Running as Nervous System Medicine

Trauma is an experience that exceeds our ability to manage stress. Clinically, it disrupts containment: we lose our capacity for self-regulation, become drawn into instinctive coping, and often remain unaware of what’s unfolding. Trauma can happen invisibly and unnoticed, bypassing conscious thought entirely; we simply act, often without realizing the deeper implications. In these moments, the body’s ancient, evolution-driven responses take precedence, guiding us toward safety and survival.

Traumatic situations induce intense emotional and psychological stress, which damages our ability to modulate thoughts and emotions. We enter a primordial state focused on survival. While most traumas are not truly life-threatening, the body does not differentiate; it simply reacts to stress as if survival is at stake. The nervous system initiates instinctual responses — flight, freeze, orient, or fight — each deeply interwoven with childhood development and the body’s survival wisdom. These are not choices but autonomic, highly effective responses crafted by millions of years of evolution.

Running presents an elegant paradox for trauma survivors: the very movement pattern that might represent flight from danger becomes, under certain conditions, a pathway toward embodied presence and nervous system regulation. This transformation from escape to encounter requires understanding how sustained rhythmic movement reorganizes the autonomic nervous system through bottom-up pathways that bypass cognitive processing entirely.

The evidence base for aerobic exercise in trauma recovery has matured considerably in the past decade. A 2025 network meta-analysis by Li, Xia, Yu, Hu, and Zhu examined 30 randomized controlled trials with 1,435 participants and identified an inverted U-shaped dose-response relationship, with greatest effects at approximately 730 MET-minutes per week—roughly equivalent to four 30-minute moderate-intensity runs weekly. Effect sizes were comparable to established trauma-focused psychotherapies. Björkman and Ekblom's 2022 meta-analysis found similar effects, with particularly robust improvements in sleep quality, quality of life, and substance use patterns—the constellation of symptoms that often prove most treatment-resistant.

So, the evidence is clear: running reorganizes traumatized nervous systems. The therapeutic action occurs not through conscious reappraisal of traumatic memory but through direct influence on nervous system regulatory systems. Running accesses these systems through interoceptive and proprioceptive pathways; bypassing the thinking mind, addressing a deeper, more evolutionary level which, in trauma survivors, is locked, repetitive, and compromised in capacity.

The autonomic nervous system as battlefield and training ground

The cardiovascular rhythm of running directly engages autonomic regulation through measurable, reproducible pathways. Cabanas-Sánchez et al.'s 2022 systematic review and meta-analysis examined exercise training effects in sedentary adults, finding significant improvements in vagal-related heart rate variability (HRV). These findings represent clinically significant shifts in vagal tone—the nervous system's capacity to downregulate threat responses and return to social engagement.

The significance of HRV improvements becomes clear when examining trauma populations specifically. Liddell et al. (2016) studied trauma-exposed individuals in a post-conflict setting and found that reductions in HRV were associated with increases in PTSD symptoms. (Reduced heart rate variability is, within standard norms, less healthy than increased variability. Greater HRV is, in some sense, associated with increased flexibility and capacity to deal with the varieties of stress encountered in human life.) A 2020 meta-analysis by Schneider and Schwerdtfeger further confirmed that PTSD consistently associates with reduced HRV. The pathway identified in the Liddell study—trauma exposure → reduced HRV → elevated PTSD symptoms → psychological distress—suggests that interventions aimed at restoring vagal tone may interrupt this cascade.

Running's effect on autonomic balance occurs through what might be termed "vagal calisthenics"—repeated cycles of vagal withdrawal during exertion followed by restoration during recovery. Each training session creates a controlled stressor that demands sympathetic activation, then provides opportunity for parasympathetic rebound. Over time, this oscillation enhances autonomic flexibility, the capacity to upregulate and downregulate arousal as context demands. The adaptation is not simply increased parasympathetic dominance but rather improved dynamic range—the ability to access high arousal when needed and return efficiently to baseline when threat has passed.

The rhythmic, predictable movement patterns of running—when maintained at moderate intensity that preserves capacity for social engagement—activate vagal pathways while simultaneously building tolerance for sympathetic arousal. But there's a flip side, as always: high-intensity interval training may prolong sympathetic activation and delay parasympathetic recovery, potentially reinforcing rather than resolving dysregulation. This is something I see often in my work: clients in early recovery who take up running, then become over-enthusiastic and do too much, too fast, with a degree of intensity that goes way beyond what would be a healthy trajectory. For some of them, there is an addictions replacement dynamic at work, in which running becomes yet another way to get a high, to keep up patterns of frenetic intensity, to run so fast they can stay ahead of the feelings they know are inside. Often these are former stimulant users who discover new and familiar ways of running away.

