Yoga and positive mental health

Authors: Jyotsna Agrawal, Matthijs Cornelissen

Introduction

Although the definition of mental health includes positive mental health and well being (WHO,
2001), its promotion requires consistent focused action, which has been missing over the years.
This is especially unfortunate since promotion of positive mental health can benefit people
anywhere on the mental health continuum, whether ‘not at risk’, ‘at risk’, suffering, or
recovering from mental health problems (WHO, 2004). The limited resources which have been
spent on mental health promotion in India have often been on programs originating in a Western
culture, which are not always appropriate in an Indian context due to low cultural and ecological
validity. Since India has a rich philosophical-psychological heritage of its own, it would be apt to
develop indigenous positive mental health programs. Apart from social structures like the
extended family system as center of community support, one can think of the Yogic tradition,
which has been honed and perfected in India over many centuries and which offers a rich source
of psychological knowledge and know-how suitable for this purpose.

Current yoga research focuses predominantly on asanas (physical postures), pranayama

(breathing practices) and brief meditation courses, and it looks at these either from within a
physicalist-objective or a social-constructionist conceptualisation of knowledge and reality. As a
result it misses out on what is most valuable in what the various yoga traditions can contribute to
modernity. And this is not a small loss, because the Indian civilization with its millennia-old
focus on consciousness and inner development has a far more sophisticated, inclusive and
multifaceted understanding of reality and the role of the human mind within it than modern
science with its one-sided focus on the physical and social domains. Modern yoga research gives
the impression of someone studying books and music by measuring their weight and volume, or
on the basis of the statistical analysis of judgments made by representative samples of the
general public. It not only doesn’t work, as Varambally and Gangadhar have argued (2016), but
it completely misses the point. Yoga was never meant to produce changes in the brain or minor
improvements in overall life-satisfaction. If we really want to know what the various yoga
traditions can contribute to psychology, positive mental health and society in general, we must
study the various yoga traditions on their own terms and familiarise ourselves with the basic
understanding of reality and knowledge that gave rise to them.

The basic understanding of reality behind yoga practice

There are many entirely different ways of “doing yoga” and so one may wonder where to start,
but there is a way in which these different systems have been classified traditionally that leads to
familiar terrain for psychologist. It is the trimarga, the three “paths” of bhakti, jnana, and
karmayoga, the yoga of devotion, knowledge and works, which is closely related to the division
modern psychologists make between emotions, cognition and volition. Before we can go into the
contributions yoga can make in these three specific areas, it may be useful to have a quick look
at how the conception of reality that forms the basis of almost all systems of Indian thought
differs from that of modern science.

In science -- and in the new global civilization as a whole -- it has become mainstream to look at
the world as if primarily physical, with consciousness arising out of the complexity of the
physical brain as if it were some kind of evolutionary after-thought. Though we tend to take this
view of reality for granted, it is not only one-sided but also actually a rather recent development.
Even in the West, till sometime back the vast majority of well-known philosophers held that the
universe was permeated with consciousness (‘panpsychism’ in European philosophy) and in
Indian thought, the modern, physicalist conception of reality is mainly mentioned as a beginners’
error (Chhandogya Upanishad). Most major systems of yoga take the centrality of consciousness
for granted, doubt at least to some extent the relevance of the physical world, and have as their
ultimate objective to achieve some aspect of pure consciousness: kailvalya, mukti, or nirvana
(Kuppuswamy, 1985; Rao, 2005).

It is crucial to keep all this in mind when we try to use practices from these ancient Indian
systems within the modern, much more materialistic setting. If we gloss over these basic
differences, serious conceptual confusion is bound to arise, while If we manage to find the right
way to integrate the two ways of looking at reality, we may not only arrive at a deep and
effective understanding of what it actually is in yoga that helps in curative, preventive, and
positive mental health, but we may also find a new, more integral understanding of reality that
goes at least in some respects beyond both approaches to realty and can bring them together.

