Yoga and Mindfulness-Based Cognitive Therapy (Y-MBCT©): Use of Yoga in Its Entirety




(1)
Department of Psychiatry, Cooper University Hospital, and Cooper Medical School of Rowan University, Camden, NJ, USA

 



Yoga is nothing but practical psychology (Aurobindo, twentieth-century Indian philosopher)



7.1 Introduction


Psychotherapy (psychological therapy; popularly known as the talk therapy) is a general term that refers to the psychological interventions executed by a trained professional to decrease distress and/or improve functioning in a client, patient, family, couple, or group. Applied psychology or psychotherapy is the study of the mind and mental states that focuses on the various mental phenomena that will facilitate or hinder one’s progress toward mental well-being. Psychotherapy in its varied paradigms and delivery models consists of an exchange of information, dialogue, and interventions directed toward eliciting change in the clients. As mentioned in chapter three, all experiences including psychotherapeutic experiences are representations in the brain, and achieving the psychotherapeutic goals (e.g., insight, affect modulation, decreased relational conflict) depends on some degree of modifications to these representations by causing changes into the perceptual, memory, and emotional systems that work both ambiently and enduringly within the brain. It is important to understand that memory is state dependent in the sense that there is a relationship between encoding cues and retrieval cues and that retrieval is a reconstructive process, not an actual replica of experience (Pally 1997, 2005).

Recent advances in our understanding of brain function associated with cognition, affect, and memory have led to new insights into the impact of experience in the individual processing of memory, emotions, motivation, and dreams (Pally 1997, 2005; LeDoux 2003). It would not be an exaggeration to say that psychoanalysis (scientific study of mind) is mother to all forms of psychotherapy. Psychoanalysis, as we know it today, is largely built upon the work of Dr. Sigmund Freud, its founding father, and his followers. Like the philosophical psychology of Buddha and Patanjali in ancient India, Freud’s biggest contribution was his concepts to understand the mechanism of the human mind, particularly that of the unconscious. Freud noted that a major part of our mind is the unconscious and that what we consciously experience is only an insignificant part of the self. According to Freud, the more significant unconscious part of the mind is the source of all conflicts between the id, ego, and superego, the three agencies of the mind. According to Freud, when a child is born, there is nothing except id or unconscious, and as he/she grows and comes in contact with the environment, the reality develops. He called this sense of reality or consciousness the ego. The reality is influenced by various taboos and constraints on the family and the society in the form of moral principles that characterize the superego. According to Freud, the unconscious contains thoughts, memories, and desires that are well below the surface of conscious awareness but, nonetheless, exert great influence on behavior. There is another part of mind he called the preconscious. The preconscious holds those mental contents the individual is usually not aware of but with conscious efforts can be made aware of. The concepts of the id, ego, and superego (and the associated ego defense mechanisms) describe the functions of the human mind (otherwise called Freud’s structural theory of mind), while the unconscious, preconscious, and conscious constitute Freud’s topographical model of the mind, i.e., conscious, preconscious, and unconscious are the three layers of mind, from the surface to the bottom, respectively. The genius of Freud lies in his argument that an individual’s behavior is governed by unconscious forces, which suggests that people are not masters of their own mind. The unconscious contains thoughts and memories that are well below the surface of conscious awareness but that, nonetheless, exert great influence on behavior. Similar to the Freudian concepts of the id, ego, and superego, the Yogic philosophers like the sage Patanjali and the Buddha elaborated upon very similar concepts of the mind, which are broadly conceptualized as the graded theory of mind, i.e., mind has various grades or levels with respect to its quality. These various levels are manasa (lower mind; cf. id), buddhi (intellect/reasoning faculty of mind; cf. ego), and Atman (higher mind or experiential faculty like the Soul, respectively; cf. superego). In addition to these functional concepts of mind, there exists a similar structural theory of mind as described in the Yoga Sutras of Patanjali. As described in the lake analogy (for more descriptions, please see chapter two), one can see the similarities between Freud’s topographical theory of mind and this Yogic model of mind. The Yogic terms that are conceptually similar to the psychoanalytic term unconscious are samskara and smriti, i.e., engraved memories of the past and the associated motives that always determine the individual’s behavior. As already elaborated in chapter four, within Yogic and mindfulness traditions, the goal of the monk in the various stages of samadhis (Pali samapattis) is achieving pure experience (i.e., unconditioning experiences from these engraved memories by eliminating the samskaras that clouds one’s experiences). This is the concept of experiencing things as they are. As we know, both the systems of Yoga and psychoanalysis agree that there is always some kind of battle (called conflict in Freudian sense and dvanda [Sans.] in Yogic sense) waged within our mind between these forces (i.e., the id, ego, and superego in Freudian sense and the various grades of mind, from lower to higher in the Yogic sense). These conflicts influence all our behavior. Both systems also agree that the conflict gives rise to suffering (Sans. duhkha) and that insight is the cure to this suffering. Both systems attest that driven by the unconscious or samskaras, people are not masters of their own minds; however, mastery is possible with insight (called jnana or knowledge in Yoga). Despite these striking similarities between Yoga and psychoanalysis, Freud, the founding father of psychoanalysis, struggled with concepts of Yoga and Eastern spirituality: to him those concepts were intangible quantities (Freud 1930, p. 72). In regard to oceanic feeling and Eastern mysticism, Freud claimed: “… to me mysticism is just as closed a book as music…” (Freud 1929). Oceanic feeling (i.e., feelings of limitlessness) is a transcendental feeling of oneness (merger) with the world. Rolland, Jung, and others, well versed in both disciplines, i.e., spiritualism and psychoanalysis, attest that this feeling is the source of all religious energy which permeates various religious systems. To Freud, however, the oceanic feeling was a primitive feeling, i.e., “a fragment of infantile consciousness when the infant begins to differentiate himself from his human and nonhuman environment.” On the contrary, the oceanic feeling, in its true sense, is the sense of wonder and awe, which leads to a humble awareness of the Truth, with some sense of the human ego’s limits as contrasted with the vastness of this whole universe. These misunderstandings about the higher meditative states have led some prominent thinkers to misinterpret these states as hallucinatory experiences or infantile regression. For more descriptions, please see Rolland (1929).

