Yoga Therapy as a Whole-Person Approach to Health. Lee Majewski
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not able to prevent the dilution of the tradition. The spiritual component of practice became very weak and the emphasis of yoga became more aligned with getting fit and the body image-conscious middle-class Westerners. It’s enough to see yoga depicted in printed media to understand this. (To break this pattern, we have included pictures of asanas performed by a 69-year-old female in what follows!)
When we hear someone saying, “I have a yoga class today,” we tend to see in our minds a studio with yoga mats and people doing all kinds of different poses. The common understanding of “yoga” nowadays, in the West and in some parts of India, seems to have been reduced to an exercise practice with perhaps some controlled breathing. Even meditation is usually mentioned separately from yoga or in addition to yoga.
This general reductionist misconception of what yoga is, paired with mistaking spirituality for religion, creates much confusion in yoga practitioners. Even some yoga therapists seem to think that spirituality is beyond the scope of yoga and yoga therapy. It seems that even we, practitioners, yoga teachers, and therapists, cannot agree on this subject. This was the question an anthropologist, Caroline Nizard, tried to answer in her paper titled “Is Yoga a Spiritual Path?” during the recent Annual Conference of the European Association for the Study of Religions (EASR) in June 2018 in Bern, Switzerland.35
In her fieldwork through 2013–2017, Nizard gathered the accounts of 56 long-term yoga practitioners of mixed religions (including some agnostics) from France, India, and Switzerland. She found no significant difference between cultural identities in the practitioners’ understanding of yoga, but she did find significant differences in their relation to the spirituality of yoga, although all participated in the same practices. So even we, as professionals, cannot agree on what yoga is offering us.
An interesting study from Smith and colleagues36 looked at the different effects of an asana-only yoga class and more comprehensive yoga practice (including ethical and spiritual components). Eighty-one students over the age of 18 at one university in the US participated in the study, and over time participants in both studies showed a decrease in depression and stress and an increase in a sense of hopefulness compared with the control group. However, only the comprehensive yoga group experienced a decrease in anxiety-related symptoms and decreased salivary cortisol from the beginning to the end of the study.
In other words, the spiritual component in the yoga protocol created additional and measurable healing value. This is in line with Daaleman et al.’s study on a geriatric population quoted earlier, in which spirituality increased the positive effect on health.37 The importance and additional benefit of the spiritual component in the yoga protocol has been confirmed in the latest meta-analysis from the Mayo Clinic.38 It concluded that yoga is a viable anti-hypertensive lifestyle therapy and produces the greatest blood pressure benefits when breathing techniques and meditation or mental relaxation are included.
This also correlates with research presented in Radical Remission in which Kelly Turner quotes two factors each in the physical, emotional, and mental domains.39 But in the spiritual domain she lists three factors that are needed for radical healing: deepening spiritual connection, having a purpose in life, and embracing social support. Thus the significance of the spiritual component, as stressed by Turner, becomes vitally important in the process of healing. It is also in line with pancha koshas—the Ayurvedic model of the multilevels of human existence—that healing is most effective when it includes the spiritual factor (anandamaya kosha).
But can yoga therapy create spiritual transformation?
A recently published ethnographic study40 asked, “Is yoga a possible vehicle for experiencing transcendence?” In Catalonia, Spain, in 2011, a yoga non-governmental organization (NGO) and the Department of Justice signed an agreement that opened the door for yoga classes and intensive courses for all Catalonian inmates. The research project was designed as a multiple case study at a number of prisons. A total of 54 inmates, male and female, engaged in intensive daily yoga practices for 2 to 3 hours over a 40-day period. Most of the participants who volunteered for the study already practiced yoga in weekly classes.
When the inmates were asked what they valued most about doing yoga, the majority referred to the possibility of transcending their constrained “here-and-now.” They described feelings of “connectedness,” “self-awareness,” and “flow.” Smith postulates that “encountering oneself” is the key component in such spiritual experience. This encounter with the “embodied self” brings about a moment in asana practice that practitioners identify as “spiritual.”41 Such acts of transcendence, singular to yoga, were seen as the most appreciated component of practicing yoga in prison.
Griera, however, mentions one more important factor—the social and intersubjective character of transcendence experiences.42 She noticed the importance of the group in favoring and sustaining the shift to another reality. That “collective energy” became a decisive factor for experiencing transcendence or, as the inmates describe it, “really doing Yoga.” “Yoga connects me with my divinity,” reports the practicing inmate. “Years ago I used to do drugs…and with yoga I have felt similar sensations… However, this comes from inside of me, comes from my own serenity and I feel happy with myself.” Based on the outcomes, Griera suggests that yoga is not only physical work but also, in some cases, a doorway to spiritual knowledge. For some inmates the practice of yoga can even be the starting point for a spiritual journey.
The importance of the group setting and intensity of practice was also stressed in another study that compared members of a yoga ashram with another group of non-ashram residents (the control group).43 The ashramites showed a higher percentage of positive responses on a number of factors, including “felt personality change,” “experience resulted in change in life,” “experience of oneness,” and being “in touch with divine or spiritual.”
Likewise, a study of yoga interventions in cancer patients reported improvements in measures of spirituality relative to the control group. In particular, the meaning or peace component of spiritual wellbeing increased within 10 weeks in the yoga groups.44, 45
More probing questions regarding intensive yoga practices and spirituality were asked in a study by Büssing et al.46—such as, what specific aspects of spirituality did yoga help to develop? The researchers looked at 160 students who had signed up for two years of yoga teacher training. They measured conscious interaction, compassion, lightheartedness, and mindfulness. The intensive yoga practice significantly increased these specific aspects of the practitioners’ spirituality, but the changes were dependent on their original spiritual self-perception. In other words, the intensity of change was dependent on the practitioners and their attitudes towards spirituality.
We see this confirmed at our retreats—Beyond Cancer and Chronic Solutions. Both incorporate six hours of yoga practice daily for 21 days. The protocol includes meditation, yoga nidra, chanting, mantras, mudras, pranayama, and asanas, and lectures on how these practices affect the body and mind (with an informal introduction to basic philosophy during lectures). Such intensity often produces dramatic and lasting transformations in the participants’ lives, when they are ready.
With time we noticed that the deeper the spiritual transformation in the client during the three-week retreat, the more profound the healing was on many levels—physical, emotional, mental, and spiritual. One of the traits we noticed in retreat participants was the existence of a deep, often unconscious, negative emotion that was hidden and had not been dealt with in the past. Commonly this was anger or hurt or some kind of emotional pain.
Practicing