C-IAYT Certification Research Paper: Yoga Therapy For Addiction Recovery

May 16

Inner Peace Yoga Therapy C-IAYT Certification Research Paper

Written by Katie Pine, Denver 2019 Yoga Therapy Training Cohort

“The opposite of addiction is not sobriety, it is connection.”

When I first heard these words in our Inner Peace training Yoga of Recovery module with Durga Leela, Clinical Ayurvedic and Pancha Karma Specialist and founder of the Yoga of Recovery program which integrates 12-Step Program addiction recovery tools with the wisdom of yoga, meditation and Ayurveda, I knew at once that they were true. At that point in our training, I was into my third year working for addiction treatment centers in the Boulder and Denver areas, and had a few years of experience offering therapeutic yoga, mindfulness, and meditation instruction to the residential treatment clients in recovery at those centers. I had never before heard such a clear explanation of what I had seen in my teaching work with students in the early days of their recovery. Teaching gentle, accessible yoga and breathwork practices to residential clients – ones who have experienced a more intense level of substance usage and who are living in a sober treatment environment for anywhere from a week to multiple months – was a fascinating window into the disconnection, and subsequently occurring anxiety, depression, pain and tension these clients can experience resulting from and throughout the course of their substance additions. It had also provided me with a direct understanding that offering quiet but powerful, inward yoga therapy practices which facilitate reconnection to the Self as a method of healing for clients in treatment for addiction is essential to the long-term success of their recovery.

As Durga explained to us, in Western societies like ours, clients experiencing and attempting to recover from addiction were historically viewed as people who experienced a moral failing rather than a health problem, which led to a prolonged emphasis on punitive rather than preventative and therapeutic actions for treating addiction (Yoga of Recovery). As a result, clients in active addiction were often punished or ostracized instead of understood and given supportive treatment. It was not until the 1930’s with the work of Bill Wilson and the development of Alcoholics Anonymous that addiction gained the status of a disease and addicts started being viewed instead as sick people trying to get well (Yoga of Recovery). Today, rather than trying to force sobriety on people struggling with addiction or sticking to medication or psychotherapy alone, many treatment programs throughout the United States are now attempting to get to the root of the disease through the implementation of more holistic practices like the ones yoga and yoga therapy offer, helping addicts reconnect with themselves and providing them with more supportive tools to support their long-term recovery.

These days, addiction is defined by the American Society of Addiction Medicine (ASAM) as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences” (American Society of Addiction Medicine). They go on to say that people with addiction “use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.” This definition of addiction is more comprehensive than ever before, taking into account an individual’s chemical and genetic makeup, the environment of their upbringing and daily life, and their experiences as factors that can all contribute to addiction. Because our understanding of addiction has shifted to this more comprehensive model, it follows that the holistic and comprehensive treatment modalities offered by yoga and yoga therapy would begin to surface as complimentary methods for addiction recovery programs that seek to treat the whole person. According to the treatment center New Method Wellness, yoga therapy is now considered by the Substance Abuse and Mental Health Services Administration (SAMHSA) – a branch of the U.S. Department of Health and Human Services whose mission is to reduce the impact of substance abuse and mental illness on America’s communities – to be one of several empirically validated addiction treatment methods (New Method Wellness). As the California-based treatment center’s website explains, when used in conjunction with other forms of clinical treatment, yoga therapy has been implemented as a holistic method in many programs that address the following:

Substance abuse
Post-Traumatic Stress Disorder (PTSD)
Depression
Anxiety
Chronic pain
Stress-related medical illness
Acute stress,

and is an excellent, non-narcotic way of relieving the withdrawal symptoms of heightened anxiety, stress, and depression by utilizing the body’s own resources to heal itself (New Method Wellness). They also cite the following evidenced-based benefits of yoga therapy in addiction recovery:

Improved mood
Better stress tolerance
Increased mental concentration
Reduced fatigue
Emotional healing
Healthier lifestyle habits, such as diet and exercise
Restored connection with oneself
Self-empowerment