For most of the twentieth century, most American and British psychotherapists kept religion and spirituality at a distance. Despite his tremendous brilliance, Freud lacked understanding of Eastern mysticism in its true sense. His antipathy toward religion and spirituality is evident in his saying that these are the black tides of occultism (McGuire and Hull 1978) which at least in part contributed to this alienation of spirituality from the mainstream psychotherapy. Since the 1990s, however, a rapprochement between psychotherapy and spirituality has occurred. Currently, most of the professional psychotherapy conferences in the USA, whether psychodynamic, cognitive behavioral, or family systems, commonly feature a spirituality track. In the USA today, it appears that most psychotherapists uncomfortable with spirituality are so due to a sense of incompetence in how to deal with these issues, rather than a theoretical objection to addressing these issues in psychotherapy. Some of the reasons accounting for increased positivity in the therapist’s attitude toward patient’s spirituality include the importance of acknowledging the client’s spirituality in facilitating a therapeutic alliance with the therapist, spiritual resources that can help build resilience when the client is confronted with life’s adversities, and an increase in research literature regarding the efficacy of these integrated or holistic approaches.


7.1.1 Seminal Contribution of the Buddha and Sage Patanjali in Laying Out the Early Foundations for Therapeutic Use of Yoga–Meditation


The Ayurveda, the ancient Indian system of healing, is based on the Yogic philosophies (Frawley 1999). The therapeutic role of meditative experiences, particularly the Buddhist meditative experiences, is well researched in various studies regarding their role in development of empathy, decreasing stress as well as improving attention, memory, and coping. As described earlier, the major innovation of Yoga in Buddhist philosophy is meditation as well as probing the structure and function of the mind in order to understand the conditioning and thus sufferings of the human being. According to Buddha, pain is inevitable in life, and the cause of suffering is the way one relates to one’s life and experiences. The culprit for one’s sorrows and suffering is desire. The mode of control is dispassion or detachment, and the remedy is the use of meditation (mindfulness) in one’s daily life. The goal of meditation is liberation (nibbana) which is essentially freedom from ones conditioned existence. In many ways, Yoga and meditation in Buddhism can be seen as the human wish to transcend the intolerable pain and suffering and uncertainty of human life. As mentioned before, while in Hinduism emphasis has been on the metaphysical concepts like the genesis theory, Buddhism relates more on psychology. Buddha was not interested in satisfying his curiosity regarding the origin of the world or the nature of the divine. He was rather concerned exclusively with the human experience of suffering and pain. His doctrine, therefore, was not one of metaphysics, but one of psychotherapies. Building upon the traditional (Indus Valley Civilization) Yogic concepts of ancient India, Buddha determined the origin of human frustrations using dynamic and directly relevant psychological interpretations and described the ways to overcome these pains and sufferings. In Buddhism, Yoga is a way or a method of transcending the basic human pains and sufferings. Because of its pragmatic focus on human psychology, Buddhism contributed significantly to the development of meditation as a systematic and deeply contemplative discipline (like a form of psychotherapy). Buddha’s major contribution was the development of meditation as a therapeutic system that facilitates the union of meditative insight and the liberating