The role of yoga during COVID-19 - Félagsvísindadeild Hug- og félagsvísindasvið Háskólinn á Akureyri 2021 - Skemman
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The role of yoga during COVID-19
Yoga and meditation as a public health support and a
holistic therapeutic mechanism during the COVID-19
pandemic
Margrét Edda Magnúsdóttir
Félagsvísindadeild
Hug- og félagsvísindasvið
Háskólinn á Akureyri
2021
<The role of yoga during COVID-19
Yoga and meditation as a public health support and a
holistic therapeutic mechanism during the COVID-19
pandemic
Margrét Edda Magnúsdóttir
12 eininga lokaverkefni í nútímafræði
sem hluti af
Baccalaureus Artium-gráðu í félagsvísindum
Leiðsögukennari: Gunnar Már Gunnarsson
Félagsvísindadeild/nútímafræði
Hug- og félagsvísindasvið
Háskólinn á Akureyri
Akureyri, maí 2021Titill: The role of yoga during COVID-19: Yoga and meditation as a public health support and a holistic therapeutic mechanism during the COVID-19 pandemic Stuttur titill: The role of yoga during COVID-19 12 eininga bakkalárprófsverkefni sem er hluti af Baccalaureus Artium-prófi í félagsvísindum. Höfundarréttur © 2021 Margrét Edda Magnúsdóttir Öll réttindi áskilin Félagsvísindadeild Hug- og félagsvísindasvið Háskólinn á Akureyri Sólborg, Norðurslóð 2 600 Akureyri Sími: 460 8000 Skráningarupplýsingar: Margrét Edda Magnúsdóttir, 2021, bakkalárprófsverkefni, Félagsvísindadeild, hug- og félagsvísindasvið, Háskólinn á Akureyri, 35 bls. Akureyri, maí, 2021
Ágrip
Jógafræðin eru aldagamalt andlegt fyrirbrigði sem á rætur að rekja í trúarlega hugmyndafræði
Hindúisma. Þessi ritgerð skoðar hlutverk jóga og hugleiðslu sem samfélagslegur
lýðheilsustuðningur í ljósi þeirra margvíslegu félagslegu- og andlegu áskoranna sem COVID-19
heimsfaraldurinn hefur leitt af sér. Alþjóðleg viðbrögð stjórnvalda við útbreiðslu
kórónuveirunnar (SARS-CoV-2) hefur verið að innleiða ýmsar takmarkanir og reglugerðir sem
talið er að hafi neikvæð áhrif á líf fólks og velferð samfélagsins. Áhyggjur af líkamlegri og
andlegri heilsu fólks hefur verið áberandi í umræðunni um áhrif faraldursins, sérstaklega
meðal heilbrigðissérfræðinga. Heilbrigðissérfræðingar telja helstu áhyggjuefnin vera aukinn
kvíði og þunglyndi sem tengja má við aukið álag og streitu. Rannsóknir hafa sýnt fram á
fjölþættan heilsufarslegan ávinning þess að stunda jóga og hugleiðslur. Jóga er úrræði sem
stuðlar að tilfinningalegri stjórnun, vellíðan, bættri virkni og framleiðni sem þar af leiðandi
eykur velferð einstaklingsins. Í þessari ritgerð er farið yfir yfir þann heildræna heilsufarslega
ávinning sem rannsóknir hafa sýnt fram á að jógafræðin og jógaiðkun bera með sér. Markmið
ritgerðarinnar er að færa rök fyrir því að innleiða jóga sem heildræna heilsustefnu til úrbóta í
samfélögum sem glíma við neikvæðar afleiðingar faraldursins með því að sýna fram á hvernig
jóga getur bætt andlega heilsu og hjálpað einstaklingum að takast á við áskoranir sem
faraldurinn hefur leitt af sér. Þessi lokaritgerð mun á sama tíma bæta skilning vestrænna
manna á jóga og hugleiðslu og hvernig megi nýta jógafræðin í okkar samfélögum.
