Keywords
psychological rehabilitation
pathopsychological symptom complexes
traumatic stress
combatants
body-oriented therapy
interoception
psychological self-regulation
How to Cite
Abstract
Background. The psychological consequences of traumatic and chronic stress remain a major concern for both combatants and civilian populations. Body-oriented interventions have demonstrated clinical relevance; however, published descriptions are often insufficiently detailed to ensure reproducibility, while individual body-based, breathing, and self-regulation techniques are frequently investigated in isolation.
Aim. To develop and provide a theoretical rationale for Kharakternyk, a body-oriented psychological rehabilitation program for individuals experiencing the consequences of traumatic stress; to identify the overarching principles underlying its protocol; and to compare its components with analogous approaches described in the scientific literature.
Methods. The study was grounded in systemic and integrative methodological approaches. The methods included theoretical and methodological analysis, systematization of the literature, content analysis, prototype analysis, comparison, and synthesis. The protocol was described in sufficient detail to support reproducibility. The evidence base comprised the authors’ own materials and relevant scientific literature.
Results. A protocol for an intensive two-week course delivered in a rehabilitation group format and supplemented by independent audio-guided practice was developed. The program comprises four components: myofascial release targeting trigger areas, movement techniques, breathing techniques, and psychological self-regulation methods. For each component, dosage, sequence, contraindications, and hypothesized mechanisms were specified. The components were organized according to a gradient of interoceptive signal intensity, while the principles governing verbal guidance were operationalized in a testable form. The protocol components were also systematically compared with analogous approaches described in the scientific literature.
Conclusions. The Kharakternyk program is presented as a structured protocol suitable for replication in clinical practice and further empirical investigation. The next stage should involve direct controlled evaluation of the protocol’s effectiveness and safety.
Keywords: stress disorders; psychological rehabilitation; pathopsychological symptom complexes; traumatic stress; combatants; body-oriented therapy; interoception; psychological self-regulation.
References
Álvarez-García, C., & Yaban, Z. Ş. (2020). The effects of preoperative guided imagery interventions on preoperative anxiety and postoperative pain: A meta-analysis. Complementary Therapies in Clinical Practice, 38, 101077. https://doi.org/10.1016/j.ctcp.2019.101077
Bartsch, K. M., Baumgart, C., Freiwald, J., Wilke, J., Slomka, G., Turnhöfer, S., Egner, C., Hoppe, M. W., Klingler, W., & Schleip, R. (2021). Expert consensus on the contraindications and cautions of foam rolling–an international Delphi study. Journal of Clinical Medicine, 10(22), 5360. https://doi.org/10.3390/jcm10225360
Berland, R., Marques-Sule, E., Marín-Mateo, J., Moreno-Segura, N., López-Ridaura, A., & Sentandreu-Mañó, T. (2022). Effects of the Feldenkrais method as a physiotherapy tool: A systematic review and meta-analysis of randomized controlled trials. International Journal of Environmental Research and Public Health, 19(21), 13734. https://doi.org/10.3390/ijerph192113734
Bertolucci, L. F. (2011). Pandiculation: Nature's way of maintaining the functional integrity of the myofascial system? Journal of Bodywork and Movement Therapies, 15(3), 268–280. https://doi.org/10.1016/j.jbmt.2010.12.006
Breznoscakova, D., Kovanicova, M., Sedlakova, E., & Pallayova, M. (2023). Autogenic training in mental disorders: What can we expect? International Journal of Environmental Research and Public Health, 20(5), 4344. https://doi.org/10.3390/ijerph20054344
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
Catani, M. (2017). A little man of some importance. Brain, 140(11), 3055–3061. https://doi.org/10.1093/brain/awx270
Charalambous, A., Giannakopoulou, M., Bozas, E., & Paikousis, L. (2015). A randomized controlled trial for the effectiveness of progressive muscle relaxation and guided imagery as anxiety reducing interventions in breast and prostate cancer patients undergoing chemotherapy. Evidence-Based Complementary and Alternative Medicine, 2015, 270876. https://doi.org/10.1155/2015/270876
