Yoga

Yoga
The philosophy and practice of Yoga date back to ancient times, originating perhaps as
early as 5,000 to 8,000 years ago.1,109,110 It has been argued that the rules or precepts set down
in the first systematic work on Yoga, Patanjali’s Yoga Sutras, do not set forth a philosophy,
but are practical instructions for attaining certain psychological states.111,112 It is important to
acknowledge the diversity of techniques subsumed under the term “Yoga.” Over many
millenia, different yogic meditative techniques had been developed and used to restore and
maintain health, and to elevate self-awareness and to also transcend ordinary states of
consciousness, and ultimately to attain states of enlightenment.110
Yogic meditative techniques have been transmitted through Kundalini yoga, Sahaja yoga,
Hatha yoga and other yogic lineages.113 Though there are numerous styles of Yoga;114 the
styles vary according to the emphasis and combination of four primary components: asanas,
pranayamas, mantras, and the various meditation techniques.115 In Kundalini yoga, there are
thousands of different postures, some dynamic and some static, and also thousands of
different meditation techniques, many of which are disorder specific.116,117 Kundalini yoga
meditation techniques are usually practiced while maintaining a straight spine, and employ a
large number of specific, and highly structured breathing patterns, various eye and hand
postures, and a wide variety of mantras. All of these techniques supposedly have different
effects and benefits in their respective combinations.
Within Hatha yoga, many “schools” have developed, each differing slightly in its
emphasis on the use of breathing and postures: in Bikram Yoga, practitioners perform the
same sequence of 26 asanas in each session; in Vini Yoga, emphasis on the breath makes for a
slower-paced practice. Iyengar Yoga is distinguished from other styles by its emphasis on
precise structural alignment, the use of props, and sequencing of poses.118,119 There are also
two Tibetan yogic practices, Tsa Lung and Trul Khor, that incorporate controlled breathing,
visualization, mindfulness techniques, and postures.120 In Yoga, it is also believed that the
practice of meditation techniques can be enhanced by the proper cleansing and conditioning
of the body through the asanas and breathing exercises, or pranayama techniques121 (though
pranayama places particular emphasis on techniques of breathing, some pranayama also
employ physical movements).122
In addition to the schools of Yoga described above, TM® and the secular meditation
techniques RR and CSM are derived from classical yogic techniques.123 It is important to note
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that the techniques in any given school or type of Yoga represent distinct interventions, in
much the same way that psychodynamic, cognitive-behavioral, and interpersonal therapies
each involve different approaches to psychotherapy.124
The purpose of asanas, pranayams, and pratyahar (emancipation of the mind from the
domination of the senses) is to help rid the practitioner of the distractions of body, breath, and
sensory activity and to prepare the body and mind for meditation and spiritual
development.114 The use of mantras is said to help cleanse and restructure the subconscious
mind, and to help prepare the conscious mind to experience the various states of
superconsciousness. The more advanced Yoga practices lie in dharana (concentration),
dhyana (yogic meditation) and samadhi (absorption). Concentration involves attention to a
single object or place, external or internal (e.g., the space between the eyebrows, the tip of the
nose, the breath, a mantra [chanted loudly, softly, or silently] or attention to all of these
elements simultaneously). When the mind flows toward the object of concentration
uninterruptedly and effortlessly, it is meditation. When it happens for a prolonged period of
time it leads to samadhi, the comprehension of the true nature of reality that ultimately leads
to enlightenment and emancipates the practitioner from the bonds of time and space.123,125
Main components. Classical Yoga is an all-encompassing lifestyle incorporating moral
and ethical observances (yamas and niyamas), physical postures (asanas), breathing
techniques (pranayams), and four increasingly more demanding levels of meditation
(pratyahar, dharana, dhyana, and samadhi).126,127 Due to the incredible diversity of techniques
in yogic meditation practice, it is impossible to describe them in adequate detail here. Instead,
we have attempted to provide the reader with a very general description of the main
components of many yogic meditation techniques. The reader is directed to the reference list
for more detailed information on specific Yoga styles or techniques.110,116,117,119,128,129
The most common translation of “asana” is “posture” or “pose” and it refers to both
specific postures for gaining greater strength and flexibility and those used specifically to help
achieve proper concentration for meditation. Asanas are practiced either standing, sitting,
supine, or prone.130 The postures for strength and flexibility take each joint in the body
through its full range of motion, stretching, strengthening, and balancing each body part.114
Depending on the particular yogic technique one follows and the individual level of practice,
each asana is held anywhere from a few breath cycles (as long as 2 minutes) to as long as 10
minutes or, in the case of some advanced practices, even 2.5 hours.
