Yogacharya Dr Ananda Balayogi Bhavanani’s presentation on YOGA AS THERAPY : Synthesis of Traditional Wisdom with Modern Scientific Knowledge in the 34th Research Methodology & Biostatistics Workshop conducted by the Tamil Nadu Dr.MGR. Medical University in July 2021.

1. ~ YOGA AS THERAPY ~
Synthesis of Traditional Wisdom with
Modern Scientific Knowledge
Yogacharya
Dr ANANDA BALAYOGI BHAVANANI
MBBS, MD (AM), ADY, DSM, DPC, PGDFH, PGDY, FIAY, C-IAYT, DSc (Yoga)
Director CYTER of Sri Balaji Vidyapeeth & Chairman ICYER at Ananda
Ashram, Puducherry, South India. yognat@gmail.com

3. SRI BALAJI VIDYAPEETH
(Deemed University Accredited with “A” Grade by NAAC)
Centre for Yoga Therapy, Education
and Research (CYTER)
Salutogenesis, our focus!

4. Salutogenesis, our Focus
• Moving from pathogenesis, the focus on disease
towards salutogenesis, the focus on health!
• CYTER is striding forward on an innovative path of
promoting holistic health for one and all.
Pathogenesis
Salutogenesis
www.sbvu.ac.in/cyter

5. Salutogenesis
• Derivation of Greek + Latin
–Latin: salus = health
–Greek: genesis = source
• In combination = Sources of health

6. Sense of Coherence (SOC)
The heart of Salutogenesis
“a pervasive, long-lasting and dynamic feeling of
confidence that
one’s internal and external environments are
predictable and that
there is a high probability that things will work out
as well as can be expected” (Antonovsky, 1979)
 SOC has strong positive correlations to perceived
health, mental health, and quality of life.

7. 3 components of Sense of Coherence (SOC)
 COMPREHENSIBLE - Cognition
- “My world is understandable”
 MANAGEABLE - Coping Skill
- “My world is manageable”
 MEANINGFUL - Motivation
- “My world has meaning”

8. SALUTOGENESIS versus PATHOGENESIS…
Pathogenesis
• What causes diseases?
• About avoiding problems
•Reactive - absence disease
• Against pain or loss
• Enables survival of species
Salutogenesis
• What causes health?
• About reaching potential
• Proactive - presence health
• For gain or growth
• Discover how to live fully

9. Health, a dynamic state
• Health is seen as a dynamic movement in a
continuum between total ill-health & total
health

10. Rudyard Kipling

11. Sorry Mr. Kipling,
they indeed have!
Through Yoga!

12. • This “East-West” dichotomy seems to have been
overcome in recent times.
• Many eastern healing traditions have slowly and
steadily percolated health care systems worldwide.
• This is especially true of mind– body therapies that
focus on the health promotive intrinsic connections
that exist between the human brain, mind, body, and
individual behaviour.
• Yoga is indeed all about integration!

13. National Health Service
www.nhs.uk
• Dozens of scientific trials of varying quality have
been published on yoga.
• While there's scope for more rigorous studies on its
health benefits, most studies suggest yoga is a safe
and effective way to increase physical activity,
especially strength, flexibility and balance.
• There's some evidence that regular yoga practice is
beneficial for people with high blood pressure, heart
disease, aches and pains – including lower back pain
– depression and stress.

15. https://nccih.nih.gov/news/multimedia/infographics/yoga_panel2

16. 2016 Yoga in America Study Highlights
• The top five reasons for starting yoga are: flexibility
(61 percent), stress relief (56 percent), general
fitness (49 percent), improve overall health (49
percent), and physical fitness (44 percent)
• 86 percent of practitioners self-report having a
strong sense of mental clarity, 73 percent report
being physically strong, and 79 percent give back to
their communities – all significantly higher rates than
among non-practitioners

17. 2016 Yoga in America Study Highlights
• Top five reasons for starting yoga are:
– flexibility (61 %),
– stress relief (56 %),
– general fitness (49 %),
– improve overall health (49 %), &
– physical fitness (44 %)
• 86 % practitioners self-report having a strong sense of
mental clarity, 73 % report being physically strong, and
79 % give back to their communities
• all significantly higher than among non-practitioners

