Bridging Yoga and Mental Health Care: A Personal Approach

I was interviewed by Rob Schware and this interview was posted on Huffington Post yesterday. That is really awesome. I feel proud and happy seeing the end result.

Please read the interview down here or at the place of origin by clicking here.


2014-05-21-AnnekeSips.jpgThis is an interview with Anneke Sips, a yoga teacher and social psychiatric nurse (RN) from Amsterdam, the Netherlands. For the last 16 years she has been working in the field of psychiatry; she started teaching yoga eight years ago. She studies with TKV Desikachar’s son and the Mohan family — both in the tradition of Krishnamacharya .


Rob: What originally motivated you to do this work, and what continues to motivate you?

My own experience is the best motivation for me. Yoga always helped me through the waves of life. Since I found yoga, my dream was to connect my passions (yoga and psychiatry). However, I wasn’t sure how, and I wasn’t verbally strong enough to convince the psychiatrist of the ward where I worked then, who was against the idea. I couldn’t get this out of my head. Then, early in 2010, I decided to go to Rwanda with Project Air to teach yoga to traumatized people with HIV. I volunteered for three months. After all I saw there, I was more motived than ever to bring yoga into my work. Knowing the challenges in bringing this mind-body approach into a medically-oriented space, I felt the need to study more, and to find people to build community. I started a network on LinkedIn, and in 2010 I organized the first Yoga & Mental Health Sangha for all who are interested in the field of yoga and mental health in Amsterdam. Since then, twice a year we meet with the community to talk, share, inspire, and connect. May 2014 is the next Sangha in Amsterdam.

2014-05-21-teaching_rwanda.jpgIs there a standout moment from your work in Rwanda?

When I was teaching there for Project Air, there wasn’t a beautiful yoga studio to be found. The people didn’t know about yoga before Project Air came. They had no preconceptions. They just practiced and it felt good! One experience: I taught in an empty, dusty little church on a hill. Once, we were locked out of the church, so we sat on the yoga mats under a tree in front of that church while I told them about the origins and philosophy of yoga. Then I asked for their experiences. One by one they began to talk about what yoga does for them. They said that they were able to sleep through the night since the genocide in ’94, now that they practice yoga. “I feel my body again,” said another, squeezing her own hands and arms. “I have less trouble with the side effects of my HIV medications.” “I feel happier.” The stories went on and on and they recognized each other’s experiences. When I think back to this afternoon under that tree, I still get tears of joy in my eyes: the true nectar of yoga!

What did you know about the population you are working with before you began teaching?

I am experienced in working with people who have chronic psychiatric illnesses. Most of my patients suffer from a psychotic disorder, in combination with drug abuse and trauma. But also we see many stress- and anxiety-related issues, depression, and personality disorders.

What are two distinct ways that your teaching style differs from the way you might teach in a studio?

In a trauma-sensitive class, or working with any population in mental health care, I would not — or rarely — touch somebody or give physical adjustments. I don’t want to trigger them and make the yoga session unsafe. This made me re-think my touching in a regular class too. Also, in my experience, teaching special populations requires a more personal approach than general teaching in a studio.

How has this work changed your definition of yoga and your practice? Your definition of service?

As I said, when teaching special populations, I create a more personal approach by teaching them one-on-one or in small groups. I think this personal approach is important, also in a regular class. Everyone is different and yoga has so many great tools that can assist every person in any challenge or at any stage of life. In my studies and practices I am diving deeper into the philosophy of yoga; yoga is a part of my life, rather than an asana practice on my mat. I feel like unraveling my practice into the unknown, off the mat; it’s a place where stillness appears, and growth and transformation are possible.

Since I use yoga in my work, I observe people and have become a better listener as a nurse, too. I have become more mindful, and see the self-healing qualities in my patients better. It helps me to “sit in my hands” more, which empowers the patients, help them trust their body signals and intuition again. It’s de-stigmatizing to support them to help themselves. What society sometimes thinks of as the “weak ones” I see as the strong ones — survivors in tough circumstances.

What has been the greatest challenge in your teaching experience, and what tools have you developed for addressing these? What advice would you give to anyone who is going to teach in the population you work with?

A great challenge is bringing yoga as a therapy (not just an activity) in a medical setting. I approach this professionally, but follow my intuition and heart. I advise to “walk the talk” and use good research on yoga. Set up a plan and evaluate. Study, practice, and research gave me the confidence to start the discussion. The community is helpful here for reflection.

Self study and practice, experience, right intentions, observation, and compassion are needed to grow as a teacher/therapist. I think whoever wants to teach specific populations should learn about them. I believe yoga is a safe practice to teach, if you know what you are doing, and have the skills to avoid triggering trauma.

What are some of your hopes for the future of “service yoga” in the next decade?

I hope that yoga becomes an evidence-based practice that will show up in the guidelines of treating mental illness. I hope that yoga teachers and therapists stay true to the yoga teachings, and keep the Yamas and Niyamas in mind, so that practices result in peace of mind.

Editor: Alice Trembour
Images: Courtesy of Delight Yoga Amsterdam and Anneke Sips



The (Dutch) Week of Psychiatry 2014

Anneke Sips, Amsterdam

The next Week of Psychiatry is from March 24 – 30th 2014. This 40th edition has the theme ‘Being owner of your own life!’. The basic principle is that people with mental health problems are as much as possible, directing their own lives.stigma 364px

The underlying question is what these people can do themselves to gain this ownership (again)? What can they do themselves to address their social responsibilities and role(s) in society and participate as citizens? Restoring you do yourself basically , but often in collaboration with others. And that leads to the question: What facilitating role can, or should, play the other? Family, social workers, friends, neighbors, police, doctors, churches , health insurers…. Yoga therapists? The Week of Psychiatry 2014 focuses specifically on this group. This all within the context of the governmental changes within and around the care of a participative society .

If you like to know a bit more about the history of the Week of Psychiatry in Holland, click here.

In my role as a Dutch health care worker (RN) I have strong ideas about how we should ban Stigma out of our work climate. Also we as health care professionals, or maybe: especially us health care professionals are should be very aware of this. I see it happen over and over and over again that psychiatrist or other workers think FOR the patient and are not really listening so well. It takes away the power of a patient who becomes weaker. Some facts about stigma:images

  • Stigma may be described as a label that associates a person to a set of unwanted characteristics that form a stereotype.
  • Stigma may affect the behavior of those who are stigmatized. Those who are stereotyped often start to act in ways that their stigmatizers expect of them. It not only changes their behavior, but it also shapes their emotions and beliefs.Members of stigmatized social groups often face prejudice that causes depression. These stigmas put a person’s social identity in threatening situations, like low self-esteem. Because of this, identity theories have become highly researched. Identity threat theories can go hand-in-hand with Labeling Theory.
  • In Unraveling the Contexts of Stigma, authors Campbell and Deacon describe Goffman’s universal and historical forms of Stigma. One of the kinds of stigma is: Known Deviations in Personal Traits – being perceived rightly or wrongly, as weak willed, domineering or having unnatural passions, treacherous or rigid beliefs, and being dishonest, e.g., mental disorders, imprisonment, addiction, homosexuality, unemployment, suicidal attempts and radical political behavior.
  • Members of stigmatized groups may have lower self-esteem than those of non-stigmatized groups.