Finding the balance, with clients who have nervous systems impacted by trauma, is always hard. There is the danger of replacing one addiction with another, the risk that a new activity becomes a different version of locked and repetitive patterns. In each of the sections below, I've explored these challenges and what it might mean to grapple with them for clients who present with different kinds of nervous system activation.

The paradox of flight: running from versus running toward

For the survivor of developmental trauma whose primary defensive adaptation was flight—literal or metaphorical running from danger—the act of intentional running creates productive confusion in subcortical systems. The body experiences the same cardiovascular activation, the same recruitment of large muscle groups, the same forward propulsion through space. Yet the context differs entirely: movement toward health rather than away from threat, chosen rather than compelled, sustainable rather than desperate.

Running provides opportunity to complete thwarted flight responses within a context of safety and control. The proprioceptive feedback from sustained rhythmic movement—feet striking ground, arms swinging, core stabilizing—triggers parasympathetic activation through mechanisms distinct from cognitive reassurance. The nervous system receives data from muscles and joints indicating purposeful, controlled exertion rather than panicked escape. Over repeated sessions, this proprioceptive vocabulary begins overwriting earlier associations between cardiovascular arousal and mortal danger.

Yet the distinction between therapeutic running and dissociative flight remains crucial and sometimes precarious. Schmitz et al. (2023) identified body dissociation—habitual disregard of interoceptive signals—as the sole significant mediator between traumatic childhood experiences and emotion dysregulation, with particularly strong effects in PTSD populations. Running undertaken to avoid interoceptive awareness, to overwhelm sensation through intensity, or to escape embodied experience may reinforce rather than resolve trauma-related patterns. The therapeutic vector points not toward speed or distance but toward sustained, rhythmic engagement with present-moment bodily experience—what the somatic psychology literature terms titrated interoceptive exposure.

Breaking the spell of immobilization: running and the freeze response

Perhaps running's most direct therapeutic action addresses freeze responses—the dorsal vagal shutdown that represents the nervous system's final defensive strategy when neither fight, nor flight, nor orienting proves possible. The freeze state combines sympathetic preparation for action with parasympathetic immobilization, creating what Levine describes as "bound energy" awaiting discharge.

Crombie et al.'s (2021) randomized controlled trial with women who had PTSD related to interpersonal violence demonstrated how aerobic exercise enhances the ability to recognize that previously threatening cues no longer predict danger. This finding suggests running helps solidify new learning that arousal need not signal danger—that the cardiovascular activation associated with trauma can occur in contexts of safety.

The neurobiological mechanisms underlying this effect are increasingly well-characterized. Crombie et al.'s (2021) companion study measured circulating endocannabinoids and brain-derived neurotrophic factor (BDNF) in the same participants, finding that both anandamide (AEA) and BDNF mediated the relationship between moderate-intensity exercise and reduced threat expectancy. The endocannabinoid system, primarily expressed in the amygdala, modulates fear and anxiety responses. Simultaneously, BDNF elevation enhances neuroplasticity, supporting the consolidation of new, non-threat associations.

For freeze-response survivors, the physical act of running—forward momentum, muscular activation, purposeful navigation through space—provides somatic evidence contradicting the immobilization narrative written into muscle memory and autonomic patterns. Each footfall, each breath synchronized with movement, each decision about pace or route exercises agency that developmental trauma may have foreclosed. The body learns through direct experience that mobilization is possible, that activation need not collapse into shutdown, that the cardiovascular arousal once associated exclusively with inescapable threat can signal empowerment.

Channeling the vigilant mind: running and hyperarousal

The hypervigilant survivor scans constantly for threat, environmental and internal. Heightened autonomic arousal creates a feedback loop: elevated baseline sympathetic tone generates cardiovascular sensations (rapid heartbeat, shortened breath, muscle tension) that the hypervigilant mind interprets as danger signals, further amplifying arousal. This pattern particularly characterizes PTSD's hyperarousal or orienting symptom cluster—the intrusive alertness, exaggerated startle, difficulty concentrating, irritability that persist long after danger has passed.

