Yoga Therapy as a Whole-Person Approach to Health. Lee Majewski
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Shifting from individuality to universality
Yoga, which emphasizes the universal, is a perfect foil to those human activities that glorify the personal experience. The process of yoga therapy helps the individual to shift from an “I”-centric approach to a “we”-centric approach. Transformation from “I-ness” to “we-ness” is the core of spiritual healing.
The Bhagavad Gita says, “Yoga is skill in action” (2:50). The real yogi is conscious and aware at the physical, mental, and emotional levels of their being. They gain great control over all aspects of life, thus developing a real skill in living. They realize that their duty is to do their best, but that the ultimate result is not in their hands. The yogi performs the needed action not for the sake of the fruits of that action, but because it is good and necessary to do so for everyone’s benefit.
This belies the Western belief that the competitive spirit produces the highest skill. To this the yogic answer is: detachment from the fruits of the action produces the greatest efficiency. The beauty of yoga is that these abstract principles become concrete in the daily practice of the techniques available in the yoga system. Once the client practices yoga with discipline and consistency, these concepts grow naturally, slowly but surely taking root in all aspects of the client’s life.
“Yogopathy”21 vs. yoga therapy
We are part of the “instant” culture. We are used to instant food and instant solutions. These are attitudes we have grown up with in our life—as yoga teachers, yoga therapists, and clients. When we go to the doctor we are focused on solving physical problems with medicine—we then get medication that suppresses the symptoms and allows us to go on living the lifestyle that caused the problem in the first place. When we go to a therapist our focus is on fixing our mental or psychological problems through different techniques, so that we can feel better without changing anything. Our focus is on the problem, on the illness—this lies at the heart of pathogenesis. In pathogenesis we want to know what can we do to avoid the problem or cure the symptoms. Our stance is reactive—we only act when there is a manifestation of the problem. Most of us do not think of our health when there is no pain or loss. This is the majority of people’s state of awareness.
The word “-pathy” is the postfix to stress “feeling” or “suffering,” and is used in words such as antipathy or sympathy. In modern language it is often used with the meaning of morbid affection or disease, such as neuropathy, psychopathy, or arthropathy, and hence it is also used in the names of systems of treating disease symptoms—allopathy, homeopathy, hydropathy, osteopathy.22 Yogopathy describes the use of yogic techniques in treating the symptoms of the disease. It is based on pathogenesis, focusing on dealing with symptoms.
Modern yoga therapy’s focus on the physical symptoms can be useful at times. If facilitated skillfully, the client will experience to a certain degree the transformative power of yoga. This can be a stepping stone to motivate the client to accept more encompassing applications of yoga therapy, rather than simply recommending yogic techniques following the philosophy of “a pill for every ill.”
Managing and suppressing the manifested symptoms with yoga techniques is just as good or bad as modern allopathic medicine managing symptoms with pharmaceuticals. In such cases the focus is primarily on symptomatic management without ever getting close to the “real” cause of the disorder. How many doctors look at the emotional and psychological issues that are the primary cause of the problem in so many of their patients? The concept of psychosomatics in modern medicine is no older than a hundred years and few doctors think about how the mind induces disease in the body.
When today we find our yoga therapists making the same mistake in merely treating manifesting symptoms without remedying the “real” cause, Dr Bhavanani prefers to call this yogopathy! It may be useful in some cases, but it misses the true strength of yoga therapy—the opportunity to address the root cause of the problem.
An example of this yogopathy trend is when we use shavasana (Corpse Pose) to manage patients with hypertension, quoting research that has shown that it reduces blood pressure. We seem happy just to bring the blood pressure down for the time being! The transformative yoga therapy would first assess the primary cause of the patient’s hypertension. Based on such an assessment, it would recommend multilevel solutions suitable for this particular client, choosing from lifestyle changes, and yogic techniques to move and cleanse the body and manage the mind and thought processes, for the client to practice over time. Without an attempt to find and deal with the root cause, it remains merely yogopathy.
Another common example is using left nostril (chandra nadi) pranayama to lower blood sugar or right nostril (surya nadi) pranayama to relieve bronchospasm without looking for the real cause of the patient’s diabetes or asthma. When we do this, how are we any different from the modern doctors who prescribe anti-diabetic and sympathomimetic agents for these patients? Where is the true potential of yoga therapy in this type of approach? Where is the effort to find and deal with the primary cause? Without a transformation of attitude or lifestyle, can it be yoga therapy?
Sometimes inexperienced yoga therapists are so taken by the available tools—from asanas, pranayama, chanting, meditation, mudras, etc.—that they lose the view of the person in front of them and get lost in choosing the best “option for the given disease/or symptom.” This was very apparent in my discussions with yoga therapy students where I had to repeatedly steer them towards the client as a person rather than the condition the client suffered from.
If we want to use the transformative potential of yoga therapy, we need to shift our paradigm from a focus on disease to health promotion, from pathogenesis to salutogenesis. Salus (Latin) means health and genesis (Greek) means source, hence salutogenesis means the source of health. In order to move our habitual pathogenic orientation as yoga teachers, therapists, and at the same time as clients, to a salutogenic orientation, we need awareness to change:
• The goal, from better medical intervention to improvement of our natural and created environment.
• Focus, from curing chronic disease to client ownership, to act in a way helps cause health.
• Norms, from paternalism and entitlement, to empowering clients to cultivate health.
• Orientation, from fixing parts of the system, to healing by bringing all systems into harmonious coherence.
According to Antonovsky,23 at the heart of salutogenesis lies a sense of coherence (SOC), “a pervasive, long lasting and dynamic feeling of confidence” that:
• One’s internal and external environments are predictable.
• There is a high probability that things will work out as well as can be expected.
SOC has a strong positive correlation to perceived physical and mental health and quality of life. It has three main components:
• Cognition—“my world is understandable.”
• Coping skills—“my world is manageable.”
• Motivation—“my world has meaning.”
Salutogenesis, as the health-promoting approach, lies at the core of yoga therapy. When we do an initial assessment of the client, we focus on multilevel functioning in harmony. We identify disharmony at each level of functioning (according to pancha kosha, doshas, gunas, and vayus), and create a protocol specific to this client’s goals to help them move from disharmony to harmony, from disease to health. Together with the client we keep evaluating the progress towards reaching their potential. We facilitate a proactive stance in the client—where they take ownership and responsibility to move forward to grow on a wellness continuum. This helps the client to discover how to live fully.
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