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The Next Generation - Yoga Therapy

If the words Yoga Therapist are in your peripheral vision lately, it’s partly because this field is growing not only in tandem with aging baby boomers, but also with the unusual convergence of prestigious western medical science and ancient eastern holistic practices. M.I.T. and Harvard studies now confirm what the yogic choir already knew-- in their own way--that meditation allows for better focus through the control of alpha rhythms in the brain.

The International Association of Yoga Therapists was formed over two decades ago, when yoga-buzz was still in the low-decibels. But what is it exactly and how does it differ from yoga, per se? YogaCityNYC’s Sharon Watts decided to nail the answer down and went to some of the leading experts in the field: Loren Fishman, MD, Director of Manhattan Physical Medicine and Rehabilitation, Bo Forbes, Clinical Psychology and Director of Center for Integrative Yoga Therapeutics, and John Kepner, Director of International Association of Yoga Therapists.

Sharon Watts: What is the essential difference between a very good yoga teacher and a certified yoga therapist?

John Kepner: At a high level and in some lineages, there is really not that much difference. Most yoga therapists are also yoga teachers. In practice, however, a well-trained yoga therapist should be able to work with individuals and groups with a wide variety of health issues, such as back care, heart disease, depression and spiritual challenges (such as a diagnosis of cancer). Yoga teachers, in contrast, usually work with healthy individuals.

Sharon Watts: It seems relatively easy to hang out a YT shingle. How do you vet the certification programs in your association?

John Kepner: It is easy to hang out a shingle or to open a yoga therapy training program. That’s why IAYT recently published standards and established an Accreditation Committee to accredit programs that meet these standards, which are high, relative to the field, and fundamentally about competencies, not just hours and curriculum. The process will be rigorous and will stress, among other things, how schools are assessing student competencies. After the accreditation process has started for programs, we will then begin to establish a credentialing process for individuals.

Sharon Watts: Dr. Fishman, you almost literally have one foot firmly planted in B.K.S. Iyengar’s backyard and the other in your Park Avenue office. How did yoga inform your decision to become a medical doctor, and how does that knowledge feed back into your yoga practice?

Loren Fishman: One of the reasons I went to medical school was to learn how yoga works. Medical knowledge has changed my yoga and vice-versa. For example, understanding the joints has heightened my vigilance about injuries from dozens of poses. But yoga has also affected my practice of medicine: for rotator cuff, osteoporosis, scoliosis, and back pain, for example. I may be one of the few physicians in the country who uses yoga this much to cure and benefit my patients.

Sharon Watts: Tell us more about how science and yoga coexist, and is there any particularly exciting breaking news on this front?

Loren Fishman: Yoga, at least up to the present, is not a science. It is a practice. It lacks the peer-group scrutiny and principles of validation of science. It is introspective rather than empirical. Although that is changing, we still must use medicine and other scientific disciplines to evaluate how and how well yoga accomplishes medical goals. For example, I have used EMG (electromyology) to understand how headstand and its variations can cure rotator cuff syndrome by incorporating different muscles to do the job of the injured supraspinatus, and for distinguishing different causes of sciatica, for which quite distinct asana are effective. We also have used MRI, in which we must train ourselves to stay motionless for some time in different poses. Currently we have a clinical trial in progress for osteoporosis, scoliosis and bunion.

Sharon Watts: How else is yoga used in treatment for physical ailments, and should a medical professional be consulted first?

Loren Fishman: Everyone at special risk for injury should consult a medical practitioner. That being said, we use yoga for many conditions, some apparently unresolvable by other means-- sciatica, rotator cuff syndrome, osteoporosis, arthritis, multiple sclerosis and unexplained pain. But we also apply yoga in a resourceful way for rare conditions such as restless leg syndrome and polycythemia rubra vera (a blood disorder).

Sharon Watts: How does yoga therapy help with issues such as anxiety and depression?

Bo Forbes: Yoga therapy doesn’t just access the mind and body; it addresses the entire mind-body network which includes our autonomic and enteric nervous systems, immune system, pain pathways, connective tissue matrix, and emotional regions of the brain. Anxiety, depression, chronic pain, and other emotionally-mediated issues don’t exist just in the mind or emotional regions of the brain; you can think of them as patterns that exist in, and are “practiced” by, each part of the mind-body network. Yoga therapy is an ideal medium for observing these mind-body patterns, and in helping to create new, healthier patterns.

Sharon Watts: What do you want to stress as the mission of IAYT?

John Kepner: Our mission is to establish yoga as a recognized and respected therapy. To support this, we provide professional publications, professional conferences, academic research conferences, and professional standards. Since we published the standards, a few colleges and universities have called, because they are now exploring establishing professional master’s degrees in Yoga Therapy. The first one should be the Maryland University of Integrated Heath. But I do want to emphasize however that IAYT is not just for certified yoga therapists, it's for anyone interested in yoga therapy .

This story was originally written in 2013. For 2015 information about the June IAYT conference in Newport Beach, California, click here.

Illustration: Sharon Watts

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