Proceedings of the Yoga & Psyche Conference (2014) [1 ed.] 9781443889773, 9781443881173

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Proceedings of the Yoga & Psyche Conference (2014)

Proceedings of the Yoga & Psyche Conference (2014) Edited by

Mariana Caplan and Gabriel Axel

Proceedings of the Yoga & Psyche Conference (2014) Edited by Mariana Caplan and Gabriel Axel This book first published 2015 Cambridge Scholars Publishing Lady Stephenson Library, Newcastle upon Tyne, NE6 2PA, UK British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Copyright © 2015 by Mariana Caplan, Gabriel Axel and contributors All rights for this book reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. ISBN (10): 1-4438-8117-1 ISBN (13): 978-1-4438-8117-3

TABLE OF CONTENTS

Preface ....................................................................................................... vii Mariana Caplan Introduction ................................................................................................. 1 Gabriel Axel Invocation .................................................................................................... 7 Rama Jyoti Vernon Establishing Yoga Studies ......................................................................... 11 Christopher Key Chapple Yoga Psychotherapy: The Integration of Western Psychological Theory and Ancient Yogic Wisdom .......................................................... 23 Mariana Caplan, Adriana Portillo, and Lynsie Seely Integrating Yoga and Psychotherapy to Treat Depression: A Literature Review .................................................................................. 49 Susan Robbins Yoga and Acceptance and Commitment Therapy for Anxiety: A Conceptual and Applied Integration ...................................................... 69 Kate Morrissey Stahl and Chad E. Drake Conceptualizing the Union of the Twelve-Step Philosophy with Yoga .................................................................................................. 89 Kelli Grock Classical Yoga Postures as a Psychotherapeutic Intervention for Autonomic Nervous System Regulation ........................................... 103 Joann Lutz

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Clinical Synergism in the Treatment of Trauma: Yoga Therapy and Psychotherapy ........................................................... 121 Anita Claney, Gina Siler, and Kausthub Desikachar Integrative Yoga Therapy to Relieve Symptoms of Depression, Anxiety, and Bipolar Disorder................................................................. 137 Aparna Ramaswamy Sound and the Subtle: Transforming Consciousness and Emotions through Mantra and Raga Yoga............................................................... 155 Silvia Nakkach Euro Hinduism in America ...................................................................... 181 Stuart Sovatsky

PREFACE MARIANA CAPLAN, PHD, MFT THE CALIFORNIA INSTITUTE OF INTEGRAL STUDIES SAN FRANCISCO, CALIFORNIA; APRIL, 2014

“One girl with courage is a revolution,” read the T-shirt that I won from my 12-year-young activist friend Samantha, in the raffle she held to raise awareness of the human trafficking that is occurring in the affluent northern San Francisco suburbs where we live. In my experience, most acts of greatness begin with a dream and are driven by conviction in one’s vision, courage, a willingness to risk both success and failure, and as much outside support as possible. In this way, my personal passion to integrate the fields of yoga and Western psychology—both of which have been my personal and professional paths of work for over 20 years—has now become a collective, global dream, of which the journal you are about to read is an important step. In April 2014, smack in the middle of San Francisco’s financial district at the Hotel Whitcomb, I, in collaboration with The California Institute of Integral Studies—where I was a graduate student in my 20s and taught as an adjunct professor for 14 years throughout my 30s and early 40s— inaugurated and hosted The Yoga & Psyche Conference. Aside from some significant and important efforts initiated by Kripalu Center for Yoga & Health in earlier decades, it was the first academic conference in the Western world to integrate the fields of yoga and Western psychology. We approached yoga not through its commonly understood notion in the West as a series of physical postures, or asanas, but from its classical, eightlimbed approach that also includes: ethics, self-care, treatment of others, right-livelihood, posture, meditation, breath, and service. Similarly, psychology is envisioned as a nascent, 135-year-old field, which includes the new fields of neuroscience, trauma theory and research, and somatics, as well as important “mainstream” schools of psychology, including but not limited to CBT (cognitive behavioral therapy), attachment theory, positive psychology, neurolinguistic programming, and short-term therapies.

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I had taught Yoga & Psyche seminars at universities, retreat centers, and yoga studios throughout the world since 2006, and it was very clear to me that not only was there a widespread interest in these subjects around the world, but that a number of extraordinary people were working independently towards this integration, teaching and publishing on different aspects of this integration. Yet I have always believed, and continue to believe, that we are far greater together than any of us alone, so I initiated the conference to find the people in the world like me: yogis—committed, long-term practitioners of yoga, whether they teach or not—who were also passionate about psychology; psychologists, counselors, and healing professionals who were interested in integrating yoga into their fields; scholars and/or scientists/neuroscientists who were researching these fields; and those who intuited that by bringing these fields together, an important contribution to consciousness, as well as personal and global healing, could take place. One element of the conference that was central for me to include was an international presence—I wanted and needed to know who, around the world, was interested in what I loved. I had traveled the world since I was 15 years old, both personally, as a spiritual/yogic seeker, and professionally. I had my BA in cultural anthropology and to this day travel is still my greatest personal hobby. For me, the world really can be held in the palm of your hand, and I wanted to know not only what India was doing regarding yoga and psychology but other nations as well. The first evening of the conference, we discovered that fifteen countries and five continents were represented. Between the conference and the first global live distance training that I had since led, I have found that there are well over 25 countries around the world interested in this material, including people from: Philippines, Egypt, The Sudan, Sierra Leone, many European countries, Brazil, Ecuador, Peru, Costa Rica, Australia, Tasmania, Bali, and Canada, Mexico, and the United States. The first evening of the conference, we invoked the psychological and yogic lineages of all those present in the room, including the great teachers and scholars who were presenting at or attending the conference. From there, there was a current of grace that permeated the conference for the next three days. I did not hear a harsh word spoken from anyone to anyone, even among the logistical stresses that myself and the organizers were facing. Many of the great teachers presenting also attended the conference as students, taking notes, doing the exercises, and learning from their peers. Moreover, I came to know of some of the great pioneers of related fields who were attending the conference, among them, Eleanor Criswell, the

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widow of and former collaborator with Thomas Hanna, who founded somatic psychology, and Janice Gates, who is singlehandedly reuniting the field of yoga therapy with its traditional roots and evolutionary possibility. Several of these guests will be invited to present in the next conference. Of all the speakers in the conference, there was one notable surprise— Gabriel Axel, PhD (pending), the co-editor of this journal, and the man I selected to be responsible for bringing impeccable management, discernment, and intellectual rigor to the selection and execution of this journal. Gabriel was the youngest speaker at the conference, and also the most popular of all the presenting scholars who were not already renowned in their fields as well as published. Just under 30, Gabriel had written to me just after the paper submission deadline, apologizing and saying that he had just heard about the conference, was available by cell, and would work as quickly as possible and prioritize all things conferencerelated. He attached a CV and paper proposal abstract on enacting a comprehensive vision for the fusion of neurological and yogic sciences. I looked at his proposal and put him in the last available slot. In the year it has taken to compile this volume for publication, Gabriel has become a colleague, friend, and one of my three favorite teachers of neuroscience, particularly as it relates to yoga, in the company only of Bessel van der Kolk and Peter Levine. He has worked tirelessly on this volume, in spite of, and throughout, his own teaching tour and relocation to Australia to conduct PhD research as a fellow at the University of Newcastle in Australia, and he has remained steadfastly committed to the publication of this volume. Together, Gabriel and I have labored deep questions at the crux of compiling a volume at this novel crossroads, including but not limited to: 1) How can we begin to fuse the Western scientific and yogic spheres together in this first volume in a way that respects and voices their unique methodologies and parlances?; 2) How can we honor and respect both traditions—one from the East and the other from the West—while presenting the papers within the context of a Western academic journal and adhering to the protocol for academic papers in the Western world?; 3) How could we balance the predominant emphasis in this volume on Patanjali’s Yoga Sutras text—one of many important texts that outlay a larger vision of yoga as opposed to the narrow but popular perspective of modern postural yoga (MPY)—with the vast, perhaps limitless, array of texts and approaches to yoga that can be integrated with developments in Western psychology to create many significant and historically unprecedented possibilities for healing in the world?; 4) How could we support, within the framework of academic peer review guidelines, the

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meaningful poetic expressions of important presenters at the conference who have been important in shaping the field until now?; and 5) How would we set the tone in this volume for the aspect of this integration of fields that is highly relevant for the academic development of both the fields of psychology and yoga (which is making its way into Western academia as a field in itself and/or valuable asset for psychological studies)? We have humbly recognized and remained cognizant throughout that this journal is just a “rough draft” of a pristine body of data that has been, and will continue to be, studied and taught in major United States and Indian universities, and hopefully will soon spread to other countries. We bring this offering to you as a beginning of a worldwide conversation, not an endpoint. We want to open the field so that we can learn what others are doing around the world, and to what disciplines, and aspects of their lives, they are finding the integration of yoga and psychology to be useful, effective, and healing. It is the sincere hope of those who have invested themselves in the conference that every other year when we meet again, we will come to know more people and learn more about what is happening around the world. We can continue to come together and teach each other and learn from each other, so that together we can do more than any of us alone.

Why Integrating Yoga and Psychology is Important Now Whether we want it to be this way or not, the movement towards globalization is all around us. Having been an avid world traveler from a young age, it is exciting to find that not only is anyone in the world a couple of airplane rides away, but now they are also a click away. The East-West movement that gained momentum in the late 1960s and early 1970s now includes every corner of the earth. We have the opportunity to blend not only yoga with Western psychology, but also other great religious and spiritual traditions from all over the world with the findings of psychology, science, medicine, and alternative and holistic healing modalities. I am one of a growing number of spiritually-oriented psychologists, or psychologically-oriented spiritual practitioners, who believes that the psychology that is still emergent in the world—a mere 135 years in its inception as compared to the 3,000–5,000-year-old yoga tradition—is in fact the Western world’s contribution to spirituality, a path in itself, you could say, when placed in a spiritual context. Furthermore, as the globalization impulse, pace, and cyber-connectivity that pervades the West spreads to other developing countries, many of the psychological wounds,

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“everyday traumas,” and psychological dysfunctions that afflict the Western psyche are being increasingly felt around the world. The gifts of Western psychology have then become not only critical to Western individuals, but, as we become an ever more globalized society, to the rest of the world.

The Fruits that Have Been Harvested and Those Yet to Come I began The Yoga & Psyche Project in 2011 with the intention of creating a published body of work on the subject, linking forces with others working in this area in order to create a greater outcome together. Since then, many fruits have emerged. In addition to this volume, we have: x Completed and published a literature review and analysis (included in this volume) of all the academic studies and reviews of this integration to date and of closely related disciplines; x Researched all popular books in English on this subject, which, combined with the above and the author’s own ideas and experience in this field, will be published as a book entitled Yoga & Psyche (Sounds True, TBA); x Created a free, online dialogue series on the author’s website consisting of interviews and dialogues with pioneers worldwide in related disciplines to explore this integration; x Completed a Yoga & Psyche workbook to help yoga teachers and practitioners integrate these skills into their teaching and personal practice; x Created the first Yoga & Psyche Conference in spring 2014, from which the papers presented were drawn on to produce this volume, which included participation from more than 15 countries worldwide; x Created an online education program (through live distance at least once per year, with the option available for CEs) on these subjects so that people can have access to this exploration from anywhere in the world. What comes next depends upon you, the reader. If I have done my job well thus far, I have opened an already-open field, but have also named and thus grounded it into this earth, where there is as much space to grow as far as there are people who wish to contribute. Yoga is the endless expanse—nobody ever “finishes” learning yoga; the psyche is the vast

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interior that has no bottom yet is inherently workable. Both fields become more effective through the discoveries and language of the other. In the near future, I am going to launch an international, web-based resource and online education hub to integrate these fields worldwide. I plan to bring the material to Harvard and Wall Street within the next two years. The world is hungry for this food—what would you like to bring to the table? I first arrived in the San Francisco Bay area in 1991. I was leaving my latest twisted shaman, fleeing from a Native American Sundance at a Hopi reservation in the high desert plains of Arizona. I had hitched a ride with a recently released Native American ex-con from San Quentin State Prison and his spiritual counselor, trying to find my way towards San Francisco to a one-of-a-kind-in-this-world graduate school I had heard of while at undergrad at the University of Michigan called The California Institute of Integral Studies. The first big workshop I attended was at the Herbst Theatre in Oakland, where authors and Buddhists Stephen and Ondrea Levine were teaching. They were the first of the many people I met in California who spoke the language of my soul and free spirit, and did so humbly, naturally, and in such a grounded and accessible way. The only thing I remember about that weekend—not even what they taught about— is their story about meeting in a rehab center: one was hitting their head on a rock while detoxing from meth, the other from heroin. “If we can come this far,” Stephen told the 300 people gathered, with the tone of conviction of one who has lived what he speaks of, “anyone can. Jesus and Buddha were just Joe and Mike down the street who had a dream and the courage to live it.” I offer this first-ever academic volume on the subject of the integration of yoga and Western psychology in this same spirit as Stephen offered to me over 20 years ago. The field is big enough for all of us, and needs us each to contribute our gifts and insights. There is nobody whose perspective is not valued or important. Welcome to the fruits of mine and Gabriel’s shared labor over the past year, with a deep thanks to Cambridge Scholars Press for following the conference’s inception, and soliciting this volume based on the merit of the work presented. “Ata yoganu asansam,” begins Patanjali’s Yoga Sutras. “Now we begin again!” Whether we are engaging this material for the first time or the one-thousandth time, we always have the choice to begin freshly again, and to choose to participate in the evolution of a field that truly knows no bounds.

INTRODUCTION GABRIEL AXEL, MSC THE CALIFORNIA INSTITUTE OF INTEGRAL STUDIES SAN FRANCISCO, CALIFORNIA

This volume of the Proceedings of the Yoga & Psyche Conference features the proceedings of the “First International Yoga & Psyche Conference,” which was hosted by Mariana Caplan, PhD, MFT, at the California Institute of Integral Studies (CIIS) in San Francisco from April 18–20th, 2014. The conference drew together diverse international scholars and practitioners—academics, teachers, and mystics—interested in exploring the intersection of yoga and Western psychology. Although an academic discussion of both Eastern and Western models of the human mind began decades ago, we are now witnessing a critical confluence where Eastern thought and practice have become more widely assimilated into Western culture. Likewise, the complexities of modern life have demanded an appreciation by yoga practitioners of the invaluable mode of inquiry for skillful navigation of the psyche offered by Western psychology. This is an exciting time in the wider field of psychology, and clearly we are on the cusp of an emerging academic field. As a teacher, student, and practitioner of both yoga and meditation, and with a background in neuroscience and cognition, I felt an immediate resonance with the vision of this international assembly and was inspired to both present my thoughts for the fusion of neuroscience and yoga and coedit this volume with Caplan. Currently I am a doctoral candidate at the University of Newcastle, Australia, investigating the potential of meditation and yoga to improve motor recovery in stroke patients, and I believe that the exciting research presented at the conference suggests the tremendous potential for many more beneficial blendings of Western and Eastern practices and approaches. This volume invites the reader to digest the wisdom and knowledge presented and to participate in the collective project. Yoga, broadly speaking, can be found in virtually all cultures as conscious attempts to enter non-ordinary states of consciousness, a phenomenon that is at its heart an expression of capacities innate to human beings. Yogic knowledge has entered mainstream culture and kindled a

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fire with Western psychology in both professional practice and theory. Examples of this convergence include integrating basic yoga techniques (for example, postures, breath management, and mindfulness meditation) with various forms of psychotherapy (for example, somatic and trauma psychology), applying yoga and psychotherapy to psychological disorders (for example, depression and anxiety), and using neurophysiological models to describe yogic processes. The authors in this volume address a range of topics that serve as a springboard for broader investigation and consideration of yoga and Western psychology. Neuroscience and trauma are two fields that have gained traction in the discussion of yoga and Western psychology and are shaping their application. The hard sciences such as neuroscience open the door for more precise explanations of yoga, but as evidenced in this volume, are in the very early stages of research. Trauma research has paved the way for exploring pertinent questions regarding how yoga and psychology can help individuals who have experienced trauma, for example, how the body might serve as an entryway to unlocking cycles of fear and self-protection that have hijacked the nervous system. The papers in this volume that address neuroscience and trauma are critical to a balanced research approach and lay the groundwork for further investigation. A major theme at the conference was the use of Patanjali’s Yoga Sutras as the authoritative reference text for yogic principles and practices employed in the syncretic methods used or reported by the authors. Although Patanjali’s Sutras present only one variation of yoga, the text expounds some key features of a general yogic landscape and ethos that are relevant to current thinking in Western psychology, such as layers of consciousness, mental imprints and shadow elements, liberation from suffering, examples of yogic abilities, and a set of principles that can be interpreted as applying to life, mind, body, and spirit. This volume embraces the Patanjali-centric discourse rather than focuses on the text’s constraints, and the editors expect the developing field of yoga and psychology to discover even more points of intersection with yogic traditions and texts and to continue embracing a more precise representation of them. Digging into these articles allowed me to probe the minds of the authors and understand their individual perspectives. The trends mentioned earlier surfaced not only from the presentations themselves but also through the process of peer review. As a volume editor, the challenge was deciding along which lines to unify and refine the papers into one cohesive narrative that reflected the spirit and intent of the yoga and psyche vision. There has been a whole lot of grace and grit, and Mariana

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and I have been rewarded through what has become a very rich growth process professionally, personally, and interpersonally. The papers presented progress from what is presently known and understood, to what is currently being explored, to the possibilities for future research. The papers also progress from applications of grosser concepts to explorations of subtler ones. Our hope is that each paper builds on the one preceding it to offer the reader new and deeper knowledge and the suggestion of future directions in the field. The first paper in the volume is titled “Invocation” by Rama Jyoti Vernon. Vernon is an accomplished yoga teacher and a leading exemplar of integrating the yogic path with a humanitarian worldly life. A citizen diplomat, mother of five, teacher, and lecturer, Vernon has focused on international conflict resolution, leaving traces of yogic knowledge wherever she goes. Her paper serves as a blessing for the initiation of the joint field of yoga and psychology. She is quick to point out the perceived abyss that lies between yoga and Western psychology yet assures the reader that the two are aligned at their core and aim to free the fractured psyche. In this way, Vernon sets the tone and intention for the logical unpacking of the articles that follow. This invocation is followed by Christopher Chapple’s piece titled “Establishing Yoga Studies.” Chapple, who holds a PhD in Theology, is an academic and scholar of Indian Yoga, Jainism, and Buddhism and has published over a dozen books on these subjects. He is the Director of the Master of Arts in Yoga Studies at Loyola Marymount University (LMU) in California and is credited as being among the first to establish a master’s degree program in yoga studies. His paper offers insights into the process of creating this program and explains how it arose from within the general sociocultural context in the United States starting in the late 19th century into the 1960s and beyond. This paper offers inspiration for all academics in the joint field of yoga and psychology by showcasing the relevance of and potential for yoga studies in modern institutional scholarship. The third paper in this volume is titled “Yoga Psychotherapy: The Integration of Western Psychological Theory and Ancient Yogic Wisdom,” by Mariana Caplan, PhD, MFT, and co-authors Adriana Portillo and Lynsie Seely, both doctoral students in psychology at The California Institute of Integral Studies. Caplan is a seasoned yoga teacher and psychotherapist and the author of seven books in the fields of psychology and spirituality, including the forthcoming Yoga & Psyche. This paper is the crucial link in the chain of papers because it brings to light the various academic fields and topics relevant in the confluence of yoga and Western

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psychology that will receive further treatment in the remaining volume. It reviews the literature on the intersection of yoga and psychology and discusses the relevance of somatic psychology; current research on the effects of yoga on stress, clinical diagnoses, and well-being; trauma research; and Caplan’s signature Yoga & Psyche Method that draws from over two decades of experience as a clinical psychotherapist and yoga practitioner. The next paper in the volume, titled “Integrating Yoga and Psychotherapy to Treat Depression: A Literature Review,” is by Susan Robbins, MEd, MA. Robbins is an avid yoga practitioner and a certified counselor in Ottawa, Canada, whose private practice integrates various therapeutic approaches. In her paper, she analyzes the current literature on yoga and depression and offers critical remarks for improving the quality of the research. She draws on keen observations from her own practice to emphasize the benefits of yoga for encouraging presence within the body, as compared with practicing mindfulness alone. And perhaps most importantly, Robbins offers experienced guidance to psychotherapists desiring to implement yoga as adjunct treatments for their clients. Robbins’ paper summarizes many of the initial questions that psychotherapists might have regarding uniting yoga and psychology in a professional setting. Also addressing the application of yoga in clinical diagnoses, authors Kate Morrissey Stahl, MA, and Chad Drake, PhD, discuss adding yoga to Acceptance and Commitment Therapy (ACT), their specialty, for the treatment of anxiety. Stahl, lead author on the paper, specializes in clinical mindfulness-based interventions and is currently a doctoral candidate in Human Development and Family Sciences. Drake is an assistant professor in clinical psychology, with a focus on contextual behavioral science. The paper summarizes how ACT is traditionally implemented and justifies combining it with yoga as a joint mindfulness-based intervention. The authors dissect an example of how yoga might be implemented with a psychotherapeutic method for research purposes and explore some of the potential issues that might arise with such an implementation. Kelli Grock’s paper, “Conceptualizing the Union of the Twelve-Step Philosophy with Yoga,” extends to chemical dependency diagnoses the implications of applying yoga to depression and anxiety diagnoses. Grock, who is a licensed substance abuse counselor and also a dedicated yoga practitioner and instructor, draws insightful parallels between the popular paradigm of Alcoholics Anonymous (AA) and Patanjali’s eightfold path. Taking the reader through a conceptual overview of the Twelve Steps in AA, Grock proposes that the practice of yoga can work to promote balance and coping skills in the lives of patients suffering from addiction. She

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invites the reader to expand his or her thinking regarding the possible applications of yoga and psychotherapy in contemporary settings. The next paper, by Joann Lutz, MSW, entitled “Classical Yoga Postures as Psychotherapeutic Intervention for Autonomic Nervous System Regulation,” moves into new territory in the volume by providing an overview of how general autonomic nervous system regulation is affected by the practice of yoga postures. Lutz, a psychotherapist with extensive experience and expertise in applying trauma-informed and nervous system-informed yoga in the context of social work, expounds on the intersection of yoga, somatic experiencing, trauma, and neurophysiology by relating them to the effects of yoga asana on the regulation and dysregulation of broad states of the autonomic nervous system. Lutz describes how mental health professionals and yoga instructors can begin integrating these elements into their practice. Anita Claney, MSc, a yoga therapist specializing in trauma and veterans, and her coauthors Gina Siler, MA, and Kausthub Desikachar, PhD, extend Lutz’s therapeutic ideas a bit further in the treatment of trauma in their paper, “Clinical Synergism in the Treatment of Trauma: Yoga Therapy and Psychotherapy.” They paint a more complex picture, using a treatment approach that integrates yoga asana with psychotherapy, somatic therapy, and mindfulness. Claney draws extensive links between yogic philosophy and trauma, employing Sanskrit terms to label various aspects of trauma-related psychology. Such an effort helps to map correlations between concepts in yoga and trauma psychology, and Claney describes two case studies that illustrate these principles. Building on the complex psychology of trauma, Aparna Ramaswamy, PhD, a psychotherapist and lifetime practitioner of natya yoga, brings us back into the body with classical Indian dance (Skt. natya) in her paper titled “Integrative Yoga Therapy to Relieve Symptoms of Depression, Anxiety, and Bipolar Disorder.” Ramaswamy offers a wellspring of healing with her integrated Natya Yoga Therapy (NYT), which fuses the delights of natya with yoga and psychotherapy to empower an individual and promote embodiment. She describes NYT using theory and case studies, resulting in an elegant exposition of a multidimensional therapeutic approach. Inviting the reader to explore the more subtle aspects of yoga and therapy is the paper by Silvia Nakkach, MA, entitled “Sound and the Subtle: Transforming Consciousness and Emotions Through Mantra and Raga Yoga.” Nakkach is an award-winning composer and director of the Vox Mundi School of Sound and Voice based in San Francisco and Rio de Janeiro. She offers a vibrant and detailed description of the intricate workings of subtle

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sound in mantra and melody (Skt. raga), explaining how the alchemical potency of various levels of sound can alleviate the psyche from suffering and lead to deeper healing and transformation. She fuses high art with advanced yogic principles to enrich the psychotherapeutic encounter. Nakkach’s exploration of the subtle leads the reader to the final paper in this volume by Stuart Sovatsky, PhD, MFT, titled “Euro-Hinduism in America.” Sovatsky is a Princeton scholar, California Institute of Integral Studies (CIIS) graduate, and tantra yoga scholar and practitioner who specializes in relationship counseling and training therapists. His diverse work ranges from teaching yoga in juvenile prisons to transforming troubled marriages. In his paper, he offers a narrative of how the first five percent of Indo-Tibetan archival wisdom was assimilated into the United States. He explains the course of yoga’s penetration into the West, from yoga and meditation to Ghandian nonviolent change and holistic health practices. This paper is a fitting culmination to the volume because it suggests that through an ongoing and deepening immersion into the heart of yoga both individually and collectively, subtler layers of yogic wisdom will continue to reveal themselves and merge with the Western psyche. This piecemeal unraveling will continually generate new directions for further study. As you read and reflect on the presentations in this volume, consider how the ideas and practices described might inform your own professional and personal work, growth, and study. The editors encourage readers to submit to subsequent volumes and participate in the conferences. These experiences bring together the wider community of players in this field and provide an opportunity for idea exchange and cross-pollination. Topics within this emerging field of yoga and Western psychology that the editors would like to see represented in future volumes and conferences include but are not limited to the following: evidence-based and quantitative research findings; case studies applying well-designed integrative approaches; an expansion into various yogic philosophies and aspects of yogic experience; the relationship between Western psychological approaches and a variety of yogic texts and traditions; integral approaches that might include societal, cultural, and sociopolitical influences; contributions from psychiatry and other areas of medicine; neuroscience-based research; and findings from clinical interventions and integrative programs for well-being. The editors and contributors of this volume offer the reader a string of works, a garland, that represents only the beginning of this emerging field. This offering is an invitation to learn, contemplate, and participate in this new field—in essence, to add more beads to the string, to create something new, with infinite possibility, together.

INVOCATION RAMA JYOTI VERNON

tadƗ draৢ৬uত svarnjpe-'vasthƗnam ||3|| For finding our true self (drashtu) entails insight into our own nature. —Patanjali, Yoga Sutras: Samadhi Pada1

Yoga. A perennial Eastern-originated science. Its name means “union” in Sanskrit, and putting its techniques into practice unites the mind, body, and spirit. Psychology. A modern day Western science that studies the physiological and biological processes that underlie cognitive behaviors in order to understand and explain the functions of the mind. Two schools of thought. One ancient. One in relative infancy. Both with the ability to bring up layers of impressions from latent depths of the psyche so they can be seen, processed, and ultimately released. The more we advance in modern psychology, the more we are finding that it parallels, supports—and really goes hand-in-hand with—the ancient yogic teachings. The experiential outgrowth of these two powerful practices combined provides practitioners of any school of thought with a more complete picture to access and transform the psyche.2 A yogin is one who accelerates the process of their personal evolution by using ancient transformative practices to unearth unconscious impressions from deep in the psyche. In this way, the yogi is a living bridge between Eastern and Western thought. Many of these practices are described in the Eight Limbs, which can be found in the Yoga Sutras of Patanjali.3 Each limb of practice relates to an aspect of living a healthy 1

Steiner, Ronald. Retrieved from http://www.ashtangayoga.info/source-texts/yogasutra-patanjali/chapter-1/item/tada-drashtuh-svarupe-vasthanam-3/ 2 The basic meaning of the Greek word psyche (ȥȣȤȒ or psnjkhƝ) was “life” in the sense of “breath,” and formed from the verb ȥȪȤȦ or psukhǀ (“to blow”). Derived meanings included “spirit,” “soul,” “ghost,” and ultimately “self” in the sense of “conscious personality" or "psyche.” 3 The Yoga Snjtras of Patañjali are 196 Indian snjtras that constitute the foundational text of Ashtanga Yoga, also called Raja Yoga. See an exposition by

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and fulfilling life. These practices go far beyond the physical postures, or asanas, to include breathing practices, meditation, and more. The Yoga Sutras of Patanjali comprise a great treatise on yoga. They transcend time, can unite East and West (given the appropriate treatment), and remain one of the deepest forms of psychology in the world of today. The second sutra, “yoga chitta vritti nirodhah,” means “to still or quiet the impulses that arise in the field of the mind.” Studying the Yoga Sutras gives extraordinary and complex insights into the human mind and reveals many distinct parallels to Western scientific views. For example, let’s examine the similarities between the enteric nervous system and the yogic concepts of nadis. The enteric nervous system has its own unique characteristics compared to our autonomic nervous system, and it is sometimes referred to as the “second brain” or the “abdominal brain.” Scientists are examining the fascinating complexities of the enteric nervous system’s function and chemistry for deeper insight into the relationships between mind, emotions, and the physical body. Specifically relevant is the chemical exchange of “information molecules.” These neurotransmitters leap between neurons, triggering a chemical change that activates a cascade of new electrical impulses. Nadis are physically invisible channels that carry the energies of the subtle body. They are interdependent with the gross nervous system; they function on a different level and there is influence between the former and latter. Nadis correlate physically to the nervous system in the same way that chakras correlate to the endocrine system. Today, our mental and behavioral patterns are increasingly giving deeper insight into the nature and function of mind and body. Sigmund Freud held that when a desire remains unfulfilled, it becomes a craving. A craving produces tension in the mind and body. When we seek to fulfill a craving, it’s fueled more by the desire to ease that tension than by attaining the original object of desire. Soon we will have another desire and the cycle repeats. This is how we get trapped in the mental patterns that psychotherapy aims to uncover and alleviate. A similar cause and effect cycle is explained in the Yoga Sutras. First, a mind wave arises from the unconscious mind, giving rise to a desire impulse that Patanjali defines as vritti. Desire leads to an action. And action leads to an experience that produces a positive or negative impression—a samskara, or scar—in the psyche. These impressions lead to new mind waves and the cycle repeats. Repeating an action creates a

Swami Satchidananda at http://www.amazon.com/Yoga-Sutras-Patanjali-SwamiSatchidananda/dp/1938477073

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mind groove. These mind grooves are the repetitive patterns we fall into. It is the aim of yoga practice and psychotherapy to bring these patterns to light where they can be removed. Sutra commentaries state that the invisible must become visible before it can be eradicated or transformed. Both yoga and Western psychology facilitate this transformation by calling on active introspection, so we discover for ourselves the answers that have been inside all along. Yogic techniques like asana, breathing, and meditation guide us inward in the same way that a good therapist will ask questions that guide us inward. In this way, yoga serves a parallel function to talk therapy in bringing stored emotions to the conscious mind where they can be recognized and worked with. Western psychology helps individuals to elucidate and adaptively own previously unseen maladaptive habits of or unhealthy patterns in the psyche, or shadow elements. The goal of both yoga and psychology is to produce a state of balance and equanimity in the physical, subtle, mental, emotional, and spiritual sheaths of our vessel. In both, we’re never given more than we can handle in the given moment. While Eastern psychology sees no separation of body and mind, Western studies of the mind have gravitated towards more partitioned analyses of psychological patterns, stages, and qualities, and a growing interest in the physical brain. Modern neuroscience is now drawing parallels on the gross level with what Eastern philosophy has known all along: that yoga and meditation practices transform the psyche; they can actually beneficially alter the physical brain.4 Every time an experience occurs, neuronal connections are shaped. In patterns of repetition, neural pathways representative of that experience are strengthened in the brain and throughout the body. Consistent yoga asana practice can help to decrease one’s identification with ephemeral sensations, pain, and fear. As a result, one becomes more capable of seeing those sensations for what they are and will not respond as strongly to them. One can allow painful experiences to rise and fall without becoming ensnared in the story.5 Practitioners often feel the benefits from this decreased stress and anxiety at a fine bio-energetic level. Likewise, Western psychology has developed methods in various modes of 4 It is now understood that Eastern practices of yoga and meditation lead demonstrably to highly disciplined minds that neuroscientists can fruitfully study. http://www.scientificamerican.com/article/neuroscientists-dalai-lama-swapinsights-meditation/ 5 Gladding, Rebecca. (May 22, 2013). This is Your Brain on Meditation. Retrieved on March 23, 2015 from https://www.psychologytoday.com/blog/use-your-mindchange-your-brain/201305/is-your-brain-meditation

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psychotherapy that help clients to more correctly and beneficially interpret their experiences, resulting in greater psychological integration. The Yoga Sutras say that we are the architects of our own destiny. It’s also a common catchphrase in the West that we “create our own reality.” More and more physical correlations of this claim are appearing every day as neuroscience has been shedding light on this in recent years. As we move forward in science, we must remember to look back to the time-tested yogic texts and practices. Modern neuropsychology is constantly making new discoveries that provide biological correlates for concepts the ancients discovered phenomenologically. Merging ancient Eastern wisdom with modern advancements in psychology leads us into a graceful and harmonious balance where the light of Spirit will fill our vessel with insights, develop our intuitive capacities, transform intellect into wisdom, and transform the way we respond to all of life.

Author Biography Rama Jyoti Vernon is an internationally acclaimed yoga instructor and peace mediator, lecturer in Asian philosophy and East-West psychology, and author of Yoga: The Practice of Myth and Sacred Geometry. She codesigned a Conflict Resolution Training Program with Rev. Max Lafser using principles of East-West psychology, integral yoga, and Patanjali’s Yoga Sutras as a basis for non-violence training that is used in churches, community organizations, and yoga institutions internationally. Rama founded five non-profit organizations, and is co-founder of Yoga Journal. Her extraordinary knowledge has shaped the foundation of contemporary yoga. She has trained yoga teachers for 45 years, and continues to work with teachers worldwide to integrate yogic practices into daily life. She was awarded Outstanding Achievement Awards from the governments of Costa Rica, India, and the former USSR. A testimony of integral yoga, Rama is a mother of five and a grandmother of twelve.   

ESTABLISHING YOGA STUDIES CHRISTOPHER KEY CHAPPLE LOYOLA MARYMOUNT UNIVERSITY

Abstract The academic study of yoga has traditionally been found within departments of area studies, religious studies, philosophy, or philology. This paper describes a new approach to yoga studies as a stand-alone discipline. With the rise of interest in the practice of yoga in the 1990s, questions began to arise: Where did yoga originate? What is the relationship between yoga and spirituality? What texts and ideas are central to yoga? The Center for Religion and Spirituality at Loyola Marymount University initiated certificate programs in Yoga Philosophy, Yoga Therapy, and related fields in response to this need, starting in 2002. Due to the strong enrollments, LMU suggested establishing a graduate degree in Yoga Studies. The first class began in fall 2013, pursuing the following course of study: three semesters of Sanskrit language and literature (Bhagavad Gita and Yoga Sutra); three courses on the physical and physiological aspects of yoga; six courses on yoga and spirituality, including classes on Vedanta, Buddhism, Jainism (in India), and Comparative Mysticism; and a comprehensive exam and final research project. By raising the level of education for yoga teachers, the university system stands poised to be of service to a new generation of emerging healers and thought leaders. In the fall of 2013, Loyola Marymount University initiated the first Master of Arts in Yoga Studies degree program in North America. Though many scientific studies have been conducted during the past several years on the effects of yoga, academic involvement with this emerging discipline had hitherto been confined to largely textual and historical studies within departments of religious studies and philosophy. In contradistinction, the LMU Master of Arts in Yoga Studies requires three parallel areas of study, offering a comprehensive immersion in this

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complex tradition: Sanskrit grammar and reading the Bhagavad Gita and Patanjali’s Yoga Sutras in the original Sanskrit language; philosophical and theological studies; and physiological and therapeutic aspects of yoga practice. This chapter will describe the conceptualization and implementation of this program. Yoga first entered the American consciousness during the 19th century, at a time when the first translations of such texts as the Upanishads and the Bhagavad Gita were published. The New England Transcendentalists, including Emerson and Thoreau, wrote glowingly of Indian thought. In 1893, Swami Vivekananda (1863–1902) spoke at the Parliament of the World’s Religions in Chicago, electrifying his audience with his message of universal truth. He subsequently founded Vedanta Societies throughout North America, including centers in New York, Boston, Chicago, Los Angeles, and elsewhere. Though he died less than ten years later, his work was carried on by several disciples. The author Christopher Isherwood (1904–1986) collaborated with Swami Prabhavananda (1893–1976) to publish versions of the Yoga Sutras, the Bhagavad Gita, and other texts that helped extend public knowledge of yoga in the 1950s and 1960s. Paramahansa Yogananda (1893–1952) arrived in America in 1920 and taught largely in Los Angeles, establishing several meditation centers in southern California. He also developed a series of progressive correspondence courses. American immigration law implemented in 1920 prohibited Asians from settling in the United States. This legislation remained in place until 1965, at which time the sentiment of the Civil Rights Movement led by Martin Luther King, Jr., swept away this racist exclusionary policy. The mid-1960s brought about many cultural changes in the United States. Numerous yoga teachers from India settled in America, with many more to follow. Organizations for meditation and yoga practice were established in nearly every American city, including the Sivananda Yoga Vedanta Centers, branches of the Himalayan Institute, and 3HO Kundalini Yoga Centers, to name a few. Simultaneously, the academic study of religion received a great boost through the work of Mircea Eliade (1907– 1986), who established the History of Religions program at the University of Chicago Divinity School and encouraged the study of Asian classical languages. Venerable Oriental studies programs at the University of Pennsylvania, Harvard University, Yale, Columbia, the University of California at Berkeley and elsewhere began to attract students of Sanskrit and Asian thought. New programs took shape at Fordham University, Temple University, the University of Iowa, and the University of California at Santa Barbara offering textual, philosophical, theological,

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and field studies about and in India, supported through repayment of wheat loaned during times of famine in 1950s India. Instead of sending rupees to the United States, the Indian government sent books to university libraries in the United States and supported American students learning in India. Physical forms of yoga gained popularity in the United States through the work of the Sivananda Yoga Vedanta Centers established by Swami Vishnudevananda and others in the 1960s and, at a later time, yoga asana as taught by disciples of Tirumalai Krishnamacharya (1888–1989), including Krishnamacharya’s son Desikachar, Patabhi Jois, Indra Devi, and B. K. S. Iyengar. By the 1990s yoga had reached an unparalleled popularity in North America. According to Yoga Journal, more than 20 million Americans practiced yoga in 2014. Unlike the Chinese discipline of acupuncture, yoga did not establish a system of licensure but opted for a loose guild-like federation of training centers operating under registration guidelines developed by Yoga Alliance, a non-profit organization established in the late 1990s. Its 200-hour training requirements have determined the foundational training for teachers offered at many yoga studios worldwide. Some of the students who adopted the practice of yoga in the 1960s and 1970s combined their personal commitment to yoga with their academic studies. For instance, Professor Frederick Smith (PhD, University of Pennsylvania), who teaches Sanskrit and religions of India at the University of Iowa, studied under B. K. S. Iyengar while engaged in the study of Sanskrit at Savitribai Phule Pune University. As founder of the Master of Arts in Yoga Studies, my own narrative will help give some background to the development of the program. I began the practice of yoga while in high school in upstate New York in 1970, having earlier begun the practice of Zen sitting as taught by Philip Kapleau in his book The Three Pillars of Zen. During my first semester of college in 1972 at the State University of New York at Buffalo, I enrolled in a four-unit class on the Bhagavad Gita taught by disciples of A. C. Bhaktivedanta Swami Prabhupada during which we chanted the Sanskrit verses and heard homilies inspired by Prabhupada’s teachings. During that same semester I was introduced through a classmate in my introductory philosophy class to Yoga Anand Ashram in Amityville, New York. Founded by a woman later known as Gurani Anjali (née Anjali Inti, 1935–2001) and located in a former hayloft on Merrick Road, it offered weekly classes and a Sunday meditation service. Grounded in the teachings of the Upanishads, the Bhagavad Gita, and Patanjali’s Yoga Sutras, it struck me as intellectually complex and spiritually grounded. I

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transferred to the State University of New York at Stony Brook, 450 miles away from home, and commuted regularly between my rented room near the university and the ashram, 25 miles to the southwest. The ashram was dedicated in 1972. One year prior, Stony Brook welcomed The Institute for Advanced Studies of World Religions to the fifth floor of its library. Staff at the Institute included Dr. Richard A. Gard, one of the first American scholars of Buddhism; Drs. Robert A. F. Thurman and Christopher S. George, who studied first with Richard Alpert and Timothy Leary at Harvard before apprenticing with Tibetan scholar Geshe Wangyal in Freehold Acres, New Jersey, and later receiving their advanced degrees from Harvard and the University of Pennsylvania; and librarian Hannah G. Robinson, who had studied Tibetan at the School for Oriental and African Studies in London, where she met her husband, Richard Robinson, who established the Buddhist Studies programs at the Universities of Toronto and Wisconsin. While still in my teens, and in the midst of these remarkable scholars, I took up the study of Sanskrit grammar and classical Tibetan, reading many chapters of the Bhagavad Gita, in my senior year in Sanskrit, and many chapters of the Bodhicaryavatara in Tibetan and Sanskrit. I completed a double major in comparative literature and philosophy and weighed various offers for graduate study from the University of Wisconsin, University of Pennsylvania, and Columbia University. However, Fordham University offered the most enticing curriculum, a mix of Sanskrit studies with theological reflection, including a course titled the Theology of Parapsychology. Thomas Berry taught wide-ranging courses on the history of religions; Anne Feldhaus offered courses in archival and field methodologies; George Elder approached Buddhist studies through a Jungian prism; Jose Pereira taught what he called the Rose Window of Hindu Theologies from Sanskrit texts in the original and Sufism; John Chethimattam, who served as my dissertation mentor, conducted private Sanskrit tutorials and regularly taught Indian theories of consciousness in the philosophy department. He was one of the co-founders of Dharmaram Seminary in Bangalore whose undergraduate division, Christ University, has become one of the top-rated institutions of higher learning in India. Meanwhile, through these three years of undergraduate education on Long Island and four years of graduate school in the Bronx, my wife and I, who had married in 1974, deepened our involvement in the ashram, participating in the opening of a restaurant and an art gallery, as well as serving as co-managers of a spiritual bookstore and community education center. Gene Kelly, a classmate at both Stony Brook and Fordham, became assistant director of the ashram and began teaching courses that brought

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our university studies to the broader ashram population on the south shore of Long Island. For nearly a full year we studied the Samkhya Karika, poring over Gerald Larson’s translation in the late 1970s, verse by verse. In 1980 we began a seven-year study of the Yoga Sutras, rendering the grammar for each sutra, reading the available translations, and examining the Vyasa commentary in the original Sanskrit and in translation. This project eventually yielded a book published in India in 1990. After receiving the PhD in 1980, the institute offered me full-time work as assistant director and Stony Brook offered for me to teach as many as two courses per semester. For five years I taught Sanskrit each semester, as well as courses on yoga philosophy, Buddhism, Hinduism, and Jainism. I also organized three academic conferences, the first on Samkhya and yoga, the second on science and religious experience, and the third on nonviolence in the world’s religions. At Moksha Community Education Center I offered courses on poetry, the Bhagavad Gita, and other topics, and organized various lecture series on philosophical topics as well as on holistic health with invited speakers from the New York metropolitan region. Tenure track positions were rare in the New York area in the 1980s. After passing on a position in western Pennsylvania, and a few days after the birth of our first child in 1985, I accepted an offer to move to Los Angeles. Less than ten years earlier, Loyola University merged with Marymount College to form Loyola Marymount University, located on a bluff overlooking the ocean. My duties included teaching all non-Christian religions, in accord with the proclamation made by the Catholic Church in the 1960s that truth can be found in all religions. In comparison with New York, California proved to be more tolerant of diversity and more open to innovation. After developing a comprehensive curriculum in the study of the world’s religions, and learning about the various avenues for opportunity within the university, I began organizing community lectures on Indian thought, inviting colleagues from India and elsewhere to our campus. By the mid-nineties, yoga had come into ascendency, with the establishment of Yoga Works by Maty Ezraty and Chuck Miller, Ana Forrest Yoga Academy in nearby Santa Monica, and regular visits to Los Angeles by B. K. S. Iyengar, Desikachar, and others. Carol Rossi, who had recently completed a master’s thesis in World Arts and Cultures at UCLA on the self-reporting of feelings after participation in yoga class, suggested that with the deep interest in our community in learning more about yoga, we form a consistent study group. Beginning in 1996 and continuing for five years, we met every three weeks at our nearby home, starting when

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our son and daughter were in bed at 8:00 p.m. Disciples of Swami Chidvilasananda and of Swami Lakshmanjoo, followers of Sivananda yoga and Iyengar yoga, members of the Vedanta Society, a sociologist and anthropologist couple who had learned yoga in India, a classicist, a movie actress, several full time yoga teachers, and numerous LMU students would gather in our living room. Starting at the beginning of the Yoga Sutras, we would chant and discuss one aphorism, sometimes two. In the late 1990s, a proposal was submitted to the Dean of the College of Liberal Arts suggesting the establishment of a Master of Arts in Yoga Studies that met a less than enthusiastic reception. Our study of the Yoga Sutras concluded within days of the destruction of the World Trade Center on September 11, 2001. The deep questioning into which the world was thrust at this difficult time prompted me to return to a new dean and ask that the establishment of a degree program be considered, thinking that the yoga and Gandhian skills of nonviolence and speaking truth to power could be invaluable for the 21st century. Our experience with the popularity of yoga in the 1990s had also shown a deep cultural craving for modalities through which to connect with the body and the senses. This time the dean did not say no, but suggested an alternative. Beginning in the 1950s, the university has offered continuing education courses for professional development that can culminate with a certificate. The Martin Gang Institute for Intergroup Relationships had been training civil servants in Los Angeles since the Watts Riots of 1967 about the joys and challenges of working in multicultural contexts. The Center for Pastoral Studies, by then known as the Center for Religion and Spirituality, had been training church workers in such areas as parish administration and Bible study leadership since the early nineties, responding to the need for a theologically educated lay populace who have taken on many duties formerly assumed by priests, brothers, and members of women’s religious orders. These certificates, and many others, continue to be open to all learners, regardless of educational history, and often provide a gateway to further studies. Thousands participate in these trainings each year, and each year LMU issues hundreds of certificates of completion in a variety of fields. Currently, several of the certificates are taught exclusively in Spanish. With this model in mind, a proposal to implement a120-hour training in yoga philosophy was born. Carol Rossi, who for nine years taught undergraduate students yoga through the dance department, served as coordinator for this program, organizing class times and promotion of the program throughout the growing southern California community of yoga teachers and students. Several faculty members were recruited to teach in

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the program, including Dr. John Casey (PhD, University of Hawaii), John Hughes (fifteen years of residential training in Kashmir Shaivism with Swami Laksmanjoo), myself, and many others. As many as 25 students joined the required classes in the Yoga Sutras, Sanskrit language, the Bhagavad Gita, the Samkhya Karika, the Upanishads, and the variety of electives that were offered, and continue to be offered, increasingly online. David Hurwitz, who had attended a Yoga Sutras study session conducted on Pioneer Boulevard in Los Angeles’ Little India, invited me to a workshop by Srivatsa Ramaswami, the senior-most non-related disciple of Krishnamacharya who taught yoga to classical Indian dancers in Madras for 30 years under Krishnamacharya’s supervision. We invited Ramaswami to initiate a new certificate program, which has grown into an annual 200-hour teacher training. Dr. Larry Payne, who had coached my wife in a back-friendly yoga practice, shared that his yoga work at UCLA medical school, where I had guest-lectured, was drawing to a close. We discussed creating a certificate in Yoga Therapy Rx, which now has grown to a four-year course of study, meeting one weekend per month. The fourth level certificate brings yoga therapy to the underserved for six private, supervised sessions at Venice Family Clinic, with amazing results. Dr. Eden Goldman and Terra Gold offer a comprehensive 200-hour training in Yoga and the Health Sciences that serves as a gateway for the Yoga Therapy certificates. The Yoga and Ecology certificate (2004) was rebooted in 2014 as Yoga, Mindfulness, and Social Change, a 100-hour weekend program through which students learn about the application of yoga and meditation in light of ecology, trauma, incarceration, and other pressing concerns. Other certificates are being considered, such as the training of schoolteachers who seek to integrate the benefits of yoga into the classroom, and the study of Ayurvedic principles of self-care. In 2008, with hundreds of LMU certificates having been awarded in various aspects of yoga, the university administration approached me with what for them was a novel idea: “How about starting a graduate program in yoga studies?” With a twinkle in my eye, I said, “Yes, what a great idea!” and the long approval process began. Some years earlier as chair of the Department of Theological Studies, I helped merge the former graduate program in Pastoral Studies with the undergraduate program in Theology and birth two ongoing MA degrees, Theology (with various emphases including Comparative Theology and Spiritual Direction) and Pastoral Theology. The former degree serves largely high school teachers and those seeking to enter doctoral studies; the latter helps train pastoral associates and directors of religious education at parishes. Many students

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enter the graduate programs in Theological Studies through continuing education courses. Being familiar with the program proposal process, I approached the various committees in charge of new program proposals. With appreciation university-wide of continuing education as a gateway to graduate studies, the path opened for the creation of a proposal to initiate a new Master of Arts in Yoga Studies. Without relaying too many details, the process of administrative approval required the drafting of a proposal that was then reviewed by departmental, college, and university committees, with improvements suggested and implemented at nearly every step. It was decided to implement a cohort model, where students enter the program at the same time, follow the same curriculum, learn together and from one another, bond as a group, and graduate as a group. This approach builds a strong sense of community and allows for certainty in the budget planning process. Through surveys conducted it was determined that Monday and Wednesday afternoons would work best for scheduling classes. The units required (42 across the equivalent of 14 classes) brings the curriculum in accord with national accreditation standards set by the Association of Theological Schools. Comparison schools consulted as part of the proposal process were S-VYASA Prashanti Vivekananda Kendra, associated with Bangalore University, and Somaiya University in Mumbai. Three tracks of parallel studies emerged requiring three semesters of Sanskrit language, three semesters on the physical aspects of yoga, and five courses in the philosophy and spirituality of yoga including summer study abroad in India. Students also complete a foundations course on entry, choose from the extension certificate offerings for an elective field, and complete a comprehensive examination and a final project. The faculty for the program includes a senior LMU professor, a second full-time professor, and three to four part time professors. Several foundations have made grants for student support and activities. Special events such as lectures, concerts, and conferences are held each year. Special curricular and extra-curricular offerings include the group study of Jaina yoga in India each summer and student participation in community outreach programs. In fall of 2014 a group of first-year students organized a yoga training for inmates at the Lynwood Women’s Detention Facility, and in the spring of 2015 a group of second-year students are planning to teach yoga to various populations at Covenant House, a transitional living facility for young adults in New York City.

