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4 4 Yo g a T h e r a p y To d a y www.iayt.org
Salutogenesis is an emphasis on client care that identifies and
addresses the causes of health/well-being with interventions focused
on health promotion and optimizing well-being.1We will go into
this more in the final section, but this shift in perspective is a key
difference from the pathology-focused care in our culture.
Eudaimonia was first described by Aristotle as a “well-lived” life
that fulfills a person’s ultimate purpose and gives that person mean-
ing. Eudaimonic happiness is a steadfast, abiding contentment
marked by flourishing rather than a short-term pleasure or comfort.
Eudaimonia was taught through an exploration of, and alignment
with, the virtue ethics—much like the yamas and niyamas. Related
terms that may be more familiar to healthcare audiences include
self-actualization and meaning/purpose, both of which are linked in
research to many positive physical and mental health outcomes.
Yogopathy is the application of yogic tools for symptom manage-
ment of a diagnosis made by another healthcare provider.2The suf-
fix “pathy” implies a focus on disease and pathogenesis with a seg-
mented approach as opposed to an integrated one.
Neurophysiological explanations about how yoga supports vari-
ous populations and conditions include regulation of the nervous
and endocrine systems, mood, and emotions.3
A review of our scope of practice and definition reveals that
yoga therapy is a practice that focuses on salutogenesis and eudai-
monic well-being.
How Are Yoga and Yoga Therapy Related?
This relationship (Fig. 1) can be seen in the IAYT’s definition of
yoga therapy4:
By Ananda Balayogi Bhavanani, Marlysa Sullivan,
Matthew J. Taylor, and Amy Wheeler
As an international emerging profession, our yoga therapy
community continues to refine how to communicate to oth-
ers what we are and what we do as yoga therapists. The four
of us struggle with this just as you do. Please join us in this explo-
ration to “say it better” and give us your feedback as we all build this
profession.
Developing common descriptions of what we do will help us
•integrate into healthcare settings and client populations.
•encourage referrals.
•increase consumer demand.
•explore alternative payment possibilities.
•clarify important dimensions for research decisions.
We acknowledge the challenge of exploring the underlying
foundations of yoga therapy in a way that welcomes the diversity of
the many wonderful lineages and traditions that make up our field.
It is our intention that this imperfect discussion will be a founda-
tion for continuing to make yoga a respected and recognized thera-
py, just as the IAYT’s earlier definitions evolved to support the train-
ing standards and scope of practice that are so critical today. Know-
ing that exploration will continue, we offer for now this unified,
consistent explanation to our various audiences.
How Do We Describe What We Do?
So how do we help those outside of our field and unfamiliar with
our practice understand what we do and its importance in client
care? Our diversity naturally creates a tension as we must make some
generalizations while trying to communicate effectively with novices
to yoga. Nevertheless, it is essential to have this common language
to present yoga therapy to those unacquainted with the field and to
address any confusion that might be engendered from yoga’s esoteric
terminology. If we begin from where audiences are in their under-
standing, using familiar and shared language, we will invite their
follow-on questions.
Our diverse practices naturally create a tension as
we must make some generalizations while trying to
communicate effectively with novices to yoga.
We begin with some shared language, then articulate how yoga
and yoga therapy are related, and finish with differentiating yoga
therapy from yogopathy. Let’s start building!
Definitions for Our Audiences
Several key biomedical terms can help to describe the role of our
profession in current contexts. We need to understand these con-
cepts, but we must also be sure to speak about them in ways our
audiences understand. For instance, “Yoga therapy focuses on health
promotion and well-being, not pathology,” versus, “Salutogenesis is
the foundation of yoga therapy.”
Features
S h a r ed Foundations for Practice: The Language of Yoga Therapy
Figure 1. Yoga therapy nests inside the larger yoga and
is therefore neither separate from nor greater than yoga.
Yoga therapy is the process of empowering individuals to progress
toward improved health and well-being through the application of
the teachings and practices of yoga.
Our motivation as yoga therapists is to share the art and science
of yoga with its many possibilities for providing answers to many
health problems troubling humankind. We cherish that yoga is first
and foremost a moksha shastra (science of liberation) meant to facil-
itate individual attainment of the final freedom or emancipation. As
the definition’s process reminds us, these are brought about by right
use of the body, emotions, and mind with awareness and conscious-
ness. Yoga also helps sustain this dynamic state of health after it has
been attained through ongoing disciplined self-effort.
