You may think of yoga therapy as useful primarily for physical problems, but a major subject area in yoga is the mind, making it particularly useful for treating mental illness. In future columns, I'll talk in more detail about using yoga to relieve stress and burnout, anxiety and panic attacks, and depression, all of which yoga can help improve.
But one of the great beauties of yoga is that it's not just about taking your students from a negative state of mind to feeling "normal," which is the goal of most psychologists and physicians. Yoga aims much higher, seeking to put its practitioners in touch with a state of peace, joy, and equanimity that yogis insist is everyone's birthright. The key is getting your mind to work for you, not against you; millennia ago, yogis discovered a wide variety of practices to help achieve this end.
Yoga and Ayurveda, and the Samkya philosophy from which they both sprang, identify three general states of mind, called gunas. The three gunas are tamas, rajas, and sattva. Tamas is the state of heaviness or lack of movement; metaphorically, being stuck. The kind of depression in which a person sleeps excessively would be considered tamasic. Rajas implies movement, and a rajasic mental state is characterized by restlessness, agitation, and even panic. Sattva is the state of clarity, peace, and balance.
Even when two people carry the same diagnosis—say, depression—if one is tamasic and the other rajasic, your approach as a yoga therapist may need to be very different. In general in yoga and yoga therapy, the idea is to raise people who are tamasic to a rajasic state. A vigorous practice involving repeated Sun Salutations (Surya Namaskar, for example) might be appropriate. Once you've gotten them out of a tamasic slump, you can shift your focus to moving them from rajas toward sattva, perhaps with inversions followed by deep relaxation (Savasana, or Corpse Pose).
When the guna of rajas dominates, it can be very useful to use an invigorating practice to "burn off steam." Afterward it may be possible for your students to settle into restorative practices or meditation, for which their minds may have been too "busy" earlier.
Thus, both the predominately tamasic and those who are more rajasic tend to benefit mentally from the kind of practice sequences that are common in general yoga classes. Most people feel sattvic after a practice that gradually builds in intensity and then winds down toward the end.
One caution, though: Students who have reached the state of physical and emotional burnout or vital exhaustion, even if their condition is rajasic, may not be capable of a strong yoga practice. Rather than giving them a workout, you'll need to focus on more soothing practices, perhaps flowing from one gentle pose to the next. Or use guided imagery exercises such as Yoga Nidra to keep their busy minds occupied while not taxing their bodies too heavily.
Svadhyaya: Studying the Mind
Yoga teaches that the more you have certain thoughts, or certain kinds of thoughts, the more likely you are to have them in the future. These are mental samskaras; like grooves in a muddy road, they tend to get deeper over time. Modern science is confirming the truth of this ancient yogic insight with new understanding of neuroplasticity. Scientists now understand that the more you think or do something, the stronger the neural pathways become that connect the specific brain cells (neurons) involved. Thus the more you beat yourself up emotionally, for example, the more likely you are to do it again and again.
Before you can change a pattern, however, you first need to see it clearly. People often aren't fully aware of recurrent thoughts that may be undermining their health and well-being, or they may not be aware of how pervasive they are. Therefore, part of the yogic remedy is to encourage your students to consciously tune in to their inner dialogue. A good place to begin such svadhyaya is during asana practice: Are your students judging themselves as they attempt a pose? Is fear limiting them from attempting practices, such as Handstand, that their bodies are ready for? Are they telling themselves that they'll never be any good at yoga? Students who have such thoughts during their practice are likely to have similar ones at other times, and these thoughts may be limiting their lives. The habit of self-study you help them cultivate on their yoga mats can spread to a broader awareness of mental habits—allowing them, for example, to bring greater precision to the work they do with a psychotherapist.
While it is not always possible for people with psychological problems to meditate, meditation is, ultimately, probably the most powerful yogic tool for studying the mind, and in the long run it often proves to be the most useful tool for dealing with psychological problems. But trying to get people who are seriously depressed or panicking to sit and meditate can be next to impossible, and potentially even counterproductive. The more sattvic they become from other practices, however, the more likely they will be to eventually tackle a sitting practice successfully, and reap its many benefits.
Dr. Timothy McCall is a board-certified internist, Yoga Journal's Medical Editor, and the author of the forthcoming book Yoga as Medicine: The Yogic Prescription for Health and Healing (Bantam Dell, summer 2007). He can be found on the Web at www.DrMcCall.com.