The essential core of what bhakti, jnana and karma yoga can contribute to psychology

Bhaktiyoga: The path of bhakti is centered around love for the Divine and ultimately leads to
ananda, pure bliss, whether experienced as a bliss of union or a bliss of oneness. There is no
upper limit to the intensity of this joy other than the bearing capacity of the practitioner, and as it
appears to be independent of circumstances and the path followed, the Indian tradition came to
the conclusion that ananda is one of the essential qualities of reality itself. Though it is hard –
and as a consequence rare – for people to arrive at a state in which the higher intensities of inner
joy are entirely uninterrupted and independent of circumstances, every step on the way helps the
seeker to get closer to this ideal. As the unconditional nature of the happiness removes the
urgency of personal, egoistic satisfaction, progress in this dimension facilitates more “objective”,
less biased observation, as well as action which is in harmony with the interests of the whole.
This not only helps in the other two paths, but provides a major support for any effort at therapy
and self-development and enhances personal qualities that are invaluable for all those working
and doing research in the field of mental health.
Jnanayoga: The processes and end result of the yoga of knowledge are in appearance quite
different but in essence the same. While in bhaktiyoga, “the Divine” is generally -- though not
always -- experienced in a personal form, in jnanayoga it is generally -- though again not always
-- conceptualized in a more abstract manner, for example as the consciousness which has
manifested the world out of itself. When one realizes this consciousness in its absolute purity,
whether transcendent, beyond the manifest world, or cosmically, as a “secret ingredient”
pervasive throughout every part of the creation, one realizes, just like in bhaktiyoga, that in the
end all is well, and that there is nothing personal to gain or to lose. This, once again, not only
helps one to move happily and unperturbed through all the vicissitudes of life, but it also allows
an unbiased and “objective” vision of subjective realities, and especially of consciousness and all
that happens inside of it. We will come back later to how valuable this could be for the in-depth
study of psychological processes.

Karmayoga: The third path, that of karmayoga, is by some authorities (e.g. Shankara and
Patanjali) looked at only as a crucial preparation during the early stages of the specific path they
advocate. In the Bhagavad Gita (and in modern times, in the work of Sri Aurobindo) it is,
however, honoured as a path in itself that can lead to sādharmya-mukti, “the acquisition of the
divine nature by the transformation of this lower being into the human image of the Divine” (Sri
Aurobindo, 2005). Though one could argue that absolute perfection on this path is not humanly
feasible, it may be clear how valuable any progress in this direction, however little, will be for
anyone interested in Maslow’s “self-actualization“ and for positive mental health in general.

A word of caution: The need for therapists to have their own yoga practice

It may also be clear, even from this nano-overview of the three paths of bhakti, jnana and
karmayoga, that the differences between yoga and modern society in terms of their basic outlook
on life and the possibilities for human growth and development, are considerable. The Indian
tradition goes far beyond what even the most positive of modern psychologies would dare to aim
at, and, if used well, this may lead to as yet unprecedented progress both in theoretical as well as
applied psychology, but… there are also considerable dangers. The mood-disorders, delusions
and self-aggrandizement that can follow from misguided efforts on any of these paths are well-
known. These risks make it essential for counsellors and therapists to be well grounded in their
own path of yoga before they use it with their clients. This may seem an unreasonable demand
that could postpone the use of yoga-based therapies to far into the future, but we hope a time will
come that people will look at psychology without yoga, as we now would look at physics
without mathematics.

Yoga and positive mental health (PMH)

After this brief overview of the yogic trimarga, we can proceed with a few pointers for PMH
based on the psychological aspects covered by them, i.e. emotions, cognitions and intentional
action, which, as we already saw, are not watertight compartments but closely interwoven in
human nature. Empirical studies based on psychological aspects of yoga tradition have reported
positive outcomes for mental health (Meissner, Cantell, Steiner and Sanchez, 2016; Dabas and
Singh, 2018). Two widely considered core yoga texts, the Bhagavad Gita and Patanjali’s Yoga
Sutras give a foundation upon which many newer PMH modules can be developed and tested.

Emotion: Happiness is an important emotion linked with PMH. As mentioned earlier, the yogic
pathway of bhakti emphasizes the ananda of a liberated person. The Bhagavad Gita has
differentiated between three common varieties of sukha on the basis of the triguna, the three
principle strands of nature, in a descending order of psychological health. Satwik sukha is the
result of a healthier living approach, taking the good path (shreyas) of values, of developing
one’s potentials and working for social and universal well-being. It requires self-discipline and
giving up of egocentric pleasures, and therefore may be difficult initially, but it has beneficial
results in terms of long lasting calm happiness, and it may take one closer to ananda (Bhagavad
Gita; Kathopanishad; Sri Aurobindo, 1997). On the other hand, rajasik and tamasik sukha are
based on desire fulfillment and maximization of pleasure by taking the pleasant path (preyas)
(Salagame, 2002; Mishra, 2019) leading to short term happiness, and suffering in the medium to
long term. These ideas are also in consonance with Greek ideas of eudemonic (Aristotle,
Nicomachean Ethics, 1985) versus hedonistic approach (Aristuppus, 4th century) from which
modern positive psychology has borrowed heavily, and have also been supported empirically in
modern times (Agrawal, 2019).

