MUSCLE DYNAMICS AND BREATHWORK
A SMALL GROUP OF WAR VETERANS HAD BEEN MEETING TO do trauma-sensitive yoga (TSY) every week for several years. The veterans had various physical injuries (and no small amount of medications being taken for both pain and psychiatric conditions) so the decision was made early on to stick with chair-based yoga. On one occasion, they experimented with some core strength in the chairs by leaning back a little and holding themselves at a slight recline (see Figure 6.1).
The TSY facilitator invited them to notice what muscles they were using to hold themselves in this position. After a few breaths, they returned back up to a neutral position, the Seated Mountain Form, and the invitation was to notice what muscles felt less intense as they moved out of the reclined position. They did this together several times and one of the group participants said, “I feel my stomach muscles.” Someone else said, “If I lean back further, those muscles feel more intense.” Someone else in the small group said, “I notice a feeling in my back.”
At this point, the TSY instructor invited them all, if they were interested in making it a little more intense, to lift one leg off the ground and notice what happened to the muscles in their leg. Somebody noticed the muscles on the top of their leg got “tighter.” Someone else said, “When I do this [lifts one leg], it feels like my stomach muscles get harder, more firm.” Several others experimented with lifting one leg a little and noticing what they felt. After a few breaths they all sat back upright in a more neutral position. The TSY facilitator asked, “Do you feel your muscles get a little less intense?” Somebody said, “My leg muscles feel a little softer” and someone else in the room said, “Yeah, I feel my stomach muscles get less intense but I couldn’t really feel it at first—it took a few seconds.”
Figure 6.1. Seated recline: Core strength exercise.
What are muscle dynamics?
As we have seen throughout this book, everything that we do with TSY involves the body. Muscle dynamics are the things about our muscles that we can feel, those things that we can interocept. As will become clear in this chapter, there are many things we can do with our bodies that allow us to have dynamic experiences, including one of the things we each do every moment of every day: breathe.
While we do not have to have an in-depth understanding of physiology in order to help people feel their muscle dynamics, here are a few useful terms to become acquainted with (readers interested in a more thorough understanding of muscle dynamics may wish to consult any number of good books on physiology, including Coulter, 2001):
Strengthen/contract: Muscles often feel stronger (get more firm, more engaged) when they contract (draw together toward a midpoint). A contraction is happening in Figure 6.1, for example, when our stomach muscles (more precisely, muscle fibers) draw toward a midpoint in order to support our body in this reclined form.
Stretch/lengthen: When we extend a muscle, we lengthen it as in the form called Back and Shoulder Stretch, Variation 2 in Chapter 8. This is an example of stretching/lengthening back muscles.
Rest: For our purposes, this is when we allow muscles to not do anything. It may not be immediately obvious but this is also feel-able. For an example of how you might bring an experience of muscles resting into the TSY session, see Figure 8.29.
With TSY, you can give your client a chance to feel any or all of the above. Like everything else, some dynamics will be more feel-able than others and the work is to help your clients find what they have access to in their bodies and to build from there.
Noticing intensity shifts
Another way to feel muscles is to experiment with noticing intensity shifts within muscles; that is, start by feeling a muscle or group of muscles do one thing and then shift dynamically to an opposite state. For example, one way to do this begins with the core strength exercise from our case example above and also depicted in Figure 6.1. Readers may wish to try this exercise themselves.
If you would like to experiment with this form, the invitation is to start by sitting comfortably tall. Maybe just pause for a moment and experiment with sitting up in a way where you are relatively comfortable and your spine is tall. When you are ready, you can recline (lean back) slightly and then hold at some point. Feel free to use Figure 6.1 as a guide but how much you actually recline is totally up to you: it’s your choice. You may wish to investigate this reclined action for a moment and find an angle that feels comfortable to you. When you recline and hold at some angle, do you feel some muscles in your body start to engage? Maybe the abdominal muscles, stomach muscles, core muscles become a little bit more intense? If you like, hang out and breathe (more on breath in TSY later in this chapter) in this reclined form for a few seconds, noticing that the muscles you feel become more intense or more active (or more firm, if a tactile cue is more helpful). The other possibility is that you might not feel anything in this form and that is ok too. Remember that the expectation is not to feel something in particular but just to notice when you do feel or when you do not feel anything.
