What is Yoga Therapy?

Most people in the West know what yoga is - about 1 in 3 people in the U.S. have tried yoga in some way. Is yoga therapy a more focused yoga class? Isn’t yoga - generally - healing and therapeutic? What, then, is the difference between yoga, yoga classes and yoga therapy?

TKV Desikachar, a leader of yoga therapy before his passing, summed it up nicely:

Yoga therapy is a self-empowering process, where the care-seeker, with the help of the Yoga therapist, implements a personalized and evolving Yoga practice, that not only addresses the illness in a multi-dimensional manner, but also aims to alleviate his/her suffering in a progressive, non-invasive and complementary manner.  Depending upon the nature of the illness, Yoga therapy can not only be preventative or curative, but also serve a means to manage the illness, or facilitate healing in the person at all levels.

~ TKV Desikachar & Kausthub Desikachar

Yoga therapy is ideal for clients with specific mental or physical imbalances or for those just starting yoga. It can be used as a safe path back from disease, injury, or pregnancy - or to manage ongoing pain or disease. Yoga therapy specialties are vast - covering everything from high-performance athletic recovery and conditioning to teaching aging yogis, veterans, trauma survivors, and recovering addicts.  

Even if the client is a yoga student just seeking a health and wellness "refresh," yoga therapy always sees the person whole, and empowers wellness in body, mind, and spirit.

Recent History of Yoga

Yoga is ancient and - in its current manifestation - extremely varied. Most group classes in the West are created for athletic, healthy adults.  The most popular forms of yoga – vinyasa, Ashtanga, power yoga, and hot yoga – descended from a man named Krishnamacharya (as did Iyengar, viniyoga, and more).  These classes can all be a part of a healthy lifestyle – especially if you are generally healthy and athletic already.

But Krishnamacharya did not spend most his career teaching group classes.  Instead, he met with individuals one on one – assessing them Ayurvedicly and assigning a personal, holistic yoga practice to meet their needs and empower their health.  Yoga therapy continues the tradition of yoga chikitsa - or yoga medicine - using its vast techniques for balance, health and wellness.

Yoga Therapy in the West

Yoga Therapy is an emerging professional field that is integrative – taking into account the whole person – and so compliments and supports Western medical care.  Yoga therapy is grounded in the ancient world view of yoga and influenced by Ayurvedic medicine – as well as cutting-edge neuroscience, kinesiology, soma-psychology, and yoga research. Yoga therapy uses yoga postures, breathing techniques, philosophical understandings of our thoughts and emotions, meditation techniques, and Ayurvedic food practices to care for the body, mind and spirit as an integrated whole.

Yoga therapy is both highly individualized and deeply integrated. Along with other mindful practices, yoga therapy excels at prevention, and focuses on the uniqueness of each individual person and situation.  Because certified yoga therapists have studied for two years more than a beginning registered yoga teacher, they have prepared to complement medical care – taking into consideration any diagnoses when teaching yoga and mindfulness. 

Yoga therapists take the long view of health and see the importance of small shifts in their clients. Healing is viewed as a process. A good yoga therapist takes into consideration the advisement of doctors and caregivers, then chooses an entry point to yoga/mindfulness that is most manageable and supportive for each client.

For example, one person with lower back pain may be best treated with a practice of flowing postures that bring warmth and energy to the body. Another person with a similar complaint might be started with restorative postures and guided meditation, such as yoga nidra. A third client with lower back pain might benefit from constructive rest, guided meditation for pain reduction, and seasoning their food with different herbs and spices to improve digestion and inflammation.

Yoga Therapy and the Nervous System

One of the most powerful and valuable effects of yoga is its ability to calm us down -- to regulate our nervous system and bring it into a stable, relaxed, and aware state.

For instance, the vinyasa format of physical exertion followed by focused rest is a tried-and-true way to bring our nervous systems back to their natural state of calm.  A yoga therapist can modify this format during an injury recovery period to bring a client that same health benefit.

