Trauma-informed yoga: healing veterans from the inside out | va greater los angeles health care | veterans affairs

Army Veteran Sarah* sits in a restorative yoga position with her head down on a pillow stretching out her back and elongating her neck. She breathes softly in and out as the yoga instructor

leads her through breathwork exercises. She slowly raises her head off the pillow, a wide smile stretches across her face as she appears relaxed and at peace. This online yoga session looks

and feels different than the typical power or hot yoga, for this is trauma-informed yoga designed specifically for Veterans who have experienced a terrible event. Sarah suffers from Military

Sexual Trauma (MST) and is a victim of domestic violence. National data from VA’s screening program, in which all Veterans receiving VA health care are surveyed, reveal that about 1 in 3

women and 1 in 50 men reported experiencing MST. MST is the term used by VA to refer to incidents of sexual assault or sexual harassment experienced during military service. VA encourages

everyone to learn about MST and its effects, and to explore opportunities to support the recovery of MST survivors. Fortunately, VA has services to support Veterans with MST recovery, one of

them harnessing the healing power of mindfulness that comes with practicing yoga. “The yoga group therapy session and the community around it helped me feel not so alone,” Sarah said.

Trauma-informed yoga is an approach that requires a safe and supportive environment. It recognizes that trauma can have profound effects on both the mind and body, and traditional yoga

classes may not always be suitable or accessible for individuals with trauma histories. The key principles of trauma-informed yoga include safety, choice, mindfulness, collaboration, sensory

awareness, and trauma-informed invitational language. The Trauma-Informed Mindful Movement for Women and Gender Diverse Veterans with MST program is a closed program offered by the VA

Greater Los Angeles Healthcare System. It lasts eight weeks (two hours per week) and is currently virtual, enabling more Veterans to participate. Given that most VA yoga classes are male

dominated, this program was developed specifically for women and gender-diverse Veterans who may not feel comfortable sharing their stories with men in the room. Sarah enjoys hearing other

women Veterans warmly share stories about their children, bodies, and struggles. She said the experience feels refreshing and uplifting. Some Veterans drop out of traditional therapy

treatment programs because they can feel burdensome and emotionally taxing. Sarah started West LA VA’s trauma-informed yoga program and Post Traumatic Stress Disorder (PTSD) group therapy

the same week. She chose not to return to the PTSD group because it just did not resonate with her. “The yoga was worth sticking it out for the next week...and the next week,” Sarah said.

Not only did Sarah complete the program once, but she also enrolled for another eight-week course. “I actively wanted to try the yoga program again to see how I’ve changed or how the program

has changed,” she said. Engaging in yoga classes can foster a supportive and healing atmosphere within a group setting and connect people with a supportive community, according to an

article on the subject from John Hopkins University. Sarah’s experience with trauma-informed yoga matches the scientific research. Trauma-informed yoga has been an effective treatment for

PTSD “that yields symptom improvement more quickly, has higher retention than cognitive processing therapy, and has a sustained effect,” according to a government clinical trial from March

2021. It took Sarah time to get comfortable with the yoga classes. Her history of domestic violence and MST made her a bit judgmental of the yoga process, but over time she loosened up and

felt more at peace as the process became familiar. “It is helpful for students to repeat the program because they know what to expect and can engage more effectively,” said Elika Razmjou,

clinical health psychologist at West LA VA and co-facilitator of the MST yoga program. Some themes include visceral bodily awareness, easy stretches to heal the body, and discussing the

impact of trauma on relationships. Staff member, co-facilitator, and therapeutic yoga instructor Jeanne Ortiz said she went from being “a grumpy New Yorker to a chill LA person,” after doing

a combination of meditation, yoga, and breathwork. “I was stressed out with two kids and grumpy in the morning, but meditation changed me. My mood shifted and I started rubbing my kid’s

backs gently in the morning,” Ortiz said. “The changes are subtle over time, but mindful meditation with body movement transforms you.” Ortiz came to yoga in the mid ‘90s because she had

back issues. “I have more sympathy and empathy for Veterans because of what I went through,” Ortiz said. The principle of mindfulness is about engaging the parasympathetic nervous systems

and down regulating. This is often done through breathing techniques such as mindfulness of breath, diaphragmatic breathing, extended exhale, equal breathing, alternate nostril breathing,

and affectionate breathing. “Many folks who have experienced trauma experience activation of their fight or flight system so the combination of breathing, stretching, and relaxation is

healing to the body,” Razmjou said. Students can take a break during the class or opt out of a certain exercise if it does not feel comfortable for them. Ortiz and Razmjou also provide

variations of the exercises, so no matter their physical ability the Veteran can participate. This program focuses on slow, restorative body movements so Veterans can reconnect to their body

in gentle ways. Trauma-informed yoga gives Veterans the opportunity to gain a sense of interoception, the perception of sensations from inside the body, like being aware of your own

heartbeat and your own breathing. “We try to be very intentional about inviting them into any part of the practice by using soft and invitational language. Veterans have a chance to see and

feel what each position feels like in the body,” Razmjou said. Students shared with Razmjou that it has been a meaningful experience and they’re grateful to learn they have tools within

their bodies they can use to help them heal. Each yoga session ends with meditation, a poem reading for reflection and an opportunity to reflect on what the practice was like for the group.

Students are welcome to scan their body allowing for feeling tones of softening, soothing, and allowing. This ends the class on a relaxing note and allows for the women Veterans to journal

with ease. The goal of trauma-informed yoga is to maximize the health, social functioning, and quality of life of Veterans who have experienced MST, and it continues to prove to do that. In

general, yoga supports stress management, mental health, mindfulness, healthy eating, weight loss, deep breathing, blood circulation, and quality sleep. After getting into a routine of

practicing yoga, people often feel an increased mental and physical energy, a boost in alertness and enthusiasm, and fewer negative feelings. “I had a student run to me exclaiming, ‘I can

reach to my top shelf in the kitchen’,” Ortiz said. She had another student come to her elated that yoga helped her be able to sit on the floor and play with her grandchildren without pain.

As you can see, the benefits of yoga are infinite and ever flowing. Namaste! To partake in the Trauma-Informed Mindful Movement for Women and Gender Diverse Veterans with MST program, women

Veterans must be referred by their mental health provider and cleared by their primary care practitioner. This program is specifically open to women Veterans and gender diverse Veterans

(including transgender and non-binary Veterans). *Throughout this article, the alias Sarah is employed to maintain the privacy of the individual.