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Yoga Therapy: Let's Include the Body
In early August 2008, Margot Andersen’s newly-married, 29-year-old son was hit and killed by a car while crossing a busy highway in Chicago. For Margot, a social worker in Chicago schools for more than 13 years, the pain of the sudden, tragic loss was overwhelming. Enrolled in a yoga teacher-training program, and recently trained in LifeForce Yoga, a type of yoga focused on mood management, Andersen turned to methods she knew would have an immediate affect on her emotional stamina — yogic breathing, visualizations and mantras.
“It’s what’s gotten me through this past month,” says Andersen, 56. “Otherwise I’d be in bed, I’d be horrible.”
When she felt too exhausted to complete daily tasks, Margot used LifeForce’s breath of joy to access untapped energy. To calm down enough to sleep she practiced nadi shodahna (alternate nostril breathing); San kalpas (intentions) and mantras (chants) gave her the strength to leave the house.
“When I had no energy, and could feel myself sinking, I used the breath,” says Andersen.
Andersen also underwent a phone session with Amy Weintraub, the Arizona-based founder of LifeForce Yoga and an international leader in the field of yoga and mental health. Weintraub designed LifeForce to train psychotherapists, social workers and yoga teachers to use classical Hatha yoga methods with their clients. She says the methods work because, “The sense of separation, which is the literal source of depression, is diminished and the sense of connection to oneself and others is enhanced.”
At a time when the practice of physical yoga poses, or asanas, is at an all-time-high (with 15.8 million practitioners nationally, according to Yoga Journal’s most recent survey), psychotherapists and yoga teachers are discovering — or rediscovering — how yogic tools might apply to therapeutic settings. At the same time, many yoga teachers, wanting to be of more service to their students, are borrowing methods from traditional Western psychotherapy. For both sides the goal is the same: integrate these practices to help people help themselves.
Teach Them To Fish
“We’re giving people tools they can use for the rest of their lives,” says Bo Forbes, founder and director of the Center for Integrative Yoga Therapeutics (CIYT) in Boston. “It’s a modality of healing that comes from within the client themselves — it’s not therapist based.”
Lauren, a high school teacher in Queens, NY, entered into “yoga psychotherapy” five months ago, because she felt she needed to talk to someone about the stresses of her job and life. “I was getting weighed down with negativity,” says Lauren.
Working with Joan Stenzler, a licensed social worker and Kripalu-trained yoga teacher, Lauren has tamed her anxiety using meditation, visualization and precepts from yoga philosophy.
“We spend a lot of time talking about the universe and how people react to you and you react to them,” Lauren explains, adding she prefers this process to the traditional talk therapy she had experienced in the past. “These are things my yoga teachers also talk about in regular classes.”
Lauren often applies her newfound coping skills on the job at school. “One of the biggest things to remember in dealing with teenagers is don’t take it personally. Deflecting what’s aimed at me allows me not to carry it through the rest of my day.”
For example, when a tardy child makes a scene about having to sign a late card, Lauren imagines surrounding herself in a white light that bounces back negativity. “It sounds corny, but even if it doesn’t completely work, it definitely puts you in the mindset of analyzing what’s going on and why they are reacting to you that way.”
Dr. Kelly McGonigal, Editor in Chief of the International Journal of Yoga Therapy, has noted a recent shift in psychotherapy as therapists, such as Stenzler, turn to yoga for more effective ways to treat clients, especially those with long-standing issues. “What psychotherapists are beginning to realize is that the body has been left out,” says McGonigal.
Opening the way for yoga-based therapeutics are the mindfulness practices of the Buddhist traditions that, over the past 10 years, have been increasingly accepted into clinical settings and taught in American medical schools. According to Paul Fulton, president of the Institute for Meditation and Psychotherapy based in Newton, Massachusetts, empirical trials such as those conducted by Dr. Jon Kabat-Zinn of the Mindfulness Based Stress Reduction program (MBSR) at the University of Massachusetts Medical Center have helped establish mindfulness as a viable treatment in the eyes of the medical establishment. In September 2008, Fulton’s own organization launched a new 9-month certificate program in mindfulness and psychotherapy for mental health care providers.
No Touching, Please
However, integrating yoga-based methods into psychotherapeutic work presents inherent challenges. More than just watching the thoughts or the breath, clients and therapists may also be working with the body. Strict licensing standards today protect clients against physical abuses from their psychotherapists, which unfortunately were all too common in the past. The body is taboo.
Ann Friedenheim, a psychotherapist, drug and alcohol counselor and yoga teacher in Allentown, Pennsylvania, gets around this restriction by using very simple yoga-based techniques with her clients, ones that don’t involve touching.
