faculty for holistic psychology · and more challenging.” - andy curtis-payne a feasibility study...

Welcome to the latest edition of the Division of Clinical Psychology’s Faculty for Holistic Psychology newsletter, looking back at our 2019.

Faculty events

Our first event of 2019 was our annual conference on 3 and 4 May at Friends Meeting House in Brighton, which

had a psychology and the body theme. On the first day, Dr Suzanne Heywood-Everett presented Heartmath:

Reducing stress and anxiety, developing self-regulation skills to build mental and emotional resilience. Suzanne’s

presentation introduced us to this model of embodied emotion, and we had the opportunity to try the mapping

technology on ourselves. The day was completely with an experiential session on Biodanza with Alice Plummer of

Mindful world.

On 4 May we welcomed Ben Brown, N.D. Naturopath and Nutritionalist, to present The Biome. This was an

informative and entertaining review of the scientific evidence surrounding this much-discussed aspect of ‘the

brain in the gut’. Finally, Charlotte Watts, nutritional therapist and yoga teacher, led a session on yoga, the gut and

mental health, which combined an informative presentation with experiential practice.

Then, on 11 October last year, we welcomed delegates for a Holistic Faculty workshop on yoga and psychology. Our

committee members Nina Dhiman and Suzanne Heywood-Everett report on having organised a successful day.

Faculty for Holistic PsychologyNewsletter – Mar 2020

Introduction and objectivesYoga is a holistic system for developing awareness of physical, psychological, spiritual and emotional wellbeing, and is increasingly recognised and practised in modern secular society.

Its value alongside therapeutic approaches is being explored more closely, with a growing evidence base. The ancient practice of yoga was described in a number of texts, notably Patanjali’s Yoga Sutras.

The workshop was to enable delegates to learn and experience a better understanding of how these ancient philosophies can inform current psychological theory and practice.

Inherent in the yoga tradition is the focus on psychological wellbeing and Patanjali’s Sutras give equal emphasis to a range of facets to develop and sustain wellbeing.

The workshop covered:

• A brief history of yoga for health, personal growth and self-development

• Patanjali’s Yoga Sutras on the mind and psychological health

• Applications of therapeutic yoga

• Experiential embodied practice

It was a collaboration with the following presenters:

• Lina Newstead (yoga teacher and trainer for BWY and mindfulness now teacher)

• Andy Curtis-Payne (yoga therapist, teacher, trainer and chair of the Society of Yoga Practitioners)

• Tracy Pellatt-Higgins (senior research fellow, counselling psychologist and yoga teacher)

• Nina Dhiman (clinical psychologist, UK-registered mindfulness teacher and yoga teacher)

• Dr Suzanne Heywood-Everett (consultant clinical psychologist)


Nina Dhiman - Recognising Dukha and SukhaA small but enthusiastic group of about 35 delegates attended the workshop, and I was delighted to be joined by four colleagues from psychology, research and professional yoga backgrounds to share our work reflecting on the connections between yoga and psychology.

Delegates took their seats and settled to the sound of Indian bells, allowing a mindful connection between body, breath and mind.

I opened the day with a personal memory from my childhood. I was around 10 years old, sitting with my mum as another lady arrived in our home to offer condolences following the loss of a family member.

My mum’s words stayed with me. “Bhaenji, ki kar sakthaaya?” she asked. “Duniyaa chei dukh bhi hundaa, thaan sukh bhi hundaa. Kuch nai kaar sakthaya.” This translates as “sister, what can we do? In life there is suffering (dukha) and joy (sukha). There is nothing we can do.” In the silence that followed, I was aware of my body, its frame, weight, my breath, and a quality of wonderment in listening and watching, as they wiped their tears.

The question was rhetorical. And far from feeling that nothing could be done, it felt like it was everything - these women held each other and me in a warm, caring space.

There wasn’t anything we could or needed to do. We could just be together in a spirit of human kindness and compassion. It was naturally therapeutic, honest and real.

In 2013 I heard the words dukha and sukha referred to by Jon Kabat-Zinn (a pioneer in secular mindfulness) at the Mindfulness in Society Conference, hosted by Bangor University.

It seems that no matters what our culture, tradition and professional background, the interplay between doing and being helps to develop awareness and insight.

