Yoga and Yoga Therapy

In the fall of 2016 I had the honor of participating in the Ghosh Yoga College of India Yoga Therapy training. It was a three week training in Calcutta by the granddaughter of Bhisnu Ghosh. It was an honor and a privilege to be there. It held a great historical and significant reference for me who has practiced Bikram yoga for so long. I am happy to provide consultations and private sessions.

Yoga Therapy, isn’t all yoga, therapy?

Yes but Yoga therapy is a genre of yoga, According to Yoga Journal: “Yoga therapy utilizes poses, breathing techniques, and meditation to benefit and improve overall health.”

Generally the idea is to have a holistic approach to well-being where yoga postures are used in tandem with other exercises (especial ones found in Physical therapy). The main difference being that in Yoga therapy, in contrast to just physical thereapy, we use the philosophical and holistic approaches of Yogaic Philosophy working the mind, the body and the spirit aimed toward an individual. Moreover, instead of being taught in the context of modern postural yoga in a group setting, Yoga Therapy is a case by case, individual approach.

Although the name uses “Therapy” in the title, the idea is that it is a compliment to any medical treatment that one follows or any physical therapy, Not as a replacement. Yoga Therapists are not doctors, and can not diagnose.
Yoga Therapy isn’t a cure,Yoga Therapists are not curing and healing, that is the job for the doctors. But what we are doing is providing yoga postures in an individual case, based on experiential data coming from decades of teaching yoga and the associated conditions yoga may help to ameliorate. Again to be clear it isn’t intended to replace a treatment and one should continue treatments as prescribe by a licensed heath practitioner.

The International Association of Yoga Therapist (IAYT)

The International Association of Yoga Therapist is an organization “committed to advancing yoga therapy education, training, and research, and the professional development of its members.” They have the official statement as follows:

“Yoga therapy is already being practiced as a complementary or adjunctive profession, and the general public is already making use of yoga therapy for health promotion, prevention and risk reduction for common lifestyle-related disorders. Even an entity as large and mainstream as the U.S. Department of Veterans Affairs is integrating yoga therapy into the services it offers. Given the current health care landscape, IAYT is responding responsibly and proactively by taking steps to protect the public, the profession and individual practitioners by creating a self-regulatory structure with real substance. It’s no longer a matter of whether the profession needs to responsibly and proactively regulate itself, but rather a matter of how soon and via which organization.”

While the IAYT organization is forward thinking and trying to create standards, as of today, it is still in the works and hardly a standardized method based on enough pier review to validate it as a healing science. But they are certainly moving in the direction of making all strides to get there. Today they are offering certificates in yoga therapy.

The Controversy

Yoga Alliance

The term Yoga Therapy has sparked some controversy within the yoga community and specifically Yoga Alliance. They claim that “the terms ‘yoga therapy,’ ‘yoga therapist,’ ‘therapeutic yoga’ and similar terms suggest that the yoga instructor can diagnose and/or treat a mental or physical health condition. They also state that practicing medicine is highly regulated and there have been many cases of individuals, who have been charged with practicing medicine without a license. And although they state that there aren’t many cases involving yoga teachers the is an increases risk if we use terms such as ‘therapy’.
This is because the term “Therapist” in most people’s minds implies a significant degree of training and certification and some medical training to diagnose, treat or cure specific mental or physical health conditions. Yoga is currently not regulated by any government agency. So until things get more cleared up, if you have or use Yoga Alliance credentials then you can not use the term in association with their organization.

