The Breath That Moves Inside You: Dealing with Trauma-an Ayurvedic perspective

By Manuela Heider de Jahnsen, MSc

In a world where trauma has become a common explanation for distress, anxiety, and depression, conventional medical approaches often fall short in providing personalized care and listening to individual narratives. Manuela Heider de Jahnsen presents a unique perspective in her book, drawing from the ancient healing systems of Ayurveda and Yoga to navigate the complexities of symptoms, behavioral changes, and safe treatment options.

Through her 40 years of dedicated work caring for traumatized patients, Manuela offers profound insights into human consciousness and a pathway to recovery. Going beyond the limitations of conventional medicine, Ayurveda and Yoga meet individuals where they are, providing personalized care and showing ways towards healing and renewal. In this transformative book, Manuela’s compassionate approach shines a light on the horizon, offering hope and guidance for those seeking a holistic understanding of trauma and a path to lasting well-being.

• Language: English
• Publisher: Austin Macauley Publishers
• Release date: Feb 2, 2024
• ISBN: 9781398435209

Manuela Heider de Jahnsen, MSc

Manuela Heider de Jahnsen, MSc in Ayurveda, has studied Oriental Medicine since 1980. Studying the ancient systems of healing and putting them into practice allowed her to meet and work intensely with people from very different cultures and backgrounds, close and abroad. Through projects for the European Union, she got involved in integration plans for refugees and created intercultural care options for children in hospices. She runs a clinic for Ayurveda, yoga therapy and acupuncture in Berlin, Germany, specialising in breathing explorations and workshops on the above themes worldwide, focusing on trauma. She is a free diver and uses water as an integrated part of treatments. She is a regular speaker in India.

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About the Author

Manuela Heider de Jahnsen, MSc in Ayurveda, has studied Oriental Medicine since 1980. Studying the ancient systems of healing and putting them into practice allowed her to meet and work intensely with people from very different cultures and backgrounds, close and abroad. Through projects for the European Union, she got involved in integration plans for refugees and created intercultural care options for children in hospices.

She runs a clinic for Ayurveda, yoga therapy and acupuncture in Berlin, Germany, specialising in breathing explorations and workshops on the above themes worldwide, focusing on trauma. She is a free diver and uses water as an integrated part of treatments. She is a regular speaker in India.

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Manuela Heider de Jahnsen, MSc 2024

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Dedication

To my grandchildren, Livi and Bela, and all the children of the world who inherit the planet and the knowledge from all of us. Let’s thrive for the best.

This work is dedicated to the unconditional love received from my daughters, Naira, Mimi and Elliot. Despite me coming home late every night; too late for their little lives. Taking full responsibility, I was carried away by the miracles of sadness, grief, surviving and healing. I love nothing more in this world than these three wonderfully strong and independent women, who say I inspire them to be passionate about what one does.

As the saying goes, If one does what one loves, one never works a single day in life. Their belief in the world as a safe place was something I thrived for, yet sometimes failed miserably. However, they always motivated me through their words and ideas of love, gender and revolution. Regardless of some disputable choices, most turned out well-thought and eventually became enjoyable self-inquiry projects leading towards a successful and happy life.

This book is, of course, dedicated to my fabulous teachers and Gurujis in Ayurveda:

First, Vaidya S.N. Gupta from P.D. Patel Ayurveda Hospital, J.S. Ayurveda Mahavidyalaya, Nadiad, Gujarat, India, who always answered when I doubted, Try! One can only wish for the support, confidence and guidance he has given! I thank him for having me as a regular speaker at the International Ayurveda Conferences in Nadiad, Gujarat, organised by the same Institute. So much gratitude.

My two loved and adored professors and vaidyas, Ram Manohar and Martin Mittwede, who have been gently guiding me through all rafts and preventing me from falling into the potholes of wrong assumptions or cultural appropriation.

Vaidya Prof. Ram Manohar, Amrita School of Ayurveda, Kollam, Kerala, India, whom I thank sincerely from my heart for accepting me as his student. At the time I started my book, I was partially blind. My papers were a mess and he just said, I would love to read more!

Thanks to him for the sheer confidence he re-established, so I could finally make it! Thanks for helicoptering me! And still seeing me!