This is relevant to psychology, yoga and mindfulness. Each offers ways to understand and learn about the mind and our ability to foster and train wellbeing through mental, physical and compassionate practices

both in ourselves and in the poeople we support, teach or ‘hold’ therapeutically.

Speakers referred to a ‘holistic model’ of yoga for physical, mental, psychological and spiritual wellbeing:

• Yama - Mindful living/values/conduct

• Niyama - Cultivating positive attitudes

• Asana - Posture, comfort and ease on and off the mat

• Pranyama - Breathing practices

• Pratyahara - Restoring the senses and tuning inwards

• Dharana - Attentional skills and focus

• Dhyana - Sustaining attention

• Samadhi - Settled mind, enlightened

The first two limbs containing guiding values and ethics.

Yama:

• Ahimsa - Non-violence, non-judgement, which is sensitivity

• Satya - Honesty

• Aparigarha - Not hoarding, openness

• Bharmacharya - Intimacy

• Asteya - Acceptance

Nyama:

• Sauca - Integrity and trust

• Santosha - Contentment

• Tapas - Effort and passion

• Svadhaya - Self-inquiry

• Ishavara Pranidhna - Higher sense of awareness, oneness, faith and a greater cause


Holistic yoga for self-development and healthLina Newstead gave a general overview of yoga psychology for heallth, personal growth and self-awareness, stating that yoga is not a swift change but a gradual one. Those changes usually stay with the person, provided that they maintain practice over time.

Yoga can be considered as a ‘toolbox’, in which you can find the right practice to deal with difficulty whether physically, emotionally or spiritually. A lot of the early postures were simply seated to make the Yogi comfortable in meditation posture as they explored consciousness. In Patanjali’s ‘Eight Limbs’ of yoga, asana - physical practice - is but one aspect to support wellbeing.

Lina felt that what most people are practising now in the West is modern postural yoga, and there are numerous published research articles that report physical benefits. She commended the holistic faculty in Clinical Psychology Forum in 2018 for featuring holistic approaches, and recognising the psychological and mental benefits of yoga practice. Lina informed delegates of the All-Party Parliamentary Group for Yoga in Society, and the drive to make yoga available through clinical commissioning on the NHS. Yoga could provide a cost-effective adjunct to health care and be made more widely available.

However, not all Western yoga teachers bring in all eight limbs of yoga, and so an unbalanced yoga is currently

being taught. In her experienced of teaching longer yoga programmes, profound change can occur when pranayama (breath practice) is practised daily. Despite anecdotal reports that pranayama is falling out of fashion in regular yoga classes, a few organisations are now set up simply to teach breathing practices - most of which are yogic ones!

Lina felt that integral and transpersonal psychology have overlaps with yoga, as all aim to increase self-knowledge - how you behave and how to function well in life. Historically, Roberto Assagiolo and Carl Jung were interested in yoga, although Jung was wary about integrating an Eastern system into the Western mind. But, over time, these prejudices have been overcome.

From her teaching career, Lina gave examples of profound changes in behaviour or lifestyle that some of her students shared through reflecting on yamas and niyamas. Such changes included becoming more altruistic and able to challenge the norms of materialistic society. She finished by sharing a student’s reflection:

“I believe that if I hadn’t started learning yoga, I may not be making this journey that I am in terms of not smoking or drinking. The yamas have made me look at who I am and where I am - then make changes as I go.”

Andy Curtis-Payne shares a person-centred approachAndy Curtis-Payne shared with us how a yoga therapist approaches the consultation process when meeting a new client. This included information gathering and establishing a good relationship with the clients. Andy said that information was generally gathered by the use of appropriate consultation proforma in a safe space where the client is able to feel comfortable at all levels - physically, psychologically and emotionally.

From a yoga perspective, two main sets of tools are employed. Darsanam - observation, or that which is seen, which beings the moment a client is met, their demeanour, body language and includes physiogonomy. All hold potential clues to the current state of wellbeing.

This was followed by Prasnam - dialogue, or that ‘which I hear’, and includes the volume, pace and clarity of the voice regarding what is said and what isn’t. Andy told us that listening skills were based on the principles outlined by the British Association for Counselling and Psychotherapy (BACP), using tools such as reflection and paraphrasing to allow the client to tell and explore their own story in their words.