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More than 20 million Americans practice yoga regularly each year in the United States. The yoga teacher has emerged for many as a confidant, a spiritual advisor, and a source of inspiration. Studies have shown the efficacy of yoga for reducing stress and enhancing a sense of well-being and being well. Yoga and related meditation techniques have been taken up in a variety of educational, recreational, and corporate settings. The implementation of the Master of Arts in Yoga Studies, while not displacing the important role of traditional modes of study, has brought the level of training for yoga teachers to a different level, one that requires immersive study of body, mind, and spirit within the university context. The intent is to create a new generation of healers and thought leaders for facing the challenges of the 21st century and beyond. Two foundations have been generous in their support of our students, providing tuition scholarships and fellowships for research in particular areas such as “Yoga in Schools” and “Yoga and Ecology.” A cluster of family foundations has also pledged money to help build out a much anticipated dedicated suite of offices with a yoga studio. Funding has been sought to study the effects of regular yoga practice on the physical, mental, and spiritual well-being of undergraduate students. Several activities take place each semester. An annual Yoga Day began in 2012, attracting as many as 700 people to campus each September. Several scholars of yoga have spoken at the monthly Wednesday lecture series. Students participate in mid-week retreats at the Insight LA 17-acre meditation retreat in Beverly Hills once each semester. Information sessions are held periodically. Plans are underway for the development of an annual spring academic conference focusing on various aspects of yoga studies. Two other master’s degrees in the study of yoga now exist, one at the School of Oriental and African Studies at the University of London and one at Venice University in Italy. As other universities consider the growing need for academic training in the discipline of yoga, many models may now be consulted. By raising the level of education for yoga teachers, the university system stands poised to be of service to a new generation of emerging healers and thought leaders.

Author Biography Christopher Key Chapple is Doshi Professor of Indic and Comparative Theology and Director of the Master of Arts in Yoga Studies at Loyola Marymount University, where he has taught since 1985. Chris began formal training in yoga sadhana in 1972 under the guidance of Gurani

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Anjali, founder and director of Yoga Anand Ashram in Amityville, New York. He has published more than 15 books, including studies of yoga traditions, Asian religions, and ecology, such as Reconciling Yogas (2003), Yoga and the Luminous (2008), Hinduism and Ecology (2000), and Yoga and Ecology (2009). He serves on the advisory boards for the Ahimsa Center (Pomona), the Forum on Religion and Ecology (Yale), the Centre for Jaina Studies (London), and the International Summer School for Jaina Studies (New Delhi). (http://bellarmine.lmu.edu/yoga/; [email protected])

References Alter, Joseph S. Yoga in Modern India. Princeton: Princeton University Press, 2004. Bryant, Edwin F., trans. The Yoga Sutras of Patanjali. New York: North Point Press, 2009. Callahan, Daren. Yoga: An Annotated Bibliography of Works in English, 1981–2005. Jefferson: McFarland & Company, Inc., 2007. Chapple, Christopher Key. Yoga and the Luminous: Patanjali’s Spiritual Path to Freedom. Albany: State University of New York Press, 2008. Eliade, Mircea. Yoga Immortality and Freedom. New York, Pantheon Books, Inc., 1958. Grinshpon, Yohanan. Silence Unheard: Deathly Otherness in PatanjalaYoga. Albany: State University of New York Press, 2002. Humes, Cynthia and Thomas Forsthoefel. Gurus in America. Albany: State University of New York Press, 2005. Jain, Andrea R. Selling Yoga: From Counterculture to Pop Culture. New York: Oxford University Press, 2015. Koelman, S. J., Gaspar. Patanjala Yoga. Poona: Papal Athenaeum, 1970. Prabhavananda, Swami and Christopher Ishwerood, trans. How to Know God: The Yoga Aphorisms of Patanjali. Los Angeles: The Vedanta Society of Southern California, 1983. Raveh, Daniel. Exploring the Yogasutra: Philosophy and Translation. New York: Continuum International Publishing Group, 2012. Ramaswami, Srivatsa. The Complete Book of Vinyasa Yoga. New York: Da Capo Press, 2005. —. Yoga Beneath the Surface. New York: Da Capo Press, 2006. Singleton, Mark. Yoga Body: The Origins of Modern Posture Practice. New York: Oxford University Press, 2005. Singleton, Mark, and Jean Byrne, eds. Yoga in the Modern World. New York: Routledge, 2008.

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Whicher, Ian. The Integrity of the Yoga Darsana: A Reconsideration of Classical Yoga. Albany: State University of New York Press, 1998. Whicher, Ian, and David Carpenter, eds. Yoga: The Indian Tradition. New York: RoutledgeCurzon, 2003.

YOGA PSYCHOTHERAPY: THE INTEGRATION OF WESTERN PSYCHOLOGICAL THEORY AND ANCIENT YOGIC WISDOM MARIANA CAPLAN, PHD; ADRIANA PORTILLO, MA AND LYNSIE SEELY, MA

Abstract This article offers a comprehensive perspective on how Western psychological theory and practice, specifically developments in somatic psychology, can be integrated with the scientific insights of yoga in order to produce a more thorough model that seeks to reduce the symptoms of psychological trauma and promote overall well-being. Toward this goal, the article offers a literature review that includes trauma studies, neuroscience, mindfulness, and yoga. By integrating these disciplines, we discover new possibilities for healing psychological trauma in the body through yogic techniques, including physical postures, meditation, and breathing exercises. The article also introduces an overview of the Yoga & Psyche Method, a process that allows practitioners to easily experience and teach this integration to clients and offers five key insights and possibilities that result from this integration. This synthesis of Eastern philosophy and modern scientific research offers a possibility for further developments in psychological theory, research, and effective therapeutic treatments. Psychology is a field in the making. Whereas many of the wisdom traditions have been developing philosophies and methods to address the great questions facing humanity for thousands of years, Western psychology is just over a hundred years old. Globalization, the increasing interest in Eastern traditions such as yoga, and significant developments in

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neuroscience, trauma research, and somatic psychology have opened up the doors for a synthesis of Eastern and Western approaches to well-being that include the treatment of clinical disorders as well as psychological health and thriving. This article offers an insight into what the integration of Western psychology and ancient yogic wisdom might look like. We begin by describing important findings and developments in somatic psychology, yoga research, breathing techniques, and mindfulness. The literature review then summarizes current trauma research in order to illustrate the importance of incorporating the body and yoga in the treatment of trauma. To conclude, we offer five key insights and implications of this integration, and consider the important questions and research directions for further developments in this emergent interdisciplinary field. An appendix describing the Yoga & Psyche Method, a process created by one of the authors of this article, is introduced as an example of a model that offers a theoretical explanation and a phenomenological experience of the usefulness of integrating these approaches. Delving into the vast field of yoga, one discovers that the physical exercises we commonly understand as yoga are but one aspect of a highly refined philosophy that offers a psychological view of the human being. When we consider yoga from this wider perspective, we discover many of the goals of modern psychology to be complementary to those of yoga. The precise origins of yoga are not known, and even great yoga scholars differ vastly on the dates they cite in yoga’s history. Eliade (1975) suggests that the first systematized form of yoga could have been written by Patanjali in his Yoga Sutras. There seems to be no consensus of when Patanjali lived and wrote this classical text, but it is thought to be somewhere between 300 BCE and 500 CE. Feuerstein (1998) dates the writing of the Yoga Sutras back to the Classical Age (100 BCE to 500 CE) and suggests that less structured yogic ideas and practices can be found dating back to the time of the Rig-Veda, which is thought to be composed before 1900 BCE. Additionally, Bryant (2009) in his book The Yoga Sutras of Patanjali talks about images of figures in yogic postures, dating to pre-vedic times (3000 to 1900 BCE), adding, ‘‘This evidence suggests that, irrespective of its literary origins, Yoga has been practiced on the Indian subcontinent for well over four thousand years’’ (p. xx). Considering that modern psychology is just over a century old, we discovered that an interdisciplinary approach that bridges this field with yoga has just begun to be articulated (Chung & Hyland, 2011). Yoga is a tool for a myriad of applications, including a reconnection with a deeper sense of self, as it is practiced by many in the East (Eliade, 1975). Yoga is

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a wide and complex subject, and for the purpose of this article, we will only make reference to three (of eight) specific ‘‘limbs’’ or aspects introduced by Patanjali in the Yoga Sutras—asana, physical postures and stretches; pranayama, breathwork; and dhyana, meditation—all of which are also mentioned in the Hatha Yoga Pradpika (Swami Muktibodhananda Saraswati, Swami Satyananda Saraswati, & Swami Svatmarama, 2000). Welwood (2000) overviews some of the distinctions in social and cultural factors between East and West—particularly the Indo-Tibetan cultures—which helps us understand some of the differences in the course of psychospiritual development between these cultures and points to why developments in modern psychology are specifically relevant to the Western practitioner of spiritual traditions. Some of the (generalized) strengths of the East include strong mother-infant bonding, intact extended families, a life attuned to the rhythms of the natural world, and maintenance of the sacred at the center of social life. He suggests that the gift of the West is ‘‘the impetus it provides to develop an individuated expression of true nature . . . [which is] the unique way that each of us can serve as a vehicle for embodying the suprapersonal wisdom, compassion, and truth of absolute nature’’ (p. 207). In other words, drawing on the strength of cultural and social factors from both East and West, the sum is greater than each of its parts. For a deeper discussion and understanding of Eastern perspectives on and practice of yoga and their contextual elements see the work of scholars such as Sovatsky.* A helpful step in integrating the yogic and Western psychological approaches is to consider the role of somatic psychology. In the West, there is increasing recognition that body awareness is an essential component to psychological well-being (Mehling et al., 2011). Somatic psychology has been shown to be effective in treating symptoms associated with anxiety, depression, psychosomatic issues, post-traumatic stress disorder (PTSD), sexual abuse, and other forms of trauma (Berg, Sandahl, & Bullington, 2010; Koemeda-Lutz, Kaschke, Revenstorf, Scherrmann, Weiss, & Soeder, 2006; Lopez, 2011; Price, 2005; Steckler & Young, 2009). Therapeutic techniques that include the body improve selfregulation, increase body awareness, reduce dissociation, foster self-care and pain management skills, and allow for the body’s innate wisdom to come forth to help complete impulses that may have been halted during the time of the traumatic event (Lopez, 2011; Price, 2005; Price, McBride, Hyerle, Kivlahan, 2007). Further building blocks that positively impact our capacity to integrate these theories and practices are the emerging fields of neuroscience and

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trauma research. Both are beginning to reveal a substantial body of research-based evidence about how trauma resides in the body, brain, and nervous system. Many of the most effective methods for working with post-traumatic stress disorder and complex trauma involve body-centered treatments (Emerson & Hopper, 2011; Lopez, 2011; Ogden, Minton, & Paine, 2006; Ogden, Pain, & Fisher, 2006; Rothschild, 2000; van der Kolk, 1994; van der Kolk, 2006). In setting out to offer an integration of yoga and Western psychology, particularly in light of the findings in somatic psychology, neuroscience, and trauma research, the authors engaged a thorough review of the literature related to our topic. We discovered that there is little scholarly material published on how these topics are integrated. There are papers and books written on the benefits of physical yoga and meditative practices for health, happiness, and psychological issues. There are many new and important studies, too numerous to mention, about the benefits of mindfulness meditation. However, only a few individuals (Emerson, Sharma, Chaudhry, & Turner, 2009; Longaker & Tornusciolo, 2003; Spinazzola, Rhodes, Emerson, Earle, & Monroe, 2011; van der Kolk, 2006) have published on how the yoga of the East and the psychology of the West can inform each other, enhancing the effectiveness of each to create an integral model seeking to reduce the effects of psychological trauma. It is our hope that this synthesis and accompanying method will form a foundation for further research and the development of practices that support healing from trauma.

Somatic Psychology: What Is It and Why is it Relevant? In beginning to articulate a synthesis between yoga and Western psychology, it is useful to understand the significance and scope of the developments in somatic psychology. A philosopher named Thomas Hanna first applied the term Somatics to the field of psychology in the 1970s. Hanna wished to merge the Western split between mind and body and declared that‘‘‘Soma’ does not mean ‘body’; it means ‘Me, the bodily being’’’ (Hanna, 1970, p. 35). Hanna (1995) later defined somatics as, ‘‘The field which studies the soma: namely the body as perceived from within the first person perception . . . the human being as experienced by himself from the inside’’ (p. 343). Although somatic psychology has only picked up momentum within the past decade, its roots date back to the early originators of modern psychology, including Freud, Ferenczi, Adler, Groddeck, Reich, and Jung (McNeely, 1987). It took the outside view of scholars, some 50 years later,

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to name this phenomenon as the single field of somatic education. Summarizing the history of somatic practices, Eddy (2009) wrote: Hanna (1985), supported by Don Hanlon Johnson (2004) and Seymour Kleinman (2004), saw the common features in the ‘‘methods’’ of Gerda and FM Alexander, Feldenkrais, Gindler, Laban, Mensendieck, Middendorf, Mézières, Rolf, Todd, and Trager (and their protégés Bartenieff, Rosen, Selver, Speads, and Sweigard). Each person and their newly formed ‘‘discipline’’ had people take time to breathe, feel and ‘‘listen to the body,’’ often by beginning with conscious relaxation on the floor or lying down on a table. (p. 6)

More recent approaches to somatic psychology and body-oriented psychotherapy include Sensorimotor Psychotherapy (Ogden, Minton, & Paine, 2006), Somatic Experiencing (Levine, 1997, 2008, 2010), BodyMind Centering (Bainbridge Cohen, Nelson, & Nelson, 2003), Somatic Trauma Therapy (Rothschild, 2000), Hakomi (Kurtz, 1990), Bioenergetics (Lowen, 1994), Integrative Body Psychotherapy (Rosenberg, Rand, & Asay, 1985), Holotropic Breathwork (Grof & Grof, 2010), Core Energetics (Pierrakos, 1987), and iRest (Miller, 2010). These approaches include both the body and mind, creating specific methods to deal with trauma and self-knowledge. Within this discipline of somatic psychology, the mind and body are viewed as an interactive whole where mental and physical symptoms are connected and are representative of an individual’s whole being. In this way somatic psychology links psychotherapy with the soma, which allows one to consider the psychological meaning of symptoms that manifest in the body (Hartley, 2004). The change from doing psychotherapy strictly in the mind to moving it into the body is a radical shift. Somatic approaches work directly with present tense phenomena in the body and ‘‘unwind’’ psychological material via the means of direct experience. Berg et al. (2010) state that becoming more aware of the connection between bodily symptoms and emotions allows clients to increase their feeling of control. This approach empowers individuals as physical symptoms morph into information about their body that they can then learn to understand and integrate. Treatment of disorders such as depression, which is increasingly recognized as a mind-body phenomenon (Steckler & Young, 2009), must include both mind and body for full recovery. Furthermore, Koemeda-Lutz et al. (2006) found that body therapy treatments significantly improved symptoms of anxiety, depression, interpersonal problems, and psychosomatic grievances just after six months. The longer the treatment

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lasted the greater the improvement, with benefits remaining for up to two years following treatment (Koemeda-Lutz et al., 2006). By understanding the bridge that somatic psychology makes between psychotherapy and somatic bodywork, we can build a similar bridge between psychotherapy and yoga. With an accompanying language and set of practices, yoga psychotherapy is an integral framework that has a powerful impact on cultivating wellness.

Yoga Research In the West, the intricacies and depth of yoga are not widely practiced to its fullest extent.* The yoga research and literature reviewed here includes studies of physical yoga, as well as breathwork and meditation; the latter is often investigated under the term ‘‘mindfulness.’’ The authors do recognize that due to all the different types of meditation and breathwork approaches, it is difficult to compare the results and psychological effects of the various methods (Sedlmeier et al., 2012). Yoga, including meditation and breathwork, has proven to be effective in reducing symptoms of several physical and psychological disorders. In a study done by the National Center for Complementary and Alternative Medicine (NCCAM), yoga, deep breathing, and meditation are in the ten most common complementary and alternative medicine therapies among adults in 2007 (Barnes, Bloom, & Nahin, 2008). The following sections summarize specific studies that explore the benefits of different yogic techniques. Given that in the West some of the terms used for different techniques are interchangeable, some of the following studies might incorporate more than one of these approaches (i.e., postures, breathwork, meditation).

Yoga and Stress Numerous studies have been conducted that demonstrate that the physical practice of yoga asana decreases stress, promoting increased relaxation and regulation at a psychological and neuromuscular level. In the Harvard Mental Health Letter (Harvard Health Publications, 2009), an article entitled ‘‘Yoga for Anxiety and Depression’’ spoke to the significance of yoga on stress management: By reducing perceived stress and anxiety, yoga appears to modulate stress response systems. This, in turn, decreases physiological arousal—for example, reducing the heart rate, lowering blood pressure, and easing respiration. There is also evidence that yoga practices help increase heart

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rate variability, an indicator of the body’s ability to respond to stress more flexibly. (p. 1)

Some researchers have conducted similar studies using short-term yoga interventions and have found a relationship between yoga and decreased stress across many different populations such as young adults (Gard, Brach, Hölzel, Noggle, Conboy, & Lazar, 2012), older adults, (Bonura & Pargman, 2009), businessmen and women (Wolever, Bobinet, McCabe, Mackenzie, Fekete, Kusnick, & Baime, 2012), and patients suffering from chronic illness (Pritchard, Elison-Bowers, & Birdsall, 2010; Salmon, Santorelli, & Kabat-Zinn, 1998). Yoga helps to train the body to relax on a muscular level, allowing the stress response to be more easily managed (Serber, 2000). Brisbon and Lowery (2011) found that compared to beginners, advanced practitioners of hatha yoga displayed lower levels of stress and increased awareness of being present in the moment. Yoga also gives individuals a framework for regulating emotions and a space to practice self-soothing techniques (Harper, 2010). Gootjes, Franken, and Van Strein (2011) conducted a study that confirmed that yogic meditative practices help with successful emotion regulation. There is also evidence to suggest that yoga aids in the development of the selfsoothing capacity of traumatized youth (Spinazzola et al., 2011). Overall, yoga practice has been shown to support stress management at a level comparable to cognitive behavioral interventions, helping to increase relaxation and improve emotion regulation (Granath, 2006). Breathwork has also been found to increase one’s ability to regulate emotions, in addition to improving heart rate variability by balancing the interaction between the sympathetic and parasympathetic systems (Brown & Gerbarg, 2009; Hölzel, Lazar, Gard, Schuman-Oliver, Vago & Ott, 2011).

Yoga and the Treatment of Clinical Diagnoses Numerous studies have revealed that yoga benefits various clinical diagnoses, as articulated by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychological Association, 2013). An example of this is children with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) for whom a yoga practice has been shown to stabilize emotions, reduce hyperactivity and impulsivity, increase attention span and feelings of calmness and confidence, and improve social skills. It also has shown to improve the quality of the parent-child relationship, sleep patterns, and positively change the child’s approach to school (Abadi, Madgaonkar, & Venkatesan, 2008; Harrison, Manocha, & Rubia, 2004; Jensen & Kenny, 2004).

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When applied to those with eating disorders, such as anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified, yoga has shown to improve mood, increase physical and emotional awareness, and decrease eating disorder symptoms. A study conducted by Dale, Mattison, Greening, Galen, Neace, and Matacin (2009) reported that ‘‘Women’s intense fear of gaining weight, preoccupation with weight, body dissatisfaction, extreme desire to be thinner, and desire to think about and engage in bouts of binge eating was reduced’’ (p. 431). Yoga has also been shown to benefit those with schizophrenia by reducing psychopathology when paired with standard psychiatric treatment. Studies have found reduced psychotic symptoms and depression, improved cognition, enhanced social and occupational functioning, and an increased quality of life (Bangalore & Varambally, 2012; Duraiswamy, Thirthalli, Nagendra, & Gangadhar, 2007; Visceglia & Lewis, 2011).

Yoga and Depression As depression and anxiety are often co-occurring, some findings related to anxiety are also included in this section. A study conducted by Kinser, Bourguignon, Whaley, Hausenstein, and Taylor (2013) found that the women diagnosed with major depressive disorder who were assigned to the yoga intervention group showed a decrease in depression and experienced less ruminations, increased feelings of connectedness, and the added benefit of a new coping method. Forbes (2008) reports that yoga’s ability to calm the nervous system, foster an awareness of the present moment, and release energy that has been trapped in the body aids in the reduction of symptoms associated with affective disorders. Studies have shown that the practice of following the breath is a valuable aid in the treatment of depression and anxiety. Miller (1994) found that yogic, diaphragmatic breathing increases ego strength, emotional stability, confidence, alertness, and perceived control over one’s environment, as well as reducing anxiety, depression, phobic behavior, and psychosomatic problems. Lalande, Bambling, King, and Lowe (2012) studied how the suppression of inner experiences, possibly triggered by traumatic events, may be linked to inhibited breathing, which in turn may be furthering states of depression and anxiety. Additionally, a metaanalysis conducted by Baer (2003) suggests that mindfulness-based interventions may be helpful in the treatment of several issues including chronic pain, anxiety, depression, eating disorders, and patients with cancer, fibromyalgia, or psoriasis, all with positive results.

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Amy Weintraub (2004) describes in detail various yoga practices that can be used to treat depression. Her work is grounded in research and based as well on the experience of healing and managing her own depression through yoga. In a more recent effort (Weintraub, 2012) she also illuminates how therapists can learn and teach a variety of yogic processes—including breath, sound, mudras (hand positions), imagery, and self-inquiry—to increase the effectiveness of psychotherapy.

Yoga and Well-Being Yoga also improves the mood of individuals who do not suffer from a diagnosable disorder and overall offers a practice that promotes general well-being. In a study by Shapiro (2004), healthy participants recorded the fluctuations of their mood and emotional states before and after yoga classes. The results showed that positive moods increased and negative moods decreased following yoga practice (Shapiro, 2004). A study that assessed yoga practice and its effect on mood compared to walking found that those who were assigned to the yoga group reported greater improvements in both mood and anxiety levels than those in the walking group (Streeter et al., 2010). Yoga practice additionally promotes greater well-being by increasing body awareness, positive affect, and satisfaction with life for both men and women, while simultaneously decreasing objectification of their bodies (Impett, Daubenmier, & Hirschman, 2006). The ability to be present increases with the practice of yoga, which has a positive effect on overall well-being. Studies on mindfulness have found how it helps people increase attention and focus (Lazar, Bush, Gollub, Fricchione, Khalsa, & Benson 2000). Shelov, Suchday, and Friedberg (2009) found that just eight weeks of yoga practice significantly increased mindfulness, insightful understanding, and an open attitude. Meditation can also be useful with deeper issues around personality and maturity of relatively healthy individuals (Epstein, 1986). Findings such as these are important in thinking about preventative mental health, protecting against disorders such as anxiety and depression, and strengthening the already existing resources that every individual possesses. Yoga has been shown to relieve suffering during periods of grief and bereavement. Philbin (2009) wrote, ‘‘The therapeutic process creates a safe and sacred space for processing sensations, thoughts, and emotions . . . Grieving adults who participated in the yoga therapy intervention showed significant improvements in vitality and positive states and a trend toward improved satisfaction with life’’ (p. 129). Yoga can also provide a space for connection and relationship building. Partner yoga can foster

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deep emotional connection, healthy boundaries, trust, and a strong sense of self while simultaneously being in relationship (Swart, 2011). Looking to neuroscience, studies show that practicing mindfulness increases positive affect (Davidson et al., 2003) and enhances selfregulation (Hölzel et al., 2011). Certain areas of the brain associated with attention, introspection, and sensory processing are thicker in participants with extensive meditation experience compared to those with little to no experience, and the UCLA Laboratory of Neuroimaging found that the brains of people who practice meditation are in fact different from those who do not (Hölzel et al., 2011; Lazar et al., 2005; Luders, Kurth, Mayer, Toga, Narr, & Gaser, 2012).

Trauma Research A significant amount of attention has been paid to the study and treatment of trauma in the last few decades. The most effective treatments for trauma often include body-centered methods as these have a direct effect on the physiological and neurological mechanisms that affect the body following a traumatic event (Emerson & Hopper, 2011; Levine, 1997; Ogden, Minton, & Paine, 2006; Rothschild, 2000; van der Kolk, 2006). We now know that yoga also contributes to the health and wellbeing of both the body and psyche, and when it is merged with modern psychology, clinicians have a wider array of tools and greater knowledge from which to draw upon in regards to treating individuals suffering from trauma. Before offering a synthesis of how these approaches to psychological transformation work together, it is important to note some of the significant findings in trauma research. Trauma is a form of stress. Under normal circumstances stress protects the human system and promotes growth. However, if the stress response is maladaptive or becomes chronic, it can lead to psychological and biological transformations that are harmful (Christopher, 2004; McEwan & Lasley, 2002). Although the stress response is a biological process that naturally occurs in every individual, trauma manifests in different ways for each unique person (Christopher, 2004). The event does not necessarily have to be catastrophic, it can be a seemingly mundane event that directly or indirectly affects the individual, but what is crucial is how the body reacts to the situation (Levine, 2008). Peter Levine (1997) stated that: Traumatic symptoms are not caused by the ‘‘triggering’’ event itself. They stem from the frozen residue of energy that has not been resolved and discharged; this residue remains trapped in the nervous system where it can wreak havoc on our bodies and spirits. (p. 19)

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Trauma symptoms arise when the arousal cycle cannot be completed, keeping the individual locked in an aroused state of fear. This traps the traumatized person in a cycle of fear that affects the entire body, including the mind, the emotional system, and the neurological system that regulates the body (Levine, 1997). Stephen Porges (Porges, 2001; Prengel, 2011), a professor in the Department of Psychiatry at the University of Illinois at Chicago, proposed, through his polyvagal theory, that in addition to the fight or flight defenses of the sympathetic nervous system, there is a vagal defense system that causes immobilization and a newer mammalian development, the myelinated vagus, which plays a role in self-soothing (Prengel, 2011). When treating trauma these systems are important to note as they are physiological components that can keep the trauma victim locked in a frozen state and unable to self-soothe. Experiencing trauma puts the individual under great physical and emotional distress, and the biological changes that happen in the body result in various forms of symptoms that can show up months or years following the event. It is the biological alterations that lead to the psychological effects of trauma, which are often not within control of the individual. A comprehensive literature review on complex trauma observed in childhood trauma revealed seven areas of impairment: attachment, biology, affect regulation, dissociation, behavioral regulation, cognition, and self-concept (Cook et al., 2005). Leading trauma researcher Bessel A. van der Kolk (2002) wrote: Once people are traumatized and develop PTSD, their ability to soothe themselves is compromised. Instead, they tend to rely on actions, such as fight or flight, or on pathological self-soothing, such as self-mutilation, binging, starving, or the ingestion of alcohol and drugs, to regulate their internal balance. (p. 386)

The limbic system, an area of the brain that is associated with emotions and survival behaviors, is also affected by trauma. The result of this is that the individual may feel the emotions as if they were a reenactment of the traumatic event, leading him or her to react irrationally to events that may be irrelevant in the moment but important during the traumatic event (van der Kolk, 2006). Emotions can be uncontrollable and overwhelming, becoming the enemy, turning the individual against his or her self, and therefore learning to self-soothe is essential in healing from trauma (Gallop, 2002). The goal of treating PTSD is to help the client live safely in the present without being pulled back into the trauma. What then, constitutes the major ingredients to effective trauma treatment? Van der Kolk (2006) suggested it needs to involve ‘‘(a)

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learning to tolerate feelings and sensations by increasing the capacity for interoception; (b) learning to modulate arousal; and (c) learning that after confrontation with physical helplessness it is essential to engage in taking effective action’’ (p. 1). Since trauma is re-enacted in the present through one’s physiological, mental, and emotional systems, effective therapy includes self-awareness and self-regulation to bring one back into the present moment (van der Kolk, 2006).

Yoga and Trauma Research Because trauma treatments often involve body-centered approaches to healing, a new body of research on the benefits of yoga on trauma has just begun to emerge. ‘‘Clinical experience shows that traumatized individuals, as a rule, have great difficulty attending to their inner sensations and perceptions—when asked to focus on internal sensations they tend to feel overwhelmed, or deny having an inner sense of themselves’’ (van der Kolk, 2006, p. 11). The practice of yoga is an excellent tool to bridge this gap. Gerbarg and Brown (2011) voiced some strong points on this topic: While talk-based and cognitive therapies can be of great benefit, there are situations in which mind-body approaches, such as yoga, qigong, tai chi, breathing practices, and meditation can be extremely beneficial and sometimes necessary for full recovery . . . Learning how to use the body to speak to the mind circumvents the prohibition against talking and can be more effective than relying solely on verbal, cognitive, or intellectual approaches. (p. 199)

Traumatized youth have also benefited from yoga. Spinazzola, Rhodes, Emerson, Earle, and Monroe (2011) conducted a study with traumatized youth living in residential treatment homes. The primary goal of the practice was to provide them with a safe space and structure in which to reconnect with their bodies. The results showed that doing yoga helped to strengthen the youth’s self-regulating ability (Spinazzola et al., 2011). Another study (Longaker & Tornusciolo, 2003) implemented yoga as a type of group therapy for severely traumatized adolescent boys and found that the boys learned how to develop effective attachments, empathy for others, trust, and a sense of security within the group. There was improved self-regulation, a foundation for which to build a stronger sense of self, which allowed for the boys to connect with bodies in a healthy way promoting a sense of empowerment and responsibility over their body (p. 80–81). One week of yoga has proven to reduce fear, anxiety, sadness, and

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interrupted sleep in individuals who survived natural disasters, suggesting that yoga may be useful in managing the negative emotional and somaticbased effects of these disasters (Telles, 2007; Telles, Singh, Joshi, & Balkrishna, 2010). Additionally, yogic breathing can help relieve psychological distress in individuals that have undergone trauma from such events (Descilo et al., 2010). Mindfulness techniques help individuals to re-focus on the present, allowing thoughts and feelings to be experienced without judgment or avoidance (Follete, Palm, & Pearson, 2006). A study by Lopez (2011) suggested that techniques that have a mindfulness component allow people suffering from PTSD to improve self-regulation. Meditation also activates structures involved in attention and control of the autonomic nervous system (Hölzel et al., 2011).

Conclusion Through our review of the major studies exploring yoga (including asana, breath control, and meditation), somatic psychology, and trauma, we have found yoga and psychology to be complementary to each other and that the integration supports the process of recovering from psychological trauma. In closing, we propose the following five insights and possibilities for this integration: x The Western psychologist can benefit from the insights of a comprehensive view of yoga and how this ancient practice can complement modern psychological theory and clinical work. Yoga and yogic techniques have been shown to reduce stress and anxiety by modulating the stress response and regulating emotions. This improves one’s ability to self-soothe, supports mindful living, increases feelings of connectedness, confidence, focus, body awareness, and perceived control over the environment, and promotes greater well-being and satisfaction with life. Using some of the key insights yoga offers to inform psychology—it particularly lends itself to somatic psychology—the clinician can begin to use these techniques to complement their clinical knowledge to benefit their clients without having to engage years of yoga studies. x As a result of these positive effects of yoga, the symptoms of a handful of DSM-5 disorders can be reduced, i.e., ADHD, eating disorders, schizophrenia, and depression. The positive benefits seem to particularly address many of the issues associated with

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PTSD and related symptomology, including the inability to self soothe and modulate arousal, fear and dissociation from the body, and persistent stress that pulls the individual out of the present and into the trauma. x The Western practitioner of yoga can benefit from this integration by expanding their understanding of yoga to include a psychological component. This can allow for a deepening of the practice to focus on how yoga can affect one’s sense of self and improve well-being both in formal yoga practice as well as in daily life. It is not expected that Western yoga teachers would know how to work psychologically, but by increasing their understanding of somatic psychology and the sensitive nature of trauma, they can significantly increase their skill set to integrate psychological material, or create a psychological frame, for themselves and their students during yoga practice. x Embodiment. There exists the possibility for human beings to become fully embodied—for the consciousness and intelligence that is ordinarily associated with the mind to become awakened throughout the whole body. The integration of yoga and psychology supports this whole body awakening by allowing one to work through their psychological holding patterns, traumas, and ailments, while also connecting one to their body and the present moment. This clearing away of psychological traumas, paired with full body and present moment awareness, allows one to come into a deeper knowing of themselves and get in touch with their natural essence that is embodied in their being. When this happens, radical changes in the phenomenological experience take place. The split between thoughts, feelings, and actions disappears, and more congruence begins to arise, adding a spiritual dimension to life that includes behaviors, vocation, health, lifestyle, relationships, and thriving. x The integration of yoga and psychology, in the light of trauma, offers many opportunities for trauma sensitive yoga techniques, informed by psychology, to be created, researched, and implemented. The authors believe that further research in this area will strengthen the links between these three fields of knowledge (yoga, psychology, and trauma), supporting its application to different populations from prisoners to youth, medicine, preventative medicine, palliative care, well-being, and thriving. We offer this foundational article, and following application of how yoga and psychotherapy can be integrated for clinical use, as a wellspring from which others can draw on and further develop.

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To conclude, as yoga becomes increasingly acceptable to mainstream and scientific communities, it is likely that many opportunities for further research will become available. As the popularity of neuroscience continues to link science with psychology and spirituality, we hope it will bridge the perceived separation between ‘‘mainstream’’ and ‘‘psychological’’ communities with spiritual traditions. Questions that remain for further study include: Could the validation of yoga, that neuroscience and trauma research are providing, make it possible to include yoga as a treatment modality in the DSM for PTSD and other anxiety-related disorders? Will the scientific discoveries and developments that are changing the way humanity lives in the world be able to further integrate the wisdom of the East and West to allow for an inclusion of not just mind and body, but of the more spiritual aspects of the soul/psyche too? Will this integration allow for trauma to be better understood and addressed? We offer this review and synthesis of the current literature and research in these areas not as a final analysis but rather as a foundation and springboard for further studies in the field.

Appendix: The Yoga & Psyche Method One practical application of the integration of yoga and Western psychology, which would benefit from further research as well as added developments as the field continues to evolve, is The Yoga & Psyche Method. Developed by one of the authors of this article, who is a psychotherapist specializing in psychological integration on the spiritual path as well as a long-term yoga teacher and practitioner, The Yoga & Psyche method draws upon 19 years of clinical experience and yoga studies, as well as Peter Levine’s Somatic Experiencing model. Through this method, clients and students are introduced to the importance of the body in their psychological healing, and taught to use yogic exercises, breathing, and meditative practices to unwind trauma and regulate their nervous system. This method can be taught in a workshop setting where the facilitator teaches, demonstrates, and guides participants through the steps listed below, followed by an opportunity to share in dyads, bring questions to the facilitator in a group setting, and then continue to practice and refine the skills. The steps can also be applied in the psychotherapy room, with the therapist directly guiding the client through the process over several weeks or months. The process deepens and becomes more effective the longer it is practiced. It can be integrated with most other therapeutic modalities, complementing their efficacy.

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The following steps are an outline of the process, which can be adapted and changed according to the skills of the therapist and needs of the clients or practitioners: x Educate the client or group about a) the field of somatic psychology, b) how yoga and psychology complement each other, c) trauma and its treatment, and d) an overview of how the exercise will be experienced in their bodies. x Teach client(s) to move awareness from their minds into their bodies by teaching exercises that create psychological safety and bring in visualization, yogic breathing, and mindfulness. x Once clients have a sense of how to experience their emotional states as bodily sensations, a process called pendulation or titration (Levine, 1997) is introduced through which clients learn to move their awareness between creating a sense of safety in their bodies to briefly (30–60 seconds) experiencing the sensations associated with traumatic experience and then moving back to that place of safety in their bodies. This process of pendulation (Levine, 1997) can be repeated several times for a gradual deepening, and clients discover they can learn to move back into a sense of safety. x The process is then applied to working with specific yoga poses. These include some general positions understood to allow the release of tension and even illness, as well as yoga postures that could be holding deep emotional content. x The possibility of receiving physical touch and support in the yoga poses while releasing traumatic emotions is introduced when appropriate in a workshop context. Workshop participants learn to provide a safe space in which to offer this. Clients and workshop participants are always offered the option of the therapist’s or facilitator’s presence without touch. x Clients and/or workshop participants are then redirected to a place of safety within their bodies and ‘‘complete’’ their process with the conscious recognition that they can engage with deep, traumatic material within themselves, and emerge from this with more energy, joy, and relaxation. This experience facilitates the eventual ability to digest very difficult emotions and experiences in the moment. x The client/participant processes with the therapist/facilitator the material that emerged.

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Once the therapist or facilitator is comfortable with these steps, these practices can range in length from a short, 5- to 10-minute individual or group process, to a 45-minute to1-hour session, including the time for integration and discussion. This practice is safe as long as the therapist or facilitator keeps the interaction between the client and their traumatic material in gentle 30- to 60-second intervals, instead of longer periods of time, which tend to facilitate catharsis rather than gradual integration. It is the hope of the authors that many new methods and practices will continue to emerge alongside the continued developments in neuroscience, trauma research, somatic psychology, and yoga research.

Note *

Although outside the scope of the present article, some researchers—especially Sovatsky—are of the position that modern psychology is incomplete and operates from a scientia sexualis (science of sexuality) perspective, thus missing further maturational states that a system operating from ars eroticas (erotic art), such as Kundalini Yoga, embraces and embodies. This position suggests that modern psychology does not fully comprehend the depth of yogic phenomena. Furthermore, it is said that asanas exported to the US are disconnected from their tantric traditions and shaped by European practices, such as ballet and gymnastics (Sovatsky, 1998). Norman Sjoman (1999) stated that modern yoga ‘‘appears to be distinct from the philosophical or textual tradition, and does not appear to have any basis as a tradition as there is no textual support for the asanas taught and no lineage of teachers’’ (p. 35). For those who may wish to further explore this matter, please see Singleton, M. (2010), Sjoman, N. E. (1999), and particularly Sovatsky, S. (1998).

Author Biographies Mariana Caplan, PhD, MFT, is a psychotherapist and the author of six books in the fields of psychology and spirituality, including Eyes Wide Open: Cultivating Discernment on the Spiritual Path (Sounds True, 2010), Halfway Up the Mountain: the Error of Premature Claims to Enlightenment (Hohm Press, 1999), and The Guru Question: The Perils and Rewards of Choosing a Spiritual Teacher (Sounds True, 2011). As a psychotherapist, she specializes in using somatic approaches to therapy to support spiritual practitioners and teachers of all traditions and religions to heal trauma and thrive, as well as working with complex spiritual traumas within spiritual communities. She has been an adjunct professor at The California Institute of Integral Studies in San Francisco since 2001, as well

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as teaching extensively at Naropa University, Sophia University, and John F. Kennedy University. Adriana Portillo, MA, is an avid meditator with over 15 years of practice and has a background in management. She earned her degree in Integral Counseling Psychology from the California Institute of Integral Studies and currently combines her work as a psychotherapist both with children, through a school-based program, and with adults, through private practice, in Berkeley, California. She is interested in finding creative ways to address trauma at all levels of existence. Lynsie Seely, MA, is a doctoral candidate in the East West Psychology Program at the California Institute of Integral Studies. She works as a marriage and family therapist intern at a private practice and for an agency working with children on the autism spectrum. Her passion is researching the relationship between body-based practices/therapies and healing from the trauma of sexual abuse. .

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151–169. doi:http://dx.doi.org/10. 1080/17432979.2010.494853 Bonura, K. B., & Pargman, D. (2009). The effects of Yoga versus exercise on stress, anxiety, and depression in older adults. International Journal of Yoga Therapy, 19(1), 79–89. Retrieved from EBSCOhost: Alt HealthWatch database (Accession No. 62669011). Brisbon, N. M., & Lowery, G. A. (2011). Mindfulness and levels of stress: A comparison of beginner and advanced Hatha Yoga practitioners. Journal of Religion and Health, 50(4), 931–941. doi:10.1007/s10943009-9305-3 Brown, R. P., & Gerbarg, P. L. (2009). Yoga breathing, meditation, and longevity. Annals of the New York Academy of Sciences, 1172, 54–62. doi:10.1111/j.1749- 6632.2009.04394.x Bryant, E. (2009). The Yoga Sutras of Patanjali. New York: North Point Press. Christopher, M. (2004). A broader view of trauma: A biopsychosocialevolutionary view of the role of traumatic stress response in the emergence of pathology and/or growth. Clinical Psychology Review, 24, 75–98. Retrieved from http://dx.doi.org/10.1016/j.cpr.2003.12.003 Chung, M. C., & Hyland, M. E. (2011). History and Philosophy of Psychology. Hoboken, NJ: Wiley-Blackwell. Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., . . . & van der Kolk, B. A. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35(5), 390–398. Retrieved from http://www.traumacenter.org/ products/publications.php Dale, L. P., Mattison, A. M., Greening, K., Galen, G., Neace, W. P., & Matacin, M. (2009). Yoga workshop impacts psychological functioning and mood of women with self-reported history of eating disorders. Eating Disorders: The Journal of Treatment & Prevention, 17(5), 422–434. doi: http://dx.doi.org/10.1080/ 10640260903210222 Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S., . . . & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570. doi: 10.1097/01.PSY.0000077505.67574.E3 Descilo, T., Vedamurtachar, A., Gerbarg, P. L., Nagaraja, D., Gangadhar, B. N., Damodaran, B., . . . & Brown, R. P. (2010). Effects of a Yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunami. Acta Psychiatrica Scandinavica, 121(4), 289–300. doi: 10.1111/j.1600-0447.2009.01466.x Duraiswamy, G., Thirthalli, J., Nagendra, H. R., & Gangadhar, B. N.

