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Interventions and Research in Health Psychology: A Special Focus on Yoga

Originated in ancient India, Yoga is a philosophy that talks about oneness between the
human consciousness and the universe. It is a spiritual discipline which focuses on bringing
harmony between the mind and the body. While Yoga and healing are often talked about
synonymously, Yoga does not simply talk about restorative programs aimed at easing physical
pain or psychological symptoms but it propagates a bigger, more holistic and spiritual quest for
the ultimate release from the miseries of life (Ranganathan, 2020).
Yoga is essentially the art of healthy living. The word ‘Yoga’ is derived from the Sanskrit
word ‘Yuj’, meaning ‘to join’ or ‘to yoke’ or ‘to unite’. As per Yogic scriptures the practice of
Yoga leads to the union of the Individual Consciousness with that of the Universal
Consciousness, indicating a perfect harmony between the mind and the body, Man and Nature.
The practice of Yoga is believed to have started with the very dawn of civilization. The science
of yoga has its origin thousands of years ago, long before the first religions or belief systems
were born (Basavaraddi, 2015).
Even today, Yoga is a big part of the Indian society’s construction and functioning.
Practiced by both young and old, with no discrimination for against any gender, caste or religion,
the values of Yoga are reflected in the greater value system of the Indian cultural ethos
(UNESCO, 2016).
Unity in Diversity, a value integral to India as its culture is also reflected in the practice
and development of Yoga in India. Ananda Balayogi Bhavanani in his paper “Yoga in
Contemporary India” has geographically traced these developments in various parts of India
(Bhavanani, 2017):
● In Southern India, Sri Krishnamacharya, who traces his lineage to the great Rishi
Natamuni, imbibed the art and science of Yoga from Yogi Ram Mohana Brahmachari at
Manasarovar that is at the foot of Mount Kailash. His son and disciple Sri TKV
Desikachar founded the Krishnamacharya Yoga Mandiram in Chennai and developed a
system that emphasizes Sanskrit chanting and tailors Yoga to the specific need of the
individual (the ViniYoga of Yoga). Sri Pattabhi Jois of Mysore, another great disciple of
Krishnamacharya has codified the system of Ashtanga Vinyasa Yoga, a system of
vigorous Hatha Yoga. Bangalore’s Sri Ravi Shankar recently gained a lot of credit and
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recognition from all over the world for his Sudarshan Kriya and “The Art of Living”. Sri
Jaggi Vasudev’s Isha Foundation in Coimbatore offers a Isha Yoga program which
consists of meditation that does not ascribe to any faith or belief system. Aurobindo
Ghose’s Integral Yoga and ideas of the superhuman and super mental have brought a
great number of devotees from all over the world to Pondicherry.
● In Central India, the Sagar University of Madhya Pradesh has been in the forefront of
bringing traditional Yoga knowledge to the academic setup. In the Western India, The
Brahma Kumaris World Spiritual University propages the Raja Yoga Meditation. Padma
Vibhushan Sri BKS Iyengar founded the Ramamani Iyengar Memorial Yoga Institute in
Pune. His system of Yoga, now known as Iyengar Yoga, and his book “Light on Yoga”
have received worldwide recognition.
● In Eastern India, the Bihar School of Yoga, established by Swami Satyananda and his
disciples, has been a major imparter of the wisdom of Yoga with it’s branches all over the
world. Swami Yogananda’s Yogodha Satsangha, the Indian wing of the Self Realisation
fellowship has also played an important role in imparting the wisdom and benefits of
Yoga to the west through employing the method of Kriya Yoga.
● In Northern India, there have been several academic advancements in understanding,
studying and incorporating Yoga with the current scientific knowledge and also lifestyle.
There are several academics like Prof TR Anantharaman, Prof Dr KN Udupa and Prof
RH Singh and institutes like Banaras Hindu University, Gurukula Kangri University and
Dev Sanskriti Vishwavidyalaya who have been actively dedicated in enhancing and
passing down the knowledge of Yoga and it’s systems. Proposed by Yug Rishi Pt.
Shriram Sharma Acharya, the Pagya Yoga system taught at Dev Sanskriti
Vishwavidyalaya seeks to create a holistic tuning of all three types of bodies (physical,
subtle and causal) by using selected asanas and pranayamas along with chanting of
mantras. The influence of Baba Ramdev in making Yoga more accessible and popular
through the means of mass media and yoga camps has also been notable.

