the peripheral nervous system that regulates a vast array of body functions such as heart rate, breathing, digestion, urination, and sexual arousal. The ANS is divided into the sympathetic nervous system and parasympathetic nervous system. These are complimentary processes in the body. The sympathetic nervous system is a constantly active system that regulates many body functions and stimulates the fight-or-flight response; it is responsible for homeostatic mechanisms in virtually all parts of the body through the regulations of neuronal and hormonal stress responses. The parasympathetic nervous system emerges from the central nervous system and stimulates the “rest-and-digest” and “feed-and-breed” activities of the body. It regulates functions such as sexual arousal, salivation, lacrimation, urination, digestion and defecation (“Autonomic nervous system,” 2015).
The ANS functions mostly unconsciously and regulates the fight-or-flight and free-and-dissociate responses. The fight-or-flight response is a physiological reaction to a perceived threat to survival, where the body is primed by a quick secretion of hormones for fighting or fleeing to ensure survival. Normally, the increase of stress hormones is temporary, and goes back to baseline once the threat is gone. In cases of persons who have experienced extreme trauma, the hormones continue to be released at high levels, do not fully return to baseline, take longer to return to baseline, and/or “spike quickly and disproportionately to mildly stressful stimuli” (Van Der Kolk, 2014, p. 46).
Trauma affects how we feel inside, interrupting our ability to accurately sense our interiority as well distinguish between past and present events. During trauma the brainstem and limbic system become overwhelmed, and the “emotions, sounds, images, thoughts, and physical sensations related to the trauma take on a life of their own” (Van Der Kolk, 2014, p. 64). While the traumatic experience has a beginning and an end, PTSD is a condition where the trauma continues to live on as flashbacks and the accompanying high levels of stress hormones. This makes persons with PTSD unable to live fully in the present — they are imprisoned by a past event.
Neuroscientists call the “default state network” those areas of the brain that are active when we are not thinking of anything in particular, sort of like an “idle” state (“Default mode network,” 2015). These are the midline structures of the brain that are involved with giving us a sense of our “self”, or self-awareness: the orbital prefrontal cortex, insula, medial prefrontal cortex, anterior cingulate, and posterior cingulate (Van Der Kolk, 2014, pp.92–93). In patients with PTSD, these areas are not activated: “In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundations of our self-awareness…” (Van Der Kolk, 2014, p. 74).
Being “stuck” in the fight-or-flight response means the person is trapped in a life-or-death situation; the body is constantly aroused to face imminent danger. When a person relives a strong emotion through a flashback, they re-experience the visceral sensations felt during the previous event; in addition, there are significant changes in the nervous system that registers signals from muscular, digestive, and integumentary systems (Damasio, 2000). In an attempt to control these processes, they “become expert at ignoring their gut feelings and in numbing awareness of what is played out inside” (Van Der Kolk, 2014, p. 99). The body of a person with PTSD is a battleground of conflicting visceral warning signs. Van Der Kolk (2014) persuasively argues that the first step to control over ones life is greater awareness of subtle, body-based feelings.
Only a healthy connection with inner feelings and sensations can give a sense of feeling in control of the body and the self. Van Der Kolk (2014) asserts, “Physical self-awareness is the first step in releasing the tyranny of the past” (p. 103). Because our “idling network” of self-awareness is intimately interwoven with the unconscious functions of the ANS, such as breathing, heartbeat, digestion, and hormone secretion (Van Der Kolk, p. 96), therapeutic practices that work in the realm of relaxed inner awareness of feeling-sensations may provide recovery from trauma. Additionally, because traumatized persons need to have experiences that restore physical safety, these therapeutic practices may help the traumatized person to “experience immobilization without fear” (Van Der Kolk, 2014, p. 87).
