Mercedes A. McCormick, Ph.D. R.Y.T.

Abstract

The purpose of this article is to discuss and demonstrate Yoga therapy as an effective stress-reducing tool to help people heal and recover from a traumatic event, such as 9/11. Post-traumatic symptoms in adults and children are described. Consultative, experiential, and practical use of Yoga therapy techniques for traumatized adults and children are given. Participants were mental health practitioners, educators, children, and families in the New York-New Jersey Metro Area who were affected by the 9/11 attacks. Yoga therapy techniques were reported by participants to reduce body tension and to increase positive thoughts and actions in a safe, supportive environment. Thus, Yoga therapy is an effective stress-reducing vehicle that provides time and structure for integration and realization.

 
The horrific events of the terrorist attacks of 9/11 awakened the entire country to the uncertainty and fragility of human life and the tentative safety of our existence. In the aftermath of this calamity, many people are experiencing frustration in their healing process.

The yogic perspective recognizes that each individual’s response to traumatic stress is unique. On the Yoga path individuals becomes aware of normal responses to abnormal events, and Yoga is the vehicle that brings awareness of disharmony between body and mind. Individuals recognize negative thoughts, feelings, and behaviors that are detours on the road to wholeness. They become resilient in dealing with stress and restore balance between body and mind as they move toward the destination of experiencing their true nature.[4]

Meditation, Breathwork, and Movement are the fuels to bring relief from intense body sensations and strong emotional feelings. Meditation helps to clear the mind of distractions and to bring a person into the present moment. Breathwork enables the individual to become open and recognize body sensations. Movement through âsanas releases emotional tension in the body and mind; this process supports the individual in becoming flexible in handling trauma. This threefold practice of Yoga thus transports practitioners into the direct experience of personal wholeness.

During the past year I have provided information, structure, and support to help people become more aware and resilient in dealing with their unique responses to terrorism and trauma. Within this context I will describe my consultative, experiential, and practical efforts as a psychologist in implementing Yoga therapy techniques for mental health practitioners, children, and families.

An adult’s reaction to traumatic events is different than a child’s. An adult’s reaction is based on his or her physical and mental health and how he or she has negotiated other losses and traumas in life. When an adult witnesses an event such as 9/11 the immediate normal protective reactions are shock and denial. Other reactions may include extreme behaviors, feelings of anxiety, nightmares, and flashbacks immediately following the event. As the initial shock subsides, reactions vary from one person to another.[12]

The symptoms of Post-Traumatic Stress may be displayed over time. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, an adult’s reactions are divided into three categories: re-experiencing (via intrusive thoughts or nightmares of the event), avoidance (through efforts to avoid thoughts, feelings, activities, people, or places reminiscent of the event), and increased arousal (characterized by difficulty sleeping, irritability, exaggerated feelings of not being safe, or being startled).[1]

A youth’s physical and emotional responses to trauma interact with variables such as age, life experiences, temperament, family, and other individuals.[2] Being younger, being female, having a family member exposed to the World Trade Center attack, having personal physical exposure to 9/11, and having prior exposure to trauma were factors found to increase negative reactions to trauma.[9]

Young people who undergo traumatic events often experience fears, sleep problems including nightmares, increased physical complaints or illness, avoidance, anger, increased aggression, shame, anxious attachment, problems in attention and concentration, and learning difficulties.[8]

Over time, traumatic symptoms in children and youth may linger on and cause disruption in students’ daily functioning. These ongoing difficulties may manifest in the inability to do usual activities, problems with schoolwork, loss of interest and poor concentration, and increased anger and having aggressive outbursts. Withdrawal from friends, school, sports, and favorite activities is the key signal of emotional distress. Specific trauma impressions may translate into patterns of action and thought that affect choices, quality of life, and behaviors. [10]

Yoga therapy is a valuable tool to be considered when working with trauma victims of all ages. I utilized a Yoga therapy framework in developing the workshop “Helping Children and Teachers Heal in the Aftermath of Trauma.” The latter was presented to members of the Child Study Teams of the Department of Special Education in Jersey City, New Jersey. Jersey City is located across the Hudson River from the site of the World Trade Center Attacks.

Overview of the Workshop for Adults

1. Opening

Participants were presented the main purposes of the workshop: to explore and observe post-traumatic reactions in themselves and in students, to identify how participants and students coped with the 9/11 attacks, and to expand their way of managing traumatic stress through meditation, breathwork, and movement techniques in themselves and students.