Hegberg, Hayes, and Hayes (2019) reviewed observational and intervention studies examining aerobic exercise and PTSD, finding that vigorous-intensity exercise was specifically associated with reduced hyperarousal symptoms (β = −.22, p = .04), explaining approximately 4% of variance—a small but clinically meaningful effect given hyperarousal's treatment resistance. Notably, light or moderate intensity exercise did not demonstrate this effect, suggesting that hyperarousal may require intensity-matched intervention. The hyperactivated nervous system, paradoxically, may find relief not through gentle calming but through purposeful, controlled discharge of elevated arousal. (However, as I noted above, high-intensity approaches can also represent a new kind of addiction.)

Fetzner and Asmundson's (2015) randomized controlled trial helps shed some light on how we might think about applying these ideas. They assigned 33 PTSD-affected participants to two weeks of moderate-intensity stationary cycling (six sessions), manipulating attentional focus across three conditions: prompts directing attention toward the body, distraction through nature documentaries, or neutral (no prompts). Remarkably, 89% of participants reported clinically significant PTSD symptom reductions regardless of what they were focusing on while cycling. Particularly strong effects were found for hyperarousal and anxiety sensitivity— the fear of arousal sensations themselves. The findings suggest that the nervous system organizes itself implicitly during aerobic exercise, even without explicit instruction to attend to bodily sensations.

This represents a form of graded exposure to the very arousal states that hypervigilant individuals fear and monitor. During running, cardiovascular activation rises predictably, breath quickens, muscles fatigue—yet the context remains one of self-determined challenge rather than threat. The nervous system receives repetitive data points: high arousal without danger, cardiovascular activation that resolves through natural recovery, physical sensation as information rather than alarm. Over time, the association between arousal and threat weakens, not through cognitive disputation but through accumulated somatic evidence.

Running also provides adaptive outlet for the vigilant attention itself. Environmental scanning during outdoor running—monitoring terrain, adjusting to grade changes, navigating obstacles—channels hypervigilance into productive engagement with present reality rather than catastrophic future projections. The attention required to maintain pace, rhythm, and form occupies cognitive resources that might otherwise fuel ruminative threat monitoring. This differs from distraction or suppression; it represents redirection of vigilant capacity toward immediate, manageable challenges.

The hypervigilant orienting response is one of perpetual assessment, constant scanning, chronic readiness—the state that precedes fight or flight, the hyperalert monitoring that determines which response is needed, but which never stops even when threat has passed. Those caught in this pattern never arrive anywhere; they constantly scan for but never find safety. Running provides, perhaps, a means of developing the capacity to settle, to trust that some moments are safe enough, that arrival is possible if they just wait, that stillness is survivable, that the world might hold them without harm. Running encourages the discovery that here, now, it might finally be safe enough to rest.

The alchemy of anger: running and the fight response

When flight proves impossible, freezing threatens overwhelm, and hypervigilant orienting provides no pathways, the nervous system activates fight—mobilization with aggression, defensive assertion, the muscular preparation for combat. In developmental trauma, this energy often becomes trapped, unexpressed, turned inward as self-harm or outward as dysregulated aggression. Running provides vehicle for discharge.

The literature offers less direct evidence on exercise for anger specifically than for other trauma responses, yet the physiological pathways suggest clear mechanisms. Dong and Lin's 2025 narrative review examined multiple systems through which exercise modulates PTSD symptoms. They note that exercise down-regulates opioid receptors, which may seem counterintuitive given opioids' association with pleasure and pain relief. However, chronic stress causes opioid receptor upregulation that contributes to emotional numbing—the inability to experience pleasure or appropriate emotional range. Exercise-induced down-regulation paradoxically restores emotional responsiveness, allowing appropriate expression of emotions including anger rather than either suppression or dysregulation.

High-intensity running particularly suits fight-response discharge. Where moderate-intensity exercise optimizes vagal enhancement, vigorous-intensity running provides an intensity-matched outlet for an always-mobilized defensive energy. The muscular exertion, cardiovascular demand, and metabolic challenge mirror the body's preparation for combat while occurring in a context that requires no aggression toward self or other. This represents purposeful assertion rather than reactive defense—agency expressed through chosen challenge.

Bryant et al.'s (2022) landmark study demonstrates this principle in clinical practice. They randomized 130 adults with PTSD to nine weeks of prolonged exposure therapy augmented by either moderate-intensity cycling or passive stretching immediately after each exposure session. While groups showed no differences at one-week post-treatment, the aerobic exercise group demonstrated significantly greater PTSD symptom reductions at six-month follow-up. This delayed emergence of benefits suggests exercise effects on trauma recovery unfold through consolidation processes rather than immediate symptom relief—the gradual reorganization of threat responses through enhanced neuroplasticity.

