research was done initially over six weeks with one session per
week, of one hour duration. The patients were assessed using the
Centre for Epidemiological Studies – Depression Scale CES-D
Radloff, L.S. (1977) The CES-D Scale. A self-report depression in
the general population. Applied Psychological Measurement, 1, 385-401.
In addition The Structured Interview Version of Hamilton Depression
Rating Scale SI-HDRS Items and Range of Response Categories was
also used. Potls M. K. Daniels M. Burman M.A. Wells K. B. (1990).
A structured interview of the Hamilton Depression Rating Scales.
Evidence of reliability and versatility of administrating. Journal
of Psychiatric Research. 24(4): 335-350.
The yoga poses used were those described in BKS Iyengar’s
book "Yoga The Path to Holistic Health", A Dorling Kindersley
We started using the depression series pp 345-347, and there was
an enormous improvement in depression. However, there were some
problems with anger, and the Irritability series was used for Anger
Management pp 337-339. This was very successful. The Insomnia Series
was applied with limited success for insomnia pp340 – 342.
Then the Anxiety Series was used pp342-344. This was not as successful
as the depression series. In summary, most benefit was obtained
from the depression and irritability series for this group of patients.
Following this, we started research using the Krishnamacharya/Desikachar
model as described in Gary Kraftsow's book Yoga for Wellness. We
did a six week programme using the depression series, and a similar
improvement in depression to that of Iyengar was noted, but an improvement
in insomnia, flashbacks, and anger management was noted with the
introduction of pranayama.
Kausthub Desikachar suggested we add a pranayama with an increased
out breath and a breath hold, and this added to the overall benefits
by causing anger to be managed very well, as well as insomnia. The
improvement in insomnia was better than with hypnotics, and the
practice of pranayama was very portable and could be implemented
in the early hours of the morning whilst lying in bed, and has proved
very effective. Finally, pranayama was compared with the addition
of Qi Gong (Tai Chi breathing), and although Qi Gong was helpful
in a similar way to pranayama, there was no improvement in depression
as there was with the yoga asanas. It was concluded at this stage
that it is best to have a combination of yoga poses with pranayama
and yoga nidra for the maximal response. Research is continuing,
as the Veterans are starting to practice daily at home because of
the combined benefits. The group experience is important, but the
Qi Gong is happening in a group, and the benefits are not there
for depression. If there is no depression and only anxiety, perhaps
Qi Gong would be enough.
research, and the presentation of the paper of two years research,
it was decided to compare yoga with cognitive behaviour therapy.
In studying cognitive behaviour therapy, it became obvious that
much of yoga has already been incorporated in cognitive behaviour
therapy, and this therapy contains a virtual grab bag of therapies
acquired from various sources, but especially from yoga. A research
review led to finding Mindfulness based Cognitive Behaviour Therapy
(MCBT), alternate nostril breathing, among other pranayama techniques,
directly lifted from yoga. Even the whole process of cognitive restructuring
fits in well with the concept of avidya (ignorance or misapprehension)
described by Patanjali, where the mind is described as quite arrogant,
making assumptions which may or may not be correct, and ordering
behaviour which can be quite maladaptive. Both yoga and CBT challenge
these assumptions, but in similar and different ways.
are continuing our pilot studies, comparing 6 patients who are doing
yoga plus a CBT program which was started with Motivational Interviewing
(MI), a specific behavioural technique to overcome ambivalence at
the outset of a process of change. Patients are not given a pre-set
out program, but a program is adapted to their needs and specific
responses each week. Already patients who were previously not communicating
are emailing each other, are searching the internet, designing alcohol
questionnaires which have already had the effect of reducing alcohol
consumption by the very process of challenging oneself with the
amount of alcohol consumed. Improvement is noted without any further
need to implement further strategies at this stage. The program
has run for three weeks thus far, and it is already noticed that
the CBT techniques, and the use of the group is overcoming the lack
of improvement in social avoidance and even reduction in alcohol
consumption, which were residual problems after the yoga group.
This has provided information for similar type interventions in
the yoga program, more handouts, feedback forms for the yoga group,
and has caused a deeper engagement by the yoga group than before
in their own improvement. It is only 3 weeks into a twelve week
program, and it will be interesting to see if the yoga plus CBT
group fare better than the CBT alone. Following this, it is planned
to administer yoga alone with these newer techniques informed back
from CBT and its methodology, to see if there is any difference.
It is important
that a very detailed expensive fuller research study with controls
is not initiated until the methodology is developed and tested in