Yoga and Care of the Self in the Promotion of Health

Alcione Cássia dos Santos Ramos/Sannyasi Gangadhara, supervisor: Kènia Lara Silva

This research is being conducted in Belo Horizonte, Brazil, by the Federal University of Minas Gerais, in the field of Education and Health.

Acting as a yoga practitioner and teacher, I have gathered testimonies from many students about how yoga has positively influenced their physical, emotional, mental and spiritual health. Living with the universe of yoga in both India and Brazil has brought me many questions regarding the application of yoga in the contemporary world and reflections on how yoga, which is an ancient practice, can act as a health promoter and assist post-modern men to improve their quality of life and their health.

Interest in yoga has increased over the past two decades and in 2012 it was estimated that 20 million Americans were practising yoga and most of them with the goal of increasing health and maintaining fitness (BARTLETT et al., 2013).

The Yoga Health Foundation estimates more than 250 million practitioners worldwide. In the United States you can find yoga in cruises, resorts, senior centres, gyms, museums, hospitals, schools and also as a means for educational purposes to awaken creativity and calm professionals in their jobs, since yoga has become a symbol of serenity (BROAD, 2013).

In Brazil, the situation does not look very different. In the non-indexed literature there are articles and news about the practice of yoga in companies, gyms, schools, museums, hospitals and health and cultural centres. We also have yoga as a great business: along with the practice a trend of consumption of clothing, accessories, specialized magazines and special mats to practise. Having travelled between Brazil and India several times, I was able to observe the evolution of this movement and especially the business correlation of yoga in India and Brazil.

According to Siegel (2010) since the creation of the Traditional Knowledge Digital Library (TKDL)*1 by the Indian government, 150 yoga postures have already been patented abroad and 134 of them have been patented in the United States. Marketing analysts identify yoga as part of an area known as Life Styles of Health And Sustainability (LOHA), where consumers of the upper middle class impart their economic power in shopping for organic and natural products (BROAD, 2013).

There seems to be a complex movement around yoga that nowadays involves health, education, paradigms, spirituality, lifestyle, individuation, subjectivities, collectively and economic market. This movement arouses our attention, because with the increasing demand for this practice, its effects, precautions and benefits should not go unnoticed. This study questions how the intervention of this practice occurs in the process of education and health of the human being in contemporary times and in a scenario where politics, health, education, freedom and autonomy are intertwined.

Literature review

The health sciences are also interested in yoga. Many studies demonstrate the positive impacts of yoga on health as support in anxiety, depression, schizophrenia, increased well being and quality of life in many chronic diseases, reduction of cellular activity in patients with early stage breast cancer and reduction of infection in patients with tuberculosis, HIV and arthritis (NAOROIBAM et al., 2016; GAISWINKLER et al., 2015; BARTLETT et al., 2013).

Yoga and health are concepts that converge. In the conception of Swami Niranjanananda Saraswati (2005), yoga is an ancient system of philosophy, techniques and lifestyle that works the whole person: his physical well being, the vitality, mind and emotions, wisdom, ethics and a healthy relationship with other people and the fulfilment of our spirituality. Health, from the perspective of Rabello (2010) is a category resulting from the interaction of man as a biological, social and spiritual being in the context of social organizations.

According to Barros et al. (2014), yoga is an Indian tradition that uses a set of psychophysical practices and in 2002 the World Health Organization (WHO) advised its use by national health systems in all member countries.

In the Brazilian health system, yoga found support for the institutionalization of the Integrative and Complementary Practices Policy (PNPIC) in the Unified Health System (SUS), in 2006 and in order 145 (of 13 January 2017) issued by the Ministry of Health that included yoga as a procedure within the organization of Integrative and Complementary Practices and as one of health promotion and prevention actions (BRAZIL, 2015, 2017). According to Luz (2003), Integrative and Complementary Practices (PICs) are appropriations of traditional knowledge and are based on a vital paradigm of the human being, which takes into account their physical, emotional, mental and spiritual integration, opposing the biomechanical paradigm that guides contemporary western medicine. They are approaches that have their own theories about the health-disease process, diagnosis and therapy and are called by the WHO traditional and complementary/alternative medicine (MT/CAM).

