The Science of Yoga: The Risks and the Rewards Hardcover – Deckle Edge, Feb 7 2012
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The Science of Yoga: The Risks and the Rewards
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As I have a scientific background, it always bothers me about the claims that yoga teachers often parrot out about the benefits of yoga. Everything from weight loss to curing every disease to " yoga is the greatest total work out there is". Often they preface "scientists have found that yoga blah blah blah". The latest was last week when a Birkram teacher informed us "The standing Bikram series is the equivalent to running for 40 minutes at 4 mph." I understand this to be nonesense.
I really appreciate the second chapter of William Broad's book about the scientific research on yoga. Like any other form of exercise, yoga has strengths and weaknesses. Let's focus on yogas strengths and to get the cardio, we can do something else to get that. Let's cut the BS and love yoga for what it is.
I think yoga consumers should start a movement to hold these teachers to task who claim unproven benefits of yoga. Too many of them sound like modern snake oil salesmen. It is difficult because we are supposed to respect our teachers but William Broad's book gives us a new approach to this discussion.
I found an excellent instructor who recognizes that it is important to be gentle yet precise. She gives excellent classes in backcare and for seniors. She has produced some audio CDs that are available online. Her name is Kumari and is based in Aylmer, Quebec. Her maiden name is Catherine Gillis. She will be giving teacher training at the Sivanada Yoga Ashram in Val Morin, Quebec, Canada from April 13 to 20, 2015.
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Where the Pulitzer Prize winning science writer shines is in debunking various myths, which continue to be spouted by well-meaning, but misinformed yoga teachers. Thus, yoga will not help you lose weight by revving up your metabolism, fast yogic breathing does not increase oxygen delivery to the brain (it actually has the opposite effect), and asana, even vigorous versions, won't give you anything like the aerobic workout of running or swimming. The book focuses on modern, athletic yoga styles, with little talk of meditation, cultivating awareness, growing spiritually, or finding your life's mission.
And sometimes in his glee to overturn sacred cows, Broad oversimplifies the science, or ignores research that doesn't support his point of view. For example, while yoga has been shown to lower the metabolic rate, we don't hear the evidence that suggests it does facilitate weight loss, likely via such mechanisms as encouraging mindful eating and better food choices, and reducing the level of the hunger-inducing, fat-depositing stress hormone cortisol. That cortisol -- implicated in everything from depression to diabetes to immune dysfunction -- is barely mentioned in the book is one of a number of curious omissions.
Though the book's injury chapter is more balanced than the Times excerpt, I still have problems with it. Strokes, the most devastating risk, do happen, but the means used to calculate how common they are (Broad estimates 300 per year) are dubious at best. Further, he fails to mention that with some teachers and some styles of yoga, and in therapeutic yoga tailored to the individual, serious injuries are exceedingly rare. And while Broad takes obvious pride in debunking myths, he's not beyond propagating a few of his own, probably nowhere more than in the chapter on sex. Yes, yoga improves sexual function and satisfaction. And, yes, some Tantric yogis employed sexual rituals. As for his assertion that "the entire discipline itself began as a sex cult"? Oh, please! He doesn't know what he's talking about.
Whatever its limitations, this provocative book has much to offer and I highly recommend yoga teachers and serious students read it, even though many will find themselves disagreeing with some of the author's conclusions.
Timothy McCall, MD, Yoga Journal's Medical Editor, teaches Yoga As Medicine (therapeutic yoga) seminars worldwide.
This review was originally published in Yoga International. You can also finds critiques of some of William Broad's more recent NY Times articles on my web site.
In spite of the fact that I have some highly critical things to say about this book, I am recommending that every yoga student, yoga teacher and teacher of yoga teachers read "The Science of Yoga." The issues that Mr. Broad raises are too important to be ignored, and need to be openly and objectively discussed by anyone who cares about truth, clarity and safety.
When he's at his best, Broad does a great service to our field by throughly investigating the history of yoga research and reporting on the actual science that's available to either support or refute many of the claims that are commonly made about yoga's promises. Several of the myths he exposes are ones that I have been trying to debunk for years. He also does a great job of documenting the evidence of yoga's benefits - for health, creativity and mental balance.
When he's at his worst, he's attempting to make his book more colorful by spinning speculative yarns about the personalities of his cast of characters. Most of them are long dead and cannot dispute Broad's assertions about their motivations, ambitions and ethics. However, some of his subjects are very much alive and I know for a fact that at least one of them takes extreme exception to the manner in which he was portrayed (full disclosure: I am referring to a good friend of mine).
