Frequent visitors to this website know that I write an advice column, "Ask Dr. Dombeck". A typical question I tend to see again and again is, "How can I best manage my (condition)?". Because I strive to be an ethical advice-giver, and because there are severe limitations of information in the online question and answer format, I usually recommend that the writer visit his or her doctor to get an accurate diagnosis of the problem, and then follow the doctor's treatment recommendations. There is simply no substitute for a face-to-face personal relationship with one's own physician, psychologist or psychotherapist.
Beyond this necessary 'stock' answer, I often try to provide a further pearl or two of wisdom that the writer might consider. Specifically, I tend to recommend activities known to be generally helpful in promoting mental health and peace of mind including socialization, exercise and relaxation. It occurred to me that it is fully possible to get the benefits of all three of these recommendations by performing only a single activity which is called Yoga.
Despite the fact that over the last maybe twenty years, Yoga has gone from a marginal activity to an almost mainstream one here in the West, my impression is that Yoga is still not altogether well understood. Most everyone has heard of Yoga, but not everyone really knows what it involves.
Yoga originated in India several thousand years ago as a system of physical and spiritual practices. It was formalized in the second century BC in the form of the Yoga Sutras, attributed to the scholar Pantanjali. The word 'Yoga' means 'union' or 'yoke' or 'joining'. Originally, Yoga was (and is in places where it is practiced as such) a method for joining a regular imperfect human being with the divine principle, or God. You could liken it to a form of prayer which serves a similar purpose, only prayer tends to be verbal, while Yoga tends to involve action.
Importantly, the bulk of the religious aspect of Yoga has not traveled to America, probably because it is more esoteric and mystical than the materialist and practical Western mind can easily appreciate. What has successfully traveled to America is a highly developed disciplined system of physical exercise that offers many benefits (physical, social, psychological and 'spiritual') to those who practice it. Personally, I see this 'stripping' off of the parts of Yoga that Americans can't easily appreciate as a good thing. While probably regarded as a bit of an abomination by yogis back in India, the secularization of Yoga has made accessible a set of powerful techniques for tangible self-improvement that would otherwise not be available.
American Yoga then is really about one subset of Yoga proper; Hatha Yoga (or the Yoga of physical postures). Hatha Yoga is specifically concerned with the learning of special physical postures which are typically named in imitation of the way animals and structures move. Some examples include 'cat pose', 'downward-facing dog pose', 'mountain pose', 'boat pose' and 'corpse pose'. There are a lot of these postures, and they are harder to get into than they look. Where very basic practice might focus on learning individual poses, more advanced students learn to link different poses together so that they flow into one another gracefully and, in so doing, complement one another. A good example is the 'Sun Salutation' posture flow which combines standing, lunging, and arching poses into a graceful flow.
Yoga lends itself to being non-competitive. There are no Yoga teams, and no Yoga trophies to win. There are no Yoga belts to earn. You simply practice Yoga because it is good for you and helps you to feel good while you are practicing it, and you get better at it (more able to do advanced poses) at your own pace. Each posture or pose is designed to one degree or another to help the person performing them to improve their physical strength, their bodily flexibility and range of motion, and their balance. My understanding is that these desirable attributes originally helped spiritually-minded yogis to be healthy enough to not have to worry about bodily pain so as to better concentrate on God. Here in America the same attributes help us to be more physically healthy, to concentrate better, to relax more fully, and to gain greater control over our emotions.
Yoga Benefits For Mental Health
I'm a clinical psychologist by education. When I recommend Yoga as a great practice to take up in order to promote one's health, I'm thinking more about the mental benefits than the physical ones although both are present. To my mind, Yoga offers the following benefits:
Yoga Provides The Health Benefits Of Physical Exercise
Psychologists have long known that moderate exercise is good for depression and anxiety. Such exercise can easily be found in Yoga practice. Yoga postures are designed to promote physical strength, flexibility and balance. Anyone who has ever taken a Yoga class will attest that there are cardio/heart benefits to be had; your heart rate is frequently up while performing postures much as it would be if you were performing more conventional exercise. Though Yoga gets your heart rate up and your endorphines pumping, it also provides for many rest periods. These rest periods lend a gentle quality to the conditioning that makes it easier to endure than 'marathon' style exercise. You seldom feel as though you can't go on.
By emphasizing gentle stretching of the joints and spine, Yoga promotes increased range of motion, and joint health. It helps work out muscular kinks and minor problems that might otherwise lead to back pain or stiffness. In promoting joint and spinal flexibility, Yoga also seems to promote a certain kind of mental freedom; there is a definitive feeling of mental ease and comfort that you experience at the end of a Yoga class that is linked to being free to move muscles that were tight before the class started. It doesn't always last long, but it is very real and very soothing while it lasts.
As with any physical workout, Yoga practice concentrates your mind on the physical sensations and on the perfection of the postures. The immersive concentration factor Yoga provides works as a helpful tonic for anxious and obsessional people. The practice of Yoga (or most any other demanding physical exercise) can be a great distraction from worry as it forces the mind to attend to the body and the breathing; the moment.
