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| Yoga: An Excellent Therapeutic Adjunct for Outpatient Recovery |
| Feature Articles - Alternative | ||||||||||||||||||||||||||||||||||||||||||||
| Written by Katie Tandon, MA, CEAP, CACD, LPC, CCAP, RYT | ||||||||||||||||||||||||||||||||||||||||||||
| Wednesday, 02 January 2008 | ||||||||||||||||||||||||||||||||||||||||||||
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For thousands of years, yoga has provided a means for establishing and
building upon inner balance. Yoga is the unity of mind and body, of
self with life. Thus, the practice of yoga seeks to purify both the
physical body and the mental/emotional facility to bring balance to the
individual by promoting strength, flexibility and internal cleansing
physiologically, as well as mentally seeking calm, focus and the
replacement of external referencing with internal referencing for
things like locus of control and self-esteem.
As counselors, we like to have as many positive, proven referral sources in our proverbial tool bags as possible. This is especially true with regard to our clients who are being released from inpatient addictions treatment, for like inpatient counselors, we worry about the fragility of abstinence and the threat of relapse once back out in the ‘real world.’ So, along with 90 meetings in 90 days and outpatient counseling that we hope is logistically manageable, we wonder what more we can do to further prevent these clients from relapse. Enter yoga — the age-old system of holistic wellness that focuses on mind/body balance. Yogic practices seek to realign the physical imbalances often created by abuse of chemical substances or behavioral compulsions; and actively calms related anxieties. Much research shows the efficacy of meditation as a therapeutic tool proven to lower recidivism (Murphy & Donovan, 1997). Yoga has been shown to significantly reduce depression, which is often experienced in recovery; and studies further indicate that its ability to counteract stress is unparalleled. Yoga classes create a positive atmosphere for growth and socialization in an optimistic, holistic and growth-oriented pursuit that actively turns self-defeating behavior into self-promoting behavior. Taken together, these create a formidable ally to sobriety. Recovery often results in stress on a person’s entire system, holistically. For instance, the mind is stressed from being divorced from its most well-known coping mechanism (the substance of abuse). The body is stressed due to physiological and behavioral withdrawal; and the spirit, by a deep sense of emptiness. One way in which yoga counteracts stress is through the stretching of muscles in asana (physical postures), which releases tension that is often transferred to and held within the muscles. Because the practice of yoga asana involves an awareness of the breath, it not only heightens mind/body awareness, but it also forces a person into the present moment in a way few activities do. This helps to experience the now, rather than regretting the past or anxiously anticipating the future. For many Americans, learning to live in the present is quite enlightening. Recent research clearly indicates that meditation is an excellent remedy for stress-induced hypertension (Murphy & Donovan, 1997). Further, new studies on the practice of yoga with post-war veterans suffering from post-traumatic stress disorder (PTSD) produces notable reductions in stress and post-traumatic response in these individuals (Tuma, 2007). Having secured a calm frame of mind, one is much less reactive, impulsive and fearful. There are profound physiological benefits to both asana practice and meditation. A 1974 study proclaims convincingly that the release of stress and tension in the nervous system resulting from these practices produces physical and mental well-being that is apparently responsible for a, “very encouraging reduction in drug abuse among meditators”( Murphy & Donovan, 1997). Another study found that meditators not only got healthier, but they also got younger: using physiological measures, such as hearing acuity, near point of vision and blood pressure, doctors estimated that meditators with five years of experience were found to be an average of 15 physiological years younger (Williams, P., 2002). Yoga asanas have a tremendous cleansing effect on not only the internal organs, but also on the energetic systems of the body — the gateways we often associate with acupuncture. In addition, yoga asanas stimulate the pineal and pituitary glands in the brain, which in turn stimulate the endocrine, metabolic, digestive, circulatory and lymphatic systems to cleanse the body of toxins more efficiently. This cleansing promotes healing in bodies that have been pummeled internally by chemical substances and immoderate imbibing. Eastern forms of medicine, and even western naturopathy, agree that the body strives for physiological balance, and then is able to rely on its inherent healing systems — the immune system, kidneys, liver, digestive facilities, etc. This state of balance is brought on by stimulating the systems as mentioned, and by activating the parasympathetic nervous system — the relaxation response — which was meant to allow the body to direct its resources inward (rather than outward in fight or flight response) for the purpose of healing and regeneration of cells. The practice of pranayam, (deep breathing) oxygenates the body approximately 80 percent better than regular chest breathing. This is significant, particularly for persons whose bodies have suffered the physical ravages of addiction to substances, including brain cells, which are often damaged by substance abuse. Deep breathing also stimulates the parasympathetic nervous system; helps to internalize awareness; and calms the mind. We often think of the physical benefits of yoga as confined to gaining flexibility and strength, but yoga asana also balances how the muscles interact with one another, lessening injuries and heightening coordination. Perhaps these are the reasons that the practice of yoga has been used for personal development for more than 5,000 years. As yoga is a mind/body approach to wellness, it