Yoga and Yoga Therapy
Yoga is one of India's oldest and most comprehensive soteriological
traditions, which has developed a vast arsenal of physical and mental
techniques geared to gain control over the nervous system in order to achieve,
at will, conscious and supraconscious states of transcendence. In order to
appreciate the unique contribution of Yoga to our understanding of the human
condition, this age-old tradition is best viewed from the kind of broad
perspective of the human potential that characterizes transpersonal psychology
and psychosomatic medicine. Yoga therapy is of modern coinage and represents a
first effort to integrate traditional yogic concepts and techniques with
Western medical and psychological knowledge. Whereas traditional Yoga is
primarily concerned with personal transcendence on the part of a "normal" or
healthy individual, Yoga therapy aims at the holistic treatment of various
kinds of psychological or somatic dysfunctions ranging from back problems to
emotional distress. Both approaches, however, share an understanding of the
human being as an integrated body-mind system, which can function optimally
only when there is a state of dynamic balance.
Yoga Past and Present
The beginnings of Yoga can be seen in India's oldest sacred corpus,
the Rig-Veda, which was compiled prior to 2000 B.C.E. In this hymnody, composed
in archaic Sanskrit, inspired sages expressed their deepest thoughts and
intuitions about human life. Yoga achieved its classical form under Patanjali,
the compiler of the Yoga-Sûtra, who is assigned to the period from 200
B.C.E. to 200 C.E. He outlined the eight "limbs" of the yogic path: (1) moral
discipline (yama), (2) self-restraint (niyama), posture (âsana), breath
control (prânâyâma), sensory inhibition
(pratyâhâra), concentration (dhâranâ), meditation
(dhyâna), and ecstasy (samâdhi). These are intended to lead the
practitioner (called yogin if male and yoginî if female) to total
transcendence, or liberation. Yogic teachings are also present in Buddhism and
Jainism, though in the West the term yoga is most commonly associated with
In contrast to Patanjali's Classical Yoga, the many schools of
Post-Classical Yoga are nondualistic. That is, they pursue their soteriological
program on the basis of the recognition that "All is One." Thus their via
negativa leans toward a more life-positive orientation, which is founded in the
understanding that if everything is an interconnected and interdependent Whole,
there is no need for escape or denial of body, mind, and world.
This orientation achieved its peak in Hatha-Yoga ("Forceful Yoga").
This type of Yoga specializes in exploring the body's potential for the
transformative processes of yogic consciousness technology. Understandably, it
is this orientation that holds the greatest appeal for contemporary Western
students, especially those concerned with the integration of body and mind.
Hatha-Yoga has always had a close relationship with India's native
naturopathic system called Âyur-Veda ("Life Science"), which is
profoundly holistic and for this reason has become fashionable in the West in
recent years. A similar osmosis has occurred between Hatha-Yoga and the Siddha
naturopathic system of South India, which, however, is as yet little known in
The psychosomatic approach of Hatha-Yoga includes many physical
purification techniques and a large number of postures that exercise the body
in various ways. The last-mentioned feature has been mainly responsible for the
great popularity of Hatha-Yoga outside India. Today an estimated six million
Americans are practicing postures and other Hatha-Yoga techniques on a more or
less regular basis to help restore or maintain their fitness and/or health.
In the West, there are several significant contemporary approaches
to Hatha-Yoga, which are based on traditional teachings to varying degrees and
also utilize the therapeutic potential of Yoga. The most traditional
orientation, which goes by the name of Viniyoga, is found in the school of T.
Krishnamacharya (1888-1989) and his son T. K. V. Desikachar. It has produced a
number of Western Viniyoga teachers, including Gary Kraftsow in Hawaii, who
recently authored a significant book on Yoga therapy.
Another well-known system, which has produced over a thousand
teachers around the world, is that of B. K. S. Iyengar, a son-in-law and
student of T. Krishnamacharya. More than any other teacher, Iyengar has
developed Hatha-Yoga for therapeutic purposes and in this context has pioneered
the use of props such as wood blocks, benches, bolsters, and straps.
A third widely used approach containing therapeutic elements is
Kripalu Yoga, as developed by Yogi Amrit Desai and the Kripalu Center for Yoga
and Health in Massachusetts.
A modified form of Kripalu Yoga is taught at Phoenix Rising Therapy
under Michael Lee, M.A., also in Massachusetts.
In California, Joseph LePage, Ph.D., is using Yoga therapy
specifically for stress reduction under the aegis of Integrative Yoga Therapy.
More recently, Dean Ornish, M.D., a student of Swami Satchidananda
of the Integral Yoga Society, has included Yoga therapy for stress management
in his program for patients suffering from various types of heart disease.
