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Yoga Therapy for Chronic Diseases: Psychosomatic Aspects

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Ananda Balayogi Bhavanani Meena Ramanathan

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 “Role of Yoga in Prevention, Management and Rehabilitation of Chronic Diseases”

YOGA THERAPY FOR CHRONIC DISEASES: PSYCHOSOMATIC ASPECTS

Dr Ananda Balayogi Bhavanani111and Dr Meena Ramanathan2 12

Introduction:
Chronic disease is something that lasts for a long time, generally three months or
more or for a lifetime and that which cannot be usually prevented by vaccines or
cured by medication. People with these diseases have a general misconception that
they are free from the disease when there are no symptoms. Healthy diet, regular
exercise, avoidance of negative habits by cultivation of the positive habits and a
healthy lifestyle can help us to prevent or postpone the onset of chronic diseases.

Important psycho-social aspects of Chronic Diseases:

 Non-Curable: In general, the disease can be kept under control so that the
further complications could be prevented but there is usually no known cure.
 Indefinite medication: Medicine controls and suppresses the symptoms, but not
address the psycho-social issues related to that. It should be taken regularly,
which might restrict the individual’s social activity. Increasing costs of the
medicines must be taken into account. Accessibility and availability as well as
the cumulative side-effects of long-term use of the medicine need to be
considered. As the disease progresses, the dosage of the medicine needs to be
adjusted and increased and the equivalent side-effects of the medicine also
increases exponentially.
 Quality of Life (QOL) and self-esteem decreases as the individual often start
comparing themselves with the others around.
 Self-confidence decreases along with diminishing hope (which is the most
important quality that inculcates interest and meaning for life and living).
 Increased stress causes autonomic imbalance. Sympathetic over-activity and
parasympathetic under-activity potentiate catabolic breakdown and
degeneration.

Components of Yoga therapy:

It needs to be well understood that the effect of the Yoga practices is more on the
mind and that the body learns to respond appropriately to signals from the mind.
Yoga tradition conceptualises ‘Adija Vyadhi’ as given in the Yoga Vashishtha,
wherein the concept of diseases is said to sprout from the mind (psyche) which is
‘Adi’ and percolates into the body as ‘Vyadhi’, the disease. Yoga is commonly
understood as a practice that is physically beneficial, while it is concerned and
related more with the mind than the body.

1 Director, CYTER, Sri Balaji Vidyapeeth, Puducherry. yognat@gmail.com

2 Deputy Director, CYTER, SBV, Puducherry.saineema@yahoo.com
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IDY National Seminar-cum-Workshop at SBV, Pondicherry 2017

Any sign of disease manifested in the body is a DADA is a formula which

result of a mental imbalance or an unhealthy explains the psychological
attitude. Mental balance produces physical plight when someone is
balance and vice versa too. (1) diagnosed with a chronic
To quote Dr Steven F Brena, “Yoga is probably ailment. The technical terms
the most effective way to deal with various and reports frighten them.
psychosomatic disabilities along the same, Fear and anxiety make them
time-honored, lines of treatment that lose their innate sense of ease
contemporary medicine has just rediscovered (Sukhasthanam) and they end
and tested. Asana-s are probably the best tool to up in a state of dis-ease
disrupt any learned patterns of wrong (Duhkha).
muscular efforts. Pranayama and Pratyahara are  Denial: The person denies
extremely efficient techniques to divert the the condition. ‘It cannot
individual’s attention from the objects of the be true, especially not for
outer environment, to increase every person’s me’. They check and
energy potentials and ‘interiorize’ them, to double-check the reports
achieve control of one’s inner functioning. and take umpteen
Moreover, in restoring human unity, the Yoga opinions with many
discipline is always increasing awareness and consultants.
understanding of ourselves, adjusting our
 Anger- When diagnosis is
emotions, expanding our intellect, and
confirmed they get angry
enabling us not only to function better in any
with everyone and even
given situation, but to perform as spiritual
the creator has no escape
beings with universal values.” (2)
from his wrath. ‘Why
Yoga helps restore harmony of psycho-neuro- me?’ ‘Why only me?’…
immuno-endocrine (PNIE) systems, by
 Depression: Subsequently
resetting and fine-tuning the interconnectivity
when the psychic clutter
between these systems. The initial command is
settles down, they begin
initiated by hypothalamus to pituitary to
to understand there is no
adrenals to combat the situation and need of
escape and sinks into a
the hour. While modern science looks outward
state of depression
for the cause of all ills, a practitioner of Yoga
followed by withdrawal
searches the depth of his own self.
from society and friends.
Yoga works towards restoration of normalcy in
 Acceptance: When they
all systems of the human body with special
finally decide to accept
emphasis on the PNIE axis. In addition to its
the problem and face it
preventive and restorative capabilities, Yoga
with courage, healing
also aims at promoting positive health that
happens. (Acceptance is
helps us tide over health challenges.
not in the form of passive
This concept of positive health is one of Yoga’s resignation, but in the
unique contributions as Yoga has a preventive, form of the undertaking
promotive and rehabilitative role in the health- of a dynamic resolute
care of common man. It is also inexpensive and decision to progress and
can be used in tandem with other systems of make the best efforts
medicine in an integrated manner to benefit towards health).
everyone. (3)

