Freedom from Addiction
Jen Levin started smoking cigarettes when she was 15. "I always used to say
that my favorite cigarette was the cigarette after yoga," says the 32
year-old playwright from Los Angeles. She practiced hatha yoga sporadically
and continued her pack-a-day habit until she made a commitment to try
Kundalini Yoga at the Golden Bridge yoga studio in Los Angeles. There,
Gurmukh Kaur Khalsa pushes her students to their physical and mental limits
with vigorous breaths-of-fire and her propensity to teach one asana for up
to 11 minutes. "As I saw my body and mind get stronger, smoking began to
make me sick, and it no longer made sense," Levin says. "I realized that if
I could endure the pain in my body, then I could deal with the pain of not
having a cigarette."
Levin used yoga as a tool to help rid herself of her addiction. Similarly, addiction specialists in private practice, rehabilitation programs, and 12-step recovery programs are starting to recognize that the mind-body-spirit approach of yoga is a great adjunct therapy to conventional treatments for drug, alcohol, and food abuse as well as addictive behaviors like gambling and shopping. "Yoga treats the biology and the psychology of an addict," explains New York City addiction psychotherapist Mary Margaret Frederick, Ph.D. "Addicts are profoundly out of control internally. They have knee-jerk panic reactions and tempers. The will and determination yoga requires helps people regain control over their body and their mind."
According to the U. S. Department of Health and Human Services, in 2000, 12 million Americans (or 6.3 percent of the population over the age of 12) used illicit drugs. The same survey reported that almost half of Americans 12 and older said they drink and that more than 5 percent of that drinking population are heavy drinkers. It is also estimated that 65.5 million Americans aged 12 and up used some kind of tobacco product. Certainly not all of these people are addicts, but the financial and emotional costs of those who do abuse drugs and alcohol are high. A study conducted for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism estimated the total cost related to treatment, prevention, health care, lost earnings, crime, and social welfare was $245.7 billion in 1992 alone.
And for those who do become addicts, long-term dependency on drugs and alcohol takes a physical toll. Getting used to living sober is equally challenging psychologically. "Yoga is hard for addicts who worked very hard to get addicted and stay addicted," observes Kaur Khalsa. She speaks from personal experience, having spent eight years of her early adulthood addicted to a variety of illicit drugs. "The minds of addicts are shattered and scattered. They have a lot of pent-up emotions that the drugs pacify. To stay sober they have to work 10 times as hard."
Quieting Compulsion
The use of yoga in addiction treatment centers is certainly not part of
mainstream therapy. "Yoga isn't a favorite topic among addiction
specialists," explains Peter Stein, a drug counselor at the North Charles
Institute for Addictions in Somerville, Massachusetts, who is a also a
certified yoga teacher. There are only a handful of studies on the subject;
subsequently, there isn't a large body of evidence to convince skeptics. In
1997, however, Stein did contribute to a study in the Journal of Alternative
Therapies that found yoga to be useful in addiction treatment. Based on a
randomized clinical trial using yoga at a methadone clinic in Boston, the
study revealed that in a group setting yoga was just as effective as
traditional psycho-dynamic group therapy.
That's one reason Stein has a bias toward yoga. When he teaches the yoga classes at North Charles, he directs his patients to turn their focus inward, to feel their physical sensations and become aware of their breath. This has a calming effect because each sensation or breath is simply an experience of the moment, acknowledged without judgment. Thus, habitual responses and defenses, which patients have established in years of drug use, attempted detoxes, and relapse, are bypassed. The postures provide access to the experience of a neglected, healthier side. Patients who participate in yoga regularly state that they feel more fully acknowledged in this form of treatment. "In Warrior Pose, set reactions and usual arguments are pretty irrelevant," Stein notes. "Instead, patients are encouraged to be in the moment and feel something outside their usual experience."