When you are ready, you may wish to sit back up straight or to even lean forward a little bit, as in Figure 6.2. When you sit up straight or lean forward a little bit you might feel a change in your core muscles. When you sit upright or lean forward a little bit, your core muscles go back toward a more neutral state. In other words, the very muscles that became very activated when you reclined may become less activated when you sit up straight and possibly less active still if you lean forward. You may feel a dynamic change in your core muscles as you move between these various forms. If you like, you can try this whole sequence again—reclining and holding, sitting up straight, and/or leaning forward—and experiment with noticing intensity shifts in your muscles.
Chapter 8 offers various yoga forms that you and your clients can experiment with in order to find opportunities to feel some intensity shifts within muscles.
Muscle dynamics add something new: Purpose
In developing TSY over time I have benefited from many conversations with clinicians, neuroscientists, and fellow yoga teachers. These discussions sometimes include anecdotal observations based on our professional experiences and occasionally those observations turn into something practical. One such anecdotal observation is that our traumatized clients often experience a lack of purpose as they navigate through life. The kind of purpose I am referring to is not equated with meaning (i.e., what is the purpose of my life?) but is rather equated with action, as in I am doing something with my body on purpose (walking, running, reaching, etc.) toward a desired result. For people who are not severely traumatized, the suggestion is that actions are usually connected to a desired result: I am getting myself to the gym because I want to get stronger; I am walking because I want to get to work; I am marching in this demonstration because I want my government to change something; I am reaching for something on the top shelf at the grocery store because I want that particular food. Here is a depiction of the relationship between action and purpose:
| Purpose | = | I do [fill in the action] because I want [fill in the desired result]. |
Even during times when we act without a strong conscious conceptualization of the outcome we desire, we are still frequently engaged in acting with a purpose, albeit sub- or unconsciously.
The implication is that, for traumatized people, action is very often disconnected from a desired outcome and therefore from purpose itself. As a yoga teacher I sometimes see this in the way a student chronically moves through the world very slowly, eyes down, breath shallow, shoulders rounded forward (again, not to say that there is one physical stance that indicates complex trauma but just to illustrate my personal experience with what I have interpreted as a sense of purposelessness in some of my students). Bessel van der Kolk refers to this phenomenon when he says, “People who suffer from PTSD seem to lose their way in the world” (van der Kolk, 2006, p. 4). When our action is decoupled from a desired result, we lack purpose or, more colorfully, we have lost our way in the world.
Figure 6.2. Seated: Leaning slightly forward.
| No purpose [lost our way in the world] |
= | I do [fill in the action] because [?]. |
Why do I act or move through the world? There is still action: we still walk here and there and move through grocery stores but we do so without purpose; we are going through the motions. With TSY we can begin to restore purpose to our actions. Specifically, using muscle dynamics, we can begin the investigation that what happens to my muscles is not random but something I can be consciously in charge of.
While at times it will be enough to just feel our muscles become more and less intense, there is also the possibility of noticing that these feelings are happening because we are doing something. Weare in charge of these dynamics (and, therefore, feelings in our muscles) and we can change them on purpose.
Your client purposefully creates the intensity in her stomach muscles when she reclines and holds. She purposefully rests her stomach muscles when she moves from that reclined position back to neutral, or when she leans slightly forward. She is purposefully creating the feeling (muscles stretching) in the side of her body when she reaches one arm up toward the ceiling and leans a little bit to the opposite side in a side stretch. You, as the TSY facilitator, can pick opportunities to make “purpose” an explicit theme as you explore yoga forms by saying something like “notice that you can make these muscles in your body more or less intense on purpose.” Or “You are in charge of the feeling you are creating in your body right now; you can make it more or less intense.” The encouragement is to intentionally use the word “purpose” (or some equivalent) from time to time connected with an actual body experience within a yoga form in order to give your client a chance to do something with her body with a desired outcome. While we cannot attribute a desired outcome to an action from the outside, we can give our client some space to do this for herself (i.e., “I will lift my leg a few inches higher because I want to feel strength in those muscles” or “I will lower my leg because I do not want to feel those muscles right now”).
The added value to trauma treatment comes through noticing that you are creating these feelings in your body. They are not just happening arbitrarily to you; you can act with purpose and change the way your body feels right now. Yoga forms offer many opportunities to purposefully create dynamics in your body and to practice feeling them.
