The therapeutic role of Yoga in anxiety reduction

Zahra (Zari) Moin Clinical Psychologist Lecturer of Clinical Psychology Islamic Azad University, Roodehen Branch mantra_psy@yahoo.com

Abstract The phenomena of anxiety became a part of our daily life and several methods have proposed to cope with and to treat this phenomenon. Yoga, which is based on a mystical approach, is one of these methods. Yoga has a history of several thousand years and is one of the philosophical and mystical schools of India. In addition to being a training tool for autognosis science and self disciplinary rule, Yoga is also useful for physical health. Yoga can be used to achieve concentration, to increase the mental discipline and to control the personal feelings and desires. Thanks to these features, Yoga is one the most propounded psychophysiological methods for copying with stress and anxiety. The aim of this paper is to evaluate the impact of Yoga on anxiety reduction in an Iranian society, based on a comparative study. The test set contained 30 yogi-men and 30 non yogi-men. The “Cattel’s anxiety test” and “t test” have been used as research and statistical tools, respectively. The results show that, with a 95% of certitude, the anxiety has been reduced significantly in yogis, comparing to non yogis. Based on these results, investigating in Yoga training is economical both in primary and in secondary preventions, thus, we suggest to planning for Yoga training in different educational and therapeutical levels.

1. Introduction Anxiety is a non separable characteristic of the human life in the contemporary industrial era and definitely, is one of the results of modernism and post-modernism in the third millennium. Anxiety has serious impacts in both loosing material-national and spiritual

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(human, emotional and affective) resources. Consequently, facing this phenomenon is a cost-effective investigation in short, medium and long term for any government. Many researches have been done in countries other than Iran, and the results of these researches showed the effectiveness of Yoga in anxiety and depression reduction and elimination [1-17]. Due to the cultural and social differences between the Iranian society and the societies where the previous researches have been done, which could be the main sources of the differences between the types and the intensities of anxiety levels in those societies, we have focused our research on the Iranian society. Therefore, the aim of this paper is to evaluate the impact of Yoga in anxiety reduction in Iranian society, based on a comparative study. The main question in this subject is: whether the anxiety level is lower in yogis comparing to non yogis? In order to answer to this important question, first, we introduce a definition for anxiety, and then, we present different aspects and elements of anxiety, its psychological and cognitive signs, different theories in anxiety and anxiety therapy, historical aspects of Yoga, theoretical frameworks and previous researches done on the impact of Yoga in anxiety reduction and elimination. Then, we continue with presenting our research method and results obtained in this framework. The last part of this paper is the conclusions.

2. Anxiety Anxiety is a very disagreeable and, in most situations, ambiguous feeling, which comes with unwanted changes in our physical situation, such as dizziness, extreme perspiration, increase in blood pressure, tachycardia, agitation, shaking, etc. The difference between fear and anxiety is that fear is based on a real danger, or on an exaggeration in a real danger, while the anxiety is caused by an ambiguous and/or imaginary danger [18]. Anxiety is not always an abnormal feeling, but it’s our natural response to threatening and pressing situations. Indeed, the anxiety is abnormal whenever it happens in problematic situations that are easily treated by a majority of people [19]. When we feel danger, we experience different physical and emotional changes, which are responses to anxiety. These answers have four components: (1) cognitive elements (expecting an ambiguous danger), (2) physical elements (physical reactions to danger),

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(3) emotional and mental elements (panic), (4) behavioral elements (dispute, escape, aggression) [20] [21]. Anxiety usually leads to an action for reducing or eliminating the threat. This action is constructive, if we use coping mechanism consciously. On the other hand, when the action relies to unconscious defensive mechanisms, it is an unconstructive action [22] [23] [24] [25].

