Yoga and Ayurveda for Psychosomatic Disorders

Yoga and Ayurveda for Psychosomatic Disorders

By Sara Ponte

Yoga  for Psychosomatic Disorders (PSD) has been practiced for many centuries in India, and has only recently been used to treat this condition in other countries.

What is a Psychosomatic Disorder?

Psychosomatic Disorder, also known as “somatic symptoms” or “somatoform” disorder, represents a group of disturbances characterised by thoughts, feelings, or behaviours related to somatic symptoms. This preoccupation with physical symptoms causes significant distress and disrupts the individual’s daily life. The physical symptoms may or may not be related to a diagnosable medical condition, but the extreme reaction to the physical symptoms is what characterises this disorder. These medically unexplained physical symptoms may include headache, dizziness, chest pain, lower back pain, nausea, muscle soreness, breathing problems, hot or cold spells, numbness or tingling in parts of the body, lumps in the throat, a weak feeling in parts of the body, and a heavy feeling in the arms or legs.

These disorders can begin in childhood, adolescence, or adulthood. Medical record studies suggest the rate of PDS between populations is around 7% to 11.6%, making this one of the most common categories of patient concerns in primary health care. Furthermore, it is known that clinically significant somatisation leads to excessive health care use, and consequently represent an annual burden over $100 billion for the US national budget.

What is a Psychosomatic Disorder….this great video from Osmosis explains.

Latest Scientific Research

The beneficial effects of deep breathing for these types of disorders are now being supported by contemporary science. As more and more research has been undertaken, it is noteworthy that scientific research of Yoga is getting a new accreditation. Studies have demonstrated therapeutic effects of Yoga in chronic pain conditions such as low back pain, headache, fibromyalgia and chronic fatigue syndrome. These types of disorders have an overlap with PDS in terms of subjective and objective clinical features and associated distress. Furthermore, there has been evidence that Yoga helps to significantly reduce the chronic pain levels.

Although Western Medicine does not understand the cause for these disorders, they have been treated and studied for centuries by Yoga Therapy. According to Yoga Philosophy the origin for PDSs is a mental conflict and emotional repression. Traditional texts describe that this conflict causes an imbalance in the subtle life energy, called the pranic body.

Traditional Yogic perspective

The three Gunas show our mental and spiritual state and allow us to know our propensity for psychological problems. While Sattva creates clarity, through which we perceive the truth of things and gives light, concentration and devotion, Rajas and Tamas are factors of mental disharmony causing agitation and delusion.

From Rajas comes the false idea of external world, the pursuit of sensory enjoyment to seek happiness outside ourselves and lose track of our inner peace. Rajas creates desire, pain, agitation, dissipation of energy and emotional upset.

From Tamas comes the ignorance that veils our true nature and weakness in our power of perception. Through it arises the idea of an ego or separate self, by which we feel ourselves to be alone and isolated. Therefore, Tamas brings about stagnation, decay and death.

Usually, these two forces work together. Raja brings about the over-expression of energy, which eventually leads to exhaustion, where Tamas prevails. In the case of PDS, these types of patients are physically-orientated, we can say that they are stagnated or stocked in their own somatic symptoms and therefore they tend to remain in a Tamasic state.

Ayurveda psychology aims at moving the mind from Tamas to Rajas and, eventually, to a Satva. This means moving from to an ignorant and physically-orientated life (Tamas) to one of vitality and self-expression (Rajas) and finally to one peace and enlightenment state (Satva).

Yoga Practice for Psychosomatic Disorders

As each of us has all three gunas, so the phases for Yoga Practice for PSD will comprise all these three elements:

Stage 1. Breaking up Tamas

• Active or stimulating postures to remove tiredness and dullness;
• Dispeling toxins or detox;
• Bringing attention into physical body to remove accumulated inertia;
• Recognition of suffering, confronting our pain and learning from it.

Stage 2. Calming the Rajas

• Calm and relaxing asanas;
• Pranayama techniques
• Remove one attention from the physical body to the mind and heart;
• Internal mantras and affirmation;
• Surrender to our pain;
• Letting go of individual hurts and sorrow

Stage 3. Nourishing Satva

• Calm an focused meditation;
• Body is largely forgotten and prana is at rest (e.g. Savasana);
• Where individual learn to transcend the limitation of human condition

As mentioned above, the mental disorders cause imbalances in the prana that governs the mind and thus manifests into somatic symptoms. To understand prana requires understanding of its subtypes, the five Vayus.

Vayus possess specific actions on our physical structure and body functions. Each triggers certain emotions and holds certain mental stages. The pranic mechanism behind psychological disorder begins with the disturbance of Prana Vayu by taking the wrong impressions or thoughts and negative emotions. Secondly, the digesting functions of Samana Vayu become disturbed through wrong intakes and poor discrimination, than the other three vayus (Apana, Udana and Vyana) become disturbed.

