Monday, April 21, 2008

The Psychology of Yoga and the Yoga of Psychology

[The following essay first appeared as an article in the March/April 2008 issue of The Los Angeles Psychologist, the bimonthly publication of The Los Angeles County Psychological Association. This publication is geared to mental health practitioners, and this particular issue focused on creative approaches to psychotherapy. As editor Meghan Moody states in her introductory comments, "This issue . . . offers a look at a few creative practices that go beyond traditional talk therapy, inviting you to color outside the lines" (5). As a psychologist and yoga teacher, I was asked to contribute.]

The challenge for me is how to be present. To my sensations, my feelings, my thoughts, and my actions. It's an awful lot to ask and very hard to achieve. But yoga has helped by providing a method. Its has given me a safe space in which to practice showing up.

One reason I love yoga is because it's concrete. I attempt to work my body without getting distracted. Without trying to escape the intensity of the moment. Bending forward, bending backward, twisting sideways, and lifting skyward. All without losing a smooth, balanced breath. All without losing a smooth, balanced mind.

But we invariably do yoga the way we do life, and the same unwholesome habits inevitably plague us. For some, it's overworking. For others, it's being distracted. For still others, it's not managing to get onto the mat. As Jon Kabat-Zinn says in the title to his book, "Wherever you go, there you are."

And that's how yoga works. We start with a posture and end up with ourselves. Increasingly aware of our distractions and habits. It's hard to see our weaknesses in all their florid glory, which is why practicing yoga takes so much courage. But the practice also encourages us to be kind, to practice ahimsa or non-violence on every level, to discern with compassion instead of judging with harshness. This makes it possible to tolerate others. This makes it possible to tolerate ourselves.

The great thing about yoga is that we get to keep practicing. And the longer we practice the more we can grow. Of course, it's always tempting to avoid growth at any cost. All we need to do is reinforce our old habits. But if we really want to change, yoga's a good bet. It gives us a chance to see what we're up to.

By revealing in living color our unconscious habits, yoga helps us cultivate non-attachment and presence. Over time, we can learn to optimize our practice. We seek sensation and avoid pain while maintaining our breath. We get stronger and more flexible and assume harder postures. We notice with greater speed when we're becoming disregulated. We think about why we are getting overwhelmed. And we change what we do so that it feels better.

Gradually, we're more able to observe our experience, to reflect on our observations, and to act on our reflections, all of which enables us to become much more present -- to maintain our homeostasis under stressful conditions. In essence, the practice helps us achieve quiet mind, which, more or less, is the definition of yoga.

And then there's psychotherapy. Being a patient is hard enough. But being a psychologist is infinitely harder. Especially when it comes to encountering yourself.

A thousand times a day, I'm challenged with feelings. Frustration with this patient for coming late again. Anguish for that patient who's binging and purging. Fear for this patient who's feeling suicidal. Sadness for that patient who's just lost his father.

Every session is another chance to be overwhelmed by the torrent of feelings that threatens to flood me. Every session is another chance to push the feelings away - by getting sleepy, becoming directive, or spinning cogent theories. These are some of the ways I unknowingly create distance, from the patient, from myself, and from the relationship between us.

This is where the yoga comes into play (not to mention the years of therapy, supervision, and classes). Because is a glacial sort of way yoga has changed me. It has helped me to notice when I'm not showing up, and it has helped me to figure out how to come back. It has also helped me notice when my patients are absent. They may appear to be there, but it's really an illusion. They're a million miles away -- angry, silent, or distracted. It's thrilling to bring them back. To guide them toward their core. To help them stay present to the pain they uncover.

How astonishing it is to be able to be present. If only for an evanescent moment now and then. Though the presence comes and goes, it's amazingly deep. It brings with it an indescribable feeling of intimacy. I can see it in my patients. I can see it in myself. It is thrilling. It is transformative. It is scary. It is sublime.

