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My Journey: Using Yoga Therapy in Addiction Treatment

Yoga Therapy can and should be used to help treat addiction and the suffering that comes with this devastating disease. Blending both the Western and the Eastern knowledge of addiction and how to address it, I believe is the key strategy in healing the suffering individual. The world’s knowledge and education NEEDS to come together cohesively to help find long term relief for a lifelong recovery. In this paper I have put together articles and research studies, as well as my own personal journey and the words of fellow recovering addicts, to help explain the nature of addiction and how Yoga Therapy can be used to help reach long term recovery.


The American Psychiatric Association defines addiction as, “a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or drug(s) even when they know it will cause problems.”


In my personal experience with addiction, I had several severe consequences resulting from my using, yet I was still unable to stay clean. My love for being a caretaker to my young daughter and husband was viciously stolen and taken over by the insidious cycle of addiction: needing to find drugs, figure out how to pay for them, use them and repeat the cycle over and over again, it was never enough; constantly using substances to control how I felt quickly became my only reason for living.


This heart wrenching poem explains drug addiction in its madness (A gentle heads up; this poem speaks truth and so therefore, can be triggering for some in early recovery, please honor and take care of your needs.)

Welcome to Hell by Nelly Barnes

'Welcome to Hell," the sign should've read, Reaching your destination-all in your head! "Last call for the train heading to Nowhere Fast," The memories you create will forever last. You want to buy a ticket? What's the cost, you ask? Just hop on board, we'll talk once you're trashed. Close your eyes and picture something grand. No peeking! Now trust me, and give me your hand! To a beach with water and the sun shining down. Open up! No beach here, you're hell-bound. Of course there's water! But it's for your rig and spoon. Lil' girl, don't be afraid; 14 years old isn't that soon. The men don't bite, but you'll be messed up beyond belief. When you do pass out, not remembering - a relief. Ashamed to face Mommy! Got to have that coke! Shooting dope every day; a girl with dreams lost all hope. I laugh at you as you toss your life in the wind. Too far gone...it's us 'til the end. I'll be there when you lose your pride. When you forget your morals, I'm at your side. You'll cheat and steal to have that fix. Won't take baby to the doctor although she's sick. Getting a pill - definitely #1 on the list. Oops. Another appointment baby missed. Nanny buys diapers because Mommy stays high. Daddy hits Mommy and the children cry. After years of this bliss the kids got took, Mommy is a junkie and fast becoming a crook. You'll land in jail, a drug addict you remain. Your heart turns cold as you play the game. Do not pass go - strip your dignity right here. This old man wants you, dry your tears, Quote a price! Self-respect long forgotten, You'd sell your soul to the devil for an Oxycontin. I told you girl the destination is in your head! "Welcome To Hell!" Next stop... Well, she's dead. I told you that I'd stick it out 'til the end. For me, you traded your dreams and kids, Your Addiction, Life, and your faithful Friend.

How does this happen? Perhaps the brain can give us more insight.

How do drugs affect the brain?

An article written by Dr. Glen Hanson titled “Drug Use Changes the Brain Over Time” states:

“Virtually all of the addictive drugs (yes, this includes pharmaceuticals) activate the dopamine system, which is a critical neurotransmitter in the brain that activates the pleasure and reward systems. Within seconds to minutes of entering the body, drugs cause dramatic changes to synapses in the brain. By activating the brain's reward circuitry, drugs deliver a jolt of intense pleasure. If we were to wipe out the dopamine pathway out of your brain you never would feel good, life would be miserable, and you would probably commit suicide. The pleasure and reward pathway is critical to enjoy life and it turns out every drug of abuse turns that pathway on. Drugs of abuse affect the brain much more dramatically than natural rewards, such as food and social interactions. To bring stimulation down to a more manageable level, the brain must try to adapt. One way the brain compensates is to reduce the number of dopamine receptors at the synapse. In addition, sending neurons increase their number of dopamine transporters, more quickly clearing dopamine from the synapse. These changes make the brain less responsive to the drug, but they also decrease the brain’s response to natural rewards. Because of these changes, after the user has "come down," they will need more of the drug next time they want to get high. This response is commonly referred to as "tolerance.”


