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How Yoga Literally Enhances Wellbeing: An Evidence Based Article

“Yoga can facilitate positive embodiment including enhanced competence, self-efficacy and agency (Piran, 2016).”


For yoga teachers and students alike.


This is a research based article written in everyday language (mostly) so that you can understand the evidence for how yoga works; by gradually enhancing our neurological, physiological, cognitive and emotional processes, allowing us to sustain greater feelings of wellbeing throughout everyday life.


Expect up to date research that helps guide how we can enhance the effectiveness of our yoga sessions, including factors that we can consider in our practise to enhance our feelings of wellbeing.


Introduction


The evidence base supporting yoga’s potential to improve our everyday physical and mental wellbeing is rapidly expanding. This is fortunate, since throughout the Covid 19 pandemic public interest in yoga for managing anxiety and depression has significantly increased (Ashish et al 2021) while healthcare professionals have become increasingly willing to combine yoga interventions within their standard evidence based practise due to the positive impact of yoga techniques (Atler et al 2020, Berlowitz 2020).


How does yoga work?


On a neurological level, Yoga is increasingly understood as a practise that can help balance our nervous systems (Birch and Mason, 2018). There are two complementary branches of our autonomic nervous system, which when working smoothly allow a person to mobilise energy for action (via the sympathetic nervous system) or allow a person to rest, relax and recover (via the parasympathetic nervous system). Chalmers et al (2014) established that the majority of mental health conditions arise when one nervous system is overactive and the other is underactive. This leads to feelings of dis-ease or stress in everyday life.


Then on a physiological level, yoga practices have been evidenced to change physiological factors associated with stress including; reducing hematic cortisol levels, systolic blood pressure and heart rate (Riley et al, 2015 and Pascoe et al, 2017). There is a concept called heart rate variability (HRV), which basically refers to the natural increase of the heart rate on the inhale and decrease of the heart rate on the exhale. Yoga techniques help us develop comfort at different heart rates so that we can efficiently use our energy for action when the heart rate increases, e.g. in potentially stressful situations, and then we can relax and recover afterwards allowing the heart rate to slow back down. Interestingly, this physiological flexibility also relates to cognitive/mental flexibility (Birch and Mason, 2018).


On a cognitive and emotional level, yoga practises can support us to ‘embody’, in the present moment, positive emotions, thoughts and experiences (Cook-Cottone & Douglass, 2017, Impett et al 2006; Mahlo & Tiggemann, 2016). With regular practise, experiencing these feelings on the mat becomes natural and they translate into everyday life, allowing a yoga practitioner to feel empowered, perceiving that they have the strength, ability and independence to perform their everyday occupations. This is known as ‘embodiment’ (Piran 2019).


Kiken et al (2015) found regularly experiencing embodied mindfulness during a meditation program led to decreased feelings of distress and increased feelings of being present,‘embodied,’ in the moment during everyday life. The key here was an initial regular practise over 8-weeks. For yoga students this suggests an initial period of more intense and supervised practise would be useful to experience embodied feelings on the mat. So what are these ‘embodied’ feelings and practises?


Yoga on the mat leads to ‘embodied’ practises off the mat.


Cook-Cottone & Guyker (2018) identify that ‘embodied practises’ in everyday life, which feel natural and spontaneous, may arise from experiencing embodiment during yoga practises on the mat. These ‘embodied practises’ include;


  • Improved physical care of the body.

  • Improved self-compassion

  • Forming more supportive relationship

  • Forming a more structured and comfortable lifestyle and living environment

  • Calm awareness of thoughts and experiences

  • Mindful ability to consciously relax and recover


Cox et al (2020) elaborate on 2 further embodied practises that may arise from regular feelings of embodiment during yoga practise.


  • Attuned exercise: Calogero et al (2019) define attuned exercise as the ability to cultivate joy, mindful attention, compassion, acceptance and a responsive connection to the body through movement. Attuned exercise can be viewed as the basis of physical and psychological longevity.


  • Intuitive eating: the ability to feel connected and trust in the body's own internal feelings of hunger and satiety, while eating for physical rather than emotional reasons. [Note intuitive eating occurs within a flexible and non-restrictive approach].


From the subjective experiences in my own life, alongside students and teachers I have worked with, there are many real life examples for these embodied practises. Of personal relevance, yoga allowed me to sustainably work though and overcome orthorexia nervosa: the disordered eating and exercise habits that occured with it and the anxious, unconstructive relationships that developed between myself and my own mind. These lived-experiences form subjective evidence and insight into how yoga facilitates positive embodiment on the mat which can literally translate to our everyday lives, sometimes even without our conscious awareness at the time.


However, as a yoga teacher and student, it is useful to understand the mechanisms behind how yoga works to help ensure our own practise and teaching is based upon objective evidence based research, and not just ‘personal experiences’.


How as Yoga Teachers can we help ensure yoga works!