Broad also loses his objectivity when, in chapter 4, he launches into the controversial issue of yoga injuries. I am the last person to deny that asana injuries happen quite regularly, as a significant part of my practice consists of helping practitioners who have sustained them. Nevertheless, the truly scary picture painted in this chapter is not based on any science that would pass Broad's own muster if he was reviewing it in the first 3 chapters of his book. He can cite no serious scientific studies done regarding the actual cause and frequency of severe injuries (stroke, pneumothorax, paralysis, etc.) because there are none. Instead, Broad reports on a handful of case studies dating back to the 70's, and some surveys of emergency room statistics. He then extrapolates from those numbers to conclude there must be a minimum of 300 strokes caused by yoga asanas per year. Any indication of how common these injuries are in the non-yoga practicing population? No. Any context for where asana practice ranks in relation to other "risky" activities (it's safer than golf)? No. Any mention of the fundamental logical rule that correlation is not causation? No. Is this good science? Hell no.
What becomes clear in his epilogue is that Mr. Broad is a man with an agenda. He wants yoga to gain more credibility and acceptance in mainstream health care delivery by medicalizing its educational standards and subjecting itself to governmental regulation (something I've been fighting against for the past 3 decades). This explains why he needed to build the case for yoga's riskiness, and why he felt compelled to unfairly and inaccurately portray the International Association of Yoga Therapists as a non-credible group with shady origins whose main agenda is to provide its members with "phony credentials." He even absurdly proposes the formation of a "Yoga Education Society" whose mission would be to collect information about yoga and disseminate it to the public - the exact same mission the IAYT has been splendidly fulfilling since its founding. Shameful.
Broad's misplaced faith in his own agenda, the medical model and in governmental controls has blinded him to the fact that much of yoga's popularity as a healing modality is precisely because we are an alternative to all that. We are not medical practitioners nor should we aspire to be. We are educators and should fight to remain so.
Nobody asked Mr. Broad to push for the medicalization, accreditation or licensing of yoga. He took it on himself to make a case for it, and its up to us as yoga professionals to show him that he's wrong by continuing to raise the standards of our educational programs, and by keeping our profession free from coercive forces of any kind. That is why I say it's important you read this book and then let your voice be heard.
2. Broad describes how the modern form of Western yoga is a "cleaned up" version of a centuries-old Tantric practice. The modern postures were developed in Mysore in the early 1900's as part of India's press for independence from the British. This clean, gymnastic & more regimented form of asana and pranayama practice developed by Krishnamacharya is what eventually caught on in America. In India, yoga remains a source of great National pride in both its modern scientific foundations as well as its relationship to ancient Indian culture and religion.
3. Broad provides a, ahem, broad, overview of the way in which scientists have tried to understand how and why pranayama and asana practice lead to wellness and longevity. He digs up research findings in India from as far back as the late 1800's and follows them up to the present day. This was my favorite part of the book ... his trips to the original schools in India to dig up and introduce us to the earliest research on yogis ... usually on yogis who could stay buried inside of airtight chambers. Back then, yogis were believed to have supernatural powers! Even today however, modern scientists study the physiology of hibernation among mammals and wonder if humans might be able to enter similar dormant states. Who knows how long humans can really extend the natural age limit? Maybe astronauts will practice yogic breathing someday as part of long-range space travel? Broad wonders.
He covers a great range of physiological systems such as oxygen/carbon-dioxide exchange (more oxygen stays in your brain when you breathe slowly), metabolism (yoga slows it), musculo-skeletal therapies (training new muscle groups to compensate for injured ones), symapthetic-parasympathetic nervous system (a good practice is when you cycle through poses that differentially activate these 2 branches of the autonomic nervous system), mood & cognition (yoga makes you feel great but you're kind of a space cadet afterwards), hormonal (poses to stimulate various glands), cellular (longer telomeres and healthier DNA), immunity (the vagus nerve stimulates the immune system) and many more.
As covered in the book, there are MANY ways in which pranayama and asana can be harnessed to heal the body and Broad reviews A LOT of relevant scientific evidence ... which, it turns out, often conflicts with popular hype in yoga media. There is a lot of healing power in these practices, but only if you do them in an informed and intelligent manner ... is a recurring theme throughout the book ... which is full of pointers to his favorite teachers (while reading this book, I bought, like, 4 new books on Amazon). Throughout the book, Broad seems to revere Iyengar teachers the most (Iyengar was a student of Krishnamacharya).
