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action
clinical meaning of, 81
definition of, 81
purpose and, 114–117
see also taking action
Adverse Childhood Experiences, 25, 31–32
afferent nervous system, 44
Ainsworth, M., 24, 25
anterior cingulate cortex, 22, 23
attachment theory, 24–28, 31
implications for treatment, 32–34, 35
attunement, 148–150
avoidance, 136–137
Back and Shoulder Stretch, 159, 160
being present
as body experience, 95, 103
clinical significance of, in TSY, 99–100
creating opportunity for, 108
definition of, 105
evolution of clinical conceptualization of, 95–100
feet on floor exercise to promote, 94–95, 104–106
interoception and, 103–105
meaning of, 100–102
trauma as barrier to, 99, 102–103
TSY practices to promote, 105–108, 175
Bowlby, J., 25, 35
breathing
awareness of movement in, 125–126
current understanding of trauma effects on, 121–122
exercise to invite awareness of, 124–125
inviting clients to deepen, 126–127
long out breath, 6–7
in mainstream yoga, 2–3
nasal, 127–128
practices to promote dynamic experiencing of, 123–124
therapeutic goals in work with, 123
in TSY, 6–7, 121, 122–123
Broca’s area, 23
chair-based yoga, 109–111
choice
adaptive response to trauma perceived as, 64–66
connecting interoception with, 71–73
contextual factors in, 61–62
as immediate body experience, 69–71
physical assists undermining sense of, 74–75
practice example with theme of, 59–61
in process of change, 87–90
professional bias in conceptualizations of, 61
taking action after, 80, 82–83
temporal component of, 63
trauma as lack of, 63–64
in TSY, 66–73, 76–77
yoga forms associated with, 157, 158, 171, 176
classification of trauma, 15
complex posttraumatic stress disorder, 15, 17–18
complex trauma
adaptive response to, 64–66
clinical conceptualization of, 1, 15, 18–19, 19–20
indications for TSY for, 37–39
constriction, 136–137
control, client’s sense of
clinical significance of, in trauma treatment, 26–27, 36–37, 38–39
empowerment goals of TSY and, 20–21
maintaining, in TSY session, 9–10, 57
core strength exercise, 109–111, 112–113
cortisol, 33
countdown, 134–135, 142
Craig, A. D., 22, 44
Davidson, R., 47
development
attachment theory of, 24–25
childhood response to trauma experience, 26
later life dysfunction from early relational trauma, 31–32, 63–64
developmental trauma disorder, 15, 19
Diagnostic and Statistical Manual of Mental Disorders, 15–16
diaphragm, 125
disorders of extreme stress not otherwise specified, 15, 17–19
effective action
clinical meaning of, 84–87
definition of, 81
see also taking action
emotion
affect attunement, 148
interoception and, 46–47
in somatic approaches to trauma treatment, 12–13
in TSY approach to healing, 13–14, 46–47, 56–57
empowerment
clinical significance of, 66–67
in context of trauma treatment, 20–21, 31
taking action and, 83
through use of invitatory language, 66–68
exteroception, 44
facilitator skills and techniques, 34–37
feeling
effects of childhood trauma on, 26, 27–28
of feet making contact with ground, 94–95
goals of TSY, 27
invitation to notice, in TSY, 49–52
trauma survivor’s estrangement from, 119–121, 128
in TSY approach to healing, 13–14
use of TSY forms to access, 4, 6
see also interoception
Feet-on-the-Ground exercise, 93–95, 104–106
forms
anatomical language for orienting client to, 152–153
Back and Shoulder Stretch, 159, 160
client’s choice-making in, 69–71, 76–77
clinical significance of, 4–6
countdown, 134–135, 142
Forward Fold, 133–135, 171–173
Gentle Spinal Twist, 158
Gentle Spine Movement, 166
Hip Stretch, 161–165
Lateral Neck Stretch, 156
Leg Lift, 131–133, 138–139, 140–141, 169, 170
modifying, for clients with physical impairments, 154
progression of time in, 142–143
prohibition against physical assists to client, 73–77
to promote experience of muscle dynamics, 109–111, 112–113