As the brain continues to adapt to the presence of the drug, regions outside of the reward pathway are also affected. Over time, brain regions responsible for judgment, decision-making, learning, and memory begin to physically change, making certain behaviors “hard-wired.” In some brain regions, connections between neurons are pruned back. In others, neurons form more connections.


Once these changes take place, drug-seeking behavior becomes driven by habit, almost reflex. The drug user becomes a drug addict.”

In my story, this is the reason I abandoned everyone I loved and ran after drugs, I wasn’t able to feel that same connection of safety, love and fulfilment I once had with my child and husband. I very quickly became numb to the everyday joys of life and was shifted into a constant survival mode, that being: scoring and using drugs to stay alive.


“Stopping drug use doesn’t immediately return the brain to normal. Some drugs have toxic effects that can kill neurons and most of these cells will not be replaced. And while changes to connections between neurons in the brain may not be permanent, some last for months. Some research suggests the changes may even last for years. This is known as P.A.W.S. Post- acute withdrawal syndrome.” According to American Addiction Centers, “Effects of this syndrome may then continue for anywhere from 2-3 months to several years.”


Long-lasting brain changes can make it challenging for addicts to stay drug-free. They often experience intense cravings, sometimes leading to relapse.”



Enter in Yoga Therapy.

Yoga Therapy is a type of therapy that uses yoga postures, breathing exercises, mudras, chakra work, meditation and guided imagery, along with many other tools, to improve mental, physical and spiritual health. The holistic focus of yoga therapy encourages the integration of the mind, body and spirit.

Yoga therapy should be used in conjunction with talk therapy, support groups, and in stages of detox and early recovery, medical supervision is highly recommended.

Benzodiazepines and alcohol can have lethal effects if inappropriately/uneducatedly detoxed; this also being true for any drug being removed from the body after a long duration of abuse, it is an incredibly taxing feat for our body to endure. Individuals needing detox are HIGHLY encouraged to seek medical advice and intervention, it could be a matter of life and death.


Healing Addiction Through Yoga Therapy:

In Yoga, addiction is a result of a root/base chakra (the Mūlādhāra) imbalance.

Common characteristics of a blocked root chakra are:

  • Lack of focus

  • Co-dependency

  • Restlessness

  • Feeling abandoned

  • Excessive negativity, cynicism

  • Eating disorders

  • Greed, avarice

  • Illusion

  • Excessive feeling of insecurity, living on survival mode constantly

  • Addictive Behavior and Substance Abuse

  • Avoidance of intimacy

  • A lack of self-worth

  • Depression

  • Anxiety

  • Fearfulness

  • Guilt

  • Resentment


In addition to the vagabond-like mentality, a blocked root chakra creates the issue of the physical and emotional toll the blockage takes on. Common physical signs of blockage involve the lower parts of the body, especially legs and genital area. The root chakra primarily governs the reproductive organs and lower extremities, including the lower spine, legs, and feet. The chakra blockage will often replicate itself manifesting as constipation, kidney stones, circulatory issues, and leg weakness.


Additional physical signs can include:

  • Sciatica

  • Hypertension

  • Impotence

  • Colitis

  • Eating disorders

  • Prostate issues in men


Key characteristics of the root chakra are noted below.

The first chakra is associated with the following functions or behavioral characteristics:

· Security, safety

  • Survival

  • Basic needs (food, sleep, shelter, self-preservation, etc.)

  • Physicality, physical identity and aspects of self

  • Grounding

  • Support and foundation for living our lives

  • Value yourself

  • Accept yourself as a whole

  • Allow yourself to be vulnerable

“The root chakra provides the foundation on which we build our life. It supports us in growing and feeling safe into exploring all the aspects of life. It is related to our feeling of safety and security, whether it’s physical or regarding our bodily needs or metaphorical regarding housing and financial safety. To sum it up, the first chakra questions are around the idea of survival and safety.”


There are many ways to open your root chakra. For example, you can engage more in grounding and earth-related activities (connection with nature, gardening, cooking healthy, and hiking are only a few examples). The main idea is to work at growing your “roots” in a safe and comfortable environment (i.e., surround yourself with earth colors, objects reminding you of nature, stability; or on the contrary, if you wish to feel less stuck, do the opposite).


Yoga poses for the root chakra:

Take the yoga outdoors, into nature.

(Questions to ask yourself or the group during practice: What keeps me grounded? What makes me feel secure? What nourishes me? What am I afraid of people knowing about me? If I felt secure and grounded with myself, what would I do? If I knew I would not fail, what would I do?)

