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Yoga Therapy for Anxiety

As a psychological therapist and yoga practitioner, I have always been intrinsically aware of the useful benefits of yoga as an adjunct for people struggling with mental health problems and I recently completed a five day training CPD in Yoga Therapy for Anxiety at the Minded Institute in London.

Many clients coming into therapy nowadays are reporting anxiety as their primary difficulty. Mixed anxiety & depression is the leading mental health complaint in the United Kingdom, with 7.8% of people meeting the criteria for this diagnosis. 4-10% of people in England will experience anxiety and depression in their lifetime. In the United States, anxiety disorders are the most common mental health problem affecting 40 million adults age eighteen and older, or 18.1% of the population every year. It is estimated that 20% of people accessing yoga in any given class are experiencing anxiety.

In recent years, the integration of yoga into mental health is increasingly recognised as a holistic approach to improving physical and mental health. Practitioners of integrated medicine say yoga improves physical wellbeing and mental health through its effects on affect regulation – the person’s ability to manage their feelings, especially when under pressure.

One leading figure in this development is yoga teacher and psychotherapist Heather Mason, who has set up a training at the Minded Institute. Her approach grew out of her own experience of working with people with depression and anxiety. After years of personal yoga and academic study in both Buddhist psychology and neuroscience, she has developed an approach that blends yoga practices with psychotherapy and neurobiology.

A possible key to the effectiveness of yoga on the mind is the relatively recent discovery of neuroplasticity, the brain's ability to reorganise itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment, which underpins sustained psychological transformation.

Yogis have long practised yoga for mental transformation, above all to calm the mind. In fact, in the yoga sutras – one of the fundamental and oldest yogic texts – it is declared that ‘Yoga citta vritti nirodhah’ – ‘Yoga stills the mind’. That yoga might offer a way of treating psychological problems is a recent notion in the West. But it is one that is attracting great interest in the wake of new discoveries about the role of the autonomic nervous system and certain neuropeptides (small protein-like molecules in the brain that are used by neurons to communicate with each other) in promoting psychological wellbeing. Increasingly, the benefits of yoga are being explored by practitioners and psychology researchers.

Professor Sat Bir Khalsa, Director of the Kripalu Center for Yoga and Health, and Assistant Professor of Medicine at Harvard Medical School, has been involved in yoga practice and instruction for over 35 years and has been researching it for over 10 years. He is also interested in the potential effectiveness of these techniques to treat insomnia that is related to other conditions, such as depression, anxiety and fibromyalgia. Yoga, he says, is increasingly being used alongside medical and psychiatric treatments for a range of mental health conditions and there is a growing body of evidence to support its effectiveness in both treatment and prevention. Increasingly, yoga is recognised as a holistic approach that works on several psycho-physiological levels. Affect regulation

For practitioners of integrated medicine, the potential of yoga to promote our physical wellbeing and steady the mind is understood principally via the concept of affect regulation. The ability to manage one’s feelings, especially when under pressure, is part of healthy child development. However, the strains that are placed on individuals in societies where attachment relationships are frequently disrupted or insecure – where basic securities can rarely be taken for granted – mean that emotional disruption is increasingly widespread. Effective and accessible solutions for mild anxiety, depression are needed and yoga may be an emerging prescription. Specialists in the field of neurobiology emphasise the interpersonal nature of our capacity to self-regulate – that we learn to recognise and manage our feelings from a caring parent, who provides safety at times of turmoil. This, over time, becomes an internalised ability that enables us to self-soothe adaptively in response to the challenges of life. The biological mechanisms of this process are becoming increasingly well understood through advances in attachment theory and neuroscience, which in particular, demonstrate that the development of the emotionally sensitive right brain is dependent on the quality of interaction between the infant and their closest parent figure. Most psychological practitioners are familiar with the workings of the autonomic nervous system and the negative impact of trauma or disturbed attachment relationships on that feedback loop. Trauma work now frequently focuses on establishing the client’s ability to stay within a ‘window of tolerance’, between the two polar extremes of dissociation/withdrawal and the fight/flight response.

