Yoga For Depression – What You Might Not Know – Amy Weintraub
Many of the practices we use in the treatment of depression are based on those developed in ashram settings, far from the common stressors and responsibilities of the householder’s daily life or the challenges of current global affairs. Some of these practices were first recorded hundreds of years ago and may have come from an oral tradition and been practiced for several millennia. What we have found in day-to-day use is that some of the customary language that those of us trained in yoga have been taught to introduce and guide these ancient practices may occasionally but predictably cause a bad reaction in the client, perhaps triggering fear or panic. When we look at the practices themselves, and their effects, here too, we have observed unexpected reactions from our students and clients, and although these reactions may be rare, in mental health treatment, they need to be considered and the practices modified.
Let’s look at three general principles that we have found, through clinical experience and current research, to be important to consider, no matter the yoga school or asana practice, in the treatment of depression (tamasic mood).
MOVEMENT
First, research has established that movement, and particularly yoga-based movement, is essential for most individuals who suffer from depression. Studies using Iyengar Yoga have shown that backbends and inversions, when included in a general yoga class, can decrease negative mood in depressed individuals. Those studies that have included yoga breathing practices, along with asana, have shown more positive outcomes for mood elevation than yoga postures alone.
ATTUNEMENT
Second, it is vital that the yoga professional remain attuned to the student. Research has shown that one of the best predictors of a positive outcome in psychotherapy is clients’ perception of the positive therapeutic relationship with their therapists. The therapeutic alliance between yoga professional and student is equally important in the outcome of the yoga treatment, especially in the area of mood disorder.
Attunement between the yoga professional and the student means that the professional meets the student’s current mood with a practice that mirrors that mood and then begins to move it into balance. Attunement means that the professional leads the practice with eyes open, so she can observe the client’s breath, facial expression and posture, and can adapt and modify the practice appropriately.
I would suggest that attunement also means that take-home practices for mood management are co-created by both client and therapist together rather than prescribed. In this way, we are increasing the client’s sense of empowerment and self-efficacy. This is important because depressed individuals often do not perceive themselves as being in control over their life circumstances. This “external locus of control” can lead to feelings of helplessness, hopelessness, and depression.
Studies show that the more we can elevate a client’s sense of “self-control,” the more we see a drop in depressive symptoms. What yoga does, more than most medical-based models of treatment, is to give people the tools for managing their depressive symptoms, thus encouraging what psychology calls an “internal locus of control” or “self-control,” and which we may commonly think of as empowerment. I personally prefer to take off the “expert” hat when working with a person suffering from depression. Instead, I encourage students to become the experts in their own self-regulation. My role is to offer the yoga skills for them to do so.
CUEING
Thirdly, cueing appropriately to sensation is a core practice in working with someone diagnosed with depression. However, it may not feel safe, especially for someone with a history of trauma, to hear the yoga professional say, “feel the sensations in your body.” This generalized language in a yoga class may exacerbate symptoms of an agitated depression or panic for someone for whom, for good reason, it doesn’t feel safe to live in the body. Instead, if our language is direct, not global, we can support the student in fully experiencing the body in a comfortable way during and after a practice. We start with **cueing to direct sensation**—face, arms, lips—and then we can decide when and if it’s appropriate to move to a more global awareness. The goal of this direct cueing practice is to anchor the awareness and consciousness in specific sensations of the body.
For example, after a balance pose on the left side, before moving to the right side, the teacher might say, “Eyes soft, sense your left foot…left ankle…left leg…the whole left side of the body. Inhale up through the left foot, up through the left side of the body to the crown of the head. Exhale down the right side…”
After leading a breath that includes arm movements, like a bellows breath, a teacher might say, “Palms open in the lap, sense the fingertips…left palm…right palm. Sense the forearms…the shoulders, left and right. Sense the lips…left cheek…right cheek. Sense the whole body…the energy shimmering beyond the body…Perhaps a sense of spaciousness, clarity, breathing through you…” To ground the energy, the teacher might end with, “Inhale to the crown, “I am”; exhale to the feet (if standing) or seat (if sitting), “here.”
Here’s an example of how a yoga therapist might attune with her client in offering a practice and also cue to sensation. LifeForce Yoga Director Rose Kress, E-RYT-500, LFYP 2, was seeing Martha, who was coming for yoga therapy to deal with her lethargy and lack of motivation after her retirement to Tucson. While leading a grounding version of a standing breath practice called Breath of Joy, Rose suggested that Martha think of the arm movements as “conducting energy in her life.” When they finished the practice, Rose directed Martha’s awareness to the hands, fingers, arms, and lips, sensing the breath moving in the body, and welcoming any clarity that was present. “I feel as though I’ve just let the air in, and not just in my lungs,” Martha said. “And my mind is clear and calm!” Even though Breath of Joy is energizing, by pausing to cue Martha to specific sensation, Rose guided her into a greater sense of self-awareness and peace.
Over the years I’ve worked with people who suffer from depression and trained other yoga teachers and health professionals to do so. I’ve learned from clients and the clients of those we have trained to secularize our language and sometimes to modify the yoga practices themselves.
If you’re interested in learning more about LifeForce Yoga for mood or in becoming a LifeForce Yoga Practitioner, please visit www.yogafordepression.com. To learn more about Amy Weintraub, Author of Yoga for Depression (Broadway Books), Yoga Skills for Therapists (W.W. Norton) and the founder of LifeForce Yoga Healing Institute, please visit her at www.amyweintraub.com.