The New York Times

The controversy over yoga wasn’t even specific to the yoga therapy community but to yoga at large. An article in the New York times titled How Yoga Can Wreck Your Body. WILLIAM J. BROAD, promoting his book The Science of Yoga: The Risks and the Rewards. Discussed many of the Valid concerns about wonders of modern postural yoga and the dangers hidden in yoga postures. He created a big storm in the yoga teaching community which is expresses so comically in the meme here.

yoga meme

In his book, he outlines many of the Myths in yoga, such as one big one on the breathing exercises thought to oxygenate the blood system. He demonstrates the myth of this in his extensive research in his book. When in fact, the fast breathing exercises (like Bhastrika and Kapalabhati) deprive the lungs of carbon-dyoxide and the body creates the balance by lowering the oxygen levels in the blood (and consequently in the brain) resulting in a lowering of the oxygen levels in the blood system. These myths are for the large part, disseminated and reinforced because of references to articles that were misguided in the first place. Broad goes on to speak to the evidence that there are cases where yoga postures may have very negative consequences such as head stand sand shoulder stand. Yet at the same time he also talked about their benefits.

This is not to say that there is no validity in the healing powers of yoga. Bond gave us an example of someone with the best candidate to have the ability to both prescribe medicine and yoga – Dr. Loren Fishman who wrote the book Relief Is in the Stretch: End Back Pain Through Yoga Prescribed. He is a world-recognized pioneer in the treatment of piriformis syndrome and rotator cuff tear and an expert in curing back pain. “A Thomas Edison of yoga therapy,” according to Pulitzer-Prize winning author William Broad, Dr. Fishman has done peer-reviewed clinical research on yoga and osteoporosis, scoliosis, and rotator cuff tear. He has integrated yoga into his medical practice for decades. Dr. Fishman received a degree in philosophy from Oxford University. Then he studied yoga in India with BKS Iyengar.

Today Dr. Fishman is treating patients From his Doctor’s office in NYC where he initially intended using yoga exercises as part of the treatment. He prescribes a lot of yoga now along side his treatment. He has an advantage over most yoga therapists because he can use modern medicine diagnostic tools to pinpoint the problem, ( I too would love to be able to see the postures in and MRI and with X-rays) most yoga therapist don’t have the training and equipment to do. This advantage helps him come up with yogic remedies. (See Foot note 3)

Yoga for the Individual

Generally, people know yoga as a collective class conducted in a yoga studio (in some cases with heated rooms) and a sequence of dynamic and static postures are performed guided by a yoga instructor. For example Bikram Yoga was born in Calcultta but unlike the 26+2 class (the method he brought to the west) “was originally not called yoga because at the time Yoga in India, at least in Calcutta, was considered mostly a meditative practice and working on self-realizton. Bishnu Ghosh, by the mid 1920’s, was already advancing a series of ‘Exercises’ for therapeutic wellbeing of individuals.” From Bishnu Ghosh, this lineage Yoga Therapy was born, and in the beginning seen and promoted as a panacea for ailments. Bikram’s approach (and this may have been the collective of the Bose family and the current thinking at the time) was to trying to have many students take one sequence and get the healing affects for all sorts of ailment instead of on an individual level.

Yoga therapy maybe still a ways from a form of healing science. And even if Dr. Fishman has the upper hand, that isn’t to say that there is no value in following the treatment from one’s medical professional, and incorporating the healing exercises with other yoga postures and meditation and breathing exercise as a wholistic approach on our path to healing. It is an effective tool especially when used as an individual approach. In my own experience of teaching, I have had many students come to me and talk about the therapeutic, and well-being benefits they have experienced from practicing yoga. I also have my own practice to thank for keeping cholesterol problems at bay and has been instrumental in restoring my body following minor injuries.

In Yoga Therapy the student is guided by the teacher one-on-one to help the student progress.

Though I agree that there are many therapeutic Benefits to group classes. I have not found it a one-size-fits-all solution. I have experienced healing effects from other yoga’s (i.e. Dharma Yoga). It was key in understanding a few concepts that are missing in the Bikram 26&2. First that all static movements are not necessarily good for certain conditions. Second, not all the postures are good for all conditions. This may seem obvious, but we as teachers have been taught that there isn’t a magic yoga classes that is a remedy and good for everyone. Through my experience of teaching, I have found that there are certain postures that end up causing trouble for certain individuals. Be them temporary issues that hinder and prevent people form having access to certain postures, or as a result of certain conditions, or even a long term effect of repeated actions over a period of time.

