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Yoga Therapy: Where Science meets the Subtle Body

Modern health science and medical education has long divided the human experience into physical and psychological disciplines. Thanks largely to the mind-body split made popular by French philosopher Descartes in the 15th century, the western understanding of bodies and minds has been built upon the premise that only the mind thinks and feels, and the body is merely a complicated machine. Perhaps it has been of benefit to human development to think in that way, allowing scientists to deeply explore singular topics within health science, and for medical specialists to evolve to the incredible technological life-saving abilities we all rely on in a health crisis.

However, what anyone who has received medical care will understand, is that even with the best of evidence-based modern medicine, there can be a sense of a lack of humanity. Taking on the role of ‘patient’ can feel dehumanising, the backless gowns and procedural efficiencies stripping one of dignity, and leaving people feeling like a number on a conveyor belt. Medicine is big business and in both private and public sectors there is a focus on conserving resources including human hours. That means very little time for nurses and support staff to chat, and allied health professions – some of which are inherently holistic, must also be shaped to fit the system.

Within biomedical training there is little room for development of ‘soft skills’, and an emphasis on striving for technical excellence which pushes trainees and registrars to the brink of burnout and beyond. Those who make it through the long and rigorous years of training, historically at least, were often privileged people from affluent backgrounds. While this has changed in recent decades, the culture of health settings tends to be slow to change, meaning that the dominant culture continues to add to a power imbalance between health care professionals and their patients.

Alongside these extraordinary achievements in medical science, has grown up a multi-billion dollar wellness industry, which presents itself as a wholesome, green, nature-based alternative to the pharmaceutical industry and biomedical professions. Yoga, meditation, and personal development have traditionally fallen into this field of complementary and alternative medicine. However, as the comedian Tim Minchin is famous for quoting ‘What do you call alternative medicine that has been proven? Medicine.’ Research into the benefits of yoga and in particular the emergence of testable, protocolised, mindfulness-based interventions, has rapidly moved yoga from the hippie fringes to the mainstream. Yoga is now a proven form of medicine, with enough evidence to justify its inclusion in medical treatment centres worldwide. Here at Wisdom Yoga Institute we are on the cutting edge of this research, passionate about contributing to high quality yoga interventions.

Many yoga students self -refer to yoga classes to treat chronic mental and physical health conditions. Yoga teachers play an important role in their communities as a source of affordable, accessible preventive health and wellbeing. However, in many cases, their foundational 200 hour training has not equipped them with the skills of critical thinking, nor has it familiarised them with yoga’s increasing role as a complementary healthcare modality which is no longer considered alternative but is truly integrative – safe and effective to use alongside conventional mainstream medicine, and filling some of the gaps in terms of providing a more person-centred, human, compassionate and holistic aspect to health care. Indeed, some yoga teachers continue to hold alternative beliefs, and some will cultivate around themselves intentional communities that are actively anti-science and anti-medicine.

Yoga and science can co-exist harmoniously. There’s a beauty and magic in the esoteric and fascinating philosophies of yoga and its sister science Ayurveda. Appealing in their use of imagery, mantra, music, mythology and offering a pathway for personal evolution and spiritual freedom, the attraction is understandable. But this is simply part of why yoga appeals to those struggling with their mental and physical wellbeing.

Yoga Therapists unite science and spirituality, which offers seekers of health, wellness and growth, an appealing, compassionate, trauma-sensitive, tailored, personal healing modality. Not all Yoga Therapy training courses are equal of course, some lean into the spiritual end of the spectrum, while others target health professionals themselves, relying on scientific evidence, and discarding the more holistic models.

At Wisdom Yoga Institute, our IAYT accredited Yoga Therapy training program is truly integrative, as we use our decades of experience in yoga and meditation communities, along with academic training in our respective disciplines, to unite science with the subtle body.

Research Spotlight: Yoga for menopausal symptoms—A systematic review and meta-analysis

The majority of yoga practitioners in the west are women, yet traditional yogic texts do not speak much to the experiences of women or the unique rhythms and stages of life they go through. Menstruation is a taboo subject both in Australia and most certainly in India, equally menopause and the symptoms women experience are rarely discussed in yoga schools and ashrams. Nonetheless women are embracing yogic practices to manage the symptoms of menopause and flourish during this time.

