"It calms me, it soothes me"

Taijiquan for people with post-traumatic stress disorder

Abstract

For people with a post-traumatic stress disorder, life can be challenging in many respects. While some aff ected persons are able to overcome the experienced traumatisation relatively quickly, others develop a complex, chronic disorder condition that puts a heavy and longterm burden on the person themself and on their family members. In such situations, Taijiquan can help to bring the organism into better balance and facilitates self-regulation of typical symptoms such as overexcitation, fl ashbacks and sleep disturbances. The specifi c nature of the physical movements induces a sense of control and self-empowerment; the movement art can become a helpful resource.

Symptoms of PTSD

In the course of numerous military deployments abroad and their consequences for those involved, the clinical picture of post-traumatic stress disorder (PTSD) has become widely known in recent decades . This symptom complex is not limited to traumatization as a result of war experiences, but can also be caused by other very threatening events such as sexual violence or natural disasters, according to the WHO definition.

However, the focus here is primarily on those affected from the military environment, as previous research on Taijiquan for PTSD has also been essentially limited to this group of people. Soldiers suffering from the consequences of deployment often develop so-called complex PTSD, which can be accompanied by massive difficulties in social interaction, self-image and affect regulation. Other mental illnesses such as depression, dissociative disorders, attachment disorders, addictions or self-harming behavior can also occur. In a high percentage of cases, various physical complaints also occur. These include chronic pain and symptoms such as palpitations, trembling, sweating, shortness of breath, nausea or fainting spells, which can be triggered by harmless triggers due to the constant state of alarm. In addition to the physical threat experienced by soldiers, there is often a so-called moral injury, a massive shake-up of their own world view, sense of values and personal meaning.

PTSD can occur both in the short term and years after the traumatic event. Psychotherapeutic treatment is all the more promising the sooner it begins after the traumatization. Soldiers and former soldiers often face the difficulty that it can take a very long time for their complaints to be recognized as deployment-related and for targeted treatment to begin. This can then drag on for years, so that it can often be assumed that the situation will remain very stressful for those affected and their social environment.

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Taijiquan and PTSD

With such a complex set of symptoms, it makes sense to look for ways to strengthen the body's ability to regulate itself.

The Western diagnosis of PTSD can be conceptualized interms of internal disturbances of energy balance and flow.PTSD symptoms can be viewed as the result of a freezing re-sponse blocking energy flow in the person.21In order forhealing to occur, these inner stores of frozen energy must bereleased and the natural flow of energy must be strength-ened. Resolving this frozen energy can reestablish a balancewithin the person and a renewed flow of energy through themind–body system, culminating in the return to a state of well-being.
(Michael A. Grodin, Linda Piwowarczyk, Derek Fulker, Alexander R. Bazazi, Robert B. Saper: Treating Survivors of Torture and Refugee Trauma: A Preliminary Case Series Using Qigong and T'ai Chi, in Journal of Alternative Complementary Medicine Sep. 2008; 14(7), p. 801-806, doi: 10.1089/acm.2007.0736)

It is also about finding a calming balance to the high levels of tension caused by the constant state of alert. In this respect, some veterans have already had good experiences with Taijiquan. For example, Vietnam War veteran and retired police officer Tom McNicholas describes his experience with Taijiquan in a YouTube video:

From the first movement, there was almost an audible click in my mind. It was the first time I felt in control in months, just from that simple movement. I was hooked. ... It’s given me a tool to manage [the PTSD]. ... At nights, if I’m struggling to sleep, especially if I've had a really bad day and all these things come up again, I can visualize the first move and ten minutes later I'm asleep. ... When the hairs on the back of my neck stand up and I'm about to explode - instead of yelling or screaming or hitting someone - I do the first movement ["Awaken the Qi"] in my imagination. I may have to do this a few times, but I don't lose control.
(https://youtu.be/mYgowthF8Ug)

Tom McNicholas now teaches Taijiquan himself.