One more way to notice muscle dynamics: Self-touch
Many people who have come through our clinic over the years have found it difficult to feel certain parts of their body and, therefore, muscle dynamics associated with those body parts. In fact, I would say that this is a normal experience in the context of complex trauma. When this is the case, one possibility is to use one’s own hands to get a tactile sense of what is happening in a particular muscle. For example, I worked with a client who could not feel his arms. It was an eerie and disturbing experience for him to be looking at his arms but not be able to feel any dynamic changes when we experimented with some yoga forms that engaged these muscles. Even when his arm muscles were intensely engaged in a form like a push-up, he reported that while he could see the muscles in his arms he could not feel them. Operating under the assumption that this was not a neurological condition (a reasonable possibility and one that may need to be looked into for some clients) because he was under the care of a physician and had no indications of such a problem, we proceeded to create an exercise together that we thought might give him a chance to feel his arms (which he was interested in being able to do). We would sit in a chair and flex and extend our arms at the elbow and use our own hands to feel what was happening to the biceps (upper arm muscles in the front of the arm) and the triceps (upper arm muscles in the back of the arm). He and I both noticed we could feel with our hands these muscles change when we moved between bending and straightening. There was something very relieving for this man to be able to use his own hand to feel his arm muscles change like this based on the gestures he was making. (In fact, to reflect back on our discussion above about “purpose,” in my observation, it was as if he was moving his arm like this because he wanted to feel his muscle dynamics—he was moving with a purpose). We ended up doing a very detailed investigation over the course of many months and, using a variety of yoga forms, into all of the different things we could feel happening in our arm muscles by using our hands to feel them. Eventually, in this case, he was able to feel his arm muscles without directly using his hands, though we came back to that practice regularly and tried it with different muscles as well.
The invitation is to feel free to experiment with using your own hands in any form as another way to feel muscle dynamics. Facilitators can present this option as another choice for clients and can also feel free to try it themselves if they are interested.
From estrangement to familiarity
Many traumatized people have the experience of not feeling safe or at home in their bodies. This sense of estrangement often involves not being able to feel certain parts of the body or certain muscular actions but it also relates to some of the theoretical underpinnings to TSY that were discussed in Chapter 1. In this case, complex trauma theory suggests that “for the infant and young child exposed to chaos, violence, or neglect interpretation of sensory stimuli will become infused with danger. At this stage, given non verbal processing, cues for potential danger will generalize and be solidified without language” (Blaustein & Kinniburgh, 2010, p. 14). For our clients, things that happen in their muscles (muscle dynamics), if they are feel-able at all, are often experienced as external sensory stimuli (exteroception): feelings that we perceive as coming at us from the outside. For our clients, a muscle contracting or extending is often interpreted as confusing and dangerous because the connection between the sensation and purposeful action is not clear: I am not making that happen; rather, it is happening to me from the outside. In addition, the feeling can often be generalized so that rather than feeling a specific muscle contract (like a bicep), we just feel a generalized sensation of intensity that we cannot pinpoint in any one part of the body. This experience further exacerbates the alienation from our body and the terror associated with random sensations that are unknowable and uncontrollable.
As an example, I worked with a 16-year-old girl with a history of early life trauma who would, on an almost daily basis, break down wailing and sobbing uncontrollably and hitting her head against a wall and sometimes collapsing into near catatonia often for an hour or two. When she would talk with staff during these episodes, she would say things like “I feel pain in my body but I don’t know where it is coming from” or “I can’t figure out where this feeling is in my body!” (Again, there did not seem to be a medical basis for these body feelings, though that is certainly a possibility that should be accounted for when working with anybody.) For this girl, the displaced body feeling was part of the experience. Our work together with TSY revolved around trying to find specific things in her body that she could feel. One day, after many months of working together, she felt the muscles in her upper back when we stretched our shoulders back. She could feel the specific action of drawing her shoulder blades closer together and then she noticed she could feel when she reached her arms forward that her shoulder blades separated a little bit. We experimented with this for a few minutes and I asked her if she noticed that she could create these different feelings in her body based on whether she was moving her shoulders forward or back and she said, with a smile, “yes!” She noticed that she was in charge of the feeling in her body based on what she was doing with her shoulders. This was the beginning of her having a new relationship with her body where sensation was not always generalized and terrifying.
Breathwork as a dynamic process
One of the most dynamic processes that we are all constantly involved with is breathing. As long as we are alive we are breathing. The truth is we are breathing when we are traumatized and we are also breathing after we are traumatized; breath is part of every experience that we have. With TSY we use breath in some specific ways as part of treatment.
In terms of the scholarly literature at this point most of the research associated in some way with breath and trauma involves the PTSD paradigm and conditions called sleep-disordered breathing (Krakow, et al., 2001) and sleep apnea (Sharafkhaneh, et al., 2005). These conditions do involve the actions of breathing and they are very interesting. As research progresses, I suspect they may well eventually have much greater bearing on TSY than is currently the case. However, at this time, there is just not enough information for us to draw any useful conclusions in terms of how we use TSY to treat trauma specifically based on this literature. However, that does not mean that we don’t attend to breath very seriously, as we will see.