Our spotlight this month is on the efficacy of yoga interventions for treating menopausal symptoms.

Article Reference: Cramer, H., Peng, W., & Lauche, R. (2018). Yoga for menopausal symptoms – A systematic review and meta-analysis. Maturitas, 109, 13–25. 

Summary 

Building on prior research, this article analyses the effect of yoga interventions on menopausal symptoms. Included were 13 high quality trials with 1306 participants. This type of research is called a “systematic review:” It is one of the strongest forms of research that often informs health sciences practices – because it is not based on one study. It seeks to analyse the findings of all studies that meet the inclusion criteria, in this case RCT studies that investigated the effect of yoga on menopausal symptoms, including studies that compared yoga to no treatment, and yoga compared to an active comparator. The type of studies included are strong due to being Randomised Control Trials (RCT), which means the subjects (participants) were randomly assigned to one of two groups – the yoga intervention, or a non-yoga group. This RCT study design is considered the gold standard in research design as it controls for factors not under direct experimental control.

In summary this article provides evidence to support the effects of yoga on menopausal symptoms, in comparison to no treatment. Yoga was found to relieve:

  • psychological symptoms
  • vasomotor symptoms (ie hot flashes and night sweats)
  • somatic symptoms (ie nausea, dizziness, headaches, fatigue, numbness, muscle and joint pain)
  • urogenital symptoms (ie vaginal dryness, burning, itching, discharge, urinary urgency, burning, and urinary tract infections)
  • total menopausal symptoms

When compared to exercise, Yoga is at least as effective in alleviating symptoms and is superior to exercise interventions on reducing vasomotor symptoms.

Implications for Teaching & Practice:

There is strong support and evidence base for recommending yoga to students with menopausal symptoms. Even if the student is already active, in some regards (vasomotor symptoms) yoga has been found to be superior, so even a class a week could be integrated into their training/exercise routine for these specific benefits. More research needs to be done to be able to advise specific practices for women, yet if we return to our last research spotlight, it is clear that dose matters more than duration, and regular or daily practice could most definitely be recommended to menopausal women.

Research Review in Detail

Title: Yoga for menopausal symptoms—A systematic review and meta-analysis

Authors: Holger Cramer, Wenbo Peng, Romy Lauche

Full article: https://pubmed.ncbi.nlm.nih.gov/29452777/

Objective: Menopause typically begins around age 50. Three quarters of women experience symptoms including hot flushes, night sweats, fatigue, pain, decreased libido, mood changes. This article updates a prior systematic review from 2012 that made preliminary recommendations for the use of yoga for women with psychological symptoms associated with menopause. The objective of this updated review is to systematically assess and meta-analyse the effect of yoga interventions on menopausal symptoms compared to no treatment or active comparators.

Methods: The authors carried out a systematic review and a meta-analysis. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines – PRISMA and the Cochrane Collaboration recommendations for conducting systematic reviews and meta-analysis. Appropriate data repositories were searched, (Medline (via PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus) for relevant articles up to 21st February 2017.

Randomised control trials (RCTs) from peer-reviewed journals were eligible for inclusion. All trials had to use yoga as the intervention and comparison groups could receive either no active treatment or an active treatment. There were no restrictions based on style of yoga or language. Multi-modal interventions where the role yoga played in results could not be clearly evaluated were excluded. However, studies with co-interventions whereby participants in all groups were allowed to have the co-intervention were included. All included studies had to assess important menopausal symptoms such as psychological, somatic, vasomotor, urogenital and/or a score assessing total menopausal symptoms.

The screening and data extraction process involved multiple independent researchers with further independent support providing mediation (during screening) and accuracy checking (during data extraction). The article succinctly articulates the process followed for replication. Risk of bias and threats to validity are clearly provided. 

Results and discussion: Thirteen eligible RCTs incorporating 1360 participants were included in qualitative analysis. This is an increase from 5 RCTs with 582 participants in the 2012 review. One RCT was excluded from meta-analysis as it used a comparison that could not be pooled with any other comparison groups.