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 “Role of Yoga in Prevention, Management and Rehabilitation of Chronic Diseases”

Techniques adopted in Yoga:

Asana-s are physical postures that steady the entire body through different
positions held in a steady and comfortable manner without strain. Physical balance
and a sense of ease within oneself enhance mental/emotional balance and enable
all physiological processes to function in a healthy manner. Physical body is the
storehouse of lifetimes of patterns and habits. Asana is the perfect catalyst to help
us overcome our self-defeating tendencies and renew ourselves mentally,
emotionally and physically. Asana then becomes a way to explore mental attitudes,
strengthen will-power and to create a healthy balance between material world and
spiritual experience. (4)
Asana-s build up proper tone in the muscles and the vital organs function well as a
result of improved tone. Asana-s nurture and culture the health of the spine by
bending forward and backward, twisting sideways and stretching laterally which
constitutes part of their regular practice, enhancing the sensory and motor
connectivity between the brain and the rest of the body.
Intra-abdominal pressure changes are observed during the practice of Asana-s such
as ‘Pawanmuktha Asana’. The internal organs get a good massage thereby improving
the blood as well as the energy flow in those regions. Similarly the intra-thoracic,
intra-pelvic and intra-cranial pressure gets altered with different practices, creating
a thorough change in the dynamics of the circulation of blood and energy flow
thereby enhancing body’s capacity to withstand stress, deal them by changing the
approach to the problem and ultimately invigorates healing to occur. Hence the
self-healing triggers a sense of wellbeing too as health also include the state of
wellbeing and not just a bunch of biochemical values. This in turn leads to reduced
dosages of medicine, reducing the side effects and complications due to that.
Asana-s, the static stretching postures in Yoga are isotonic and isometric in nature;
thereby they are non-strenuous, non-fatiguing and can be performed comfortably
by all. The shortened muscles are stretched gradually and pain in joints is reduced
along with an improvement in the range of movement and mobility on the whole.(5)
Slow, conscious controlled breathing in Pranayama helps in adjusting and activating
the circulatory-respiratory complex of the body. It also provides them emotional
stability. Purificatory processes called Kriyas help in removing imbalances in
various secretions of body. Yoga improves control over autonomic mechanisms
though various breathing patterns that manipulate and generate energy leading to
enhanced emotional stability. The mind and emotions are related to our breathing
pattern and rate and hence slowing down of the breathing process influences
autonomic functioning, metabolic processing as well as emotional response.
Yoga practices help focus mind positively on activities being done, enhancing
energy flow and resultant healthy circulation to different body parts and internal
organs. Where the mind goes, there the Prana flows (Yatho Manah; Tatho Prana)
resulting in a calm internal environment that in turn enable normalization of
homeostatic mechanisms. Yoga is all about regaining balance or Samatvam at all
levels of being. The practice of focus, concentration (Ekagratha-Dharana) and
meditation in any form reduces the feeling of loneliness and provides peace of
mind. Emotional upheavals no longer exist. Directing attention to various parts of

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IDY National Seminar-cum-Workshop at SBV, Pondicherry 2017