Table 1 distinguishes between what is often sold or understood
as yoga in the United States from what we are aspiring to establish
as yoga therapy.The chart in no way means to disparage this broad
spectrum of yoga and its sincere teachers. We acknowledge that we
are offering incomplete generalizations here, and that there are dif-
ferences in terminology such as “client” in the United States and
“patient” or “participant” in India.
Summer 2019 45
Table 1 reflects the integrative nature of yoga therapy and
health and well-being as both ancient wisdom and current biomed-
ical/scientific knowledge. Two other distinctions in discussing the
contrast are (1) our strong, aspirational emphasis on providers’
responsibility to arrive having done their own practice; and (2) the
role larger environmental systems play in the encounters. Much like
the supports of a three-legged stool, three mutually dependent fac-
tors are crucial for offering yoga therapy as a well-being practice:
clients, providers, and systems. Failure to address any one leg affects
the foundation and quality of yoga therapy.
As providers, and one leg of the stool, we co-facilitate the
process of healing through our knowledge base, our set of skills, and
our ability to see the bigger picture or the “yoga” of our clients’ life
circumstances. The development and maintenance of these three
aspects of our profession generate the stability illustrated in Fi g u r e 2.
We might understand the client and provider legs of the stool,
but what is the systems leg? The systems are of key importance, as
they require care and management of not just the relationship sys-
tem between clients and providers, but wider influences of relation-
ships, such as social structures, power dynamics, environmental
health, vocation, and spiritual support, which support or thwart
eudaimonia and salutogenesis for both the providers and the
clients.5
It is also critical we communicate that yoga therapy is adjunc-
tive/complementary to other kinds of client care, not a stand-alone
solution. This can include both allopathic “Western” modalities as
well as other cultural models of medicine. Working together by
building a better health foundation, yoga therapists can add strength
as vital members of an integrative, person-centered health team.
Consider the following sound bites to use in communication
about who we are and what we offer.
Yoga therapists . . .
• are skilled at and assist in discovering what is keeping
someone in a state of imbalance and can teach specific
techniques to bring the person back to balance on any
given layer.
•join clients on their personal journeys—not our ideas of
what their journeys should be. Yoga therapy is a co-facili-
tative process between providers and clients.
• create a safe container for clients to do their own work in
and around their challenges.
Feature
Table 1. Yoga and Yoga Therapy
Quality
Population
Focus
Student
engagement
Transmission
of knowledge
Provider
scope of
practice
Student
lifestyle
modification
Yogic
techniques
Yoga
Individuals or general
audiences
On the teacher and the
teacher’s perfection of
postures or practice,
acquiring new pos-
tures, presentation of a
“nice” branded experi-
ence, and keeping the
studio full
Often passive and
dependent on the
teacher’s instruction
Often passive and
aimed at fixing a prob-
lem/pathology
Broad and loosely
defined, with provider
often a technician, lim-
ited depth
Not necessary, minimal
accountability for
behavior change
Provider uses/repli-
cates them as taught
Yoga Therapy
(Chikitsa)
Individual or small,
focused audiences
On client and source
of suffering, surren-
der to never being
perfect; improvement
across koshas vs. an
external visible cor-
rectness; the client
identifies her or his
swadharma (purpose)
and advances toward
independence
Self-empowered,
moving away from
dependence on the
teacher’s guidance
Co-active engage-
ment, reflection, and
discovery/learning
toward salutogenesis
A defined scope of
practice and clinical
mastery developed
through continuous
learning
Expected, as is an
understanding of self-
responsibility for
lifestyle choices
Provider knows their
effect and varies use
with clients’ needs or
circumstances
Figure 2. Yoga therapists co-facilitate healing by drawing
equally on key aspects of professional development.
Qualities developed together
p rovide a stable clinical base
4 6 Yo g a T h e r a p y To d a y www.iayt.org
• provide a scaffold, through study and practices, to what
can otherwise feel overwhelming or structureless.
•foster self-actualization, meaning/purpose, and the flour-
ishing of individuals within their unique sense of them-
selves through prescribed practices and study.
•monitor themselves too, asking, “Do we (provider and
client) each have the wisdom to see when change is need-
ed in the dynamic dance across time?”
So is using yoga to treat medical conditions yoga therapy?
