Yoga and Yoga Therapy in Germany Today
by Daya Mullins, Ph.D., M.S.C. President of the WdM Health Foundation and ECYT, Germany
Over the years, yoga in Germany has become a valid and strong field with many skilled teachers and respected schools and has recently boomed in the field of fitness and health. Fewer people proportionately, however, seem to be interested in the original purpose of yoga, which is self-development and awakening. Yoga first became known to the general public mainly through the "Volkshochschulen"—the evening school system, a powerful phenomenon in Germany. Every little town has such an evening school where people can meet and learn about a wide variety of topics. Over the years, this has been the place where many housewives and other interested people have first learned about yoga. It was and is an inexpensive way to learn something about your primary interest or hobby. It was these Volkshochschulen and the 1973 television program "Yoga for Everybody" that popularized yoga in the early years, along with the very few yoga schools that then existed in Germany. Later, health insurance plans joined in, which indicates that they were starting to become aware of the great health benefits yoga can have. This is significant considering that every person in Germany has to be a member of a health insurance plan up to a certain income level.
Approximately 10 years ago yoga took on significant importance when several health insurance companies started reimbursing for yoga classes, and it became "in" for the general public to participate in them. If yoga had been looked at with a bit of suspicion until then, this rapidly changed when we saw yogis smiling from advertisements and on television. Om became a mantra that was even used as a joke, as the advertising industry did not seem to understand its meaning.
Standards for Yoga Teachers
This growing interest resulted in health insurance companies starting to offer yoga classes themselves, often with only marginally qualified instructors, however. It soon became apparent to the insurance companies that some minimum standards needed to be established regarding basic qualifications for a yoga teacher. Their subsequently established standards, however, did not quite meet the requirements of the minimum standards that had long been established by the German Yoga Teacher Union (BDY), their associated schools (we are one of them), and the European Yoga Union (EYU). These BDY/EYU standards have thus far been accepted by 13 European countries, their Yoga unions, and several yoga schools. They include a 4-year yoga teacher education with a minimum of 670 classroom hours and a final oral and written examination, as well as a teaching demonstration in front of a yoga class. The WEG DER MITTE Health Foundation (WdM) and its European College for Yoga and Therapy (ECYT) follow these standards as a basis, but our yoga teacher education is more encompassing and comprises approximately twice the hours.
It has proven of great benefit to yoga that such standards have been in place here for many years, and yet you will still find yoga centers that offer a one-month "teacher education" program or programs of even shorter duration than this. As the adaptation of standards is voluntary and the title "yoga teacher" is not legally protected in Europe, it remains a title anyone can adopt. If we read the political signs correctly, however, this will change in the future. Our staff has been very involved for many years in the German yoga union BDY together with several other yoga schools working seriously to help lift the standards, create quality management, and have yoga properly presented in the media.
Because of the lack of regulations and general clarity in yoga education, the current development with health insurance companies is that they have gone to a new extreme. Participants of yoga courses can at present receive reimbursement for part of the course fee by their health insurance plan (approx. € 75.00 = $ 89.00 a year) only if the purpose of the course is not yoga for self-development and enlightenment! A yoga course must, according to them, be solely for increasing the flexibility of muscles, enhancing the mobility of the skeletal system, or enhancing cardiovascular circulation. This reflects a typical Western medical point of view, completely ignores yoga's original purpose as a self-developmental path, and does not take the transformative healing aspects of yoga into account.
In addition, teachers giving insurance-reimbursable courses must meet standards similar to those outlined above—i.e., they must have completed a four-year yoga teacher training program at an acknowledged yoga school with a final diploma according to the German and European Yoga Union standards (in some regions a teacher training with 500 hours has been accepted), as well as have obtained either a university degree or have a professional background in a health or social profession. If any of these requirements is missing, the insurance company will refund nothing. Several insurance companies in the larger towns offer their own yoga courses and only pay if one attends those classes.
Yoga Therapy and the Law in Germany
History shows that yoga, yoga therapy, and Ayurveda have been natural integrative approaches from the beginning, with a high level of benefit for the user/practitioner. Yoga therapy is at present just on the verge of becoming known to the general public in Germany and of finding its place in holistic medicine in the areas of prevention and health enhancement.