Professor Martin Mittwede, Germany, for his kindness and strong support of wild ideas, for being my inspirational mentor and never short on best advice.

There are so many more family, friends and assistants over my 45 years of practice that should all be named and thanked, but there is not enough space on paper however, an endless list of gratitude.

To all my friends and family here and in India who contributed in many different ways: Helga Heider, my mother, Gisela Borras, my auntie, Sanjay Sharma and his entire family, Kamal, Dimpy and Pamela Sharma and my aunties and uncles Sharma, Deepak Barthwal, Deepak, the astrologer, Maha Devdas and—

Elmar Stapelfeldt, for challenging my taste buds with his famous dravya guna introduction! Without him, all my studies would have lacked bite and taste!

Surinder Singh, Rishikesh. He is my most beloved yoga teacher of all time. I sat with him for twenty years, still wondering how it is possible to be so loving and kind. He allowed me to see a pure sattvic mind.

Giovanni Frazzetto, whose exploration in the art and science of intimacy and relationship, love and family, has always been a long discussion and cultural inquiry (with almost no—coffee).

Bettina Schuler from Citizen2Be, for allowing me to share her views and work with the most amazing Syrian refugee project I know.

Kerstin and Mark Rosenberg, founder of The Rosenberg Akademie, Birstein—Europe’s biggest Ayurveda and Yoga Academy. They created a place of learning, studying, connection and excellence from which I could always start fresh, feel inspired and stay connected to my Indian roots. I am so grateful to be a teacher and lecturer at the Ayurveda Yoga Chikitsa Department and a speaker at the regularly held Symposium in Birstein.

To my friends who became assistants and assistants who became friends, without whom I would not have accomplished so much:

Bnaya Halperin-Kaddari, a special thanks for exploring the heart’s prana, sound and soul connection. Without him and his curiosity, the deep dive would not have been possible.

Dr Anastasia Shchedrina, my other Ayurveda-half and Ocean sister, exploring the wonder oils of life and friendship: abhyanga means love; indeed the second best abhyanga therapist in the world (the first one I have not met yet).

Beate Friede, a kind soul at my side for thirty continuous years of deep yoga practice, acupuncture training and deep friendship without boundaries. Pure trust and playfulness.

Masami Kurihara, for our famous silent communication with her deep understanding and practice of loving-kindness and deep yoga.

Romi Deift, for the beauty of precision in style and numbers, pure pranayama—diamond-cut.

Magda Torres, for grace and day-glow to the yoga artwork and therapy of mindfulness in a jaguar style.

Yuri Kadzman, for a constant inspirational quest for truth; heart and mind can be one until it gets separated for a question.

Christopher Farrugia, adding taste to healing.

Endless thanks to these remarkable friends for the study:

Sueno, the great loss.

Kapil Malhotra, the open wounded and healing soul of the Taj.

Namic Macik, the light in the darkness of fire.

Ashkan Sepahvand, the radiating galaxy that always turns back home.

Jasmin Kokkola, the forest, moss and the lake of honesty.

Sejla Pierrot, close to the heart, always.

Gerda Klingenböck, the guardian angel with a golden heart and ghee, living in the forest.

Jadi Carboni, the graceful dancer through life’s music.

Sooki Raffael, whose love for life was like the breath itself.

Natasha Ginwala, for adding the subtleness and cultural responsibility.

Catrina Armendariz, for a fresh outlook on the next project, her courage and open-mindedness.

To the trust and faith that my patients have in me. They were ready to open their wound again for contributing to the healing of many.

Special thanks to Milena Kremakova and Farisa Sepahvand for hours of patient editing and dedicated blind support from the heart!

Berlin, Germany, 2023

Acknowledgement

As human beings, we have a penchant to connect. Like waves cling to shore, so we are inclined to attach. There may be seasons of low tide, an occasional desire to drift solo, or storms that strand us, but eventually we will seek or return to a harbour. Loneliness can kill, while togetherness revives.

Giovanni Frazzetto

Is it a gift having survived trauma oneself, having grown into the understanding of recovery and healing? As one patient said, I would not call it a gift, as I don’t want to give it to anyone else.

From there on, I decided to pass on my knowledge of healing.

