Qigong for Post-Traumatic Stress Disorder (PTSD)

Wikipedia defines post-traumatic stress disorder (PTSD) as follows:

"PTSD is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity, overwhelming the individual's ability to cope. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen post traumatic stress (also known as acute stress response). Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal-such as difficulty falling or staying asleep, anger, and hypervigilance."

As a follow up to a previous article called "Qi Therapy for Returning Active Duty Military with PTSD" where I postulated that qigong could be useful for PTSD, I recently found an article that studied this idea already.

In the September 2008 edition of the Journal of Alternative and Complementary Medicine in a Boston University School of Medicine sponsored article entitled "Treating survivors of torture and refugee trauma: a preliminary case series using qigong and t'ai chi" authors stated that "preliminary observations from four cases and a review of the literature support the potential efficacy of incorporating qigong and t'ai chi into the treatment of survivors of torture and refugee trauma".

The authors state that "the popularization in the West of Eastern forms of exercise over the past few decades has led to their investigation as possible complementary therapies. A holistic treatment perspective recognizing the interrelationship and unity in the mind-body system is key to healing those affected by traumatic stress. This view is fundamental to Traditional Chinese Medicine as well as other healing traditions. A holistic model seeks to restore overall balance within the mind-body system and views health as an ongoing process encompassing interdependent physical, psychologic, and social factors, with disease and trauma representing a disruption in the balance of the whole system. Importantly, the body and mind are seen as interconnected, with changes to one affecting the other.

The flow of energy or life force, known as qi in Traditional Chinese Medicine, is fundamental to this view. Ancient Chinese physicians charted an interconnected system of channels through which qi circulates. It is thought that when the channels are open, energy can flow freely and unobstructed, bringing about good physical health, emotional balance, mental clarity, and a sense of wholeness. According to Traditional Chinese Medical theory, if energy flow is obstructed, corresponding physical, emotional, or mental imbalances can result and manifest as illness.

The Western diagnosis of PTSD can be conceptualized in terms of internal disturbances of energy balance and flow. PTSD symptoms can be viewed as the result of a freezing response blocking energy flow in the person. In order for healing to occur, these inner stores of frozen energy must be released and the natural flow of energy must be strengthened. Resolving this frozen energy can reestablish a balance within the person and a renewed flow of energy through the mind-body system, culminating in the return to a state of well-being.

Since trauma is often grounded in the body, healing should unfold through a process of restoring the body, with the healer addressing the patient's body in treatment. The dynamic balance of energy is the unifying scheme of well-being, and the proper manipulation of energy can promote healing of the mind-body system."

The authors had the following to say about qigong (keep in mind that some authorities consider tai chi to be distinct from qigong, while others consider tai chi to be a specific sub-form of qigong):

"We examined findings from studies using t'ai chi and qigong, with the view that they are alike in more ways than they differ and share the potential for assisting in the treatment of survivors of torture and refugee trauma. Qigong and t'ai chi share many similarities, with aspects of qigong appearing throughout t'ai chi movement sequences or forms. T'ai chi is a practice that developed over several centuries in China, involving a series of dance-like postures that flow into one another, integrated by mental concentration, physical balance, muscle relaxation, and relaxed breathing. T'ai chi combines movements from martial arts with Chinese philosophy and exercises for balancing and healing the body and mind. Qigong, one of the core practices of Traditional Chinese Medicine, means working with or manipulating the vital energy or qi in the body. Qigong can refer to exercises for cultivating internal or external qi, but in this study we refer only to the individual practice of cultivating internal qi. Though both qigong and t'ai chi have a meditative aspect and focus on breathing, qigong is known more for these qualities, and qigong exercises are generally easier to learn and less physically demanding. T'ai chi has a martial aspect missing from qigong, even though t'ai chi is not practiced primarily as a means of self-defense.

Anxious, troubled states of mind and erratic thought processes can be expressed in the body, just as problems in the body can affect mental attitudes. Many physical problems can be attributed at least partially to mental or emotional stress. Trauma, whether "complex" or not, may be the original source of persistent physical, emotional, or cognitive problems, but it is the constant repetition of this trauma in the subject's mind-body system that creates the problems that must be addressed in treatment. The slow, focused movements of qigong and t'ai chi may counteract erratic movements and thoughts by increasing awareness of and eventually releasing muscle holding patterns and their associated attitudes caused by stress, trauma, or past injuries. Qigong and t'ai chi are practiced slowly to develop sensitivity and awareness of the body as it moves through the immediate environment. By focusing on movement control, tension and muscle holding patterns can be released. Emphasis is placed upon the development of flexibility and internal energy, or qi, with each focused movement aiming to manipulate qi in a particular area of the body."

The authors had the following to say about how qigong assists in the treatment of PTSD:

"A qigong and t'ai chi intervention has the potential to contribute to the relief of psychologic and psychosomatic sequelae of torture at two levels. In populations of nontorture survivors, qigong and t'ai chi have been demonstrated to relieve the same symptoms that are highly prevalent in survivors of torture and, as such, have the potential to contribute to alleviating symptoms of tortured individuals. Additionally, the increase in bodily awareness and mental focus accompanying the practice of qigong and t'ai chi may aid torture survivors in processing the bodily aspects of their trauma and facilitating the healing of related psychologic disturbances.

Qigong and t'ai chi incorporate a cognitive aspect not present in most exercise, which may explain why some controlled studies have found greater benefits from t'ai chi or qigong than activities of comparable intensity. Due to their low impact on the body, qigong and t'ai chi are especially useful when aerobic exercise may be too physically strenuous for the individual.

T'ai chi and qigong have been shown to produce statistically significant improvements in psychologic well-being, including significant reductions in mood disturbance, anxiety, stress, tension, depression, anger, fatigue, confusion, and state-anxiety.

The cognitive component of qigong and t'ai chi practice is an important source of their therapeutic potential. The practice of being fully attuned to one's surroundings and aware of the present moment is often called mindfulness. Mindfulness practice can help address dissociative alterations in identity by facilitating the person's identification with their inner self rather than their physical body, which is often a source of suffering in survivors of torture. Qigong and t'ai chi involve an essential mindfulness component, similar to meditation practice that may aid in treating the dissociation characteristic of PTSD.

Both qigong and t'ai chi have been shown to reduce cortisol levels, possibly implicating the hypothalamic–pituitary–adrenal axis in t'ai chi- or qigong-induced stress and anxiety reduction."

The full text of the article is available here.