Yoga For Depression – What You Might Not Know – Amy Weintraub
Yoga For Depression – What You Might Not Know – Amy Weintraub
Many of the practices we use in the treatment of depression are based on those developed in ashram settings, far from the common stressors and responsibilities of the householder’s daily life or the challenges of current global affairs. Some of these practices were first recorded hundreds of years ago and may have come from an oral tradition and been practiced for several millennia. What we have found in day-to-day use is that some of the customary language that those of us trained in yoga have been taught to introduce and guide these ancient practices may occasionally but predictably cause a bad reaction in the client, perhaps triggering fear or panic. When we look at the practices themselves, and their effects, here too, we have observed unexpected reactions from our students and clients, and although these reactions may be rare, in mental health treatment, they need to be considered and the practices modified.
Let’s look at three general principles that we have found, through clinical experience and current research, to be important to consider, no matter the yoga school or asana practice, in the treatment of depression (tamasic mood).
MOVEMENT
First, research has established that movement, and particularly yoga-based movement, is essential for most individuals who suffer from depression. Studies using Iyengar Yoga have shown that backbends and inversions, when included in a general yoga class, can decrease negative mood in depressed individuals. Those studies that have included yoga breathing practices, along with asana, have shown more positive outcomes for mood elevation than yoga postures alone.
ATTUNEMENT
Second, it is vital that the yoga professional remain attuned to the student. Research has shown that one of the best predictors of a positive outcome in psychotherapy is clients’ perception of the positive therapeutic relationship with their therapists. The therapeutic alliance between yoga professional and student is equally important in the outcome of the yoga treatment, especially in the area of mood disorder.
Attunement between the yoga professional and the student means that the professional meets the student’s current mood with a practice that mirrors that mood and then begins to move it into balance. Attunement means that the professional leads the practice with eyes open, so she can observe the client’s breath, facial expression and posture, and can adapt and modify the practice appropriately.
I would suggest that attunement also means that take-home practices for mood management are co-created by both client and therapist together rather than prescribed. In this way, we are increasing the client’s sense of empowerment and self-efficacy. This is important because depressed individuals often do not perceive themselves as being in control over their life circumstances. This “external locus of control” can lead to feelings of helplessness, hopelessness, and depression.
Studies show that the more we can elevate a client’s sense of “self-control,” the more we see a drop in depressive symptoms. What yoga does, more than most medical-based models of treatment, is to give people the tools for managing their depressive symptoms, thus encouraging what psychology calls an “internal locus of control” or “self-control,” and which we may commonly think of as empowerment. I personally prefer to take off the “expert” hat when working with a person suffering from depression. Instead, I encourage students to become the experts in their own self-regulation. My role is to offer the yoga skills for them to do so.
CUEING
Thirdly, cueing appropriately to sensation is a core practice in working with someone diagnosed with depression. However, it may not feel safe, especially for someone with a history of trauma, to hear the yoga professional say, “feel the sensations in your body.” This generalized language in a yoga class may exacerbate symptoms of an agitated depression or panic for someone for whom, for good reason, it doesn’t feel safe to live in the body. Instead, if our language is direct, not global, we can support the student in fully experiencing the body in a comfortable way during and after a practice. We start with **cueing to direct sensation**—face, arms, lips—and then we can decide when and if it’s appropriate to move to a more global awareness. The goal of this direct cueing practice is to anchor the awareness and consciousness in specific sensations of the body.
For example, after a balance pose on the left side, before moving to the right side, the teacher might say, “Eyes soft, sense your left foot…left ankle…left leg…the whole left side of the body. Inhale up through the left foot, up through the left side of the body to the crown of the head. Exhale down the right side…”
After leading a breath that includes arm movements, like a bellows breath, a teacher might say, “Palms open in the lap, sense the fingertips…left palm…right palm. Sense the forearms…the shoulders, left and right. Sense the lips…left cheek…right cheek. Sense the whole body…the energy shimmering beyond the body…Perhaps a sense of spaciousness, clarity, breathing through you…” To ground the energy, the teacher might end with, “Inhale to the crown, “I am”; exhale to the feet (if standing) or seat (if sitting), “here.”
Here’s an example of how a yoga therapist might attune with her client in offering a practice and also cue to sensation. LifeForce Yoga Director Rose Kress, E-RYT-500, LFYP 2, was seeing Martha, who was coming for yoga therapy to deal with her lethargy and lack of motivation after her retirement to Tucson. While leading a grounding version of a standing breath practice called Breath of Joy, Rose suggested that Martha think of the arm movements as “conducting energy in her life.” When they finished the practice, Rose directed Martha’s awareness to the hands, fingers, arms, and lips, sensing the breath moving in the body, and welcoming any clarity that was present. “I feel as though I’ve just let the air in, and not just in my lungs,” Martha said. “And my mind is clear and calm!” Even though Breath of Joy is energizing, by pausing to cue Martha to specific sensation, Rose guided her into a greater sense of self-awareness and peace.
Over the years I’ve worked with people who suffer from depression and trained other yoga teachers and health professionals to do so. I’ve learned from clients and the clients of those we have trained to secularize our language and sometimes to modify the yoga practices themselves.
If you’re interested in learning more about LifeForce Yoga for mood or in becoming a LifeForce Yoga Practitioner, please visit www.yogafordepression.com. To learn more about Amy Weintraub, Author of Yoga for Depression (Broadway Books), Yoga Skills for Therapists (W.W. Norton) and the founder of LifeForce Yoga Healing Institute, please visit her at www.amyweintraub.com.
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