When Yoga Becomes Therapy
- Janet Nash, MSW, LISW-S
- Aug 11
- 9 min read
Begin With the Body When the Mind Won’t Sit Still
For many people, meditation sounds perfectly reasonable until they are asked to sit still and do it.
Within thirty seconds, the mind has reorganized your closet, considered next week’s meal plan, and begun investigating whether the refrigerator is making a new noise.
Some of us do not find stillness by beginning with stillness. Sounds a bit like a Japanese koan, doesn’t it?
Yoga offers another doorway. When movement follows the breath, the mind has something else to attend to: “Inhale and raise your arms overhead. Exhale and fold forward.”
For a moment, at least, you are no longer replaying last week’s conversation at the mailbox, when your neighbor invited you to his church and you produced an incredibly awkward, noncommittal reply.
Instead, you feel your feet against the floor, the movement of the spine, the expansion of the ribs, and the rhythm of the breath. Attention returns to the body and to this particular moment. Whew.
In this way, yoga can become a form of meditation for people who need movement before stillness becomes possible.
Yoga Is More Than Exercise
In the West, yoga has become closely associated with physical postures—and sometimes with heated rooms, expensive leggings, and people performing arm balances that appear to require an entirely different relationship with gravity.
Physical yoga has genuine benefits. It can build strength, flexibility, endurance, confidence, and community. But it is only one part of a much larger tradition encompassing ethics, philosophy, breath, meditation, self-study, and a sophisticated understanding of the relationship among body, mind, and spirit.
Yoga is a complete science and system of practice concerned with how we live, how we understand the mind, how we respond to suffering, and how we move toward greater freedom.
The Sanskrit word ashtanga means “eight limbs.” Here, I am referring to the sage Patanjali’s eight-limbed path of yoga, not Ashtanga Vinyasa, the vigorous physical practice commonly called Ashtanga today.
The eight limbs include:
Yama — ethical principles governing how we relate to others
Niyama — personal practices and observances
Asana — physical posture
Pranayama — the intentional regulation and cultivation of breath
Pratyahara — turning our attention inward
Dharana — concentration
Dhyana — meditation
Samadhi — profound integration or absorption
Posture occupies only one limb. Breath, ethics, self-study, concentration, and meditation are not accessories added to make an exercise class seem more spiritual. Together, the eight limbs form an integrated system for working with the whole human being.
Patanjali’s Yoga Sutras are primarily concerned with the mind, the nature of human suffering, and the possibility of freedom. Perfecting a handstand was not identified as a requirement.
It is this broader understanding of yoga that makes yoga therapy possible.
What Makes Yoga Therapy Different?
A yoga class generally offers one practice to a group of people. The teacher may provide modifications, but everyone still participates in some version of the same sequence.
Yoga therapy is not simply a smaller yoga class with more props and extra time to discuss your lower back. It is an individualized therapeutic practice shaped around the needs of the client.
A yoga therapist considers the person’s health history, mobility, pain, breathing patterns, energy, nervous-system state, emotional concerns, daily responsibilities, and goals. Practices may include movement and posture, pranayama, mantra, meditation, visualization, guided relaxation, yoga philosophy, self-reflection, and changes in daily routines.
The therapist begins with the person—not with a standard sequence that must somehow be made to fit.
Two people with the same diagnosis may need very different practices. One person with anxiety may benefit from slow, grounding movement and a longer exhalation. Another may become more anxious when asked to move slowly or focus closely on the breath.
The most useful question is not simply, Which yoga poses are good for anxiety?
It is, What does this particular person need today?
The Roots of My Yoga-Therapy Lineage
This individualized approach has deep roots in the tradition in which I was trained.
Tirumalai Krishnamacharya, born in India in 1888, was a scholar, yoga master, and Ayurvedic healer. Often called the father of modern yoga, he taught several people who profoundly influenced how yoga is now practiced throughout the world.