18. 6,306
results for
“Yoga Therapy” in
PUBMED
6,306 results

19. Prof MADANMOHAN
The Pioneer of
Integration of Yoga in
Modern Medicine

23. http://www.yogatherapy-india.org/

24. Bhavanani AB, Sullivan M, Taylor MJ, Wheeler A. Shared Foundations for Practice: The
Language of Yoga Therapy. Yoga Therapy Today 2019. 15 (3): 44-47.
Yoga
Yoga
Therapy
Yoga therapy nests
inside the larger
Yoga & is
therefore
neither separate
from nor greater
than Yoga.
Yoga and Yoga Therapy

25. “Yoga therapy is the process of
empowering individuals to
progress toward improved health
and wellbeing through the
application of the teachings and
practices of Yoga”. – IAYT

26. Traditional concepts and a
revised modern understanding

29. Structural existence
(annamaya)
Functional mechanisms
(pranamaya)
Cellular memory
(manomaya)
Intelligent feedback
(vijnanamaya)
Systemic interactivity
(anandamaya)
Cellular Panchakosha !

30. (Low)
0
0 (Low)
∞
(High)
(High) ∞
Challenges
Skills
Anxiety
Boredom
Increasing
challenges
Increasing skills
Increasing skills
Increasing
challenges
FLOW
Channel

31. (Low)
0
0 (Low)
∞
(High)
(High) ∞
Challenges
Skills
Anxiety
Boredom
Increasing
challenges
Increasing skills
Increasing skills
Increasing
challenges
FLOW
Channel
Yogah karmasu kaushalam-BG

33. Rehabilitate
& heal !

34. Relaxation is the key to healing!
• An essential prerequisite for healing.
• We cannot heal when we are stressed.
• Conscious relaxation facilitates self-healing
• All about educing the “Relaxation Response”
• Yoga’s greatest contribution
to modern healthcare!

36. Role of pranayama ratios in
prolonging exhalation phase
thereby reducing HR

38. Reduction in HR lengthens diastole
phase enhances coronary perfusion!
Heart
supplies
itself
only in
diastole!

39. Broncho-pulmonary segments

41. Understanding the Prana Vayu in a modern scientific manner
for diagnosis and management in Yoga Therapy
Functional energies of :
1. Respiration
2. Communication
3. Circulation
4. Digestion
5. Excretion
Helps us to work
using Yogic
diagnosis rather
than only the
medical one!

44. E = mc2

45. E = mc2 Power of the mind!

46. Psycho-neuro-immuno-endocrinological
correlates of rehabilitation
NERVOUS
SYSTEM
ENDOCRINE
SYSTEM
IMMUNE
SYSTEM
Retards healing & delays
rehabilitation

47. Perceived
Stimulus

48. Mental
Agitations
Haphazard
Flow of
Prana
Unstable
Nadis
Hypo-cellular
activity
(Ajeeranatvam)
Hyper-cellular
activity
(Ateejeeranatvam)
Altered cellular
activity
(Kujeeranatvam)
VYAADHI
Physical
Ailments
Yogic understanding of Psychosomatic Disorders
AADHI
Manomaya
Kosha
Annamaya
Kosha
Pranamaya
Kosha

49. From the Yogic viewpoint of disease, psychosomatic,
disorders progress through four phases.
1. Psychic Phase
 vijnanamaya & manomaya kosha
2. Psychosomatic Phase
 manomaya & pranamaya kosha
3. Somatic Phase
 pranamaya & annamaya kosha
4. Organic Phase
 annamaya kosha

50. Stress management through Yoga
• Dr W Selvamurthy gave a beautiful
message at SBV recently. He said:
Yoga enables and empowers
individuals to
– Modify their perceptions of the stressors,
– Optimise their responses to them, and
– Efficiently release the pent up stresses.
• We can think of it as a 3-in-1 action!!

52. Psycho-neuro-immuno-endocrinological
correlates of rehabilitation
NERVOUS
SYSTEM
ENDOCRINE
SYSTEM
IMMUNE
SYSTEM
Enhances healing & facilitates
rehabilitation

53. “The treatment of the
part shouldn’t be
attempted without a
treatment of the entirety.
The treatment of the
body without treating
the mind and soul is a
useless waste of time”
- Plato
(428 – 348 BC)

54. Relevance to health care professionals
• Yoga is an experiential science and a dynamic state
of health is a by-product of Yoga
• “Re-orients the functional hierarchy of the entire
nervous system” - Dr B Ramamurthy
• Effective in preventing and combating the modern
pandemic of stress borne disorders.
• Scientific evidence indicates that Yoga has
– promotive, preventive and curative potential,
– is a safe, non-pharmacological therapy and is
– an effective lifestyle adjunct to reduce drug
dosage and improve QOL of patients