vAbstract
Modern yoga practice and meditation may be described as a modern invention with ancient
eastern roots of spirituality. This thesis will discuss the role of modern yoga practice and
meditation during the COVID-19 pandemic. Yoga will be viewed as a community public health
support in light of the multiple challenges and disruptions that have emerged from the
coronavirus outbreak. The international response of governments and leading figures to the
outbreak of the coronavirus (SARS-CoV-2) has been to implement various restrictive measures
and regulations which has negatively impacted social and mental health of the public. Health
experts have been vocal about their concerns of public health during the pandemic. The
subject of yoga and meditation as a social solution and a holistic health strategy to cope with
these challenges is presented in this thesis. A great variety of research has demonstrated that
regular and consistent practice of yoga and meditation contributes to a better overall health
and wellbeing by reducing stress, anxiety and depression. This thesis suggests that yoga is a
resource that provide individuals with coping mechanisms, or tools, such as emotional
regulation, acceptance and sense of control during times of uncertainty. This thesis provides
arguments for the implementation of yoga as a public health strategy and as a therapeutic
mechanism for the betterment of societies who are struggling with the negative consequences
that have emerged during the COVID-19 pandemic. By presenting the positive effects and
multiple benefits that can be achieved through yoga practice, this thesis demonstrates how
yoga can improve mental health and help individuals cope with the challenges of the
pandemic. Therefore, this topic is of great importance and will contribute to the developing
western understanding of yoga and meditation and how it may be useful in our societies.
viÞakkarorð
Þessi ritgerð er lokaverkefni mitt til BA gráðu í nútmafræði við félagsvísindadeild Háskólans á
Akureyri. Ritgerðin var unnin vorið 2021 undir leiðsögn Gunnars Már Gunnarssonar. Fyrst og
fremst vil ég þakka leiðbeinanda mínum fyrir góða leiðsögn, gagnlegar ábendingar og
ánægjulegt samstarf. Sérstakar þakkir fær Andri Már Rúnarsson fyrir ómælda þolinmæði,
yfirferð og stuðning í gegnum þetta ferli og í gegnum skólagöngu mína almennt.
viiTable of Contents
1 Introduction .............................................................................................................. 1
2 Public mental health and COVID-19 ........................................................................... 4
2.1 Public mental health: A theoretical explanation.................................................. 5
2.2 The implication of COVID-19 for mental health and wellbeing............................. 7
Psychological effects of COVID-19 ..................................................................................... 7
Social impact of COVID-19 ................................................................................................. 9
Unemployment during COVID-19 .................................................................................... 10
COVID-19 and mortality ................................................................................................... 11
3 Yoga for health and quality of life ............................................................................ 12
3.1 Yoga explained: Historical perspective, modern practice and yoga philosophy .. 12
History and yoga philosophy ............................................................................................ 13
Modern yoga .................................................................................................................... 15
The practice of yoga and meditation ............................................................................... 16
3.2 Yoga research: Evidence of health role and how it affects the quality of life ...... 17
Psychological benefits ...................................................................................................... 18
Physiological benefits ....................................................................................................... 19
Social benefits of yoga ..................................................................................................... 20
Yoga for suffering ............................................................................................................. 21
4 Main findings: Spiritual/religious yoga during COVID-19 .......................................... 24
4.1 Yoga: Public health support during COVID-19 ................................................... 24
Yoga as a public mental health strategy .......................................................................... 26
Yoga, physiology and COVID-19 ....................................................................................... 27
4.2 Yoga: A holistic therapeutic mechanism for the social impact of COVID-19 ........ 27
5 Concluding remarks ................................................................................................. 30
5.1 Further research............................................................................................... 31
Bibliography ................................................................................................................... 32
ix1 Introduction
Yoga and meditation practice may be described as a mental, physical and structural practices
based on yoga philosophy. Yoga history spans thousands of years with roots in eastern
religious and spiritual practices and yoga philosophy has been a part of Indian culture from
the very beginning. It may very well be the most valuable cultural export of India because
today, yoga has transformed into an enormous global industry and has been assimilated into
various cultures from all over the world. Yoga and meditation are being systemized and
institutionalized around the world in various forms. Yoga is used as a physical exercise and to
improve physiology, yoga is used as a therapeutic tool to improve mental health and yoga is
also a form of spiritual or religious practice. This thesis will consider all these aspects in an
attempt to demonstrate how yoga and meditation can be a valuable instrument for
individuals, corporations and communities, especially during challenging times. Yoga and
meditation research have shown that there are multiple psycho-, physical- and physiological
benefits that can be achieved through regular and consistent practice of the two.
