"I was in triangle pose and experiencing a lot of sensation in my right hip," recalls yoga therapist Michael Lee. "I would have quit, but my yoga partner placed his hand on my chest and said to breathe. I began to shake and I started to get flashbacks of being eight years old, on the playground where I was beat up."
Some psychologists and yoga teachers are concerned that innovators like Lee, founder of Phoenix Rising Yoga Therapy, may be producing undertrained therapists blithely chirping "the body has its own wisdom" while encouraging vulnerable clients to "open up." Especially at risk, they argue, are the people who may be most drawn to yoga therapy, like sufferers of posttraumatic stress disorder (PTSD).
In India hatha yoga is practiced as a system of aligning oneself psychologically and spiritually not just physically. Here, in contrast, yoga has been practiced mainly as physical exercise since its introduction a century ago. The growing dissatisfaction with traditional psychotherapy, however, has prompted American yogis to explore yoga's psychological power. Yoga-based therapies are proliferating, the most widespread being Lee's, created in 1987. Lee, whose company has trained roughly 800 yoga therapists, says, "The body has a knack of letting you into little pieces of yourself that years of talk therapy wouldn't get you into."
Because they express psychological distress with their bodies, trauma survivors "are strongly drawn to body-based modalities like yoga therapy," says Dr. Susan Shapiro, who lectures on PTSD at Manhattan Institute for Psychoanalysis.
Trauma is stored in the brain's primitive limbic system, which processes feelings and sensory input but not language. The Vietnam vet startled by a lawn mower and the woman who retches when she smells the cologne worn by her childhood molester are being flooded with sensations triggered by traumatic memories stored in their limbic systems. The veteran may not realize his heart is pounding because the mower sounds like a machine gun; the woman may not even remember being sexually abused. During the original traumas they dissociated.
Dissociation protects us from an overwhelming experience of pain or terror. It's technically defined as the separation of one part of memory from another. As psychologists Jean L. Yates and William Nasby explain, "Dissociation is not forgetting in forgetting, something is lost to a memory system through decay, whereas in dissociation the item is encoded but cannot be retrieved."
Hypnosis can override the code, according to Yates and Nasby. "[Hypnotized] patients seem to re-create the condition of memory at the time of encoding . . . a critical mass of excitatory linkages is made and . . . the patient's memory is flooded with the previously unavailable memories."
That's what happened to Lee, only he wasn't hypnotized he was practicing yoga. "We're all walking storehouses of information," he believes. To access that storehouse, yoga therapy practitioners at Phoenix use supported yoga postures to bring clients to "the edge where you know something is happening, but the sensation isn't so overwhelming that you want to run from it. We work there with focus and breath and see what comes up." Lee tells his staff "not to be alarmed if a client has a flashback. The body is a safe instrument to work with. It's not going to let you in too deep."
Shapiro disagrees. "It's not enough to say 'The body won't let you in too deep.' " In downward-dog, for example, the anus is exposed, which might bring up psychological trouble that a yoga therapist may not be prepared to handle. "Many have not been adequately trained in transference," Shapiro continues, "and the feelings between them and clients can become exceedingly intense."
Having used both yoga and psychotherapy to recover from PTSD induced by childhood sexual abuse, I thought a therapy that combined them sounded promising, despite Shapiro's reservations. When Lee offered me a session with yoga therapist Kathy Newton, I accepted.
First, Newton picked up my right leg by the heel. She slowly moved it toward my head in a gentle stretch, asking me to tell her when to stop. Next, she carried the leg to the left, stretching my right hip.
When she carried the leg to the right, it reminded me of my abuser pulling my legs apart. Newton noticed my quickening breath and asked whether I could stay with it. I tried but felt panicky until she put my leg down. When she began the same procedure with my left leg, I cut short the time spent with my legs apart. We concluded by talking about images and feelings the stretches had evoked.
Frankly, I found having my legs held apart closer to what Shapiro calls "retraumatization." According to Shapiro, "Many survivors will use whatever therapy they're doing to retraumatize themselves." Dr. Steven Knoblauch, who treats adults with PTSD, agrees, adding, "Survivors can be addicted to the calm after the storm of a violating or potentially violating situation."
When I raised these issues, Lee responded: "Phoenix Rising Yoga Therapy is not a substitute for psychotherapy. When evidence arises in a session that someone has suffered a severe trauma, the therapist must recognize his or her limitations and work with a qualified psychotherapist.
"Look, if the F.A.A. had been around when the Wright brothers were flying, they would've been grounded," Lee added. "The best we can do is learn from our colleagues and not duck when someone says, 'Hey, what's going on here?' "
What's going on here is what Sharon Gannon and David Life, directors of Jivamukti Yoga Center, wondered when a Phoenix therapist demonstrated there, with Lee observing.
"The student who volunteered had some deep issues," Gannon recalls. "In front of all these people she had a breakdown, and the person handling the workshop was fairly insensitive."
"Gave her a pat on the back and sent her into the audience," Life interjects.
"It was like, 'See, Phoenix Rising works, it gets people to open up and cry,' " Gannon says. "But all kinds of emotions can surface during asana practice. That's why it's so important to teach yoga along with sound advice based on Patanjali's Yoga Sutras, which is really a book of psychology."
Patanjali wrote the 196 Sanskrit sayings, or sutras, that form yoga's spiritual foundation several thousand years ago. "Unfortunately, most yoga teachers have never even opened the Yoga Sutras," Gannon sighs. "Yoga is a buzzword these days, so is therapy. Put the two together and, wow, you have a career. But most yoga teachers are not qualified to be teachers, much less therapists."
"I would recommend finding a good psychotherapist who likes yoga," adds Life. "Then, do yoga and go to the therapist. Don't try to find it all in one package."
Shapiro encourages PTSD patients to take yoga, although "it often takes a few years [of psychotherapy] before someone is ready to take a yoga class.
"Yoga is a great path for reclaiming your body," Shapiro adds. "You don't need anybody touching you. You don't have to trust someone else, so you can learn to trust yourself with your body. Also, survivors had to burst into another realm to survive. But they don't have a framework for that experience until they do some spiritual work. Yoga can provide that framework.'
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