by Michael Lear
A few months after turning 22 in 1986, having a degree in finance and working in a management position, I was found to have impressively high blood pressure measuring 162/105 and elevated cholesterol levels.
I also suffered from compromising chronic back pain which became acutely sharp at times. Being 40 pounds heavier than the average weight for my height didn’t help the situation. Being allergic to many medications, including the most widely used array of prescription pain-killers, I had to explore other alternatives to find relief. My body had rejected even muscle relaxants which left me with little latitude to journey comfortably forward. Fortunately, through some serendipitous events, a unique method of neuromuscular bodywork or movement re-education system called the Trager® Approach came on to my radar. Named after Dr. Milton Trager® who developed the technique over his lifetime and professional
career, it seemed like a good place to start. At that time, I had only the pain to lose.
Alternative approaches, including massage, were considered ‘fringe’ in the late ‘80s as they
still lacked wide acceptance. Nearly a decade later, in 1995, hands-on therapies, including the Trager® Approach, were cited as “Eye of the Newt Therapies” in the Market Place section of a Wall Street Journal issue. The Trager® Approach has stood the test of time.
My first experience with The Trager® Approach was profound and would prove to be pivotal.
Though I had arrived at the session with some discomfort, there was no time during the session that I experienced pain. In fact, most of what I felt was curiosity mixed with relaxation. I was feeling that most, if not all, of my body felt good, not heavy or restricted as it had an hour before.
Often during the session I wondered why the practitioner was working on a part of me seemingly not related to the pain I had been experiencing. Yet, when the session was over, all traces of functional limitation and discomfort were gone. “Where did they go,” I thought to myself, “if they were not worked on directly?”
After my session I was given movement exploration exercises to do on my own, Trager® Mentastics® (mental gymnastics), to help me meet my world differently; to explore movement possibilities outside my default, habituated way of moving about my environments such as work and home. It was through these homework movement exercises that the Trager® Approach got its traction within me.
I began receiving sessions monthly to ensure that the pain did not return. In other words, so I did not fall back in to old movement patterns that set up the painful conditions. Also, I had become a committed student of the Mentastics® which are like Tai Chi or gentle yoga- type movements that leverage principles of autogenic training, a widely recognized method of biofeedback used to lower blood pressure as it elicits physiological change through silently repeated phrases. Mentastics® also encourages memory of the session, of how it felt when I received the work, re-living the therapy in my mind. Every movement after a session is an opportunity to reprogram how one moves in their body and in relation to their world.
Mentastics® requires mindfulness and, indeed, this was changing my relationship to the world around me. I even found that the underlying principles of the Trager® Approach worked in dialogues, meetings, negotiations and in my relationships. They impacted all aspects of my life.
To note, the Trager® Approach can be likened to piano lessons, where the student studies with a teacher and then practices in between each lesson so the next lesson can build upon the previous one. I discovered that each session was a lesson for my nervous system which then was reinforced by living differently through my body afterward. It was more than a treatment for my physical body as it worked on my mind as well which, in turn, affected my body’s function.
The phrase “One doesn’t have to feel bad to feel better,” comes to mind as, although comfortable, I continued to receive the sessions regularly. Not only did I remain pain-free, but also I noted increasing fluidity, grace and lightness in my body, qualities that had been shut down through restricted habituated movement patterns which were compensatory responses to injuries and to surgeries which I had as a child.
