Yoga, eastern medicine, and mindfulness are not panaceas

Yoga, eastern medicine, and mindfulness are not panaceas
“Pandora” by Arthur Rackman

Because nothing is

This essay was originally published by Christina Waggaman on her Substack, The Body Electric.

I am seeing a pattern play out within the yoga, eastern traditional medicine, and buddhist-adjacent wellness communities. It goes like this: someone struggles with an ailment that they’ve unsuccessfully attempted to heal using mainstream methods for a long time. Then one day they encounter one of the many of the wonderful eastern modalities that had until then been unknown to (or even dismissed by) them, they find relief in a way or with a speed that they never thought possible, and they immediately jump from the humility that comes from the miracle of healing to declaring that they’ve found the cure-all for the world’s suffering. Grace turns to hubris, as they start to extol the virtues or their cure above all other cures (and perhaps then get certified to teach or administer it). Attachment to any theory that justifies the cure’s benefits strengthens, and these theories harden into indisputable facts. When a patient or a client for whom the cure doesn’t work is encountered, as is any other piece of data that suggests that their cure is not The Cure but perhaps just one of many cures, they become hostile to and blame those who fail to heal from it rather than accept the cure’s non-universality.

This pattern seem familiar? This is because the same thing happens in western biomedicine, public health, psychology, and every other professional group or community centered around medicine or healing. Rather than say that this is just a thing that other people do, I think it’s worthwhile to see this tendency within ourselves and to remember that it often starts from a good place: we are bothered by the suffering in the world because we care. As such, we wish to understand and address that suffering, and when we do find a way to address it, we wish to feel certain that we’ve conquered it universally. Unfortunately, it turns out that the last wish is unrealistic because we are merely humans, not Gods, Buddhas, or all-knowing scientists in a deterministic universe. Regardless, that temptation to avoid uncertainty by falling into hubris exists in all healthcare workers and scientists. It certainly did in me when I initially stumbled upon the combination of postural yoga and mindfulness-based somatic awareness.

That Limits of Eastern Healing Modalities

I had been a patient of psychotherapy since age seven, when in my early thirties, I started practicing yoga daily. Around the same time I had also started up a daily buddhist meditation practice, and I ended up blending some of the mindfulness methods I had learned in buddhist meditation with the uncomfortable sensations that arose in my body after putting myself in certain yoga poses. Through this method, I was able to connect reticence to assume certain postures with painful emotions and disturbing thoughts, find love and acceptance for them, and then finally relief while I watched them dissipate or morph into some deeper form of wisdom about myself. All of the sudden, issues that had I had barely made a dent in fixing as a patient of psychoanalytic and cognitive behavioral therapy for decades, started rapidly improving in a way I never thought possible. “OH MY GOD WHERE HAS YOGA BEEN ALL MY LIFE???” I thought, “If only this had been available to me as a kid, maybe I wouldn’t have had to hold on to so much suffering for so long!”

With only a year of practicing yoga under my belt, but convinced nevertheless that I could use it to save the world, I got certified to teach children’s yoga, and started teaching in afterschool programs for elementary school students. There I immediately encountered a lot of children who had no interest in, and some who actively hated yoga. The beautiful thing about children is that wanting to do right by them can melt through your defenses and cause you to stop yourself in your tracks and question every single thing you do and say. The children’s reactions gave me a much needed pause. As I was sensitive to having things forced on me when I was a child, I could not in good conscious make any kid who didn’t want to participate in my yoga class do so. So a bit disappointed, I ended up telling the kids that since they’d had a long day in school already, they were free to color or read or do something else in lieu of the yoga poses, as long they didn’t disrupt the kids who wanted to do them. It seemed to me that self-care should be about finding what works for you, not being told what should work for you, and the last thing I wanted to do was take away autonomy from children who were discovering for themselves how they preferred to relax after school. Interrupting that process didn’t sound much to me like yoga.

Working in children’s yoga stopped me from becoming a born-again yogi, and I realized that while a part of me wished that yoga was The Answer, perhaps a more modest wish should be for yoga to be available to those who were interested in trying something new and who ended up benefiting from and liking it, and that the right thing to do would probably be to support others in discovering and implementing whatever it is that works for them. I now feel the same way about yoga therapy as I do acupuncture, herbal medicine, and all of the traditional eastern healing modalities I am studying: I don’t believe they will cure every health condition, or that they need to compete as “alternatives” to biomedicine, but I do believe these healing modalities should be accessible options for those who aren’t finding adequate relief through what they’ve already tried. If some of these modalities have been used for thousands of years to treat health problems in other cultures, they should at least be considered seriously, and worthy of research by western biomedicine.

The Limits of Western Psychiatry and Psychotherapy

I have friends, even yoga friends, that still look at me sideways when I say yoga has done things for my mental health that (talk-based) psychotherapy or antidepressants have never been able to. For them, talk-based psychotherapy like CBT is the main thing that they’ve turned to when experiencing issues with mental health and, unlike for me, it has been incredibly effective for them. An often-repeated mantra in the yoga community is “yoga can help complement therapy, but it is no substitute for psychotherapy or meds!” and this is true to some degree. A 200-hour trained yoga teacher does not have the qualifications a psychotherapist needs to have in order to safely work with those experiencing moderate to severe manifestations of mental illness, so we should never tell someone in deep suffering from a mental health issue “just go to yoga class!” but this does not mean that yoga and other somatic-based therapies are ineffective, it just means that those who tend to teach or practice them lack the years of training required to practice integrative psychiatric medicine safely.

