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Research Completed

The research was done initially over six weeks with one session per week, of one hour duration. The patients were assessed using the Centre for Epidemiological Studies – Depression Scale CES-D Radloff, L.S. (1977) The CES-D Scale. A self-report depression in the general population. Applied Psychological Measurement, 1, 385-401. In addition The Structured Interview Version of Hamilton Depression Rating Scale SI-HDRS Items and Range of Response Categories was also used. Potls M. K. Daniels M. Burman M.A. Wells K. B. (1990). A structured interview of the Hamilton Depression Rating Scales. Evidence of reliability and versatility of administrating. Journal of Psychiatric Research. 24(4): 335-350.

The yoga poses used were those described in BKS Iyengar’s book "Yoga The Path to Holistic Health", A Dorling Kindersley Book, 2001.

We started using the depression series pp 345-347, and there was an enormous improvement in depression. However, there were some problems with anger, and the Irritability series was used for Anger Management pp 337-339. This was very successful. The Insomnia Series was applied with limited success for insomnia pp340 – 342. Then the Anxiety Series was used pp342-344. This was not as successful as the depression series. In summary, most benefit was obtained from the depression and irritability series for this group of patients.

Following this, we started research using the Krishnamacharya/Desikachar model as described in Gary Kraftsow's book Yoga for Wellness. We did a six week programme using the depression series, and a similar improvement in depression to that of Iyengar was noted, but an improvement in insomnia, flashbacks, and anger management was noted with the introduction of pranayama.

Kausthub Desikachar suggested we add a pranayama with an increased out breath and a breath hold, and this added to the overall benefits by causing anger to be managed very well, as well as insomnia. The improvement in insomnia was better than with hypnotics, and the practice of pranayama was very portable and could be implemented in the early hours of the morning whilst lying in bed, and has proved very effective. Finally, pranayama was compared with the addition of Qi Gong (Tai Chi breathing), and although Qi Gong was helpful in a similar way to pranayama, there was no improvement in depression as there was with the yoga asanas. It was concluded at this stage that it is best to have a combination of yoga poses with pranayama and yoga nidra for the maximal response. Research is continuing, as the Veterans are starting to practice daily at home because of the combined benefits. The group experience is important, but the Qi Gong is happening in a group, and the benefits are not there for depression. If there is no depression and only anxiety, perhaps Qi Gong would be enough.

Following this research, and the presentation of the paper of two years research, it was decided to compare yoga with cognitive behaviour therapy. In studying cognitive behaviour therapy, it became obvious that much of yoga has already been incorporated in cognitive behaviour therapy, and this therapy contains a virtual grab bag of therapies acquired from various sources, but especially from yoga. A research review led to finding Mindfulness based Cognitive Behaviour Therapy (MCBT), alternate nostril breathing, among other pranayama techniques, directly lifted from yoga. Even the whole process of cognitive restructuring fits in well with the concept of avidya (ignorance or misapprehension) described by Patanjali, where the mind is described as quite arrogant, making assumptions which may or may not be correct, and ordering behaviour which can be quite maladaptive. Both yoga and CBT challenge these assumptions, but in similar and different ways.

Currently we are continuing our pilot studies, comparing 6 patients who are doing yoga plus a CBT program which was started with Motivational Interviewing (MI), a specific behavioural technique to overcome ambivalence at the outset of a process of change. Patients are not given a pre-set out program, but a program is adapted to their needs and specific responses each week. Already patients who were previously not communicating are emailing each other, are searching the internet, designing alcohol questionnaires which have already had the effect of reducing alcohol consumption by the very process of challenging oneself with the amount of alcohol consumed. Improvement is noted without any further need to implement further strategies at this stage. The program has run for three weeks thus far, and it is already noticed that the CBT techniques, and the use of the group is overcoming the lack of improvement in social avoidance and even reduction in alcohol consumption, which were residual problems after the yoga group. This has provided information for similar type interventions in the yoga program, more handouts, feedback forms for the yoga group, and has caused a deeper engagement by the yoga group than before in their own improvement. It is only 3 weeks into a twelve week program, and it will be interesting to see if the yoga plus CBT group fare better than the CBT alone. Following this, it is planned to administer yoga alone with these newer techniques informed back from CBT and its methodology, to see if there is any difference.

It is important that a very detailed expensive fuller research study with controls is not initiated until the methodology is developed and tested in detail.


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