Among his best-known students were B.K.S. Iyengar, founder of Iyengar Yoga; K. Pattabhi Jois, who developed and popularized Ashtanga Vinyasa Yoga; Indra Devi, one of the first women to bring yoga to a broad Western audience; his son T.K.V. Desikachar; and longtime students Srivatsa Ramaswami and A.G. Mohan.
The very different methods these teachers developed speak to the breadth of Krishnamacharya’s knowledge. His teaching was never confined to one sequence, one method, or one kind of student.
He adapted yoga to the person in front of him, considering age, health, physical capacity, occupation, family responsibilities, and stage of life. His therapeutic work might include posture, but also pranayama, meditation, chanting, diet, and practices drawn from yoga and Ayurveda.
Krishnamacharya sits at the top of my own teaching lineage. His student A.G. Mohan carried this individualized approach forward, and I was fortunate to study with Mohan’s son, Dr. Ganesh Mohan, who is trained in both modern medicine and Ayurveda.
Dr. Mohan taught that a person experiencing anxiety generally needs a calming practice, while someone experiencing depression may benefit from a more active and energizing one. A vigorous practice could leave an anxious nervous system even more activated. A very quiet practice could reinforce the heaviness and lethargy that sometimes accompany depression. The intention is to help restore balance rather than give us more of the state we are already in.
These are guiding principles, not rigid formulas. An anxious person may need movement before stillness feels tolerable. A depressed person may also be anxious, depleted, overwhelmed, or in pain. The practice must account for the whole person.
That is where yoga becomes therapy—not because one particular posture is inherently therapeutic, but because the practices are thoughtfully chosen and adapted for the person receiving them.
Anxiety Is Not Only a Thought
Anxiety certainly manifests in thoughts. Many of them irrational. Often several of them speaking at once. But anxiety does not live exclusively in the mind. It may appear in the jaw that will not unclench, shoulders hovering near the ears, a racing heart, restless legs, shallow breathing, or a stomach preparing for a catastrophe that has not actually been placed on the calendar.
Anxiety is an embodied state. The nervous system has mobilized to protect us, whether the danger is happening now, might happen later, happened twenty years ago, or was developed entirely by the mind’s Department of Future Disasters.
This is one reason yoga therapy can complement psychotherapy. Insight matters. Understanding our patterns matters. But sometimes the body needs more than a good explanation. It needs an experience of slowing down, feeling supported, breathing more freely, and discovering that it does not have to remain on alert indefinitely.
Polyvagal theory offers one framework for understanding how the nervous system responds to cues of threat and safety. Somatic therapies also recognize that regulation does not happen through thought alone. Yoga arrived at this understanding through a different language and tradition, using movement, breath, sound, and attention to work with the whole person.
I do not tell people that yoga “resets” the nervous system. Nervous systems do not have reset buttons, which is inconvenient but probably just as well.
Regulation is gradual. Through repeated experiences of rhythm, steadiness, support, and safety, we may become better able to move out of a heightened state and return to a more regulated one.
The Particular Power of the Breath
Pranayama is often translated as breath control, although its meaning is broader and much more nuanced. Prana refers to vital energy or life force. Pranayama uses intentional breathing practices to influence our energy, attention, and internal state.
When we are anxious, the breath often becomes fast, shallow, or held. This is not a personal failing. It is part of the body’s preparation for action.
Gently slowing the breath—particularly allowing the exhalation to become somewhat longer than the inhalation—may support parasympathetic activity and reduce physiological arousal.
The important word is gently. A calming breath should not become another demanding assignment at which we can fail.
If a prescribed count causes strain, breathlessness, dizziness, or greater anxiety, shorten it or return to normal breathing. The practice should meet the capacity of the person.
Why Mantra Can Help
Mantra gives the mind something steady to return to.
A mantra may be a traditional Sanskrit phrase like So Hum, meaning I am that, a prayer, or something as simple as Here now. It can be repeated silently, spoken aloud, or carried on the exhalation.
