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Ware, C. J. (2007, June). Yoga and psychotherapy. Yoga Therapy in Practice, 15-17.

YOGA, MEDITATION, AND PSYCHOTHERAPY

Yoga is a “potent tool of mental health promotion.”

(Singh, 1986, p. 67)

The integration of therapy and yoga*

Yoga practitioners, mental health professionals, and researchers have become increasingly aware of the health benefits of yoga practice, including stress-reduction, physical benefits, and mental health benefits. Although yoga is not a substitute for professional psychological and psychiatric care, many mental health professionals will agree that yoga practices can greatly benefit their clients in a number of important ways (through exercise, relaxation, deep breathing, and the support of spiritual practices, beliefs, and communities). Yoga is a holistic practice that integrates and develops the mind, body, breath, and spirit. For some clients, yoga practice may be an important or essential adjunctive treatment, complementing standard psychotherapeutic and psychiatric modalities. For other clients, the integration of yoga practices and psychotherapy may enhance the benefits of talk-therapy or medication. Some clients may benefit more when traditional therapy and body-oriented, nonverbal, intrapsychic therapies are combined.

The word “yoga” is derived from the Sanskrit root yuj, which means to yoke, bind, unite, join, or harness. Yoga can be seen as a philosophy and practice of connection, as an individual develops his/her sense of relatedness to other people, other beings, the environment, and the universe. An individual also develops his/her sense of connection to him/herself through yoga, becoming more and more aware of the links between mind, body, breath, feelings, memories, experiences, health, and states of consciousness. The techniques of yoga aim to uncover and highlight these connections.

Yoga begins with the body and the breath, but also develops the mind, awareness and concentration, and levels of consciousness. Yoga practices are one way to integrate work with the body, the breath, emotions, thoughts, interpersonal relationships, self-acceptance, healthy lifestyle choices, and self-awareness (emotionally, physically, mentally, socially, and spiritually/existentially). In addition to bodily changes, yoga practices involve behavioral, cognitive, and affective changes. Yoga may help increase one’s self-awareness and insight, altering one’s relationship to others, the environment, and the universe. Yoga may help cultivate and strengthen healthy attitudes and behavior such as mindfulness, compassion, focus, generosity, equanimity, joy, and ethical behavior. Yoga may help one learn to be present and cope with anxiety, tension, anger, negative memories, and conflicts. In a world where stress is so prevalent, yoga practices can help reduce physical and mental tension. Although we are surrounded by messages to avoid pain and to seek pleasure and gratification, yoga may help teach clients to be present with what is. Yoga practices can help one access one’s natural healing capacity.

Yoga can be a powerful tool when combined with psychotherapy. It can be a way to work with clients who have more difficulty expressing themselves and healing through traditional (talk) therapy. We are beings with bodies and experiences that are sometimes difficult to describe through language. Emotions and sensations are often embodied in physical experiences. Clients may be blocked or struggling with powerful physical reactions and memories, such as those evoked by trauma, eating disorders, anxiety, or medical concerns. Physical work may assist therapeutic goals such as helping clients feel more comfortable in and accepting of their bodies, as well as helping clients who have problematic reactions to their bodies and bodily functions. Relaxation, deep breathing, and the release of physical tension may help clients, not only feel better and be more self-aware, but alter their perspectives and patterns. 

The definition of ideal psychological health proposed by yoga psychology is enlightenment, awakening, or realization. Health is seen as more than being free of symptoms, or adjusting and compromising to life’s constraints and difficulties. Yoga promotes physical and mental health, rather than being curative medicine or seeking physical wellbeing alone (Singh, 1986). Yoga practice promotes physical and mental health, through “the maximization of joy and the complete unfolding of the human potential” (Ramaswami, 1989, p. 53).

Yoga practices encourage health by promoting physical and mental suppleness, strength, endurance, balance, and relaxation. Working with the body can affect the mind. One of the goals of physical postures is to gain perspective on the body by gaining distance from it, fostering neutral observation and promoting higher levels of growth (Rama, Ballentine, & Ajaya, 1976). As the body releases tension and postures become effortless, the mind becomes calmer. Mental concentration and focused attention result and one naturally becomes more introspective, allowing access to intuition and one’s inherent wisdom.

Because the breath is both a voluntary and involuntary function (regulated by mind and body), it can be considered an intermediary between mind and body (Morse, Cohen, Furst, & Martin, 1984). The rhythm of the breath is often one of the most obvious physical indications of a person’s emotional and mental state. Although mental and emotional states often feel difficult to control, the irregularities of the breath can be easily observed and controlled. Yogic breathing exercises (pranayama) teach awareness of the breath, healthy breathing, and concentration. The breathing practices also teach one to be aware of and to control energy shifts.

In addition to promoting physical health, the physical yoga practices release tension and calm the body. The breathing and concentration practices calm both the body and mind, increasing focus and naturally promoting meditation. The mental and physical benefits of meditation practices, such as mindfulness meditation, have been very well documented. Many mental health practitioners already incorporate meditation into treatment. Yoga practices involving the physical body, the breath, and concentration prepare practitioners for meditation. Meditation ultimately leads to the experience of higher states of consciousness. This transpersonal consciousness – in which awareness is manifested as intuition and wisdom – must be directly experienced (Rama et al., 1976). The “witness consciousness” results in great bliss, joy, and peace. Ultimately, the practices involve the experience of universal awareness, in which the distinction between subject and object (knower and known) dissolves.

