In answer to these demands, yoga teachers have reached into many other healing
modalities—those that were familiar to them, or readily available—and
wedded them to hatha practice. This kind of yoga therapy is well-intentioned
and may be effective, but there is a sophisticated and powerful tradition of
ancient yoga therapy which is rooted in Sankhya philosophy, one whose viewpoint
is radically different from that of yoga as a fitness movement with a modern
therapy of some sort tacked on the side.
“The yoga star is rising: this child of the East is becoming a citizen of
the world,” Gary Kraftsow writes in Yoga for Wellness. One aspect
of full citizenship is defining just what yoga therapy is relative to yoga, and
in the process, defining yoga as well. Gary Kraftsow has been studying and
practicing yoga from many angles for many years, in the renowned Vinivoga
lineage of T. Krishnamacharya and T. K. V. Desikachar. The Viniyoga system is
noted for its therapy aspects (which stem from the ancient tradition) and for
its adaptation of yoga technology, as the author calls it, to individuals and
the unique circumstances of their lives. He spends much of his time traveling
and teaching these days, with time out for retreats in Italy and Hawaii, where
he lives with his wife and son. He also trains teachers in the Viniyoga and
yoga therapy tradition.
Yoga International interviewed Gary Kraftsow in Palm Springs at the
Southwest Yoga Conference.
It seems that yoga itself is inherently therapeutic, so how
is yoga therapy distinguished from yoga?
Traditionally, yoga is a path of self-transformation, self-realization, and
transcendence. In my book Yoga for Wellness I used the image of a launch
pad to explain that kind of yoga. Therapeutically, yoga is more like a life
raft. When you’re drowning, yoga therapy gets you back up and integrated
into yourself. Traditional yoga sadhana [practice] is a spiritual
discipline, not a system of health and fitness as it has become in the United
In the West, yoga has been reduced in the public eye to asana practice, and yoga
therapy has been reduced to a kind of glorified physical therapy Some
practitioners have added other techniques such as gestalt-like counseling or
massage therapy to this structural therapy; there are psychotherapists who love
asana practice and integrate it into their practice; there are all kinds of
synthetic, mixed traditions. These approaches may all be useful in helping
people, but there is an ancient tradition in yoga therapy that is not a
combination of Western psychotherapeutic techniques, massage therapy, physical
therapy, and asana practice. The ancient therapeutic adaptation of yoga was a
synthesis of yoga and ayurveda that was often combined with jyotish (Vedic
astrology). The application of yogic technologies in this therapeutic model is
called yoga chikitsa.
The idea in this traditional yoga therapy is that the practices are adapted to
suit the condition of the individual to help them with duhkha (suffering)
at the level of the physical body or at the psycho-emotional level.
Traditionally the masters were well-versed in a wealth of Vedic
sciences—including the use of amulets, the prescription of mantra, the
consideration of diet, how to work with family deities, and of course, the
appropriate use of asana, pranayama, self-reflective meditation, prayer, and
ritual activities. So that’s the ancient idea of yoga therapy and therapy
and it’s very different from its modern evolution.
I would imagine that this caliber of yoga therapy is hard to
find these days.
Most yoga people in the United States today don’t have a clue about any of
the ancient teachings or sciences. Even my own teacher, T.K.V. Desikachar, who
is a master therapist, would probably not consider himself a master in either
ayurveda or jyotish. His teacher and father, T. Krishnamacharya, was an
ayurvedic master and a yoga master. He knew jyotish, as well as all the
religious traditions of India, and so does Desikachar. There are very few like
him, and probably none in the United States. Still, there is much we can do
working with asana, pranayama, meditation, prayer, ritual, chanting, and
lifestyle counseling, without having to be an expert in ayurveda or jyotish. We
also need to know something about allopathic medicine and pathology to
understand the kinds of diagnostics that patients come with and the effect of
some of the medicines they are taking. If someone is on antibiotics, or
undergoing chemotherapy, or taking HIV cocktails, for example, we have to be
careful about our methodology
The primary perspective of the yoga therapist is different from that of a
Western physician, or even an ayurvedic physician. An allopathic doctor’s
job is to work with disease and cure it. Our approach is to work with the human
beings who have the disease—to help them develop a better attitude and get
a better perspective on themselves and basically to help them with their mind.
