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Yoga as Medicine
The Yogic Prescription for Health and Healing
By Yoga Journal Bantam
Copyright © 2007 Yoga Journal
All right reserved. ISBN: 9780553384062
Chapter 1Yoga as Medicine"Whether you are sick or weak, young, old or even very old,
you can succeed in yoga if you practice diligently."
—Svatmarama (Hatha Yoga Pradipika)
If you are new to yoga, welcome. Yoga can change your life. If you are currently practicing yoga but want to learn more, you probably already know something of yoga's life-changing potential. If you are sick, it can help you feel better. If you are depressed or anxious, tired all the time, addicted to drugs, or bothered by low back pain, yoga can set you on the path to recovery. For those with chronic health problems like arthritis, diabetes, multiple sclerosis, or HIV/AIDS, regular yoga practice can help you live better and, in all likelihood, longer. And for people suffering temporary symptoms—such as tension headaches, hot flashes, or sinus pressure—specific yoga postures, breathing techniques, and other practices can bring relief.
As someone who has been an MD for over twenty years, I can tell you that yoga is quite simply the most powerful system of overall health and well-being I have ever seen. Even if you are currently among what might be called the temporarily healthy, as preventive medicine, yoga is as close to one-stop shopping as you can find. This single comprehensive system can reduce stress, increaseflexibility, improve balance, promote strength, heighten cardiovascular conditioning, lower blood pressure, reduce overweight, strengthen bones, prevent injuries, lift mood, improve immune function, increase the oxygen supply to the tissues, heighten sexual functioning and fulfillment, foster psychological equanimity, and promote spiritual well-being . . . and that's only a partial list.
Yoga has a decidedly different view from Western medicine's about what constitutes health—and this may be a big part of why it's so effective. The absence of symptoms is in no way equated with health in yoga. Health to the yogi extends far beyond not having a headache or knee pain—or even being cured of cancer. It is about optimizing the function of every system in your body from the muscles to digestion, circulation, and immunity. It is about emotional well-being, spiritual resilience, and buoyancy, even joy. Yoga teaches that only when these elements are aligned can you maximize your chance for health and healing.
Yoga envisions a web of causation that is much more complex than the limited number of factors most doctors consider. In the case of heart disease, for example, it looks beyond cholesterol and blood pressure to stress and the role of the mind in perpetuating it, your emotional temperament, your connections to other people, and whether you are living your life in accordance with some larger purpose. The idea is that a wide variety of factors can affect your well-being, and the most efficient way to remedy health problems is to work on many areas simultaneously. This is precisely what the practice of yoga does.
In yoga, you do your spiritual work and it affects the body. You stretch and strengthen your muscles and that affects your circulation, digestion, and breathing. You calm and strengthen the nervous system and it affects the mind. You cultivate peace of mind and it affects the nervous system, the immune system, and the cardiovascular system. Yoga says that if you look clearly you will see that everything about you is connected to everything else. From a therapeutic standpoint, this provides the insight that you improve the functioning of any one organ or system by trying to improve all.
Thus a crucial difference between yoga as medicine and conventional medicine is yoga's holistic emphasis on strengthening you throughout your body and mind. If you go to most doctors feeling out of sorts but without specific pain or other symptoms, with the exception of ordering a few tests to rule out the possibility of various diseases, they generally won't have much to offer you. If you're interested in making your nervous system more resilient, boosting immunity, or improving your ability to breathe, they'll have little to suggest.
The opposite is true of yoga. But rather than being in competition with conventional medical care, yoga can complement it. Indeed, in my experience, yoga can help you get the most out of whatever other care you receive, alternative or conventional. As an adjunct to other care, yoga has an advantage over many other modalities that typically get labeled as alternative medicine. It can amplify the benefits and, since yoga can often allow you to use fewer drugs and herbs or use them in smaller doses, the chance of side effects is lessened. In addition, unlike other treatments, which can interfere with each other—the way vitamins can interfere with chemotherapy or some herbs with anesthetics—a properly chosen yoga practice is extremely unlikely to interact in a harmful way with any other treatments.
