Patricia L Gerbarg and Richard P Brown

Nowhere is the link between mind and body more evident than in the experience of abuse. This connection gives us a unique opportunity to employ body-centered methods to heal emotional scars. While talk-based and cognitive therapies can be of great benefit, there are situations in which mind-body approaches, such as yoga, qigong, tai chi, breathing practices, and meditation can be extremely beneficial and sometimes necessary for full recovery.

Victims of abuse, especially children, are often unable to talk about what happened either because they are too young to have words to describe the experience or because the perpetrator has frightened them into permanent silence. When they reach adulthood, the prohibition against telling may still prevent them from talking about the assault, even to their therapist. Neuroimaging studies suggest that when a person with post-traumatic stress disorder (PTSD) is reminded of the traumatic event, there is a decrease in activity within the speech areas of the brain.1 Moreover, the victim may need to avoid talking or thinking about the assault because just remembering can evoke painful or revolting physical sensations.

Mind-body practices provide a therapeutic approach using the body's own internal communication network, a system that does not require words. Learning how to use the body to speak to the mind circumvents the prohibition against talking and can be more effective than relying solely on verbal, cognitive, or intellectual approaches.

Dr. Susan Franzblau and colleagues2 studied the effects of yogic breathing and testimony (disclosing the abuse to a nonjudgmental receptive listener) on forty women who reported intimate partner abuse. The women were randomly assigned to four groups: yogic breathing only; testimony only;

yogic breathing plus testimony; and no intervention. They were given two forty-five-minute sessions on two consecutive days. Testing revealed improvements in self-efficacy in the three intervention groups, but women who received both yogic breathing and testimony improved the most, including four out of five factors assessing self-control, security, fear, and confidence.

Dr. Sharon Sageman3 described her work with seven women in spiritually oriented group therapy. All of the participants had severe, chronic mental illness and histories of abuse. The group expressed interest in working with a yoga teacher. Dr. Sageman arranged for them to be taught a basic breathing practice for thirty minutes at three of their group meetings. They learned to do a resistance breathing called Ujjayi in Sanskrit, also known as Victory Breath or Ocean Breath. Resistance to airflow is created by a slight tightening of muscles at the back of the throat, producing a soft sound like the sound of the sea or the inside of a seashell. The women learned to breathe at about five breaths per minute. Combining slow breathing with airway resistance further stimulates the vagus nerves and the relaxing, soothing part of the autonomic nervous system. The result is a state of calm alertness.4 Dr. Sageman observed striking improvements in mood and interactiveness after the group did the yoga breathing. Relieving depression is particularly important because it can seriously interfere with engagement and recovery.

While mind-body programs have been recognized for their ability to relax the mind and body, and to relieve symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD), their potential to induce deeper changes in trauma formations is not as well known.5-12 We will start with the story of a woman who was sexually molested in childhood. Six levels of trauma healing will be explored. This will be followed by a discussion of abuse during mass disasters and genocide. Along the way, we will offer basic techniques the reader can start at home along with resources and recommendations for further healing and thriving.

SUSAN—"I CAN'T STOP CRYING AND I DON'T KNOW WHY."

Susan was repeatedly molested from the age of three until puberty by a middle-aged male cousin. He had frightened her into silence by convincing her that if she told about it, her family would throw her away. Although she suffered severe night terrors during childhood and anorexia during adolescence, no one suspected sexual abuse, she never spoke about it, and she never received treatment. Susan felt there was something defective about her buttocks (the focus of the molestation), and she worried that people could see what was wrong with her body. After two years of intensive psychotherapy, three times a week, she was finally able to tell her parents about the abuse.

On the outside Susan appeared well adjusted, an excellent student and an outstanding athlete. Although she had friends, her relationships were superficial. She developed an impenetrable façade, appearing poised and aloof while living in constant fear that someone would discover her secret. Susan never dated. She could not allow anyone—male or female—to become close to her. Any attention from men made her panic and freeze. She lavished her love on animals.

Susan started therapy with me (Dr. Gerbarg) at age twenty-five, saying, "I can't stop crying and I don't know why." She refused medication because to her it meant she was weak and defective. During eight years of intensive psychotherapy three times a week, she developed more self-confidence, overcame depression and many of her fears, formed deeper friendships with both women and men, and was able to tell her parents about the abuse. She stopped relentlessly criticizing and punishing herself, started her own business, and bought her dream house in the country. In many respects, she was happy, but she longed for an intimate relationship with a man, marriage, and children. Unfortunately, paralyzing fear of men still stopped her cold. At the age of thirty-three, she had not been on a single date. Week after week she expressed frustration, loneliness, and desire for a life partner. I suggested Susan try a yoga breathing course to help reduce anxiety, perhaps enough to enable her to start dating.

