TRE stands for Tension and Trauma Release Exercises. It is a new form of releasing stress through working with the body. To understand why and how TRE works we need to take a look at physiology and a polar bear.
Theory
In mammals we can find a natural response to extreme stress that keeps them from getting traumatized. They start shaking and releasing energy that built up in their body when they got immobilized. It seems like they are convulsing but when we look closely we can see a pattern to the movement, that shows typical flight/fight behavior and it is suggested that they finish the sympathetic action that was suppressed. A famous example of this is a polar bear that got hunted and stunned by researchers. Waking up is shows this classical pattern of feet that move to run and roaring in fight and finally deep breathing. It gets up without lasting harm when it is able to finish the sequence. (You can find the video here, please note that for some it might be a bit triggering.)
We can often observe some kind of physiological reaction in our body when trauma is processed, not just in body work. People might start to shake, especially in a pattern of running away or defending themselves from an attack. We are processing the trauma on all levels and the body is releasing energy as well.
Execution
This led to the idea that we could make our body start shaking and that could help us to release the tension in the muscles and the trauma that is stuck in the body. TRE was born.
In TRE we perform certain exercises that are meant to burn out the muscles. We then take a certain lying position that encourages muscle contractions that look very similar to what we see in the polar bear. The shaking can be stopped at all time by moving the legs into a different position. Patients are usually left to experience this for about 20 minutes and often report that they feel unusually relaxed and generally better. (I am not adding a video for that because it can be highly triggering, but you can find them on YouTube.)
TRE is practiced in groups or single sessions and it claims that it could be used at home as well. It is supposed to help with all kinds of stress-related conditions and treat PTSD. There is an official disclaimer that people with complex trauma should seek single sessions with a professional.
A personal commentary
The exercises suggested for TRE are extremely stressful for the body, so if you have back issues or similar problems it can be harmful. If you want to try this you need to check with your doctor first.
I regularly see a tendency in therapy approaches to make trauma healing work without the support of a helping other. „Relational trauma requires relational repair.“ (Treisman) We can’t heal in a space that is independent of a co-regulating other and a felt-sense of safety with someone, so the idea of doing this alone at home should be off the table completely.
I think that TRE might be an intervention that can help with acute sympathetic stress and releasing that before it becomes ‘chronic’ and diagnosed as PTSD. Especially after disasters and for first responders this might be a good way to support bigger numbers of people to release tension from their bodies. It also seems a valid way to release muscle tension from general stress and anxiety.
There are many accounts that this technique has helped people with PTSD and there is a scary amount of people who report getting re-traumatized. The difference between these people is that those who got re-traumatized have a more complex history than a simple shock trauma and/or dissociated during the process. The lying position and the shaking can be triggering, people get flooded with memories, their nervous system does not have the capacity to deal with that and they are unable to move themselves out of their position to stop the shaking, therefore experiencing another loss of control. That is why I am recommending not even to try this in a group. Someone needs to keep an eye on us, someone who is trained to notice when something goes wrong and knows how to interrupt it. But who will be able to tell apart if this is an abreaction or TRE induced tremors? Highly dissociative people shouldn’t try it at all.
Specific issues of trauma storage in DID are not addressed. Whatever happens with the body probably won’t lead to a release of tension other parts carry. It is one body, but it is a very different body depending on who is fronting. TRE alone is not going to be helpful for trauma in DID.
Fundamental problems
I have had the privilege to experience the naturally occurring release of traumatic tension in the body, both in regular trauma treatment like EMDR and body work and it makes me doubt that TRE is the optimal way to treat real trauma. It sure releases muscle tension, but it is incredibly unspecific. We artificially create a response that looks like natural trauma release. But does it release more than the muscle tension we are carrying around today? TRE seems to work more with muscles instead of actually addressing the nervous system.
In my experience trauma release in the body can look very different. Sometimes it is shaking. Sometimes it is in different breathing, sometimes in suddenly sweating or feeling hot in the face or body, sometimes it is in noises, sometimes it comes with deep emotion that is felt in the body, sometimes it even shows in aggression. The natural release is very specific to the trauma that is processed. There are very specific patterns of movement for this one traumatic event to finish actions that have been suppressed before. When we experienced developmental trauma, always living in a place where we were not valued or safe, release might not even have a motor pattern at all. It is not shaking itself that releases trauma, the process is more complex than that.