That first Trager® session was May 13, 1987 and my latest was just two days before beginning to write this chapter. Discovering the Trager® Approach changed the course of my life significantly. It made me interested in, curious about, and aware of how I moved in my body; who I was towards myself as I lived in my body; and how all that impacted my movement experience, either by limiting it or by opening it up to new potential, like doing Yoga. My body was feeling better and the deep relaxation fostered by the sessions facilitated the release of deeply seated muscle holding patterns that clearly had subconscious emotional counterparts. The insights I gained were game-changing. The work took me into foreign territory. Terrain that was inside of me, not outside, and which connected me to what was and what wasn’t comfortable. The Trager® Approach’s capacity to provide a safe context for my body-mind to assess, re-organize and let go of dysfunctional muscle holding patterns that manifested as functional limitation and pain was extra-ordinary, comfortable, pleasurable. It facilitated a ‘remembering’ of my body’s inherent coherence and, once it felt safe, my body naturally migrated toward more balance and harmony. I had let go of learned dysfunctional muscle patterns developed and valid at an earlier time which were now simply limiting. The relaxation and release of stress promoted by the mindfulness of The Trager Mentastics® led to a controlling of my body's 'fight or flight' response. This produced a decrease in cortisol and adrenalin release, normalizing my blood pressure and leading to a lowering of my cholesterol levels. In addition, the decreased stress curbed my emotional eating and encouraged me to make better nutritional choices. As I was pain-free, I became more active which also contributed to a reduction in my body weight. So affected by the experiences that I continued to have, I began to wonder what education one needed to be able to impart such a feeling state to others. I then registered for the professional Trager® Approach training and became a certified Trager® Practitioner in 1991. Also, Trager® had led me to Ashtanga yoga and Vipassana meditation. Today, these three form the tripod of daily practices upon which my days rest.
So what is The Trager® Approach and what are its applications for addressing Post Traumatic Stress Disorder related pain? Succinctly stated by Deane Juhan, Senior Trager® Instructor and author of “Job’s Body, A Handbook for Bodywork”: “Unconsciously habituated muscular responses and adaptations to life’s adverse circumstances, such as accidents, illness, surgery, emotional traumas, or high levels of daily stress, often develop into poor postures and patterns of movement that can become the silent accumulative context for further pain, injury or disease. And wasteful, ineffective muscular patterns can also frequently slow down, compromise, and even ultimately limit the process of recovery from physical or emotional breakdowns of many kinds. The Trager® Approach is a rapid, effective, and painless, indeed pleasurable method of deprogramming these accumulated negative muscular pattern, and of restoring the positive body image and feeling, tone, and organized responses that are essential to healing and healthy development.” The purpose of my work,” Dr. Trager® has said, “is to break up these sensory, motor, and mental patterns which inhibit free movement and cause pain and disruption of normal function.” The Trager® Approach consists of the use of hands-on contact and movement re-education to influence deep- seated psycho -physiological patterns in the mind, and to interrupt their dysfunctional projection into the body’s tissues. The method is to impart to the patient what it is like to feel right in the sense of a functionally integrated body-mind. Since the inhibiting patterns are affected at the source, the mind, the patient can experience long -lasting benefits. “ Juhan Continues, “ During a Trager® tablework session, the practitioner uses gentle, pleasuring rocking motions, compressions and elongations, gravity-assisted swings and hangs of the limbs, and shimmers of the tissues to facilitate a more and more painless and passive perception of movement throughout the patient’s body. These manipulation are not perceived as intrusive because they do not work against the organism’s basic reflexes and defenses, but rather simulate the normal ranges of elongation, compression, and jiggling of coordinated movement in the body. And the pleasuring aspect of each exploratory movement is not incidental to the treatment. On the contrary, it is of the essence, and any pain or discomfort is always an indication to modify the depth, range, or speed of the practitioner’s imposed movements.
This pleasuring is important for three reasons: 1) Pain inevitably engages reflex muscular defensiveness, producing amplified, not reduced contractions and holding patterns; 2) Pleasuring is a potent biofeedback element which leads to deeper relaxation, softening, and increased ranges of motion within the limitations of the actual conditions in the body; 3) Trauma and pathology themselves have created pain and fear, frequently to the extent that the patient can no longer imagine any part of their body as a source of pleasure, comfort, or strength. The goal is to create in the session a sense of safety and ease in which new and better patterns can be learned, a delicate process that can be easily disturbed by any increase in pain or discomfort. “Every shimmer of the tissue,” Dr. Trager has said, “is sending a message to the unconscious mind in the form of a positive feeling experience. It is the accumulation of these positive patterns that can offset the negative patterns so that the positive can take over.”