cognition in order to achieve liberation from suffering. Mindfulness and the Noble Eightfold Path were the prescriptions of the Buddha (scriptures actually describe Buddha as a physician) for curing the sufferings of mankind. Studying the Buddha’s own life, one realizes that based on his personal experience of severe sufferings, he experimented with the utility of mindfulness on himself (for 7 years) and ended his own sufferings by achieving the enlightenment. After tremendous success in his personal use of mindfulness, he proposed it as a cure for the sufferings of all sentient beings. Mindfulness and samyama (for more descriptions, please see chapter four) are deep contemplative methods of self-analysis and self-transformation as proposed by Buddha and Patanjali and can be considered the earliest psychotherapeutic use of Yoga.


7.2 Yoga as Psychotherapy


Within the Eastern spiritual traditions including Hinduism and Buddhism, there lays significant historical development of the psychological analysis of human existence, suffering, as well as psychological ways to ameliorate sufferings. These philosophies have extensively evaluated the human mind and psychology, focusing on human consciousness of the self (Sanskrit purusha), the emotional attachment (clinging according to the Buddha) to the self, and the consequent suffering (Pali dukkha) the individual (Sanskrit jiva) experiences due to this excessive attachment. For very good reasons, the Buddha’s teachings are considered psychological, and his methods of yoga–meditation are described as forms of psychotherapy similar to cognitive therapy (because of the Buddha’s emphasis on the liberating cognition during the meditation). Symbolism of disease and healing is prominent in the teachings of the Buddha. The Four Noble Truths are a reflection of the ancient scheme of disease, diagnosis, cure, and treatment used in early medical science and most likely the reason why the Buddha was called the king of physicians (Santina 1997). Buddha was interested in curing and not metaphysical categories. We find his use of various techniques for healing throughout the discourses in the Sutta Pitaka. To summarize, we can use terms like philosophy and psychology in relation to the Buddhist tradition as long as we remember that we are interested in philosophy not as it concerns essences and absolute categories but as a description of phenomena and that we are interested in psychology as it relates to psychotherapy. These qualities of the philosophy and psychology of the Abhidhamma are unique in the history of human thought. Nowhere else, in the ancient or modern world, in the East or the West, has such a phenomenology and psychotherapy evolved. What is unique about Buddhist phenomenology and psychotherapy is its rejection of the idea of a permanent self and its affirmation of the possibility of liberation. In all other systems, even those of Western philosophical phenomenology and psychotherapy, we find an inability to reject the idea of a permanent self—the very rejection so characteristic of the teaching of the Buddha and of the Abhidhamma. And nowhere within modern psychology do we find that possibility of ultimate and absolute freedom so central to the teachings of Buddhism. This is one of the familiar and recognizable features that have attracted modern Western intellectuals and academics to Buddhist philosophy. Modern psychologists, too, are now deeply interested in the Buddhist analysis of the various factors of consciousness: feeling, perception, and volition. They are increasingly turning to the ancient teaching of the Buddha to gain greater insight into their own discipline. In the context of contemporary Western culture, scientists, psychologists, and philosophers have found that Buddhism is in harmony with some of the most basic principles of the Western thoughts.