Thereby, for the therapeutic approach of PDSs it’s important to consider the role of all five vayus in asana practice, as therapeutic movements. It requires energisation (Prana), expansion (Vyana), contraction (Samana), upward movements (Udana) and downward movements (Apana) in the right proportion and balance. However, the degree of these pranic movements should vary by condition and by dosha, as well.

Repression of Emotions

Other internal pathological factors that contribute to PDS are the repression of emotions. Ayurveda recommends that emotions should be observed with detachment and then allowed to dissipate. When emotions are repressed, that can cause disturbance in the mind and eventually, in the functioning of the body. Most people learn in childhood not to express these negative emotions. As results, one begins at an early age to repress the natural expressions of these feelings.

In this context, it’s relevant to remember that during the asana and meditation practice negative emotions should be observed and released. This process also correlates with the stages of Yoga practice mentioned before. For example, when anger appears one should be completely aware of it; watch this feeling as it unfolds from beginning to end (breaking-up tamas). From this observation, one can learn about the nature of anger and then let the anger go (calming rajas). This last case mirrors how the therapeutic concepts in Ayurveda science interrelate perfectly.

Physical Benefits

In what regards physical benefits, Yoga is linked to the release of β-endorphins and the shift caused in neurotransmitter levels linked to chemicals such as dopamine and serotonin. This activation of parasympathetic nervous system, increases the inhibitory action of a hypoactive GABA system in brain pathways and structures that are critical for threat perception, emotion regulation, and stress reactivity.

Watch: Activate your parasympathetic nervous system with Alternate Nostril Breathing

In summary Yogic therapies are based on self-regulation of the patient, whereas pharmacotherapy or most of the psychotherapies foster dependence either on a physician or on a drug. Besides, Yoga Therapy remains an essential part of the multidimensional model of natural and spiritual healing.

Yoga Philosophy explains that PDSs is due to a mental conflict and emotional repression, which can causes imbalances on the subtle energetic body (i.e. disturbance of the neurovegetative system). Therefore, the yogic therapeutic approach should consider the stages for mental healing, the balance of the 5 prana vayus, associated with the cultivation of concentration, deep breathing techniques, observation and internal management of emotional conflicts.

Taken from ‘Yoga for Psychosomatic Disorders’ a research article by Sara Ponte

Sara Ponte is a Family General Physician trainee and also a 500Hr Himalaya Yoga Valey Graduate. Her work as a Yoga teacher is dedicated to scientific research and community-based programs. You can follow her projects on Facebook.

Yoga for Trauma

Yoga for Trauma

by Gayle Newbolt

Anyone who has experienced a traumatic event can be left vulnerable to developing symptoms of post-traumatic stress disorder and other trauma related illness. According to current research, between 50 to 60 percent of all Americans will experience trauma at some point in their life. In this post we explore Yoga for trauma, and how Yoga can play a supporting role in its treatment.

Seemingly commonplace incidents such as car accidents, burglary or even a distressing experience in hospital can lead to the development of trauma-related illness. Certain groups, such as veterans, are more at risk, due to their exposure to sustained and recurrent trauma and lack of support on their return from duty.

The science of Yoga has been offered increasingly in recent decades as a new healing modality for a multitude of conditions. Yoga should be used as a complementary practice to current treatment, and rather than simply reducing a person’s symptoms, it can empower them to regulate their body’s reactions and meaningfully increase their wellbeing during and after treatment.

Here’s a short video explaining trauma.

Yoga and its benefits for trauma

An indigenous science of India, the perception of Yoga in the west is often associated with a body-focussed practice, but the tradition includes other often overlooked aspects that can be beneficial during trauma treatment. The work with the body involves the practice of asana that strengthen the physical body and balance the body’s systems improving overall health and wellbeing. Each movement is united with the breath, which reinforces the mind-body connection leading to greater awareness and control over our thought patterns.

Another central feature of yoga is meditation and the development of mindfulness, of striving to be present in the here and now. All three of these methods have a profoundly soothing effect on the nervous system and balance the hormonal release within the body; promoting self-awareness, a positive attitude and a significant increase in overall well-being.

When used as an in conjunction with other trauma treatments, Yoga practices will complement existing methods and are potentially more potent in their capacity to bring clarity of mind and ease in emotion regulation. Beyond this, as negative thought patterns are reduced, and emotional balance becomes more attainable, yoga has the potential to empower a trauma survivor to reconnect to their vital energy and forge their own path to healing.

A Trauma Sensitive Yoga Class and Practice Sequence

The Trauma Centre uses four, clinically informed themes that define how they offer yoga as part of their treatment programs.

1. Experiencing the Present Moment
. Students are encouraged to ‘let their guard down’ and be present in their body. They are guided through breath awareness exercises and are helped to find breath awareness as they practice the postures. Students are encouraged to notice when they feel calmer and explain that breath awareness leads to body and present moment awareness.

