TRE (Tension & Trauma Releasing Exercises)

The originator's account

A 2014 pilot study co-written by David Berceli, whose listed affiliation is Trauma Recovery Services in Phoenix, Arizona, states that he developed Tension and Trauma Releasing Exercises (TRE). The paper describes the method as an integrative neurophysiological approach that treats tremor under stress as having a homeostatic, and therefore therapeutic, value, and says that TRE was first developed for international use in high-conflict zones and areas affected by natural or man-made disasters. This is the originator's own account, published by the originator, and it is not independent history.

The same paper says that muscle tremors are a common response before, during or after stressful events, are usually read as a sign of pathology, and have received scant research attention. TRE is presented as a way of using a similar, self-induced tremor to discharge physical tension. The sources reviewed for this page do not include a biography of Berceli or an independent historical study of how the method spread, so dates of first teaching are not stated here.

Spread through organizations and research

TRE for All, the organization that runs the official certification program, presents TRE as a body-led modality developed by Dr. David Berceli and states that teaching TRE without certification violates his copyright and trademarks. Later published studies come from several countries, including a Danish pilot study and randomized trial in multiple sclerosis, a randomized trial with East African refugees in the United States, and a Chinese trial protocol for adolescents. A 2026 scoping review located 22 studies in the literature.

Names and the tremor vocabulary

The method is written as Tension and Trauma Releasing Exercises, Tension and Trauma Release Exercise, and, in a 2026 review, Trauma Releasing Exercises, always shortened to TRE. TRE for All uses the trademark symbol with the name. Researchers call the shaking 'neurogenic tremor' in the Chinese trial protocol, and Berceli and colleagues propose 'self-induced unclassified therapeutic tremor' (SUTT) for it.

Berceli and colleagues state that the tremor evoked by TRE remains unclassified under the 1998 Movement Disorder Society consensus statement on tremor, and that it is closest to an enhanced physiologic tremor while having its own activation conditions, topography, frequency and amplitude. 'Unclassified' here means it does not fit an existing category, not that it has been shown to be a distinct physiological state.

Distinction from related Machipedia pages

TRE is a body-based release practice. It is not one of the tapping approaches described on the Energy Psychology page, which this page is grouped under for editorial reasons only; none of the sources reviewed describes TRE as energy psychology. It is also separate from Somatic Experiencing, which a 2017 trial describes as an integrative body-focused therapy delivered in weekly sessions by a therapist, and from Psychotherapy, Breathwork, Mindfulness and EMDR (Eye Movement Desensitization and Reprocessing), each of which has its own page.

What practitioners describe

Published descriptions say that TRE consists of seven exercises done in a set order, involving the feet, legs, hips and lower trunk, that stretch and mildly tire the muscles. Tremors may appear during the exercises and are described as most prominent in a final resting position. Practitioners describe the tremor as something participants can regulate, and the Danish trial team describes TRE as a self-help method that can be practiced at home once learned. This page does not give the exercises themselves.

TRE for All states that the practice is self-guided, that people can stop or modify the exercises if uncomfortable, and that beginners are advised to use a certified provider. It lists a limit for beginners of 15-minute sessions, practiced no more than three or four times a week. This is guidance from the organization, not a clinical protocol.

Formats used in studies

In the South African pilot study, staff at a children's village received weekly group training for ten weeks, alternating three-hour and seven-hour sessions, with 20 hours of theory and 30 hours of practice in total. The Danish pilot study used weekly individual sessions with a certified TRE instructor and then home practice, and the later randomized trial used eight sessions followed by daily practice at home. The Chinese protocol describes an eight-week group program for adolescents and their mothers delivered by internationally certified TRE providers. These are research formats and not standard practice.

Stress and trauma release

The originator and later authors describe TRE as a way to release muscular tension accumulated through stress and trauma and to move the body toward a calmer, parasympathetic-dominated state. The Chinese protocol states that TRE was originally designed for stress and post-traumatic stress disorder, drawing on animal studies of neurogenic tremor. These are descriptions of intent and proposed mechanism, and the Danish authors state that the exact mechanisms of action have not been scientifically demonstrated.

Conditions that researchers have explored

Studies have looked at quality of life in caregivers under chronic stress, trauma symptoms in refugees, and fatigue, spasticity and pain in people with multiple sclerosis. A planned trial is testing TRE as an add-on to medication for adolescents with emotional disorders. A 2026 scoping review says the method has mainly been applied to stress- and trauma-exposed groups, with possible benefits for mood, anxiety-related sleep difficulties and cognitive functions, and preliminary signals in Parkinson's disease and multiple sclerosis.

