Integrating Yoga and Ayurveda For Therapeutic Purposes:

An Overview and a Case Study

This article covers three separate subjects and the connections between them: Yoga, Ayurveda and Yoga (as) Therapy.

Yoga is an ancient tradition. It is also contextual. In the Bhagavad Gita it is “skill in action”. (1) This statement when meditated upon reveals that action is one of the three inherent and indivisible qualities of nature known as Rajas. Skill in action would be an action that sustains or brings about a state of clarity: Sattva. In addition, skill in action would include the management and appropriate use of the third inherent quality: Tamas. For instance, the proper use of sleep.

In the Yoga Sutra`s, a later text, yoga is what occurs when the mind stops acting and becomes still. (2) But upon reflection, the Mind being still is also of two types: still with clarity/sattva and still as in unconscious/tamas. Either can be the goal of Rajas. Thus, still skill in action.

Yoga is also contextual in terms of functionality. The Yoga Yajnyavalkya describes the practices and functionality of yoga in a similar manner to the preceding Yoga Sutra`s. (3) In fact, one could say that the Yoga Sutra`s themselves are informed by all previous authoritative texts.

Characteristically, Patanjali makes the case that he is clearing the air (even then!) about what Yoga is, by relating it to its authoritative tradition: anusasanam (4). Only then does he explain what it is, why we should do it, what results we should expect and what our condition is sans yoga. (5) This too would be skill in action.

Context in yoga would also relate to the time and place of its practice. In our current time and place, yoga is a multi-billion dollar industry. (6) If we talk about context, yoga is a forest of ideas, views and styles of practice. And for the most part, yoga is synonymous with one of its anga`s, asana. Even if we assume that our practice includes pranayama and meditation, our focus is on what is of prime importance to us today: the health and wellness paradigm. Yoga has become a form of healthcare. (7). Is there any precedence to this? And if so, where does it fit in?

If we look at the ashtanga model first referred to in the Yoga Sutra’s and later in the Yoga Yajnyavalkya, there are five outer limbs to the practice of yoga referred to in its Sadhana Pada. (8). And they are preceded first by the three kriya`s, or purifying procedures. We cleanse the mind. By restraining the senses (tapaha), appropriate study (swadhyaya) and surrender to a higher source (Ishwarpranadhanani) or, as I like to call it, trusting that there is a higher intelligence than the rational mind (9). This is obviously of some importance because it not only precedes the upcoming eight-limb path but is also repeated within it (10). Once we are in the ashtanga, we still are required to go through the yama-niyama limbs before we attempt asana.

The truth is we do not pay that much attention to this today. There is no purification (tapas) or protocol (krama) to our asana practice. We have assumed that asana is in itself a complete healing tool. And in a sense it can be if we understand it as skill in action: that which reduces rajas and increases sattva.

Of course the context of asana has itself undergone many changes from the original 84 of Lord Shiva (11) and even prior, to the eight specific asana`s mentioned in the Yoga Yajnyavalkya. (12) Let us not however, think that we have expanded upon something that did not exist. It is said that Lord Shiva told of 8.4 million asana possibilities! (13) Thus, all we can truthfully say is that our need for more than eight asana`s (most of them seated) is because we cannot do them without discomfort!

To counter this, we have had to seek access to a variety of postures: standing, seated, prone, supine, asymmetrical, symmetrical, upside down and then combinations of forward, backward, balancing, sideways and twisting versions in all of these. Perhaps all just to get us back to the ability to stay comfortable in our bodies. Because of this knowledge we have been able to scientifically relate the value of these postures to our anatomy. And in the process we have created a new field of yoga therapy by marrying yoga and contemporary medicine. (14)

There are those who might say that this is redundant, Yoga is therapy. There is ample literature on the therapeutic values of yoga both in traditional yoga texts as well as Ayurvedic texts, specifically by Charaka and Vagabhata (15). However, there is indeed a difference between yoga and yoga therapy (16). There is no therapy without diagnosis. In no traditional texts that I am aware of is there a chapter on diagnosis (17).