Critically, Voorendonk et al.'s (2023) study of intensive trauma-focused treatment augmented by physical activity offers nuance to this optimism. They randomly assigned 119 individuals with PTSD to eight-day intensive treatment supplemented by either 90-minute daily physical activity sessions or 90-minute daily creative activities (crafts, reading, board games). Both groups showed massive improvements with no differences between conditions: 81% lost PTSD diagnosis post-treatment, 94% lost complex PTSD diagnosis, with very large effect sizes. The authors suggest potential ceiling effects—intensive trauma-focused therapy may produce such robust improvements that additional physical activity provides no incremental benefit. Alternatively, non-specific factors (social connection, behavioral activation, outdoor time) may matter as much as aerobic exercise specifically.

Those with a locked-in fight response are not choosing to be angry or oppositional; the entire system is organized around the impossibility of accepting powerlessness without fighting back, around the survival strategy that says defiance is the only way to maintain any dignity, any agency, any sense of self—even when that defiance destroys everything they might otherwise want. Running provides, perhaps, a way of finding that power can be claimed constructively rather than grasped desperately, a means of discovering purposeful engagement rather than opposition to everything.

The body as informant: interoceptive awareness and self-regulation

Beneath these diverse mechanisms lies a common pathway: running develops interoceptive awareness—the capacity to perceive, interpret, and respond adaptively to internal bodily signals. Leech, Stapleton, and Patching's (2024) scoping review traced how "interoceptive awareness" originated with clinicians treating trauma, particularly van der Kolk's observation that PTSD survivors struggle to attend to internal sensations without becoming overwhelmed by residual trauma-related perceptions.

Running provides continuous interoceptive training: monitoring heart rate and cardiac output, tracking respiratory rate and depth, sensing muscle tension and fatigue, registering temperature changes, detecting energy depletion. This feedback arrives constantly, demanding interpretation and response. Should I slow? Push slightly harder? Walk briefly? Drink water? The questions require attending to bodily signals, appraising their meaning, making decisions based on interoceptive data. Over time, this practice builds interoceptive awareness skills: identifying sensations, accessing inner experience, sustaining attention to sensation, and appraising internal signals adaptively.

Critically, running allows titrated exposure—gradual, controlled increases in interoceptive intensity. A beginning runner might experience overwhelming sensation at moderate intensity; starting with walk-run intervals provides manageable doses of interoceptive input. As tolerance builds, intensity can increase, expanding the window of tolerance for arousal. This mirrors the pendulation and titration principles central to Somatic Experiencing: oscillating between regulated and dysregulated states while ensuring exposure remains within capacity for integration rather than overwhelm.

The quality of attention during running determines whether interoceptive exposure proves therapeutic or dysregulating. Mindful body scanning while running, attending to breath-footfall patterns, monitoring form and perceived exertion—these practices cultivate the adaptive interoceptive awareness associated with emotion regulation. Conversely, dissociating during runs, pushing past signals of pain or exhaustion, using intensity to override bodily awareness—these patterns may reinforce body dissociation and turn running into yet another unregulated activity that leads to harm.

The problem of specificity: when running helps and when it doesn't

The research reveals important limitations and individual differences. While meta-analyses show moderate aggregate effects, substantial vareity exists in individual responses. Not all trauma survivors benefit equally from running; some may find it activating, triggering, or ineffective.mSample sizes remain small in many studies, limiting confidence in effect estimates and precluding robust analyses or conclusions.

The intensity question also lacks complete resolution. While vigorous exercise specifically reduced hyperarousal in observational studies, some evidence suggests moderate intensity optimizes fear extinction and endocannabinoid activation. Very high intensity may prolong sympathetic activation and delay parasympathetic recovery, potentially contraindicated for some trauma survivors. Individual differences in baseline fitness, trauma type, symptom profile, and exercise history likely moderate optimal intensity.

Van der Kolk et al.'s (2014) study of yoga for treatment-resistant PTSD in women provides instructive contrast. Yoga—combining controlled breathing, postures, and meditation—produced remission in 52% versus 21% of controls, with large effect sizes. The yoga group maintained improvements while controls initially improved then relapsed. This suggests that gentle, rhythmic movement with explicit interoceptive focus may suit some survivors better than vigorous aerobic exercise, particularly when trauma involved profound helplessness or when aggressive intervention feels threatening rather than empowering.