Yoga interventions lasted between 4 and 16 weeks (average of 12 weeks), with 1 to 14 sessions per week (average of 2 sessions), between 20 and 120 minutes each (average of 60 minutes). Each study included 30 to 355 women (average of 54 participants). The studies included Hatha yoga (n=4), Iyengar (n=1), Integrated Approach to Yoga Therapy (n=1), Mindfulness based yoga (n=1), Yogasana and Tibetan yoga (n=1), Integral yoga (n=1) or unspecified (n=4). All 13 RCTs included postures, 11 included breathing and 8 included mediation. Six of the RCTS were carried out in Asia, one in Europe and 6 in America. The Menopausal Rating Scale and the Menopausal Quality of Life Questionnaire were the most commonly used instruments to measure outcome.

Compared to no treatment, yoga interventions were found to have a significant effect on total menopausal symptoms, psychological, somatic, vasomotor and urogenital symptoms. A significant difference was only found for vasomotor symptoms, compared to exercise as an intervention. When compared to health education, single studies found superior effects of yoga on total menopausal symptoms but not on psychological, somatic or vasomotor symptoms.

Also noteworthy, the review includes 13 RCTs with 1306 participants, which is a 2.6-fold increase in terms of published RCTs and a 2.2-fold increase in terms of participants compared to the 2012 review. Unlike the 2012 review where all participants had psychological symptoms associated with menopause, the women in this review appear representative of the general population.

Limitations and Threats to Validity:

Each of the RCTs had some risk of bias. However, when only studies with a low risk of selection bias were included the results did not change substantially. Given that selection bias has been empirically shown to be the most important source of bias in RCTs, the internal validity of the findings can be regarded as acceptable. The results of this review are applicable to the vast majority of women with menopausal symptoms in clinical practice and can thus also be regarded as externally valid.

Many of the RCTS did not report on safety related data. Of the 4 RCTs that did report on safety, none reported any serious adverse events.

The variety of underlying styles of yoga limits the interpretability of the findings. That is, it is not possible to drill down on what component(s) of yoga are providing the biggest impact. However, another review of 306 yoga RCTs found no difference in positive or negative conclusions between 52 different styles of yoga, which may suggest that effective yoga interventions do not depend on a specific yoga style.

Implications for Teaching & Practice:

The review finds significant evidence to support the use of yoga interventions to reduce menopausal symptoms. Yoga seems to improve all menopausal symptoms (not just psychological symptoms) when compared to no intervention and is at least as effective as other forms of exercise.

Yoga can be clearly recommended as an adjunct intervention for menopausal women.

Guidance for Future Research:

Future yoga research should be reported in a manner whereby the components of yoga can be clearly determined.

Given the potential bias in the included trials, future high quality studies are needed. Future studies need to reduce the potential bias found in all the included RCTs through more rigorous methodology and reporting. In particular, future studies should attempt to ensure adequate randomisation, allocation concealment, intention to treat analysis, safety reporting and blinding of at least outcome assessors.

Reporting of yoga trials needs to be improved, for example, by adhering to standard reporting guidelines such as the consolidated standards of reporting trials (CONSORT).

Comparisons of yoga to adequately matched active control interventions are equally needed as comparisons of different yoga styles.

Scientific jargon explained

Trial: A research study performed to evaluate a medical, surgical, or behavioural intervention.

Randomised Control Trial (RCT): A trial in which participants are randomly assigned to one of two groups: the experimental group receiving the intervention that is being tested or the control (comparison) group receiving an alternative or no intervention.

Threat to validity: Risk that the research experiment and/or results are not valid.

Internal validity: The extent to which you can be confident that a cause-and-effect relationship established in the study cannot be explained by other factors.

External validity: External validity is the extent to which you can generalize the findings of a study to other measures, settings or groups.

Selection bias: Bias introduced when the participants in a study are not representative of the target population about which conclusions are drawn.

Detection bias: Bias that can occur in trials when groups differ in the way outcome information is collected or the way outcomes are verified.