The table-work portion of the session takes place on a massage table with the client draped and clothed to the degree they’re most comfortable with. No oils or lotions are used. A typical session with Mentastics® Instruction lasts about ninety minutes, however time varies depending on the setting and the practitioner. Some reported benefits from the Trager® Approach include:
Increased mobility, vitality, clarity, capacity to relax and a sense of overall peace
Improved sports performance without injury
Quickened recovery from surgery or injury
Relief from stress, joint pain, muscular pain, sciatica, chronic back/neck pain, headaches and temporomandibular joint (TMJ) pain
Relief from fibromyalgia and chronic fatigue
Improved neuro-muscular function in those with Parkinson’s disease, cerebral palsy
and multiple sclerosisImprovement in status with ankylosing spondylitis and post-stroke paralysis
Please understand, this is not to claim that Trager® is a cure for these or any other pathologies. “But in the absence of a cure, improved emotional balance, superior coping mechanisms, more effective compensations, and a measure of control over and active engagement in their own present and future will always be of extreme importance to these patients, and to anyone personally associated with them.” Deane Juhan. Over the course of my career, I have successfully worked with clients with various painful or limiting physical conditions, stress-related symptoms, congenital neuromuscular disorders and survivors of various kinds of trauma as well as with clients who, although comfortable, wish to expand their range of motion and physical capabilities. During the time that I spent in post-tsunami Sri Lanka, I worked with numerous disaster survivors who still experienced pain and limited mobility long after the apparent healing of the initial injury. Self-medication, sometimes imprudent, did not help with their pain. The Trager® Approach greatly improved their conditions, almost always decreasing or even eliminating pain and restoring greater degrees of function and enhancing ease in mobility. One specific client experienced arm swelling a year out from the tsunami. She had been pinned down by that arm when a cabinet fell upon it, trapping her as the waves were rushing in. She nearly drowned before she was rescued. After her first Trager® session, the swelling reduced by about 80% and subsequent sessions relieved the situation completely. In this particular case, it was the artifact, the memory of the experience that had remained frozen in her mind and body and produced a physical expression long after the original incident. Through the gentle touch and inquiring movements of Trager®, her mind was able to experience safety and eventually release the pattern holding the physical expression.
Similarly, the effects of sexual abuse are present long after the trauma takes place, sometimes producing a fear of physical contact altogether or a dissociation with bodily identity. Through the Trager® Approach I have been able to help such clients to acknowledge their physicality and reset their level of comfort with healthy normal contact with others. The touch dialogue that the Trager® Approach sets up can be compared to the approach of “Non Violent Communication” as described by Marshall Rosenberg in his book of the same name. For example, if you were yelled at, how long would you listen? In the same way, to force the body to do something that it is not ready to do sets up a similar resistance-push back.
It’s important to emphasize that Trager® is not a form of psychotherapy or “talk” therapy and references made to the “touch as a language” or touch dialogue” pertain to the use of hands to engage in a conversation with the unconscious mind. Trager® practitioners feel/listen for resistance patterns and honor their set points. They do not attempt to move into muscular resistance or change what is true for the body-mind. Instead, the Trager® Practitioner will emphasize ranges of motion that are acceptable, safe and comfortable so as to invite the client’s letting go of such patterns that may be no longer relevant. As the body feels safe and ‘heard’, it can choose to let go of valid but outmoded patterns that may have projected into the tissue as pain or limitation. For Veterans experiencing pain, this non-intrusive process may be of particular benefit. Like any learning process, success requires repetition and continuity of practice for a new pattern to establish itself. The restoration of optimal sensorimotor patterns through neuromuscular re-learning, or through the choice of the body-mind or on the nervous system’s terms, contributes greatly to the health of the body by improving joint mobility, circulation, and reducing pain and functional limitation.