the body during relaxation helps improve blood flow to the area being
contemplated upon thereby facilitating healing. All traditional texts emphasise that
regular practice of Yogic techinques bring beneficial results to one and all. (6)
Synchronisation of breath and bodily posture harmonizes the flow of energy in the
individual, thus creating a fertile field for the evolution of the spirit. Yoga teaches
the practitioner to align the five main sheaths of existence- the body, breath,
emotions, intellect and spirit, so that one’s own Prana can heal, connect and unite
the disintegrated individual thereby creating a chance for the bounce-back to
happen through the re-integration of the fragmented individual.
Relaxation: Relaxation of the body-emotion-mind complex through physical and
mental techniques enhances our coping ability in responding to external and
internal stressors. Yoga as an adjuvant therapy in chronic diseases, promotes
patient compliance. The sympathetic overload is decreased; the allostatic load on
the patient’s systems is reduced, thereby enhancing the vagal tone resulting in
normalizing of autonomic activity. As a result, anabolic regenerative environment
is built up, improving the physiological functioning which promotes emotional
stability. A balanced equilibrium between the sympathetic and parasympathetic
wings of the autonomic nervous system leads to a dynamic state of health. (1)
Relaxation is a key element of any Yoga therapy regimen and must not be forgotten
at any cost. Shavasana has been reported to help along with practices such as Savitri
Pranayama, Chandra Nadi Pranayama, Kaya Kriya, Yoga Nidra, Anuloma Viloma
Prakriyas and Marmanasthanam Kriya can also be practiced by anyone requiring this
state of complete relaxation. It is important to remember that relaxation on its own
is less effective than relaxation that follows active physical exertion.
Self-confidence and internal healing capacities are enhanced through cultivation of
right attitudes towards life, moral-ethical living through Yama-Niyama and various
Yogic psychological principles. Faith, self-confidence and inner strength are most
essential if at all we wish for healing, repair, rejuvenation and re-invigoration.
Increase your self-reliance and self-confidence: Life is full of challenges that are
there only to make us stronger and better. The challenges should be understood as
opportunities for change and faced with confidence. We must understand we have
the inner power to overcome each and every challenge that is thrown at us by life.
Yogic Diet: Yoga fosters and promotes proper w-holistic values of a proper diet.
Yoga can help a person to learn the right attitude towards food as well as
understand concepts based on the Trigunas and Tridoshas for better health. Yoga
teaches us that the cause of most disease is through under (Ajeeranatvam), over
(Atijeeranatvam) or wrong (Kujeeranatvam) digestion. Yoga also teaches us about the
approach to food, the types of food as well as the importance of timings and
moderation in diet (Yuktha Ahara).
The great Tamil poet-saint Thiruvalluvar (7) offers sane advice on right eating when
he says, “He who eats after the previous meal has been digested, needs not any
medicine.” (Marunthuena vaendaavaam yaakkaikku arundiyathu atrathu poatri unnin-
Tirukkural 942). He also says that life in the body becomes a pleasure if we eat food
to digestive measure (Attraal alavuarinthu unga aghduudambu pettraan nedithuuikkum
aaruTirukkural 943). He also invokes the Yogic concept of Mitahara by advising that

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 “Role of Yoga in Prevention, Management and Rehabilitation of Chronic Diseases”

“eating medium quantity of agreeable foods produces health and wellbeing”

(Maarupaadu illaatha undi marutthuunnin oorupaadu illai uyirkku –Tirukkural 945).
Importance is given to keep up the hydration levels of the body. Sprouts (bio-genic
in nature) have an important role to play in regeneration of the body-mind-emotion
complex. Raw diet is emphasised (40% of the meal should be raw, uncooked food,
says Swami Gitananda Giri) and consumption of seasonal and local vegetables and
fruits is also advised.
Lifestyle modifications: Yoga helps patients take their health in their own hands.
They learn to make an effort and change their life style for the better so that their
health can improve. Yogic diet, Asanas, Pranayamas, Mudras, Kriyas and relaxation
are an important aspect of lifestyle modification. To live a healthy life it is important
to do healthy things. Yoga places great importance on a proper and healthy lifestyle
whose main components are Achar (healthy activities on a regular basis), Vichar
(right thoughts and attitude towards life), Ahar (healthy, nourishing diet), Vihar
(proper recreational activities to relax body and mind) and Vivahar (right way to
relate with people).
Adoption of right attitudes: Shraddha (faith, conviction) and virya (strength,
courage) are important qualities fostered by Yoga. The practitioner gains the
conviction that he can heal himself by regular and dedicated practice which triggers
and encourages strength in the practitioner to do the practices and face the
challenges with courage. He is able to oppose and resist the loss of hope. The
concept of acceptance can be related to complete surrender as Ishwara Pranidhana.
Yoga teaches us to untie/ untangle the knots that make us identify with our
suffering. Acceptance is not just a skill or an attitude. It is our contact/connection
with the clear core of egoless awareness behind our individual personalities. It’s the
attitude of deep acceptance that let us experience the inevitable hardships and
disappointments of life without resistance, without constantly wishing that things
were different. An in-depth assessment helps understand what can be improved
/changed and what cannot be. Even when conditions can’t be changed, it can be
explored in terms of attitudes and perspective, learning to live in the present
moment is an opportunity for self-growth.
Discernment or Viveka guides us to make the very subtle decision about things that
we value that makes us happy, without any subjectivity. According to traditional
yogic philosophy, Viveka is a quality of the Buddhi, the higher mind operated by the
three Shaktis, which decides what is of value and what is not. Discernment induces
awareness and clear insight that precedes thoughts and emotions. Most of us carry
loads of emotional baggage that makes it hard to discriminate the Vital Self within
so many layers of thoughts and feelings. Yoga successfully helps peel away the
layers around our basic awareness.
Yoga is the conscious path of breaking-free from the old conditioning subconscious
tendencies and patterns (Samskaras and Vasanas) that get us nowhere. Yoga
promotes the skill of stepping beyond one’s limitations to step-up by self-
transformation through qualities such as insight (Antardrishti), empathy and the
ability to calm and focus the mind (Ekagratha), ultimately transcending individual,
and self-limiting traits. To undo the inner knots, to remain calm in times of

