Yoga Therapy as a Care Plan in Medical Facilities

According to the National Center for Health Statistics, trends towards the use of yoga as a form of exercise in the USA has nearly doubled from 2002 to 2012 and continues to increase at a rapid rate. According to Jossphine Briggs of the National Center for Complementary and Integrative Health (NCCIH), this rise is thought to be because of yoga’s inherent connection to reducing stress and thereby increasing pain relief, especially related to musculoskeletal pain that is associated with inflammation from both physical and non-physical causes. With the rise in stress and preventable diseases causing greater morbidity and mortality currently, even greater than communicable diseases, it is apparent that Americans need a different mode of healing. One that is focused on preventative, acute, and long term health solutions for ailments that are caused by, or exacerbated by, stress which leads to further inflammation, thus chronic pain and dis-ease that we now know leads to dysfunction on a cellular level and, eventually, disease. Because yoga therapy has been shown to address all of these points through many objective randomized control studies and also subjective patient studies by practitioners, researchers, clinicians, and yogis alike since 2012 (1), it is scientifically evident and a significant sign for the implementation of yoga therapists as a standard component of the integrated medicine approach in the American healthcare system and to also be regarded as a medical competency pathway for medical professionals to receive continuing education credits for those who desire to be dual-credentialed as Yoga Therapists in order to stand in the gaping gap and be a bridge between two seemingly divided healthcare modalities of medicine and mental health, while bringing in the spiritual, emotional, and social aspects involved in true healing.

As anecdotal evidence, a veteran nurse of over 20 years reports that she was merely surviving in 2017 with 19 medical diagnoses that filled a 3 inch thick medical chart despite being a nurse manager, pioneering and implementing new medical programs, a Crossfit athlete and coach, and doing all the things (exercise, nutrition, medication, surgeries) deemed “right” and acceptable as “treatments” by the American medical system that she believed in and worked for. Upon reflection, in the spring of 2018 she realized that she was merely surviving as she laid in the floor of her shower desperately pleading to God, whom she had felt disconnected from for healing, along with medicinal side effects and surgical complications that failed to fix the complex trauma of her past and high performance distress that manifested into extreme mental fatigue and physical ailments that had been increasing in severity since the age of 13 - a year after her childhood abuse ended- ultimately culminating into diseases. After implementing nature-based, holistic, integrative therapies such as yoga (which she refers to as mindful, therapeutic, soul to sole movement, not to be confused with Americanized yoga that tends to primarily focus on physical exercise), essential oils, removing environmental toxins, DNA based supplemental nutrition and exercise, moving away from toxic relationships, and dealing with her medical, spiritual, physical, and sexual misuses and abuses through professional talk therapy counselors and spiritual mentorship including Sozo therapies, she remained free of medication and medical specialists for 5 years with only general and gynocological annual check ups!  (4)

Like the example above, most Americans who use non-mainstream approaches to their health and wellbeing also use conventional health care. (1) which is considered an integrated medicine approach. As evidenced by the veteran nurse of over 20 years and the ever increasing mortality and morbidity rates despite more “improved” healthcare and biotech advances than ever before (1, 6), western medicine alone does not work well for treating diseases related to the long term impacts of dis-ease related to trauma. Trauma specialists and several neuroscientists agree, like Peter Levine, Bessel Van der Kolk, and Dr. Caroline Leaf, every single person lives with trauma.  Trauma can be from surgical or medical procedures, and/or from physical, emotional, sexual, spiritual/religious misuse, neglect, or abuse… and the list goes on.(6,7,8)  Therefore, it is paramount that we incorporate trauma release and trauma recovery measures into our healthcare practices. 

Historically, healthcare was paramount in treating communicable diseases, and why it is more appropriate to call it a “sick-care” system. That being said, according to the World Health Organization (WHO), while morbidity and mortality rates have decreased for communicable diseases, they have drastically increased and reached epidemic proportions. 80% of noncommunicable diseases (NCD) are due to the top 4 causes of morbidity and mortality are: #1) cardiovascular disease (specifically heart disease and stroke), #2) cancer, #3) diabetes, and #4) respiratory diseases. It needs to be duly noted that all of these are caused by or exacerbated by chronic distress and are typically preventable with lifestyle changes. (1)