Unsurprisingly, this has led to a growing interest in the subject amongst health experts,
sociologists and other professionals. Hindu- and Buddhist-derived mindful practice has been
continually spreading and applied around the world in healthcare and educational settings
and even in the corporate world. Popular interpretation of yoga in western countries is often
as a physical postural practice. In the following thesis the term Yoga will mostly be used as a
broad and general term, with only occasional references to references to particular types of
yoga practices.
Modern yoga, as we know it today, mostly derives from the Yoga Sutras by Patanjali, a doctrine
of the earliest Vedas that teaches the theory and practice of yoga and dates back to ancient
India (circa 1700-1500 B.C.E.) (Jain, 2014, p. 2). Yoga has been continually globalized for the
last two hundred years. But before the beginning of the twentieth century, yoga was usually
perceived as a mystical and foreign reality to what most people were accustomed to in the
Western world. To begin with, yoga was not perceived well by the mainstream culture and it
1was generally feared or loathed as it was foreign to them (Jain, 2014, p. 22). Nevertheless,
many variations and forms of yoga and meditation developed around the world that have
been assimilated and adapted into various social context accordingly. This thesis will focus on
yoga in the Western world and on the important role of yoga to improve public health and
community prosperity. As the concept of Yoga is very ambiguous and might be described as
an umbrella term, this thesis answers questions as to what exactly yoga and meditative
practices are, how they are practiced and what the benefits are of engaging in these practices.
Furthermore, this paper will highlight what yoga research has already found. This will be
discussed in context with the COVID-19 pandemic which has greatly impacted the lives of
many throughout the world. To demonstrate how yoga should improve the lives of people
during challenging times, public mental health and the social impact of COVID-19 will be
discussed in more detail.
The second chapter includes an explanation of the COVID-19 pandemic and how governments
and leading figures have responded to the challenges that the coronavirus outbreak has
presented. The measures and regulations that have been implemented will be observed. The
subject of public mental health will be explored as it is highly relevant in this discussion.
Beginning with a definition of the concept and the role of public mental health in this context.
That includes definitions and observations by the Mental Health Foundation and The World
Health Organization, also referred to as the WHO throughout the paper, and how it mental
health relates to the challenges that the coronavirus outbreak has presented in communities
all over the world. The social impact of COVID-19 is of particular importance, which includes
the impacts that the pandemic has had on public health, social relations and the labor market.
Having established some notion of public health, the thesis moves on to consider how yoga
and meditation can be used to tackle health and social challenges, and to improve both
individual and public health, well-being and functionality. This will be discussed in chapter 3
where explanations of yoga and meditation are presented, as well as providing a historical
overview of modern yoga practice which is necessary as it gives the reader a better
understanding of yoga and meditation practices. Chapter 3 also outlines the yoga philosophy.
This is relevant for the theoretical arguments in this paper which are to show that yoga and
meditation with focus on yoga philosophy could improve public health and reduce long-term
2effects of COVID-19. The fourth chapter outlines the main findings in this thesis where the
multifaceted benefits of yoga philosophy and practice are placed in context with public mental
health and the COVID-19 pandemic.
This thesis draws its arguments from pre-existing studies and research on yoga and meditation
as well as recent studies of the impact of the COVID-19 pandemic. The argumentative
structure of this thesis is twofold. Many of these studies will be referenced in this paper to
strengthen and support the main argument of this thesis which is to demonstrate that mindful
yoga and meditation practices during challenging times are important as a mental health
strategy and social support strategy. This is observed in context with the social disruptions
that have been caused by the COVID-19 outbreak. The second argument draws its conclusion
from observing spiritual/religious yoga and meditation as a holistic therapeutic mechanism.
Adding to the first argument, spiritual/religious yoga practice helps individuals come to terms
with difficult challenges that they are facing, for example: isolation, unemployment and loss
of loved ones. This may be achieved by facilitating acceptance and provide comfort and
resilience. This thesis concludes that yoga and meditation can improve the lives of individuals
during and after COVID-19 as it enhances their self-esteem, stimulates positive emotions and
improves their emotional regulation, which leads to increased happiness and well-being. In
this way, yoga and meditation improve the functionality and productivity of individuals and
workforce, and ultimately society in general.