I recommended a yoga breathing course with an atmosphere of safety, caring, and understanding. During her first course, Susan told other participants about the abuse, and they responded supportively. This course included slow resistance breathing, brief rapid breathing, and cyclical breathing at varying rates. The first time Susan tried the breath practices she cried uncontrollably. Nevertheless, afterward she felt unusually calm and relaxed. The second time, she actually enjoyed it and wanted to do more. For the next eight months Susan practiced yoga breathing every day and attended group sessions twice a month. She repeated the breathing course. One month later during a group yoga breathing session, she had a healing experience:

"I felt a warm sensation in my uterus and genitals." She reflected, "I knew it was good for me, a healing sensation. And then it felt like an opening-up and I thought that it was just what I needed, that what had happened to me as a child, the molestation, would no longer have such an effect on my life."

Two weeks later, Susan went on her first date. Although she felt some anxiety, she neither panicked nor froze. The relationship ended after three dates, but she promptly started seeing another man, Jason. As their relationship developed, Susan felt ready for her first sexual experience as an adult.

She had read many books about post-traumatic stress disorder and how difficult it can be for abused women to engage in sexual activities. After eight years of therapy, she felt mentally prepared for any reaction that might occur. Would it trigger a flashback? Would she panic or freeze or dissociate? She discussed her concerns with Jason, who was totally supportive. The first time they made love, Susan's sexual response was completely normal. She had no fear, no anxiety, no panic. She enjoyed sex with Jason, and her positive responses continued as they engaged in sex almost every day. Now Susan and Jason are together in her country house, where they plan to live happily ever after.

Although Susan made considerable progress in talk therapy, there were three problems that were not responding: (1) a distorted image of her body as defective; (2) defensive closing off of her genital area; and (3) panic and freeze reactions to men. How did yoga breathing change her body image, genital sensations, and fears of sexual intimacy?

Research on the effects of mind-body practices on trauma formations is preliminary. At this time we have more questions than answers, but we do have some viable theories based on neuroscience and physiology. We know that messages are constantly sent from the body to the brain carrying information about the internal state of the body. This process is called interoception. Much of this sensory information, including pain, pressure, temperature, air hunger, genital sensations, and information about respiration as well as all the internal body organs is carried by the vagus nerves, the main pathways of the parasympathetic nervous system, the calming, healing, recharging part of the nervous system.13 This information goes to a part of the brain called the interoceptive cortex, where it becomes part of the body image and is interconnected with centers of emotional regulation, emotional reactions, decision-making, and behavior.14 The physical sensations, reactions, and emotions associated with sexual abuse are processed in these networks and can become frozen in time, like a fly in amber, unchanged by subsequent experiences, for years. Such locked-in trauma formations are called schemas.15

It can be extremely difficult to access trauma schemas through verbal therapy alone. However, we can log on to the interoceptive network using mind-body practices to send therapeutic messages to penetrate schemas that may be resistant to verbal interventions. The fastest and most powerful way to do this is by changing the patterns of breathing. The pathways between the respiratory system and the brain are very strong and very rapid because breathing is our most vital function. When we change the pattern of the breath, tens of thousands of receptors throughout the lungs and respiratory passages change the messages being sent to the brain.4 So, for example, by deliberately breathing very slowly the body can tell the brain that we are safe and no longer need to worry, be hypervigilant, or react with fear.9 The ideal breath rate for balancing the stress response system and calming the mind is between 3.5 and 6 breaths per minute for most adults.16-19 In Susan's case, yoga breathing began to help her feel calm and relaxed the first day she tried it. However, it took months of daily practice for it to penetrate and ultimately transform the trauma schema to restore a healthy body image with normal genital sensation and emotional reactivity.

SIX LEVELS OF HEALING WITH MIND-BODY PRACTICES

Level 1—Change Starts at the Cellular Level

Changing the mind-set of trauma involves changing the connections among brain cells (neurons) and thereby changing patterns of interaction among neural pathways where trauma memories are stored and PTSD symptoms are generated. Plasticity refers to this complex process of changing how the brain works. There are many ways to induce plasticity. Whenever we learn something new, somewhere in the brain, plasticity is occurring. The challenge in post-traumatic conditions is to access the problem areas, disrupt trauma-related connections between neurons, sprout new connections, and guide the course of reconnection toward healthy transformation.

Among the many elements that can influence this process of change are the following:

1. the intensity of input through the nerve networks and the repetition of input

2. the balance of excitatory and inhibitory (calming) neurotransmitters

3. the frequency, amplitude, and coherence of brain waves

4. the emotional state and the emotional meaning of input from other people and the environment

5. neurohormones such as oxytocin and prolactin—antistress, social bonding hormones that increase feelings of love and connectedness

Mind-body practices can disrupt trauma formations, stimulate neuro-plasticity, and steer the system toward healthy recovery. Yoga breathing and movement stimulate interoceptive input to neural networks. We have already discussed ways that this interoceptive messaging can access and alter trauma formations (schema). We recommend daily practice because the repetition is necessary to bring about changes over time and to maintain improvements. Evidence suggests that yoga can reduce excitatory and increases inhibitory (calming) neurotransmitters toward a healthier, more stable balance.20,21 Studies have shown that slow yoga breathing and resistance breathing can shift brain-wave frequencies toward more synchronous relaxed alpha rhythms associated with states of relaxation. They also increase coherence and synchrony, which further enhance plasticity and learning.22,23

Through yoga, an anxious, fearful, defensive person can become calm, unafraid, more trusting, and open. When in this more receptive state, they are better able to experience positive emotions (their own and those of others), to internalize positive messages, to learn from their therapy, and to incorporate all of this new information into their emotional and psychic reconstruction.