As we make our way toward some breathing practices, it is also worth noting that there have been anecdotal stories told and observations made by us and others who treat complex trauma, which seem to suggest a connection between trauma and chronic breath holding or regular breathing in a shallow, choppy, erratic way. I want to be clear that even though I and my colleagues are aware of these anecdotes they have not led us to conclude that there is any one specific, defining breathing pattern attributable to complex trauma. Instead, we are inclined at this point to suspect that, as a result of chronic trauma exposure, no one person’s experience with breath is completely transferrable to another. But that is perfectly okay in the context of TSY where the subjective experience trumps the objective every time. The most important thing about breath in the context of TSY is that it is a fundamentally dynamic phenomenon that involves a lot of body movements (rib cage, abdominal muscles, shoulders, and more), which we can interact with.
Because of these dynamics, breath provides many opportunities to feel things in the body. That said, it is clear to us through our experience that breath is also a very complex and fraught phenomenon in the context of trauma. Many of our clients have reported to us how difficult it is just to breathe freely. We hear things like “I wish I could breathe better”; “I want to breathe but my body won’t let me”; “I don’t take deep breaths because I don’t want to be alive”; “I find myself holding my breath, even now, so no one will notice me.”
Yoga has a very old and rich history of working with breath, and interested readers will find many resources that discuss detailed and complex breathing practices (for examples, see Farhi, 1996; Feuerstein, 1998). With TSY, we take a very simple approach to breath. For our purposes, we do not use our breath as a way to change our physiology: we don’t practice breathing in order to get energized (activate the sympathetic nervous system) or to calm ourselves down (activate the parasympathetic nervous system). We do not approach breath as if there is one way to breathe that is “better” than another. For us, breathing is primarily just another way to experience the dynamic possibilities that having a body entails; to notice what we feel; and to make some choices. Working with the dynamic qualities of breath also offers opportunities for our clients to have new body experiences that may be very different from trauma (assuming that trauma limits or constrains our capacity to breathe in some way). Any time we breathe or move in a new way as part of trauma treatment we begin to challenge, in a gentle but clear way, the traumatic notion that my body is not capable of having new experiences and that all it can do is hunker down and resist traumatic memories that are hidden inside every seemingly innocuous muscle movement.
I’d like to share with you some specific practices that provide opportunities for experiencing breath as a dynamic thing. We will focus in detail on a practice called Sun Breaths in Chapter 7 when we explore rhythms so I won’t go into it here other than to say that Sun Breaths incorporate the synchronization of breath and movement. In Chapter 7, Sun Breaths will be discussed for their rhythmical quality but it is also possible to emphasize the dynamic qualities of the form instead (i.e., “when you breathe in and reach your arms up you may feel muscles in your back and shoulders strengthening and lengthening”). In addition to Sun Breaths, there are four more breathing practices that we use as part of TSY that I want to emphasize here. Each one of these breathing practices can be incorporated into any yoga form in this book, and each one focuses mostly on the dynamic qualities of breath in some way: noticing breath, movement of breath, adding a little breath, and nasal breath.
Noticing breath
One way to experiment with noticing breath is for the TSY facilitator to invite an awareness of breath from time to time throughout the practice by simply stating, “You may notice that you are breathing.” This invitatory statement calls attention to breath without imposing any expectations and without requiring any further interaction. It is presented more as a statement of fact than as something that needs to be acted on in some way. For a comment like “you may notice that you are breathing” to be sensible it doesn’t matter how you are breathing (short choppy breath, long shallow breath, etc.); it is just an invitation to notice that you are breathing.
Another way to practice noticing breath is to experiment with feeling some of the physical qualities or sensations related to breath. For example, you may feel the movement of the air around your nose or mouth. This also includes the possibility of feeling some of the ways your body moves when you breathe. For example, your rib cage moves with each breath and this may be feel-able (more specifically, the muscles called intercostals that are between your ribs are active when we breathe and because they are attached to our ribs, our rib cage moves); also, there is movement around our stomach as well as in our chest and upper back. There is one big muscle in particular called the diaphragm, considered to be the primary breathing muscle, that sits more or less around your lower ribs. With each breath you might feel some particular activity around your lower ribs due to this muscle.