32 Public mental health and COVID-19
This chapter presents the concept of public mental health, especially relating to the COVID-19
pandemic. This topic is highly relevant now, as the coronavirus outbreak continues to harm
public mental health. The unprecedented situation that has followed the COVID-19 outbreak
has disrupted the lives of many. This chapter will discuss how governments have reacted to
the multifaceted crisis that the coronavirus outbreak has presented but also, more
importantly, the consequences of their reactions. The concepts of social isolation, social
disruption, and loneliness are important to this chapter and will be observed along with the
consequences and negative mental health outcomes that have followed the restrictive
measures implemented and integrated in response to the COVID-19 outbreak.
In answering what the Coronavirus disease 2019 is, and how it has affected societies all over
the world, it is appropriate to start at the beginning. A global health crisis emerged in 2019 as
a result from the outbreak of the coronavirus SARS-CoV-2. The outbreak was declared a
pandemic in March 2020 (World Health Organization, 2020). It is safe to say that this outbreak
has greatly impacted the lives of many, and therefore is rightfully described as a matter of
Public Health Emergency of International Concern (PHEIC) (World Health Organization, 2020).
The virus was first identified in Wuhan, China, and quickly gained attention from the rest of
the world as it rapidly spread in the global community. Governments all over the world
responded by implementing and integrating various, and sometimes drastic, measures in
order to control further spread of the coronavirus. The global community has raised concern
regarding the negative mental health outcome and possible long-term effects that might
accompany the pandemic. As the COVID-19 pandemic has greatly impacted various aspects of
our society, the consequences have started to appear. The consequences that this paper is
concerned with are those relating to public mental health and individual prosperity. Number
of policies and strategies that have been implemented to improve public mental health are
observed and described as well as social challenges that the pandemic has created.
Furthermore, this chapter looks at how the World Health Organization has defined public
mental health and what their responses to the Coronavirus Disease 2019 the organization has
prescribed as appropriate. Following the discussion of public mental health, the social impact
4and implications of the COVID-19 pandemic will be observed in more detail. This subject will
also be connected to the discussion of public mental health and the well-being of individuals.
2.1 Public mental health: A theoretical explanation
The Mental Health Foundation defines and describes public mental health as “the art, science
and politics of creating a mentally healthy society. The pursuit of a public mental health
agenda is concerned with how individuals, families, organizations and communities think and
feel, individually and collectively” (Rogers & Pilgrim, p. 220). As stated in Public Mental Health:
guidelines for the elaboration and management of national mental health programmes,
“Mental health is an essential part of health, and mental health programs play an important
part in general medical care by using specific mental health techniques to promote health”
(World Health Organization, 1996, p. 1). Public mental health has become a global movement
(Rogers & Pilgrim, 2014) and the World Health Organization (hereinafter referred to as WHO)
is the most prominent influencer and advocate of mental health on a global scale. The WHO
defines mental health as “a state of well-being which every individual realizes his or her own
potential, can cope with the normal stresses of life, can work productively and fruitfully, and
is able to make a contribution to her or his community” (World Health Organization , 2001).
The organization views mental health promotion in terms of individual’s ability to increase
control over, and to improve, their health which should allow individuals reach a state of
complete physical mental and social wellbeing (World Health Organization, 1986). In
answering the question of what health promotions actually entail, the Ottawa Charter for
Health Promotion (1986) is most helpful. It states that “Health promotion works through
concrete and effective community action in setting priorities, making decisions, planning
strategies and implementing them to achieve better health” (World Health Organization,
1986, p. 3) but even more so do health promotions support personal and social development
because it provides information and education for health therefore enhancing life skills, as
observed in the charter. This will also assist individuals to cope during challenging times and
the WHO states in the Ottawa Charter that health promotions have to be facilitated in various
settings such as school, home, work and community settings (World Health Organization,
1986, p. 3). This is a shared responsibility among individuals, community groups, health
professionals, health service institutions and governments (World Health Organization, 1986,
5p. 3). They should all work together in implementing strategies that would improve public
health. The organization launched a comprehensive Mental Health Action Plan for 2013-2020
that was approved by the World health Assembly in 2013 (World Health Organization, 2018).
This plan presented actions designed to improve mental health and reach certain global health
targets that all member states of the organization had committed to. The key objectives that
were outlined by WHO in promoting mental well-being are relevant in this paper. These are:
strengthening effective leadership and governance for mental health; providing
comprehensive, integrated and responsive mental health and social care services in
community-based settings; implementing strategies for promotion and prevention in
mental health; and strengthen information systems, evidence and research for mental
health” (World Health Organization, 2018)
These objectives are essential as they outline conditions and resources for health. The WHO
advocates for a strong and effective leadership providing comprehensive, integrated and
responsive mental and social health care services along with implementing strategies for
promotion and prevention of mental health. Good health is important for quality of life as it
is a resource for social, economic and personal development (World Health Organization,
1986).
