In this article, I discuss my experience as a Trauma Center Trauma Sensitive Yoga (TCTSY) facilitator, set within the wider Western Yoga teacher community, and my recommendation of using Polyvagal Theory practices, as a relational resource, as well as a tool to combat burn-out/vicarious trauma. The concept of neuroception, how we unconsciously surveil someone as safe or unsafe, can help facilitators embody compassion, an anchor for co-regulating energy.
Yoga in the West
The practice of Yoga, and more specifically to my experience, the practice of Yoga in the West, has become embedded within the wellness world as having benefits for body and mind. (John Hopkin’s Medicine, n.d.) Yoga Alliance (YA), as quoted on their website, “...is the largest nonprofit association representing the yoga community, with over 7,000 Registered Yoga Schools (RYS) and more than 100,000 Registered Yoga Teachers (RYT) as of April 2020. We foster and support the high quality, safe, accessible, and equitable teaching of yoga.” (Yoga Alliance, 2020) Two-hundred-hour teacher training that is registered with YA, is accredited by their organization, yet YA is an unregulated body, and so what is considered standard teaching is created from within, without feedback loops or outside licensing oversight. In fact, YA is opposed to government regulation. (Yoga Alliance, 2016) Currently, there isn’t a requirement for teacher training to learn or talk about trauma, although there are elective hours where yoga schools can offer such insights. The practice of Yoga, fundamentally, is asking a person to yoke or bring together aspects of their life into a felt sense of wholeness. YA doesn’t include information about trauma and its impact on our sense of wholeness, which I feel is worth further advocacy.
What is TCTSY: “TCTSY is an empirically validated, clinical intervention for complex trauma or chronic, treatment-resistant post-traumatic stress disorder (PTSD).” (TCTSY, n.d.) In a relationship, facilitator and participant are invited to experiment with movement choices and the possibility of noticing inner sensations called interception (Armstrong, 2019). In contrast to YA yoga training, TCTSY certification involves trauma, attachment, and neuroscience studies. Cohorts of this training include therapists with varied credentialed licenses, as well as yoga teachers (many with YA certifications) and some who are both therapists and yoga teachers. Each facilitator is bringing their own unique experiences into the space, with TCTSY methodology and theoretical underpinnings as safety guardrails.
What is Polyvagal Theory (PVT) & Neuroception through the lens of trauma and trauma care
In the Western medical model, trauma is often categorized as acute, resulting from a single event; chronic, often repeated, and prolonged; or complex, varied, and interpersonal exposure. (Missouri’s (ECE), n.d.) As mentioned, yoga teachers are not only unaware of their student’s trauma history but are also unaware of the impact of trauma on their students (as informed by their YA teacher training). TCTSY was created and researched for Complex Trauma.
“In 1994 (Dr. Porges) proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of the physiological state in the expression of behavioral problems and psychiatric disorders.” (Polyvagal Institute, n.d.) The three main principles of PVT are hierarchy, neuroception, and co-regulation. (UNYTE, n.d.)
“Polyvagal Theory is a science-based theory that provides explanations of how our autonomic nervous state influences and is influenced by the dynamic challenges of life.”(8)
According to PVT, our nervous system states are hierarchical through three pathways of responses. (Phoenix Rebellion Therapy, 2020) The autonomic nervous system is made up of two main branches, the sympathetic and parasympathetic. The sympathetic branch is found in the spine. In the parasympathetic branch, Polyvagal Theory focuses on the two pathways of the vagus (wandering) nerve, “from the brain stem at the base of the skull; the vagus travels in two directions: downward through the lungs, heart, diaphragm, and stomach and upward to connect with nerves in the neck, throat, eyes, and ears.” (Dana and Porges, 2018)
The ladder, or hierarchy, has a predictable and evolutionary order. Our most evolved and complex system is our ventral vagal “new” part of our parasympathetic system, our system of safety and connection, whose emergent properties can be feelings of awe, love, curiosity, compassion. It is our state of growth and restoration. The second oldest is our sympathetic nervous system, our “fight or flight” system whose emergent properties can be feelings of rage, anxiety, hypervigilance, the escape. It is our mobilizing survival state. The oldest of this three-part system is the dorsal vagal, a part of our parasympathetic nervous system whose emergent properties can be feelings of despair, numbness, dissociation. It is shut down as protection. These pathways each are working in service of survival. It is our biology rather than pathology. When we are faced with a challenge that overwhelms our ventral state, we move down this ladder and mobilize a response. If that response doesn’t resolve our survival needs, then we move down the ladder towards collapse and immobilization.