Although there have not yet been any studies of the effects of mind-body practices on levels of the bonding hormone, oxytocin, there is reason to think that it probably plays a role in the increased capacity for feelings of love, bonding, and connectedness many people describe when they engage in yoga. Also, the pathways of the parasympathetic system stimulated by yoga breathing are rich in oxytocin receptors. We hope to see studies measuring oxytocin levels in yoga practitioners someday.

Level 2—Tension Release

Mind-body practices release tension, relieve stress, and induce a calm state. This is crucial for trauma victims, who often hold a lot of tension in their bodies, causing muscle aches, back pain, shallow breathing, and headaches. Being in an acute or chronic state of stress and tension has negative effects on mood, physical health, relationships, and the ability to think clearly and make good decisions.

Level 3—Sense of Safety and Personal Boundaries

Trauma survivors need to lower anxiety and feel secure to engage in therapy and to develop trust in their therapist as well as other people they want to be close to. Yoga breathing, movement, and meditation engender feelings of safety and calmness. Movement practices help develop better awareness of the body and its boundaries. Mastery of physical postures with increasing strength and balance helps to build confidence.

Level 4—Restoring Balance in the Stress Response System

The sympathetic nervous system has both activation components (getting ready to fight or flee) and inhibition components (to hold us back when necessary for survival). Trauma and stress can cause either or both components to malfunction. The use of mind-body practices can strengthen both components and shift them back into proper balance. By correcting imbalances in the sympathetic nervous system as well as between the sympathetic and parasympathetic systems, mind-body practices reduce hyperarousal, hypervigilance, overreactivity, irritability, anger, impulsivity, and inappropriate fight, flight, or freeze reactions. This enables the survivor to respond more appropriately to people and situations based on the here-and-now reality rather than on impressions from the past.

Level 5—Self-Awareness and Reconnection with One's Body

During sexual trauma, victims are helpless, unable to stop the abuse or to run away. They describe feeling like they are going crazy, losing their mind, being destroyed, or exploding. Sometimes the only way out is to disconnect the mind from the body, which is being abused. Once this occurs, the victim may feel permanently disconnected, unable to experience the body as her own. This can lead to neglect of the body, fear of physical experiences, hatred of the body, self-inflicted injuries such as cutting or burning, and abnormal reactions to physical sensations. By focusing attention on the experience of gentle movements and breathing, yoga slowly reintroduces the survivor to her body as a source of comfort, pleasure, strength, and self-efficacy.

MIND-BODY PRACTICES FOR TRAUMA RECOVERY

Hundreds of mind-body practices for health and healing have evolved over the last 8,000 years in countries all over the world.24 Although there is very little research on mind-body practices specifically for sexual trauma, a number of studies show that yoga, qigong, and tai chi can reduce the physical and emotional symptoms of PTSD, which in many ways overlap with symptoms related to sexual assault.7,25-29

We are going to focus on a simple set of practices that are easy to learn, safe for everyone, and that have been shown in clinical research to relieve symptoms related to stress, anxiety, trauma, and depression. In applying these techniques to victims of sexual trauma, the sensitivities of the individual must be anticipated and taken into consideration. Precautions must be taken to protect against overwhelming experiences such as flashbacks. Therapists should be knowledgeable in methods to assist victims who may be triggered into such distressing experiences despite the best precautions during any treatment, whether standard therapies or mind-body practices. While we offer basic practices that anyone can do at home, we recommend working with a certified yoga or qigong teacher who has experience with trauma victims for more advanced work. Establishing a safe environment is essential. The teaching and class atmosphere should be gentle, kind, gradual, supportive, noncompetitive, and nonjudgmental. Attention and awareness should be focused on the practices. The most effective programs include movement, breathing, and meditation. Here is a simple sequence to get you started.

MOVEMENT

Grounding helps restore the sense of being stable, centered, in the here and now. It is widely used at the beginning of yoga practices as well as to help abuse survivors stay in the present when they are being pulled into the past by trauma memories or flashbacks.

Grounding can begin in a comfortable standing position with feet shoulder-width apart. The chin should be slightly down and the knees kept soft. Gently shift your weight from side to side and back and forth to find your center of gravity. Come to rest with weight evenly balanced on both feet.

Become aware of your feet in contact with the floor. Notice how your body feels.