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INTEGRATING YOGA AND PSYCHOTHERAPY TO TREAT DEPRESSION: A LITERATURE REVIEW SUSAN ROBBINS SAINT PAUL UNIVERSITY

Abstract Depression is one of the most prevalent and debilitating mental health conditions worldwide. Increasingly, yoga has become a complementary alternative treatment of choice for people with depression, particularly those for whom standard psychopharmacological interventions are less effective. While yogic elements such as breathing exercises and mindfulness have become mainstream inclusions in many modern psychotherapeutic theories and practices, there has been less emphasis on the integration of movement, or yoga asana, into traditional treatment plans. Through a review of the literature, this paper will explore the various ways in which the physical practice of yoga has been used to treat depression therapeutically. It will also summarize our current understanding of the mechanisms of depression and how its symptomatology might be addressed using yoga as a therapeutic and spiritual intervention. Limitations to current research methodologies and considerations for clinical practice will also be discussed. Interest in the use of yoga as a complementary therapy for physical and mental illness has increased steadily over the past 50 years (Forfylow, 2011; Mehta, 2010; Pilkington, 2005; Saeed, 2010; Woodyard, 2011). In the area of mental health and wellness, elements of this complex, holistic system have made their way into individual and group-based treatment approaches; primarily as an adjunctive treatment to more traditional psychopharmacological and psychotherapeutic interventions. In mental health circles, yoga is understood as helping to reduce the stress that

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typically contributes to and exacerbates many of the more prevalent mental health conditions, such as anxiety, depression and post-traumatic stress disorder (Salmon 2009; Spinazzola, 2011; Streeter, 2012). The relative accessibility of yoga, in terms of its widespread availability, its affordability, and its focus on promoting health and wellness, has made it one of the most popular and preferred complementary medicines in North America (Forfylow, 2011). It has garnered particular attention from those who suffer with depression, mainly because of the long-term adverse effects of many antidepressant medications, such as weight gain and sleep disturbances (Uebelacker, 2010a). Because yoga tends to focus on promoting good physical and mental health as opposed to treating specific maladies, movement-based yoga may help depressed patients manage their weight more effectively as well as contribute to more consistency in sleep patterns (ibid.). Despite yoga’s increasing popularity, research examining its efficacy as a treatment for depression is relatively limited and the actual mechanisms underlying yoga’s direct therapeutic effects remain somewhat unclear (Evans, 2009). Research attempting to quantify yoga’s effectiveness at both a neurophysiological and psycho-social level has generally lacked the level of scientific rigor and empirical reliability required for more mainstream acceptance and endorsement from healthcare providers and practitioners, including psychotherapists (Shapiro, 2007; Uebelacker, 2010b). For the most part, clinicians who opt to incorporate yogic principles and practices into psychotherapy tend to focus on its breathing and meditative components to support or enhance existing treatments (Brown, 2013); however, few approaches make use of yoga’s body-centered interventions. Given increasing evidence which points to the importance of physical movement in the regulation of the nervous system and emotions (Salmon, 2009; Zope, 2013) the relative absence of movement-based interventions in psychotherapy therefore warrants further investigation (Salmon, 2009). Though a comprehensive literature review, this paper aims to summarize and critically evaluate current research related to the integration of yogic movement and psychotherapy to treat depression. Main themes and clinical applications will be summarized and practical considerations and limitations discussed. Yoga and psychotherapy share a common intent—to cultivate self-awareness, self-understanding, and selfacceptance and to promote an increased sense of authenticity in one’s relationship with oneself and with others. Learning how the interplay between psychotherapy and yoga asana (postures) can be leveraged to provide benefits to individuals with depression offers potential value to

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clients with depression and merits further consideration in terms of its clinical relevance.

Literature Review Understanding Depression Depression can be generally described as “an emotional state experienced by people when they have had a loss” (Zahourek, 2000, p. 77). The DSM-V (American Psychological Association, 2013) defines a spectrum of depressive disorders ranging from disruptive mood dysregulation disorder, to dysthymia, to major depressive disorder. It also includes qualifiers that more specifically describe how the depression is presenting; for example, as anxious or melancholic. Diagnosing depressive conditions depends on a number of different criteria including frequency and duration of physical symptoms, psychosomatic indicators, depressive thought patterns and suicidal ideation, and psychosocial impairments, such as low self-esteem and feelings of unworthiness (American Psychological Association, 2013). Despite this refinement in diagnostic criteria, depression remains a complex, multi-dimensional and, often, debilitating mental illness. It impacts biological processes that regulate the functioning of the nervous, endocrine, and metabolic systems and impairs cognitive, psychosocial, and physiological functioning to varying degrees and intensities (Meyer, 2001). Depression can affect memory, reduce self-confidence, impair relationships, and increase the risk of high blood pressure, heart disease and illnesses of the immune system (ibid.). People with depression also report high levels of ruminations, anxiety, and interpersonal difficulties (Kinser, 2013a). Ruminating, or repetitive negative thinking, influences the stress-depression cycle and increases the overall loading on the body’s regulatory and immune systems, which, over time, increases susceptibility to harmful long-term health effects such as hypertension, heart disease, obesity, osteoporosis, and heart attack (McEwan 2004; Streeter, 2012). For those who suffer with depression, the burden of living in a perpetually stressful state therefore impacts not only cognitions, behaviors, and emotions but also overloads the underlying neurobiological systems, jeopardizing physical as well as mental health.

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Defining Yoga With its roots in ancient India, yoga originated as a spiritual and ascetic discipline in the Hindu tradition consisting of breath control exercises, meditative practices, and a series of bodily postures (Forfylow, 2011; Nagendra, 2008). Pantajali, the Indian sage whose writings form the foundation of our modern-day interpretation of yoga, describes eight limbs of the yoga system, which include postures (asanas), breathing exercises (pranayamas), concentration (dharana), and meditation (dhayana) (Satchidananda, 2012; Weintraub, 2004). The Yoga Sutras also articulate a set of values that serve as guiding principles not only for the yoga practice but also for how to apply and integrate yoga to all aspects of life. Yama (ethical behavior), niyama (selfdiscipline), pratyahara (sense withdrawal), and samadhi (deep meditative awareness) serve as the philosophical and ethical practices (Desikachar, 1995). When combined with the postures, breath, and meditative aspects, this interconnected system creates a holistic prescription for overcoming the obstacles to our inner awareness (Evans, 2009). In many yoga traditions, the asanas are considered the primary yoga practice with the view that some degree of physical preparation and strengthening of the body is required in order to be able to engage in the controlled practices of the breath inherent in the pranayama practice (Weintraub, 2004). Moreover, the physical practice offers sufficient training ground for being able to observe the body from a more introspective place, eventually detaching from the external world and augmenting the volume on one’s interiority. Ultimately, the postures help create fertile soil for the exploration of discipline, intentionality and devotion, and serve as metaphors for the challenges and triumph we face in life (Cortright, 2007). As yoga has steadily gained in popularity in the West, integrating yogic philosophy and practices into health and wellness disciplines to help relieve pain and suffering has become more accepted and widespread. In the case of depressive illnesses, several yoga therapists (Iyengar, 2008; Simpkins & Simpkins, Sparrowe, 2002; Weintraub, 2004) have devised posture-based treatments to strengthen the body, ease the mind, and offer a way of being. These include restorative postures, such as supta sukhasana (reclining easy seated pose), savasana (corpse pose), and setu bandha sarvangasana (supported bridge pose) (Sparrowe, 2002). Standing postures such as adhomukha svanasana (downward-facing dog), uttasana (forward fold), and ardha chandrasana have also been proposed as well as inverted postures such as salamba shirsasana (headstand) and urdhva

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dhanurasana (back bending) (Iyengar, 2008; Sparrowe & Sparrowe, 2002). These authors maintain that, ultimately, the physical yoga postures require a rigorous and continuous self-examination of the body and, inevitably, a kind of tension and strain that will shine a light on the condition of one’s inner resources.

Yoga to Treat Depression Overall, the literature documents four main types of yogic interventions in the treatment of depression, including: Hatha, Iyengar, Vinyasa, and Sudarshan Kriya Yoga (SKY). Mindfulness-Based Stress Reduction (MBSR) therapy has also integrated yogic movement into its group-based treatment program as part of a multi-modal approach for managing depression and other mood-related disorders (Uebelacker, 2010a). While the empirical evidence is still accumulating, preliminary studies point to the voluntary regulation of the breath as the likely mechanism that mediates the therapeutic effect of these forms of yoga in treating depression (Da Silva, 2009).

Hatha Yoga Hatha relies on a series of physical postures, such as seated, standing, and inverted poses, and focused breathing and relaxation practices, including guided meditation and restorative postures, intended to facilitate the union of body and mind (Sparrowe, 2002). In a study examining the effectiveness of hatha yoga in the treatment of depression among women, Kinser (2013a, 2013b) found that a combination of instructor-led gentle hatha yoga classes combined with an at-home practice with videos and handouts reduced self-reported feelings of depression in a small group of women with major depressive disorder or dysthymia. The results of this eight-week intervention suggested that the hatha yoga practice provided women with a self-care strategy for the stressful and ruminative thoughts associated with the participants’ depression, took the focus off their ruminations, and helped them manage their persistent thinking patterns more effectively (Kinser, 2013a). It has also been postulated that the conscious regulation of the breath, induced through a series of yoga postures, modulates the autonomic nervous system (ANS), namely by reducing the tone of its sympathetic branch (Salmon, 2009). Furthermore, because depression is often associated with a cessation of awareness of the body and with excessive

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patterns of negative thinking, the hatha yoga intervention may have encouraged participants to become more aware of sensations in specific parts of their body while holding different poses (Kinser, 2013a). This mindful attention to the postures may have facilitated better integration of the mind and body and diminished cognitive ruminations. Additionally, the calming and restorative elements of the yoga practice may have enhanced feelings of safety and allowed for the activation of neural circuitry associated with social engagement, which contributed to participants’ increased sense of connectedness (Kinser, 2013a). As having a sense of self is highly correlated with mental wellness, this particular finding has important implications for longer-term recovery from depression (Kinser, 2013b). The researchers further proposed that developing this non-judgmental, more mindful practice may have allowed for more positive self-talk and cognitive restructuring, thereby decreasing participants’ depression. The notion of being able to confront limitations through challenging yoga postures was also deemed to be instrumental in stopping the negative self-judgments typically witnessed in depressed individuals. Butler (2008) also found hatha yoga to show promise as an intervention aimed at symptom reduction in clients with dysthymia and other long-term forms of depressive illness. In a study that compared yoga and meditation with group hypnosis, participants were offered instruction and practice in mindfulness meditation, hatha yoga, breathing techniques, guided imagery, and mantra repetition in a staged, group-based intervention that took place over a 12-week period and included a 9-month follow-up. The results indicated that while participants in the yoga and meditation treatment group were more likely to experience a remission in their depressive condition at follow-up, nearly just as many in the hypnosis group reported the same results (Butler, 2008). While the data provided preliminary support for the use of both kinds of interventions to improve depression, the differences were not statistically significant from that of a control group, who received only the psycho-education element. The researchers speculated that because depression is a mood disorder that dominates cognitions, a longer-term treatment period is warranted in order for yoga and meditation-based interventions to show significant effects. The use of multiple types of interventions in one treatment group may have also confounded results (Butler, 2008).

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Iyengar Yoga Another widely recognized and practiced branch of hatha, Iyengar yoga has also shown promise as an intervention for treating depression (Khattab, 2007; Riley, 2004; Woolery, 2004). Based on the teachings of yoga master B. K. S. Iyengar, this practice is primarily posture-based and places strong emphasis on physical alignment, with the view that willpower is gained through strengthening the body and the mind (Iyengar, 2008). Within the Iyengar tradition, specific postures and posture sequences are thought to be particularly effective for alleviating depression; namely, back bends, inversions (i.e., postures that require the head to go below the heart), and vigorous standing poses that often involve deep forward bending and/or balancing elements (Iyengar, 2008; Simpkins, 2011; Woolery, 2004). In a pilot study that investigated the effects of a short-term Iyengar yoga course on mood in mildly depressed young adults, Woolery (2004) tested how an Iyengar-derived sequence of physical postures, as opposed to breathing and meditation, impacted mood in persons who were depressed. After attending 2 one-hour classes for five weeks, participants showed significant decreases in self-reported measures of depressive symptoms (Woolery, 2004). Reductions were also documented in participants’ levels of confusion and total mood disturbance by the end of the test period. During the intervention, participants were encouraged to learn fairly difficult postures, particularly those that lifted and opened the chest, such as back bends, which may have contributed to stress relief and a sense of mastery and may have helped counter the slumped body posture that is often associated with depression (Woolery, 2004). Overall, the findings provide supporting evidence for the effectiveness of yoga postures in helping to improve mood in mildly depressed persons; however, the study incurred several methodological flaws including small sample size, short-term intervention period, and inconsistent control group conditions (Woolery, 2004).

Vinyasa Yoga Also derived from the hatha tradition, vinyasa yoga includes components of breath control, physical postures, and meditation and incorporates a breath-linked movement from one posture to the next with a coordinated breath pattern (Jois, 1999). The results of a two-month intervention of vinyasa yoga showed decreases in depressive symptoms and an increase in mindfulness and behavior activation (Uebelacker,

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2010b). Benefits included emotional regulation, demonstrated by greater feelings of calmness and a lowered incidence of crying; physical improvements in terms of sleep, weight, and decreased pain; and social gains related to a sense of being able to connect with others. Interestingly, none of the participants reported a preference solely for the physical component of the intervention; rather they preferred a focus on both the meditative and movement-based aspects of yoga as well as on breathing exercises. These findings indicate that the practice of yoga may offer some kind of intrinsic reward to depressed individuals, which, when combined with a mindfulness component, may provide them with an alternative way of thinking about themselves, others, and the world that is less ruminative and may subsequently enable them to engage in other pleasant, enjoyable activities (Uebelacker, 2010a, 2010b).

Sudarshan Kriya Yoga (SKY) Sudarshan Kriya Yoga, or SKY, has been implemented in group settings to support symptom relief and healing from conditions such as anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (Brown 2005a; Brown 2013; Javnbakht, 2009). SKY is a unique yogic breathing practice that involves five different types of cyclical breathing patterns, including ujjayi, or “ocean breath,” wherein the gentle contraction of the laryngeal muscles and partial closure of the glottis generates a wave-like sound and controls airflow so that each phase of the breath can be sustained according to a specific count. Other techniques include bhastrika pranayama, or “bellows breath,” the rapid inhaling and exhaling of air, the chanting of the mantra Om with prolonged exhalation, along with advanced Sudarshan Kriya cyclical breathing technique, all aimed at shifting the dominant nervous system state from sympathetic to parasympathetic via stimulation of the vagus nerve (Brown, 2005a; Brown, 2005b; Zope, 2013). It has been postulated that using alterations of breathing patterns from calming to stimulating improves autonomic nervous system function and neuroendocrine release, and modulates the hypothalamic pituitary adrenal (HPA) axis by releasing prolactin, vasopressin, and oxytocin, the latter of which has been found to be low in people with major depression (Zope, 2013). Practiced primarily as a self-help stress management strategy, SKY participants claim that it reduces stress, anxiety, and depression and increases optimism (Kjellgren, 2007). In a study comparing the effects of SKY to antidepressant and electroconvulsive treatments (ECT) in the treatment of major depressive

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disorder, Janakiramaiah (2000) found that the mean scores on two depression inventories following a four-week SKY intervention were comparable with mean scores of those receiving antidepressants but not lower than the ECT group. Notably, the SKY treatment group that experienced remission from their depressive symptoms showed a stability of responses over time. Unlike hatha-based yogic interventions where there is a strong focus on physical movement, SKY does not typically include the use of postures or posture sequences; rather the approach includes more resting and restorative postures such as savasana (“corpse pose”) and a yoga nidra, or deep-sleep-like experience in order to calm the body, direct the focus to the breath, and induce a more meditative state. Encouragingly, preliminary investigations demonstrate that the SKY intervention shows treatment results that may be on par with psychopharmacological interventions without the side effects often reported with the use of antidepressants; however, its use in clinical settings has been quite limited and longer-term effects have yet to be determined (Zope, 2013); further and more robust research in this area is warranted.

Mindfulness-Based Stress Reduction (MBSR) The use of yoga interventions in group settings is a component of Mindfulness-Based Stress Reduction (MBSR) therapy. Originated by John Kabat-Zinn, MBSR integrates two separate sequences of hatha-based yoga postures aimed at encouraging participants to focus on the present moment by moving through a series of postures and focusing on the breath (Hazlett-Stevens, 2012). Studies examining the effectiveness of MBSR point to the strong association between the yoga practice element of the intervention and improvements in psychological well-being and stress reduction (Hazlett-Stevens, 2012; Salmon 2008). The posture sequences in MBSR consist of poses typically found in other yoga traditions, such as Iyengar and Ashtanga practices. These include forward bending postures, back bending, standing postures with extensions, and spinal twists (Iyengar, 2008). In MBSR, the postures are used as part of a two-staged intervention and are neither overly strenuous nor practiced in a static way; rather they are sequenced in such a way as to promote smooth and flowing movement, rhythmic breathing, and focused attention. Reportedly, the physical postures have shown to be more highly correlated with improvements in well-being over the other program components, such as body scanning and meditation (Salmon, 2008).

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Based on these findings, it is reasonable to assert that incorporating the physical practice of yoga as part of a multi-faceted approach to the treatment of depression has important implications that warrant consideration from a broader psychotherapeutic vantage point; and yet, with the exception of mindfulness-based intervention models like MBSR, few Western psychological models have availed themselves of movementbased interventions in any kind of methodical, systematized manner (Forfylow, 2013; Salmon, 2008). Research points to several plausible factors that may explain the reluctance to integrate yogic movement into psychotherapy.

Research Design and Methodology In a literature review of the research examining the effectiveness of yoga as a treatment for depression, Pilkington (2005) summarized a total of five randomized control trials (RCTs) that studied the effectiveness of yoga as an intervention for depression. The findings of this review indicated that yoga-based interventions that involved rhythmic breathing exercises and postures may have potentially beneficial effects on depressive disorders; however, because the interventions varied from one study to the next, the levels of depression ranged along the continuum from mild to severe, and each study employed different measures to diagnose severity; it was difficult to conclusively deduce which of the interventions or which aspects of the interventions were most effective in treating the depressive symptoms. Further confounding the generalizability of these findings was the omission of basic details of the design and trial methodology, such as the methods of randomization and whether or not assessors were blinded to the treatment and control groups (Pilkington, 2005). In a similar review, Da Silva (2009) found a total of nine RCTs and six open trial studies that investigated the use of yoga in the treatment of mood disorders. The findings provided similar conclusions about the overall effectiveness of yoga in the treatment of depressive disorders, including major depressive disorder, depressive episodes, and dysthymia. Notably, the review suggested that yoga has relatively good evidence as a standalone or complementary therapy to antidepressants in the treatment of mild to moderate depression and was found to be a mostly effective monotherapy in the treatment of dysthymia. It was shown to be less effective in the treatment of more severe, chronic depression. In the absence of controls for placebo effect or publication bias, however, these results are best considered with caution (DaSilva, 2009).

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The author also noted the drawbacks to existing research methodologies, such as the limited number of comparative studies of yoga against pharmacotherapy, the small numbers of study participants, variations in the use of measurements tools and assessments, and poor documentation of procedures and blinding methods (Da Silva, 2009). Most studies also reported issues with attrition rates of participants and few, if any, monitored effectiveness of the yoga treatment in decreasing depressive symptoms over the longer term (Da Silva, 2009; Salmon, 2009; Pilkington, 2005).

Emphasis on Dual Certification Reluctance on the part of psychotherapists to view yoga as a therapeutic intervention might also explain why asanas have been slow to make their way into the therapy room. This might be due to the current lack of specificity or standardization with respect to yoga postures or practices, coupled with discomfort on the part of therapists to introduce yogic interventions in the absence of formal training or certification (Salmon, 2009). From a professional and ethical standpoint, dual certification is becoming increasingly recognized and required for therapists who are recommending yoga to their clients and/or using yogic techniques such as mindfulness and meditation in their practice (Briere, 2012; Forfylow, 2011). In terms of yoga’s relevance to psychotherapeutic practice, its focus on incremental, deliberate movement and inner-directed attention serves to create a sense of intentionality and presence in the here-and-now, which for depressed clients helps cultivate a mindset that is more focused and less ruminative and allows for a gentler, kinder brand of self-regard and self-acceptance (Kinser, 2013a). Valente and Morotta (2011) suggest that yoga can be prescribed as a supplement and support to psychotherapy. They maintain that as in psychotherapy, clients who practice yoga are encouraged to reflect and analyze their emotional states and act in an intentional and appropriate manner to reduce their levels of emotional reactivity. They further suggest that as clients experience the benefits of breathing through difficult yoga postures and accepting their own strengths and limitations in the practice, so, too, are they able to confront challenges in other aspects of their lives in a less stressful and anxious manner.

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Assessing Client Readiness When determining whether or not a yogic intervention is appropriate, it is imperative that the clinician assess its therapeutic value as well as gauge openness and receptivity on the part of the client. Given the high comorbidity of depression with other mental health conditions, careful consideration must be afforded to possible negative consequences of a somatic-based intervention, particularly with trauma survivors (Briere, 2012; Rothschild, 2005). A thorough exploration of the client’s history, including any pre-existing physical ailments, is also an important part of the therapist’s screening criteria. Where a likelihood of contraindications to physical movement is noted, the therapist is also required to consult with other medical care professionals to ensure that yoga postures will not exacerbate any existing injuries. Likewise, the therapist is obliged to inform clients of the potential risks of a yogic intervention and comply with a client’s choice to continue or cease the intervention (Forfylow, 2011). Many clinicians may refrain from using yoga in psychotherapy because they do not know how to thoroughly assess client readiness for physical movement. They may also lack access to resources with whom they could collaborate in order to correctly and confidently suggest a yogic intervention suited to client needs and abilities.

Training and Competence Whether integrating yogic principles and practices directly in session or recommending yoga as an adjunct therapy, it is incumbent on the therapist to uphold the continuum of care and ensure that clients are informed of their choices and options with regard to treatment. Because of the increasing use of complementary and alternative medicine, particularly amongst those suffering with symptoms of anxiety and depression, it bodes well for the therapist to become knowledgeable as to the nature and effectiveness of these therapies and be able to either implement them or refer to other qualified resources if it supports the treatment plan (Evans, 2009; Forfylow, 2011; Olsen, 2011). For therapists who choose to implement yoga in a more integrative way with psychotherapy, specialized training and certification in a specific yogic tradition is highly advisable. If referring out to other yoga therapists or resources, it is recommended that the therapist become familiar with local yoga professionals who are suitably qualified to collaboratively manage clients with depression.

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Like psychotherapy, yoga is a multifaceted behavioral intervention that can be taught in many different ways, depending on the teacher’s training and personality. Working in this inter-disciplinary, multi-modal manner creates opportunities for the client to explore treatment methods and interventions that align with their physical, mental, and spiritual needs (Valente, 2011). Consulting with a yoga teacher as a co-therapist is not entirely dissimilar from how a therapist would work with other care providers such as psychiatrists, doctors, or social workers.

Informed Consent Unlike psychotherapy, posture-based yogic interventions may require the therapist to adjust or help align the client in a given posture. This will necessitate that the therapist touch the client and possibly perform slight physical manipulations to ensure that the client is doing the pose correctly and not at any risk of injury. It is therefore professionally and ethically sound for the therapist to disclose this possibility to the client at the beginning of the therapeutic process and acquire the client’s informed consent. Furthermore, the therapist who holds dual certification in psychotherapy and yoga therapy must be mindful of ethical boundaries and be able to manage the codes of ethics, scopes of practice, and licensing and accreditation protocols associated with both fields (Forfylow, 2011).

Adapting to Client Needs and Ability Because depression can be such an enigmatic illness with varying clinical presentations, the therapist must be able to customize, tailor, and adapt yogic interventions to meet the physical and mental capabilities specific to each client. Research findings consistently emphasize adaptations of yoga postures and practices as a key differentiator affecting not only symptom reduction but also longer-term adherence to the intervention (Kinser 2013a; Riley, 2004; Uebelacker, 2010b). This is especially relevant in client populations with special physical and psychological limitations. Collaboration with experienced teachers in specific movement-based yoga traditions to ensure careful assessment and selection of postures and breathing exercises is therefore essential for ensuring maximal effects for clients and minimal risks and injury (Evans, 2009).

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Discussion While there is mounting research endeavoring to concretize the link between yoga’s effectiveness in treating depression, very few studies have done so in a way that employs rigorous research designs, methodologies, and clearly documented procedures. Much of the existing research on the effectiveness of yoga is hampered by methodological problems that detract from its empirical foundation and limit its clinical applicability. These problems include lack of a standardized interview to diagnose depression and a shorter treatment length when compared with other standard treatments for depression, such as cognitive-based therapy (CBT) and antidepressants. Small sample sizes, substantial variations in yoga intervention protocols, failure to control for confounding variables, and lack of specificity concerning randomization procedures further contribute to skepticism around the clinical applications of yoga within the psychotherapeutic community. Findings might be augmented and more empirical support might be generated by improving study designs so as to involve larger groups of participants followed in a longitudinal manner, including standardized measures for assessing depression, employing consistent implementation of yogic interventions, and using documented protocols and treatment manuals. Shortcomings are further complicated by the inherently integrated nature of a yogic intervention. Since the breath—an integral part of all yoga practices—is often linked to movement and to mindfulness, it is difficult to assert which aspect of yoga (i.e., movement, breathing, or meditation) is influencing the outcome and potentially treating depressive symptoms. To date, the yoga posture series included in MBSR is the only existing yoga program that incorporates a standard sequence of physical movement that has been systematically administered to and practiced by thousands of participants. In addition, the postures are integrated within a mindfulnessbased cognitive framework, which emphasizes the non-dualistic aspects of the underlying yogic philosophy and activates the hypothesized neurobiological mechanisms of action. It is therefore reasonable to assert that incorporating the physical practice of yoga into a multi-modal approach to the treatment of depression has important implications that warrant consideration from a broader psychotherapeutic vantage point. Nevertheless, with the exception of mindfulness-based intervention models like MBSR, few Western psychological models have availed themselves of movement-based interventions in any kind of methodical, systematized manner. The commonly held view on the part of many

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psychotherapists that yoga is associated more with physical fitness than it is with treatment for mental illness may also be contributing to the relative absence of yoga postures from psychotherapy. These limitations notwithstanding, the convergence of psychotherapy and yoga is gaining wider appeal as an integrated treatment approach to many mental illnesses, including depression. Because yogic practices incorporate elements of traditional psychological relaxation techniques and cultivate physical movement patterns that increase feelings of wellbeing, yoga provides a unified mind and body experience; a goal that psychotherapy also strives to achieve. As increasing numbers of people turn to complementary approaches to treat depression, it benefits the field of psychotherapy to become better acquainted with how and when these approaches are best served as part of the therapeutic discourse or how they may augment and support some of the more traditional interventions. On the one hand, an argument is made in favor of yoga solely as an alternative therapeutic intervention; one that is separate from the psychotherapeutic process and takes the form of community group programs or more private instruction outside of the therapy room. On the other, there is growing support and interest in practitioners with dual certifications who can offer yoga and psychotherapy in an integrated manner. Consideration of yoga as a method of self-care and professional development for the therapist may also encourage the integration of yoga with psychotherapy. Therapists are not immune to the relational dynamics and emotional dysregulation that can occur during therapy; therefore, in order to continue to be effective, uncovering one’s own biases, assumptions, beliefs, and prejudices requires regular and ongoing thoughtfulness and vigilance on the part of the psychotherapy practitioner. The ability to maintain one’s own internal balance and personal integration in the face of challenging psychotherapeutic work is imperative to the integrity of the process itself and the therapist’s well-being and professional longevity. Because a regular yoga practice can foster selfexploration and self-awareness, therapists stand to gain an enhanced ability to engage with clients more sensitively and empathically while remaining grounded in their own autonomy and emotional functioning.

Conclusion and Future Study As the incidence of depression in society increases, so, too, do the costs of treating what can be an elusive and enduring condition. Consequently, the search for alternatives to medication and other longer-

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term, less expensive treatments figures prominently in research circles, both in the fields of medicine and psychology. Investigating how yoga postures can be integrated directly into psychotherapy to treat individuals with depression appears to be an area of research that has yet to be fully explored due primarily to difficulties in sound research design and the prevailing view of yoga as an alternative or adjunctive treatment and not as a viable psychotherapeutic intervention. Efforts to enhance methodological rigor, clearly define concepts, and document treatment protocols would be key for future research. Focusing on how yoga asana specifically affects depression may provide more direction in terms of the kinds of postures that can be realistically integrated into the psychotherapeutic setting and the subsequent training that would be required for psychotherapy professionals.

Author Biography Susan Robbins, MEd, MA, is a Canadian Certified Counselor (CCC) in Ottawa, Canada. She recently completed a Master of Arts degree in Counseling and Spirituality from Saint Paul University. Susan currently runs her own private practice in the Ottawa area where she sees individuals and couples. She practices in an integrative manner, incorporating object relations, self-psychology, and psychobiological approaches into her counseling and therapy techniques. Susan is also a yoga practitioner in the ashtanga and hatha traditions. She has a particular interest in bringing yogic movement into her psychotherapy practice as an intervention for common psychological conditions such as depression, anxiety, and panic disorders. She is currently undergoing further certification in PACT (Psychobiological Approach to Couple Therapy) and will soon been commencing yoga teacher training. (www.galencounselling.com; [email protected])

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and students from accredited marriage and family therapy programs in the U.S. and Canada. Explore, 7(5), 320–325. Pilkington, K., Kirkwood, G., Rampes, H. & Richardson, J. (2005). Yoga for depression: The research evidence. Journal of Affective Disorders, 89, 13–24. Riley, D. (2004). Hatha yoga and the treatment of illness. Alternative Therapies in Health and Medicine, 10(2), 20–21. Rothschild, B. (2000). The Body Remembers. New York: W. W. Norton & Company. Saeed, S. A., Antonacci, D. J. & Bloch, R. M. Exercise, yoga and meditation for depressive and anxiety disorders. Complementary and Alternative Medicine, 81(8), 981–986. Salmon, P., Lush, E., Jablonski, M., & Sephton, S. (2009). Yoga and mindfulness: Clinical aspects of an ancient mind/body practice. ScienceDirect, 16, 59–72. Satchidananda, S. (1999). The Yoga Sutras of Patanjali. Buckingham, VA: Integral Yoga Publications. Shapiro, D., Cook, I.A., Davydov, D. M., Ottaviani, C., Leuchter, A. F., & Abrams, M. (2007). Yoga as a complementary treatment of depression: Effects of traits and moods on treatment outcome. Evidence-based complementary and alternative medicine. Advance online publication. doi:10.1093/nel114 Simpkins, A. M., & Simpkins, C. A. (2011). Meditation and Yoga in Psychotherapy: Techniques for Clinical Practice. New Jersey: Wiley. Sparrowe, L., & Walden, P. (2002). The Woman’s Book of Yoga and Health. Boston: Shambala. Spinazzola. J., Rhodes, A., Emerson, D., Earle, E., & Monroe, K. (2011). Application of yoga in residential treatment of traumatized youth. Journal of the American Psychiatric Nurses Association, 17(6), 431– 444. Streeter, C. A, Gerbarg, P. L, Saper, R. B., Ciraulo, D. A., & Brown, R. P. (2012). Effects of yoga on the autonomic nervous system, gammaaminobutyric-acid and allostatis in epilepsy, depression and posttraumatic stress disorder. Medical Hypotheses, 78, 571–579. Uebelacker, L. A., Epstien-Lubow, G., Gaudiano, B. A., Tremont, G., Battle, C. L., & Miller, I. W. (2010a). Hatha yoga for depression: Critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. Journal of Psychiatric Practice, 16(1), 22–33. Uebelacker, L. A., Tremont, G., Epstein-Lubow, G., Gaudino T. G., Kalibatseva, Z., & Miller, I. M. (2010b). Open trial of vinyasa yoga for

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persistently depressed individuals: Evidence of feasibility and acceptability. Behavior Modification, 34(3), 247–264. Valente, V. G., & Marotta, A. (2011). Prescribing yoga to supplement and support psychotherapy. In Worthington, E.L., Spiritually Oriented Inventions for Counseling and Psychotherapy (pp. 251–276). Washington, DC: American Psychological Association. Weintraub, A. (2004). Yoga for Depression: A Compassionate Guide to Relieve Suffering Through Yoga. New York: Broadway Books. Woodyard, C. (2011). Exploring the therapeutic effects of yoga and its ability to increase quality of life. International Journal of Yoga, 4(2), 49–54. Woolery, A., Myers, H., Sternlieb, B. & Zeltzer, L. (2004). A yoga intervention for young adults with elevated symptoms of depression. Alternative Therapies in Health and Medicine, 10(2), 60–63. Zahourek, R. (2000). Alternative, complementary, or integrative approaches to treating depression. Journal of the American Psychiatric Nurses Association, 6(3), 77–86. Zope, S. A., & Zope, R. A. (2013). Sudarshan Kriya Yoga: breathing for health. International Journal of Yoga, 6(1), 4–10.

YOGA AND ACCEPTANCE AND COMMITMENT THERAPY FOR ANXIETY: A CONCEPTUAL AND APPLIED INTEGRATION KATE MORRISSEY STAHL AND CHAD E. DRAKE COLLEGE OF FAMILY AND CONSUMER SCIENCES AND SOUTHERN ILLINOIS UNIVERSITY

Abstract Yoga can offer great value to psychotherapeutic work. To consider the effectiveness of yoga supplemented with established psychotherapeutic practices, two pilot groups were conducted to explore a combination of Acceptance and Commitment Therapy (ACT) and yoga in a group setting to address the needs of clients who self-identified as having struggled with anxiety. A rationale for the combination of these two approaches and a detailed description of a group combining yoga and ACT are offered here. The results are discussed and offered critical appraisal. Yoga has a range of positive effects for people experiencing difficulty with their emotions, from depression to anxiety to other issues. However, the research on how yoga is applied and how it could be integrated with more evidence-based forms of care is limited. This initial exploration considers how yoga could be combined with a strongly evidence-based approach to therapy, Acceptance and Commitment Therapy (ACT, pronounced “act”) (Hayes, Strosahl, & Wilson, 2012), to create a therapy that might capitalize on the substantial overlap between the well-

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researched effects of ACT and the well-known but less researched benefits of yoga.

Review of Literature Combining yoga with psychotherapy is a relatively new idea, therefore research is somewhat limited in terms of how and whether it works. The research that has been conducted on yoga for anxiety, however, has yielded fairly positive results, as has research on the component parts of yoga as they apply to well-being, like mindfulness. ACT has been better researched than yoga for use with anxiety. In combination, these two approaches might complement each other. Some research hints at possible benefits for yoga combined with ACT in the treatment of anxiety. Here, the literature on each part of the proposed integration between yoga and ACT are discussed.

Yoga Yoga, for the purposes of this study, has been defined in a relatively narrow way—as a series of movements synchronized with the breath and performed with attention to physical sensations. The breath, in the case of this particular yoga practice, was controlled and slowed throughout the practice. When participants noticed their mind wandering into thoughts, evaluations, or other distractions, they were encouraged to bring their attention back to their breath as a way to bring attention back to the body. The poses shared with participants were consistent with the broad tradition of hatha yoga (or modern postural yoga) as it is taught in the West, which is the most typical and popular type of yoga taught in the United States (Raub, 2002). However, yoga has been defined in different ways by different people, and has been used for a range of purposes. Indeed, this is one challenge in studying its therapeutic effects. Another challenge is that people practice for different amounts of time in different studies. Furthermore, varying approaches to yoga have very different types of movement and different foci, from losing weight to healing illness to self-realization (Khalsa, 2004). While the history of yoga is a convoluted one dating back hundreds, if not thousands, of years, the modern yoga tradition has generally taken root in Patanjali’s Yoga Sutras, a text compiled with commentary by Vyasa around 400 CE (Shearer, 1982). The system has expanded over the years and became popular in the West starting in the mid-nineteenth century

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(Fowler, 2010). In the West, yoga has largely been taught as a physical discipline, whereas traditionally it had much broader applications, such as the goal of achieving states of higher consciousness (Bachman, 2011). Much more could be said about yoga as a tradition; however, to do so is beyond the scope of the current project.

Yoga for Anxiety Yoga has been studied for use with anxiety, with generally positive results. A review of eight randomized studies in which researchers used yoga as an intervention for treating anxiety suggested that overall yoga was effective on its own for reducing symptoms of anxiety (Kirkwood, Rampes, Tuffrey, Richardson, & Pilkington, 2005). Other studies have suggested that anxiety scores can be reduced with even a single session of practicing yoga (Netz & Lidor, 2003) and especially with longer-term practice (Harinath et al., 2004; Waelde, Thompson, & GallagherThompson, 2004; West, Otte, Geher, Johnson, & Mohr, 2004). Active yoga poses, combined with rest, were found to have a greater effect on anxiety scores than a relatively inactive relaxation pose alone (Subramanya & Telles, 2009). Also, the physical practice of yoga and learning yogic philosophy both proved to lower anxiety, but the practice of yoga was more effective than learning the philosophy (Telles & Balkrishna, 2009). Overall, although the research is in its infancy, existing research suggests that yoga on its own may be helpful for anxiety.

Acceptance and Commitment Therapy ACT was originally known as Comprehensive Distancing and has its origins in behavior analysis (Zettle & Hayes, 1982). The first mature ACT protocol was published by Hayes, Strosahl, and Wilson in 1999, followed by an updated version in 2012. Currently, the ingredients of ACT are conceptualized via the “Hexaflex,” a hexagonal figure that displays the interrelations between the six components of ACT treatment (Hayes et al., 2012). Clinicians and clients alike learn to practice the skills represented by these components, which together make up a target of treatment known as psychological flexibility (Wilson & Dufrene, 2008). Psychological flexibility is defined as the ability to experience unpleasant and unwanted feelings and thoughts while simultaneously choosing to take action based on values (Hayes et al., 2012). ACT as a therapeutic approach includes activities that enhance and promote values, committed action, present-

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moment awareness, self-as-context, defusion, and acceptance. Each of these will be discussed in further detail below. The first two components of the hexaflex are values and committed action, though “first” could be somewhat misleading because the six components can be delivered in treatment in any order and they all overlap with each other (Hayes et al., 2012). These two can be clumped together as representing a broad repertoire for taking meaningful action, or being “engaged” (Hayes et al., 2012, p. 67). Values are directions or domains of life that a person cares about and finds meaningful in life. As the founders of ACT put it: Effective working tends to produce a sense of vitality, life connectedness, and a sense of health and well-being. This sense of flow and engagement emerges as a person makes contact with reinforcing events in the present that are intrinsic to deeply meaningful life actions. (Hayes et al., 2012, p. 92)

Values are qualities one would like for behavior to be inspired by; qualities that one finds meaningful. ACT therapists assist clients in exploring the values that are vital to them (rather than, for instance, vital to some other authority), and considering the difference between valuing, which has a sense of aliveness, and simple adherence to social norms and expectations, which may feel mindless or coerced or just lacking in emotional richness (Hayes et al., 2012). People do not “accomplish” their values, but instead are driven by them. Being loving, for instance, is a common value that could never be checked off of a “to-do” list because there are always more opportunities to engage in loving behavior as long as the person chooses to continue valuing it. In ACT therapy, goals are considered in terms of committed action: if one is taking action on values, what specific things might she do? As the founders of ACT put it, “committed action refers to a values-based action designed to create a pattern of action that is in itself values-based” (Hayes et al., 2012, p. 95). Committed actions are instances of values-directed behavior. These actions are clarified because in the absence of clarity around values-linked actions, people often take actions that are only beneficial in the short term. For instance, if a client is afraid of doing yoga in public, she might avoid doing this even though it might be meaningful for her to practice in a public group because she wants to cultivate relationships with others as well as develop her practice. In ACT therapy, then, she would be encouraged to take actions that link to the value of being compassionate towards her body through doing yoga, rather than actions that necessarily link to feeling comfortable, especially in the short term, like avoiding public classes. As will be described later, she would

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learn ways to relate to barriers to taking action like difficult thoughts or feelings in more sustainable ways. The next two components of ACT on the hexaflex are contact with the present moment and self-as-context. These can be referenced together as a repertoire for centered awareness (Hayes et al., 2012). Contact with the present moment includes noticing and appreciating the sensory details inherent in any situation as they are occurring, as opposed to being preoccupied with thoughts about the past, future, or another place. It is the practice of paying attention, and being able to direct attention to particular aspects of experience at will. This is important because “[c]lients who are not able to contact the here and now typically have difficulties in altering their behavior to fit the changing demands of their social context” (Hayes et al., 2012, p. 78). Self-as-context refers to a set of perspective-taking abilities (Hayes et al., 2012). This process is sometimes expressed as the verb “selfing.” It also can be described as flexible perspective taking; for example, an individual may be able to fluidly shift their perspective of self and others in different times, places, or situations. Empathy, selfcompassion, and a transcendent sense of self are thought to be potential products of self-as-context. Sometimes self-as-context is taught as being the opposite of self-as-content, with the latter including holding tightly to ideas and beliefs that one has about oneself regardless of context (i.e., I am bad, I am right). Defusion and acceptance comprise the last group of two, which could be regarded as repertoires for openness. Defusion entails opening up to thoughts in particular, noticing thoughts as thoughts rather than getting stuck in the literal content of the thought (Hayes et al., 2012). It also is being aware of thoughts rather than trying to change or suppress them. For instance, if a client notices the thought “I am bad” in a defused way, she might notice the physical properties of experiencing that thought more than the meaning of the words in that thought. When defused, people are more able to see a thought as an experience that is occurring now rather than a declaration or rule that must be followed or believed. Engaging in defusion with troubling thoughts makes it less likely that a person will engage in private dialogue about whether the thought is literally true. Since ACT rests on pragmatic philosophy (Vilardaga, Hayes, & Schelin, 2007), the relevant question about thoughts once they are recognized is whether they are helpful in that context or not, rather than whether they are true in some absolute sense. Acceptance is the sixth component of the hexaflex (Hayes et al., 2012). It is often practiced with emotions, and is the process of becoming aware of emotional sensations in an open, curious way, rather than taking actions

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to try to distract from or get rid of them. With acceptance, one would especially work to create space for difficult emotions that are likely to arise when taking valued action. For instance, if a client wants to reunite with his estranged children after ten years of separation from them during a time of alcohol dependence, he is likely to feel a range of emotions in taking this action, some more pleasant and easy to accept than others. If a person is starting a yoga practice after years of very little activity, she may feel embarrassed when she comes to class. With practice, emotions can be seen less as threatening and more as intense physical sensations that are not dangerous even when they are uncomfortable. Thus, activities that enhance and promote values, committed action, present moment awareness, self-as-context, defusion, and acceptance make up the therapeutic approach of ACT. They are the main skills that clients learn. They are not regarded as independent of each other, but rather interconnect and support each other. For this reason, current ACT protocols do not prescribe any particular order in the delivery of these components in treatment. Instead, practitioners may deliver particular components strategically based on assessment of a client’s relative strengths and weaknesses among the processes. ACT has some overall assumptions that support it. Well-being, according to this model, is measured by psychological flexibility, as previously mentioned. Success with ACT means that clients are less concerned about their thoughts and feelings and more engaged in valued areas of their lives, not necessarily and definitely not only experiencing lower levels of symptoms (Hayes et al., 2012). Therapists tend to view clients as “stuck” rather than “sick,” as this is not a medical model of functioning. Clinicians also practice, in training and then in sessions, modeling psychological flexibility for their clients, “not as an expert, but as a fellow human being” (Hayes et al., 2012, p. 148). The overarching idea is that the therapist and the client are both humans with all the wonder and challenge implied by that. Both have life struggles and are working to lead meaningful lives, even though the details of the struggles and what is considered meaningful may be different.

ACT for Anxiety Many studies of ACT have found it to be effective for anxiety, in addition to a broad range of other problems (Ruiz, 2010). In a review of studies of ACT used for anxiety, Swain, Hancock, Hainsworth, and Bowen (2013) found support for the effectiveness of the approach for a broad range of types of anxiety and populations experiencing anxiety. In another

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review, Bluett, Homan, Morrison, Levin, and Twohig (2014) found that ACT is as effective as treatments like manualized cognitive behavioral therapy for anxiety and obsessive-compulsive disorder-spectrum issues. The American Psychological Association’s (APA) Division 12, which tracks evidence-based practices, lists ACT as efficacious for treating mixed anxiety (as well as depression, psychosis, obsessive-compulsive disorder, and chronic pain) (Society of Clinical Psychology, n.d). Mixed anxiety, in this case, means that it is effective with a broad range of types of anxiety, from panic to obsessive-compulsive disorder to generalized anxiety disorder. On its own, ACT is effective in treating anxiety. Because of ways it philosophically and practically overlaps with yoga, it is likely that yoga would support this type of treatment.

