Yoga Therapy as a Whole-Person Approach to Health. Lee Majewski
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the importance of the spiritual component in healing.47 In recent years, we have seen the emergence of tools for spiritual assessment, such as the FICA-Spiritual History Tool or HOPE-Questions for Spiritual Assessment.48 For those who are connected to religion, spiritual guidance is accessible through the chaplaincies available in many hospitals or through churches. However, those who are not connected to any particular religion usually have no means to improve their spiritual health as part of healing. Yoga therapy’s capacity to influence spiritual well-being presents a unique opportunity to offer the solution within a medical setting, where there is none offered to non-believing patients at the moment.
This data also points to the importance of a few other factors:
• The extended length and intensity of yogic practices seems to create more profound spiritual shifts.
• The social and intersubjective character of transcendental experience—the collective energy of the group—is helpful in creating and sustaining these shifts.
• The changes depend on the individual’s spiritual self-perception.
• It is necessary to revive spirituality in yoga by reinforcing the spiritual component of yogic practices such as yamas and niyamas, chanting, yoga nidra, use of mudras and bandhas, meditation, and understanding philosophy through yoga courses and discussions.
The ancient yogi knew that the intensity of practice over time speeds up the goal of furthering the development of the student. The gurukul system was based on the student or disciple staying with the guru for longer periods of time, with daily spiritual discipline and study, as per the guru’s direction. Today, only a few ashrams are left to fill this role, places where you can immerse yourself in longer intensive yogic practices. The role of the guru, however, became less accepted after revelation of the many power and sexual abuses around even the most respected names.
“The reason Yoga therapy is so effective in both preventive medicine and in assisting conventional treatment methods is because Yoga addresses all three aspects of wellness—physical, mental and spiritual.”49 This sums up the opinion of serious practitioners and students of yoga—yoga encompasses the art of self-realization, self-transformation, and self-healing.
Patanjali compiled the tools for such profound transformation in 300 CE in what is called “Ashtanga Yoga,”50 or the eight limbs of yoga. This first, most translated and commented-on classic Indian text, which organized and synthesized yoga—Patanjali’s Yoga Sutras Darshana—provides the roadmap to healing and spiritual transformation. The collection of 196 short aphorisms outlines the tools and results of practicing them, of which spiritual transformation is at the core. The Sutras clearly explain the process and practical methods of raising levels of awareness, gaining deeper wisdom, exploring the potential of the mind, and eventually going beyond the mind. If this is not spirituality, then I do not know what is… Sadly this has sometimes either been either ignored or misunderstood by the growing population of contemporary young yoga teachers and yoga therapists.
It seems that we have been so taken in the West by our need to be forever young and to have perfect-shaped bodies that the body postures (asanas) have completely dominated our understanding of yoga and anything else has fallen off the radar. Yet in Patanjali’s Yoga Sutras only 3 out of the 196 Sutras deal with postures! Even the majority of research tends to be focused on the biomedical effects on the body, which excludes the much wider impact of yoga on human existence. With once- or twice-a-week asana classes, the deep transformative value of yogic science and the promise of spiritual transformation eludes us.
But new voices are beginning to point back to the richness of the ancient science. In their 2015 book, The Eight Limbs of Yoga: A Handbook for Living Yoga Philosophy, Stuart Sarbacker and Kevin Kimple point to the “great potential for self-transformation through Yoga” and its capacity “to transform one’s relationship with others and the world in profound ways.”51 As Michael Lee mentions in his recent article, “The gold nugget of Yoga therapy—its capacity to be a catalyst for meaningful and lasting transformational change—remains largely hidden.”52
We hope that the future can be changed in a positive way, and the maturing of professional organizations such as the IAYT in the US, Japan Yoga Therapy Society, or Yoga Australia can be the catalyst we need. These organizations must work towards the creation of a healthy and wholesome image of yoga and yoga therapy. Only by educating members as well as the public about the true essence of yoga and yoga therapy can we do this.
CHAPTER 4
Yogic Tools for Assessment and Health Evaluation
Yoga has its own traditional and cultural system of assessment, diagnosis, and health evaluation. However, as it does not seem to have a “standardized tool,” many in yoga therapy practice claim (mistakenly) that it doesn’t have its own system. This misconception often fosters an unhealthy dependency on the modern medical diagnosis alone. We need to be clear that we cannot move out of our scope of practice (SoP) and “borrow” assessment tools from other professions, and furthermore, it will not be correct to create therapeutic yogic plans based on the results of such borrowed assessment tools. It follows that both the assessment and therapeutic plan should be based on knowledge from the ancient texts, and should, as far as possible, merge together seamlessly.
The development of these yoga therapy tools for clinical assessment is, as we speak, a work in progress worldwide. What we can do today, however, is set the standards for assessment tools in the field of yoga therapy. We can show examples of this work in progress. We can encourage others to read the ancient texts and then find ways to bring this knowledge into the modern-day clinical setting. Perhaps at the end we will not be limited to one standard assessment tool. Perhaps there will be as many tools developed as the situations and environments in which the assessment takes place. Nevertheless, we need to be aware of the standards and frameworks of yoga therapy in order to create adequate tools.
Need for yogic assessment tools
Yoga therapy must never be limited to a mere treatment of an externalized diagnosis or to symptoms. Hence, it is imperative we have tools to “tailor make” individualized protocols or modules, that take into account a thorough search for the “root cause” of the disease and then try to find a way out of it with awareness.
It is also important that an attempt be made to help the client understand and accept the root cause of their problem and further familiarize themselves with factors causing, aggravating, or mitigating it. Self-awareness of the client is often the only way to prevent worsening of the condition and its relapse, and to facilitate self-reliant conscious measures towards the adoption of a healthier lifestyle by the client.
Of course, the inference drawn from such a detailed yogic analysis can assist us in forming a baseline for pre-treatment and post-treatment comparisons. This also acts as a reference to assess progress in therapy at various points of time in order to make modifications or advancements accordingly.
Framework of yoga therapy
The often-quoted traditional basic framework for the application of yoga as therapy is usually based on a derivative of the teachings of Maharishi Patanjali as codified through his Yoga Sutras.1 Verses 16 to 26 of the second chapter (“Sadhana Pada”) elaborate the concept of addressing the problem, finding its cause, and then applying the therapeutic remedy (the goal of therapy) through use of appropriate tools (heya-hetu and hana-upaya).
• The first and foremost step in this comprehensive template of yoga therapy is to try and understand as completely as possible the nature of the problem/issue/challenge/manifest suffering (heya). It is important to focus on how long the problem has been in existence,