Yoga Therapy and Yogopathy
Yoga therapy focuses primarily on salutogenesis. The heart of salu-
togenesis is the sense of coherence that was defined by sociologist
Aaron Antonovsky as “a pervasive, long-
lasting and dynamic feeling of confi-
dence that one’s internal and external
environments are predictable and that
there is a high probability that things
will work out as well as can be expect-
ed.”1This idea of living life to one’s
fullest potential is familiar across cul-
tures and time.
Such coherence correlates in
research to cognition, coping skills, and
motivation. Yoga therapy improves cog-
nition, allows a clearer perception of life
that enhances the ability to cope with
the increasing demands of society, and
sustains motivation even during chal-
lenging times. Yoga therapy therefore
goes beyond treating aches and pains,
taking clients into the deepest recesses
of the mind and heart and asking them
to consider life’s important questions. In
other words, it is a mental, emotional,
and spiritual self-discovery system.
Yogopathy, with the suffix “pathy,”
implies a focus on disease and patho-
genesis. The same root word is used in
allopathic medicine, which also tends to
concentrate on making a diagnosis and
then treating the symptoms (as opposed
to finding and uprooting the cause). Yes, it is true that yoga thera-
pists sometimes assess the client’s acute symptoms and even develop
a therapeutic plan that pacifies the symptoms of the illness or dis-
ease, but this is only the first step in the journey of yoga therapy. We
imply no judgment of anyone who practices yogopathy, as this is an
excellent way to establish trust with clients by helping them to feel
better quickly so that they will come back again.
The ultimate goal, though, is for the therapists and the clients
to develop lifestyle management routines that allow for improved
well-being for the clients, or salutogenesis. The progression then is
from pain or anxiety to a neutral level of existence, and then this
ideally continues onward to support clients to be the best version of
themselves. This is the beauty of the art of yoga therapy.
As yoga therapists, unless we aim to correct the manifest psycho-
somatic disassociation as well as the underlying distorted perception of
reality in the individual, we are not practicing yoga therapy. This
bears repetition, and the distinction is important. We need to be
clear about where we aim to take the client in the long term. We are
not just attempting to pacify the symptoms of dis-ease. In our
symptoms-based culture, it is fortunate that this process also often
brings the side-effects of decreased pain, anxiety, depression, and
many other symptoms. The heart of the matter is that we support
the clients to see their lives from new perspectives, gain clarity, and
cultivate the sense of new possibilities in life. In summary, the REAL
work is to thrive instead of just survive.
Co-Creative Assessment
The yoga therapy assessment is a co-
c r e a t i v e, collaborative pro c e s s
between therapist and client. This is
quite different from an assessment
that is the yoga therapist’s unilateral
perspective. To assist someone out of
their suffering, it is critical that the
client’s point of view and perspec-
t i v es are taken into consideration.
The whole person needs to be under-
stood to help transform the client’s
suffering and not merely treat a diag-
nosis or suppress manifest symp-
toms.
In relationship to healthcare, this
assessment changes dramatically in
the yoga therapy approach because
we are facilitating healthy living
beyond diagnosis. Additionally, in
yoga therapy we are creating space
for something bigger to also manifest
in the clients’ lives. This manifesta-
tion is facilitated by enabling clients
to understand their patterns and
consciously move away from the ten-
dencies that cause suffering. Yo g a
therapy then is an ongoing process of
transformation in the ever-evolving
life journey vs. the end point in
yogopathy, which is mere symptom relief.
Generalized Protocols vs. Individualized Treatment Plans
Yogopathy’s interventions become modifications in the practices
that are usually limited and generalized and seek protocols and for-
mulas to manage the condition, for example, a “one size fits all”
yoga therapy protocol for diabetes or cardiovascular conditions. On
the other hand, in yoga therapy there are truly no generalized pro-
tocols; rather, the modifications are based on a deep understanding
of the individual clients, their circumstances, and their response to
the therapeutic practices. In addition, the protocol and treatment
plans are constantly modified to meet the emerging needs of the
clients as they shift and change with each new step of the process.
Feature
Conclusion
This common language is intended to clarify our own and our many
audiences’ understanding of what yoga therapy is and why it is
important. We hope that yoga therapists will incorporate this lan-
guage into their communications. We acknowledge this article is but
a stepping stone in our common mission to make yoga a respected
and recognized therapy. Please join us in this evolving conversation
with your feedback and questions. Contact the authors directly or
by email through ytteditor@iayt.org.