Patients are expected to commit to one hour of Yoga a day for the period of one
year, in addition to adhering to a low-fat vegetarian diet, regular exercise,
and utilizing group support. Currently the Ornish Program is used at eight
hospitals and since its inception in 1985 has involved hundreds of patients.
Medical and Psychological Research on Yoga
In the course of its several thousand years of existence, Yoga has
accumulated a huge store of experiential data, some of which is contained in
the extensive native literature written in Sanskrit and various vernacular
languages. Much of the information, however, is still passed on from teacher to
disciple by word of mouth, and therefore to learn the subtleties of yogic
technology one is obliged to undergo a traditional pupilage even today.
Ever since classical Greece, Westerners have been intrigued by the
extraordinary physical and mental abilities of Yoga practitioners. There are
numerous anecdotes about yogins being able to stop their pulse and heart beat,
to experience no pain when cut or burned, to suffer no injury when ingesting
lethal doses of poison, to be buried underground for several days in an
airtight box, and not least to remain transfixed in concentration for hours and
Some of these feats have been tested and fully or partially
verified in medical laboratories. One of the better known contemporary yogins
capable of extraordinary somatic and psychological responses was the late Swami
Rama (1925-1996), founder of the Himalayan International Institute in
Pennsylvania. In 1970 he was tested at the Menninger Foundation in Topeka,
Kansas, and among other yogic skills demonstrated extensive control over his
brain waves. While few Yoga practitioners actually attain this level of
mastery, in principle everyone is held to be capable of it. Swami Rama's
expertise and humanitarianism attracted many physicians and psychologists,
which, in 1989, led to the creation of one of India's best equipped hospitals
with 500 beds and a plan for 2,000 more. This hospital, which is meant to be
expanded into a medical city, uses Yoga therapy as a complement to conventional
The earliest medical studies of Yoga were conducted at the Yoga
Institute in Santacruz, Bombay. The Institute was founded in 1918 by Shri
Yogendra as a research and educational organization and today is directed by
his son Jayadeva Yogendra, Ph.D., who is also the editor of the quarterly
magazine Yoga and Total Health, now in its forty-second year of publication.
Another well-known Indian Yoga research institution is Kaivalyadhama in
Lonavla, which was founded in 1924 by Swami Kuvalayananda, who also launched
Over the years, numerous medical studies have been carried out that
typically bear out the modest-to-moderate claims made by Yoga authorities.
These range from Yoga's beneficial effect on physical flexibility, muscle tone,
and stamina to poor eyesight, obesity, indigestion, back pain, hypertension,
various respiratory diseases, sinusitis, arthritis, diabetes (I and II), as
well as anxiety, nervousness, attention deficit, and memory loss.
In the 1970s, the immense popularity of Transcendental Meditation
(TM) introduced to the West by Maharshi Mahesh Yogi led to many studies of this
and other forms of meditation. Again, the benefits of regular meditation for
physical and mental health have clearly been demonstrated in experiments. The
Yoga Research and Education Center in California is currently creating a data
base of medical and scientific studies on Yoga, which, when completed, will be
made accessible to Yoga teachers and investigators. Some aspects of
Yoganotably meditationhave been fairly thoroughly (and repeatedly)
investigated, while others are in need of systematic study. In particular,
illness-specific and longitudinal studies are needed toexplore the effects of
regular Yoga practice on a person's psychosomatic well-being.
Following are two case histories that illustrate the approach of
Two Practical Examples
Morgan, a forty-six-year-old businessman who owned several
successful companies, had been referred to me by the trainer of the sports team
he was sponsoring and which I was teaching a modified version of Hatha-Yoga.
Over the phone he told me that he wanted to learn meditation rather than
physical exercises and asked whether I could see him at his home. I told him
that my schedule did not allow me to make house calls, especially when
long-distance travel was involved, and asked whether he would not be able to
come see me instead. I gathered from his cryptic remarks that when he was not
in the office, he did not go out much. I insisted that he should come to me for
the initial consultation, which he did a few days later.
Morgan was a six-foot-tall lanky figure, slightly stooping, and
obviously depressed. I asked him a little bit about his life and medical
history, and he admitted to having been on antidepressants on and off for the
past several years but currently was not taking anything because he did not
like the side effects. He was told by a friend that meditation could prove
beneficial. I confirmed this, but at the same time pointed out to him that
meditation is never a quick fix and for it to be helpful must become part of an
I asked him about his diet, which consisted of restaurant food or
snacks at home. He never exercised and had his chauffeur drive him everywhere.
He stayed up late, slept little and fitfully, and stayed in bed till noon
reading the papers and making phone calls. On the positive side, he did not
smoke and drank alcohol only with meals.