Searches and overall picture

A PubMed search for the full name returned 31 records, a title and abstract search for 'trauma releasing exercises' returned three, and an author search for Berceli returned two, of which one concerned TRE. A search for neurogenic tremor together with TRE found the Chinese protocol. No systematic review with meta-analysis was found. The 2026 scoping review included 22 studies, reported that designs were not consistently rigorous, and called for more research; it was read as an abstract only.

Caregivers and refugees

The 2014 South African study had no control group and enrolled 21 staff at a children's village, 17 of them 'House Mothers'. Overall impressions of quality of life rose from 3.81 to 4.35, but the authors report no significant change in physical state, mental and emotional state or stress evaluation, and they used a more lenient significance threshold of .10 because of the small sample. Retention was 91.3%.

The 2024 refugee study assigned 33 East African women to TRE or to a delayed-treatment group that held non-facilitated discussions, and 14 treatment and 19 control participants were analyzed. Average Harvard Trauma Questionnaire severity fell from 2.12 to 1.42 with TRE and from 1.86 to 1.63 in the control group, and the between-group difference was significant (p = .023). The three-month follow-up was dropped because of attrition, outcomes were self-reported, and the paper contains an inconsistency in its reporting of control group change.

Multiple sclerosis

The 2021 Danish pilot study enrolled 11 people with multiple sclerosis; nine completed nine weeks of TRE, and two left because of health problems. Mean fatigue on the Modified Fatigue Impact Scale fell from 43.7 to 22.0, and most self-reported symptoms improved, but an objective measure of ankle spasticity did not change significantly. With no control group, the authors say the results cannot confirm or disprove an effect.

The 2025 randomized trial included 28 members of the Danish MS Society, comparing eight TRE sessions plus daily practice with usual care. Unadjusted analyses found no significant group difference on the primary fatigue measure. After adjustment for imbalance between groups, fatigue differed significantly (p = .03), and self-reported spasticity and pain were lower. The authors conclude that an effect on fatigue cannot be ruled out and that further research is needed; this was read as an abstract only.

The tremor mechanism is untested

The central claim, that evoked tremor discharges tension and resets the nervous system, rests on the originator's neurophysiological account and on descriptions in later papers. The Danish authors state that the mechanism has not been scientifically demonstrated, and Berceli and colleagues write that the function of stress-related tremor has received little research. None of the sources reviewed tests the claim that shaking is a natural evolutionary stress response, so that part is best read as a hypothesis.

Design limits and independence

Most studies are small, several have no control group, outcomes are largely self-reported, and comparators were usual care or delayed treatment, not an active alternative such as a trauma-focused therapy. Participants cannot be unaware they are practicing TRE. Some work is not independent: the 2014 study was written with the originator, and the authors of the refugee study include people from the organization that delivered the intervention. No trial reviewed compared TRE with Somatic Experiencing, Psychotherapy or EMDR.

What the sources report

The 2014 pilot reports no negative outcomes among 21 participants, and a Danish ethics committee judged the intervention mild and non-invasive, so that pilot did not need formal review. These are small studies and an absence of reported harm is not evidence of absence. In the Danish pilot, two participants left early because of health issues, and the authors do not link these to the exercises. The sources reviewed, including the scoping review abstract, contain no systematic adverse-event data, and no source reviewed addresses epilepsy or pregnancy.

Cautions and exclusions

TRE for All states that the method is safe for most people when practiced responsibly, that people with severe trauma or medical conditions should consult a qualified provider before starting, and that someone who finds emotions overwhelming should slow down or pause. The organization also states that TRE has not been evaluated by regulators and is not intended to diagnose or treat disease. The Chinese protocol excludes adolescents with nervous system disease, personality disorder, recent substance misuse, or diagnosed or suspected schizophrenia spectrum disorder, and the Danish pilot excluded people with a recent relapse, severe depression or heart disease. Exclusion criteria in trials are not contraindications.

Anyone with pain, a neurological condition or trauma symptoms who is considering TRE should discuss it with a doctor or mental health professional, and it should not delay or replace necessary care.

Training and certification

TRE for All, the organization that sets the standards, says certification combines personal experience, education and supervised training, including required three-day face-to-face trainings, and that a trainer confirms readiness. Providers may teach within the scope of their training and certification. The page lists no renewal requirements, and individual trainers set their own fees. This describes one organization's program and has not been independently audited, and no statutory regulation of TRE providers was sought or found.