3. Different anxiety therapies Most used therapies for anxiety are a mixture of different psychophysiological therapies including pharmacotherapy, behavioral therapy (systematic desensitization, relaxation training, flooding, modeling and applied tension), cognitive therapy, cognitivebehavioral therapy and logotherapy [18]. Among these, the cognitive- behavioral approach is one of the most effective therapies [26-36]. As we have just mentioned, systematic desensitization and applied tension are two important therapies for anxiety. There are equivalences for these therapies in Yoga, named progressive relaxation and meditation. Several researches have been done on the impact of these techniques on diminishing the anxiety. Relaxation has a long history in medicine, clinical psychology and psychiatry. It has been shown that the muscle relaxation reduces the anxiety considerably [1] [2] [3] [4] [12] [14] [15] [17]. Recently, psychologists and people working on the subjects of meditation and oriental mysticism determined the relation between muscle relaxation and exercises of Yoga [5] [6][14]. The transcendental meditation (TM) has been also used extensively to control the anxiety and to generate the feeling of health and comfort, through relaxation and relax minding. Relaxation excites a response system, which competes with excitation caused by anxiety[1] [2] [3] [4] [7] [12] [14] [15] [17] [37] [38] [39]. The regular and transcendental meditation (TM) with muscle relaxation and Mantra expression prevent the generation of anxiety and also can be used to reduce this undesired phenomenon. Meditation completes the relaxation [1] [2] [3] [4] [10] [11] [12] [14] [15] [17].

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4. Yoga Yoga is an ancient, Indin art and science that seeks to prmote individual health and welbeing through physical and mental exercise and deep relaxation. Although known to be at least 5,000 years old, Yoga is not a religion and fits well with any individual’s religious or spiritual practice. Anyone of any age, religion, health or life condition can practice Yoga and derive its benefits. [44] Some researchers believe About 15 to 25 centuries B.C., Indian had a developed civilization and on the walls of two beautiful and strange Indian cities named “Mohengo” and “Darohaba”, images of yogis have been found. However, other researchers believe that Yoga belongs to Arians which moved to India in 15 century B.C.. Their language was Sanskrit and the word Yoga, which means “unification”, has been used for the first time in Sanskrit. Later, Indians interpreted Yoga as the unification of the human soul and the truth [40]. Patenjli, an Indian, is the official founder of Yoga, 2 centuries B.C.. He presented Yoga in a relatively complete manner, in a book named “Yogasotra”, which is one the most credible documents on Yoga. Patenjli is also named “Father of Yoga”, therefore, Yoga is known as an Indian philosophical-mystical school [40]. If you are interested in yoga for spiritual benefits or for health and fitness, Power Yoga can provide both. Synchronous breathing with strong, flowing movement combines for a hot, high energy workout. Different from other style, Power Yoga is based on a choreographed sequence of poses (called asanas). These asanas flow into one another, creating a moving dance. Joints unwind in the process, muscles are release, energy is moved. Throughout the practice, a person builds strength, flexibility, and mental focus with the final result being a release of tension.[41] Yoga helps us to develop our different potentials, to discover and to strengthen our internal forces, to reach the self-consciousness and a happy spirit, and to extend our life.

5. Research method The research method presented in this paper is non experimental and comparative, and it has been managed in 2003 in Tehran, with the aim of studying the impact of Yoga in anxiety therapy. The statistical dataset contained 900 non yogi-men and 1200 yogi-men

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from three Yoga clubs, after finishing their last course level. Except the Yoga term, we have tried to equalize the other features of the non-yogis with those of the yogis. Using an ordered random selection method, we have selected 30 subjects from each group. The features of the selected samples are as follows: • • • • Age group: 25-35 Education: at least bachelor Marital status: single Occupation: 85% with non governmental governmental sector and 1% unemployed The “Cattel’s anxiety test”, proposed by R. B. Cattel, has been used as research tool. It contains 40 questions about the difficulties in the life of a majority of population. business, 14% working in

Table 1. Statistical test results

Number of subjects Mean Variance

Standard deviation

Degree of freedom

Calculated t

Yogis Non yogis F Significance level

30 30

24.166 39.9

646.90 1719.65 2.652

25.43 41.47

29 29 1.779

0.05

6. Test results Table 1 shows the test results, including the mean and the variance of the anxiety levels of two different test groups. The important point is to prove that the anxiety level obtained in our sampling procedure for yogis is different from the anxiety level for non yogis. This can be done by showing the significance of the difference between the means of anxiety levels of two different groups.

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In order to examine the research theory, which is the significance of the difference between the means of anxiety levels of two different groups, we have used the t statistical test of independent groups, by accepting the equivalence of variances of the two groups. The results of this test show that the calculated t in level 0.05 is 1.779. This value is greater than the t obtained from the t table with level 0.05, which is 1.671. Thus, we can deduce that with a probability of 95%, the difference between the means of anxiety levels is not caused by sampling error, and the research theory is accepted.

