Valued as a form of exercise and recreation, yoga is also emerging as an adjunct to medical treatment in clinical and hospital settings.
Yoga for treating dis-ease
Yoga means ‘union’ and is one of the oldest holistic approaches to mind/body health. The fundamental premise in yoga is that suffering begins in the mind and comes from a sense of separation: when you lose connection with your own values, purpose, sense of self or spiritual inspiration, dis-ease occurs. Yoga treatment addresses the re-integration of the body, mind, breath and, ultimately, the spiritual self.
Yoga is not a religion. The spiritual component of a yoga therapy program should incorporate your own faith and philosophy and not impose anything from another culture or tradition. The techniques of breathing, relaxation and meditation are universal and can be applied to any lifestyle or religious belief.
Yoga is traditionally linked with Indian Ayurvedic medicine. Vaidyas, or Ayurvedic doctors, often prescribe certain movements, breathing practices, meditation techniques or even mantra repetitions among their treatments for numerous complaints.
Techniques of yoga, including simple stretching postures, progressive relaxation and meditation practice, have been appropriated into mind/body medicine programs in the US and now also in Australia as a complement and adjunct to traditional medical treatment. In several programs that use yoga techniques substantial research supports its benefits in terms of health improvement.
Alleviating chronic stress
Dr Dean Ornish, a cardiologist in California, USA, believes the stress-reducing effects of yoga can benefit cardiac patients and possibly prevent the necessity for repeated bypass and artery surgery.
Dr Ornish’s study, conducted over a period of five years in the late 1980s and published in the journal Lancet in 1990, revealed that patients who followed a program of stress reduction using practices like yoga postures, relaxation and meditation, along with walking, a low-fat vegetarian diet and communication support groups, were able to reverse artery damage and avoid surgery. These patients also reported their chest pain was reduced or disappeared and they felt more energetic and happy.
Another pioneer in the field of mind/body medicine is Dr Herbert Benson of Harvard Medical School, USA. According to Dr Benson, “Many patients with chronic stress-related conditions, for lack of self-help strategies, never get better. Whether the condition is migraines, back pain, PMT [pre-menstrual tension] or hot flushes, drugs or surgery will not be sufficient. Too often when people are diagnosed with an illness, they are left to fend for themselves.” Over the past several years, research has been conducted by Dr Benson’s Mind/Body Clinic in the Behavioral Medicine Department, with patients following a program of techniques including yoga postures, relaxation techniques and meditation. Some of the results from these studies are as follows:
- Insomnia patients were able to fall asleep four times more rapidly.
- Visits to the doctor were decreased by 36 per cent.
- Symptoms of severe pre-menstrual tension were reduced by 58 per cent.
- One-third of patients in the infertility program became pregnant within six months.
- In menopausal patients hot flushes were reduced without the use of hormone replacement therapy (HRT).
Relieving menopausal symptoms
Dr Ramesh Manocha and the Natural Therapies Unit at the Royal Hospital for Women, Sydney, conducted an eight-week pilot study in May/June 2000 on the efficacy of meditation for women experiencing hot flushes. Ten women with hot flushes who were not taking HRT were studied. After eight weeks, during which they meditated twice daily, six out of 10 of the women experienced effects similar to using HRT, with a 65 per cent reduction in their hot flushes. The practice, called Sahaja Yoga, involves creating a state of ‘thoughtless awareness’ during meditation.
Promoting the ‘relaxation response’
Yoga therapy is particularly effective for reducing back pain by developing strength and flexibility in the spine. It is also helpful in reducing the body’s stress response; that is, high blood pressure, rapid heart rate and shallow, restricted breathing. Through yoga therapy you can train your mind and body to promote the ‘relaxation response’; that is, lowered blood pressure and heart rate, deep breathing and mental and physical calmness. In the case of asthma, yoga also helps to reduce the frequency of asthma attacks and dependency on inhalers. The asthma sufferer can be trained to forestall an impending attack by focusing on long and deep exhaling breaths using yoga breathing techniques with relaxing stretching movements.
