Personal reflections on teaching yoga to people accessing mental health services
During my time as a Yoga Teacher, I have had the honour and great joy of sharing yoga with people at times when they were really struggling with their emotional and mental health. As a Clinical Psychologist who practices yoga for my overall sense of wellness and psychological health, I am continually driven to bring the same benefits to other people. However, it is not possible for everyone to make it to public yoga classes (for countless reasons, too many to reflect on here!). Over the years I have managed to get my colleagues and managers on board to let me offer some group yoga sessions to the clients accessing our community and inpatient NHS services – they let me teach yoga as part of my Psychology job! Here are some of the things I learned that have stayed with me from these experiences…
If you have ever been into a locked mental health ward (as staff, visitor, or patient) then you might know something about the challenges faced by the people staying there as patients. As the door closes behind you, you realise that the only way to leave and get out is with a set of keys. If you are a visitor to the ward or working there, then you are safe in the knowledge that your time on the ward is limited, and you can leave at the end of your shift or when the visit comes to an end. This obviously isn’t the same for people on the ward receiving treatment for their mental health. In this case, you are governed by the rhyme and rhythms of the ward; there are expectations about when to wake up and go to sleep, mealtimes are set for you, medications are prescribed, activities are pre-planned, and your ability to leave the ward is mostly decided for you by someone else. Your freedoms are limited. And for some people, the experience of coming into a mental health ward served as a traumatic experience (sometimes added onto a history of traumas and difficult life experiences). Bringing yoga into this setting helped me learn more about the ways that the body is the one thing that we all have ultimate control over – we decide what we do to our bodies and how we do it, and yoga was one extra way of helping other people experience this for themselves.
The yoga classes I ran in this setting were with small groups of people, and I encouraged people to decide for themselves whether they might like to join the class. The yoga pace was generally slower, and the focus was always about choice. Sometimes we moved the body in ways to create a sense of calm and stillness, helping to reduce anxiety and worry. At other times we practiced movements that helped to build energy and stimulate motivation to improve mood. The yoga movements were always practiced deliberately with focus and care for oneself, helping to foster greater self-awareness and better concentration. Given that I held the position of Psychologist at the same time as being the Yoga Teacher, then I often had some awareness of a person’s history and story, meaning that I could avoid focus on certain parts of the body if I felt this might be unhelpful. Even when a patient was less known to me or new to the ward, they were invited to join and I developed a style of yoga teaching that is always trauma-informed: sensitive to a person’s life experiences, supportive to the whole-person healing process, and always avoiding potential re-traumatisation.
What was special about these yoga classes were that some of the staff wanted to join too! When it was possible with ward tasks, breaks and shifts, the yoga was shared between patients and staff and I felt that this really helped to build a sense of connection on a different level – a common humanity in the unspoken recognition that we all struggle and experience pain, and we can do something together to help us manage those experiences. On a personal level, it felt rewarding (essential, actually…) to give something back to the staff who always worked so hard and managed the pressures of the NHS workplace so calming and skilfully.
From these experiences teaching yoga in mental health settings, I have reflected more on some necessary adaptations to keep in mind when offering therapeutic yoga. One consideration (I’ve already mentioned it but it’s so important that I’ll mention it again!) is choice. Enabling the person on the yoga mat to make the conscious choice to choose what they might like to do with their body including choosing not to do something, taking pause and rest, and coming out of yoga postures at any point when needed. Another important consideration is the focus of the mind on the body – getting to know how the body feels in different movements, working within a pain-free range of motion, and using the feedback and information given to us by the body. I’ve found it helpful to de-emphasise posture intensity, to use a slower pace of guidance, and to have longer restful practices towards the end of the class to build relaxation skills. I’ve found that Vinyasa Krama yoga has worked well in these settings and have been given feedback from yoga participants that this style of yoga fitted well as it gradually built towards more knotty yoga postures (or in one person’s words, “going from being straight spaghetti to twisted fusilli” 😊).
Take a look at BAM Therapy's post about the mental health benefits of yoga.