Everyone enrolled in an inpatient treatment program at Gateway Rehabilitation Center in western Pennsylvania is required to attend a yoga class three times a week. Participation in the techniques of yoga isn't mandatory, but the client's presence is. Some clients (such as middle-aged males who haven't felt particularly fit for some time) are skeptical at first, say Gateway staffers, but the organization finds that before long most everyone is practicing the classes’ meditation and deep breathing exercises.

“One thing I like about yoga is that when the patient leaves here they can take it with them,” says Jan Curry, senior director at Gateway's main campus. “It doesn't require any special equipment.”

Likely seen by many clients and professionals as an oddity not that long ago, yoga classes have become an integral element reinforcing the “mind/body/spirit” orientation of many addiction treatment facilities today. The availability of regularly scheduled yoga classes to many treatment clients reflects a wider acceptance of yoga and other holistic practices in today's society.

“We initially ran into a little resistance from people who thought yoga was more of a religious experience,” says Curry, whose organization has offered on-site yoga classes for the past nine years. “We eventually found that it really helped people with cravings. Many of our inpatient clients would end up requesting it as part of their outpatient treatment.”

This of course doesn't mean that everyone takes to yoga right away, or even at all. Charlene Fox, a certified yoga instructor who taught classes at the Memorial Hermann Prevention and Recovery Center in Houston about a decade ago, found that at least some patients never progressed much beyond the stage of “I'm here because I was told to be” in their acceptance of yoga. Yet others saw tremendous benefits, which she says points to the wisdom of treatment facilities’ trying to expose clients to a variety of mind-body interventions that might assist in their recovery.

“Not everyone is going to find that one thing resonates for them,” Fox says.

Kundalini yoga

Fox practices and teaches Kundalini yoga, an ancient technique that emphasizes maintaining a balance among the physical, mental and spiritual. One of its most well-known practitioners is Mukta Kaur Khalsa, PhD, who conducts trainings around the world under the organization name SuperHealth and who formerly ran a rehabilitation hospital in Tucson, Ariz., that emphasized yoga and dietary interventions.

In written information provided by Khalsa, she explains that Kundalini yoga works to correct imbalances in the parts of the brain affecting relaxation and activity-imbalances that often lead individuals to using substances at harmful levels. Kundalini yoga is considered the yoga of awareness, Khalsa says.

“By learning Kundalini yoga techniques, recovering addicts can adjust their nervous systems to respond to the stresses of life through the practice of yoga and meditation,” the written summary states. It adds, “Kundalini yoga uses words or sounds called mantras, which create positive thoughts within the mind. The sounds are linked to the rhythm of the breath and serve to remind us to breathe properly.”

In practice, Khalsa believes Kundalini yoga can be useful to individuals in treatment, even at the earliest stages-although clearly individuals’ stamina will be fairly low at that point. “Whatever a person can do is going to have a benefit,” she says.

A person who learns deep breathing techniques, from the abdomen instead of the chest, will achieve greater clarity simply by virtue of how much oxygen he/she is taking in, Khalsa says. Using a positive mantra to command one's thoughts will help withstand pressures associated with going through treatment and maintaining sobriety over the long haul, she says.

Khalsa emphasizes in working with the addiction treatment field that yoga should be looked at as an adjunctive service, not a replacement for other therapeutic interventions.

“Kundalini is very specific; it's about strengthening a broken-down nervous system,” says Khalsa, author of the book Meditations for Addictive Behavior: A System of Yogic Science With Nutritional Formulas. “Kundalini is 5,000 years old. We think it's new because it's new to us.”

Integrating the classes

At Gateway Rehab, yoga classes are taught by a certified recreation therapist, Curry reports. The clients do not participate while they are in detox.

Once inpatient treatment has begun, clients are encouraged at least to engage in the deep breathing and meditation exercises at the outset. The mandatory classes are 45 to 60 minutes in duration and generally are scheduled in either the late afternoon or evening, after the day's heavy work of group meetings and other treatment activities is generally completed.

The classes have proven to be so popular that it is also not uncommon to find some Gateway staff members sitting on the floor with their legs crossed and engaging in deep breathing exercises during the sessions, Curry says.

Gateway tends not to overemphasize the heavily physical aspect of yoga. “We see it as helpful in reducing anxiety and helpful with flexibility,” Curry says. “It helps the patients focus. It offers a healthier way of dealing with the stress of inpatient treatment.”

Curry says she finds that about 20 to 25 percent of Gateway patients have had some prior experience with yoga. Fox found in her work at the Houston treatment program that a very small number of patients had any familiarity with yoga.

As is the case at Gateway Rehab, yoga classes at Memorial Hermann started after patients had gone through detox, Fox says. The classes were scheduled immediately before patients attended their group meditation sessions.

While she says not all patients appeared to engage fully in the classes, Fox recalls that the techniques worked particularly well for those individuals who had continued to smoke while in recovery from an alcohol or drug addiction.

“Many of the patients used the breathing and breath control exercises to help them cut back on their cigarette consumption,” Fox says.

She says she stopped teaching the classes at Memorial Hermann after the arrival of a new manager, who reportedly de-emphasized these types of activities in the treatment program. But in a sign of these services’ lasting influence, Fox has heard that the facility has since resumed with offering yoga to patients.

Gateway's Curry summarizes yoga's appeal in treatment programs by saying, “This mind/body/spirit approach, this is what recovery is all about.”