Finally, when we remember to engage the philosophy, princi-
ples, and holistic lifestyle of yoga in our everyday practice and help
our clients to understand them, thereby assimilating the practices in
their own lives, we are practicing yoga as yoga therapy.YTT
References
1. Antonovsky, A. (1996). The salutogenic model as a theory to guide health pro-
motion. Health Promotion International, 11(1),11–18.
2. Bhavanani, A. B. (2011). Are we practicing yoga therapy or yogopathy? Yoga
Therapy Today, 7(2), 26–28.
3. Gard, T., Noggle, J. J., Park, C. L., Vago, D. R., & Wilson, A. (2014). Potential
self-regulatory mechanisms of yoga for psychological health. Frontiers in Human
Neuroscience, 8, 770. doi: 10.3389/fnhum.2014.00770
4. Taylor, M. J. (2007). What is yoga therapy? An IAYT definition. Yoga Therapy in
Practice, December, 2007, 3.
5. Humpf, L. (2019). Yoga therapy beyond the koshas: Examining unearned privi-
lege and oppression. Yoga Therapy Today, Winter, 44–47.
Yogacharya Ananda Balayogi Bhavanani, MBBS,
MD (AltMed), C-IAYT, is Director and Professor
of Yoga Therapy at the Centre for Yoga Therapy,
Education and Re s e a r ch in the Sri Ba l a j i
Vidyapeeth, Pondicherry, India.
Marlysa Sullivan, PT, C-IAYT, is an assistant pro-
fessor in integrative health sciences at Maryland
Un i v ersity of In t e g r a t i ve Health. She is also
adjunct faculty at Emory University in the Doctor
of Physical Therapy program and co-founder of the
Center for Integrative Yoga Studies.
Matthew J. Taylor, PT, PhD, C-IAYT, is a past
IAYT board president and a frequent contributor
to YTT. He co-chairs the Rehab Common Interest
Community and has taught marketing for yoga
t h e r apists at numerous SYTARs. Contact
matt@yogatherapy.com.
Amy Wheeler, PhD, C-IAYT, is the current board
president of the International Association of Yoga
Therapists.
Summer 2019 47
In yoga therapy, the clients are given the tools and the support
to heal themselves. Each individual must adopt appropriate and
healthy attitudes, remedial dietary measures, and conscious physical
and mental practices. Conversely, in yogopathy the healing process
is dependent on the healthcare providers and fosters a tendency
toward dependence. This dynamic difference in the source of heal-
ing fosters empowerment of the clients as they take charge of their
own lives. Furthermore, the role of the providers in yoga therapy
transforms from one of being the healers, or the experts, with the
source of healing (as in yogopathy), to being facilitators of self-heal-
ing, with the source of healing being the clients’ own healing poten-
tial. The emphasis then is on self-healing rather than on “being
healed.” Consequently, adherence to the new daily routine by the
client is critical to successful health and wellness outcomes in yoga
therapy.
Table 2 summarizes these differences and has the same limita-
tions as Table 1 re g a r ding generalizations and cultural va r i a n c e
in terminology.
Feature
Table 2. Yogopathy and Yoga Therapy
Quality
Focus
Who and
what heals?
Empower-
ment
Assessment
Who
assesses
Relationship
to healthcare
Process
Emphasis
Modifications
Protocols
Endpoint
Yogopathy
Pathogenesis and the
diagnosis
The healer-provider,
fostering paternalism
and dependence
To the provider
Linked to someone
else’s diagnosis
The therapist
Practitioner is one of
many providers who
address the diag-
noses
Reactive; doing to
Symptom
suppression
Limited, generalized
Seeking
protocols/formulas
Symptom relief
Yoga Therapy
Salutogenesis and cul-
tivating well-being
The clients them-
selves, through the
culture of active health
To the clients taking
charge of their own
lives
Toward the source of
suffering/promoting
health through co-
determined, collabora-
tive assessment
Therapist and client
through a co-facilitat-
ed process
Facilitates healthy liv-
ing beyond diagnoses,
natural intrinsic heal-
ing potential, and
eudaimonic wellbeing
Proactive; being with
Source of duhkha
(suffering), dissocia-
tion from inherent ten-
dencies, and facilita-
tion of sukha (ease)
Deep understanding of
the individual and the
person’s responses to
practices
No protocols
The ongoing process
of an ever-evolving life
journey
