Thursday, December 15, 2011

Yoga and Obsessive Compulsive Disorder

By: Jade Weisensee


Introduction

Throughout the semester, I have been struggling with which aspects of yoga I find useful and which aspects I find a bit ridiculous. I had really high hopes going into the class, and as the semester drew to a close I began to wonder what it was that I could really apply back to my own passions in life. That is why I think this paper was so important to the class. It gave me a chance to find the connection between yoga and my own interests, which lie heavily in psychology. After some thought about what aspect of psychology I wanted to go more in depth with, I chose to do my paper on yoga and its use as a therapy for those with Obsessive Compulsive Disorder. I feel as though this is a topic I am familiar with from previous classes, but still have a lot to learn about. I feel that learning more about Obsessive Compulsive Disorder and how the West has begun to use yoga as a method to treat it will prove to be very interesting.

What Is Yoga?

Before I started to examine the uses of yoga, I thought it was important to define what exactly yoga is. In Sanskrit the word yoga means “"to yoke or join together” which most closely translates to the English term “union” (Strasuss, 2004). However, yoga is a very diverse word with a variety of meanings depending on the person, the place, and the time period. One article said, “Yoga. The word evokes a range of images and ideas, from white-bearded Indian mystics on mountaintops to cross legged hippies burning incense to urban business people at a lunchtime fitness class” (Strasuss, p 2, 2004). It’s true, especially since yoga first came to America in the early nineteenth century there has been a lot of dispute over how yoga was to be perceived. Yoga has been around for thousands of years, but it does not mean the same thing to our culture as it did to those of the past.

Originating in India, yoga was used as a “system for increasing physical and mental clarity so as to transcend our limited concepts of self” (Douglass, p 35, 2007). So how did it get to America? Swami Vivekananda was among the first people to convince Westerners that yoga was a “spiritual commodity” (Strasuss, 2004). He told Americans that people in India had an abundance of spiritual wealth, a wealth that Westerners were lacking. Swami Vivekananda said that yoga could lead even people of the west to spirituality, and he could help them in exchange for material goods. However, when Yoga first came over to the West, Americans had trouble integrating this belief system into their own. The Christian belief system of the West made it difficult for Americans to follow and accept this Hindu path to spirituality. Once again, Swami Vivekananda was an essential piece to convincing Americans. He told them that yoga was more than a spiritual path, it was also a system of health (Douglass, 2007).

The integration of health was when the American perspective of yoga was really born. Especially in today’s society, yoga is seen as something to test and research. It has become something of interest to the academic community instead of the spiritual community. Most Westerners in today’s culture see yoga as a health system and nothing more. Especially in films such as Yoga, Inc. we see the American take on yoga. Much like kick boxing or running on a treadmill, yoga is a way for people to get in shape. Many people do not take the time to learn the background, or understand the spirituality components. We are even exporting our new beliefs of yoga back to India, where it is beginning to be perceived as a health system more than a spiritual one.

However, in recent years, there have been attempts at linking the Western perspective back to the older Eastern look on yoga. Carl Jung was one of the first people to try and bridge the gap between these two beliefs of yoga. Sadly, for the most part, Jung’s attempts were met with opposition. He tried to link yoga traditions with the therapeutic model of the West, but the relationship was hard for either side of yoga to see. Jung’s therapy model was about curing souls, where the main point of yoga is that our souls are always pure no matter what mental conditions we face. There were more questions formed than answered made, and the gap between Western beliefs and Eastern beliefs of yoga only seemed to grow. Both sides continued to analyze and study yoga in their own ways, sometimes crossing paths, and always examining the perception of yoga to the public (Douglass, 2007).