4. There is, a now (in)famous, chapter on injuries ... which he concedes are rare in yoga ... perhaps even less common than participation in other physical activities? ... especially among office-bound weekend warriors who push themselves too hard, too fast. He interviews several teachers who share first hand experience with injuries, and who feel that many yoga practitioners have a false sense of security when it comes to poses like, for example, shoulder stand ... where they should take more care to protect their neck and the delicate arteries that pass though the bones in the spinal column there. This being the case, Broad suggests that American yoga teachers need more rigorous training in protecting students against possible harm.
5. All of this medico-scientific study of yoga forms a very strong foundation for what Broad sees is a modern American medical system that is increasingly embracing asana & pranayama therapies. According to Kaitlin Quistgaard, editor in chief of Yoga Journal, "Yoga as medicine represents the next great yoga wave. In the next few years, we will be seeing a lot more yoga in health care settings and more yoga recommended by the medical community as new research shows that yoga is a valuable therapeutic tool for many health conditions."
So, I guess, someday, we'll pay for our yoga classes using health insurance? That would be nice. Broad suggests that the forms and certifications for such "medical" uses will need to be standardized and that yoga therapists will require far more training. OK ... it seems that the driver here will be the public/private insurance companies. Perhaps they might someday pay M.D.'s with yoga certifications? or for specific forms of yoga and breathing? I dunno ... it's their $$ and they will embrace yoga in ways they see fit. (from "The New Medicine" - Deborah Schwab, RN, NP, MSN of Blue Shield of California noted how a study of guided imagery was associated with shorter hospital stays, and lower medication costs to the tune of $2,000 per patient.)
6. There are final chapters on better sex and creativity through yoga. Skip them. Reading the physiology, brain and hormonal science - or worse - doing the specific poses, will NOT help you get laid or be a better lover. And as far as creativity and left/right brain activation goes, it's kind of a myth. "Evidence provides little support for correlating the structural differences between the sides with functional differences."
7. Which kind of brings me to the way the book really made me feel at the very end ... like I just emerged from a window-less, sterile doctor's examination room ... healthier, I suppose, but feeling sort of uninspired. I mean, is this what I'm really looking for ... to feel more relaxed and limber?
READ THIS BOOK if you want to be a yoga therapist in the United States! READ THIS BOOK if you work for a health insurance company and set up reimbursements for members to begin asana and pranayama classes ... the book is invaluable in separating the hype from the real data. READ THIS BOOK and be a more educated yoga consumer ... there is so much bewildering kooky hype out there in the U.S. yoga "free marketplace". I will definitely use a supporting blanket in shoulder stand!
But, on a purely personal, non-judgemental, for me only, personal level ... I'm practicing and studying yoga so that I can have a truly transformative, emotional, spiritual experience ... where I feel more connected to nature ... more connected to the people around me ... where my ego can be lost in a sea of love that wells up inside of me.
Yes, of course, I'll practice pranayama and asana ... to help strengthen my body. The strength and breathing will help me with meditation ... so that I can sit quietly for hours ... and still my mind. The stillness will help me listen and feel ... the earth and other people around me. The physical and breathing practices form a foundation for meditation ... which helps me become more empathetic, attentive, attuned, aware and open-minded. I care more about others ... and THAT is what feels so transformative.
I guess "Yoga" for me ... is when I seek to experience my "true self" as simply being dissolved and inter-woven in everything and everyone around me. An ego-less union with everything ... that's sort of where the magic happens for me.
I dunno if Broad would agree that THIS type of social-emotional experience is where a somewhat deeper joy and fulfillment of Yoga can be found ... not in pranayama and asana per se, as ends in themselves, but in all the wonderful things that can happen after you've been practicing ... like when you go out into the world and LISTEN and CONNECT? I dunno.
Perhaps though, he would agree that there is a ton of social, evolutionary and cognitive science to this experience too. The science of Yoga (part II) ... perhaps?
It is worthwhile to read this book for an introduction to some of the science that has been done to understand some aspects of some types of yoga. The book has many issues and the reader should maintain a critical attitude when reading it. The author's main message is that yoga needs quality control and that science can help to separate the good from the bad and the myths from the reality because yoga has consequences and should be done with care and attention. He does a so-so job of making his case. For more details, see below.