That doesn’t mean that we don’t work in a curative direction with
certain conditions. But if we’re working with somebody who has cancer, we
encourage them to see a doctor; we don’t say, “Why don’t you
stop using chemotherapy and try pranayama instead?” If somebody is
undergoing chemotherapy, I’ll work with them to improve their digestion,
help their sleep, stimulate the immune system, or help them feel better about
themselves. So yoga therapy is complementary, not primary for conditions like
cancer or AIDS.
What kinds of conditions respond well to yoga therapy?
The first thing most yoga teachers who move into the therapeutic application of
yoga will be confident with, if they get good training, is structural
problem—low back pain, and chronic neck and shoulder tension. We can do
good work with sciatica or sacroiliac problems, and some shoulder conditions.
That’s the beginning. But as teachers get more deeply trained, they can
work effectively with conditions such as asthma, high blood pressure, diabetes,
irritable bowel syndrome or inflammatory bowel disease, reproductive disorders,
chronic fatigue syndrome, and serious hormonal challenges. There is a science
of training teachers to adapt practices that will either benefit patients with
these conditions or allow them to exercise without harming themselves.
The point of yoga therapy is to reduce patients’ suffering, to develop a
practice for them without aggravating their condition, and to build confidence
that they can improve their condition through their own actions. But this is
not a substitute for medical attention, especially in the case of more serious
or acute conditions. A lot of yoga teachers hold a negative view of modern
medicine. But we must be realistic. If you were a survivor at the World Trade
Center you’d want to get to the hospital as quickly as possible; you
wouldn’t want somebody standing over you with a pendulum or saying,
“Well, let’s try garlic.”
It’s also important to point out that the best yoga therapy takes place
one-on-one. If you are working with someone with diabetes or cancer or
depression or anxiety, you have to be one-on-one with them. In a group of heart
attack survivors, one person might have thoracic kyphosis, another might be
obese, and still another might be emaciated. One might have hypermobile
ligaments. One might have asthma. Everybody’s symptoms are unique, and
the prescription must be unique if you’re going to do effective work. As
yoga therapists, we help patients develop a practice that they can do on their
own. In a group of twenty, we can’t create individual practices for
You also mentioned yoga therapy as treatment for emotional
On another level we work with psycho-emotional problems. In our society we have
an epidemic of depression and anxiety, and there is a way to adapt yogic
technology to help someone suffering from chronic depression, chronic anxiety,
manic conditions, or low self-esteem. We do very well with what I like to call
normal neurotic minds—people who are reasonably well-integrated in their
life, but have typical insecurity problems, or are suffering over a
relationship, or have blind spots, or an excessive sense of self-importance, or
self-pity, or mild depression. These are not pathological, not biochemically
based, clinical depression or schizophrenia.
How do you treat the normal neurotic with yoga therapy?
Again, we almost never work with just the back or just the blood pressure or
just the emotions. We’re working with the whole human being. So when I do
the intake interview I’ll find out if there’s a tendency toward
anxiety. If there is chronic anxiety I try to find a way of engaging the person
in activities that will help them stay calmer. For example, sometimes someone
is agitated mentally but sedentary physically—the state of mental
agitation and the level of physical activity are disconnected. In order to calm
down the mental agitation we have to increase the physical activity and
integrate the mind and the body. Then, having done that, we’ll develop
practices to calm the whole system. On the other hand we might do the opposite
for someone who’s depressed: their paradigm is that they don’t want
to get off the couch.
