A paradigm shift has happened in how people view wellness that has given rise to the increasing popularity of integrative approaches to health and healing. In addition to acupuncture, reiki, and other energy-centered modalities, we have tai chi, qigong, and yoga. Although yoga has been around for thousands of years in other parts of the world, it really only arrived on American shores in 1893 when Swami Vivekananda stepped onto the stage at the Parliament of the World’s Religions in Chicago. He had uttered just five words when the crowd burst into a standing ovation that lasted more than two minutes .
Since that day in Chicago, yoga has become ubiquitous in western culture, morphing into various styles and practices that vary from sitting in meditation to tapping into energy centers of the body by using particular hand and finger positions to sweating through an active moving practice in rooms set to 110 degrees. It can be practiced by one person alone in a quiet corner of one’s house or hundreds of people in colorful clothing spread out on the National Mall in Washington, D.C. But is any of this really yoga? The answer is: Yes. If it helps align body and mind and brings us closer to knowing our True Self, it is yoga. If it allows us to look beyond the weight of depression and tap into our deep well of compassion and self-acceptance, if it heals low back pain or allows us to not be held hostage by chronic pain, it is yoga.
All yoga can be therapeutic: We see this in our students who come to class to “get a good workout” but return soon after because they confessed they hadn’t felt so calm in a long time. Or the student, who engages in Nadi Shodhana (alternate nostril breathing) and six months later, discovers that her panic attacks disappeared. But all yoga isn’t necessarily yoga therapy.
Yoga therapy is an emerging field within the integrative health sciences that has found a seat at the table with the established medical community, merging the boundaries of its ancient teachings with biomedicine, philosophy, physiology, and mental health. There is a growing body of evidence that supports its value in the arena of contemporary healthcare, as demonstrated by a recently published book, Yoga Therapy and Integrative Medicine: Where Ancient Science Meets Modern Medicine , which is a collaboration of more than 35 physicians and yoga professionals who represent both Ivy League universities and yoga therapy institutions worldwide. Furthermore, a recent study by Columbia University and Harvard researchers and published in the Journal of Alternative and Complementary Medicine demonstrated a significant reduction in depressive symptoms, some as much as 50%, in people who practiced twice-weekly yoga and coherent breathing for twelve weeks .
Yoga therapy as taught in training programs across the United States-and I’m sure beyond-is based on the understanding that humans are a holistic entity, that each individual is unique. Yoga is self-empowering, meaning the client is his/her own healer . I and my colleagues believe that much of our ability to heal is within us; we only need to tap into that source of healing. But it’s easy to understand why there is confusion between yoga as exercise and yoga therapy. Below I’ll try to explain with a brief Q&A format.
What’s the difference between a yoga teacher and a yoga therapist? Let me begin by saying all yoga therapists start out as yoga teachers. Yoga teachers need at least 200 hours of training as a foundation. However, one cannot enter into formal training as a yoga therapist without having achieved, in most cases, 500 hours of teacher training. Yoga teachers receive their training through Yoga Alliance-approved schools (“schools” can refer to yoga studios who are Yoga Allianceapproved). Additionally, yoga teachers are trained by professionals in their respective fields or other yoga teachers who have met a certain level of experience (for instance, E-RYT, meaning “experienced registered yoga teacher”).
Yoga therapists must meet stringent competency-based educational standards set forth by the International Association of Yoga Therapists (www.iayt.org). Schools that want to offer yoga therapy training must be accredited by IAYT, another rigorous process that involves demonstration of inclusion of these competencies in the schools’ curriculums. Yoga therapists are also trained by IAYTapproved faculty. Yoga therapy training consists of at least 1000 hours, and in most cases includes practicum experience where each student works with clients within a supervised clinical setting. For instance, students at Maryland University of Integrative Health in Laurel, Maryland spend a full year honing their skills in the on-site clinic. In addition to being one of the schools fully accredited by IAYT, MUIH is also the first school in the country to offer a graduatelevel degree in the field.