Simply teaching ‘yoga’ techniques may not be enough, as you are likely aware, there are many variables which could impact how students respond and interpret instructions, guidance, postures and techniques. Cox et al (2020) identify factors which can impact upon the effectiveness of yoga practises, which I have expanded upon below. Each should be given due consideration and each would be worthy of their own article.


  • Language used: for cues and in general conversation (including body language and non-verbal cues).

  • Context of the class: what is the purpose - does the teaching match up with expectations.

  • The class environment: including clothing, space, mirrors, lighting, warmth.

  • The focus of the class: does the class encourage students to be internally mindful and aware or is the class all about fitness and postures?

  • Students individual variables: including, social/cultural identities, personal backgrounds, personality and motivational types, physical limitations/abilities, gender and body type.


Fortunately, Cox et al 2020, provides a model for understanding the components of yoga interventions/classes, which actually enhance feelings of wellbeing leading to longer term positivity in everyday life. This provides a useful framework for yoga teachers and therapists to work from. Below I summarise in everyday language the 8 components and provide additional commentary on them.


The 8 mechanisms by which yoga may facilitate wellbeing and positive embodiment as listed by Cox et al (2020) are:


  • Reduced Self-Objectification and Body Surveillance

  • Mindfulness

  • Self-Compassion

  • Body Appreciation

  • Body Image Flexibility

  • Self Confidence

  • Joyful Immersion and Flow

  • Connection to Pleasure and Desire



To visit Cox et al’s (2020) original journal article please follow this link: A conceptual model describing mechanisms for how yoga practice may support positive embodiment


1. Reduced self-objectification and body surveillance


Self-objectification means viewing the body as an object without accounting for internal experiences (Piran 2017). Yoga likely directs our attention inwards and reduces our external focus (Impett et al 2006). Self-objectification, and the preoccupation with external looks, is a consequence of cultural upbringing. This promotes habitual body surveillance, a fairly constant monitoring of what we look like or how we act. Fredrickson & Roberts (1997) state this is a key contributor to anxiety, depression and disordered eating.


Many yoga techniques help us avoid self-objectification. For example yoga postures are designed to steadily bring our awareness to an internal focus so that we can maintain a steady focus and not be distracted by the outside world or even our bodies own external responses. For example, students are asked to link the breath with the movement and hold postures for x number of breaths. With practise students are encouraged to allow the breath to become increasingly subtle and soft naturally drawing the attention inwards. Keeping a soft steady gaze at a given point in each pose aids this process.


Yoga teachers, with well considered verbal cues, can facilitate a student to explore and discover their own internal landscape within the safe space of the yoga mat. For example, asking students to feel the ‘weight’ of the body grounding down in tree pose, would not be useful for anyone anxious around their weight. This cue would become an external distraction. Instead, asking students to notice the texture of the mat on their feet and inviting them to find the action of pushing the feet into the ground, would likely have a more positive outcome for everyone.



2. Mindfulness


A study by French et al (2016) concluded that the more mindful a student is of the physical experiences during yoga, the greater increase in self-worth they experience over an 8-week intervention. Mindfulness refers to the process of honest self-observation, meeting oneself where you are actually at, and accepting this, to intelligently move forwards.


Mindfulness is facilitated by yoga techniques that bring students into the present moment. Each of the 8-limbs of traditional ashtanga yoga work to bring us to the present moment. With practise a student can become more established and learn simple techniques e.g. bringing the awareness to the breath, that maintains awareness within the present moment, so that it is all the easier to observe one's own actions and thoughts and intelligently choose how to act and think.


3. Self compassion


Yoga participation has been reliably found to increase self-compassion (Braun et al 2012, Cox et al 2019, Gard et al 2012). Further to this, self-compassion is thought to be a mechanism explaining how yoga may help to reduce stress (Gard et al 2012).


It is useful to refer to Crew et al’s (2016) 3 components of self-compassion.

  1. Mindfulness: the ability to observe and remain with uncomfortable thoughts and emotions in order to find balance and clarity.

  2. Self-Kindness: the ability to generate positive thoughts towards one’s own self.

  3. Common Humanity: understanding that negative experiences are shared and also occur to other people, so that feelings of isolation and suffering can be reduced.


Within a yoga session, the teacher aims to hold a ‘safe space’ in which students can feel comfortable to be themselves and explore their own body and mind. The teacher acts as a guide to the student and may often be viewed as a role model, a friend or even like family. Compassion, is arguably, essential for the effectiveness of therapeutic interventions in health care, acting as the foundation which allows collaboration between the person and the therapist (Finlay-Jones 2017). For the yoga teacher, this should be no surprise as the first limb of Yoga emphasises ‘Ahimsa’ a.k.a compassion as a first step!


Being aware of the 3 components of compassion can help teachers facilitate feelings of self-compassion:

  • Providing encouragement to reside within postures or stay with an exercise may be more useful to students if the purpose of this is explained to students first, namely to give themselves the time to become ‘mindful’ and find balance or clarity within the thoughts and feelings that may arise.