Attrition bias: Bias that can occur by an uneven loss of participants from groups in an RCT study before completion.       

We Are Not Fitness Instructors

This is a short blog. It’s primary purpose is to convey that

We are not fitness instructors.

We won’t be helping you count your calories. 

That’s about diet culture. We want you to enjoy, celebrate and nourish your body. 

We won’t only teach you asana.

An asana based practice not only reeks of cultural appropriation but it leaves students bereft of experiencing yoga as a full practice – which begins with the yamas and niyamas (ethical and moral foundations).

We won’t only share from our perspectives on yoga

We have a diverse teaching team of people from all cultural and religious backgrounds. Trainers who have been immersed in the lived experience of yoga as part of family life. We seek out current information and diverse perspectives on issues pertinent to modern yoga. When we know better, we do better.

We won’t advertise yoga while on the beach in our bikinis

Because honestly, what is that about? Sex sells, right? That is just as true for yoga as it is for all wellness traditions.

We will teach in ways which are accessible and inclusive

Can’t touch your toes? No problem. Need to practice in a chair? Great, we can do that. Living with a chronic illness? As Yoga Therapists, we know how to help.

We won’t focus on how you look

We are more interested in how you feel. How is yoga flowing into your life? How does it support you to be authentic and real? How can we help? What is your felt experience of the practice? We won’t tell you HOW you should feel.

The intersection of yoga, diet culture, weight loss and appearance has begun to shock us. We became yoga teachers as this felt like our Dharma. Sure we can teach you how to do a great chaturanga push up, but that’s not where our interest lies. 

We want you to shine bright. To undo all the damage and conditioning that fitness culture has created. We want you to love your body and find ways to heal.

We don’t need you commenting on our yoga pants and how tight they are. We don’t need to be told we look “puffy” six weeks after giving birth. Why does a yoga teacher return to teaching only weeks after birthing? Because it is her dharma, not because she is a fitness instructor. We also don’t need to hear “you look better and fitter than ever” during a time in life wherein there is a lot of inner turmoil and that external physique is not a healthful state.

We are not fitness instructors. We don’t train teachers to be so.

Yoga is so much more than the side effects it brings.

We would love to celebrate you and unpack all of this together in training.

For yoga training that encompasses the whole person, join us…

 

Yours in yoga

Jean & Chandrika

Research Spotlight: Yoga Interventions for Treating Depressive Symptoms

Our spotlight this month is on the effect of yoga interventions for treating depressive symptoms. Our article of focus is a systematic review and meta-analysis from 2019 published in the British Journal of Sports Medicine. We provide a summary of the article, implications for practice and a link to the full publication. 

Summary 

This article reviews 19 randomised controlled studies to determine the effect of yoga interventions on depressive symptoms compared with control groups. The studies involved 1080 participants in total with 578 assigned to yoga interventions and 502 assigned to control groups. Three different types of control groups were used: (i) wait list control (ii) treatment as usual and (iii) attention control groups. Of the 19 studies reviewed, 13 studies provided depressive symptom scores that could then be pooled to evaluate if the impact (if any) was statistically significant.

The authors found that there was a moderate effect of yoga on depressive symptoms over a range of mental disorders. This is important as it suggests that yoga may be effective on depressive symptoms irrespective of the mental disorder that leads to the symptoms (bi-polar, depression, schizophrenia, post-traumatic stress, alcohol dependence, anxiety). The authors also found that the effect was mediated by frequency of yoga sessions with more sessions yielding greater improvements in symptoms. Other variables such as the length of the intervention or length of the session did not influence outcome. All of the yoga interventions involved asana, pranayama and mindfulness/meditation. The asana portion made up at least 50% of the intervention. Given the small number of studies, the diversity of interventions and inconsistent reporting it was not possible to evaluate which components of yoga interventions lead to better outcomes.