In addition to courses such as advanced anatomy and yoga philosophy, depending on the training program, the yoga therapist is also trained in clinical research, ethics and business practices, legal and regulatory issues that affect their scope of practice, building relationships with other professionals, designing and writing case reports, as well as foundations of Ayurveda, yoga’s sister science. The yoga therapist must also be well versed in disease pathology and contraindications that may affect a client’s practice.
What is a yoga teacher qualified to do? Yoga teachers are qualified to teach classes and workshops, and offer private yoga instruction. Yoga teachers also are usually trained in certain styles or lineages. Classes focus on correct posture, breathing and meditation.
What is a yoga therapist qualified to do? Yoga therapists are qualified to work in hospital, physician, and mental health settings, with individuals who present with physical, emotional, and spiritual challenges that require one-on-one, in-depth work. Sessions focus on specific application for a specific purpose. IAYT’s definition states “Yoga Therapy is the process of empowering individuals to progress toward improved health and well-being through the applications of the teachings and practices of yoga.” These teachings refer to anatomy, philosophy, lifestyle, pranayama (breathwork), mudra (hand gestures), mantra (sound vibration), meditation, self-inquiry, as well as moral restraints and observances such as non-violence, truthfulness, contentedness, self-discipline and self-study, purity, non-possessiveness, among others. (Yoga teachers are also versed in these principles).
Yoga therapists are highly trained in all aspects of these practices to empower individuals to help reduce or eliminate suffering on a physical, emotional, and spiritual level, and to change their relationship to and identification with their condition (i.e. pain).
What is a yoga therapist not qualified to do? Yoga therapists are not qualified to diagnose illness or other pathologies, offer nutritional advice, massage, or medication, or practice psychotherapy. These are outside the YT’s scope of practice and should be referred out.
Yoga therapy is client-centered and views humans as multidimensional. Understanding that each individual brings his or her own physical and emotional challenges and life experiences into the session, the yoga therapist also understands that the client’s yoga practice must be specifically tailored to address the client’s needs and goals, whether it’s managing chronic pain, controlling anxiety, managing symptoms of depression or PTSD, or improving one’s relationship with oneself.
The origin of yoga is rooted in ancient texts that go back 5,000 years, with the application of these teachings still in existence today, having been adapted to the modern world. In the words of Dr. Margaret Chan, Director-General of the World Health Organization:
“The two systems of traditional and Western medicine need not clash.
Within the context of primary health care, they can blend together in a
beneficial harmony, using the best features of each system.”
Yoga therapy is different than a yoga class, as explained above. But as I said, all yoga can be therapeutic. Whether we find well-being in a room full of people being led through poses and breath work, or through working individually with a practitioner trained by an IAYTaccredited school, we can all experience a profound sense of healing through the modern application of these ancient principles.
Suzanne Ludlum, MS, C-IAYT, E-RYT500, YACEP, is a faculty member at the Maryland University of Integrative Health in Laurel, Maryland, and is a certified yoga therapist and owner of Trinity Yoga and Healing in Fredericksburg, Virginia. She is a conference presenter and conducts trainings for yoga teachers and mental health professionals.
- Goldberg P. An American Veda: From Emerson and the Beatles to Yoga and Meditation; How Indian Spirituality Changed the West. New York, NY: Three Rivers Press. 2010.
- Payne L, Gold T, Goldman E, Rosenberg C, Soratorio A. Yoga Therapy & Integrative Medicine: Where Ancient Science Meets Modern Medicine. Laguna Beach, CA: Basic Health Publications, Inc. 2015.
- Streeter Chris C, Gerbarg Patricia L, Whitfield Theodore H, Owen Liz, Johnston J, Silveri M, et al. Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study. J Comp Alt Med. 2017; 23: 201-207.
- Desikachar K. The Yoga of Healing: Exploring Yoga’s Holistic Model for Health and Well-being. Int J Yoga Therapy. 2005; 15: 17-39.