The most significant impact on the health of individuals is changed patterns of life, work, and
leisure, as is observed by the WHO in the Ottawa Charter for Health Promotion (1986). This is
highly related to the discussion of public health during the multifaceted crisis that has
emerged from the COVID-19 outbreak. In light of the multiple challenges that the pandemic
has presented, and the consequences that have followed, there is a calling for improvements
in the area of healthcare and an obligation to improve health among the public, referring to
both the mental and the physical aspect of health. Alongside the health concerns there is also
indication that the pandemic has and will continue to have social consequences, even after
the pandemic has ended. Referencing a title of an article in the World Economic Forum:
“[COVID-19] Lockdown is the world’s biggest psychological experiment – and we will pay the
price” (Hoof, 2020) which is an appropriate observation, and relevant to the discussion of the
social impact of COVID-19. In essence, humans are social beings and social support is a “well-
proven buffer against mental health problems” (Rogers & Pilgrim). Therefore, it is safe to
assume that social isolation, lockdown procedures and other restrictive measures enforced by
6governments during the COVID-19 pandemic might negatively impact mental health as well
as social skills of individuals concerned – which are estimated to be around 2.6 billion, that is
around one-third of the world’s population (Hoof, 2020).
2.2 The implication of COVID-19 for mental health and
wellbeing
The COVID-19 outbreak has forced substantial behavioral changes upon individuals by means
of the various restrictions and other measures that have been implemented. Governmental
interventions and restrictions that have been most evident are making mass quarantine and
self-isolation obligatory for people travelling between countries (Cowie & Myers, 2020),
placing restrictions upon movement in and out of the country, closing down businesses and
services, imposing lockdown procedures, and redefining the practices and environment of
work. Educational institutions have also been closed down, with teaching and learning being
carried out in a digital format or in the form of homeschool, and that places the burden and
responsibility of education on parents. Governments have placed rules regarding social
distancing, physical contact and social interactions in general, therefore limiting contact
between people and changing the way people interact and behave as well as limiting their
mobility. Undoubtedly, this is a challenging situation for most people, and households have
had to rearrange their lives accordingly since most of their daily activities are now carried out
from within the home by means of digital technologies. Health experts have been very vocal
about this concern of public mental health in light of the COVID-19 situation since the national
response seems to have only focused on “monitoring and controlling the spread of the
disease” (Smith & Lim, 2020). Multiple studies and research projects have supported the
discussion of addressing public mental health during the pandemic by observing the negative
social and psychological effects that have emerged and the possible consequences that could
follow.
Psychological effects of COVID-19
The issue of public mental health during COVID-19 has been recognized by the World Health
Organization. The main psychological impact of COVID-19 are higher levels of anxiety, stress,
7loneliness, depression and self-harm or suicidal behavior (World Health Organization, n.d.).
Many surveys and studies on mental health have been conducted during the COVID-19
pandemic and many more are on the way. A study published in June 2020 (Holmes, et al.,
2020) observed the clearly evident psychological and social effects that the outbreak and
governmental measures had caused. The study notes that the virus causing the coronavirus
disease might infect the brain or trigger immune responses which could negatively affect brain
function and mental health in COVID-19 patients which is why they stress the urgency in
addressing the situation and take action to improve public mental health and the social
challenges. The study (Holmes, et al., 2020) further discusses the mental health consequences
of the COVID-19 lockdown and social isolation for vulnerable groups which has already shown
to have negative outcomes with reports of increased anxiety and depression. It was also
revealed that increased concern among the public regarding the possible effects of social
isolation and social distancing on wellbeing, that phycological distress will be heightened as it
might contribute to fear and anxiety (Holmes, et al., 2020, p. 547). One should not
underestimate the psychological impact of social isolation. Indeed, in its most extreme form,
social isolation is even used as a form of punishment and torture (Ross, Bevans, & Friedmann,
2014). Moreover, it was observed after the influenza pandemic known as the Spanish flu in
1918-1920, that the public do not appreciate the risks they run (Soper, 1919). George A. Soper
discusses the lessons of the 1918 pandemic where he states that “It does not lie in human
nature for a man…to shut himself up in rigid isolation as means of protecting others” (Soper,
1919, p. 502).
