Yoga Therapy as a Whole-Person Approach to Health. Lee Majewski
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of medicine. Health is understood to be the balanced harmony of the three humors in accordance with individual predisposition, while disease results from an imbalanced disharmony. The Tirumandiram of Tirumoolar, the 3000-versed Tamil treatise by the Dravidian saint, prescribes the practice of yoga at different times of the day to relieve disorders arising from these imbalances. According to him, the practice of yoga at dusk relieves mucous, phlegmatic (kapha) disorders, practice at noon relieves gaseous, movement-based (vata) disorders, and practice in the morning relieves acidic, bilious (pitta) disorders.
According to the Bhagavad Gita,2 yoga is defined as the disassociation from our tendency to attach to our suffering, pain, and illness (dukkhasamyogaviyogam yoga samjnitham; Bhagavad Gita VI:23). People with health conditions often tend to identify themselves with that condition and as a patient of that condition. This results in statements such as, “I am a diabetic” or “I am a hypertensive.” In some cases this actually becomes a very strong identification and they claim ownership of that condition with statements such as, “My diabetes,” “My hypertension,” or “My cancer.” Unless this mal-identification with their diseased state is broken, it becomes very difficult to actually bring about a “cure” for the individual.
One of the foremost concepts of yoga therapy is that the mind (adhi) influences the body, thus creating disease (vyadhi). This is the basis of psychosomatics and mind–body medicine, and is termed adhi vyadhi or adhija vyadhi, where the mind causes the disease in the physical body. In modern language, this is also termed psychoneuroimmunology, as modern health systems have started to realize that how we think and feel can positively or negatively influence our nervous, endocrine, and immune responses. One path leads to health while the other leads to disease and suffering.
Virtually every health problem that we face today either has its origin in psychosomatics or is worsened by the psychosomatic aspect of the disease. The mind and the body seem to be continuously fighting each other. What the mind wants, the body won’t do, and what the body wants, the mind won’t do. This creates a dichotomy, a disharmony, in other words, a disease. Yoga helps restore balance and equilibrium by virtue of the internal process of unifying the mind, body, and emotions. The psychosomatic stress disorders that are so prevalent in today’s world can be prevented, controlled, and possibly even cured via the sincere and dedicated application of yoga as a therapy.
The yogic concept of health and disease enables us to understand that the cause of physical disorders stems from the seed in the mind and beyond. The disturbed mind (adhi) is the primary root cause while the physical disease (vyadhi) is only the final manifest effect in yogic philosophy. By paying careful attention to personal history, the origins of psychosomatic disease can nearly always be traced back to patterns of mental and emotional distress.
According to yogic thought, all diseases start not with the body, but from blockages in our subtler energy systems. All disturbances start at the psychic level beyond the mind (the psyche in Indian thought goes all the way up to the sense of Self), come down through a disturbed mind, and then manifest in the subtle energy channels (prananadi), and finally settle in the physical body. Therefore, the five-layered model of existence (pancha kosha or pancha maya) is one of the ancient Indian models that helps us to look for a root cause of the manifest problem or disease.
The five koshas
Anandamaya kosha
The pancha kosha model considers the human being to exist on multiple levels at the same time. According to this system of thought, the human being emerges out of “oneness,” forming a sense of self-identity, just like the drop comes out of the ocean and has its outer membrane (anandamaya kosha). Each of the subsequent layers of existence (koshas) then represents the next level of separation, and their energy and vibration slows down and becomes grosser (see below). Note that in the figure below, although each kosha is represented by a separate circle, they are inseparable and completely interdependent, as they all exist at the same place at the same time. If we change something in one kosha, all other koshas also respond to that change.
The five koshas
Vijnamaya kosha
Our wisdom, the non-judgmental witness, and our intellect manifest through the vijnamaya kosha. As this is a part of conscience in our higher mind, this kosha is responsible for discerning between good and bad, making us the master of our basic instincts, which lie in manomaya kosha. This kosha also represents the chemical activity at the cellular level of various organs in the body and maintains the optimum level of ingredients at tissue and blood level, that is, homeostasis.
Manomaya kosha
This is the energy of the basic mind (our core belief system, our conscious mind), and it is of denser energy. Our mind is what we think, feel, and express from our thoughts and impressions. The mind is working according to the signals it receives from the outside environment through the five sense organs. As the smell of a perfume that we recognize will give rise to a memory that reminds us of a person or an occasion, this memory will create emotions that get expressed in our gross body, such as happiness or dislike. In this way the mind has a great influence on our lower and denser pranamaya kosha and annamaya kosha, as the emotions that rise affect and change our normal breathing pattern and heart rate.
If such an emotional state continues over a long time, we will see vigorous affects in the annamaya kosha (gross body), initially as pain, and later on as more serious diseases. Here, the interstitial tissue fluid performs the important function of receiving an impulse from the brain and taking it from the cell to the sensory cortex. These strong affects of our mind through thoughts and emotions are the reason that we need to give importance to control and direct the movement of the mind towards the things that keep us balanced and healthy. As described by Patanjali, our identification with the mind and its movements is the cause of our suffering in life, and he describes how to overcome our miseries with the help of yoga. For many people, the claim that we are not the mind and that we can, in fact, manage our mind, is revolutionary.
Pranamaya kosha
The pranic kosha, the vital energy body, which is of even denser energy, engulfs our physical body—annamaya kosha. The prana is the life energy that stays in and around the annamaya kosha as long as the body is alive. It flows through the nadis (channels used for the prana to move within) to each and every cell in the body according to its needs. It will change the direction and quantity of flow according to the need—when we are running, we need more energy in the legs and lungs, and after eating food, we need more energy in the digestive system. If the prana does not move in its right direction or there are some blockages in its flow, we will experience it as a pain or disease in the annamaya kosha (physical body).
Annamaya kosha
The word anna indicates nourishing substances that enable survival at the physical level. Gross matter is something we can experience, see, and feel with our five senses. Our body is made out of cells, different tissues, bones, and muscles, and all of these need to be taken care of with a supply of energy and nutrients through eating, digestion, movements or exercise, cleansing, and giving the body rest. On this level we give importance to what is described in the texts about cleanliness of our body from inside and outside, eating appropriately, using our muscles in a good way, and having proper rest and sleep.
From the yogic viewpoint of disease, psychosomatic, stress-related disorders appear to progress through four distinct phases. These can be understood as follows:3
• Psychic: This phase is marked by mild but persistent psychological and behavioral symptoms of stress such as irritability, disturbed sleep, and other minor symptoms. It can be correlated with the intellectual (vijnamaya) and psychological (manomaya) aspects of one’s existence, and yoga as a therapy can be very effective in this phase.
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