Window of tolerance is a term used to describe the zone of arousal in which a person is able to function most effectively. When people are within this zone, they are typically able to readily receive, process, and integrate information and otherwise respond to the demands of everyday life without much difficulty. This optimal window was first named by Dr. Dan Siegel, and is now widely used in understanding normal brain/physiology reaction responses, as well in trauma treatment terminology.

What Is the Window of Tolerance?

When a person is within their window of tolerance, it is generally the case that the brain is functioning well and can effectively process stimuli. That person is likely to be able to reflect, think rationally, and make decisions calmly without feeling either overwhelmed or withdrawn. However, during times of extreme stress people often experience periods of either hyper- or hypo-arousal.

  • Hyper-arousal, otherwise known as the “fight/flight” response, is often characterised by hyper-vigilance, feelings of anxiety and/or panic, and racing thoughts.

  • Hypo-arousal, or a freeze response, may cause feelings of emotional numbness, emptiness, or paralysis.

Using your breath for Anxiety

There are many ways to use your breath to reduce anxiety.

Coherent Breathing

  • Coherent breathing, or deep breathing, helps to calm the body through its effect on the autonomic nervous system. Whether it is practiced as part of yoga or meditation, or simply on its own as a relaxation strategy, coherent breathing is a simple and easy way to reduce stress and calm down when feeling anxious.

  • Focus on your natural breaths. Count the length of each inhale and exhale to obtain a baseline.

  • Find a comfortable position to practice coherent breathing. Place one hand on your stomach.

  • During this process, keep your hand on your stomach to make sure that you are breathing deeply from your diaphragm and not shallowly from your chest.

  • Breath in for four seconds and then out for four seconds. Do this for one minute.

  • Repeat, but extend your inhales and exhales to five seconds.

  • Repeat again, extending further to six seconds.

Ujjayi Breathing (Ocean Breath)

  • Ujjayi breathing is a breathing technique employed in a variety Yoga practices and it is sometimes called "the ocean breath". the ujjayi breath is typically done in association with asana practice.

  • Ujjayi is a diaphragmatic breath, which first fills the lower belly, rises to the lower rib cage and finally moves into the upper chest and throat.

  • Inhalation and exhalation are both done through the nose.

  • As the throat passage is narrowed so, too, is the airway, the passage of air through which creates a "rushing" sound.

  • The length and speed of the breath is controlled by the diaphragm, the strengthening of which is, in part, the purpose of ujjayi.

  • The inhalations and exhalations are equal in duration and are controlled in a manner that causes no distress to the practitioner.​

Further Help

For anyone suffering from anxiety, incorporating a holistic approach using traditional therapy and yoga therapy can help. Yoga therapy is never about how strong or flexible you are, but understanding what’s best for you. Whatever your age, body shape or fitness level, you can apply yoga therapy to your own self-care routine, addressing mind and body in order to help manage and treat the symptoms of anxiety.

If you, or someone you know are experiencing anxiety, and are looking to take the first step in reaching out for psychological support, The Awareness Centre (TAC) can help you find a therapist that’s right for you. TAC has a team of over 300 therapists offering confidential counselling, psychotherapy and psychology, in more than 30 languages, on a short-term and open-ended basis to support the mental health and emotional wellbeing of individuals, couples and families. To get started, call 020 8673 4545 and one of our friendly reception team can answer your questions and help find you the right therapist for you. You don’t need a GP referral if you’re looking for a private therapist. The Awareness Centre is also a private healthcare provider.

For those people interested in working with a qualified yoga therapist, The Minded Institute offer an 8-week course in yoga therapy for the mind and is a comprehensive and evidence-based program for anyone looking to reduce stress, anxiety and/or depression.


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