What the Yoga Therapy offers us is a chance to tweak our practice to provide relief in areas that we are challenged by our conditions. These conditions can be helped by following the main concepts of Yoga therapy and a holistic approach to a very individualized practice.

The Main Principles in Yoga therapy, and evidence of its powers.

There are two main concepts in Yoga Therapy involve Dynamic and static yogasanas.

“Dynamic practices often involve energetic movements of the body. They are not intended to only develop muscles or make the body fitter (though it may be a side effect) but its aim is to increase flexibility, speed up circulation, loosen the muscles and joints, release energy blocks and remove stagnant blood from different parts of the body. These asanas tone the skin and muscles, strengthen the lungs, encourage movement in the digestive and excretory systems. Dynamic practices are particularly useful for beginners.

“Static practices are performed by intermediate and advanced practitioners. They have a more subtle and powerful effect on the pranic and mental bodies. They are performed with little or no movement, the body often remaining in one position for a few minutes. These asanas are intended to gently massage the internal organs, glands and muscles as well as to relax the nerves throughout the body. They are specifically concerned with bringing tranquillity to the mind and preparing the practitioner for the higher practices of yoga, such as meditation. Some of them are particularly useful for inducing the state of sense withdrawal, pratyahara.” (Swami-Satyananda-Saraswati—Asana-Pranayama-Mudra-Bandha p, 23-24).

The importance of these distinctions can be seen in for example someone with Kyphosis or an abnormally excessive convex kyphotic curvature of the spine or Lodosis which is inward concave lordotic curving of the cervical and lumbar regions of the spine. Static movements may be counter productive. Another example, someone suffering from Carpal tunnel syndrome takes a class with a lot of postures on the hands and wrist may do more damage then good. Even if the overall effects have show positive results in studies like in 1998, the Journal of the American Medical Association (JAMA) that reported that an eight-week yoga program had positive results for people with carpal tunnel syndrome. These promising results got a lot of publicity, sparking interest among the general public and health care professionals about yoga’s potential as a therapeutic modality.
In addition to the Asanas (or the exercises) there is the Prayama, meditation and relaxation that makes yoga therapy more holistic then just the Physical Therapy exercises.

The Yoga Therapy of Ghosh Yoga.

In the Ghosh College, we follow the same principles outlined above. The process is simple, the individual comes to the Yoga Therapist for an initial consultation where they have a discussion based on the age, sex, weight, height and physical condition of the individual. Then, according to that discussion, the yoga instructor will have a personalized series of exercises to do for the individual’s personal condition. A good therapist will give a routine that will encourage the student to continue a home practice. The methods derived from the Ghosh school are mostly quantitative and experiential. Two of Bishnu’s students pioneered medical research around the therapeutic benefits of the Yoga postures. Dr. Das (Yoga Panacea 2004) and Dr. Gouri Shankar Mukerji, 84 asana, are two of the books that have made rudimentary strides as to the study of the effects of the postures. Today, the methods of Bishnu Ghosh are still being taught in Calcutta, where the granddaughter Muktamala Mitra is still holding up to the tradition. I have had the honor of attending their training program in the fall of 2016. I am currently available to teach this either privately or at Hot Yoga Malmo.

Bibliography
1.Yoga Alliance Therapy Policy
2.International Association of Yoga Therapist REaction to Yoga Alliance
3. Broad, William J. The Science of Yoga: The Risks and the Rewards (p. 143). Simon & Schuster. Kindle Edition.
4. Das, Dr. PS, Yoga Panacea, Indian Publishing House, Kolkata, 2004
5. Dr. Gouri Shankar Mukerji, 84 YOGA ASANAS

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