Research details

Title: Effects of yoga on depressive symptoms with mental disorders: a systematic review and meta-analysis

Authors: Jacinta Brinsley, Felipe Schuch, Oscar Lederman, Danielle Girard, Matthew Smout, Maarten A Immink, Brendon Stubbs, Joseph Firth, Kade Davison 

Full article: https://bjsm.bmj.com/content/early/2020/04/05/bjsports-2019-101242?fbclid=IwAR2VyEDBui-EjfEkG-q2r6iIPIDNyV_CPGMJIvOgMvM7OObRpWMU6BWXsc0

Objective: To compare the effect of interventions using physically active yoga (where yoga is composed of at least 50% asana practice) to waitlist control, treatment as usual and attention control in alleviating depressive symptoms in people with a diagnosed mental disorder (as recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM)).

Methods: The authors carried out a systematic review and a meta-analysis.  Randomised control trials were eligible for inclusion where the yoga intervention was was composed of at least 50% asana, and all participants had a DSM disorder and were over 18 years of age.

The review and meta-analysis followed well-established guidelines (PRISMA) for systematic reviews and for evaluating underlying study quality (PEDro checklist). Data sources and search terms appear appropriate. The screening and data extraction process involved multiple independent researchers with further independent support providing mediation (during screening) and accuracy checking (during data extraction). The article succinctly articulates the process followed for replication. Bias and threats to validity are provided. 

Results: Nineteen eligible studies were identified, incorporating 1080 participants (n=578 assigned to yoga and n=502 assigned to control). Participants had a DSM disorder of depression, post-traumatic stress, schizophrenia, anxiety, alcohol dependence and bi-polar. Sample sizes of the studies ranged from 18 to 122 with nearly 70% of participants being women.

Yoga interventions lasted between 1.5 and 2.5 months (average of 2.4 months), with 1 to 6 sessions per week (average of 1.6 sessions), between 20 and 90 minutes each (average of 60 minutes). The studies included hatha yoga (n=7), vinyasa (n=1), SVYASA (n=2), Kundalini (n=1), Kripalu (n=1) or unspecified (n=7). Two studies were solely home study with all others supervised by a yoga practitioner. 

Meta-analysis on the effects in depressive symptoms incorporated 13 studies (632 participants). The remaining six studies were excluded from meta-analysis as they did not report depression symptoms scores.

A moderate effect of yoga on depressive symptoms compared to control groups was found. This effect was significant only with the sub-group of waitlist control but still present with the other two groups. The sample size is small and larger study is needed to further evaluate the effect. With respect to the various categories of disorders the effect was significant with depressive disorders and schizophrenia, no effect identified with PTSD, and a small but not significant effect found with alcohol use disorders. Further study is needed given the small number of studies involved.

Meta regression analysis revealed that the number of sessions per week had a significant effect on depressive symptoms with the higher session frequency leading to greater improvements in symptoms. Other intervention variables such as session duration, intervention length, supervision or the number of yoga components (as reported) did not influence depressive symptoms. 

Implications for teaching & Practice: The review finds significant evidence to support the use of physically active yoga interventions to reduce depressive symptoms across a range of diagnosed mental disorders. The transdiagnostic viability of the intervention is also significant suggesting that yoga interventions are beneficial in treating depressive symptoms irrespective of the underlying mental disorders.  

Also of note is the finding that the number of sessions per week mediated the effects. This is an important finding and should be considered in the design of future yoga interventions targeted at depressive symptoms in people with mental disorders. Interventions should aim to increase the frequency of their sessions per week, as opposed to the duration of each session or the overall duration of the intervention. 

Call for future research:

  • Investigating the mechanisms by which yoga may reduce depressive symptoms is important and worthwhile
  • Extrapolating an effective, and even optimal ‘dose’ of yoga to facilitate clinically significant change would help inform clinical practice.
  • Determining the benefits of mindful exercise, such as yoga, against conventional exercise should be explored further. Significant evidence to suggest that both mindfulness and exercise independently reduce depressive symptoms has been found but exploring whether the effects are strengthened when these are combined is worthy of study. 
  • Future yoga research should be reported in a standardised manner whereby the components of yoga can be clearly determined. Intervention variables such as type of yoga, intensity, environment, instructor qualification, specific postures, cueing, philosophical focuses, mindfulness techniques and breathing techniques should be adequately reported. The question of longevity of the effects of yoga following intervention cessation requires further investigation. The effects of yoga may be moderated by participant specific factors, such as comorbidities and time since diagnosis, and therefore these factors warrant reporting and investigation in future studies.

