Meditation and Yoga in Psychotherapy by Annellen M.Simpkins and C. Alexander Simpkins

Meditation and Yoga in Psychotherapy
Techniques for Clinical Practice

Annellen M.Simpkins and C. Alexander Simpkins.

John Wiley & Sons, Inc.
2011 296 p.

Previously published reviews of the Simpkins books (ESH Newsletter 2010-2) and the title of this one were sufficiently inviting for me to start reading. Practicing plenty of sports activities and yoga, I sometimes feel annoyed by the immobility in classical psychotherapy settings. Even the work with hypnosis, bringing about mental activity, flexibility, creativity is most of the time characterized by some immobilization of the body, keeping patients and therapists in some fixed position.

As for different therapeutic methods, evidence is necessary for methods to be integrated in professional practices: the authors start with an overview of efficacy and neuroscience research where studies on yoga and meditation are reviewed. Surprising is the “Maharishi Effect” where is illustrated that “crime, illness and other negative aspects of social life diminish sharply when about one percent of city’s population meditates. “(p.9) Hopeful for our ever larger group of elderly is that yoga and meditation slows aging processes and can rejuvenate to about 12 years younger than biological age. An interesting question about how yoga works is answered by summing up ingredients illustrated in some studies: spirituality (and changing pain threshold), absorption, self-regulation, dual action of relaxation and activation as showed in EEG patterns. Research in neuroscience could demonstrate that yoga practices increase executive functions in the frontal lobe (p25), useful for self-control and affect regulation. They get more of the brain activated or increasing coherence, useful in education and stress control. Breathing rebalances the autonomic nervous systems, and different postures or mantras activate different brain patterns. “One of the most important tools of yoga is meditation and the key component is attention.” (p. 30) Where direct voluntary control of attention can be seen as quite similar to induction in hypnosis, further aspects of meta-attention, open-ended forms of meditation, with free flowing attention and engagement of unconscious processes seem to be somehow different processes, with different neurophysiological aspects.

Reviewing the long tradition and history of yoga, you read how it matches with the human search of people to find truth and is as well a philosophy as a practical system. In the historical overview, the authors bring you back to ancient traditions, to the 5th -2nd century BCE….Some words and concepts you may have heard before as ‘Vedas’ ‘Upanishads’ ‘Bhagavad Gita’, now are explained, with their meaning, historical roots, contexts and teachers. You learn about different kinds of yoga, to help you choose which yoga classes match with you. You see how f.i. Kundalini Yoga method combines the flow of prana energy and the pranayama breathing, easy to integrate as personal training or as method to share with clients. The method is combined with chakra’s concepts. They are represented by specific lotus-flowers with a particular number of petals, colors and location. Chakra work offers a nice map for transition from one emphasis and concern in life to another, matching with development and with symbolic work as in hypnosis.

Yoga and the link with psychotherapy?

One of the main ideas in this book is linking the philosophy of yoga with aims of psychotherapy. What is really and essentially necessary for people in need of psychotherapeutic help? What can psychotherapy do and how can yoga be helpful. Starting with the concept that clients want to free themselves from illusions, develop clarity of perception, help resolve conflicts and find inner peace, yoga meets these demands. Read thread in this book is the eight limbs of yoga, from Patanjali’s system, essentially a system to help “master relationship between material and mental, direct focus toward consciousness and bring awareness of our true nature.” (p.75)

  • Yama’s (what not to do or abstinences) and Nijama’s (what to do or observances) as the first two limbs, seem common and simple, but sticking onto these practices will require discipline and practice.
  • Asanas (the third limb) refer to postures, requiring focus and discipline, train discipline and entailing some confrontation with oneself. Some postures have a symbolic as well as a practical meaning. They are learning experiences, and because of that considered as important teachers.
  • Pranayama, involves focusing attention on breathing for control, distribution of prana or vital energy. This is particularly important in psychotherapy where body postures with breathing patterns bring “emotions with their corresponding mental states into consciousness” (p 82), opening a window to client’s inner world.
  • Pratyahara, the fifth limb is withdrawing from engagement with outer world, a form of renunciation, which in psychotherapy is a way to “disengage from unhealthy patterns, emotions or behaviors” (p.83)
  • The higher 3 limbs help to reach Samyama – Dharana as one-pointed focus of attention, limb 7 or Dhyana where there is a free play of thought and feeling and Samadhi, the 8th limb, where there is union, joining with the object. Enlightened consciousness can emerge through the practices of Samyama.