In the 21st Century, Yoga Therapy is gaining popularity internationally for its
exceptional healing properties. Specifically, the four out of its eight limbs, namely, posture
(asana), breathing exercise (pranayama), concentration (dharna) and contemplation (dhyana) are
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being increasingly recognised for their contribution in physical, mental and spiritual well-being
(Bussing et. al., 2012).
Involving the application of yoga postures and practice for the treatment of health
conditions, Yoga as being referred to and practiced today does not involve the traditional,
multicomponent yoga discipline practiced with a goal for attaining optimal psychophysiological
functioning for eventually achieving spiritual advancement. Instead, modern yoga practices in
India and even internationally are more limited in their adoption of the Yoga philosophy,
practicing only three or four out of it’s eight limbs. The goal of doing Yoga now is limited to
maintaining physical fitness and psychological health (Khalsa, 2013).

Figure 1
Yoga - Integrated Health Neuroscience Paradigm

Note. From “Yoga-Integrated Health Neuroscience Paradigm (YOGIHANSAM): Integration of

Yoga Philosophy, Health Psychology and Medical Neuroscience as a Paradigm for Holistic
Healthcare,” by Anand Ramanujapuram in Ramanujapuram, A. (2018). Yoga-Integrated Health
Neuroscience Paradigm (YOGIHANSAM): Integration of Yoga Philosophy, Health Psychology
and Medical Neuroscience as a Paradigm for Holistic Healthcare. International Journal of
Advanced Scientific Research and Management. 3. 165.
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Multiple studies have corroborated modern day Yoga practice’s beneficial properties. A
meta analysis of the existing research on Yoga found that practicing Yoga enhances muscular
strength and body flexibility, promotes and improves respiratory and cardiovascular function,
promotes recovery from and treatment of addiction, reduces stress, anxiety, depression, and
chronic pain, improves sleep patterns, and enhances overall well-being and quality of life
(Woodyard, 2011). Studies have also illustrated that Yoga is instrumental in facilitating
emotional regulation, significantly affecting emotional intensity, depression, fatigue, energy and
anger (Wang & Liu, 2021). Especially during the pandemic, practicing Yoga can help deal with
unpleasant emotions, have a positive impact on an individual’s psychological well-being and in
turn positively affect their own perception of their physical health (Joshi & Joshi, 2021). Hence,
yoga as an intervention has its utility for both psychological and physiological concerns.

