Yoga Therapy for Selected Diseases

“This small but rich informative book on Yoga Therapy is successful in providing comprehensive, scientific and to the point elaboration of selected diseases and their treatment through yogic methods. Illustration of the yogic poses has made this book highly useful for those who have some exposure to yoga and are keen to help themselves or others against disorders such as arthritis, asthma, spondylosis, backache, hypertension, diabetes and several other psychosomatic disorders which are very common in society mainly due to modern style of living. It is’a must collection for every family.”

Today yoga has become more popular because of its potential to rejuvenate body-mind complex and to re-establish the healthy condition of the practitioner. Through scientific research it has been found that yoga is helpful in controlling stress disorders particularly essential hypertension, insomnia, hyperacidity, diabetes, asthma etc. However, the applied aspect of Asanas, Pranayama, Kriyas is not so easy to work out. It requires a qualified yoga therapist who would guide the patient once he knows the principles of yoga therapy.

The Ministry of health published a marvelous book ‘Yoga therapy’, written by Swami Kuvalayanand and Dr. S.L. Vinekar in 1963, Detailed information regarding the principles of yoga therapy and yoga techniques was given. The book is mainly useful for doctors who are interested in practicing yoga therapy. However, today people want to know in brief but easily and instantly about the diseases, symptoms and the yogic remedy. As warned by Hathayoga, if yogic practices are performed erroneously it would be quite dangerous to the individual. Knowing this and the need of today the present booklet has been brought out as a complementary publication.

Mostly the yoga therapy is misunderstood as a method consisting of few asanas and Pranayama only, to cure any disease. Unfortunately this is not correct. On the contrary the yoga therapy is successful only when the patient understands and observes some of the important principles behind the concept of yoga therapy. The lifestyle changes are mandatory in combination with the prescribed yoga practice.

The idea of explaining these principles of yoga therapy in a lucid language and to provide at hand information about a few most common psychosomatic disorders along with the remedial part of yoga would be appreciated by the readers. The present booklet is a result of studious presentation from four authors who are related to yoga therapy and experts in their fields such as yoga research and naturopathy, modern medicine, Ayurveda, and psychology. We hope that readers will welcome this booklet and would reap the benefits. I congratulate all the four authors for their endeavor to write such a ‘ready reference at hand’ for patients, yoga therapists and teachers.

Where there is a health, there is happiness. Here the meaning of happiness is not the pleasure out of fulfillment of the desire but the jubilant feeling all the time that is free from fears and tensions. The primary objective of yoga is spiritual advancement and not to cure the diseases. However, it has been observed that many psychosomatic disorders are controlled best with the help of yoga practices and the persons who practice yoga regularly (Sadhana), can very well maintain their health, throughout their life. This indicates that the resistance power against the diseases i.e. immunity is improved due to the regular practice of yoga. The long life span of the yoga practitioners also indicates that the yoga practice can slow down the aging process. Today, many people are taking best advantage of this preventive and promoting aspect of yoga. There however is a growing tendency to apply yogic methods as the last resort for each and every disease, irrespective of its severity, duration and the age of the patient. This is however a wrong concept of yoga therapy.

Man has conquered the diseases like Malaria, Typhoid, Small pox and Tuberculosis arising out of infections caused by germs, bacteria, viri etc. But doctors and scientists have realized that in spite of good number of medicines, most sophisticated diagnostic tools and other medical facilities, it is difficult to cure the patients suffering from stress related disorders such as, Hypertension, Hyper-acidity, Insomnia, Heart diseases, Diabetes, Asthma, Arthritis, Spondylitis etc. with the conventional line of treatment. These disorders are even worse than usual infectious disorders. The human being has been challenged by these germless disorders. The reason is we often ignore the causative factors of these diseases.

Concept of health
As per WHO health does not mean merely an absence of disease but a jubilant of well being at physical, mental, social and spiritual levels According to Ayurveda too the same message is seen:

In short, when all the anatomical-physiological factors are in balanced condition and the mind, soul as well as sense organs are working in harmony, it is considered as a healthy state. Dissatisfaction or unhappiness in mind would cause imbalance in these factors. We know that in spite of all the luxuries at home, if the mind is dissatisfied we cannot enjoy anything. Happiness comes from within and does not depend on material gain or physical enjoyment (Nagarathna 1990). That is why the mental health is very important component of total health. Disturbances at the mental level can even alter the neuro-musculo-glandular mechanism of the body. It can also disturb the autonomic balance and hence the vital regulatory systems like cardiovascular system, as well as endocrine system. The word ‘to heal’ is incorporated in the word ‘health’. It indicates that the perfect healing is ‘health’.

