Justice Lauren, Brems Christiane, Ehlers Karrie
1. Pacific University, School of Graduate Psychology, Hillsboro, Ore.
Int J Yoga Therap. 2018 Nov;28(1):39-50. doi: 10.17761/2018-00017R2. Epub 2018 Feb 12.
Individuals who suffer from trauma-related symptoms are a unique population that could benefit from the mind-body practice of yoga-or have their symptoms reactivated by it, depending on the type of yoga. Trauma-informed yoga (TIY), that is, yoga adapted to the unique needs of individuals working to overcome trauma, may ameliorate symptoms by creating a safe, tailored practice for students to learn how to respond, rather than react, to symptoms and circumstances. Yoga not thus adapted, on the other hand, may increase reactivity and activate symptoms such as hyperarousal or dissociation. This article reports on expert input about adapting yoga for individuals with trauma, with special considerations for military populations. Eleven experts, recruited based on literature review and referrals, were interviewed in person or via telephone and asked seven questions about trauma-informed yoga. Verbatim transcripts were subjected to open-coding thematic analysis and a priori themes. Findings revealed that TIY needs to emphasize beneficial practices (e.g., diaphragmatic breath and restorative postures), consider contraindications (e.g., avoiding sequences that overly engage the sympathetic nervous system), adapt to limitations and challenges for teaching in unconventional settings (e.g., prisons, VA hospitals), and provide specialized training and preparation (e.g., specialized TIY certifications, self-care of instructors/therapists, adaptions for student needs). TIY for veterans must additionally consider gender- and culture-related barriers, differing relationships to pain and injury, and medication as a barrier to practice.
患有创伤相关症状的个体是一个独特的群体，他们可能会从瑜伽这种身心练习中受益，或者根据瑜伽的类型，其症状可能会因瑜伽而再次激活。创伤知情瑜伽（TIY），即根据努力克服创伤的个体的独特需求而调整的瑜伽，可能会通过为学生创造一种安全、量身定制的练习方式来改善症状，让学生学习如何应对而非反应症状和情况。另一方面，未经如此调整的瑜伽可能会增加反应性并激活诸如过度觉醒或解离等症状。本文报告了关于为创伤个体调整瑜伽的专家意见，特别考虑了军人群体。基于文献综述和推荐招募了11位专家，对他们进行了面对面或电话访谈，并询问了七个关于创伤知情瑜伽的问题。逐字记录的访谈内容接受了开放式编码主题分析和先验主题分析。研究结果表明，创伤知情瑜伽需要强调有益的练习（如腹式呼吸和恢复性体式），考虑禁忌（如避免过度激活交感神经系统的序列），适应在非常规环境（如监狱和退伍军人医院）教学的限制和挑战，并提供专门的培训和准备（如专门的创伤知情瑜伽认证、教师/治疗师的自我护理、根据学生需求进行调整）。针对退伍军人的创伤知情瑜伽还必须考虑与性别和文化相关的障碍、对疼痛和损伤的不同态度以及药物治疗对练习的阻碍。