There is nuance to our states and our experiences; for example, one can feel themselves in a loop of panic and then shut down, or perhaps dejection to anger and back to dejection. The human experience is meant to be lived through all our states, and a flexible nervous system is a resilient nervous system. Our well-being is when our nervous system can transition within and between our autonomic states. If a person can feel safe enough, they can experience other states and return to ventral. Anchored in ventral, one can experience sympathetic as an inspired, passionate state and dorsal as restful and restorative.
Figure 1: Image or information courtesy of Beacon House Therapeutic Services & Trauma Team | 2021 | www.beaconhouse.org.uk
Dr. Stephen Porges has coined the term neuroception, “which describes how neural circuits distinguish whether situations or people are safe, dangerous, or life-threatening.” (Porges, 2004) This happens below the surface of consciousness. Information is coming in from inside our body, our environment, and between nervous systems. For those who have survived trauma, those signals can become highly sensitized to danger.
In terms of trauma care, for TCTSY facilitators and yoga teachers, when we enter a space, we are two (or more) nervous systems, checking each other out, our body’s surveillance system. According to neuroception, facial expressions, tone of voice, eye contact, hand gestures can all be clues and cues for whether this relationship is something to survive or perhaps a shared space, where there is shared power and safe (enough) connection. “We wear our hearts on our faces and in our voices.” (NIACBM, n.d.)
Oftentimes, chronic and complex trauma happens in relationships, and as Judith Herman says, “Recovery can take place only within the context of relationships; it cannot occur in isolation.” (Herman, 1993). As shown in figure 1, when relationships have been the source of trauma, then it’s understandable and in the service of survival, that those who enter our space for TCTSY and other forms of yoga, will move quickly and perhaps straight to sympathetic or dorsal, for a variety of protective reasons. With PVT, “rather than a perpetual feeling of being “too much” (e.g., needy, emotional, volatile, anxious, unstable), clients can redefine themselves as having an internal surveillance system that is sensitive to cues of danger.” (Dana and Porges, 2018)
The importance of Understanding our own Nervous System States as TCTY-F and Yoga Teachers:
According to neuroception, when we enter a space, virtual or live, the state we are in matters. If a participant’s surveillance system is sensitive to cues of danger, then it’s up to me to understand the state I’m in, whether calming energy or a threatening one.
When I facilitate TCTSY, there is often a discussion about trauma, in whatever capacity the participant feels comfortable discussing (although there is no requirement for a participant to share their trauma history to participate, and it’s above my scope of practice to engage with their history, interpretation or analysis). As mentioned before, yoga teachers do not have to learn about the impact of trauma, or the adaptations people have used to survive. Ideally, in both spaces, the focus is on
The participant/student and our intention are to provide care and support to our best capabilities.
While we may be focused on them, their nervous system is surveilling us. For example, a participant may share their pain in some way, and I empathize, meaning I feel their pain. The participant may be in some nuance of sympathetic or dorsal or a combination, and I’m going there with them. I may feel triggered or feel the impact of burn-out or vicarious trauma. Burn-out is the impact of chronic workplace stress. (WHO, 2019) Vicarious trauma is “a profound shift in worldview after being repeatedly exposed to the traumatic experiences of others.” (Interconnections Counseling, 2019) We’re two dysregulated systems, and I can no longer support them in a way they deserve, and it could be a moment for them to survive in defensiveness or in shut down.
In contrast, I can hear their pain from a place of ventral calm and hold compassion. I’m there with them, bearing witness, and perhaps they can feel heard and even feel my ventral energy of calm as a resource for their nervous system. This feedback loop opens up choices in the present moment and in a relationship differently. This can happen, moment by moment, opening possibilities of “creating autonomic pathways of safety and connection.” (Dana and Porges, 2018) The third principle of PVT is co-regulation, “the sending and receiving of safety signals.” (UNYTE, n.d.)
Polyvagal Mapping as a pathway towards co-regulating and self-regulating:
Deb Dana, is an LCSW, who has worked with Dr. Porges, utilizing PVT in clinical settings and is the author of,
“The Polyvagal Theory in Therapy, Engaging the Rhythm of Regulation.” This book offers ways to get in touch and befriend our nervous system. I’ve completed a year-long study with Deb Dana, where we, in connection with people from all over the world, were able to learn about PVT and share and listen to a community of nervous systems. In contrast to my training as a yoga teacher and TCTSY facilitator, the focus was on my nervous system as a resource for my well-being and my impact on those around me.
