Yoga – the bridge to becoming a better Psychologist

When I showed up to my first yoga class, aged 17, it was simply because I wanted to maintain a healthy lifestyle. It may sound like a cliché, but after that first class, I fell in love with it. Yoga felt genuinely transformative. However, at that time, it was simply something that sat alongside my psychology studies. It was only after my MSc in Forensic Psychology and while working at a locked rehabilitation service that I started to recognise how important my 'hobby' could be for the people I worked with.

I knew from my practice that difficulties with sleep, anxiety and intrusive thoughts could be improved by yoga and meditation, so I decided to offer a yoga and meditation group at the unit. It was always my plan to be a forensic psychologist and before starting my doctorate in September 2018, I took a 200-hour yoga teacher-training course. It was during my training that I started to note how these practices and skills could improve psychological practices for everyone.

The mind-body connection

The role of somatic experiences in trauma therapy is well understood, thanks to Bassel Van Der Kolk's book The Body Keeps The Score, as well as Polyvagal Theory developed by Stephen Porges. Put simply, the nervous system and body change in response to trauma, as a means of ensuring one's safety. The organisation and structure of the brain and nervous system adapts to have a heightened response to perceived threat, leading to more intensive and rapid reactions to events that are believed to be threatening (even if they are innocuous). Ultimately, this change can lead to a range of different problems such as impacting our ability to emotionally regulate and the development of mental and physical health problems.

As I progressed through my yoga training, it almost became difficult for me to understand how we could offer trauma therapy without also being aware of practices that are taught in yoga, since the two are so closely connected. I saw more transformation and true deep expression and experiences of trauma within the yoga room than I did in trauma groups through my therapeutic work.

I believe there is a tendency to intellectualise trauma, and to 'understand' it from a logical point of view. To say, 'this is what happened to me, which is why I feel like this', without truly feeling it. This is why I was motivated very early on to bring in somatic experiencing into any therapy. I started a yoga and compassion focused therapy group in a low secure female hospital and trained in polyvagal theory to start giving names to experiences that I felt through my yoga practices. I also started to teach yoga in my own time on an individual basis to people with debilitating anxiety, disabilities, and histories of trauma.

Yoga transcends the mere physicality of touching toes or standing on your head – it embodies focus, the connection between mind and body, and control and regulation. Its benefits are extensively documented, showing efficacy in managing and reducing anxiety, offering short-term improvements for depression, (Cramer et al., 2013), serving as a complementary treatment for trauma symptoms and mental health issues, enhancing sleep quality, reducing psychosis illness severity, and diminishing aggression and anger.

In therapeutic settings, the emphasis often shifts towards yoga's breathing and focusing techniques rather than its physical aspects, especially in individual sessions. This holistic approach is credited for its dual influence on top-down and bottom-up processes, including the regulation of the autonomic nervous system to balance stress responses and fostering mindful intentions alongside focused attention.

Focusing through meditation

A significant part of yoga is improving one's ability to focus and control the mind, honed through poses but also throughout meditation practices. This is a part of yoga that has been adopted by various therapeutic models that incorporate mindfulness skills and metaphors. Therefore, although further yoga skills aren't integral for working on focus, the teacher will have access to a plethora of exercises and practices to allow for more creative and unique means of developing this with clients.

'Clearing your mind' and 'moving your thoughts to one side' is much easier said than done, so I always appreciate my handy yoga manual for the number of exercises I have access to when supporting a client on developing this skill. Some examples of focusing techniques could include:

• Practice of tuning out external stimulation through breathing.
• Object meditation (choosing an object and narrowing your attention on it over time).
• Creating imagery of objects that have been studied.

Yoga helps with 'feeling'

The models that I use for therapy mostly contain a mixture of the 'cognitive' understanding (e.g., formulation and discussion), and the 'feeling' element needed for therapy (e.g., role play, imagery, and mindfulness). Yogic skills significantly strengthen one's ability to feel, and to listen to themselves on a more intuitive level.