William Broad took on a large and thankless task when he started writing "The Science of Yoga". The 222 pages of the hardback 1st edition could never quite do the topic justice, but I commend the attempt and welcome it as a beginning. It's a necessary book that draws together for a wide audience a large body of information on yoga and the science trying to elucidate its nature and its effects on the human mind and body. He sets himself up as a whistleblower with the subtitle focusing on the "Risks" of yoga but then tries to temper that characterization by painting himself as a longtime yoga insider who's only goal is to improve the experience of yoga for everyone. He contends that the maturation of yoga out of its "wild west" phase will be hastened by a closer relationship with science and the embrace of standards that would enable practitioners and interested beginners to distinguish high quality teachers and therapists from people who think they can create their own yoga and catch the wave of interest to make a quick buck. I agree with this hope and concur with the optimism that yoga's collision with the West will improve the practice and understanding of yoga. Does "The Science of Yoga" do a good job of making these arguments and clarifying the current scientific understanding of the practice in a way that is faithful to the title? Not so much.
I'll start with some obvious criticisms that undermine the book. There is a wealth of good information in the endnotes, but you wouldn't know it from the body of the text as there are no numbered references. Is this a printing error, a publishing oversight, or a stylistic choice to maintain the reader's flow? I don't know, but in a science book it's not a good thing. Broad uses language inconsistent with his references. For example, he cites James Mallison's translation of the Gheranda Samhita when describing the Hatha yoga purification technique Agni Sara, but the Gheranda Samhita calls this practice Vahnisara. It leaves me wondering if Broad cited Mallinson's work to improve the credibility of "The Science of Yoga" without actually reading the cited work himself. That would be not good. He quotes statistics on neck mobility that support his argument about the risks of yoga without providing adequate context. He describes how "scientists have measured the neck's normal range of motion" to be "backward 75 degrees, forward 40 degrees,..." but fails to mention "N" (the number of people in the study), their age range (kids or seniors?), or other important factors, like their occupation (i.e. were they desk jockeys or yoga teachers?). At other points in the book he subtly disparages researchers who fail to apply experimental controls and individuals who make bald claims without data, but to support his argument about the risk of injury he mentions the "public alert" issued by W. Ritchie Russell on the dangers of excessive neck bending. Russell made this alert on the basis of no data; it was only his well-considered opinion. Broad further supports the risk argument by citing the cases of injury for single individuals (N = 1) who were either practicing alone, holding single poses for extended periods (vajrasana for hours a day? really?), showing off for a camera, or obviously making a mistake in a posture. He fails to acknowledge that isolated cases cited without context are insufficient for the strength of his claims.
The picture he paints of yoga in the West is incomplete. This may be an editorial decision to maintain the pithiness of the text, but it wouldn't take much to qualify his descriptions. He claims there are three phases of yoga, starting with the earliest Hatha yoga in medieval times. He neglects the older currents of moral restraint that were thrown out by Hatha as too difficult and distracting and the cessation of the fluctuations of the mind which still inform yoga practice today and which draw a large number of practitioners towards their archetypal forms. It may be that he views such connections to more ancient perspectives, as other writers such as Alter and Singleton have done, as slightly disingenuous attempts to enhance the authenticity of modern forms, but that doesn't mean the older forms can be ignored. Broad focuses too much on the raw physicality of postural yoga and fast breathing without providing the reader the full picture of a discipline that has been described as "skill in action" in the Bhagavad Gita, as eight-limbed by Patanjali and which led the sages of the Upanishads to describe Taraka-yoga as a discipline that provides the realization that all demonstrable things are "not this, not this". These perspectives appear to have greater relevance to the neuroscientific research on consciousness than the oxygen uptake and metabolic changes on which he spends so much text.
Broad falls into the trap of viewing harshly those whose assumptions and simplifications don't support his argument but viewing favorably his own assumptions and simplifications and those of people who support his argument, like Ritchie Russell mentioned above (and if you think eminent scientists' opinions can't be wrong, read up on the latter thoughts of James Watson). He describes a situation in which Krishnamacharya, a very influential yoga guru, is "humiliated" when his claim of being able to stop his heart is tested using EKG by Basu Bagchi, an early yoga scientist. Krishnamacharya is reported to have reduced his heartbeat below a level detectable by stethoscope, but the EKG still registered a "blip, blip, blip". So this is an argument over the definition of heart-stoppage. If you are able to reduce your heartbeat below a level detectable by the technology you have at hand, is a claim of heart-stoppage wrong? If you view the claimant harshly, then "Yes". If a more sensitive technology comes along that shows there is still some heart activity below the level detectable by the earlier technology, is the claimant "humiliated"? If the answer is "Yes", then Galileo, Newton and Hawking and almost every other scientist has been "humiliated" at some point. But Broad fails by this standard when he describes how he suddenly saw the "big picture" that yoga began as a sex cult, even though he had no data and only limited science to back up such a claim.