Obsessive Compulsive Disorder

Briefly I would like to talk about what exactly Obsessive Compulsive Disorder is. Firstly, it is a type of anxiety disorder. What makes this disease unique is that it is composed to two very different characteristics called obsessions and compulsions. An obsession is a recurrent thought, usually negative, that an individual just cannot push away from their conscious. It could be anything from constant thoughts of death to having to count every step you take. A compulsion is typically the person acting on their obsessive thoughts. This could be repetitive behaviors or rituals that a person does, in the hopes that their negative thoughts will go away, or at least be quieted (Natural Standard, 2011). This disease can range from mild to severe, but usually has an impact on an individual’s day to day functions, such as school, work, and social interactions. There are even instances of this disease being so severe that it has pushed individuals to substance disorders, depression, and in some cases even suicide. This is a disease that affects both, male and female, young and old. Statistics show that in the United States alone, over 2.2 million people are suffering from Obsessive Compulsive Disorder (Natural Standard, 2011).

Although it is not a curable disease, the effects of Obsessive Compulsive Disorder can be somewhat alleviated from a variety of methods. The most common methods of treatment for this disorder are medication and treatment. The most popular medication prescribed are SRIs or Serotonin Reuptake Inhibitors, also used for depression (Franklin, et. al., 2002). It has been found that one of the most effective treatments to help patients suffering from Obsessive Compulsive Disorder is a cognitive behavioral therapy approach. This approach includes exposure exercise and ritual prevention to help patients get over their obsessions and compulsions and limit their occurrences (Franklin, et. al., 2002). However in recent years they have also begun experimenting with integrative therapies such as relaxation therapy, yoga, and most commonly Kundalini yoga (Natural Standard, 2011).

Kundalini Yoga

Kundalini yoga is the most common form of yoga used in treatment to help those with Obsessive Compulsion Disorder; however, I did not have a lot of knowledge as to what made Kundalini yoga unique. Mackenzie (2011) says, “All types of yoga can help you learn this practice of ‘being in the moment.’ What's different from style to style is pace, intensity, and degree of spirituality” (p. 1). What makes Kundalini yoga special is the emphasis on the Eastern philosophies of yoga and their focus on the breath during practice. Their philosophy involves balancing the body’s energy, and the use of the chakra system. They also tend to use gongs and singing during their practice. It is usually a very spiritual experience alongside the physical one (Mackenzie, 2011). Kundalini yoga also includes breathing exercises, chanting, meditation, prayer, visualization, and guided meditation (Natural Standard, 2011). Although there is not as much research on this type of yoga specifically, the studies that have been done suggest a broad range of psychological benefits.

Yoga as Therapy?

According to Mohan (2006), “An example definition of modern Yoga therapy is ‘the application of Yoga to individuals to empower them to progress towards greater health and freedom from disease.’ The words empower here is important, because a key aspect of Yoga is the active participation of the patient in the process of therapy” (p. 14). As I have said before, Kundalini yoga seems to be a very popular one for the use of yoga therapy, but it does not have to be the only practice. The yoga therapist must be knowledgeable in both the history and culture of yoga, but also have grounding in the psychological world. However, the article pointed out that yoga was never intended to be a medical system all on its own. Yoga does not have any systematic ways of diagnosing people (Mohan, 2006). Instead, yoga should be used as a tool that has shown to have many benefits in the medical system. There are fundamental requirements that a yoga approach must have in order for it to be a good fit for yoga therapy. Firstly, the yoga therapy is that the work done by a patient must be observable. A practitioner cannot observe another individuals energy flow, so that is not a branch of yoga that would work in the field of yoga therapy (Mohan, 2006).

The other two “fundamental requirements” that are important characteristics to yoga therapy are quite similar and both express that the yoga philosophy used must be clear and rational, and not contradictory (Mohan, 2006). After everything I have learned in this class, I am not sure if this is possible. How does one find a yoga philosophy that is not contradictory in some way or another? It seems that contradictions were the one thing you found in every type of yoga across the board. Is that the role of the yoga therapist verse the yoga teacher? In teacher about yoga you point out all the contradictions found in the yoga philosophies. However, maybe as a yoga therapist, you avoid these contradictions, and focus on the aspects of yoga that remain true no matter what. I really enjoy that the article says to approach the contradictory statements of yoga with caution (Mohan, 2006). Maybe that is true difference of yoga therapy, people acknowledge that there are contradictions in the theories, but they examine them logically and do not follow every aspect of yoga in their practices, just the ones that are clear and authentic.

