Trauma Informed Yoga Resource Guide

Experiencing a trauma can change the way a person perceives the world.

Whether trauma is caused by a single event such as a natural disaster, or by repeated or prolonged exposure to abuse, an individual’s thoughts, feelings, and behaviours are filtered through experience and perspective.

Increasing our awareness about trauma in general and the specific trauma a person has experienced and the impact it has on the individual can help us when clients or students become anxious, disruptive or unresponsive.

As we deepen our understanding of our clients’ experiences, our relationships can strengthen, and the potential rapport that develops can make allow our interventions to be more supportive.

When we have the trust of a client or student who exhibits challenging behaviour, we have tools to reach them, to communicate with them, and help them to calmly feel safe and prepared to use the technology of yoga in a loving and supportive environment.

This guide Shares Ideas about:

• Deeper awareness about key trauma- related concepts.

• A greater understanding of trauma’s effects on behavior.

• 7 tips for preventing re-traumatization.

• A helpful De-Escalation Preferences Form.

• Resources to explore the subject further with our community.

Defining Terms

TRAUMA

An event or series of events, an experience or prolonged experiences, and/or a threat or perceived threats to a person’s well-being. The individual’s daily coping mechanisms can be negatively impacted by trauma. Subsequent behavioral responses to daily life may be filtered through this perspective.

TRAUMA-INFORMED CARE

A framework of thinking and interventions that are directed by a thorough understanding of the profound neurological, biological, psychological, and social effects trauma has on an individual—recognizing that person’s constant interdependent needs for safety, connections, and ways to manage emotions/impulses.

TRIGGERS

Signals that act as signs of possible danger, based on historical traumatic experiences and which lead to a set of emotional, physiological, and behavioral responses that arise in the service of survival and safety (e.g., sights, sounds, smells, touch).

Triggers are all about perceptions experienced as reality. The mind/body connection sets in motion a fight, flight, or freeze response. A triggered individual may experience fear, panic, upset, and agitation.

Trauma Types
There are three main classifications of trauma.

Acute trauma - results from exposure to a single overwhelming event.

• Examples: Rape, death of a loved one, natural disaster.

• Characteristics: Detailed memories, omens, hyper-vigilance, exaggerated startle response, misperceptions or overreactions.

Complex trauma - results from repeated/extended exposure to traumatizing situations over a long period of time.

• Examples: Prolonged exposure to violence or bullying, profound neglect, series of home removals, partner violence.

• Characteristics: Denial and psychological numbing, dissociation, rage, social withdrawal, sense of foreshortened future.

Crossover trauma - results from a single traumatic event that is devastating enough to have long-lasting effects.

• Examples: Mass casualty school shooting, car accident with fatalities involved, refugee dislocation.

• Characteristics: Perpetual mourning or depression, chronic pain, concentration problems, sleep disturbances, irritability.

Vicarious/Secondary Trauma and Compassion Fatigue

Also known as compassion fatigue, vicarious/secondary trauma is a process through which one’s own experience becomes transformed through engagement with an individual’s trauma.

That is, trauma may not only impact the individual who experienced it. It can also impact those around them, including you as the yoga teacher.

Signs of Compassion Fatigue:

• Reduced sense of efficacy. 
• Concentration and focus problems. 
• Apathy and emotional numbness. 
• Isolation and withdrawal.
• Exhaustion.
• Jaded, bitter pessimism.
• Secretive addictions and self-medicating.

The Effects of Trauma on Behavior

An example: You approach a client to join the group in an icebreaker to welcome someone new. It appears your client is finishing up an earlier task. You ask, “Want to play?” while touching their shoulder lightly. The person turns suddenly and strikes out at you, screaming, “Get away from me! Don’t touch me!”

Trauma Informed Approach …

Always ask permission before touching anyone. We never know what another persons experience is and it is best to always ask if it ok to put a hand on a shoulder and definitely not from behind. Take the time to walk around the client and make contact verbally, ideally, using their name and or a welcoming gesture to invite them into your conversation or activity.

How would you look at this through a trauma-informed lens?

Think about:

• What type of trauma could be at play here?

