I Don’t Treat Mental Illness or Trauma
By Kristine Kaoverii Weber | February 3, 2024
I’ll be teaching An introduction to Yoga for Trauma Recovery with psychotherapist Brett Sculthorp (my husband) on Friday, February 16 at the University of North Carolina Health Sciences at MAHEC. It is a hybrid course so you can attend in person or virtually. CEUs provided for most mental health professionals upon request. Replays are not available. Please contact MAHEC for registration.
My husband Brett is a psychotherapist, a licensed clinical social worker, and a certified prevention specialist. He’s worked at several agencies, mostly with people with trauma histories who have mental health and addiction issues and few economic resources. Some of his jobs required him to be on call for a week each month. The phone would wake us up in the middle of the night and it would be first responders asking him to come and help with suicide attempts, domestic violence situations, psychotic episodes, and other emergencies.
In his early 50s he realized being on call was no longer sustainable and he switched to private psychotherapy practice. He now specializes in working one-on-one with folks with trauma, he uses a lot of yoga in his treatment strategies. And though he no longer leaves the house in the middle of the night, he still works with some very serious cases.
Watching the trajectory of Brett’s work has taught me a lot about what goes into the treatment of trauma. It’s complicated, serious, and takes a special kind of person who is able to hold space. It also requires significant training.
When I was a teenager and in my early 20s, I had eating disorders, body dysmorphia, depression, and a pretty nasty habit of self-loathing. My parents were very supportive and paid for several years of therapy. I also did a lot of yoga, including meditation, and I traveled and studied yoga deeply. In my late 20s, I started to emerge from my issues as the person that I was meant to be. My eating disorders subsided, and my coping skills became healthier. Also, I started to like myself. (Just to be clear, I met Brett afterwards – he was never my therapist. In fact later I strongly encouraged him to seek out his masters degree and become a therapist).
Yoga has been integral to my healing process and also to simply dealing with the regular stressors of life. But even though I used yoga rigorously to help me cope with my own eating disorders and depression, I am acutely aware that my healing process is not the right path for everyone.
But just because I got so much out of yoga doesn’t mean that I can treat depression or eating disorders in others with my yoga skills. While I can certainly help people learn to use yoga to support their healing, I’m careful about the language I use and what I claim I can do to help.
As a yoga teacher and yoga therapist, I can help folks use yoga:
- as a complementary tool for any mental health challenge.
- to build greater self-awareness.
- for self-care.
- to develop a greater sense of agency.
- for nervous system self-regulation.
- for spiritual growth.
- for stress reduction.
- for health promotion and positive psychology.
But I don’t treat mental illness with yoga, and I don’t treat addiction or trauma. Rather, I support folks who are in treatment for those issues, or folks who would not be diagnosable but want to build greater mental health. What I’ve learned from my husband and his work, as well as from my work training mental health professionals to use yoga in their clinical practices for the past 15 years, is that the treatment of mental health disorders is out of my scope of practice. When someone comes to me with a serious mental health issue, I can only work with that person if they are under the care of a trained, licensed provider who has signed off on their participation in yoga.
By the way, I’m under no illusion that this is a perfect system. There are plenty of licensed people treating trauma who are out of their league and perpetuating harm. But this is the only system of regulation that we have at the moment.
And because there is no regulation at all in the health and wellness space, it can be even worse. Over the years I’ve witnessed so many cure-alls and blanket statements about how this or modality, or yoga practice will evaporate your mental health and addiction problems.
I’ve watched teachers tell students to stay in postures until they are shaking, sweating and in pain because “this is how you face your addiction.” I’ve heard people claim that certain poses will “destroy your anxiety.” I’ve heard teachers claim pranayamas as cure-alls for depression. I’ve seen teachers tell students with trauma to build strength and will power, meditate more sincerely, make better choices, and/or chant mantras. I’ve heard of teachers using sex (with them) as trauma therapy.
But none of these – nor ice baths, ayahuasca coaching, aromatherapy oil, or 20 minutes of kapalabhati – are evidence based treatments for trauma.
These kinds of claims are irresponsible – and also bad for the professionalism and reputation of yoga.
Treating trauma is difficult. It requires time, skill, and training. The reason evidence base exists is to provide effective therapies and to prevent harm. And people with trauma histories have already been heartbreakingly harmed.
There is emerging evidence for the use of yoga in trauma therapy and the treatment of depression, anxiety, and addiction. It’s promising and hopeful. What I envision in the future are integrative mental health clinics all over the world that employ yoga professionals as equally respected therapeutic team members to help people overcome their mental health issues.
But we’re not there yet.
The reality is that it’s not only outrageous wellness claims that are a problem – very few western health care professionals understand the extent of trauma, its shattering impact on people’s lives, and how to treat it. People with complex trauma or PTSD are often misdiagnosed, prescribed the wrong medications, and/or taught some basic coping strategies – rarely is the root of the problem addressed. In fact, western culture is largely set up to deny trauma, ignore mental health, and normalize addiction.
So of course people seek out other therapies – often alternative. When they come to yoga and they like it and they are doing well with it, that’s fantastic. But if they get retraumatized, that’s a big problem. Everyone deserve compassion and kindness, but many people also need appropriate, effective treatment.
Please let me know your thoughts in the comments.