55. • Preventing and managing psychosomatic - stress
related disorders
– DM, hypertension, bronchial asthma, IBS,
epilepsy, back pain and functional disorders
• Reduce / eliminate drug dosage / dependence in
– DM, hypertension, epilepsy, anxiety, bronchial
asthma, constipation, dyspepsia, insomnia,
arthritis, sinusitis and dermatological disorders
• Yoga therapists must work in tandem with medical
doctors when managing patients on medical
treatment.
“COLLABORATION” is the key word

56. • LIFE STYLE MODIFICATIONS: “Yoga is a system of
perfect tools for achieving union as well as healing”
-Dr Dean Ornish
• REHABILITATION: “Modern medicine kept me alive,
Yoga gave me back my life”- Dr Swami Gitananda Giri
• COPING SKILLS: “Yoga may not be able to always cure
but it can surely help us to endure”- Sri BKS Iyengar
• HEALTHY DIET : biogenic, guna based diets
• RELAXATION: spanda -nishpanda concepts
• EXPENDITURE: cost effective, cost lowering
• AGING : anti-aging, regenerating, “young at heart”
• PSYCHOTHERAPY: the mind and beyond
• WOMEN’S HEALTH: puberty, pregnancy, menopause
• RESEARCH: Basic and applied scientific & literary

57. SOME THERAPEUTIC BENEFITS
• Yoga modifies coronary artery disease risk factors
and helps reverse heart disease
• Patients of respiratory disorders have shown
improvement with Yoga therapy
• Therapeutic tool for MR children -improvement in
IQ and social adaptation
• Has shown great potential in metabolic conditions-
diabetes, obesity, metabolic syndrome etc
• Psychiatry: OCD–improvement in Yale/Brown &
perceived stress scales , anxiety, depression

58. • Comprehensive bibliometric analysis of Yoga
therapy research between 1967 & 2013 by Jeter PE,
Slutsky J, Singh N & Khalsa SB. (J Altern Complement
Med 2015)
• Three-fold increase in number of publications seen
in the last decade, inclusive of all study designs.
• 45% RCTs, 18% controlled, and 37% uncontrolled.
• Most publications originated from India (n=258),
followed by USA (n=122) and Canada (n=13).
• Top three disorders addressed by Yoga
interventions were mental health, cardiovascular
disease, and respiratory disease.
Other reviews by Kim Innes (2005, 2007 & 2012), Yang
(2007) and Sengupta (2012) have also highlighted role
of Yoga therapy.

59. © www.indeedcare.com/blog/tag/yoga-therapy

61. Yoga places great importance on a proper and healthy
lifestyle whose main components are:
ACHAR – healthy physical activities & exercise
VICHAR – right thoughts and right attitude towards
life that are vital for wellbeing.
AHAR – healthy, nourishing diet with adequate intake
of fresh water; balanced intake of fresh food, green
salads, sprouts, unrefined cereals & fresh fruits.
Sattwic diet, prepared & served with love & affection.
VIHAR – proper recreational activities to relax body
and mind are essential for good health.
VYAVAHAR – healthy relationships for social health

62. And not merely the absence of disease.
Physical well-being
Mental well-being
Spiritual well-being
Social well-being
Definition of Health (WHO)
Health is a
dynamic
state of
complete…

68. It doesn’t matter how many resources you have.
If you don’t know how to use them,
it will never be enough.

69. Research in Swara Yoga
Uni-nostril & alternate nostril Pranayama techniques
have captured imagination of researchers world wide.
Recent studies have reported differential physiological
and psychological effects including :
– O2 consumption,
– metabolism and body weight,
– blood glucose,
– involuntary blink rates and intraocular pressure,
– heart rate and heart rate variability,
– stroke volume and end diastolic volume
– galvanic skin resistance,
– digit pulse volume, and blood pressure.

70. Uni-nostril / alternate nostril Pranayamas
Suryanadi asana Chandranadi asana

71. Forced UN / AN breathing
Surya nadi/ bhedana Chandra nadi/ bhedana
• activity phase of BRAC*
• activates SNS
• increases O2
consumption
• increases metabolism
• corrects low BP
• increases HR
• increases body temp.
• rest phase of BRAC*
• reduces SNS activity
• increases GSR
• lowers blood sugar
• decreases BP
* BRAC- Basic Rest Activity
Cycle ~ 90 (80–120) min

73. • Dhyana / meditation -
union with our
Supreme Nature.
• Fixing the mind on the
Higher Self with
devotion and discipline.
• Seventh step in
Ashtanga Yoga of
Patanjali.
• Dharana -one pointed
concentration helps us
flow into meditation
and Samadhi
~ Samyama.