So you have to strategize (this is called upaya) the right means to help
someone move their energy in the right direction. There are different
methodologies—it depends upon the nature of the person. Certain strategies
of communication will help them feel more empowered and feel better about
Once I asked someone to drink coffee in the morning for a period of time just to
give herself a lift. That’s an extreme prescription, but it worked. So
our idea about upaya is to use whatever helps somebody feel better about
themselves. This boosts their immune system, helps them sleep better, improves
their digestion, and helps them have healthier relationships. A big piece of
our work is measured in healthy relationships. Dysfunctional relationships are
symptomatic of something else, and one of the means of healing is to help
people transform these relationships and create healthy ones. Sometimes
it’s a matter of encouraging them to stop relating to certain people in
their lives—or, conversely to start relating to certain people in their
In the tradition in which I was trained, the foundation for practice for most
adults is to create stability at every level—structural stability,
physiological stability (which could be equated to immunity, perhaps), and
psycho-emotional stability, which is essential given the volatile nature of the
external world. The next goal is to help them to awaken slowly and
appropriately to a deeper dimension in life—the spiritual
dimension—and then help them find a way of linking to that dimension
through their heart in a way that’s not counterfeit. You must find an
authentic link, something that inspires them. For example, I might ask
somebody, “Do you remember what inspired you when you were five or six?
Did you go to church? Do you remember the joy?” The point is to reconnect
to something they felt in childhood, and to go back to that. Help them return
to something deeper inside themselves that gave meaning to their life.
Would it be fair to say that stability at all levels is the
goal of yoga therapy?
That’s a good starting point. Again, we’re talking about therapy.
We’re talking about the life raft. What you want to do is get out of
danger and reach a stable place. Then if something else awakens we can think
about the launch pad to help people elevate to another dimension. I had a
powerful epiphany, which I wrote about in my first book. I was watching PBS
interview the man who developed the rocket science to launch the Voyager out of
the solar system. It was a tricky thing because this satellite was quite small
and couldn’t hold enough fuel to propel itself out of the solar system.
So this man figured out how to use the “gravity well” of the
planets to ricochet the satellite to its next destination. If you shot it too
close to the planet, the satellite would crash into the planet. If it was close
but not too close, it would go into orbit. But if it was just right it would
swing around the planet and pick up momentum from the gravity of the planet and
go on. I was watching this and suddenly a light bulb went off in my head.
I thought about the normal neurotic who’s in orbit around the planet
called me. It’s me, me, me. It’s all about me. (The seriously ill
people have crashed into themselves.) Now, we all have challenges, and what
I’ve learned in my own life is that when I’m suffering, if I get
caught in the loop I just circle around the suffering and I don’t get
anywhere. But if I sit with it and relax into it and let myself feel it, I can
gain momentum from it and it can propel me forward. That for me is helpful
diagnostically. I can watch someone and I see where they’re preoccupied
with this neurotic thing, with themselves. Then I figure out how to apply what
we call pratipaksha bhavanam, a reframing of a person’s
perspective on their own challenges. Pratipaksha is a key idea in yogic theory,
not only for working with psychological problems but also for someone who has
cancer or diabetes. What we’re trying to do is reframe their way of
dealing with emotional challenges.
Is the concept of pratipaksha bhavanam part of traditional
Patanjali uses the word twice in the Yoga Sutra. One sutra [2.33] says,
“Vitarkabadhane pratipaksha bhavanam.” That’s a very simple
sentence. It means that when we have afflicted thinking, then
“Pratipaksha bhavanam”: Contemplate and take another view—look
at the situation from another perspective. In another sutra [2.34] Pantanjali
says if you have negative thinking that comes from anger, greed, or delusion,
whether you’re actively in it or just thinking about it, the fruit will
be unending suffering and ignorance. Therefore, “Pratipaksha
bhavanam”: Take another view, reframe your perspective on the situation.
You include the notion of personal ritual as therapy.
I’m intrigued. There is so much misunderstanding in the yoga community
about what ritual is and how to use it. What do you mean by personal ritual,
and how do you use personal ritual in a therapeutic context?