A study exploring how COVID-19 affects the mental health of healthcare workers (Pappa, et
al., 2020) included analysis of thirteen individual research projects that all had reports of mood
and sleep disturbances among their participants. These studies reported prevalence of
depression, anxiety and insomnia among healthcare workers which provides early evidence
of the negative mental health effects that have emerged during the pandemic. While many
have been raising awareness of the negative mental health effects as is pointed out by the
National Institute of Mental Health (Gordon, 2021), less has been done to improve it. A
systematic review of Mental Health interventions and supports during COVID-19 and other
medical pandemics (Soklaridis, Lin, Lalani, Rodak, & Sockalingam, 2020) showed that those
8who are more likely to experience psychological distress, sleep disorders, anxiety, and post-
traumatic stress-disorder (PTSD) are individuals that have been affected by pandemics, for
example survivors, orphans, caregivers and health professionals (2020, p. 133). These
concerns of the psychological distress that is associated with pandemics are worrisome as it
can lead to “suicidal ideation, substance abuse and significantly reduced quality of life”
(Soklaridis, Lin, Lalani, Rodak, & Sockalingam, 2020, p. 133).
Social impact of COVID-19
The outbreak of the coronavirus has had tremendous effect on our everyday lives. An
observation study conducted to improve the COVID-19 pandemic response by using social and
behavioral sciences (Bavel, et al., 2020) discussed the social concerns that have emerged.
There it is suggested that reinforcing positive norms (for example health-promoting) might
affect people’s behavior. As is pointed out in this observation, the pandemic functions as a
major stressor for households and the biggest influencers are self-isolation policies as social
distancing “clashes with the deep-seated human instinct to connect with others” (Bavel, et al.,
2020, p. 466) therefore contributing to the state of loneliness. Loneliness and social isolation
negatively impact the stress which in turn produces “deleterious effects on mental,
cardiovascular and immune health” (Bavel, et al., 2020, p. 466). It is important to make the
distinction between social isolation and loneliness, as social isolation does not necessarily
mean that the isolated individual is lonely, social isolation is rather an objective measure of
few interactions with other people (Hartt, 2020). However, it can lead to the emotional state
of loneliness. These forms of social control implemented by governments neglects the
importance of social relations. To prevent loneliness, epidemiological studies have revealed
that a large social network with more daily social interactions is crucial (Shimamura, 2017).
Social support is supposed to enhance the quality of life and ‘provide a buffer against adverse
life events’ along with providing emotional support (Earl E. Bakken Center for Spirituality &
Healing, n.d.). Digital technology is a solution for many during the COVID-19 pandemic as it
allows individuals to engage in social interactions without the risk of further spreading the
virus. Digital technology therefore plays a key role in responses to the COVID-19 pandemic as
it has also enabled a lot of individuals to continue their ‘normal’ lives in a new context. Remote
9working has become the ‘new normal’ during COVID-19, which again digital technology has
made possible, but it has also presented some new challenges. Most evident have been
challenges such as ‘work-home interferences, ineffective communication, procrastination,
and loneliness (Wang, Yukun, Qian, & Parker, 2020). A number of factors affect these
challenges such as social support, household arrangements and work responsibility, just to
name a few. As shown in a study on remote working experiences during the COVID-19
pandemic, more negative experiences were reported as people were forced to work from
home irrespective of their preferences, capabilities and the nature of their work (Wang,
Yukun, Qian, & Parker, 2020).
Unemployment during COVID-19
Further social disruptions have followed since the outbreak of the Corona virus, such as
economic challenges that have affected the labor market. Unemployment rates have
increased since many organizations, corporations and other operations have been unable to
conduct their work due to regulations and restrictions or have had to make cutbacks in order
to make ends meet. The International Labour Organization estimates that unemployment
rates have increased globally from 1.1 to 6.5 per cent and the reduction rate of global labor
force participation has gone from 2.2 percentage points in 2020 to 58.7 per cent (International
Labour Organization, 2021). The projections for 2021 predict further declines as high levels of
uncertainty is still apparent. With high levels of unemployment and work inactivity, it is safe
to say that communities are facing a lot of economic distress as individuals are burdened with
financial concerns and troubles.