British Gulf War veteran Shaun Foulder writes:

Anyone who has experienced any kind of trauma often finds themselves being a part of a vicious circle with the feelings of being stressed not only starting to affect the mind but also causing physical ailments in the body.  In my case Joint Pains, Chronic Fatigue, Asthma, Headaches etc was triggered off by the onset of stress.  I never substituted my NHS treatment but instead used Tai Chi alongside it. I found this a very useful strategy for me to move forward as I had to emanate from this circle and break the chain. …
(www.ptsduk.org/how-tai-chi-can-help-ease-ptsd-symptoms/)

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Regulate body, mind and soul

In a medical context, Taijiquan is considered a Chinese "mind-body exercise" that combines martial arts and meditative movement and promotes physical and mental balance. The combination of concentration, physical balance, flexibility, muscular relaxation and natural breathing can have positive effects in the prevention and rehabilitation of numerous physiological and psychological disorders. The effects on physical illnesses, in particular the cardiovascular system, the respiratory tract, type 2 diabetes, osteoarthritis, rheumatoid arthritis, fibromyalgia, breast cancer and as a fall prophylaxis for the elderly, are far better scientifically documented than in the area of mental illnesses.

However, there is clear evidence that practicing Taijiquan has a positive effect on depression, anxiety, insomnia and post-traumatic stress disorder.
(Fang Wang, Eun-Kyoung Othelia Lee, Taixiang Wu, Herbert Benson, Gregory Fricchione, Weidong Wang, Albert S. Yeung: The Effects of Tai Chi on Depression, Anxiety, and Psychological Well-Being: A Systematic Review and Meta-Analysis. (2013) Int. J. Behav. Med. (2014) 21:605–617, DOI 10.1007/s12529-013-9351-9)

Research to date on PTSD suggests that practicing Taijiquan can help manage stressful thoughts, improve concentration and reduce overexcitement - it has a profound calming effect on the nervous system. The brain becomes calmer and the mind clearer. The physical and mental relaxation is accompanied by an increasing feeling of inner and outer stability and centering. These effects can also make it easier for those affected to engage in psychotherapeutic treatments.

By calming the body and mind, Taijiquan can help people to cope more easily with stressful situations and react more appropriately to stimuli and triggers. People with PTSD who practise Taijiquan report that they feel more relaxed, can enjoy life again and have more energy. They can once again turn to people and activities that they previously avoided.

Essential aspects that apparently contribute to an improvement in mental well-being:

  • Taijiquan has a structuring effect.
  • The upright, stable basic posture conveys a feeling of security.
  • Superfluous tension is relieved and muscle tone is reduced.
  • The anterior vagus nerve is activated and can help to reduce latent stress.
    (see Ralf Rousseau: Lächelnd die eigene Welt verändern. Trauma, vegetatives Nervensystem, Taiji und Qigong, in TQJ 4/2021)
  • The flowing movements have a calming and harmonizing effect.
  • Taijiquan promotes neuronal integration (1) as well as
  • sensorimotor integration, the feeling of being in the body is intensified.

Through constant practice, those affected can get out of their stress program and the feeling of standing on the ground in a safe and relaxed manner can grow. In this sense, Taijiquan is a useful stress management method.

Even standing regularly in the basic pose can convey a feeling of stability and inner strength. Practicing calm, clear and slow movements reinforces the feeling of control and self-efficacy. It conveys a way in which each person can take good care of themselves. You learn the tools to be able to regulate yourself better and better.

The flowing movements counteract the frequent feeling of being frozen or blocked and convey the feeling of getting back into a flow.

Of course, these effects cannot only be achieved through Taijiquan; other holistically oriented movement methods can also be helpful. In particular, the aspects mentioned can apply to Qigong in motion in a similar way. The priority should be a clear focus on movement. The advantage of Taijiquan is that the movements have a clear purpose and there is also an outward orientation, unlike methods where you are completely absorbed in yourself. As a result, the tendency of PTSD sufferers to constantly keep an eye on their surroundings is taken up and integrated into the practice.

An important point is always the individual acceptance of the respective method. In a pilot study at Boston University Medical Center, it was found that the offer of an introduction to Taijiquan for PTSD sufferers was very well received and satisfaction was high.
(Barbara L. Niles und andere: Feasibility, qualitative findings and satisfaction of a brief Tai Chi mind-body programme for veterans with post-traumatic stress symptoms, in BMJ Open, 2016; 6 (11): e012464 DOI: 10.1136/bmjopen-2016-012464)

As a martial art, Taijiquan offers (former) soldiers in particular points of reference and opportunities to transcend their own ideas about combative conflict.