Participants then shared their experience of the 9/11 terrorist attacks. Several members admitted the need to restore a feeling of control and security in themselves and their students after this traumatic event.

2. Breathwork

Abdominal breathing and a guided meditation about feeling safe and secure were introduced. Participants experienced “riding the breath,” relaxing, and welcoming and identifying body sensations.[11]

3. Movement/Awareness of Emotions

Chair Yoga was practiced to further explore body sensations and to discover emotional blocks associated with stress. The following postures were utilized: Seated twist in a chair, exercises for the neck, eye, shoulders, wrists, fingers, and arms, seated cat lifts and rolls, seated lateral bends, knees-to-chest pose, final spinal twist, and relaxation. A body scan was incorporated at the start of relaxation.[2]

4. Expression

Participants were requested to share the parts of their body that hold stress and encouraged to label and identify the emotions and thoughts experienced. Anger, fear, sadness, uncertainty, and lack of control were revealed.[5]

5. Sharing

Participants were requested to talk about their experiences. How did you hear about the attack? Where were you? What did you do? Participants were encouraged to discuss thoughts, feelings, and reactions openly and to discuss the impact of the horrific event on their work with school-aged children. Participants were asked to discuss ways they manage stress.[5]

Participants shared their reactions. They mentioned physical symptoms of anxiety, such as rapid heart beat and rapid breathing, headaches, and stomach problems for a period after the attack. Uncertainty about the future and suspicion that an attack might occur again also were common reactions.

Participants mentioned that a few students lost a loved one in the attack. Other students were said to watch the attacks from the classroom window. Participants described students’ traumatic responses, which included crying spells, emotional outbursts, and a change in regular school attendance. Other students displayed a decrease in concentration and attention and lower school grades subsequent to the event.

6. Guided Meditation

The purpose of the culminating meditation was to bring participants into a state of safety and peace. They were requested to sit comfortably in their chair, place both feet on floor, and feel their back upright against the chair. They were then guided in a body scan, asking them to follow and feel their breath in each part of their body—chest, belly, legs, feet, toes, calves, thighs, etc. Participants were guided to release tension from their head to their toes. 

As the participants released tension, they were requested to allow an image of safety and peace to appear to them—it could take the form of a person, an animal, a place, a word, etc. As the image became part of their awareness, they were encouraged to let questions, fears, desires, go out to their image of safety.

Participants were then encouraged to continue to follow their breath as the image became clearer and to feel quietness within them. They were requested to listen within. They were asked: “What is the image telling you about your safety and peace?” Time was given for participants to enter a state of safety and peace, and an atmosphere of quietness was provided.

At the conclusion of the meditation, participants were reminded that this information permeated each cell of their body, that the image of safety and peace was within them and could be call upon when needed. They were requested to give thanks to themselves for the image that came to them this day.

7. Relaxation

Sitting yoga-nidrâ.

8. Closing

Chair yoga-mudrâ closed the session to seal in the benefits of practice. The affirmation “I am safe and in control” followed. Om was chanted with hands placed near the heart in namaste.

Outcome

Workshop evaluations were positive. Relief and gratitude were among the strongest expressions. Overall, Yoga was recognized as a practical means to handle stress. Participants indicated that their feelings of peace and stillness could likely be carried over into daily activities.

Group Session with Children

Another group therapy session was held with groups of children and families who were directly influenced by the 9/11 attacks through Project HART—Healing and Recovery after Trauma—via the University of Dentistry and Medicine in New Jersey. The Project’s format focused on creative expression to release emotional blocks associated with traumatic stress.[3]

Yoga therapy techniques were presented in the children’s groups. Children were given an exercise to contact and experience prâna. They then moved into Yoga postures (tree, frog, mountain, cobra) to develop body awareness. This was followed by a guided meditation about dinosaurs and survival. Children let go of tension as they acted out the meditation script. Art activities were next introduced, and their drawings depicted the letting go of sad and angry feelings associated with the event.

The energy of prâna flows through all parts of our beings; it is the conscious and healing aspect of all of us. The children were requested to access the energy of prâna through their physical bodies and to direct the prâna to an area of their body that needed attention/healing.

They were requested to find a comfortable seated position in a chair, to keep their spine as straight as possible, and to shake their hands as if trying to shake a “bug” off their body. Next the children placed their hands palms up on their knees or thighs. They closed their eyes and took long, deep breaths, as if they were blowing out the candles on a birthday cake. They were asked to feel the breath flowing in their bodies and to observe how their body was feeling.