Ritual activity is designed to bring another level of consciousness to daily
activity. Its purpose is to bring a dimension of the sacred into the profane,
to elevate the profane daily activities to the level of the sacred. The most
common kind of communal rituals we have in our secular Western society are
probably shopping and football and CNN and CNBC and watching the stock market.
Of course, within our general American culture there are subcultures such as
practicing Catholics, Jews, Muslims, and Buddhists, all of whom have
traditional sanctioned rituals that the community celebrates. So that is
Personal ritual is different. A personal ritual could be saying grace before you
eat, or washing your hands before you eat. But when I talk about ritual in the
context of yoga therapy I mean integrating personal practice into ritual. It
might be asana, but adapting the asana in the service of some breathing. It
might include pranayama, but adapting the pranayama in the service of
meditation or chanting—and selecting the chanting in the service of a
meditative quality. That opens the heart.
The idea is that ritual integrates many elements. It doesn’t have to
include all of them. It doesn’t have to include any one in particular.
But it integrates many different elements and organizes them and points in a
certain direction to lead the person to a sense of deeper connection. In
traditional yoga therapy, or at least in my approach to yoga therapy, I
consider the five mayas (dimensions), which you probably know as the
Annamaya is the physical structure and asana is a primary tool. But we
want to bring the structure back into balance, so for us yoga therapy
doesn’t necessarily mean asana. It could mean going for a walk. Then
there is pranamaya, the vital system, the physiology—and pranayama
is the primary tool, but diet is also very important.
Manomaya, which is often overlooked in the yoga world, has to do with the
mind that learns from the outside via the senses. We take in information from
the world around us via the senses, and with that information we learn more
about ourselves and can thus make more intelligent choices about, for example,
our diet, or which asana is good for us. So we’re always encouraging
people to continue their education. If you have heart disease, you might want
to study food. Or the topic you choose may be unrelated to your health: it may
just be an interest that stimulates you. Often as people age, they lose
enthusiasm. They are so overwhelmed with the responsibilities of family,
mortgage, taxes, and so on that when they have any free time they choose
entertainment such as drinking, which dulls the senses. And so the curiosity,
the hunger to learn that youth has, which is very healthy, goes flat. We often
just encourage those people: “What are you interested in? What
didn’t you do when you were younger that you’ve always wanted to do
as a hobby?” That’s manomaya.
Then vijñanamaya, that’s the character or the personality.
This is where svadhyaya (self- reflective meditation) comes in, and
maybe counseling, and having good friends that are healthy and can influence
you in a positive way. Finally there is anandamaya, the emotions in the
heart. There we work through relationships and singing, prayer and ritual,
chanting. So the idea is to develop a personal ritual that integrates practices
for all five dimensions.
Patanjali in the first chapter of the Yoga Sutra offers contemplations to
help the mind remain in a state of what he calls chitta prasadanam (tranquil
mind). So these dimensions are a kind of pratipaksha to help us cultivate a
balanced mind. If you want to do it pragmatically, try to see the same
situation from a different perspective. But that requires more than sitting
down and doing it intellectually. That would be working only on manomaya, the
intellectual level. To have that reflection penetrate to a deeper level, to
vijñanamaya, we use asana or pranayama or different chanting techniques
to help us access a deeper place within us from which we can then do a
And so the first step in effective yoga therapy is careful and holistic
assessment of the individual’s condition. We do this by examining these
different dimensions, recognizing their manifest symptoms, and working toward
identifying their causes. And then we determine the right strategy for the
practice, considering what elements should be included, when it should be done,
and for how long. The clearer we are about the needs, the tools available, and
how to adapt and apply them, the more effective the practice will be.
Founder of the American Viniyoga Institute and author of Yoga for
Wellness and Yoga for Transformation, Gary Kraftsow conducts seminars and
retreats throughout the United States and Europe, working with students and
training teachers and therapists. He makes his home in Maui, Hawaii.
Reprinted with permission from Yoga International, April/May 2002.