Yoga was a monastic practice and was done under the guidance of a guru. It was up to the guru to design the yoga practice for the individual. There are numerous references in all the ancient texts for the need of a guru in yoga (18). Today we are churning out yoga teachers in vast amounts and we are picking and choosing styles, times of practice, levels of practice and different teachers almost without any thought to the trust we are putting in these novice teachers and/or random classes. And we are getting hurt (19).

Indeed, yoga therapy is a new field that is dedicated not just to yoga students but also to any and all who may be suffering a variety of difficulties from anatomical to other medical conditions such as heart disease, hypertension, stress, emotional, psychosomatic, digestive and even old age (20). And yes, we are responsibly creating yoga therapists who are being schooled in receiving a diagnosis and crafting a practice based on the interpretations of the Medical Community and the yogacharya`s that are pioneering this shift by their prescience into the changing needs of our busy world. We are being taught to trust our yoga cikitsa in dealing with our daily lives that are so contradictory to its tenets. And in the process we are learning to slow down and make changes that give us very measurable improvements in the quality of our lives (21).

We are creating a new paradigm. But are we also reinventing the wheel?

There is no doubt in my mind that this new field of yoga therapy is a forward motion that will yield good results. Does it, however, have the ability to access the deeper secrets of yoga; the deeper healing abilities of yoga that arise from the wisdom of its roots, the Vedic tradition? These are the shared roots between yoga and the original science of medicine that it based its therapeutic language upon. A science of medicine so rooted in spiritual healing that among the upa-veda`s (22) it was conferred the title of Science of Life? Ayurveda literally translates as the Science of Life.

There is a logical, seamless interface to yoga and Ayurveda because they arise from the same philosophical, theoretical and practical language of the Veda`s. Any mixing of yoga and Contemporary Medicine is done despite there being no traditional interface. In a sense we do not even know if they are compatible although studies are showing that there is compatibility (23), but it is too soon to tell how effective and how lasting. On the other hand, all traditional texts refer to values of yoga`sana and pranayama in the language of Ayurveda including dosha, dhatu, mala, agni, manas, indriya, atman et al (24).

There are numerous references in older yogic texts to the therapeutic effects of certain yogic practices but no related references to diagnosis. Where there is a reference to diagnosis it is simply to refer to either a vaidya (Ayurvedic Doctor) or to an imbalance in dosha, dhatu, vayu etc. All Ayurvedic terminology could be as easily understood back then as basic medical terminology is today; a language by which a medical professional can communicate with his/her patient.

The healing potentiality of yoga was also recognized by Ayurveda and referred to even in the very first texts such as the Charaka Samhita and the Ashtanga Hrdyam, as mentioned above. By integrating the principles of Ayurveda into yoga therapy we are not just acknowledging the traditions, but we are learning that there is no need to reinvent the wheel. Yoga done Ayurvedically is therapeutic yoga.

Let us look once again at yoga’sana but now from the eyes of Ayurveda. In Ayurveda, the practice of yoga (yoga’bhyasa) would fall under the category of self-care (swasthavritta) as part of the daily regimen known as dinacharya. The Ashtanga Hrdayam describes this schedule as that which encourages appropriate diet, activity, behavior, and those daily chores most compatible with one’s own wellbeing/satmya (25). This would be the general application of yogic practices especially asana as vyayama or exercise. The purpose is three-fold: physical strength, tolerance and lightness of body. Because Ayurvedic terminology includes complete system integration of body, mind and spirit, wellbeing is personal to the individual’s constitution and condition. Thus one is admonished to:

• Exert the body in such a manner as to cause one to become tired, with the specific requirement that we exercise at half our strength when healthy and less when not.
• Mold the body into different shapes, which means development of self-control in the form of asana-s (26).

Simple guidelines to follow indeed. And when coupled with other Ayurvedic modalities, the result is often striking. I would like to present one such example.