After a few minutes the children were guided to focus upon their hands and to imagine that they were breathing through their fingertips. They were directed to focus more on the tips of their fingers as they began to feel the vibration of the breath (prâna) flowing in and out. As they continued to concentrate on the prâna/energy flowing into their hands and becoming weightless, the children were encouraged to allow their hands to slowly float up from their knees. They were reminded to keep focus on the feelings/sensations in their hands and their breath as their hands began to move. 

After a few moments the children moved their hands towards their face. Keeping their hands 1-2 inches away from their face, they allowed their hands to move gently around their face, head, and neck, giving their aura a prânic bath. Next the children were asked to let their hands flow to an area of the body that needed attention/healing. It was observed that children placed their hands on their heart, forehead, and even the knees.

At the conclusion of the exercise, children discussed what accessing prâna felt like for them. They revealed that heat and an electrical pull were felt in their hands and facial features. Their sensations varied from scary, weird, jerky, and shaky to sleepy and calm. Two children were not able to experience the flow of prâna. One child noticed that prâna did not flow evenly in his body.[7]

Dinosaur imagery was used because dinosaurs are popular with children. They learn about dinosaurs in school and through the media. They are fascinated by dinosaurs’ huge body size, which includes long arms and legs and large mouth, facial, and torso features. Children like to imitate dinosaurs’ squawking sounds and to dramatize their fearlessness, especially lumbering through a forest looking for food to survive.

The guided meditation was selected to provide a safe, enjoyable opportunity for the children to explore their imagination about being a dinosaur, and how their body felt after being a dinosaur, and to stimulate the children’s potential to develop relaxation techniques, especially under stress.

Outcome

Workshop feedback and observations were used to determine the outcomes of the workshops. All age groups presented an increase in awareness about physical and emotional responses to trauma. Adults expressed better control and the feeling of resiliency in accepting traumatic events. Children were more spontaneous after participating in creative expressive and movement activities. [13]

Conclusion

Yoga therapy can help people of all ages to heal after traumatic events. It encourages the exploration of thoughts, feelings, body sensations, and behaviors related to traumatic events in a safe, supportive environment, recharging and healing the body and mind and helping to restore it to a condition of harmony and balance. Yoga therapy is thus an effective stress-reducing vehicle that provides time and structure for integration and realization.

Endnotes

[1] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV). Washington, D.C.:American Psychiatric Association, 1994.

[2] Clampett, Cheri, and A. Peal. Therapeutic Yoga Training Manual. Santa Barbara, Calif.: Cheri Clampett and A. Peal, 2000.

[3] Cohen, J. A., L. Berlinger, and J. S. March. Treatment of children and adolescents. In E. B. Foa, T. M. Keane, and M. J. Friedman, eds., Effective Treatments for PTSD Practice Guidelines from the International Society for Traumatic Stress Studies. New York: Guildford, 2000.

[4] Epstein, M. Going to Pieces without Falling Apart. New York: Broadway Books, 1998.

[5] Le Page, Joseph. Integrative Yoga Therapy Manual. Santa Barbara, Calif.: Joseph Le Page, 1994.

[6] McCormick, Mercedes. Family issues and outcomes of adjustment to spinal cord injury. Unpublished doctoral dissertation, Seton Hall University, New Jersey, 1995.

[7] Migdow, Jeff. Prana Yoga Teacher’s Manual. New York: Jeff Migdow, 1999.

[8] Nader, K. Treatment methods for childhood trauma. In J. P. Wilson, J. Lindy, and M. Friedman, eds., Core Treatment Approaches for PTSD. New York: Guildford Press, 2001.

[9] New York Public Schools, Columbia University School of Public Health - New York State Psychiatric Institute. Effects of the World Trade Center Attack on New York City Public School Students. New York: Applied Research and Consulting, 2002.
 
[10] Saigh, P. A. The validity of the posttraumatic stress disorder classification as applied to children. Journal of Abnormal Psychology, 1989, 98:189-192.

[11] Schiffmann, Erich. Yoga : The Spirit and Practice of Moving into Stillness. New York: Pocket Books, 1996.

[12] Van der Kolk, B., A. McFarlene, and L. Weisaeth,. Traumatic Stress: The Overwhelming Experience on Mind, Body, and Society. New York: Guilford Press, 1996.

[13] Wiener, D. Beyond Talk Therapy: Using Movement and Expressive Techniques in Clinical Practice. Washington, D.C.: American Psychological Association, 1999.

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