How can we help them? First: create awareness and…. STOP STIGMATIZING! I created lots of awareness and learned much about how to do this in the LEAP training by Xavier Amador. How to build relationships with clients. How to really listen. How not to think ‘we know everything better’ as a mental health care professional. How to work at common ground on a solution the person you work with prefers. It’s empowering! Think well about how someone can be the owner of their own life again!stigma bpd

As a yoga teacher/ therapist we should also be mindful about this too. Do you label yourself? Others? What about a yogi from another tradition? Do you ever decide what is ‘good yoga’ and what is ‘bad yoga’? A good or bad yogi perhaps? Do you think of fellow yogi’s as weak willed or with rigid beliefs? Being dishonest or untrue? Could you judge this? Non-judgent can be a practice too!

• Yoga Therapy is a self-empowering process, where the Care Seeker is responsible for his/ her healing process.
• Yoga Therapy is taught in an individualized one-to-one setting .
• Yoga Therapy is multi-dimensional in its approach, often utilizing many tools of Yoga
• Yoga Therapy is based on the individual’s needs
• Yoga Therapy is context sensitive, respecting the stage of life, occupation, ability and other parameters of the individual
• Yoga Therapy is an evolving process, not an instant solution
• Yoga Therapy is a collaborative and complementary system of self health care


Yoga is an ancient, self-empowering practice that utilizes a wide range of tools to enhance well-being and to maintain and restore health. I want to teach people to let go of expectations and fear and learn from their own direct experiences, make contact with their intuition and trust (and Love) themselves (again). I don’t believe in changing people or ‘fix’ them, but rather help them find their own true nature and healing. This counts actually in both my work as a social psychiatric nurse as well as being a yoga teacher/ therapist.

“Yoga, as a way of life and a philosophy, can be practiced by anyone with inclination to undertake it, for yoga belongs to humanity as a whole. It is not the property of any one group or any one individual, but can be followed by any and all, in any corner of the globe, regardless of class, creed or religion.” – Sri K. Pattabhi Jois

In both Yoga and social psychiatry our work is based on connection. Connection within yourself but also the connection with the world outside one self. With others. In social psychiatry we learn that you cannot see the individual separate from the context. Then again, what facilitating role can, or should, play the other? In mental health care? And what facilitating role can play the teacher of yoga? These are very interesting question to think of. And I Love to invite you all to talk about this in the next Yoga & Mental Health Sangha. Do you like to connect with like-minded people to discuss this more? Please leave a message if you like to be invited too!! Because our great teacher Desikachar quoted:

“With the right connection – beautiful things can happen.” – T.K.V. Desikachar

With Love,


Invitation and news

Sangha Yoga & Mental Health.

a free network meeting

In 2011, I started to organize meetings. I met people from different professional fields/ disciplines and yoga lineages, but we all had in common that we agreed that yoga could be great to add to existing therapy to the patients in Mental Health care. During these meetings there is room to exchange knowledge and to network.

With this INVITATION: join for free! Please send an email if you are planning to come.

  • When: Thursday September 12th 16.00u – 18.00u
  • Where: Delight Yoga location Weteringschans 53, Amsterdam (the beautiful 1st floor room)

On request a special edition: We will talk about Trauma Sensitive Yoga. So, please join when you did a training on this subject and share experiences (maybe match up with others?)

  • Did you manage to set up a (Trauma Sensitive) Yoga class?
  • Did you manage to set up a yoga class for another special population?
  • How did you do this?
  • What are difficulties in setting up such yoga classes?
  • How did training by David Emerson help you (or another training)?

Please join the network on the Facebook-group if you were ever at one of these meetings before. Let’s make this network more useful this way.


I’ll give a talk about Yoga and Social Psychiatry on September 19th ’13 in Amsterdam at the ‘SPV Regiobijeenkomst Amsterdam’. Join for free! (limited spaces). Click here for info. And click here to get tickets directly.

Another talk will be on October 31st at GGZ Noord Holland Noord. The subject will be Yoga and the Social psychiatric treatment of PTSD.

Yoga Magazine.

Please check out the new edition of the Dutch Yoga Magazine (number 3 – 2013) on page 54 and 55 to read about Yoga in Africa. An interview with me, Anneke.


This and more in the newsletter. To receive the newsletter and invitations and updates click here.

Yoga & Mindfulness may enhance PTSD treatment


July 19, 2013

Mindfulness interventions are safe, inexpensive and effective adjuncts to posttraumatic stress disorder treatment, according to Marina Khusid, MD, ND, MSA, who recently published an article on the subject in the July issue of Psychiatric Annals. The article is the last of a seven-part series on the use of complementary and alternative medicine in the treatment of PTSD.

Mindfulness-based approaches rapidly grow in popularity and are increasingly employed to treat a number of mental health conditions,” said Khusid, a member of the clinical faculty at the department of family medicine, University of Illinois at Chicago.
Marina Khusid, MD, ND, MSA Marina Khusid

In her article, Khusid explores four types of mindfulness techniques that have the most supportive evidence for their use: mindfulness meditation, mantram repetition, yoga, and relaxation response training.

Although the evidence base is not robust enough to recommend either one as a first-line treatment for PTSD, these techniques can be integrated with more traditional, proven interventions, such as cognitive-behavioral therapy.

According to Khusid, mindfulness encourages veterans to self-manage their care, shifting treatment responsibility from the clinician to the patient. Recent data suggest that self-help strategies have been effective in treating patients with PTSD and anxiety disorders.

Khusid said mindfulness encourages treatment compliance and helps alleviate symptoms associated with the disorder.

“Mindfulness-based interventions decrease avoidance behaviors and negative ruminative thought patterns, improve emotion regulation and impulse control, and encourage self-compassion and successful re-integration into civilian life,” she said.

Khusid mentioned that there are currently three times as many clinical trials of mindfulness interventions for PTSD registered with the federal government compared with 2010, indicating a growing interest in the field.

“Mindfulness-based approaches are acceptable in veterans and service members, safe, easy to learn, portable and cost-effective, with encouraging preliminary results in clinical and neuroimaging studies,” she said. “Engaging patients in a patient-centered collaborative care model through use of mindfulness approaches to self-manage their chronic mental illness may lead to increased levels of functioning, improved health outcomes, and decreased health care costs.”

Disclosure: Khusid reports no relevant financial disclosures.

extra: Meditation helps dealing with PTSD for African refugees.

Can Yoga play a role in the social psychiatric treatment of PTSD?

‘When the body speaks.’