is sometimes hard to separate the physical benefits from the mental/emotional benefits, since they are, in some sense, one: the stimulation of brain cells via deep breathing is mentally invigorating; the para-sympathetic nervous system response creates calm in the mind; and the stimulation of the pituitary gland which regulates hormonal secretions has an effect on mood. Clearly, the practice of yoga asana and meditation can have a positive effect on emotional life. In study after study, the results are clear and consistent: psychological tests administered to control groups indicate that meditators show increased satisfaction, ability to adjust, and self-acceptance, as compared to non-meditating controls (Murphy & Donovan, 1997). A recent Stanford University study concludes that meditation techniques have been extremely helpful in reducing symptoms of anxiety, depression and pain management (Tuma, 2007), each of which can be significant obstacles to recovery. Perhaps the most profound emotional effect, however, is the reduction of anxiety. Many yoga practitioners do yoga because it is, above all, calming. A calm state of mind is not only happier, clearer and more productive; it is more creative, less fearful, less impulsive and much more insight-oriented. In a 1978 study, researchers found that the reduction of anxiety in control group members who were taught meditation prior to discharge from inpatient rehabilitation, was the single most significant therapeutic benefit, as this was found to be related to rehabilitation success rates (Murphy & Donovan, 1997). In meditation, one can calmly observe thoughts arising and passing away, and thus, become aware of a deeper part of the mind that can control thought content. In learning to detach from thoughts, it becomes clear that thoughts do not ‘rule’ us, and that we are more than just our thoughts. If one can detach from thought, one can detach from emotion — watch anger or fear arise, and rather than react, take the opportunity to study, wonder, accept or laugh at that emotion, and then choose a course of action. In combating depression, yoga asana offers the backward bends, which stimulate the adrenal glands that secrete adrenaline and norepinephrin — the stimulating hormones. Rythmic pranayam (deep breathing) has also been proven to stimulate the secretion of positive neurochemicals like seratonin and other endorphins (especially in the periaqueductal gray area, or PAG in the midbrain, the site of the body’s largest supply of opiate receptors) (Khalsa, 2002). A recent study at the University of Toronto showed conclusively that the use of meditative techniques, as an adjunct to cognitive therapy, halved the risk of relapse in patients with a history of three or more episodes of major depression (Tuma, 2007). Additionally, the calm state produced by the practices of yoga and meditation, combined with clarity and a propensity for living in the moment, create a centering that counters rumination and supports detachment from downward-spiraled thought paths that often are followed by those who suffer from depression. Further, the best-kept secret is that the deeper meditative states that produce alpha and theta waves in the brain, bring the added benefit of a blissful emotional state as part of the experience. The relevance of this epiphany —being able to feel euphoria naturally — cannot be understated for those in recovery, who grieve the loss of euphoric states. This contains a revelation in terms of what is possible for the mind to achieve without external aids. Finding, in fact, the heretofore ‘hidden’ possibilities in the working of the mind is one of the many ways the practice of yoga improves self-esteem, so integral, often, to problems with anxiety, depression and addiction. The awareness exercises of yoga asana teaches about the mind/body relationship — how we affect our bodies by how we ‘talk’ to them, how the way we use the body affects our mood. This all occurs within an emotional framework in which a person is encouraged to accept where he or she is today, and gently and patiently seek change, inviting persons to balance self-forgiveness with continued growth. Yoga encourages people to realize how much more there is to who they are than just their physical bodies, and therefore, works actively against body obsessions and identification with external cues. Relaxation techniques use imagery — which is well documented to improve everything from sports performance to sales — to assert the peaceful beauty within. Meditation invites insight to the goodness within, inspiring thereby a sense of wholeness and inherent worth. Social benefits for recovering persons The format of group yoga classes creates a much-needed, healthy context for socialization. Many are the friendships I have seen blossom between students in my classes over the years, with many after class discussions stretching into hours. Persons who are in recovery often face some difficulty in finding a new social framework, and this can be resolved by a context like yogic practice and its interest in personal growth and holistic healing, wherein self-awareness, tolerance, compassion and peace are actively pursued. Movement, exercise, flexibility, peace, connectedness, endorphins, release of toxins — what more could one ask for? Having a positive social environment, as all addictions counselors know, makes an incredible difference in lessening the possibility of relapse. Recent research that studied the addition of meditation to participation in Alcoholics Anonymous (AA), indicates that persons who also meditate increased the long-term effectiveness of AA by 2.6 times; in effect, making it twice as effective (Gelderloos, P., Walton, K.G., Orme-Johnson, D.W., Alexander, C.N., 1991). Addiction, by its definition, bespeaks a life out of balance. At its base, the intention of yoga is homeostasis. Eastern philosophy and medicine believe that in a balanced state, the organism thrives. This philosophy teaches that when we have reached a balanced state mentally and physically, spiritual work can begin. Thus, the benefits of yoga practice are, and were meant to be, incredibly generalized. In one study on self-development, meditators