Morgan seemed reticent to talk about himself, and I had to remind
him that although I was not a physician, I needed to know something about him
in order to help him. I carefully explored the issue of his depression, and it
turned out that he had a long history of failed relationships with women and
feared he was becoming impotent. Also, his businesses were more or less running
by themselves, and so he had a lot of free time on his hands to brood over his
situation, which only made things worse. He had seen a psychiatrist for several
months but then grew tired of spilling his guts without ever seeing any change
I told Morgan quite frankly that before he could benefit from
meditation, he would have to do regular physical exercises and breathing
techniques to "ground" as well as "energize" himself and thus become able to
relax more. He agreed that he had difficulty concentrating and expressed his
willingness to try my approach. In turn, I agreed to see him at his home once
or twice a week for a while.
On my first visit, I quickly determined Morgan's flexibility, which
was poor. I designed a thirty-minute program for him involving spinal twists in
the supine position, easy forward, backward, and lateral bends. I had him do
the exercises and helped him find his own optimal form for each. In between
each exercise I had him rest for several minutes. I asked his permission to
touch him during these relaxations and took the opportunity to help him
stabilize his bodily energies by placing my right hand on his solar plexus and
then on his heart. His energies responded well, which I conveyed to him. I
sensed that he needed all the encouragement I could give him.
We ended the session with a fifteen-minute guided relaxation, which
involved first tensing the entire body and then relaxing it limb by limb. When
he was adequately relaxed, I asked him to breathe more deeply, filling first
his abdomen and then his chest (diaphragmatic breathing). He had difficulty
with this, and again I assisted by gently placing my right hand on his solar
plexus and guiding the movement of his breath.
At the end of the session, I asked him for feedback, and he said
that he found the relaxations very good. I encouraged him to practice them
every day together with the physical exercises, which he promised he would do.
On my second visit, he sheepishly confessed that he had not kept
his promise and had no real excuse for this omission either. I reminded him
that he must want to overcome his problems before he could overcome then. Then
I very firmly told him that I would not return for further sessions unless he
were to practice every day. He seemed surprised at that, but promised to do
better. Thereafter he kept his word with only a few exceptions, which I did not
hold against him.
Over the next several weeks, Morgan's flexibility and capacity for
relaxation slowly but steadily increased, and also his energy level seemed to
improve. Now and then I got him to talk a little more about his life, though it
was difficult for him to open up. Mainly I endeavored to convey to him that we
are meaning-creating beings, and that it is largely up to us what meanings we
allow to influence our life. I explained that his particular crisis was an
opportunity to find or create new meaningsfor himself. Now that his businesses
no longer demanded all his energy and attention, he was free to explore new
possibilities. At the moment, he felt himself in a vacuum, but looked at
differently the same vacuum was an open space for new meanings to emerge. He
understood in theory but was frustrated by the fact that he had allowed himself
to sink into chronic depression, which now required a lot of remedial work. I
had recommended that he see a homeopathic physician for additional help, but he
never did; I regarded this as part of his self-sabotaging program.
Just when I felt we were making some progress, he had to go on an
extended business trip. I found out from our mutual friend that during his
travels Morgan had completely dropped his Yoga practice, had another disastrous
relationship with a woman, and then had promptly succumbed to his usual
emotional gloom. He was too depressed and embarrassed to call me after his
return. Old patterns are difficult to change.
Although this case is not a success story, it illustrates well the
yogic approach to remedial work. All healing is self-healing, and healers
merely assist this process. This is a pivotal message to communicate to
clients. Those who are eager to assume responsibility for their own healing
inevitably will benefit more deeply and quickly from Yoga.
This was the case with Sally, a fifty-two-year-old woman who had
gone through the trials of her husband's bankruptcy followed by an ugly divorce
initiated by him. She was suddenly faced with the realization that, after years
of being a housewife, she had to make a new life and career for herself. She
came to one of my group sessions twice before she plucked up enough courage to
ask me for a private consultation. For years she had been suffering from back
problems, which she realized were partly due to prolonged marital strain. Now
they were flaring up with a vengeance. I had noticed her discomfort and had her
do modified versions of some of the group exercises.
Sally had seen a physician and, apart from chronically contracted
muscles in the lower back, there were no structural abnormalities. She had
tried a certain style of bodywork but found she was unable to bear the pain of
this particular treatment. Yoga, she found, was helping her relieve the
discomfort somewhat. She also was aware that she needed to deal with the
emotional side of the problem, which was the stored-up anger directed against
her husband. Since she understood her difficulties so clearly, I could be very
direct with her.
I proposed a two-pronged course of action to Sally. First, she had
to let go of the angry "holding pattern," which caused her lower back muscles
to be in a chronically contracted state. Second, she had to use the energy
freed up by releasing her anger in a creative way. She expressed a great
eagerness to do both.