Can Yoga play a role in the social psychiatric treatment of PTSD?

by: Anneke Sips

Background: Emotional pain and traumatic experiences long after the trauma has ended stored in the body. It is natural for man to survive and that the body and the mind reacts to danger and trauma. It is good to remember these dangerous situations so that they in the future can be avoided. However, the maintenance of stress in the body can also cause unpleasant side effects. According to the social psychiatric ideas, psychological symptoms are understood as a result of four levels of functioning (psychological, physical, social and individual) and patients diagnosed with Post Traumatic Stress Disorder (PTSD) can develop symptoms on all levels. However, there are indications that in the treatment of PTSD, the attention to the interaction of these four levels is lacking. Objective: To investigate what PTSD is and which (social-psychiatric) treatment should be offered. Examine how yoga relates to the four levels of functioning in social psychiatry and if yoga can be part of PTSD treatments. If yes; at what level and how to add value. implementation: A review of the literature on the effects of a traumatic event or yoga and a useful addition to treatment can be. Results: There is an emerging scientific basis are shown that yoga as a possible complementary treatments supports it, in patients with PTSD. Conclusions: There is sufficient evidence to yoga as to consider. additional treatment within the regular treatment provision This research offers opportunities for further development of yoga in the treatment of PTSD but also other psychiatric disorders such as for example psychoses.

keywords: trauma, PTSD, yoga, social psychiatry, psychiatry


From my practice as a yoga teacher, I thought yoga classes to women in Rwanda who are traumatized as a result of the genocide in 1994. I did this in 2010 for three months for a U.S. non-governmental organization called Project Air as yoga discipline within an ACT team with the aim relief of symptoms and thus a better quality of life. Professionally, as a community psychiatric nurse (hereafter referred to as SPV) in Amsterdam, I am also dealing with patients suffering from post-traumatic stress disorder (hereafter referred to as PTSD) and complex trauma.

In practice in the Netherlands I hear that patients like the Rwandan women complain that they don’t feel their bodies or even experience physical symptoms, loss of control over their feelings and body (not being able to sleep and relax whenever they want), depression and stress. This is no coincidence. Emotional pain and traumatic experiences are long after the trauma has ended stored in the body. Van der Kolk (1994) describes this as “the body keeps the score”.

It is natural, that humans want to survive and that the body and mind react to danger and trauma. It is good to remember so that these dangerous situations can be avoided in the future. However, the maintenance of a stress in the body can also cause unpleasant side effects as described above. Patients diagnosed with PTSD often experience symptoms at all four levels of function, but according to the literature on PTSD treatment I read there is little attention the four levels in its entirety (i.a. Jongedijk, 2008; Jongedijk, 2010). I wonder if yoga can play a role here. Can Yoga be used as a complementary method of treatment in the social psychiatric treatment of PTSD?

Theoretical findings defined.

PTSD, what is that?

The word ‘trauma’ literally means harm or injury. This can be physical injury, but another possibility is psycho-trauma. A clear distinction should be made between ‘ordinary’ unpleasant and stressful life events on the one hand and traumatic events on the other.

PTSD was introduced in 1980 in the DSM III and is classified among the anxiety disorders. To operationalize psycho-trauma clearly, a definition is included in the DSM-IV-TR (1994): “The person has been exposed to a traumatic event in which both of the following are applicable are:

  1. Person has experienced, witnessed, or was confronted with one or more events that involved actual or threatened death or serious injury itself, or posed a threat to the physical integrity of self or others.
  2. Responses to intense fear, helplessness or horror. “

According to the DSM-IV, patients with PTSD constantly relived the traumatic event. They are persistent in avoiding the stimuli associated with the trauma or suffer from numbing of general responsiveness, and this was not present prior to the trauma. They have persistent symptoms excitability, which was also not present prior to the trauma, the duration of the disturbance is longer than one month and the disturbance causes clinically significant distress or impairment in social, occupational, performance, or other important areas of functioning. These symptoms (immediately after a traumatic event) are regarded primarily as a normal reaction. They are manifestations of a imbalance that needs to be recovered. This acute stress reaction can be seen as a natural response, focused on survival (Gersons Olff 2002 through 2002). People have mental resilience and self-healing ability that is trusted in the first place. Each has its own processing. It only becomes dysfunctional when symptoms persist. Actually: PTSD so the stagnation of a normal process.

There are several factors that affect the mental (un-) health as shown in the dynamic stress-vulnerability model of White (2004). This model shows how a event in someone’s life, the characteristics of the individual and the environment together influence and thus influence the risk of mental health.

A large part of the world experiences one or more psycho-traumatic events during their life. The largest and most influential study include the prevalence of PTSD is the National Comorbidity Survey (NCS) ,carried out by Kessler (Kessler et al, 1995). This study found that about 61% of men and 51% of women had experienced a traumatic event. Fortunately, not everyone developed PTSD. The NCS (Kessler et al, 1995) found a PTSD prevalence of 7.8% of the total trial and PTSD occurs twice as often in women than in men (10.4% v. 5%). Co-morbidity with PTSD is also common, and it is rather norm than the exception (Kessler et al, 1995; Creamer et al, 2001). The disorders which are mainly present parallel with PTSD were abuse or dependence on resources (75%), generalized anxiety disorder (44%) and depression (20%). On an annual basis, according to the Nemesis research (2) 18% of the Dutch population suffers from psychological problems. At number two with 19.6% are the anxiety disorders (de Graaf, Dorsselaer & ten Have, 2010).

Symptoms of PTSD.
Reliving and active avoidance can be seen as quite specific symptoms in PTSD (Young Dijk, 2008). Other symptoms such as decreased interest, increased irritability and concentration problems, according Jongedijk (2008) are less specific and are strongly associated with depressive symptoms. Trauma symptoms that are not or insufficiently described in PTSD, but according to Jongedijk often present, include lack of resilience, confidence, problems with handling emotions and affects, re-traumatization, psychosomatic complaints and reduced physical health.

Psychosomatic symptoms have long been associated with trauma. At the end of the 19th century many physical complaints were described in traumatized patients (include sexually traumatized patients) by psychologists and psychiatrists as Freud, Janet and Briquet. Research shows that a having PTSD and traumatic experience may result in physical symptoms (Olff, 2002). It is stated that 70% of patients with PTSD has sleep disorders and are misunderstood because of their unexplained physical complaints (LOK in Dutch) (Jongedijk, 2008; Van Liempt et al, 1994). PTSD and co-morbidity of these (unexplained) physical symptoms require particular attention because of the potential impact this has the further course of the disease and functional limitations that it can give (Jongedijk, 2008; From Liempt et al, 1994). Olff (2002) describes (unexplained) physical symptoms such as fatigue, back pain, chest pain, palpitations, muscle pain, nausea, shortness of breath, dizziness, stomach and intestinal complaints etcetera. Often patients with LOK receive extensive medical examination, but do not get the proper treatment. This causes inconvenience and high costs. Both the patient and therapist are not satisfied with the treatment (Olff 2002). Finally, it is due to psycho-trauma clients can create lack of social support system. This social vulnerability may arise due to patients behavior.