Using the term "therapy" in Germany, however, signals that your intent is to heal people. The law from 1939 pertaining to "HPG", the law for healing practitioners, or Heilpraktikergesetz, is of major importance. You are not permitted to use the term "therapy" unless you are a medical doctor with approbation, a psychologist or a Heilpraktiker/Healing Practitioner (HP) with examination and acknowledgment by the state. Whatever you do that has the purpose of diagnosing and healing or easing illness, as well as eliminating suffering, is viewed in Germany as practicing medical science-it makes no difference whether it is natural medicine or allopathy. You can study to become an HP through appropriate schools or via self-study with additional training in your chosen complementary medical field of interest. The examination that is done by the state, is very tough, however, and at the moment about 90 % do not pass the first time. When you do succeed, you are licensed in the whole of Germany and in some European countries to work therapeutically. You can prescribe natural remedies, but you are explicitly not allowed to treat either infectious diseases or dental problems.
Using yoga therapeutically is thus more difficult for yoga teachers in Germany than for those in the United States, as they must undergo HP education and examination if they do not have the required qualifications. This entails additional years of study in biomedical sciences, naturopathy, and other subjects. There are no legally qualified yoga therapists as such in Germany—meaning qualified by state examination. We have, however, created standards in this emerging field for our school, the European College for Yoga and Therapy (ECYT), that we are applying, and we are working toward European requirements and standards in yoga and yoga therapy.
We have no statistics on how many yoga teachers adapt yoga therapy in their classes or in private sessions, but interested yoga teachers have started to take further training to learn yoga therapy at ECYT. They become registered as yoga teachers when they have completed a four-year teacher training, and with further education in yoga therapy they become a certified BENEFIT-YOGA™ Therapist. Qualified yoga teachers usually have the short initials from the educating school behind their name. If they also have been examined by the Yoga Union, their title is, for example (for our school), as follows: yoga teacher WdM and BDY/EYU (yoga teacher WEG DER MITTE and the yoga unions Berufsverband der Yogalehrenden in Deutschland/European Yoga Union).
Crisis in Health Management
In the past few years the political situation regarding health care has become strained due to the enormous cost explosion in this field. New ways of managing this situation must be found. One attempt this year was to launch a new law that requires patients, in addition to their health insurance plans, to pay much higher fees for their medications and clinical visits. Up until now, only MDs could cooperate with the health insurance companies, and only their patients could gain the benefits. As a result, MDs and Healing Practitioners (HPs) are becoming more equal from the point of view of the patients. Whereas before a person may have hesitated, due to economic reasons, to choose a natural healing method that was not paid by health insurance, now, since s/he has to pay anyway, there is a growing trend to try natural medicine, yoga, and yoga therapy. Patients choosing natural health methods make an investment in the future - they introduce no chemical pollutants into their body and the environment, they lower costs, and they learn health and life-affirming methods for self-application.
In addition, the new focus of health research is increasingly more on health than on illness. Originating from social medicine and psychosomatic medicine, as well as humanistic and transpersonal psychology, it now includes salutogenesis (life style, social relationships, and psychological and spiritual health) in addition to the genetic and pathological factors underlying illness. Furthermore, the concepts of patient self-responsibility and self-empowerment have gained an increasingly important role. This change of approach within the world of medicine, and the opening to and integration of natural healing sciences, the Theory of Cognition, and modern philosophy, can increasingly be seen, although it has taken a long time to manifest.
The integral approach is becoming more accepted for a number of reasons, primarily economical. A rapidly increasing number of people are choosing alternative medicine and healing methods and, instead of going to a conventional doctor's office, are seeking alternatively educated health professionals. Several European research projects have found that many symptoms in patients have been created through wrong medication that has subsequently led to severe diseases. This has significantly escalated costs for health insurance companies, and consequently this has led them to seek measures to lower expenses. They have, however, in spite of the aforementioned evidence, not reduced their cooperation with the pharmaceutical industry nor have they initiated the development of less harmful remedies. Unfortunately, it is not the benefit for patients that they have in mind.
It Is Important to Draw Attention to Factors that Create and Sustain Health
The concept of creating and sustaining health as an approach to healing is essential in the traditions of yoga, Ayurveda, Chinese Medicine, and Western naturopathy. Currently, yoga has become part of the field of holistic health and complementary medicine in the area of prevention.
The purpose of yoga therapy can be viewed as supporting people in their health and healing process through the science of yoga. The term "yoga therapy," however, has found its way into the general yoga scene in Germany only in the last few years. Although the yoga unions and many of the most well-known yogis in Germany have for years proclaimed that yoga therapy does not exist, since yoga is in itself therapy, those very same yogis are now using the term "yoga therapy" for their work. One notices that the yoga scene also has "fashions," and when something becomes fashionable everyone wants to jump on the bandwagon. It seems that yoga therapy is going to be the next big thing here, very much like what is happening in the United States. In the last few months alone, you can find on the German internet about 10 new places that claim they are now working with yoga therapy, but without defining what that means.