A study by Kwaohl and Nordt (2020) on unemployment and suicide during COVID-19, found
association between rising unemployment and increased numbers of suicide. As worries of
suicide have already been mentioned in this paper and publicly addressed as a concern by the
World Health Organization (World Health Organization, n.d.), the issue of mental health
should be a top priority. Viewing suicide as a social consequence that is affected by
unemployment might act as an incentive for leading figures, mental health providers,
corporations and other institutions and to act accordingly to improve public mental health by
following the recommendations of the Ottawa Charter (World Health Organization, 1986) and
10WHO’s key objectives (World Health Organization, 2018) to promote, implementing and
integrate strategies that have shown positive results on all these challenges that have been
observed.
COVID-19 and mortality
The estimated number of COVID-19 related deaths and cases are over 140 million, worldwide
(Johns Hopkins University CSSE, 2021). With illness and death follows grief and emotional pain
such as sadness, guilt, anger, denial, blame, and difficulty accepting the death (Tang & Xiang,
2021). A quantitative study (Tang & Xiang, 2021) demonstrated that over one-third of COVID-
19 related grievers suffered from PGD (Prolonged Grieving Disorder) or PCBD (Persistent
Complex Bereavement Disorder). Their study indicates that many people are having a difficult
time coming to terms with their loss, or the illness of a loved one during the COVID-19
pandemic.
Durkheim considered rapid and uncontrolled changes to cause individuals more vulnerability
to suicidal tendencies which is most likely to happen during a crisis (Tomasi, 2000). Although
Durkheim mostly observed this in context with economic crisis, we are now presented with a
health crisis although it may have led to a social and economic crisis as well. In Durkheim’s
sociological theory of suicide, he maintains that the any rapid and unexpected change,
whether it is good or bad, increases the risk of suicides but before repairs are to be made
many have already committed suicide (Tomasi, p. 16). Durkheim states in his book Suicide: A
study in Sociology, that there is a correlation between societies regulative action and suicidal
rates and that when “society is disturbed…thence come the sudden rises in the curve of
suicides” (Durkheim, p. 213). This is in line with the WHO’s statement on increased self-harm
and suicide (World Health Organization, n.d.) Furthermore, increased suicide rates were also
observed after the 1918 influenza pandemic (Wasserman, 1992). Moreover, a study
researching suicidal behavior during viral disease outbreaks (Leaune, Samuel, Oh, Poulet , &
Brunelin, 2020) found social isolation to be a significant contributor for death by suicide during
the 2003 SARS outbreak. The importance of social support is essential as it has preventative
effects on suicides (Kawohl & Nordt, 2020) which brings us back to the discussion of public
health strategies and interventions.
113 Yoga for health and quality of life
The discussion so far has focused on public mental health and the implications of the COVID-
19 pandemic on public mental health and wellbeing. This chapter discusses the multiple
benefits of yoga and meditation practices. It provides an understanding of yoga and
meditation practices and how they can contribute to society, especially during critical times.
In this chapter the term Yoga is defined and described. The chapter presents some
interpretations of the role of yoga that are relevant for this thesis. To begin to understand the
yoga phenomenon, historical overview and an articulation of yoga philosophy is necessary.
The history of yoga and its modern practice are deeply interconnected although the modern
practice may have lost some of the core ethical values in yoga philosophy. In the discussion
of yoga, a number of questions arise such as what does the word “yoga” mean? What are the
origins of yoga practice? Is modern yoga different from traditional yoga? How is yoga practiced
today? And what are the health benefits of yoga practice? This chapter will discuss each and
every question, as well as present various studies that have shown the profound and
numerous positive effects that yoga practice has. Yoga may seem like a relatively new
phenomena to the modernized Western world but that is not the case because yoga has a
very long and complicated history. This thesis not only discusses yoga as in ‘modern yoga’
which refers to a type of yoga that has gone through many modernizing processes such as
individualization, rationalization and secularization, but also addresses the yoga philosophy
which is not apparent in ‘modern yoga’
3.1 Yoga explained: Historical perspective, modern
practice and yoga philosophy
Yoga is a tradition with history spanning over thousands of years. The word Yoga derives from
ancient Sanskrit and refers to ‘union’ or ‘to join’ as it implies that the union of the individual
to that of the universe - “the personality with the Universality“ (Bhavanani, n.d., p. 1). When
thinking of yoga today, the first image that pops into mind is usually of athletic, toned
12individuals engaging in the practice of postures [asanas1] usually in a social setting of a group
of people. However, the history of Yoga portrays quite a different picture. Modern portrayal
of yoga fails to address the philosophy of yoga which is important for this paper. Yoga is a
broad term that many have interpreted in their own way, therefore many branches within the
global yoga sphere can be identified. Yoga and meditation are intrinsically intertwined, and
while you can practice meditation without the physical and postural yoga practice, it proves
more difficult to separate meditation from physical/postural yoga practice – although popular
interpretation of yoga in Western countries is often as merely a physical postural practice –
[asanas] along with breathing exercises [pranayamas]. In this thesis, yoga and meditation are
viewed as a form of mental, spiritual and physical practice with the goal of enhancing the
overall well-being of an individual – it is viewed as a wellness tool that contributes to a healthy
lifestyle. Yoga seeks to combine the mind, body and spirit by means of meditation, exercises,
and philosophy. Yoga as a therapeutic tool, however, is classified by The National Institute of
Health as a Complementary and Alternative Medicine (CAM) (Williams, Steinberg, & Petronis,
2003) since research has shown the holistic healing benefits that yoga practice generates. The
health benefits of yoga will be further examined in chapter 3.2.