What meditation, yoga therapy, and the evolving Western neuroscience approach to trauma know is that regulating one’s nervous system is a skill.  As a skill, it is teachable and learnable. Cultivating this skill positively affects the choices one makes to interact with self, others and nature. With this skill on board, these choices tend toward what we know to be healthier: Less anger and irritability; more kindness and generosity; more connection; better sleep habits; better food choices; and less interest and engagement in harmful behaviors, such as drug and alcohol consumption, smoking, and more.

Yoga therapy excels at teaching clients how to manage stress - and therefore is deeply valuable when managing stress-related diseases and conditions.

Yoga Therapy Empowers the Client’s Health

Yoga therapy, above all, seeks to empower individuals to take the best care of themselves as possible. Yoga therapists can teach practices and techniques to manage pain and discomfort, to calm and relax, and/or to strengthen and energize. The foundational goal of all of these practices is to engender love and compassion for the self. Practicing yoga postures, meditation, breathing techniques, Ayurvedic eating principles, and improving one’s outlook are all actions of selfcare.

Yoga Therapy Research

Yoga therapy has been researched and found to be effective in the Western medical model for a variety of ailments including heart disease, back pain, diabetes, cancer care, stress, depression, and anxiety.  Some of the most interesting and provocative research is happening in the fields of neuroscience and trauma.

Manifestations of trauma have traditionally been viewed as mental health issues, yet new research is showing that trauma is not only “stored” in the body, but often the body is the best (and in some cases only) access point to healing from trauma. The relatively new Polyvagal Theory of human nervous systems also suggests that mental and physical health issues are not only inextricably intertwined (despite centuries of effort to see, speak about and treat them as separate), but that effective treatment requires an integrated approach.

Yoga Therapy Standards and Education

Yoga therapists are also trained in the views and language of Western medical science (including 100+ hours of university-level anatomy and physiology and 50+ of psychology) so that they can communicate effectively within the prevailing healthcare system. Increasingly clinics, hospitals and doctors’ offices are seeking out yoga therapists as complementary providers.

The International Association of Yoga Therapists (IAYT) is the governing body for Yoga Therapy.  IAYT has created rigorous certification standards for schools, and is in the process of developing a licensure examination. The Veteran’s Administration, certain state disability programs, and integrative hospitals and clinics have all used yoga therapy as part of a complimentary approach to wellness.

Yoga Therapy is bringing integrative yogic techniques and practices to the Western healthcare system.  Because of its unique ability to address the body and mind, to empower health, and to manage stress, it is a perfect complement to Western healthcare.

Are you a yoga teacher or healthcare provider looking to deepen your knowledge and therapeutic yoga skills?  PYI Yoga Therapeutics Essentials is a great place to start!  (In 2020, the training runs 2/7 – 3/1.)

Looking to bring yoga therapy into your clinic, business, or hospital? Contact us at info@premayogainstitute.com.

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Photo Credit:
People photo created by yanalya - www.freepik.com

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Deb McDermott is a first-year student in Yoga Therapy at Prema Yoga Institute. She has been a Yoga teacher for 20 years and recently completed a 40-hour training on Trauma Center Trauma Sensitive Yoga (TCTSY) with David Emerson and Jenn Turner.

Faculty Spotlight: Therapeutics Essentials Teacher Jon Witt

As a student in Prema Yoga Institute’s Yoga Therapy Certification program, I’ve had the privilege of studying under Jon Witt who, in partnership with Dana Slamp, teaches the foundational one hundred-hour Yoga Therapeutic Essentials course.

Jon has been a yoga professional for over a decade, having begun his teaching career in tandem with the opening of the flagship Pure Yoga studio in Hong Kong.  He completed his Yoga Therapy training in Mysore, India, under the aegis of Yogacharya V. Venkatesha.  Now based in New York City, Jon teaches at both Pure Yoga locations, and is a practicing yoga therapist who also offers teacher trainings and workshops.

I personally found Jon to be a remarkable teacher.  I work in higher education, where it’s common to encounter academics who have mastered their subject to a degree that actually inhibits their ability to effectively teach it on an introductory level; in other words, they’ve forgotten what it’s like to be a beginner.  If you were to attend Jon’s Saturday afternoon Hatha class at Pure Yoga East (which I recommend), you would witness him guide a room full of yogis with wide-ranging levels of experience, strength, flexibility and injury through an hour-long sequence, and somehow attenuate his teaching to encompass the individual needs of entire class.  He not only remembers what it’s like to be a beginner, he seems to remember every step along the road to mastery, and speak to it with specificity and tact, all in the course of one class.  As a lifelong teacher and student, I can say with confidence that it’s a rare skill to encounter.