75. Maharishi Patanjali says,
• “desha bandhah chittasya dharana” -
concentration is the process of binding the
consciousness to a point, place, region or object
(a duality between SEER -SEEN).
• “ tatra pratyaya ekatanata dhyanam” -
meditation is a STATE where there is a steady &
continuous flow of attention and concentration
on a point, place, region or object (cessation of
duality between SEER and the SEEN).

76. Dorland’s Illustrated Medical Dictionary
defines meditation as:
“An intentional and self-regulated
focusing of attention, whose
purpose is to relax and calm the
mind and body.”
Dorland’s Illustrated Medical Dictionary. 32nd ed.
Philadelphia: Saunders (2012). 2147 p.

77. According to a mini-review by Innes & Selfe
(Frontiers in Psychiatry2014): Meditation
• reduces perceived stress, anxiety and
depressive symptoms,
• enhances quality of life,
• decreases sleep disturbance,
• improves several domains of cognition,
• reduces sympathetic activation and
• enhances cardio-vagal tone,
both acutely and long term in clinical as well as
non-clinical populations.

78. Meditation promotes :
• beneficial changes in CNS dopaminergic and
other neurochemical (GABA) systems,
• increases blood flow, O2 delivery, and
glucose utilization in specific regions of the
brain associated with
• mood elevation, memory, and attentional
processing,
• including the hippocampus, prefrontal
cortex, and anterior cingulate gyrus.

79. Long-term meditation practice is associated with
• cortical thickening & increased gray matter
volume in brain regions involved in attentional
performance, sensory processing & intero-
ception apparently offsetting typical age-
related cortical thinning and gray matter loss.
Meditation programs can enhance
• immune response and clinical outcomes,
• reduce BP, insulin resistance and glucose
intolerance, oxidative stress, inflammation and
other related risk indices.

80. Potential Underlying Mechanisms
Innes KE and Selfe TK (2014) Meditation as a therapeutic intervention for adults at risk for Alzheimer’s disease –
potential benefits and underlying mechanisms. Front. Psychiatry 5:40. doi: 10.3389/fpsyt.2014.00040

81. Potential uses
• All stress related conditions
• Anxiety disorders, panic attacks and depression
• Asthma and other respiratory conditions
• Cancer and terminal conditions
• Arthritis including fibromyalgia
• Atherosclerosis, hypertension and CAD
• Stroke, dementia and other neurological conditions
• Chronic pain and sleeping disorders

82. Healing is multifactorial
Lifestyle Attitude
Relaxation Breathing
Healing

83. An Integrated Set Up
At CYTER we are:
– Educating future Yoga therapists,
– Helping patients recover from their illnesses,
– Scientifically researching ‘Hows & Whys’ of Yoga.
Joseph & Lilian Le Page,
Integrative Yoga Therapy,
USA
“There are many centers where you can get a
Yoga degree, attend a Yoga therapy session or
find Yoga research being undertaken. However,
to have all three happening in one place is
surely innovative. This center is indeed a role-
model that combines the best of the East with
that of the West.”

84. Clinical Services@ CYTER
• Daily OPD consultations
• Individual & group sessions
• Master Health checkups
• IP wards
• > 70,000 participants in targeted
individualized and small group (~ 30,000) &
salutogenic (~ 40,000) general sessions

89. Some of our work in recent times
1. Randomized controlled trial of 12-week yoga therapy as lifestyle
intervention in patients of essential hypertension and cardiac autonomic
function tests. Natl J Physiol Pharm Pharmacol 2016; 6: 19-26.
2. Finding peace on a Psychiatric Ward with Yoga: Report on a pilot
anthropological study in Pondicherry, India. Annals of SBV 2016; 5(2): 14-9.
3. Effect of yoga therapy on fasting lipid profile in chronic kidney disease: a
comparative study. Int J Adv Med 2018;5: 294-98.
4. Effects of overnight sleep deprivation on autonomic function and
perceived stress in young health professionals and their reversal through
yogic relaxation (Shavasana). Natl J Physiol Pharm Pharmacol 2018;8
5. Effect of adjuvant yoga therapy on pulmonary function and quality of life
among patients with Chronic Obstructive Pulmonary Disease: A
Randomized Control Trial. J Basic Clin Appl Health Sci. 2018; 2(3):117-22.
6. Immediate effect of Sukha Pranayama: A slow and deep breathing
technique on maternal and fetal cardiovascular parameters. Yoga
Mimamsa 2018; 50:49-52.

