Trauma Releasing Exercises (TRE): Why the Body Shakes and Where Acupuncture May Fit
Trauma is often talked about as something that happened in the past. But anyone who has experienced significant trauma knows that the body does not always behave as though the danger is over.
You may consciously know that you are safe and still feel your heart race. Your jaw tightens. Your shoulders rise. Your stomach turns. You startle easily, stop breathing normally, feel restless for no clear reason, or suddenly disconnect from your body altogether.
This is what people often mean when they say “trauma is stored in the body.” It is a useful phrase, but it is not quite literal. Trauma is not a physical substance trapped inside a muscle or piece of fascia waiting to be shaken out. What research does show is that traumatic experiences can become associated with lasting changes in threat processing, autonomic regulation, bodily awareness, startle responses, and the way internal sensations are interpreted. PTSD in particular can involve persistent hyperarousal and increased physiological reactivity even when the original danger is no longer present.
That is one reason body-based approaches to trauma have become so interesting.
What Are Trauma Releasing Exercises?
Tension & Trauma Releasing Exercises, or TRE, were developed by David Berceli as a series of movements designed to deliberately evoke involuntary muscular tremoring or shaking.
The exercises typically fatigue and activate certain muscle groups until a spontaneous tremor begins, often around the legs and pelvis before potentially moving through other parts of the body. TRE describes this as activating a natural tremoring response that can help reduce muscular tension and stress.
The shaking is usually the part people remember.
If you've never experienced it before, it can look strange. The body may tremble, shake, pulse, or move without the person consciously deciding to produce each movement.
The theory behind TRE is that this tremoring may allow patterns of chronic muscular tension and physiological activation to soften.
The important distinction is that the exact biological mechanism of TRE has not yet been established. Even researchers studying TRE describe its proposed nervous-system effects as a theory that still requires much more investigation.
Why Does Trauma Feel So Physical?
For most people, these reactions eventually settle once the situation has passed.
With PTSD and chronic traumatic stress, that system may remain unusually reactive. Research has documented changes including heightened startle responses, increased physiological reactions to trauma reminders, hypervigilance, and alterations in autonomic regulation.
Trauma can also become closely linked with interoception, which is the brain's perception of sensations coming from inside the body. A racing heart, tight chest, stomach sensation, trembling, or shortness of breath can become part of the trauma response itself. In some people, those physical sensations can later act as cues that reactivate fear even when there is no present danger.
This is a more scientifically accurate way of talking about the body “holding” trauma.
The body may learn patterns of protection.
And those patterns can become automatic.
So What Is Happening When the Body Shakes?
Shaking is a normal human physiological phenomenon. We can tremble when we are cold, frightened, overwhelmed, physically exhausted, or experiencing intense emotion.
Somatic approaches to trauma have proposed that trembling may sometimes accompany a shift in autonomic activation. Somatic Experiencing literature, for example, describes trembling, warmth, changes in breathing, and other physical responses occurring as people work with previously overwhelming bodily sensations.
TRE intentionally creates conditions in which tremoring can occur.
What we cannot yet say scientifically is that each tremor represents a specific trauma physically leaving a muscle or that shaking literally “discharges” a stored traumatic memory from tissue.
I think the more useful way to look at it is this:
The shaking may give the body an opportunity to experience movement, sensation, and release without having to consciously control every part of the process.
For someone who has spent years bracing, holding, suppressing, or staying hypervigilant, that experience can feel significant.
What Does the Research on TRE Actually Show?
TRE research is still very early.
A 2024 study examined 33 female East African refugees with histories of trauma. Participants were randomly assigned to TRE or a delayed-treatment control condition. After eight weeks, the TRE group showed greater reductions in overall trauma-related symptom severity than the control group. However, only 14 participants completed the TRE phase analyzed in the study, making this a small preliminary trial rather than definitive evidence for treating PTSD.
TRE has also been investigated in people with multiple sclerosis. A small nine-person pilot study reported improvements in self-rated stress, fatigue, sleep, and several other symptoms, although objective spasticity did not significantly change. A later randomized trial involving 28 people with MS produced mixed findings: the primary outcomes were not significantly different in the initial unadjusted analyses, although some differences emerged after statistical adjustment.
So TRE is interesting.
But we are still at the “promising and needs more research” stage.
Where Acupuncture Becomes Interesting
Acupuncture approaches the body from an entirely different tradition, but there is an interesting point of overlap.
Both acupuncture and somatic practices can involve working with physical sensation rather than relying entirely on verbal processing.
And acupuncture now has some meaningful clinical research behind its use in PTSD.