Foreword

I have known Manuela Heider de Jahnsen as a compassionate practitioner of Yoga therapy in Germany and a passionate student of Ayurveda. Over the years, she has evolved into a skilled therapist offering solace to mentally traumatised patients. She also words with people suffering from addictions. It was no surprise to me that she was inspired to apply the knowledge she gained from Ayurveda to benefit her patients.

Post-traumatic stress disorder (PTSD) is a debilitating mental disorder prevalent worldwide, affecting people of any ethnicity, nationality or culture. A deeply threatening or scary event can trigger this mental condition and though effective treatments are available, the patients experience much pain during recovery.

As a result of scholarly engagement with the classical ayurvedic texts and interaction with Ayurveda clinicians and her insights, Manuela has developed an ayurvedic narrative of PTSD as a type of extrinsic unmāda (mental disorder). Classification and description of the stages in Trauma experience based on the dosa response to the trauma from an ayurvedic perspective is a clinically helpful framework to fine-tune the treatment based on ayurvedic principles and maximise the outcomes.

A vibrant and diverse collection of patient case studies illustrate the practical benefits of her integrative approach of combining yoga and ayurvedic with the modern medical understanding of PTSD.

Manuela has painstakingly put together her clinical experiences in managing PTSD in her patients and stitched a very interesting framework for integrative therapy to fulfil the requirements of the Master’s Program in Ayurveda at Rosenberg’s European Academy of Ayurveda, Birstein, Germany.

She was ably guided by Prof. Martin Mittwede, who oversees the Master’s Program in Ayurveda that is validated by Middlesex University, UK.

It was an engaging experience for me to co-guide Manuela during her thesis word. I am sure her thesis will open new avenues for integrating Ayurveda, Yoga and Modern Medicine into novel approaches to improving mental health. The fact that Manuela’s word is based on actual clinician patient encounters supports her insights and discussions with an experiential backdrop that would be extremely valuable for clinicians and researchers in the field.

With Yoga, Ayurveda and Modern Medicine integrated into a comprehensive treatment program, Manuela addresses the human being in totality and give attention to the individual’s soul, mind and body.

Vaidya Ram Manohar is an Ayurveda physician based in India and heads Research in Ayurveda at Amrita Vishwa Vidyapeetham, ranked first amongst the private Universities of India. He has a particular interest in ancient Indian psychology and its clinical applications.

Prof. Ram Manohar

Ayurveda is a comprehensive traditional health and medical system that originated in ancient India over 2500 years ago. Yoga can be described as a path of self-awareness and self-knowledge that is meant to lead to an inner clear wisdom-filled realisation. With its application of meditative, breath—and body-related methods, it has numerous therapeutic implications.

In western reception, these two actually independent traditions have sometimes become mixed, so that the contours of the two systems do not always emerge clearly. In therapeutic work, however, ayurveda and yoga can enter into fruitful symbioses and complement each other.

Manuela Heider de Jahnsen is one of the pioneers of yoga therapy in Germany. In her decades of working with patients, she has not only built up a wealth of experience but also a special expertise in dealing with traumatised patients and those affected by addictions.

She accompanies these patients not only with a great deal of empathy, commitment and human attention, but also enables them to gradually regain contact with themselves through meaningful combinations of yogic exercises with ayurvedic therapeutic measures.

In both groups of patients or in the combination of the disorders, the inner centre of life is not seldom lost. Dissociative gaps open up between the psychic activities and the physical sensitivities. The separated dynamics provide for a variety of symptoms, such as anxiety, depressive episodes up to psychotic states.

Manuela successfully completed her studies in ayurvedic medicine under my supervision and wrote a master’s thesis on the above-mentioned topic. In it, she reflects on the ayurvedic and western view of the clinical symptomatology and probes the various therapeutic approaches in a systematic overview.

A central core of the work is the carefully elaborated and touching case documentations, in which the therapy strategies and the underlying rationale are described in an exemplary way. In this way, the reader gains an insight into work in progress and can develop therapeutic paths for severely burdened patients through his or her own reflection.