90. Some of our work in recent times (contd..)
7. A comparative study on the effect of music therapy alone and a
combination of music and yoga therapies on the psycho-
physiological parameters of cardiac patients posted for
angiography. J Basic Clin Appl Health Sci. 2018; 2:163-8.
8. Yoga training enhances auditory & visual reaction time in children
with autism spectrum disorder: A case - control study. J Basic Clin
Appl Health Sci. 2019; 2:8-13.
9. Effectiveness of adjuvant yoga therapy in diabetic lung: A
randomized control trial. Int J Yoga 2019;12:96-102.
10. The efficacy of yogic breathing exercise Bhramari pranayama in
relieving symptoms of chronic rhinosinusitis. Int J Yoga
2019;12:120-3.
11. Yoga therapy as an adjunct to traditional tooth brushing training
methods in children with autism spectrum disorder. Spec Care
Dentist. 2019; 1–6.
12. Effect of adjunct yoga therapy in depressive disorders: Findings
from a RCT. Indian J Psychiatry 2019; 61:592-7.

91. Some of our work in recent times (contd..)
13. Gupta K, Bhavanani A B, Ramanathan M, Rajasekar B, Sarkar S, Dayanidy
G. Effect of Adjuvant Yoga Therapy on Craving in Participants of an
Alcohol De-addiction Program: A Pilot Study. 2019; 2 (4):138-141.
14. Balaji R, Ramanathan M, Bhavanani AB. Nephroprotective Impact of
Adjuvant Yoga Therapy on Diabetes - A Randomised Controlled Trial. J
Clin Diagn Res.2020; 14(12): KC01-KC04.
15. Ramanathan M, Bhavanani AB. Yoga training enhances auditory and visual
reaction time in elderly woman inmates of a hospice: A pilot randomized
controlled trial. Yoga Mimamsa 2020;52:56-60.
16. Artchoudane S, Ramanathan M, Bhavanani AB, Muruganandam P, Jatiya L.
Effect of Yoga Therapy on Neuromuscular Function and Reduction of
Autism Severity in Children with Autism Spectrum Disorder: A Pilot
Study. International Journal of Health Systems and Translational Medicine
(IJHSTM). 2021; 1(1): 76-85.
17. Thiruvalluvan A, Sekizhar V, Ramanathan M, Bhavanani AB, Chakravathy D,
C. Reddy JR. Effect of pranayama techniques with Marmanasthanam
Kriya as yogic relaxation on biopsychosocial parameters prior to
endodontic therapy: A cross sectional study . Int J Yoga 2021;14:146-51

95. 95

96. “Path breaking innovation
indeed. Much needed for the
modern world. Congrats SBV!”
Ammaji
“CYTER is such a huge
inspiration. There should be
many more projects like
this.”- Yogacharini Kalavathi,
Wales, UK
“CYTER is balancing the
difficult path of staying true to
tradition on one hand, and
adapting it to the modern
world on the other .
Dr Ramesh Bijlani, AIIMS
CYTER is engaged in spreading
awareness about traditional Yoga
and its benefit for the welfare of
society, in addition to carrying out
research in yoga to establish strong
scientific foundation for Yoga, which
is most needed of the hour.
-Dr HR Nagendra, Chancellor
S-Vyasa Yoga University

97. CYTER is doing the perfect seva,
with a strong knowledge base.
-Dr Shirley Telles, Patanjali
Research Foundation
Haridwar
“CYTER is not just a centre, it
is the medicine of the future.
Joseph Le Page, Integrative
Yoga Therapy, USA.
“CYTER will surely be one
of the torch bearers in
Yoga Therapy worldwide in
time to come.”
Sri S Sridharan, KYM
“A great opportunity to train
‘hands on’ in the application
of Yoga in medicine.
Excellent training in a yoga
therapy department within a
modern medical hospital
with a unique team!” -
Nathalie Cazach,
Student PGDYT, France.

98. 98

100. Gratitude
is the
highest
attitude.

103. Thank You!