Brian came to see me in 2006 on the advice of his chiropractor (27). He had been diagnosed with a slight bulge at L4/L5. Brian had received a cortisone steroid shot for the excruciating pain and now they wanted to give him an epidural. He did not want to do this. We did a full Ayurvedic Consult and determined his prakrti to be predominantly Vata. However, due to poor living, his job condition, poor eating habits and lack of exercise, he had built up some toxicity (Ama) in his system that was reflected in high cholesterol, unhealthy pallor, weight gain (especially around the middle), coated tongue and exhaustion. And of course there was the pain.

We created a simple yoga practice for him to do at home and I would give him a yoga based massage twice weekly. We also spent some time talking about his lifestyle and eating habits. Gradually as the pain began to lessen, he became more interested in working with his diet. As he started to eat healthier, at first I had suggested a simple cleansing diet, he began to lose weight and gain energy.

After about a year, the pain was gone completely and Brian’s posture had improved and his energy and confidence were high. We were now doing a yoga practice together twice a week and working in some pranayama and meditation. Then Brian, who is a film editor, disappeared. He had gone overseas to work on a film and upon his return had not contacted me, as he felt much better. In time, some of his concerns returned including the pain. When sufficient time had passed and knowing something of Brian’s nature, I felt it appropriate to contact him again. He was most grateful I had called.

Once he was back into the practice (a new therapeutic take-home practice first and then twice weekly with me) he swiftly regained his health and was most enthusiastic about our practice. At this time I suggested pancha karma (PK). With two weeks of preparation and two weeks of rejuvenation practices for after, we did a 5 day pancha karma. This was in Sept of 2008. Ten days after the PK, these are my notes: Review of PK. Feels light and good. Waking up lighter and sleep is better. Appetite is better and he is not craving any meat. Has been eating vegetables and taking Trikatu before meals and Triphala at night. Tongue looks so clean.

Brian and I continued his yoga practice twice a week. It was much stronger. His lower back pain was completely gone.  In 2011, Brian had met someone in Spain and told me he was going to get married. He asked if I would officiate. In the end I did not but I did do a short Vedic wedding prayer at the ceremony.

They practice yoga, eat healthy and are very happily married. Brian and I worked together from 2006 to 2011. When I called him to ask if I could use him as a case study in this article, we reminisced about the healing that had taken place. But we also knew that that chapter had ended. If we did practice together again, it would be just that. A practice. I asked Brian if he had had any tests done to check on the bulging discs. He said he had no desire to. He had no pain. His life was good.

I believe that it was the combination of Ayurveda and yoga that worked. I suggest it highly. Although in much of my practice there is not this degree of intermingling, I have found that in every case where I include some yoga for my Ayurvedic clients or some Ayurveda for my yoga clients, the results are multiplied exponentially.

It is from this place of experience that I have built a strong conviction that the time for Ayurveda and yoga to join forces for the sake of relieving human suffering has come. And perhaps we are only rediscovering the connection. I do not know for how long we have thought of them as separate. But it has not always been so, this I do know deeply.