• What are some possible triggers? They could be obvious or subtle.

• How could you respond in a trauma-informed way?

7 Tips for Preventing Re-Traumatization

1. We all have some sort of trauma, determine best practices and use them in all classes and with all clients.

Collect data and screen for trauma histories. Use the De-Escalation Preferences Form below.

2. Grow your skill of attunement.

Listen to the verbal and non-verbal cues of clients, other teachers and team members. Look for opportunities to hold space and provide a safe container for the yoga community you are hosting or participating in.

3. Look for the causes of behaviours.

Seek to understand the function of behaviours and what the behaviours are communicating. What we might view as a frustrating behaviour may actually be a coping mechanism attempt. If our response is not trauma-informed, it cause the individual to feel less safe and more disconnected. Remember that we do not need to know what caused the trauma to respect the individual and create a safe space for all around those behaviours.

4. Use person-centered, strength-based thinking and language.

Shift from a deficit-based mindset to a strength-based mindset. Instead of looking at how a person is “a victim” or “damaged,” we can view them as a survivor. Focus on what they can do, and not on what they cannot do.

5. Provide consistency, predictability, and choice-making opportunities.

Meet the person where they are, in a way they understand. Consistency and predictability provide feelings of safety for the individual, helping to reduce anxiety. And by providing choice-making opportunities, we allow that person to have control. All of this can go a long way to empower the person.

6. Always weigh the physiological, psychological, and social risks of any physical interventions.

Be sure to choose the least-restrictive option possible in every situation. If a student is behaving inappropriately in a yoga class, take them aside and have a talk about what the rules are in the studio environment and how we are respecting each other when we comply with those rules/boundaries.

7. Debrief.

Prioritize debriefing after any crisis. This will help us to find patterns and triggers—and prevent crises from reoccurring. It will also help us help the person foster resilience and develop successful coping skills.

De-Escalation Preferences Form (example) feel free to copy and modify for your purposes.

This form is a guide to help you gather information and develop personalized de-escalation strategies. Person-centered, trauma-informed de-escalation strategies are powerful prevention tools to help you avert difficult behaviors, and avoid restraint and seclusion. Use this form to develop strategies that are unique to your environment and to the individuals in your care. After clinical review, incorporate the following information into a client’s behaviour support or treatment plan. You can add to or take away any elements that make this form right for your client base and tools available.

Name: _______________________________ Preferred Pronouns: ________ Date:______________________

1. It’s helpful for us to be aware of the things that can help you feel better when you’re having a hard time. Have any of the following ever worked for you? We may not be able to offer all these alternatives, but I’d like us to work together to figure out how we can best help you.

___Playing a computer game.
___Using ice on your body.
___Breathing exercises.
___Putting your hands under running water.
___Going for a walk with the yoga therapist or teacher.
___Lying down with a cold facecloth.
___Wrapping up in a blanket.
___Using a weighted vest or sand bag.
___Voluntary time out in a quiet space.
___Voluntary time out (any where specific?):
___Other:
___Listening to music.
___Reading a newspaper/book.
___Sitting by the nurses’station/principal’s office/lobby, etc.
___Using a cell phone.
___Talking with a peer.
___Walking alone.
___Talking with staff.
___Calling a friend.
___Having your hand held.
___Calling your therapist.
___Getting a hug.
___Pounding some clay.
___Punching a pillow.
___Physical exercise - yoga asana.
___Writing in your diary/journal.

2. Is there a person who’s been helpful to you when you’ve been upset?

___Yes ___No
If you are not able to give us information, do we have your permission to call and speak to:
Name: ________________________________ Phone: ______________________________ ___Yes ___No

If you agree that we can call to get information, sign below:
Signature: ____________________________________Date: __________________________________
Witness: _____________________________________ Date: __________________________________

3. What are some of the things that make it more difficult for you when you’re already upset? Are there particular “triggers” that you know will cause you to escalate?