Because 1 in 3 Americans, and many healthcare professionals, are realizing these statistics, yoga based entities are increasing their research and developing scientific medical studies to better understand why and how integrative therapies are helping in order to justify implementing them into the healthcare system. Though this is promising, the National Institutes of Health (NIH) shows that most studies still only include nutritional, psychological and physical aspects of health that aim to provide both treatment and prevention. (1) It’s also apparent in the American Healthcare system, medical bodies believe that psychological (brain) and physical (body) components are to be separately addressed, and results in a division of various competing and comparing sub-specialties leading to a very dis-embodied, dissatisfying, and dysfunctional implementation of care rather than the continuum of care health care providers like to dream and boast about. Addressing only the physical (including nutritional needs) and psychological factors does not lend to a deeply rooted and secure foundational support system for whole health to grow from and be nourished by, and, thus, leaves glaring gaps in emotional, social, and spiritual dimensions that impact psychological and physical health as well…maybe even moreso. (1)

Furthermore, the downfall of the American healthcare reductionist approach is that disease is reduced to a list of symptoms related to 1 system that is deemed to need “fixing” or is already a “fixed mindset” to be treated either by medication or medical procedures. (6) This approach also reduces humans to being defined by their diagnoses and is detrimental to treating the source of the problem and “treating” the whole human as they are designed to thrive. This diagram emphasizes how a strong root system includes the 5 dimensions (or roots) of human health and they are spiritual, emotional, social, alongside physical and psychological aspects of health that in turn defines the strength of the tree and allows for expansion and healthy branches to grow to create a more abundantly flourishing, highly functional, fruitful “tree” where whole health contributes to the betterment of an individual, their families, and extends into being able to be a contributor within a wider community. Rather than competing with American healthcare systems, YogaFaith Therapists are trained and aim to be a bridge to provide assessments, insights, and therapeutic practices complementary and integrative to current healthcare practices that are truly complementary for anybody, anywhere, at anytime as they collaborate with nearly any medical, mental, or even personal trainer’s (exercise/nutrition) protocol that a patient/client may need that provides a more practical continuum care.(9) As the empirical evidence grows, other benefits are being witnessed in reducing multiple risk factors associated in populations with higher risk of morbidity and mortality rates. Here are just a few of the ever increasing positive reports that yoga has made for the advances in true healthcare of its participants:

• Increased spiritual, emotional and social community support systems
• Greater financially sound opportunities to get and stay healthy
• Increased self advocacy and self care (empowerment)
• Adaptable, efficient, effective, simple and safe modalities to improve health
• Increased coping strategies and skills
• Improved work, rest, play rhythms
• Improved outlook on life
• Client/Participant Centered vs Disease Centered (feeling seen, heard, cared for)
• Greater resilience to mental and physical decline
• Increased prevention efforts and early detection due to increased attunement to the mind and body.
• Increased homeostasis per lab values (1)

Nurses are already a bridge between a variety of healthcare professionals and patients, therefore, they are in the ideal position to use their skills and their educational backgrounds to become Yoga Therapists to serve as bridges between medical and mental facilities and homes. In doing so, it is possible for a more holistic approach to be implemented within the medical and mental health systems, but even outside medical centers’ doors since the general population has voted nurses as the #1 trusted health professional in America for the 20th year in a row as of 2021 according to the Gallup Poll. (3)

Yoga therapists serving clients with specific health needs have been reported to be more: attentive, inclusive, cost effective, gentle, complementary rather than antagonistic with other providers, consider the human experience rather than just a disease, make time and space to seek out underlying causes that may seem unrelated to the disease but increase functionality and healing when addressed. Furthermore, unlike many healthcare providers in other fields, yoga therapists are perceived to “practice what they preach.” They tend to embrace spiritual wellness as well. As Tom Alden puts it, “wellness in your spirit is the source of purpose in your life. While spirit is the least tangible and the least measurable part of you, it is also the most essential aspect of wellness. One crucial element of spiritual wellness is to know what is important to you and why it is important, so every aspect integrates around what you truly want, value, love and trust.” (of self first and foremost) so that everything genuinely flows in, through and out of a yoga therapist to support others as an overflow rather than a ‘have to.’ (1) Therefore, nurses as yoga therapists, lends to a continual personal and professional ongoing commitment to grow, to improve, and to share as” lifestyle consultants” for lack of a better succinct description.

