by Baxter and Nina
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| 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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That is a clear and appropriate line in the sand!
Rather than restrict teachers or students, this line creates a safe space for both to enter into an authentic relationship of inquiry that is so uniquely yoga…much like a fence around a playground allows youngsters to play with abandon within its confines.
An additional perspective regarding the line, is to understand it as an artifact of the first yama of ahimsa as well…both the student's and teacher's first standard of yoga. Fully aware that seeing a professional offers no surety or certainty of an accurate diagnosis every time, as a risk management practice, it fair exceeds as you so accurately point out, having an untrained yoga teacher make a diagnosis. "I don't know but let's find out together." makes a wonderful mantra to repeat when approached by a student. Assisting them in finding an appropriate professional not only practices ahimsa for both, but is smart network marketing practice as the professional then comes to know the teacher as someone who is prudent and cares for the student first.
I offer this now somewhat old, but timeless article that I wrote on the topic for your readers.
Thank you for drawing the line!
Respectfully, Matt
http://matthewjtaylor.com/consciousahimsa.pdf
An important post for teachers and students! I have taught Yoga for nearly 20 years and have no formal training as a physical therapist or doctor. It can be tricky when students are persistent and look to the teacher for advice. But there is a delicate balance here. Important to remember the ancient teachings are imparted through you and you are offering the space for each to discover the Self.
I had a more eloquent response written – and somehow it got lost in cyber-translation. ;) Nonetheless, I want to agree with Matt, and want to emphasize the importance of establishing that healthy dialogue between health care providers and yoga teachers or therapists.
Working in partnership – rather than the old clunky and inefficient dominator model – there is room for everyone (health care pros, health care pros who specialize in yoga, yoga teachers, and yoga therapists) to thrive – safely and creatively – so we can all work toward improving the quality of healthcare and life enjoyed, together.
Grace and peace,
Ginger
Baxter & Nina, thank you for this well-written & valuable post. It helps educate the public & also helps clarify scope of practice for yoga teachers and yoga therapists who may not be trained as licensed health care professionals. We all can work together, as Ginger points out above, to ensure yoga is used safely, effectively & responsibly delivered as a therapeutic approach to healing and overall wellness. I work closely with yoga teachers and yoga therapists and we have a mutual respect (& partnership!) that ultimately & optimally serves the patient/client. Thank you for this!
This comment by Matthew is SO important: "Fully aware that seeing a professional offers no surety or certainty of an accurate diagnosis every time, as a risk management practice, it fair exceeds as you so accurately point out, having an untrained yoga teacher make a diagnosis."
I've been in this business for over 30 years, and from early on, I had a reputation for helping people that other approaches or modalities — both orthodox and alternative — did not. And I've had physical therapists in my training programs, and worked side-by-side with a few Medical Doctors, Osteopaths and Chiropractors.
The PTs especially often commented to me that what I was teaching was the exact opposite of what they were taught in PT school, but what I taught made more sense, and worked MUCH better in practice, than what they learned in PT school.
SO, while I agree that it is that a medical diagnosis SHOULD be done, and in some cases is very useful, I do not hold them in anywhere near as high regard as some people do.