___Being touched.
___Being isolated.
___Door open.
___People in uniform. 
___Loud noise.
___Yelling.
___A particular time of day(when?): __________________________________________________________ 
___A time of the year(when?):________________________________________________________________
___Specific scents (please explain):___________________________________________________________
___Not having control/input (please explain):___________________________________________________
___Others (please list ):______________________________________________________________________

___________________________________________________________________________________________

4. Have you ever been restrained?

___Yes ___No
When:
Where:
Please describe what happened:

5. Do you have a preference regarding the gender of staff assigned to respond during a crisis?

___Female ___Male
___No preference

6. Is there anything that would assist you in feeling safe here? Please describe:
___________________________________________________________________________

___________________________________________________________________________

Resources:

Books:
The Comfort Garden: Tales From the Trauma Unit
Laurie Barkin, RN, MS. A personal account of working as a psychiatric nurse at San Francisco General Hospital.

Helping Traumatized Children Learn Volumes I and II
Landmark publications from the Massachusetts Advocates for Children’s Trauma and Learning Policy Initiative.

Managing Change With Personal Resilience
Mark Kelly, Linda Hoopes, and Daryl Conner. Outlines 21 keys to being resilient in turbulent organizations.

Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience Through Attachment, Self- Regulation, and Competency
Margaret E. Blaustein and Kristine M. Kinniburgh. Provides a flexible framework for working with kids and their caregivers.

Websites and Articles:
3 Keys to Help Staff Cope with Secondary Trauma
Hearing the shocking stories of our clients can have a devastating effect. This article offers antidotes.

12 Ways to Help a Developmentally Traumatized Child
When a kid with trauma explodes like the Tasmanian Devil, here’s how to get them back on track.

CDC’s Adverse Childhood Experiences (ACEs) Study
Info on the landmark study that measures 10 types of childhood traumas and their effects on health.

ChildTrauma Academy
Features Dr. Bruce Perry’s books, resources, and training offerings.

Compassion Fatigue: Could It Be Compromising Your Professionalism?
For those who excel at taking care of others, but put themselves last on the priority list.

From Complex Trauma to Triumph: How a Woman With DD Makes It on Her Own
What this woman with developmental disabilities accomplished is incredible, especially in light of her trauma.

How to Help People Handle Trauma
Strategies for attuning your own emotions can help you care for people who carry the weight of trauma.

How Schools Can Help Students Recover From Traumatic Experiences
A helpful toolkit from the Rand Corporation for supporting long-term recovery.

How Therapeutic Writing Can Help Crisis Workers
One night, unable to sleep, a psych nurse found catharsis from the intensity of her patients’ tragedies.

Incorporating Trauma-Sensitive Practices
Tools for schools from the Wisconsin Department of Public Instruction.

Is Trauma-Informed Care Just Another Buzzword?
A movie about a doctor in 1980s East Germany shows how important trauma-informed care is.

Life, Unrestrained
An informative article about professor Elyn Saks’ battle with schizophrenia and the trauma of being restrained.

National Institute for Trauma and Loss in Children
Resources and training from TLC, the National Institute for Trauma and Loss in Children.

National Center for Trauma-Informed Care and Alternatives to Seclusion and Restraint
Offers resources to help health care workers develop trauma- informed practices.

Personal Resilience: How to Be Resilient When You’re a Caregiver
Dr. Linda Hoopes of Resilience Alliance on how to flex your seven resilience muscles.

Resources for School Personnel
Resources from the National Child Traumatic Stress Network. Take special note of the Child Trauma Toolkit and the Psychological First Aid manual.

Supporting Children and Families Under Stress: Resilient and Trauma-Informed Schools
A slide presentation from Audra Langley, Ph.D., of the UCLA Semel Institute for Neuroscience and Human Behavior.

There’s No Such Thing as a Bad Kid in These Schools
A great article on what makes elementary schools in Spokane, WA trauma-informed.

This High School Is Trauma-Informed, and Suspensions Dropped 85%
An account of how this school lowered suspensions, expulsions, and written referrals.

Trauma Center
Features the work of Dr. Bessel van der Kolk at the Justice Resource Institute.

Unrestrained, Episode 20 With Guest Laurie Barkin
Podcast with nurse Laurie Barkin, who worked in psychiatry for 22 years and suffered secondary trauma.

please feel free to suggest edits or additions to this list