He reports an incomplete picture of styles like Ashtanga, Power, Vinyasa and Bikram which expressly focus on deep, rhythmic, non-labored breathing linked to the postures being performed and on developing core strength that is explicitly designed to improve stability and prevent injuries, particularly in the back. The Bikram misrepresentation is most clear. He describes a Bikram class as having the most difficult postures at the end followed by rapid breathing exercises that parallel the experience of sexual climax. I'm not sure what Bikram class Broad went to, but if I assume that Bikram maintains tight control over the sequence of postures and their mode of execution (actually, I don't need to assume that), then Broad gets it all wrong. Following an initial set of breathing exercises, Bikram's style has an unbroken sequence of standing poses. After the standing poses there is a savasana and the remaining postures are done on the floor, interspersed with more short savasanas. The peak of activity is not at the end.
So, would I recommend this book? Yes. There is much value in it, but the reader should keep their mind open for inconsistencies, biases and agendas. Follow up on the references and the recommended reading and maintain a critical attitude. It will help your perspective if you practice yoga and have the benefit of the lens of personal experience. The book is still useful as an introduction for people who don't practice yoga, but they should be aware the book is imbalanced and misleading in places.
The Science of Yoga offers considerable original insights into the risks and rewards of doing yoga, yet it is also somewhat unbalanced and selective in reporting on various instances of injury. It's of some concern that only one of one his seven advance reviewers whose comments appear above, David Gordon White, has any claim to yoga expertise - and White is an insightful philosopher and historian of religion, not a yoga teacher or yoga posture expert.
Broad betrays a very limited reading of the classics, such as claiming that the legendary B.K.S. Iyengar never addresses risks in yoga poses - quite the contrary - and confused knowledge of basic functional anatomy (as when he confuses hyperextension with hyper-flexion is his discussion of shoulder stand and cobra pose). See Iyengar's first book for yourself: Light On Yoga So we can reasonably approach this book aware that we are being given a journalistic perspective buoyed by spicy assertions certain to stoke controversy but perhaps not shed as much light on teaching and practicing yoga as the title suggests.
My primary criticism concerns Broad's assertion that "yoga can wreck your body, " which reifies yoga - makes it into a thing that is given the power to affect other things (say, your body). But yoga is not a thing. Rather, yoga is a world of practices that one can do; you do yoga, yoga does not do you. See Ganga White, Yoga Beynd Belief to learn more: Yoga Beyond Belief: Insights to Awaken and Deepen Your PracticeOnce one gets this basic idea, then it's a simple step to realize that how one does yoga along with what sort of yoga one does will have different effects. If you skip over the first couple hundred pages of Iyengar's Light on Yoga to the few pages on shoulder stand, look at the pictures, read the brief instructions, then attempt to do it without all the preparation discussed in the previous two-hundred pages, then you're likely to end up like some in Broad's book who feel that yoga is hurting them. I feel for those folks. Forget for a moment, as Broad seemingly has, that Light on Yoga was written 50 years ago and that Iyengar has published extensively since then and given more nuanced guidance around things like how to reduce hyper-flexion of the cervical spine. That's not exactly responsible scholarship. See Iyengar's more recent work: B.K.S Iyengar Yoga the Path to Holistic Health
All that said, it's also very clear that Broad is a fan of yoga, albeit yoga with a warning label. In support of this perspective (or conclusion), Broad does marshall significant evidence that reveals the extent of certain types of injuries to some students. It is especially interesting to read reports of the systematic data on emergency room admissions collected by the Consumer Product Safety Commission, data that is coded to indicate what led to the emergency room visit. Simply bringing this data to light is very helpful. There are, however, some problems with Broad's interpretations of that data, including ecological fallacies and questionable assertions of causality.
Again, there is no question that many students (and teachers) are getting injured doing yoga, and Broad marshals some credible evidence to highlight this fact. And he is right that yoga teachers need better training and ongoing support. Hopefully, this book will further motivate the ongoing conversation about standards in the yoga profession and how the yoga community might better address problems arising from teachers who don't understand the difference between a counterpose and a contraindication. For more on practicing yoga safely, see my most recent book, Yoga Sequencing: Designing Transformative Yoga Classes.