Yoga as an Interventions for Psychological Concerns

Yoga as an intervention has been found to be helpful with different psychological
concerns with varying levels of severity. A study with Young Adults who had moderate to severe
levels of anxiety and were not taking any psychiatric interventions for it demonstrated the
significantly positive effects of practicing Yoga. Participants who attended two 1-hour Iyengar
yoga classes each week for 5 consecutive weeks demonstrated significant decreases in self-
reported symptoms of depression and trait anxiety. These effects started emerging by the middle
of the course and were sustained till end. Changes were also observed in acute mood, with
subjects reporting decreased levels of negative mood and fatigue following yoga classes,
compared to controls (Woolery et. al., 2004).
Another study with Major Depressive Disorder (MDD), one of the most common and
debilitating health conditions in the US and worldwide, also reported the effectiveness of Yoga
as an adjunct or alternative intervention. The study derived its findings from interviews and daily
logs by 12 women with MDD who took part in an 8-week gentle yoga intervention. Results
showed that the women's experience of depression primarily involved stress, ruminations, and
isolation. The interpretations of their experiences of yoga revealed that the intervention served as
a self-care technique for the stress and ruminative aspects of depression. It also served as a
relational technique, facilitating a feeling of connectedness and shared experiences in a safe
environment thus helping with the isolation aspect of depression (Kinser et. al., 2013)
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While Yoga's effectiveness with people suffering from anxiety and depression has been
long studied and proven, it's efficacy as an intervention for children on the Autism Spectrum was
recently explored. The study aimed to explore the efficacy of structured yoga intervention for
sleep problems, gastrointestinal problems and behaviour problems of children on the Autism
Spectrum. In this experiment, children were made to sit face to face with their mother while
sloka chanting as well as yoga practice which helped the children improve their eye contact,
attention span and even imitation skills over time, one of the key skills needed for learning.
According to the parents’ report the children were always excited to come to the sessions and
after one month of continuous classes, they had started showing remarkable improvements in
sleep and gastrointestinal issues. They stopped taking naps in the middle of the day, slept
through the entire night and started consuming a more balanced diet on the recommendation of
the researchers as Yoga has shown to increase the absorption of nutrients by the body (Verma et.
al., 2017). This experiment proved that structured yoga intervention, when conducted for a large
group of children with autism, with the involvement of parents and teachers does help in the
improvement of sleep problems, gastrointestinal problems and behaviour problems, thereby
reducing the severity of symptoms (Narasingharao, Pradhan & Navaneetham, 2017).
A similar study showed that aggressive and self-injurious behaviour of children with
ASD reduces post Yoga intervention (Sharma & Sharma, 2016).
Posttraumatic stress disorder (PTSD) is a critical type of anxiety disorder that might be
experineced by people who have witnessed or been a part of a traumatic event such as a natural
disaster, terrorist attack or sexual violence. A self report interview based study with 40
individuals with PTSD revealed that participating in an 8 week Kundalini Yoga program created
notable changes in areas of health and well-being, lifestyle and psychosocial integration
Additionally, it also positively affected their perceptions of self in relation to the world (Jindani
& Khalsa, 2015).
A similar study with medical undergraduate students showed that a 16 week brief and
structured yoga intervention significantly improved their overall health, perceived stress and
depressive symptoms (Simard & Henry, 2009).
While Yoga is certainly a valuable and efficacious intervention for serious mental health
concerns, it has also been used in academic and work settings to boost productivity and reduce
stress. In a 2014 study, an entire men’s Division I athletic team participated in eight ninety
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minutes group intervention sessions immediately followed by one hour of Hatha yoga sessions
over the course of 5 weeks. Since mindfulness-based interventions teach tolerance and
acceptance of negative thoughts and emotions, participants reported greater mindfulness, greater
goal-directed energy, and less perceived stress than before the intervention (Goodman et. al.,
2014).
Another study examined the efficacy of yoga practice in reducing music performance
anxiety. Undergraduate and graduate music conservatory students, including both vocalists and
instrumentalists attended a 9-week yoga intervention. The course consisted of fourteen 60-
minute yoga classes almost twice every week followed by a brief daily home practice.
Participants who completed the measures at both pre- and post-intervention assessments showed
large decreases in music performance anxiety as well as in trait anxiety. Improvements were
even sustained at a seven to fourteen month follow-up (Stern, Khalsa & Hofmann, 2012).
Another research tried to seek out the effect of practicing Yoga on creativity. With
creativity being a highly in demand skill for marketing students and employees, 92 MBA
students were chosen for the purpose of the study. The study used the experimental method to
determine if an intervention involving both physical and mental exercises embodied in Hatha
yoga can improve individual creativity. While the experimental group participated in 20-minute
Hatha yoga sessions, the control group took part in a short 20-minute case study session.
Divergent and convergent thinking are the two markers of creativity. Hatha yoga showed
significant improvement in the divergent thinking skills of the student but had no impact on
convergent thinking skills (Bollimbala, James & Ganguli, 2020).
While Yoga is helpful as an intervention for severe psychological distress and is also
instrumental in boosting creativity and productivity, it can also be employed as a preventative
measure to manage future distress.
A 2009 study examined the increase in mindfulness brought about with the practice of
Yoga. After 8 weeks of Yoga, the participants who were in the experimental group and received
the intervention experienced a significant increase in overall mindfulness, and in three
mindfulness subscales, namely, attention to the present moment, accepting and open attitudes
toward experience, and insightful understanding. This shows that the use of Yoga can not only
help in dealing with stress, depression or anxiety when they arise but can also be helpful in
building a more resilient and hardy psyche (Shelov, Suchday & Friedberg, 2009).
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Figure 2
Evidence-Based Psychophysiological Effects of Yoga

Note. From “Yoga-Integrated Health Neuroscience Paradigm (YOGIHANSAM): Integration of

Yoga Philosophy, Health Psychology and Medical Neuroscience as a Paradigm for Holistic
Healthcare,” by Anand Ramanujapuram in Ramanujapuram, A. (2018). Yoga-Integrated Health
Neuroscience Paradigm (YOGIHANSAM): Integration of Yoga Philosophy, Health Psychology
and Medical Neuroscience as a Paradigm for Holistic Healthcare. International Journal of
Advanced Scientific Research and Management. 3. 165.

