In 2003, the World Health Organization decided to collect reliable information on Traditional, Complementary and Alternative Medicine (TM and CAM) from its member states to promote proper use of these systems for consumers and health providers. ‘Traditional Yoga’ developed in ancient India and mostly practiced for ‘Self-realization’ was also included in this category. The WHO (South-East Asia) in co-operation with the M.D. National Institute of Yoga, Ministry of AYUSH, Govt. of India developed technical guidelines and information on Yoga to help and ensure the safety of consumers and health providers. These guidelines were approved in the WHO Consultation Meeting held in New Delhi.
Keywords:Yoga; Preventive; Yoga therapy; Yoga techniques; Body-mind work
In recent times, there is a global interest in using ‘Yoga’ as preventive, promotional and palliative health care adjunct. There is a growing trend amongst patients to take a more proactive approach to their own health and to seek out different forms of self-care measures, including ‘Yoga’. In addition to the many benefits of ‘Yoga’, recent reports have shown that there are also risks associated with the different types of Yoga employed as ‘Yoga Therapy’ (TM/CAM). Although consumers today have widespread access to various Yogic practices used as treatments and therapies, they often do not have enough and proper information on where, how and what to find and check the reliability and correctness of various Yoga techniques and protocols used in Yoga therapy.
‘Yoga practices’ are being applied in the management of various clinical conditions. Most of these studies indicate application of ‘Yoga intervention’ for patients (human population) i.e. phase four of accepted protocol in medical research. Study of various research articles published in peer reviewed indexed journals are seen to miss or omit the following type of information which is usually carried out in the first and second phase of medical research:
a) Proper standardization and validation of different
Yoga techniques or practices used as intervention in Yoga Therapy.
b) Validation and verification of the expected outcome of each Yoga technique used as intervention in Yoga Therapy.
c) Recognition, confirmation and quantitative and/or qualitative measurement/s of the expected outcome of the Yoga technique/s by the experimenter and/or the patient.
d) Recognition, confirmation and measurement of the unwanted or negative effects of the Yoga techniques employed as interventional practices.
e) The basis of deciding the time duration of each Yoga technique (comparable to the Dose of medicine) and the foundations used for deciding this basis or only empirical basis is used.
f) In what way or manner, the patients experience and/or recognize various parameters used for objective study by the experimenter?
g) Will the practitioner/patient of Yoga will be able to get guided by various parameters used for study or the patient will have to depend on laboratory studies and how far?
Generally, these are the areas of work expected to be studied during first and second phase of studies before applying the desired interventions on human/patient population. It appears that almost negligible number of investigators working in the field of Yoga are interested and want to take interest in this fundamental research studies.
Almost all the training and educational programs involving
conscious human beings involve ‘Body-Mind’ work. For example,
learning to sit, stand, walk, swallowing food, drinking water
as a child; learning to memorize alphabets, playing games,
working with computers, etc. require body-mind work. In
Yoga, techniques such as mental recitation of ‘Mantras’ and
experiencing transcendental states of consciousness are mostly
‘mental activities’ where participation of the physical body
is mostly unconscious in nature. Therefore, presenting Yoga
as ‘Body-Mind work’ serves as misguiding and misleading
statement for the beginners in Yoga as well as for the ignorant
Jon Kabat-Zinn says, “Mindfulness means paying attention
in a particular way; on purpose, in the present moment, and
nonjudgmentally.” Usually the minds of most of the people are ‘full’
of something or the other, even during sleep. To empty the mind
and to keep it empty for some time is a real achievement which
is not very easy to achieve and maintain. The important thing
is to highlight and streamline the exact nature of ‘mindfulness’
as has been highlighted by Ekhart Yoga by mentioning sound,
body sensations and breath as ‘anchors’ during Yoga practice.
Generally, this is not mentioned nor explained in details in clearcut
language and the methods used to attain and confirm the
Traditional Yoga texts mention about experiencing the trunk
area having an internal space or a cavity (e.g. pelvic cavity,
abdominal cavity and thoracic cavity in medical sciences).
