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Integrative Psychiatry

Releasing Trauma and Stress with the Psoas Muscle

The psoas major is a large muscle connecting the back, legs, and pelvis, and it plays a critical role in mobility. Physiologically, the psoas major, arising from the spine and attaching to the femur bone, supports bending the hips and outward rotation of the thigh as well as bending the trunk forward and to the sides. Evolutionarily, the psoas major is activated during the body’s fight or flight response, contracting in preparation for self defensive action. In some spiritual traditions, the psoas major is associated with the root, sacral, and solar plexus chakras–which are, more or less, involved with qualities of safety, emotion, and taking action.

Given that the psoas major is contracted during times of perceived threat (either physical or psychological), it is a reservoir for holding trauma and stress through lingering tightness. Large bundles of sympathetic fibers are innervated throughout the psoas major. When our bodies feel fear, the muscles ready themselves to attack, run, or bend forward, protecting vulnerable organs of the abdomen and pelvis. After the threat has disappeared, the muscles need to dispense excess energy through movements such as shaking or stretching, returning the muscles to their relaxed states. However, while we are at work or in a car or rushing around to finalize our checklists, we don’t often get the chance to fully release our stress in this way. Stressors combined without proper release of the hip muscles (i.e., sedentary lifestyles) often results in shortened psoas length, and associated tension in the psoas muscles. This storage of stress can then influence everything from our breathing patterns and organ function to our posture and biomechanics to our sense of relaxation and readiness to respond to the environment.

Physical and Mental Health Implications

A chronically contracted psoas due to traumatic events or chronic stressors will affect structural balance and alignment as well as internal organ functions. A tightened psoas major is the common cause of lower back pain, hip joint issues, cramping sensations in the pelvis, and impaired mobility. The impact of a tight hips will negatively affect posture and may begin to cause discomfort during walking or exercising, limiting a person’s physical activity level and self-care routines. Tension in the psoas muscles can lead to inflammation of the area, impinging local nerves and tendons. It may also cause shallow breathing, limiting oxygen intake, and inhibit digestion. Consequently, people may experience a range of symptoms, including disrupted sleep, digestive disorders, and a general sense of unease. It is thought that a tightened psoas may also exacerbate anxiety by signaling back to the brain that it is contracted and hypervigilant, being in a constant state of alert.

Caring for the Psoas

Addressing the health of the psoas muscle requires a comprehensive approach that might encompass physical, emotional, and spiritual perspectives. 

  • Physical Care: Gentle movements that stretch the psoas such as a kneeling lunch or pigeon pose, can help release muscle tension. Likewise, targeted pressure release by foam rolling or massage gun can stimulate muscle relaxation; however, a note of caution here to watch for pain that might actually contribute to even more tightening. There is emerging research for a number of exercises such as Trauma Release Exercises for muscle relaxation; plan for emotional release to occur in parallel here and make sure you have the support you need. Professionals like physical therapists or chiropractors can offer additional insights and modalities including massage, myofascial release, or exercises for strengthening weakened muscles in the area. An integrative approach to muscle care might include heat or cold therapy, which may activate various aspects of the nervous system, increase muscular blood flow, and reduce inflammation. 
  • Emotional-Spiritual Care: Deep abdominal breathing stimulates the vagus nerve, telling the body it is safe. Trauma-informed therapies may help individuals explore and resolve the emotional burdens that may be contributing to their physical symptoms. Mindfulness and meditation practices can be particularly effective in bringing awareness to bodily sensations, including muscle tension/relaxation, fostering a deeper mind-body connection. 

Conclusion

The psoas-brain connection is a network of convergence for emotional, physical, and spiritual wellbeing. Paying attention to the psoas muscle and incorporating energy releasing therapies for clients may actually support healing for a number of physical and psychological ailments. 

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.