According to Lima (2012), the National Center for Complementary and Alternative Medicine (NCCIH) distinguishes complementary terms when practices are used in conjunction with biomedicine practices, alternatives, when practices are used instead of biomedicine, and integrative when practices are used along with biomedicine based on scientific safety assessments. In this context we can name yoga as a practice, complementary, alternative and integrative.

Bibliography review

For this study, a research was conducted in the Pubmed Database, which crosses the word 'yoga' with health promotion, 'yoga and education' and 'yoga and health education'', and 340 articles were found. Most of them are in the United States of America and later in India.

As we find in most of these articles yoga more as a strand of yoga therapy than as an educational practice, we find, therefore, a gap with regard to yoga as an educational practice that promotes a health built on the subjectivity of its practitioners.

To extend the performance of yoga as an educational practice in health is to point out that health, understood in its holistic aspect, demands learning processes. In order for approaches of care in education and health to be truly meaningful for the subject, it is necessary to have an education process that is experienced and understood beyond a simple training imposed by behaviours and norms external to the subjective reality.

This study intends to show an education, transforming a personality and based on the subjectivity of the human being. For Larrosa (1995), some pedagogical practices include techniques that establish some type of relation of the subject with him/herself. They are constituted of practices oriented to the construction and the transformation of subjectivity, understanding this as the way in which the subject makes the experience of himself in a game of truth in which he/she is in relation with him/herself.

It is assumed that the educational role of yoga lies in the process of transformation of the subject and expansion of his/her consciousness, emphasizing the libertarian character of health promotion. Thus, the referential of education as an experience of self is adopted.

For Foucault, the experience of self enables a process of subjectivities, that is, a process by which we transform ourselves from individual into a moral subject, in which the person learns and perceives himself/herself (VEIGA NETO, 2016).

One of the action plans of yoga is in the expansion of consciousness. Limited consciousness is the product of a conditioned world where the individual does not have autonomy and repeats a way of thinking and expressing himself that does not belong to the construction coming from his personal experience. For us, the educational experience is a means capable of bringing meaning to the events of life through a process of subjectivities. As a practice, yoga is a manifest experience in the physical, emotional, mental and spiritual plane, capable of enlarging our consciousness.

This expansion of consciousness that yoga proposes is related to the process of self-knowledge, transformation and autonomy of the human being in relation to the socio-historical and political context in which he lives. It brings us the possibility of differentiating ourselves from a hegemonic culture and acting as active and reflective subjects capable of effective transformations for a better life with us, with others and with the society in which we live, evidencing a broader sense of health. For Jung, consciousness is always consciousness of myself; to become aware of myself, I must be able to distinguish myself from others; only when there is such a distinction can a relationship appear (JUNG, 2002, p.195).

To educate in health is to broaden the subject's awareness of relationships with himself and the world and this interferes with his health. Work, relationships, city life, economics, politics, availability of food and water, responsible care, being ethical and kind with ourselves are key determinants of health.

For yoga, health care is a means to the goal of realization of the human being. According to Tesser (2009), in the perspective of health promotion, this aspect is observed in the incentive of a process of personal transformation and fulfilment as individual trajectory and harmony of the person with the world and with others.

However, a problem is presented here. In contemporary times, the physical aspect of yoga is overly highlighted to the point where it is confused with a mere physical exercise, capable of producing a physical body shaped by a hegemonic and alienating aesthetic of the subject.

In this context, control over the bodies has constant vigilance and a capillary power over health in an image of a body that is always beautiful and young (RAMIRO, 2015), rather than 'health' lived in the subjectivity of the users.

Ferreira Neto (2010) points out that, according to Foucault, from the Greek culture we find attempts to improve living conditions in a set of self-practices to be observed by the man of the polis, based on philosophy and medicine. Both in the culture of care of the self as exposed by Foucault and in the vedic context, philosophy and spirituality were part of the same practice. For Foucault, by spirituality is understood the practices by which the subject modifies himself to have access to the truth (CASTRO, 2014). In this understanding, the relation of body and self-care involves the body in a body-soul unit, which must be understood in an integral way (BOLSONI, 2012).