Literature on Yoga–mindfulness, deep psychotherapies, functional neuroimaging studies, and cognitive neuroscience embarks upon the basic fact that because experiences are just representations in our brain and mind, they can be changed. Both the Yogic philosophies and contemplative therapies propose that this change in representations can be effected by knowledge (insight) regarding reality. Our experiences in life are like virtual reality (likened to the map) which can be made more real or actual (likened to the territory) by further knowledge (likened to the programming of brain in computational model of the neurolinguistic programming, NLP; Gray and Liotta 2012; Wake et al. 2013). The knowledge in Yogic tradition is called the meditative insight (Sans. jnana; Pali nanna, panna, vipassana). Buddha and Pantanjali had noted this long back and went further by proposing the two closely related paths, i.e., the Noble Eightfold Path and the EightLimbed Yoga, respectively. Insights from modern research including cognitive neuroscience, functional neuroimaging, and psychotherapy, particularly the studies involving stress and adaptation, provide evidence for this, albeit in a different language. In summary, the fact that experience can change the brain and vice versa drives the whole paradigm of self-healing and thus the psychotherapeutic potentials of Yoga and mindfulness.


7.2.1 Yoga and Contemplative Psychotherapies Including Psychoanalysis: A Comparison


[This author gratefully acknowledges teachings of Drs. Rao (2011: personal communication) and Freeman (2010–2012: a series of discussions) that inspired this writer about elaborating this section of this chapter. Both are prominent psychiatrists and academicians and serve as experienced training and supervising psychoanalysts in the USA.]

Apart from their shared experiential and existential nature, both Yoga and psychotherapy (including psychoanalysis) are essentially investigative pursuits into one’s personal Truths. These investigative, existential, and pragmatic aspects in Yoga–meditation probably explain why such a complex philosophy like Buddhism was adopted so well by the very practical cultures (who tend to emphasize on the pragmatics of the daily life) like the Chinese or the Japanese. Possibly the first explicit comparison between Yoga and psychoanalysis was made by Winter (1918). He contrasted psychoanalysis, as depicted in the work of Freud and Jung, with Patanjali’s Yoga Sutras. Since then, other writers have revisited this topic (Jung 1933, 1969, 1999; Bion 1967, 1970; Loewald 1979; Wilber et al. 1986; Epstein 1990; Brickman 1998; Alfano 2005). It is important to note that like Jung, most of these writers had some kind of experiential background in Eastern spiritual philosophies. Meissner’s (2005) writings about this adequately summarize these concerns: “….a revision of analytic theory of mystical states is long overdue….” These writers proposed a need for developing healthy flexibility within mainstream thinking of the deep contemplative therapies like psychoanalysis that will allow a new path for integration between psychotherapy and spiritualism. Below is description of some parallels between the psychoanalytic concepts and the Yogic concepts, keeping in mind that both Yoga and contemplative psychotherapies like psychoanalysis are theories of the mind and its various operations. Prominent psychoanalyst and Yoga practitioner (mostly the tantric form) Carl Jung specified his psychological understanding of tantric yoga as follows (as quoted in Shamdasani 1996, p. xxiii): “Indian philosophy is namely the interpretation given to the precise condition of the non-ego, which affects our personal psychology, however independent from us it remains. It sees the aim of human development as bringing about an approach to and connection between the specific nature of the non-ego and the conscious ego. Tantra yoga then gives a representation of the condition and the developmental phases of this impersonality, as it itself in its own way produces the light of a higher supra-personal consciousness.” Alfano ( 2005, p. 242) writes about transcendental attunement and proposes that the psychoanalytic process itself can be approached as a contemplative discipline. Newman (1996, p. 113) opines that “transference interpretations (in psychoanalysis) are guides to exercises in attention,” thus emphasizing the role of attention in clinical practice. Comparing the commonalities between Christian mystics (the Hesychastic monks), Buddhist meditation, and psychoanalysis with respect to the disciplines of attention, Newman (1996, p. 6) describes further: “the participant (in each of the three disciplines) is asked to practice a careful moment-by-moment attention directed to the contents of the stream of consciousness and to do two apparently contradictory things: on the one hand, to let the thoughts go, to let the inner cinema roll, to free associate; on the other hand, to focus attention on these very same unrolling thoughts.” He goes on (p. 7): “….each of these exercises imposes on its participant a kind of systematic sensory deprivation, what I will call an asceticism of the perceptual field.” He also notes that the fundamental rule of psychoanalysis is a kind of mindfulness practice and that close similarities lie between the two processes (i.e., mindfulness and transference).