Where yoga has been integrated into addiction recovery, it tends to mirror the larger trend of treating disease holistically. For example, at Sierra Tucson Psychiatric Hospital in Arizona, yoga is one of several complementary therapies including acupuncture, equine-assisted psychotherapy (using horses to mirror emotional response), Eye Movement Desensitization Reprocessing (using auditory and visual stimulation to deal with traumatic memory), and dance/movement. All of these options offer patients the opportunity to create customized programs and explore the notion that bodies, like minds, also hold and manifest emotional trauma. "Our approach is to find different ways of unlocking what's going on inside," explains Sierra Tucson spokesman Keith Arnold. "Yoga is one way to help repair from the inside out."
Turning It Over
Of course, the 12-step model is the core of most addiction treatment. Aruni
Nan Futuronsky, the director of retreat and renewal at the Kripalu Center
for Yoga & Health, teaches a program called "Yoga of Recovery‹12-Step
Spirituality" because she believes yoga and the 12 steps complement each
other. She points out that the second step acknowledges a power greater than
ourselves and the 11th step dictates meditation and prayer: "I see addiction
as the ultimate disconnection from the body. Yoga philosophy teaches us
about addiction when it teaches us about running from sensations in the
body."
Futuronsky speaks with firsthand knowledge. Fifteen years ago she was working in Newark, New Jersey, as a teacher. By all appearances, she seemed just fine. But under the surface, she was in an unhealthy relationship and she used food, drugs, and alcohol to run away from her feelings. "I had no internal world, no connection. I was a big victim who didn't take responsibility for myself or my actions," she recalls. One night after she passed out, she regained consciousness only to discover she was knocking her head on the floor. "I wondered how long I had been doing this. At that moment, I realized I was sick and tired of being sick and tired. I dialed an AA [Alcoholics Anonymous] hotline and found out there was a meeting two blocks away starting in seven minutes."
Divine intervention or self-discovery? Whatever the impetus, that evening Futuronsky began the quest that helped her gain sobriety and find the spiritual connection to her soul and her physical being. "I don't think I could have gotten sober on the yoga mat," she admits. Most addiction specialists agree that yoga should merely complement the therapy of choice. "But yoga is certainly a great way to reveal the contradictions of mistreating your body and to deepen the spiritual aspect of recovery. After all, what is yoga? It's prayer in motion."
While 12-step programs are the dominant approach to addiction treatment, G. Alan Marlatt, Ph.D., director of the Addictive Behaviors Research Center at the University of Washington in Seattle, says they don't work for everyone. He points out that a 1996 study published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) concluded that on the average, only 20 percent of those who had a year of treatment were still abstaining from drinking. "Half of the people never come back after one meeting, there's a high drop-out rate, and the somewhat Christian-based approach isn't appealing to some," he explains.
That's why Marlatt and his colleagues have secured a grant from the NIAAA to conduct a study entitled "Effects of Meditation on Alcohol Use and Recidivism." In 1997, the North Rehabilitation Facility (NRF), which houses nonviolent offenders of low-level felonies like drug possession, DUIs, and shoplifting, began offering a 10-day vipassana meditation course, as taught by S. N. Goenka. The curriculum already proved successful in one of the largest prisons in India, and after NRF instituted the voluntary program, they found that among those who took the course the recidivism rate was reduced by one-third.
"The inmates said they were surprised by the painful memories and fears that came up during the 10 days, but they found they could stay with them. They learned how to cope by seeing them as thoughts and learned they didn't have to act on thoughts, urges, or their cravings," says Marlatt. For Marlatt, a cognitive behavioralist, the idea that teaching mindfulness could help deter negative compulsions and behavior is compelling. "It's possible that just becoming aware of the process of enlightenment can lead to de-addiction and impulse control."
Controlling Impulses
It's no surprise that the core issue in overcoming addiction is impulse
control. In fact, everyone, addict or not, can benefit from self-restraint.
That's why clinical psychologist Marcie Berman, Ph.D., began introducing
yoga into her sessions after she personally took up yoga to explore her own
body-image struggles. "I used my clinical intuition and introduced yoga
because I realized that a lot of what patients were experiencing wasn't just
emotional or psychological but involved some feeling in their bodies."