Scientific jargon explained

Trial: A research study performed to evaluate a medical, surgical, or behavioural intervention.

Randomised Control Trial (RCT): A trial in which participants are randomly assigned to one of two groups: the experimental group receiving the intervention that is being tested or the control (comparison) group receiving an alternative or no intervention.

Waitlist control: This is a group of participants who are put on a wait list for the duration of the study and receive the intervention (treatment after the study has concluded. 

Treatment as usual (TAU): the standard treatment given to a group

Attention control:  A group of participants who receive the same amount of interaction as intervention participants but no other elements of the intervention. Within this article attention control groups received health education, yoga education, social support and book therapy. This is to control for the benefits of attention that may come from interventions.

Body Positive Yoga – or how to make our teachings more body accepting and inclusive

“You only have to let the soft animal of your body love what it loves” – Mary Oliver

…I read today a yoga teacher discussing her personal decision to get and later remove her breast implants.

…I see yoga influencers sharing images of relaxing their abdomen next to images of their taut lean bodies as if she is somehow showing courage to “let it all hang out”.

…A student recently commented that she is often aware of being the biggest person in the room when she attends yoga and Pilates classes. 

…I also recently saw a teacher I know complaining of disenchantment with her Ashtanga practice, yet she seems to be pushing through daily and filming herself working hard on the mat, as if a puritanical discipline is to be admired? To me, that’s body-denying asceticism. I wanted to offer her permission to chill out, rest, change to a restorative practice, or scale back the sequence to match her needs better. 

When teachers and students share these types of body image stories, it can be raw and real and quite lovely. However, it also demonstrates clearly how the body image issues of yoga teachers impact not only the teachers themselves, but through them their students.

Without undermining anyone else’s inner life and process, this is potentially disempowering to students and people living in bodies that may exist beyond the narrow parameters of social acceptability.

More than half the adult population is medically classified by their BMI as overweight or obese (we will leave aside for now the fact that experts disagree on using BMI as a genuine measure for anything!). 

The point being is that the way yoga is currently being portrayed and promoted in popular culture is that a “yoga body” is a fit, thin body able to perform gymnastics-like poses. And we need to seriously ask ourselves how this affects the majority of the population that does not fit this mold.

Yoga and the Body Positivity movement 

“Body positivity” arose in the 1960s with a movement for fat acceptance, which has evolved into the Instagram hashtag driven movement of Body positivity (#bopo) we see today. Yet there’s a performative aspect to #bopo that’s not quite aligned with the original ethos of the movement. Earlier incarnations of the message focused on helping marginalised people, while these days it’s become a marketing tool that sometimes misses the mark.

We all have a body image, an idea of our physicality in our own minds, that may or may not align with the reality of the spaces we inhabit. While a greater awareness of body image issues in the yoga community is generally helpful, the co-opting of body positivity into commercialised wellness culture has been problematic. 

Rather than focusing on feeling positive about the body we have, many influential voices now call for neutrality or acceptance of diversity in bodies, rather than relentless positivity. This makes sense for an inclusive society that welcomes those #spoonies living with chronic illness, for cancer survivors, trauma survivors, and those with different abilities, as well as those with more or less adipose tissue than the dominant culture prefers. 

Acceptance rather than positivity. It’s a subtle yet radical shift that makes room for way more possibilities in how we relate to our own and other people’s bodies. Radical self-acceptance requires breaking up with our conditioning. Yoga and mindfulness practices can help us be more self-aware, and retrain our thinking about how we relate to our own body and to our students’ bodies. It makes sense then that yoga teachers, studios and communities should work to understand and embody the principles and practices of body acceptance.

How can teachers/studios be good allies to people in unconventional bodies?

It starts with Svadhyaya (Self Study). What do you think when you see your own body? Reflected in the mirror, in photos and videos, when you look down in the shower or on your yoga mat? What sort of self-talk do you have towards your body? Are you critical of some or all aspects of your physical existence?