Experiencing these spaces or cavities getting filled as ‘Pūraka’
and ‘the spaces getting emptied as ‘Rechaka’. The direction of the
internal movement during ‘filling phase’ (pūraka) related with
‘inhalation’ is from ‘below→up’ and from ‘above→down’ during
the ‘emptying phase’ related with exhalation. The movement
of breath perceived through the touch of air movement
inside the nostrils and the mouth during ‘inhalation’ (svāsa
in Yoga) is from ‘above→down’ and from ‘below→ up’ during
exhalation (prasvāsa in Yoga). Thus the experiential aspects of
‘inhalation/pūraka’ and ‘exhalation/rechaka’ are opposite in
nature. Therefore, these terms cannot be used as synonyms as is
being done presently .
Likewise, the scientific and the Yoga worlds are seen to use
‘Oxygen gas’ and ‘prāna vāyu’ of Yoga and ‘Carbon-di-oxide gas’
and ‘apāna vāyu’ of yoga as synonyms. Detailed analysis of the
terms, ‘prāna vāyu’ of Yoga imply gross voluntary as well as
involuntary movements of the body (pyscho-physical and neuromuscular
actions and activities) responsible for taking in or
receiving air, water, food because of the expanding movements
of the trunk and internal organs while ‘apāna vāyu’ being the
retracting movements of the body responsible for evacuation and
expulsion of materials from the body (exhalation, micturition,
defecation, etc.). These two ‘vāyus’ belong to a group of ‘ten
vāyus’ mentioned in yoga texts, subjectively experienced by the
person/patient in an intact body. On the other hand, ‘lotuses’
and ‘chakrās’ are the descriptions of certain types of subjectively
experienced happenings taking place inside the body after some
suitable Yoga practices [9,10]. ‘Lotus flower like expansion
and retraction’ of the trunk can be experienced by placing our
hands over the sides of the trunk at different levels. In Yoga,
after suitable practices, such movements can be subjectively
experienced at the level of the
vi. The forehead in relation to breathing during the
practice of ‘prānāyāma’.
At the level of the mind, various feelings, thoughts and
behaviors can give rise to conflicting and whirlpool like state of
consciousness keeping the person under stress and tensions all
the time requiring medical guidance and help. In a very practical
way, the concept of “Lotuses” can be understood in terms of
the gross body movement related with breathing subjectively
experienced and recognized by the person in the region of
the trunk, neck and head and the concept of “Chakrās” as the
functional state of the mind as subjectively experienced and
recognized by the person.
We come across two technical terms in Yoga literature:
‘Lotuses’ are ‘flowers’ belonging to the vegetable kingdom in
the Nature. The plant grows from a bulb and survives in water.
There can be a number of lotus plants in a pond or a lake and
the lotuses can remain at different levels over the surface of the
water connected by its stalk with the bulb at the bottom of the
pond. Lotuses have a ‘stalk’, ‘calyx’ and ‘petals’ like any other
flowers. Lotuses open around sunrise, remain open throughout
the day and start closing around sunset and remain in a closed condition (like a bud) throughout the night. This movement
takes place in horizontal plane.
‘Chakrās’ (wheels or circular discs moving around their axis)
are made by man using different materials such as wood, stone,
metals, plastic, etc. They have ‘spokes’ connecting the periphery
with the central hub serving as an axis around which the wheel
moves in different planes: vertical, horizontal or even oblique
plane on the ground, in air or water. The movement can be in a
clockwise or anti-clockwise direction with different speeds.
Modern authors (including well qualified medical men) are
using ‘lotuses’ and ‘chakrās’ as synonyms and making a statement
that ‘Chakras’ have ‘petals. They are even trying to equate them
both with different nerve plexuses and endocrine glands. Nerve
plexuses and endocrine glands are anatomical structures. These
structures and their functions cannot be [11,12].
It can be said that research studies of more fundamental
nature are required to be undertaken by the scientific
community to have clear understanding about the exact nature
of the Yoga techniques employed as interventions in therapy
or health care. Levine AS and Balk JL have come to the similar
conclusion by declaring that, ‘although participation in yoga
programs appeared to benefit patients with breast cancer,
greater methodological rigor is required to understand the
mechanisms that contribute to their effectiveness.’ Field T has
opined in a similar way by reporting, ‘Multiple physical and
physiological measures need to be added to the self-report
research protocols and potential underlying mechanisms need
to be further explored. In the interim, the studies reviewed here
highlight the therapeutic effects of yoga, a practice that could
come to be called yoga therapy.