The latter has proved particularly poignant for Berman's patients who suffer
from addictions. It helps them quell their compulsive urges by introducing
the idea that comfort, or at least tolerance, can be achieved during
uncomfortable physical and emotional states. A great way to achieve that is
with simple forward bends because, she explains, "nothing can make your body
go crazy like a forward bend. My whole focus in therapy is to help my
patients bear reality. When the body stops in a forward bend, they can
observe what their mind says and experience the direct physical experience
instead of going to a place with negative messages like ŒI can't do this' or
ŒI quit.' That requires patience and tolerance, which ultimately lead to
impulse control."
Using yoga to eliminate negative thought patterns has been a savior for Texan Terri Laird who celebrated her 11th year of sobriety this past Christmas. While she's only been practicing Kundalini Yoga for two years, this Los Angeles musician claims it has helped her maintain sobriety and shed other addictions like cigarettes, coffee, and antidepressants. "When I'm taking care of my body, mind, and spirit, I don't have to fill the void with substances," she says. "It also helps curb the power of the subconscious to fill my head with all those negative voices. I really believe that yoga has changed my brain chemistry."
Laird's instinct may be correct. Yoga can, in fact, alter brain neurology and help reduce cravings, anxiety, and fear‹all responses that can lead to destructive behaviors. Roy King, Ph.D. and M.D., an associate professor of psychiatry and behavioral science at Stanford University, has studied the biological impact of yoga on drug abuse. He explains that a neurotransmitter called dopamine is elevated in the basal ganglia of the brain when drugs are introduced to the body and during other pleasurable states like sexual arousal and romantic love. One physiological reason addicts go back for more is that their brain begins to crave that dopamine surge even when they just think about drug use. King explains, though, that yoga and meditation may actually dampen dopamine activity in the basal ganglia. "This is the part of the brain that's involved with control over motivation and attraction," he says. "By inhibiting that dopamine impulse, yoga helps inhibit cravings and negative emotional states that trigger drug use."
King also points out that some forms of yoga, like Kundalini which emphasizes intense breathing patterns, may actually trigger endorphins and activate the body's natural pleasure producer. In fact, Kaur Khalsa was initially attracted to yoga after she heard Yogi Bhajan proclaim, "I'm going to teach you how to get high on your breath." "I thought that was great," recalls Kaur Khalsa. "Little by little the drugs fell off. I realized I was experiencing a kind of high, but it was natural." But when dealing with addicts who may suffer from deep-seated emotional and mental disorders, King warns that yoga teachers need to be cautious that students don't substitute one high for another.
The idea of a yoga community is also a compelling notion for addicts and their caregivers. From a behavioral standpoint, a significant way to overcome temptation is just staying away from people who use substances or from situations that prompt anxiety. "Yoga teachers tend to be calm, peaceful people with healing personalities," says Frederick. "Yoga class is a great place to observe quiet and inner strength. You also have a greater potential to make a healthy friendship than you would in a bar."
A yoga studio can offer addicts, who often turn to abuse because they feel alienated, a community of like-minded people. "Some people don't realize the ladder you have to climb to become sober," says Kaur Khalsa. She has observed that addicts (especially those who are newly sober) may get headaches or nausea, or their bodies may shake like jackhammers. That's why she's worked hard to create a safe haven at her yoga studio: She serves tea after class; music and chanting play a big role in her practice; and she even invites students to dine with her on Sunday nights.
Laird has become a regular fixture at the Golden Bridge. When she first
started doing yoga, she cried during and after class. "But," she says, "I
knew I was in a healthy, supportive atmosphere, where I could allow these
emotions to surface." Those emotions still surface, but they no longer
smother her. When she experiences anger and depression, she can watch these
feelings melt away by using her breath to quiet her mind. "I no longer
succumb to the drama," she says with relief.
Stacie Stukin is a writer based in Los Angeles and a regular contributor to
Yoga Journal. Thomas Beall, MA and RYT, is a Tuscon, Arizona drug counselor
and Kripalu Yoga teacher.