PTSD from the perspective of the social psychiatric thinking.
From the psychiatric social vision a human is not seen in isolation from the context around it. Querido (3) explained that each man lives in an environment of forces and counter-forces. He was convinced that people have a large repertoire to respond to outside threats. Typical of the social psychiatric thinking is that the focus is on the interaction between the four levels of function (van der Padt & Venneman, 2010). These levels are:

  • The psychological level
  • The individual level
  • The social level
  • The physical level

At the physical level, it often happens that patients with PTSD psychosomatic complaints such as described in the preceding paragraph. According to Zwart (1998) PTSD symptoms are often physically experienced and presented. At the individual level it means that the experience and difficulty in processing of traumatic life events says something about the coping behavior, lack of resilience,psychological functioning and self-image in which a patient may have a feeling of disgust. The latter is according Jongedijk (2008) something common in PTSD. Just as fear, disgust and pain can provide protection. Sometimes, the disgust is so extreme that it is no longer functional. This can lead to, for example, self-mutilation (disgust own body) or excessive washing (to be feeling dirty). On social level PTSD and trauma can cause problems in relationships with colleagues at work, etc. because people either obsessed with the trauma or  are running away from it. In has been shown that people who receive less social support are more likely to develop PTSD more show symptoms of PTSD  (Hadders & Utrecht, 2008).

Case: R. L. (a veteran who fought in Bosnia in 1993 (4)) explained in an interview that his peer support-system quickly became less. ‘At one point, I only had my wife, the rest of my support system left. This had to do with my irritability, my short fuse, I was surly, curt and others found it more uncomfortable to be with me. To talk to my wife about my problems was difficult. I tried to run away for the trauma by working 12 hours a day and therefore i became completely exhausted. I thought that having many distractions would help me to keep my head away from trauma. I thought when I would come home exhausted, I could sleep through the night.’

At the social level, vulnerability may occur when patients have problems around embedding in society by (long-term) absence from work because of the symptoms, loneliness, social isolation, poverty and stigma (Beek-Schelee Akker, 2011). Patients with PTSD are at risk to develop multiple levels of functioning. complaints.

The treatment of PTSD, and the role of the SPV (social psychiatric nurse) herein.

According to the Multidisciplinary Guideline (psychiatric guidelines PTSD) The treatment consists medication and psychological interventions. In these guidelines, the trauma-focused therapies (TFT) such as cognitive behavioral therapy (CBT), exposure therapy and EMDR (Eye Movement Desensitization and Reprocessing) is recommended. The result of treatment depends on the type of trauma and in which phase of life it’s emerging. There is little attention to body-oriented therapy in treatment of PTSD. It has been argued that body-oriented therapy an integral part in the treatment of PTSD should be next to the psychotherapy (Black, 1998). Studies in ‘De Vonk’ (5) showed that as patients present more physical complaints, they develop the less active coping mechanisms because they thereby avoiding more and are seeking support. The guideline for the diagnosis, treatment and guidance of adult patients with an anxiety disorder was overhauled in 2009. This includes the diagnosis PTSD.

In both versions, the stepped care model starting-point for the instruction. The purpose of treatment is defined here as the pursuit of recovery. After recovery, relapse prevention is offered before treatment is completed. If a SPV (social psychiatric nurse) is skilled for this, then besides Prevention also  cognitive behavioral interventions can be performed. In addition, the SPV has an important role in identifying symptoms and seek treatment (from the draft guideline revisions Multidisciplinary Directive, 2009). Off course there will also focus on the social network of a client and the SPV should involve them in the treatment and counseling.

Case RL: ‘I am treated for three traumatic experiences in the years of treatment. The first treatment (2000 – 2002) consisted of writing therapy and the second in 2007 EMDR treatment. In the beginning I missed personal attention to me as a human in the PTSD treatment. It had rapidly fill in questionnaires. I did not feel seen as a person but found that a sticker was on me too fast. I was seen as the problem and solutions too fast instead of looking at me as a person. At home, my wife did not know what to make of me. I was an emotional wreck! I had to bring my partner to therapy once, but she should have been more involved. In all that time she was invited one or twice I think. My wife never knew what happened to me at all. Only when I started therapy, I told her. The understanding since has gotten better. Here I see an important role the SPV in treatment. Seeing the person behind the patient and the involvement of the system at the treatment. I’ve also never been offered body-oriented treatment, no one ever talked to me about this.

In the treatment of PTSD, little attention is paid to the entirety of the four levels. Certainly the physical aspect seem not or just little addressed. The question is: Would yoga and body-oriented intervention can contribute to the treatment of at least the physical symptoms of PTSD? Could this affect the further course of the condition and recovery? And how can the SPV herein play a role?

Yoga, what is it?

Yoga is a general term for the practice of physical postures and breath work, in which attention is carried out, to be described. There are many types of yoga and in the West, especially the most famous and popular forms practiced. Although yoga in the West is often seen as just a physical practice, because the practice often begins with postures such as in a yoga studio or gym, it is more than that. Yoga is an ancient, self-empowering practice that uses a range of tools to enhance well-being and to maintain and restore health. It can be a powerful tool on the journey of personal and spiritual growth, as well. Krishnamacharya (1888-1989) is considered the grandfather of today’s Yoga seen together with two of his famous students BKS Iyengar and P. Jois. Yoga is traditionally divided into eight aspects (in Sanskrit “Astanga” see Table 1).

According to Iyengar (2002) yoga can be seen as consisting of three layers: the external – internal – and the inner layers. Or mentally, physically and spiritually. The eight aspects of Yoga can be divided in these three levels. The first level of yoga consists of do’s and don’ts. Yama and niyama are the social and individual ethnic disciplines that are also seen historically in all civilizations. Niyama teaches about what should be done for the good of the individual and society. Yama is about what we should do to prevent to harm the individual and society. The second level, asana, pranayama, Pratyahara. Asana is practicing various postures with the body. Pranayama is the science of breath. And pratyahara is observing the conditioned response.

The third and final level of yoga is described separately in yoga sūtras (6) as ‘wealth’ of yoga. Dharana, Dhyana and Samadhi, the effects of yoga are not part of the exercise itself. Dharana means concentration or complete attention. Dhyana is meditation and Samadhi is the culmination of yoga: total bliss. Yoga is a complete exercise of combining elements of mindfulness, meditation, breathwork and rhythmic motion in the form of postures (asanas) with a focus on the present. When this rhythmic movement is performed with others it brings togetherness (Spinnazola et al, 2011). The meditative aspects of yoga have been shown effective in reducing anxiety, depression, stress, and in the treatment of substance use/ abuse. Also, it has been shown that meditation helps with emotion regulation, processing through self reflection and seeing perspective. Physical pain can be softened and physical condition improved through yoga. The therapeutic qualities of yoga asanas, are probably related to neuro-cognitive aspects of PTSD.