Similarly, the American Addiction Centers website also endorses that more and more treatment programs in the United States are focusing on a “whole person” or holistic approach to recovery that encompasses a variety of methods and tools to help achieve, maintain and enhance recovery, and that yoga is a complementary health practice among those being utilized that is often considered a natural form of medicine (American Addition Centers). “Yoga is often beneficial when used in tandem with other traditional substance abuse treatment methods” their site explains, and is “increasingly being used in substance abuse treatment programs and throughout recovery to help prevent relapse, reduce withdrawal symptoms and drug cravings, and provide a healthy outlet to cope with potential triggers and daily life stressors…when practicing yoga, people are attuned to their bodies, learn to regulate their breathing, and to really listen to their bodies…by focusing all energy inward, individuals can learn to take ownership for the way they feel and gain control over themselves and their subsequent actions. In so doing, they may also become more self-reliant and self-confident. By recognizing cravings when they occur and not attempting to avoid them or give in to them, for example, a person may be more able to cope with and manage these feelings if they are more physically aware of them when they occur” (American Addiction Centers).

As Durga’s Yoga of Recovery program outlines, psychotherapy has long been popular in addiction treatment. However, “treating the mind directly with the mind has its limitations. In yoga, with its deeper understanding of the different levels of mind (brain, mind, consciousness) it is understood that it is not easy to effect a change at the level of consciousness by merely changing our thoughts on the analytical level or altering the chemistry of the brain” (Yoga of Recovery). This concept supports the increasingly popular idea of holistic, whole person healing that we are seeing more and more throughout Western societies, as well as in addiction recovery environments. It also indicates why solely medication-assisted addiction treatment programs or those that only focus on treating the symptoms of the addiction on one level of a person’s being without addressing the underlying causes of that dis-ease are not often successful long-term. Indeed, many Western addiction treatment programs build into their recovery models the notion that relapses are a common part of the recovery journey. If we think of addiction as a disconnection from Self, it stands to reason that only treatment programs which support or facilitate reconnection to the Self would prove effective in supporting long-term sobriety. In support of this notion, in his book In the Realm of Hungry Ghosts, renowned addiction expert Gabor Mate states that during drug addiction, “we constantly seek something outside ourselves to curb an insatiable yearning for relief and fulfillment” (Yoga of Recovery). Yoga and yoga therapy practices offer a union, a return, and a reconnection to the sources of relief and fulfillment which are inherently within us, thereby rendering unnecessary the desire for external relief or outward distraction that cause so much of our addictive behaviors.

On an even more scientific level, yogic practices have increasingly been shown to enlarge areas of the brain associated with dampening stress, directing attention, and actualizing our sense of self, as found by studies done by the National Center for Complementary and Alternative Medicine in Bethesda, Maryland (Scientific American). These enlarged areas of the brain support more ease in daily life, better decision making, a healthier sense of self and less emotional reactivity, all of which support people in recovery to develop new tools for dealing with triggers and the feelings of stress or disconnection that often coincide with relapses. American Addiction Centers elaborates further on the benefits of yoga practices in overcoming addiction, stating that “the practice of yoga may actually help to balance some parts of the brain and body that are impacted by drug abuse in a natural way. In addition to the physical aspects of yoga, there are also many emotional benefits as well” (American Addiction Centers). Again here, the benefits of yoga are acknowledged to support those in recovery on multiple levels, rather than only addressing a client’s immediate mental or physical symptoms. Yoga is also known for its spiritual component, which is highly valuable in supporting reconnection to the Self. In the past, the spiritual component was often absent entirely from treatment programs, as addicts were viewed as being beyond moral redemption. With the change in understanding around addiction as a disease that developed over time and the creation in particular of the 12-Step treatment program, the spiritual component was introduced to addiction recovery in a way that mirrors some elements of yoga therapy practices. American Addiction Centers makes this correlation directly in their explanation of how yoga can assist addiction treatment: “Many of the 12-Step programs individuals join during treatment and recovery to garner support are steeped in spirituality and spiritual concepts. Yoga can enhance this and help individuals to reach that spiritual connection through breathing techniques and mindfulness meditation. Quieting down all external influences through yoga may help a person to find inner peace through self-reflection and come to a personal realization of what may need to change to improve life” (American Addiction Centers).