7. Conclusions Researches done in the countries other than Iran showed the effectiveness of Yoga in anxiety reduction and elimination. However, due to the cultural and social differences between the Iranian society and those societies, and consequently the differences between the types and the intensities of anxiety levels in those societies, in this paper, we have focused our intention on the Iranian society. As a step toward a comprehensive study and research in this subject, we have done a complete test on a sampled population, i.e. three different Yoga clubs in Tehran. The results of our tests showed the existence of a significant relation between Yoga and anxiety reduction. Based on the results of the previous researches and our research, we have three suggestions: (1) determining precisely the different kind of anxiety in Iranian society and their source(s), (2) performing vaster and more detailed research on bigger samples taken from Iranian societies, with the aim of determining the impact of Yoga on different kind of anxiety, in the light of the results of the suggestion no. 1, (3) investing on the training Yoga in different school levels, universities, sport clubs, companies, etc., as an inexpensive and cost effective therapy and prevention for anxiety. Indeed, due to the congruencies between different Iranian sub-cultures and this physical and spiritual oriental sport, different organizations can contribute on development of Yoga in Iranian society, including Iranian Sport Organization, sport clubs, primary and higher education Ministries, Iranian Broadcasting Organization, newspapers, and healthcare system (physical and psychological). By exercising Yoga, starting with muscle relaxation in the age of childhood and continuing with meditation and transcendental meditation in adolescence and adulthood,

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we can expect to educate relax and happy people and to improve the individual and mental health of the Iranian society.

References [1] Jacobson, E., “Progressive relaxation”, University of Chicago press, 1929. [2] Schultz, J.H. and Luthe, W., “Autogenic training”, New York: Grune & Stratton, 1959. [3] Haugen, G.B., Dixon, H. H. and Dickel, H.A., “A therapy for anxiety tension reaction”, New York, MacMilan, 1963. [4] Lamaz, F., “Painless childbirth: Pscychoprophylactic method”, London: Burke publishing Co., 1958. [5] Bhushan, Siddhartha, and pammi sinha. “Yoga nidra and management of anxiety and hostility” .Jornal of Indian Psychology, 2000. [6] Stoyva, J., “Skinerian zen or control of psychological responses through information feedback”, Denver University symposium on behavior modification, 1968.

[7] Ost, L.G., “Applied relaxation: description of a coping technique and review of controlled studies”, Behavioral research and therapy, 25, 397-410, 1987. [8] Lang. P.J., Melamed, B.G., and Hart, J., “A psychophysiological analysis of fear modification using an automated desensitization procedure”, Journal of abnormal psychology, 76, 220-234, 1970. [9] Paul, G.L., “Outcome of systematic desensitization I: background procedures, and uncontrolled reports of individual treatment”, In C.M. Franks (Ed), Behavior therapy: Appraisal and status. New York: Mc-Graw-Hill, 1969. [10] Eppley, K., Abrams, A. and Shear, J., “Differential effects of relaxation techniques on trait anxiety:Ameta-analysis”, Journal of clinical psychology, 1989. [11] Butler, G., Fennell, M., Robson, P. & Gelder, M., “Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder”, Journal of consulting and clinical psychology, 59, 167-175, 1991. [12] Miller, J.J./ K. Fletcher, and J. Kabat-Zinn. “There-years follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in treatment of anxiety disorders.” General Hospital Psychiatry, May 1995, 17(3):192-200.Reprinted

7

in The International Journal of Yoga Therapy, 1998, no, 8,pp.45-53. [Abstract available from PubMed] [13] Levine, Martin. “The Positive Psychology of Buddhism and Yoga: Paths to Mature Happiness.” Mahwah, N.J.: Lawrence Erlbaum Associates, 2000.

