Shake Away Stress with Tension and Trauma Release Exercises

I loved being a paramedic and spent 30 years serving in emergency services. What I didn’t count on was the nightmares, depression, anxiety and panic attacks.


I found myself withdrawing further and further inward behind the wall of protective coping mechanisms that had developed.

Something had to change. In looking for alternative treatment methods, not just another prescription, I found TRE®. It was really intriguing, sounded like what I needed, but I was convinced there was no way I’d be able to do it. Shake in front of other people? Look out of control? I don’t think so. There was a local workshop scheduled for the next week so I decided to just go and learn more. That didn’t mean I’d actually let myself do it!

Much to my surprise, it was an amazing experience. I walked out of that first session feeling like a hundred pounds had been lifted off my shoulders. I could breathe! My mind was calmer that it had been in a long time. Finally, something that felt right, gave me hope.

Within three months, a regular practice had made such a difference that I started exploring what it would take to become a TRE Provider. I wanted everyone to know about TRE! What if we could equip all responders with this incredible self-help tool? How can we make it a part of our initial training programs? We need to learn to be proactive in managing our stress levels instead of others going through what I did. That’s the great thing about TRE, once you learn safety and regulation, it’s yours to use any time you need it. You’re not dependent on someone else. You have stress management tools for life!

Do a quick search for EMS and stress. You’ll find titles like Stress: “The Silent Killer of the EMS Career” ( or “EMS Responders-The Stress is Killing Us” (American Addiction Centers). There’s no denying that a career in EMS can be stressful. We witness things like horrific accidents, unresponsive people including small infants and disturbing suicides. Left unchecked, as the stress accumulates; it can manifest into more severe conditions such as depression and anxiety or can even lead to post-traumatic stress disorder.

According to the National Institute of Health, all first responders, but especially EMS providers, face high levels of acute and chronic stress. This leads to high rates of depression and substance abuse, which increase their risk of suicide. I don’t think any of us in emergency services are surprised by that information. We live and work in it every day.

So, what is TRE? The description on the global TRE website ( reads as follows: “Tension and Trauma Release Exercises (or TRE) is a simple yet innovative series of exercises that assist the body in releasing deep muscular patterns of stress, tension and trauma. Created by Dr. David Berceli, PhD, TRE® safely activates a natural reflex mechanism of shaking or vibrating that releases muscular tension, calming down the nervous system. When this muscular shaking/vibrating is activated in a safe and controlled environment, the body is encouraged to return back to a state of balance.”

Our sympathetic nervous system charges us up to respond to threat or danger but we seldom get the chance to completely discharge. We’ve also been taught to hold it all in. Especially as first responders, we have to be the professional who’s there to take care of everyone else. We feel this in our bodies with tight muscles, clenched jaw, digestive issues, high blood pressure and many other physical ailments. By releasing the deep tension patterns held in our body, the excited autonomic nervous system is downregulated, allowing calmness to return, reducing anxiety and restoring homeostasis. TRE releases the contracted state of the human body and thus improves our physical and mental health. Many times, this release is accomplished without having to revisit the “story,” memories or emotions that accompanied the original incident or trauma.

We’re familiar with our autonomic nervous system, the sympathetic “fight or flight” and the parasympathetic “rest and digest,” but there’s more. Dr. Stephen Porges’ Polyvagal Theory shows that in addition to our “rest and digest” functions of the vagus nerve, there’s another side. In times of severe acute stress or accumulated stress, we can reach the “preparation for death” or “freeze response” of the vagus nerve which includes hopelessness, depression and living in survival mode. We’re designed to respond to stress then drop back down to the “rest and digest” side of vagus control where we feel safe. Unfortunately, when we continue to charge up again and again, without the necessary discharge, we get stuck in the on position and feel the effects both physically and mentally.

What’s a TRE session like? First we review any medical conditions, injuries or physical restrictions to make sure you are safe during the exercises. Clinically trained TRE providers are able to modify or adjust the sequence to meet your individual needs. Whether in a group or a private session, it can be customized to the needs of each person, no matter the age or ability level. The exercises are designed to gently stretch and fatigue major muscle groups, which assists in activating the tremors or shaking mechanism. You’ll lie comfortably on the floor, usually on a yoga mat, while the tremor mechanism works to bring balance back into your organism. Your body does the work while the TRE provider monitors the process and checks in to keep you safe and make sure you’re comfortable. Your body uses your natural stress relieving mechanism while the provider guides you and teaches regulation and safety. You remain in control at all times and are able to slow down or stop the process whenever you wish.

People report many benefits such as less worry and anxiety, better sleep, reduced back and muscle pain, increased flexibility, more energy and endurance. I know first-hand the incredible results from my own TRE practice and now as a provider, I’ve had the opportunity to work with people from all walks of life and witness their journey toward healing. Paramedics, firefighters, police officers, dispatchers, nurses, teachers, military, parents, children, seniors, all have been able to use TRE with positive outcomes.

My vision is to train enough providers to make it readily available for work with first responder agencies and for all initial training programs. Larger agencies could even have a TRE® provider on staff. This unique process is inherent in our own bodies. Showing people how to tap into it safely and support them as they heal has been amazing. Our founder, Dr. David Berceli, says his vision is to have TRE® become a household name within the next five years. I’m willing to do my part. How can we help your agency bring TRE to the emergency responders who need it?

Want to learn more? I offer private and group TRE® sessions at Waxhaw Health and Wellness in Waxhaw, North Carolina and at A Knead for Nurturing in Monroe, North Carolina. Interested in hosting a TRE® workshop at your agency? I can easily bring TRE® to you. Let’s start taking care of ourselves like we look after everyone else.

Betsy Ross lives on the family farm with her husband of 32 years, has two sons, a daughter in law and a one year old grandson. She is certified as a TRE Provider and is part of a select group from around the world, currently working with Dr. Berceli, TRE Founder, to become a TRE Certification Trainer.

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