Following assessment, Andy said he draws on a range of models provided in ancient yoga texts to investigate how yoga can be used by the client to improve their psychological wellbeing. The simplest and most profound tool in the yoga therapist’s toolkit is the breath - by enabling the client to regular their breathing to influence the mind in a positive way. This includes


learning to gradually extend exhalation and through basic body movements, and/or the use of chanting and sound if comfortable to the client.

Andy was delighted by the enthusiasm and energy of the group, the presence of a young cohort of professionals, and recognised common ground and shared generic skills that exist between yoga therapists and psychologists.

Following the day, Andy shared a book which might be of interest to psychologists and yogis - Freud and

Yoga: Two philosophies of mind compared, by TKV Desikachar and Hellfried Krushe.

“I am sure that there is very much more that we can learn from and teach each other about improving our clients’ mental wellbeing and, more importantly, empowering our clients to care for themselves in a world whose demands seem to become ever greater and more challenging.” - Andy Curtis-Payne

A feasibility study of a therapeutic hatha yoga and motivational for stress, anxiety and burnout in a UK universityDelegates were guided by Nina for a 30-minute practice of Yoga-Nidra after the lunch break, before she and Tracy Pellatt-Higgins copresented their study to explore whether attendance of a six-week yoga course has the potential to improve stress, burnout and anxiety outcomes in university staff members. The study was a double blind, single centre, active control, prospective, cluster randomised study.

Tracy shared that existing data suggested that more than a third of university staff reported often or always experiencing levels of stress that are unacceptable. Yoga practices have been shown to be beneficial in a range of mental health conditions: depressive and anxiety disorders, PTSD, eating disorders and psychosis.

However, there are no published trials which address the effective ‘dosage’ of yoga for stress and burnout, or ways of maintaining yoga practice longer term and the impact of home yoga practice. These factors contribute to the effectiveness of yoga and were explored in the study. Study objectives:

• To explore whether a six-week therapeutic hatha yoga course has the potential to improve stress and burnout outcomes in university staff members resporting stress and/or anxiety in the previous six month period

• To explore whether a motivational intervention can affect behaviour change through the potential to increase uptake of class and home yoga practice

• To estimate the difference between the intervention and active control group in stress and burnout outcomes on the Perceived Stress Scale and Maslach Burnout Inventory General Survey after three months

• To explore the ‘dose’ response of stress and burnout outcomes based on yoga practice hours and class attendance after three months

Constructing a therapeutic yoga courseNina then presented on how she planned the course content, drawing on Patanjali’s classical yoga text and a range of contemporary resources appropriate for secular teaching. While yoga is traditionally a spiritual path, yoga confers benefit to everyone regardless of spiritual belief.

She shared the first four Sanskrit sutras of Patanjali’s work, and their relevance to psychology:

• Atha yoganusasanam - Now the teaching of yoga begins


• Yogaasgcittavrrtinirodhah - Yoga is the settling of the mind (from distraction)

• Tada drastuh svarupe vasthanam - Then the observer/’seer’ abides in presence, otherwise...

• Vrttisarupyamitaratra - we identify with the waves of thinking!

We cultivate this ‘observer’ capacity to develop insight on and off the mat repeatedly.

Practices were also selected with reference to contemporary published consensus statements on beneficial practices for reducing anxiety, improving positive emotions and wellbeing.

All participants attended the course between January and March 2019 - classes included the repetition of yoga postures, sequences, breath practices and relaxation which could be practised at home.

Course materials and workbooks were compiled and given to aid home practice. In the intervention group, participants received an additional workbook about developing a regular yoga practice, with personal motivation, goal-setting and strategies for overcoming barriers to promote behaviour change. This workbook was drawn from the NHS health trainer handbook.

Integral in the teaching was drawing from secular

evidence-based mindfulness - intentional present moment awareness. This was guided by inviting awareness to an interplay of ‘doing’ and ‘being - sensations, movement, kinaesthetic feedback, breath, thoughts, feelings.

“Although it looks like exercise and conveys the benefits of exercise - yoga is far more than exercise. Done mindfully, it is meditation just as much as the sitting practice or the body scan is meditation.” - Jon Kabat-Zinn in Full Catastrophe Living

Some of the themes that emerged from participants’ comments included:

• Improved sleep

• Better stress management

• Transferring yoga practice and breathing techniques to prepare for assessments/when frustrated by work/anxious moments

• Easier relaxation

• Eating more healthily

Some comments from participants on the course:

• “Feeling calm after each session. I was able to use this feeling at other times.”



