Dr. Bessel van der Kolk is considered one of  the world’s leading authorities on Post-Traumatic Stress Disorder (PTSD). He has pioneered the use of Yoga as a therapy that is helping these individuals to work through their PTSD and regain a sense of mastery that has been absent since the trauma occurred. In this interview he discusses mind-body connections in trauma, how Yoga works and precautions for teaching trauma-sensitive Yoga students.

Integral Yoga Magazine (IYM): How did you get interested in Yoga for the treatment of PTSD?

Bessel van der Kolk (BvdK): I began my own practice six years ago. I was looking for a way for people to regulate the core arousal system in the brain and feel safe inside their bodies. My interest came from doing research that discovered how trauma affects the brain. I was looking for a way people could befriend their bodies and feel safe inside their own skins. Yoga turned out to be a way to get people to safely feel their physical sensations and to develop a quiet practice of stillness.

Lots of Yoga sites claimed that Yoga could change basic brain functions, but that was based on intuition, not scientific investigation. So  I decided to see if  Yoga can  positively affect the core regulatory mechanism in the brain. As we developed our Yoga program it turned  that Yoga is great for most people, but some trauma-sensitive people can feel frightfully unsafe experiencing the sensations that are evoked by certain asanas.  What most people do not realize is that trauma is not the story of something awful that happened in the past, but the residue of imprints left behind in people’s sensory and hormonal systems. Traumatized people often are  terrified of the sensations in their own bodies. Most trauma-sensitive people need some form of body-oriented psychotherapy or bodywork like Tai Chi, Rolfing or craniosacral therapy in order to regain a sense of safety in their bodies.

IYM: How does exposure to extreme stress affect brain function?

BvdK: Neuroimaging studies of human beings in highly emotional states reveal that intense emotions, such as anger, fear or sadness, cause increased activity in brain regions related to fear and self-preservation and reduced activity in the brain regions related to the ability to feel fully present.

People with PTSD lose their way in the world. Their bodies continue to live in an internal environment of the trauma. We all are biologically and neurologically programmed to deal with emergencies, but time stops in people who suffer from PTSD. That makes it hard to take pleasure in the present because the body keeps replaying the past. If you practice Yoga and can develop a body that is strong and feels comfortable, this can contribute substantially to help you to come into the here and now rather than staying stuck in the past.

IYM: What is the main challenge for people who are trauma sensitive?

BvdK: The challenge is to learn how to tolerate feelings and sensations by increasing the capacity for interoception or sitting with yourself, noticing what’s going on inside. This is also the basic principle of meditation. They need to learn how to modulate arousal. Trauma-sensitive people have their sense of time thrown off. They think something will last forever. Their challenge is to learn how to notice what is happening and how things can and will shift, rather than jumping up and running away or turning to alcohol or drugs to self-medicate.

IYM: You have said that people with PTSD, who have chronically overwhelming emotions, lose their capacity to use emotions as guides for effective action.

BvdK: The function of emotion is e-motion, to engage in action. If you are afraid, you want to move away from the object of fear. If you become angry, that emotion makes you feel as if you want to engage or get physical with whomever is making you angry. If you love someone, naturally you want to make some movement toward that person. That is the purpose of emotion—to propel us toward action. When you are traumatized your motion is paralyzed. A victim of violence—as in the case of a rape victim for example— almost invariably has been trapped, pinned down or unable to move. What happens later is that, if there is a perceived threat, the body reacts as if it has to move but it once again feels helpless and paralyzed, prevented from being able to act effectively. All the chemicals are released to engage in action but the body doesn’t know how to move. Their challenge is that after confrontation with physical helplessness, it is essential to engage in taking effective action.