Spiritual, emotional, and social considerations are missing components in bridging our current mental and physical healthcare systems and personal training protocols. Yoga therapy challenges the status quo. It challenges our Americanized ideas of health (looking good on the outside while popping pills for dysfunctions on the inside) and success (like weight loss, high performance role acquisition all while climbing corporate ladders at the detriment of true holistic health) that are all too often related to distress but is still considered acceptable by our society. Yoga therapy encourages exploration of self and others and working in common unity. It’s noticing and trying new things that grow inner self awareness that increases spiritual, mental, and physical resilience which in turn provides greater definition, strength, power, agility, flexibility, and adaptability without sacrificing self esteem or increasing distress, but actually building greater confidence, peace, and joy! True healthcare should be a multisystem, multidisciplinary approach that concerns itself with supporting healthy mental, musculoskeletal, neurological, endocrine, cardiorespiratory, and cellular replication strategies and consider non-western medicine remedies that restore homeostasis and resiliency when these human root systems are out of rhythm or harmony with one another. It should never be a singular approach, especially when it comes to trauma, as there are often long-lasting effects if left undealt with. (9)

All these things being considered, nurses as yoga therapists also bridges the well known Hippocratic oath (do no harm) while honoring the Ahimsa concept (respect for all living things and avoidance of violence = toward self and others.)...in which both align with the greatest commandment that most Americans (even non-Christians) acknowledge as sacred “Love others as yourself.” (9) Moreover, the author hypothesizes that encouraging medical professionals, specifically nurses, to be trained in yoga therapy or to become yoga therapists while providing continuing education credits for licensure renewal, the healthcare industry would likely see more positive job satisfaction surveys, decreased financial losses due to sickness, burn out, compassion and caregiver fatigue, as well as reduced employee turnover rates among healthcare providers and staff which also creates a ripple effect to improve the care of patients, families, and communities with socioeconomic impacts as well.

In conclusion, there’s not a dis-ease or disease that a holistic yoga lifestyle will not support and likely improve. All in all, yoga therapy is a lifestyle strategy backed by science that is complementary to our design by encompassing and building stronger root systems of the spirit, mind, and body through a synergistic form of continuum of care that needs to be a standard component of the Integrated Medicine Approach within the American Healthcare system as medical providers, especially nurses, are trained in Yoga Therapy as part of their continuing education credits for both ethics and standard of care. Yoga Therapy is where science and spirituality meet, incorporating a yoga therapist as a part of the healthcare team provides the currently missing bridge between the two medical and mental health entities. Therapeutic yoga practices can be strategically interwoven in a patient’s bed or on a client’s mat, while also being transferrable off the mat/bed and into daily living. Through mindful yoga practices, patient’s can begin to unwind the lies that have bound their minds, as yoga therapists help them mindfully deconstruct the body on a cellular level to prune, replace lies with truth, rewire the body and brain, and restore synergistic connections within the spirit, mind, and body to rebuild the ruins and reduce, or even remove, to heal from dis-eases and diseases. 

Citations:

1. Khalsa, Sat Bir Singh; Cohen, Lorenzo; McCall, Timothy; Telles, Shirley, “The Principles and Practice of Yoga in Healthcare.” (East Lothian:Handspring Publishing Limited, 2016); 5-11, 24-25, 487-492, 525
2. National Center for Complementary and Integrative Health (NIH),  “Complementary, Alternative, or Integrative Health: What's In a Name?,” April, 2021 https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name
3. Gaines, Kathleen, “Nursing Ranked as the Most Trusted Profession 20th year in a Row,” in “Nursing.org” January 19, 2022 https://nurse.org/articles/nursing-ranked-most-honest-profession/
4. McCall, Trish, RN, BSN, YFYT - personal and professional anecdote; October 11, 2022
5. McCall, Trish, RN, BSN, YF YT - “Wild Haven’s RMP Trail Guide,”  (Self Published, October 2022) REALignment Migration Pathways Diagram 
6. Leaf, Caroline, “Switch On Your Brain; The Key to Peak Happiness, Thinking, and Health,” (Michigan: Baker Books, 2015)  
7. Van der Kolk, Bessel A., 1943-, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, New York, Penguin Books, 2015.
8. Levine, Peter A, In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, Calif., North Atlantic Books, 2010.
9. Presenters/Instructors: Thielen, Michelle; Sander, Maryann; YogaFaith Yoga Therapy Training Levels 1-3; 2021-2022, https://www.yogafaithlearn.org/