In preparation for this interview, I asked some of Jon’s current and previous students at Prema Yoga Institute to reflect on their experience learning from him. Here’s a representative sampling of their responses:

Jon is a gifted teacher who guides you from strength to strength.

—Teri Ryan, PYI graduate

Jon Witt creates an environment that is safe and comfortable.  He relays his expert knowledge and ability with creativity, clarity, charm and wit.  Jon’s energy is full of love and caring for both the practice and for his students.

—Judy Glassman, PYI graduate

Jon is deeply knowledgeable and skilled in alignment and anatomy, making for a space that feels utterly safe and secure. His casual and friendly style allows for a student to feel totally open to taking modifications and breaks if things get too challenging. I learn something new about my body and what it needs every time I take class with him.                                                                                        

— Jennifer Cabrera, PYI student

I recently had the opportunity to sit down with Jon and ask him some questions about training yoga professionals in advance of the next course offering of Therapeutic Essentials at PYI, which begins on February 7th. What follows are excerpts from that conversation.

Molly Goforth: What in particular drew you to yoga therapy?

Jon Witt: I had been teaching yoga for probably about seven years and I came to a realization that many of the classes I was teaching were more dynamic and progressive, and I enjoyed teaching them. But I was also teaching beginners, and I found that many people couldn't do most of things within that basic class. And I really wanted to help people who were struggling or who were dealing with limitations or with injuries. That was what drew me in: that I wanted to be able to work with someone who was older, or who was, for example, working through a chronic disease.

MG: What do you think yoga therapy addresses particularly or uniquely well, as opposed to another type of complementary therapy?

JW: Yoga therapy provides something different in that it’s purposely calming. If you take someone who has a knee injury or a back injury, they probably don’t realize that they’re overly stressed, and that simple breathing techniques can make a difference. Simply repositioning the body can make a dramatic difference. I mean, chiropractic therapy and physical therapy, aromatherapy, all of these thing have their value and their place.  But a consistent yoga practice is really what helped me the most.  A consistent yoga practice just works. Yoga has worked for so long. And especially if you haven’t been exposed too much to yoga, you would benefit even more greatly than someone who has.

MG: Can you expand on that?

JW: If you’re someone who has a background in yoga, it's all very repetitive. If you’re doing something repetitively, at some point it still continues to be beneficial, but not as beneficial as it would be to someone who has been training with weights, or running, who has never been exposed to yoga or breath work. Yoga is a completely different form of training, so they will adapt in a completely different way.  

MG: Could you give me an example?

JW: Take someone who’s been lifting weights their whole life. They can’t raise their arms over their head, and it's progressively getting worse. Repositioning them on the floor and teaching them basic breathing techniques can completely change the way they stand and walk.  And you’re able to see what’s been declining in their routine over all this time.

MG: Such as range of motion?

JW:  Sure. Just opening that up, shifting that perspective, allows them to go back to the gym and train in ways they couldn’t before.  Before they were just pushing through it, but now they can thrive in it. It's a shift in perspective.

MG: Speaking of perspective, when you’re training yoga professionals, whether it’s teacher training or yoga therapy training, is there a core belief or a residual message that you want them to come away with after studying with you? 

JW:  I mean, to love your students. Take good care of your students. Look out for their best interest. In any yoga setting where you are being looked after by another individual, the intentions of that individual should be high. If you go in with that intention of care, whether it’s a private session or a public class, you’re bound to be successful.

I think initially, when someone first starts teaching yoga, they're most likely not going to be very good at it. But if they have the intention of helping people, over time they will refine their teaching. They will get better and they’ll have a sustainable teaching practice where it becomes a profession. When someone doesn’t really have that love for people, it makes teaching less possible.

MG: What’s the most common injury or physical problem you see in your yoga therapy practice?