The practice of yoga nidra is one such technique that may help people with PTSD. A healthy, vibrant life requires efficient dialogue between the autonomic and somatic nervous systems. Olsen (2004) writes “As we receive information about our outer environment and make choices between activity and rest, we are affecting and affected by our inner environment” (120–121). Swami Satyananda Saraswati developed yoga nidra and provides a systematic explanation of the practice (1998). In yoga nidra one assumes a relaxation posture and “awareness is progressively withdrawn from the external world, the body, the process of breathing, the conscious mind, and finally, the unconscious mind” (Saraswati, 1998, p. 29). My teacher explained to me that this practice is a critical part of pratyahara, a limb of yoga much neglected in American yoga practice (Krishna Prakash, private communication). The progressive and sequential pointing of awareness to body parts attunes the nervous system with the body, by exercising the brain’s internal body map, or “motor homunculus” (Saraswati, 1998). This is a “neuronal abstraction of the physical body, operating in the realm of neurotransmissions and conscious electrical energy flowing throughout the central nervous system and the network of nadis which form the pranic body” (Saraswati, p. 36). Saraswati (1998) asserts that yoga nidra increases perception of feelings and emotions in the body and “develops control of the emotional reactions and autonomic responses…” (p. 42). Saraswati (1998) cites various studies that show that yoga nidra produces positive outcomes over a wide variety of stress disorders, and asserts that it lessens the effect of the fight-or-flight response by “changing the neuro-humoral reactivity to stress, creating somatic conditions essentially opposite to those prompted by sympathetic over-activity” (Saraswati, 1998, p. 189).
I believe that yoga nidra is a powerful practice that may help PTSD patients. By guiding awareness sequentially to parts of the body, people are invited to be fully aware as well as fully relaxed. The default mode network is invited to respond to embodied, energetic, and archetypal prompts of selfhood in the form of sensations, feelings, and images. Agency, something that goes awry with patients with PTSD (Van Der Kolk, 2014) is gently restored to the individual, as well as the practice of immobilization without fear. Instead of ignoring gut feelings, one can observe them from a detached perspective, empowering them to gain a higher perspective (and even control) over autonomic processes that are normally involuntary. Saraswati (1998) cites one brain imaging study that indicates that during yoga nidra the most activated regions (before entering deep-relaxation-meditation) were the optic center in the posterior of the brain, the tactile center, and the limbic system, which suggests processes of (visual and tactile) visualization while in contact with emotions (p. 243). PTSD patients lose contact with their bodies, and by being imprisoned in a past event, cannot imagine a new future. I contend that the embodied imagination stimulated by yoga nidra allows one to come face to face with physiological effects of trauma, work on transcending those effects, and envision a new embodied life forward.
Imagination and Metaphor
During the deep relaxation phase of yoga nidra, the practitioner induces contrasting sensations in the body, such as hot/cold, heavy/light, and happy/sad. This “balances our basic drives and controlling functions that are normally unconscious” and “memories of profound feelings are relived” (Saraswati, 1998, p. 72). Yoga nidra exercises a bodily imagination that might allow greater freedom for PTSD patients to fully feel imprinted memories in way that allows perceptual flexibility. Since PTSD patients are trapped in a physiological response to a past event that is too profound to put into a simple narrative, they need help in exercising a body-based imagination so that the feelings can later be described. Modell (2006) presents a theoretical discussion on the role of perception and sensation in human feelings, and argues that the suffering of traumatized patients is due to a “degradation of an unconscious metaphoric process” where the interpretive ability of sensations is so severely constricted that there is a failure to transform raw sensations into meaning, or a complex perception of feeling (p. 147). The practice of yoga nidra may assist trauma patients become more conscious of the unconscious metaphoric process that has been frozen inside them. In this way they may ease their burden by gaining greater imaginative skill in recontextualizing memory, so that the transfer of meaning of a horrific past event may be sublimated into the present (Modell, 2006, p. 40).
If the big problem with PTSD is dissociation, wherein split-off fragments of memory cannot be integrated due to their horrific nature into an autobiographical narrative, then how might they integrated into the individual’s narrative? I do not think an isolated yoga nidra practice alone can help heal PTSD patients. Since Breuer and Freud (1893), it is clear that talk therapy is a necessary element in recovering from trauma. Doing yoga nidra is extremely helpful in feeling more, but there is the additional requirement for trauma patients to learn to describe the feelings. As Breuer and Freud (1893) write,
…[W]e had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and had put the affect into words. Recollection without affect almost invariably produces no result.
