The Role of Yoga in Embodied Recovery

Let me start off by explaining what I mean by the term, “embodied recovery.”

I view recovery as an ongoing process of healing that may include moderation, any reduction in risk and harm, and/or abstinence. When I use the word embodied, I mean the capacity to be connected to one’s somatic experiences in the present moment in a way that is compassionate and without judgment.

My role is to facilitate a process with clients so they can acknowledge and access important information that is stored in the body, and build on that awareness to cultivate a path towards recovery. My approach initially involves helping people gain awareness into patterns that result in substance misuse and other problematic behaviors. Once we have a sense of these patterns, we begin an exploration of goals and the ideal relationship they wish to have with alcohol or other substances. Then, we collaborate on the techniques and strategies we will use to reach those goals.

It’s as if they are living at a distance from their own bodies; they might be aware of their stream of thoughts, actions or moods, but perhaps don’t connect them with sensations in the body.-Jenifer Talley

Substance misuse and other problematic behaviors frequently stem from a desire to self-medicate to cope with overwhelming emotions, trauma, relational conflict, and other difficult life circumstances such as being a member of a stigmatized or marginalized group. So it follows that one of our roles as clinicians is to assist in the development of enhanced self-regulation skills. (Khantzian, 1985; Tatarsky, 2007) And, as I’ve witnessed in my own clinical practice, many people are unaware of the connection between their somatic experiences, emotions, thought processes, and behaviors. It’s as if they are living at a distance from their own bodies; they might be aware of their stream of thoughts, actions or moods, but perhaps don’t connect them with sensations in the body. Or, sensations in the body are misperceived, mislabeled and responded to as if they are a problem – something to be eradicated.

This type of attitude may lead one to pursue substances or other behaviors as a way to manage the disconnection and sense of fear or anger towards bodily sensations. If we label a sensation as “bad” or “unwanted,” we may inadvertently prolong it or exacerbate its expression. By slowing down and witnessing our physical experiences, we can listen for what is truly needed in the moment rather than acting based on aversion, fear, doubt, or judgment. Once we slow down and observe this process, space opens up so that a decision can be made about how to proceed.

My clients often state that the experience of noticing a craving or urge to use is unpleasant. I encourage them to pay attention to the sensory experience that accompanies a craving (e.g., tightening in chest, heart racing, tingling in stomach, restlessness in arms) and invite them to be curious about how the craving is presenting itself. We then note the narrative he or she may have about the craving (e.g., “this is bad,” “not now,” “when is this going to go away?”), and how that impacts the sensations in the body.

As we slow down and pause with the craving, we can explore what might be underneath it. Can these sensations provide us with important information? I may ask, “What do you feel you truly need in this moment?” A response might be, “I’m really tired. I just want to rest, but my mind won’t stop worrying.”

The Body’s Role in Psychotherapy

It’s imperative that we reevaluate the role of the body in psychotherapy practice. We have to “invite the body to join the mind” as my close friend, Jill Satterfield says in her meditation trainings. This is the approach I use in individual therapy and in the weekly mindfulness-based skills group I run. I incorporate elements of mindfulness-based relapse prevention and utilize aspects of yoga to help clients increase their capacity to be present with their moment-to-moment experiences in a way that is kind, curious, and compassionate so they may reduce their reliance on risky and problematic behaviors.

I incorporate elements of mindfulness-based relapse prevention and utilize aspects of yoga to help clients increase their capacity to be present with their moment-to-moment experiences… so they may reduce their reliance on risky and problematic behaviors.-Jenifer Talley

I view yoga as a way to practice mindfulness in action or mindful movement. Several studies have been conducted that demonstrate yoga’s positive effects on physical and mental health. Specifically, yoga has been associated with improved stress management and immune system functioning; reductions in symptoms of anxiety, depression and pain; and restoration of deep sleep. There are few studies examining the efficacy of yoga as a treatment for substance use disorders and more research is needed so that we have a better understanding of how yoga can be applied to this population.

We begin very gradually, by first focusing on sensations of breath in the body – “observing the breath from the inside out” as Tara Brach recommends. We then begin practicing with the body scan, which allows for a focused investigation of sensations in the body. It’s amazing to witness the shift in my clients’ perceptions of their emotions, the meaning and function of cravings, and how they begin to focus on self-care, possibly for the first time. And, as appropriate, I will introduce very gentle yoga practices such as legs up on the wall and mountain pose. With mountain pose, I may start the session with a body scan practice and then invite the group members to stand in a circle and apply the body scan practice to a standing position, noticing sensations in their bodies as they make gradual adjustments in posture. We then discuss how mountain pose can be practiced anywhere and at anytime.

Another common theme among my clients is an inability to relax without the aid of substance. I address this by showing clients that they can learn to promote the relaxation response in the body and re-engage the parasympathetic nervous system, which leads to reduced arousal in the sympathetic nervous system, our “flight/fight system.” (Khanna & Greeson, 2013) I tend to incorporate the leg up on the wall pose, which I modify depending on my clients’ needs. One variation includes simply propping one’s legs up on a chair or couch and softening and releasing the body on the floor. Clients have remarked how calming it is to “feel supported” by the floor. Some are surprised that they have the capacity to settle themselves and feel calm on their own, with something as simple as reclining on the floor and following one’s breath.

We feel the shift in energy in the room during our group sessions and reflect on what feels different and how we accomplished it. Group members may initially walk in feeling agitated, irritated, rushed, and tense. We observe that in their postures, facial expressions, and breath patterns. Then, once we have done a practice together, there is a palpable shift in terms of clients reporting feeling more at ease, open, and grounded in the present moment. I’ve heard clients remark that they feel supported by their bodies and connected to (and more aware of) the physical space we are in.

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