Yoga Promotes Relaxation And Emotional Control
As much as us mental health types like to emphasize language and verbal expression (or the blunt hammer of Valium) as the best ways of dealing with emotional problems, body-based therapeutic interventions have a role to play too. After all, the 'stress response that so many anxious and depressed people have problems with begins with the fight or flight reflex - the physical preparation of the body to defend, or flee. Chronic stress has an impact on the body in the form of chronic muscle tension and stiffness, and this very stiffness and tension seems to produce some of the worry and agony that anxious and stressed out persons report.
Yoga is a very effective stress reduction and relaxation tool. Performance of various postures requires the tensing and stretching and then relaxing of muscle groups and joints, which effectively produces relaxation in much the same way that a massage or Progressive Muscle Relaxation (a technique used by behavioral psychologists) does. Yoga practice also draws attention towards breathing, which produces a meditative and soothing state of mind. Yoga methods for stress reduction and self-soothing are generally cheaper than other professional interventions (Yoga can be done for free if you know what you're doing, and classes are no more expensive than group psychotherapy prices), pretty much safe, free of side effects, and empowering in comparison to medication alternatives.
On a more theoretical note: In the last decade, leading therapists have discovered that coupling a self-soothing, relaxation-inducing group of techniques with action oriented (cognitive behavioral) therapy often produces better results for difficult-to-treat patient populations than action-oriented therapies alone. I'm thinking of Linehan's Dialectical Behavioral Therapy (aimed primarily at Borderline Personality Disorder patients), and Hayes' Acceptance and Committment Therapy as examples. Yoga techniques promoting relaxation, self-soothing and body awareness skills are a good fit with these newer therapeutic approaches, and might prove helpful in getting impulsive and chaotically driven patients to engage the structured tools and techniques of cognitive therapy that could help them progress.
Yoga Provides Structured Social Opportunities
With due respect to stereotypes of yogic mystics sitting cross legged in splendid isolation on a mountain top, most Yoga in the west (and I suspect in the east) is done in classrooms. As such, the practice of Yoga on any regular basis becomes a significant social opportunity as much as anything else. You don't necessarily get to know everyone, or quickly, but if you commit yourself to the practice of Yoga, you'll soon enough find that you recognize faces in the class, and sooner or later, you end up making friends unless you do something to discourage that from happening. The friendships of our childhood were formed in just such a group crucible, only this one is available to adults. I know I don't have to mention that participation in social events is a way to combat depressive withdrawal, but I will anyway (grin!).
Not For Everyone
As practiced in the West, Yoga is basically a form of exercise. Many of the things about Yoga that promote mental health can also be gained from other forms of exercise, as Psychologist Kate Hays will tell you. This is important to keep in mind, becuause not every personality will click with Yoga. To my mind, Yoga works best for people who are anxious or depressed or frantic or impulsive or obsessional and who are looking for stress relief, self-soothing and a calm way to get in some gentle exercise. More competitive persons may find Yoga boring, but might derive similar benefits from some other form of exercise more to their liking.
If You're Thinking About Attending A Yoga Class...
Check With Your Doctor Before Attending
Because Yoga is a form of exercise, each person contemplating actually signing up for a Yoga course is advised to check with their physician beforehand to make sure they are fit enough to safely participate in such a class. This warning applies double to any person who has a pre-existing medical condition.
Pick The Right Kind Of Yoga Class
There are as many different sorts of Yoga out there today as there are people teaching it. Some of the Yoga forms are safer and more gentle than others. I've personally had very good experiences with Iyengar style, and with Kripalu style Yoga teachers. Be careful around Astanga "Power" Yoga, any Yoga that occurs in a "hot" room, and especially Bikram Yoga as these Yoga forms tend to be very physically demanding. Databases listing classes are available on the Internet in various places, such as this one offered by Yoga Journal
For your best bet, look for a teacher who has been teaching for a while and who is certified by a national or internationally recognized Yoga school (like the Kripalu Center in Lenox, MA or the Iyengar Foundation). Tell the teacher you are interested in 'gentle beginners hatha Yoga'.
Like any physical exercise, Yoga can be dangerous if not practiced properly! Although not common, physical injuries can occur if you follow incompetent instruction (e.g., your teacher pushes you to do something improper), or (more commonly) if you push yourself too hard. When practicing Yoga properly, you should push yourself somewhat (so that improvement occurs), but never so hard that you hurt yourself or experience serious pain. Stop what you are doing if it hurts.
A Closing Anecdote
One of the things I like best about my own personal Yoga practice is how it has helped teach me patience. When I first started classes in the Spring of 1997, I was unable to touch my toes. This galled me as many people around me were able to do this. I had a wise teacher named Stella at the time, and I recalled her noticing how I was straining to get to the floor. She talked to me about it one night, telling me that Yoga was more about experiencing where you are now than about where you should be. She told me I should relax because the floor would be there when my body was ready to reach it. Sure enough, a few weeks later it was.