7.2.2 Common Grounds Between Yoga and Contemplative Psychotherapies Including Psychoanalysis


Some themes that are common between Yoga and contemplative psychotherapies like psychoanalysis are already described in chapter three. Yoga is a process of introspective self-analysis and involves investigation of the various internal states of one’s mind using that person’s own mind as the instrument: does this not sound similar to the insight theory of psychoanalysis? Yoga proposes the use of the reflexive powers of the mind in looking back into its own depths, with a hope or broader goal of transcending the sufferings of mankind through liberation from the constraints of mind, whereas psychoanalysis uses the same power of mind to resolve the basic conflicts of mind. The most basic overlap between yoga and deep psychotherapies is that both are contemplative disciplines and both give central importance to the mind as compared to the body. Qualitatively, like psychoanalysis, Yoga and mindfulness contemplate on the various mysteries of mind as well as revisiting to solve mystery. Both are considered universally applicable in that both are theories of the mind, albeit in different languages. The common grounds between Yoga and psychoanalysis have attracted prominent thinkers like Jung, Fromm, and Bion. Given their great experiences with both psychoanalysis and Yoga, they can be called as mystic psychoanalysts. Like Bion, Jung was deeply interested in the Yogic philosophy, especially those of Kundalini Yoga and the mandala, both of which belong to the tantra, the most modern school of Yoga. According to Jung (1999), mandala is the tantric symbol (Sans. yantra) that symbolically represents the total expression of the psychological self. For more descriptions, please see also Jung (1933, 1969).

Bion, a British psychoanalyst and one of the most prominent thinkers of the psychoanalytic tradition, described Yoga as harnessing the mind to unharness itself of memory and desire (Bion 1967, 1970). He suggested that desire and memory are enemies of psychoanalytic attention. Buddha in his various dialogues on meditation and the sage teacher Patanjali in his classic textbook the Yoga Sutras attest that the main process in deep meditative states like the samadhis (samapattis) involves maintaining a dispassionate attitude to make oneself free of desire (Buddha called it nonclinging attitude) and getting past ones memory (to make oneself free of the engraved memories of past deeds [Sans. samskaras]). Patanjali, when describing the Eight-Limbed Yoga, goes into elaborations on the various types of samadhis (deep meditative states) and how one’s memories and desire can be difficult obstacles when one attempts to achieve these meditative states (please see Taimni 1961, for more elaborations). In the sequential process of the samadhis, the practitioner [Sans. sadhaka] realizes the absolute truth by the process of samyama by having the pure experience which is not colored by one’s desire (Sans. kamana) and memories (Sans. samskara). These are also ingrained in the third and fourth Noble Truths of Buddha, i.e., desire and clinging are the main reasons for one’s sufferings in life, and by putting an end to these two hindrances, one can achieve freedom from the shackles of the sufferings in life. As one reads through the Yoga Sutras (Vedic) or the Abhidhammic texts (Buddhist), it is quite striking to see that Bion, who advocated that his patients not only to get better but also to pursue the Truth, echoes Pantanjali’s ideas as detailed in his textbook the Yoga Sutras (circa fourth century BC). In advocating for providing pure experience, to avoid any exercise of memory and to ensure the therapist’s full presence during the therapy sessions, Bion strongly recommended that his followers not take any notes. He also strongly proposed that the therapist should not harbor any desire(s) regarding the patient because such desires interfere with analytic work, erode the analyst’s power to analyze, and lead to progressive deterioration of analyst’s intuition.