  • Come to Easy Pose. Invite class to set intention and mantra. Repeating intention silently three times. Continue repeating mantra with breath. 10 deep belly breaths while seeing the red root chakra growing roots into the earth. Breathing into this and the base of the belly.

  • Inhale to Cow pose (Bitilasana) and exhale to Cat pose (Marjaryasana), flow here for 5-10 breaths

  • Allow for 10 breaths in each pose going forward. Connecting to your mantra and breath.

  • Standing Forward Bend (Uttanasana) — By stretching the legs and hips, standing forward bend strengthens the knees and thighs which allows for stable grounding and opening of the root chakra.

  • Garland (Malasana) — Frequently used to lead into standing forward bend, garland pose strengthens the ankles and lower back to help activate the first chakra.

  • Head-to-knee Forward Bend (Janu Sirsasana) — Benefiting the spine, hamstrings, and groin muscles, this pose stimulates kidney and liver function and increases energy flow through the first chakra.

  • Reclining Bound Angle (Supta Baddha Konasana) — As you stretch your inner thighs, knees, and groin muscle, reclining bound angle pose also stimulates organ function in the bladder, kidneys and reproductive organs which helps balance chakra energy.

  • Wide-Legged Forward Bend (Prasarita Padottanasana) — An asana similar to the standing forward bend, this position helps stretch and strengthen the legs and spine, which helps open and activate the root chakra.

  • Warrior II (Virabhadrasana II) — This pose helps strengthen and stretch the legs and ankles while nurturing a strong core. Mastering this pose will increase your stamina which is key to maintaining a balanced first chakra.

  • Savasana – essential oils to use for grounding (defuse or use on a wash cloth and place over face in Savasana)

Essential Oils for Muladhara

· Frankincense

· Patchouli

· Myrr

· Cedarwood


A Guided meditation for your root chakra:

Sit in a comfortable cross-legged position with your spine straight, or lie down in Savasana, Corpse Pose.

Take a few deep breaths through the nose to ground yourself and to start calming the mind.

Feel your sit bones on the ground and the connection with it, know you are supported.

Imagine roots growing from your root chakra into the Earth. Imagine the roots digging deep towards the center of the Earth. Take your time, stay connected to your breath and keep the spine lengthened.

Keep breathing steadily and enjoy that feeling of groundedness. You can also visualize the roots of the tree below expanding in the Earth.


Even better if you can do this meditation in nature, as you will receive even more earth energy. Stay here for as long as you need.

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People who suffer from addictive behaviors have almost always learned how to completely cut off from their feelings, thoughts, emotions and body sensations, being completely numb becomes the natural state; numbing the horrific actions, the bad choices but also the joy and love of life. Teaching someone how to become aware of the sensations and feelings going on inside the body and mind is a powerful tool. This helps in becoming aware of the thought pattern(s), trauma(s), the grief, resentments, physical pain and so much more; we cannot heal what we do not know about. Suppressing emotions, sensations, trauma and old “stories” keeps the person in a perpetual state of dis-ease.


Let’s touch on trauma.

What is trauma?

The definition of trauma: “an experience that produces psychological injury or pain; the psychological injury so caused an emotional wound or shock that creates substantial, lasting damage to the psychological development of person.” Psychological trauma often occurs in those who have experienced significant damage to their psyche. This may take place because a patient has lived through a particularly stressful event or situation. This kind of trauma can occur any time a person is faced with stress that exceeds their ability to cope with the respective stress, and because of this, trauma and its consequences are highly subjective. “Substance abuse/drug addiction is often seen in patients who have experienced psychological trauma. Nearly 25 percent of children and adolescents have experienced some sort of trauma; furthermore, experiencing trauma early in life increases a person’s susceptibility for drug addiction. A person is also more susceptible to drug addiction if they experience any trauma whatsoever, whether early in life or later. Psychological trauma and drug addiction can occur in any person, regardless of their age, gender, religion, class, or any other factor. Research shows trauma and addiction are highly linked to each other. Trauma = War Zone. People who are addicted to drugs and alcohol and the life style are living in a constant war zone. “Giving a boost to the use of yoga for addicts in treatment and recovery has been the work of Bessel A. van der Kolk, MD, a professor of psychiatry at Boston University Medical School and medical director of the Trauma Center at Justice Resource Institute in Brookline, MA; and author of Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society and The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. His research demonstrates that trauma and sensory experience are linked by the residue of trauma residing in the body. His work points both to the limitations of language in the counseling of individuals who have experienced trauma and its lingering somatic consequences and to the value of employing nonlinguistic methods.”