According to yoga health is an integrated state of body, mind and spirit. There is a harmony in all the psycho-physiological functions. It is well coordinated and balanced condition of body and mind wherein the homeostasis is adequately maintained. Therefore a feeling of happiness and contentment are essential factors of the sound health.

Concept of disease
When there is no balance between desire, need and the availability of money one feels dissatisfied. Out of dissatisfaction, frustration and dejection, stress is produced when there is a negative interaction between the self-projection and the surrounding environment. The self projection is influenced by our cravings, desires, likes and dislikes, attitudes, ambitions, beliefs, negative emotions, hopes and failures. Even our life-style is affected due to these factors.

The main reason is ‘ignorance’ on our part. Sloth (styan) and laziness (alasya) are other two vikshepas. The modern lifestyle, based on ‘button technology’ (remote control technology) makes us lazier. The way we eat, perform the exercises, take rest, play, behave with others, think, plan, sleep are all included under ‘Life-style’. Most of the time, in a quest for maximum earning with minimum work, we choose wrong life-style. Sedentary working pattern, improper diet and irregular timings of food, inadequate rest and sleep and lack of exercise constitute wrong life –style. This will be further affected adversely by addictions to harmful habits like tobacco chewing, smoking and drinking alcohol. In addition, the environmental conditions, social, political and economical situations are constantly working on us, which again affect our mental state and physical health. With the imbalanced mind our responses to the incoming stimuli also go towards the negative direction. Sudden mental irritation or depression, frequently changing moods, lethargy, and mental dissatisfaction are the first signs of disturbed mind. Under such conditions our digestive system is greatly affected. General tone of the digestive musculature in disturbed.

It is known that the continuous stressful situation leads to sympathetic over-activity suggested by the raised levels of adrenaline and nor adrenaline. This causes spasm of the coronary arteries and an increase in cortisol level causing formation of blockages in the arteries speedily. Thus the stress, which is actually the normal defensive mechanism of the body to protect us in danger situations, now becomes harmful. The emotions play a significant role in our life. Positive emotions are constructive while negative emotions and emotional conflicts are destructive in nature. They produce disturbed condition of mind (daurmanasya) and also disturb the tone of the muscles including those of the blood vessels. This further impairs the vital autonomic functions like respiration, circulation, and glandular secretion and finally weakens the very immune process. Thus, the psychosomatic conditions slowly move from functional impairment to cellular disturbance and finally lead to the structural alternation (pathological changes). If this situation is not tackled early it leads to permanent organic changes in the various organs.

The effect of interpersonal stress on 20 women with rheumatoid arthritis (RA) was studied by Zautra (1999) and his colleagues. They found that there is an aggravation in RA following an increase in inter-personal stress. Women having stronger and positive marital relationship with their husbands were less affected. It is obvious from this study that the diseased condition is reversible if the stress is tackled correctly.

As it is observed in cases of diabetes mellitus, bronchial asthma, essential hypertension and rheumatoid arthritis that the conventional medical treatment can alleviate the symptoms and the patient also experiences the relief temporarily but the root cause of the disease remains mostly ignored.

Principles of Yoga therapy
In order to achieve and maintain the healthy condition, yoga lays emphasis on the following steps.

1. Purification of ‘nadis’ by removing the obstructing toxins from the body.
2. Reconditioning of the neuro-muscular and glandular system so that adequate immunity is regained.
3. Cultivation of proper psychological attitude so as to increase the ability of the individual to cope with the stressful situation if any.

It is wiser to wear a good quality shoes instead of removing nails and thorns spread on the road. Yoga is doing the same thing. Every living being is well equipped with the healing power. It is with us right from the birth. Yoga recuperates this natural strength of the body and mind to eliminate disturbing factors on the gross and subtler levels. Thus yoga supports and enhances this healing power by maintain the equilibrium or homeostasis, through the development of optimum muscle tone, giving complete mental relaxation and constructing the proper emotional make-up. Along with the yogic therapy the main medicines from Ayurveda, Homeopathic or Allopathic systems may be continued, modified or stopped only on the advice of the respective treating physician.

Any variation in the results of the given yoga therapy will depend on the following two things.

1. Techniques of the yogic practices
For the desired effects from the yoga therapy one should ensure that the technique adopted is correct from the traditional as well as the scientific point of view. Our body responds as per the stimulus. Long lasting beneficial physiological changes will take place only when the proper techniques are repeated in the same sequence and at the same timing every day. The correctness of the technique may be checked with the experienced yoga therapist. Appropriate modification in the technique may be done by him/her for the particular patient as per his/her age and other conditions.

2. Constitution and nature of the patient
The disordered physical-mental-spiritual condition of the patient is known as Prakriti. The response of his body would depend on it. A yoga therapist should consider all the physical abilities and the psychological make-up, as well as, the limitations of the patients while deciding the line of yogic treatment. Most of the time, the preliminary reconditioning of the individual patient is necessary before starting the main yogic treatment.

