Yoga is extremely popular, with half a million people in the UK and over eighty million worldwide practising regularly. Many seek exercise, improvement of strength and flexibility, or relaxation, with some also looking for spiritual development. At its roots, yoga was originally intended as a technology for personal transcendence. Whilst yoga therapy draws on the principles and practices of yoga, its intention is more particularly the holistic treatment of a wide range of health conditions.
You attend a yoga class to learn yoga, but if you visit a yoga therapist you will work together to develop and adapt specific practices designed to help relieve a particular condition and promote overall wellbeing.
“If you can breathe you can do yoga.”
T. Krishnamacharya.
What is Yoga Therapy?
Yoga Therapy was pioneered in the 1920’s by Swami Kuvalyanda who began to apply modern scientific methods to study the physiological effects and therapeutic application of yoga for specific ailments, believing that we could potentially offer people a ‘yoga prescription’.
Adapting movement, breath practices, meditation, visualisation and relaxation techniques to enhance mental and physical wellbeing, yoga therapy can target a variety of health conditions. It uses therapeutic techniques drawn from yoga and mindfulness traditions alongside the principles of physiotherapy and psychotherapy to help improve the function of our musculoskeletal system, build resilience in our nervous system (Geetha et al., 2022), reduce inflammation and improve brain function (Gotnik et al., 2016). Overall, it facilitates a biopsychosocial or whole person systems approach to improved health and wellbeing.
Yoga therapy guides people towards present moment awareness, allowing for the exploration of mind, body and mood in the here and now. It offers practices to help facilitate positive change whilst allowing clients to release unhelpful patterns and create space for new ways of being.
There is a growing body of research that suggests yoga therapy can help reduce the effects of stress (Streeter, 2012), known to be a significant aggravating factor in many chronic health conditions. Yoga therapists will work with their clients to help mitigate these effects.
In the field of mental health, research highlights yoga therapy’s considerable potential, particularly for the treatment of PTSD (van der Kolk, 2014), depression (Brinsley, 2020), sleep disorders (Khalsa, 2004) and anxiety (Streeter, 2010). In 2016 The Minded Institute’s 8-week Course For The Mind group intervention for people experiencing anxiety and depression showed very promising results, with participants reporting significant psychological benefits (Kahla, 2016).
There are clear signs that the global medical establishment is also beginning to embrace yoga therapy. In the USA, Dr. Dean Ornish’s yoga-based programme for reversing heart disease is now reimbursed by Medicare, Blue Shield of California, and Aetna. Whilst in the UK the Yoga For Healthy Lower Backs programme was included in the 2016 NICE guidelines for treating back pain with sciatica.
Who Can Benefit?
The yoga and mindfulness practices used in yoga therapy settings can be helpful for many conditions, including:
Back Pain
Musculoskeletal problems
Diabetes
High Blood Pressure
Parkinson’s
Asthma
COPD
Cancer
HIV
Alzheimer’s
Brain Injury
Multiple Sclerosis
Autoimmune Diseases
IBS
Obesity
Stress
Depression
Anxiety
PTSD
Schizophrenia
ADHD
Eating Disorders
Addiction
Post-Natal Depression
Heart Disease
Insomnia
Arthritis
Peri/Menopausal symptoms
CFS/ME/Long Covid
Osteoporosis
The Yoga Therapist
A qualified yoga therapist will be accredited by the British Council for Yoga Therapy or the International Association of Yoga Therapists. They will have undertaken several years of study including all aspects of yoga, mindfulness, foundational neuroscience, physiology, anatomy and psychotherapeutic principles, will have conducted several case studies with a supervisor and be receiving ongoing supervision.
The Intake Process
The therapist will assess the client through an intake process that includes listening, questioning and observing to help understand the client’s needs. This is followed by ascertaining the client’s goals and a discussion about how yoga therapy might help in the reduction or management of symptoms as well as exploring possible practices to help them navigate their mindset.
The yoga therapy session
Having assessed the client’s requirements, the client and yoga therapist will then co-create a session specifically for the client’s situation. Part of the yoga therapist’s role is to empower the client through self-awareness towards better self-care, so it is important that the process is collaborative.
A yoga therapy session will look very different to a regular yoga class. It might include focussing on your feet and other grounding practices for someone with PTSD or bringing together breathing practices and compassion to encourage prosocial behaviour and connection in someone struggling with loneliness. When working with a client experiencing hypertension, the yoga therapist may suggest isometric exercises (Edwards et al., 2023) and breathing practices as part of a therapeutic yoga intervention to lower blood pressure (Dhungana et al., 2021).
In some circumstances, particularly when a health condition is unlikely to improve, this journey might also include the cultivation of self-compassion and acceptance to help increase quality of life.