Although important differences do exist, the various similarities between Yoga and deep psychotherapies like psychoanalysis are manifold as detailed below:

(a)

Both Yoga and deep psychotherapeutic concepts are universally applicable, apolitical, nonsectarian, and secular concepts about the human mind and its various functions.

 

(b)

Both are investigative pursuits of personal truths (insights).

 

(c)

Both emphasize the centrality of the mind, as compared to the body, and propose the various therapeutic ways to change the functioning of mind so to improve quality of life.

 

(d)

Both rely on the existential and experiential bedrock in order to affect change.

 

(e)

Both involve an optimal sensory deprivation, which can be considered as a preparatory set before one delves deeper.

 

(f)

Attention is fundamental to both the contemplative disciplines.

 

(g)

Free association, the key technique in psychoanalysis, has many similarities with the process of mindfulness.

 

(h)

Both Yoga and psychoanalysis have similar goals, although the goals may seem more radical in Yoga. Freedom from mental conflicts through self-analysis is a crucial goal in both.

 

(i)

Yoga is a way to find one’s inner analyst, a goal shared with psychoanalytic treatment.

 


7.2.3 Other Similarities Between Yoga and Deep Psychotherapies (Psychoanalysis)


In addition to the general and conceptual similarities described above, there are technical overlaps between the Yoga and mindfulness and contemplative psychotherapies as described below:

(i)

Technical similarities between free association and mindfulness: Freud’s free association, one key technique in psychoanalysis, is grounded in the human ability and need for mentation to be free and creative. In addition to Freud’s, work of other prominent psychoanalysts like Strachey and Bion claims that practice of the techniques, conscious control of desire, postponement of wish fulfillment/gratification, and some amount of sensory deprivation (like the couch, silence of the consulting chamber, therapist anonymity, etc.) are prerequisites for free association. Referring to chapters two and three in this book, one can see that the same parameters are quintessential for samyama and satipatthana, the key techniques of Yoga and mindfulness, respectively. In free association, psychoanalysis is radical in its pursuit of the moment-to-moment experience of human beings and is consistent with similar claims by Yoga and mindfulness. The uniformly hovering attention in the mindfulness meditation is very similar to Freud’s evenly suspended attention in the free association.

 

(ii)

Conceptual similarity between the various three types of Yoga and various concepts in psychoanalysis:

The three major types of Yoga are Jnana Yoga (Yoga through insight), Bhakti Yoga (Yoga through devotion), and Karma Yoga (Yoga through desireless action). Like in psychoanalysis, the most prominent goals of Yoga are the promise of freedom from mental conflict and certainty of knowledge. As one can see in the schemes of Buddha and Patanjali, Yoga and mindfulness are processes of learning to discriminate, through meditative wisdom, between what is real and what is not and what is eternal and what is not: this is the essence of Jnana Yoga. Similarities also exist between Bhakti Yoga and the concept of idealized transference in psychoanalysis: Bhakti ([Sans.] loving devotion) Yoga signifies the spiritual practice of fostering loving devotion to a personal form of God (Cutler 1987; p. 1). Similarity also exists between Karma Yoga and the process of working through in the psychotherapy.

 

(iii)

Overlaps do also exist in both disciplines (psychoanalysis and Yoga) with respect to descriptions on the various models of mind, e.g., with respect to structural organization of mind (id, ego, and superego, as compared with the various grades of mind, from lower to higher grades, from crude to finer to the finest) and the layered concept of mind (preconscious, conscious, and unconscious versus the lake model as described earlier). The Yogic concept of lower mind (Sans. manasa) has similarities with the concept of id, a psychoanalytic concept.

