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What is Yoga Therapy?

People open up to me. They feel comfortable sharing some of their deepest secrets. This awareness has been with me for a while. It happened on many occasions at a party or gathering that someone I did not know would sit down and tell me their life story within a few minutes. A stranger once told me she saw her father shooting her mother when she was 8 years old. I somehow knew how to listen and hold space for such heavy truths.

Carola conducting a breathing assessment (Adam Kang Photography)

As a yoga teacher, you quickly realise that people trust you and find it safe to share what is going on in their lives. Since I trained as a yoga teacher, I knew I had to gather more training to hold this space better. Students often expect a teacher to have counselling skills not covered in basic teacher training. However, things changed when I met Mark Stephens, who introduced me to yoga therapy — his influence and my private clients inspired me to embark on this training journey. After undertaking the 2-year yoga therapy diploma, I felt I could counsel my clients.

The Wounded Healer

Often the best healers are the ones that have suffered the most — the myth of the wondered healer. To be a good yoga therapist, you need to do your work. You need to dig. The more you unravel, the more you can hold space. Even if you do not advertise it, you will get clients with similar experiences, questions and troubles.

In yogic traditions, we do not find the wounded healer concept. Indeed, yoga was a practice of solitude, self-contemplation and hardship (tapas). Traditionally, yogis were not going about healing people. They were more busy working on transcending the cycle of life and death. Yet, if you speak to yoga teachers or yoga therapists, you quickly realise that yoga has been healing for them. It helped them overcome suffering, challenges, and find purpose.

Carola assisting a client (Adam Kang Photography)

What is yoga therapy?

Yoga Therapy is a contemporary evolution of yoga, grounded in research and informed by ayurveda, biomechanics, somatics, counselling, psychology, physiotherapy, neuroscience, anatomy, physiology, pathology and holistic medicine.

Yoga means to yoke, to unite. Indeed, yoga therapy combines disciplines from the West and the East to provide a holistic complementary modality. Yoga therapy looks at the client as a whole. It analyses what are the underlying needs behind symptoms and diagnosis. It assesses the client’s body, breath, attitudes, habits, tendencies, likes, aversions, thought patterns, and emotions, and guides clients to become aware of their symptoms' roots.

It is a client-centric therapy modality, where the therapist is an attentive and non-judgmental guide rather than the solution. It fosters clients’ independence and agency: they are empowered to be the masters of their healing, promoting self-care, functional breathing and movement, and behavioural change. Goal-driven and subjectively measurable allows for accountability and enables the client to track progress.

The yoga therapy approach is based on multiple models. Models are like maps. They are a representation of reality, not reality itself. They help us navigate the world and identify relevance. These models include the gunas, doshas, vayus, koshas, and chakras. These models have roots in the Upanishads (late Vedic texts that form the basis of Hinduism, even though yoga is not religion-based). These models have been reinterpreted and transformed through the centuries. For example, the koshas' symbolism and practical application are contemporary. The Koshas represent the five elements or layers of our being. The physical, the energetic or breath, the mind and emotions, our wisdom and ability to be in bliss. The chakras mentioned in most 20th-century literature are an evolution of Carl Jung’s interpretation and Satyananada Saraswati (founder of the Bihar School of Yoga) expansion in the 1960s.

The yoga therapy models help the yoga therapist to analyse their client’s presentation, fragilities, and strengths and pinpoint emotional blocks and breath restrictions. With this information, a therapy plan and home practice are crafted, answering clients' priorities and goals.

Is yoga therapy rooted in contemporary research methods? You bet it is!

Modern yoga therapy is intertwined with clinical research. It finds its roots in the 1920s in India with Shri Yogendra, Swami Kuvalayanada and Tirumalai Krishnamacharya as the grandfathers of yoga therapy.

India's first Prime Minister, Jawaharlal Nehru, with Swami Kuvalayananda.

Shri Yogendra and Swami Kuvalayanada founded India's first two yoga research centres to investigate yoga’s neurophysiology, and Krishnamacharya was one of the first to offer individualised yoga therapy. In his youth, Krishnamacharya promoted a rather acrobatic form of yoga and is likely the founder of modern postural yoga (what we think of when we think of a yoga class). Later he started working individually with people with various diseases. His son TKV Desikechar continued his work and founded viniyoga, a form of dynamic yoga (hello vinyasa yoga group classes!), marrying movement with breath. One of his students, Gary Kraftsow, took this further and started scoping yoga therapy.

As yoga reached the West in the 1960s, some practitioners happened to be healthcare providers. Some witnessed the benefits of the practices on themselves and then applied them to their patients. One of the earliest examples is Dr Dean Ornish. In his 1998 work, "Intensive Lifestyle Changes for the Reversal of Coronary Heart Disease", he suggests yoga, diet, and stress reduction techniques to improve cardiovascular disease outcomes. His work, together with other doctors, set the foundations for yoga therapy in the West.

What happens at a yoga therapy session?

Ahead of the first session, which lasts 90 minutes, the yoga therapist sends a health form and asks for priorities and reasons to seek yoga therapy.

The session starts with discussing the health questionnaire and establishing goals and priorities. The interview is followed by a postural, breathing, and movement assessment, moving into a guided restorative experience. The yoga therapist uses the yogic models to identify imbalances and the client’s underlying needs, such as being heard or feeling safe. These often match with symptoms and tendencies. These insights will be woven into a home practice, co-created with the client at the end of the session. Home practices range between 1 and 20 minutes to ensure manageability. The home practice is discussed, reviewed, and modified according to the client’s needs at follow-up sessions. The yoga therapist actively listens to the client and provides motivational interviewing.

Yoga therapy is not a panacea. Yet, if used in conjunction with medical care, it can give patients a space to be heard, to work with emotions via movement and breathing, to improve awareness and support them towards healthier and fuller lives. The best way to understand yoga therapy is to experience it. Find below a 15-minute guided emotional enquiry. Play with it. If you have any questions, feel free to get in touch.


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