Outcomes
My clients have reported many positive outcomes, including a better connection with their body, improved self-regulation, mood, sleep, strength, balance, range of movement, better pain management and changes in their perspective that reduce stress.
A few examples from my work include a client with COPD who self-reported his breath capacity had improved and another struggling with menopausal hot flashes found the Sitali ‘cooling breath’ helpful. Several clients with chronic pain have found relief, including some who have been in pain for years. A client with CFS/ME found a breathing practice that was ‘enlivening’, was able to move away from her perfectionist tendencies and at the end of our six sessions had found more joy in life.
Yoga has few contraindications and side effects, making it a safe (Cramer, 2015) and valuable tool in the treatment of many mental and physical health conditions, especially those where conventional treatments have little to offer or where stress can make symptoms worse. It can also be effective as a tool for clients to use alongside other treatments, for example clients with cancer and depression, who are undergoing toxic treatments, report that yoga therapy can improve quality of life and/or reduce dependency on expensive, toxic, pharmacological treatments.
As well as improving clients’ health and wellbeing whilst receiving treatment, people who receive their own yoga therapy prescription effectively have tools for life, allowing them to more easily maintain an ongoing optimal state of health.
References:
Brinsley, J., Schuch, F., Lederman, O., Girard, D., Smout, M., Immink, M.A., Stubbs, B., Firth, J., Davison, K. and Rosenbaum, S. (2020). Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. British Journal of Sports Medicine, 55(17), p.bjsports-2019-101242. doi:https://doi.org/10.1136/bjsports-2019-101242.
Cramer, H., Ward, L., Saper, R., Fishbein, D., Dobos, G. and Lauche, R. (2015). The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. American Journal of Epidemiology, [online] 182(4), pp.281–293. doi:https://doi.org/10.1093/aje/kwv071.
Dhungana, R.R., Khatiwoda, S.R., Gurung, Y., Pedišić, Ž. and de Courten, M. (2021). Yoga for hypertensive patients: a study on barriers and facilitators of its implementation in primary care. Global Health Action, 14(1). doi:https://doi.org/10.1080/16549716.2021.1952753.
Edwards, J.J., Deenmamode, A.H.P., Griffiths, M., Arnold, O., Cooper, N.J., Wiles, J.D. and O’Driscoll, J.M. (2023). Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. British Journal of Sports Medicine, [online] 57(20). doi:https://doi.org/10.1136/bjsports-2022-106503.
Geetha, Mb., Shobana, R., Maheshkumar, K., Venkateswaran, S. and Padmavathi, R. (2022). Effect of long-term yoga training on autonomic function among the healthy adults. Journal of Family Medicine and Primary Care, 11(7), p.3471. doi:https://doi.org/10.4103/jfmpc.jfmpc_199_21.
Gotink, R.A., Meijboom, R., Vernooij, M.W., Smits, M. and Hunink, M.G.M. (2016). 8-week Mindfulness Based Stress Reduction induces brain changes similar to traditional long-term meditation practice – A systematic review. Brain and Cognition, [online] 108, pp.32–41. doi:https://doi.org/10.1016/j.bandc.2016.07.001.
Kahya, H.H. and Raspin, C.G. (2017). Yoga Therapy for the Mind Eight-Week Course: Participants׳ Experiences. EXPLORE, 13(2), pp.116–123. doi:https://doi.org/10.1016/j.explore.2016.12.006.
Khalsa, S.B.S. (2004). Treatment of Chronic Insomnia with Yoga: A Preliminary Study with Sleep?Wake Diaries. Applied Psychophysiology and Biofeedback, 29(4), pp.269–278. doi:https://doi.org/10.1007/s10484-004-0387-0.
Streeter, C.C., Whitfield, T.H., Owen, L., Rein, T., Karri, S.K., Yakhkind, A., Perlmutter, R., Prescot, A., Renshaw, P.F., Ciraulo, D.A. and Jensen, J.E. (2010). Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study. The Journal of Alternative and Complementary Medicine, [online] 16(11), pp.1145–1152. doi:https://doi.org/10.1089/acm.2010.0007.
Streeter, C.C., Gerbarg, P.L., Saper, R.B., Ciraulo, D.A. and Brown, R.P. (2012). Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical Hypotheses, 78(5), pp.571–579. doi:https://doi.org/10.1016/j.mehy.2012.01.021.
van der Kolk, B.A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M. and Spinazzola, J. (2014). Yoga as an Adjunctive Treatment for Posttraumatic Stress Disorder. The Journal of Clinical Psychiatry, [online] 75(06), pp.e559–e565. doi:https://doi.org/10.4088/jcp.13m08561.