THE FOUR GOLDEN WHEELS BY MASTER ROBERT PENG

This is the first of the Four Golden Wheels of qigong. Letting your arms hang loosely at your sides, start to gently bounce up and down, keeping your feet on the floor and your knees loose. As you bounce, allow your arms to flop like wet noodles and let your head bob. Close your eyes if you are comfortable doing so. Continue gently bouncing for one, two, or three minutes. You may wish to enhance this practice by imagining a waterfall starting at the top of your head and flowing down through your body, flowing in steps with each bounce all the way down and out through the soles of your feet, washing away all negative emotions.

When you stop, notice the change in how you feel. This releases the first level of body tension. If you want to learn more about Four Golden Wheels from a course or videotape, you may visit www.RobertPeng.com.

BREATHING—BREATH AWARENESS, BELLY BREATHING, COHERENT BREATHING

Sit in a very comfortable chair or lie on your back on a bed or the floor with whatever pillows you need, under your legs or head, to feel relaxed. Close your eyes if you are comfortable doing so. Closing your mouth, breathe through your nose only.

Breath awareness. Become aware of your breathing. Feel the rise and fall of your belly and chest, the movement of your ribs. Next focus your attention on the feeling of the air as it moves in and out of your nose. Breathing deeply but without any straining, feel the air move through your nose and down into your lungs, then feel it move out again.

Belly breathing. As you take a deep breath in, relax your belly muscles so that your belly rises with each inhalation. Rather than actively pushing your belly out, just let the breath fill you up, causing it to rise naturally. Then let your belly come down naturally as you breathe out. Repeat this slowly several times. Take these deep belly breaths in and out two more times as you relax the muscles of your face and let your whole body relax.

Coherent Breathing. Focus your attention on the sensation of air moving in and out through your nose and airways to your lungs. If other thoughts enter your mind, just notice them and let them float through. Refocus your attention on the sensations of your breath. All breaths should be comfortable, not forced in any way.

Breathing through your nose with your eyes closed . . .

Taking your time, count slowly and silently in your mind: As you breathe in, count 1 . . . 2 . . .; as you breathe out, count 1 . . . 2 . . . for two breaths. Taking your time, count slowly: As you breathe in, count 1 . . . 2 . . . 3; as you breathe out, count 1 . . . 2 . . . 3 for three breaths.

Taking your time, count slowly: As you breathe in, count 1 . . . 2 . . . 3 . . . 4; as you breathe out, count 1 . . . 2 . . . 3 . . . 4 for four breaths. Taking your time, count a little more slowly: As you breathe in, count 1 . . . 2 . . . 3 . . . 4; as you breathe out, count 1 . . . 2 . . . 3 . . . 4 for four breaths.

Work on this until you are able to breathe at a rate between five and six breaths per minute. This is called Coherent Breathing. The best way to do this is to use the Two Bells chime track on Steven Elliot's Respire-1 CD available at www.coherence.com, or download the chime track onto an MP3 player. Listening to the chime track, just breathe in with one tone and breathe out with the next. You won't have to count and you can relax even more.

Start with five to ten minutes of coherent breathing once or twice a day and gradually increase up to twenty minutes at a time. Once you master Coherent Breathing, you can go right into it without having to slow your breath in stages. Whenever you feel stressed or anxious, use Coherent Breathing to stop worrying and relax. If you have difficulty falling asleep, just get into bed, turn on the chime track, turn out the light, and breathe yourself to sleep.

After two months of practicing with your eyes closed, you may also do Coherent Breathing with your eyes open. Just play the chime recording and breathe along with it as you putter around the house, commute on the train, or take a walk. You can even breathe coherently while working on the computer, doing paperwork, taking tests, or any other anxiety-provoking activity. No one will know how slowly you breathe or how you manage to stay so calm when all around you people are stressing out.

MEDITATION

Meditation allows the effects of movement and breathing to be integrated or stored in the mind. In this way, meditation takes the healing even deeper. This is a simple body-scan meditation. It can be used by itself or as preparation for other meditation practices.

Keeping your eyes closed, relax your eyelids, your eyebrows, and your forehead. Relax your cheeks, jaw, chin, and mouth. Then relax the muscles of your shoulders, arms, and hands. Relax all the muscles of your back, starting at the top of your spine and going all the way down your back. Relax the muscles of your chest, belly, and pelvis. Relax your legs starting at the top and going down to your calves and feet. Relax all the muscles of your body from your head to your feet.

POSITIVE AFFIRMATIONS

Now that you feel relaxed, you may give yourself a positive message, either one of your own or one you have read and found to be especially meaningful for you. Let this positive message sink deep into your mind.

FINISHING

Roll over onto your right side. Lie still, curled up and cozy. Use a blanket if you feel cool. Just rest for a while.

Before you open your eyes, notice how your mind and body are feeling.

Then slowly and gently open your eyes.