  • Explaining methods to generate positive thoughts and feelings, then exploring these with students in an interactive manner, may be more effective and empowering than simply instructing a student to think positively.

  • If appropriate, inviting the sharing of common experiences within the class may help consol students who are experiencing negativity in their lives. Likewise, encouraging open discussion regarding experiences of postures or practising yoga techniques, may facilitate a feeling of ‘common humanity’: a.k.a ‘keeping it real’.

4. Body Appreciation


85% of 542 students who practised yoga reported that yoga had enhanced their body appreciation (Park et al, 2016). Body appreciation is different to body satisfaction. Body appreciation refers to the internal feelings that the body is serving its role and purpose well. A person can still seek to improve the body while being simultaneously content with its current state.


Yoga sessions may provide a conducive environment for learning to accept, respect and appreciate the body for how it actually is. Alleva et al (2017) note these feelings towards the body are independent of how the body looks or functions. It should be noted that research studies do not always support yoga being conducive to improving body appreciation. For this reason it is useful to refer to Halliwell et al’s (2019) study which specifically tailored yoga sessions to facilitate body appreciation.


Halliwell et al (2019) utilised themes to enhance body appreciation in yoga sessions, which lead to self-reported feelings of body appreciation after the sessions and 4 weeks later. These themes included:


  • Connection to the body.

  • Gratitude and appreciation of body function.

  • Body acceptance.

  • Developing respect and self-care towards the body.


For yoga teachers, consideration should be given to how these themes can be woven into lessons in a way that is sensitive and relevant for students. Discussing the themes in class, exploring how the yoga techniques may help develop these different aspects of body appreciation, may empower students to understand how yoga can work for them.


5. Body Image Flexibility


Body image flexibility, allows the myriad of thoughts and feelings, both comfortable and uncomfortable, to be embraced rather than avoided. This enables intelligent action to be taken in the moment, to alleviate discomfort or stagnation.


Sandoz et al (2019) identifies 6 skills that enhance body image flexibility:


  • Noticing the body in the present moment.

  • Acceptance of the body’s experiences in comfort and discomfort

  • Cognitive defusion (observing thoughts regarding the body without them becoming the focus of attention)

  • Recognizing the self as more than what the body experiences.

  • Valuing a purpose that guides the body's actions in comfort and discomfort.

  • Committed action/behaviour in line with the valued purpose, even in times of perceived discomfort.


The above skills can be easily seen at play in yoga postures which tend to generate a potentially uncomfortable stretch response. Provided a student is not too ambitious, the attention is first drawn to the body ‘stretching’ in the present moment, this sensation can then be accepted, the attention can then be diverted (cognitive defusion) to the breath and gaze point, then a student can realise the physical body is not defining their experience. This gives the opportunity for a student to value and realise the purpose of yoga postures bringing their awareness to the present moment and allowing them to feel at ease even in ‘discomfort’. Then motivation and commitment can be built to explore yoga, their own personality and abilities, further.


Of note, the guidance of an experienced teacher is highly recommended when committing to a course of action that leads the student through discomfort (outside their current comfort zone). The teacher can guide the student to remain safe and aware while exploring their potential in order to avoid injury or sustained discomfort.


6. Self-Confidence


Cox et al (2019) state yoga teachers should seek to find variations on poses that work for each person and encourage students to refer to their own internal cues to find just the right challenge for them. This approach can then lead to enhanced feelings of physical self-worth (Cole et al, 2016).


However, yoga teachers and students should note that some yoga students in Neumark-Sztainer et al’s (2018) study, reported that practising yoga created more social comparison and negative self-talk about their own body. So, yoga teachers must take care to avoid presenting any one way of doing things as the ‘correct or only way’.


‘Vinyasa Krama’ is the traditional method of yoga passed down from Shri, T Krishnamacharya. ‘Vinyasa Krama’ is the art of intelligently sequencing to best suit the individual. This approach to teaching yoga guides the student to safely explore and expand their comfort zone in order to make steady progress. Finding just the right challenge, provides feelings of achievements, whilst motivating self-development. This approach, although not referred to as ‘Vinyasa Krama’ is also the foundation of Occupational Therapy interventions, in which considered grading and analysis of the activity in question allows just the right challenge to be explored with the service-user.


7. Joyful Immersion and Flow


Flow is defined by Csikszentmihalyi et al (2014) as total absorption in a task or activity with a sense of effortless control, high level concentration and performance. Joyful immersion often coincides with flow, occurring when an activity provides inherent and intrinsic rewards, e.g. enjoyment and satisfaction throughout a person's participation in it.


For flow to be more likely in a yoga session 3 factors should be accounted for:


  1. Student’s abilities match up with their perception of the challenge presented to them.

  2. Clear goals should be set beforehand.

  3. Feedback from the teacher should be unambiguous and provided immediately.