This is just not my opinion though, the idea that talk therapy is not universally appropriate to treat every mental health problem, and that there should be a focus on the body over the mind for treating or managing certain conditions like PTSD and neurodivergence, is not just mine, but is espoused by many respected people who work in the field of psychotherapy such as Dr. Peter Levine, and Dr. Bessel van der Kolk author of “The Body Keeps the Score.”

I think a lot of us who have healed or manage our health through an traditional or non-mainstream modality carry a bit of a chip on our shoulder because we have been told that our own experiences of healing are invalid, as the methods that other people told us should have worked did not, and the methods we ended up turning to were the ones we were told that shouldn’t have worked but did. However, we should attenuate the impulse to then turn around and play the same invalidation game with others. There are plenty of popular healing modalities that don’t do much for me — Internal Family Systems (IFS) is something widely lauded by many people I know as one of the most effective forms of therapy they’ve ever tried, but it doesn’t seem to work for me. But just because I’m not into it doesn’t mean that I should discourage others from using it.

About a year a go, a meme was floating around Twitter that went like this “Men will literally do ____ instead of going to therapy.” An example would be: “Men will literally buy Twitter instead of going to therapy.” The meme was based on the observation that men sometimes do silly, ambitious, and outrageous things to avoid working on their personal issues, which is a real phenomenon that definitely exists, because working on yourself is not only hard but requires space, time, and resources. But the thing I found troubling about this meme was two assumptions: one was that this habit applied men but not women, and the other was that talk therapy was the obvious solution to all of men’s mental health problems but they were just too stupid or pig-headed to pursue it. I am really not into thinking that there is something inherently wrong with men, and I am also really not into making fun of people who suffer from mental health struggles. In the ethics of epidemiology if we see a disparity in suffering between two different demographic groups, our first impulse is not to blame the more sick group, but to become more curious about why this disparity exists. Questions we should consider asking are “In what ways is mainstream psychotherapy not serving men? Are there different types of therapies that are more appropriate for men or more masculine-identified people? Is there something else going on in society that maybe individual psychotherapy can’t fix?” This lack of compassion toward men who suffer from mental health struggles seemed to originate from heterosexual women who harbored some unhealed grievances about their romantic life who then combined that with health dogma in order to collectively lament the fact that there were any limits at all to psychotherapy’s ability to Fix Men. It was a more than a little disturbing to see people who actually worked in the mental health field tweet this stuff.

The combination of health dogma and unhealed grievances around our own unmet health needs (whether they be physical, emotional, or social) can block healthcare workers from our compassion whenever we encounter those who heal or don’t heal in the ways we expect them to. And many of us, me included, harbor grievances around not feeling really listened to when it has come to our own health struggles or our insights about how we heal. Avoiding countertransference requires great skill.

Compassionate Healthcare Requires Patience and Acceptance for What We Cannot Cure

In the tradition of buddhism I have taken refuge in, the concept of the bodhisattva is very important. A bodhisattva is (sort of) like a buddhist version of a saint, a person who attains a great deal of spiritual liberation but who then vows to put off Nirvana for themselves so that they can stay in this world and assist others in becoming liberated. Many American converts to Tibetan Buddhism I know have taken the bodhisattva vow, because they feel that they have to in order to advance in their practice. However, I once heard a Tibetan Buddhist Rinpoche warn us that we should really understand what this vow entails before we commit to it. He said something along the lines of: “if you really want to be a bodhisattva you have to become very very patient. You will watch people suffer lifetime and after lifetime before they even begin to find their way out of suffering, and you will need to express compassion for them instead of getting frustrated and turning away. Few people understand what kind of patience is needed for that.” Patience and acceptance are necessary virtues to cultivate for anyone that works in medicine or wellness because we will encounter suffering we cannot fix all of the time, and we have to be compassionately present with our patients and clients as they experience it without our ego getting in the way.

As someone who has been involved in political activism, healthcare, and religion at various points in my life, I have been around many different varieties of people who all seem to share the same quality of being particularly sensitive and bothered by the suffering in the world — whether it be environmental destruction, social or economic injustice, or people getting sick. And as such, I have had to contend with the impulse within myself and within others to want to find The Thing That Will Save Us and mass implement it. Part of growing up was learning to swallow the tough pill that there are no universal cures, only local or relative ones, and often those are only temporary. One thing that eastern philosophy and religion has brought forth in me is more acceptance around this, which paradoxically, allows me to become a better actor in smaller and more specific contexts. However, cultivating the compassion necessary to act wisely requires letting myself feel sad about the suffering in myself and others without always jumping to try and fix it, and that means being at least a little bit sad always. Feeling sadness on a day to day basis without letting it become overwhelming, is often very challenging and sometimes starts to tip back into anxiety or depression for me.

The beautiful thing is that by being present with this sadness, creative small ways to address suffering, even if they are just local and temporary, reveal themselves. I also am less likely to become a tyrant when connected to my own sadness, and that’s a good thing. I always thought that striving for mental health or spiritual liberation would one day mean I would banish sadness, anger, and fear from my life. Instead I have found those emotions, if handled with care, are doorways into my Heart, into bodhicitta, into Christ, into Love, into whatever you may prefer to call it. This, it turns out, is more important to me than any idealistic concepts I ever had about Health or how the world should be.

Living with uncertainty is difficult, but love makes it bearable.