Yoga Therapy as a Whole-Person Approach to Health. Lee Majewski
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(upekshanam), and so on. Conscious adoption of the right attitude towards the situation, person, place, and/or event is one of the most important aspects of yoga as a therapy. If this is not done, we practice yogopathy, and not yoga therapy.
Mental therapies
There are a great many useful techniques of relaxation and visualization, and these are found in the higher introspective aspects of Jnana and Raja Yoga10 as well as yoga nidra. There are also practices such as concentrated gaze (trataka).
Spiritual therapies
Scriptural study and self-introspection (swadhyaya), spiritual community seeking knowledge of the reality (satsangha), devotional singing (bhajana), and chanting sessions and yogic counseling are important aspects of yogic therapy that are often neglected in favor of physical therapies alone. These are described in more detail in a separate chapter dedicated to yoga therapy and spirituality (Chapter 3).
The correct use of these modalities according to the condition and needs of clients can enable us to strike at the root cause of the disease. If this is done properly and early enough in the process of disease, the manifestation of the disorder can correct itself, and health and harmony can manifest once again.
Managing the breath
The vital life force acts as a catalyst in all our activities, and yoga, through the enhancement of this energy, attempts to help achieve optimal health and healing. Pranayama may thus be defined as the art and science of controlled, conscious expansion of such vital energy through managing the breath. Masters of ancient (Vedic) times placed great importance on pranayama and advocated its practice in order to unleash the inner potential energy (kundalini). Indian culture lays great emphasis on prana and pranayama—ancient Vedic literature says, “God is breath” as well as “Breath is life and life is breath.”11 Atharvana Veda even goes on to state, “prana is the fundamental basis of whatever is, was and will be.”
In the Prasnopanishad we can find the following statement: “All that exists in all the three worlds is under the governance of prana.” It is said in the Shiva Swarodaya, “The life force (prana) verily is one’s greatest friend, companion and there is no greater kinsman than the life force.”12 In the Yoga Vashista, sage Vashistha says that when the energy of the life force (prana) is restricted, then the mind dissolves, like a shadow of a thing when the thing is absent.13
In the Hatha Yoga Pradipika, Yogi Swatmarama says, “When respiration is disturbed, the mind gets disturbed. When breath is steady and undisturbed, mind is also steady and undisturbed. By consciously controlling respiration, the Yogi attains steadiness of mind” (II:2).14 He also says, “Mind is the master of the senses, while the breath is its Lord. Mastery of the breath lies in its absorption that depends on conscious vibrations induced during smooth, steady inhalation and exhalation” (IV:29). He lists the important breath-based energy practices (kumbhaka) such as skull shining breath (kapalbhati), sun-cleaving breath (surya bhedana), victorious breath (ujjayi), hissing breath (sitkari), beak tongue breath (sitali), bellows breath (bhastrika), and bee-sounding breath (bhramari), among others.15 He also warns us that, although pranayama can eradicate all diseases, it may cause a multitude of problems if performed improperly (II:16).
According to the Hatha Yoga Pradipika, when the nerves are purified by pranayama, the body becomes slender and lustrous, gastric fire increases, inner sounds are heard, and excellent health is attained. Chapter II, verses 36–68 describe the benefits of each pranayama:
• Kapalbhati balances kapha, stimulates blood circulation, slows peristaltic movement, and improves digestion.
• Surya bhedana cures vata disorders, purifies the sinuses and blood, removes parasites, and rejuvenates cells.
• Ujjayi is said to remove the disorders of phlegm and structural elements (dhatus), increases stamina and agility, and alleviates nerve disorders, stress, and depression.
• Sitkari alleviates hunger, thirst, the need for sleep, or lassitude.
• Sitali balances pitta, relieves colic, spleen disorders, fever, tumors, and bile disorders, and neutralizes even the most dangerous of poisons.
• Bhastrika balances all three doshas (vata, pitta, kapha), pierces three granthis, has the capacity to cure phlegm, bile, and gas disorders, infuses vigor, stamina, and alertness, improves memory, removes depression, and helps increase the gastric fire.16
The practice of pranayama helps to regulate our emotions and stabilize the mind, which is said to be as restless as a “drunken monkey stung by a scorpion.” Emotions and breath are known to have a deep relationship. When we get angry, we can experience that our breathing becomes rapid, and it is slower when we are cool and relaxed. Thus the slow, rhythmic, and controlled breathing in pranayama leads to the emotional control seen in dedicated yoga practitioners. Conscious, deep, and regular breathing can synchronize and reinforce inherent cardiovascular rhythms and modify baroreflex sensitivity, which may be attained by practicing ujjayi and pranava.17 The sound-based vibrational breaths (pranava and bhramari18) enable the manifestation of an inner harmony that results in the attainment of a state of mental calmness.
According to Dr Swami Gitananda Giri, the inherent message of pranayama can be summarized as follows: “There is an absolute and direct correlation between the way the man breathes and his energy level, the length of his lifespan, the clarity and subtlety of the thoughts, and the quality of the emotions.”19
Deep, slow breathing is economical20
Many novices have a false notion before they begin pranayama as they think that slowing down the breath will limit the air they take in, and hence reduce the amount of gaseous exchange! This is, however, totally wrong as in fact we increase the efficiency of gaseous exchange by enhancing ventilation during deep breathing. The table below illustrates this concept, that shallow breathing makes us work a lot (30 breaths/minute) for very little (1500 ml volume of gas exchange) while slow, deep breathing gives us 40 percent more alveolar ventilation (5100 ml with just 6 breaths/minute). We must also remember that pranayama is concerned with much more than just alveolar ventilation; it also deals with the enhancement of subtle energies that will be proportionately enhanced by such slow and deep conscious breathing.
| Normal | Shallow | Deep | |
| Volume (ml) | 500 | 200 | 1000 |
| Rate (/minute) | 12 | 30 | 6 |
| Ventilation (ml) | 6000 | 6000 | 6000 |
| Dead space (ml) | 150 | 150 | 150 |
| Dead space volume (ml) | 1800 | 4500 | 900 |