A 2024 randomized clinical trial published in JAMA Psychiatry studied 93 combat veterans with PTSD. Participants received either true acupuncture or sham acupuncture, with up to 24 treatments over 15 weeks. The true acupuncture group experienced a significantly greater reduction in PTSD symptoms than the sham group. Researchers also measured fear-potentiated startle, a physiological marker related to fear learning, and found improvement in fear extinction in the acupuncture group.
That finding is particularly interesting because it suggests acupuncture may be doing more than simply making people feel relaxed during a treatment.
Earlier systematic reviews have also found possible benefits of acupuncture for PTSD symptoms, although the overall quality of the evidence has historically been low and studies have varied considerably in their methods.
The newer research is encouraging, but acupuncture is still best understood as an adjunctive option, not a replacement for established PTSD treatment.
Could TRE and Acupuncture Work Together?
This is the part I find especially interesting.
I could not find a published clinical trial specifically testing TRE combined with acupuncture for PTSD, so I cannot say that the combination has been scientifically proven.
But conceptually, they may offer two different ways of working with a system that has become stuck in patterns of protection.
TRE introduces movement and controlled tremoring. Acupuncture introduces stillness, sensory input, and a period in which the body is not being asked to perform or respond.
Someone might use TRE to explore movement and release and then use acupuncture as a quieter integration practice. For another person, acupuncture might come first—helping them become more comfortable noticing bodily sensations before beginning more active somatic work.
The goal would not be to force the body to “release trauma.”
It would be to gradually increase its capacity to experience sensation, activation, and rest without becoming overwhelmed.
That distinction matters.
Trauma Work Should Never Be About Pushing Through
More sensation is not automatically more healing.
For someone with significant PTSD, complex trauma, panic, dissociation, or a history of feeling unsafe in their body, intense shaking can potentially become overwhelming rather than regulating.
TRE itself emphasizes self-regulation: slowing or stopping if the experience becomes too intense and learning the practice with appropriate guidance. The organization recommends working with certified TRE providers, particularly when trauma is complex.
I take the same approach with acupuncture.
Trauma-informed acupuncture should involve choice, explanation, pacing, and ongoing consent. Sometimes that means fewer needles. Sometimes it means leaving certain areas of the body untouched. Sometimes it means sitting instead of lying down. And sometimes it means deciding that today is not the day to do a more activating practice at all.
The nervous system does not need another experience of being forced.
The Bigger Idea: Giving the Body More Than One Way to Heal
Trauma can affect thoughts, memory, relationships, emotions, sleep, attention—and the physical experience of living inside your body.
It makes sense that recovery may sometimes need more than one doorway.
For some people that doorway is psychotherapy. For others, movement becomes important. Breath, qigong, acupuncture, meditation, and other body-based practices may provide additional ways to work with regulation and physical symptoms.
For diagnosed PTSD, the treatments with the strongest evidence remain trauma-focused psychotherapies including Cognitive Processing Therapy, Prolonged Exposure, and EMDR. Acupuncture and TRE are better thought of as complementary approaches that may sit alongside appropriate mental-health care rather than replace it.
But I think there is something valuable in recognizing that healing does not happen only through understanding what happened.
Sometimes the body also has to learn something new:
The danger is not happening now. I can feel something without being consumed by it. I can activate and come back. I can soften without losing control.
That is the part of trauma-informed acupuncture and somatic work that interests me most.
Not forcing something out of the body.
Helping the body discover that it no longer has to hold itself in quite the same way.
Interested in a body-based approach to trauma?
If trauma, chronic stress, or nervous-system dysregulation is showing up physically, we can explore a trauma-informed acupuncture approach and other mind-body tools that make sense for where you are now.
Sources
Hollifield M, Hsiao A, Smith T, et al. Acupuncture for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2024.
Grant S, Colaiaco B, Motala A, et al. Acupuncture for the Treatment of Adults with Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis. Journal of Trauma & Dissociation. 2018.
Parker J, Shook B, Washington D, English B, Tatum C. The Effect of Tension and Trauma Releasing Exercises (TRE) on Trauma Symptoms in East African Refugees. Psychology. 2024.
Lynning M, et al. Tension and Trauma Releasing Exercises for People with Multiple Sclerosis—An Exploratory Pilot Study. Journal of Traditional and Complementary Medicine. 2021.
Payne P, Levine PA, Crane-Godreau MA. Somatic Experiencing: Using Interoception and Proprioception as Core Elements of Trauma Therapy. Frontiers in Psychology. 2015.
VA National Center for PTSD. Overview of Psychotherapy for PTSD.