In most schools, during each posture attention is directed to the breath—to the deep, inout,
rhythmic sensation—and awareness is brought to the area of the body that is being
stretched or strengthened.130 Though poses may be held for a few seconds to a few minutes,
the body can also be in constant dynamic motion. Muscles relax and loosen, changing the
shape of the pose, and the in and out breath moves in rhythm with the body. The practitioner
simply observes the physical or psychical sensations and emotions arising while suspending
judgment. The asanas are interspersed with brief moments of relaxation during which the
practitioner attempts to redirect or maintain an inward focus.130
In postures used specifically for meditation, for example in Kundalini yoga, the spine is
kept straight and the practitioner can be seated in a chair with the feet flat on the floor or
seated in a cross-legged posture, and specific directions are given regarding the positioning of
the arms, hands, and eyes, (e.g., the palms of the hands can be pressed together with the
fingers together pointing up at a 60-degree angle, and the sides of the thumbs rest on the
sternum in what is called “prayer pose,”129 and the eyes are closed as if looking at a central
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point on the horizon, the “third eye,” or the notch region between the eyes). A mantra (again
technique specific) may also be chanted, and/or a simple or complex breathing pattern may be
employed.129 Alternately, the eyes might be kept open and focused on the tip of the nose or
closed and focused on the tip of the chin or top of the head, again in conjunction with any
number of a wide variety of breathing patterns, and/or mantras.129 In Sahaja yoga,
practitioners sit in a relaxed posture with hands in front, palms upward. Attention is directed
to a picture placed in front with a candle lit before it. Gradually when thoughts recede,
meditators close their eyes and direct their attention to the “sahasrara chakra” or top of the
head. The individual sits in meditation for about 10 to 15 minutes.131 The amount to which the
eyes are open or closed also varies; eyes may be fully open, fully closed, or half-closed.
Breathing. A central focus for most yogic meditation techniques is the breathing
pattern.119 Pranayams, or breathing exercises, involve the conscious regulation of rhythmic
breathing patterns, where some or all of the inspiration, breath retention, expiration, and
breath out phases are regulated according to specific ratios or times. The inspiration and
expiration phases can also be regulated by breaking each breath of the inspiration and
expiration into 4 parts, 8 parts, or 16 parts or only the inspiration may be broken while the
expiration remains unbroken.132 In addition, a breath pattern may be employed selectively
through either the left or right nostril (or a sequential combination of both), or specific
combinations of the nose and mouth. A wide variety of broken breath patterns have been
discovered that have varying effects. Some techniques may also require holding attention on
the imagined flow of energy along the spinal column collaterally with the breathing rhythm,
on the sensation of inhaled air touching and passing through the nasal passage, on other parts
of the body, or on a mantra.129,133
In Hatha yoga, various patterns of respiration are closely coordinated with the body in
either a static posture or with movement.134 There are many pranayama techniques described
in Hatha yoga texts; however, the practice of pranayama in this tradition has four primary
objectives: (1) a stepwise reduction in breathing frequency, (2) attainment of a 1:2 ratio for
the duration of inspiration and expiration respectively, (3) holding the breath for a period at
the end of inspiration that lasts twice the length of expiration, i.e., a 1:4 ratio between
inhalation and retention, and (4) mental concentration on breathing.121,135 The four objectives
are united in the achievement of a single purpose, namely, the slowing down of respiration to
achieve an immediate intensification of consciousness through the elimination of external
stimuli.136
Practices such as Sudarshan Kriya Yoga involve rhythmic breathing at different rates
following ujjayi pranayama (long and deep breaths with constriction at the base of throat) and
bhastrika (fast and forceful breaths through the nose along with arm movements).137,138 Other
practices, such as Iyengar Yoga, instruct the practitioner to breath through the nostrils only
while performing the asanas.139 Some varieties of pranayama require the practitioner to inhale
and exhale through one nostril selectively, a practice called unilateral forced nostril
breathing.119,140 These breathing exercises are often practiced in combination with different
postural locks (bandhas). Bandhas are restrictive positions or muscle maneuvres that exercise