Table 1 the eight-fold path of yogademonstration

Astanga Yoga

  • yama – social awareness (social-ethical requirements)
  • niyama – individual consciousness (personal ethical disciplines)
  • āsana – postures synchronized with the breath (yoga starts here with many people)
  • Pranayama – breathing awareness (breathing exercises)
  • Pratyahara – withdrawal of the senses (observing the conditioned response)
  • Dharana – concentration
  • Dhyana – meditation / maintenance of attention (mental focus)
  • samādhi – association / self-realization

Contraindication to yoga.

Yoga is often practiced in the context of a search for answers to questions in life and purpose. It assumes that it needs a balanced psyche and knowledgeable yoga teacher. Decuypere (1986) says in the magazine for psychiatry that there may already be a vulnerability present when someone is psychotic after a yoga session. Yoga would may have provoked it. According Decuypere yoga is harmless as long as you use your wits. “In the hands of unbalanced people it can sometimes be explosive material”. It is good as a practitioner to be with the patient. Talking about their interest in existential problems and focus on philosophical themes promotes understanding and patient will be more inclined to speak about it.

Yoga and the social psychiatric thinking

As described previously, patients with sleep disorders and PTSD are often misunderstood and have unexplained physical symptoms. Yoga  is often first applied on the physical level. At yoga, sometimes physical postures are performed that affect the physical and mental condition. If a patient can relieve themself from physical pain and make he body powerful, it can help to restore a sense of confidence in one’s own body. A patient may loose the feeling of powerlessness when he or she experience that he or she can do something themselves to fight the pain. This also applies for insomnia. When they learn how to make themselves sleep better they will be gain self-confidence. When they attributes these success experiences to themselves , this will work motivating. Patients can get to know their physical reactions, develop body awareness and lean that their physical tension pains can be reduced by exercises. As they explore the relationship between psychological stress with physical pain, they are better able to recognize, express, identify these feelings and thereby processing (Black, 1998). Avoidance can pass into control and a patient can get more grip for the strong feelings around trauma.

Patients learn to deal with their physical limits and can improve self-image. By improving the self-image, the individual level is touched, which is also a gripping point yoga can be in social psychiatry. Yoga is a mindful practice. Hereby it’s creating a way of ‘exposure’ that one himself has control over. In contrast to what occurs in trauma, one in yoga always have a choice. The practice of yoga can be discontinued at any time by a patient. This allows coping to develop. They might be looking for meaning or spirituality. Yoga is not a religion and is independent of religion, though there is some overlap with visions in Hinduism and Buddhism which also engages the individual level.

The social level from the social psychiatric viewpoint is not the main point engaged in yoga, but it is possible level to be touched. Yoga can be an individual practice with a teacher or trained therapist but often in a (small) group. The teacher or therapist also practice along, this can create equality. There is peer support. From this social contacts arise. The strength of the patient and his or her network are central to social psychiatry. In PTSD treatment, having a shared experience with others to contribute to recovery by learning not to repel others. Integrated motion and breathing with others, can create a sense of connectedness (Emerson, 2011). “The individual is a part of a collective, united by rhythmic elements in synchronous movement which can give a sense of connection and is a part of healing traumas (Spinnazola et al, 2011).

This can also counteract loneliness and social isolation which is a characteristic of the social level within the social psychiatry. In social psychiatry it’s in principle not about the individual patient but always about the patient in the social and cultural context and social intercommunication. By having better control on (unexplained) physical symptoms, when sleep better and being in better health, one will be less vulnerable to (long-term) absenteeism from work (Beek Schelee Akker, 2011). This will reduce the risk of loneliness and social isolation.

Can Yoga play a role in the social psychiatric treatment of PTSD and what can the SPV do this?

In the treatment of PTSD oe complex trauma, little attention is paid to the four levels in its entirety. Certainly the physical aspect seem little to be addressed. At the physical level, yoga can definitely answer offer to shortcomings in the treatment of social psychiatric treatment of PTSD. The physical practice of yoga postures can ensure that a patient learns to be in contact with his or her body in the present. This gives them a sense of security because they are often overwhelmed by bodily sensations (van der Kolk, 2006). As described, the main features of yoga (Postures, breathing and meditation) proved effective in reducing symptoms of trauma. Psychiatrist van der Kolk has partnered with yoga teacher David Emerson in America and they developed a method where yoga is used in the treatment of PTSD: ‘The Trauma Center Yoga Program (7).

Van der Kolk (1994) said that the purpose of the treatment of PTSD is to assist people to live in the present life, without feeling or behaving according to the irrelevant demands belonging to the past. Due to the natural survival system of the body, many people with PTSD mainly focused on trauma and not on the here and now. This method it is also called “Trauma Sensitive Yoga ‘. This method has been thoroughly researched and successfully applied in the treatment of PTSD in America. ‘Trauma-sensitive yoga’ is a physical down-to-earth form of yoga. It is aimed at skills. It is structured but there is always choice. It is a slow process where patience and repetition is used. David Emerson describes in his book ‘Overcoming trauma through yoga’ (2011) that there are four major themes have emerged from the research use of yoga in people with trauma. These are: the experience of the present moment, having a choice, take effective measures and the creation of rhythm.

There are several ways that yoga could find a place within the social psychiatric treatment of PTSD. In the new draft guidelines is said that there is always started with the based interventions psycho-education, activation and prevention of avoidance (draft guideline revisions the Multidisciplinary Directive, 2009). These interventions can be implemented by a SPV (Social Psychiatric Nurse). There may at least be given psycho-education about yoga and are used for activation. In addition to obtaining a history and making an analysis, a SPV can create (treatment) plan with the patient.

If a patient would like to participate in yoga (especially for the target group), the SPV can support this by processing trhis into that plan. As the SPV also uses for example CBT interventions (or part techniques) when trained for this, the same applies to yoga interventions. For instance, the SPV can start or end a treatment session with a patient with some techniques from yoga. To close the nursing methodical framework is off course evaluated and the plan adjusted if necessary. The above interventions are partly the result of best practice and effective partly shown and would need to be further investigation. In the Netherlands, yoga programs in the treatment of PTSD is in development. In June 2012 starts a pilot at Centrum ’45 to Oestgeest: Trauma sensitive yoga to a group of veterans using the method of van der Kolk.

Conclusion and recommendations

Patients diagnosed with PTSD often experience symptoms at all four levels of functioning according to the social psychiatric thinking, and not always there is attention to the four levels in its entirety. Especially on the physical and social level treatment sometimes lack. Yoga grabs mainly on the physical level where physical symptoms that are often present in PTSD can be reduced and patients can find body control again.  Yoga does not fully connect on all four levels of functioning but it does at those levels where conventional therapy fails. Given the beneficial effects of yoga with PTSD can be said that this physical approach is become an evidence-based complementary treatment method in multidisciplinary social psychiatric treatment of PTSD. However, it appears that there is a need for more formal controlled research on trauma sensitive yoga within the social psychiatric treatment of PTSD to evaluate it’s efficacy and effectiveness. Finally, possible bias of the writer is not excluded in this article. Besides being a community psychiatric nurse (SPV) she’s also a passionate yoga teacher.

