What Is Yoga Therapy for Complex Trauma?

Complex trauma is as individual as the person who suffers with it.

I. Maya's Story

What follows is a fictional case study that represents experiences commonly shared by survivors of complex trauma.

Maya sat on the floor of her new townhome, and wondered what was wrong with her. She stared at the stack of unpacked boxes. The walls still smelled of fresh paint. Despite waiting for this moment for months, maybe even years, Maya felt numb. She took a few deep, even breaths like her therapist had taught her, and noticed her numbness was accompanied by guilt. This was the first time she'd been away from her kids for more than a day or two. They were staying with her now ex-husband (they'd almost made it to their 15th anniversary) while she moved.

She also felt exhausted, so exhausted. Why couldn't she be happy? She's the one who asked for the divorce. Her friends all told her she had to leave. They said she shouldn't put up with the yelling and walking on eggshells. Plus, they said it wasn't good for the kids to see their dad treating their mom so poorly. Her therapist agreed. She cringed to think of the look on her 12-year-old's face when he heard his father scream "you're not as good as you think you are!" at her. If everyone--herself included--knew this was the right decision, why was she wracked with self-doubt?

Her negative thoughts spiraled. Who would ever love her again? She was a 45 year old divorcee, with two kids, a dog and lots of baggage. She'd be alone forever. What if her friends got sick of hearing her problems? With a bunch of new bills, growing kids, a new mortgage--what if she couldn't keep up financially? What if she ended up like her father, destitute and alone?

When she was 14 years old, her mother, sister and she found her father slumped over dead, the cause of death later established as cirrhosis of the liver. Though her father had lost his battle with alcohol, he'd been the nurturing parent. She still thought nostalgically of their camping trips together when he showed her sister and her how to pitch a tent, and how to fish. Her mother had been the stable one, but was often cold and judgmental. As a single mother working three jobs, she had little time for her children, and seemed to resent the loving relationship her daughters had with their father. She often said Maya was like her dad, something that smacked of insult to Maya.

Despite her success as the CFO of a tech start up, Maya felt plagued by the feeling of not being enough. She'd wanted so badly to remaster her unfortunate childhood with a loving family of her own. But then she accidentally married a man who was as cold and blaming as her mom. She'd come so far from her tough beginnings. But now she felt ashamed, unlovable and desperate for reassurance.

A familiar pang of queasiness rose from the pit of her stomach into her throat. The room began to spin. She felt like a little kid again, alone in her room, unseen, unheard and unloved. She heard the echo of her mom's words, "You're too sensitive. Why do you have to make a big deal about everything?" The heat of embarrassment and shame rushed into her cheeks. Her breath became choppy and labored.

Maya recognized these body sensations as the beginnings of a panic attack.

"Ground, ground. I need to ground when I'm panicked," Maya said to herself. Still seated cross-legged on the floor, Maya closed eyes and reached down, feeling the varnished floorboards beneath her palms. Her yoga therapist had taught her to focus attention on body sensations when she felt panicked and scared. Feeling a bit more grounded, she began to press down on the floor as she exhaled. She noticed her breathing became deeper, and she was more focused on the here and now than her traumatic childhood. She intentionally brought her children's faces to her mind, and smiled.

In therapy six months prior, Maya had learned that her depression and anxiety, panic attacks, low self esteem, and perfectionism (that turned into an eating disorder in college) were symptoms of complex trauma. Whereas posttraumatic stress disorder (PTSD) is generally the result of a single incident or event, complex trauma stems from pervasive, oftentimes childhood, traumas that persist into adulthood. And complex trauma (CPTSD) is one of the silent issues fueling a global mental health crisis.

II. What Is CPTSD?

Like other survivors of complex trauma, Maya thought she was damaged, defective and unlovable. These beliefs resulted in feelings of shame, doubt and unworthiness that caused her difficulty in relationships and life (Courtois & Ford, 2016; National Health Services [NHS], 2022). 

The National Child Traumatic Stress Network (NCTSN) defines complex trauma as "exposure to multiple traumatic events—often of an invasive, interpersonal nature—and the wide-ranging, long-term effects of this exposure" (2025). The interpersonal nature of complex trauma is an important feature of it (Courtois & Ford, 2016; Schwartz, 2021).

In summary, these four conditions are the main culprits of complex trauma:

1) at least one threatening event

2) prolonged or repetitive injury or exposure to a major stressor

3) escape is difficult or impossible

4) the injury is interpersonal--meaning one person inflicts injury on another. In the case of complex trauma, the one who inflicts injury is often a person who is a caregiver, authority figure or someone the victim depends upon in some way.

To get a sense of how complex trauma emerges, let's take a closer look at Maya's story. Her father was a man of color born in Jamaica, and adopted by a white American family. He joined the military at age 18 years old, and saw a friend killed in battle at the tail end of the Vietnam War. He met Maya's mom (a white woman) two years later. In 1979, they were married and Maya was born in 1980, her sister in 1983.

Maya's mom said that at first things were "great." Her parents were in love, had a beautiful baby girl, and her father became known as the CPA to get clients the best tax return in town. But over time, the wounds of war and the systemic racism Maya's father endured in a small town compounded with the pressures of job and family life. Maya said that alcohol was a much more condoned form of self medication than therapy in the early '80s, so her father drank. His drinking led to "raging fights," according to her mother.