For those of you who want to learn more movement and breathing practices, we suggest taking classes such as our Breath~Body~Mind workshops, using our new book and CD set, The Breathing Cure, or finding instructional videotapes. Master Robert Peng offers Elixir Light Qigong classes and his DVDs are available at www.robertpeng.com. Many women enjoy Amy Weintraub's program, LifeForce Yoga. Her courses and DVDs can be found at www.yogafordepression.com. Heather Mason trains yoga therapists in her Yoga for the Mind sequence and teaches trauma-sensitive yoga; see www.yogaforthemind.info. See the resources section at the end of this chapter for information on finding programs and teachers in your area.

YOGA POSTURES FOR EMPOWERMENT AS TAUGHT BY AMY WEINTRAUB

Yoga postures can help develop a sense of empowerment. Here is a sequence of yoga postures that Amy finds helpful in working with sexual abuse survivors30: Five-Pointed Star, Victory Goddess, Victory Goddess with Lotus, and Warrior Pose. Amy uses sounds to enhance the effects of movement. The a sound is pronounced like the a in the word calm. As you make each sound, feel the vibrations resonate within your body, providing more interoceptive stimulation to the healing parts of your nervous system.

Before you begin, think of an image that represents strength to you, perhaps an image from nature. Then choose an intention for your practice this day. For example, your intention could be self-healing or any other goal for your personal development. When repeating or holding poses, do only what is comfortable for you.

Five-Pointed Star

Stand straight with feet about twenty-four inches apart and turned slightly outward. Raise arms to shoulder level, held straight out on each side. The head, hands, and feet create the five points of the star. Bring into your mind an image for strength. With your feet grounded firmly in the earth, radiate strength out through your fingertips and up through the crown of your head. Take five full breaths through the nose, and then hold the last breath with your image for strength in your mind. Using your imagination, move the image for strength from your mind into your heart. From the Five-Pointed Star, move into Victory Goddess.

Victory Goddess

Exhale forcefully while making this sound loudly, "di-ri-hah!" as you bend your knees into a partially squatting position with your tailbone tucked while bending your elbows with arms and hands pointing upward. Inhale through your nose as you rise back up into Five-Pointed Star. Repeat this squatting and rising sequence five to ten times. On your final round rise to Five-Pointed Star and hold the breath as you see your image for strength. Exhale with "di-ri-hah!" moving back into Victory Goddess. Hold the Victory Goddess pose with your body while you hold your image for strength in your mind and heart, and breathe slowly and deliberately for five more breaths. Say to yourself, "I am that." Relax standing for a moment, feeling your feet on the earth.

Victory Goddess with Lotus

Inhale to Five-Pointed Star one more time, holding the breath for five counts, and think of your intention. Exhale into Victory Goddess with Lotus by bringing arms to your sides with elbows bent and hands moving toward the center of your chest. Bringing the base of the palms, the pinkies, and thumbs together near your heart, form a lotus cup. Hold your intention close to your heart and nourish it with this sound softly: "yyyyyam."

Warrior Pose

Raise arms above your head, bringing palms together as you step your left foot forward and bend your front knee, squaring your hips toward the front. Take five deep breaths as you hold the pose. You may wish to repeat the word "rrrrram" to energize your solar plexus, the seat of identity and self-esteem. Repeat on the right side. When you finish, close your eyes and stand straight and tall with your arms at your sides and your palms open and facing forward. Feel your own healing energy vibrating through your arms, your legs, the palms of your hands, awakening your spiritual warrior.

MIND-BODY PROGRAMS FOR MASS DISASTERS, WAR, AND GENOCIDE

During mass disasters such as war and genocide, women and children suffer extreme physical and sexual abuse complicated by witnessing the murder of loved ones, loss of community, displacement into refugee camps or foreign countries, and the stress of an ongoing life of poverty, deprivation, and grief. Sexual abuse may involve permanent internal damage or external mutilation.

After peace is established, some countries, such as Kosovo, have managed to provide large-scale public mental health services that incorporate mind-body programs. Dr. James Gordon and colleagues26 of the Center for Mind-Body Medicine found that mind-body practices significantly reduce symptoms of post-traumatic stress disorder and depression in postwar Kosovo. However, there have been no published studies of mind-body practices that focus specifically on sexual trauma related to genocide. It is extremely difficult to do treatment studies soon after natural or man-made disasters, particularly in remote areas and in countries lacking resources and infrastructure.

In one yoga study for relief of trauma in survivors of the 2004 Southeast Asian tsunami, we (Dr. Brown and Dr. Gerbarg) worked with Teresa Descilo, traumatologist and director of the Trauma Center of Miami. We collaborated with the National Association for Mental Health and Neurosciences of India and the International Association for Human Values.25 Symptoms of PTSD and depression were measured before and after an eight-hour yoga breathing and movement program created by Sri Sri Ravi Shankar. The program included Ocean Breath (Ujjayi), brief rapid breathing (Bhastrika), and cyclical breathing (Sudarshan Kriya). Within one week of doing this program, scores for PTSD fell 60%, while depression scores dropped 90%. The benefits were maintained throughout the six-month follow-up period.