2. Making Choices. 
It’s important to give students control over the situation, avoiding giving demand like instructions. The aim is to develop a self-paced, non-competitive yoga practice that helps students find bodily autonomy.

3. Taking Effective Action. 
This furthers the idea of students having control by encouraging them to have the confidence to action their own decisions. Using yoga props as an example: The props are made available in class, but their use is left as an open choice. If the students wish to use them they can make the autonomous decision to do so. This translates to giving them the power to choose self-care over discomfort and helping them develop the ability to self- sooth. Points 2 & 3 both emphasise taking control over our sensations without shame or judgement.

4. Creating Rhythms
. Creating experiences that have a beginning and an end with a clear timing structure to each posture – using controlled counting from 3 or 5 to 0 during the postures. This helps the students to develop distress tolerance through the knowledge that the posture and therefore the experience of the moment has an end.

Use of language is extremely important within a trauma Yoga class, teachers need to recognise how students may have disassociated from their body and view it as ‘not theirs’. This affects the language of the teacher and the way they relate to the students in the room. The Trauma Centre also recommend using invitatory language, for developing a non-competitive atmosphere, and the language of inquiry, to encourage curiosity and experimentation.

Finally, it’s important for teachers and students of trauma yoga to understand that the practice of yoga is one tool on the “complex path to recovery” (Emerson and Hopper, 2012). It should always be practiced complementary to formal medical treatment and not be considered a quick fix. Practice of all the techniques must be regular to have any meaningful effect on wellbeing.

A Trauma-Sensitive Yoga Sequence

What follows is a sample trauma-sensitive class for use by a Yoga teacher. It is sequenced using the above considerations and is derived from a restorative perspective rather than a dynamic one. The idea is to gently promote movement and awareness of the body, whilst reflecting on the physical and spiritual benefits of the yoga asana themselves. There is an additional sample class made available by The Trauma Centre in the book Overcoming Trauma Through Yoga by David Emerson (Emerson and Hopper, 2012), which demonstrates their personal approach to trauma-sensitive yoga.
Opening Breathing Exercise:

Nadi Shodana (Alternate Nostril Breathing):

This technique (breathing through one nostril whilst the other nostril is closed, alternating throughout) balances the nervous system and reduces blood pressure thereby promoting balance and calm in body and mind. It also has profound spiritual benefits by opening the bodies energy channels and stimulating the flow of prana. Teaching of the technique should be clear and easy to understand with full benefits given to enable students to practice independently.

Seated warm ups:

Kneeling: raise arms on exhale, lower fingertips to floor on exhale, side flexing with arms.
Encourage awareness of arms moving through space. “How does it feel to connect
movement with breath?”

Gentle shoulder and neck rolls: encouraging all the time to be conscious of how these parts
of the body feel in motion. Finding individual pace, quality of movement

Tabletop: awareness of spine long and neutral

Cat Cow: awareness of self-directed and isolated movement of spine linked with own
breath and at own pace

Extended Child’s Pose: lots of options given for placement of knees, hands and arms.

Encourage independent enquiry, what is most comfortable position for you, what sensations arise within the body from this position?

These general warm up exercises are an effective way to introduce the types of movement participants will be asked to undertake, whilst being gentle enough to not overwhelm them. They gently warm up the bodies joints and begin to awaken the body-awareness and autonomy we are striving for.

Standing Postures:

Mountain Pose

Triangle Pose

Chair

Warrior I (modified) 

Standing postures should be grounding and steady, they should stimulate the Muladhara (root) chakra to encourage a sense of physical and emotional stability. These are strong but stable postures that could encourage a person to feel the sense of their body in the space. Postures like triangle and warrior can include lots of options for arm, hand and feet placement encouraging people to explore their bodies potential for movement.

Seated Postures:

Seated forward fold

Open seated twist

Baby cobra or Sphinx Pose

Bridge

Seated bent knee twist (open or closed twist)

Legs up the wall

Final resting outstretched pose

These seated postures also activate the root chakra further encouraging a sense of grounding whilst promoting a sense of safety. They allow the student to explore the muscles and joints of the body in different ways; backbends like cobra and bridge mobilise the spine for improved posture and twists are detoxing whilst also relieving stress and anxiety. Legs up the wall and the final resting pose are both deeply calming due to their activation of the parasympathetic nervous system, they both help to relieve the overactive adrenal glands and deepen the detoxing and balancing effects of all the postures.

Taken from ‘Yoga for Trauma’ a research article by Gayle Newbolt (Himalaya Yoga Valley Graduate and Intern)

You can follow Gayle’s Yoga adventures on her Facebook page or on Instagram @elsewhereyogi

Read More: Yoga for PTSD