Combination of Yoga and ACT Little research has been conducted combining yoga and ACT. To our knowledge, the only study published exploring yoga and ACT has been for treating epilepsy (Lundgren, Dahl, Yardi, & Melin, 2008), and in that case the two treatment methods were not combined, although both proved helpful. Those authors, in their discussion, point out that “[b]oth protocols include mindfulness training, acceptance of private events, discussions about losses of meaningful life directions, commitment towards important life directions and inclusion of significant others during both individual and group sessions” (Lundgren et al., 2008, p. 106). Despite this lack of research, it is reasonable to believe that ACT and yoga could be complementary practice and to lay the groundwork for gathering empirical support for this claim. Theoretically, ACT and yoga complement each other in terms of goals and practice. In terms of goals, both yoga and ACT work to connect people flexibly to their own experience. The practice of yoga has been linked to more claims about what one’s own deepest experience might be, which is not true of ACT. Nevertheless, this focus on being aware of experience in the moment is similar. Usually, practicing yoga is part of a committed action linked to people’s values: they may want to care for their bodies or practice being able to bring their attention to their breath so that they are more likely to take effective action in the world. ACT is a very experiential type of therapy—indeed, too much focus on understanding the concepts of ACT without practicing experientially can be deleterious (Hayes et al., 2012). Yoga provides an excellent opportunity for experiential engagement with ACT philosophy. For example, it is common that during a hatha yoga practice, a practitioner would experience

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a range of thoughts and feelings. To the extent that they are encouraged to notice the thoughts and feelings and to respond with curiosity to them, they are enacting an ACT approach. One might think, for example, that she cannot hold a plank position and may experience intense physical sensations along with this thought. Her shoulders and core burn and her legs shake. Her mind says “I have to stop” long before she physically would collapse. In yoga, she could practice staying with these intense physical sensations, noticing the thought, anchoring her attention back on the breath, and staying for a bit longer in that position. This is similar to what a person can learn to do when intense emotional experiences arise or when thoughts that are not helpful make a person want to stray from the path she has chosen for herself. The therapeutic processes are similar in both approaches. Beyond this, other similarities exist. In yoga as well as in ACT, a non-pathological approach tends to be applied. People do not typically come to yoga due to pathology; more often they are simply seeking to make their lives even better. When people are having difficulty in yoga, they are encouraged to work through difficulty, possibly being similar to ACT in seeing people as “stuck” rather than “sick,” as discussed above. In many westernized forms of yoga, an egalitarian relationship also is practiced between teacher and student, although traditionally some fairly rigid hierarchies did and continue to exist in the teacher-student relationship. Through these similarities, ACT and yoga could be complementary to each other in treatment, and these dimensions have been shown to be helpful in therapy. Beyond this, both yoga and ACT target core processes of mindfulness, acceptance, and finding meaningful direction. Each part will be discussed in detail below. The processes also will be linked to other related therapeutic approaches to support the argument that these processes are important for living well. Mindfulness. Mindfulness training is a component of a wide range of therapies, from Mindfulness Based Stress Reduction, to Dialectical Behavioral Therapy, to Mindfulness-based Cognitive Therapy, to Metacognitive Therapy, to Acceptance and Commitment Therapy, and beyond (Baer, 2006). The proliferation of mindfulness in evidence-based forms of therapy suggests its usefulness, and indeed much research supports the benefits of mindfulness for use in therapy (Baer, 2006). Yoga can be used as a form of mindfulness training. For instance, yoga practitioners may be taught to bring their attention repeatedly back to their breath and body. Also, yoga practitioners are often encouraged to notice thoughts and sensations with curiosity and openness. This could help practitioners to use executive control in directing their attention and to

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cultivate openness and curiosity towards difficult sensations such as those associated with anxiety. Acceptance. A component of mindfulness is often acceptance. This involves taking a stance of observing rather than working to change uncomfortable private experiences. In yoga, this component would be practiced regularly by practitioners staying with the practice although difficult body sensations could be occurring. An important element of acceptance is having a sense of what can and cannot be changed. For instance, it is more likely that one can change one’s current actions rather than one’s history or the automatic thoughts that show up based on one’s history (Hayes, 1994). It is more likely that one could consistently show up to yoga class than that one could put one’s leg behind her head on the first day of class. This approach has shown to be useful in therapy with anxiety. Indeed, some studies have suggested that avoidance of internal distress and anxiety are positively associated (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). Rather than trying to change difficult internal events, “techniques that promote active problem-solving for those concerns that can be addressed practically, as well as interventions that involve exposure to worrisome cues and engagement in desired activities, may be beneficial” (Roemer & Orsillo, 2002, p. 59). Yoga could be a useful place to practice this skill: sometimes the pose itself can be changed, and other times it might be best to practice with awareness that some discomfort is normal. Knowing when to do which comes from the cultivation of wisdom. Meaningful life directions. The importance of encouraging people to do meaningful things with their lives has been important in a range of therapies. Through the identification of valued life directions and engagement in committed action, ACT emphasizes clarifying what is important in one’s life and taking action in the areas that are important (Hayes et al., 1999; Hayes et al., 2012). Yoga can itself be an action that is part of a meaningful life direction, such as taking care of one’s physical and psychological health. In addition, many yoga classes encourage setting intentions for one’s life and sorting out ways to live according to one’s values. Given the apparent overlap between yoga and the behavioral repertoires promoted by ACT, we decided to explore the viability of adding ACT components to a yoga group attended by people with concerns about anxiety. We devised a six-session protocol, each of which involved yoga and contained additional activities oriented to one of the hexaflex processes. Attendees were invited to respond to a set of self-

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report measures administered at various times in order to assess their response to this treatment.

Pilot Study: Method Participants Participants were recruited with posters displayed at a yoga studio in central Georgia advertising “Yoga for Anxiety.” Participants self-selected to join the group and paid a minimal fee ($10 per session) to participate. All participants self-identified as having difficulties related to anxiety. Two separate groups of participants received the intervention. Each group contained nine participants.

Measures A package of self-report measures was provided before the first session and at the conclusion of the sixth session. The Acceptance and Action Questionnaire (AAQ-II) is a seven-item scale measuring psychological flexibility, the target of ACT treatment. Psychological flexibility is associated with improved well-being on a number of measures, including anxiety, depression, and many others (Bond et al., 2011). The Valued Time and Difficulty Questionnaire (VTDQ) is an experimental measure of committed action. It assesses the importance of particular life domains, the amount of time engaged in each, and the degree of difficulty in engagement due to private experiences. The General Health Questionnaire (GHQ-12) is a measure of general psychological distress (Schmitz, Kruse, & Tress, 1999). Participants also filled out a brief questionnaire at the beginning of sessions two through six called the Weekly Experience Questionnaire (WEQ). This measure contained four questions about the respondent’s experience in the past week. The questions were designed to assess ACTrelevant experiences, inquiring about suffering (“how often did you feel stressed, anxious, depressed”), efforts to control suffering (“how often did you try to control your discomfort”), engagement in mindfulness activities (“how often did you do mindfulness activities from group”), and valuesconsistent action (“how often did you do activities that are consistent with your values”). At the end of each group, participants also filled out qualitative evaluations that helped to provide insight and recommendations for subsequent groups. Questions inquired about level of participation,

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whether goals were met, aspects of the group that worked well and less well, and space for other feedback.

Procedure Each group received six weekly sessions of Yoga for Anxiety. The first was provided during the fall of 2011 while the second occurred in the winter of 2012. The treatment protocol for the second group was slightly different from the protocol for the first group because between the first and second session, some of the session protocols were reworked in an effort to adapt to the results from the first session. Both groups were led by the first author, a clinical social worker and certified yoga teacher. Sessions consisted of one hour of generally didactic exploration of ACT principles followed by one hour of yoga during which the principles learned were explored more experientially through asana practice, which is the practice of holding certain poses and being attentive to one’s breath and body in the poses.

Pilot Study: Intervention Two different six-week interventions were offered. The second version of the intervention will be described in detail below. This is because evaluation data indicated that this second approach was more effective than the first at achieving the stated goals of the group. As applied integrations of ACT and yoga continue, this intervention could be used and reworked as needed. To explore what structure would work best for the group, Morrissey Stahl led two different groups. In the first, she tried one protocol based on existing literature about running ACT groups for anxiety. With feedback from the first participants, she improved the protocol for the second series. The groups were broken into two weeks addressing issues of body, two weeks exploring issues of mind, and two weeks considering taking action in the world. In the first week, Morrissey Stahl led the group in an exercise simply called “Centering Exercise” in ACT for Anxiety Disorders (Eifert & Forsyth, 2005). The exercise offers instructions for being aware of physical stimuli like breath and sounds. Following this, each participant checked in, answering this question: “What is one thing you would do if you were less anxious?” This set the stage for consideration of what might be valued actions or goals that the group could support beyond symptom reduction. Morrissey Stahl then led the group in a discussion about anxiety. The group considered when anxiety might be useful, and when it

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can seem like a problem. The intent here was to get a sense of how participants were thinking about anxiety and also to start to loosen inflexible ideas about anxiety like the idea that anxiety is always in and of itself a problem. Morrissey Stahl next led the group in the “Sweet Spot” exercise (Wilson & Dufrene, 2008). This practice includes a variety of elements of ACT, including mindful body awareness, values, defusing from unhelpful thoughts of needing to convince by the speaker or needing to say the right thing by the listener, a sense of perspective-taking (I-herenow vs. you-there-then). It also illustrates powerfully the possibility of connection between participants, as the speaker and listener often report feeling much closer after this exercise. The group took a short break to set up yoga mats and then completed a gentle 60-minute hatha yoga session including sun salutations, standing poses, gentle back bending, forward bends, and then muscular tensing and releasing while lying on the ground followed by 10 minutes of savasana, final resting pose, in which one relaxes in a reclining position on the ground. Modifications were offered in cases where certain poses were not appropriate or contraindicated. The participants were invited to write out a self care plan for the next week as one simple way to start engaging with a valued direction they all expressed caring about. In the second session of group one week later, the group began with an exercise of noticing physical sensations and setting an intention for themselves in group that day. In check-in, each group member discussed their experience with the self-care lists they had made. The bulk of the rest of the time was spent with breath practice. Morrissey Stahl offered the idea that attention to the breath might not get rid of anything, but rather might serve as an anchor (Harris, 2008). The physical yoga practice for this time was designed to include a lot of held poses that cause intense sensations but are unlikely to cause harm like shoulder plank. Participants were invited to explore using the breath as an anchor and to imagine creating space around difficult sensations experienced during practice. Session three began the exploration of the “mind” components of ACT, with the distinction between body, mind, and action used for organization but not insisted upon as discrete categories. The session began with a mindfulness practice of just noticing the body, emotions, and thoughts, and then setting an intention for group for the day. Next, Morrissey Stahl presented the idea of the “willingness machine” (Hayes et al., 1999). This is a visual representation of the difference between struggling with private events like difficult emotions rather than continuing to act on values even when difficult or painful thoughts or feelings were present with willingness to have difficult thoughts and

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feelings. Then, the group “took their minds for a walk” (Hayes et al., 1999). This included role-playing in pairs with one person playing the mind and saying the sorts of things a mind might say out loud. Examples would be descriptions, judgments, planning for the future, etc. After a brief break, the group reconvened to do “yoga with your mind.” This included noticing the mind throughout the practice as though it were another person speaking to you. Finally, Morrissey Stahl handed out a home practice in the form of a worksheet on which one could write difficult thoughts one experienced during the week in an effort to relate to unhelpful thoughts in a more defused way (Hayes et al., 2014). The fourth session began with “leaves on a stream” (Hayes et al., 1999). This exercise involves imagining leaves drifting down the surface of a river. Participants practice setting down thoughts and feelings on the leaves. From there, the group went through an exercise of writing down the five best and five worst things about themselves (Hayes et al., 1999). This invites participants to explore self-as-content (Wilson & Dufrene, 2008), or a conceptual sense of oneself as opposed to an ongoing awareness of “self.” Finally, the group discussed ways of holding evaluations lightly with awareness in a defused or unstuck way (Hayes et al., 1999). From there, the group took a short break and then moved into doing a gentle yoga practice as an observer, a variation in the self-asobserver exercise from ACT for Depression (Eifert & Forsyth, 2005). Group members were invited to write repetitive thoughts on cards and to notice those thoughts and evaluations, practicing holding them lightly. In session five, the participants moved into considering valued action in the world. After the check-in, Morrissey Stahl read the values meditation from Mindfulness for Two (Wilson & Dufrene, 2009). After reading through the exercise, participants wrote about what they noticed during the values meditation, starting to sort through the things that they cared about. After a brief break, participants were led in a moderate yoga practice. They set an intention for the value they wanted to bring to their practice and were asked to experientially apply the value to the poses they did. What would it feel like, for instance, to practice a warrior pose with kindness? Each group member then took home the Valued Living Questionnaire, a short questionnaire to help participants to sort through the aspects of life that are important to them (Wilson, Sandoz, Kitchens, & Roberts, 2010). They also took home a reading from Healing Through the Dark Emotions about the possibility of fear being a helpful emotion (Greenspan, 2004). In the chapter on fear that Morrissey Stahl gave the group to read at home, Greenspan describes United States culture as fearshaming and discusses problems that result when fear is suppressed. This

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reading offered another perspective on the emotions of anxiety and fear from a broader cultural perspective. On the final week of the group, again Morrissey Stahl led the group in a brief noticing exercise. Morrissey Stahl then talked about how to make a valued living plan and each group member started their own. They were encouraged to keep a valued living plan in a conspicuous place in their homes; for example, on the bathroom mirror. In this way, when they were feeling at a loss about what to do, they could check in with their plan to come up with committed actions they could take. Having a valued living plan in writing also creates an opportunity to celebrate things that participants are doing that are consistent with their values but that they might not be aware of or praised for. Last, group members decided on an area that was most important to them and made a public statement of commitment to their valued actions. During yoga the group practiced a visualization used to cultivate self compassion. In closing, each person completed the paperwork for the study and then checked out about what was helpful to them that they did in the group. Group members generally expressed gratitude for the group. They also reported finding many of the exercises helpful. More formal evaluation for both sessions of the group is described below.

Results The amount of data collected was not sufficient for statistical analysis. However, it did shape how to rework the intervention. It also provides some support for the group being helpful. Seven of the 18 participants provided pre-intervention data. For each of these measures, a change score was calculated by subtracting the pre-intervention score from the postintervention score for each participant. Six participants provided both preand post-intervention data. These change scores were subjected to a onesample t-test. Overall, marginally significant benefits were exhibited for psychological flexibility and for general distress after treatment. A significant effect was found for values importance, suggesting an increase over the course of treatment. Results for time engaged in valued actions and for difficulty engaging in valued actions due to unpleasant private events were non-significant. In terms of the qualitative responses, most group members in both groups reported finding the groups helpful. Due perhaps to the significant content focus in the first hour of the sessions, a number of participants commented on wanting more time for discussion. After the first group, some participants also said that they would forget to do the home practice

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and would benefit from having a reminder by e-mail during the week. In response to this, an e-mail with a quote emphasizing the theme for the week and a reminder about the home practice for the week were sent midweek to the second group. A number of participants in that group reported finding this helpful.

Discussion The combination of yoga and ACT has much to offer, as evidenced by the individual benefits of each. That participants reported a greater capacity to value, or rated their values more highly towards the end of the group, likely reflects a benefit that the ACT approach brings to life. Clarity of life direction is important in yoga, but it is often not explored explicitly in classes in the way that it is in ACT. In qualitative feedback, one participant said that she was less clear about her values before starting but that she became more clear on what her values and goals were through the group. Another participant mentioned the emotional pain associated with becoming aware of her distance from her values, and that it was helpful to have support around valuing. The group dimension and the yoga and ACT practice were likely helpful in creating a space in which participants could claim values that could be painful, in terms of acknowledging a gap between what participants were doing and what they wanted to be doing. Why mindfulness activities would decrease during the group is somewhat mysterious, although a range of possibilities exists. One is that as the group moved from simpler to more applied forms of mindfulness, participants did not recognize the activities as mindfulness. For instance, at the beginning of the group, participants were invited to simply notice their reactions to something, which was clearly a formal mindfulness practice. Towards the end, they were invited to take an action that felt risky to them and to notice their reactions. Often simpler exercises are identified as mindfulness but more applied actions that require mindfulness skills are not. It is also possible that participants simply did practice fewer mindfulness exercises because they were busier with the group and the between-session activities. Asking for more qualitative feedback in future groups will help to shed light on these questions. Also, repeating the important concept that mindfulness extends far beyond one’s practice in group or on the mat could have a significant impact on the applicability of these practices to participants’ lives. A number of challenges arose when combining ACT and yoga. The most significant challenge was participants’ expectation that yoga practice would be intended to bring about calmness or bliss rather than presence

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with whatever actually was happening, including distressing experiences. The group explored this idea a lot, and it was discussed more with the second group than the first group due to some feedback indicating that some participants in the first group might not have understood this fundamental point. It is possible that yoga is being taught by some yoga instructors as a way to get rid of uncomfortable experiences rather than a way to cultivate openness to a range of human experiences, and in that case, that approach to yoga would not be a fit with ACT. Research on ACT and yoga could bear much fruit in the future. The two traditions, one much newer and one more ancient, share many assumptions. Yoga adds an embodied practice to ACT that powerfully illustrates key ideas from ACT in an experiential way. Also, the practice of yoga movement and breath adds value to the time spent in-group in terms of the well-established benefits of exercise and of body awareness. As feedback from the group and preliminary quantitative data suggest, the integration is one well worth continuing to pursue.

Conclusion This review and preliminary group exploration suggests that melding ACT and yoga to treat anxiety merits further conceptual and empirical exploration. The two can be taught in conjunction with each other in a very sensible and accessible way, such that the strengths of both ACT and yoga are enhanced. At the same time, combining the two also creates some challenges compared to using ACT alone with groups, especially because of preconceptions that people bring to yoga and the many different types of yoga. Combining yoga with more evidence-based approaches is one possibility for creating a helpful, integrated, yoga-informed approach to well-being.

Author Biographies Chad E. Drake is an assistant professor of clinical psychology at Southern Illinois University. He supervises an Acceptance and Commitment Therapy practicum team as well as the SIU Contextual Behavioral Science Lab, which focuses on psychotherapy treatment components and processes. He is developing a program of related research on behavioral measures of cognitive processes. ([email protected]) Kate Morrissey Stahl, MA, MSW, LCSW, clinically specializes in mindfulness-based interventions, including Acceptance and Commitment Therapy (ACT), Dialectical Behavioral Therapy (DBT), and yoga at North

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Star Therapy Group. She works with individuals, couples, and families. She has master’s degrees in communication and clinical social work, and is also a certified yoga teacher. She taught interpersonal communication at UGA and worked as a mind-body therapist before receiving continued training as a full-time PhD student in Human Development and Family Sciences. She has received her certificate and doctoral-level supervision in Marriage and Family Therapy. She is also working on certification as a sex therapist through AASECT. She has co-led professional trainings in ACT, and she co-founded an ACT peer consultation group that meets monthly in Athens, Georgia. ([email protected])

References Bachman, N. (2011) The Path of The Yoga Sutras: A Practical Guide to the Core of Yoga. Boulder, CO: Sounds True, Inc. Baer, R. (Ed.). (2006). Mindfulness-Based Treatment Approaches: Clinician's Guide to Evidence Base and Applications. Burlington, MA: Elsevier. Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E., & Twohig, M. P. (2014). Acceptance and Commitment Therapy for anxiety and OCD spectrum disorders: An empirical review. Journal of Anxiety Disorders, 28(6), 612–24. Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. C., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire – II: A revised measure of psychological flexibility and acceptance. Behavior Therapy, 42(4), 676–688. Eifert, G. H., & Forsyth, J. P. (2005). Acceptance and Commitment Therapy for Anxiety Disorders. Oakland, CA: New Harbinger. Fowler, K. (2010). The No OM Zone: A No-Chanting, No-Granola, NoSanskrit Practical Guide to Yoga. New York: Rodale Inc. Greenspan, M. (2004). Healing Through the Dark Emotions: The Wisdom of Grief, Fear, and Despair. Boston: Shambhala Press. Harinath, K., Malhotra, A., Pal, K., Prasad, R., Kumar, R., Kain, T., Rai, L., & Sawhney, R. (2004). Effects of hatha yoga and Omkar meditation on cardiorespiratory performance, psychologic profile, and melatonin secretion. Journal of Alternative and Complementary Medicine, 10(2), 261–68. Harris, R. (2008). The Happiness Trap: How to Stop Struggling and Start Living. Boston: Trumpeter.

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Hayes, S. C. (1994). Content, context, and the types of psychological acceptance. In S. Hayes, N. Jacobson, V. Follette, & M. J. Dougher (Eds.), Acceptance and Change: Content and Context in Psychotherapy. Reno, NV: Context Press. Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: Guilford Press. Hayes, S. C, Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd edition). New York: The Guilford Press. Hayes, S., Wilson, K., Gifford, E., Follette, V., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168. Khalsa, S. (2004). Yoga as a therapeutic intervention: A bibliometric analysis of published research studies. Indian Journal of Physiology and Pharmacology. 48(3), 269–285. Kirkwood, G., Rampes, H., Tuffrey, V. Richardson, J. & Pilkington, K. (2005). Yoga for anxiety: A systematic review of the research evidence. British Journal of Sports Medicine, 39, 884–891. Lundgren, T., Dahl, J., Yardi, N., & Melin, J. (2008). Acceptance and Commitment Therapy and Yoga for drug refractory epilepsy: A randomized controlled trial. Epilepsy and Behavior, 13, 102–108. Netz, Y., & Lidor, R. (2003). Mood alterations in mindful versus aerobic exercise modes, The Journal of Psychology, 137(5), 405–19. Raub, J. A. (2002). Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: A literature review. Journal of Alternative and Complementary Medicine, 8(6), 797–812. Roemer, L., & Orsillo, S. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/ acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology Science and Practice, 9, 54–68. Ruiz, F. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125–162. Schmitz, N., Kruse, J., & Tress, W. (1999). Psychometric properties of the General Health Questionnaire (GHQ-12) in a German primary care sample. Acta Psychiatrica Scandanavia, 100(6), 462–8. Shearer, A. (Trans.) (1982). The Yoga Sutras of Patajali. New York: Bell Tower.

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Society of Clinical Psychology (n.d.). “Psychological treatments.” Retrieved from http://www.psychologicaltreatments.org/ Subramanya P., & Telles, S. (2009). Effect of two yoga-based relaxation techniquest on memory scores and state anxiety. BioPsychoSocial Medicine, 3, 8. Swain, J., Hancock, K., Hainsworth, C., & Bowen, J. (2013). Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review. Clinical Psychology Review, 33, 965–78. Telles, S., Gaur, V., & Balkrishna, A. (2009). Effect of a yoga practice session and a yoga theory session on state anxiety. Perceptual and Motor Skills 109(3), 924–30. Veteran’s Health Administration (2008). VHA Uniform Services Handbook 1160.01. Washington, D.C.: Department of Veteran’s Affairs. Vilardaga, R., Hayes, S. C., & Schelin, L. (2007). Philosophical, theoretical and empirical foundations of Acceptance and Commitment Therapy. Anuario de Psicologia, 38, 117–128. Waelde, L., Thompson, L., & Gallagher-Thompson, D. (2004). A pilot study of a yoga meditation intervention for dementia caregiver stress. Journal of Clinical Psychology, 60(6), 677–87. West, J., Otte, C., Geher, K., Johnson, J., & Mohr, D. (2004). Effects of hatha yoga and African dance on perceived stress, affect, and salivary cortisol. Annals of Behavioral Medicine 28(2), 114–118. Wilson, K. G., & DuFrene, T. (2008). Mindfulness For Two: An Acceptance and Commitment Therapy Approach to Mindfulness in Psychotherapy. Oakland, CA: New Harbinger. Wilson, K. G., Sandoz, E. K., Kitchens, J., & Roberts, M. E. (2010). The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. The Psychological Record, 60, 249– 272. Zettle, R. D., & Hayes, S. C. (1982). Rule governed behavior: A potential theoretical framework for cognitive behavior therapy. In P. C. Kendall (Ed.), Advances in cognitive behavioral research and therapy. New York: Academic.

CONCEPTUALIZING THE UNION OF THE TWELVE-STEP PHILOSOPHY WITH YOGA KELLI GROCK, MS, LADC, MFT-INTERN, CYI

Abstract Previous research has found positive physiological and psychological benefits for utilizing yoga in the treatment of depression and anxiety. These benefits open the door to an important area of study that examines the use of yoga on other disorders. The important social problem of chemical dependency is commonly related to depression and anxiety. Chemical dependency is therefore an appropriate disorder to investigate using yoga as a value-added addition to treatment. A common tool utilized in the Western world to assist those struggling with chemical dependency is Alcoholics Anonymous (AA) and its Twelve Steps for Recovery. This paper proposes creating a set of guidelines for embodying the treatment of addiction by utilizing and integrating the Twelve Steps of Alcoholics Anonymous and Patanjali’s Eight Limbs of Yoga. The cultural and societal stresses of daily life are at an all-time high (Fisher & Harrison, 2012). As a result, Americans are suffering economically, spiritually, and socially from the associated pressures, resulting in depression and anxiety (Roberts, Friedman, Brady, Pouget, Tempalski, & Galea, 2010). Since the beginning of recorded history, people who have utilized alcohol and drugs to sedate some of these pressures have struggled with the effects of alcohol and drug abuse (Inaba & Cohen, 2004). It is now understood that alcohol does not reduce tension; rather, it causes distress and has a negative effect on health over time (National Institute on Alcohol Abuse and Alcoholism [NIH], 2010). Given the rise of these pressures, substance abuse is likely to increase

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among those people unable to cope with stress in more healthy ways (Roberts et al., 2010). Yoga offers a possible response. For example, a research study by Smith, Hancock, Blake-Mortimer, and Eckert (2007) found yoga effective in reducing stress and anxiety, and Calajoe (1986) suggested that yoga decreases and possibly eliminates the need for mind- and mood-altering drugs. Thus, resources spent on fighting addiction through the War on Drugs might be better utilized by including an early intervention and relapse prevention model that incorporates an understanding of the “whole” individual. Chan, Ng, Th Ho, and Chow (2006) suggest that a treatment perspective with a paradigm that integrates all aspects of the individual from a mind-body perspective would be valuable, so such a viewpoint is not foreign to the addiction treatment field. Accordingly, to reduce the pressures of daily life, a yoga practice might be a better choice in lessening the need to use and abuse substances. By quieting the ruminating and compulsive mind through movement, people struggling with addiction could look within themselves and increase their understanding of the causes and activities available for changing their risky behavior. As a result, the self-awareness gained through integrating yoga and therapy can accelerate the recovery process (Calajoe, 1986). The focus of this paper, therefore, is to examine the value of incorporating yoga into the 12-step paradigm for adults having substanceuse disorders. Incorporating yoga with the Twelve Steps of AA would result in a holistic approach that strengthens the essential self. It is hypothesized that the outcome of such a union would include a reduction in stress, anxiety, and depression as well as result in greater chances for successful recovery.

Addiction Recovery Philosophies The story of Alcoholics Anonymous began when co-founders Bill Wilson and Doctor Bob Smith met in 1935 in Akron, Ohio. They determined that alcoholism was a sickness of the mind, body, and emotion. They also discussed how it was a disease of the spirit since individuals lacked a spiritual presence in their lives, known as a “higher power” or a “God figure.” In an effort to integrate spiritual acceptance and behavioral adaptation to addiction, the 12-step philosophy has become a core tool of addiction recovery and these steps are credited with making Alcoholics Anonymous successful. The Twelve Steps of Alcoholics Anonymous (Alcoholics Anonymous World Service, Inc. 2001) are:

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1. We admitted we were powerless over alcohol—that our lives had become unmanageable. 2. We came to believe that a Power greater than ourselves could restore us to sanity. 3. We made a decision to turn our will and our lives over to the care of God as we understood Him. 4. We made a searching and fearless moral inventory of ourselves. 5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs. 6. We were entirely ready to have God remove all these defects of character. 7. We humbly asked Him to remove our shortcomings. 8. We made a list of all persons we had harmed, and became willing to make amends to them all. 9. We made direct amends to such people wherever possible, except when to do so would injure them or others. 10. We continued to take personal inventory and when we were wrong promptly admitted it. 11. We sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out. 12. Having had a spiritual awaking as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. In spite of the success of AA, one component that this program lacks is the integration of the mind, body, and spirit connection. People struggling with addiction suffer disengagement from their body and do not connect the body to the mind and the spiritual aspects of self. When treatment of psychological pain and the body is overlooked in counseling, an essential part of the self is ignored, and successful amelioration of symptoms is limited (Calajoe, 1986). Eastern cultures have used yoga therapeutically for centuries (Coulter, 2001). In the West the practice of yoga has been studied in relation to anxiety, stress, and depression. A meta-analysis by Kirkwood, Rampes, Tuffrey, Richardson, and Pilkington (2005) found that yoga was effective in the treatment of anxiety and related symptoms, with yoga participants anecdotally reporting that they experienced decreased levels of anxiety and increased levels of concentration, balance, strength, and flexibility. A recent study by Smith et al. (2007) also found yoga to have effective

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outcomes on managing stress, reducing anxiety, and an overall sense of wellbeing. Yoga is thought to change the mind, the body, and the spirit. When all three are in healthy harmony, there is connectivity and a union of the three into one (Iyengar, 1979). The core meaning of the word yoga, which is “yoke” or “union” in Sanskrit, is reflected in the mind-body connection and the endeavor to integrate the many parts of the individual. Mahadev Desai (1979), in his introduction to The Gita According to Gandhi, defined yoga as: . . . the yoking of all the powers of the body, mind and soul to God; it means the disciplining of the intellect, the mind, the emotions, the will, which that Yoga presupposes; it means a poise of the soul which enables one to look at life in all its aspects evenly (p. 19).

When the individual understands this union of body, mind, and soul, there is a better understanding of one’s own nature and how to live harmoniously with the environment and others (Chanchani & Chanchani, 1996). When the mind, body, and spirit are integrated through yoga, the person has a better understanding of what is occurring within the body (Calajoe, 1986).

Importance of Yoga in Treatment When addressing stress, anxiety, and depression, it is important to consider healthy coping skills that might be adopted in lieu of substance use and abuse. As previously cited, Kirkwood et al. and Smith et al., research has shown that yoga has a positive effect in the reduction of anxiety and stress on the individual. What is known so far is that yoga has been used as therapy for centuries, with yoga practitioners reporting decreased levels of anxiety and increased measures of concentration, balance, strength, and flexibility (Coulter, 2001). Individuals suffering from depression or stress may use substances to help change the way they feel. Alcohol, opiates, cocaine, and methamphetamine are just a few of the many potential substances often used and abused in an effort to alleviate negative mental-emotional states. Yoga has been shown to reduce the symptoms of emotional distress without the use of external chemicals (Telles, Naveen, & Dash, 2007). The anterior cingulate gyrus in the brain is activated during the practice of yoga, helping to regulate distress and conflict and providing a means for cognitive and emotional control (Deshmukh, 2006). The relaxing and stress-reducing exercises of yoga also increase the release of the

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neurotransmitter GABA (Streeter et al., 2007). As one continues to practice yoga, the response of the neurotransmitters occurs more quickly due to sensitization of the neurons; normalization of cortisol and catecholamines has also been attributed to yoga treatment (Khalsa, Khalsa, Khalsa, & Khalsa, 2008). In addition, the yoga postures and breathing stimulate the somatic and autonomic nervous systems (Coulter, 2001). The somatic system encompasses everything from skeletal control and muscle activity to sensory systems such as touch, pressure, pain, vision, and auditory. The autonomic nervous system is involved with the unconscious level of functioning in the brain, heart, and the glands, including all internal functioning such as blood pressure regulation, viscera, sweat glands, digestion, and elimination (Coulter, 2001). Through yoga, there are changes in neurochemistry within the brain, which potentially enhances addiction recovery and relapse prevention. Yoga has promise in becoming a better coping mechanism than drugs or alcohol.

Eight Limbs of Yoga The Yoga Sutras by Patanjali lays out an eight-limb path that creates the structural framework in yoga practice. Unlike with the linear process of the 12-step approach, a practitioner of yoga can start anywhere within the eight limbs, as the limbs are not linear. As can be seen below, the eight limbs of yoga illustrated in Sherry Robert’s (2015) “Pantanjali and his eightfold path of yoga” are also conceptual and pragmatic at the same time: 1. Yama: Moral principles. Includes nonviolence, truth and honesty, non-stealing, non-lust, non-possessiveness 2. Niyama: Inner discipline and responsibility. Include purity, contentment, austerity, study of the sacred text, and living with awareness of the divine 3. Asanas: Postures of yoga 4. Pranayama: Breath 5. Pratyahara: Withdrawal of the senses 6. Dharana: Concentration 7. Dhyana: Meditation 8. Samadhi: Bliss Three out of the eight limbs include the breath, the yogic postures, and meditation. An inner positive focus can be achieved when using these

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three components of yoga: stretching within the yoga postures (asanas), practice of breath control (pranayama), and meditation (dhyana) with mind-body awareness (savasana) (Kirkwood et al. 2005). Iyengar (1979) stated that the restlessness that is produced by desire is freed when there is an integration of the eight limbs allowing the spirit of the individual to become one in communion with God. When the body can be still and the restlessness of the mind quieted, then the person is able to feel the spirituality of yoga (Schiffmann, 1996). This union of the self and spirit allows for greater meaning. The strength of utilizing yoga when being challenged in one’s life can make that person stronger in the face of adversity. The actual practice of yoga can have a different meaning to each person. Some people start yoga with the physical practice of the asanas, while others start with meditation or pranayama. To a degree, it does not matter where the person starts since one path will gradually lead to another (Desikachar, 1995). The direction of the path will be different for each person, which is why it is important to learn how to pay attention to the internal cues of the body while practicing yoga postures. Tree pose provides a great avenue for the individual to practice listening to their own internal cues. When in this posture a person stands with both feet on the ground and the palms of the hands pressed together in front of the chest. They then shift the weight of the body to the left foot. As the weight is shifting to the left foot, one draws the right leg up and places the sole of the right foot to the inside of the left thigh. If the balance is maintained, the arms are extended over the head. This pose takes focus and concentration. A steady breathing pattern helps to quiet the mind, but if the individual is unable to keep the focus on their breath or is distracted by thoughts, the person will lose their balance and fall out of the pose. Clients with addiction issues often have self-doubting behaviors that may be fed by an unbalanced and unhinged mind. Yoga can serve as a supplement to the 12-step recovery program by utilizing the body as well as the cognitive and spiritual faculties of the individual which increases awareness of all parts of self. By including yoga and allowing the body to be incorporated, the “stinking thinking” of a person struggling with addiction can be calmed and prepared for change. In summary, yoga could be an important treatment paradigm because it: teaches healthy coping skills; increases resilience/adaptability/ flexibility; increases inner self-awareness; stimulates and integrates the entire body; teaches the individual how to still the body and quiet the ruminating mind through meditation; helps release tension in the body;

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teaches breath control; and decreases depression and stress by reducing symptoms of emotional distress.

Union of the Two Philosophies and Treatment Application One can blend the 12-step philosophies with Patanjalii’s Yoga Sutras because both present a guide on how to live life, and their written formats are similar (Miovic, 2005). As each of the 12 steps is explored and the yoga philosophy is applied, it is important that the postures (asanas), breath control (pranayama), and meditation with mind-body awareness are woven into all 12 steps. As said previously, the 12 steps are intended to be “worked” in a linear fashion, while yoga is not. In yoga, an individual can start anywhere within the eight limbs as each path will lead to another. To better explain the union of yoga with the 12 steps, however, the author will follow the linear progression of the 12 steps. Step one: “We admitted we are powerless over alcohol and our lives have become unmanageable” (Alcoholics Anonymous World Service, Inc., 59). Through yoga practice, the individual learns how to surrender. Surrendering self in a yoga practice is consistent with admitting powerlessness in this first step of AA. This is done through the physical, energetic, and emotional experience of the body. The attention and focus on breathing teaches the individual how to let go of their thoughts and focus their attention on themselves. The quieting of the mind enhances the likelihood for this surrender. Through letting go of the ruminating mind and becoming more conscious, the individual’s awareness starts to change within. As this change happens within the person, their relationship with self and society is also affected. The fact that the individual is letting go of old patterns and accepting their powerlessness over their addiction while instilling new behavior patterns is also thought to be a form of surrender, one of the niyamas. Step two: “We came to believe that a Power greater than ourselves could restore us to sanity” (Alcoholics Anonymous World Service, Inc., 59). Believing in the “higher power” AA references, one must look outside of self. This form of a higher power can be anything the individual wants to make it. The reality is that one must recognize and overcome their barriers, prejudices, and stereotypes in order to accept the existence of a Higher Power. Isvara prandihana is dedication to the Lord (niyama). Through breath and surrender, the individual learns to quiet their doubts and allow the powers outside of the self to be experienced.

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Step three: “We made a decision to turn our will and our lives over to the care of God as we understood Him” (Alcoholics Anonymous World Service, Inc., 59). The concept of a “Supreme Universal Spirit” is underlying in yoga as well as the 12 steps, and the individual human spirit that is in all of us is permeated with that Spirit. When the restlessness of the mind is freed and the negative desires have subsided, our individual spirit and the Spirit from within unite and unite with God, thus, embracing the God within (Iyengar, 1979). Step four: “We made a searching and fearless moral inventory of ourselves.” (Alcoholics Anonymous World Service, Inc., 59). The five yamas are considered the universal moral commandments or restraints and are thought of as “attitude” or “behavior” patterns. These patterns apply to “relationships between individuals and the outside world” (Desikachar, 1995, p. 98). The five niyamas are self-purification by discipline or observances, which are more intimate and personal as the attitude is adopted by the individual (Desikachar, 1995). One of the yamas is non-violence. As the individual takes their inventory, it is important to put all violent thoughts and actions towards the self and others aside. For example, self-derogatory thoughts are damaging to the self and putting them aside could prevent individuals from triggering a relapse. Another yama is to tell the truth, satya. It is a difficult task to be honest with others, let alone with the self. In the sutras, truth is the highest moral rule of conduct (Iyengar, 1979). When the mind thinks the truth, the tongue speaks the truth, and the individual’s life is based on truth, “then one becomes fit for Union with the Infinite” (Iyengar, 1979, p. 33). To apply the five yamas in the fourth step is an exercise in ethical practice that changes the direction of the person’s thinking (Iyengar, 1979), providing an opportunity for a fair and truthful inventory is necessary in the 12 steps as honesty is a key component. Step five: “We admitted to God, to ourselves, and to another human being the exact nature of our wrongs” (Alcoholics Anonymous World Service, Inc., 59). The practice of satya or truth in the niyamas, along with the yama practice of non-violence, is carried through in this step. The breath is necessary to calm the mind. Pratyahara (withdrawal of the senses) will help with the physical discomfort associated with awareness of their wrongdoing. By directing the mind elsewhere through the breath the mind becomes still and void of all senses. The integration of all the steps with the sutras helps an individual restructure the senses of “Self” and complete the self-study (svadhyaya), which will help with the guilt and shame they

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might be experiencing. In this admission it would be important for the individual to forgive himself or herself first before they go on to ask forgiveness of others. Step six: “We’re entirely ready to have God remove all these defects of character” (Alcoholics Anonymous World Service, Inc., 59). The theme of this step is to be content by embracing and accepting one’s character flaws. Part of the change in character includes embracing the yamas and niyamas into one’s daily life. Surrender and acceptance and all of the other limbs have led the individual to this place. Yet, each repetition of postures will be a different experience. Sometimes the movement is with ease. Other times, the movement may bring discomfort or imbalance. Through surrender and acceptance of the individual’s experience as it is, without judgment or self-criticism, individuals learn to stay calm and in the moment. This awareness can help the individual when they are challenged and the struggles of daily life become a trigger. To be able to accept oneself in each moment is critical to help prevent relapse and strengthen the recovery process. Step seven: “We humbly asked Him to remove our shortcomings” (Alcoholics Anonymous World Service, Inc., 59). The theme of this step is to own and recognize one’s shortcomings, followed by surrendering them to the higher power. Isvarapranidhana is to pray daily, to offer up the fruit of one’s actions, and “to lay all your actions at the feet of God” (Desikachar, 1995, p.102). Thus isvarapranidhana is incorporated into the practice of yamas and the other niyamas. Prayer and acceptance of a higher power is continually encouraged within the 12-step community. Step eight: “We made a list of all persons we had harmed, and became willing to make amends to them all” (Alcoholics Anonymous World Service, Inc., 59). There are multiple themes in this step. They are: (1) non-attachment (vairagya) to the outcome, or “letting go of the outcome”; (2) nonviolence (ahimsa), meaning no further harm to others; (3) satya, or truth telling; (4) cleanliness (sauca), which means to clean up the mess one has made in their lives and in others’ (Kalechman, 2002); (5) modesty, or contentment (santosa), which is the acceptance of the outcome and to learn from those outcomes. It takes courage and inner strength to determine the people that have been hurt by one’s behaviors during their active addiction. Through the process of combining both philosophies the individual develops the courage to face the people they have hurt.

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Step nine: “We made direct amends to such people wherever possible, except when to do so would injure them or others” (Alcoholics Anonymous World Service, Inc., 59). Ahimsa is practiced here as one does not want to harm or injure others or the “Self.” A continuation of the theme is to surrender and let go of the outcome, as one does not have power or control over the situation. This develops humility in the individual as one does not expect a thank you, forgiveness, or praise. Asteya, non-stealing, is practiced in this step as the individual returns stolen property to the owners, and returns what has been taken both physically and psychologically. Inherent within this step, the individual must accept the possibility of being rejected by the other person. Thus, keeping on the path of recovery, ahimsa can be put into practice in order that the person does not create harm in thoughts or action towards the self when rejected. Step ten: “We continued to take personal inventory and when we were wrong promptly admitted it” (Alcoholics Anonymous World Service, Inc., 59). A continuation of the niyama is svadhyaya, or self-study: inquiry and examination as one cultivates self-awareness. Through the self-awareness and self-study, the individual becomes more honest with themselves and others, stronger, and more able to accept one’s past behaviors. Step eleven: “We sought through prayer and meditation to improve our conscious contact with God as we understand Him, praying only for knowledge of His will for us and the power to carry it out” ( Alcoholics Anonymous World Service, Inc., 59). Yoga, a moving meditation, teaches the individual how to control their mind via the eight limbs. With instruction, the practitioner learns how to sit comfortably and meditate, letting the body settle into stillness as the mind becomes quiet. The inner focus increases the opportunity for a deeper self-exploration with control and understanding of all aspects of their emotions, thoughts, and the physical body while also surrendering the ego to the experience. Meditation brings all aspects of yoga into play, connecting the physical body with the ethereal body. All of the limbs are working in this step. Step twelve: “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs” (Alcoholics Anonymous World Service, Inc., 60). We only get to keep what we have by sharing with others. AA believes that it is important to model the life you have made for yourself by service. Meditation and conscious movement become part of one’s life.

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Throughout the 12-step process the person has a sponsor. This also is true of yoga, with the yoga sponsor being called a guru, or teacher who helps guide the individual through their journey. The hope is that the person will take what they learn from meetings and the yoga mat and apply that knowledge to their daily lives.

Summary Yoga is a mind-body practice that teaches the practitioner how to tap into their higher state of consciousness. In this state of self-awareness, a person recovering from an addiction will learn necessary tools to increase self-control and self-efficacy, reducing the chances of relapse in the future. Yoga can be a component in aiding abstinence from addiction. The newfound coping skills found through the practice of yoga can help the person abstain from using and abusing drugs, a key factor in the ability to handle the complexities of life. The calming spiritual qualities facilitated through a change in brain neurotransmitter activity and balance offer the person struggling with addiction an opportunity to replace substance use and abuse with a positive outlook towards sobriety.

Author Biography Kelli Grock is a Certified Yoga Instructor and has been an advanced practitioner for nineteen years. She is a Licensed Alcohol and Drug Counselor in California and Nevada, a current Marriage and Family Therapy Intern, and holds a Master’s of Science in Human Development and Family Studies with a specialization in addictions. She is currently working at Renegade Counseling and in private practice in Nevada and California. Her practice focuses on adolescents, adults, couples, and families. ([email protected])

References Alcoholics Anonymous World Service, Inc. (2001). Alcoholics Anonymous (4th ed.). New York: A.A. World Services. Calajoe, A. (1986). Yoga as therapeutic component in treating chemical dependency. Alcoholism Treatment Quarterly, 3(4), 33–46. Chan, C. L., Ng, S., Th Ho, R., Chow, A. Y. (2006). Making sense of spirituality: East meets West: Applying Eastern spirituality in clinical practice. Journal of Clinical Nursing, 15, 822–832.

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CLASSICAL YOGA POSTURES AS A PSYCHOTHERAPEUTIC INTERVENTION FOR AUTONOMIC NERVOUS SYSTEM REGULATION JOANN LUTZ NORTHAMPTON, MA

Abstract Recent neuroscience research supports approaches to psychotherapy that use somatic interventions such as yoga to regulate the autonomic nervous system. This paper describes the importance of a regulated autonomic nervous system for psychological health; presents relevant research results; elucidates key principles of both classic yoga and a somatic approach to psychotherapy; and describes the elements of a “nervous system–informed yoga,” developed as a response to current research and theories. This paper explores the use of yoga as a somatic intervention in psychotherapy through examining its philosophy and practice and elucidating its value for nervous system regulation. The client’s experience of his or her body, an essential ingredient for healing, has been neglected in the practice of psychotherapy (Ogden, Minton, & Pain, 2006). Pat Ogden, a pioneer in the field and one of the authors of Trauma and the Body, cogently states, “Cognitive processing is inextricably linked with our bodies.” Body feelings, or “somatic markers,” influence cognitive decision-making, logic, speed, and context of thought (Damasio, 1994, 1999, p. 41). Ogden et al. (2006) found that the background body sensations that arise during cognitive processing form a biasing substratum that influences the functioning of the individual in all decision-making processes and self-experiences. Studies showing that talk therapies alone have limited success in treating Post Traumatic Stress Disorder (PTSD) add further evidence to support this approach (Stoller, Greuel, Cimini, Fowler, & Koomar, 2012).

