Evidence review
Yoga and PTSD
An evidence-aware exploration of what research suggests about trauma-sensitive yoga and mindfulness as complementary practices for people living with PTSD — alongside, not in place of, professional care.
By Bhavin Thakker · Published
Important notice
This article provides an educational overview of research concerning yoga and PTSD. It does not constitute medical or psychological advice, and Yoga for Mental Wellbeing does not diagnose or treat PTSD or trauma-related conditions. Yoga may be considered as a complementary wellbeing practice alongside appropriate professional assessment and trauma-informed care.
Understanding PTSD
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop following exposure to a traumatic event or series of events. It is characterised by intrusive re-experiencing of the trauma (such as flashbacks and nightmares), avoidance of trauma-related stimuli, negative alterations in cognition and mood, and heightened arousal and reactivity.
PTSD involves significant dysregulation of the body's stress response systems. Research has highlighted the role of the amygdala, hippocampus and prefrontal cortex in PTSD, as well as dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system. These neurobiological changes can result in a persistent state of hypervigilance, emotional dysregulation and disconnection from bodily experience.
First-line treatments for PTSD include trauma-focused cognitive behavioural therapy (TF-CBT), Eye Movement Desensitisation and Reprocessing (EMDR), and in some cases medication. There is growing clinical interest in body-based and somatic approaches as adjuncts to these established treatments, given the significant role of the body in trauma responses.
What the research suggests
Trauma-sensitive yoga and the body
The most significant body of research in this area concerns trauma-sensitive yoga (TSY), a modified form of yoga developed specifically for trauma survivors. A landmark randomised controlled trial by van der Kolk and colleagues (2014), published in the Journal of Clinical Psychiatry, found that a ten-week trauma-sensitive yoga programme led to significant reductions in PTSD symptoms compared to a control group, with effects maintained at follow-up.
The proposed mechanisms relate to the role of interoception — the awareness of internal bodily states — in trauma recovery. Trauma can disrupt the connection between mind and body, leading to dissociation or hypervigilance to physical sensations. Yoga practices that cultivate gentle, non-threatening body awareness may help individuals gradually re-establish a sense of safety within their own bodies.
Breathwork is another area of interest. Slow, regulated breathing activates the parasympathetic nervous system and may help modulate the hyperarousal that characterises PTSD. Practices such as diaphragmatic breathing and extended exhalation have been associated with reductions in physiological markers of stress, though the evidence base for their specific application in PTSD remains preliminary.
A 2021 systematic review in the European Journal of Psychotraumatology found moderate evidence supporting yoga as an adjunctive intervention for PTSD, while noting significant heterogeneity across studies in terms of yoga style, duration and population. The authors concluded that yoga shows promise but that larger, more methodologically rigorous trials are needed.
Study limitations and important caveats
The evidence base, while growing, remains limited by small sample sizes, heterogeneous study designs and a lack of long-term follow-up data.
Yoga for PTSD must be delivered with a trauma-informed approach. Standard yoga classes that involve physical adjustments, closed-eye practices, or certain postures may be re-traumatising for some individuals without appropriate adaptation.
Yoga should not be positioned as a standalone treatment for PTSD. It is most appropriately considered as a complementary practice alongside evidence-based trauma therapies delivered by qualified clinicians.
Individual responses to yoga vary considerably. Some trauma survivors find body-based practices helpful; others may find them activating or distressing. Careful, person-centred guidance is essential.
A trauma-informed approach to yoga
Trauma-sensitive yoga differs from standard yoga in several important ways. It emphasises choice and agency at every point — inviting rather than instructing, offering options rather than corrections, and creating an environment in which participants feel safe to move at their own pace. Physical adjustments are not made without explicit consent. Language is carefully chosen to avoid inadvertently triggering trauma responses.
Bhavin Thakker's approach to private yoga is informed by an understanding of trauma and the nervous system, drawing on his postgraduate study in neuroscience and mental health. Sessions can be adapted to an individual's general wellbeing needs. However, they are not a substitute for trauma-specific clinical treatment. If you are living with PTSD, please ensure you are working with a qualified trauma therapist or mental health professional.
Interested in exploring yoga for your wellbeing?
Private sessions can be adapted to your individual needs and circumstances. They are not a substitute for condition-specific healthcare — please consult an appropriate professional where necessary.