As we have seen, many psychotherapeutic goals are identical to those of yoga practice: promoting health, regaining a sense of peace and joy, balancing physical, mental, and energetic imbalances, creating cognitive, behavioral, and affective change, promoting introspection and self-awareness, coping with difficult experiences and mental states (e.g., anxiety), and developing self-acceptance and connection with others. There are also elements of yoga practice that are beyond the realm of traditional psychotherapy, such as discussion of higher consciousness and the integration of work with the physical body, breath, and mental experience. Likewise, traditional psychotherapy and medication utilize different methods and well-documented ways to support clients and promote mental health. Although it is important to remember that they may be appropriate in different combinations with different clients, yoga, psychotherapy, and psychiatric medication can be seen as complementary approaches that will certainly enhance and inform one another.

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Yoga is based in a number of “principles” that may be useful psychotherapeutically:

• There is wisdom in experiencing, in being. There is wisdom in your experience.
• You are just right as you are. You have likely forgotten this; all you have to do is remember or realize it.
• Your body-mind is just right the way it is; you are full of light.
• Yoga (union) is your natural state. We are all interrelated. If everything is connected, you can watch the body-mind-breath to understand the self, the universe, and your relationship to the universe.
• Change is inevitable. Everything can and will change, including your body, your thinking patterns, your lifestyle, and your breath. Yoga helps prepare for change when and as it occurs. Yoga teaches you to be mindful of the transitions in life.
• Yoga practices can help you become more aware of your body, breath, mind, spirit, and your link to the universal.
• You are different from your thoughts. Your mind is usually filled with continually changing thoughts, images, internal commentary, and fantasies. It is possible to observe your thoughts if you cultivate the ability to separate yourself from them. Although you are likely to initially experience your identity as a stream of thoughts, emotions, and urges, you will eventually witness the stream of consciousness. This is the experience of the observer, the witness, or the witness-consciousness.  Eventually, both the witness and that which is witnessed will dissolve into the experience of pure consciousness.
• Yoga practices bring you into the present. Breath and movement are your connection to the present moment.
• Yoga practices bring calm, peace, and happiness to the moment.
• Yoga helps you accept difficulties, accept pleasure and pain. Yoga helps you experience relaxation in action – living life as free of tension as possible.
• Yoga encourages moderation (e.g., eating until you are satisfied; neither eating too much nor too little; eating in a way that is healthy for your body and questioning assumptions that we have about this)
• Yoga teaches you to be “where you are,” physically, mentally, spiritually. Rather than pushing, “flow.” Witness your experience – thoughts, feelings, sensations. Do that for which you are ready. Postures are not the goal – but mindfulness and flow.
• In terms of hatha yoga: you will feel better if you physically strengthen, stretch, cleanse, and stabilize your body (muscles, joints, spine, skeletal system, internal organs, glands, and nerves). You will feel better if you learn to tune in to your energy level and internal energy flow (prana). Yoga practices will help you revitalize, control, and enhance your energy. Meditation and concentration practices will increase your positive thinking, mental clarity, and focus. A conditioned, healthy body that holds as little tension as possible will help you be mindful, rest and watch the mind/breath, and sit in meditation more easily. The body moves to help calm the mind. The movement is also a point of focus for the mind, creating “meditation in motion.”

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A number of reported (mental and physical) health benefits of yoga:

Increases/improves

Attention span/concentration

Cognitive/academic performance

Interpersonal skills/relationships

Calmness (quiets the mind)

Quality of life/wellbeing

Relaxation of body

Creativity

Respiratory operations

Coping with medical problems

Self-esteem

Assertiveness

Body and sensory awareness

Self-control/discipline

Mental alertness

Learning readiness/capacity

Balance/coordination

Flexibility

Strength

Respect for others, self, body

Ethical behavior/awareness

Peacefulness/conflict resolution

Emotional awareness/control

Decreases                                                       

Anxiety/Depression                                       

Stress/tension                                                

Hyperactivity and impulsivity                                  

Posttraumatic stress                                      

Anger                                                             

Mental activity                                              

Physiological arousal                                    

Cholesterol                                                    

High blood pressure                                      

Chronic pain                                                  

Substance use/abuse                                      

Asthma/allergies                                           

Headaches                                                      

Test anxiety                                                   

Disruptive behavior                                       

Phobic reactions                                            

Shyness                                                          

Fatigue                                                                       

Nightmares/sleeping problems

Helps regulate

Blood pressure                                   

Heart rate

Metabolic rate

Brain waves

Body temperature

Skin sweating

Energy/mood fluctuations

Sleep patterns

Digestion/assimilation/elimination

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References

Morse, D.R., Cohen, L., Furst, M.L., & Martin, J.S. (1984). A physiological evaluation of the yoga concept of respiratory control of autonomic nervous system activity. International Journal of Psychosomatics, 31, 3-19.

Rama, Swami, Ballentine, R., & Ajaya, Swami. (1976). Yoga and Psychotherapy: The Evolution of Consciousness. Honesdale, PA: Himalayan International Institute of Yoga Science and Philosophy.

Ramaswami, S. (1989). Yoga and healing. In Sheikh, A.A. & Sheikh, K.S. (Eds.), Healing East and West: Ancient Wisdom and Modern Psychology (pp.33-63). New York: John Wiley & Sons.

Singh, R.H. (1986). Evaluation of some Indian traditional methods of promotion of mental health. Activitas nervosa superior, 28, 67-69.

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* Note: the term yoga is used broadly to denote all yogic practices, such as physical flow and postures (asanas), breathing practices (pranayama), cleansing practices (kriyas), concentration practices (dharana), meditation (dhyana), devotional practices (bhakti), and more.

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