PTSD is a heterogeneous disease that is associated with a wide variety of co-morbidity (Creamer et al, 2001). It requires an individual treatment protocol. Yoga would need to be considered alongside the existing PTSD treatment when the patient is open to this. It is important that yoga is offered by a confident, competent teacher. A teacher is involved, accessible, highly skilled in yoga and is willing to receive feedback and listen (Emerson, 2011). When this is not the case, it is advised to consider another teacher. The SPV or other practitioner would need adequate training when applying (partial) yoga techniques. This practitioner should be able to provide adequate information and psycho-education on the indication and contraindication of yoga. It’s advised to learn more about complementary treatment. The counselor with final responsibility as the psychiatrist, SPV or other practitioner should recognize the meaning of yoga to enjoy it’s potential role in treatment. The PTSD treatment should of course meets the needs and wishes of the patient.



  1. within the Acute Behandelteam (ABT) and long-term psychiatry (F)ACT-team – The ABT is a part of the Emergency Department of Psychiatry Amsterdam (SPA), and this is one of the services of  the organization called Arkin in Amsterdam.
  2. ‘Netherlands Mental Health Survey and Incidence Study’ (NEMESIS-2) is a study of the mental health of adults 18 to 64 years in the general population.
  3. Querido, Arie. From 1901 to 1983. An important psychiatrist in the development of vision and method of social psychiatry
  4. R. L. has been in Bosnia experienced trauma 6 months. He is 43 years old, married and has a son (2000). He did not directly suffer from PTSD. End of 2000, he first treated to 2002. Then it started again in 2007. Interviewed by Anneke Sips on 03-06-2012.
  5. De Vonk: Since 1994, Centrum ’45 a department for traumatized refugees and asylum seekers. This section is called ‘De Vonk’ and is in the town of Noordwijkerhout. De Vonk has a day clinic and a clinic.
  6. One of the most important ancient texts of yoga, which include these eight aspects are described. The yoga sutras are over 2000 years
    ago written by Patanjali, which is seen as one of the greatest yogis ever.
  7. The Trauma Center Yoga Program, is a collaboration of yoga teachers and trauma expert doctors and has been developed as a form of Hatha yoga in addition to treatment for PTSD and related disorders since 2003 (Emerson et al., 2009).


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Project Air via

The Trauma Center, Brookline, MA via


This article in Dutch: wanneer je lichaam spreekt

Happy Wesak! (Buddha Day)

This wisdom and light that flashed and radiated under the historic Bodhi Tree at Buddha Gaya in the district of Bihar in Northern India, more than 2500 years ago, is of great significance to human destiny. It illuminated the way by which mankind could cross, from a world of superstition, or hatred and fear, to a new world of light, of true Love and happiness.


But what is this about and are the Buddhist teachings connected to the Yogic ones? The Buddha says life is suffering; both the ancient Yogis and the Buddhists point to the kleshas as the causes of our suffering. These “afflictions” distort our mind and our perceptions effecting how we think, act and feel. Here some basic ideas about the subjects in both Buddhist and Yogic philosophy.

The main kleshas vary in intensity on our psyche, from being inconsequential in their effect to utter blindness. The kleshas not only create suffering, but are said to bind us to the endless cycle of birth and rebirth, and thus preventing us from achieving enlightenment.

  • Avidya (ignorance)
  • Asmita (I-am-ness)
  • Raga (attachment)
  • Dvesha (repulsion)
  • Pratigha (anger)
  • Māna (pride)

The first stage of working with the kleshas is to simply acknowledge them. Reflection promotes self-awareness, self-understanding and self-knowledge to uncover and see the kleshas and their roots as well as how they create suffering. The direct opposition of concentration and other yogic techniques can counteract simple kleshas. Gross kleshas are overcome with meditation, tapas and seeking wisdom. The four internal cleansing practices are pratyahara, dharana, dhyana, and samadhi bring the mind under control. These Yogic techniques are said to burn away the impurities of the kleshas to purify the mind. By ridding ourselves of our kleshas, we are able to clearly see the reality of the world and our own true nature.

The heart of the Teachings of the Buddha is contained in the teachings of the Four Noble Truths, namely,

  • The Noble Truth of Dukkha or suffering
  • The Origin or Cause of suffering
  • The End or Cessation of suffering
  • The Path which leads to the cessation of all sufferings

The First Noble Truth is the Truth of Dukkha which has been generally translated as ‘suffering’. But the term Dukkha, which represents the Buddha’s view of life and the world, has a deeper philosophical meaning. Birth, old age, sickness and death are universal. All beings are subject to this unsatisfactoriness. Separation from beloved ones and pleasant conditions, association with unpleasant persons and conditions, and not getting what one desires – these are also sources of suffering and unsatisfactoriness. The Buddha summarizes Dukkha in what is known as the Five Grasping Aggregates.

Herein, lies the deeper philosophical meaning of Dukkha for it encompasses the whole state of being or existence.

Dukha is spoken bout by Patanjali too. Patanjali’s investigation of dukha is brilliant. The principles of craving, aversion and delusion he found are the same that the Buddha taught. We think craving is a good thing, like a civic duty. But people are surprised to find, when they investigate, that its full of suffering. The experience of craving is unsatisfactory. The real meaning of dukha is “pervasive dissatisfaction.”

Henry David Thoreau said, “Most men lead lives of quiet desperation.”

Dukha is a sense of not being really at home in the moment. It is the war with reality, with what is. The three different kinds of craving are

  • Grasping for another moment other than what we’ve got
  • Aversion or pushing away how it is
  • Delusion or twisting away from reality.

In Buddhism: Our life or the whole process of living is seen as a flux of energy comprising of the Five aggregates, namely the Aggregate of Form or the Physical process, Feeling, Perception, Mental Formation, and Consciousness. These are usually classified as mental and physical processes, which are constantly in a state of flux or change. When we train our minds to observe the functioning of mental and physical processes we will realize the true nature of our lives. We will see how it is subject to change and unsatisfactoriness. And as such, there is no real substance or entity or Self which we can cling to as ‘I’, ‘my’ or ‘mine’.

When we become aware of the unsatisfactory nature of life, we would naturally want to get out from such a state. It is at this point that we begin to seriously question ourselves about the meaning and purpose of life. This will lead us to seek the Truth with regards to the true nature of existence and the knowledge to overcome unsatisfactoriness. From the Buddhist point of view, therefore, the purpose of life is to put an end to suffering and all other forms of unsatisfactoriness – to realise peace and real happiness. Such is the significance of the understanding and the realisation of the First Noble Truth.

The Second Noble Truth explains the Origin or Cause of suffering. Tanha or craving is the universal cause of suffering. It includes not only desire for sensual pleasures, wealth and power, but also attachment to ideas’, views, opinions, concepts, and beliefs. It is the lust for flesh, the lust for continued existence (or eternalism) in the sensual realms of existence, as well as the realms of form and the formless realms. And there is also the lust and craving for non-existence (or nihilism). These are all different Forms of selfishness, desiring things for oneself, even at the expense of others.

