Yoga
Miriam E. Cameron
Anyone can benefit from yoga, regardless of health, beliefs, age, or culture (White, 2012). The systematic practice of yoga heals body and mind. Yoga’s do-it-yourself prescription for stress management and well-being has no side effects and does not require medications or expensive treatments and equipment (Noggle, Steiner, Minami, & Khalsa, 2012). Nurses practice yoga themselves and also use it as a complementary and primary therapy. Around the world, millions of people do yoga primarily for physical fitness and relaxation (Sibbritt, Adams, & van der Riet, 2011); however, yoga has a much deeper dimension (Cameron & Parker, 2004).
Yoga is a way of life to transform consciousness, as yogis for centuries have advocated and Western researchers now are discovering (Bachman, 2011). As practitioners let go of ego, which yoga teaches underlies suffering and most dis-ease, they realize that they are linked to every being, the environment, and larger forces in the universe. Grateful for this vast interconnectedness, they reach out to relieve suffering in other living beings. They sort out the unreal from the real and allow their true natures to shine. Their inner wisdom flows spontaneously through all cells of the body, promoting optimal health, inner freedom, creativity, peace, and joy (Cameron, 2002).
DEFINITION
Yoga, an ancient art and science that originated in India, means integration of mind, body, and universe. Two millennia ago, Indian sage Patanjali systematized yoga into the Yoga Sutra, a treatise of 196
compact observations called sutras (Ravindra, 2009). This unique blend of theoretical knowledge and practical application is the primary textbook for all schools of yoga. In the Yoga Sutra, Patanjali analyzed how we know what we know and why we suffer. He explained that the primary purpose of consciousness is to see things as they really are and to achieve freedom from suffering. Through yoga, we can rein in our tendency to seek happiness through external phenomena. Only by turning inward and becoming aware of one’s true nature, Patanjali wrote, can we understand how to develop wisdom and happiness. By becoming still, we can abide in this deep, absorptive knowing (White, 2012).
compact observations called sutras (Ravindra, 2009). This unique blend of theoretical knowledge and practical application is the primary textbook for all schools of yoga. In the Yoga Sutra, Patanjali analyzed how we know what we know and why we suffer. He explained that the primary purpose of consciousness is to see things as they really are and to achieve freedom from suffering. Through yoga, we can rein in our tendency to seek happiness through external phenomena. Only by turning inward and becoming aware of one’s true nature, Patanjali wrote, can we understand how to develop wisdom and happiness. By becoming still, we can abide in this deep, absorptive knowing (White, 2012).
In the Yoga Sutra, Patanjali described yoga as consisting of eight interconnected limbs, or aspects of the whole. Practicing these limbs simultaneously leads to progressively higher stages of ethics, spirituality, and healing. The first five limbs still the mind and body in preparation for the last three limbs. The eight limbs, their Sanskrit names, and definitions (Ravindra, 2009) are:
1. Ethical behavior (yama)—nonharming, truthfulness, nonstealing, responsible sexuality, and nonacquisitiveness
2. Personal behavior (niyama)—purity, commitment, contentment, selfstudy, and surrender to the whole; niyama includes sattvic (pure) mind, food, beverages, air, and environment
3. Posture (asana)—physical poses that stretch, condition, and massage the body
4. Breath regulation (pranayama)—regulation and refinement of the breath to expand prana (life force) and get rid of toxins
5. Sensory inhibition (pratyahara)—temporary withdrawal of the senses from the external environment to the inner self, for example, by closing the eyes and looking inward
6. Concentration (dharana)—locking attention on an object or field, such as the breath, mantra, or image
7. Meditation (dhyana)—increasingly sustained attention, leading to a profound state of peace and awareness
8. Integration (samadhi)—a transcendent state of oneness, wisdom, and ecstasy.
The ancient Indian sacred text, Bagavad Gita (Mitchell, 2007), describes schools of yoga and their focus: Kundalini Yoga: energy; Jnana Yoga: knowledge; Mantra Yoga: recitation of sacred syllables; Tantra Yoga: technique; Bhakti Yoga: devotion; Karma Yoga: action, good deeds; Raja Yoga: control of mind and body through the eight limbs; and Hatha Yoga: willpower.
Hatha Yoga, which is popular in the West, consists primarily of physical postures, breathing techniques, and relaxation, despite yoga’s historic quest for inner development. Hatha Yoga has many styles, including a Himalayan tradition, Tibetan Yoga, Iyengar, Ashtanga, Viniyoga, Sivananda, Kripalu, Kundalini, and hot yoga. Even when Hatha Yoga classes focus on physical fitness, they can open the door to yoga’s deeper dimension (Cameron, McCall, & Prasek, 2012).
SCIENTIFIC BASIS
Yoga is based on ancient observations, principles, and theories of the mind-body connection. For thousands of years, yogis have passed down this precise knowledge from one generation to the next. Western researchers are now validating many of these health claims. Studies have found that yoga generally is a safe, therapeutic intervention that treats symptoms and/or prevents their onset and recurrence. Yoga practices are hypothesized to reduce allostatic load in stress-response systems and restore optimal homeostasis (Streeter, Gerbarg, Saper, Ciraulo, & Brown, 2012). After reviewing a variety of studies, two different research teams concluded that yoga produced considerable health benefits (Boehm, Ostermann, Milazzo, & Bussing, 2012); yoga improved cognition, respiration, immunity, and joint disorders, as well as reducing cardiovascular risk, body mass index, blood pressure, and diabetes (Balaji, Varne, & Ali, 2012).