[14] Ambikananda Saraswati, swami. Anxiety or panic attacks. In Swami Abikananda, “Healing Yoga: A guide to Integrating The Chakras with your Yoga Practice .” New York: Marlow & Co., 2001, pp. 138-139 [15] Houten, Peter Van “ Overcoming Anxiety and Depression: A Holistic Approach.” Nevada City, Calif.: Crystal Clarity Publishers, 2002. (Contains a section on meditation.) [16] Payne, Larry, and Richard Usatine. “Mental health: Anxiety and sepression. In Larry Payne and Richard Usatine, “Yoga Rx: A Step-By-Step Program to Promote Health, Wellness, and Healing for Common Ailments. New York: Broadway Book,2002, pp. 232-248. [17] Khasky Ad, Smith JC, “relaxation states, and creativity.” ,Percept Mot Skills, 1999Apr;88(2):409-16 [18] Kaplan, H.L., Sadock, B.G. and Greeb, J.A., “Synopsis of psychiatry”, New York, Williams & Wilkins, 1994. [19] Atkinson, R.L., Atkinson, R.C. and Hilgard, E.R., “Introduction to psychology”, New York: Harcour Brace Javanovich, 1983. [20] Rachman, S.J., “Fear and courage”, New York:Freeman, 1978. [21] Lang. P., “Fear reduction and fear behavior”, Research in psychology, Washington DC: American psychological association, 1967. [22] Silverman, L.H., “Psychoanalytic therapy: the reports of my death are greatly exaggerated”, American psychologist, 31(9): 621-631, 1976. [23] Loftus, E., “The reality of repressed memories”, American psychologist, 48, 518-37, 1993. [24] Nisbett, R. Ross, L., “Human inference: strategies and short-comings of social judgment”, Englewood Cliffs, NJ: Prentice-Hall, 1980. [25] Hellbrun, A.B. Jr., “Hallucinations. Symptoms of schizophrenia”, New York: Wiley, 1993.

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[26] bandura, A., “Fearful expectations and avoidant action as coeffects of personal selfinefficacy”, American psychologist, 41 (12), 1389-91, 1986. [27] Jones, R.T., Benowiz, N., “The 30-day trip: clinical studies of cannabis tolerance and dependence”, Pharmacology of marihumana, New York: Academic press, 1976. [28] Seligman, M.E.P. and Abramson, L.Y., “Depressive attributional style”, Journal of abnormal psychology, 88, 242-247, 1979. [29] Kelley, H.H., “Clinical psychology and personality”, New York: Wiley, 1969. [30] Beck, A.T., Rush, A.J., “Cognitive therapy of depression”, New York: Guilford Press, 1979. [31] Beck, A.T. and Emery, G., “Anxiety disorders and phobias: A cognitive perspective”, New York: Basic books, 1985. [32] Beck, A.T. and Sokol, L., “Focused cognitive therapy of panic disorder: A crossover design and one-year follow-up manuscript”, 1991. [33] Ellis, A., “Reason and emotion in psychotherapy”, New York: Lyle Stuart, 1962. [34] Meichenbaum, D., “Cognitive-behavior modification”, New York: Plenum, 1977. [35] Borkovec, T. and Costello, E., “Efficacy of applied relaxation and cognitivebehavioral therapy in the treatment of generalized anxiety disorder”, Journal of consulting and clinical psychology, 61, 611-619, 1993. [36] Barlow, D.H., “Anxiety and its disorders: the nature and treatment of anxiety and panic”, New York: Guilford press. [37] Ost, L.G., “Applied relaxation: description of a coping technique and review of controlled studies”, Behaviour Research and Therapy, 25, 397-410, 1987. [38] Ost, L.G., Sterner, U. and Fellenius, J., “Applied tension, applied relaxation and the combination in the treatment of blood phobia”, Behaviour Research and Therapy, 27, 109-21, 1989. [39] Ost, L.G., “Cognitive therapy versus applied relaxation in the treatment of panic disorder”, Annual meeting of the European Association of Behavior Therapy, 1991. [40] Valizadeh, H., “Philosophy and training of Yoga”, Tehran: Taban, 1992 (in Persian). [41] “What is Power Yoga?” 2002, http://www.yoga.com/What is Power of Yoga_com.htm

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[42] “Natural Treatment of Anxiety”, http://altmedicine.about.com/cs/conditionsatod/a/Anxiety.htm [43] “What is yoga?” http://ga.essortment.com/whatyogatherap_rguc.htm [44] “Stress Reduction and General Well-Being”, http:// serendip.bynmawr.edu/biology/b103/f02/web2/masassan.htm [45] “A Few Words About Power Yoga” http://www.yoga.com/ydc/enlighten/enlighten_document.asp?ID=71&section=9&cat=92 [46] “Anxiety relaxation techniques for panic attacks”, http://www.essortment.com/ Anxiety relaxation techniques for panic attacks.html

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