The first step of learning to feel the bodies messages without fearing them can take a very long time, and is mixed in with psychoeducation, formulation, and various other techniques from the models we use. This area can also be the most intimidating for a practitioner because you may struggle to contain your clients' reactions. Yoga will give you the skills to improve your confidence in this regard and can directly improve a client's ability to feel and connect to bodily experiences and emotions without it becoming overwhelming or un-contained.

Coping strategies

When we understand the messages of the body and how these converge with the messages of the mind, yoga can help us to cope. We're not trying to push the emotions away, or move them somewhere else, or get rid of them all together – we are learning to live with them in a non-judgmental and curious way. Yoga and associated practices are the cornerstone to all mindfulness, relaxation and coping practices.

Put simply, being trained in yoga gives me a much larger repertoire of how I can help my clients. It gives them access to an expanded choice of coping strategies that work for them, rather than trying to fit to those provided to us by the models that we use. Here are some examples, although it is not recommended that these are practiced without correct training or reading around the subject…

• Diaphragmatic breathing. This is where we support the client to do 'Belly Breathing' to regulate the nervous system.
• Ujjayi breathing. This is where we support clients to slightly constrict the back of their throat to create heat and noise while breathing. This can help with improving attention on the breath and slowing down the breath leading to stabilisation.
• Alternate nostril breathing. This is a practice where we support clients to breathe in and out with alternate nostrils to enhance concentration on the breath.
• Simple asanas (poses) to help with focus and grounding.
• Meditations to convey messages (e.g., safety, compassion, values)
• Visualisations (for example, focusing on an object or safe space)

Recommendations for colleagues

I recently spoke about the use of yoga with another psychologist, who asked me how I balance being a qualified psychologist and offering classes. To her, they were two distinctively different professions that would muddle people's understandings of what our role was. I remember that she described it as having two different hats. Although a completely understandable query, for someone who trained in both at the same time, they are both one and the same. To me, it is simply another model that I can use within my integrative approach to therapy.

I appreciate that a busy psychologist cannot always also be a yoga teacher and offer classes, nor can all services hire their own yoga teacher. But I encourage practitioners who work with trauma or any associated experiences to be open to the idea of incorporating yoga practices and somatic experiencing into their sessions. We are not changing therapeutic models, simply borrowing exercises and skills from yoga to enhance and improve what we are already doing. It must be made clear that I follow models as they are intended. I use Schema Therapy, Compassion Focused Therapy and Cognitive Behavioural Therapy as they are grounded in research. I simply borrow yogic exercises to help with the somatic part of therapy. And it helps me immensely.

Some yogic exercises that can be useful are:

Pre-session - Usually, it can be as simple as sitting and noticing the body's messages at the beginning of session to identify what might be coming up for someone. A grounding exercise can be used to connect the client into the session, and a joint breathing exercise can be used to connect client and practitioner.

During a session - Throughout the session, one may use yoga skills to help with assessment (e.g. understanding somatic messages), and to understand reactions. Imagery techniques can be used to develop focusing and regulation skills. We can also use yoga to support a client with regulation should something become difficult for them.

End of session - Each session could end with a breathing exercise to regulate the nervous system, of which yoga teachings has a variety of options. There are many that yoga teachers are trained in, such as Shitkari Kumbhaka (the 'Hissing Breath'), Bhastrika Pranayama (the 'Bellows Breath') and the Bhramari Pranayama (the 'Humming Bee' breath).

There is a plethora of ways that teachings of yoga can improve trauma therapy and associated therapies, and the majority of this comes down to helping someone feel, focus and regulate. Otherwise, we fall into the intellectualisation trap, thinking too cognitively instead of using our body, nervous system and intuition.

If you are a practitioner who is looking for ways to improve your therapeutic approach, support clients and to develop your own relationship with yourself, I encourage you to start practising/studying yoga. Yoga serves as a perfect supporting or secondary modality to almost every model we use for therapy today. Yoga is not just a personal practice, but a valuable tool that enhances professional practice.