In this sense I wish the work an attentive readership, which opens the possibility to comprehend holistic and individually adjusted therapy ways. The spiritual dimension is not to be disregarded. However, this does not come in a dogmatic form, but is oriented toward the reality of the patient’s life.

Of fundamental importance is the question of how the loose ends of life can be put back together, how a person can regain the courage to look forward and find his or her own way into a lost space of freedom.

Prof. Dr Martin Mittwede habilitated with a research project on Ayurveda medicine at the Goethe University Frankfurt am Main. He directs a master’s program in which physicians and other medical professionals are trained in ayurvedic medicine at an academic level. He has published numerous books and professional publications on the topics of Ayurveda, yoga and Asian philosophy.

In his psychotherapeutic practice, Prof. Mittwede combines holistic approaches of humanistic and analytical psychology with mindfulness, meditation and spirituality.

Contact:

www.mittwede.net

[e-mail]

0049 176 24159749

Manuela has always taught me to be curious. Her interests are extremely broad and she is open to everything—that is, everything which she can use to help her patients. She has been active in the field of naturopathy for more than 40 years. This book embodies Manuela’s professional journey as a naturopathy practitioner, conceptualised through an academic, scientific lens.

For the past years, ayurveda and yoga have been the main systems within which Manuela has been working; she has chosen to treat trauma and PTSD using the two systems. Ayurveda puts much emphasis on the need for balance and her book is also about balance between western and eastern medical systems; between science and intuition; between critical thinking and faith.

Manuela herself admits to being of mixed descent, as well as to having been connected to Asia since her childhood. This is clearly reflected in her book, as she treats yoga and ayurveda with great respect, avoiding both the western colonial approach and an unreasonable fascination for the two systems. Manuela’s book discusses the phenomenon of trauma and PTSD as well as standard psychotherapy methods from unexpected angles.

For instance, she uses her own example to illustrate that trauma may result in a seemingly ‘normal’ behaviour such as an ideally clean house or any other type of extreme perfectionism—something to which the western therapeutic school pays little attention. Of great interest are her reflections on memory and reminiscences, e.g., on how patients get tired of having to turn to their reminiscences frequently.

Thus, the corporal approaches and the ancient knowledge offered by ayurveda and yoga can prove highly effective in treating trauma and handling PTSD. The classification of stages of PTSD based on the doshas and gunas dominant at each stage, along with the ensuing therapeutic recommendations, has particularly fascinated me, as this is the first time I encounter such an approach. Notably, these are not mere ideas or hypotheses—these are the results of Manuela’s extensive empirical research.

The author pays particular attention to the issues facing women in modern society, including the violence they have to endure—something that is still frequently silenced. Most notably, Manuela always respects her patients’ cultural identities and backgrounds and she considers those factors during therapy.

Of course, this has been reflected in the book as well. Detailed descriptions of yoga breathing exercises and ayurvedic procedures showcase the author’s professionalism, but they also speak volumes about how she has been transferring the knowledge provided under the two Indian systems into the western one.

The book will be of interest to a wide range of readers because it significantly broadens one’s perceptions of trauma and PTSD, providing unexpected perspectives on those issues.

Therapists will be interested in this book because it gives an account of the author’s unique, years-long experience in naturopathy, conceptualised academically within the context of the western medicine. As for me, I am endlessly grateful for having Manuela in my life; for the many years of joint work; for the fact that she has become my friend and mentor; for how she discovers the untapped potential in her friends and colleagues and helps them harness it.

We have been working together for many years now and I still learn something new from Manuela—not just in terms of Ayurveda, but also in terms of the sheer curiosity about the various aspects of life, the desire to try them out—and then to offer the best to patients!

Dr Anastasia Shchedrina

Introduction to the Discussion of Trauma

and Intercultural Dialogue

An Overview

Trauma is part of life. Nasty things happen to us, loved ones die, we lose and win and lose again; we suffer from unexpected illnesses, assault, accidents and so we all will be experiencing the pain of losing loved ones. However, some of us might come out of it and live even better or meaningful lives while others struggle and don’t blossom. In this book, I will try to shed light on options to end the frozen time, the burnouts, the stormy rocky times of victims’ narratives.