Not realizing the true nature of one’s Self, one clings to things which are impermanent, changeable and perishable. The failure to satisfy one’s desires through these things; causes disappointment and suffering. Craving is a powerful mental force present in all of us. It is the root cause of our sufferings. It is this craving which binds us in Samsara – the repeated cycle of birth and death.

The Third Noble Truth points to the Cessation of suffering. Where there is no craving, there is no becoming, no rebirth. Where there is no rebirth, there is no decay. no, old age, no death, hence no suffering. That is how suffering is ended, once and for all.

The Fourth Noble Truth explains the Path or the Way which leads to the cessation of suffering. It is called the Noble Eightfold Path. The Noble Eightfold path avoids the extremes of self-indulgence on one hand and self-torture on the other. It consists of Right Understanding, Right Thought, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness and Right Concentration.

These path factors may be summarized into 3 stages of training, involving morality, mental culture and wisdom.

Morality or good conduct is the avoidance of evil or unwholesome actions — actions which are tainted by greed, hatred and delusion; and the performance of the good or wholesome actions, – actions which are free from greed, hatred and delusion, but motivated by liberality, loving-kindness and wisdom.

The function of good conduct or moral restraint is to free one’s mind from remorse (or guilty conscience). The mind that is free from remorse (or guilt) is naturally calm and tranquil, and ready for concentration with awareness. The concentrated and cultured mind is a contemplative and analytical mind. It is capable of seeing cause and effect, and the true nature of existence, thus paving the way for wisdom and insight.

Yoga explanation in the Yoga sutras consists two words: yoga chitta-critti-nirodah, which may be translated: “Yoga is the restraint (control, mastery) of the modifications (changes, movement, thought-forms) of the mind.”


The word yoga is derived from the root yuj, which means to unite or to join together. The practice of yoga may lead to the union of the human with the divine – all within the self.  According to Patanjali’s Yoga Sutra, the classical text on yoga, the purpose of yoga is to lead to a silence of the mind (1.2). This silence is the prerequisite for the mind to be able to accurately reflect objective reality without its own subjective distortions. Yoga does not create this reality, which is above the mind, but only prepares the mind to apprehend it, by assisting in the transformation of the mind – from an ordinary mind full of noise, like a whole army of crazy monkeys – to a still mind.

“Yoga is known as the disconnection (viyoga) of the connection (samyoga) with suffering.” – The Bhagavad Gita

Carl G. Jung the eminent Swiss psychologist, described yoga as ‘one of the greatest things the human mind has ever created.’

Wisdom in the Buddhist context, is the realization of the fundamental truths of life, basically the Four Noble Truths. The understanding of the Four Noble Truths provide us with a proper sense of purpose and direction in life. They form the basis of problem-solving. Wisdom in the Yogic context is found in practice that lead to stillness of the mind. This can be a basis of problem-solving but more important.. this can be the basis of problem prevention and living a happy life.

For now,

Happy Wesak! Happy Buddha Day!

~ Anneke ~

Q&A: In asana practice – left or right foot first?

Question: In the January–April 2004 issue of Yoga Studies, Richard Rosen responded to the question: “I’ve been teaching for a number of years, always leading clients in standing âsana with the left foot or left side. I have always done this because that was what I was taught. Could you please send me any literature references or other references giving the reasoning behind this practice? Does it extend to all âsana, standing or not?”

In this issue, Dr. Ananda Balayogi Bhavanani, chairman of Yoganjali Natyalayam and the International Centre for Yoga Education and Research in Pondicherry, India (,, further elucidates from the traditional Indian point of view: I felt that I have to try and address some of these core issues for non-Indian Yoga practitioners, as we often have our Western students (never an Indian student!) ask these same questions.

The major problem facing Yoga in the West is the fact that Yoga has been cleaved from Indian culture (sanâtana-dharma; editor’s note: lit. “eternal teaching,” the name traditionally given to Hinduism by adherents). Without an understanding of the Indian (Hindu) culture and way of life from which Yoga originated, it is difficult to find answers to such questions.

The concept of polarity, or balancing the opposites, is vital to both Yoga and Indian traditional life. The right side of the body is related to the solar/positive/masculine flows of energy that are manifest by the sûrya-nâdî, which is related to the termination of the pingalâ-nâdî. Similarly, the left side is related to the lunar/negative/feminine flows of energy that are manifest by the candra-nâdî, which may be said to be the termination of the idâ-nâdî (editor’s note: nâdîs are subtle energy channels).

Traditionally in Indian culture, all daily activities are always started on the right side, because the right side is considered to be auspicious. If an Indian (a traditional Indian, that is) were given an offering by the left hand, he or she would consider it an insult and refuse it! Similarly, receiving anything with the left hand is totally out of the question! Modern Indians tend to be as uninformed as Westerners in this regard, and I am not considering their example here.

When a newly married bride in India comes to her in-laws for the first time, or when we enter the premises of a newly constructed building or any such new “starts,” we always use the right leg first  (as in “put your best foot forward”). Thus, to my mind, the traditional answer to the question would be to start on the right and then make sure you follow it with the left for balance.

In spinal twists, the turn is always clockwise first, as the concept of pradakshina or circumbulation around Hindu temples is always clockwise. It is interesting to note that the Hindu swastika turns clockwise, whereas Hitler’s swastika turns anticlockwise. (Speak of opposite energies bringing about opposite effects! Auspicious in the first and inauspicious in the second.) Yogamaharishi Dr. Swami Gitananda Giri also always taught us that the energy in the cakras moves in a clockwise direction. If you take ten traditional Indians and ask them to turn around, they will all, at least almost all, turn in the clockwise direction. Twists are thus done first to the right, then to the left.

Regarding the forward and back bending âsanas, when we bend forward we stimulate the solar plexus, and so this is termed the loma, or positive action. When we bend backward, we relax the solar plexus, and this is termed the viloma, or negative action. In practice it is thus better to do forward bends before back bends if we follow the polarity concept.

Some interesting research in South India (at VK Yogas Bangalore) showed that relaxation practices done following strenuous activity provided greater benefit than the pure relaxation practices done alone. Viewed from the standpoint of right and left, if we do the right, or active, side first, then we may benefit more from the practice by ending with the left. This will lead to a state of balance (of steadiness, relaxation). On the contrary, if we do the left, or passive, side first, then we may end up stimulated (hyperenergetic, imbalanced). As Yoga is the science of balance, performance on the right side before the left side may help us to maintain homeostasis (samatvam).

We must also remember that even the term Hatha-Yoga has the right side placed before the left in its esoteric association of ha with the sun and tha with the moon (editor’s note: hatha lit. means “forceful”).

With regard to the common question of how to tell whether one is doing the left side or the right side in standing poses, I would say that the side that bears the maximum weight of the body in the pose is the side one is doing. For instance, many students get confused when they first stand in natarajâsana on the right leg with the left arm and foot raised behind the back, thinking that they are doing the left side because both the left arm and leg are being used, whereas they are actually doing the right.