Classen, C. C., Hughes, L., Clark, C., Hill Mohammed, B., Woods, P., & Beckett, B. (2021). A pilot RCT of a body-oriented group therapy for complex trauma survivors: An adaptation of sensorimotor psychotherapy. Journal of Trauma & Dissociation, 22(1), 52–68. https://doi.org/10.1080/15299732.2020.1760173
Clemente, R., Murphy, A., & Murphy, J. (2024). The relationship between self-reported interoception and anxiety: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 167, 105923. https://doi.org/10.1016/j.neubiorev.2024.105923
Dahiya, M., Dwivedi, D., Kaur, N., Lamba, P., & Chamola, S. (2025). Impact of Makarasana on cardiovascular parameters: A prospective interventional study. Journal of Clinical and Diagnostic Research. https://doi.org/10.7860/JCDR/2025/77677.21370
Donato, K. O., Falcão, L., Nishizima, A., Oliveira, A. S., Gonzalez, J. V., Ribeiro, N. N., Abbud, C., Braga, G. A., Garrido, G., Donato, A. O., Eckeli, A., Cruz, M. M. E., & Salles, C. (2026). Progressive muscle relaxation technique improves sleep quality and mental health: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychosomatic Research, 203, 112563. https://doi.org/10.1016/j.jpsychores.2026.112563
Duncan, E., O'Cathain, A., Rousseau, N., Croot, L., Sworn, K., Turner, K. M., Yardley, L., & Hoddinott, P. (2020). Guidance for reporting intervention development studies in health research (GUIDED): An evidence-based consensus study. BMJ Open, 10(4), e033516. https://doi.org/10.1136/bmjopen-2019-033516
Erickson, M. H., & Rossi, E. L. (1975). Varieties of double bind. American Journal of Clinical Hypnosis, 17(3), 143–157. https://doi.org/10.1080/00029157.1975.10403733
Fincham, G. W., Strauss, C., & Cavanagh, K. (2023). Effect of coherent breathing on mental health and wellbeing: A randomised placebo-controlled trial. Scientific Reports, 13(1), 22141. https://doi.org/10.1038/s41598-023-49279-8
Füstös, J., Gramann, K., Herbert, B. M., & Pollatos, O. (2013). On the embodiment of emotion regulation: Interoceptive awareness facilitates reappraisal. Social Cognitive and Affective Neuroscience, 8(8), 911–917. https://doi.org/10.1093/scan/nss089
Gan, R., Zhang, L., & Chen, S. (2022). The effects of body scan meditation: A systematic review and meta-analysis. Applied Psychology: Health and Well-Being, 14(3), 1062–1080. https://doi.org/10.1111/aphw.12366
Hanna, T. (1988). Somatics: Reawakening the mind's control of movement, flexibility, and health. Addison-Wesley.
Havenith, M. N., Leidenberger, M., Brasanac, J., Corvacho, M., Carmo Figueiredo, I., Schwarz, L., Uthaug, M., Rakusa, S., Bernardic, M., Vasquez-Mock, L., Pérez Rosal, S., Carhart-Harris, R., Gold, S. M., Jungaberle, H., & Jungaberle, A. (2025). Decreased CO2 saturation during circular breathwork supports emergence of altered states of consciousness. Communications Psychology, 3(1), 59. https://doi.org/10.1038/s44271-025-00247-0
Heim, N., Bobou, M., Tanzer, M., Jenkinson, P. M., Steinert, C., & Fotopoulou, A. (2023). Psychological interventions for interoception in mental health disorders: A systematic review of randomized-controlled trials. Psychiatry and Clinical Neurosciences, 77(10), 530–540. https://doi.org/10.1111/pcn.13576
Jamison, A. L., Slightam, C., Bertram, F., Kim, S., & Roth, W. T. (2022). Randomized clinical trial of capnometry-assisted respiratory training in veterans with posttraumatic stress disorder hyperarousal. Psychological Trauma: Theory, Research, Practice, and Policy, 14(5), 883–893. https://doi.org/10.1037/tra0000525
Laborde, S., Allen, M., Borges, U., Dosseville, F., Hosang, T., Iskra, M., Mosley, E., Salvotti, C., Spolverato, L., Zammit, N., & Javelle, F. (2022). Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neuroscience & Biobehavioral Reviews, 138, 104711. https://doi.org/10.1016/j.neubiorev.2022.104711
Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in processing emotional memories. Journal of Behavior Therapy and Experimental Psychiatry, 44(2), 231–239. https://doi.org/10.1016/j.jbtep.2012.11.001
Leech, K., Stapleton, P., & Patching, A. (2024). A roadmap to understanding interoceptive awareness and post-traumatic stress disorder: A scoping review. Frontiers in Psychiatry, 15, 1355442. https://doi.org/10.3389/fpsyt.2024.1355442
Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, 756. https://doi.org/10.3389/fpsyg.2014.00756
Lindholm, P., & Lundgren, C. E. G. (2009). The physiology and pathophysiology of human breath-hold diving. Journal of Applied Physiology, 106(1), 284–292. https://doi.org/10.1152/japplphysiol.90991.2008
Löken, L. S., Wessberg, J., Morrison, I., McGlone, F., & Olausson, H. (2009). Coding of pleasant touch by unmyelinated afferents in humans. Nature Neuroscience, 12(5), 547–548. https://doi.org/10.1038/nn.2312
Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Sciences, 12(4), 163–169. https://doi.org/10.1016/j.tics.2008.01.005
Mansour, M., Joseph, G. R., Joy, G. K., Khanal, S., Dasireddy, R. R., Menon, A., Barrie Mason, I., Kataria, J., Patel, T., & Modi, S. (2023). Post-traumatic stress disorder: A narrative review of pharmacological and psychotherapeutic interventions. Cureus, 15(9), e44905. https://doi.org/10.7759/cureus.44905
Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E. (2008). Relaxation training for anxiety: A ten-years systematic review with meta-analysis. BMC Psychiatry, 8(1), 41. https://doi.org/10.1186/1471-244X-8-41
McGlone, F., Wessberg, J., & Olausson, H. (2014). Discriminative and affective touch: Sensing and feeling. Neuron, 82(4), 737–755. https://doi.org/10.1016/j.neuron.2014.05.001
Muhammad Khir, S., Wan Mohd Yunus, W. M. A., Mahmud, N., Wang, R., Panatik, S., Mohd Sukor, M. S., & Nordin, N. (2024). Efficacy of progressive muscle relaxation in adults for stress, anxiety, and depression: A systematic review. Psychology Research and Behavior Management, 17, 345–365. https://doi.org/10.2147/PRBM.S437277
Nordbrandt, M. S., Sonne, C., Mortensen, E. L., & Carlsson, J. (2020). Trauma-affected refugees treated with basic body awareness therapy or mixed physical activity as augmentation to treatment as usual–a pragmatic randomised controlled trial. PLOS ONE, 15(3), e0230300. https://doi.org/10.1371/journal.pone.0230300
Öst, L. G. (1987). Applied relaxation: Description of a coping technique and review of controlled studies. Behaviour Research and Therapy, 25(5), 397–409. https://doi.org/10.1016/0005-7967(87)90017-9
Pal, G. K., Nanda, N., Renugasundari, M., Pal, P., & Pachegaonkar, U. (2020). Acute effects of prone asanas and Pal’s pranayama on myalgia, headache, psychological stress and respiratory problems in the COVID-19 patients in the recovery phase. Biomedicine, 40(4), 526–530. https://doi.org/10.51248/.v40i4.334
Palser, E. R., Palmer, C. E., Galvez-Pol, A., Hannah, R., Fotopoulou, A., & Kilner, J. M. (2018). Alexithymia mediates the relationship between interoceptive sensibility and anxiety. PLOS ONE, 13(9), e0203212. https://doi.org/10.1371/journal.pone.0203212
Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93. https://doi.org/10.3389/fpsyg.2015.00093
Penfield, W., & Rasmussen, T. (1950). The cerebral cortex of man: A clinical study of localization of function. Macmillan.
Pérez-Martínez, C., Gogorza-Arroitaonandia, K., Heredia-Rizo, A. M., Salas-González, J., & Oliva-Pascual-Vaca, Á. (2020). INYBI: A new tool for self-myofascial release of the suboccipital muscles in patients with chronic non-specific neck pain: A randomized controlled trial. Spine, 45(21), E1367–E1375. https://doi.org/10.1097/BRS.0000000000003605
Price, C. J., & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: Theory and approach of mindful awareness in body-oriented therapy (MABT). Frontiers in Psychology, 9, 798. https://doi.org/10.3389/fpsyg.2018.00798
Rhinewine, J. P., & Williams, O. J. (2007). Holotropic Breathwork: The potential role of a prolonged, voluntary hyperventilation procedure as an adjunct to psychotherapy. The Journal of Alternative and Complementary Medicine, 13(7), 771–776. https://doi.org/10.1089/acm.2006.6203
Rosendahl, S., Sattel, H., & Lahmann, C. (2021). Effectiveness of body psychotherapy. A systematic review and meta-analysis. Frontiers in Psychiatry, 12, 709798. https://doi.org/10.3389/fpsyt.2021.709798
Schleip, R. (2003). Fascial plasticity – a new neurobiological explanation: Part 1. Journal of Bodywork and Movement Therapies, 7(1), 11–19. https://doi.org/10.1016/S1360-8592(02)00067-0
Shaffer, F., & Meehan, Z. M. (2020). A practical guide to resonance frequency assessment for heart rate variability biofeedback. Frontiers in Neuroscience, 14, 570400. https://doi.org/10.3389/fnins.2020.570400
Shatrova, D., Cáncer, P. F., & Caperos, J. M. (2024). The role of interoception in reducing trauma-associated distress: A feasibility study. European Journal of Psychotraumatology, 15(1), 2306747. https://doi.org/10.1080/20008066.2024.2306747
Sillevis, R., & Hansen, A. W. (2024). Could the suboccipital release technique result in a generalized relaxation and self-perceived improvement? A repeated measure study design. Journal of Clinical Medicine, 13(19), 5898. https://doi.org/10.3390/jcm13195898
Simons, D. G., Travell, J. G., & Simons, L. S. (1999). Myofascial pain and dysfunction: The trigger point manual (2nd ed.). Williams & Wilkins.
Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ, 374, n2061. https://doi.org/10.1136/bmj.n2061
Stecco, C., Porzionato, A., Lancerotto, L., Stecco, A., Macchi, V., Ann Day, J., & De Caro, R. (2008). Histological study of the deep fasciae of the limbs. Journal of Bodywork and Movement Therapies, 12(3), 225–230. https://doi.org/10.1016/j.jbmt.2008.04.041
Stetter, F., & Kupper, S. (2002). Autogenic training: A meta-analysis of clinical outcome studies. Applied Psychophysiology and Biofeedback, 27(1), 45–98. https://doi.org/10.1023/A:1014576505223
U.S. Department of Veterans Affairs, & U.S. Department of Defense. (2023). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder. https://www.healthquality.va.gov/guidelines/MH/ptsd/
Наказ Міністерства охорони здоров'я України від 19.07.2024 № 1265 «Про затвердження Уніфікованого клінічного протоколу первинної та спеціалізованої медичної допомоги «Гостра реакція на стрес. Посттравматичний стресовий розлад. Порушення адаптації»». (2024). https://moz.gov.ua/uk/decrees/nakaz-moz-ukrayini-vid-19-07-2024-1265-pro-zatverdzhennya-unifikovanogo-klinichnogo-protokolu-pervinnoyi-ta-specializovanoyi-medichnoyi-dopomogi-gostra-reakciya-na-stres-posttravmatichnij-stresovij-rozlad-porushennya-adaptaciyi
van de Kamp, M. M., & Machorrinho, J. (2026). Association between interoceptive awareness and symptoms of post-traumatic stress disorder: A meta-analysis. European Journal of Trauma & Dissociation, 10(1), 100638. https://doi.org/10.1016/j.ejtd.2026.100638
van de Kamp, M. M., Scheffers, M., Emck, C., Fokker, T. J., Hatzmann, J., Cuijpers, P., & Beek, P. J. (2023). Body- and movement-oriented interventions for posttraumatic stress disorder: An updated systematic review and meta-analysis. Journal of Traumatic Stress, 36(5), 835–848. https://doi.org/10.1002/jts.22968
van den Hout, M. A., van der Molen, G. M., Griez, E., Lousberg, H., & Nansen, A. (1987). Reduction of CO2-induced anxiety in patients with panic attacks after repeated CO2 exposure. American Journal of Psychiatry, 144(6), 788–791. https://doi.org/10.1176/ajp.144.6.788
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. The Journal of Clinical Psychiatry, 75(6), e559–e565. https://doi.org/10.4088/JCP.13m08561
Wang, S. K., Feng, M., Fang, Y., Lv, L., Sun, G. L., Yang, S. L., Guo, P., Cheng, S. F., Qian, M. C., & Chen, H. X. (2023). Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review. World Journal of Psychiatry, 13(6), 331–339. https://doi.org/10.5498/wjp.v13.i6.331
Weng, H. Y., Feldman, J. L., Leggio, L., Napadow, V., Park, J., & Price, C. J. (2021). Interventions and manipulations of interoception. Trends in Neurosciences, 44(1), 52–62. https://doi.org/10.1016/j.tins.2020.09.010
Zasiekina, L., Duchyminska, T., Bifulco, A., & Bignardi, G. (2024). War trauma impacts in Ukrainian combat and civilian populations: Moral injury and associated mental health symptoms. Military Psychology, 36(5), 555–566. https://doi.org/10.1080/08995605.2023.2235256
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Viacheslav Smyrnov, Olena Ladyhina