Trager®’s gentle and subtle approach may also serve those suffering with phantom limb pain associated with amputations. The initial trauma to the body usually produces a variety of protective bracing patterns and subsequent compensatory patterns to aid the body in healing. If these patterns persist after the healing is completed, the potential exists for there to be excessive limitation and sensitivity near the point of amputation. The Trager® Approach in general, helps the body to experience greater integration, helping it release such patterns. This may also assist the nervous system at its subtlest level to decrease the triggering and sensitivity of the portion of the nerve fibers associated with the lost limb. Painful muscle spasms may be reduced using The Trager® Approach. It was shown that 20 minute sessions of Trager® Therapy three times per week had a significant impact on the level of spasticity within Parkinson’s patients in a study published in the Journal of Manipulative and Physiological Therapeutics, September 2002. (The Effect of Trager® Therapy on the Level of Evoked Stretch Responses in Patients with Parkinson’s Disease and Rigidity by Christian Duval, Denis Lafontaine, Jacques Hebert, Alain Leroux, PhD, Michael Panisset, MD, and Jean P Boucher, PhD) The relaxation response of The Trager® Approach is also profound. The practitioner him/herself cultivates a state of deep relaxation from which to do the hands-on table work so that the relaxed state can be imparted to the client. This relaxed state after only ten minutes of Mentastics® is measurable in Heart Rate Variability studies. (Dr Gebhard Breuss, Heidi Stieg-Breuss, Dr Alfred Lohinger, www.autonomhealth.com). The Heart Rate Variability of the client is also measurably changed. Heart rate variability is a well-known measure of emotional resilience and relaxation/stress measurement. Shifts in mind states to enhance relaxation increase levels of comfort whereas stress is known to exacerbate pre-existing painful conditions.
Dr. David Hubbard, formerly Medical Director at Sharp Pain Rehabilitation Services, Sharp Health Care, San Diego, CA published studies in Spine, 18, 13, 1803-1807, 1993 that showed that intrafusal muscle fibers that figure prominently in fibromyalgia were innervated by the sympathetic nervous system. It was found that painful muscular conditions were exacerbated by sympathetic nervous system arousal. Dr. Hubbard used The Trager® Approach in his clinic to facilitate the release of these sympathetically stimulated mechanisms that were causing pain. He found that The Trager® Approach, with its invitatory touch dialogue which includes compressions and elongations of the muscle spindles, elicited relaxation responses. Muscular changes may also be elicited through the mental movement explorations, Mentastics®, of the Trager® Approach. Utilizing self-inquiry, Mentastics® helps to keep a moment-by-moment awareness of what is occurring within the framework of the body, the mind in relationship to the environment and how that is feeling to us. An important component of these movement explorations is to stay within pain-free ranges of motion to reinforce movement without painful consequence. The range of motion expansion should remain acceptable and comfortable. Much like the table-work explorations performed by Trager® Practitioners, who move the body while maintaining the body’s comfort, Trager® Mentastics® help the nervous system drop anticipatory contraction patterns that can exacerbate painful conditions. Once anxiety over possible discomfort is relieved, the body mind can make a truer assessment of what is happening.
Much like the success of autogenic training in biofeedback, Mentastics® mindful movement utilizing self-inquiry can elicit new and more comfortable shifts in the musculature. Self-inquiries such as “What would feel lighter or freer, more fluid here?” or the visualization of something that embodies these qualities, can invite the body to follow the mind. This process is much like how a dancer or actor will take on the characteristics of the role they’re playing and, by getting in to character, they initiate change in their carriage, deportment and gestures, even tone of voice.
Our bodies are designed to get good at what we practice, even when we practice in our thoughts. All of us have been able to call on a memory and bring forth a physiological response with a recalling of the feeling. Perhaps too often we reflect on negative experiences rather than recalling and re-living positive, relaxing or soothing ones with the enjoyable feelings that accompanied them. We can go there too, but only through practice. By recalling the Trager® session where lightness and fluidity are experienced, one can begin to elicit similar muscular changes and comfort. For those suffering from trauma, this may present some challenges, but the Mentastics® process is gentle and patient. When practiced properly, Mentastics® does not re-traumatize the body mind but rather provides a safe movement experience.