Prescription for wellbeing
In working with their client, a yoga therapist will consider the diagnosis of the referring practitioner or conduct an observational and diagnostic assessment. A prescribed therapeutic practice specific to the individual needs of the client is then developed. Depending on the client’s needs, the focus might be on structural problems (biomechanical), physiology (organic problems such as asthma, cancer, diabetes and so on) or emotional states (for example, depression, anger or anxiety). Because each client presents with a unique set of conditions, each case must be examined individually. There is no such thing as a set group of yoga practices that will help any particular condition. Generally, a person will have several issues to address, and priority must be given to the most critical.
The range of tools used by a yoga therapist might include: asana (stretching postures), pranayama (breathing exercises), relaxation, meditation, dietary improvement and possibly some suggestions for self-reflection on lifestyle direction and purpose.
Case studies*
Overactive thyroid and kyphosis
Donna is a 40-year-old woman who was referred by her massage therapist for a yoga therapy session with me to address an overactive thyroid. During the assessment process it was also discovered that a broken collarbone had caused some restriction on the left side of her body. Donna had developed a slight kyphosis (rounded back and shoulders), probably from her occupation. She also complained of a ‘racing’ heart and tremors.
A yoga practice was devised for Donna, with the primary aim of slowing her heart rate through slow, regulated breathing, which would produce a para-sympathetic response in her nervous system and reduce the effects of the overactive thyroid. The yoga poses selected were intended to improve her rounded shoulders and back and open her thoracic spine, as well as concentrate circulation in the thyroid area.
Donna performed this practice for two weeks. Happy that she had learnt how to manage her stress response with simple breathing practices, she could also feel increased energy returning. We worked together for several weeks until she felt she could continue to practise independently, with occasional review of her treatment program.
Scoliosis
Melanie was concerned about a scoliosis (a curve between her thoracic and cervical spine) that was causing her much back and neck pain. She resolved to learn to address the problem herself, so as not to become completely dependent on chiropractic treatment.
A yoga practice was developed to teach her to balance the misalignment in her spine. At first she found that her mind was too distracted and performance-oriented, but she persisted with the practice and was happy with the benefits. As Melanie became more physically comfortable she grew more open about emotional issues that were causing her a lot of angst. We developed a nurturing meditation practice to address what she described as fear and hysteria. She was very happy with becoming able to manage her emotions and use awareness of her own breath to calm herself. On a subsequent visit, Melanie wanted to address her inability to maintain focus in her work. We developed a meditation practice that was aimed at developing concentration and training the mind.
After a few weeks of practice Melanie was very happy with the positive results and the confidence she was developing from being able to control her mind and emotions. She was also able to reduce the imbalance caused by the scoliosis.
Emphysema
Malcolm is a 58-year-old with advanced emphysema, a condition that cannot be reversed. His physical activity had been limited for several years because of restrictions to his breathing. His physician and physiotherapist had advised him to exercise but had given him no instruction on breathing techniques.
A simple stress-reducing yoga practice that trained Malcolm to focus on developing a smooth and long exhaling breath was developed. This automatically increased his inhalation capacity. After each 15-minute practice he would experience renewed energy and mental clarity. Furthermore, Malcolm claims that during a severe respiratory episode for which he had to be hospitalised these exercises saved him from undergoing invasive treatment, as he was able to recall the breathing technique he had learnt and thereby restore his breathing.
The efficiency of Malcolm’s breathing has been greatly increased by working with the primary muscles of breathing (intercostal and diaphragm) through simple stretching yoga postures combined with smooth breathing. Malcolm has also benefited enormously from meditation practice and the chanting of mantras to calm his nervous system. These have also helped him address the emotional issues pressed by his chronic illness. While such practices cannot reverse Malcolm’s condition, they have been effective in increasing his quality of life.
Therapist qualifications
With yoga therapy becoming more widely accepted as a complementary therapeutic modality, training standards for yoga teachers and yoga therapists are being developed to ensure that medical practitioners can confidently refer patients to qualified yoga teachers and therapists. This process has been completed in the US and the UK and is currently underway in Australia. Many tertiary and adult education colleges now offer accredited training diplomas for yoga teachers.
* Names have been changed to protect confidentiality.
Karen Schaefer is a yoga therapist in Sydney. She conducts the Diploma of Health (Yoga), an accredited training course for yoga teachers and therapists, at Nature Care College, Sydney.
See also the articles ‘Yoga for Asthma’ (WellBeing #79) and ‘Meditation’ (WellBeing #82).