Starting in 2007, working with the nonprofit Serving Those Who Serve (www.stws.org), we have been using a two-day, twelve-hour workshop, called Breath~Body~Mind, to relieve symptoms of anxiety, depression, and PTSD in people affected by the September 11 World Trade Center attacks in New York City. Two open studies in collaboration with Dr. Martin Katzmann and Dr. Monica Vermani found significant reductions in measures of anxiety, worry, depression, and PTSD among those who completed our workshop.31,32,33

Many African nations, ravaged by war, are unable to provide mental health care to vast areas, leaving tens of thousands of survivors without treatment. Moreover, thousands of sex slaves captured during wars are still being held and abused. Among the numerous organizations working with survivors of genocide and sexual abuse in Africa, Global Grassroots and Christian Solidarity International have focused on assisting women survivors. Global Grassroots integrates mind-body practices, consciousness training, and nonprofit start-up skills to help village women become social change leaders within their communities. Christian Solidarity International raises money to purchase freedom for enslaved women and return as many as possible to their homelands.

Gretchen Wallace, president of Global Grassroots, and Ellen Ratner of Talk Radio news service (working with Christian Solidarity International, www.csi-int.org) asked us (Dr. Brown and Dr. Gerbarg) to create a mind-body program that they could implement in disaster areas. We had to take into account the strengths, limitations, and coping methods of each culture. For example, among African survivors, most women cope by not thinking about the past and by suppressing their feelings, because the pain from the past is so overwhelming that it can render them unable to function. Therefore, the program had to be gentle enough to reduce stress without opening the floodgates to painful memories and unbearable emotions. Also, we had observed that rapid or forceful breath practices sometimes trigger panic attacks or flashbacks. Consequently, we only used slow breathing techniques.

Based on our research and experience, we developed the following guidelines for the disaster relief program:

1. portable, inexpensive, requiring no equipment and no electricity

2. easy to teach and learn in one short session (no more than two hours)

3. effective in providing immediate relief the first time it is practiced

4. effective with less than ten minutes of daily practice and increasing benefits the more it is used

5. safe for everyone, causing no adverse physical or emotional reactions regardless of age or health status

6. containing no religious words or elements that could offend or frighten people of different cultures

7. containing no physical movements that could make abuse victims feel unsafe

8. sustainable in the community by training of local leaders

By selecting four simple qigong movements (derived from the Four Golden Wheels of Master Robert Peng) and Coherent Breathing, we created a mind-body intervention that fulfilled our guidelines.

Having taken several of our Breath~Body~Mind courses, Ellen Ratner was able to teach Coherent Breathing to Sudanese survivors of war, abduction, and slavery. She reported that they responded well with rapid relief of stress symptoms. The women continued doing the Coherent Breathing regularly on their own with a village matron keeping time with a chime bowl. A program evaluation of nineteen Sudanese women documented that those who did the Breath~Body~Mind practices for twenty minutes a day five days a week for eighteen weeks had a mean improvement of 71% in PTSD and 66% in mood on test measures.33

Gretchen Wallace taught the qigong and Coherent Breathing to Haitian women two weeks after the January 12, 2010, earthquake. She observed immediate improvements in anxiety and physical discomforts. Women being trained in the Global Grassroots Academy for Conscious Change in Rwanda also responded well. Now Global Grassroots is incorporating these practices into all of their disaster relief and women's empowerment programs.

When Gretchen teaches a group of disaster survivors, she first explains that stress and trauma can cause the symptoms the women are experiencing, such as fear, anxiety, shaking, inability to sleep, fatigue, and physical pains. This explanation provides relief because many survivors mistakenly interpret their symptoms to mean that they are crazy. Naturally, they feel reassured to find out that they are not. Next, she invites them to learn practices to calm the stress reactions and restore balance to their nervous system. She leads them through four qigong movements (Four Golden Wheels)

standing up. Then, the women sit or lie down for breath practices. First they learn to inhale slowly, letting their bellies rise, just as we described above. Then, listening to a small handheld bell, they breathe in with one ring and out with the next. Within ten minutes, most of the women feel relaxed, and some fall asleep. They wake up feeling better and notice that some of their aches and pains are gone. The women can do the practices on their own, but they particularly enjoy meeting to breathe together as a group.

SELF-HEALING THE MIND-BODY WAY

Because breathing is automatic, we tend to take it for granted, not realizing that within our own bodies we have a profound healing potential. Anyone who has suffered abuse or trauma of any kind can use breathing and movement practices to cope with immediate symptoms, to enhance recovery, and to continue to thrive despite the inevitable stresses life brings. We believe that these programs should be an integral part of any therapeutic plan.

Understanding the scientific basis for the effects of mind-body practices and reading about the success stories of other survivors may help to convince our doubting minds that this is something worth trying. We can only give you a small sampling of the many techniques and programs available. The next steps, actually starting some simple practices, and finding a teacher or therapist to help you get the most out of the techniques will make a real difference in your life. We hope that the resources listed below will help you take those steps.

