APPLICATIONS OF YOGA THERAPY

The Chapter V of the International Classification of Diseases focuses on mental disorders and consists of ten main groups. Some remarks about the use of yoga are included.

Organic mental disorders.

Many elderly people come to yoga classes. Mild physical activity is beneficial for their mental health and cognitive functions including memory. The contraindications and limitations are rather physical – e.g. staying long in the asana with the neck bent backward is not advisable because it may impair the blood supply to the brain.

Mental and behavioural disorders due to use of psychoactive substances.

Avoid all practices which may impair self-confidence of these people (i.e. too difficult practices). Long meditation and even long yoga nidra may not be the best choice in people who are disturbed or psychotic because of previous drug abuse. Concurrent medical treatment should be recommended.

Schizophrenia, schizotypal and delusional disorders.

Avoid long meditation and long yoga nidra. Simple physical practices, emphasizing body awareness and karma yoga are advisable. Antipsychotic drugs are not addictive and they protect they the brain of people with schizophrenia.

Mood (affective) disorders

The duration of depressive mood should be at least two weeks to be classified as depression.

Any physical sufficiently intensive exercise, such as Surya Namaskar, can alleviate depression. Yoga can be very beneficial (Shapiro et al., 2007). Unfortunately most depressive people do not like intensive exercises. Relaxation and simple pranayama may be also useful to replenish their energy, if they can and want to practice them.

Depressive problems often last only for limited time period. Between these depressive periods these people are more or less normal. They can practice and benefit from most kinds of yoga. Concurrent medical treatment should be recommended in severely depressive or suicidal people. Antidepressants are not addictive but their effect is felt only after 2 – 4 weeks of regular use. That is why these drugs are not useful in sad mood states lasting only for a short time.

Neurotic, stress-related and somatoform disorders

Yoga, including yoga nidra, can be helpful. Especially people with anxiety benefit from yoga and like it. Benzodiazepines and some other anxiety and sleeplessness relieving drugs are addictive and have side effects. Yoga represents often better option here. The combination of yoga and psychotherapy is useful, because yoga increases self-awareness and replenishes energy and thus enhances progress in psychotherapy.

Behavioural syndromes associated with physiological disturbances and physical factors

This group includes eating disorders (anorexia nervosa, overeating, etc.), sleep disorders, sexual dysfunction and abuse of non-dependence-producing substances (e.g. purgatives). Yoga is usually beneficial. When dealing with sleep disorders we teach shavasana and/or yoga nidra to be practiced at night. A trainee should not finish the practice but remain in relaxed state after.

Disorders of personality and behaviour in adult persons

Personality disorders: You can find here e.g. paranoid, schizoid, dissocial or histrionic personality disorder. Personality disorders are difficult to influence. A realistic aim is to help to these people to improve self-control and learn useful social skills. Schizoid persons should not practice long relaxation or meditation. Do not expect that somebody with histrionic personality will practice yoga regularly and without an audience. Also do not expect that the criminal with dissocial personality disorder will be totally reformed after his first lesson of yoga.

Pathological gambling resembles addictions. Its treatment is similar to the treatment of other addictive diseases. Yoga can help here to increase self-awareness and to cope with stressful life situations.

Disorders of sexual preference such as exhibitionism, paedophilia or sadomasochism may be accompanied by criminal activities. They should by treated by a sexologist. Yoga can be used but not as the main tool.

Mental retardation. Yoga has been successfully applied here. The instructions must be simple, clear and should be repeated. Yoga enhances the social adaptation of these people.

Disorders of psychological development: You can find there e.g. developmental disorders of speech and language, reading disorder, disorder of arithmetical skills or childhood autism. There is not enough published experience with the use yoga in these problems.

Behavioural and emotional disorders with onset usually occurring in childhood and adolescence

Hyperkinetic disorder (or attention-deficit hyperactivity disorder) belongs to this group. It is quite common. These children, even if intelligent, represent considerable challenge both to parents and teachers. They should have enough physical activity and their short attention span should be respected – it means e.g. shorter periods of learning with more breaks. The use of yoga in this problems is not an established treatment but is may be useful (Jensen and Kenny, 2004).

Yoga teachers as outsiders and insiders

When I practice yoga with my patients, I am an insider. The advantage is that it is easier to organize the session and I know my trainees better. When I come to a women’s department to practice yoga, I am an outsider. The advantage is that my role as a teacher is not mixed with feelings related to the functioning of this department. I feel more warmth there.

This distinction would be even more apparent when teaching yoga in prisons or in the army where hidden tensions and suppressed anger can be strong.

Both positions have their advantages and limitations. Many yoga teachers have their civilian occupations and can teach yoga as insiders there and in the same time as outsiders elsewhere.