Among somatic practitioners it is a no-no to try to tease the body into doing something that it doesn’t do naturally. The main idea of trauma body work is to stay with what is naturally happening, to experience it with awareness and let it do its thing. Our body and nervous system needs to build a capacity to hold the experience without getting overwhelmed (More) and it will release things when it is ready. If we try to force it before there is enough capacity we will just get overwhelmed and it drives the traumatic stress deeper into our nervous system.
There is a fundamental flaw in the idea that we have to ‘release’ trauma from the body. We need to build capacity in our nervous system so it can be integrated. That is when a release happens naturally. Like so often in trauma, the solution is in embracing and integrating, not in getting rid of something. Seeking quick fixes puts us in danger. Healing our nervous system is a long-term process. There are no short-cuts.
So this is my educated opinion:
TRE might help people with a single shock trauma who grew up in a safe environment or those with an acute sympathetic stress response. Most of the readers of this blog have different experiences of chronic trauma and living in chronic functional freeze/shutdown and because I don’t want to see you get hurt I highly recommend staying away from TRE and look for proper long-term body work instead.
More about physiology in
This website is so brilliant. I really haven’t found a resource like this before.
I am an odd case, it seems, and I have yet to find anything which works for me. I had a big muscle release 5 years ago, and I slipped into parasympathetic mode, for what seemed like the first time, but it really freaked me out, and I went into a terror spin which left me with a very strong clenching contraction in my left hip. I’ve seen 2 SE therapists, 1 TRE practitioner, and one therapist who actually works with Kathy Kaine.
No one has been able to help me, and my body is stuck in what seems to be a mix of freeze and fight/flight. My emotional life is virtually non existent, and I feel dense, tense, and completely devoid of any flow. There is also this very intense buzzing, which emanates from the contraction, and often fills most of my body. It’s so weird, and debilitating.
I’ve spent years doing body awareness exercises in an attempt to release this buzzing, but it’s gotten worse, so I think I’ve driven it harder into the system. I am always wired, and my sleep has been destroyed because I just can’t settle.
I sometimes get moments where my body relaxes a bit, and there’s a sigh and a yawn, and a maybe a warm feeling, but it doesn’t seem to be brought on by anything specific that I’m doing, so It’s not something I’m able to affect with any regularity. The buzzing always comes roaring back after too long. It’s like there’s a locked stress cycle under a layer of numbness which is hidden, and that I’m not able to reach.
The hip contraction is constant, and if I focus on it I sometimes get waves of heat and sweat, which feel like it might be a release, but nothing ever changes. It’s actually gotten worse over the past two years.
It’s very bewildering to not know if you’re making something better (releasing) or making it worse (reinforcing, driving it further in).
Your website has given me a good reason to stop all body detective exercises, and to do some more vigorous stomps, runs etc. maybe to discharge this energy. It’s really the only thing I can think of at this point, and it’s not been recommended by anyone so far.
Thank you for providing all this information for us. It’s a real treasure trove.
hey there, please don’t take anything written here as therapeutic advice. It is a personal blog and you will be better off listening to your therapists.
If you have layers of stress responses and there is numbness on the surface and something else buzzing underneath, that is a typical pattern of strucutral dissociation. Maybe it is time to leave the body work behind for a bit and move toward ego state work or Somatic inner famimly systems work. I honestly don’t think that stomping will do you any good. Good luck!
Thanks Theresa,
Don’t worry, I’m being cautious. A lot of your info does actually map onto the advice of my last therapist, but she was unfortunately not able to answer some of my questions – I really like to know the theory before the practice, and I didn’t understand the whys of what she was telling me.
Reading your blog, a lot of what she said seems to make more sense to me, so I’m really just grateful for having a clearer picture for once. She was encouraging me to squeeze and push, so it seems like a stomp is maybe part of the same picture (only maybe).
I was making no progress because I didn’t quite understand why I was doing the things she was suggesting, which was making me more stressed out.
I may need to explore other options at some point, but for now I’m revisiting prior advice, with a new sense of direction.
We shall see.
Thank you for your concern though. This is tricky stuff.
You had mentioned that you recommend other long-term body work for chronic PTSD. May I ask what types of body work do you recommend looking into for CPTSD? Thanks
There are psychotherapy techniques that work with the body and stress responses that are relatively new compared to traditional therapy but the results are pretty good. Somatic Experiencing and Sensorimotor Psychotherapy are the leading 2 approaches right now. You can check it out when you look into Peter Levine’s work and that of Pat Ogden/Janina Fisher. Those have very solid foundations.
Other than that, some less specific practices that include the body can be super helpful, like trauma-sensitive yoga or qigong. They aren’t actual psychotherapy but they are good as additional treatment to include the body in case no body work therapist is available.