TRE exercises can supposedly cure PTSD by inducing tremors. Not credible. And there’s no science to support the claims.
This bear is running away. After he has escaped the danger, will he lie down on his back in the woods and deliberately tremor to release the aroused stress? I doubt it!
Pseudoscience and silliness are rampant. I couldn’t hope to keep up with it all, but my vigilant correspondents help keep me informed. I had never heard of Tension and Trauma Releasing Exercises (TRE). I was asked to look into it by a friend whose book club was reading Pure Landby Annette McGivney. That book is by a journalist who investigated the brutal murder of a Japanese tourist in the Grand Canyon. It’s an interesting story, but it devolves into an account of the author’s nervous breakdown, her treatment for post-traumatic stress disorder (PTSD), and her amazing cure through TRE, with details that I didn’t find believable. The account of her TRE treatment occupies only a couple of pages and is only a brief and somewhat bizarre intermission in what is otherwise a well-told murder mystery and human story. My friend’s alarm bells rang loudly when she read this:
symptoms stem from the frozen residue of energy that has not been resolved and discharged; this residue remains trapped in the nervous system where it can wreak havoc on our bodies and spirits….
The idea is that forcing your muscles to shake like they do with lactic acid buildup supposedly releases the trapped residue, permitting recovery. This method was invented by David Berceli, who is of course selling his books and has trained many coaches who are available for people to hire. The website is traumaprevention.com.
My friend was rightfully skeptical and wondered if there was any science behind TRE. When I looked into it, my alarm bells went off too. I concluded that it was a good example of pseudoscience, not science.
TRE is a series of six exercises starting at the ankles and progressing up the body to the psoas muscle. In turn, the targeted muscles are stretched and then stressed by contracting until a tremor develops. In one exercise, you assume a sitting position with your back against the wall; in the last exercise, you lie on the floor and do various maneuvers to stress your muscles until a tremor develops. The psoas muscle connects the legs to the trunk and is supposedly critical to the prolonged retention of stress after a trauma.
In the case of PTSD, aroused energy generated at the time of the event is prevented from being discharged and remains trapped in a bio-neural-physiological loop that causes a repetition-compulsion behaviour. Until the brain receives a signal from the central nervous system that the danger is over, the body will continue to repeat the bio-neural pattern of protection and defense.
Some patients have violent tremors with moaning and emotional reactions, others simply quiet have quiet muscle tremors. Dr. Berceli explains:
The body releases what it needs to release. It understands what it must do[emphasis added] to soften and relax the patterns of tension that have been created over the years. For some, this deep relaxation allows deep emotions to surface. Others can just have a physical reaction of shaking.
McGivney says she had PTSD. I’m not convinced; her symptoms were not the characteristic ones of PTSD. Her description of her mental illness and her multiple different diagnoses didn’t ring true for me. When she did the exercises, they produced an emotional response and triggered a vivid memory of abuse she had experienced in childhood. She had forgotten the abuse and had developed distorted memories that were inconsistent with reality. Acknowledging that she had been abused was apparently a major factor in her recovery. At any rate, she received a succession of treatments, not just TRE; and TRE shouldn’t get all the credit.
David Berceli is not a doctor or a scientist. He has a PhD in social work. While observing families in a bomb shelter in Lebanon in 1979, he noticed that children trembled as they clung to their parents, while parents showed no signs of fear and did not tremble. The children bounced back and had no sequelae, but the adults developed post-traumatic stress disorder (PTSD). He suspected that tremoring played a role in releasing trauma and reduced the risk of PTSD. To figure out how that might work, he consulted neurologists and “did extensive research.” He came up with a sciencey-sounding hypothesis that he didn’t bother to test. He just leaped from hypothesis into action. Today, the exercises he developed have spread to over 30 countries and are used by therapists to treat PTSD and by individuals as a self-help method to relieve stress and anxiety, or simply to improve their life in some way.
An online account tells us:
During the workshop Berceli showed us a video of a bear who had to run away from danger. After escaping, the bear lay on his back, trembling uncontrollably. The bear then let out a huge, loud sigh, calmed down and continued with his normal activities seemingly as if nothing had happened.
This is what allows wild animals to survive as they don’t live in constant fear or panic. Tremoring and release allow them to heal and to build resiliency for future trauma.
Can experts in animal behavior confirm that this is typical animal behavior? I doubt it. I watch a lot of veterinary programs on TV where animals are regularly stressed by handling and by medical treatments, sometimes to the point that the veterinarians have to stop and come back another day; and those animals never show any behavior like that of the bear. Stress causes adrenaline release, but after the stress stops, the adrenaline levels soon fall back to normal
Not everyone is impressed
For what it’s worth, A commenter on Reddit said:
I then read Bocelli’s [sic] paper on his experience developing TRE, which is basically a how-to-guide of saying “fuck you science and research, I’m going to use inductive reasoning as if I’m the first to tackle this”. This shit is jaw-droppingly unethical and shocking.
Another called TRE “somewhere between a massage and a really good night’s sleep.”
A commenter on the Amazon website said, “Works but not sure if it is helpful or just natural response to exercises.”
Does TRE work?
Testimonials report relief of anxiety, headaches, pains in various parts of the body, and nightmares; spiritual benefits; increased energy and endurance, improved marital relationships, less worry, better sleep, cure of fibromyalgia, even clearing of blockage in the carotid arteries! Testimonials are notoriously unreliable, and there have been no scientific studies to evaluate clinical benefits. I don’t doubt that TRE relaxes people and can produce placebo responses and subjective improvements due to expectation, suggestion, and other psychological factors.
But the rationale and the alleged mechanisms don’t make any sense from a medical or scientific viewpoint. The language they use reeks of energy medicine beliefs and New Age fantasies. The tremors induced by the exercises are simply a natural response to muscle fatigue; they are an annoying side effect of strenuous exercise and they have no documented benefits. The idea that muscles can remember may have originated with Wilhelm Reich, a questionable character whose fraudulent orgone accumulators led to legal prosecutions and whose ideas about muscle memories of physical and psychological traumas led to the development of the pseudoscience of bioenergetic analysis.
The bottom line
TRE is not based on science. People may enjoy the experience and may report subjective improvements, but there is no evidence that it has any objective clinical benefits. Side effects have been reported: mild nausea, headaches, and muscle aches. We can assume it is probably safe to try. But you must be willing to dedicate the necessary time and follow the detailed instructions or pay a TRE therapist to supervise you. And there are plenty of other relaxation methods that might work just as well, or even better. So I can’t recommend TRE.
This article was originally published in the Science-Based Medicine Blog.