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For example, a psychotherapy client may speak of how much she likes a particular relative, but with guidance from the therapist, a mental selfscan of her body reveals that her facial muscles tense when the relative is mentioned. This discrepancy, which most likely is out of the subject's conscious awareness, points to an important area of exploration. The introduction of a somatic intervention such as yoga may help the client bridge the gap between his or her current level of awareness and the truth of what is happening in his or her body, particularly for trauma survivors. In addition to expanding the client's somatic awareness, the performance of yoga postures can help to regulate the autonomic nervous system (ANS) and improve the functioning of the body in general.

The Triune Brain In the 1970s, the neuroscientist Paul MacLean presented a model of the brain that emphasized the evolutionary structures which he called the triune brain, including the neocortex, governing language, cognition, reasoning, and voluntary movement; the limbic brain, which governs emotional reactions, among other functions; and the reptilian brain, which governs the autonomic nervous system and the functions of digestion, reproduction, circulation, breathing, and the fight-flight-freeze mechanism (Cozolino, 2002, p. 3). These parts of the brain, though distinct, also work together. It is the functioning of the reptilian brain that pinpoints the potential value of yoga as an adjunct to psychotherapeutic treatment. Brain imaging shows that when a person is stressed or traumatized, the higher functions of the brain, located in the frontal lobes, shut down, and the sympathetic nervous system, with its fight-flight-freeze reaction, becomes activated (van der Kolk, 2014, p. 42). Therefore, a fruitful focus in psychotherapy can be on working with the autonomic nervous system (Levine, 2010, p. 15; see also Robin, 2009, p. 766). Yoga seems to have been designed centuries ago to do just this.

Window of Tolerance The “Window of Tolerance” diagram, developed by Dr. Daniel Siegel, author and clinical professor of psychiatry at the UCLA School of Medicine, is a representation of the somatic approach to psychotherapy (Siegel, 2010, p. 50). Picture a blank page with three equal-sized zones separated by horizontal lines. The central area, between the horizontal lines, is the window, the zone where our nervous system is oscillating

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evenly between the sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) activation. This rhythm is shown by a smooth wave, indicating that one feels comfortable in one’s body. When a traumatic shock strikes, the ANS can break out of this “zone of tolerance” to the elevated, SNS domain between anxious and manic. After maintaining this highly activated state, which requires a high level of energy, the ANS charge could eventually fall below the zone of tolerance into a depleted, dysthymic, or depressed state, characteristic of a dysfunctional PNS. This dysregulation is reflected in a jagged pattern of autonomic nervous system (ANS) functioning. In a healthy nervous system, the ANS soon re-regulates itself. In the trauma survivor, or someone with other mental and/or physical health issues, this dysregulated pattern can become that person’s norm. Dysregulation seems to be increasing as society becomes more complex. As Kinser, Goehler, & Taylor (2012) explain: Whereas activation of the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal axis (HPAA) are essential for dealing with acute stressors, these systems can become chronically over activated given the “on-the-go” multitasking expectations of individuals within modern society. Ongoing arousal of the SNS/HPAA has both physical and psychological consequences: (it) . . . increases risk of anxiety and depression.

This SNS/HPAA activation can become a habitual pattern, triggering stress reactions even when no stressor exists. A primary function of somatic psychotherapy becomes helping the client change the pattern, bringing the nervous system back into the regulated zone more quickly, and eventually widening the window of tolerance.

What is Classical Yoga? The practices outlined in the eightfold path of raja (Skt. “kingly,” “royal”) yoga are the basis for the classical yoga approach (Satchidananda, 1978, p. 147). The first two limbs are the yamas and niyamas, which are moral and ethical principles. The yamas include non-killing, truthfulness, non-stealing, continence, and not accepting gifts. The niyamas are described as internal and external purification, contentment, austerity, scriptural and self-study, and the worship of God, which are recommended in order to build an ethical, moral, and physiological framework which enables one to practice yoga successfully. Ethics aside, these principles minimize the defensive responses of fight, flight, and freeze in ourselves or others.

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The third limb is asana (Skt. “steady and comfortable posture”), popularly known as hatha yoga. In Sanskrit, ha means sun, and tha means moon. The sun is a symbol of the body's heating, active qualities, suggesting the functioning of the SNS. The moon, its complement, symbolizes the cooling, more passive qualities, which suggests PSN activity. The joining of these words underscores one purpose of the postures, which is to integrate these polarities. The fourth is pranayama, the breathing practices, which are crucial to the regulation of the nervous system. The fifth through seventh limbs focus on establishing a meditation practice, and the eighth, samadhi, alludes to the ultimate goal of yoga, a state of absorption in the oneness of all existence. Although the breathing practices and higher states of meditation can be powerful adjuncts to psychotherapy, the focus of this paper is on the healing and balancing properties of the asanas.

Yoga as Energy Psychology Yoga, seen in a different frame, is a complete system of energy psychology. The author maintains that spirituality, coming from the Latin word spiritus, meaning “of breathing, of wind” (Merriam-Webster’s dictionary online), has an energetic component. In the system of classical yoga, spirit is generally interpreted as the subtle energy that interpenetrates the physical body. Yogic texts call this energy prana (Frawley, 1999). When prana is dysregulated, dis-ease results. This play on words is true from two perspectives; the client is uneasy, and the potential for the disease process to progress in increased. By becoming more attentive to prana—and calming and directing its flow through yogic practices—we work to regulate the body's systems, including the ANS. The prana flows through subtle nerves called nadis. There are three major nadis that begin at the base of the spine. One of them, the ida, characterized by receptivity, coolness, introspection, and rest, ends at the left nostril; the other, the pingala, expressing the energetic qualities of action, heat, and decisiveness, ends at the right. B. K. S. Iyengar (2002) notes that the SNS corresponds to the ida nadi and the PNS to the pingala nadi. According to Swami Sivananda (1994, p. 31), when the central channel that runs along the spine, the sushumna, is activated, it carries energy from the ida and pingala through the higher centers to the top of the head. Yogic texts describe the right nostril as heating, activating, and externally oriented, and the left as cooling, passive, and internal. These

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qualities again suggest the functioning of the SNS and PNS. By manipulating the nostrils, one can work to regulate the subtle energy channels and consciously switch dominance from one branch of the ANS to the other. This practice is part of the science of swara yoga (Rama, Ballentine, & Hymes, 1979, p. 79). As Robin (2009, p. 627) states, “connections between nasal laterality, cerebral-hemisphere laterality, and the two branches of the ANS are implied in the ancient accounts of swara yogis.”

Subtle Goals of Yoga Practice The subtle goals of yoga practice are not only to regulate prana but also to build and store it so that it can be used for healing and transformation. According to Viniyoga Therapy founder Gary Kraftsow in Yoga for Transformation (2002), “the means and methods of personal practice that we suggest—postures, breathing exercises, meditation, dietary restriction, fasting . . . are all designed to help us build sufficient energy to break free of our conditioned responses.” Among the subtle goals of yoga is an emphasis on keeping the subtle energy moving. Ayurveda, the medical umbrella of yoga, maintains that if we don’t keep our prana flowing, it’s going to get stuck in the places in our body that are most vulnerable. Each person has different vulnerabilities; for some it may derange their mind (Gerson, 1993). The yoga poses offer support for this energetic goal, relieving congestion in the subtle body as well as the physical. An ancient yogic aphorism attributed to South Indian Saint Thirumular states that “prana flows where our attention goes” (Satchidananda, 1970, p. 68). When practicing postures, the client can learn to consciously send their attention and subtle energy where he or she wants it to go, magnifying its healing effect.

The Gunas In The Yoga Sutras of Patanjali (4:13–4:14), the gunas are described as the operating properties, or qualities, of nature; they are called rajas, tamas, and sattva. In the rajasic state, the body is agitated, anxious, and irritable; the mind can be angry, fearful, demanding, and impatient. In the tamasic state, the body is heavy, sluggish, toxic; the mind is dull, in denial. Sattva is the energy of lightness, purity, flexibility, and peace. These qualities are applied to everything in nature (Frawley, 1996). Interestingly, they also correspond to autonomic nervous system states.

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The hypervigilant, anxious, sympathetic-dominant state above the zone of tolerance could be seen as a rajasic state. The depressed, lethargic, overly parasympathetic area below the zone of tolerance could be seen as tamasic. In the zone of tolerance, there is a smooth oscillation between the SNS and PNS activation that could be viewed as a sattvic state of balance. This framework is a link between yoga therapy and somatic psychotherapy practice. If a person is tamasic and depressed, it’s practically impossible to bring him or her directly into a sattvic state. The therapist needs to first gradually bring the person into the rajasic zone, into sympathetic dominance, and to increase the energy in his or her system (Hoskinson, unpublished classroom notes obtained during Somatic Experiencing Practitioner Training, Beginner Level, 2011). Once that state is established, the client can gradually be brought into sattva. Someone who is already rajasic, hyperactive, and anxious is not ready to immediately engage in a sattvic practice. He or she may need a stimulating practice for a period of time in order to gradually step down into a sattvic state.

Physical Benefits of Postures As Ogden has said (p. 9), the experience of our bodies informs our functioning on all levels. Yoga can keep the organism in a state of optimum physical health. For example, according to Satchidananda (1970, p. 21), the half spinal twist (ardha matsyendrasana), a commonly practiced posture, “contracts vital organs and tones them.” It can improve the functioning of the muscles, glands, and the organs as they are compressed in the posture. Compression can help to squeeze out toxins; if a muscle is compressed in one pose and then stretched in another, a fresh supply of blood will come to that area (Robin, 2009, p. 9). The postures improve all of the major body systems, including circulation. According to the Teacher’s Training Manual (Satchidananda Ashram-Yogaville, Inc., 1979), when the body is inverted, the heart can rest, because these poses facilitate the drainage of venous blood back to the heart with no effort. The bow (dhanurasana) and plow (halasana) poses stimulate the digestive organs (Satchidananda Ashram-Yogaville, Inc., 1979; also Satchidananda, p. 64). Muscle relaxation therapies, including yoga, have a role to play in reducing anxiety (Pluess, Conrad, & Wilhelm, 2009). As Dr. van der Kolk says in The Body Keeps the Score (2014, p. 56), “Any effective treatment for trauma has to address these basic housekeeping functions of the body.”

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Toward a Nervous System-Informed Yoga Research Results Recent research studies confirm the value of yoga to “support pharmacological and psychological therapies by improving autonomic responses to stress and self-regulating coping behaviors . . . ” (Kinser et al., 2012, p. 123). One paper points out that “controlled studies have demonstrated that yoga practices decreased symptoms in Post Traumatic Stress Disorder, Obsessive-Compulsive Disorder, Generalized Anxiety Disorder, Panic Disorder and anxiety after natural disasters . . . ” (Streeter, Gerbarg, Saper, Ciraulo, & Brown, 2012). The slow rhythmic breathing practices and meditative/relaxation practices of yoga are designed to induce a sense of calm, well-being, stress tolerance, and mental focus, all of which may minimize depression, anxiety, stress, and rumination (Kinser et al., 2012, pp. 21, 31–35). As a form of mindful, low-impact exercise, the physical movements in yoga may have antidepressant and anxiolytic effects (Kinser et al., 2012, pp. 37–41). It is noteworthy that, in these studies, the benefits of yoga are generalized to several mental health diagnoses which exhibit dysregulation of the ANS as an underlying factor. This expands the focus on yoga from a treatment for PTSD to a more generalized mental health intervention; it also suggests that somatic interventions developed for PTSD treatment can be useful when treating other conditions such as anxiety and depression. Another research study targeted treatment-resistant women with PTSD, offering them weekly hatha yoga classes (van der Kolk et al., 2014). Van der Kolk (p. 119) states: At the end . . . 16 of 31participants (52%) in the yoga group no longer met criteria for PTSD compared to 6 of 29 (21%) in the control group . . . both groups exhibited significant decreases in PTSD symptoms during the first half of treatment, but these improvements were maintained in the yoga group, while the control group relapsed after its initial improvement. Yoga significantly reduced PTSD symptomatology, with effect sizes comparable to well-researched psychotherapeutic and psycho-pharmacologic approaches. Yoga may improve the functioning of traumatized individuals by helping them to tolerate physical and sensory experiences associated with fear and helplessness and to increase emotional awareness and affect tolerance gradually so as not to be retraumatized.

The body is constantly giving us information on the state of our organism through bodily sensations, the language of the ANS. The information can be used to phenomenologically (through self-awareness)

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assess our state of health and disease and to help us make more proactive, healthy decisions in the here and now; for example, to notice fatigue and to rest; to notice hunger and thirst and to eat and drink. This is the input from the body that the untreated trauma survivor (or dysregulated person) can lose awareness of, at a great cost to the experience of their aliveness. If the individual can learn to be aware of body sensations, he or she can regain the present-moment experience of life and eventually penetrate subconscious patterns of reactivity. Yoga practice helps the individual to develop this type of awareness.

Yoga for Trauma Dr. van der Kolk emphasizes that psychological trauma occurs when the victim is not able to physically move to protect him/herself (p. 55). Levine confirms that “the experience of fear derives from the primitive responses to threat where escape is thwarted” (p. 85). Patterns of immobility can remain stuck in the body, limiting the client's connection with their inner and outer environment. The ability to empower oneself by moving the body can be essential to trauma recovery. Again, in hatha yoga, the experience of physical postures can be the key to a gradual, safe recovery of conscious movement. In a somatically-based model of trauma-recovery, part of the work of the therapist/mental health worker is to monitor the client’s state of ANS arousal and guide him or her to continually bring it back into the window of tolerance. A somatic intervention can include asking the client to shift his or her focus from the thoughts and emotions, which may be skewed to the negative, to body sensations; to pause the narrative and to engage in a regulating activity, such as looking around the room; or to slow down habitual movement patterns to break through to a deeper awareness of what is happening in the body. Practicing yoga postures can give the client additional experience and skill in achieving these shifts. This approach encourages the client to keep their cognitions in the positive zone. It builds the client’s inner resources and counteracts the nervous system’s evolutionary tendency toward hyper-vigilance which, in the past, may have maximized the chances for survival. When the client slips into a negative thought pattern, he or she can be encouraged to notice that, at that moment, there is no threat. To intensify a feeling of safety, clients can be encouraged to focus on somatic resources, such as a positive body sensation experienced in a yoga pose. According to Levine, “Touching in to positive experiences gradually gives a client the confidence to explore his/her internal bodily landscape and develop a

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tolerance for all sensations, comfortable and uncomfortable, pleasant and unpleasant” (p. 77). Research shows that in the brain scans of frightened people, the verbal areas shut down and an area responsible for visual imagery lights up (van der Kolk, 2014, p. 70; also Shin et al., 1999, p. 580). A powerful intervention can be to use visual orientation to take in the environment, reestablish safety, and remain anchored in the present moment. This technique can be used whenever the client is losing connection with their here-and-now experience. Orientation refers to two activities: the scanning of the environment with the senses, particularly the eyes, which is done by animals in the wild to protect their safety; and the playful activity of exploratory orientation which exercises our creativity and engagement with the world (Levine, 2010, p. 77). Yoga provides opportunities for both types, encouraging the practitioner to play with the full spectrum of visual foci, from the focused external gaze of the balancing postures to the internal experience of classic meditation, done with eyes closed. Yoga postures also provide the opportunity for creative exploration of the body as the practitioner twists and turns his or her body into new shapes. According to Dr. Stephen Porges, PhD, a pioneer in the study of the function of the vagus nerve, approximately 80% of the vagus nerve fibers are afferent, bringing messages from the body to the brain (Porges, 2003, p. 505). They constitute a main peripheral pathway of the PNS, making it an important focus for nervous system regulation. Slow, deep yogic breaths compress the diaphragm, an action which sends a message of relaxation through the vagus nerve to the brain. Yoga postures have also been shown to correct underactivity of the PNS and of GABA, a neurotransmitter associated with improved mood and decreased anxiety (Streeter et al., 2003, p. 505). Porges has hypothesized that the ventral vagal nerve is a resource for nervous system recovery from trauma because it promotes social engagement: if one is relating to a warm, attentive human being, the ventral branch of the nerve becomes activated and sends messages of safety and well-being to the brain which then relays them to the facial muscles, the back of the throat, the inner ear, heart, lungs, and gut. This positive activation, and its accompanying potential for human connection, can contradict previous traumatic experiences and build a new experience of the world as a safe place. This theory emphasizes the importance of the relationship with the therapist and/or yoga instructor to assist in reregulation of the ANS.

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Porges’s model for the human body’s mobilization of resources mirrors the functioning of the triune brain. In an interview, Porges states (2006): We use the newest circuit (the neo-cortex) to promote calm states, to selfsoothe and to engage (in relationships). When this doesn’t work, we use the sympathetic-adrenal system to mobilize for fight and flight behaviors. And when that doesn’t work, we use a very old vagal system, the freeze or shutdown system.

Peter Levine first noticed the freeze state, also known as “tonic immobility,” in animals in the wild. Levine states (Yalom & Yalom, 2010): If animals (are) physically restrained and frightened, they . . . go into a profoundly altered state of consciousness where they (are) frozen and immobilized, unable to move. And it turns out that this is one of the key survival features that animals use to protect themselves from threat.

The same mechanism is found in traumatized humans.

Contributions from Somatic Experiencing According to the author’s experience, two techniques from the Somatic Experiencing model (Payne, Levine, & Crane-Godreau, 2015), pendulation and titration, can be blended with yoga for a powerful effect. They can be incorporated into the psychotherapeutic session—and into yoga practice—whenever the client is dealing with uncomfortable physical, emotional, or cognitive states outside of the window of tolerance. Pendulation describes the shifting of attention back and forth from uncomfortable sensations, memories, thoughts, and so forth, to a more pleasant or comfortable experience (Levine). Levine (p. 79) explains, “The experience of pendulation, the body’s natural restorative rhythm of contraction and expansion . . . tells us that whatever is felt is time-limited . . . that suffering will not last forever.” According to current theory, through pendulation, new neural networks are being created in the brain that can bridge positive and negative experiences (Brown & Milner, 2003). Also, on the subtle level, since “energy flows where attention goes,” prana is being directed from one point to the other. For example, if the client is in pain, if he or she finds a part of the body which is either pleasant or neutral and then alternates or pendulates attention between there and the painful place several times, the pain may modulate. This process can also be done with thoughts. In titration, a term most familiar from chemistry, one starts with a concentrated substance and adds water, drop by drop, to dilute it (Brown

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& Milner, 2003, p. 83). In therapeutic work, the therapist can take a client’s physical sensation or traumatic memory and dilute it with another resource to promote integration without re-traumatizing the client’s nervous system. For example, when a therapist sees signs of the client’s nervous system going above or below the “window of tolerance,” such as the tensing of muscles along with rapid speech, the therapist can suggest that the client stop the narrative to focus on his or her body sensations. The therapist can then titrate it with one bit of a yoga pose at a time, offering the client the opportunity to deeply experience each movement and each moment of stillness, to his or her capability, before going back to the narrative. This technique may assist the client in becoming curious about his/her sensations. Since there is currently no research on the fusion of yoga and Somatic Experiencing, the author suggests this topic as a fertile area for new research.

The Body Tells the Story The body is always telling its deeper story in present time, just beneath consciousness. The therapist is there to help the client experience what is going on in his or her body in the moment, rather than focus on a story that has already happened. Experience with yoga can facilitate this exploration. When the client’s body is tense, the therapist could suggest a gentle yoga pose that addresses that tension. In this approach, by bringing more awareness to the sensation, new information can emerge from deeper levels of experience than can be accessed by talking alone, as the conceptual mind, disconnected from body awareness, filters out experience that is not easy to talk about. Eventually, the activation related to the “story” could be discharged or neutralized and the client would be trained to focus on and titrate their experience on their own. The belief underlying somatic psychology is that the ultimate release of the residue of trauma, either acute or chronic, happens through the body. This energy can be released as trembling or vibration; as gentle fasciculations (muscle twitches) and/or changes in skin temperature; and as “micro-movements” (Brown & Milner, 2003, p. 93). Somatic release can also emerge from yoga practice; signs include tingling, warmth, vibrations or trembling, expanded breathing, coughing or throat-clearing, clearing of the sinuses, the release of phlegm, crying, laughing, burping, stomach gurgling, itching, yawning, and feeling cold (Leitch & MillerKaras, 2010, p. 38). The client can be encouraged to experience these symptoms of release without shame or embarrassment.

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Defensive Responses In response to threat and injury, animals, including humans, execute biologically based, nonconscious action patterns that prepare them to meet the threat by defending themselves. According to an interview with Peter Levine, “When threatened or injured, all animals . . . orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based . . . ” (Yalom & Yalom, 2010). Psychological problems may stem from the over- or underdevelopment of the defensive responses of fight, flight, or freeze. These responses can be either too highly charged to be effective, as in the example of the person who punches someone over a small disagreement; underdeveloped, as in someone who has difficulty speaking up for himself or herself; or inoperable, as in the freeze response. The fight impulse is often experienced through a chronic tightening of the arm muscles or the clenching of fists and flight though the impulse to move the feet and legs (Ogden, 2006, p. 91). And in the freeze response, the client loses the experience of body sensation. Yoga postures can be consciously chosen to address, titrate, and release these states. Negative, fearful, or distorted thoughts can accompany defensive responses. They range from the racing mind of the hyper-aroused state, to the denial and suicidal thoughts of the hypo-aroused states. Yoga practice can also strengthen the “witness consciousness” to be with these thoughts without identifying with them and reacting.

The Value of Holding the Posture Still When the client has achieved enough internal stability to tolerate some uncomfortable sensations, the therapeutic edge may become the holding of the postures. By holding the posture still, the client has more time to identify, experience, and tolerate physical sensation. The holding of the posture may allow deeper layers of tension to emerge, be experienced, and be released. Holding the posture steady may also provide a strong container for the prana, which then assists in quieting the mind. As Levine says, “In order to unravel this tangle of fear and paralysis, we must be able to voluntarily contact and experience those frightening physical sensations; we must be able to confront them long enough for them to shift and change” (p. 74). It is very beneficial for the client to understand the role that the ANS plays in moving toward optimal health and its connection to yoga practice.

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To this end, I recommend psycho-education in a group and/or individual format.

Recommendations for Teaching Nervous System-Informed Yoga Yogic interventions are very adaptable. They can be used as a planned intervention, where a set sequence of postures is chosen ahead of time and performed by the client with specific goals in mind, or as an organic one, where the client's tensions present in the moment are modulated or ameliorated through postures chosen at that time (or a combination of the two). They can be taught individually or in a group class, in a chair or on a mat. This author is proposing the following guidelines, appropriate for the individual or group mat-based class, inspired by the Integral Yoga Hatha class created by Sri Swami Satchidananda and organized specifically around its effect on the autonomic nervous system: 1. Begin with a warm-up consisting of a rotation of the joints to engage the body and focus the mind as well as lubricate the joints. 2. As a general guideline, choose postures in the following order, from these categories (the specific posture is not important, as long as it is comfortable for the practitioner and fits into the appropriate category): backward-bending postures, such as the cobra pose, which open the chest, require muscular effort and stimulate the SNS (Shapiro et al., 2007); forward-bending postures, such as the full forward bend, which involve release and increase PNS tone; twisting poses, such as the half spinal twist, which are sympathetically activating and releasing muscular or neurologic tensions in the spine; and meditative relaxing poses such as the seated yoga mudra. This alternation of SNS and PNS activation can help reestablish the oscillating pattern of the optimal functioning ANS. 3. Demonstrate each pose before teaching it, to maximize use of the client’s “mirror neurons.” Mirror neurons refer to the capacity of certain brain cells to respond similarly when we perform an action and when we witness someone else perform the same action. (Robin, 2009, p. 143) and prime the body for doing the posture. 4. Include rest in the relaxation pose for one minute between each dynamic mat-based pose, which gives the body an opportunity to absorb the benefits of the poses and to bring the SNS and PNS into balance. This practice, known as “cyclic meditation,” has been the

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focus of a research study which concluded that cyclic meditation reduces nervous system arousal more than relaxation alone (Telles, Reddy, & Nagendra, 2000). 5. Focus on teaching the coordination of attention and movement. For example, moving one’s arm while watching TV has a different physiological effect than moving it when one’s focus is on the arm. This focus distinguishes yoga from exercise. 6. Move slowly and in coordination with the breath. Slow movement modulates SNS activation, which tenses the muscles, and also trains the observer part of the mind to remain focused. 7. Teach the same sequence of poses (whichever postures are chosen) for at least eight weeks to enhance the ease of learning and home practice and to minimize the possible defensive response that can accompany the process of learning. 8. Offer the client a point of concentration in the body for each pose, to steady the mind and promote present-moment awareness. 9. Teach bi-lateral poses first to the right and then to the left, since a focus on the right side is activating to the ANS and a left-side focus increases PNS tone. 10.The therapist/yoga instructor is the gatekeeper, responsible for offering the session in a private, comfortable, quiet, welcoming space. Instructions should be provided in invitational language, using phrases like “when you are ready” or “if you like,” which gives the client as many choices as possible. Since the instructor/ therapist is the source of safety and comfort during the class, every detail of his/her presentation is important: how he or she dresses, the pace of the class, tone of voice, choice of words, level of selfawareness and self-care (Emerson and Hopper, 2011, pp. 43–50).

Summary and Conclusions A study of classical yoga theory and practice reveals a multi-layered discipline which meshes with current theory about the functioning of the autonomic nervous system and is a valuable component in a somatic approach to psychotherapy. Researchers are currently working to develop a comprehensive theory, supported by empirical evidence, of yoga’s efficacy for a variety of psychological conditions. This theory would integrate some key aspects of physiological, emotional, cognitive and energetic/spiritual systems that would lead to into a cohesive model of healing.

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On the physiological level, the practice can regulate the balance between the SNS and PNS, resulting in a healthy oscillation between the two. On the emotional level, it can mediate dysfunctional states such as anxiety and depression into a state of contentment. On the cognitive level, it can assist equanimity to emerge from various cognitive distortions. On the spiritual level, it can facilitate the transmutation of the rajasic and tamasic energies into the peaceful, easeful sattvic energy. The focus on nervous system-informed yoga shows much promise as an effective, natural, low-cost remedy for a variety of psychological disturbances.

Author Biography Joann Lutz, MSW, LICSW, E-RYT, has been training mental health professionals internationally on bringing classical yoga into psychotherapy for the past six years. Current training opportunities are listed on her website, www.yogainpsychotherapy.com. She is the author of “Bringing Yoga into Social Work Practice,” a continuing education course published by The National Association of Social Workers, MA Chapter, in 2014. She maintained a private psychotherapy practice in Northampton, MA for more than 20 years and has taught trauma-informed and nervous systeminformed yoga classes through various social service agencies in that area. Joann was the New England Regional Coordinator for the Spiritual Emergence Network during the 1990s and developed the first east coast continuing education course on spirituality and social work during that time. ([email protected])

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Weintraub, A. (2012). Yoga Skills for Therapists: Effective Practices for Mood Management. New York: W. W. Norton. Yalom, V., & Yalom, M. H. (2010, April). Peter Levine on somatic experiencing. http://www.psychotherapy.net/interview/interview-peterlevine

CLINICAL SYNERGISM IN THE TREATMENT OF TRAUMA: YOGA THERAPY AND PSYCHOTHERAPY ANITA CLANEY, MS; GINA SILER, MA, MSC, LPC AND KAUSTHUB DESIKACHAR, PHD

Abstract Trauma is an event or series of events that overwhelms an individual’s resources and often results in an inability to cope with life’s challenges. While the seemingly irrational behaviors or reactivity of a traumatized individual is perplexing and is often minimized by the external world, the interior life of a chronically traumatized person is, simply put, maddening chaos. Yoga therapy and psychotherapy are two modalities used to heal trauma. This paper examines the clinical implications of the close collaboration between yoga therapist and psychotherapist to create a novel therapeutic model for each patient that draws upon theory, research, and their respective therapeutic techniques to treat trauma and support treatment plan goals. When a traumatic event occurs, its energy gets trapped in the physical body and is stored in energy centers near the organs long after the experience is over. Trauma is also mentally stored in the form of emotions and memories that are often buried deep within the unconscious mind. Yoga therapy and psychotherapy are two methods used to heal trauma. Both aim to bring these traumatic experiences out of their hiding places and into the light where they can be recognized, understood, and integrated. Yoga uses movement, breath practices, visualization, sound, and meditations, while psychotherapy uses talk and may include somatic awareness. In both professions the end goal is the same—freedom from suffering.

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Complex trauma and post-traumatic stress disorder have received a great deal of attention over the past couple of decades. Many types of treatments incorporating somatic awareness to varying degrees have been developed to address the myriad symptoms arising from trauma. Some of these include: Mindfulness Based Stress Reduction (MBSR), Mindfulness Based Cognitive Therapy (MBCT), Virtual Reality Exposure Therapy (VRET), Eye Movement Desensitization and Reprocessing (EMDR), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), and Somatic Experiencing. This paper examines the clinical implications of the close collaboration between a yoga therapist and psychotherapist. When two therapists work together to integrate their respective therapeutic techniques in the treatment of trauma, it increases the efficacy of both modalities to help alleviate the client’s suffering. The authors’ orientation is to create a novel therapeutic model for each patient that draws on the theory and research of both psychotherapy and yoga therapy to support the treatment plan goals.

The Psychology of Trauma Trauma, which means “a wound” in Greek, is an event in which an individual’s cognitive, emotional, physical, and spiritual resources are overwhelmed, creating a sense of powerlessness and inability to cope with the event. Basic structures of ego function are impaired, often resulting in splitting, insulation, denial of affect, and the inability to share experiences with others. Whether or not an event will produce trauma depends upon other factors such as the ego functions and capacities of the client and the support structure in their environment. There are two basic types of trauma. Type I traumatic events are single incidents, while Type II traumatic events (also called complex traumas) occur repetitively over a long period of time. Type II traumas include things like physical abuse, poverty, torture, genocide, and neglect, and they often involve a fundamental betrayal of trust in a primary relationship. Type II traumatic events often occur in combinations. Complex trauma, along with its manifest affects of dysregulation and intolerance, is borne from a lack of what is termed “secure attachment” during the early years of life (Diamond, 2004; Schore, 2002; Schore, 2009; Schore, 2011), when one’s sense of self within the world is developed. Secure attachment is a healthy adaptation that occurs when the infant learns to differentiate and identify feelings (Wallin, 2007) that result from the mirroring process of caregivers. When an infant experiences a lack of emotional attunement and mirroring, they develop alternative affect

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strategies for staying connected to the primary object, namely deactivation or hyperactivation of the attachment behavioral system (Wallin, 2007, p. 101). This results in over- or under-stimulation of the parasympathetic nervous system, and shows up as dissociation or hyperarousal (Schore, 2011). These early experiences form the bedrock of neural pathways and impact the developing brain, heart rate variability and homeostasis (Van der Kolk, 2006). The psychotherapeutic process often emphasizes the world that was primary during the first few years of life, before the prefrontal cortex became active. This is the realm of the unconscious. It’s the world of the felt and sensed, of drives and desires, and of dreams and of symbols. This early unconscious world becomes evident in the complex interactions that occur between therapist and client. In patients who have experienced complex trauma, affect containment on the part of the psychotherapist is tantamount. Robert Stolorow refers to this empathic attunement as “emotional dwelling.” He writes, “ In dwelling, one does not merely seek to understand the other’s emotional pain from the other’s perspective. One does that, but much more. In dwelling, one leans into the other’s emotional pain and participates in it, perhaps with aid of one’s own analogous experiences of pain” (Stolorow, 2013). The capacity of the psychotherapist to “lean into” and contain the seemingly unbearable affect of another mimics early attachment experiences of soothing and comfort provided—or often neglected—by primary caregivers. On a physiological level, the cortex in the right hemisphere of the brain has “mirror neurons” that allow for a felt sense of the other, while the limbic system allows for the development of empathic attunement with the client (Lewis, Amini, & Lannon, 2001). At times the psychotherapist will allow for a rupture in the relationship in order to provide repair. In early attachment failures, a rupture is often a negation of the infant’s affective displays that can involve deprivation or terrorizing (Liotti, 2004; Schore, 2002). Without acknowledgement or soothing, the rupture has become a wound. The failure of the therapist to attune with the client’s communications can deepen their sense of isolation and re-traumatize them. The therapist will then provide for a repair of the error so the client can experience a caring other recognizing and soothing a mis-attunement in the relationship. This manner of psychotherapy emphasizes the relevance of affect, which is often disavowed by clients via internalizations in early development that feelings are bad and will not establish a much-needed relationship with another person. As the patient discloses his or her narrative and the therapist leans into the client’s past, present, and future,

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the emotional life registers as feelings and thus affect (Panksepp, 2003). The psychotherapist develops a frame that allows the client’s world to unfold with acceptance and containment of what arises, and depathologize what they held as shameful, unforgivable, or unlovable (Atwood, 2012).

Yoga Therapy and Trauma: A Holistic View of the Human System The mind at its grossest level is a sense organ that engages with objects according to its current state and the activity in which it is engaged. The English word “mind” is limited in expressing all that yoga philosophy describes as the mind. In the Yoga and Samkhya orthodox schools of philosophy, the mind is defined as grahana and is also called a cittendriya, which means “a sensory faculty.” The cetana citta is the active, cognitive mind that is able to respond with its defense mechanisms. The acetana citta is the hidden non-cognitive mind that may hold the trauma memories. The greater the disharmony between the two minds, the greater the problems the individual can face because each aspect of the mind is influencing the system in different ways and is the difference between what we feel and what we think. Yoga therapy works with the mind and body to holistically reconnect with what has been split through trauma. Just as trauma affects each individual uniquely, yoga therapy is individualized in its approach to gently lead him or her step-by-step towards deeper self-awareness and healing. The Pancamaya Model was developed in ancient India and applied by the legendary yogi Tirumalai Krishnamacharya and his son T. K. V Desikachar, who together made notable contributions to building a bridge between traditional yoga therapy and modern medicine. The model is widely incorporated into today’s clinical applications of yoga therapy. In the Pancamaya model, the human system is understood to be a synergistic composition of five interconnected dimensions (Deussen, 2010). Understanding them will help us see the body in a multidimensional manner and look at healing and illness beyond just the gross, physical body. The following five dimensions are also called koshas (Skt. “sheaths”) in some yoga traditions. The annamaya is the physical body that is nourished by food, touch, and sensory stimuli. The pranamaya is the energy dimension and is nourished by prana, a subtle energy closely related to the breath. The manomaya is the intellectual structure. In yogic philosophy, the mind is in the body and the body is in the mind, and hence they are intimately

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interwoven together. The vijnanamaya includes our beliefs, behavioral patterns, and personality. Because while knowledge or learning may be similar, how it’s applied into practical life is what makes each person unique. The anandamaya is the emotional dimension that transcends conditions and associations. This is the dimension closest to the authentic self and reality’s perception, and is the subtlest dimension towards which the yogic journey leads. Each maya is in a relationship with and affects all the others. They are reflective of influences from the past. For example, a child is born with genetic tendencies and a particular constitution (part of the annamaya) that can influence their perception and integration of experience. The child begins to experience through the sense organs including the mind (manomaya) that define the manner in which they will communicate and engage with life (vijnanamaya). Another example is when fear in the vijnanamaya influences mental patterns, which triggers energy patterns, which create body patterns. This explains how chronic somatic tension may influence breath patterns and effect mental states. There is constant fluid movement between the dimensions in all directions, as each is allpervasive, cause and effect mutually influencing each other. (Bryant, 2009) (Yoga Sutras I.11, I.20, IV.8, IV.9) When a particular experience is sensed repeatedly, the impression, called a vasana, becomes stronger and crystallizes as an object. In yoga, this is called a samskara—a groove or pattern we get stuck in. In psychotherapeutic terms, the personality develops with these impressions that determine how a person reacts to life. In both yoga and psychology, these patterns are expressed through all dimensions of the human system and when repeated become conscious memory. There is also the consideration of the mind’s momentum, or pravrtti. Pravrtti is a dynamic concoction of the aforementioned samskaras, vasanas, and memories called smrti that have been initiated in the past. These may include traumatic experiences that have gathered momentum and influence actions. Momentum gains energy, like a snowball rolling down the hill gaining speed and mass. Not only does the scope of activity expand, but also the velocity in terms of response to stimuli or triggers. (Yoga Sutras I.35, III.25 IV.5) The vasanas, samskaras, and smrti that lead to symptoms of complex trauma may be due to a sustained momentum that determines why a person is drawn to an object. Or they may have enough strength to alter the momentum and determine a new direction of behavior. Momentum is always carrying the individual in a certain direction. Part of trauma care can include identifying the momentum influencing the client’s behavior

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and subsequently finding suitable interventions to create a new momentum that is positive. Two extreme patterns of the mind are recognized (Yoga Sutra III.9). The vyutthana samskara is a state of agitation similar to flight or fight response, and the nirodha samskara is a state of clarity and equanimity, as in a relaxation response. Yoga therapy is a process of creating new patterns that will facilitate transformation from vyutthana samskara to nirodha samskara (Yoga Sutra 111.9). Practice develops discipline, lessens distraction, and replaces old maladaptive habits with new adaptive patterns (Yoga Sutra 111.10). This effort increases the chances of the mind being in a full state of attention (Yoga Sutra 1.50). As new samskaras or patterns develop throughout all layers of the human system, the old patterns recede (Yoga Sutra 1.13). The tools yoga therapy uses to do this are vast. They affect different dimensions with different intensities, so care and discrimination must be taken to choose the following tools that are most suited to the client. Asana introduces new body patterns by changing the current and habituated patterns through which the body is living. This includes alignment, posture, gait, and somatic tone. Pranayama creates new breath patterns with various breathing techniques that can include ratios, movement, and classically sequenced breathing practices. Ahara and Vihara integrate new lifestyle patterns that may include diet and exercise. Pratyahara creates new patterns for the senses. This literally means providing the “opposite food,” and presents a multitude of possibilities for the yoga therapist. Dhyanam creates new patterns for the mind which may include meditation, guided imagery, and visualizations. Mantra may include a range from monosyllabic sounds to chants and prayers from different faiths and cultures, or meaningful lines from poems. Nyasa are gestures and specific placements often combined with breath or visualization, which are not only palliative, but also bring attention and vitality to the region of focus. Bhavana is positive visualization that empowers the mind with specific focuses. The various tools are used to design practices that create new patterns in all five dimensions of the human system so perception and actions can eventually change. Before choosing appropriate tools and combinations for the student, one must be clear on the presenting symptoms. The yoga therapist relies on observations and interactions with the student to determine what is occurring within the five layers of the system, and connections to the vyutthana or nirodha state. Also considered are the obstacles, called antarayas. In complex trauma the following obstacles

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may manifest as symptoms that result in further expression of these obstacles. Vyadhi is illness, a disconnection, or imbalance. Styana is mental exhaustion or burnout that leads to irritation. Samsava is confusion or doubt. Pramada is haste. Alasya is laziness in which one can’t think with clear discrimination. Avirati is excess sensual temptations. Bhranti darsana is delusion of grandeur or states of denial. Alabdhabhumikatva is the inability to reach the goal. Anavasthitatva is regression. (Yoga Sutra I.30) Trauma patients often turn to coping mechanisms that result in exaggerating these obstacles. For example, a patient might remember the traumatic event in a certain way which, over time, redefines the event. This is a form of delusion. They might develop and embrace shame-based or pride-based identifications as their reality, another form of delusion. They might become dependent on substances, which are a form of excess sensual temptations. Often trauma patients begin to engage in healing methods but fall back or regress in their journey because revisiting the trauma is so painful. This is anavasthitatva. There are many ways that psychological obstacles can be addressed and lessened by implementing the healing approach of yoga therapy. One of the yoga therapist’s roles is to help establish a realistic goal for the client. The first focus of treatment is pacifying the symptoms, or samanam. Then comes purification, or sodhanam, removal of the cause, and refinement and reduction of illness. As a complementary healing modality, the goal is not necessarily to eliminate illness in its prevailing layer, but rather reduce or eliminate manifestations of it in the other layers. It’s important to remember that the objective is more important than the tools. Let’s consider two people who both suffer from depression and obesity, and exhibit similar symptoms and behavior. In one, the obesity is a trigger for depression, while in the other, the depression is the trigger for obesity. For the one in whom obesity is triggering depression, the main tool could be practice of physical postures, or asana. For the one in whom depression is triggering obesity, the main tool could be a meditation practice. As in psychotherapy, each case is unique and must be given specialized care. And if the goal is not achievable with yoga therapy alone, we must refer the student to someone else to get the help needed. When the yoga therapist and psychotherapist work together to identify a patient’s goals and obstacles, specialized care is amplified and an even more tailored practice is possible.

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Synthesizing the Two Models In both psychotherapy and yoga therapy, the body informs the practitioners through gross and subtle expressions, both visible externally and sensed internally. The implicit encoding of the right brain weaves coherently with the vasanas, samskaras, and smrti so defenses can rise from the unconscious to the conscious, allowing for integration and new meaning. This is similar to the yoga therapy tradition of change from vyutthana to nirodha samskara. After a psychotherapeutic or yoga therapy session, the practitioners come together to discuss salient experiences and integrate the experiences of the prior sessions. The frequency of communication between the practitioners provides a second pair of eyes, akin to having a professional consultation group. They assess changes in affect regulation, defenses, language, insight, body language, and perception. It’s important to note when the patient transfers his emotions to the psychotherapist and yoga therapist in different ways. One therapist might perceive a developing issue and share it with the other, who can integrate it into their own conceptualization of the patient’s progress. The collaborative relationship between both practitioners in the following case studies has created a wide angle lens through which the patients can be seen from both Western and Eastern models. While the degree of communication required is high and can be time-consuming, the benefits for the client are similar to having two primary caregivers who are synchronized in thought, feeling, and action. The case studies demonstrate how this collaboration can be a new, reparative experience, especially when this manner of relationship was absent in the early years of life. This integrative approach reiterates the importance of both therapists remaining humble and open to learning, as the complex human psyche is still a fascinating teacher.

Ann: Psychotherapeutic Processes and Results Ann was a 37-year-old single Native American female and mother of an adolescent son. She was initially referred to psychotherapy for treatment of PTSD, occasional alcohol abuse, and conflicts with her partner. After several sessions developing a comprehensive psychosocial history, Ann’s developmental history of chronic abuse and neglect became apparent. She had no affect tolerance and a strong sense of self-loathing, typical of complex trauma. The psychotherapeutic relationship was complex, vacillating between

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Ann’s intense need for the therapist and a strong aversion to sharing anything personal. During the first year of therapy she spoke little and building trust was difficult. Much focused on her history of tumultuous relationships, and the devolving relationship with her current partner. As therapy progressed, she displayed a vital aspect of Kohut’s selfobject theory: an unconscious idealization of the therapist. Emulating the therapist, she became interested in exercise, nutrition, and spirituality. She ceased using alcohol and tobacco although these were rarely discussed in session. While Ann’s physical health improved, her affect awareness remained constricted. Ann was referred to yoga therapy as a means of experiencing somatic feeling, and in the hopes that working with the yoga therapist would provide another safe haven. Prior to the first yoga therapy session, the psychotherapist provided the yoga therapist with a detailed psychosocial history.

Ann: Yoga Therapy Processes and Results At her first appointment, Ann reported that her energy levels were “pretty good.” She was preparing for an upcoming half marathon. Her low back and left hip hurt at times and she had neck pain due to an unidentified thyroid problem. She mentioned anger issues and a goal of finding spirituality. Physically, Ann was strong and healthy. Her posture was slouched and hunched over in the chair and she had difficulty maintaining eye contact. She appeared anxious, and talked a lot with a flat affect. She didn’t engage easily, only showing interest when the yoga therapy process and its connection to spirituality were explained. The yoga therapist designed a short 15-minute practice that included asana, pranayama, nyasa, and a visualization practice in which Ann chose a canyon because of the positive associations it brought up for her. Ann was able to engage and follow instructions well. Anxiety levels did not increase during the practice and her breathing pattern was stable and even became slightly more subtle. With this success, the yoga therapist gave her further instruction to slowly extend her exhales during movements and breathing over the next two weeks when she practiced at home. Ann returned two weeks later with much higher levels of anxiety than the first class, and reported that things were “really bad” in her personal life. She reported that although the practice was calming and she felt better when she did it, she was usually too tired at the end of the day to practice. Her neck and back were hurting more than before. During practice with

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the yoga therapist, focus was difficult. She talked on and off throughout the practice, but at the end was visibly more focused and relaxed. The yoga therapist designed a new shorter practice to increase compliance, and oriented it more for her neck pain. An MRI was scheduled to check for thyroid and neck nodules. Ann cancelled her following appointment and never returned to yoga therapy.

Synthesis of Ann’s Case Ann indicated to the psychotherapist that she found yoga therapy helpful, but she was unable to be self-directed to practice without the yoga therapist present. After a consultation between both therapists, a determination was made that due to Ann’s attachment pattern she could not tolerate feeling good. Historically feeling good was followed by abandonment, abuse, and feeling bad. Since Ann didn’t have a secure base upon which to develop cohesiveness in her emotional life, no emotion was safe. Tolerating good feelings from yoga therapy practice likely triggered an avalanche of unconscious associations and the threat of unendurable chaos in the mind and body. Yoga therapy brought relief to her anxiety symptoms, but her state of mind couldn’t tolerate any awareness of her traumatizing experiences. The therapists determined that at the time of referral, yoga therapy was contraindicated and would be beneficial at a later stage in Ann’s process.