The Traumatised Self

Trauma, a psychological impact, has reached the daily lives of everyone as a term for describing the aftermath of shock, grief and terror. However, in contrast to the common knowledge of the word, understanding victims and their individual needs, reactions and adaptations are far from it. Nevertheless, victims have to live with a stigma. It ranges from provoking an assault or attack, getting over it, it was not that bad, or they were weak personalities anyhow.

Stigmatisation of victims and disbelief are often causing more harm in the long term than the traumatising situation itself by creating repression. These strategies, which consume significant cognitive resources, have been associated with negative effects on interpersonal, physiological and emotional functioning (—) (Trauma Therapy in Context, 2012).

The victim becomes imprisoned in shame, guilt and denial. For recovery, stepping out of the shame trap seems to be an essential first step to self-care and responsibility for further actions.

Trauma induces constant distress to the body and the mind, most likely reducing decision-making abilities, sleep, good health and long life. The various ways the victim adapts to the constant stress often include self-harm and risky behaviour, commonly associated with substance abuse, eating disorders, violence or depression. Suicide is sometimes the only way for the victim to escape the pain.

To induce self-care, modify the stress response and initiate self-healing processes, therapists become challenged with multiple reactions to the same stress factors of trauma. To develop successful treatments, they react differently, with significant differences in cultures, personalities, circumstances, repetition, single trauma, co-dependency, addiction, self-harm and violence. While the treatments are numerous, very little research is done to understand how and why patients respond to which type of intervention.

The base for the new data published in this book is my practice Society of Friends, a small clinic for complementary medicine and naturopathy in the centre of Berlin.

As the founder and head of the clinic for the last 40 years, my clinic developed complementary and alternative treatment schemes and solutions for traumatised patients. A group of assistants, apprentices, friends and students constantly accompanied, contributed and observed the treatments, but the best help came from the patients themselves. Since starting from scratch, I came across patients with unexpected troubling or paradox reactions to regular Ayurveda therapies.

Intense studies on trauma followed, from the recent research publications in the western hemisphere, classical Chinese and Japanese medicine, to ayurvedic scriptures and yoga texts concerning the topic. The topic, in respect, what it could have been in the ancient scriptures of other cultures. However, encouraged through my professors I developed a scheme of interpreting symptoms and factors in relation to therapies.

This foundation developed a unique classification of the patient’s individual needs and strengths. With this information, there is the possibility to optimise Trauma and PTSD (Post Traumatic Stress Disorder) treatments through a simple symptom related tables in relation to the Ayurveda Dosha system. This system is developed out of hundreds of patients’ experiences in my clinic and published here for the first time. The traditional Ayurveda treatment plans evaluated are suitable for modern patients.

However, the main question had to be asked initially:

Is it possible to authentically adopt medical systems, understandings and beliefs from other cultures?

And, how do we discover the differences when they might as well remain invisible to an observer whose thought process is shaped by their own culture? A common problem of intercultural studies is, assuming to understand what the other speaker is talking about, thus missing out on crucial cultural differences. In the words of a Korean feminist translator of Walter Benjamin:

Translation is a Mode= Translation is an Anti-neo-colonial Mode. She states re-translation or racial-hybrid as a conclusion of all translation attempts. A form, a mode. This productive tension (a possible mistranslation?) indicates a formative activity simultaneous to the occupation of translation’s modality: an incorporeal material, language trans-forms, re-forms, con-forms, de-forms. (Ashkan Sepahvand, 2020)

Is it possible to penetrate high complexity beliefs and insights from other cultures? Below we try to ask, analyse the methodic views and present a holistic approach that highlights the eastern and western ways to integrate modern trauma therapy concepts, evaluate and use them in a holistic context of Ayurveda.

Is it possible to reveal and discover one’s assumptions, beliefs and convictions as unconfirmed concepts?

Is it possible to integrate different ways of thinking into dominant western thinking, in which consciousness, unconsciousness and matter play an entirely different role in the complexity of a human being? Is it possible to see the individual’s health separately from the health of the environment, the ocean and the planet as a whole? Ayurveda imposes the duty to dedicate and contribute to universal factors such as dharma as a duty.

How do we use western medicinal research within systems in which healing is more than healing of the mind or the body, but always of a mind-body continuum, as there is no natural separation between those? This work dedicates to finding those answers.