repetition of, 152
Seated Mountain, 28–30, 79, 109, 155
Seated Warrior, 174–177
Shoulder Circles, 157
Shoulder Stretch, 167, 168
Sun Breaths, 123–124, 135, 146–147, 178–181
therapeutic relationship in experience of, 35–36, 149–150
therapeutic utilization of, 151–154
TSY approach to, 3–4
TSY themes associated with, 153
Forward Fold, 133–135
variations, 171–173
Fowler, C. J., 45
Gentle Spinal Twist, 158
Gentle Spine Movement, 166
Hanlon Johnson, D., 10
Hanna, T., 10
health risks of early relational trauma, 31–32
Heraclitus, 101–102
Herman, J., 16, 17, 20, 31, 38, 66, 136–137
Hip Stretch, 161
variations, 162–165
hypothalamus, 140
immobilization, 136–138
insular cortex, 22
intentional action
clinical meaning of, 82–83
definition of, 81
see also taking action
intercostal muscles, 124
internal orientation
breathing practices and, 7
significance of, in TSY, 4, 54–56
in use of yoga forms, 4
interoception
barriers to, as result of trauma, 55–56
behavior and, 46
being present and, 103–105
connecting choices to, 71–73
definition of, 22, 43–44, 45
emotional valence and, 46–47
evidence for benefits of, 47–49
as goal of mindfulness, 8
language to promote, in TSY, 49–52
neuroscience of, 22–23, 44–45
self-regulation and, 56–58
significance of, in TSY, 8, 32, 33–34, 46–47, 57–58
taking action and, 84
trauma effects on, 22–23, 54–56
in TSY process of change, 87–90
yoga forms associated with, 155, 156, 167, 168
interpersonal relationship
attachment theory of, 24–28
in developmental trauma disorder model, 19
healing potential of, 32–34
physical contact in, as uncomfortable for trauma survivors, 75–76
power dynamics in, 20
reconnecting with others through rhythmic interaction, 143–145
traumatization in context of, 16–17
in TSY theory of trauma, 31–34
invitatory language
empowerment of client through use of, 66–68
example of, 28–30
to notice feelings, 49–52
in TSY, 8–9
Kabat-Zinn, Jon, 7, 95, 96
Kurtz, R., 10–11
language
avoiding adjectives and adverbs in, 52
for communication about forms to client, 152–153
neural outcomes of trauma and, 23–24
to promote interoception, 49–52
see also invitatory language
language of TSY facilitator, 8–10
Lanius, R., 22–23
Lateral Neck Stretch, 156
Lazar, S., 47
Leg Lift, 131–133, 138–139, 140–141
variations, 169, 170
Levine, P., 11–12
limbic system, 98
meaning-making
in traditional somatic models of trauma, 12–13
TSY approach to healing and, 13–14
medial prefrontal cortex, 22–23
mediation, 47–49
memory
neurophysiology of, 98
in somatic approaches to trauma treatment, 12
traumatic, as resistant to change, 98–99, 104
traumatic, encoded as emotion, 12–13, 97–99, 104
mindfulness
being present and, 96–97
definition of, 7
in Hakomi method, 10–11
interoception and, 8, 47–49
in mainstream yoga, 2–3, 7
TSY approach to, 8
Mindfulness Based Stress Reduction Program, 47
Morey, R. A., 98
movement
healing potential of, 139
to overcome immobilization, 136–139
muscle dynamics
awareness of purpose through awareness of, 116–117
in breathing, 124–125
client’s estrangement from body feeling and, 119–121, 128
contraction, 111
intensity shifts, 112–113
lengthening/stretching, 111–112
rest, 112, 182
self-touch to promote awareness of, 117–119
techniques for promoting awareness of, 109–111
terminology of, 111–112
therapeutic goals in work with, 128–129
yoga forms associated with exploring, 160, 161, 167, 168, 174
neuroscience
of interoception, 22–23, 44–45
memory processes, 98
of sleep, 139–140
of trauma, 21–24, 31
noticing feelings, 49–52
Ogden, P., 11
Physicians’ Desk Reference, 15–16
poses, yoga, 3–4
posttraumatic stress disorder
avoidance in, 136–137
in classification of trauma outcomes, 15
evolution of clinical conceptualization of, 15–17
power dynamics
empowerment in context of trauma treatment, 20–21, 31