certain parts of the body. The most common of these are the abdominal lift (uddiyana
bandha), the root lock (mula bandha), and the chin lock (jalandhara bandha).123
In Kundalini yoga, there are hundreds of different breathing patterns, each having unique
and specific benefits and effects. In “Sodarshan Chakra Kriya,” considered one of the most
powerful pranayama meditation techniques in Kundalini yoga, a unilateral forced nostril
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breathing pattern is employed selectively with inspiration through the left nostril, with breath
retention, and with selective expiration through the right nostril. During the breath retention
phase the abdomen is pumped in and out 48 times and a three-part mantra is mentally
repeated 16 times in phase with the abdominal pumping (one repetition of the three-part
mantra with three pumps), and the eyes are open and focused on the tip of the nose. As the
technique is mastered, the rate of respiration is eventually reduced to less than one breath per
minute and practiced for a maximum of 2 hours and 31 minutes.129
Attention and its object. Inherent in the practice of Yoga is an effortful progression
toward increased concentration, or, more precisely, toward entering a state in which the mind
is highly stable and still, consciously and purposely focused, and ordinary thoughts are
suspended, and the meditator is more aware of the present moment (samadhi).141,142 This state
has been described as the complete merging of the subjective consciousness and the object of
focus.130 Hatha yoga has been defined as gentle stretching and strengthening exercises with
constant awareness of breathing and of the sensations that arise as the meditator assumes
various postures.76,128 By manipulating the body and making minute, detailed adjustments to
perfect each posture, a person develops “one-pointed” concentration and ceases to become
distracted by extraneous thoughts.130
One Hatha yoga technique, Shavasana, or corpse pose, involves lying on the back, with
legs resting on the floor slightly apart, arms at the sides, palms facing up, and eyes closed.
This seemingly simple pose is actually one of the most demanding to perfect because of the
practitioner's need to achieve absolute stillness and total concentration as well as control over
the breath.119 If drowsiness occurs, practitioners are told to increase the depth of their
breathing. If the mind is restless, attention to the breathing cycle or other bodily sensations is
encouraged. The goal is to rest in a state of relaxation, yet be aware of raw, sensory
information and to let go of any reactions or judgments.121
In Kundalini yoga, one complex meditation technique called “Gan Puttee Kriya”, with
multiple aspects of focus, is said to help eliminate negative thoughts, “psychic scarring,” and
acute stress.116 The practitioner sits with a straight spine, either on the floor or in a chair. The
backs of the hands are resting on the knees with the palms facing upward. The eyes are open
only one-tenth of the way, but looking straight ahead into the darkness, not the light below.
The practitioner chants consciously from the heart center in a natural, relaxed manner at a rate
of one sound per second. The practitioner begins by chanting “SA” (the A sounding like
“ah”), and touching the thumb tips and index fingertips together quickly and simultaneously
then chanting “TA” and touching the thumb tips to the middle fingertips, then chanting “NA”
and touching the thumb tips to the ring fingertips, then chanting “MA” and touching the
thumb tips to the little fingertips, then chanting “RA” and touching the thumb tips and index
fingertips, then chanting “MA” and touching the thumb tips to the middle fingertips, then
chanting “DA” and touching the thumb tips to the ring fingertips, then chanting “SA” and
touching the thumb tips to the little fingertips, then chanting “SA” and touching the thumb tips
and index fingertips, then chanting “SAY” (like the word “say”) and touching the thumb tips
to the middle fingertips, then chanting “SO” and touching the thumb tips to the ring fingertips,
then chanting “HUNG” and touching the thumb tips to the little fingertips. The thumb tips and
fingers touch with about 2 to 3 pounds of pressure with each connection which supposedly
helps to consolidate a circuit created by each thumb-finger link. The techniques can be
practiced for 11 minutes (or less) to a maximum of 31 minutes. When finished, the
practitioner remains in the sitting posture and inhales and holds the breath for 20 to 30
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seconds while shaking and moving every part of the body vigorously, with the hands and
fingers moving very loosely, then exhaling and repeating this two additional times,
immediately followed by opening the eyes and focusing them on the tip of the nose and
breathing slowly through the nose for one minute.