RESOURCES

The Breathing Cure, Richard P. Brown, M.D., and Patricia L. Gerbarg, M.D., Shambhala Publications (in press).

www.haveahealthymind.com. Dr. Patricia Gerbarg and Dr. Richard P. Brown provide information, courses, updates, and a free newsletter on complementary and alternative treatments.

Organizations

The following organizations can provide information on how to find yoga teachers, courses, and resources in your area.

International Association of Yoga Therapists, www.iayt.org International Yoga Teachers' Association, www.iayt.org.au Yoga Alliance, www.yogaalliance.org The Center for Mind-Body Medicine, www.cmbm.org

International Association for Human Values, www.iahv.org Mind and Life Institute, www.mindandlife.org.

Yoga Websites, CDs, and DVDs

Coherent Breathing, www.coherence.com. Offers Respire-1 CD with tracks for pacing at five breaths per minute.

Yoga for Depression, www.yogafordepression.com. Amy Weintraub's Life Force Yogaa site offers videotape programs at all levels, courses, newsletter.

Yoga for the Mind, www.yogaforthemind.info. Heather Mason offers classes, private consultations, a CD set of breathing practices, and a You-Tube video on how to do ocean breath (Ujjayi): http://www.youtube.com/ watch?v=PqR_HSDXuEk.

Elixir Light Yoga, www.robertpeng.com. Master Robert Peng provides qigong teachings, courses, videotapes.

Kripalu Yoga Center, http://www.kripalu.org, yoga courses in Massachusetts

Yoga Journals

International Journal of Yoga Therapy, www.iayt.org/site/publications/ journal.php

The Yoga Journal, www.yogajournal.com Yoga Magazine, www.yogamag.netsubs.shtml

Acknowledgments: The authors wish to thank Amy Weintraub, Gretchen Wallace, Ellen Ratner, Dr. Sharon Sageman, and Master Robert Peng for their support in the preparation of this chapter.

REFERENCES

1. Rauch, S.L., van der Kolk, B.A., Fisler, R.E., Alpert, N.M., & Orr S.P., et. al. (1996). A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery. Archives of General Psychiatry, 53(5), 380-387.

2. Franzblau, D.H., Smith, M., Echevarria, S., & VanCantford, T.E. (2006). Take a breath, break the silence: The effects of yogic breathing and testimony about battering on feelings of self-efficacy in battered women. International Journal of Yoga Therapy. 16, 49-57.

3. Sageman, S. (2004). Breaking through the despair: Spiritually oriented group therapy as a means of healing women with severe mental illness. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 32(1), 125-141.

4. Brown, R.P., & Gerbarg, P.L. (2005). Sudarshan Kriya yoga breathing in the treatment of stress, anxiety, and depression part I: Neurophysiological model. Journal of Alternative and Complementary and Medicine, 11, 189-201.

5. Becker, I. (2000). Uses of yoga in psychiatry and medicine. In P.R. Muskin (Ed.), Complementary and alternative medicine and psychiatry (pp. 107-145). Washington, D.C.: American Psychiatric Press, Inc.

6. Benson, H. (1996). Timeless healing: The power and biology of belief (pp. 222-234). New York: Scribner.

7. Brown, R.P., & Gerbarg, P.L. (2005). Sudarshan Kriya yoga breathing in the treatment of stress, anxiety, and depression part I: Neurophysiological model. Journal of Alternative and Complementary and Medicine, 11, 711-717.

8. Brown, R.P., & Gerbarg, P.L. (2009). Yoga breathing, meditation, and longevity. In C. Bushness, E. Olivo & N. Theise (EdsJ, Longevity, Regeneration, and optimal health, integrating Eastern and Western perspectives (1172, pp. 54-62). Annals of the New York Academy of Sciences.

9. Gerbarg, P.L. (2008). Yoga and neuro-psychoanalysis. In F.S. Anderson (Ed.), Bodies in treatment: The unspoken dimension (pp. 127-150). Hillsdale, NJ: The Analytic Press, Inc.

10. Katzman, M., Vermani, M., & Gerbarg, P.L., et al. (2009). Art of living course (SKY) as adjunctive treatment in GAD. Albuquerque, NM: Anxiety Disorders Association of America.

11. Shapiro, D., Cook, I.A., & Davydov, D.M., et al. (2007). Yoga as a complementary treatment of depression: Effects of traits and moods on treatment outcome. http://ecam.oxfordjournals.org//cgi/reprint/nell14v1

12. van der Kolk, B.A. (2006). Evidence based clinical implications of neuroscience research in PTSD. Annals of the New York Academy of Sciences. 1071, 277-293.

13. Porges, S.W. (2001). The polyvagal theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42(2), 123-146.

14. Craig, A.D. (2003). Interoception: The sense of the physiological condition of the body. Current Opinion Neurobiology, 13(4), 500-505.