Over the course of my work in addiction treatment centers, I have seen firsthand how the tools of yoga therapy can support people in their recovery by initiating a profound reconnection to themselves, and by giving them accessible tools to utilize in moments of stress, anxiety or craving. This work showcased how offering a quiet space for recovery clients to become more mindful of and present to themselves and teaching them supportive awareness and breathing practices offered them new insights into their feelings and experiences, and gave them more supportive tools to access in moments of discomfort or the space between a trigger and turning to a substance for numbing or relief. Yogic practices of non-attachment, self-compassion, physical and energetic opening, and meeting what arises from moment to moment were also powerful complements to the talk therapy, EMDR and other emotional processing recovery clients had experienced with their therapists in their comprehensive treatment programs. These offerings resulted in many clients reporting that they became less rigid and controlling over time and felt better overall, and taught them to show themselves more grace and compassion as they navigated the ups and downs of their recovery journeys.

The group and individual addiction therapists at Sandstone Care, the Denver treatment center I currently work for, also offer a range of yoga-based practices and tools to their adult and adolescent clients in the course of their therapy work, with great success. “From my clinical experience, I find that client engagement in mindfulness activities including body scans, square breathing, and 5-finger tap counting can lead to a decrease in anxiety symptoms” says Sandstone’s Clinical Director Sarah Fletcher. “Clients who regularly practice short-term daily meditation exercises also verbalize their ability to regulate high levels of emotional dysfunction, including the reports of a decrease in panic symptoms.” These natural, personalized practices support clients in moments of anxiety or intense emotion, and remind them that they can regulate within themselves rather than externally with the use of a substance or other detrimental behaviors. Sandstone’s therapists also utilize yoga-based tools like visualizations, diaphragmatic breathing and guided meditations to help clients calm their nervous systems, better identify feelings and triggers, and feel more in control of and connected to their bodies. Yoga practices that normalize sitting with and breathing through feelings and moments of discomfort and which highlight the ever-changing emotional and mental states we all experience were also found to support clients with the physical, emotional, mental and energetic fluctuations that occur during and after substance withdrawal and throughout the recovery process.

Finally, one of the most impactful benefits of yoga therapy for addiction recovery is the enduring nature of the practices and tools it offers recovery clients. The benefits of the time spent reconnecting to oneself can be accessed again and again, independently and at any time, which is especially relevant for people in recovery who often experience long-lasting effects of their addiction and constantly need tools to support lasting wellness and sobriety. “When used in conjunction with other traditional therapy practices, yoga can be a wonderful adjunct therapy that individuals can practice throughout their lifetime to calm themselves and improve clarity of mind whenever needed” reads the American Addiction Centers website on using yoga to support recovery. “Yoga goes way beyond just stretching” their site continues, and “can be beneficial as a part of a substance abuse treatment program and can be practiced independently as well” (American Addiction Centers). Similarly, a 2013 study on yoga and mindfulness as complementary therapies for addiction stated that “current theoretical models suggest that the skills, insights, and self-awareness learned through yoga and mindfulness practice can target multiple psychological, neural, physiological, and behavioral processes implicated in addiction and relapse” (Science Direct).

All of this research and experientials together support the direct correlation between the benefits we know yoga therapy can offer and successful addiction treatment which facilitates long-lasting reconnection and recovery. Ultimately, Durga’s Yoga of Recovery program defines health as and works its recovery clients toward Svastha, a yogic term that means “to abide in the Self”. When we are able to reconnect with and abide in our true selves through the practices of yoga, health is achieved and it is not necessary to seek external relief any longer. Over time, I hope to see more and more Western addiction treatment programs recognize this and offer yoga therapy to their clients in conjunction with their other treatment modalities the way Sandstone Care does, and like so many other centers across the United States have started to do. I am sure that the more addiction treatment centers shift the goal of their programs from client sobriety to true client reconnection, the more we will see successful, enduring recovery outcomes.

References

American Addiction Centers, Using Yoga in Recovery (2021)

https://americanaddictioncenters.org/therapy-treatment/yoga

American Society of Addiction Medicine, Definition of Addiction (2019)

https://www.asam.org/Quality-Science/definition-of-addiction

Leela, Durga. Yoga of Recovery, Presentation and Research (2019)

New Method Wellness, What Is Yoga Therapy? (2021)

https://www.newmethodwellness.com/treatment-methods/yoga-therapy/

Scientific American, How Yoga Changes the Brain (2014)

https://www.scientificamerican.com/article/how-yoga-changes-the-brain/

Science Direct, A Narrative Review of Yoga and Mindfulness as Complementary Therapies for Addiction (2013)

https://www.sciencedirect.com/science/article/abs/pii/S0965229913000265