Of course, all of the above discussion applies to normal, balanced individuals, of whom very few seem to practice modern Yoga! In cases where stimulation is required, as in patients with depression, excessive sleepiness or drowsiness, and so on, then right after left may be preferable.

Studying Yoga: A National Priority?

Studying Yoga: A National Priority?

Yes, that’s right. It was published on the Yoga Journal that P. Murali Doraiswamy, M.D. appeared on CBS, was claiming that ‘If there was a drug that could mimic the effects of yoga, it would probably be the world’s best-selling drug’.
I do believe yoga has many health benefits!

Doraiswamy is talking about Yoga’s benefits, in addition to relaxation, also he include helping those with ‘mild depression, insomnia and ADHD.’ And he says ‘It affects virtually every tissue and every system in our body.’ I’ll agree. But I think studying health, nutrition and fitness should be an international priority too!


The 5,000-year-old Indian practice — may have positive effects on major psychiatric disorders, including depression, schizophrenia and sleep problems, according to a review of over 100 studies. Once thought of as a mystical spiritual practice taught by swamis to devout practitioners sitting cross-legged in a cave somewhere, yoga is now everywhere, it has joined the mainstream as both a favorite of celebrities and cultural staple for health consumers.

It is practiced by 15.8 million adults in the United States alone, according to data from the Harris Interactive Service. Although many people seek out their first yoga class looking for a mild form of exercise to keep them in shape and relax them, many find an added bonus — that yoga can calm the mind as much as it can relieve stress in the body. And a study published today in Frontiers in Psychiatry suggests it can also help with the symptoms of serious illnesses.

The analysis reviewed in these more than 100 studies, the effect yoga has on depression, schizophrenia, ADHD, sleep complaints, eating disorders and cognition problems. It was found that yoga had positive effects on mild depression and sleep complaints even in the absence of drug treatments, and improved symptoms associated with schizophrenia and ADHD in patients on medication.

Dr. P. Murali Doraiswamy is a professor of psychiatry and medicine at Duke University Medical Center and author of the study. He said yoga helps psychiatric conditions by reducing stress and affecting our emotions and mental status.

“The physical aspects of yoga do affect endorphins, serotonin, and blood flow,” he says. “Yoga also enhances parasympathetic system, which is how it produces the relaxation response and combats stress. Plus yoga also likely affects dozens of other brain chemicals such as antioxidants and reduces inflammatory changes. Long term practice can change brain circuits — what we call neuroplasticity — and enhances cognitive reserve (i.e. our resilience to damage by effects of aging and stress). Yoga also releases nerve growth factors that can boost strength of nerve connection and might even lead to production of new connections. We still don’t fully understand all the many effects and in some studies yoga has been found to affect the function of as many as 5000 different genes.“

Doraiswamys study finds regularly engaging in pranayama (breath control practice) and hatha yoga practices beneficial. “However, yoga has become such a cultural phenomenon that it has become difficult for physicians and patients to differentiate legitimate claims from hype,” researchers said in a statement. “Our goal was to examine whether the evidence matched the promise,” they wrote in the study published in the journal Frontiers in Psychiatry.

Dr. Murali Doraiswamy explained that the emerging scientific evidence in support of yoga on psychiatric disorders is “highly promising” and showed that it may not only help to improve symptoms, but also play ancillary role in the prevention of stress-related mental illnesses. Doraiswamy said his review is preliminary, and based mostly on studies with small samples. He recommends more study, particularly of yoga’s impact on clinical depression and anxiety disorders.

New York Times senior science writer William J. Broad has written about the downside of yoga. Commenting on the study, he said yoga’s benefits outweigh its risks. “A century and a half of science suggests that yoga is a great antidote for depression and related disorders,” said Broad, author of The Science of Yoga: The Risks and Rewards (Simon & Schuster, February 2012). “The risks of yoga tend to be few and rare while the benefits are many and commonplace.”

Biomarker studies

The review found evidence from biomarker studies showing that yoga influences key elements of the human body thought to play a role in mental health in similar ways to that of antidepressants and psychotherapy. One study found that the exercise affects inflammation, neurotransmitters, oxidative stress, lipids, growth factors and second messengers.

“While there has been an increase in the number of medications available for mental health disorders, many of which can be life-saving for patients, there remains a considerable unmet need,” Dr. Meera Balasubramaniam, lead author of the study, said.

Poor compliance and relapse as well as treatment resistance are growing problems, and medications are expensive and can leave patients with significant side-effects. “The search for improved treatments, including non-drug based, to meet the holistic needs of patients is of paramount importance and we call for more research into yoga as a global priority,” said Doraiswamy.

So, that’s really good news again!!

Yoga for the Heart

A week after researchers announced evidence that yoga is good for the mind, a new study has found it appears to work for the heart as well. The latest study, by scientists at the University of Kansas Medical Center, looked at yoga’s impact on 49 individuals suffering from atrial fibrillation, a common heart condition. The researchers monitored various indicators of heart health — including blood pressure, heart rate, and episodes of atrial fibrillation, a particular kind of irregular heart rhythm. They found that symptoms improved when study participants attended yoga class at least twice a week while continuing to take their prescribed medication.

Participants experienced an average of two episodes of irregular heart rhythm while taking yoga, compared to nearly four episodes pre-yoga. The study, published online Jan. 30 in the Journal of the American College of Cardiology, is one of the first to test the effects of yoga on atrial fibrillation. And it was published less than a week after a study found that those suffering from depression, schizophrenia and other psychiatric conditions would benefit from yoga.

~ Anneke ~

Meera Balasubramaniam, Shirley Tellesand P. Murali Doraiswamy – “Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders.” Front. Psychiatry, 25 January 2013.

Yoga, passion, mental health and.. money?

An article where I speak about these subjects for a Dutch magazine. You can click on the link down here that say: PGGM to open the article. It’s in Dutch… what ya think?


Love, Anneke

Yoga & Mental Health network meeting

Omdat jij op één of andere manier te maken hebt met YOGA én een SPECIALE DOELGROEP in bijvoorbeeld de gezondheidszorg, ben je uitgenodigd voor de 2-jaarlijkse ‘Y&P netwerk bijeenkomst’. Het doel is netwerken en ervaringen en informatie delen.  Er zijn meer mensen (in en rond Amsterdam) die yogales geven aan een bijzondere doelgroep of yoga therapeutisch gebruiken. En dit geeft de gelegenheid elkaar te ontmoeten in een ontspannen sfeer. 

Wanneer: maandag 24-09-2012 om 16.00u tot 18.00u

Waar: MoleMann Tielens, Hoogte Kadijk 61 hs, 1018 BE Amsterdam (centrum)

Info: of bel: 06-18786883 

Wil je even laten weten of je komt? Er zijn geen kosten aan verbonden, maar netwerken is leuker met meer mensen. Een (kleine) donatie voor een goed doel is natuurlijk welkom!  Tot dan! Groet Anneke – twitter: @Yoga_Amsterdam