References

• yoga karmasu kaushalam: skill of action lies in the practice of Yoga: Bhagavad Gita: 2:50- Any edition
• yogascitta vrtti nirodhaha: Yoga is the complete stoppage of the mind/brain’s activities: “Patanjali’s Yoga Sutras” Based on the teachings of Srivatsa Ramaswami by Pamela Hoxsey: Printed by Pam Hoxsey-1503 Seward St, Evanston, IL 60202
• Yoga Yajnyavalkya: A.G.Mohan, Ganesh Mohan. Svastha Publications.
• “Patanjali’s Yoga Sutras”: 1:1. Based on the teachings of Srivatsa Ramaswami by Pamela Hoxsey: Printed by Pam Hoxsey-1503 Seward St, Evanston, IL 60202
• 1:2-4
• http://www.examiner.com/article/from-rooms-to-retreats-yoga-becomes-multi-billion-dollar-industry May 21, 2013
• NIH: http://nccam.nih.gov/health/yoga/introduction.htm Quote: Ask a trusted source (such as a health care provider or local hospital) to recommend a yoga practitioner. Contact professional organizations for the names of practitioners who have completed an acceptable training program.
• second chapter: “Patanjali’s Yoga Sutras”: 1:1. Based on the teachings of Srivatsa Ramaswami by Pamela Hoxsey: Printed by Pam Hoxsey-1503 Seward St, Evanston, IL 60202:.
• Ibid: 2:1
• Ibid: 2:32
• Goruksha Padhathi: translated by Khemaraja Shrokrishnadasa: 1:9: http://relaxeagora.weebly.com/uploads/3/9/3/8/3938575/goraksha_paddhati.pdf
• Yoga Yajnyavalkya 3:1: A.G.Mohan, Ganesh Mohan. Svastha Publications.
• Goruksha Padhathi as also Gheranda Samhita: 2:1-2. translated by Rai Bahadur Srisa Chandra Vasu: Shri Satguru Publications. 40/5 Shakti Nagar Delhi-110007
• IAYT: Our mission is to establish Yoga as a recognized and respected therapy. http://www.iayt.org/site_Vx2/about/mission.aspx
• Ashtanga Hrdayam: Sutrashtana 2:10-12. Translated by Prof. K. K. Srikantha Murthy: Chowkambha Krishnadas Academy, Publisher
• There are many articles and writings on the differences between the two. A simple definition: Going to the pose (no compromising) vs. bringing the pose to you (compromising) For example, trying to do a standing forward bend to touch the floor and not bending your knees vs. trying to do a standing forward bend to touch the floor and bending your knees.
• From conversations with Pandit Vamadeva Ji/Dr. David Frawley, who has numerous books on the subject. vedanet.com
• Hatha Yoga Pradipika is best known. There are many versions available.
• http://www.nytimes.com/2012/01/08/magazine/how-yoga-can-wreck-your-body.html?pagewanted=all&_r=0 Draws very biased opinions based on good facts. Good rebuttal: http://drmccall.com/yoga/manbitesdowndog.pdf
• Many studies: Here is one: http://online.liebertpub.com/doi/abs/10.1089/acm.2005.11.267 As also look on IAYT.org under publications for research studies.
• A lovely article on IAYT.org: http://www.iayt.org/site_Vx2/publications/articles/HealingYogaComesToAmerica.pdf
• https://en.wikipedia.org/wiki/Vedas#Upaveda
• IAYT.org They publish two research based journals: YTT and International Journal of Yoga Therapy
• Yoga and Ayurveda by Prof. Satyendra Prasad Mehra: Publisher: Chowkambha Sanskrit Sthana, Varanasi, India and Encyclopedia of Traditional Asanas-Editor in Chief: Dr. Manohar Laxman Gharote. Published by The Lonavla Yoga Inst, B-17 Rachana Gardens, Lonavla, India 410401. Numerous citations and references in both texts.
• Ashtanga Hrdayam: Sutrashtana 2: dinacharya. Translated by Prof. K. K. Srikantha Murthy: Chowkambha Krishnadas Academy, Publisher
• Ibid:
• Although there were a number of similar clients, this has been the single most satisfying one for me in combining yoga and Ayurveda for two connected reasons: by working with me for over 5 years, Brian gave me an opportunity to mature my abilities and skills. For this and for letting me mention him with his real name in this article, I am most grateful to him.

Bio:

Arun Deva, DASc, AYT, E-RYT500, YTRx is a yogin and practitioner of Ayurvedic medicine who likes to roam the world teaching. Born in India he moved to Los Angeles in 1975 and got stuck there. Travel allows him to bring yoga and Ayurveda with him but now he is looking to settle down and let yoga and Ayurveda come fully to him. http://www.yogarasayana.com