The efficacy of Mindfulness practices, such as Mentastics®, is supported by the growing body of evidence-based research regarding the benefits of Mindfulness practices and Trauma-informed Yoga. Mindfulness implies keeping a moment-by-moment awareness of what is occurring within the framework of the body, our feelings, bodily sensations, surrounding environment (what comes through the five sense doors) and even our thoughts. An important component of this state of awareness is being equanimous with, or accepting of, what we observe as it is in particular physical sensations. In doing so we are in the present moment, not ruminating over the past or being anxious about the future and experiencing their associated emotional states. Coupled with curiosity, self-inquiry, these mindful movements have a capacity to reprogram our motor function to be more efficient, comfortable and easy. In addition to controlling heart rate variability, Mindfulness has been shown to result in a decrease of the grey matter of the brain’s amygdala, the region known for its flight or fight role in stress. This decrease of the amygdala allows for increased self-control as it decreases impulsivity allowing for more emotional resilience. These studies have also shown a beneficial thickening of the grey matter in the pre-frontal cortex, the area of the brain responsible for emotional control, awareness, concentration, problem-solving and planning. The hippocampus of the brain, which helps with memory and learning as well as emotion, also has been shown to have increased amounts of grey matter with mindfulness practices. This is especially important for those suffering with depression or Post Traumatic Stress Disorder as the hippocampus is covered with receptors for the stress hormone cortisol which can be damaged by chronic stress such as those conditions may cause.
Additional evidence that Mindfulness and Trauma-informed Yoga can reduce symptoms of anxiety and depression was reported in a research study found in the February, 2018 Journal of Alternative and Complementary Medicine. The study, “Mind-Body Therapy for Military Veterans with Post-Traumatic Stress Disorder: A Systematic Review” was co-authored by Kathryn Braun, professor at University of Hawaii at Manoa and Robin Cushing, Army Physician Assistant. Braun and Cushing researched the effects of Mindfulness, mind-body therapy and Yoga on Veterans diagnosed with Post Traumatic Stress Disorder and found a significant reduction in symptoms for all the Veterans studied who had participated in the Mindfulness, mind-body therapy and Yoga practices.
My own personal experience teaching Trauma-informed Yoga in prison and residential juvenile justice settings demonstrated the benefits of mindful movement practices with a breath awareness component. In these settings, many within the populations suffered from unresolved abuse trauma and PTSD that led them to engage in behaviors that resulted their incarceration. Trauma-informed yoga, like the Trager ®Approach and its Mentastics® mindful movement component, focuses on greater body awareness, development of enhanced mind-body integration. Ensuring safety, predictability, consistency and choice, coupled with non-violent communication as well as meta-cognition techniques also facilitates favorable results.
Gains were noted in the empowerment of survivors by increasing emotional resilience,
decreasing impulsivity and de-escalating hyper-vigilant nervous systems. Over the course of my career, whether as a Trager® Practitioner, a Trauma-informed Yoga Instructor or working with international relief efforts in disaster areas such as Sri Lanka and Haiti or in post-conflict regions such as South Sudan and Uganda, the creation of a safe environment for those affected by PTSD has been a priority as its benefits cannot be overstated. Until they can safely experience what is true for them in the moment, with a high degree of equanimity fostered by mindful breathing and movement practices, the potential exists for persons with PTSD to be governed by their symptoms, physical or emotional.
This holds true for everyone. Safety is paramount for the body to let go of protective and limiting patterns, whatever they may be. Both The Trager® Approach and Trauma-Informed Yoga with Mindfulness provide a safe context for the body to migrate back to balance and harmony, the place where it is designed to rest when given the proper support.
For more information about The Trager® Approach, or to find a Practitioner in your area,
please contact The United States Trager® Association.