Elle: Psychotherapeutic Processes and Results Elle is a 52-year-old single Jewish female and adoptive mother of a severely mentally and physically disabled Native American male. She is the granddaughter of a Holocaust survivor. Her mother and father had high status in the Jewish community, and her mother was consumed with presenting her children and family as the quintessential successful Jewish family. Most of her memories are of her mother’s emotional lability. Elle felt like a “wallflower” much of her youth and disdained dressing up for the multitude of parties her parents hosted. She spontaneously became deaf for six months at four years of age. As she spoke of it, she smiled remembering the peace and quiet experienced for the first time in her life. In her early 20s, she travelled to Israel and joined the military. Despite the volatile area, she loved this period of her life and felt like she could express herself for the first time. After completing her military commitment, she returned to the United States and completed a graduate degree in special education. In her 30s she adopted a young Native

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American boy with severe disabilities. He required a high degree of care. She was in a relationship for nine years with a very abusive man. After termination of the relationship, he came to Elle’s house one night, knocked on the window, and shot himself in the head. Elle became extremely isolated and developed obsessive-compulsive behavior. Her sleep patterns became erratic, she became very thin, and she disengaged from most of her relationships. Elle was referred to psychotherapy for PTSD related to watching her ex-boyfriend’s violent suicide. When the psychotherapist began seeing Elle she had PTSD symptoms for four years. She was initially doubtful of therapy because she had seen two psychologists prior and felt worse after terminating each relationship. Her initial impression was that of rigor. Her neck was taut and her jaw clicked when she spoke. Her head craned forward and she was incredibly thin underneath oversized overalls. She had a strong disposition towards self-analysis, compartmentalizing, and intellectualizing, with minimal somatic and emotional awareness. The initial work was educational, teaching her about trauma and its physiological effects. Empathic attunement was emphasized, with the therapist frequently reflecting to Elle the visceral experience of her narratives. The psychotherapist provided simple somatic awareness practices, and recommended books related to mindfulness so she could practice between sessions. Elle incorporated journaling as part of her therapy and recorded her experiences with clarity and sensitivity to her emotional states. She struggled with unpleasant affects associated with internalized messages from her childhood. She recognized the deep fear she had experienced most of her life, and was able to stay with the visceral and visual images that arose while “sitting with” the experience until the affect storms subsided. She became aware of the transitory and ephemeral qualities of her emotions. Elle was referred to the yoga therapist for a deeper exploration of her somatic experiences and to begin a meditation practice.

Elle: Yoga Therapy Processes and Results At her first appointment, Elle was physically healthy. She was strong, flexible, and petite. She had ADHD. She was quick and rapid in her movements, and her speech was fast and soft. She had a socially engaging presentation, a positive attitude, and was extremely motivated to continue to move in a direction of psychospiritual transformation. She had a sense of humor and could laugh about herself. She wanted to “arrive at harmony.”

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When designing Elle’s practice, the first goal was to lower her anxiety. She was given asana, pranayama, and gesture-based visualization in which she chose a set of Hebrew letters that gave her great comfort. At her second visit she reported feeling a sense of peace when she did the practice. The therapist changed the breathing practice to build breath capacity, and introduced short mantra in preparation for meditation. Elle’s current practice at the time included longer exhales during movement, pranayama in a 1:2 inhale-to-exhale ratio, and a meditation practice using a physical image. She enjoyed chanting loudly. When she would start to feel anxious she went “into breathing” which “[brought] down her heart rate.” When she practiced yoga, “the brain [became] softer, and the fierceness [went] away. I [felt] calm, an absorption.” The last session, as of this writing, focused on beginning ritual, informed by her growing awareness of her inner life. Elle felt it would help her “slow down and feel what she’s feeling.”

Synthesis of Elle’s Case Since beginning yoga therapy, unconscious material related to the horrors of her childhood started to surface and she was having difficulty with the smallest of tasks. Elle had been able to tolerate and “stay with” the affect storms, due to empathic attunement from psychotherapy, mindfulness practices, and the tools of yoga therapy. The psychotherapist and yoga therapist worked together to provide a port in the storm. Both recognized the importance of Elle’s process and the value of noninterference. Elle recognized the importance of this phase of her process. In Elle’s case, yoga therapy was very helpful in lowering anxiety, teaching her self-soothing, and helping her connect with her faith, not as therapy alone. Although Elle had virtually ceased psychotherapy, the yoga practitioner observed changes in Elle that seemed reminiscent of previous symptoms. The yoga therapist shared session material with the psychotherapist who suggested to Elle that she return to psychotherapy. When future therapy becomes possible, it would require leaning further into Elle’s experiences and containing all the underlying emotional material.

Discussion The emphasis on integrative care in the United States has been growing over the last decade; yet there is still no clear and universal model

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for integrating such care or consensus on the inclusion of particular modalities and services. The synthesis of yoga therapy and psychotherapy is more than finding the overlapping edges of theory and practice and conceptualizing the case through a myopic lens. It requires regular discussion between practitioners, sharing of observations and personal experiences, and continuous re-conceptualization of the patient’s case. More important than academic knowledge is the willingness to reflect on another therapist’s observations that may be contrary to one’s own conclusions. Being non-attached to a particular theory or intervention permits both therapists to open their minds in order to understand their patients in a more authentic and profound way. An adage from psychotherapy states, “The client will only go as far as the therapist is willing to go.” This speaks to the depth of self-awareness and openness required to not only best serve the client’s needs, but also to work in a truly collaborative fashion with another professional. This collaboration casts a wider net and fosters continuity and consistency for the client. In this type of therapeutic relationship, a parallel exists that is similar to having two unified caregivers. This parameter of social learning and modeling can be of great importance. In the case of Ann, time was devoted to ascertaining the reason for ceasing yoga therapy. By evaluating the case, the therapists determined that at the time of referral, yoga therapy was contraindicated and would be beneficial at a later state in Ann’s process. Elle expressed relief that the collaboration between practitioners provided a sense of being truly cared for and a deep sense of safety. She shared that she felt safe and truly cared for by both therapists. She did not have this in her family of origin. The clinical synthesis of yoga therapy and psychotherapy is very much in its infancy, and many methodological questions arise that suggest interesting avenues of exploration for further research. The unique integration of the two results in a strengthening of both, and provides trauma patients with an efficacious, integrative model of healing throughout all dimensions of the human system: physical, mental, emotional, and spiritual.

Author Biographies Anita Claney, MS, is a certified SKY yoga teacher and yoga therapist. Since 2009 she has been a yoga therapist in the Evaluation and Brief Treatment of PTSD Unit (EBPTU) of the Southern Arizona Veterans Healthcare Administrative System main hospital. Anita therapeutically applies the tools of yoga such as gentle movement, breathing, and

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visualization when working with veterans. Her private practice Healing Yoga Arizona (www.healingyogaarizona.com) includes a wide variety of students ranging from Type I and Type II trauma victims to people suffering from autoimmune conditions, cancer, and orthopedic issues. Anita works holistically with all dimensions of the human system to complement the work of other healing professionals. Dr. Kausthub Desikachar is an acclaimed yoga teacher, yoga therapist, and trainer. For more than 15 years, he has taught a multitude of students and teachers around the globe and has conducted numerous yoga teacher and yoga therapist training programs. As a yoga therapist he offers clients astute and effective solutions for all sorts of physical, mental, and emotional problems. He received his PhD from the University of Madras, where his topic of research was “Effect of Individualized Yoga Training on Quality of Life.” He has also authored and co-authored numerous books on yoga. Kausthub is known for his remarkable, deep, and wellversed knowledge and his ability to present the ancient teachings in a way that is profound as well as applicable for modern day practitioners. For more information visit www.kausthub.com. Gina Siler is a Licensed Professional Counselor by the Arizona Board of Behavioral Health Examiners. Ms. Siler has a Master of Arts in Somatic Psychology and a Master of Science in Community Counseling. In addition, Ms. Siler has several years of postgraduate study in psychodynamic psychotherapy and participates in semi-monthly seminars to review cases and gain a deeper understanding of psychoanalytic theories. Ms. Siler has additional training in mindfulness, Eye Movement Desensitization and Reprocessing, the Trauma Resiliency Model, and transpersonal psychology. Ms Siler has worked in social services and residential treatment and currently has a private practice in Tucson and Chandler, Arizona. Ms. Siler’s clinical work has focused on complex trauma, sexual abuse and Post Traumatic Stress, primarily with Native American populations.

References Atwood, G. (2012). The Abyss of Madness. New York: Routledge. Bryant, E. (2009), The Yoga Sutras of Patanjali. New York: North Point Press Buirski, P. (2005). Practicing Intersubjectively. New York: Jason Aronson. Damasio, A. (1999). The Feeling of What Happens: Body and Emotion in the Making of Consciousness. New York: Harcourt Brace & Company.

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Deussen, P. (2010) Sixty Upanisads of the Veda: Volume II. Delhi, India: Motilal Banarsidass Publishers Diamond, D. (2004). Attachment Disorganization: The Reunion of Attachment Theory and Psychoanalysis. Psychoanalytic Psychology , 21 (2), 276–299. Ford, J. D., & Courtois, C. A. (2009). Defining and Understanding Complex Trauma and Complex Traumatic Stress Disorders. In J. D. Ford, & C. A. Courtois, Treating Complex Traumatic Stress Disorders: An Evidence-Base Guide (pp. 13–30). New York: Guilford Press. Lewis, T., Amini, F., & Lannon, R. (2001). A General Theory of Love. New York: Random House. Liotti, G. (2004). Trauma, Dissociation, and Disorganized Attachment: Three Strands of a Single Braid. Psychotherapy: Theory, Research, Practice, Training , 41 (4), 472–486. Panksepp, J. (2003). At the interface of the affective, behavioral, and cognitive neurosciences: Decoding the emotional feelings of the brain. Brain and Cognition , 52 (1), 4–14. Schore, A. N. (2002). Advance in Neuropsychoanalysis, Attachment Theory, and Trauma Research: Implications for Self Psychology. Psychoanalytic Inquiry , 22 (3), 433–484. —. (2009). Relational Trauma and the Developing Right Brain: An Interface of Psychoanalytic Psychology and Neuroscience. Annals of The New York Academy of Sciences , 189–203. —. (2011). The Right Brain Implicit Self Lies at the Core of Psychoanalysis. Psychoanalytic Dialogues, 21, 75–100. Srikantha Murthy, K. R. (2000). Vagbhata's Astanga Hrdayam, Krishnadas Academy Oriental Publishers: Varanasi, India. Stolorow, R. D. (2007). Trauma and Human Existence. New York: Taylor & Francis Group. —. (2013 10-August ). Psychology Today. Retrieved 2014, 4-January from Blog: Feeling, Relating, Existing: http://www.psychologytoday.com/blog/feeling-relatingexisting/201308/undergoing-the-situation Stolorow, R. D., Brandchaft, B., & Atwood, G. (1995). Psychoanalytic Treatment: An Intersubjective Approach. New York: Routledge. Van der Kolk, B. (2006). Clinical Implications of Neuroscience Research. Annals New York Academy of Sciences , 277–93. Wallin, D. J. (2007). Attachment in Psychotherapy. New York: The Guilford Press.

INTEGRATIVE YOGA THERAPY TO RELIEVE SYMPTOMS OF DEPRESSION, ANXIETY, AND BIPOLAR DISORDER APARNA RAMASWAMY, PHD, LCPC

Abstract The International Association of Yoga Therapy (IAYT) describes yoga therapy as the process of empowering individuals to progress towards health and well being through the application of the philosophy and practice of yoga (Taylor, 2007). This paper draws from Patanjali’s seminal text, the Yoga Sutras, that describes eight (ashta anga, or ashtanga) concepts of yoga that interact to generate an immersive experience of meditative calm and oneness (Shastri, 1975). Yoga is approached both as an integrated state of oneness and as practices that cultivate oneness. This paper situates yoga as both a process and its outcome. The article situates the eight core concepts of ashtanga yoga as underpinnings for an integrative healing approach (Natya yoga therapy) that is dedicated to creating an integrated and empowered self. Natya yoga therapy (NYT) combines traditional practices of Indian dance (natya) with practices of yoga and cognitive behavioral psychotherapies to create a meditative inner calm and emotional strength. The International Association of Yoga Therapists (IAYT) describes yoga therapy as the process of empowering individuals to progress towards health and well-being through the application of the philosophy and practice of yoga (Taylor, 2007). To clarify and clearly situate yoga as an experience of meditative calm, this paper draws from Patanjali’s seminal text of Yoga Sutras, which first described eight concepts (ashtanga) of yoga that interact to generate an immersive experience of meditative calm and oneness (Shastri, 1975). Yoga refers to a state of integrated oneness and also to practices that create such oneness. Yoga is both a process and its outcome. In the context of psychotherapy, this paper

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positions yoga as a meditative and restorative practice to integrate the self, and as remedial therapy for symptoms of mood disorders. The first portion of the paper situates yoga as therapy and describes eight core concepts of ashtanga yoga that create its meditative experience. These concepts are described from a transdisciplinary perspective, prior to positioning them as underpinnings for an integrative healing approach (natya yoga therapy) that is dedicated to creating an integrated and empowered self. Natya yoga therapy (NYT) combines traditional practices of Indian dance (natya) with practices of yoga and cognitive behavioral psychotherapies to create inner calm and emotional strength. While therapy helps people develop a strong self-belief in their ability to overcome emotional distress, natya and yoga practices are used to promote a meditative immersion, wherein there is spontaneous emergence of healing and relief from inner agitation and emotional distress. This paper grounds cognitive, behavioral, and meditative practices of NYT as embodiments of the core concepts of ashtanga yoga, as described from a transdisciplinary perspective.

Yoga as Therapy Yoga as therapy is an East-West synthesis of appropriate combination of physical, psychological, and spiritual practices (Butera, 2010). While yoga as therapy has been in use for several centuries in India, the formal articulation of what constitutes yoga therapy is relatively new. IAYT is a pioneer in introducing an evolving yet comprehensive credentialing standard for yoga therapy in the United States. Yoga therapy is in the service of empowering people to progress towards wellness while using the philosophy and practices of yoga. The essential suggestions are twofold: x The practice and philosophy of yoga fosters wellness. x A person’s sense of empowerment energizes them to move towards wellness. In the context of yoga therapy for mental wellness, the National Institute of Mental Health and Neuro Sciences (NIMHANS) in India studies the use of yoga as therapy in psychiatric disorders (Deepak, 2013, p. 343). Dr. Nagendra with Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA) reports that yoga as therapy helps people with mental illness in at least five ways: yoga has a calming effect; it increases awareness of self and surroundings; it increases attention span; it improves

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self-acceptance and adaptability; and it reaffirms security in this world (2013, p. 337). Dr. Sat Bir Khalsa with Harvard Medical School corroborates SVYASA’s reports with studies that show effectiveness of yoga therapy in reducing stress, enhancing emotion regulation, improving mood and well-being, and increasing cognitive functioning in persons diagnosed with mental illness (2013, p. 334). While there is recognition of some of the benefits of yoga as therapy for mental wellness, there is a limited consensus of what constitutes practices of yoga therapy (Ramaswamy, 2014). Often, yoga therapy practices are a blend of physical postures and breathing exercises that are selected by the therapist. As such, it is not surprising to hear the question Jeffrey E. Barnett asks in Complementary and Alternative Medicine for Psychologists (2014): “How would yoga postures be integrated into psychotherapy?” However, in order to stay rooted in the integral essence of yoga, Dr. Bhavanani with the International Center for Yoga Education and Research (ICYER) urges researchers to stay true to the core concepts of yoga and avoid correlating a specific posture or breathing exercise to a corresponding outcome (2011, p. 21). To accurately represent what constitutes yoga practice in yoga therapy, it is therefore essential to directly reference the core concepts of ashtanga principles of yoga. While there are several schools of yoga practices, the text of the Yoga Sutras attributed to sage Patanjali is the first known separate treatise on yoga and is used as a seminal text in this paper (Shastri, 1975, pp. 15–17). It is the earliest known systematic statement of philosophical insights and practical psychology that define yoga (Miller, 1995, p. 1). Additionally, Feuerstein recommends the Yoga Sutras as the “best entry point” into the theoretical side of yoga (Bharati, 2001, p. xv). The Yoga Sutras is dated between 100 BCE and 500 CE (Feuerstein, 1998, p. 85) and attributed to a single author, Patanjali, who later came to be known as the “father of yoga” (Satchidananda, 1990, p. xii).

Yoga as Process and Outcome The root word in yoga (yuj) means union, to connect, to bring together and link, to act as a yoke. Patanjali described eight concepts that lead to a meditative state of oneness, the ashtanga concepts of yoga. However he did not offer any examples of practices that are exemplars of ashtanga principles of yoga. The text simply offers the eight concepts as guiding principles that lead to a yogic outcome of oneness. As such, various schools of yoga (such as raja yoga, hatha yoga, and laya yoga) have traditionally interpreted and practiced these principles of yoga differently,

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even while working to develop an integrated self in and through yoga, and natya yoga is one such approach. Guiding principles of ashtanga yoga. A transdisciplinary approach is used to present the essence of ashtanga principles of yoga by integrating interpretations of scholars and practitioners from various schools of yoga. The eight concepts of ashtanga yoga are yama (moral principles), niyama (observances), asana (postures), pranayama (breath control), pratyahara (withdrawal of senses), dharana (concentration), dhyana (meditation), and samadhi (oneness) (Miller, 1995, p.52). x Yama: the moral principles of ahimsa (non-injury), satya (truth), asteya (not stealing), brahmacharya (seeking the Ultimate knowing of Brahman), aparigraha (not coveting) (Iyengar, 2008; Feuerstein, 1989). x Niyama: observances and practices including saucha (purity), santosha (contentment), tapas (austerity), svadhyaya (self-study), ishvara prannidhana (surrender to the Ultimate) (Mishra, 1973). x Asana: physical position that is held steady and balanced, with ease (Rama, 1983). x Pranayama: energizing the body’s vital energy (prana) by regulation of breath (Satchidananda, 1990). x Pratyahara: disengagement from external sensory stimulation (Sivananda, 1960). x Dharana: Single-pointed focus and concentration (Mukherji, 1981). x Dhyana: Meditative immersion with deep sense of oneness between experiencer and experienced (Sivananda, 1970). x Samadhi: Complete meditative oneness where separation dissolves between experiencer and experienced (Kripalvananda, 1977)

Natya Yoga Therapy: An Integrative Yoga Approach NYT approaches healing as a reiterative process of psychotherapy and meditation. While therapy strengthens a person’s sense of self, their ability to engage in disciplined and healthy life practices reinforces their sense of self-competence. Movement and music are used as meditative aids to affirm their innate ability to meditate and access their own intuitive guidance. NYT’s integrative approach is based on the underlying guiding principles of ashtanga yoga as described in the preceding section. NYT views the first two principles of yama and niyama as lifelong pursuit of ethical values and disciplined living, essential in developing a mindset of one who is introspective, inquisitive, disciplined, and

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discriminating (Ramaswamy, 2012, p. 150). The third and fourth principles are understood as physical practices that are not predicated on completion of the previous two principles. While personal growth may be closely related to progress on the first two principles, the ability to meditate is tied to the practice of third and fourth principles. Dedicated practice of asana and pranayama can lead to progressive emergence of concentration, disengagement and meditation (fifth, sixth, and seventh ashtanga principles). Said differently, meditation is a spontaneous outcome of practice of asana and pranayama through a process of intense concentration and disengagement from the outside sensory stimulations, distinct from life-long pursuit of developing a yogic mental disposition. Yoga as a practice of meditation involves asana and pranayama practices that create a spontaneous emergence of disengaged concentration and meditation. However, a strong sense of self and discipline provide the personal structure and form to sustain and hold the intuitive guidance that emerges in meditation. As a therapeutic approach dedicated to selfempowerment, NYT emphasizes concurrent development of both meditative abilities and a strong sense of self-concept and belief. The three words in natya yoga therapy refer to distinct practices that work together in creating a strong and integrated sense of self in each person—a self that feels stronger and larger than any stressor. Natya refers to rhythmic movement, expressive dancing with gestures (mudra) and music (instrumental and vocal) drawn from the Natyasastra, an authoritative text on Indian dance and dramaturgy (Rangacharya, 1986). Yoga refers to practice of postures, breathing exercises, and mental concentration leading to meditation, based on the eight core concepts of yoga (ashtanga yoga), as described in the Yoga Sutras, a seminal text on yoga. Therapy includes cognitive behavioral interventions that help a person understand the complexity of any situation and reinforces selfconcept and confidence in their ability to overcome any problems they might face. As an integrated practice, natya yoga therapy is dedicated to developing a strong sense of personal agency in changing thinking, behavior, and mood in oneself. While therapy reinforces self-confidence, natya and yoga practices create a meditative access to intuitive guidance and healing that offers relief from inner agitation and emotional distress. As a therapeutic model, NYT follows the ashtanga principles to engender yoga and interprets it as a three-pronged integrative approach to an empowered and integrated self: x Yama: Cognitive therapy that reinforces self-concept, moral values, and beliefs that empower an individual to feel competent and

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capable of making choices that reflect responsibility for their thoughts, feelings, and actions. x Niyama: Behavioral practices that reinforce discipline, positive thinking, and introspective actions of change, with faith in intuitive wisdom and guidance. x Asana and Pranayama: Physical natya and yoga practices that lead to meditative immersion (dhyana) wherein self-acceptance and integration emerge through a process that also relaxes the body, contains its distractions, and leads to inner calm, relieving emotional distress and agitation.

Natya Yoga Therapy: Praxis Natya yoga therapy is dedicated to creating a strong and integrated self in yoga. It is important to reiterate this paper’s usage of the word yoga—it refers to both practices and an emergent state of oneness. The Yoga Sutras states that when an integrated state of yoga is absent, symptoms of sickness, such as pain, depression, confusion, and conflict arise for which yoga practice is prescribed as remedial and preventive treatment (Hartranft, 2003, p. 13). Yoga is suggested as preventive and remedial for emotional distress and dysfunctions. In the context of developing mental wellness and oneness, NYT practices concurrently develop a person’s selfconcept through psychotherapy and their meditative ability through natya yoga practices. Intake. At the first meeting, a complete intake and needs assessment is completed. It may include medication assessment to evaluate not only psychiatric need, but also to ensure that the body’s nutrient and vitamin levels are healthy. Each person is encouraged to develop and maintain regular physical exercise several days in a week, along with healthy and nutritious eating habits. Emphasis is placed on maintaining balance in life, healthy habits, and disciplined practices such as optimal bedtime, hours of sleep per night, and social activity. Each person attends one individual therapy session and at least one group session. Individual cognitive behavioral therapy sessions address principles of self-concept (yama) and disciplined life-style (niyama) while group sessions may include movement, expressive dancing, or meditation with music. Cognitive therapy. Cognitive therapy challenges a person’s negative thinking, biased automatic thoughts, underlying belief systems, and cognitive distortions (Robins, 2004). Using reflective listening, Socratic dialogue, and a direct therapeutic approach, a person’s self-confidence is strengthened. The individual’s irrational cognitive bias regarding self-

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competence is replaced with newly cultivated rational and healthy ones (Robertson, 2010). The individual is empowered, with a strong self-belief, and develops preferred thinking patterns that are more conducive to healthy and adaptive emotional responses. Cognitive therapeutic changes affect a person’s thinking, emotions, and resulting behaviors. While conventional cognitive behavioral interventions are utilized, in NYT the focus remains on building a strong sense of self-competence and selfbelief as agents of change for self. Behavioral practices. Behavioral interventions build on cognitive restructuring that challenges a person’s negative view of self (Meichenbaum, 2004). NYT’s behavioral interventions are consistent with cognitive behavioral therapy and behavioral modification. It does not follow other behavioral therapies such as Pavlov’s classical conditioning or Skinner’s operant conditioning. The behavioral practices are solely for the purpose of developing an individual’s confidence in their ability to persevere in a discipline and active lifestyle that includes activities such as daily exercise, regular sleep habits, healthy diet, and creative activities such as dancing that are especially meaningful to each person. While behavioral therapeutic interventions are utilized, NYT’s focus is to reiterate an individual’s capacity to engage in disciplined behavior towards self-improvement and self-care goals. Their self-belief in their ability to overcome distress is strengthened by regular practices of healthy living, fervor in seeking knowledge, dedicated introspection, and self-study to raise awareness. Each individual is offered an opportunity to recognize other aspects of their self (such as their creativity or athleticism), reclaim their empowered self, and have agency over their diagnosis and its associated symptoms. Natya. When natya is used to increase self-awareness of body, its practices include rhythmic movement that energizes the body, physical practices that relax the body, movements to balance both sides of the body, mudra to bring together the hand-eye-mind, and postures that are steady and conducive to meditation. When rhythmic movements are used, they are adaptations of dancing steps used in Bharatha Natyam, a classical Indian dance style. Often, fingertips and pads press against other fingers in holding mudra that develop hand-eye synchrony while also influencing subtle energy within. When natya is practiced as expressive dance, a dancer narrates stories drawn from mythology and learns to step into the role of a chosen character (Ramaswamy, 2014). In the context of this paper, the words dance and movement refer to dancing movements of Bharatha Natyam.

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Yoga. Breathing exercises include energizing, alternate-nostril breathing, balancing both sides of the body using single-nostril breathing, forceful exhaling of breath clearing the chest, regulating breathing rhythm to enhance vital energy, creating resonance with acoustic pitch (sruthi), sound intonation with exhaled breath, humming to create inner harmony, and using melody to develop meditative calm. While breathing exercises are practices of pranayama, the use of music and acoustic pitch to cultivate subtle energy is a key aspect of the practice of natya yoga. Natya yoga meditation. As an integrated meditative practice, natya yoga can be a seated practice (listening to music) or active practice (moving to music). The music used in NYT is resourced from Natyasastra and is remarkable in its ability to evoke aesthetic experience (rasa) in its listeners (Gautam, 1993, p. 35). Select melodies on preferred musical instruments are used to evoke rasa, which in turn promotes a meditative experience of oneness (Ramaswamy, 2012, p. 228). When used in seated meditation, the focus is to shift preoccupation from mental processes to subtle experience. Active meditation with movement is used as a primer before seated meditation in those circumstances where there is hyperactivity, restlessness, and agitation. Since this paper’s focus is to showcase efficacy of NYT in overcoming mood disorders, the following sections represent bipolar disorder, depression, and anxiety as emotional experiences, besides being a diagnosis of mental illness.

Understanding the Experience of Bipolar Disorder The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes bipolar disorder as mood fluctuations that can range from depressive lows to manic highs with a propensity to fluctuate back and forth (2013). A person showing symptoms of bipolar disorder demonstrates a capacity to experience a wider range of emotions, seemingly between two polar ends of an emotional continuum. This person travels between the two emotional poles, experiencing both the lows and the highs of mood, sometimes recurrently as if cycling between them. While preference may be to hover along the imaginary middle ground of equanimity, the emotional highs give them energy, inspiration, creativity, motivation and vitality in contrast with the lows which makes them sluggish, depressed, despondent, and withdrawn. While at an emotional low, this person may cry easily and seem deeply distraught, sometimes suicidal, questioning the purpose of their life. In contrast, when experiencing an emotional high, this person may seem bustling with new

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ideas and a zest for life, engaging in multiple activities that stimulate and inspire them. They may also feel an exaggerated sense of themselves and feel a sense of self-importance and entitlement. In a benign disposition, this may be expressed by behaviors such as generosity, excessive spending, heightened sexual appetite, signing up for multiple classes, and frequent switching of projects that don’t reach completion. In an aggressive disposition, this can be expressed by acts that include aggression, anger, violence, harsh words, abusive language, and assault. In their search for the elusive middle ground, this person may selfsoothe and medicate using alcohol, cannabis, nicotine, and other narcotic substances. Their moods can affect their concentration, ability to complete tasks, and sleeping. Their thinking often reinforces their self-concept of being misunderstood, underappreciated, and disrespected, provoking behaviors that may be intended as self-advocacy and assertiveness. Their social aggression can lead to legal charges of assault and violence. Cognitive interventions describe how insecurities and fear of inadequacies can situate them in a hypersensitive mode in interactions. They step back to view how some interactions trigger their reactive aggression that is both retaliation and self-protection from perceived threats. They strengthen their self-concept, reinforced by values of nonviolence and honest perception of events. Maladaptive behaviors such as aggression can be regulated through behavioral modifications that build on the cognitive understanding that there is no moral justification for abusive and provocative aggression. Through regular psychotherapy and meditation, they consistently use selfintrospection and make changes in thinking and responsive actions, rather than react impulsively. They delay retaliatory actions, remain patient, and regain control over self. Meditation builds discipline and offers an opportunity to reorder their inner processes and develop calm, clarity of thought, and emotional strength. When active movement and dancing is used, it helps dispel restless energies in the body and regulates internal rhythm. Meditation creates space between thoughts and action, which affords them time to choose responsive rather than reactionary action.

Understanding the Experience of Depression and Anxiety A person with symptoms of bipolar disorder may experience severe and recurrent bouts of depressed moods. Others may only tend to become depressed (unipolar) without a propensity to travel to the other extreme in mood. Often, people with depression experience anxiety that can be worry

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or nervousness or even agitated energy that makes them restless. When depressed, they may feel a lack of purpose like their existence does not have any meaning. They may feel easily overwhelmed by life activities, unable to complete tasks, disinterested in social interactions, unmotivated to engage in activities, and as though life takes more effort than they can offer (DSM-V 2013). They feel sadness, cry, and may feel like life is uninspiring. There is often a sense of despair and despondency, but even that feeling sometimes takes more energy than they have. They simply do not have the energy to care about anything. In younger people, depression can look like irritability—especially as a reaction to when adults prod them to be active. It can come across as reactive anger (in contrast to provocative aggression), as if to say, “Leave me alone.” Anxiety can be excessive worrying about life situations, anticipating or fearful of possible outcomes (DSM-V, 2013). Anxiety can be nervousness and avoidance of provocative situations. Anxiety can be agitation, restlessness, and feeling unsettled inside. Anxiety is frequently reflective of a person’s fear that they may not be able to cope with a situation and so anticipation of it creates agitation. While anxiety can be present in numerous different circumstances, often an underlying theme is an absence of selfconfidence in their ability and competence to overcome the stressor. Three volunteers generously offered to share their personal circumstances and experiences with a desire to help others. Two of the volunteers had a natural preference for dancing and seated meditation, while the third volunteer enjoyed seated meditation. All three volunteers engaged in cognitive therapy and developed strong behavioral practices that were especially meaningful to their sense of self-competence. Since each person’s experience of anxiety and depression is best understood in context of their circumstances, the narratives provide an understanding of each situation prior to describing how NYT was used to help them overcome their distress. These particular examples imply a cultural preference for Indian dance since the volunteers drew on their prior experience as dancers. However, NYT is used as a treatment approach inclusive of genders, ethnicity, and dancing abilities. As a sample to understand how NYT is practiced, three case studies are offered, each given freely with informed consent and knowledge that participation was optional and voluntary.

Narrative: Meeting Expectations Diane felt overwhelmed and unable to meet occupational, social, and familial expectations. She isolated herself when she felt depressed and

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lonely. Her anxiety at being unable to meet expectations caused her to withdraw even further and question the purpose of living. She believed that she was a depressed and anxious person. She did not think she could change that. She was on anti-depressant medications that allowed her to complete her daily tasks but over time did not improve her mood. Cognitive therapy established safety and security in the relationship before venturing into her vulnerable psyche. Her negative self-deprecating thinking patterns and beliefs of incompetence were challenged until she chose to replace them with affirming positive beliefs about her capacity to overcome her limiting thoughts. While she was keenly aware of her experiences of depression and anxiety, she did not feel overpowered or defined by them. She reclaimed her sense of self as more than her symptoms of depression and anxiety. She recognized that she had sufficient agency to define herself as someone with life experiences that included depression and anxiety. Behavioral interventions helped Diane implement lifestyle changes that included a nutritious food plan, regular physical exercise, an appropriate sleep routine, and weekly therapy sessions. She developed a disciplined practice of weekly natya dance sessions and/or seated meditation with music. Building on her prior experience with classical Indian dance, she used rhythmic movement to energize the body. While balance, coordination, and stamina increased over time, hand-eye-mind coordination strengthened her concentration, while also developing whole body synchrony. Diane’s increasing proficiency and grace reminded her of her identity as a skilled and talented dancer. Seated meditation calmed her mind and settled inner agitation and restlessness. Her ability to engage in disciplined group meditation practice reassured her of her patience, perseverance, and, above all, her social belonging in the group. Over time, the combination of psychotherapy, dance, and meditation reinforced her self-confidence and created a strong sense of competence. She reclaimed her sense of self-agency in overcoming problematic moods and initiating active interactions. After a year of sustained NYT, Diane was able to wean herself off medication and engage in her life with renewed vigor. Diane’s Experience of NYT. I did not realize that I could change how I felt—I did not know that I could change my depression and anxiety. My practice of dance, meditation, and therapy changed how I felt. I am no longer depressed or anxious. I am happy. I used to find schoolwork very difficult and challenging. I thought I was the only one feeling so overwhelmed and intimidated by the work. I now know that the work is really not that difficult as long as I keep at it. I believe I can do what most

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others my age can do. I don’t feel scared or doubtful of myself. While people had told me I was competent, I didn’t feel it and didn’t believe them. Recently, on a day when I was feeling especially dejected, my family told me how wonderful I was—and for some reason, I believed them. And since then I have not felt anxious about completing schoolwork. I used to love dancing but I had stopped and didn’t want to dance anymore. When I started movement, I enjoyed the rhythmic movement and how it made me feel afterwards. I wanted to dance again. I now dance regularly and enjoy it. When I meditate with music, it gives me a break from worrying and thinking. I feel proud that I have maintained my practice of meditation, dance, and therapy.

Narrative: Head and Heart Nicole felt extremely unhappy with her relationship and yet stuck in it, unable to make changes. She felt depressed, sad, and devastated that this may never change. She desired joy and love, and yet felt constrained by traditional expectations. She felt deeply conflicted and agitated by the impossibility of her life circumstances. She wanted more out of her life but did not feel she had the courage to act or make choices to secure her own happiness, especially if it involved upsetting others in the family. She felt stuck and deeply saddened by her circumstance. Psychotherapy helped her understand her conflict between what is sensible and what is desired—the dialogue between an analytical mind and an emotional heart. Cognitive therapy challenged her self-concept as incapable of acting in her interests. Therapy questioned her dichotomous thinking that life was either boring and structured or fun and unstable. She was able to conceptualize this as colors of black and white. As an artist, she understood her desire for color and contrast in her life, while maintaining a base of stability. She chose to challenge her black-and-white thinking to include red streaks that were symbolic of passion and zest for life. Nicole understood the power of peers in influencing choices, and reclaimed her self-power to be who she wanted to be, irrespective of societal and cultural expectations. Psychotherapy helped her identify core values she wished to live by and strengthened her self-expression to be authentic and true to her personhood. Nicole engaged in a regular practice of running as a form of physical exercise and followed a healthy nutrition plan. She attended meditation elsewhere since she had a positive relationship with her meditation teacher, whom she considered a mentor. Nicole’s treatment included cognitive therapy to build self-belief and behavioral practices to strengthen

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self-concept and competence. While she attended yoga meditation elsewhere, she used natya yoga and seated meditation with music on occasion during therapy sessions. On one occasion, when she was deeply conflicted and felt guilty about her choices, Nicole used meditation as part of an extended therapy session to access her own intuition and selfguidance. After a deep and prolonged immersion in meditative silence, she said she could hear the clarity of her own inner silent voice. She gave voice to her self-concept that was unfiltered by outside influences. She felt compassion for her struggles and unfulfilled desires. She heard the resolve in her own voice, and she heard herself speak in a deeply reflective state, and felt empowered by her inner resilience and determination. In Nicole’s case, she experienced the cognitive and behavioral interventions of NYT and received yoga meditation instructions elsewhere. The natya yoga component was included only when she meditated with music. Yet, the focus on self-empowerment and yoga meditation appears to have been effective in changing her perspective and urging her towards mental wellness. She made life-altering choices that reiterated her capacity to be a self-advocate and her own agent of change. Nicole’s Experience of NYT. I expected others to do what I wanted them to do so that my life was picture-perfect. When they did not do this, I became upset and distraught that life did not give me happiness. Now, I realize that this picture-perfect life is in my imagination and I cannot expect others to make me happy. It is up to me to make myself happy. Therapy has helped me accept who I am—both the light and dark sides. I have always believed that you need a mix of both in life, but I could not appreciate it in me. I like myself and am taking control over my choices in life. I used to ask friends for advice, often following their suggestions. Meditation has connected me with my own core. I don’t ask others for advice anymore. I listen to myself and act accordingly. When there is an open wound on the skin, we place a bandage to protect and heal. I think meditation does that to our inner wounds. It heals.

Narrative: Is This Love? Sheela felt conflicted by her love for another, despite inconsiderate behavior that felt abusive. She was distraught, despairing, confused, agitated, sad, and tearful, and felt anxious, hopeless, and powerless. Should she persevere and follow her heart, trusting that love will prevail? Should she demand respectful actions, risking separation? Was this a story of life testing love and strength of convictions? Was life challenging her to be a self-advocate? Her dilemma was uncertainty about which story was

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hers. While objective thinking may suggest actions of self-preservation, Sheela’s emotional needs and desires provoked reconciliatory acts. Cognitive therapy separated facts from preferred interpretation and provided clarity in thinking. Sheela let go of self-blame and worked towards reclaiming agency in making life choices. She accepted past choices without self-recrimination, even while a part of her wished that the future could fulfill the promise of her love. She engaged in regular dance sessions, meditation to music sessions, and cognitive therapy. Her love for dance helped her stay active and she reclaimed her identity as a talented dancer who had mastery over her body. Regular meditation provided relief for her agitated and troubled mind, allowing her to be part of a group of fellow meditators who were non-judgmental and loving in their empathy for her pain. Sheela’s Experience of NYT. Consciously striving to understand and choose “who I am” in the story, rather than letting it just happen on its own, was an eye-opener for me. The realization that I have the power to choose was incredibly empowering because I had assumed that it was already decided who I must be in this story. But that's not true. I can decide who I want to be in every situation. This subtle yet profound shift impacts how I tell the most important story I have to tell: the story of my life. Dance has helped me feel alive. It has shown me that no matter how big my problems are, they are not a match to the powerful vital energy of life that flows through us. It allows me to disconnect temporarily from the monotony of worrying about my problems and connect to a different pace and rhythm. I find peace while dancing and a refreshing perspective dance inevitably offers me. Meditation gives me confidence in my self, my words, and my actions. Meditation helps me find resonance with thoughts, words and, experiences that find me in my “waking” life. It allows me to connect with and consult my deeper, true self. Not only does the meditative guidance help me in making life decisions, the very act of making time each day to honor my inner voice is an act of self-love that gives me self-confidence and inner peace. I have faced outright rejection, emotionally abusive behavior, and an all-pervasive uncertainty about the future. As I navigate through this difficult experience, meditation has helped me center myself through the chaos and focus on my self and my inner voice. This in turn has helped me to maintain a sense of agency in what could otherwise feel like a powerless situation.

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Efficacy of Yoga as a Restorative Practice and Therapy Approach This paper described core concepts of yoga as utilized by NYT in helping people overcome symptoms of psychiatric mood disorders. While individual experiences are unique, there appeared to be some common themes that emerged in efficacy of yoga as therapy in relieving emotional distress. Diane reclaimed her sense of self-agency to overcome her selfdefeating belief that depression was unchangeable. She recognized her talents as a dancer and her ability to persevere and change her life. Nicole realized that she had choices and could make changes for a better life. She was able to soothe her fears of societal rejection and ground herself in her inner intuitive guidance. Sheela was able to replace her self-critical thinking with an empowered and energized self that felt in control over her life choices. The rhythmic movements of dancing were rejuvenating for Diane, while the expressive aspect of dance was life-altering for Sheela. Nicole appreciated the intuitive guidance that meditation offered, while Sheela found it calming. While initially empowered by the therapist’s validation and self-assurance, each person was later able to feel a strong sense of self-competence and empowerment to re-envision and change the reality of their circumstances. Stepping back to view the efficacy of NYT as an integrative approach, these three case studies affirm that an empowered self can regain agency over life choices. While more studies are certainly necessary to validate the efficacy of NYT, it seems clear that cognitive therapy challenged each person’s negative thinking patterns and replaced them with adaptive and affirming thoughts. Concurrently, behavioral interventions reiterated individual perseverance and discipline to engage in healthy life choices that promoted self-care. Natya invited each person to step into their identity as a dancer and also created movement in the inner self. Yoga breathing exercises were inclusive of all three cases, irrespective of their physical dexterity, and guided them into an experience of yogic meditative calm. Music restored equanimity of mood and inner meditative calm while meditation offered intuitive self-guidance. Additionally, the format of meeting in groups offered social belonging and acceptance by others within the group. While cognitive reiteration of self as larger than stressor appears to be invaluable in propelling a person to overcome moods, each person’s ability to engage in disciplined self-care practices reinforced their sense of self-worth and competence. This dedicated focus of self-empowerment to guide and restore is remarkable and possibly unique to yoga therapy. It

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affirms the two-fold essence of what constitutes yoga therapy—to empower a person so that they progress towards wellness using practices of yoga, guided by the underlying philosophical approach of promoting an integrated oneness. Yoga therapy as a person-centered approach believes in a person’s ability to self-actualize and emphasizes the role of behavioral practices in the self-actualization process. Yoga therapy as a cognitive and behavioral approach places importance on changing thinking and behavior, while stressing the role of meditation in augmenting such changes. Yoga therapy as an existential approach situates a person as a cosmic instrument and reiterates the necessity of yoga as practice to stay connected with the cosmic process. Yoga therapy reinforces the need for a person to be one with self and with transpersonal energies that guide and restore harmony. Yoga as meditation and spiritual therapy reminds a person of transpersonal strengths that are available to them. While each of therapeutic approaches is beautiful and beneficial, an integrative yoga therapy model that includes the healing aspects of many such modalities can offer more. Natya yoga therapy is one such integrated yoga approach whose practices encourage individuals to become a self-guided resource for restorative healing and intuitive guidance.

Author Biography Aparna Ramaswamy is a dancer, teacher, and psychotherapist whose passion is to help others reclaim their innate ability to heal and overcome emotional distress. She is founder of an integrative healing model (natya yoga therapy) that combines movement, music, and meditation with conventional psychotherapy, a direct outcome of her PhD research and lifetime practice of natya yoga. (www.HealingTradition.org, [email protected])

References American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Association. Barnett, J. E. (2014). Complementary and Alternative Medicine for Psychologists: An Essential Resource (1st ed.). Washington, DC: American Psychological Association. Bharati, S. V. (2001). Yoga Sutras of Patanjali with the Exposition of Vyasa. Delhi, India: Motilal Banarsidass.

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Bhavanani, A. B. (2011). Don’t put yoga in a small box: The challenges of scientifically studying yoga. International Journal of Yoga Therapy, 21, 21–22. Butera, R. (2010). Yoga Therapy: East-West Synthesis. International Journal of Yoga Therapy, 20, 83–85. Deepak, K. K. (2013). Yogic Intervention for Functional Psychotic Disorders. Indian Journal of Psychiatry: Yoga and Mental Health Supplement, 55, 340–343. Feuerstein, G. (1998). The Yoga Tradition: Its History, Literature, Philosophy and Practice. Prescott, AZ: Hohm Press. Feuerstein, G. (1989). The Yoga-Sutra of Patanjali: A New Translation and Commentary. Rochester, VT: Inner Traditions International. Gautam, M. R. (1993). Evolution of Raga and Tala in Indian Music. New Delhi, India: Munshiram Manoharlal. Hariharananda Aranya, Swami. (1981). Yoga Philosophy of Patanjali (P.M. Mukherji, Trans.). Albany, NY: State University of New York Press. Hartranft, C. (2003). The Yoga-Sutra of Patanjali. Boston: Shambala Publications. Iyengar, B. K. S. (2008). Light on the Yogasutras of Patanjali. NOIDA, UP: HarperCollins. Khalsa, S. B. S. (2013). Yoga for Psychiatry and Mental Health: An Ancient Practice with Modern Relevance. Indian Journal of Psychiatry: Yoga and Mental Health Supplement, 55, 334–336. Kripalvananda, S. (1977). The science of meditation. Retrieved from http://www.naturalmeditation.net on 8/7/11. Meichenbaum, (2004). Changing Conceptions of Cognitive Behavior Modification: Retrospect and Prospect. In Mahoney, M.J. (ed.), Cognitive & Constructive Psychotherapies: Theory, Research and Practice (insert page numbers). New York: Springer. Miller, B. S. (1995). Yoga—Discipline of Freedom—The Yogasutra attributed to Patanjali. Berkeley, CA: University of California Press. Mishra, R. S. (1973). Yogasutras: The Textbook of Yoga Psychology. New York: Anchor Press. Nagendra, H.P. (2013). Integrated Yoga Therapy for Mental Illness. Indian Journal of Psychiatry: Yoga and Mental Health Supplement, 55, 337–339. Rangacharya, A. (1986). Natyasastra: English Translation with Critical Notes. Bangalore, India: IBH Prakashana. Rama, S. (1983). Choosing a Path. Honesdale, PA: Himalayan International Institute of Yoga Science and Philosophy of the USA.