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IDY National Seminar-cum-Workshop at SBV, Pondicherry 2017

adversities, it is essential to find out who we really are, and discover how to work
with everything that happens to us.
The explosion of stress-related health concerns has affected society in such a way
that the medical profession has related most of our physical ailments to stress.
Stress is omni-present and we can attempt to reduce the stress levels by change in
attitude and proper perception and also through adopting yogic qualities such as
forgiveness (Kshama), and generosity. Gratitude is one of the basic requisites of
contentment and stress resilience.
If we are able to learn from our mistakes (rather than deny them), see obstacles as
challenges, that is when we stop simply existing and truly start living qualitatively.
Even when conditions can’t be changed, it can be explored and endured in terms
of changing attitudes and perspectives. Learning to live in the present moment is
an opportunity for self-growth.
Advantages of group sessions: A group session of Yoga is a big motivation that
helps one to enhance their skills and overcome individual limitations. When they
interact with people of their own age and caliber, their problems and pain seems
insignificant in comparison to that of others. Group session is a therapy on its own
as it enhances the meaning and purpose of their lives. For an individual in this state
of mind, the group yoga sessions step in as a great therapeutic tool. It enables them
to come out of isolation thereby strengthening the social health which facilitates self
enhancement. (8)
Research evidence is building slowly but steadily: Many studies have reported
positive significant changes in the qualitative aspects that are deeply embedded
with the Yoga practices. Yoga appears to have very good potential for impacting
multiple aspects of health and well-being such as the physical, mental and social
aspects of health and quality of life which are interdependent. (9) Interventions that
are more holistic and comprehensive can address multiple aspects of health and
well-being at the same time. (10,11) Although a variety of behavioural interventions
have been linked to aspects of improved health, mind-body interventions such as
Yoga may produce broader changes and impact multiple health outcomes
simultaneously. (12)

Conclusion:
Yoga is an applied science that re-establishes the lost balance in the human affairs
caused by the one-sided growth of science helping us to overcome its shortcomings
by enriching our mind. Yoga is known as the goal as well as the means to attain
undisturbed state of consciousness which obviously is a long journey, but every
step on the path covers some distance. With the adoption of a proper attitude and
lifestyle through the Yogic way of life, we can rise above our own expectations and
can blossom with creativity and fulfilment. Enhancing the social health and
spiritual connectivity, enables the empowerment of the individual. The problems
and stresses of life seem smaller and negligible due to change in perspectives and
attitude and challenges are easier to combat. Yoga is beneficial in prevention and
control of common health and emotional problems that are linked with old age. It

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 “Role of Yoga in Prevention, Management and Rehabilitation of Chronic Diseases”

helps elderly to become more in touch with them-self and their body, enabling them
to accept who they are and the state they are in (accept their individual short
comings and limitations) which improves gaining a positive outlook and approach
in life. The miracles of modern medicine, improved diets, better living conditions
and awareness help people maintain their physical health, fitness and promote
vivacity in their lives. “Yoga may not be able to always cure but it can surely help
us to endure”. It helps to address the problem by bringing about a change in the
attitude and hence the problem is dealt with absolute positivity and optimism. Self-
esteem and self-confidence grows exponentially; as the whole purpose and goal of
yoga therapy is to ultimately empower the individual.

References:
1. Bhavanani AB. Yoga Chikitsa: Application of Yoga as a therapy. 1st ed.
Pondicherry, India: Dhivyananda Creations; 2013.
2. Brena Steven F. Yoga and medicine. Penguin Books Inc. USA. 1972.
3. Bhavanani AB. Yoga in health care. Annals of SBV 2012; 1 (2): 15-24.
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2007
5. Ramanathan M, Bhavanani AB, Trakroo M. Effect of a 12-week Yoga therapy
program on mental health status in elderly women inmates of a hospice.
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Venkateswara Nagar, Saram, Pondicherry-13.2007
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