Yoga and Obsessive Compulsive Disorder

It was not until recent years that yoga was first looked at for the use of therapy. One of the first studies of the effects was through the work of Kundalini yoga. This practice begins with the process of “tuning in” which helps establish a meditative state (Shannahoff-khalsa, 2004). A pose is assumed, a mantra is chanted, and the breathing becomes steady. This technique is typically how a session would start for someone with obsessive compulsive disorder because it is said to create a “meditative state of mind” (Shannahoff-khalsa, 2004). Many of the other techniques used for those with Obsessive Compulsive Disorder are really focused on the breath. Sometimes the focus is placed on the sound of the breath, or the speed of the breath. In some techniques the breath is being sped up, as opposed to in most yoga practices where the breath is to be slowed down (Shannahoff-khalsa, 2004).

I was sad when I got to the end of the section on Obsessive Compulsive Disorder for the article. Until the end, the article had been pretty sound in their explanations of reaching a meditative state, focusing on the breath, and connecting with the mind. All of that sounded like it would be very beneficial to an individual with Obsessive Compulsive Disorder. However, the article had to through in some rather outlandish “finding”. The article stated, “Yogic experiments (Yogi Bhajan, personal communication) claim that 90 days of 31 minutes per day using the perfected rate of 1 breath per minute with 15 seconds per phase will completely eliminate all OC disorders” (Shannahoff-khalsa, 2004).

As a counseling major, with background information on Obsessive Compulsive Disorders, I know that it is not a “curable” disorder. It is a disorder that there are a lot of treatments for that can lessen symptoms and make life easier, but it is not a part of a person that can really be “fixed”. My hope for the Shannahoff-khalsa article is that they are stating a claim made by some yogic experiments, and not stating that they are completely true. In fact, it was this statement from the article that makes me the most concerned. Not only is it a bit of a ridiculous statement, but if an individual with Obsessive Compulsive Disorder focuses all their time on counting their breath, then they are not really being “cured” at all. In fact, I would argue quite the opposite. Focusing on the breath and changing the breath, I see the benefits of these things for people with this disorder. However, counting breaths makes no sense to me. Who decided to make people who already count their steps focus on counting their breaths? This is just validating that obsessions are a great way to be healthy! I have no idea who missed that concept here, but I was sold on yoga as positive therapy for Obsessive Compulsive Disorder until I got to that part of the article.

Does Yoga Really Work?

I found some articles that were based slightly more in the scientific side of yoga then the practice alone. One article explained the neuropsychological side of Obsessive Compulsive Disorder, as well as other disorders. The article said, “studies of the brain during the past decade using highly sophisticated neuroimaging techniques have shown notable patterns of abnormal activity in the brains of patients with various types of lesions and organic disorders” (D'epiro, 2000). The article went on to say that all the yoga practices being used were supposed to target the abnormalities in the right frontal lobe. The article said, “Unilateral breathing has been shown to have nostril-specific effects on the CNS and the autonomic nervous system, he explains, and it has been shown to selectively stimulate the contralateral cerebral hemisphere, resulting in alterations in cognitive performance, mood, EEG, and magneto-encephalography findings” (D'epiro, 2000). This was a more concrete way to look at yoga for me. As sad as it is, I must admit I have a very Western perspective when it comes to some things. Holistic therapies are great, and I am all for using them in our medical system, as well as our psychiatric systems. However, there are times when the only way to see if a practice really works is to examine what exactly the practice is supposed to be doing. Learning that research has shown unilateral breathing has certain effects on the body and the nervous systems, makes it more legitimate that yoga could be beneficial to those with Obsessive Compulsive Disorder.