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Ramaswamy, A. (2012). Natya Yoga: the yoga of Bharatha Natyam. Doctoral dissertation, CA: California Institute of Integral Studies. —. (2014). Natya Yoga therapy: Using Movement and Music to Create Meditative Relief in Schizophrenia (based on ashta anga yoga). Action Research, (Vol. 12:3), pp. 237–253. UK: Sage Ramaswamy, A., & Deslauriers, D. (2014). Dancer-Dance-Spirituality: A Phenomenological Exploration of Bharatha Natyam and Contact Improvisation (pp. 105–122). In Dance, Movement & Spiritualities (Vol.1: 1). Bristol, UK: Intellect Books. Robertson, D. (2010). Philosophy of Cognitive-Behavioural therapy: Stoic Philosophy as Rational and Cognitive Psychotherapy. London, UK: Karnac Books. Robins, C. J., & Hayes, A. M. (2004). An Appraisal of Cognitive Therapy. In Mahoney, M.J. (ed.), Cognitive & Constructive Psychotherapist: Theory, Research and Practice. New York: Springer. Satchidananda, S. (1990). The Yogasutras of Patanjali. Yogaville, VA: Integral Yoga. Shastri, L. (1975). A historical review of yoga. In D. Digambarji (Ed.), Collected papers on yoga (pp. 14–23). Lonavla, India: Kaivalyadhama. Sivananda, S. (1960). Fourteen lessons in Raja Yoga. Tehri-Garhwal, U.P., India: Divine Life Society. —. (1970). Practice of yoga (rev. 4th ed.). Tehri-Garhwal, U.P., India: Divine Life Society. Taylor, M.J. (2007). What is Yoga therapy? An IAYT definition. In Yoga Therapy in Practice. Dec 2007, (vol. 3: 3), pp. 3–3.1.

SOUND AND THE SUBTLE: TRANSFORMING CONSCIOUSNESS AND EMOTIONS THROUGH MANTRA AND RAGA YOGA SILVIA NAKKACH CALIFORNIA INTEGRAL OF INTEGRAL STUDIES, SAN FRANCISCO, CA VOX MUNDI PROJECT AND MYSTERY SCHOOL OF THE VOICE (INTERNATIONAL)

Abstract The author attempts to bring new light to the affective quality of sound in the human psyche, and examine the ways that sound production, transmission, and transformation can determine emotional, psychological, and physiological states by drawing connections between ancient Vedic sciences and the wisdom of the Yoga of Sound (nada yoga) with the aims of modern models of counseling and psychotherapy. In order to understand the value of the most current yogic practices based on sound, the focus will be on mantra and raga singing, and defining and describing how these vocal arts transform consciousness and emotional states by enhancing the sensibility of the subtle in the mind and the body of the practitioner. The paper yields integrative insights and valuable possibilities when the roles of the yoga practitioner and the therapist inform each other through the intentional use of sound to assist a person heal and grow: to enrich inner work; to enhance trust and inner serenity, flexibility, and balance; to build awareness and emotional stability; and to cultivate devotion, discipline, and compassion. The value of sound and the experience of deep listening in human healing is an arena that has long been overlooked by many therapeutic theories and by many practicing therapists. The integration of the subtle qualities of sound can be

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especially appreciated in mainstream Western cultures that often have noticeable difficulties handling silence. It is on the horizon of the human potential models that the evolving collaboration— between the yogis of sound and the therapists of the psyche—will lead to the refinement of the quality of life and the competence of life-service. In time, this collaboration includes the aim that yogis and therapists become better listeners.

Sound as Nada Brahma: The Creator Real music is not for wealth, not for honors. It is one kind of yoga, a path for realization and salvation to purify your mind and heart and give you longevity. (Ali Akbar Khan, cited in Ali Akbar College of Music, 2013)

Sound as vibration has the ability to permeate all things. Sound originates when molecules vibrate within space. We live in space, breathe air, receive energy from the sun and the earth at every moment, and yet, the awareness of the essential relationship with these primal elements only happens during heightened states of consciousness, when we become sensitive to the gross and subtle dimensions of these essentials. Sound travels through us, activating our bodies and our imagination and modulating our mood in the process. Our brain connects and processes sound as information. Everything we do, think, sense, and feel carries a vibrational frequency that creates and can change our circumstance at every moment. The condition of the person, the setting, and the nature of the sound delivered are variables to consider. The most ancient cultures on the planet believed that material reality is the manifestation of primordial vibration. The Bible (John 1:1) teaches, “In the beginning was the Word, and the Word was with God, and the Word was God.” Early and contemporary spiritual traditions, the mystical experiences of sages and shamans, and scientists alike propose that vibration (spandam, the first sound) is the beginning of all creation. Both the material and the absolute realities are nothing but pulsations and at every level there is the sound component of the universe. Through the finesse of their yogic practices and meditation, the sages as well as the scientists distilled the microscopic and molecular stratus of sound in detailed scales. The ancient Bön and Dzogchen teachings, which predate Buddhism in Tibet, also state that sound is in the basis of all manifestation. In a newsletter of the International Dzogchen Community, Costantino Albini (1996) writes:

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In the most ancient Tibetan mythological cycles, sound is considered to be the original source of all existence. Sound, which from the beginning of time has vibrated in ineffable emptiness, arises through mutations of light and then differentiates into rays of various colors from which the material elements that make up the entire universe originate. (p. 17)

Albini is describing how sound gives birth to light, and how light shines out in rays that become the elements—quite literally the physical matter of the universe. In many ancient traditions, sound and vibration are present as a gateway to contemplation, divination, and spiritual development. In the Vedic tradition, derived from texts originating in ancient India, the “Word,” as it is conceived of in the Western Bible, is called the Nada Brahma. The primordial and transcendent sound is considered the seed from which all of creation evolved. This is the Nada Brahma. Nada, or vibration, is the first audible sound, the primordial roaring, the resounding flow that heralds the beginning of the evolutionary process from which energy and matter radiate. Brahma, the creator deity, is the creative power that animates one’s divine consciousness with the power to move the heart. The original, eternal nada vibrates at the highest frequency. In physics, when an object vibrates at an inconceivable speed, it appears to the eye that it is not moving. It is beguiling that the highest point of vibration is apparent stillness; in the dimension of sound, this is experienced as silence. Above a certain level of high frequency, sound becomes inaudible, and can only be perceived subjectively. The ears cannot perceive sounds that are vibrating at such a high frequency.6 Thus, nada is both the beginning of all sounds and all manifestations. In the realm of consciousness, nada is the vibratory frequency rate of silence. As part of a meditation or contemplative practice, an experience of nada, when savored in the intimate and spacious union of sound and silence, creates an opening to the therapeutic process. As a practitioner of sound as yoga with a professional background in transpersonal music psychotherapy, the author ponders the idea that the guided, shared experience of nada during a session signals the healing power of sound and silence. As in the sequels of meditation, the journey to wholeness starts with awareness, clarity, and a moment of suspension. The Hatha-Yoga-Pradipika (Muktibhodananda, 1998, 4.90f) states that the mind absorbed in nada does not crave sense objects. The unstruck 6 It is accepted that humans can generally sense sounds at frequencies between 20 and 20,000 cycles per second, or hertz (Hz) (Paul, 1998–2015a).

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sound, anahata nada, is heard in the anahata-chakra, the psycho-energetic center located at the heart, the seat of transcendental consciousness. In this seat of the divine can be heard the immortal sound not produced by anything. It is the divinity inherent in music and poetic discourse that connotes this sound of the soundless, and endows the yogis with super sensuous sound and listening awareness, from the audible to the inaudible, transcendental sound. They stir the depth of the ocean. The original unmanifested sound rests in a state of involution against the background of the fundamental silence, i.e., mahamuna, from this primordial transcendental state or original vibration as mahanada, it descends to the subtle, less subtle, and the gross level wherein it becomes a physical audible phenomenon. This sound holds within itself the potential for becoming an expressive utterance. . . . Synonymized with para-vak, nada is the sakti or vital energy of Brahman, and as such is inseparably close to Brahman. The transcendental para-vak descends to levels of subtleties through pasyanti and madhyama, the levels of differences felt but still not manifested, and finally to the gross physical level of vaikhari, externalized by clearly articulated syllables along with their expressive arrangements endowed with physical audibility. (Mutatkar, 1999, p. 22)

The practices of nada are comprised in Nada Yoga as the path of those who through worshipful devotion (bhakti) and practice travel these four steps of the experience of sound, through states of consciousness and silence. Like moving up and down the musical scale, the practitioner is ascending and descending, from gross to subtle and from dimensions of subtle to gross in the scale of auditory and spiritual discernment. The perception of these levels of sound becomes sensation and affects the emotional connection to others and the self. This evolving quality of appreciation and detachment is essential to the function of the many styles of yoga, and is also the ultimate goal of most of the advanced therapeutic modalities, as well as wisdom-based technologies of self-transformation that aim for liberation from the mundane mind formations at a higher level. For thousands of years yoga has been exploring and creating tools to improve our personal and interpersonal experience, so that we live a harmonious and helpful life.

Outer, Inner, and Secret Sound Not one sound fears the silence that extinguishes it. And no silence exists that is not pregnant with sound. (Cage, 1961, p. 135)

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Another ancient tradition of yoga and sound that offers centuries of indepth wisdom on the field of the subtle in sound, and sound as a seed of transformation, is the ati yoga or dzogchen, considered one of the highest teachings of Tibetan Buddhism. According to ati yoga, sound comes from emptiness and dissolves into emptiness (space). This wisdom tradition describes three ways to experience sound: Outer sound is physical; we hear it with our ears and we produce it with our bodies. Inner sound is energetic; we feel it on the energetic plane as an opening in the chakras or as inward expansiveness. Secret sound just is; we perceive it with a mind that’s clear. It arises as a result of states of meditation. It’s like a light or a revelation that comes from a non-conceptual state, and when it engages our intellectual faculties, it becomes what we know as an “insight” (Norbu, 2001, p. 2). The experience with sound in these three dimensions provides a way of harmonizing our energy disposition at a deep level. This threefold appreciation of sound and discourse introduces the practice of deep listening to therapists, particularly those who are informed by transpersonal psychology and Integral Yoga.7 There can be a great transformative value in this tri-dimensional shared experience of sound between the therapist and the client. Likewise, the therapeutic value of mantra chanting rests on this tri-dimensional perception of sound.

The Sound of Chanting Let us assume sound is a seed for transformation. When we chant with a voice as a fabric of breath, body, and expression, we might begin to perceive the luminous nature of the mind and the radiance of the spirit. When we hear chanting, or sing in this conscious way, we become sensitive to the outer sound, the inner sound, and the secret sound. Chanting effortlessly reveals the healing energy within the voice, like the original soothing voice of the newborn’s mother. Instantly, a kind of archetypal longing is appeased. This aligns with Austrian occultist, Rudolf Steiner’s (2005) concept of tone as a spiritual reality, and his fascination with what he described as inner, outer, and universal tone. Universally and from time immemorial, the devotional art of communal singing is able to reach the place of joy and fulfillment in a few minutes. At the end of every phrase or long breath, there is a taste of nada, 7

A 20th century spiritual teaching developed by Indian mystic, poet , and revolutionary, Sri Aurobindo Ghose, and his partner, European occultist, Mirra Alfassa—aka the Mother.

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in the form of a peaceful silence. In the conscious dance of the spiritually inspired word and silence, there is always a landing in the subtle field of nada. Thus, yogic chanting has the potential to fuel intuition, a direct apprehension of truth beyond discernment that leads to balance and positive personal transformation.

Nada Yoga Through music one can transcend into the mysterious sphere of silence, through time-bound rhythm cycles to timelessness, through sound space to sacred space. Music is therefore called Nada-yoga, a union of the body and Spirit through vibrations. (Srinivasan, 2002, p. 132)

Nada Yoga is the practice of deepening consciousness through sound that originated in ancient India. We become familiar with the formless beauty of searching for and chanting sacred sound. It is a skillful means by which to develop a connection with sound as vibration, vibration as energy, and energy as life force, or prana. In Nada Yoga, words are not fixed in meaning—just sound. Nada Yoga practices are like meditation through sound. The source of the sound may be external or internal, obvious or subtle. But the mind is focused only in the dimension of sound, becoming free from feelings, thoughts, and wants. Many yoga philosophies agree that this is the best use for that space we call the mind. By cultivating familiarity with the nature of the mind through sound unattached to meaning or expectations and unwinding the subjective quality of experience, the person becomes calmer and clearer, giving rise to wisdom and creativity. Creative expression proves to be an antidote to depression, which is in the base of most psycho-spiritual illness. Through Nada Yoga as a daily practice, we use specific sounds to stimulate dormant currents of energy in our body-mind, and we lead our consciousness to the heart of deep love and devotion—sounds like Om, which represents the total vibratory nature of the universe. According to ethnomusicologist Lewis Rowell (1992): The syllable Om has been interpreted as the eternal syllable that contains in itself the entire phenomenal universe, and as a nucleus from which all audible sounds proceed and to which all such sounds must ultimately return. The utterance of the sacred syllable is, then, at once, an invocation to the gods, a salutation to the structure of the created universe, an aid to meditation, a protection against error, a hymn of praise to life in all its forms and manifestations, and a symbol of integration and completeness. (p. 36)

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Swami Niranjanananda Saraswati (1981) teaches that when we chant Om, or any sacred sound, all the cells in our body—particularly our brain cells—are affected: Specific sound vibrations have been shown to influence metabolic functions of the body, other sounds reduce anxiety and mental restlessness, and so on. Research at Barcelona University revealed that alpha wave synchronization and intensity increases at certain sound frequencies, while the vibrations of Om induce theta activity in the brain. (para. 15)8

When the body is vibrating while the mind is chanting, we might experience a sense of harmony between the two. The body and mind fall in tune. And “I”—the “I” that is neither body nor mind—can be at peace because it is no longer being pulled in one direction by the body and in another by the mind. The author calls this an experience of soundness, a sonorous remembrance of wholeness. These Nada Yoga practices are already used by healers and psychotherapists and can benefit other healing modalities. According to Osho (1979), the Indian mystic and spiritual teacher, while the body and mind are absorbed in chanting, the other “I” can slip out and become a witness. Watching from the outside, we experience amazing tranquility. We watch our body swaying and our mind feeling calm and quiet. We are at once the being who experiences utter peace and the neutral observer who stands outside the body and witnesses this phenomenon. We are in “ecstasy,” which comes from the Greek verb meaning “to stand out” (Merriam-Webster’s online dictionary, n.d.). Nada Yoga is the fast track to a state of cosmic consciousness, a selfless and illuminating state of interconnectedness with the web of life, and the sonorous yogic practices of Nada Yoga are in the foundation of devotional chanting and other Eastern informed modalities of healing with sound. Most people experience release with this practice because it is intrinsically rewarding, and one doesn’t need to be a trained musician to practice Nada Yoga. It is yoga, an ancient healing art. Hence, Nada Yoga practices are about traveling states of sacredness through contemplative sound. There is a sense of timelessness, and of being in a space that is greater than our psyche. In the sound-asana (pose) of the Silent Om practice, the reader can have a glimpse of the path of Nada Yoga. It is an ancient practice for getting acquainted with the realm 8

See Kalyani, et al, 2011, and Froeliger, Garland, & McClernon (2012) for more recent studies on the effects of chanting on the brain, and Mooventhan & Khode (2014) for a study of the effects of OM chanting on the heart.

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of inner and outer sound. One can implement this mental sound-asana at night to facilitate sleep or lessen agitation. The steps are: (1) sit comfortably with your back straight and eyes softly closed. Silently repeat the sound of Om for several minutes; (2) next, focus on your spine and visualize a blue light ascending through the energy centers of your energetic etheric body; (3) try this exercise again, this time vocalizing the sound of Om. To connect with inner sound, be equally focused on the vowel “o” and the length of the articulation of the consonant “mmmm.” Notice if it feels any different when the sound is vocalized. This is a primordial yogic practice to become familiar with the affective quality of sound.

The Unstruck Sound The fundamental purpose of Nada Yoga is to lead the mind to discover the ultimate inner sound and the secret sound current of one’s divine essence. The intention is to realize that we are not just our body or our mind, but our nature is the state of instant presence and awakening. Through Nada Yoga practices one can discover one’s true natural potential and explore the mystery of the unseen soundless. To connect with this inner current of sound, practitioners can begin with audible or external sounds—music playing or their own voice audibly breathing or toning, for example—and gradually shift their attention to the silence after the sounds are made. Another way to connect is to play a singing bowl and follow the ringing frequency until it completely fades. This transports our mind gently toward deeper states of consciousness as we merge with the “unstruck” sound, or the anahata nada, the sound that is not generated by an external strike or hit, but the inner sound that is heard in deep meditation. It has a leading quality. It leads the practitioner toward the state of soundless sound—the silence within, where we connect with the primordial energy that is the Source of all that is. This is well described by the Sanskrit concept of sahaja: the spontaneity of the experience when the opposites indivisible unite, everything that lives is pure and empty. Lokesh Chandra (2000), a contemporary scholar of Buddhism and Indian art, explains the location of this transcendental sound: The unstruck sound, anahata nada, is heard in the anahata-chakra, the psycho-energetic center located at the heart, the seat of transcendental Consciousness. In this secret seat of the Divine can be heard the immortal sound not produced by anything. The musical goddesses connote this sound of the soundless Absolute. They endow the worshipper with super sensuous or inner sound. From the vocalized sound they lead to the

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inaudible, transcendental, beyond-all, sound. They stir the depths of the ocean. (p.149)

In seeking a deeper understanding of the nature of unstruck sound, this next practice can be experienced as illuminating and transforming. Some scholars like the term anahad nada better to describe the unstruck sound. Anahad implies “unlimited” sound or “sound on which no boundaries can be set,” suggesting freedom and liberation of the spirit from its earthly bondage. Whichever definition we choose, the yogic traditions affirm that those who hear that inner vibration and meditate on it are relieved from the burden of worries, sorrows, fears, errors, and diseases. The spirit is freed from the captivity of the senses and the physical body; consciousness becomes free from all limitations of the mind. The mind is what the brain thinks and feels.

Bhramari Pranayama: The Humming Bee Breath This practice releases stress and tension, alleviating anxiety and insomnia. It also builds up tone and the voice. Sit comfortably with your back straight and eyes softly closed. The hands are resting on the knees. The lips are softly closed with the teeth slightly separated, and the tongue remains on the bottom of the mouth throughout the practice, which allows for the vibration of the sound to be felt more distinctly in the brain. Next, raise the arms with the elbows bent and bring the hands to the ears, using the index or middle finger to plug the ears, to avoid all external sounds. Become aware of the center of the head, where the ajna chakra is located. Breathe in deeply through the nose and breathe out slowly and long while making a deep and steady humming sound like that of a bee. The smooth and soft humming sound is continuous for the duration of the exhalation, making the center of the head vibrate. We repeat the process for 5 to 10 minutes. Remain a few minutes in meditation. The awareness of the unstruck sound is a powerful practice that takes our psyche directly to a place of emptiness and clarity. The only requirement is to approach it as yoga, a skillful method, and to cultivate familiarity with the practice and where the practice leads the practitioner. Many people report a sensation of being “cleansed” from within when doing Nada Yoga exercises. The function of yogic sound is to clear thought and purify the mind. Expectations and the body slowly relax. There is a healing that happens, conveyed by a shift in perception from self-center-ness to spaciousness, and an increased sense of participation, unification, and spiritual autonomy.

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Sound: The Transformer Subtle: 1. not immediately obvious or comprehensible; 2. difficult to detect or analyze, often through being delicate or highly refined; 3. showing or making or capable of showing or making fine distinctions of meaning; 4. marked by or requiring mental acuteness or ingenuity; discriminating. (Collins English Dictionary Online, n.d.)

Most musicians and practitioners enjoy playing but few take the time to dive deeper into the nature of sound itself. Sonorous yogic practices are about bringing breath, sound, and awareness together before entering into the dimension of chanting, music, or song. They collectively take the practitioner to a transpersonal zone of experience where attention becomes both very inclusive and spacious, as imaginative resources and the capacity for concentration increases. The practices of Nada Yoga are especially a good therapeutic complement for people who have trouble relaxing or sleeping. For those who have pain or ongoing physical difficulties, opening the voice with Nada Yoga might allow them to detour from the pain and move toward a lighter and more subtle emotional state. Sound travels through consciousness and has the power to transform everyday occurrences into a spiritual dimension through qualities of tone, rhythm, and vocal expression. A simple example of this is the piercing tone produced by ringing Tibetan bells or cymbals, which generates highly acute harmonics that permeate the mind with a sense of transcendence leading to silence and serenity. Every spiritual tradition of the world uses sound to facilitate the passage between states of consciousness and the spirit world. Many Nada Yoga practices are shamanic in nature due to their capacity to empower the person with spiritual qualities. According to Strupp, the modern psychotherapist relies on the same psycho-spiritual mechanisms used by yogis, shaman, and other kinds of healers, and the results, as reflected by the evidence of therapeutic outcomes, appear to be similar.

Shabda Yoga: The Yoga of the Word Sacred words introduce us to the realm of Shabda Yoga. In Sanskrit, shabda means “sound, speech, or utterance” in the sense of linguistic performance. Whereas Nada Yoga focuses on sound, pure vibration, and non-lexical syllables, Shabda Yoga connects sound to the realm of language and meaningful relating (Paul, 1998–2015b).

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Shabda Yoga is the path led by the inspired word, specifically the practice of chanting seed syllables and mantras. These revered sounds transmit to the practitioners the blessed power of their ancient lineage and help balance the brain and the body, and positively affect the psyche. Like mantra they also serve to protect the mind from any spiritual harm. This is clearly an example of a concept and a function that are not yet embedded in traditional Western psychotherapeutic research and practice. In the Hindu tradition, the very beginnings of language are represented by what we call bija, or seed syllables. Seed syllables are a combination of vowels and consonants. Bija syllables, ancient vibrational formulas that have come from unbroken traditions through the ages, are charged with healing and spiritual information. Each sound in the Sanskrit language is a seed syllable, which is one reason the Vedic mantras (compound and composed of seed syllables) are so potent and timeless. Seed syllables are matrikas, or “little mothers.” They represent the moment of conception of nurturing energy and power—the merging of male and female, solar and lunar. The vowels are female, receptive, and illuminative, bringing light and radiance to the mind and consciousness. The male qualities of action and penetration are in the consonants. For maximum benefit, when intoning these sounds practitioners must be conscious of giving the same attention and duration to the vowel and to the consonant—the female (Shakti) and male (Shiva) merging in unity.

Bija: Planting the Seed Each seed syllable is pregnant with the energy of a deity from which it manifests and into which it dissolves, with the power to evoke a particular quality such as compassion, healing, or clarity. By sounding the syllable we bring the quality of the deity into felt experience, supporting the process of opening and the free flow of energy through the subtle body channels. These ancient seed sounds also open the mind to a deeper receptivity. Chanting these sounds purifies thoughts and transforms emotions. The mind clears. The body feels. The voice is the conduit. Tenzin Wangyal Rinpoche (2013), lineage holder of the ancient Tibetan Bön tradition, which is also considered a yogic path, speaks of a commentary in one of their most profound texts, the Mother Tantra, which describes the genesis of seed syllables in this way: From the body of the unborn essence arises the sphere of light, and from that sphere of light arises wisdom. From the wisdom arises the seed syllable and from the seed syllable arises the complete mandala, the deity and the retinue. (para. 20)

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Rinpoche goes further to describe the singularity of seed syllables in terms readily understood by the contemporary Western mind. Just as radios and television sets tune into particular frequencies that already exist in space, we are able to tune into the particular exalted qualities embodied in the sound. We don’t have to invent or create these frequencies or qualities; they already exist within us. With practice, we can upgrade our receiver from a fuzzy old black-and-white TV to a modern high-definition home theater system with surround sound. In any case, the frequencies remain the same, but our experience of them can be greatly enhanced. Dhrupad is a vocal genre in Hindustani classical music, said to be the oldest and most erudite still in use in that musical tradition. Ancient civilizations all over the world have considered sacred music as yoga and as therapy, and so it was in India. Indeed, dhrupad had been regarded as a spiritual path by the musicians of ancient India for centuries. The transcendent sound of dhrupad singing is mostly achieved by singing seed syllables. Dhrupad singers start with a primordial mantra, such as Ananda Hari Om, and deconstruct it, dissecting it into separate sounds for each syllable of the sacred word, with undulating variations of tone and duration until it is no longer recognizable, yet deeply felt. The demanding focus of this classical vocal art of North India enhances cognitive processes in the expert practitioner. Thus, intoning and chanting seed syllables is the best possible preliminary practice to unfold the affective power of sound and to finetune the voice, which can serve as a mirror of our energetic disposition. These condensed sounds are charged with powerful frequencies; singing them with short tones is suggestive of kinesis—movement and action. Intoning them slowly with long tones is in contrast more conducive to absorption: entering fully in the realm of selflessness and luminous expansion. From ancient Tibetan sound healing, Rinpoche (2013) offers us this explanation: The Mother Tantra describes specific sound practices to treat physical ailments such as headaches, chest pain, and other problems. The right sounds create balance between the five elements of earth, water, fire, air, and space. These elements, present in nature, are also present in each one of us. So maintaining this balance is essential to good health. There are practices of chanting certain sounds, certain syllables, which activate or pacify each of the elements. These have a subtle but potent effect on our organs, and on our mental and spiritual states. These seed sounds contain elemental qualities that vibrate different parts of the body and different chakras. As our chakras are affected in this way, a higher vibration may be activated. (para. 5–6)

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In the beginning, it is beneficial to practice seed sounds from traditional practices. They come to us already charged with the healing power of lineage and repetition, and they become a rapid vehicle to activate the same strength in ourselves. After a few months of doing these traditional practices, practitioners of these healing sounds may be inspired to research seed sounds from other cultural backgrounds, or find ourselves resonating with spontaneously occurring seed sounds that spring from awakened consciousness. These sounds will strengthen our body and mind when the person feels weak or vulnerable, and these practices are an essential part of any soundcentered yoga therapy. At present, many transpersonal oriented psychotherapists are combining the implementation of sacred seed sounds with meditation in the beginning and the end of their sessions.

Mantra Chanting: The Yoga of Transforming Emotions As masterfully described by Muz Murray (2001), mantra is a profound and practical method of self-awakening, opening, and self-transcendence. The translation of the word mantra is “the force which liberates the mind from bondage.” So, quite literally, mantras are “protectors for the mind.” It is a form of yoga that speaks to the deep organic roots of man’s being by the use of vocalized and mental sound-currents of both audible and subtle frequencies. Those subtle vibrational formulas awaken dormant centers of the brain attuning the psychological, physiological, and spiritual faculties to the primordial and sustaining vibration of creation. When we come into harmony with the vibratory rate of sub-atomic pulsation in consciousness (as in deep meditation) we hold the key to universal knowledge and selfhealing. Murray (2001) continues by stating that among many western practitioners of yoga, one finds that the major focus of interest rarely goes beyond that of the physical aspect. While every effort is made to perfect the basic developmental asanas of the various systems of hatha yoga, scant attention is paid to the higher forms of practice, which include the in-depth pranayamas (breath expansion control exercises), patyahara (withdrawal of consciousness to the external world), raja (Skt. “kingly”) yoga exercises of a psychological nature, and the teachings and evolving practice lead to the higher experience of laya yoga (the yoga of transformation) through the practice of visualizations and mantras (sacred syllable repetition). Murray (2001) indicates that there is scientific evidence that if we chant a sacred mantra for a long time, we might not need to do anything else to boost our energy or to relax our mind, or at best, to expand the

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heart’s capacity for feeling and love. Hence, the psychological conditions conducive to these positive effects of mantra lie in a sustained systematic practice reinforced by the healing power of faith and devotion. Successful psychotherapies are supported by a similar discipline realized as a combination of deep listening, conviction, and compassion. Since the Vedic period in India (at the dawn of recorded history) mantra repetition has been a scientifically replicable practice. . . . The subtle harmonic vibrations of chanted mantras, both mental and vocal, act as a cleansing and purifying agent on consciousness. The yoga-rishis (seers) discovered that certain sounds brought them joy and ecstasy, some brought tremendous psychic powers (siddhis), profound tranquility or boundless energy, freedom from fear, or mental and physical healing. . . . In India, is not unusual for homeopathic doctors (as well as sages) to prescribe specific mantras instead of the usual remedies. . . . Mantra is known for its vibrant pulsation of subtle healing frequencies, and because its capacity to resonate in consciousness and states of emotions, it is considered by the great sages as the most efficacious method of trace back to unfelt feelings blocked in childhood, mantra (with its internal massage of rigid cellular structures) often allows such frozen pains and tears to be released. In occasion, even traumas have been experienced following a mantra session, allowing practitioners to relive and release past-life memories that created hidden tensions in the body. (para. 8–14)

Practitioners of Ayurvedic medicine, an ancient comprehensive system of medicine from India, often prescribe adaptogens, plants or herbs that normalize and regulate the systems of the body. They can either wake the person up or settle them into sleep, whatever is needed. They convey vitality, serenity, coherence, and the evolving practice of mantra yoga has the potential to transmit love in the form self-acceptance and an intoxicating state of joy. All cultures have mantras, and mantras have many meanings, or no meaning at all. Basically, a mantra can be any empowered word or phrase that is chanted repetitively in order to clear the mind and attain oneness with cosmic consciousness where infinite bliss abides. In the ancient Eastern traditions (including those of India and Tibet), the words or sounds of a mantra are sacred syllables that contain in their essence psychic powers; repetition of the mantra (japa) leads the mind toward the realization of the principle being evoked by the words, heightening consciousness to the appreciation of the sacred. Through mantra repetition, sacredness abides like a groove in the mind. Many seed syllables can be chanted as a mantra. The most well known is Om, which represents the entire vibratory nature of the universe. It is

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said in ancient Vedic teachings that the Om mantra is Divinity in the form of sound, together with more attributes previously described in this paper. The simple elongated intoning of the mantra Ah is understood to be able to awaken us to our primordial awareness, through clearing the mind of obscurations. Mantras serve as auditory centering devices that have the power to protect, purify, and transform the emotional state and consciousness of the individual who repeats them. They are energetically “active” and can convey the antidote of a negative emotion. For example, if a person feels angry, the mantra practice can convert the anger into forgiveness, while alleviating the chest or heart area of the body. At the same time, the mental concentration involved in a mantra awakens energies that recharge and relieve nervous tension in the body (Gurjar, Ladhake, & Thakare, 2009). Ultimately, mantra chanting induces devotion in the mind of the singer, activating a state of blissful liberation through sound. This is essential to the Hindu tradition of bhakti yoga, the path of devotion. The word bhakti comes from the root bhaja, which means to “love, adore, serve,” coming closer to our real nature. Bhakti yoga creates the most beneficial environment for mantra healing and positive thinking. As a devotional practice, mantra chanting with the intention of prayer has been preserved for centuries and can be found in all cultures. The rhythm of a devotional chant is repetitive, with subtle alterations of tempo, pace, and pulse. The sacred meaning of the words or syllables adds to the magnetic and ecstatic effect enhanced by the harmonious entrainment of a group of people chanting the mantra simultaneously. If required, mantras activate healing, as they have the alchemical capacity to transform energy. The sounds themselves are intoned, with the power to purify and protect the one who repeats them—and anyone who is listening. In his illuminating book Mantra and Meditation, Pandit Usharbudh Arya (1981) describes how a mantra that is kept in the mind serves as a protection for the six internal mental enemies: passions, anger, greed, attachment, jealousy, pride (or malice). Therefore, by repetition and concentration, the mantra serves as an antidote to these mind formations, and the nurturing power of the voice finds its fullest expression through mantra chanting, followed by the bountiful resonance in the soundless ending. The more we connect subtly with the movement of the mantra, the more we can feel it spin like a wheel. As an essential part of the yogic path, mantras are like sonic chakras, or wheels of sound power. Part of the delight of chanting a mantra is that we don’t really need to know what it means to get the effect. The transformative power of the mantra lies in the

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sound of the words and the fully conscious mind and intention of the user. One can think of mantra as abstract art, leaving it open to interpretation. This allows the mind to open freely, detached from meaning and culture. When we release the need to know what the words mean, we enter more fully into the affective dimension of mantra. Our mind has been purified. The mirror is clean. Equally, knowing the proper pronunciation and meaning of the mantra will boost its healing power. This explains why, in the many Buddhist traditions such as tantra and ati yoga, mantra chanting is used as a device to overcome attachments and conditioning throughout the human journey of spiritual liberation. By the combination of breath and sound, mantra yoga clears the oscillations of the mind, allowing the mind to reveal its true nature: emptiness and clarity.

Raga Yoga: The Yoga of Melody Music involves a vital power of expression with inspiration coming from above. In its relation with sound, music can induce ecstatic trance as a form of spiritual intoxication, and through the practice of music, devotion and aspiration can grow and prepare one’s nature for realization. (Alfassa, 1998–2013, p.8)

It is always a special delight to introduce what master musicians believe to be the most sophisticated form of musical expression—the art of raga singing. It is easy to get captivated by this mystical melodic art, endowed with deep and subtle psychic powers. Encountering the ragas elevates the appreciation of music as a cosmic generated art form. The selfless essence of the ragas involves not just how to sing or play, but how to nurture a spiritual practice. Ragas are the essence of Indian classical music, and the voice is the most esteemed instrument for expressing them. On the simplest level, a raga is an ancient tonal arrangement conveyed through a series of five to seven notes belonging to a particular scale, which is governed by specific rules for ascending and descending patterns and microtonal ornamentation. Indian music virtuoso and composer Ravi Shankar (2009–2013) describes raga in more detail: A raga is a scientific, precise, subtle and aesthetic melodic form with its own peculiar ascending and descending movement consisting of either a full seven note octave, or a series of six or five notes (or a combination of any of these) in a rising or falling structure. It is the subtle difference in the order of notes, an omission of a dissonant note, an emphasis on a particular note, the slide from one note to another, and the use of microtones together with other subtleties, that demarcate one raga from the other. (para. 5)

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It is said that human beings did not create the ragas. Ragas are like galactic visitors, the artistic manifestation of ghandarvas, or celestial beings known for their superb musical skills. Ragas are gifts to humans and transmit spiritual information, passion, and healing from these divine beings through the medium of melody and emotion. The author devoted to the study of raga singing for more than thirty years as a disciple of maestro Ali Akbar Khan (1922–2009), regarded as the most illustrious contemporary figure in North Indian classical music. Khan is acclaimed worldwide for his luminous compositions and renowned as a distinguished performer of the sarod, at all times devoting his playing to God. The late concert violinist Lord Yehudi Menuhin (cited in Ali Akbar College of Music, 2013) proclaimed Ali Akbar Khan “an absolute genius, the greatest musician in the world.” Yet the maestro rarely claimed to have composed a raga, even when he composed a few. He would claim to have received the ragas. The ghandarvas who supposedly send the ragas to humans are said to be supernatural sky dancers, so ragas are intimately connected with the natural and supernatural worlds. Each raga is associated with a certain time of day, season, quality of light, color, divinity, and other attributes. There are ragas that have the magical power to bring rain or fire; others pay homage to the moon. If you are familiar with these attributes, it is most beneficial to practice the ragas at the appropriate times. The word raga is derived from a Sanskrit root meaning “to color, to dye.” Figuratively, it evokes the qualities of passion, love, desire, and delight, particularly when applied to music or singing. The term as we know it first came into use in a classical Sanskrit treatise on music (dated between the fifth and eighth century) that describes raga as a combination of tones which, with beautiful illuminating graces, colors the mind with an emotion. Another inspired passage implies that ragas are melodic entities that live at the threshold between passion and music, humanness and cosmic-ness, religion and paganism, the sacred and the profane, shamanism and yoga, sound and consciousness. It is a challenge to define in a few words a simple melody that has so many extra-musical meanings. Its development through rules and patterns of ascending and descending notes and circular microtonal movement inspires a melodic development that is as complex as a symphony and as on-the-spot as jazz improvisation. At the same time, practicing the ragas as yoga is so freeing, and also so effective in shifting the mood of people. When a raga is playing, it is impossible not to be affected by it—even if a person is not particularly attuned to it, or does not know anything about the music.

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It is possible that ragas represent the first structured psycho-acoustic music ever conceived. In his book, Hindustani Music: A Tradition in Transition, author Deepak S. Raja (2005) claims that “Raga is a psychoacoustic hypothesis, which states that melody, created and rendered in accordance with a certain set of rules, has a high probability of eliciting a certain quality of emotional response” (p. 392). Raja goes on to explain: As a melodic entity, a Raga is represented by a set of rules governing the selection, sequencing, and treatment of tones swaras. These rules define a framework, which is tight enough to ensure aesthetic coherence, while also providing sufficient freedom for individual creativity.

This approach comes from a tradition that combines the role of the composer, the performer, the yogi, the healer, and the deity in the same individual. A raga is like a tonal poem, a melodic narration with the power to induce deep emotional clearing and a sensitive aliveness rooted in beauty. The practitioner approaches the development of a raga as a complete yoga session, with a series of coordinated sound-asanas that complement each other around a theme. The ragas offer a direct experience of music and singing as a healing art backed by a strong lineage. Similar to chanting the mantras, singing the ragas awakens the subtle energy centers of the body, where the sacred becomes commonplace, and music touches a source beyond ordinary listening. The poised aural architecture hidden in the raga moves us toward a spiritual sense of self that is free from the poverty of the ego. The singer and the listeners are immersed in the unfolding of what the author refers to as a medicine melody that evokes archetypal consciousness. We are living inside a prayer. We are making art with each movement of tone to tone in a delicate balance between organization and imagination. Like all yogas; we experience the delicate balance between flexibility and control, imagination and structure, discipline and freedom. We are also outside of time. In “The Predicament of Raga Music,” Menon (1999) writes: The hidden agenda of Indian classical music has always been spiritual . . . [it] has no truck with history or man’s passage through time. Yesterday and today is the same for the music of the raga. It only accepts the leading edge of now as its principal concern . . . This nonhistorical quality, this built-in timelessness and autonomy in the core of its still centre, is achieved by a highly resolute use of the voice as its substance . . . The more crucial attribute of the raga is that it is never finished. It merely ceases for the time being . . . This also is among the reasons why the raga is traditionally understood to be a living thing. . . . Thus, the meaning of learning music is

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a process of affirmation and transformation of the student rather than the acquisition of skills and information. (pp. 55–57)

This spiritual melodicism we find in the ragas might not be unique to Indian classical music. When musicians of varied backgrounds attain a certain level of genius and the spirit calls, the musicians begin longing for melodic poetry as in the ragas—and the ragas come to them, whether they know them by name or not. We find raga architecture within the saxophone solos of John Coltrane and in the compositions of George Harrison, both of whom studied the ragas. It also appears in Mahler’s adagio movements, Bach’s cello suites, and Mozart’s piano concertos in which one heart melody becomes the seed of monumental music. As mantras are initiatory vibrational formulas, the ragas are the journey. Both are yogic practices (sadhanas) in their movement towards the subtle, and they both require discipline and an equally devotional and intellectual engagement. Herein lies the beneficial power of this distinctive music that has no composer and no ownership, except for the intervention of the divine. In particular, we benefit from Raga Yoga by connecting with the universal dimension of consciousness and emotions.

Rasa: The Taste of Mind Raga cannot be considered separately from its counterpart, rasa. If raga is that which colors the mind with emotion, rasa is the emotion, the experience of that color, and the “tasting” of the mood conveyed by the tones of the raga. If raga is a garland of flowers, then rasa is the perfume of the flower, the delicate essence of a fruit. Rasa is an essential part of India’s theory of art. It speaks of the pure delight we feel when we encounter a work of art—the kind of bliss that can be experienced only by the spirit, which Indian treatises refer to as the “taste of the mind.” (Nakkach, 2012, p. 166)

We can explore the meaning of rasa through words such as “taste,” “relish,” or “essence.” Like perfume, rasa isn’t easy to describe, because its effect comes from non-physical properties rather than the physical matter from which it derives. In Indian alchemy, rasa is related to the essence of mercury, whose principal alchemical attribute is awareness. In music listening, rasa conveys the idea of an aesthetic emotion to be tasted, knowable only in the activity of sensing. It exists only to the degree that it has been relished by the rasika, the hearer, and it compels an act of communion. Rasa does not belong to the work of art, the musician, or the listener, but it unites them all in the same state of consciousness and delight. In the Vedas, the experience of rasa is described as a flash of

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super-worldly blinding light that appears to those for whom the knowledge of ideal beauty is innate and intuitive. In practice, we can distinguish 10 principal rasas that convey the emotional nature of the ragas and can be applied to other therapeutic forms of interaction and outcome: shringar: eroticism, passion, divine sensuality; karuna: pathos, sadness, longing, psychic pain, loss; hasya: mirth, laughter, joy, celebration; vira: heroism, courage, valor; adbhuta: wonder, surprise, the fantastic; shanti: peace, inner serenity; tyag: renunciation, detachment, a cause for liberation; bhakti: devotion; gambhir: solemnity, seriousness; chanchal: restlessness, playfulness. Rasa leads us to an in-depth exploration of the connection between emotion and music, yoga that implements sound and psyche. Sentiments conveyed by music have not been given a lot of attention in Western musical education, captivated as it is by the accumulation of intellectual knowledge. The appreciation of rasa allows us to experience the most profound emotions. The mind experiences conscious joy even in the representation of painful events because of the integration of perceptual, emotional, and cognitive faculties, refined by subtle aesthetic dimensions of sensing, feeling, and listening. The understanding of the concept of rasa is key to the healing potential of music as well as any therapy. When we release emotion, we free ourselves from mental burdens. While singing or listening to music infused with rasa, our emotions appear like a cloud in the sky that dissolves into emptiness. Psychologically, a continuing practice and study of the system of raga-rasa improves the ability to realize and release the emotional quality of a conflict we desire to resolve, or allows repressed memories to surface where they can be dealt with and released. If this happens, we may continue to generate a broader, more universal, less egoistic sense of well-being, and a brighter ear for great music and its affective power to lessen stress and suffering in all our relationships. Through singing the ragas (and mantras, invocations, prayers, or any song), the conscious experience of rasa trains the ear and the imagination. Understanding rasa also enhances the quality of the voice or any other instrument and medium of communication, inspiring us to explore more deeply the interdependence between timbre, tonality, sound, harmonic progression, duration, inner pulse, rhythm, and the way that these musical elements affect consciousness and the fabric of emotions. Rasa evolves and changes with the movement of melody. In the chant form of kirtan (repetitive call-and-response chanting performed in India’s devotional traditions), the chanting—if trustfully and tunefully performed—conveys devotion, joy, and peace. The ragas in their melodic

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grandeur may also render more than one rasa in their development; they might start with pathos, move to devotion, then joy, then detachment, then serenity, all unintentionally conveyed by the complete absorption of the singer in the music. Some of the psycho-spiritual qualities that may be conveyed by the practice of mantra and the raga yoga include inner wisdom, serenity, openmindedness, selflessness, compassion, devotion, calm acceptance, wonder, affliction, detachment, inner joy, radiance, and relaxation. In music and sound therapies, both the clinician and patient can benefit from sharing these sonorous yogic practices because they generate an atmosphere of greater receptiveness and deep listening.

Spiritual Melodicism Meditation (smayama) on the relationship between space and the power of hearing engenders the divine power of hearing (Patanjali, n.d., 3.42)

Western culture is notorious for supporting music as a culture of entertainment and celebrities, what the author refers to as a kind of musical materialism. It’s time to counter this approach with a more ceremonial alternative: spiritual melodicism. This concept encapsulates the conscious and elegant treatment of all the musical elements—spiritually inspired melodies in perfect synergy with ethereal harmonies and rhythmic awareness abiding in time as duration and space—with a taste of rasa and a dash of cosmic energy. This devotional treatment of music, inspired by the Eastern art of melody, conveys the language of intimacy, tells a story, and evokes meaning. In times of suffering and pain, the spiritual melodicism in music will hold, embrace, and comfort, like a loving friend. Throughout human history, music has always been a source of spiritual nourishment, and the voice has been its most potent instrument. The concept of spiritual melodicism taps into the core of Raga Yoga and the primordial healing power of music. To benefit from the affective power of music, we attend to economy and mindful use of all musical components: melody, rhythm, mood, and harmony. The author recommends cultivating deep listening habits, including a subtle quality of tone in each breath of empathy. What matters most is the awareness and evolution of the transformation that follows.

Conclusion When you begin to see the possibilities of music, you desire to do something really good for people, to help humanity free itself from its

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Sound and the Subtle hang-ups. I think music can make the world better and, if I’m qualified, I want to do it. I’d like to point out to people the divine in a musical language that transcends words. I want to speak to their souls. (John Coltrane, as cited in Hall, 2001, p. 148)

Everything in us and around us is in motion and has sound—some we can hear and some we can’t. But vibration is everywhere and permeates everything. Produced and transmitted by the vibration of matter at the molecular level, sound is a phenomenon that is both objective and subjective. The transmission of vibratory motion is directly proportional to the degree of perception in the auditory centers in the brain after resonating in the ear, the skin, and the bones. This is how we hear. Thus, how we listen is voluntary and involves a conscious filtering of the sounds we want to listen to or sing. Yoga invites us to listen to the body and to quiet the mind. How we subtly integrate sound, how we apply it, and how we assess and advance subtle levels of auditory awareness, becomes our evolving practice of nada, mantra, and raga yoga. Mental illness, genius, and spiritual experiences are all points on the continuum of human consciousness, and our essential human nature compels us to search for meaning and expression. As in psychotherapy, there has to be a moment in music making when we listen, intuitively, searching for truth and beauty—as the splendor of truth—transcending personality fixations, and reaching the depth and freedom of our imagination. Besides the aesthetic delight, the fruit of the practice of music is mukti, or liberation from worldly bondage, and shanta, the state of inner serenity that clears the heart and leads the mind to silence. Ancient and modern therapeutic interventions pursue similar goals with different tools and approach. Allopathic medicine, as well as Western psychotherapy, has its roots in shamanism, and needs to explore avenues of potential cooperation with ancient and new models of therapeutic yoga systems. We have arrived at a time when these ancient and modern technologies of human development greatly benefit from the exploration of their differences and commonalities, bringing forth integrative insights and surprising possibilities as the roles of the yogi and the therapist inform each other.