In Chapter five you discover how yoga and meditation can be integrated into clinical practice. No need to perform complex poses for therapeutic effect. Practitioners are “put back into the driver’s seat of their cognitive processes.” (p105) The brain is enhanced, the body improved and the mind sharpened and then much more becomes possible. Down-top work, changes in the body or in attitudes as explained on p. 90 ‘attitudes can be encouraged and even adopted physically first, thereby paving the way for an easier cognitive and emotional change’ offers a different entry. Asana’s – moving into a pose, holding and coming out – go along with directing attention, unifying thought and action together, holding a point of focus. Even practitioners who don’t feel ready to introduce asana’s, will find ideas in specific breathing techniques, discovering how it acts “as an internal activity that forms a bridge between outer and inner world”(p.100).

Guidelines and rationale for breathing exercises and asanas are clearly explained, introduced step by step being a help to get started. As you’re reading you can practice yourself, take a pause now and then and turn to some exercises. Your own experience as a reader will help to share these experiences with others. You can discover which changes the simple asana’s bring about, how breathing is useful for emotion regulation, self – control and activation of Kundalini energy, how meditation helps to withdraw from problematic behaviors, thought patterns and emotions.

Authors use nice metaphors like “how do you quiet down a group of children who want to play?”(p106) to illustrate Pratyahara control. You can allow thoughts, being aware, and discovering how they settle down like children after running and jumping around. Dharana as one pointed attention comes late in the process, in contrast with hypnosis f.i. where it’s a starting point. Dharana on a mantra like “OM” combines the sound, visualizing the word, contemplating the meaning of unity and creation. Effect of holding the focus in a meditative process, is that a transformation begins to happen, that in contemplating self and object join together as one flowing process reaching the state of “dhyana, a current of unified thought”.

When as a reader or therapist you study the eight limbs carefully and start knowing each one thoroughly, the appropriate application will readily come to mind, as a do-it-yourself project. When you know what meets your client’s demands, you may feel ready to introduce one of the limbs into their therapeutic process.

Part III on clinical applications, gives specific guidelines for overcoming stress, anxiety, depression, working with children and elderly people.

In my opinion, this book can be considered as an all-in-one work, where you find information on yoga and meditation from the fields of neuroscience, research, history, clinical practice and applications. Even readers who have neither experience in yoga nor in meditation can get started with the well described exercises; therapists can find which exercises to teach or share with their clients, how and for which indications, enrich their therapeutic approach. Text is enriched with illustrations of lotus flowers and asanas. The idea that “the wise therapist incorporates yoga” (p. 160) might sound over enthusiastic for some therapists, but is worth wile to give it a try.

The reading stimulates me to reflect on integration of Eastern and Western practice. The first time meditation was brought onto Western soils was at the “World Parliament of Religions”1893. Vivekananda “encouraged people to embrace an experience of universal oneness” (p. 60)

It still sounds up to date in our contemporary efforts on unifying mind, body and brain in therapy, on integrating body work in therapy, on using symbols or postures as a way to facilitate change, on bridging East and West.

By reading you can feel interested in further study of similarities, parallels and differences between hypnosis, meditation, mindfulness and yoga. The wisdom of this book invites to reflect on the essence of psychotherapy, to open up yourself for other approaches and utilize new entries for treatment and development. You also are encouraged to add a spiritual dimension or to discover spirituality in your work with clients. Is therapy a philosophy? What philosophy or spirituality do you have as therapist and which impact does it have on your work? How can you bring this dimension into your work? How do we look at ourselves: with neuroscience glasses, seeing that we are embodied beings, or according to yoga theory that we are en-souled, and that the we can see that “the soul is knowledge itself.” (p241) How far are you as therapist in this discovery? Can a therapeutic process be seen as helping clients to attune to their “deeper inner sensing, to find an anchor in troubled waters, a way to steer the ship through treacherous storms”? (p. 242)

This book can be considered as an enriching present for therapists, colleagues and clients stimulating personal reflection. It is written in an accessible language, covering common and new concepts and stimulating further study and reading.


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