Poor body alignment and improper breathing are major factors in health problems. Yoga decreases fatigue and improves physical fitness, balance, strength, flexibility, body alignment, and use of extremities (Galantino et al., 2012). Vital organs and endocrine glands became more efficient and the autonomic nervous system stabilizes (Büssing, Khalsa, Michalsen, Sherman, & Telles, 2012). Yoga improves quality of life and reduces anxiety (Chung, Brooks, Rai, Balk, & Rai, 2012). The systematic practice of yoga promotes a healthy lifestyle; increases exercise; and reduces smoking, alcohol consumption, and stress (Penman, Cohen, Stevens, & Jackson, 2012).
Because of these and other therapeutic effects, yoga therapy (www.iayt.org) has emerged as a discipline. Yoga practitioners use it for healing and health promotion. In several studies, yoga therapy was an effective sole or additional intervention for individuals with depression, anxiety, and schizophrenia (Bangalore & Varambally, 2012). Okonta (2012) reviewed 10 randomized controlled trials, quasiexperimental studies, and pilot studies; yoga therapy modulated the physiological system of the body, including the heart rate, and also reduced blood pressure, blood glucose levels, cholesterol levels, and body weight.
INTERVENTION
Technique
Each of Patanjali’s eight limbs is a potential nursing intervention for children, adults, older subjects, pregnant women, people with a disability and/or illness, and individuals who are dying (Bryant, 2009; Ravindra, 2009). Some people need encouragement to behave with nonviolence and compassion toward self and others (limb 1). Other individuals benefit from teachings about cleanliness, nutrition, and self-discipline (limb 2). Nurses can suggest yogic poses (limb 3) and breathing techniques (limb 4) to relax and replenish body and mind (see Exhibits 9.1 and 9.2). Withdrawal of the senses can help individuals to let go of external stimuli and sleep (limb 5). Learning to concentrate and meditate can create meaning in suffering and motivation to develop optimal health (limbs 6 and 7). Through a moment of integration, individuals can experience oneness and joy, even when seriously ill or dying (limb 8) (see Exhibit 9.3).
Guidelines
The best way to learn yoga is to do it. Yoga publications, videos, online postings, and modules (www.csh.umn.edu/Integrativehealingpractices) describe guidelines for beginning through advanced levels. Some individuals use these resources to learn yoga on their own. Other people benefit from yoga classes and individual instruction. Qualified teachers can assist nurses to do yoga themselves and to use yoga as a nursing intervention (Cameron, McCall, & Prasek, 2012).
Exhibit 9.1. Corpse Pose or Deep Relaxation (Savasana)
1. Lie on your back with arms relaxed near your sides, palms up, and head, trunk, and legs straight. If you are uncomfortable, put a pillow or blanket under your head and/or knees.
2. Close your eyes, relax, and let your body sink.
3. Breathe in a circular manner: slowly, evenly, deeply through nostrils, from the abdomen, with the in-breath the same length as the out-breath, and no break in between.
4. When ready, open your eyes, bend your knees, turn to your right, and get up.
Corpse pose promotes deep relaxation and decreases hypertension, anxiety, insomnia, stress, and fatigue (Cameron, 2008; McCall, 2007).
Exhibit 9.2. Alternate Nostril Breathing (Nadi Shodhana)
1. Sit comfortably with straight back; breathe in a circular manner, as in Exhibit 9.1.
2. Place right thumb on right nostril, ring finger on left nostril, and inhale through both nostrils.
3. Use thumb to close right nostril; exhale slowly through left nostril, and then inhale slowly through left nostril.
4. Use ring finger to close left nostril; exhale slowly through right nostril, and then inhale slowly through right nostril.
5. This sequence constitutes one round; repeat for five more rounds.
This pranayama technique promotes balance, gives each side of the body equal time, and strengthens the breath in the weaker nostril (Cameron, 2008; McCall, 2007).
Exhibit 9.3. Withdrawal of Senses, Concentration, Meditation
1. Lie in corpse pose or sit comfortably with a straight back in a chair or on a meditation cushion; close eyes, relax, look inward, and breathe in a circular manner, as described in Exhibit 9.1.
2. Focus on your breath. As you inhale through your nose, silently count “one.” Exhale. On the next in-breath, count, “two,” and so on. When your mind wanders away, bring it back to your breath and start with one again. At 10, go back to one again.
3. When you are deeply relaxed and focused, open up to your inner experience; simply observe and let go of whatever arises, without attachment, judgment, or direction.
Concentration and meditation promote deep relaxation, healing, balance, replenishment, and development of insight and joy (Cameron,
2008; McCall, 2007).
Measurement of Outcomes
Nurses can determine the effectiveness of yoga by asking individuals how they feel after doing it. Most health problems develop over time, and yoga may not alleviate them immediately. Minor health issues may improve quickly, but serious problems require sustained, patient practice. Yoga advocates gradual change. Optimal benefits occur from systematic practice. Short-term outcomes, however—including a more relaxed attitude, decreased anxiety, improved balance, and increased musculoskeletal flexibility—are notable. Faithful practice can produce long-term outcomes of better physical, spiritual, and mental health (McCall, 2007).
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