 

(iv)

Both disciplines propose that insight (psychoanalytic insight versus meditative wisdom) is the tool to upgrade the mind.

 

(v)

Similarities do exist in the following aspects also: (a) between psychoanalytic concepts of conflict and Yogic concept of maya (illusory principle of mind), (b) between the concept of detachment from libido (decathexis) in psychoanalysis and dispassion or renunciation in Yoga, and (c) between the psychoanalytic concepts of the childhood conflicts or experiences and the Yogic concept of samskara (engraved memories of past deeds).

 

(vi)

The therapeutic process of psychoanalysis involves reconstruction of the psychological apparatus which is similar to purification of mind/concept of mental development one comes across in the concept of cultivating the Right Mindfulness. The processes in both Yoga and psychoanalysis, like in the life cycle model of human life, are developmental and sequential. The sequential steps and developmental sequence of various stages of the samadhis in which one revisits and rediscovers one’s true self are like the uncovering process of attaining insight in any deeply contemplative psychotherapy including the psychoanalysis.

 

(vii)

Although more elaboration on these is beyond scope of this book, conceptual similarities do exist (1) between the observing ego (Strachey 1934; Ormont 1995) and the Soul/real self, (2) between the experiencing ego (Strachey 1934) and the sensorial mind (manasa), and (3) between the therapeutic dissociation (Sterba 1934) and the mindful awareness and detached observation during meditation.

 

Noting these close similarities at many different levels, in this author’s opinion, it would not be an exaggeration to say: Yoga is the psychotherapy of the East. Self-analysis is a goal of Yoga as it is for every analytically oriented therapy. For more descriptions on mindfulness (Zen Buddhism) and psychoanalysis, please refer to Suzuki (1963).


7.2.4 Some Basic Differences Between the Yogic Philosophies and Psychoanalysis


Despite the similarities mentioned above, there exist important differences as well. Psychoanalysis is two-person process, whereas Yoga is one-person process after one is initiated into the training during which one needs a personal teacher. Yoga begins with a guru or teacher or guide and ends with a healthy aloneness. The work of yoga is a far more individualistic, uncensored, and unsupervised act than psychoanalysis. In psychoanalysis, there is impersonal, mutual collaboration, whereas in (Bhakti) Yoga there is the idealized teacher–disciple (guruchela) relationship. Mind (consciousness) in Yoga is much more broad (see the concept of extended consciousness in chapter two) than the mind in psychoanalysis. In general, goals, objectives, and the scope of the common parameters are broader in Yoga as compared to those in psychoanalysis. Yoga aims at alleviating suffering through transcendent calming of the mind, whereas psychoanalysis aims at management of competing aims within the mind to achieve relative harmony. Prescription for health and happiness in Yoga is no longer confined to mind but actually is more holistic and extends to one’s lifestyle, body and breath control, as well as mind. The therapist’s interpretation plays a larger role and is an integral part of each session in psychoanalysis, unlike in Yoga. The difference also exists in descriptions of different levels of self in Yoga: individual self, universal self, subtle body, or subtle self. Yoga is concerned with universal self or transcendental self, whereas psychoanalysis is concerned with individual self only. In this sense, with respect to the concept of self, where psychoanalysis ends (individual self), Yoga begins (transcendental self). Yoga is primarily an exploratory (wonder and wonder) venture, whereas psychoanalysis is primarily an interpretive venture. The goal of Yoga is transforming the healthy to the healthier, whereas that of psychoanalysis is to transform the unhealthy to healthy. Thus, the goals, objectives, and scopes are broader in Yoga as compared to psychoanalysis.


7.3 Psychotherapeutic Use of Yoga in Its Entirety: The YogaMindfulnessBased Cognitive Therapy (Y-MBCT, Pradhan and Mishra 1998 onward)


Large studies involving populations with severe mental disorders like schizophrenia have proven the feasibility of Yoga and meditation (Vancampfort et al. 2012). Also contrary to popular beliefs that practice of Yoga and meditation takes much time, a recent study from the Mayo Clinic in the USA (Prasad et al. 2011) finds that even 15 min of practice daily has been proven useful and effective. The Y-MBCT© is the psychotherapeutic version of Pradhan’s Standardized Yoga and Meditation Program for Stress Reduction (SYMPro-SR©, 1993, the wellness model of Yoga and meditation).