Spirituality and belief. Yoga is a science and philosophy of the human mind and body; it
is a way of life, moral as well as practical.143 Yoga predates all formal religions,1,129 and,
perhaps for this reason, the practice of Yoga does not presuppose an individual’s commitment
to a particular philosophical or religious system.144,145
Training. The ethical principles of Yoga describe the essential attitudes and values that
are needed to undertake the safe practice of Yoga. The physical practice of Yoga focuses on
the development of the strength, flexibility, and endurance of the body, strengthening of the
respiratory and nervous systems, development of the glandular system, and increasing the
ability to concentrate. In its complete form, Yoga combines rigorous physical training with
meditation practices, breathing, and sound/mantra techniques that lead to a mastery of the
body, mind, and consciousness. Both ancient commentaries on Yoga and more modern books
of instruction stress the importance of learning under the guidance of an experienced teacher,
Guru or Master.110,121,139 However, some Yoga techniques, especially asanas, pranayams, and
meditation techniques, have been described and illustrated in books and videos produced for
the purpose of self-study.139 In terms of specific training requirements, it is recommended that
Yoga exercises be practiced daily, preferably in the morning, and on an empty stomach.139
Exercises can last from 15 minutes to several hours and it can take several years of consistent
practice before a practitioner is able to practice properly the more demanding asanas and
meditation techniques.121
Criteria of successful meditation practice. The ideal instruction in and assessment of
Yoga techniques comes from a Guru or Master. Nevertheless, as books and video instruction
are available, it can be assumed that the practitioner is able, to varying degrees, to assess the
correctness of at least some asanas, pranayams, and a wide variety of meditation techniques.
Yoga is ultimately a tradition of spiritual self-discipline and practice for the pursuit of
enlightenment.136 Like Vipassana and Zen Buddhism, the success of meditation practice is
judged on the basis of the practitioner achieving this state of enlightenment or other
intermediate psychological or spiritual states. For example, the central experience achieved
through Sahaja yoga meditation is a state called “thoughtless awareness” or “mental silence”
in which the meditator is alert and aware but is free of any unnecessary mental activity.12 The
state of thoughtless awareness is usually accompanied by emotionally positive experiences of
bliss. In general, the outcome of the meditative process is associated with a sense of relaxation
and positive mood and a feeling of benevolence toward oneself and others.146
As Yoga also involves exercises to strengthen the body and voluntarily control different
aspects of breathing, success in these techniques can be evaluated against the standards for
practice (e.g., achieving a 1:4:2 ratio in inhalation, retention, and exhalation), or developing
the ability to reduce the rate of respiration to one breath per minute for 1 or 2 hours.
Successful practice can also be determined by a subjective and objective evaluation of the
achievement of some of the reported health benefits.