Do you judge other people’s bodies? We have all internalised to a greater or lesser degree, the dominant gaze – which is a male gaze, and looks at women’s bodies in particular with judgement and objectifies them, judging and categorising. 

Layered onto that we may have been exposed to subcultures such as dance, gymnastics and, of course, yoga culture, which add to our internalised structure of belief about what is a “good” or attractive or desirable (to have or to hold) body. 

Yoga culture preferences and privileges thin bodies, mobile bodies, youthful looking bodies. 

Developing genuine compassion is another key here – yoga teachers who conform to the conventionally accepted body type may struggle to understand the sense of alienation that anyone who is not thin, mobile, youthful, or has a visible difference, experiences. 

It’s hard for everyone to cultivate a steady, regular yoga practice, then imagine how hard it is when you add in the inner and outer obstacles of feeling not quite welcome, not quite good enough, and you have unconventional looking people staying away from yoga classes. If yoga teachers are willing to look at the issues of race, gender, and socio-economic disadvantage, they must also be willing to look at their body biases and issues. All these issues intersect, and require pro-active education and effort to address.

When yoga teachers get it wrong, they consciously or unconsciously give preference to bodies that fit the current ideal. This is conveyed verbally, and nonverbally, in person and via marketing platforms. 

Yoga and Diet Culture

Have you ever noticed how yoga culture allows or encourages diet culture conversations? Imagine being the student inhabiting the biggest body in the room, already aware of your difference, when the students next to you start discussing their juice fast and how they are desperate to lose the “stubborn last 5kgs”. That my friends, is a shitty feeling, and while some people can shrug it off, most will have an experience of shame to some degree.

Even worse is when teachers/studios start the conversation by theming classes or practices around “burning off the Easter eggs” or “30 days to a flat stomach challenge” or sell diet shakes/meal replacements. Even the green washed ones that look healthy, still send a message about what is acceptable and preferable in that space.

I once went to give a talk to prospective teacher trainees and one person started by saying how she’d lost 20kg since she discovered yoga and she wants to pass on the benefits. It was very hard to shift the conversation once people started talking about numbers, size, and yoga’s capacity to tone and tighten a rebellious body. It is so far from an interoceptive, reflective, meditative, inner life. Yet we are all soaking in the dominant diet and body conscious culture. Not many teacher trainings go far enough to address and dismantle these systems of oppression.

Weight loss desire may bring some people to yoga, but body acceptance and a richer, more peaceful inner life, will surely keep them engaged better than the ephemeral, ever shifting goal posts of body toxicity. 

How to be a better ally, and more inclusive to diverse bodies

Let’s start with Social Media.

Social media is well evidenced to be harmful to people’s body image. While we know intellectually that images are manipulated, absorbing a feed full of seemingly “perfect” bodies showing off their contortion ability in gymnastics poses in order to sell yoga does more harm than good. 

As teachers, we have a responsibility when we have a platform, whether that’s 3 people in a room or 30,000 people online.

Use diverse images in your marketing – if nobody with a diverse body type is coming to your classes, that speaks volumes about the culture and community you are creating. Do better, and they will come. Empower them, make them feel like yoga is theirs, and you will have willing participants for photo shoots that tell the world that you are there for those who seek yoga, in precisely the body they live in. 

Teach yoga from the inside out – encourage people to enquire, feel, get curious, explore, and offer options that make poses easier without shaming anyone.

Avoid diet culture for yourself and everyone else, it’s toxic and hateful and pointless. What a world we live in where food, the very stuff that sustains life, is classified as morally right or wrong. Get over it, get through it, and find your path to eating from a place of love not fear. 

Stay out of the nutrition field unless you are qualified. Yoga teachers often overreach in this area and give advice that is potentially harmful, even though their intentions are generally good. You don’t know if someone is recovering from an eating disorder, or has an invisible health condition, so your advice to drink green smoothies, go vegan, or eliminate food groups is misguided at best, and harmful at worst. Just because a style of eating suits you, doesn’t qualify you to advise others. Nutrition is a complex field requiring years of study of anatomy and physiology, biochemistry, and food science. If a student is asking for nutrition support, suggest they consult with your friendly neighbourhood degree qualified dietitian or nutritionist. Even better, refer to HAES (Health at Every Size) aligned practitioner.

