The aim of Trauma Adapted Yoga (TAY) is to increase self-regulation skills and promote a sense of safety in the present moment. It consists of controlled physical movements, mindfulness techniques, and conscious breathing. It is an evidence-based form of yoga that serves as an excellent complement to therapeutic treatments.

Many clients who have experienced trauma or neglect in childhood hold pain in their bodies, which can be difficult to access cognitively. By including the body in the therapeutic process, we can access early material in the Child ego state in a non-threatening way. TAY, in combination with therapy, helps clients increase their embodied sense of interoception, slowly finding words to express what sensations mean to them. “Interoception is a combination of actual sensory input and our perception of it, providing an embodied experience of how we feel, thereby contributing to our overall sense of self” (Craig, 2015).

The humanistic philosophy of transactional analysis (TA), with elements from existential and intersubjective philosophies, resonates well with TAY. We keep the Adult ego state in focus while accepting and taking the Child and Parent ego states of clients into consideration. Existential positions, early decisions, and script development, as well as the script matrix, are also very useful concepts.

TA aims to treat everybody as equal, as does TAY, which means we do not tell people what to do but invite them to try movements. Like TA, invitation in the form of empathic inquiry works best. TAY considers that people are individuals, offering undemanding time for self-acceptance, choice of what to do, control, and agency. It invites and guides clients toward embodiment, self-confidence, community, a sense of belonging and bonding, and moving physically and rhythmically.

On first meeting a client, we often follow Berne's original steps in assessment. Clients may be nervous and in a state of fight, flight, freeze, or fawn (Porges, 2023). The first steps involve making contact, using all our ego states to calm and soothe the client and help them relax.

Sometimes, we start by asking clients to follow our movements in basic yoga. This usually takes about two minutes, and clients can remain in their seats. Before knowing the client well, we do not talk about breathing, as this is often associated with trauma and can trigger old experiences. Breathing comes naturally as we move the body in expansions (breathing in) and contractions (breathing out). If the client has another breathing pattern, that is okay too.

In a TAY session, we start with grounding exercises, either standing or sitting on the floor or a chair, depending on what is possible for the client. Moving into dynamic exercises, we activate large muscles in the body. We hold some poses to create tension and increase our sense of balance. As therapists, we do the exercises with the client to demonstrate that we are equal, giving different options so the client can choose what is most comfortable. We finish with a short, structured, mindful relaxation. The aim is to calm the nervous system and aid interoception in order to feel our bodily sensations in a non-threatening and accepting way.

TAY is individually tailored. When in a group, we work in a half-circle so there is nobody behind anyone else. We do not touch clients, as this can trigger trauma. Interestingly, Berne also writes about being cautious with touching (Berne, 1972:8). There are movements we rarely use, like downward-facing dog, standing on all fours, or resting in child's pose, which can be especially triggering for clients who have been sexually abused.

Case Study: Anna

Anna first came to therapy because she had conflicts with colleagues. She talked incessantly and quickly, and it was difficult to stop her flow of words to ask questions. I worked primarily on a behavioral level to help her slow down so she could think before she spoke. She realized that she was not able to change her colleagues and eventually chose to stop working with them.

When she returned some years later, the sessions focused on her childhood and the negative impact it still had on her life and relationship with her partner. She now had a slower tempo, taking time to reflect on what to say. In these sessions, she gained valuable insights and was able to make script changes.

The third time Anna came to therapy was because of a stressful process of selling her business. She alternated between stress and collapse—sympathetic and parasympathetic nervous systems—and was using alcohol to soothe stress and anxiety. I offered TAY as a complement to her TA therapy.

With Anna, I started with a grounding sequence, then challenging exercises using large muscle groups, with the aim of reducing anxiety. Later, I added breathing techniques for her to regulate the autonomous nervous system. Additionally, I used bilateral movements to activate her right and left brain, as she probably had undiagnosed attention-deficit/hyperactivity disorder (ADHD).

In the evaluation afterward, she reported having drastically lowered her alcohol intake, that the pain from her rheumatism had almost gone, and that she performed short yoga sequences regularly. Her irritability, anger, anxiety, worry, and low-level depression were almost gone, and she often felt happy and enthusiastic. She also had a sense of belonging, feeling safe and secure, and had increased concentration.

This work with Anna is a good example of what can be achieved when the mind and body are treated through a combination of TA therapy and trauma-adapted yoga.