Yoga appears to be effective in the treatment of a wide variety of health conditions. We'll be reviewing the scientific evidence later but, for now, let's see what people who've tried therapeutic yoga have to say. In 1983-84, the London-based Yoga Biomedical Trust, run by Robin Monro, PhD, surveyed twenty-seven hundred people, most between the ages of thirty-one and sixty, who used yoga therapeutically. To be included, participants had to have practiced yoga for at least two hours a week for a year or longer. Though the number of people with some of the conditions in question was small, the results (see table 1.1) were impressive: 96 percent of back-pain sufferers found yoga helpful, 90 percent of cancer patients, 86 percent of people with insomnia, and 100 percent of alcoholics. The lowest success rate in the survey was for women with "menstrual problems," two out of three of whom found that yoga helped.
TABLE 1.1 CONDITIONS IMPROVED BY YOGA, SELF-REPORTED.
Medical Condition Number of People Reporting Percentage Helped by Yoga
Alcoholism 26 100
Anxiety 838 94
Arthritis and Rheumatic Disorders 589 90
Asthma or Bronchitis 226 88
Back Disorders 1,142 98
Cancer 29 90
Diabetes 10 80
Duodenal Ulcers 40 90
Heart Disease 50 94
Hemorrhoids 391 88
High Blood Pressure 150 84
Insomnia 542 82
Menopausal Disorders 247 83
Menstrual Problems 317 68
Migraine 464 80
Neurological and Neuromuscular Diseases 112 96
Obesity 240 74
Premenstrual Syndrome 848 77
Smoking 219 74
Source: The Yoga Biomedical Trust, London
Imagine how much you'd be hearing about a new drug that could accomplish even a fraction of this. Nevertheless, it's my experience that few in the medical community or the general public have any conception of what yoga has to offer. Part of the problem, I'm convinced, is that many people who could benefit from yoga shy away due to misconceptions about what it is and isn't, or who can do it and who shouldn't. So before we get more deeply into the substance of how to use yoga as medicine, I'd like to address those subjects.
Common Misconceptions About Yoga and Yoga TherapyYOGA ISN'T . . . ONLY FOR THE FLEXIBLE AND FIT
Some people avoid yoga because they think it's only for people who can bend like Gumby. They think it's for the young, strong, and athletic—and if you look at pictures in magazines or sample some vigorous yoga classes you could easily get that impression.
Interestingly enough, if you feel that you couldn't possibly do yoga, then yoga might be especially helpful for you. It's well-known among yoga therapists that people with no experience in yoga often make quicker progress with health problems than students with years of experience. Indeed, it is those who find yoga the most challenging, think they are terrible at it, and can't seem to quiet their minds who have the most to gain.
YOGA ISN'T . . . ONLY FOR THOSE IN GOOD HEALTH
While I was researching yoga therapy in India, I visited centers that treated people with all kinds of physical, mental, and emotional problems: old people, stiff people, people with years of chronic disease, people in pain, people who were too depressed to get out of bed. Yoga has been used successfully on schizophrenics and on children with Down syndrome, cerebral palsy, and autism. Those who are bound to bed or wheelchairs can do yoga modified for their needs and abilities. There are people in their eighties, nineties, and beyond doing yoga, and I'm convinced that if you embrace the practice, you'll increase your odds of making it that far and feeling good when you get there.
Yoga has helped cancer patients and people with heart disease so advanced that emergency surgery was recommended. In almost all instances, yoga therapists encourage their students to continue their coventional medical care. But many yoga students notice after a while they need less of it: medication may be reduced and some drugs become entirely unnecessary, surgery may be delayed and then canceled. In India, I spoke with patients in whom all signs of rheumatoid arthritis or type 2 diabetes disappeared with regular practice. This is not everyone's experience, of course, but it shows what may be possible.
YOGA ISN'T . . . A RELIGION
Yoga is not a religion. Although yoga came out of ancient India it is not a form of Hinduism. In fact, yoga is happily practiced by Christians, Buddhists, Jews, Muslims, atheists, and agnostics alike (see p. 303). There is certainly a spiritual side to yoga, but you don't have to subscribe to any particular beliefs to benefit from it. It's probably more appropriate to view yoga as somewhat akin to Alcoholics Anonymous (AA). Like AA, yoga has a spiritual dimension that you can focus on or totally ignore, depending on what's most useful to you. Like AA, yoga is compatible with any religion, or none, if that's your preference.