Brom et al.'s (2017) RCT of Somatic Experiencing for PTSD participants found effect sizes comparable to established treatments through 15 sessions focused on body awareness, titration, pendulation, and discharge through subtle movements. This body-focused therapy working with sensations rather than a trauma narrative provides complementary approach that might integrate with running: using running's interoceptive intensity as material for somatic processing rather than as an endpoint itself.

Toward therapeutic prescription: translating research into practice

The accumulated evidence suggests several principles for therapeutic application of running in trauma recovery:

Dosage optimization: Li et al.'s (2025) network meta-analysis identified 730 MET-minutes weekly as optimal—approximately four 30-minute moderate-intensity runs. Lower doses show benefits but smaller magnitude; higher doses may show diminishing returns or risks of overtraining that decrease HRV.

Intensity matching: Moderate intensity (60-75% maximum heart rate) optimizes fear extinction consolidation, endocannabinoid activation, and parasympathetic enhancement. Vigorous intensity (75-85% maximum heart rate) may better address hyperarousal specifically but requires careful titration to avoid dysregulation.

Integration with trauma therapy: Bryant et al. (2022) and Crombie et al.'s (2023) work suggests running after exposure or trauma-processing sessions may enhance consolidation of therapeutic gains through BDNF elevation and behavioral tagging mechanisms. This differs from running as standalone intervention or running before therapy sessions.

Interoceptive focus: The quality of attention during running matters. Mindful body awareness, rhythmic breath attention, monitoring of internal states—these practices cultivate adaptive interoceptive awareness. Dissociation during running or intensity that overwhelms capacity for interoceptive processing may reinforce rather than resolve trauma patterns.

Gradual progression: Starting with walk-run intervals, gradually increasing duration and intensity, allows titrated exposure that respects individual windows of tolerance. Progress measured not by speed or distance but by capacity to remain present and regulated during and after activity.

Social context when possible: Group running provides co-regulation opportunities and ventral vagal social engagement that enhance individual autonomic regulation. Hegberg et al.'s (2019) review noted that social connection during exercise may amplify benefits.

Monitoring for overtraining: Excessive exercise can decrease HRV and compromise recovery. Tracking subjective energy, mood, sleep quality, and resting heart rate helps identify overtraining that would undermine therapeutic goals.

The body's argument: running as counter-narrative to trauma

Ultimately, running's therapeutic action may reside less in specific neurobiological mechanisms than in the cumulative embodied argument it makes against trauma's central claims. Trauma teaches that arousal means danger, that the body cannot be trusted, that freeze or dissociation provides the only safety. Running offers counter-evidence written in the language of direct experience rather than cognitive reappraisal.

Each run demonstrates that cardiovascular activation can signal challenge rather than threat, chosen exertion rather than helpless terror. Each return to baseline breathing proves that arousal resolves, that the nervous system can upregulate and downregulate rather than remain stuck. Each increase in endurance or pace shows capacity expanding rather than permanently fixed by past trauma. Each run completed despite initial resistance exercises agency—the capacity to choose adaptive challenge despite fear.

This somatic education occurs through channels more fundamental than cognition. Running speaks to subcortical systems in their native language: the language of sensation, movement, rhythm, breath.

The research base, while growing, requires continued development. Larger samples, more precise measurement of exercise parameters, direct assessment of proposed mechanisms, longer follow-up periods, and attention to individual differences all represent priorities. Yet the existing evidence, converging across diverse methodologies and populations, supports running and aerobic exercise as promising interventions for trauma—not as replacement for trauma-focused psychotherapy but as powerful adjunctive approach that addresses trauma's embodied residue through direct reorganization of nervous system patterns.

For the survivor whose body learned to associate arousal exclusively with danger, whose interoceptive awareness became either overwhelming or absent—running offers opportunity to complete interrupted movements, to experience controlled arousal in safety, to rebuild trust between awareness and bodily sensation. The therapeutic action unfolds not through insight but through accumulated moments of staying present in an activated body, of choosing forward momentum, of discovering that the rhythm of footfalls and breath can carry one toward rather than away from embodied life.