As demonstrated in Figs. 7.1a, b, both the SYMProSR © and YMBCT © models use Yoga in its entirety and, thus, includes meditation, the 6th and 7th steps of Eight-Limbed Yoga. Both models are based on the three original scriptural schools of Yoga and mindfulness, i.e., the Eight-Limbed Yoga (Ashtanga) of Patanjali (the fourth century BC), the mindfulness (satipatthana) model of Buddha (the sixth century BC), and the standardizations of the technique-rich style of Tantra (the second century CE). These models use Yoga in its entirety from body to mind to soul (the finest grade of mind), and in this scheme the key meditation is the samyama (the combination of 6th, 7th, and 8th limbs of Yoga) combined with the satipatthana in the form of staged meditation protocols (SMPs) as elaborated later. Inspired by the insights provided by the original scriptural traditions as well as by the evidence-based formats of the modern medicine, both models include standardized techniques and incorporate the meditative lifestyle in the form of Buddha’s Middle Way [Pali majhima magga], a lifestyle of moderation and compassion. Both models combine Yogic philosophies, techniques, and practice into pragmatic and user-friendly formats. Recognizing the need and utility of complementary and alternative medicine (CAM), more so for youth, this model was initially piloted on children and teens. Based on his personal and clinical experience, as well as the openness and resilience one sees in the youth, Pradhan believes that children and adolescents are the best meditators. Later on, Pradhan et al. extended these models to adult population. Both of these models are holistic models of care and can be flexibly combined with other evidence-based treatments including medications and other behavioral interventions and psychotherapies.

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Fig. 7.1
(a, b) Yoga & Mindfulness Based Cognitive Therapy (Y-MBCT)©: Adapted from three ancient sc riptural schools

SYMPro-SR is a wellness model initially conceptualized by Pradhan during his monastic training (1992–1994). Initially, he piloted this in normal and healthy population in India including on himself for stress reduction, improvement of productivity, and improvement of quality of life. The SYMPro-SR, being a wellness model, is meant for use in promoting and sustaining health. For its public use as a wellness model, Pradhan uploaded the SYMPro-SR onto YouTube in August 2011. Y-MBCT, the psychotherapeutic adaptations of the SYMPro-SR model, uses all of the facets of Yoga flexibly and sequentially (called the staged meditation protocols: SMPs) in self-exploratory therapy and self-care formats that target the specific symptoms as well as promotes generalization of the therapeutic gains to client’s daily life. Y-MBCT integrates the ancient philosophies and techniques of Yoga and meditation with the evidence-based therapeutic techniques of the West including those of psychodynamic psychotherapy (object relational therapy format) and compassionate cognitive behavioral therapy (CBT). Both SYMPro-SR and Y-MBCT use the original philosophies of Yoga and meditation, particularly the concept of the five objects that constitute the mind (thoughts, feelings, sensations/perceptions, will/impulse, and memory that are the basic elements in any human experience, normal and pathological; please see chapters two and four of this book) and the tripartite model of human experience (please see chapter two and three of this book). These five objects in the mind serve as the anchoring points or the meditation objects (Sans. pratyaya; Pali kasina) for the client to bring the mind into focus during the actual practice of concentrative and mindfulness meditations. These elaborate models about nature and functions of mind that are based on the phenomenological psychology inform the practitioner more about the various experiences of the mind and body (both normal and abnormal), their origin, phenomenology, and expression in various forms. These expressions include stress and its various sequelae, psychiatric symptoms, and the attending dysfunctions. Contemplative practices (meditation) upon these models provide powerful perspectives including nature of the human experience and in addition provide a sense of detachment from the experience which paves the way for more keen observation and impulse control: all these are chief element in mindfulness that are being applied to client’s daily life, both for improving wellness and ameliorating illnesses.
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