This is the hope that keeps me alive. To go deeper. To get closer. To stay longer. To be more present. To move nearer and nearer to a state of quiet mind. To move nearer and nearer to the essence of yoga.


Anonymous said...

How do you lead a patient to this moment without overwhelming them and if they are overwhelmed how do you make sure they do not leave the sesion and re-enter the world in that state?

Dr Raphael Gunner said...

In general, I try to follow the lead of my patients. They start the session with whatever's on their mind, and I try to understand what they are feeling. My hope is that we'll be able to think together about their experience -- and that eventually they'll be able to do this on their own.

That said, one of the greatest challenges I face is to allow the process organically to unfold. This requires sensitivity to the magnitude of the patient's feelings, an empathic sense of timing, and a willingness to wait.

If despite my best efforts the patient does become overwhelmed, I try to remain emotionally present in the moment -- interested in their experience, compassionate toward their pain, and supportive of their struggle psychologically to survive. This is easy to say but difficult to do and lies at the heart of the art psychotherapy.

Dr Raphael Gunner said...
This comment has been removed by the author.
Anonymous said...

How does the relationship help the other person be present to tehir pain....and why would they want to do that in front of someone else. It sounds excrutiating to do alone let alone with another person their

Dr Raphael Gunner said...

In my experience, one of the greatest challenges in life is to experience one's painful feelings. On the face of it, it seems like the last thing one would want to do. On the contrary, it seems natural to avoid one's pain at all cost -- let alone to experience it in the presence of another.

And yet, avoiding our pain does nothing to heal it. And the ways in which we avoid it can generate chaos: from substance abuse to overwork to binging and purging to promiscuity.

Often, exploring our pain is most easily done with a therapist. Someone trained to help us understand what has happened, who can support us when we're afraid, and who can comfort us when we're embarrassed.

Ultimately, we have to learn to live with ourselves. But few experiences are more effective in helping us to do so then feeling fully accepted someone we trust. For many the first person we trust is the therapist. A good place to start the wondrous process of healing.

Anonymous said...

What do I do if those feelings make life seem not worth it. Is it still a good idea to explore them? Can a therapist help with that or is it too serious? Is that an automatic trip to the hospital?

Dr Raphael Gunner said...

It's an open secret that many of us at some point wonder if life is worth living. Most people won't admit it, but it's a common reflection.

As it turns out, this is a wonderful time to begin psychotherapy. Why? Because in this frame of mind one has access to all kinds of deeply rooted feelings. Many of these feelings may be overwhelming at the time, and having a professional to discuss them with can bring great relief.

There's nothing quite as comforting as sharing your pain with a person who's not only compassionate, supportive, and insightful, but trained to help others work through these moments.

Like the president of the famous "Hair Club for Men," I myself can speak from personal experience. I've had wonderful therapists who have transformed my world. A big reason why I became a therapist myself!

Anonymous said...

So you went to therapy before deciding to become a therapist? How did you decide to go to therapy....oh and thanks for answering all these questions. Your blog makes it seem so appealing (and scary)but I feel like deciding to actually start therapy is a huge decision and I am just curious as to how other people decided to start.....

Dr Raphael Gunner said...

I've been in therapy at different times in my life. The reason has always been that things seemed too difficult, harder than it appeared they really ought to be. For the most part, I've hoped to live a happier life and thought that psychotherapy would be a good place to start.

What I've discovered is that life always includes pain -- the pain of loss, the pain of change, and the pain of disappointment. But I've also discovered that it doesn't have to include suffering. Pain is part of life. Suffering is optional.

We invariably create suffering when we try to avoid pain. We over eat, over work, over sleep, over exercise, under eat, do drugs, become promiscuous, clean maniacally, all in order to avoid the discomfort of painful feelings.

Therapy can help us to tolerate our pain, to steer us clear of suffering, to think about our experience, and to make skillful decisions based on our reflections. For these reasons alone therapy can be transformative. What a wonderful way to improve the quality of our life!