I asked her to lie down on her side and then placed my hand on her
lower back to let her feel the "holding pattern." Simultaneously, I explained
to her that these contracted muscles were her own unloving feelings and that no
one but herself was responsible for them and the pain they were causing her.
She cried a little, which was a good beginning. I encouraged her to see her
life in the larger context of yogic meanings. This included the idea that by
projecting anger toward someone, we not only do damage to them, because,
according to Yoga, thoughts are forms of energy, but that this action also has
inevitable repercussions for ourselves.
I then surprised her by asking her to daily send positive, blessing
thoughts to her ex-husband, audibly saying words of forgiveness. She found this
very difficult at first and shed some tears, but with some practice she began
to feel the transformative power of this exercise and in the end could do it
quite naturally. She understood that body and mind go together and that she
needed to take care of both. At the same time, I taught her to visualize all
muscle tension being released during exhalation and while lying in the supine
position with a cushion under her knees to prevent any strain on her lower
As she acquired more of a sense of the energy freed up by means of
this exercise, I asked her to visualize that energy filling her body with
strength and radiance during inhalation. In addition, I designed an individual
exercise program for her, which she could do at home. I also recommended that
she take a hot bath prior to exercising so as to loosen her muscles, especially
for the stretches, and suggested some vitamin supplements to aid this process.
Her physical condition improved surprisingly quickly, mainly because she
practiced consistently, intelligently, and with enthusiasm. She also visibly
gained in self-confidence, and before long she initiated the necessary steps
toward a career in bodywork.
As an emerging field, Yoga therapy is still in the process of
defining itself both relative to the medical and psychological profession and
the Indic Yoga tradition. Throughout its long history, YogaÕs proven vitality
has always been integrally connected with the traditional initiatory structure
and oral transmission of yogic teachings. In the West, a new approach to Yoga
is evolving, which tends to downplay these two traditional elements but which
has introduced a battery of new concepts and practices stemming from medicine
and psychology. While this direction is necessary and inevitable, it also
exposes Yoga to reductionism, which must be avoided. Specifically, to the
extent that Yoga therapy understands itself as little more than physical
therapy or breath therapy it will have failed in preserving the holistic
paradigm of original Yoga. The challenge confronting Yoga therapists is to
remain true to the holistic (psychosomatic and spiritual) content of
traditional Yoga while simultaneously serving clients who are suffering from
physical and emotional dysfunctions and who may not be prepared to hear that
their problems have a spiritual component. To express it differently, Yoga
therapists will have to become highly skillful in navigating the potentially
hazardous waters between therapy and religiona challenge they share, for
instance, with some psychotherapists.
Yoga has been part of the American cultural kaleidoscope for the
past hundred years and is undoubtedly here to stay. Yoga teacher training in
the United States is becoming ever more professionalized through the efforts of
organizations like the International Association of Yoga Therapists in Mill
Valley, California, and International Yoga Studies in Phoenix, Arizona.
Training specific to Yoga therapy is also increasingly subjected to higher
professional standards, which will serve both Yoga therapists and their
clients. The first fruits of these various efforts can be seen in the recent
interest by health insurance companies in admitting Yoga and Yoga therapy into
their programs. The future for Yoga and Yoga therapy looks bright.
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Resources Listed in alphabetical order
American Viniyoga Institute. Directed by Gary Kraftsow, M.A.
Address: 1030 E. Kuiaha Road, Haiku, HI 96708.
Integrative Yoga Therapy. Directed by Joseph LePage, Ph.D.
Address: 5237 Darrow Rd. #6, Hudson, OH 44236.
International Association of Yoga Therapists. Directed by John
Kepner, M.A.. Address: P.O. Box 2513, Prescott, AZ 86302.
International Yoga Studies. Directed by Sandra Summerfield
Kozak, M.S. Address: Northern California..
Kaivalyadhama. Directed by Swami Digambarji. Address: 117
Valvan, Lonavla 410 403, India.
Kripalu Yoga Teachers Association. Address: P.O. Box 793, Lenox,
Phoenix Rising Yoga Therapy. Directed by Michael Lee, M.A.
Address: P.O. Box 819, Housatonic, MA 01236.
Preventive Medicine Research Institute. Directed by Dean Ornish,
M.D. Address: 900 Bridgeway, Suite 1, Sausalito, CA 94965.
Yoga Biomedical Trust. Directed by Robin Monro, Ph.D. Address:
P.O. Box 140, Cambridge CB4 3SY, England.
Yoga Institute. Directed by Jayadeva Yogendra, Ph.D. Address:
Santa Cruz (East), Bombay 400 055, India.