• “I have learned that very short but mindful yoga movements are very effective for my own wellbeing and both achievable and enjoyable.”

Tracy shared that although the study was only a feasibility study, the results were promising and there was evidence of benefits from therapeutic yoga in qualitative and quantitative data in both groups:

• Participants in the intervention group practiced more therapeutic yoga at home in week six

• The amount of home therapeutic yoga was similar in both groups at week 12 (follow-up)

• Participants in both groups showed evidence of greater wellbeing at week 12

• There was some evidence of potentially greater wellbeing in the intervention group, compared to the control

• The data suggested that the motivational intervention had an impact on encouraging and sustaining therapeutic yoga

Tracey and Nina hope to publish the study and to extend the study into mental health services.

How psychological therapies are commissioned and delivered in the NHSDr Suzanne Heywood-Everett covered what is meant by ‘evidence-based practice’, and the challenges we currently have around the evidence base for psychological therapies. Methodological challenges mean that gold standard RCTs are often lacking, particularly where the individual’s psychological difficulties are complex.

Research is often diagnosis-specific, or modality-specific, and increasingly there has been a need to examine the non-specific variables in therapy.

Suzanne drew parallels with the study of yoga. Whilst yoga is an ancient practice, and has been associated with a way of life that can balance emotional, physical and spiritual health for more than 2,000 years, only recently has there been a move to substantiate these claims through research.

Ethical and mindful considerations:

• Is yoga an intervention?

• Are we potentially dissecting yoga to something that is longer yoga?

• A series of postures?

• A way of life - mind, body, spirit?

• Lanaguage - do we acknowledge Sanskrit words, what are we comfortable with in the NHS?

• How can we respect the cultural context of yoga and deliver yoga in a secular society?

Some features to consider in bringing yoga into the NHS:

• A clear evidence-based RCT gold standard

• Outcome-based, ie measureable change

• Condition-specific for physical and/or mental health

• Structured and protocol driven

• Reproducible

• Scalable

• Quality-assured and certified

• Timed return on investment

Interest by the Holistic Pre-Qualification CommitteeCindy Toloza, faculty representative for the pre-qualification committee, was keen to inform her peers who were unable to attend the workshop about the day. She found it inspiring and said:

“The information from the event was really valuable and it was surprising to learn that there are so many links with yoga and psychological therapies, which overall can help to inspire or spark ideas for aspiring psychologists.”


Taking applications of therapeutic yoga forward in the BPSDelegates were keen to build on issues discussed on the day, and expressed interest in creating a psychology and yoga sub-group within the faculty. We’ll be exploring this further. Feedback from the BPS survey about the workshop was encouraging and positive:

“I enjoyed the interaction, discussion, the energy of the speakers and what they said, the furthering of links

between yoga, psychology and mindfulness, increasingly East meets West. This can only be more inclusive for the wide range of clients/patients we serve.

There was a lovely combination of personal, knowledge sharing and audience interaction. To sum up, I felt energised, enthused and eager for more! Looking forward

to future events.”

Our next eventHolistic Faculty Annual Conference - 29 & 30 May 2020

“When you can’t fix it: Evidence-based practice and practice-based evidence in complex physical and mental health.”

We’ll be joined by Andy Bellt (Centre for Mental Health), Ursula Philpot (Diet and Health) and Jess Bolton (emotioHealth) for our next faculty event in Brighton on 29 and 30 May. . Save the date, and we’ll have more details on registration soon.

Get involvedWe’ll be discussing and organising further therapeutic applications of yoga, among other faculty activities. If

you’re interested in getting involved with the Faculty for Holistic Psychology, please get in touch.

Committee membersChair: Jane Street

Secretary: Susan Quinn

Treasurer: Vacant

DCP Rep: Stuart Whomsley

Service User Rep: Tracey Bennett

Other members: Lawrence Yusupoff, Jonathon Cash, Helen Card, Galen Ives, Ann Childs, Gwendolyn Ball, Catherine Dooley, Daljit Sandhu, Nina Dhiman, Suzanne Heywood Everett

faculty for holistic psychology · and more challenging.” - andy curtis-payne a feasibility study...

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