In scientific studies on the effect of Taijiquan on mental illness, the effect of practicing Taijiquan is usually only observed over a relatively short period of time (typically over twelve weeks), and often a very simplified form of Taijiquan is practiced. This means that only the surface is scratched - which makes it all the more astonishing that positive developments can already be observed in this short period of time. If Taijiquan becomes your own way of practicing, the effects can become far more profound over time. The good thing is that it is always available, regardless of time and place, to bring yourself into a better balance.

The Protestant military chaplaincy in Germany offers people suffering from the consequences of deployment and their families various formats of "time-outs" lasting several days, which are accompanied by a multi-professional team. In some of these time-outs, a Taiji exercise session is occasionally offered. This gives those affected a very low-threshold opportunity to try out Taijiquan for themselves. The response has been overwhelmingly positive. The soldiers often immediately felt a clearer body experience and better body awareness.

In the words of one participant who then got a little more into Taijiquan:

Taiji calms me, it soothes me. The flowing movement calms you down. You find yourself. The stable stance, feeling the center, allows me to channel my aggression, to control myself, to focus my energy. I become clear-headed. I have no end of stress, I quickly ramp up. Taiji helps me to regulate my stress. I find myself in a state of being that I actually am.

Continuing to learn Taijiquan is made more difficult for those affected by the fact that they often feel uncomfortable in groups and find it difficult to keep regular appointments due to their various complaints, mood swings and life situation. If participation in a general course is possible, care should be taken to ensure a calm, trusting, protected atmosphere. It can be helpful if a trusted person is present to provide emotional support and reassurance.

Taijiquan is not a therapeutic method, but can be a helpful and interesting exercise path for people suffering from PTSD, which a person can follow regardless of their illness. In other words, it offers a space in which someone takes care of themselves, but which is not defined by the illness. In the long term, it can lead to ever greater stabilization and increasing serenity.

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Footnotes and literature

(1) The term "neuronal integration" refers to the coordination and alignment of neuronal activities in different regions of the brain. In the case of PTSD sufferers, triggers can lead to the limbic system controlling the reaction, as in an acute threatening situation, and access to the neocortex, which enables conscious handling of the situation, being blocked. By focusing attention on specific body movements, those affected can overcome the blockage and find their way back to consciously dealing with the current situation.

  • Barbara L. Niles, DeAnna L. Mori, Craig P. Polizzi, Anica Pless Kaiser, Annie M. Ledoux, Chenchen Wang:
    »Feasibility, qualitative findings and satisfaction of a brief Tai Chi mind-body programme for veterans with post-traumatic stress symptoms«,
    in BMJ 2016 Vol. 6 (11),
    https://bmjopen.bmj.com/content/6/11/e012464 
  • Pao-Feng Tsai, Stephanie Kitch, Jason Y. Chang, G. Andrew James, Patricia Dubbert, J. Vincent Roca, Cheralyn H. Powers:
    »Tai Chi for Posttraumatic Stress Disorder and Chronic Musculoskeletal Pain: A Pilot Study«,
    in Journal of Holistic Nursing 2018 36(2), p. 147-158,
    https://journals.sagepub.com/doi/10.1177/08980101176976 
  • Barbara L. Niles, Kieran F. Reid, James W. Whitworth, Elaine Alligood, Sarah Krill Williston, Daniel H. Grossman, Maria M. McQuade, DeAnna L. Mori:
    »Tai Chi and Qigong for trauma exposed populations: A systematic review«,
    in Mental Health and Physical Activity Vol. 22, March 2022,
    www.sciencedirect.com/science/article/abs/pii/S1755296622000114 

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The author

Almut Schmitz

studied medical ethnology and began learning Taijiquan with Christel Proksch in the early 1980s.

She teaches Chen-style Taijiquan in the tradition of Chen Xiaowang and Qigong in Ostholstein and internationally and has been working for the editorial team of TQJ since 2000.

www.taiji-qigong-ostholstein.de 

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