Survey of the therapeutic research
Swami Kuvalayananda was the pioneer to investigate the effects of yogic practices on the scientific basis. These were the fundamental experiments in the field of yoga. Later on many scientists conducted the scientific researches in yoga. The applied research in the field of therapy was mostly carried out in the last 4 to 5 decades. Bhole, (1967 and 1979) revealed that Asthma could be controlled successfully in 69% patients with the yogic treatment in which vastra dhauti was found very effective. Datey, (1969) for the first time found the relaxative posture - shavasana as most effective for the management of hypertension. Later on Deshmukh, Dalvi, Vinekar, (1969), Patel, (1973) and Udupa (1980), not only confirmed these results but also further reported a reduction in catacholamine level after yogic therapy. Rajalaxmi also could treat 20 patients of hypertension effectively with Yoga. Gopal, (1973) has reported a significant improvement in blood pressure and respiratory functions after practicing yoga. Rajalaxmi treated 15 patients of bronchial Asthma with yogic treatment for 20 to 90 days and found that their vital capacity, PEFR and breath holding time was increased. On the basis of these investigations it seems that yoga helps asthmatics by improving their broncho-pulmonary functions and different respiratory capacities. It is also noticed that yoga therapy helps in removing the mental and emotional instability and establishes the balance in hormonal secretions. Parkodi, (1979) found that Shavasana practiced for 5 months could reduce blood pressure and catacholamine metabolism and improved adreno-cortical function. Tulpule, (1980) showed that a set of relaxative hathayogic postures could prevent myocardial infarction. Gore (1980) found that the air trapping observed in the spirogram of asthma patients was effectively removed immediately after practicing Vastra dhauti. Sharma, (1981) treated 27 patients of hypertension with shavasana for 2.5 months successfully PEFR of normal subjects was found to improve significantly after 45 days yogic training (Gore, 1981). Gore (1982) found that one-month yogic training could improve pulmonary functions of asthmatics.

Diabetes mellitus is another stress disorder where the number of patients is increasing day by day. After Udupa and Singh, (1972) reported significant reduction in blood sugar in normal subjects, many doctors came forward to conduct scientific studies on yogic treatment for diabetes. Koshti, (1972) studied serum proteins in diabetics before and after 6 weeks yogic treatment and found that A:G ratio was corrected along with the reduction in blood sugar. Melkote and Varandani, (1973) also reported promising results of yogic treatment for diabetes. Rugmini and Sinha, (1975) investigated 123 diabetics and found the yogic treatment effective in 64% patients. Gore, (1988) emphasized 15 min shavasana for two times along with other yoga postures for 45 days and found reduction in insulin intake from 44 units to 24 units.

Besides this, yoga therapy was also tried in other clinical conditions such as Neuroticism (Kocher, 1972), Obesity (Gharote, 1977), Insomnia (Joshi, 1979), Mental retardation (Rajalaxmi, 1979), Epilepsy (Parkodi, 1984), Udupa, Singh, 1984) and showed encouraging results. There was a comparative study on the effect of Yoga and Aerobics on obesity with 6 months follow up observations at Kaivalyadhama institute. The study revealed that yoga training was better in improving the level of health related fitness of obese patients in terms of reduced body weight and fat%, flexibility, hip girth and muscular strength (Bera, 2003). Both yoga as well as the aerobics training has beneficial effect towards reducing their blood pressure and heart rate in the age group of 35 to 60 years. The yogic treatment was more effective in case of residential group where diet regulation was also followed. Yoga was seen more effective in improving the respiratory efficiency than the aerobic exercise. The cardio-respiratory effect of yoga is long lasting and deeper as compared to aerobics (Gore 2004). Yoga regimen in residential group was found better than aerobic exercise in reducing anxiety in obese people (Bhogal and Oak 2005). Recently in Vivekananda Yoga Kendra, 18 patients of anxiety neurosis were treated with yoga therapy for 4 weeks. More emphasis was given on Pranayama and Shavasana. Increase in GSR, decrease in RR, increase in BHT and CE as well as, psychological status of the patients were observed. A sense of well-being and deeper relaxation was felt by all the patients. Udupa studied effect of yoga therapy for anxiety neurosis and has observed improvement after 3 months together with a reduction in the levels of acetylcholine and catacholarnine in blood and urine. Wahia, after 6 weeks yogic treatment including meditation, has reported an improvement in 68% patients. Several studies have been reported on the yogic treatment for effective control of spondylitis, backache, arthritis, rheumatism, menstrual disorders and gastro- intestinal disorders. Since 1991, Yoga has been included in the rehabilitation program of the mentally challenged patients of the Govt. Mental hospitals at Thane and Nagpur.