Cultivation of other-directed positive emotions such as, maitri (friendliness, loving kindness),
karuna (compassion), mudita (appreciative, sympathetic joy) and upeksha (equanimity),
collectively known as Brahmavihara, are similarly important for PMH. In the yogic traditions
there is a sense of the inherent oneness of all beings, interconnected and emerging as we are from
the same original divine Consciousness. From this perspective one can cultivate feelings of
friendliness for all beings, along with softness (mardava), straightforwardness (arjavam), non-
hurting and non-violence (ahimsa). Further, on the foundation of maitri, one needs to develop
mudita, an ability to be happy for other’s well-being while overcoming jealousy; karuna for
someone who is suffering along with kindness (daya) and giving (dana); and upeksha along with
forgiveness, for the ones whom one may consider as difficult (Bhagavad Gita; Patanjali’s Yoga
Sutras).

Cognition: Clear perception of reality, without the interplay of cognitive errors is important for
mental health, therapy, as well as research. The Vedantic perspective of reality as discussed in
the beginning, is based on the idea that the entire universe is permeated with consciousness.
Before one has direct perception of That, one can try to work on diminishing the separative ego
sense along with concomitant cognitive errors as per yogic perspective.
One such important error is that of attachment (asakti, or raga), discussed both in the Bhagavad
Gita and in Patanjali’s Yoga Sutras. To find freedom, one needs to contemplate (manana,
nidhidhyasana) the idea that material things are temporary and they may not be as important as
we may tend to treat them in our priority list. Whatever we consider as ‘good’ has its limitations
and what we consideras ‘not good’ has its strengths. One can try to develop non-attachment and
equality of ideas by trying to find something useful in all events and ideas (Sri Aurobindo, as
cited in Banerji, 2016). Some amount of desirelessness can also lead to growth in equality
(samata). Sri Aurobindo has differentiated this equality into passive and active types, whereby
one may start from tolerance (titiksha), go on to cultivate an active acceptance and appreciation,
culminating into a complete surrender (nati) (Banerji, 2016). There are also ideas in the
Bhagavad Gita, which overlap with modern definitions of wisdom such as rich knowledge about
life, emotional regulation, insight, and a focus on the common good (Jeste and Vahia, 2008).
Cultivating such qualities may cumulatively contribute to PMH.

Intentional Action: Goals and related activities constitute a large part of human life, however the
way people approach them can lead to a variety of problems, from excessive worry about the
outcomes, to performance related anxiety, to disappointments or boredom. Instead of withdrawal
from all actions to avoid such psychological difficulties, the Gita has given the option of Karma
yoga, which is a healthier process of engaging in intentional actions. It has multiple aspects
from: a) selection of goals, not for materialistic benefits but for inner perfection or larger social
wellbeing; b) initially not clinging to preferred outcomes and later, as one develops, not clinging
to the process of action itself; c) treating all outcomes and then all moments, good and bad, with
a sense of equality; d) offering all one’s work to the highest consciousness, the Divine or the
wisdom and optimal order inherent in things (Sri Aurobindo, 1997). We may notice that the
connection between karma yoga, nishkama yoga and samata is a mutually interactive
relationship, since desirelessness can lead to equality, while on the other hand seeing all
outcomes with equal mindedness, can lead to desirelessness.

However another note of caution is required, so that non-attachment and equanimity should not
lead to a tamasik withdrawal from all action, where the desire is present to avoid all actions. If
understood correctly, non-attachment gives up desire but not action, and equality involves
treating all situations without personal preference. This will not lead to an unhappy life since one
finds a greater happiness within, irrespective of the external rewards and deprivations.

