Amy Weintraub is the author of the book “Yoga Skills for Therapists: Effective Practices for Mood Management” and the founder of the Lifeforce Yoga Healing Institute. She is a pioneer in the field of yoga and mental health and has been studying the mental health benefits of yoga for more than 20 years. The following interview has been edited for clarity and length.
In your book, “Yoga Skills for Therapists,” you share a bit about your own experience with anxiety-based depression and the role that yoga played in your recovery. Can you expand a bit on that for us?
I had been meditating for many years, and suffering from an anxiety-based depression. Although when I meditated I felt better, the anxiety was still not something I was able to control without medication.
When I began a physical practice, which included pranayama yogic breathing, I not only recovered, but felt really good for the first time in my life. Meditation was difficult for me because of my rumination and anxiety, but when I did the resting pose at the end of yoga practice I found that I was in a much calmer state.
Though meditation was challenging in the beginning, it became easier after I used my body and breath to bring myself into a place from which I could meditate.
I became a yoga teacher because I wanted to deepen my own experience of the miraculous transformative effects of my own yoga practice. My first training was a month-long immersion at Kripalu Center. I finished the program and was really excited about teaching and sharing what had literally saved my life with others.
I began to collaborate with researchers, write articles, including the first article on yoga and mental health for Yoga Journal in 1999 called “Yoga: The Natural Prozac.”
From there, I began to think about writing a book, interviewing people and doing more research. I found that the most efficacious aspect of what we do in yoga does not necessarily require a yoga mat. What it requires is an ability to breathe, and to sit straight.
So I continued my studies in-depth into yogic breathing practices, or pranayama, and practicing with the vibration of sound and of tones and kriya breathing practices, which are cleansing breathing practices, contraindicated in some anxiety conditions and bipolar disorder I and not appropriate in clinical settings.
When you talk about yoga, it’s clear that you’re not just talking about doing poses, or asana. What are some of the ways clinicians can bring yoga into their work without actually having patients get on a yoga mat?
The practices that we teach in the LifeForce Yoga Healing Institute trainings are appropriate for clinical medical settings and don’t require a yoga mat. They are ancient practices that we have adapted mostly in terms of language so that the person who is yoga-naive or even resistant to the idea of doing yoga in a clinical setting will more easily embrace the techniques.
They’re ancient techniques, with new names.
For example, for patients with upper chest breathing, which is a characteristic in both anxiety and depression, we emphasize something that’s called anuloma and viloma krama, but we call it stair step breath.
Simply stated, at the patients’ pace, we ask them to inhale in little steps, through the nostrils, as though they’re climbing a mountain. And then with the exhale, they slide slowly down the mountain. This helps people deepen the breath.
Most folks who practice yoga are familiar with yogic three-part breath, which is an instruction to breathe down to the bottom of the lungs, mid section and then upper chest. The problem is if you introduce this practice to someone who is unable to breathe deeply, they may fail.
You’re introducing something that your client might not be able to do, so right away you’re creating failure. If, on the other hand, a patient is able to breathe deeply, but they are habitual upper chest breathers, they’ve been upper chest breathers for a reason: they’ve been tamping down and repressing a lot of emotion.
So if in your very first session, you get an upper chest breather to breathe deeply, there can be emotional flooding. When there’s an established therapeutic relationship and the client feels safe, that can be cathartic, but in the initial session such a release can be scary.
So therapists can use yoga skills in therapy to help people self-regulate, focus and have greater access to feelings, but they don’t need to roll out a yoga mat in order to do so.
As mentioned earlier, there are many different breath practices that meet the client where they are, and there are mudras — hand gestures that can be done while sitting in a chair — which can stimulate cranial nerves, bring energy into the brain and impact where the breath is landing in the body.
Also, the use of bhavana can be effective in therapy. This is a mental image that is not just in the mind but is a visceral, felt sense that arises from the patient’s own experience and memory. For example, an empowering or calming image may evoke in the client attributes like self-acceptance and self-compassion.
Another practice from yogic tradition that therapists can find useful is the setting of intention or affirmation that arises from the clients own body-mind. A therapist might ask a client before doing any yoga training, “why are you here today?” But if the client’s mind is very busy, intention will be harder for them to access than if you do a little breathing, hand gesture or imagery practice first to clear the space.
After leading a brief practice, you cue to direct sensation of being in the body—perhaps a tingling feeling in the palms. Because the body is always present, you bring the client into the present moment. From this place with eyes remaining closed, you can invite them to allow an intention for their session with you to reveal itself. Now, you’re much more likely to get a clear, focused intention and the work of therapy can go much deeper, much faster.