Complex systems of philosophical inquiries enrich the cultural beliefs in western culture through trade and exchange for thousands of years. However, the Jewish-Christian-Cartesian cultural heritage carries out one of the significant differences in western view towards eastern conception: the duality of mind and body. An aspect of Ayurveda is majorly vital for this thesis; Ayurveda has no psychology, only psychiatry.

As Professor Ram Manohar (Amrita College, Kollam Kerala) states: "The mind can only be studied separately when it is insane. From an ayurvedic perspective, the body and mind are one single continuum. Like a vessel and ghee, they are interconnected as Vaidya Ram Manohar says: Looking at things that are the same like hot and cold—they are related as a continuum, that keeps on influencing every other point on the continuum." (Ram Manohar, 2012)

A synthetic philosophical approach like Ayurveda can integrate an analytical approach, like western psychology, nutrition, etc. However, the western biomedical approach to health is analytical, non-holistic, dualistic and therefore disabled to integrate a complex system like Ayurveda.

The Mind can only think of what is already known. Ludwig Wittgenstein states in his book Tractatus Logicus Philosophicus, that we can only ask questions of which the answers are known. Even if a particular thought could appear ground-breaking or out of the box, it is only a product of the limitation of human and, in particular cultural, thinking works.

Therefore, ayurveda and yoga could represent a way of bridging western and eastern therapeutic measures and thinking. Ayurveda and yoga are empirical sciences with the knowledge that can be experienced and observed. It is inductive-synthetic. However, both can be seen as inter-cultural empiric sciences because their science of experience and the applied methods are sensational and not limited to a particular country, belief, concept or paradigm. Experience is bound to the concept of experiencing and can only come through diligent practice.

Uniting and Dividing

Different cultures are different only to a certain extent. There is always an overlap of content, as all human beings share the same dreams and fears. Ultimately, similarities become overseen when focusing on differences. Differences become missed by focusing on similarities. Both options will not serve the purpose.

Instead, a middle ground must exist; a clear and respectful open dialogue. Beginning a profound, meaningful and constructive discussion is necessary to clarify terms and context. By translating singular words out of context, the translation cannot reflect the whole possible meaning. Meaning depends on context, story, background, history and the speaker and listener. Interpreting is the interaction of the speaker and the listener. Interpreting words instead helps to understand the experience and brings words into life.

Some words are kept in their original language to avoid misinterpretation. The original words clarify and classify the topic without discourse. The actual terminology in Sanskrit allows a deep inspection of the meaning of Ayurveda and the practice and philosophy of yoga. Although not all texts have been published in Sanskrit, it is the primary source language used in this thesis.

Simplifying and mixing concepts from different traditions can induce misleading assumptions. Clarifying terms and concepts are crucial to start a deep and meaningful dialogue between cultures to realise ideas and goals.

Eastern mind and medicine are based on an empirical and philosophical approach toward life, death, health, happiness and the mind’s function. Empirical wisdom has been generated and collected over thousands of years, including countless case studies displaying success and failure.

Although Empirical knowledge is not ideological, it serves no other than the patient’s interest. Over long periods, if a system becomes inefficient, it simply disappears. Ayurveda and yoga are collections of wisdom and philosophy spanning several millennia. The effectiveness of ancient systems of knowledge and practice, such as ayurveda and yoga, is proved by their continued existence.

In the sciences and concepts of yoga and ayurveda, the function of the mind—body—continuum is revealed in clear terms and with practical guidance. Empirical knowledge and hundreds of techniques for self-inquiry are present. Physical exercise (asana) and deep meditation (dhyana), breathing (pranayama), daily routine (dinacharya) and detailed description of the cause and effect of thoughts and actions (karma) are structured and explained. Nutrition and lifestyle (ahara and vihara) are the pillars of a system of rules and ethics that follow philosophical outlines. It follows the newer discoveries of the biorhythm of hormones and physiological changes.

Unlike western analytical philosophies that analyse particles and elements to explore the entire object, eastern philosophical traditions follow a so-called synthetic tradition that tries to understand form and function from wholeness.

The meaning of the word yoga is often translated as unity, connection, while Ayurveda translates as the science of life and death. Both