Sources

Björkman, F., & Ekblom, Ö. (2022). Physical exercise as treatment for PTSD: A systematic review and meta-analysis. Military Medicine, 187(9-10), e1103–e1113. https://doi.org/10.1093/milmed/usab497

Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic experiencing for posttraumatic stress disorder: A randomized controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312. https://doi.org/10.1002/jts.22189

Bryant, R. A., Dawson, K. S., Azevedo, S., Yadav, S., Cahill, C., Kenny, L., Maron-Katz, A., Williams, L., de Wet, C., Galatzer-Levy, I., & Harvey, S. B. (2022). Augmenting trauma-focused psychotherapy for post-traumatic stress disorder with brief aerobic exercise in Australia: A randomised clinical trial. The Lancet Psychiatry, 10(1), 21–29. https://doi.org/10.1016/S2215-0366(22)00368-6

Cabanas-Sánchez, V., Guallar-Castillón, P., Higueras-Fresnillo, S., Rodríguez-Artalejo, F., & Martínez-Gómez, D. (2022). Does exercise training improve cardiac-parasympathetic nervous system activity in sedentary people? A systematic review with meta-analysis. International Journal of Environmental Research and Public Health, 19(21), 13899. https://doi.org/10.3390/ijerph192113899

Crombie, K. M., Sartin-Tarm, A., Sellnow, K., Ahrenholtz, R., Lee, S., & Matalamaki, M., Adams, T. G., & Cisler, J. M. (2021). Aerobic exercise and consolidation of fear extinction learning among women with posttraumatic stress disorder. Behaviour Research and Therapy, 142, 103867. https://doi.org/10.1016/j.brat.2021.103867

Crombie, K. M., Sartin-Tarm, A., Sellnow, K., Ahrenholtz, R., Lee, S., Matalamaki, M., Almassi, N. E., Hillard, C. J., Koltyn, K. F., Adams, T. G., & Cisler, J. M. (2021). Exercise-induced increases in anandamide and BDNF during extinction consolidation contribute to reduced threat following reinstatement: Preliminary evidence from a randomized controlled trial. Psychoneuroendocrinology, 132, 105355. https://doi.org/10.1016/j.psyneuen.2021.105355

Dong, Y., & Lin, J. (2025). The effects of exercise on post-traumatic stress disorder: Multiple dimensions, nonlinear mechanisms, and clinical perspectives. Frontiers in Psychology, 15, 1483523. https://doi.org/10.3389/fpsyg.2025.1483523

Fetzner, M. G., & Asmundson, G. J. G. (2015). Aerobic exercise reduces symptoms of posttraumatic stress disorder: A randomized controlled trial. Cognitive Behaviour Therapy, 44(4), 301–313. https://doi.org/10.1080/16506073.2014.916745

Hegberg, N. J., Hayes, J. P., & Hayes, S. M. (2019). Exercise intervention in PTSD: A narrative review and rationale for implementation. Frontiers in Psychiatry, 10, 133. https://doi.org/10.3389/fpsyt.2019.00133

Leech, T., Stapleton, P., & Patching, S. (2024). Interoceptive awareness and trauma: A scoping review of the literature. Frontiers in Psychiatry, 15, 1355442. https://doi.org/10.3389/fpsyt.2024.1355442

Li, X., Xia, H., Yu, G., Hu, Y., & Zhu, F. (2025). Optimal exercise dosage and type for improving post-traumatic stress disorder: A systematic review and network meta-analysis of randomized controlled trials. Complementary Therapies in Clinical Practice, 60, 102004. https://doi.org/10.1016/j.ctcp.2025.102004

Liddell, B. J., Kemp, A. H., Steel, Z., Nickerson, A., Bryant, R. A., Tam, N., Tay, A. K., & Silove, D. (2016). Heart rate variability and the relationship between trauma exposure age, and psychopathology in a post-conflict setting. BMC Psychiatry, 16, 133. https://doi.org/10.1186/s12888-016-0850-5

Schmitz, M., Bertsch, K., Löffler, A., Steinmann, S., Brück, C., Herpertz, S. C., & Bekrater-Bodmann, R. (2023). Body connection mediates the relationship between traumatic childhood experiences and impaired emotion regulation: Evidence from a cross-sectional study. Borderline Personality Disorder and Emotion Dysregulation, 10, 12. https://doi.org/10.1186/s40479-023-00212-5

Schneider, M., & Schwerdtfeger, A. (2020). Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: A meta-analysis. Psychological Medicine, 50(12), 1937–1948. https://doi.org/10.1017/S003329172000207X

Van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry, 75(6), e559–e565. https://doi.org/10.4088/JCP.13m08561

Voorendonk, E. M., De Jongh, A., Rozendaal, L., & Van Minnen, A. (2023). Adding physical activity to intensive trauma-focused treatment for post-traumatic stress disorder: Results of a randomized controlled trial. Frontiers in Psychology, 14, 1215250. https://doi.org/10.3389/fpsyg.2023.1215250