Yoga philosophy reminds us of impermanence, and the folly of overly attaching to the vehicle of the body. Some interpretations of yoga philosophy are quite anti- the physical body and privilege escaping it, getting off the wheel of samsara, and never needing to be born into a body at all.

Yet modern life is already disembodied, maybe more so since Covid and our increased time spent online. We don’t need yoga and meditation communities to also take us away from ourselves, we want to use the body, breath, and present moment awareness to go deeper, perhaps to transcend, but not to avoid, deny, punish or negate these incredible meat suits.

Bodies change throughout our lifespan. Yoga needs to change to accommodate bodily variations, states, and traits. Pain, injury, disability, disfigurement, hormonal changes, medication side effects, pregnancy, post-natal recovery, health conditions, lifestyle factors, broader societal and cultural issues, and genetics all play into the current state of our body. 

Yoga is remarkable medicine for healing, yet many people feel like yoga doesn’t suit them, isn’t welcoming to their body and therefore isn’t welcoming to them. We believe the yoga community can do better.

All our trainings and offerings are informed by a culture of body acceptance and positivity. We are advocates for peacefully embodying the body you live in right now, and respecting and loving diversity in ourselves, our students and communities.

To Cue or Not to Cue?

As yoga teachers we offer verbal cues to our students to guide them through practice.

As a teacher trainer I am often questioned as to why I do not provide prescriptive cues for the trainee to utilise in their classes.

I know that doing so would be part of a good business model! The larger trainings I know of in Australia and Asia offer set sequences and cues which teacher trainees can use to guide students through their yoga practice. Assessment of teaching then often comes down to how well these cues are delivered, to what extent the sequencing is followed and whether the cues are coming at the right moment in the sequence. As a trainer this is a simpler way to deliver teacher trainings and to try ensure, especially with larger groups, that the format being taught is followed. Yet, this practice of providing prescriptive cues and sequencing formats is changing yoga in a way I am not comfortable with. Often approaching training teachers in this way might result in a more Les Mills style of class in which content is delivered, but not experienced deeply.

Mostly, to be a genuine teacher I believe we need to be able to teach the person in front of us, from experience and guide people into the actual experience of yoga. When we offer prescriptive cues and sequencing all of a sudden, we create rules and ways in which to experience the practice of yoga which might suit some but will most certainly not be inclusive of all.

Cues can help us cultivate a space in which students either turn their attention outwards, to physical alignment and whether they are doing a posture or practice ‘right’ or ‘wrong’ (as if there was one universal right or wrong expression of a posture!). Or cues can help our student’s turn their attention inwards to the felt experience of their practice, giving them the ownership to move in ways that feel right to them. This is more of an embodied way of practicing, one wherein we create the conditions for people to feel embodied and to use their practice to meet their needs on that day and time.

To teach in this way requires that we have an immense trust in ourselves and our ability to be present and true with our students. It means that we must have gone on a journey in our practice, over time and learnt what it means to embrace the space of being, rather than doing yoga. It means we are teaching in a way that is inclusive, and sequencing in a way that is open and has many possibilities. This is a context in which multiple variations of the asana being taught is welcomed.

To teach in this way means to utilise cues which encourage sensitivity and curiosity towards our experience. We can ask students how it feels and give them some options to adapt depending on their answer, or perhaps the student will find the answer themselves.

Therefore what we offer as teachers becomes a collaboration between student and teacher. We use cues to remind our students to breathe, to gently pay attention, to cultivate awareness. We trust that in most ways and times student’s will find the ways to move that their body needs, even if it is different to what we are offering exactly as a teacher at the front of the room. We relinquish the need to control exactly how a student expresses the posture.

Essentially we discover our own voice as a teacher and drop the need to rely on someone else’s prescriptive cuing. In doing so we can meet each student where they are and cultivate a space in which their journey is personal, intimate and about getting to know their own mind, body and heart and what is needed in each moment, or practice session.

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