By the time Maya was 4 years old, her parents divorced. She said she doesn't consciously remember the screaming fights her mom recounts, but notices her body goes on high alert if someone raises their voice. Maya's hypervigilance regarding raised voices was a trauma symptom from her childhood. "Children who witness domestic abuse are at risk of both short and long-term physical and mental health problems" (Barnardos.org.uk).

On the other hand, Maya also recalls feeling loved and doted on by both parents early on. But then something changed in her mother after the divorce when Maya was six or seven. "My mom had to work a lot--she often had three jobs as a single mom, whereas my dad just had one. He became spotty with child support, and yet we loved seeing him. She had this faraway look in her eyes. She just kinda checked out on us." Lacking the necessary support she needed as the head of the household, Maya's mother most likely suffered from depression. And her symptoms impacted her children, especially Maya.

To make matters worse, Maya took after her father in many ways, "We had similar features, the same cappucino-toned skin. I liked math like he did, and started winning all the math competitions in school." Maya said she thought her mom never quite got over her father, even though she left him. Maya speculated that her similarities to him were painful for her mom. She said her mother was often absent for big events that mattered to her, like her math competitions or soccer meets. "When she did notice me, it was to judge or compare me with my younger sister." Maya felt like she couldn't please her mom or live up to her standards.

As Maya and her sister got older, their father's mental health issues got worse. He stopped working, and became reclusive. "We'd check on him from time to time, make sure he was eating and wasn't lonely." One day when Maya was 14 years old, her mother, sister and she dropped by her father's for one of their visits. "I remember a weird feeling coming over me when he didn't answer the front door. We went around to the back, where he had a sliding glass door that usually unlocked. And there he was--lying face down on the living room floor. I knew immediately that he was dead."

Maya's story is an example of complex trauma, as well as intergenerational trauma. Many threatening events impacted its members: her father's experiences in Vietnam and in his own community as a man of color, Maya's witnessing of her parents' fights, and three family members finding her father dead. All family members endured prolonged stress that was inescapable: her father could not change what he'd seen in war or the racist society he lived in, her mother was stuck caring for her children on her own while also caring for a debilitated ex-spouse, and Maya and her sister were children who depended on their overstressed caregivers and could not change their circumstances. These circumstances were made worse by the interpersonal injuries her parents inflicted on each other, and then inadvertantly inflicted on their children.

III. An Integrative Solution

The most vulnerable in our communities are at greatest risk for complex trauma (Courtois & Ford, 2016; National Child Traumatic Stress Network [NCTSN], 2023). The NCTSN website (2023) lists multiple populations commonly impacted by CPTSD: LGBTQ youth, immigrant children and families, military soldiers, personnel, veterans and their families, trauma and substance abuse survivors, individuals with intellectual and developmental disabilities, those who are unhoused, and those with economic stress.

Given the longstanding and complex nature of CPTSD, what facilitates healing? The answer is an integrated approach. Maya started by finding an experienced trauma therapist who specialized in issues for people of color. Her original reason for starting therapy was insomnia and panic attacks. But therapy soon showed her that these symptoms were linked to the stress of her home life, and the unhealed wounds of her childhood.

Maya's therapist also referred her to a yoga therapist who helped her develop strategies to improve her sleep and decrease her panic attacks. As a mind-body intervention, yoga can unlock body sensations, memories, and triggers. Yoga therapy is the therapeutic use of yoga tools to treat an individual’s symptoms. When traditional talk therapy and yoga therapy are integrated, they can help increase a client’s awareness and coping skills in ways that neither can on their own. With the help of both her therapists, Maya learned to decrease her symptoms of anxiety, depression and complex trauma.

The calming techniques Maya used on the floor of her new townhome when she felt panicked were yoga tools she'd learned in therapy. Her yoga therapist introduced Maya to panchamaya kosha (or the five-body system), an ancient system of yoga therapy that postulates five layers, or bodies, of human experience: the physical body (annamaya kosha), the energy or breath body (pranamaya kosha), the mental/emotional body (manomaya kosha), the intuitive or wisdom body (vijnanamaya kosha), and the joy or bliss body (anandamaya kosha). Feeling the ground when she noticed her rising panic was the way Maya brought her attention to the physical body (annamaya kosha). While still feeling the ground beneath her, she brought her awareness to her breath (pranamaya kosha). Once her breathing had slowed down, she turned her attention to her thoughts and intentionally thought of something happy, her children (manomaya kosha).

As she sat in the darkness of her new home, Maya continued her deep breathing and pictured her thoughts like clouds in the sky. As she watched thoughts and worries arise she noted the thought, and then let each one pass. She realized she was practicing witness consciousness, a form of vijnanamaya kosha practice. She now felt a sense of stillness and of being ok--really and truly ok. Out loud she said, "It's Friday night. I am sitting in my new living room. I am a successful businesswoman and mother of two." Then she said the mantra she'd created in therapy: "I am enough, I am enough, I am enough." She opened her eyes and smiled. In this moment, she felt excited about her new beginning (a moment of anandamaya kosha).

If you'd like to learn more about panchamaya kosha and how yoga therapy can help transform complex trauma, check out our new book Yoga Therapy for Complex Trauma: Working with Child, Adolescent, and Adult Clients (Singing Dragon, 2025). Its official release is August 21, 2025, but you can preorder it by clicking the name of the book in the previous sentence.