When working with people who have substance use disorder, it is smart to assume and treat everyone as if they have trauma.

A few things I recommend are:

· Use empowering statements; reminding clients they are in complete control of their bodies and their practice. Use statements like: “I invite you”, “ Let’s explore”, “Follow your breath”, “You are completely free to follow your natural flow of energy into and out of each pose”, “Be curious”, “No judgement”, “Allow”. These gentle words promote mindfulness and shows there is no right or wrong in yoga, just experimentation and curiosity.

· Using a slow, soothing voice helps individuals feel safe in the external world, and this helps to ease into their internal world more calmly and mindfully.

· Empowering your students with different choices, variations, modifications and props for their bodies. (Remember, a yoga studio with straps and hip opening poses can be triggering for sexual trauma survivors, knowing this, look for the subtle clues to assist someone if they appear stuck or frozen.)

· Talk to the class as a whole, not to single anyone out, this helps everyone, even yourself feel peace and harmony in the group.

· Allow yourself to let go and laugh. Adding a fun pose such as lion, coupled with loud vocal exhales, makes for a great release for all. Enjoy your class, and others will feel that same enjoyment in their own practice; “Like attracts Like”.


Mindfulness:

Yoga teaches us the tool “Mindfulness”. Webster’s dictionary defines mindfulness as “a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.”


An article published by Scientific American states: “Mindfulness has been accepted as useful therapy for anxiety, depression, chronic pain, addiction and tinnitus as well as help relieve symptoms of certain physical conditions, such as irritable bowel syndrome, cancer and HIV. MRI scans show that after an eight-week course of mindfulness practice, the brain’s “fight or flight” center, the amygdala, appears to shrink. This primal region of the brain is associated with fear and emotion and is involved in the initiation of the body’s response to stress.

As the amygdala shrinks, the pre-frontal cortex; associated with higher order brain functions such as awareness, concentration and decision-making; becomes thicker. The “functional connectivity” between these regions – i.e. how often they are activated together – also changes. The connection between the amygdala and the rest of the brain gets weaker, while the connections between areas associated with attention and concentration get stronger. Researchers have found a reduction in biomarkers of stress and inflammation. Markers like C-reactive proteins, interleukin 6 and cortisol – all of which are associated with disease.”


Most mindfulness meditations focus on being aware of the present moment and simply noticing feelings and thoughts as they come and go, without judgement. Taking someone through a body scan guided meditation is one example of mindfulness practice.


I am a part of a healing team at a holistic drug and alcohol rehabilitation facility. I have found the practice of mindfulness incredibly grounding for our clients in early recovery, and I, myself use this practice in my personal recovery journey daily. I teach mindfulness to our medical detox clients who are consumed with anxiety and have become very sick (spiritually, mentally and physically). I teach mindfulness in group yoga classes, one on one yoga sessions, and I also use this as the opening of an emotionally intense process group to help bring the clients awareness to the present moment to reduce anxiety, stress and fear, thus cultivating Sattvic Energy (which is a Sanskrit word meaning "light," "goodness" and/or "purity"). Mindfulness helps clients become grounded and more open and willing to learning and diving deep.


Before going into the practice, I invite everyone to set a mantra; one word (to continually repeat in their mind) for the inhale and one word (to repeat) for the exhale. An example of this is to inhale “Serenity” and exhale “Peace” or “Sat” “Nam” (which is Sanskrit for “true name” “true identity” “God’s Name is Truth”).


According to the Yoga Journal article, “Introduction to teaching Japa, Yoga Mantras”, meaningful mantras have two functions: to instill within the reciter a particular spiritual doctrine and to serve as a vehicle for meditation. The purpose of these mantras is not to impart a particular doctrine but to affect a certain state of consciousness in the reciter. Mantra is said to quiet the habitual fluctuations of our consciousness, and then steer consciousness toward its source in the “True Self” also referred to as the Soul.


I have attached the following guided mediation for your practice.