JW: I think the most common injury would be back pain. From lack of activity, or too much of one activity, or it’s simple postural issues, often from the way they sit. I mean, most people go set up their cubicle or their office in a particular way, and it's been like that for so long that they're always turning to one direction.

MG: Oh, you mean like, the phone is to the left, and they’re always turning to the left, for years and years?  

JW: Yes. They’re spending eight hours a day doing it. They can make a difference just by changing their workspace around, as an example.

MG: Wow, that kind of blows my mind.

JW:  It doesn’t really take that much to actually help someone, it’s really just using the right techniques and the right kind of approach.

MG: Can you expand on that?

JW: I think with most yoga teachers, when they find themselves unsuccessful, it’s because they’ve made it too dynamic; they're not using the right approach and that's why they're not finding success with the people that they're working with. They don’t know how to scale it back.

MG: By too dynamic you mean too challenging at the beginning?

JW: Yeah. Dynamic has its place, if someone isn’t ready to be more quiet or be more still, but you have to be able to adjust.  It’s really just knowing your student.  And communicating.  With private clients, if you’re communicating and paying attention in the session, and you’re communicating after the session within that week, and then in the next session…you’re slowly building a rapport, and the information you’re getting from the student will basically tell you how you should teach them.  And on top of that, if you’re observing them in practice, you’ll be able to see what they need.

MG: Final question: is there anything that you find particularly inspiring about training yoga professionals, whether it’s teacher training or yoga therapy training, or anything that makes you feel excited about the future of yoga therapy?

JW: It’s good to know that there are other teachers who are willing to modify and adapt a practice for someone who needs it, as opposed to just giving them a general practice, something that's not appropriate, maybe something that’s actually going to harm them. So it's nice to know that people actually are interested in working with someone who is experiencing some limitations or who’s really struggling or even bit desperate, and they really want to get better but they don't necessarily know how. It's good to know that younger teachers are willing to do more study than just general study and be able to work with just about every age or ability.

 MG: Jon Witt, thank you so much for your time.

JW: You’re welcome.

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Enrollment is currently open for Yoga Therapeutic Essentials at Prema Yoga Institute, with Dana Slamp and Jon Witt. The course runs from February 7th – March 1st.

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Molly Goforth is a yoga and meditation teacher and a student at Prema Yoga Institute. She specializes in accessibility and trauma-informed yoga teaching and practice.

Medical Journal Publishes PYI-Led Pilot Study on Yoga for Cardiac Health

Really good tidings! Motivated by her mother’s own cardiac event, Prema Yoga Institute alumna and faculty member Sonja Rzepski created a yoga therapy program alongside doctors at New York’s Lenox Hill Hospital to help manage stress in female patients recovering from similar experiences. The cardiac care program was part of PYI's Clinical Yoga Therapy Practicum, and was staffed by PYI grads completing their yoga therapy certification.

The results are in and not only are they are encouraging but they are now published in the Annals of Clinical Cardiology (Jesus SD, Schultz E, Bond RM. The yoga–meditation heart connection: A pilot study looking to improve women's heart health. Ann Clin Cardiol 2019;1:24-9). 

While on the decline overall, the CDC still declares heart disease the leading cause of death for women in the United States. For women older than 55, the data shows a stagnation in the decrease of fatal incidents. Stress, anxiety, and depression are nontraditional risk factors for cardiovascular disease (CVD) that are more common in women. Sonja’s hypothesis appears to be supported by evidence that regular, supervised sessions of chair yoga and meditation can be a complementary measure to decrease these factors in female patients with or at risk for CVD, as well as increase their likelihood to pursue lifestyle modifications. 
 
Sonja’s program addressed this specific group by providing 16 female participants with or at risk for CVD and with a mean age of 64, 45-minute supervised sessions of complimentary chair yoga and meditation over 24 weeks. Through the practice of Yoga Nidra, psychic sleep or deep relaxation with inner awareness, the patients reported a lower level of depression overall as well as a 3-9 pound weight loss in 1/3 of the students which reflects the program’s encouragement to mindfully eat heart-healthy foods.
 
Kudos to Sonja and her team that included PYI Practicum students Yuliana Kim Grant, Irina Chernova, Judy Glassman, and Michelle Lauren. Want to dig in and read the complete study?  Click here! 

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