15. Bucci, W. (2001). Pathways of emotional communication. Psychoanalytic Inquiry, 20, 40-70.

16. Bernardi, L., Porta, C., Gabutti, A., Spicuzza, L., & Sleight, P. (2001). Modulatory effects of respiration. Autonomic Neuroscience, 90(1-2), 47-56.

17. Brown, R.P., Gerbarg, P.L., & Muskin, P.R. (2009). How to use herbs, nutrients, and yoga in mental health care (pp. 71-139). New York: W.W. Norton.

18. Karavidas, M.K., Lehrer, P.M., Vaschillo, E., Vaschillo, B., & Marin, H., et. al. (2007). Preliminary results of an open label study of heart rate variability biofeedback for the treatment of major depression. Applied Psychophysiology and Biofeedback, 32(1). 19-30.

19. Vascillo, E.G., Vascillo, B., & Lehrer, P.M. (2006). Characteristics of resonance in heart rate variability stimulated by biofeedback. Applied Psychophysiology and Biofeedback, 31(2), 129-194.

20. Streeter, C.C., Jensen, J.E., Perlmutter, R.M., Cabral, H.J., & Tian, H., et al. (2007). Yoga Asana sessions increase brain GABA levels: A pilot study. Journal of Alternative and Complementary and Medicine, 13(4), 419-426.

21. Streeter, C.C., Whitfield, T.H., Owen, L., Rein, T., & Karri, S.K., et al. (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA Levels: A randomized controlled MRS study. Journal of Alternative and Complementary and Medicine, 16(11), 1145-1152.

22. Bhatia, M.A., Kumar, N., Kumar, R.M., (2003). Pandy Kochupillai V. electrophysiologic evaluation of Sudarshan Kriya: An EEG, BAER, P300 study. Indian Journal of Physiology and Pharmacolpgy, 47, 157-163.

23. Larsen, S., Yee, W., Gerbarg, P.L., Brown, R.P., Gunkelman, J., & Sherlin, L. (2006). Neurophysiological markers of Sudarshan Kriya Yoga practices: A pilot study (pp. 36-48). Proceedings World Conference Expanding Paradigms: Science, Consciousness and Spirituality. 24-25 February 2006. New Delhi, India, All India Institute of Medical Sciences.

24. Feuerstein, G. (1998). The yoga tradition: Its history, literature, philosophy, and practice. Prescott, AZ: Hohm Press.

25. Descilo, T., Vedamurtachar, A., Gerbarg, P.L,, Nagaraja, D., & Gangadhar, B.N.G. (2010). Effects of a yoga-breath intervention alone and in combination with an exposure therapy for PTSD and depression in survivors of the 2004 Southeast Asia tsunami. Acta Psychiatrica Scandcandinavica, 121 (4), 289-300.

26. Gordon. J.S., Staples, J.K., Blyta, A., Bytyqi, M., & Wilson, A.T. (2008). Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: A randomized controlled trial. Journal of Clinical Psychiatry, 69(9), 1469-1476.

27. Grodin, M.A., Piwowarczyk, L., Fulker, D., Bazazi, A.R., & Saper, R.B. (2008). Treating survivors of torture and refugee trauma: A preliminary case series using Qigong and T'ai Chi (pp. 801-106). Journal of Alternative and Complementary and Medicine, 14(7).

28. Telles, S., Naveen, K.V., & Dash, M. (2007) Yoga reduces symptoms of distress in Tsunami survivors in Andaman Islands. Evidence Based Complementary and Alternative Medicine, 4, 503-509.

29. Telles, S., Singh, N., Joshi, M., & Balkrishna, A. (2010). Post-traumatic stress symptoms and heart rate variability in Bihar flood survivors following yoga: A randomized controlled study. BioMed Central Psychiatry, 10, 18-28.

30. Weintraub, A. (2004). Yoga for depression. New York: Broadway Books of Random House, Inc.

31. Brown, R.P., Gerbarg, P.L., Vermani, M., & Katzman. (2010). First trial of breathing, movement, and meditation PTSD, depression, and anxiety related to September 11th New York City World Trade Center Attacks. American Psychiatric Association, New Orleans, LA, May 22, 2010.

32. Brown, R.P., Gerbarg, P.L., Vermani, M., & Katzman. (2010). Second trial of breathing, movement, and meditation PTSD, depression, and anxiety related to September 11th New York City World Trade Center Attacks. American Psychiatric Association, New Orleans, LA, May 22, 2010.

33. Gerbarg, P.L., & Wallace, G. (in press). Mass disasters and mind-body solutions. International Journal of Yoga Therapy.

Crystal Healing

Crystal Healing

Crystal Healing And The Power It Gives You. Learn How Crystal Healing Can Help You. Crystal therapy or crystal healing is a sort of vibrational medicine. Crystal therapy necessitates the application of crystals or gemstones to help healing.

Get My Free Ebook


Post a comment