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Friday, February 22, 2013

Drawing a Line in the Sand: Where Yoga Teachers Should Not Go

by Baxter and Nina

Silver Beach by Brad Gibson
Yesterday Baxter was interviewed by YogaU (we will announce when the interview is available online, sometime in April), and he was asked to discuss the concept of yoga as “Lifestyle Medicine” looking at its potential and its challenges. One of the challenges that came up during the discussion was something Nina mentioned to Baxter while he was preparing for the interview, and we both realized it was something so important that we decided to share our thoughts with you about it on the blog today.

The challenge is: Where do we draw the boundary between yoga therapy and practicing medicine, physical or other types of rehabilitation therapy, or psychotherapy?

One clear line in the sand we can draw is that yoga teachers should never try to diagnose a medical or psychological condition. This is because we are not trained to do so and, in fact, are not legally permitted to. This means if a student comes to you with a complaint that has not been formally diagnosed, you must refrain from offering an opinion as to what could possibly be wrong. However, as you are in an influential position, you can—and probably should—encourage your student to go and get a diagnosis.

Once you have the diagnosis, if you’ve had proper training in yoga therapeutics, you can then make suggestions for yoga tools that could help your student. This is where you come into your own! Yoga has an enormous repertoire of different physical movements—some not available through other forms of exercise—that can be of tremendous benefit to a large number of conditions. Teaching asana to release held tension, build strength, increase flexibility, and improve balance and mobility provides a powerful approach to healing that western medicine typically doesn’t include. And teaching stress reduction techniques can be tremendously helpful for a number of both physical and psychological problems.

If you don’t yet have a diagnosis but the student’s complaint seems like one of those problems whose symptoms can be relieved by yoga, such as back pain, muscle soreness or joint stiffness, you can suggest some possible poses without promising any particular result but being willing to stay open to see what happens. An undiagnosed back pain, for example, might be relieved by general low back practices but also might not be if there is a serious underlying condition. If the complaint seems like one that would be helped by stress management, such as anxiety or insomnia, you can always offer relaxation techniques, as these are safe for anyone. And, finally, as Nina wrote yesterday in Yoga to Reduce Suffering, we can always offer possible suggestions for reducing suffering. But this is all with the understanding that if the problem persists, the student should consult a professional.

Conversely, if you are a student hoping to get some help from a yoga teacher, you need to understand that your teacher is not licensed to diagnose your problem even if he or she is billed as a “yoga therapist." And if your teacher is offering you what seems to be diagnostic advice, you might want to check to see what their training is. If your teacher has additional training, such as Baxter (an MD) and Shari (a physical therapist) do, you might feel more comfortable taking his or her advice. But without a thorough physical examination, even a medical doctor or physical therapist can only make an educated guess, which you should take as a suggestion more than as a definitive diagnosis. (And if he or she does not have additional training, you should definitely be wary.)

And if you want to get the best out of your teacher, go see a professional first and find out exactly what is going on. Then share your diagnosis with your teacher. At that point, your teacher will be free to make suggestions and recommendations that might be very helpful for you, and he or she can also do a better job of keeping you safe in the classroom. Keep in mind that yoga therapists will often have areas of specialty, such as back care, cancer care, or depression, so you may need to find a different teacher or yoga therapist who has expertise your area. The good news is that yoga has been taught in the US for over 50 years, and there are experienced teachers now in almost every part of the country. So after you’ve been to the doctor or therapist and received your diagnosis, if you've taken the time to find a teacher with the right expertise, you’ll have someone with a powerful set of tools to help you on the road to healing.

How’s that for a line in the sand?

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