United States Trager Association
3755 Attucks Drive
Powell, Ohio 43065
Tel: (440) 834-0308
www.tragerapproach.us
Books on The Trager® Approach:
Trager® for Self-Healing: A Practical Guide for Living in the Present Moment -Audrey Mair
Mentastics: Movement As A Way to Agelessness, Dr. Milton Trager and Cathy Guadagno
Moving Medicine, The Life and Work of Dr. Milton Trager: Jack Liskin
Additional information can be found at. http://www.tragerfordailylife.com
For more information on Trauma-informed Yoga and Veterans PTSD, the following books
and organizations may be helpful. It has been reported that Veterans tend to prefer Yoga
teachers who are also Veterans as they better identify with those who have shared experiences.
It is always best to find a Yoga teacher with whom you resonate, one who is interested in
empowering the student to perform on his or her own.
The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma -
Bessel Van Der KolkTrauma-Sensitive Yoga in Therapy: Bringing the Body into Treatment - David Emmerson
Best Practices for Yoga with Veterans Editor: Carol Horton, Ph.D - Yoga Service
Council PublicationNon-Violent Communication: Marshall Rosenberg
The Pocket Guide To Polyvagal Theory: The Transformative Power Of Feeling Safe:
Dr. Stephen Porges, (Norton Series on Interpersonal Neurobiology)
Organizations:
Veterans Healing Veterans from the Inside Out http://veteranshealingveterans.com/index.html
Veterans Yoga Project www.veteransyogaproject.org
Warriors at Ease http://warriorsatease.org/
About Michael Lear
Michael Thomas Lear is an internationally-recognized Senior Trager® Bodywork Practitioner/Instructor and Ashtanga Yoga Instructor with a client base spanning five continents and including a few Academy Award and Grammy winners as well as many figures prominent in business and industry.
For over 25 years, Lear has been at the forefront of mind-body medicine, yoga and meditation. He has studied Yoga with Sri K. Pattabhi Jois, the founder of Ashtanga Yoga, as well as with many of Ashtanga's foremost instructors. Holding a Yoga Alliance RYT 500 Certification, he teaches Yoga Anatomy for Yoga Alliance Teacher Certification courses and conducts workshops internationally.
Lear is also a seasoned Vipassana meditator in the tradition of Sayagyi U Ba Kin as taught by S. N. Goenka. He was recognized with a cover article in Massage Therapy Journal for his work introducing Trager® to physical therapists in post-tsunami Sri Lanka, which he also has done in Japan. Lear who is on the management team for Instructors for Trager® International, also holds Plant Based Nutrition certification through Cornell University, taught by Dr. T. Colin Campbell, author of “The China Study” and “Whole.”
While working as Director of International Relations for Real Medicine Foundation and working closely with UN Agencies and foreign governments, Lear was an integral part of many international relief programs to improve primary health care service in disadvantaged areas of post-conflict, disaster affected and poverty-stricken countries, including Sri Lanka, South Sudan, Uganda, Kenya, Nigeria, Pakistan, Armenia and post-earthquake Haiti. South Sudan’s Medical Journal/JubaLink has cited Lear as a principal in establishing the country’s first College of Nursing and Midwifery.
In addition to his international service, Lear serves locally as a founding board member, trauma recovery yoga instructor, and lead trainer with The Shanthi Project a non-profit
organization which conducts trauma-informed yoga and mindfulness classes at the county
prison, juvenile justice center, Boys and Girls Club, and area school districts for grades K-12.
A life-long musician playing drums, Lear feeds his soul behind the kit. He has many years’
experience playing professionally and in a variety of genres. In addition to playing
professionally, he developed an entire on-line yoga and mindfulness program specifically for drummers www.yoga4drummers.com to help them access their full potential. He holds a Bachelor's Degree in Finance and International Management from Rider University in
Lawrenceville, N.J. and has worked extensively in the corporate world. A native of Easton, PA, Lear makes his home on the East Coast when he is in the United States where he enjoys visiting with family, friends and his cat Sayagyi.