Author Biography Silvia Nakkach, MA, MMT, is a Grammy-nominated musician, awardwinning composer, voice-culturist, former psychotherapist, and accredited authority in the field of sound in yoga and transformation of consciousness. She is on the faculty at the California Institute of Integral

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Studies where she created the premier academic certificate on Sound, Voice and Music in the Healing Arts. She is the founder and academic director of the Vox Mundi School of Sound and the Voice, based in San Francisco and Rio de Janeiro, Brazil. For more than 30 years, she has studied classical Indian music under the direction of the late maestro Ali Akbar Khan and with several masters of the Dhrupad Nada Yoga tradition. She is the contributing author of the books Music and the Human Process, Music in Human Adaptation, and Music Therapy at the End of Life. Her latest book is Free Your Voice, published by Sounds True. She has released several CD albums. (www.voxmundiproject.com; [email protected])

References Albini, C. (1996). The Magic Sound. The Mirror: Newspaper of the International Dzogchen Community. September/October 1996, 37. Alfassa, M. (1990–2023). On Music, Words of Sri Aurobindo and The Mother, Questions and answers 1953. Anand, K. C. (Ed.). (1999). Sri Aurobindo Ashram Trust, Reprint from: All India Magazine, May 1988. Publisher: Sri Aurobindo Society. Pondicherry, India. Ali Akbar College of Music (2013). Retrieved from aacm.org/school_faculty_aak.html. Arya, U. (Pandit). (1981). Mantra and Meditation. Honesdale, PA: Pennsylvania Himalayan Publishers. Cage, J. (1961). Silence. Middletown, CT: Wesleyan University Press. Collins English dictionary online. http://www.collinsdictionary.com Desay, G. (2009). Raga unveiled: Evolution and essence of a spiritual tradition [DVD]. Los Angeles, CA: India’s Voice DVD series. Froeliger, B., Garland, E. L., & McClernon, F. J. (2012). Yoga meditation practitioners exhibit greater gray matter volume and fewer reported cognitive failures: Results of a preliminary voxel-based morphometric analysis. Evidence-Based Complementary and Alternative Medicine, Article ID 821307, 8pp. doi:10.1155/2012/821307 Gatling-Austin, H. (2006). The healing power of sound: An interview with Tenzin Wangyal Rinpoche. Retrieved from https://bonpacificnorthwest.wordpress.com/2013/08/09/interview-withtenzin-wyangal-rinpoche-tibetan-sound-healing/ Gurjar, A. A., Ladhake, S. A., & Thakare, A. P. (2009). Analysis of acoustic of “OM” chant to study it’s effect on nervous system. IJCSNS International Journal of Computer Science and Network Security, 9(1),

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January 2009, pp. 363–367. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.186.8652&r ep=rep1&type=ddf Hall, J. C. (2001). Mercy, Mercy Me: African-American Culture and the American Sixties. New York: Oxford University Press. Kalyani, B. G., Venkatasubramanian, G., Arasappa, R., Rao, N. P., Kalmady, S. V., Behere, R. V., Rao, H., Vasudev, M. K., & Gangadhar, B. N. (2011). Neurohemodynamic correlates of ‘OM’ chanting: A pilot functional magnetic resonance imaging study. IJOY: International Journal of Yoga, Jan-Jun; 4(1), 3–6. doi :10.4103/09736131.78171 Lokesh, C. (Ed.). (2000). Song of the Spirit: The World of Sacred Music. New Delhi, India: Tibet House Publications. Menon, R. R. (1999). The Predicament of Raga Music. In S. C. Malik, (Ed.). Dhvani: Nature and Culture of Sound. New Delhi: Indira Gandhi National Center for the Arts. Merriam-Webster online dictionary. http://www.merriam-webster.com/ Mooventhan, A. & Khode, V. (2014). Effect of Bhramari pranayama and OM chanting on pulmonary function in healthy individuals: A prospective randomized control trial. IJOY: International Journal of Yoga, Jul-Dec, 7(2): 104–110. doi: 10.4103/0973-6131.133875 Murray, M. (2001). The mystery of mantra. Retrieved from www.mantrayoga.com/mantra.html Muktibhodananda (Swami). (1998). Hatha Yoga Pradipika: Light on Hatha Yoga. Bihar, India: Yoga Publications Trust. Mutatkar, S. (1999). What silence means to music, Dhvani: Nature and culture of sound. S. C. Malik, (Ed). Delhi, India: Indira Gandhi National Centre for the Arts & DK Printworld. Nakkach, S. & Carpenter, V. (2012). Free Your Voice: Awaken to Life Through Singing. Boulder, CO: Sounds True. Niranjanananda Saraswati (Swami). (1981). Scientific yoga therapy response. Retrieved from http://www.yogamag.net/archives/1981/ajan81/the.shtml Norbu, N. (Chögyal). (1991). The Dzogchen Ritual Practices. London, UK: Kailash Editions. Norbu, N. (Chogyal). (2001). Understanding the essence. The Mirror: Newspaper of the International Dzogchen Community. May/June, 2001, 57. Osho. (1979). Nadabrahma, from The Buddha Disease: A Darshan Diary. Poona, India: Rajneesh Foundation. Patanjali. (n.d.). Yoga Sutrani Patanjali. Retrieved from

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http://www.ashtangayoga.info/source-texts/yoga-sutra-patanjali/ Paul, R. (1998–2015a). Nada yoga: The science of sound. Retrieved from http://www.russillpaul.com/articles/article/1162814/10604.htm Paul, R. (1998–2015b). Shabda yoga: Developing the voice of wisdom. Retrieved from http://www.russillpaul.com/articles/article/1162814/10598.htm Raja, D. S. (2005). Hindustani Music: A Tradition in Transition. New Delhi, India: D. K. Printworld. Sanyal, R. & Widdess, R. (2004). Dhrupad: Tradition and Performance in Indian Music. Surrey, UK: Ashgate Publishing Group. Shankar, R. (2009–2013). On appreciation of Indian classical music. Retrieved from http://www.ravishankar.org/-music.html Srinivasan, R. (2002). Sacred Space: A Journey Through the Spirit of Asian Art. Delhi, India: Tibet House. Steiner, R. (2005). The inner nature of music and the experience of tone. Schmidt number S-1443. Originally published 1906. Retrieved from http://wn.rsarchive.org/Lectures/GA283/English/AP1983/19061203p0 2.html Strupp, H. H. (1972). On the technology of psychotherapy. Archives of General Psychiatry. 1972; 26(3): 270–278. doi:10.1001/archpsyc.1972.01750210078015. Wangyal, T. (Rinpoche). (2006). Tibetan Sound Healing. Boulder, CO: Sounds True.

EURO-HINDUISM IN AMERICA STUART SOVATSKY EDITED BY ROBERT A. F. THURMAN CONTRACTED BY COLUMBIA UNIVERSITY PRESS FOR COLUMBIA DESK COMPANION ON EASTERN RELIGION (2004)

In Puri, India, each summer for thousands of years, an idol of Jagannatha (Krishna as Lord of the Universe) that purportedly bears the tooth-relic of Buddha is installed onto a wooden cart three stories tall and weighing some sixty-five tons, and is then drawn through the streets for three days as millions ecstatically cheer it by. Known as the Ratha-yatra (Chariot Festival), this event is second only to the Kumbha-mela (Great Gathering of Yogis, sixteen million strong in 2001) among the largest ritual gatherings in the world. The unpredictable stops and out-of-control lurches (created by intentionally uneven wheels) of this mammoth, rumbling cart are meant to engender delights of surprise and breathless awe, all understood as moods of worship befitting the (ever-present) moment in which the Lord Krishna manifests as the entire (vibration, living) Universe. The incompletelycarved idol of a dramatically wide-eyed God portrays Being and Consciousness as constantly evolving and embracing of all human strivings, differences, and imperfections. Thus, mixed into their prayers, devotees hurl jibes as the cart passes by, deepening their intimacy with Jagannatha. At the conclusion, this and two other ritual carts and their passenger Deities are disassembled and the tons of wood sold as sacred relics or used to fuel cooking stoves that will feed the devotees over the next nine months. We derive the English term juggernaut from the whole affair, meaning a wonderful, world-shaking enterprise that gets wildly beyond human conventionalities and control as, reordering everything in its wake, it heads unstoppably toward its (hopefully beneficent) goal. In the Hindu context of reincarnation and over the evolutionary course of hundreds of centuries or yugas, Jagannatha’s goal is nothing less than the moment-to-moment vibrational quickening of every being in the Universe to progressively, yet

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fluctuatingly, achieve the complete maturation or highest purpose of each, its sva-dharma. However, complete maturation or enlightenment is neither linear nor terminal, but immediate and infinite. Thus, the indigenous name for the tradition is not Hinduism (a Persian coinage), but Sanatana Dharma, The Eternal Ordering Way of a beginning-less history that mysteriously (indeterminately) has forever unfolded now and now and now, ordered by this, then that, thought, action, feeling as the juggernaut of world creation wavers, races forward, jolts, and then proceeds anew. As a nondual (advaita) vision of existence, Sanatana Dharma speaks to the awe, opportunity, quantum uncertainty, and situational ethics of every conceivable aspect of life. From its consciousness-matter integrated field cosmology and prescribed ethics governing conflict as depicted in the Bhagavad Gita and in Gandhian activism, to the plethora of yogic pathways activating demonstrably the deepest of psychophysical potentials (culminating in enlightened sainthood, extreme longevity, and supernormal powers), this living tradition has accumulated some 7,000 years of (largely yet-untranslated) research.9 Thus, too, we find no clear separation of secular and sacred domains in Sanatana Dharma to generate any grand antagonism between science and religion or body and soul, a matter that boggles simplistic binary contrasts. Instead, an over-arching experimentalism has prevailed over the millennia where hundreds of millions of people have explored breath, sex, technologies, linguistics, healing, vibration, the elements, ethics, politics, thousands of bodily poses, profound stillness and, foremost, consciousness itself, all with the careful reverence of a saint merged with the scrupulous objectivity of a scientist.10 Euro-Hinduism refers to how elements in this cosmic historical process that are traceable to Indian Hindu or Hinduistic sources came to look (to Westerners and native onlookers from the subcontinent, as well) as they

9

See archeological discoveries 2,000 years older than any previously uncovered that were made by the National Institute of Ocean Technology, Chennai, India at www.niot.res.in. Cave paintings, however, go back some 40,000 years while scriptural accounts depict hundreds of thousands of years of cultural history. 10 These people are known as rishis (seers), kavis (poet-healers), siddhas (power holders), yogis (union seekers), tantrikas (energy transformers), Brahmins (priests), bhaktis (deity lover), swamis (upward monastics), vratins (vow-takers), vidyaharas (wizard physiologists), pandits (philosophers), sannyasins (worldshedders), grihastins (sacred household parents) jivan muktis (liberated souls) and by many other names.

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entered Western culture.11 For, accounts of Indian spirituality have inspired centuries of Western Romantics, from the Ancient Greeks, Renaissance Indophiles, transcendentalist poets and 19th century Spiritualists, to the 1950s beats, 1960s civil rights activists and cultural reformers, 1970–2000s transpersonal psychologists and holistic scientists, and the 21st century x-generation, with their postmodern pastiche of Aum signs, Shiva images, and globalized cyberculture and tens of millions of yoga, meditation, and kirtan enthusiasts meeting in thousands of yoga studios and evermore spreading out into a globalized culture of rockstar Western yoga teachers, blog websites, New York Times cover exposés, and scholarly revisions of wide-spread errors of translation and a “Sixties Skew” that has greatly distorted the unavoidable piecemeal cultural transmission of this vast, 6,000-year tradition. Likewise, Euro-Hinduism has engendered both a revival of Indic traditions within India (an upsurge of interest in hatha yoga, for example) preceded by a (continuing) colonialistic self-effacement in moods of assumed inferiority within Indian culture and an assumed superiority of “the West” (a preference within its academy for Western psychologies and philosophies, for example). And, as these accounts became a manifest reality of translated texts and visiting Yogis coming Westward (and returning home, Eastward), the reverberations in America (and in India) have penetrated ever deeper into mainstream religious, healthcare, artistic, political, scientific and academic spheres, transforming each in dramatic and often controversial ways. Indeed, Barack Obama is known to have carried a Hanuman pendant. For, as in the Ratha-yatra, moods from doubt and scorn to reverence and idolization have greeted Euro-Hinduism in America and Europe at every turn. Indeed, the importation of “yoga” (the practices of hatha yoga) to tens of millions of Westerners constitutes the grandest, bloodless dissemination of a set spiritual practice from one culture to another in the shortest period of time in recorded history.

11

I grant ontological status to the cosmic process of historical unfoldment represented ritualistically in the Jagannatha procession that embraces Hindu orthodoxy, “Hinduistic”heterodoxy and even commercialized or “pop”Hinduism. Thus, too, we can imagine various Indian perspectives on the history of EuroHinduism and on the very definitions of “East” and “West.” See E. Said, Orientalism (New York: Vintage, 1979) on European “construction” of “the Orient”and G. Prakash, Another Reason: Science and the Imagination of Modern India (Princeton, NJ: Princeton University Press, 1999) for detailed studies of the colonialist importation of concepts of “modernity”and “science”in India.

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In The Distance, the Chariot Stood Poised The allure of something more felt to exist in some other time or place—a glorious past, a deeper present, a wondrous future—outside of all that has been conventionalized or currently known is at the core of the Romantic narrative. The idea of an “exotic India” has held this romantic spell in the West for centuries. India’s material wealth of spices, silks, and gold fueled the European era of global exploration (literally, by being drained of its superior wealth to boost European living standards). Its mathematics (the invention of the zero and of “Arabic” numerals), navigational methods (by which European explorers, including Columbus, guided their ships to the “New World” while searching for new trade routes to India), structural linguistics (a field instigated by Saussure’s reading of the Indian grammarian, Panini), and literature contributed to the West’s rise to modernity. The Hindu Brahman, the Source of Consciousness-Time-SpaceEnergy-Matter, spoke directly to Romantic sensitivities and served as the revered Over-Soul for 19th century transcendentalists Emerson, Whittier, Thoreau, Whitman and, later, W. B. Yeats, Pound, Eliot, Ferlinghetti, Ginsberg, diPrima, and others. As Thoreau adulated, “In the morning I bathe my intellect in the stupendous and cosmogonal philosophy of the Bhagavad Gita in comparison with which our modern world and its literature seems puny.” 12 In 1875, as Creationists reeled from the ramifications of Darwinian evolutionism, H. P. Blavatsky’s froth of theosophical writings went in the opposite direction and depicted Indo-Tibetan Masters as the spiritually evolved exemplars of the “new mankind” and of a new, universal and scientific religiosity based in personal spiritual experiences—what Huxley would call “the perennial wisdom”—more than adherence to mandated doctrinal beliefs. In 1909, they declared the 14-year-old J. Krishnamurti to be the current “World Teacher.” Later rejecting this grandiose role, his Vedantic message encouraging self-reliance and that consciousness precedes matter, time, and all else influenced Rudolf Steiner, Alan Watts, David Bohm’s “implicate order” physics, and thereby the work of Fritjof Capra, Gary Zukav, Rupert Sheldrake, and the focus-group psychology of organizational consultants.13 12

H. D. Thoreau, The Writings of Henry D. Thoreau. Princeton, NJ: Princeton University Press, 1989, p. 298.  13 In Rath-yatra fashion, R. Sloss’s Lives in the Shadow with Krishnamurti (Ontario, Canada: Addison-Wesley Longman, 1994), depicts Krishnamurti as a

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Via complementary efforts of the turn-of-the-century New Thought Movement, Mesmerism, and Christian Science, a new concept of a scientifically verifiable religiosity was brewing. Soteriological hope was becoming a Darwinesque matter of an “evolving mind” or consciousness of each person, more than a righteously attained afterlife or redemptive belief in a singular Savior—a perspective that would be highly compatible with Hindu spiritual science (adhyatma-vidya), meditation practices, and contemporary grace-bestowing gurus. Nietzsche’s nineteenth century pronouncement that the Judeo-Christian God had died from centuries of dispirited piety pleaded as well for some new type of post-religion spirituality. The anxiety-laden “leap of faith” that Kierkegaard required of modern man would be ripe for the clearly described yogic paths across the great abyss. Indeed, meditation would reveal an overlooked profundity within the void itself. In the twentieth century, Martin Heidegger would surreptitiously lift large portions of Zen Buddhism via his little-known correspondence with Japanese practitioners in crafting his philosophy of “being in time.” His constructive and deconstructive methods drew heavily from the former’s concern with impermanence and doctrines of “name and form coorigination” and deconstructive meditations that “empty of the mind” toward the Heraclitean, primordial flow of anicca, impermanence itself.14

fraud, while M. Luytens’s The Years of Awakening (New York: Avon, 1987) reveres him, with reservations, as an enlightened teacher. Physics concepts influenced by Vedanta include Schrodinger’s wave mechanics, Heisenberg’s uncertainty principle, Pribram’s holotropic theory, Prigogine’s chaos/complexity theory and the “process”theories of Whitehead and Arthur Young, while the Einsteinian relativity of observer and observed and Bell’s Theory of non-local relatedness are consistent with Vedanta, up to a point. For, most Vedantic philosophies hold that consciousness is immutable. Tantric theory, however, depicts universal creation as emanating from vibrating, ultra-subtleties within consciousness, perhaps as described in the hypothetical ten dimensional vibrating superstring theory. Tantric meditators have claimed to directly experience (as a vibrating bliss-radiance) a “universal-causal dimension,” as well as a serpentine bio-spiritual energy with the same genetic properties as the doublehelix DNA molecule. 14 Schopenhauer’s glorification of the transcendental emptiness of Hindu and Buddhist meditation also mischaracterized these traditions as world-negating. Humanitarian works have always been part of these traditions and emerges in Euro-Hinduism and Euro-Buddhism in a host of “engaged spirituality” projects, worldwide.

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Leaning East, Then West, the On-Lookers Ponder Where It Will Go Concurrently, late 19th-century physician theorists were pioneering their own “soul science,” Psychology, to traverse the abyss of spiritual, moral, and philosophical uncertainty. Not the silence of meditation but the psychoanalytic “talking cure” was the result. These scientific hopefuls led by Freud met the available information on Hinduism and yoga with dismissive pathologization. Yoga was “a killing of the instincts” and meditation a “regression to the womb.”15 Even the sympathetic Jung would conclude that these Eastern paths, though profound, were inappropriate for Westerners. Yet, over the course of the 20th century, their sober successors would verify scientifically some of yoga’s powers. To be repeated by Swami Rama at the Menninger Foundation in 1970 and thereby catalyzing biofeedback therapies and mind-body medicine, the first such test of volitional control over the “autonomic” nervous system in 1926 thoroughly astounded physicians: “. . . with the chest-pieces of our stethoscopes . . . we listed to the stopping [willfully sustained fibrillation] of his [Yogi Deshbandhu’s] heart.”16 Not a killing, but a profound fathoming of the instincts emerged at the core of yoga and meditation. Later, a vast array of Eastern-influenced or imported physical and mental healing practices would flood American culture in hospitals, spas, and healing and “yoga retreat” centers. At the collective level, a Marxian intelligentia was redirecting the severely shaken other-worldly hopes of Judeo-Christian soteriology into a socio-economic utopian dream of communal sharing. This dream would struggle to blossom in the anti-capitalistic counter-culture of the 1960s and 70s as Euro-Hinduism burst forth in a scattering of Aum-chanting communes and yoga ashrams. Within twenty years, the overly competitive powers of capitalism and advertising and sexual hype will have distorted its indigenous spiritual purpose to even the most diehard faddists.

See R. May, Heidegger’s Hidden Sources: East Asian Influences in His Work. Trans. G. Parks. (London: Routledge, 1996) on Heidegger’s unacknowledged, pervasive appropriations from Buddhism. 15 S. Freud, Civilization and Its Discontents. 1930. In Vol. XXI The Complete Psychological Works of Sigmund Freud. London: The Horgarth Press. 1964, p, 79. 16 V. Rele The Mysterious Kundalini. 10th ed. Bombay: Taraporevala, 1960[1927], pp. xxii-xxiii. Heart-slowing meditation has since been verified as beneficial to various cardiac disorders by Dean Ornish, et al.

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Hindu nature mysticism blended with a new eco-spirituality while feminism found obvious inspiration in Hinduism’s rich tradition of Goddess worship. In the reverse direction, longstanding patriarchal aspects of Indian culture would undergo dramatic critique and cultural transformations.17 In the activist politics of Mohandas Gandhi the West saw Hinduism’s universality where our highest spiritual ideals and shared vulnerability merge perfectly in the “truth-power” (satyagraha) of principled harmlessness (ahimsa). The Mahatma’s bold, yet nonviolent, activism centrally informed Martin Luther King’s civil rights politics and Cesar Chavez, the “Gandhi of the field” of oppressed farm workers, and Janez Drnovsek, president of Slovenia and chair of Unaligned Nations of the World. He also gave Euro-Hinduism its first statesman-saint, as made vivid in Richard Attenborough’s 1982 film, Gandhi, in a single, scripted quote by Albert Einstein: “Generations to come will scarce believe that such a one as this ever, in flesh and blood, walked upon this earth.” In contrast with such Indophilic appreciation, many Western theologians viewed Hindu polytheism (which, ironically, includes strong monotheistic currents) as theologically inferior to the “more advanced” monotheistic Abrahamic religions. Confusions with “new age” superficialities clouded the source traditions, as well. The social sciences pejorative, “going native,” further melded Eurocentric racism and religious prejudice with a concern for objectivity in the study of “the other.” Even so, such third-person approaches remain particularly limiting in the study of human consciousness, the central focus of all Hindu worship/ investigation, for “subjectivity” (consciousness itself) is inherently personal and internal, a matter that continues to vex the cognitive and neuro-sciences and their high-tech laboratory methods and quantitative models for perception, decision-making, and consciousness itself. Despite such conflicting pressures, a few Christian missionaries adopted Eastern spiritual practices, beginning with Roberto de Nobili (1577–1656) who did so to further his missionary-ism and, in the 20th century, Jules Monchanin, Henri Le Saux, C. F. Andrews, and Bede Griffiths, who directed a Bangalore Ashram for some 37 years while seeking an interfaith monasticism. Indeed, as Hindu and Buddhist meditation practices began to attract many Christians, including the Trappist monks, Thomas Keating, and Thomas Merton, a Christian Centering Prayer Movement emerged, quietly blending concepts and 17

See C. Chapple & M. Tucker, eds. Hinduism and Ecology: The Intersection of Earth, Sky and Water. Cambridge: Harvard University Press, 2000. See E. Gadon, The Once and Future Goddess. San Francisco: Harper San Francisco, 1989.

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techniques appropriated from the Indic traditions with their own. Similarly, cognitive scientists Francisco Varela, Evan Thompson, and Eleanor Rosch ventured into first-person consciousness research (via Buddhist meditation) as published in The Embodied Mind (1991). Struggles with Eurocentric views of Hinduism also strongly affected the Indian Motherland. Via so-called Macaulayism (British colonialist proscriptions against the native study of Indic traditions, including banning Indian study of Sanskrit to “break” Indian culture) and other modernizing and missionary pressures, many educated native Indians sought the “sophistication” of their colonizer’s science, politics, and religion. (For example, when I gave a paper on Indian meditation in Delhi in 1985, local Indian journalists asked me, “Why waste your time sitting there doing nothing?”) Thus, the missionary-educated Swami Vivekananda’s famed presentations at the 1893 World Parliament of Religions in Chicago (by invitation of William James) would contribute to the revival of cultural pride in Hinduism among educated Indians, as well as give Americans their first look at a “real Yogi.”

Suddenly Rolling Forward, its Deity is greeted with Delight and Jeers With his simple but politically provocative greeting of “Sisters and Brothers of America,” the 30-year-old disciple of the illustrious Ramakrishna roused an immediate standing ovation. As Christopher Isherwood commented, the confusingly dark-skinned Swami’s racially uniting welcome “released one of those mysterious discharges of enthusiasm which seem to be due to an exactly right conjunction of subject, speaker, and occasion.” Yet, in this post-Civil War era of Christian revivalism, Vivekananda’s “many paths, but One God” message relativized white Christianity more than many could bear while his pointed criticism of missionary conversions shocked those who had been devoutly engaged in “saving heathen souls.” 18 While lecturing on an East/West universal religion that would foster a “new type of superior man,” the Swami joked, “I have emptied entire halls.” His message of social reform, influenced by both Vedanta and J. S. Mill, urged equal opportunity for men and women of all social classes and

18 C. Isherwood, ed. Vedanta for the Western World. Hollywood, CA: Vedanta Press, 1961 [1948}, p. 23.

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the realization that each Self (Atman) was God (Brahman).19 Through the sustained Vedantic gaze, knowledge of God becomes as close as the very consciousness by which you now read this page, and the Sanatana Dharma as alive as your every turn of thought, feeling, and action. (One hundred years later, Eckhart Tolle would be featured on Oprah conveying similar missives from his three-million-copy-selling The Power of Now.) By 1899, Vivekananda had completed a second American tour and Vedanta Centers had been established throughout the country with more than 100 worldwide by the year 2000. Though he declined James’s invitation to a Harvard chair in Eastern Philosophy in order to pursue his activist agenda, his talks stimulated further interest in Indian Philosophy throughout the academy.20

And His Vibrations Begin to Ripple through The Land . . . Thus began the procession of extraordinary yogis to come to America, with the next prominent figure being the 27-year-old Paramahansa Yogananda, who arrived in 1920. Described (strategically) as a “Hindu Christ,” his early followers included Luther Burbank, George Eastman and Leopold Stokowski. Upon his death in 1952, the West encountered another inexplicable instance of yogic power, even saintliness. In a notarized memo, the presiding mortuary director wrote, “No physical disintegration was visible in his body even twenty days after death.” 19

Vivekananda and many other Hindu reformers also criticized Indian caste inequities, while also noting the original positive intent of the varna (caste) system wherein enlightenment is available to anyone. 20 Yale, Columbia, Berkeley, Harvard, and the Universities of Wisconsin and Chicago initiated the first Indology programs in America. W.D. Whitney’s Sanskrit grammar, first published in 1879, remains a standard text with other important contributions by E.E. Salisbury, E.W. Hopkins, C.R. Lanman (initiator of the Harvard Oriental Series), A. Jackson, F. Edgerton, D. Ingalls, G. Cardona, B. Stoler Miller, W. Doniger, F. Staal and A.K. Ramanujan. In the wake of MacCaulyist proscriptions, Western Indology helped to inspire 20th century native Indian scholarship, as well. Mircea Eliade’s dissertation, published as Yoga, Immortality and Freedom (Trans. W. Trask. Princeton, New Jersey: Princeton University Press, 1973 [1954]) and Joseph Campbell’s Hero With a Thousand Faces (New York: Pantheon, 1949) brought scholarly Indology to the popular audience. Indian Philosophy has shown its relevance to Western Philosophy via close analyses of mystical texts, showing that meditative insights can be gained through reasoned discourse, alone (as in the ancient Pandita traditions), as in the work of B. Matilal, S. Philips, M.S. Deshpande, P. Granoff, et al. 

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Eleven years later, yogi Govindananda Bharati would die in London at a purported 137 years of age, raising other astonished eyebrows and moods of reverential awe. (At the 2009 Kumbha Mela [Great Gathering of Yogis] in India, Devraha Baba’s estimated 240 years of age would seem too preposterous to believe, despite the Baba’s remarkable memory and corroborations of numerous state officials.) Yogananda’s Autobiography of a Yogi (1946) went on to sell over 500,000 copies in eighteen languages, while some 800,000 members of his Self Realization Fellowship carry forth the ancient Kriya yoga involving esoteric spinal meditations and a Christian/Advaita philosophy of universal consciousness and love. The Euro-Buddhist and yogic motifs of Maugham’s The Razor’s Edge, Hesse’s Siddhartha, Joyce’s streaming, reincarnational Finnegan’s Wake, Watts’s The Wisdom of Insecurity, Kerouac’s On the Road, Salinger’s “Teddy,” Coltrane’s torturously world-embracing India, and others held the edgy “now” beat of Sanatana Dharma from the 1940s into the mid60s. Thereupon Euro-Hinduism received a literal chemical catalyst when Jagannatha entered the molecular realm in the guise of mind-expanding LSD. Just as Vedanta had said, in untold depths of conscious awareness, intellectuality and emotionality itself is the Holy of Holies.21 As the implications of this discovery matured far beyond psychedelics, the dharma (world-reordering duties) of future Euro-Hindu generations was set. Via the inner peace of meditation and Gandhian nonviolent activism, war could be ended and the postcolonial world united into one multicultural family. Via non-dual oneness with Nature, a passionate ethos was fashioned to save the planet from ecological devastation and create globally-inclusive economies and sustainable technologies, including holistic medicine as in the work of Deepak Chopra. From George Harrison, Ravi Shankar, and Paul McCandless’s Oregon to all-night DJs, musicians have joined with numerous graphic artists to create an elaborate tapestry of world-fusion art-forms to celebrate the myriad aspects of consciousness. Embracing this dharma for the past 50 years, Euro-Hinduism (and Euro-Buddhism) took root and has flourished in America and the world, just as its early visionaries imagined it would. When I found myself secretly taken to chant healing mantras over the cancer-stricken Janez

21

H. Smith’s Cleansing the Doors of Perception (Los Angeles: J.P. Tarcher, 2000) and R.G. Wasson’s Soma: Divine Mushroom of Immortality (San Diego, CA: Hartcourt Brace-Jovanovich, 1968) stirred much controversy. Was the ancient Vedic“soma”the psychedelic Amanita muscaria mushroom?

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Drnovsek, he said to my bewilderment, “I am president of this small country.” Then I knew that the political hopes of Euro-Hinduism had come alive, even if only for a few hours in a remote cabin outside Ljubljana. The guide-extraordinaire for 1960s hippies becoming Euro-Hindus was ex-Harvard Professor Richard Alpert, a.k.a. Ram Dass. His book Be Here Now (1971) served as their bible (selling some two million copies in 30 years) and describes perhaps the crystallizing moment in the shift from LSD to Aum. Seeking an explanation for the psychedelic mysticism, Alpert gives the mind-reading Indian guru Neem Karoli Baba three hits of LSD. The guru responded, “Ahhh, siddhis” (yogically-empowered consciousness) and “dropped” (swallowed) this mega-dose with no discernible change in his state. He was already “there,” telling Alpert that the yoga of love, service, and remembrance of God, not drugs, was the path. Following this advice, Ram Dass created his Prison Ashram Project, carried forth by Bo Lozoff, that now brings yoga to some 30,000 prisoners. At the same time, in the early to late 70s, I was introducing yoga, meditation, and kirtan chanting to juvenile facilities, behaviorally-disturbed students in inner city and suburban schools, juvenile probationers and their parents, a hospital emergency and suicide-prevention center, Atlantic City boardwalk flop-houses with geriatric, developmentally- and psychiatricallydisabled adults living on the fringes, police officers, and even the Atlantic City Mayor, Jay Bradway (he didn’t get it). My state law enforcement grant, Project Together (a rough translation of “yoga” as “together”), which taught meditation to troubled teenagers, was confused with medication treatments by the reviewer who came to my office in 1977 to reject my application. Before leaving to begin his long drive back to Newark, he agreed to a short instruction in a simple meditation technique. I asked him to close his eyes and breathe slowly, and watched his face for the slightest sign of boredom, though, even after three or four minutes, he showed none. After about five minutes, I guided him to slowly open his eyes. His first words were “I’ll get you the money,” and thus, the first (and last) governmentally-funded use of meditation with this young population was awarded. I would sleep outside of the lockup facility, midwinter with the snow flurrying, to impress my young charges and to greet them at 4:00 a.m. for morning yoga and chanting. The kids would sneak spoons from the cafeteria to use as percussion instruments during the Sanskrit kirtan sessions I would lead. Known as “Mr. Yoga Man,” 25 years later, in 2001, I would convene the first international prison-meditation conference with 12 organizations represented, including one informed by the work of Kiran Bedi, who

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introduced Doing Time, Doing Vipassana to the infamous Tikar Prison in Delhi. Ram Dass’s Seva Foundation and his Dying Project brought meditative compassion to hospice work while his American travelling companions, Krishna Das and Bhagavan Das, spread the bhakti tradition of group chanting around the country. Ram Dass’ first Hatha yoga teacher, the unswervingly devout Baba Hari Dass, settled in California in 1971 and founded the Mt. Madonna [yoga] Center, known for its orphanage service, authentic Tantric rituals, and Broadway-esque musical performances of the Hindu myth, the Ramayana. In 1965, while Ram Dass’s guru bhakti (love of his guru) was inspiring thousands to find their own guru, Jagannatha facilitated their search by causing the US government to remove its 41-year-old quota on Indian immigration. Within four years, Indian entrance to the US increased fivefold to 30,000. (By 2002, some 1.5 million Indians would be living in the US, adding other dimensions to Euro-Hinduism in America, including second-generation Indians discovering their roots in American-led yoga classes.) Stirred by an initial association with the Beatles in the early 1960s and later convincing laboratory studies, nearly 5 million people learned a simple mantra meditation from Maharishi Mahesh Yogi that he called Transcendental Meditation (“TM”). The 600 published studies at over 200 universities (including Harvard, Princeton, and Stanford; and published in Lancet, Science, and the Journal of Crime and Justice), have focused on two areas: health or “stress reduction,” including the Vedic medical system of Ayurveda, and the controversial “Maharishi Effect,” the power of group meditation (the square root of one percent of a local population) to lower crime and even induce world peace. Thus, the Vedantic view that consciousness unites all entered schools, prisons, hospitals, and hundreds of corporate trainings via scores of TM projects. Having created numerous Maharishi International Universities, 1,200 centers worldwide, the Natural Law political party (in 85 countries) and a global television channel, Maharishi recently initiated a $100 million endowment to support some 4,000 full-time meditators, ten percent of the requisite number needed to induce world peace via the Maharishi Effect. Srila Prabhupada Bhaktivedanta arrived in the US nearly penniless in 1965 to teach a classic, temple-focused Vedic lifestyle he called Krishna Consciousness. Publishing some 60 books, including many original translations, and staging annual Jagannatha Festivals in cities world-wide, the Hare Krishnas taught that a Golden Age was immanent. After much internal struggle and a shadow-side of alleged abuses that emerged upon Prabhupada’s death in 1977, the group expanded to nearly 300 temples

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worldwide and some 100 gurus carrying on his work, including B. T. Krishnapada, the first African-American Swami. In 1970, the American Swami Rudrananda (née Albert Rudolph) brought the shaktipat Siddha (“energy transmitting, power-embodying”) Baba Muktananda to the US. In keeping with his title and drawing from the Pratyabhijnahrydam (the secret of self recognition) of Kashmir Shaivism, Baba “awakened” tens of thousands of Westerners (including Werner Erhard, creator of the culturally influential est training and Stan Grof, founder of Transpersonal Psychology) by touch or mantra into the charismatic path of Kundalini yoga, what Pandit Gopi Krishna called “the evolutionary spinal energy, the biological basis of all spirituality.” Within 30 years, some 200 Siddha Yoga Centers and five ashram communities were active in the US, now led by Baba’s female successor, and (after controversial and shocking reports of her predecessor’s improprieties) Swami Chidvalasananda. Bhagwan Rajneesh, a Jain professor-turned-guru, attempted, by far, the most radical modernization of Sanatana Dharma. Side-stepping Hatha yoga as too rarified for these times, his eclectic “neo-tantra” surfed the 1960s–80s wave of sexual liberation, emotive therapies, and the psychedelically-inspired longing for instant God-consciousness. Cheered and jeered as saint and charlatan, his Rajneeshpuram, Oregon commune soared, then collapsed scandalously in the late 1980s under the weight of this impossible dream, shaking some 200,000 Rajneeshees world-wide.22

The Body as Chariot of the Spirit: Hatha Yoga Comes to America The spellbound intimacy between Yogi and radiant God who, in the somatic context of Tantra, is called Shiva, “transforming God,” or Kundalini, “Mothering Goddess,” draws them ever closer. Limb-stretching and spinal-twisting longings and fulfillments emerge as the bodily asanas and mudras (yoga postures and “delight gestures”), permeated by a 22

Other influential 20th century Indian gurus include: Ramana Maharshi; Nisagardatta Maharaj; Poonja-ji; Dhyanyogi, who lived to 116 years; Sri Chinmoy, Director of the UN Meditation Council; Ramamurti Mishra, the controversial Sai Baba “god-man”; Bhakti guru, Sant Keshevadas; Amritananda-mayi-ma; Mother Meera; and Sri Sri Ravi Shankar. Western gurus (now often termed “spiritual teachers”) include: Subramuniyaswami, publisher of Hinduism Today; M. Govindam; Da Free John Avabhasa; Lee Lozowick; Ma Jaya Bhagavati; Swami Kriyananda; Roy E. Davis; Andrew Cohen; Ganga-ji; Adyashanti; Eckhart Tolle; and Byron Katie.

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fundament of ever maturing virtues (yama-niyamas). Awe-struck breathing becomes pranayama (carefully savored or extended breath) or anahata-nad (ecstatic utterances, inaudible sighs). A transfixed attentiveness, dhyana (meditation), merges all This into a singular unity of source-consciousness, samadhi. Such is the mystical passion of inspired Hatha yoga, as buried in every human body as the puberty of a ten-yearold, or the labor contractions of a woman who has yet to give birth.23 And such is the (largely hidden) physio-spiritual depth of the mostly fitness-focused yoga that has proliferated in the US in thousands of yoga studios with over 18 million Americans “doing yoga.” While shaktipat Swamis Muktananda, Kripalvananda, and others often awakened such profoundly inspired Hatha yoga in Americans who met them in the 1970s and 80s, nearly all other yogis taught the formalized postures as described in B. K. S. Iyengar’s Light on Yoga, Vishnudevananda’s The Complete Illustrated Book of Yoga, and a flood of other how-to books. Iyengar’s guru, Krishnamacharya (1891–1989) sought a modernization of yoga via the rigors of European gymnastics while his own instruction drew from the pedagogical aesthetics of European ballet, complete with balancing props, mirrored walls, hardwood floors, and an emphasis on correct anatomical alignment. By 2000, over 500 teachers in North America would bring “Iyengar Yoga” to athletes, pregnant mothers, the elderly, the incarcerated, and tens of millions of others world-wide, while also inspiring the creation in 1975 of popular newsstand magazine, Yoga Journal, with a 2006 circulation of 280,000, a tripling since 1999. Indeed, in Russia where I lead yoga retreats, some three million yoga enthusiasts pursue postcommunist era personal spirituality, stirred by the same energizing and compromising powers of capitalism as in the US. Another Krishnamacharya student, Pattabhi Jois, based his teaching on the Yoga Korunta, an ancient text describing vinyasa, chained-together asana sequences, an allusion to the inspired yoga described above. Likewise, but with specific pedagogical design, Amrit Desai, a disciple of Kripalvanand, developed his “posture-flows” as a step toward the devotional worship of Sahaja (inspired) yoga. Swami Sivananda of Rishikesh, a physician-turned-yogi, trained many other teachers who came to the US from 1954 on, including Swamis Vishnudevananda, Sivananda Radha (née Sylvia Hellman), the first Western female Swami, and 23 See C. Collins, The Iconography and Ritual of Siva at Elephanta, Albany, NY: SUNY Press, 1988). According to the Pashupata and Ganakarika Sutras, the inspired yoga involved wild laughter, sacred singing, “dancing consisting of [all possible] motions of the hands and feet: upward, downward, outward and shaking motion.”

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Chidananda, whose student Lilias Folan would bring yoga to some 200 television stations by 1977. Sixteen years earlier, the greatest of all Western popularizers, Richard Hittleman, began his widely televised yoga classes. His mass-market yoga books would sell over ten million copies, as Jess Stearn’s breezy Yoga, Youth and Reincarnation (1965) also hit the bestseller lists, with two million sold.24 Swami Satchidananda, another Sivananda disciple, had just opened his Integral Yoga Institute in 1969 when he was invited to lead the invocation of the legendary Woodstock Festival, the first “American Kumbha-mela.” In 1986, he founded his Yogaville and currently leads some 40 centers worldwide. Paramahansa Yogananda’s brother, Bishnu Charan Gosh, became the “Holywood guru” with the physical culture yoga he taught from 1938–68. His student Bikram Choudhury further developed a dynamically aerobic Hatha yoga, typically conducted in a sauna-like heated room, an externalized simulation of the spiritually transformative inner heat of tapas. With thousands of teachers, Bikram Yoga is perhaps the most widely practiced and exoteric of the many contemporary “styles” of yoga.

The Chariot Turns This Way, Then That Way, and East and West Blurr Unrecognizably Together Could the postmodern intermingling of categories of “East” and “West” become any more hybridized than in the life and integral spirituality of Sri Aurobindo? Disinterested in his own Indic tradition, the young Aurobindo excelled at Greek and Latin at Oxford while also reading of Nietzsche’s (himself influenced by the Manusmirti) Super-man and Darwin’s theory of the “evolutionary descent of man.” Returning to India, Aurobindo protested British rule, was imprisoned and, in rediscovering Sanatana Dharma, he integrated its profuse variations in several massive tomes—The Life Divine, The Synthesis of Yoga, and Savitri among them—while fashioning a vision of a spiritually evolving humanity via a “descent of the Supra-mind.” Along with his French cohort, Mira Richard (The Mother), he founded an Ashram in 1929 that led to the creation of Auroville in 1968, an international community that models the gender-balanced eco-sustainability and in-the-world 24

Other noteworthy, pioneer yoga teachers include: Swami Kuvalayanda and Y. Mastamani, who introduced yoga to physicians in 1919-21; S. Yesudian, whose Sport and Yoga sold some 500,000 copies, and the Russian-born Indra Devi, author of the highly popular Yoga for Americans.

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enlightenment of the new humanity. Aurobindo influenced the work of Teilhard de Chardin and Ken Wilber while the first US graduate school devoted to Euro-Hinduism, the California Institute of Integral Studies, was his inspiration, as was Michael Murphy’s Esalen Institute. In 1994, Jagannatha’s Ordering Way even swayed the American Psychiatric Association’s diagnostic manual, the DSM-IV, to differentiate healthy meditative states from the dismissive “depersonalization” and “dissociation” states with which they had been confused for nearly one hundred years. Going further, we must ask: Why is it that “voluntarily induced experiences of depersonalization or de-realization [do, in fact] form part of meditative and trance practices that are prevalent in many religions and cultures” (DSM-IV, p. 488)? Perhaps because their transfixing power reflects the overwhelming profundity of the new personhood or reality they reveal, that within the ego is Atman, and within that, is Brahman.25 Indeed, from Assagioli’s higher-self therapy described in Psychosynthesis (1965) to Tart’s state-specific knowledge set forth in Transpersonal Psychologies (1975) and Wilber’s voluminous integral psychology of hierarchically nested “holons,” an evermore sophisticated literature in “spiritual, ”East/West,” or “transpersonal” psychology has emerged. But they unwittingly drew from Monastic texts, and in the rebellious spirit of the 60s combined with a general pathologization of family life, liberalization of divorce and its financial accessibility, and “every successful psychoanalysis ends in divorce” views of marriage, we find no mention of lifelong creative marriage as the sine qua non of enlightened “householder” (grihasthya) life. Indeed, no transpersonal writer, nor any clinical educators or seasoned clinicians out of the hundreds I have queried, have more than the scantest appreciation of the grihasthya dharma. Instead, they draw from monastic-audience texts, creating pseudo-problems of “disembodied” or “unengaged” spirituality when applied to career-seeking, sexually-active, homebuilding individuals. Likewise, physician Deepak Chopra’s mind-body medicine maintains that we all have the profound yet typically undeveloped capabilities of yogis to revitalize and heal our bodies. Along with works by David Frawley, Vasant Lad, and Maharishi, Chopra’s popular works on Ayurveda’s extensive herbal pharmacopia and highly individualized 25

See L. Sannella, Kundalini: Transcendence or Psychosis? (San Francisco: H. Dakin, 1976), W. Donkin, The Wayfarers: Meher Baba with the God-intoxicated (Hyderabad, India: Meher Mownavani Publications, [1948] 2002), and the work of Stan and Christina Grof on “spiritual emergence.”

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diagnostic and treatment regimes are bringing traditional Hindu medicine into America’s $27 billion “holistic health” revolution.

This Ratha-Yatra will be followed by Another and Another, as The Chariot Whirs Endlessly On and On . . . Much more can be said about the Euro-Hinduism of American popular culture and academic discourse, for example, “Hindu Motifs in Star Wars” and Rannolf Junuh as a surreptitious Arjuna in Hollywood’s allegorical The Legend of Bagger Vance. Of course, “Themes from Shakuntala in Wittgenstein’s Philosophical Investigations would make a nice dissertation. Medical research has yet to fully evaluate Ayurvedic treatments, and we await 40,000 full-time TMers supported by one billion dollars to induce world peace. And, beyond all such outer displays of Jagannatha’s power, there is the vast inner array of wondrous, poignant, and silencing awes, the rasa poignancies or personal feel of The Eternal Ordering Way coursing, moment-to-moment, through this fleeting life and into the next and the next, propelled by indeterminate karmic forces. For example, in 1977, while telling a rapt group of us Euro-Hindus the story of Buddha’s arduous spiritual search and final attainment, my guru (2,500 years later), humbled by this utterly human story of a man distraught by the limited succor available to those suffering around him, inhaled hard and began to weep. He had, himself, spent some 10 hours a day for 30 years in inspired yogic worship in achieving such an end. Years later, while telling me the story of my (by then deceased) guru’s rare yogic attainments, his eldest disciple stopped suddenly and drew his hands to his lips, choked up, and (too) could not go on. And now, I too gasp and pass this story on, yet again, to another generation of Euro-Hindus. As Hindu philosophies and yogas continue to spread throughout the world, may such depths of where we tread give us pause. For only in such compelling, meditative silences does another, and another, dimension of The Eternal Ordering Way emerge. While barely more than five percent of the Indo-Tibetan archive has been translated into English, the deeper subtleties of its philosophies and yogas continue to be revealed in piecemeal, and often bowdlerized, ways. Indeed, a world of such creative lineages rings with the utopian manifestation of the centermost maxim of Hinduism, Vasudhaiva kutmubakam! (“The world is, indeed, one caring family.”) This is the Grand Collective Asana toward which all yogas mature us.