Similar to character strengths as studied in positive psychology, the Bhagavad Gita and
Patanjali’s Yoga Sutras have emphasized cultivation of positive traits which may contribute to
PMH. In the Gita, these traits range from non-attachment, perseverance, non-violence and non-
greed to modesty, stability, forgiveness, fearlessness, self-control etc. Similarly, Patanjali’s Yoga
Sutras have given a set of five yamas to be cultivated as the first step in yoga, such as practicing
non-violence (ahimsa), truthfulness (satya), non-stealing (asteya), non-possessiveness
(aparigraha) and restraint (brahmacharya). Self-control is one of the most emphasized traits, to
the point where the entire ‘astangayoga’ of Patanjali has been considered as an integrated
program of self-regulation, bringing together top-down and bottom-up pathways (Gard, Noggle,
Park, Vago and Wilson, 2014; Schmalz, Powers and Blom, 2015; Pascoe and Bauer, 2015).
These positive qualities are easily tied within the model of triguna, whereby they generally
belong to the satwik meta-trait (of light and harmony), which is related to better mental health
(Sharma, Salvi and Sharma, 2017, Chandana, Agrawal, Sharma and Murthy 2018).

How to develop these qualities?

The qualities related to PMH we have discussed so far, are in the yogic literature sometimes
mentioned as outer changes that will facilitate an aimed for inner change, and sometimes as the
spontaneous outflow of an inner realization. Below we are giving some broad attitudinal changes
and inner gestures that can help with the development of PMH.

1. The first step on the path is wanting something different, an aspiration to grow from
one’s present stage of development.
2. In this process, one will need to bring together all the different voices within oneself,
resolve any lingering conflict or divided sincerity, remove mental or emotional barriers, and
finally make it a deep commitment (sankalpa).
3. The next step is to keep reminding oneself of one’s commitment (smriti) and go on
practicing (abhyasa), without worrying much about immediate outcomes.
4. One may require a feedback loop by regular self-observation and reflection to remove
immediate or distant barriers to the path and not to give in to undesirable impulses (shuddhi).
5. Cultivating discipline of attention, of speech and of mind is another helpful step. Being
able to hold attention on something is necessary in daily life and this training is in the Astanga
Yoga of Patanjali further cultivated in terms of pratyahara (bringing one’s attention back from all
the various things, to the present moment); dharana (holding it on an object of attention) and
dhyana (continuous flow of unbreakable attention). This also has been discussed in terms of a
constant remembrance (smriti) of one’s original nature and/or the Divine. Further, one is
expected to have discipline of speech, saying what is true, pleasant and good.
6. Finally having a deep faith in divine guidance (shraddha), along with surrender to Divine
will (the Ishwara pranidhana in Patanjali’s Yoga Sutras), and active offering of one’s actions
and experiences (Gita) is a required component for progress on the path.

Conclusion

To conclude, we would like to stress once more the desirability of a deeper theoretical as well as
practical understanding of yoga amongst mental health professionals. If the practice of yoga can
make a major contribution to positive mental health, then it makes sense to promote yoga
education first amongst those working in the field. There are several reasons why this might well
be considered a public mental health priority. The first is simple: one cannot teach yoga, or even
convincingly advocate its practice, unless one has made at least some progress on one’s own path
first. The second is that given the large influence therapist-variables have on the outcome of
therapy and counselling (Stubbs & Bozarth, 1994; Norcross & Lambert, 2011), any positive
influence of yoga on mental health professionals should logically multiply in the population they
serve. As such it should be cost-effective in the long run. The third is an area that is as yet only
beginning to receive the attention it deserves. It is that the emotional detachment and mental
clarity that yoga engenders, together with the attention to minute inner movements and gestures
which the practice of yoga demands, provide an excellent training ground for anyone who wants
to get a deeper understanding of how the human mind actually works. This is not only invaluable
for psychotherapists, counsellors and others in the helping professions, but potentially even more
so for researchers in psychology and other human sciences. The qualities that according to the
tradition are promoted by the practice of yoga come strikingly close to those that are needed for
good qualitative research in the field of psychology (Petitmengin-Peugeot, 1999).

Though the increasing appreciation of yoga in the treatment of mental health problems is without
the slightest doubt a positive development, we should not forget that in the culture of origin, it
developed not only to cope with suffering, but also to go beyond humanity’s normal capacities
(Braud, 2010). In the words of the Brihadaranyaka Upanishad, it aims to develop in us an
inalienable, unconditional happiness, an absolutely perfect knowledge, and a direct realisation of
the immortality of our soul.

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