As seen on a Sussex Directories Inc siteby Stacey Hellman, LCSW-C

Though I’m not a certified yoga instructor, I’ve had some formal training with using yoga in therapy as well as many years of personal practice and experience. More and more, I’m finding it useful to integrate yoga into therapy sessions with clients. If you’ve never done yoga, you might have some ideas about what it is and who can do it. For example, some people think that yoga is “just stretching,” or maybe you’ve seen the popular “power yoga” workout programs. The fact is that there are many types of yoga, and some are quite different from others. You may think that only flexible people can do yoga, or those who are very physically fit. In reality, if you can move and breathe, you can do yoga. The way to get more flexible and fit is to just start where you are and do what you can. Yoga is an ancient practice that combines physical movement, deep breathing, and mental focus. Its effects are cumulative over time, so the more you do it, the more you will see and feel the benefits.

When it comes to using yoga in a therapeutic session, getting a great workout isn’t the focus, though the physical advantages are countless.  The mental and emotional benefits can be just as noticeable as the physical ones, and many people practice yoga regularly for “stress management” more than anything else. Recently I was talking with a client (I’ll call her Hilary) about how she felt her therapy was going. We had been doing yoga at almost every session, at least for part of the session, and I wanted to confirm she felt she was getting what she needed from therapy. Her answer was very interesting and surprising to me. She said that she has noticed that her self-esteem had improved due to yoga because she is learning that it’s okay to take up space and have opinions (I always give clients options about what poses they want to do that day). As a child, Hilary grew up in a chaotic, verbally abusive household where she learned that keeping to herself, staying quiet, and not expressing herself decreased the likelihood of being yelled at for hours on end. It is no surprise that Hilary developed chronic anxiety just by living in her house. She wished she could disappear and live somewhere else. Her body unconsciously learned to adapt a hunched posture, literally making her appear smaller. Hunched shoulders often develop when a person has been through ongoing trauma, since this posture is protective of the vital organs (think of a boxer’s protective stance). Unfortunately, it’s difficult to breathe deeply and fully in this body position and thus causes decreased oxygen intake to the brain and organs. Adequate oxygen is necessary for maximum functioning of the human body, and a lack thereof can cause, among other problems, heightened anxiety.

In order to reverse this physical pattern, two things must happen. First, it’s necessary to teach the body repetitive movements that open up the chest and shoulders, expanding the rib cage and making more space for increased oxygen intake. Second, the body’s breathing mechanism must be reprogrammed, and breathing slowly and deeply during every pose is what makes yoga different from “just stretching.” Many yoga poses involve outstretched arms, and being in positions that expand the body. Hilary’s physical experience in our sessions was the very opposite of how she was used to being in her body during her childhood and it was freeing for her to know that she didn’t have to hide anymore. There are several yoga poses that she particularly enjoys, and we come back to those again and again.

YogaWhen we breathe slowly and deeply, into the abdomen as well as the chest, it automatically slows down the heart rate, lowers blood pressure, and calms the mind. Bringing our conscious attention to breathing during yoga helps keep us grounded in the present moment as well as our bodies. Many trauma survivors have difficulty feeling grounded and often find themselves feeling that they are “floating,” or not completely attached to their bodies. Hilary shared that what really helps her is when I direct her attention to her feet on the floor during yoga poses, and remind her to breathe deeply and often. One of my favorite things about yoga is that it is really applicable in daily life, not just on the mat. For example, the quickest way I know to get grounded is to ask yourself “Where are my feet?”, and “Am I still breathing?” When you direct your attention to your feet and to your breathing, your mind immediately focuses on the physical sensations of your body and your present experience, thus interrupting whatever thoughts or emotions you may have been having.

Another way that yoga can change you on a deeper level is by setting an intention for yourself at the beginning of the practice. For example, if you want to work on having more compassion for yourself (or for others), you can take a moment to close your eyes, and affirm this intention in your mind. If you like, you can silently repeat a mantra such as “I accept myself just as I am,” or whatever feels right for you. You can also come up with a visual image that represents compassion, and try to create the feeling tone of compassion within you as you breathe deeply. Then, throughout your practice, you can revisit your intention many times, bringing conscious awareness to it. When we focus our minds on something and really put emotional energy into it, it actually changes our brain chemistry and a new emotional pattern is created in the brain. Of course, this new pattern needs reinforcing, just like with learning anything else initially, but eventually it becomes second nature. Yoga, in many ways, is about letting go of judgments we hold about ourselves, not comparing ourselves to others, and just being in the moment to notice what it feels like to be alive.

Some yoga postures are designed to feel somewhat uncomfortable (not painful though!), and the idea is to learn to notice the physical sensations and breathe through them rather than resist them. When we fight feeling uncomfortable, we actually make it worse by creating a second layer of uncomfortable feelings. So by learning to soften and make space for all of our feelings, we end up feeling less stressed and better able to handle life. When you hold a challenging yoga pose for 3 slow, deep breaths, it can feel like a long time, but then it’s over and you learn that the sensations are temporary and you can get through it! Again, this is a way that yoga can translate into day to day life. You start making changes on your mat, and then you take those changes out into your life.

In writing this blog, I hope that you are inspired to try yoga and to think about yoga in a different way than perhaps you previously did. I welcome all feedback and any questions you may have, so please feel free to contact me. If you are interested in setting up an individual session for therapeutic yoga, I am currently taking new clients. Please visit my website for more information: You may also email me at or call me at 410-206-8573.

I also want to bring your attention to the work of my dear friend and brilliant Yoga instructor, Amy Weintraub. Below are some resources featuring her work. I know you will find them incredibly useful in your practice.

Yoga Skills for Therapists: Effective Practices for Mood Management, by Amy Weintraub

LifeForce Yoga Centering Meditation for Self-Acceptance: Simple use of yogic breath, movement, and sound

LifeForce Yoga to Beat the Blues

2 thoughts on "Incorporating Yoga into Therapy"

  1. Nadine Arafa says:

    I hope this email finds you well. I am a registered psychotherapist with the Order of Psychologists of Quebec and a Yoga Alliance certified teacher (I completed the 200-hour training). I’m originally from Egypt but I completed my MA in Counselling Psychology at McGill University in Montreal between 2012 and 2014.
    Recently I moved back to Egypt and I have been working with clients in a private practice. My vision is to find a way to integrate yoga into my sessions, as so many points I feel that clients could benefit from the tuning into their bodies particularly those who report experiencing anxiety or self-esteem issues. However, I am quite uncertain as to how to make the shift from talk therapy to yoga therapy.
    If you have any thoughts on how I could start doing this, I would be incredibly happy and grateful for the guidance.

    All the best,
    Nadine Arafa

    1. lisaferentz says:

      One of the best resources I can pass on to you is Amy Weintraub’s book, “Yoga Skills for Therapists.” She does a terrific job of combining yoga breath work and poses into the more traditional therapy process. She created LifeForce Yoga, so you can also Google that and get her excellent videos as well. Also, Hopper and Emerson wrote “Overcoming Trauma Through Yoga: Reclaiming Your Body,” another good book that combines yoga and therapy. Wishing you all the best on your important work!

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