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If it’s therapeutic, is it therapy?
If you are thinking of taking up yoga to help you on your cancer journey, or whether you are keen to share yoga with others, it's worth asking yourself this question about the role of yoga in recovery. This article discusses therapeutic power relationships and what it means to work on a whole-person level
Jane was a mother of three young children, and she had been diagnosed with bowel cancer when I met her at Penny Brohn Cancer Care in Bristol. I began teaching there in 2011, having completed yoga for cancer training as part of a broader yoga therapy course. Like most of the participants on the yoga course at Penny Brohn, Jane wasn’t doing yoga for her cancer, she was doing it for herself. She was seeking a way to relax and feel good in her body again and she felt that a mainstream class would be too vigorous.
Throughout numerous surgeries and ongoing treatment, she came back to yoga as often as she could. She began practising at home, and soon started meditating in the mornings before her children awoke. Over the two years I knew Jane, her tumour grew so large that she was unable to do twists or poses lying on her front and she was often fatigued from her illness and the endless treatment. Nonetheless, she never stopped her yoga practice.
Yoga did not cure Jane’s cancer, but it helped her to live the best life possible in her final years. Although Jane was not a yoga therapy client, I have no doubt that her yoga was therapeutic for her.
Healing is a process, which results not in a definitive outcome,
but in an ever-deepening understanding of who we are right now
We are currently undergoing a cultural shift, where the perception of healing is no longer of a conclusive cure but a process of finding meaning and acceptance through difficulty. Cancer is no less devastating and unwanted than it was but, increasingly people find in their illness an opportunity for personal development. Alastair Cunningham, author of The Healing Journey, advocates yoga as a selfhelp technique - a way to reclaim ownership of the body and its disease from the disempowered state of patient-hood. In fact, part of the therapeutic effect of yoga is that it is not therapy.
Participants may come to a cancer yoga class following a diagnosis, but they are not diagnosed by the yoga teacher, and they are not subject to yoga practices as one would be subject to a therapy method. The yoga teacher’s job is to present a range of tools – the technologies and tenets of yoga – and to guide the student in how to use them. The student is then empowered to choose the tools suited to their own individual healing path. So, what is yoga for cancer, if it is not yoga therapy? People with cancer experience a common set of conditions which are not universal, but which are shared by the majority.
Following a cancer diagnosis, it is common to suffer from anxiety, depression and insomnia. Those undergoing treatment may experience nausea, fatigue, constipation and “chemo brain” – a foggy state of mind. Surgery leaves people with painful scars, restricted mobility and a feeling of being a stranger in their own body. Most people feel that their body has let them down or even entered a state of mutiny. The person with cancer and their loved ones can feel shocked, angry and scared, to name just a few responses.
In a yoga class for people affected by cancer, the practice is modified to avoid aggravating the physical discomforts of cancer, and directed at soothing, easing and strengthening the body. The focus is on what participants can do to gently improve mobility, increase their energy levels, befriend the body and relate to their discomfort with compassion. People affected by cancer who have attended my classes over the years have reported that yoga has helped them to manage their pain, learn to relax and even self-diagnose. Others have felt fitter and more attractive after doing yoga. Others have learned to connect to spirit.
One thing guaranteed, is that everyone will take something different from their yoga practice.
To call what I do yoga therapy would be to deny the participants agency in their endeavour. As highly complex physical, emotional, intellectual, relational and spiritual beings we have highly individual needs and responses. While some participants may choose to attend yoga classes as part of their therapy programme, others will come just to stretch their hamstrings, albeit often getting a lot more than they bargained for. In the case of the individual seeking a remedy for a problem, I am, as a teacher and yogini, responsible for helping as I can and referring to a health professional where necessary. I believe that yoga therapy is an essential branch of yoga and I absolutely believe that therapeutic application of the practices should be used when required.
Nevertheless, we must beware of trying to reduce yoga to a closed system where we can point at one approach and say, “that’s not yoga!” and point at another and say, “that’s not therapy!”. I do not wish to diminish the importance of open debate within the yoga community, but if we polarise the teachings, reduce yoga to a scientific methodology or segregate the diverse approaches, we cut ourselves off from a full appreciation of yoga’s unifying potential. An attempt to apply a reductionist approach to an expansionist philosophy will result in an inability to cultivate the “open and ready mind” propounded by Buddhist thinkers – the very state of mind required to attain wisdom.
By its nature, yoga philosophy grapples with ideas that are greater than the intellect, and if we are to practice with true authenticity, we must have the courage to not know. To get caught up in the semantics and the trappings of yoga will sorely limit our ability to elevate our own knowledge. A holistic practice like yoga cannot be compartmentalised and administered like a treatment programme and still succeed in honouring the whole person.
God may be in the details, but the goddess is in the questions - Gloria Steinem
Feminist activist Gloria Steinem's words encapsulate the necessity to disseminate the teachings of yoga with a balanced view, keeping sight of both the Ha (masculine) and Tha (feminine) principles which abide in all that is. For yoga to keep its integrity in the West, we need methodology, scientific research, boundaries and organising principles – elements attributed to the masculine aspect. However, we also need an inquiring mind, an acceptance that there may be multiple right answers and a sense of wonder at the infinitely unfolding mystery of being – the fearsome attributes of the feminine. I am reminded here of the Zen proverb, “The finger pointing at the moon is not the moon”. Yoga practices are devices that point us in the direction of self-knowledge and, ultimately, liberation from ignorance.
As yogis, we must take courage to look past the finger pointing at the moon towards the moon herself - symbol of surrender, creativity and our mysterious inner landscape. With the confines of form comes the mystery of being. Seek the freedom of not knowing.
1. The Healing Journey, Alastair Cunningham. Healing Journey Books (2010) 2. Your True Home, Thich Nhat Hanh. Shambhala Publications Inc (10 Dec. 2011) 3. Wherever You Go, There You Are, Jon Kabat-Zinn. Piatkus (2004)
1 “Yoga is expansionist, science is reductionist”. Peace activist and teacher, Satish Kumar, on the immeasurable nature of holistic science. (Joy of Life Yoga Teacher Training 2015). From the author's lecture notes.
4. Mindfulness for Health, Vidyamala Birch and Danny Penman. Piatkus (2013) 5. https://en.wikiquote.org/wiki/Gloria_Steinem