Yoga as an Intervention for Physiological Concerns

Yoga as an intervention has multi faceted applicability, such that it can not only be
included in psychological interventions but physiological ones as well. For example, when
introduced to older adults (above 65 years old), yoga as a biweekly 12 week intervention
including both physical postures and breathing exercises, significantly decreased their fear of
falling, and increased their static balance and lower body flexibility (Schmid, Puymbroeck &
Koceja, 2010).
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Another study was conducted to see the utility of Yoga as an intervention for Parkinson's
Disease, a condition often leading to poor balance, increased falls, and fear of falling, all of
which can reduce participation in life activities. The results revealed that the use of Hatha Yoga
as a community-based rehabilitation intervention for individuals with PD can be extremely
beneficial. Yoga, as part of an interdisciplinary approach to treatment, was shown to improve
many types of activities and participation outcomes, including but not limited to, mobility,
social relationships, self-care, handling stress, recreation (Hawkins et. al., 2018).
A research on older adults with mild cognitive impairment studied the restorative impacts
of 12 weeks of Yoga on cognitive decline. The participants demonstrated a statistically
significant improvement in depression and visuospatial memory. Improved verbal memory
performance was also reported (Eyre et. al., 2016).
Another study reported that practicing yoga daily for 1 month, weekly until the
subsequent 3 months and finally without supervision for the next 6 months had a significant
impact on the elderly in terms of improvement in all the domains of Quality of Life and total
sleep quality (Hariprasad et. al., 2013).
With the elderly population in India expected to grow from 7.6 million in 2001 to 137
million in 2021, the demands posed on the health care services are increasing day by day (Dhar,
2005). The practice of Yoga can be one useful tool in preventing illnesses and/or managing
them.
With the increasing elderly population and the global pandemic, optimal health of the
health care workers also becomes a priority. Yoga as an intervention has also been successful in
sustaining good health in that population.
A study about yoga as an intervention to help reduce or alleviate work stress and sleep
problems among nurses was conducted in 2015. One hundred and twenty nurses were
randomised into two groups: a yoga group and a non-yoga group. The results revealed that the
nurses in the yoga group had significantly better sleep quality and lower work stress compared
with nurses in the non-yoga group (Fang & Li, 2015).
Group mindfulness-based yoga intervention, spanning over a period of 8 weeks, was also
successfully shown to manage burnout and improve wellbeing among health care professionals.
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At post intervention, the participants also had significantly better scores on personal
accomplishment, depression, anxiety, stress, perceived resilience, and compassion (Ofei-Dodoo
et. al., 2020).
Yoga has also been proven to be a beneficial adjunct therapy for various physiological
ailments, including Diabetes, an increasingly common disease in the Indian population. A
randomized parallel study carried out in Medical College Trivandrum, Kerala showed the
benefits of Yoga for people with Type 2 Diabetes Mellitus. The yoga group practiced yoga daily
for 1 hour along with oral hypoglycemic drugs for 3 months. After intervention with yoga the
participants showed a decrease in total cholesterol, triglycerides and LDL cholesterol levels, with
an improvement in HDL cholesterol levels (Shantakumari & Sequeira, 2013).
Another study found that among Indians with elevated fasting blood glucose,
participation in an 8-week yoga intervention resulted in greater weight loss and reduction in
waist circumference when compared to a walking control. The study concluded that Yoga offers
a promising lifestyle intervention for decreasing weight-related type 2 diabetes risk factors and
potentially increasing psychological well-being (McDermott et. al., 2014).
Other than Parkinson’s, burnout and Diabetes, existing literature and data also show that
yoga is an effective tool for improving health-related outcomes in breast cancer survivors
(Buffart, 2012; Côté & Daneault, 2012; Harder, Parlour & Jenkins, 2012; Piet, Würtzen, &
Zachariae, 2012 and Sadja & Mills, 2013). While breast cancer is the most commonly diagnosed
cancer among African-American women, they are also less likely to engage in yoga compared to
other ethnic groups. A study assessed the feasibility of an 8-week restorative yoga program
among African-American breast cancer survivors. While the results revealed that the depression
scores at follow-up were significantly lower in the yoga group, no significant differences were
observed for sleep quality, fatigue, or perceived stress. The Yoga program as a whole got an
average rating of “very useful.” from the participants (Taylor et. al., 2018).
Myeloproliferative neoplasm (MPN), a type of blood cancer, is a rare hematological
malignancy with a significant symptom burden often left unresolved despite recent advances in
the western medicine therapy. Yoga, a nonpharmacological intervention, has been shown to
improve symptoms in other cancers (Buffart, 2012; Côté & Daneault, 2012; Harder, Parlour &
Jenkins, 2012; Piet, Würtzen, & Zachariae, 2012 and Sadja & Mills, 2013). Hence its
effectiveness to relieve some symptoms in MPN patients was also tested. Participants were asked
 10