A BODY SCAN SCRIPT

Begin by making yourself comfortable. Sit in a chair and allow your back to be straight, but not stiff, with your feet on the ground. You could also do this practice standing or if you prefer, you can lie down and have your head supported. Your hands could be resting gently in your lap or at your side. Allow your eyes to close, or to remain open with a soft gaze.

Take several long, slow, deep breaths. Breathing in fully and exhaling slowly. Breathe in through your nose and out through your nose or mouth. Feel your stomach expand on an inhale and relax and let go as you exhale.

Begin to let go of noises around you. Begin to shift your attention from outside to inside yourself. If you are distracted by sounds in the room, simply notice this and bring your focus back to your breathing.

Now slowly bring your attention down to your feet. Begin observing sensations in your feet. You might want to wiggle your toes a little, feeling your toes against your socks or shoes. Just notice, without judgment. You might imagine sending your breath down to your feet, as if the breath is traveling through the nose to the lungs and through the abdomen all the way down to your feet. And then back up again out through your nose and lungs. Perhaps you don't feel anything at all. That is fine, too. Just allow yourself to feel the sensation of not feeling anything.

When you are ready, allow your feet to dissolve in your mind’s eye and move your attention up to your ankles, calves, knees and thighs. Observe the sensations you are experiencing throughout your legs. Breathe into and breathe out of the legs. If your mind begins to wander during this exercise, gently notice this without judgment and bring your mind back to noticing the sensations in your legs. If you notice any discomfort, pain or stiffness, don't judge this. Just simply notice it. Observe how all sensations rise and fall, shift and change moment to moment. Notice how no sensation is permanent. Just observe and allow the sensations to be in the moment, just as they are. Breathe into and out from the legs.

On the next out breath, allow the legs to dissolve in your mind. And move to the sensations in your lower back and pelvis. Softening and releasing as you breathe in and out. Slowly move your attention up to your mid back and upper back. Become curious about the sensations here. You may become aware of sensations in the muscle, temperature or points of contact with furniture or the bed. With each outbreath, you may let go of tension you are carrying. And then very gently shift your focus to your stomach and all the internal organs here. Perhaps you notice the feeling of clothing, the process of digestion or the belly rising or falling with each breath. If you notice opinions arising about these areas, gently let these go and return to noticing sensations.

As you continue to breathe, bring your awareness to the chest and heart region and just notice your heartbeat. Observe how the chest rises during the inhale and how the chest falls during the exhale. Let go of any judgments that may arise. On the next outbreath, shift the focus to your hands and fingertips. See if you can channel your breathing into and out of this area as if you are breathing into and out from your hands. If your mind wanders, gently bring it back to the sensations in your hands.

And then, on the next outbreath, shift the focus and bring your awareness up into your arms. Observe the sensations or lack of sensations that may be occurring there. You might notice some difference between the left arm and the right arm – no need to judge this. As you exhale, you may experience the arm soften and release tensions. Continue to breathe and shift focus to the neck, shoulder and throat region. This is an area where we often have tension. Be with the sensations here. It could be tightness, rigidity or holding. You may notice the shoulders moving along with the breath. Let go of any thoughts or stories you are telling about this area. As you breathe, you may feel tension rolling off your shoulders.

On the next outbreath, shift your focus and direct your attention to the scalp, head and face. Observe all of the sensations occurring there. Notice the movement of the air as you breathe into or out of the nostrils or mouth. As you exhale, you might notice the softening of any tension you may be holding.

And now, let your attention to expand out to include the entire body as a whole. Bring into your awareness the top of your head down to the bottom of your toes. Feel the gentle rhythm of the breath as it moves through the body.

As you come to the end of this practice, take a full, deep breath, taking in all the energy of this practice. Exhale fully. And when you are ready, open your eyes and return your attention to the present moment. As you become fully alert and awake, consider setting the intention that this practice of building awareness will benefit you and everyone you come in contact with today.

Diaphragmatic Breathing:

In addition to the body scan guided meditation practice, teaching diaphragmatic breathing (aka belly breathing and abdominal breathing) has proven to decrease stress responses in the brain thus aiding in inducing a state of well-being and peace.


Healthline’s article “What is Diaphragmatic breathing?” states the many benefits of breathing from the belly:

· It helps you relax, lowering the harmful effects of the stress hormone cortisol on your body.