Exploring flow in sport and exercise therapy with war and torture survivors

- War and torture survivors may experience flow in spite of posttraumatic stress.
- Sport and exercise therapy may facilitate flow only under certain conditions.
- Flow may provide a focus on the present and a respite from intrusive memories.
- Sport and exercise therapy should target the facilitation of flow experiences.

War and torture survivors often suffer from posttraumatic stress and intrusive memories from past experiences. Thus, they can hardly focus on the 'here and now'. However, there are some indications that people may fade out illness-related thoughts while exercising, e.g. through flow experiences, which may be therapeutically meaningful. Therefore, the present study focused on exploring whether and how flow occurred during a sport and exercise therapy programme with war and torture survivors. Data from participant observation were coded and analysed for the intervention groups (2013-2015) with a category system using the software Atlas.ti. Event-focused analysis was complemented with person-focused analysis identifying the occurrence of flow and potential influencing factors. The results suggest that four participants achieved flow several times, particularly during team sports, games, movement improvisations and dance tasks. Hindering factors included task and setting-related aspects that triggered trauma-related distress, quick changes in affective experiencing and momentary well-being. Sense of safety was identified as a condition for the occurrence of flow in this study. The experience of pleasure, the distraction from illness-related thoughts, the being in the present 'here and now', the experience of mastery and achievements, as well as activation and motivation for physical activity seemed therapeutically meaningful effects relating to flow in this population. Therefore, the minimisation of potential hindering factors is recommended, together with the provision of adequate tasks and a setting that favours flow occurrence in sport and exercise therapy.