Humming and chanting add rhythm, sound, and vibration to the practice while naturally lengthening the exhalation.
Mantra does not require us to stop thinking. It gives thought a quieter place to rest. When the anxious mind convenes its next emergency meeting, the mantra offers a competing agenda.
A Short Practice for Anxiety
This 10- to 15-minute sequence is slow, grounding, and organized around a longer exhalation. It is an example of how yoga practices can be selected for a particular purpose, but it cannot account for every reader’s physical or emotional needs.
Move within a comfortable range, breathe without strain, and stop any part of the practice that increases pain, dizziness, breathlessness, or distress.
1. Arrive and orient — 1 minute
Sit in a chair with your feet supported by the floor and your hands resting on your thighs.
Before turning inward, look around the room. Notice several colors or shapes. Listen for sounds near you and farther away.
Feel the chair beneath your body and the floor beneath your feet. You do not need to close your eyes.
2. Seated cat and cow — 1–2 minutes
As you inhale, gently tip the pelvis forward and allow the chest to lift.
As you exhale, tip the pelvis back and gently round the spine.
Let the movement follow the breath. It does not need to be large or impressive. No one is scoring spinal mobility.
3. Side-body breathing — 1–2 minutes
Let one hand rest on the chair and lift the opposite arm as high as is comfortable.
Lean slightly to the side and notice the ribs expanding as you inhale. Return to center as you exhale.
Repeat several times and then practice on the other side.
4. Arms moving with the breath — 1–2 minutes
Let your arms rest beside you.
As you inhale, sweep the arms outward and upward, stopping wherever your shoulders remain comfortable.
As you exhale, slowly lower them.
Repeat four or five times, allowing the downward movement to become unhurried—as though you have nowhere else you must be for the next thirty seconds.
5. Lengthened-exhale breathing — 2–3 minutes
Return your hands to your thighs.
Inhale gently through the nose for a count of five. Exhale for a count of seven, without holding the breath in between.
Inhale: 1, 2, 3, 4, 5 Exhale: 1, 2, 3, 4, 5, 6, 7
If five and seven feel too long, inhale for three and exhale for four, or inhale for four and exhale for five.
The precise numbers matter less than ease and a slightly longer exhalation. After several rounds, allow the breath to return to its natural rhythm.
6. Supported forward rest — 1–2 minutes
Place your forearms on your thighs and lean forward slightly, keeping the spine and neck comfortable.
You may also rest your arms on a table or on pillows in your lap. Let the back widen and soften the muscles around the eyes and jaw, if that feels comfortable.
The purpose is not to achieve a deeper forward fold. The purpose is support.
7. Mantra or humming — 1–2 minutes
Return to an upright position.
You might silently repeat:
Inhale: Here Exhale: Now
Or use the traditional mantra So Hum:
Inhale: So Exhale: Hum
You may also hum gently during the exhalation, noticing the vibration without forcing the sound.
8. Notice what has changed — 1 minute
Release the technique and sit quietly.
Notice the breath without changing it. Feel the contact between your body and the chair. Observe whether anything has shifted.
You do not need to feel completely calm. Perhaps the shoulders have dropped slightly. Perhaps breathing feels easier. Perhaps the anxiety has moved from an eight to a seven.
That counts.
Begin With the Person
The purpose of yoga therapy is not to perform yoga correctly, become impressively flexible, empty the mind, or produce serenity on demand.
It is to draw upon the full system of yoga in ways that support the person who is actually here—with this body, this history, this nervous system, and this life.
Sometimes movement leads us toward stillness. Sometimes breath gives the mind a little more room. Sometimes mantra provides a steady thread to follow. Sometimes yoga philosophy changes how we understand what we are experiencing.
The practice does not ask us to become someone else before we begin. It meets us where we are and may, over time, help us move toward greater steadiness, awareness, and freedom.
That, to me, is the heart of yoga therapy: beginning with the person who is here.