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Tai Chi
Tai Chi (also romanized as Tai Chi Ch’uan, T'ai Chi Ch'uan, Taijiquan, Taiji, or T'ai Chi)
has a history stretching back to the 13th century A.D. to the Sung dynasty.147 There are five
main schools, or styles, of Tai Chi, each named for the style's founding family: Yang, Chen,
Sun, Wu (Jian Qian), and Wu (He Qin).148 Each style has a characteristic technique that
differs from other styles in the postures or forms included, the order in which the forms
appear, the pace at which movements are executed, and the level of difficulty of the
technique.148 Though differing in focus on posture and the position of the center of gravity, all
styles emphasize relaxation, mental concentration, and movement coordination.147 Tai Chi
practice usually involves the need to memorize the names associated with each posture and
the sequence of postures.148
Main components. The practice of Tai Chi encompasses exercises that promote posture,
flexibility, relaxation, well-being, and mental concentration.148,149 It is characterized by
extreme slowness of movement, absolute continuity without break or pause, and a total
focusing of awareness on the moment.150 Unlike most exercises that are characterized by
muscular force and exertion, the movements of Tai Chi are slow, gentle and light. The active
concentration of the mind is instrumental in guiding the flow of the body’s movements.151
Thus, Tai Chi is not only a physical exercise, but also involves training the mind, and this has
prompted some to consider the practice “moving meditation.”148-150 Although Tai Chi follows
the principles of other types of martial arts that focus on self-defense, its primary objective is
to promote health and peace of mind. In contrast to other martial arts, Tai Chi is performed
slowly, with deep and consistent breathing.151 The movements should be performed in a quiet
place that will help the practitioner to achieve a relaxed state. The muscles and joints are
relaxed and the body is able to move easily from one position to another. The spine is in a
natural erect position, and the head, torso, arms, and legs should be able to move freely and
gently. The upper body is straight, never bending forward or backward, or leaning left or
right.152
Breathing. Several different breathing techniques are employed in Tai Chi; however, the
principal breathing technique, called “natural breathing,” is the foundation for all other
breathing techniques. In natural breathing, the practitioner takes a slow, deep (but not
strained) breath, inhaling and exhaling through the nose. The mouth is closed, but the teeth
are not clenched. The tip of the tongue is held lightly against the roof of the mouth. As the air
is taken in, the lower abdomen expands. Once the lungs are adequately filled with air, the
person exhales and the lower abdomen contracts. The breath is never held. The eyes should be
lightly closed.152
The movements of Tai Chi are coordinated with the breath, and the pattern of breathing
follows the succession of opposing movements of the arms: inhalation takes place when the
arms are extended outward or upward, exhalation occurs as arms are contracted or brought
downward. Breathing eventually becomes an unconscious part of the exercise; however, its
importance in the practice never diminishes.150
Attention and its object. Throughout the practice, the mind remains alert but tranquil,
directing the smooth series of movements and focusing on one's internal energy. This active
concentration is integral to the practice.149,151 It has been argued that if Tai Chi movements are
performed without concentration, Tai Chi is no different from other forms of exercise. The
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variety and distinctiveness of the movements ensure that one concentrates on the execution of
the movements.151
Spirituality and belief. Tai Chi derives its philosophical orientation from the opposing
elements of yang (activity) and yin (inactivity) and from qi (breath energy).147 In accordance
with the symbols of yin and yang, Tai Chi movements are circular. The movements are
designed to balance the qi, or vital energy, in the meridians of the body, and strengthen the qi,
thus preventing illness.153 Like Yoga, the practice of Tai Chi does not require adopting a
specific spiritual or belief system and has been used clinically as a therapeutic intervention.
Training. The exercise routines of the different forms of Tai Chi vary in the number of
postures and in the time required to complete the routine,147 with some Tai Chi programs
being modified to suit the abilities of practitioners with declining physical and mental
function.148 Classical Yang Tai Chi includes 108 postures with some repeated sequences.
Each training session includes a 20-minute warm-up, 24 minutes of Tai Chi practice, and a
10-minute cooldown. The warm-up consists of 10 movements with 10 to 20 repetitions.
However, the exercise intensity depends on training style, posture, and duration.154
When practiced solely as an exercise form, sessions should occur twice a day and last
about 15 minutes, 4 or more days per week.147 Practitioners are not required to continue
training permanently with a Tai Chi teacher, and can continue practice as a form of self therapy.
152 When used as a system of self-defense, Tai Chi must be practiced with a Master
and long enough to develop a deep understanding and “body memory” of the movements.155
However, as a healing practice, years of study are not required and the typical practitioner
may be able to learn the fundamental movements within a week.155
Criteria of successful meditation practice. The overall aim is not to “master” the
movements, but to appreciate a developing sense of inner and outer harmony as the
movements become more fluid, yet controlled, and the mind more alert, yet peaceful.149 To
learn and practice Tai Chi successfully, practitioners must adopt and practice specific
traditional principles of posture and movement such as holding the head in vertical alignment,
relaxing the chest and straightening the back, using mental focus instead of physical force,
and seeking calmness of mind in movement.