Working with BENEFIT-YOGA™ Is a Whole-Person Approach to the Art of Healing through Yoga Science
The WEG DER MITTE Non-Profit Foundation for Holistic Medicine, Health Education and Social Services (WdM), founded in 1977 in Berlin, was the first health center in Germany to utilize a combination of natural medicine and yoga in healing. Natural medicine has a long tradition in Germany, and many powerful techniques and healing methods have come out of this tradition, e.g., Hildegard von Bingen and her medieval healing tradition, Hahnemann and the homeopathy, Kneipp and his method of applying water in various health-related ways, and more recently Gindler and Goralewski and their unique bodywork and Middendorf and Breathing Therapy, to mention just a few.
It took over 30 years of research and practical application of yoga as a healing science, the application of Eastern and Western natural healing methods as well as the understanding and respect for the interconnectedness of life, to create BENEFIT-YOGA as it is today. At the Weg der Mitte Health Centers and the European College for Yoga and Therapy (ECYT),our Yoga educational facility, BENEFIT-YOGA with all its levels of working including yoga therapy is applied as a powerful approach to health care and rediscovery of a person's health potential.
In our case, the combination of more than 30 years of research and practical application of yoga as a healing science, the application of Eastern and Western natural healing methods, and the understanding of and respect for the interconnectedness of life have led to the creation of BENEFIT-YOGA. At the WEG DER MITTE Health Centers and the European College for Yoga and Therapy (ECYT), our yoga educational facility, BENEFIT-YOGA, with its many levels of approach including yoga therapy, is applied as a powerful method of health care and a means for rediscovering a person's health potential.
In the multidimensional work of BENEFIT-YOGA we emphasize a holistic approach, which is the very nature of yoga, rather than an "allopathic yoga" aimed at curing symptoms. It is thus of major importance that the teachers and therapists who practise BENEFIT-YOGA have a thorough education in and profound understanding of the physical, emotional, and mental aspects of yoga, of Ayurveda and biomedical science, and as well of the energy-based teaching leading to meditation and yoga's spiritual dimensions. It requires many years of personal practice in order to work with patients/clients in this way.
We work integratively with yoga and yoga therapy on different levels:
- On-going yoga classes
- yoga seminars for beginner, intermediate, and advanced students
- yoga and meditation retreats
- yoga vacations
- Individual BENEFIT-YOGA therapy sessions
- Patient Education Programs (PEP) done in conjunction with patients with tinnitus, rheumatic illness, or heart disease, where the core teaching is Yoga therapy
- yoga teacher trainings, four years
- Postgraduate education for yoga teachers, e.g., Yoga for Health and Healing
- yoga therapy training on multiple levels including YogaheilpSdagogik (theory and methodology for working with yoga in healing)
- Postgraduate training in yoga therapy
Our training programs include international guest teachers from India, Europe, the United States, and Canada.
Although there are now many yoga schools in Germany, only 26 of them are associated with BDY. ECYT is the only school in Germany thus far that trains yoga therapists. There is one other German yoga school that teaches a two-year introductory sequence on yoga and health. All of our main yoga teachers and yoga therapists have extensive and long-term yoga teacher and yoga therapy training and many years of practice as yoga teachers and HPs in addition to whatever other qualifications they may have
Ayurveda in Germany has become very popular over the last five to eight years. It was initially of interest to insiders only, but you will now find articles in most women's magazines about the doshas and the benefits of the different massages, foods, etc. You will find many health centers that offer Ayurvedic treatments and several schools in addition to ours that offer trainings in this field. Yoga therapy traditionally was integrated with Ayurveda, and we find this useful today as well, along with the incorporation of Western diagnostic methods.
Most of what is on the market today under the name "yoga therapy" could more accurately be called "allopathic yoga," i.e., yoga for this and yoga for that, yoga for the back, yoga for the heart, and so on. To our understanding, however, yoga therapy is not at root allopathic. It can be very useful in this way if the apparent symptoms are recognized as "doors" through which one can holistically explore with clients what yoga is for them, including the spiritual dimension.
Core Competence for Yoga Therapists in a Health Care System
According to the illustrative standards published in the 2003 issue of the International Journal of Yoga Therapy, "A yoga therapist is a well-trained and well-experienced yoga teacher with substantial additional training in therapeutic applications, clinical practice, and biomedical science."1 We agree with this statement. The two most important things in yoga therapy are the ability of the yoga therapist to know his or her mZtier in a deep and profound way and for yoga to be applied as each situation requires. The key abilities for a yoga therapist to cultivate in addition to compassion are those of mindfulness, observation without judgement, and an understanding of how the many parts work together for the whole.