For the individuals suffering from Psychotic and neurotic depression the results are encouraging such as reduction in restlessness, mental irritation and negative thinking. An improvement in mental concentration, sleep pattern and positive attitude was also observed afater the practice of selected asanas, Anuloma viloma and Bhramari pranayama, Om recitation and Dhyana. am recitation has been found to be the powerful psycho-physiological technique for calming and relaxing the mind (Bhogal, 1993 and Gore, 1997). Dean Omish has proved that the heart diseases can be reversed and the bypass surgeries may be avoided when the patients follow the yogic life style. Improvement in cardiovascular efficiency due to one month yoga training was long back reported by Ganguly and Gharote, (1977). All these studies reveal that the yogic therapy has got a definite potential to heal the patients suffering from psychosomatic disorders due to its integrated approach.

Limitations of yogic therapy
Like any other therapy yoga therapy also has limitations. Truly speaking, we should consider it as a supporting therapy, which would help the healing process. Patience, experience, skill and zeal are very much required while treating various patients particularly the neurotics and the heart patients. Proper selection and application of yogic practices is very important. In case of patients of hysteria, psychosis and endogeneous depression, yoga therapist should not, normally, use yoga theraphy. In case of diseases like leprosy, cancer, malignant tumors, fibrosis, fractures, and severe structural or pathological changes, the yogic therapy is not advisable as a treatment but is definitely helpful to modify person's outlook towards the disease. However, yogic therapy is most effective in cases of psychosomatic diseases as mentioned earlier. It is an excellent preventive regime.

Supporting therapies
1. Observance of principles of Astanga Yoga
Patanjali Muni has recommended observance of Yamas and Niyamas of Patanjali for cultivation of correct mental attitude of the individual in relation to the self and with the society respectively and culturing the emotions. Eight fold approach of Patanjali brings about necessary changes in the mind body complex and its harmony.

Yamas include Ahimsa (non injury at the physical, mental and intellectual level), Satya (speaking and following the truth in all actions), Asteya (not taking the things which belong to others), Brahmacharya (not only celibacy or control in sex but also indicates interest in every aspect of education and to have balanced outlook regarding the success and failure in life) and Aparigraha (avoidance of unnecessary hoarding of objects).

Niyamas include Shauch (cleanliness at physical, mental and intellectual levels), Santosh (contentment in the present situation), Tapa (physical austerity and intellectual discrimination between what is good in the long run and the objects which give only temporary pleasure), Swadhyay (personal experience about the structure and functions of the body, as well as self study related to spiritual matters) and lshwar pranidhan (offering all the credit to the almighty for one's achievements).

Our body has got energy in three forms. Jnana shakti (wisdom power), Kriya shakti (work power) and Ichchha shakti (will power). Asanas release and divert the energy from our upper and lower extremities to the internal organs in our abdomen, chest and brain. Asanas distribute this energy as per priority basis. This is achieved by raising the hands and legs from the ground or folding them together without a rise in pulse rate. The extra energy, produced by our internal organs is returned to our extremities during the relaxative asanas resulting in the increase of the endurance power of their muscles. Asanas are mainly centered upon the spinal column. This improves the conduction of neural impulses to the muscles, as well as, the blood supply to the spinal column. Increased blood supply provides adequate nutrients to all the muscles and joints and at the same time removes the toxins effectively. Alternate contractions and stretching of various muscles during cultural asanas give rise to alternate positive and negative pressure changes that stimulates various endocrine glands. A normal belief that a particular cultural asana is useful for a particular psychosomatic disorder is based on the wrong assumption that only a specific part of the body is affected by a specific asana. This however is not true as the benefits of asanas are collectively received by all the parts of the body.

Pranayama controls the energy supply to all the parts of the body with the help of voluntary regulation of the breathing. It balances and produces psychophysiological relaxtion by minimizing the tensions, leading to a stress free condition. Regular practice of pranayama not only improves breathing efficiency or capacity, co-ordination between CNS and ANS, concentration, will power and self- confidence but also strengthens the immune system. Pranayama reduces instability of mind, increases tolerance and patience in the practitioner that helps the healing power. Practice of pranayama leads one to Pratyahara. Here one learns the non-attachment with the usual sensory inputs which otherwise are quite troublesome.

Meditation increases the inner awareness. It develops a proper witnessing attitude by which one learns to accept the reality. It reduces the stress by tranquilizing the mind. It improves the mind - body coordination. The regular practitioner experiences the calmness, freshness and a feeling of well being throughout the day. This keeps one away from all the negative thinking and dwelling into the past incidences. Meditation increases the will power and rational thinking.