One woman who had a long history of abuse both as a child and as a spouse, came to Friedenheim in physical and psychological pain, barely able to cope with daily tasks. Friedenheim used breath and hands-off bodywork to ease her client’s emotional paralysis. “Every session began with just breathing for five or ten minutes. She always refers back to it. She says, ‘Remember when we started breathing?’ It had a big impact.”
Other practitioners have kept their yoga therapy distinct from their clinical practices, sometimes having separate offices or studios for the two techniques. Boston-based Bo Forbes — who has nearly 20 years experience as a psychotherapist and over 10 years as a yoga teacher — has found yoga-based techniques so effective, she plans to close her private practice to focus exclusively on integrative yoga therapeutics.
“Talking can almost activate and rehearse issues that you’re trying to work through,” says Forbes, whose Elemental Yoga Mind-Body Teacher Training Program has been approved by the American Psychological Association and the National Association of Social Workers as ongoing training for psychotherapists and social workers. “Some people have done 15-20 years of therapy, are motivated and insightful, but they can’t change because their nervous system is holding and retaining its pattern.”
That’s certainly been true for Maria Ray, a Chicago-based flight attendant. When she got out of rehab for alcohol abuse, she knew she didn’t want to go back to traditional therapy. “All of the therapists suggested taking medications or talking about stuff that happened in the past but they could never really solve it,” says Ray.
That was until she stumbled on a Kundalini yoga center whose director, Shabad Kaur Khalsa, was also a licensed counselor. They began their sessions talking through what was happening in the moment and spent the second half doing breathing and meditation exercises, and a few simple poses. “Talking helps with the release, and the meditation brings me full circle,” says Ray. “The relaxation therapy helps to integrate it.”
Ray says friends and colleagues have observed the change. “My friends noticed that my face has gotten more relaxed and there’s a sense of calmness to me from how I used to be.”
“Shabad taught me how to be in control of my own mood,” says Ray, who is now off medications altogether. “It’s been a miracle.”
Down Dog Processing
On the other end of the spectrum, a growing number of yoga teachers who are not licensed to diagnose or prescribe treatments are bringing more traditional Western psychological insights — and training — to bear on their clients’ practices and issues. Ashley Turner of Los Angeles, who recently completed her MA in Counseling Psychology at the Pacifica Graduate Institute, uses tools from her academic work, techniques from her yoga teaching, as well as images, sounds and insights drawn from yoga’s built-in psychology to guide her clients to greater self-awareness.
Stephen Lewis in New York also brings a psychological orientation into individual yoga sessions. Trained in Phoenix Rising Yoga Therapy, a form of yoga therapy that incorporates witnessing, dialoguing and reflecting in client-centered sessions, Lewis has also enrolled in an MA program in Counseling for Mental Health and Wellness at NYU’s Steinhart School of Culture, Education, and Human Development. For his clinical internship, he is providing yoga therapy to the psychiatry inpatient unit of New York’s Bellevue hospital. “There’s so much demand, they are hungry for it. I just go where I’m needed,” says Lewis, 31. In a separate project at Bronx Psychiatric Center, Lewis is collaborating with psychiatrist and yoga-practitioner Dr. Elizabeth Visceglia on a two-month trial assessing how yoga helps people with severe mental illness such as schizophrenia.
For some, “yoga psychotherapy” could become a one-stop shop for addressing physical and emotional issues in the same session. Leah Metzger, a client working with Ashley Turner, likes the integrative nature of the sessions. “I can see Ashley for everything,” says the LA-native. “For other things I’m going through like relationships, career, health things. It’s a well-rounded way to grow myself.”
Yoga In The Lab
While individual yoga teachers gain more clinical tools and experience, and psychotherapists puzzle over how to best use yoga techniques to help their clients, pioneers at the junction of yoga and psychotherapy are undertaking clinical trials in medical or research settings, helping the field to grow and gain traction. Bo Forbes and Amy Weintraub are running separate trials on using yoga for pain management and depression; Richard Miller, founding president of the Center for Timeless Being in Sebastopol, CA, is doing research on yoga and post traumatic stress disorder; and Bessel Van der Kolk, founder of the Trauma Center at the Justice Resource Institute in Brookline, Mass., is conducting the first NIH-funded study of yoga. This is in addition to the International Association of Yoga Therapists’ scholarly journal and annual conference. The results of these trials, studies, papers and teachings could help bring yoga-based psychotherapeutic methods into mainstream practices.
Find more on mindfulness-based therapy at meditationandpsychotherapy.org or browse the websites of Phoenix Rising Yoga Therapy (pryt.com) or the International Association of Yoga Therapists (iayt.org) for a list of counseling-trained yoga teachers.
Poet and yoga journalist Joelle Hann has written for The New York Times, Time Out New York, Poets & Writers and McSweeney’s among others, and had poems in numerous publications including the 2006 anthology, Broken Land: Poets of Brooklyn. Visit her website and yoga blog at joellehann.com.