Below are examples of a condensed personal profile map and regulating resource map (Dana and Porges, 2018). By having a framework that I can use, come back to, and re-vision, I can become aware of and be in alliance with my own nervous system. I can have access to my resources of self-regulation and/or co-regulation
“Safety is the treatment,” (Stillpoint, 2020) our ventral vagal state.
Our nervous system is our command center, and as TCTSY facilitators and yoga teachers, we are entering spaces with other nervous systems. We may not know how they’re feeling, but we can get in touch with how we’re feeling, and those in our care can feel the opportunity to be in ventral through neuroception.
This is an important, and often wordless, part of creating a safe connection. Regardless of our techniques and credentials, if a person feels a sense of danger, their system will respond in service of their survival. As David Emerson, co-founder of TCTSY, once said in an organizational seminar, “How to care for those who feel unworthy of care?” Perhaps, PVT and PVT practices are done by facilitators and yoga teachers can be a source of co-regulating, ventral energy for those in our care. In addition, red flags of burn-out and vicarious trauma can perhaps be felt sooner. I propose that using Polyvagal Theory practices, including the mapping shown above, can be useful reminders to reach out for support as well as taking time for self-care: self-regulating and co-regulating practices.
“Earth will be safe when we feel in us enough safety.” Thich Nhat Hanh (Hanh, 2001)
About the Author
Mindy Levine is a yoga teacher, TCTSY Facilitator, and volunteers as a crisis counsellor with Crisis Text Line. Correspondence: https://www.tctsywithmindy.com/
In dedication to my mother, in gratitude and grief (1939-2022)
Armstrong, K. A. (2019, September 29). Interoception: How we understand our bodies inner sensations. APS: Association for Psychological Science. Retrieved from https://www.psychologicalscience.org/observer/interoception-how-we-understand-our-bodys-inner-sensations
Dana, D., & Porges, S. W. (2018). The Polyvagal theory in therapy: Engaging the rhythm of regulation (Norton Series on Interpersonal Neurobiology) (Illustrated ed.). W. W. Norton & Company.
Herman, J. L. (1993). Trauma and recovery: The aftermath of violence--from domestic abuse to political terror. Basic Books. https://doi.org/10.1046/j.1440-1819.1998.0520s5S145.x
Hanh, N. T. (2001). Call me by my true names: The collected poems of Thich Nhat Hanh (1st ed.). Parallax Press. https://doi.org/10.2307/40150833
Interconnections Counseling. (2019, October 8). Burn-out compassion fatigue, and vicarious trauma. https://www.intraconnectionscounseling.com/blog-1/2019/10/8/burnout-compassion-fatigue-and-vicarious-trauma
Johns Hopkins Medicine.(n.d.). 9 Benefits of Yoga .https://www.hopkinsmedicine.org/health/wellness-and- prevention/9-benefits-of-yoga
Missouri’s Early Care & Education Connections. (n.d.). Trauma-informed care. https://earlyconnections.mo.gov/professionals/trauma-informed-care
Nicabam National Institute for the Clinical Application for Behavioral Medicine. (n.d.). How the brain works with the Vagus: empathy and more. https://www.nicabm.com/brain-how-the-brain-works-with-the-vagus-empathy-and-more-4/
Phoenix Rebellion Therapy. (2020, December 31). Three organizing principles of PVT part 1. https://phoenixrebelliontherapy.com/brain_ladder_theory/
Polyvagal Infographic. (n.d.). UNYTE ILS Integrated Listening Systems. https://integratedlistening.com/polyvagal-theory-a-primer/
Polyvagal Institute. (n.d.). Polyvagal Institute. https://www.polyvagalinstitute.org/about-stephen
Porges, S. P. (2004, May). Neuroception: A subconscious system for detecting threats and safety. ED.Gov: Ies Institute of Education Sciences. https://eric.ed.gov/?id=EJ938225
Porges, S. P. (2021, August). Polyvagal theory: Background & criticism. Polyvagal Institute. https://www.polyvagalinstitute.org/background
Stillpoint, L. S. (2020, December 24). Cues of safety. Lynn Fraser Still point. https://lynnfraserstillpoint.medium.com/cues-of-safety-96291ec02de5
Trauma Sensitive Yoga. (n.d.). About Trauma Sensitive Yoga. https://www.traumasensitiveyoga.com/about
World Health Organization. (2019, May 28). Burn-out an occupational phenomenon”: International classification of diseases. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
Yoga Alliance. (2020). Yoga Alliance. https://www.yogaalliance.org/About_Yoga_Alliance
Yoga Alliance. (2016, June 8). Yoga Alliance’s Stance on Government Regulation. https://www.yogaalliance.org/About_Yoga/Article_Archive/Our_Official_Stance_on_Government_Regulation