Memories from highly aroused states are extremely difficult to work with and comprehend. Yoga nidra may be a great tool, but a psychotherapeutic process must support it.
Integral and transpersonal psychotherapeutic considerations
Trauma patients need to not only be safely present with others, but allowed to express themselves and be completely held in a therapeutic container. Fosha (2003) writes,
…the roots of security and resilience are to be found in the sense of being understood by and having the sense of existing in the heart and mind of a loving, caring, attuned and self-possessed other, an other with a mind and heart of her own…. When the caregiver’s emotional availability, responsiveness and reflective capacities are compromised, often as a result of her own trauma and loss, dyadic affective regulation cannot proceed optimally.
I contend that an integral and transpersonal approach to psychotherapy is well suited for therapy that includes that practice of yoga nidra. During yoga nidra one encounters dimensions of experience that may come from one of several psychic centers, emotional centers, vital centers, etc. If yoga nidra is followed by a psychotherapeutic session, it becomes clear that the therapist must honor the multidimensional nature of inquiry of yoga nidra. Cortright (2007) astutely describes the defining features of psychotherapy as a mindfulness practice that acknowledges the realms of being and knowledge that is possible for a human as well as core wounding that prevents us from accessing our psychic center. The effects of severe trauma on the nervous system discussed above make for an impossible problem if we restrict ourselves to only top-down, mind-centered approaches. An integral approach to therapy addresses the healing of lower, central, and higher emotional levels of the self as well as an inner opening of the psychic center through the heart.
Trauma survivors desperately need reciprocity and safety in the therapeutic relationship in order to remember and describe past events. Moreover, if they have lived with trauma for any period of time, it has damaged the foundation of their unconscious self-narrative. Cortright (1997) writes, “healing and growth of the self involves more than simply reowning disowned parts…. The self needs to grow and develop new structures to manifest fully” (p. 36). A transpersonal approach to therapy places all the psychological work in “a larger context of spiritual unfolding”, which can be a deeply purifying process for the trauma survivor (p. 41). This requires an accepting and empathetic therapist that can hold a sacred space for the unfolding of remembering and integrating traumatic memories. I support Cortright’s (2007) assertion that therapies can be joined with psychic aspiriation on the part of the therapist, which helps bring about an atmosphere of love and compassion into therapeutic relationship.
The integral approach to therapy upholds an evolutionary vision of human progress. If “wounding affects all levels of the self — somatic, lower, central, and higher emotional, mental”, then a therapeutic approach to trauma that uses yoga nidra could transform wounding at various levels of the self into potentials for opening a path of healing (Cortright, 2007, p. 73). Where traditional approaches to PTSD treatment fail is the ongoing need for psychic evolution on all these levels. Yoga nidra has the potential to be modified and custom-tailored to an individuals needs and may address all areas integral therapy as conceived by Cortright (2007). It can awaken and purify the body, and open up the consciousness in the body; it can open the heart, by increasing the capacity to feel strong emotions; it can expand the mind by augmenting powers of visualization; and it can bring forth the psychic center, allowing divine aspiration to supplant the feelings of helplessness and wounding.
The problem of healing from trauma is becoming increasingly better understood as we gain new insights into human anatomy and physiology. Yoga nidra is a powerful technique that allows individuals to open to greater feeling and sensory awareness. As they progress, a multi-dimensional inquiry opens up that includes all levels of the self. It is recommended that trauma patients compliment yoga nidra with psychotherapy. Integral and transpersonal approaches are highly apt for therapies that include yoga nidra, because they honor a multi-dimensional approach to human evolution, as well as inviting an aspiration for the divine. Since each individual experiences, embodies, lives with, remembers, and heals from trauma differently, transpersonal therapy is appropriate because it can also include any other psychotherapeutic technique while maintaining a spiritual container. Further research is necessary to show how yoga nidra could be custom-tailored for PTSD patients.
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