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   Table of Contents     
BOOK REVIEW  
Year : 2012  |  Volume : 5  |  Issue : 2  |  Page : 161-163
Kundalini yoga meditation for complex psychiatric disorders


Assistant Professor, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samasthana (SVYASA), Bangalore - 560 019, India

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Date of Web Publication9-Jul-2012
 

How to cite this article:
Jagannathan A. Kundalini yoga meditation for complex psychiatric disorders. Int J Yoga 2012;5:161-3

How to cite this URL:
Jagannathan A. Kundalini yoga meditation for complex psychiatric disorders. Int J Yoga [serial online] 2012 [cited 2019 Dec 11];5:161-3. Available from: http://www.ijoy.org.in/text.asp?2012/5/2/161/98252

Author: David S Shannahoff Khalsa

Year: 2010

Publishers: Norton Professional Book, New York, USA.

Through his book titled, 'Kundalini Yoga Meditation for Complex Psychiatric Disorders - Techniques specific for treating the psychoses, personality and pervasive developmental disorders', Shannahoff-Khalsa has provided field-tested protocols of Kundalini Yoga Meditation for severe psychiatric disorders. These protocols are substantiated with evidence-based case studies, which add to the validity of the prescribed Kundalini yoga techniques. The author has written this book as an extension of his first book on Kundalini Yoga Meditation, where he focused on protocols for specific psychiatric disorders like OCD, couples therapy and personal growth. His introductory chapter clearly states that the focus of the present book is to target Kundalini yoga meditation for severe psychiatric disorders like schizophrenia, pervasive developmental disorders and personality disorders and toward dealing with psychiatric 'multimorbidity' conditions (Chapter 5, Page 270) which seem to be common in USA. [1]

In each of his subsequent chapters on treating schizophrenia and other psychotic disorders (Chapter 2), treating personality disorders (Chapter 3), treating pervasive developmental disorder (Chapter 4) and treating multimorbidity in psychiatric disorders (Chapter 5), he eloquently details the diagnostic details of each disorder, its prevalence, conventional modalities of treatment, yogic view of etiology and yogic protocols for treatment along with successfully treated case histories. Certain notable and new concepts have also been discussed in each of the chapters. For example: in chapter 2 on 'treating schizophrenia', the patient's 'desire to self-heal' in the process of treatment has been emphasized (page 53). In chapter 3 (treating personality disorders), the traditional method of therapy for patients with personality disorders i.e., of Dialectical Behavior Therapy is mentioned along with that of yoga through scientific research studies (pages 122-131). Further, how certain symbols can be used as associations in therapy have been detailed (e.g., cave, tall tree, low tree, spiral shell, stick or branch, waterfall, snake, stone, claw, bird; page 150). In chapter 4 (treating pervasive developmental disorders, PDD) the authors have emphasized the need for therapy as an important part of the treatment, as in PDD's medications are observed to only help deal with the behavioral problems. Yogic methods to improve eye-to-eye contact and other symptoms of PDD have been detailed with the surmise that the effectiveness of the therapy would depend on the degree of trainability of the patient (page 280). Finally in the last chapter on 'multimorbilities', the author has detailed the principles of therapy to deal with these complex cases (page 270) and the importance of continued therapy for effective outcomes.

Certain issues raised by the author during the course of the book could, however, require further thought and debate:

  1. Desire to self heal: All the case histories reported in this book have been successful in healing the patient, because of their 'desire to self heal' (Chapter 2, Page 53). However, the basic challenge in treating any psychiatric patient with the conventional modalities of treatment and more so with the yogic protocols is the patients' lack of insight regarding their own disorder. The Mental Status Examination (MSE) of any psychiatric patient involves assessing his insight which in turn enables the psychiatrist to prescribe pharmacological/non-pharmacological treatment. [2] The level of insight (about one's own disorder) in a patient can indirectly predict his co-operation to treatment and recovery. [2] Psychiatrists, hence, aim to first stabilize the patient's symptoms and insight through pharmacological treatment modalities, and once the patient is amenable to suggestions of a therapist, the patient could be prescribed conventional or alternative therapy. In cases of severe psychiatric disorders like schizophrenia, personality disorders and autism, yoga as a therapy, requires the patient to have at least a moderate level of insight [2] ('desire to self heal'), without which results could be discouraging.
  2. Add-on therapy with medication: In continuation with the above point of discussion, yoga could possibly be looked at as a more effective add on treatment, than a stand alone treatment especially in psychiatric disorders such as schizophrenia, where some psychiatric symptoms (positive symptoms of schizophrenia) show initial good response only to drugs. [2] This issue is indirectly validated in this book as two out of three cases of psychosis mentioned, were either already on medications when they started the yoga treatment or were advised to start yoga along with medication treatment. Kundalini yoga could be looked at as a stand alone treatment in the case of personality disorders and pervasive developmental disorders where the mainstay of treatment is non-pharmacological. Therapists however need to be cognizant that in dealing with 'multimorbid' psychiatric disorders, the decision to prescribe yoga as a stand alone treatment could be complex.
  3. Continuing yoga therapy: Yoga is as an effective alternative treatment in patients who do not obtain remission or satisfactory symptom-relief even after taking pharmacological treatment. [3] This effectiveness is, however, pronounced only if yoga is practiced on a continuous basis over a period of time. [4] The negative symptoms of schizophrenia such as lack of motivation deter patients from indulging in any activity. Further lack of insight about ones disorder may make the patient believe that they do not require the treatment. Research studies in yoga have reported logistic as well as illness related barriers to yoga therapy which requires to be understood before prescribing yoga to patients with psychiatric problems. [5] Most of the cases in this book were referred by the consultant doctor or by the family member of the patient, a possible cause for continuing with the treatment.
  4. Chakras stimulation/ Meditation: The Kundalini yoga meditation techniques mentioned in this book are novel in the field of psychiatry as most other studies on patients with psychiatric disorders are limited to yogasanas and pranayama variants only. This is because, studies have depicted that meditation could possibly result in a risk of exacerbating psychosis. Some patients have the risk of activation of psychosis during meditation. [6] In patients with schizophrenia, a good proportion of who suffer from motivational defects, ensuring these mindful practices is a challenge. [7] The effectiveness of Kundalini yoga meditation techniques though seen to be effective in this book could require further investigation in large sample randomized controlled studies to counter the criticism of including meditation techniques in yoga protocols for treatment of (especially) patients with psychosis.
  5. Tackling macro issues of mental health care through Yoga: The author has concluded his book with an epilogue which discusses yoga as an effective preventive treatment to counter the health care market forces. It is true that in the USA (where health care is privatized) as well as in developing countries like India, liberalization, privatization and globalization of mental health care have caused rise in the costs of medication and mental health care treatment. Despite the success of District Mental Health Programme in some states, the common person of India finds it difficult to access affordable mental health care in the community. To tackle this growing issue, introduction of yoga as a preventive, alternative and complementary treatment for patients with psychiatric disorders in India could be an effective solution for three basic reasons: (1) yoga which originated in India is seen to be a practical and accepted therapy for patients to practice at home, (2) the number of yoga therapists is more than the number of mental health professionals available in India, and finally, (3) yoga is cost-effective and has no side-effects as in the case of psychiatric medications.


Overall, the book provides practical and feasible yogic protocols for treatment of severe psychiatric disorders which were considered till date to be incurable even with pharmacological medications. By reading the success stories of the cases mentioned in this book, family members of psychiatric patients can seek solace in the existence of a possible alternative treatment for severe psychiatric disorders.

 
   References Top

1.Angst J, Sellaro R, Ries Merikangas K. Multimorbidity of psychiatric disorders as an indicator of clinical severity. Eur Arch Psychiatry Clin Neurosci 2002;252:147-54.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.Sadock BJ, Sadock VA. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 7 th Ed. USA: Lippincott Williams & Wilkins; 2000.  Back to cited text no. 2
    
3.Buckley PF, Stahl SM. Pharmacological treatment of negative symptoms of schizophrenia: Therapeutic opportunity or cul-de-sac? Acta Psychiatr Scand 2007;115:93-100.  Back to cited text no. 3
    
4.Patañjali (1989; Feuerstein, G. translation). The Yoga-Sutra of Patañjali: A New Translation and Commentary, Inner Traditions International; Rochester, Vermont, Verse/Page: 1.14.  Back to cited text no. 4
    
5.Baspure S, Jagannathan A, Kumar S, Varambally S, Thirthalli J, Venkatasubramanain G, et al. Barriers to yoga therapy as an add-on treatment for schizophrenia in India. Int J Yoga 2012;5:70-3.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.Walsh R, Roche L. Precipitation of acute psychotic episodes by intensive meditation in individuals with a history of schizophrenia. Am J Psychiatry 1979;136:1085-6.  Back to cited text no. 6
    
7.Gangadhar BN, Varambally S, Thirthalli J, Jagannathan A., Kumar S., Venkatasubramanian G., et al. Therapeutic efficacy of add-on yogasana intervention in stabilized outpatient schizophrenia: Randomized controlled comparison with exercise and waitlist. Indian J Psychiatry 2012 [in press].  Back to cited text no. 7
    

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Correspondence Address:
Aarti Jagannathan
Assistant Professor, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samasthana (SVYASA), Bangalore - 560 019
India
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Source of Support: None, Conflict of Interest: None


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