Another article I found shared one particular story of a woman suffering from Obsessive Compulsive Disorder that was looking for anything that could be of help to her. This individual, like many others, did not have profound results from the usual treatment of medication and Cognitive Behavioral Therapy (Kuo, 2004). This individual decided to begin using yoga and other mindfulness techniques to treat her Obsessive Compulsive Disorder. The article said she “improved her quality of life by accepting her OCD as a strength and enhancing her mindfulness so that she was able to incorporate her OCD into her daily life” (Kuo, 2004). Within six months this individual had been taken off her medication, and was finally back in control of her own life. They even went back three years later, and the individual continued to be medication free and was living a healthy lifestyle. She admitted that some obsessive thoughts remained, but she now had control of them (Kuo, 2004).

Other articles I found showed various studies and statistics. One of the articles was a bit older, but it talked about how there had been very few clinical trials to actually test the validity of yoga (Archer, 2006). The article went on to examine the most sound of the trials that had been done, saying that it did show some amazing results. In just three short months, there were significant improvements in the Obsessive Compulsive Disorder of all twelve subjects using yoga as treatment in the study (Archer, 2006). People of the academic and scientific communities are really hoping that more research be done so as to have more evidence backing the findings that have already been made. People are optimistic that yoga will be a common treatment option in the future because “it does not have the adverse side effects of drug therapy and is popular and available worldwide” (Archer, 2006). I agree with this article, I hope that the future will bring nothing but more sound evidence that yoga is a great treatment option. As the article said it is a safer and more available option than medication. Yoga could have a positive effect on a whole range of psychological disorders, but the only way to find out is to continue doing research.

Conclusion

I still have a lot of mixed feelings on both yoga as a whole and its uses to the psychological world. As I said early in my paper, I feel as though more research still needs to be done in order for yoga to become a valid therapy for the treatment of Obsessive Compulsive Disorder. I believe that yoga is beneficial in many ways though. I may not believe that it can cure the incurable, or find that every aspect of the practice makes sense to me, but I do believe there is a lot that can be gained from yoga as a whole. I look forward to future studies, because I believe yoga as therapy is just beginning. There is still a lot to learn about what yoga has to offer our Western world.

References

Archer, S. (2006, March). Yoga practice may help OCD. IDEA Fitness Journal, 3(3), 87.

D'epiro, N. W. (2000, April 15). Can yoga tame OCD? Patient Care, 34(7), 14.

Douglass, L. (2007). The Yoga Tradition: How Did We Get Here? A History of Yoga in America, 1800-1970. International Journal Of Yoga Therapy, (17), 35-42.

Franklin, M. E., Abramowitz, J. S., Bux, D. r., Zoellner, L. A., & Feeny, N. C. (2002). Cognitive-behavioral therapy with and without medication in the treatment of obsessive-compulsive disorder. Professional Psychology: Research And Practice, 33(2), 162-168. doi:10.1037/0735-7028.33.2.162

Kuo, F. E. (2004). A mindfulness-based treatment of obsessive-compulsive disorder. Yoga Studies, 29.

Mackenzie, N. (2011). The Right Yoga For You. Prevention, 63(10), 32-35.

Mohan, G. (2006). Invited Article: Exploring Yoga as Therapy. International Journal of Yoga Therapy, (16), 13-19.

Natural Standard. (2011). Obsessive Compulsive Disorder (OCD). Retrieved from www.naturalstandard.com

Shannahoff-khalsa, D. S. (2004). An Introduction to Kundalini Yoga Meditation Techniques That Are Specific for the Treatment of Psychiatric Disorders. Journal Of Alternative & Complementary Medicine, 10(1), 91-101.

Strasuss, S. (2004). Re-Orienting Yoga. Expedition, 46(3), 29-34.

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