The Challenge by John Duncan
After I ranted yesterday about this rather strange explanation from Blue Shield about why yoga helps anxiety:"The poses are designed to put the body into stressful, sometimes uncomfortable physical positions. By pushing through this discomfort, practitioners are essentially creating their own exposure therapy, forcing their bodies to learn their limits and stay mindful of their body."I said that I thought it was possible that yoga asanas could be used as exposure therapy. Would you like to know why I said that? It’s not because I know anything about exposure therapy, but rather because I remembered this other rant I wrote several years ago Changing the Brain's Stressful Habits.This post was about an article in Psychology Today Yoga: Changing the Brain’s Stressful Habits by a neurobiologist, Alex Korb, who took his first yoga class and had the following little epiphany:
“I came to realize that yoga works not because the poses are relaxing, but because they are stressful. It is your attempts to remain calm during this stress that create yoga's greatest neurobiological benefit.”After you ignore this extremely reductionist vision of the asana practice, you will notice it sounds a lot like the definition of exposure therapy I found at Exposure Therapy for Anxiety Disorders:“Exposure therapy is defined as any treatment that encourages the systematic confrontation of feared stimuli, with the aim of reducing a fearful reaction.”While Dr. Korb from the Psychology Today article seems to believe—like the anonymous author of the Blue Shield article—I’m starting to think that the Blue Shield article author has been reading Dr. Korb—that all yoga poses are stressful, we know that is not true. However, some yoga poses definitely are. Remember the first time you did Headstand, Handstand, or Shoulderstand, for example? Or was it another pose that struck fear into your heart? And we also know that which poses cause stress differs from person to person, whether due to body type, emotional state, previous experiences, body image, etc. For example, a seated forward bend for one person can be soothing and quieting while for for another person it is claustrophobic and/or extremely uncomfortable. Regardless, Dr. Korb described our reactions to an uncomfortable or disorienting yoga pose this way:
“Your brain tends to react to discomfort and disorientation in an automatic way, by triggering the physiological stress response and activating anxious neural chatter between the prefrontal cortex and the more emotional limbic system. The stress response itself increases the likelihood of anxious thoughts, like "Oh god, I'm going to pull something," or "I can't hold this pushup any longer". And in fact, your anxious thoughts themselves further exacerbate the stress response.”Furthermore, Dr. Korb claimed that yoga “works” because by doing challenging yoga poses mindfully, with attention to breath and physical sensations, we teach our nervous systems to react more calmly to challenging poses:“Even actions as simple as changing your posture, relaxing the muscles on your face, or slowing your breathing rate, can affect the activity in your brain (beyond, of course, the required activity to make the action). These changes are often transient, but can be long-lasting, particularly if they entail changing a habit.”
This conscious practice in the yoga room retrains our nervous systems to stop reacting to stress with our habitual ways, which can help us handle stress more effectively in our everyday lives.
“Some people might think that the stress response is an innate reflex and thus can't be changed. To clarify, the response is partly innate and partly learned in early childhood. Yes, the stress response comes already downloaded and installed on your early operating system. However, this tendency is enhanced, by years of reinforcement. In particular, you absorb how those around you, particularly your parents, react to stressful situations. Their reactions get wired into your nervous system. However, just because a habit is innate, and then reinforced, does not mean it is immune to change. Almost any habit can be changed, or at least improved, through repeated action of a new habit."In yogic terms, this means using your practice to change your samskaras (see Meditation and Brain Strength). And obviously if you tend to react to stress with anxiety, changing your habitual reaction—or samskara—is going to be very beneficial. So if this intrigues you, it might be an interesting way to try to work with anxiety. You could create your own exposure therapy by incorporating poses you fear, poses you hate, or challenging poses you hold for a longer time than usual into your practice. And as you practice each stressful pose, consciously relax as you face the difficulty, perhaps by focusing on slowing your breath, especially your exhalation. It could even be an interesting class or workshop.
It’s probably important to do this gradually. The article in Psychiatric Times says:
"Most exposure therapists use a graded approach in which mildly feared stimuli are targeted first, followed by more strongly feared stimuli. This approach involves constructing an exposure hierarchy in which feared stimuli are ranked according to their anticipated fear reaction. Traditionally, higher-level exposures are not attempted until the patient’s fear subsides for the lower-level exposure.”So I wouldn’t start with the poses that are super stressful for you, but rather with the ones you feel only mildly anxious about. Then when you grow more comfortable with those mildly stressful poses, move on to bigger challenges. And I would also not make my entire practice be stressful poses. I doubt it’s necessary to make the entire practice stressful for this to help you retrain your nervous system, and you won’t enjoy your practice if you only do poses that are stressful, which could discourage you from practicing. So start with comfortable warm-up poses, mix in poses you love throughout the sequence, and finish with a relaxing pose that you love.
If anyone decides to try this—or already has—I’d love to hear from you!
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