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And what about spirituality and yoga? We know that it brings about better health, but does yoga relate to spirituality? How relevant is it? Does the research confirm the correlation between the effects of yoga and the pancha kosha model—the multilevel of existence, which incorporates the spiritual level as well?

Despite a wide body of research, we still do not know the mechanism by which yoga produces these effects in the body and in our psyche. Yoga therapy is a young discipline in the West, and the research so far is applying scientific methods that exclusively focus on the discrete effects of particular practices and biochemical changes. As Michael Lee suggests, “exclusive focus on discrete effects ignores the reality of the yoga of Patanjali… This limited view gives rise to the second, and perhaps more significant, impact. The focus on the evaluation of yoga using a cause-and-effect model tends to discount the potential of yoga to address the complex issues underlying the condition being studied.”26 Yet “the reason why yoga therapies are so effective, both in preventive medicine and in assisting conventional treatment, is because Yoga addresses all 3 aspects of wellness—physical, mental and spiritual,” writes Dr D. Sarkar,27 vascular surgeon and certified yoga therapist.

Swami Kuvalayananda writes in Yogic Therapy, “Yoga regards no disease as a local affection [sic] but as a critical change in the body system as a whole.”28 He writes further, “no disease, according to Yoga, can be completely cured by the practice of one single posture (asana) or even mudra, nor, for that matter with the performance of these yogic exercises (asanas) alone. All these are part of a composite treatment.” The reality of Patanjali’s Yoga (as outlined in the Sutras) is “clearly defined as a transformational process,” claims Michael Lee, in his recent article.29

This last statement resonates to my core. I always struggled with expressions such as “Yoga for cancer,” “Yoga for back pain,” or “Yoga for hormonal balance.” In my understanding, yoga does not heal specific diseases. Yoga restores balance to the human multilevel existence. It heals by transforming the human being and thus may heal the human being, although it may not cure them from the disease. So often I would receive a plea from a distraught family member—“My mother has cancer and doctors say they cannot help any more. Can your retreat heal my mother’s cancer?” It pains me to disappoint them and explain at length that we do not treat the disease; we treat human beings suffering from a disease.

On the other hand, although there is an intrinsic value to have a small group of clients afflicted with the same disease such as cancer, diabetes, or cardiac problems, the group then becomes cohesive and creates a strong support and resource for each other. It also helps the therapist create more specific, targeted yoga therapy for such a group, with individual adaptations.

However, we need to keep in mind that yoga therapy is not a prescriptive science. No specific prescription can be made for yoga for cancer or yoga for diabetes or yoga for X for that matter, although this kind of thinking is very common as we have been brought up in a culture of “a pill for every ill.” Such an attitude defies the essence of yoga therapy. When we consider applying yoga therapy, we need to change the paradigm completely in two respects. First, we have to stop focusing on a medical diagnosis of disease with just its symptoms. We need to consider and assess a deeper cause of the imbalance of human existence that resulted in the manifestation of disease in the body. We describe this process in detail in Chapter 4.

Second, following our assessment, we need to consider the whole human being and focus on health—what can bring balance back to this particular client? It may be yogic tools dealing with attitudes and ethics (yamas and niyamas). It may be higher practices like yoga nidra, chanting, or meditation. It may be breathing management and techniques, kriyas, or asanas. It may be diet and the way food is consumed. It may also be an irregular circadian rhythm. Or it may be all of the above. The determination of the most appropriate path will entirely depend on the client, their goals, and the level of ownership of responsibility for their own health, and how much they are prepared to implement. I often get asked about what yoga (usually meaning asanas) I use for cancer. Invariably I will answer—none! I use yoga therapy tools to assist human beings to heal the disease conditions by bringing balance to their life.

The great T.K.V. Desikachar30 taught that the spirit of yoga starts from where you find yourself. As everyone is different and changes from time to time, there can be no common starting point, and ready-made answers are useless. Yoga (therapy) should be offered according to aspirations, requirements, and the culture of the individual, and in stages, progressively.

Ancient yogis knew experientially how to deal with all levels of human existence and passed on this science verbally through generations, until, in 300 CE, Patanjali noted it all down in what is considered today the bible of yoga—Patanjali’s Yoga Sutras Darshana. Throughout millennia this and other ancient yogic texts became a roadmap for adepts in yoga to follow on the path to enlightenment.