internal orientation and, 4
interoceptive process and, 53–54
interrelational and intrapersonal, 20
in rhythmical interaction, 144–145
in therapeutic relationship in TSY, 145
in TSY perspective, 4
prefrontal cortex, 98
proprioception, 44
purpose, 114–117
Ram Dass, 95
reconnecting, 143–145
rest, 112, 182
rhythm
awareness of passage of time as aspect of, 139–143
case vignettes, 131–135
clinical aspects of, 136
in movement to overcome immobilization, 136–139
reconnecting with others through, 143–145
in therapeutic attunement, 148–150
therapeutic significance of, 150
yoga forms associated with, 166, 179, 181
Seated Mountain Form, 28–30, 79, 109, 155
Seated Warrior, 174–177
self-regulation, interoception and, 56–58
self-sense
interoception in, 22, 44–45
self-validation in TSY process, 36–37
trauma outcomes, 22–23
in TSY theory of trauma, 31
sensorimotor psychotherapy, 11
Sherrington, C. S., 44
Shoulder Circles, 157
Shoulder Stretch, 167, 168
single-incident trauma, 37
sleep apnea, 121
sleep-disordered breathing, 121
sleep patterns, 139–140
somatic experiencing, 11–12
somatic models for trauma treatment, 10–14. see also trauma–sensitive yoga
spontaneous management behavior, 11
Stern, D., 148
Sun Breaths, 123–124, 135, 146–147, 178–181
taking action
choice and, 83
clinical meaning of, 81
components of, 81–87
importance of client’s autonomy in, 90–91
trauma as impediment to, 80–81, 86
in TSY process of change, 85–90
yoga forms associated with, 159
temporal orientation, 90
awareness of passage of time, 139–143
choice and, 63
trauma effect on sense of time, 139–141
see also being present
Terr, L., 16, 38
thalamus, 22–23, 140
therapeutic relationship
client’s sense of control in TSY, 9–10, 26
clinical significance of, 33
facilitator’s authenticity in, 125
facilitator’s language in TSY, 8–9
goals of TSY, 27
power dynamics in, 145
prohibition against physical contact with client, 73–77
rhythmical attunement in, 148–150
rhythmical interaction in, 145
as shared authentic experience in TSY, 35–37
Tick, E., 38
Tolle, E., 95–96
trauma experience
action disconnected from purpose as result of, 115–116
adaptive responses to, 64–66
as barrier to being present, 99, 102–103
body feelings and, 26, 27–28, 54–56
in captivity, 17
in complex trauma model, 18
disruption of sense of time after, 139–141
evolution of clinical conceptualization of, 14–20
as impediment to taking action, 80–81, 86
lack of choice in, 63–64
later life dysfunction from early exposure to, 31–32
memory processing of, 97–99
neuroscience of, 21–24
significance of context in, 16–17
single-incident, 37
see also trauma treatment
trauma-sensitive yoga (TSY)
approach to breathing practices in, 6–7
avoiding coercive communication in, 52–54
compared with other somatic interventions, 10–14
connection between emotion and body experience in, 13–14
distinguishing features of, as yoga practice, 3
empowerment goals in, 20–21
facilitator’s language in, 8–10, 67–69
focus on present moment in, 90
indication for, 37–38
integration of foundational principles for change in, 87–90
mechanism of change in, 32, 55–56, 86–87
neural changes associated with, 24
practice examples and case vignettes, 41–43, 59–61, 79–80, 93–94, 109–111, 131–135, 138–139, 140–141
prohibition against physical contact with client in, 73–77
theory of trauma in, 14–21, 31–34
use of forms in, 3–6
use of mindfulness in, 8
trauma treatment
benefits of empowerment in, 66–67
current somatic models for, 10–14
relational nature of, 144
self-regulation goals in, 56–58
see also trauma-sensitive yoga (TSY)
TSY. see trauma-sensitive yoga
van der Kolk, B., 21, 23, 89, 99, 104, 116, 137
visceral experience, 44–47
war veterans, 37–38
Yehuda, R., 98
yoga
common features of practices in, 2–3
poses in, 3–4
TSY and, 3
see also trauma-sensitive yoga (TSY)