were found to experience more personal development than students usually do in four years of college. This was particularly remarkable, since this study occurred in a maximum security prison where many inmates had grade school educations (Alexander, C.N., 1982). Another study of 120 skid-row alcoholics found that those who had been taught meditation while inpatient were, at the end of 18 months, 65 percent abstinent, compared to 25 percent in the control group. Also, at six months, the majority of those who were taught meditation were still practicing meditation regularly (Gelderloos, P., Walton, K.G., Orme-Johnson, D.W., Alexander, C.N., 1991). Thus the balance yoga imparts becomes more than panacea — rather, it becomes a guiding principal that steers both thought and behavior in healthy directions. Yoga and meditation can be practiced either within or outside of a spiritual context. In its original intention, it was designed as a practice that would lead to spiritual awareness. However, it need not be practiced for that reason or to that depth. Certainly, it is most usually practiced here in the West outside of its spiritual context, and yet, to great and enduring benefit. However, any spiritual focus, regardless of the specific religious orientation, can be deepened by meditative and balancing practices. The practices of yoga transcend the distinctions between religious contexts, offering a deepening of self that can be utilized to heighten whatever spiritual or religious path a practitioner adheres to; or it need not have any spiritual context at all. Yoga is not a religion, but a philosophy of life and a science of mind. Therefore, no judgments of a religious sort exist in yogic practice or philosophy. The 12 steps of AA recovery include a spiritual context, and recommend prayer and meditation without giving any instructions for learning meditation. Yoga offers the optimum tools for learning such meditations through a systemized curriculum that makes meditation easy to learn for anyone, and easy to practice. Remember that all meditative practices were built from the common root of yoga philosophy and practice, which have survived for thousands of years as a way to optimize health physically, mentally, and if you so choose, spiritually. A system of holistic healing can be a valuable ally to persons in recovery who are struggling to regain their equilibrium. Self-induced and self-practiced, yoga brings balance, greater awareness, acceptance of self, personal growth and calm; lessens anxiety and depression and heightens self-esteem; and creates a positive social activity in an insightful context. Studies over 30 years have consistently concluded that meditation enhances recovery therapies and dramatically reduces relapse, as well as diminishing anxiety, stress and depression. Furthermore, if we assume Abraham Maslow, creator of the “Hierarchy of Needs”, was right, and happiness lies in self-actualization, it is interesting to note that in a recent study on therapies that lead to self-actualization, meditation techniques yielded extreme effectiveness, showing substantial positive gains in virtually every category of self-actualization, and in just two months (Williams, P., 2002). The Taoists say, “the wrong path is by its nature self-punishing.” Though pain is often necessary to gaining a clearer path in life, and recovery is certainly no exception, yoga gently cushions the struggle toward self-awareness by providing a context of compassion, and a set of directions for inward exploration without judgment, regret or anxiety. It teaches people to honor their bodies as the outward reflection of mind and spirit, and of their enormous potential. Instead of feeling powerless to overcome a substance or a compulsion, yoga highlights a person’s innate ability to manage his or her thoughts, emotions and behaviors. By looking inward in meditation, yoga practitioners gather awareness of the workings of mind and personality, and knowledge is power. Many are the yoga treatises that speak to a person’s responsibility for his or her own happiness, and the ways of learning to direct thoughts and emotions — using natural abilities to proactively seek calm, tolerance, detachment and compassion. From physical, to mental, to spiritual empowerment, studies consistently demonstrate that the practice of yoga and yogic meditation create an outstanding support to sobriety, and therefore, should become a usual referral source for counselors who are looking to proactively support those clients who are struggling to remain abstinent in general, and especially those in need of an effective adjunct to post-inpatient treatment. References Alexander, C.N. (1982). “Ego Development, Personality, and Behavioral Change in Inmates Practicing the Transcendental meditation Technique or Participating in Other Programs: A Cross-sectional and Longitudinal Study.” Dissertation Abstracts International. 43 (2): p. 539b. Gelderloos, P., Walton, K. G., Orme-Johnson, D. W., Alexander, C.N. (1991). “Effectiveness of the Transcendental Meditation Program in Preventing and Treating Substance Misuse: A Review. International Journal of the Addictions. 26: pp. 293-325. Khalsa, Dharma Singh. (2002). Meditation as Medicine. New York: Simon and Schuster, First Fireside Edition. Murphy, M. & Donovan, S. (1997). The Physical and Psychological Effects of Meditation: A Review of Contemporary Research with a comprehensive Bibliography 1931-1996, Institute of Noetic Sciences. Sausalito, Calif. Tuma, Rabia, S. (2007). “What Monks Know and We Can Learn About the Fruits of Meditation,” Yoga and Joyful Living, May-June 2007, p. 42. Williams, Patrick Gresham. (2002). The Spiritual Recovery Manual: Vedic Knowledge and Yogic Techniques to Accelerate Recovery. Incandescent Press, Palo Alto. Katie Tandon, MA, CEAP, CACD, LPC, CCAP, RTY has worked in the addiction field since 1992, and has been a teacher of Yoga and Meditation since 1983. She is registered with the Yoga Alliance, a Professional Member of the International Association of Yoga Therapists, and conducts ongoing classes and private sessions in therapeutic yoga.             
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