Also like AA, yoga allows a "take what you can use and ignore the rest" approach. Meditation, which many people find effective for a variety of problems, originated in yoga and remains an integral part of it. (Although meditation is often thought of as a Buddhist practice, the Buddha himself was a yogi.) But if meditation seems too foreign to you, don't do it. If chanting
Om strikes you as weird, chant something else, a prayer to Jesus or Allah or for world peace, or don't chant at all. In the thousands of classes I've attended, I've never once seen a teacher object to a student skipping it. I've also found that even those who aren't the least bit interested in spirituality, or whose childhood religious experiences were traumatic, don't have a problem with what goes on in most yoga classes or therapeutic settings. This is one of the beauties of yoga. There are so many practices and so many ways of modifying those practices that virtually anyone's needs can be met.
What Is Yoga?Yoga is a systematic technology to improve the body, understand the mind, and free the spirit. Yogis tend to be more flexible, stronger, more energetic, thinner, and more youthful than people who don't do yoga. And what's happening on the outside is a reflection of what's happening to every system of the body. With the practice, you are strengthening and calming the nervous system. You are increasing the blood flow to internal organs and bringing more oxygen to your cells. You are clearing the mental clutter that can wreck your life, allowing you to see things more clearly. You are cultivating the spiritual muscles in a way that can make you happier, less anxious, more at peace.
Yoga has a number of tools that can help overcome one of the chief factors undermining the health and well-being of many in the modern world: an out-of-balance stress-response system. Since stress is a factor in a host of medical conditions—from heart attacks to infertility—yoga's role in stress reduction helps explain why it is useful in so many situations. But stress reduction is good for everybody, not just the sick. One yoga class or even a single breathing exercise can leave you feeling calmer and more centered. Chapter 3, "Yoga for Stress Relief," will cover this topic in detail.
Yoga is strong medicine but it is slow medicine. Don't expect overnight cures with yoga (though for many people it does start to yield benefits right away). One major difference between yoga and many other approaches to healing is that yoga builds on itself, becoming more effective over time. This is not true of most drugs or of surgery, which often gradually diminish in effectiveness. In this sense yoga is something like learning to play a musical instrument: the longer you stick with it and the more you practice, the better you get and the more you will get out of it. A corollary to this is that yoga, by and large, is not the proper treatment for acute problems like broken bones, overwhelming infections, or surgical emergencies. These are best cared for in a conventional medical setting, and indeed the treatment of such acute problems is allopathic medicine's strength.
Yoga's health benefits can in part be explained by the fact that the various stretching, breathing, movement, balance, meditative, and strength practices—the elements of what's known as hatha (pronounced HOT-uh, not HATH-ah) yoga—provide many of the benefits of other worthwhile activities like walking, weight lifting or biofeedback, plus a whole lot more. And unlike such health-club standards as StairMasters, stationary bikes, and treadmills—where the minutes seem to go by painfully slowly—yoga can be fun. Most people who do it regularly discover that yoga gets more interesting over time. I don't know anybody who feels that way about stomach crunches.
There is a continuum of effects from yoga. First, it can relax you. It can also, sometimes in fairly short order, lead to the relief of some symptoms of illness. With sustained practice, particularly of the stretching and strengthening exercises known as asana, and the breathing techniques known as pranayama, the body and breath become stronger. Posture and lung capacity improve, as does bowel function, lymphatic drainage, and the functioning of the immune system. Gradually one feels more balanced, better able to endure the slings and arrows of outrageous fortune.
In fact, yoga is all about balance. Many people have the impression that the physical practice of yoga is about being flexible, but physical flexibility is not the primary goal of asana practice; balance is. Some people who come to yoga, particularly some women, are very flexible; what they need is strength. Other people, including many men, are pretty strong when they first come to yoga, but lack flexibility. Some yoga students are debilitated by fear. Others have trouble staying motivated. Some people can't relax. What the practice of yoga does is challenge you wherever you need it, transforming liabilities into strengths, making you a more balanced person. Asana practice is itself balanced because it involves doing different poses from each of the major categories (see pp. 14-15). Ideally, if your condition allows, your practice will include some vigorous poses which are balanced with relaxation. This is one reason why yoga classes almost always end with Savasana (shah-VAH-sah-nah), the Deep Relaxation pose. Similarly, you can balance asana with pranayama, meditation, chanting, guided visualization, and other techniques.
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