The following standards for applying yoga in a therapeutic way reflect our understanding and experience at ECYT and at the WEG DER MITTE Health Foundation. Substantial training, experience, personal maturity, and accomplishment in yoga therapy are needed and can be gained in the following order:
- Personal practice At least three years (BDY and ECYT standards).
- Yoga teacher training A thorough training (4 years, min. 880 Ð 1,500 hours) including supervised hours of teaching and biomedical science, with written and oral examination and a demonstration of teaching skills. ECYT also requires a written thesis (min. 60 pages on A4 paper) on a self-chosen topic related to one's personal work with Yoga during the 4 years of education.
- Experienced yoga teacher A minimum of 5 years and 1,000 hours of teaching yoga to beginner, intermediate, and advanced students. The teacher must demonstrate a thorough understanding of yoga in all its aspects, including yoga psychology and Yoga philosophy.
- Yoga therapy training I (250 classroom hours with certificate of completion): Ayurveda, anatomy, physiology, understanding the nervous system and stress alleviation at the appropriate levels, therapeutic applications, variations and adaptation of asanas, yoga philosophy, yoga psychology, communication skills, understanding the dimensions of the human being and the different sources of suffering, personal practice and development.
- Yoga therapy training II (250 classroom hours and supervision, examination through ECYT, certificate of completion): Deepening understanding of the subjects in level I, plus pathology, Eastern and Western diagnostic skills, theory and practice of prevention and healing, including clinical practice skills, and more in-depth study of subtle anatomy and pranayama. Case studies.
- Yoga therapy training III (250 hours and supervision, examination through ECYT, certificate of completion): Deepening understanding of yoga and Ayurveda, physiology and pathology, profound personal work and practice, learning and application of further practice skills, internship and externship with documented practice.
- Postgraduate training for BENEFIT-YOGA therapists
The Yoga Therapist Certificate at ECYT is given only when the student has reached maturity in his/her own practice, understanding, and application of the learned principles and after final examination through the board of examiners. I would like to emphasize again that to work as a therapist in Germany one also needs to have the certificate either of an HP, an MD, a physiotherapist, or a psychologist and must document this for ECYT.
Health is more than the absence of illness, and the trend in society today is toward more natural, powerful, and non-harming healing methods. One of the primary reasons for this is the growing consciousness of humans. There is a deeper interest in health and health issues, and a growing understanding of the necessity for self-responsibility and self-initiative in prevention.
Socrates is documented to have said: "When somebody wishes to become healthy, ask first if he in the future is ready to avoid the causes of his illness, and only then are you allowed to help." This is, of course, a strong and quite controversial statement, and must be seen in the light of the underlying philosophy. In the case of hereditary diseases and a disease such as cancer, suffering is obvious and leaves patients often with hopelessness and no means of cure. The statement indicates additionally, however, that we must be responsible for what happens to us and for our own health and that there are measures we can take ourselves and strategies we can apply. The therapeutic aim of holistic treatment through yoga therapy must therefore be not only to help, but to provide means of self-help.
On May 1, 2004, a major historical change will take place in Europe. The European Union will grow overnight from 15 to 25 states, adding 75 million people for a total of 450 million! The EU has never before been so large or so cooperative. What this shall mean individually and politically is still to be experienced, but it will be a great challenge for all the health care systems.
It is our intention to further promote yoga therapy in Germany, Europe, and the United States as a recognized and responsible discipline and as a contributor to natural health care in cooperation with professionals in other health care modalities. The acceptance of yoga therapy largely depends, however, on the quality of the work of yoga therapists. We thusappreciate and value the initiative of the International Association of Yoga Therapists to define and establish standards for yoga therapists in a cooperative worldwide effort to integrate alternative perspectives into modern health care systems.
BENEFIT-YOGA™ is a registered trademark in Europe and the United States.
1International Journal of Yoga Therapy, 2003, no. 13, p. 98.
About the author: Daya Mullins, Ph.D., M.S.C., is one of the pioneers of holistic health in Germany. She founded the WEG DER MITTE Non-Profit Foundation for Holistic Health, Health Education and Social Services in 1977 in Berlin and has established centers in Berlin and Gerode. Daya travels internationally presenting at conferences and giving lectures and seminars on healing, Yoga, and Yoga therapy for the purpose of personal growth and spiritual development. She has created the most comprehensive Yoga teacher training in the West, and she has received outstanding achievement awards for her pioneering work in health education. She is also founder of the European College for Yoga and Therapy (ECYT).Contact: firstname.lastname@example.org. URL: www.ecyt.de.