As the Opioid Epidemic has become a daily news topic, the treatment industry has also become inspired to advance the possibilities of what may help sustain recovery. What is becoming more and more apparent is the value of an integrative and more holistic approach to treatment. It is no longer an alternative thought to treat addicts from a mind-body-spirit paradigm.
When I began my career as a young social worker in the early 90’s, I came into the work with a little bit of fire, rebelliousness, and a deep personal value of holistic well-being. I had been exposed to yoga philosophy in childhood with a family that was also deep in the trenches of 12 step recovery from all the possible avenues to arrive into the rooms of recovery. However, in my early attempts to bring a simple breathing practice into “stress management” groups, I was quickly told that it would “never be allowed in therapy.” As I landed my career in Flagstaff, AZ in 1997, I took my first official yoga teacher training at that same time. When asked what I planned to do with “another career”, I boldly said, “I am going to use yoga as a part of therapy.” At that time, I was working on an adolescent psych unit and co-facilitating IOP groups along with other things. Using yoga in treatment was only permitted under Recreation Therapy. By 2002, I opened my private practice so that I could more freely bring yogic practices into the clinical work. I spent those early years exploring different approaches, methods and tools. Fortunately, I attracted a population of clients who wanted a non-pharmaceutical approach, and who were tired of feeling unsuccessful in counseling that was more cognitive in orientation. They were open to learning ways to manage symptoms that they could use on their own. Because I was able to do training with several different therapeutically inspired programs and teachers, I explored a variety of practices. Some of these prescribed practices were complex, while others were more simple. What I came to realize was that using more simple techniques seemed to be more effective, practical and sustainable.
In 2010, I was asked to come on board as a primary therapist for Back2Basics Outdoor Adventure. Because they really promoted a more holistic approach to recovery, such as Wilderness Therapy, nutrition, Kung Fu and fitness encouragement, it was the perfect environment to do more integrative work with clients using yogic principles and practices. I have had the opportunity to bring yoga into the Back to Basics setting in a variety of forms as a supplement to individualized treatment. In addition to getting the clients involved in public yoga classes, every group therapy that I run begins with a practice in mind-body centering. I have a personal assessment process of watching how the guys progress in the ability to do these practices. When they first arrive, they won’t or can’t even close their eyes or even sit for a moment of stillness. As the drugs wear off and the brain begins to heal, they are able to sit more quietly and actually listen to the guidance. As time progresses, they become eager to learn more progressive relaxation skills, guided imagery and even meditation. We will eventually do a practice called Yoga Nidra, which is a 30 minute deep relaxation practice that involves progressive mindfulness, breath work, body relaxation, imagery and deep stillness. This practice is a cornerstone in Yoga Therapy as way to balance the nervous system, assist in increasing the brain’s bioavailability for oxygen and neurotransmitter balance and the increase of Alpha wave activity in the brain. The practice then weaves in therapeutic intention and 12 Step philosophy (such as serenity, acceptance, gratitude, etc). When the practices of body calming, mind centering and therapeutic intention are brought together, we see definite changes in the client’s ability to regulate emotions, deal with conflict, manage stress and self-reflection. I like to think of these practices as the glue that bridges all of the modalities into interpersonal wholeness.
In addition to the group work on progressive mindfulness, clients who are open to more personal work in this area may work with me in a variety of ways. For example, some clients are interested in understanding the psychology of yoga as it relates to 12 Step philosophy. Years ago, I wrote a lengthy paper on the similarities of yoga philosophy and 12 Step recovery. It has been a foundation of how to bring concepts such as “Ahimsa”, or “do no harm” into the personal process. Yoga begins with ethics, called the Yamas and Niyamas, which have to do with how we treat others, our world and ourselves. These practices include living a life with integrity, honesty, compassion and the ability to self-reflect in spaces of conflict. All of this deeply supports what they learn in 12 Step. I may not be using the Sanskrit terminology of the practices, but the teachings are for sure a part of the framework of all individual therapies. Perhaps my favorite part of the work is the journey into reflection of the ego. In yoga, we recognize that the flaws in egoic thinking are a source of suffering. I find that recovery communities are far more conditioned to reflect into these not so pleasant spaces than that of my non-addict clients. Fortunately, their sponsors and sober peers are also encouraging them to take a look at the addict way of thinking and ego antics as a necessary part to be able to successful in sobriety. While they may not always love the feedback they are given about the ego traits, they eventually come to embrace and reflect the work as a more natural progression in recovery. Because the fundamental practice of yoga is to “notice without judgement”, they are able to learn to take a humble inventory without it creating more self-deprecation.
Last but not least, once these guys are sold on the value of a more integrative way of being, we develop a personalized “Sadhana” that compliments a morning routine in 12 Step work. For example, this may include to begin the day with a 5 minute practice of centering, breathing and intention setting. Some may choose a simple yoga posture sequence, followed by a prayer from the Big Book. The beauty is, they don’t have to go to a class. It can be something very simple and personalized, with or without postures. It can a place they always come back to find their space of serenity.
The word sober, means to be “awake”. The path of yoga, invites one to “awaken.” Even if I never use the word “yoga’ in working with these clients, it is always at the backbone of my therapeutic work. For nearly 25 years, I have witnessed that people show up “on the mat” for similar reasons they show up in treatment. It is all a journey of some kind of personal healing. I am beyond grateful that the work in yoga is being more and more recognized by the clinical community at large. Over the years, the research around Mindfulness and Neuroscience has gotten so much recognition that it has had a spillover effect into the promotion of yoga for depression, anxiety, PTSD and addiction. Yoga is more frequently found in treatment centers in current time. I hope this way of treating addiction can have a helpful impact on the opioid problem. From management of pain on the physical level, to the emotional level, and all of the other reasons people are drawn to numb. We as the treatment industry, can no longer ignore that to treat the person, we have to address the mind and body together.
By Keelyn Riley, LCSW, E-RYT, CYT, YACEP
Keelyn Riley is a Licensed Clinical Social Worker and Certified Yoga Therapist with the International Association of Yoga Therapy. She is also registered with Yoga Alliance as a Yoga Alliance Education Provider. She actively teaches in multiple settings in the Flagstaff community is as a primary teacher for the Vertical Soul yoga teacher training. She has mentored and trained countless yoga teachers and has over 7000 hours of yoga teaching experience. She frequently teaches public workshops on the Psychobiology of Yoga and the Neuroscience of Yoga Nidra.