to complete 60 minutes per week of online, home-based yoga and were asked to participate in a
15 to 20 minutes phone interview post intervention. The 39 MPN patients that participated in the
study reported physical (eg, improved sleep, reduced fatigue) and mental (eg, reduced stress)
health benefits and liked the convenience of being able to do yoga at home (Huberty et. al.,
2018).
Another common condition that Yoga has shown great results with is Restless Leg
Syndrome. A study on Restless Leg Syndrome (RLS), a strong and often irresistible urge to
move one's legs, usually accompanied by uncomfortable sensations, also showed and
corroborated the benefits of practicing yoga in improving physical conditions. Ten women, aged
32–66 years, completed the study. During weekly follow ups, the participants demonstrated
striking reductions in RLS symptoms and symptom severity, with symptoms decreasing to
minimal/mild in all but 1 woman and no participant scoring in the severe range by week 8.
Participants also showed significant improvements in sleep, perceived stress, and mood (Innes et.
al., 2013).
Migraine, a headache that can cause severe throbbing pain or a pulsing sensation, is
reported by over 10 million people per year in India. A study investigated the effect of 12 weeks
yoga training on headache frequency, severity and duration as well as headache impacts on
female migraineurs’ lives. After 3 months of Yoga intervention, there was a significant reduction
reported in the impact of headache on patients’ lives, headache frequency, and severity but a
non-significant reduction in headache duration (Boroujeni et. al., 2015).
Since several studies had reported significant positive impacts of yoga intervention for
women and children, a study also explored the health effects of yoga on pregnancy. The research
evaluated ten randomized controlled trials and consistently found that yoga intervention
presented with lower incidences of prenatal disorders, and small gestational age, lower levels of
pain and stress, and higher score of relationship. In addition, the study also found yoga to be a
more effective exercise than walking or other prenatal exercises and even reported that it was a
safe and beneficial practice for pregnant women who are depressed, at high-risk, or experience
lumbopelvic pain (Jiang, 2015).
While Yoga is found to be a very useful practice for soon to be mothers, studies have also
explored its benefits among children. A 2014 study examined the effects of a classroom-based
ten week yoga intervention on cortisol concentrations and perceived behavior in second and third
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graders. Only second graders showed a significant decrease in baseline cortisol from before to
after the yoga intervention. While the second-grade teacher perceived significant improvements,
the third-grade teacher perceived some, but fewer, improvements in students’ behavior (Butzer
et. al., 2015).
A study to test the effects of mindful yoga intervention on substance use and its
psychological and psychophysiological correlates in high-risk adolescents showed promising
results. A 20-session mindful yoga intervention was introduced to adolescents at high-risk for
dropping out of school. The 50-min classes were offered three times a week. The participants
were randomly assigned to the control and experimental group. After the yoga intervention was
complete, students in the experimental condition, as compared to control students, exhibited
trends toward decreased alcohol use and improved teacher-rated social skills. The participants
from the yoga condition also showed a (while statistically non-significant albeit) increase in
arousal in response to relevant stimuli when measured through skin conductance (Fishbein et. al.,
2016).
Even when adopted in parts, the philosophy and practice of Yoga has undeniable and
immense psychological and physiological benefits. The academic field has certainly taken notice
of this fact and the research on Yoga as an adjunct or preventative therapy has progressed by
leaps and bounds in the last two decades. It has, time and time again, proven to be a beneficial,
cost effective and efficacious practice that facilitates short term recovery and long term well
being. Despite that, gaps continue to remain in the actual acceptance and integration of Yoga in
medical settings and its in depth scientific exploration, not just as a form of exercise, but as a
way of life. Yoga philosophy, while first introduced 5000 years ago, to this day stays as relevant
and holds the potential to not only heal modern ailments but also to take an individual towards
complete mental, physical and spiritual well being.
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