Yoga for Mental Illness
Yoga classes usually come with an unspoken promise: If you breathe and stretch, if you follow instructions and tune in to your body, you'll come out feeling better. It's probably not an exaggeration to say that most people do feel some level of relief—physical, spiritual, mental, or otherwise—after a yoga practice, most of the time. But what happens when there's something serious troubling one of your students—for example, if they are struggling with ongoing psychological issues such as depression. Can yoga help them do more than just feel a little bit better? Can it heal their mental illness?
The short answer, according to experts in the fields of yoga and psychotherapy, is yes. But though they give yoga the nod as a potential mental health panacea, practitioners warn that for certain ailments, including depression, it's typically best to combine yoga with intensive supervision by a trained therapist to ward against the possibility of negative effects.
asanas for EmotionsYoga has long been seen as a tool for improving mental health, although concepts of what that entails have shifted over time and are distinct in different cultures. Today in the U.S., many therapists incorporate yoga and other body-focused practices in their therapeutic work. There are several schools of yoga that focus specifically on the intersections between asana practice and emotional health, and a growing body of studies indicates that yoga is often an excellent tool to treat the troubled mind.
How does it work? According to Dr. Eleanor Criswell, a licensed psychotherapist who has taught courses in the psychology of yoga at California's Sonoma State University since 1969, "Yoga is incredible in terms of stress management. It brings a person back to homeostasis [or equilibrium]. For people who have anxieties of many kinds, yoga helps lower their basic physiological arousal level."
Criswell is on the advisory board of the International Association of Yoga Therapists and is also the author of How Yoga Works: Introduction to Somatic Yoga. She points out that "for the general person, yoga greatly enhances mental health: mood, sense of self, motivation, sense of inner direction and purpose, as well as physical health—and physical health is so important for mental health." In the therapeutic context, adds Criswell, yoga "lowers the ego boundaries, so you are more receptive to other people's input, including the therapist's. The person becomes more somatically comfortable, so they can actually hear what's being said and can reflect on it. It also enhances sleep and increases contact with dreams," which can be useful tools in therapy.
Criswell's experience is borne out in dozens of small studies on the effects of yoga on mood changes. Dr. David Shapiro, a professor in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles, has overseen several such studies. In his research, he's repeatedly seen negative emotions drop while positive emotions rise. Even more encouraging, students dealing with more severe depression saw a greater increase in positive moods than other students.
Reverse EffectsDr. Sophia Reinders, a Jungian-oriented psychotherapist based in San Francisco, emphasizes the importance of working closely with a therapist attuned to body-centered emotional healing. "An emotional release during the practice of asanas can lead to an unexpected experience of joy and ease—or it can bring up fear, sadness, or other difficult feelings," she explains. "If we get frightened by what is coming up, we might push it back down, which means back into the body."
Reinders, who is also a certified Iyengar Yoga teacher and an adjunct faculty member at the California Institute of Integral Studies in San Francisco, adds that a therapist's guidance through the process of dredging up emotions helps patients settle into a new sense of themselves, as they begin to let go of old hurts and bad patterns. "Before we can shift out of an imbalance, since we have used the imbalance to feel safe, we need to find a new way to feel safe, a new place to dwell. And for this, it is important to first find or create a sense of empowerment somewhere in the body."
Extra Help RequiredFor any person, this can be a delicate process. For those dealing with mental illness, there's at least some potential for yoga to be harmful if it's not monitored. "Without proper supervision, a student can have increased sadness or suicidal ideation, so you'd want to be really on top of whether the yoga experience is beneficial or not," says Criswell. "Sometimes the higher sense of alertness enables acting on bad impulses … depressed people can feel more depressed with relaxation." That doesn't mean yoga is inappropriate, Criswell insists. It's just that those with imbalances should embark carefully on a practice that can open up a person so deeply.
The same, Criswell says, is true for post-traumatic stress sufferers, people with psychotic tendencies, or manic-depressives. "Sometimes yoga can increase the manic state," she says. "Sometimes that's a good thing, and sometimes it's not. In general, what you see in yoga class is people becoming happier—but it needs to be within a manageable range."
While the idea of helping a student through serious mental health challenges is probably overwhelming to new teachers, remember that you don't have to do it yourself. Keep a referral list of body-aware therapists on hand, and keep a watchful eye on any students who have confided in you about their mental health status. If they seem to be withdrawing emotionally or socially, Criswell advises, offer them your referral list, or suggest they find a therapist of their own.
Stay PositiveUltimately, the yogic mindset that unpeels psychological worries is the same sort of focus that helps all yogis, whatever their mental health status. Reinders outlines a process of "refining the qualities of attention," which begins with asking students to become aware of any chronic criticism or devaluing that is part of their habitual thinking. Instead, Reinders says, suggest that they bring a "spacious, loving, curious, playful attention" to their mental and physical state (through yoga or psychotherapy)—and positive change will occur.
For more information, visit www.iayt.org, www.ciis.edu, or www.wisdombody.com.
Rachel Brahinsky is a writer and yoga teacher in San Francisco.