All of these things are potentially feel-able and provide ways for us to notice that we are breathing. In this way, breath becomes another thing to interocept. As in any interoceptive practice, we do not require people to feel anything, we just invite them to notice what they feel, even if that is nothing at all in terms of body movement associated with breathing.
A general encouragement to TSY facilitators is that when you introduce breath as a feel-able thing, make sure you yourself can feel the dynamic. In other words, as long as you can feel your rib cage move, then you can feel free to say to your client, “You may notice some movement around your rib cage when you breathe.” If you cannot feel your ribs move when you breathe, better to not bring it up. I am encouraging a general authenticity to your use of TSY that begins with the “truth” of your own interoceptive experience. If you don’t feel something but bring it up as feel-able, the whole endeavor lacks an integrity that is vital.
Movement of breath
Along with movement within our body associated with breath, breath itself is also moving. The TSY facilitator can add a simple reminder that “breath is moving” at different points throughout the practice. We can safely say this because it is true. Someone might be breathing very slow, very fast, erratically, shallowly, and so on, but, as long as he or she is alive, there is movement to the breathing patterns. The movement of breath that I am referring to here is a relationship between the inhale and the exhale.
Adding a little breath
This practice provides an opportunity to use muscles in a new way or new muscles altogether. For example, most of us emphasize some muscles over others when we breathe; we get into a rut. For traumatized people this breathing rut may be related to trauma; for example, we have had people tell us that one way they learned not to be found by a perpetrator was to breathe in a very shallow, quiet way and that this breathing pattern has become habitual. However, for our purposes, whether or not a breathing pattern is directly connected with trauma isn’t even the most important thing. The important thing is that by adding a little breath we may give ourselves access to a new dynamic in our body and therefore to something new that is feel-able.
To get this one started the invitation could be something like “beginning from wherever you are, if you like, you could experiment with adding a little to your inhale and a little to your exhale.” (In general, we encourage our clients who are interested in adding a little breath to experiment with making their inhale the same as their exhale, especially so that they don’t end up overdoing an inhale, which might cause them to feel lightheaded or anxious.) The purpose is primarily to investigate what it feels like in the body to take a slightly deeper breath without any expectations or coercion. You might invite your clients to notice if, when they add a little breath, they feel some ways that their bodies move as they breathe. Your clients, heretofore, may not have felt their bodies move as they breathed and they may only start to feel the dynamic qualities of their breath once they experiment with breathing a little deeper than normal. In this way, adding a little breath provides an opportunity to have a new body experience. In the context of trauma, new body experiences may well elicit traumatic memories but they also give your clients a chance to step out of rigid trauma paradigms and experience a new visceral sense of possibility. My suggestion is that you, as a clinician working within the sphere of your professional training and licensure if appropriate, will know how to help your clients manage this complex experience that new breathing patterns will bring up (in other words, there will be a time to talk about it and a time to experience it).
Nasal breath
This last one can be introduced simply as a way to try something specific with breath, not as a way to identify nasal breathing as better than mouth breathing. The TSY facilitator can say something like “If you like, you can experiment with breathing in and out through your nose.” It may be that your client, for whatever reason, has been breathing primarily through his mouth and an invitation to try some nasal breathing might open up possibilities for new experiences. Nasal breathing may activate different muscles. You can invite your client to notice if he feels like he is using different muscles in his body when he breathes through his nose as opposed to his mouth.
When I introduce nasal breathing I always remind my clients that they can always go back to mouth breathing at any time if nasal breathing is uncomfortable.
Again, and this can’t be emphasized enough, no one way of breathing is inherently better than another in the context of TSY. These exercises are all just opportunities to interact with your body in some new, intentional ways. Your client is always in control and you are always presenting the material in an invitational and not a prescriptive way.
Conclusions
For survivors of complex trauma, the most common body experiences are the estrangement of feeling nothing at all or the horror of feeling something happening in the body that they cannot exactly pinpoint and over which they have no control. With the practice of sensing muscle dynamics, including those dynamics involved with breathing, we can begin to investigate both tolerable sensation in the body and our ability to make things happen on purpose in specific muscles. We can use any number of yoga forms and breathing practices but always remember that the forms and breathing practices are just a means to an end, not the ends themselves. The client gets to choose which forms and breathing practices are useful; we only present ideas. Ultimately, the more comfortable we get with having a body that is feel-able and muscle dynamics that are both very specific and under our control, the more we heal the impact of complex trauma.
The final aspect of trauma treatment that we will focus on involves various aspects of the phenomenon of rhythm, including reestablishing a sense of movement and flow right within the context of our body; our perceptions of the passage of time; and connection with others.