In view of this, we are concerned about yoga as a practice invested by public health policies: if on the one hand yoga can contemplate a greater number of users with possibilities of greater care and new ways of dealing with the health of the human being, then on the other hand, it can also serve the reductionist logic of the body and biomedicine, which are tied to late capitalism.

Facing these reflections, we bring our questions: Has yoga, at present, preserved its transformative and educational essence? What do practitioners learn about yoga in relation to health? Is there evidence that such learning goes beyond the physical dimension of health and reaches the mental, emotional, spiritual and social realm? This is intended to investigate the learning of self-care of yoga practitioners.

For Foucault (2005) medicine is a knowledge-power that focuses on the body, population and biological processes producing disciplinary and regulatory effects. For the author, this power was entrusted with both body and life. In a limiting perspective, health promotion aims at a unification of behaviours, unwinding individuals from their capacity to take care of themselves (FRANCO et al., 2011). In a liberating perspective, effective changes in the promotion of individual health require an educational process of transformation of habits and behaviours from a process of subjectivity. In the perspective of learning to care for oneself through yoga, subjectivity is understood as heterogeneous practices and processes through which human beings come to relate to themselves and to others as subjects of a certain type (PARASO, 2012, pp. 30).

From the above we have a field of contradictions: yoga originated in India and in the pre-classical and classical period was constituted within a context of practices aimed at liberating a conditioned existence. Assimilated by modernity it has become transcultural. In later capitalism, it seems to serve as the object of alienation and consumption of a particular social class. On the other hand, yoga is part of a set of non-hegemonic health practices. Those who assimilate the practices of yoga can become agents of opposition to a dominant way of life. Therefore, it is intended to investigate yoga as part of a health model that now repeats, sometimes reinventing life based on subjectivities capable of positively interfering with health.

Methodology

For this study we opted for the qualitative research of an exploratory and descriptive nature and chose as a theoretical-methodological reference the post-structuralism. The investigations that adopt this referential are more concerned in describing and problematizing processes that produce certain knowledge in a context of certain power networks. These theoretical approaches point out that language, culture, truth and power are inseparable (MEYER, 2012).

It is understood that this study questions hegemonic ways of health promotion and approaches the subjectivity in capturing the perception of what the subjects learn in relation to health and care of self.

For this research the city of Belo Horizonte, Brazil, was chosen as the location and the Association of Employees of the City Hall of Belo Horizonte (ASSEMP). The data collection was carried out from March to May of 2017 in the form of a descriptive observation of the yoga classes and a narrative interview with the practitioners of yoga. Fifteen practitioners of both sexes, aged between 20 and 74, were interviewed. The narrative interview is a qualitative research method with specific characteristics. It is a type of interview less imposed and therefore more valid from the perspective of the informant (BAUER; JOVCHLOVITCH, 2002).

The narrative interviews were recorded and later transcribed and the reports are in the analysis phase of the discourse, evidencing yoga as a mediating practice of self-care that sometimes presents itself as a personal transformation, self-knowledge, an opportunity for refection, care for the other and now as superficial attitudes of caring for the body. In the discourses of practitioners, health is understood as a process of integration of body, mind and spirit. Practitioners integrate spirituality into their conceptions of health: If people are well physically and spiritually, we can get a little more relaxed, if we can take care of ourselves, we will have a better health.

(E4 interview code) Health is so important that it relies on the body, mind and spirit. (E1 interview code))

Final considerations

Yoga is now in a field of health promotion forces where the health of individuals can be controlled by normative and hegemonic lifestyle practices or by liberating practices. Our challenge is to preserve it as an educational practice capable of teaching practitioners to care for themselves through a relationship with themselves, as an ethical option in post modernity. This study will be finalized in March 2018.

*1. Indian government-organized database of approximately thirty million pages containing archives on ayurvedic medicine, unani and siddha medicine. According to Siegel (2010), this database has the project of including 1,500 positions of yoga and one of its objectives is to organize or standardize yoga therapy.