History and yoga philosophy
Yoga can be traced back to ancient India and is believed to be one of the four main Hindu
paths to reach salvation [moksha] in Indian philosophy (Morris, 2006). Indian scriptures are
full of theories and ways/paths of optimal living. Yoga has a long history of development but
was most evidently systemized by Patanjali’s Yoga Sütras where yoga is most explicitly
articulated (Alter, 2004). The yoga philosophy that is presented here is drawn from Patanjali’s
Yoga sutras as it is the most popular presentation of yoga philosophy in Western countries.
The yoga philosophy that Patanjali presents is known as Ashtanga Yoga (Ashtanga translates
to eight limbs), and the eight limbs refer to eight steps in the process of becoming a true Yogi
(individual who is an expert in yoga) (Raina & Singh, 2018) and reaching complete awareness,
1 Asanas is the practice of postures with emphasis on aerobic exercises and precision. Also evident in many postural yoga
practices is the use of breathing techniques [pranayama] or breathing control (Jain, p. 1). Less evident is the spirituality in
yoga practices although becoming increasingly more popular in recent years.
13enlightenment (Woodyard, 2011) and equanimity (Sarbacker & Kimple, 2015). These steps
have a certain purpose in the lives of the participant. These limbs refer to “universal ethical
principles, individual self-restraint, physical poses, breath work, quieting of the senses,
concentration, meditation, and self-absorption” (Ross, Bevans, & Friedmann, 2014). The
framework of the eight limbs is presented as follows:
The limbs themselves are restraint (yama), observance (niyama), posture (āsana), breath
control (prāṇāyāma), withdrawal (pratyāhāra), fixation (dhāraṇā), meditation (dhyāna),
and contemplation (samādhi). (Sarbacker & Kimple, 2015, p. 22)
The purpose of each limb is further articulated in Sarbacker and Kimple’s book, The Eight Limbs
of Yoga:
Yama is...divided into five parts: nonharming (ahiṃsā), truthfulness (satya), nonstealing
(asteya), sexual restraint (brahmacarya), and nongreed (aparigraha). Niyama is divided into
five parts as well: cleanliness (śauca), contentment (saṃtoṣa), self-discipline (tapas), self-
study (svādhyāya), and dedication to the lord (īśvarapraṇidhāna). The components of yama
represent a reorientation to the social world, and those of niyama to the practitioner’s
body and spiritual life. Yama and niyama…provide the larger frame of meaning in which the
discipline of yoga is performed. The limbs of āsana, prāṇāyāma, and pratyāhāra represent
a mastery of physical form, of energy, and of the senses. The limbs of dhāraṇā, dhyāna,
and samādhi represent a progression from the very beginning of developing concentration
to the deep meditative absorption or contemplation of samādhi. Together these last three
constitute yogic mastery (saṃyama) (Sarbacker & Kimple, 2015, p. 22).
Sarbacker and Kimple’s simple and direct presentation of the eight limbs of yoga is most
helpful in introducing the basic structure of Patanjalis Yoga Sütra philosophy. The ethical
principles are most important for an individual to be able to live a meaningful life filled with
purpose. These principles foster a healthy “moral and ethical conduct and self-discipline, they
direct attention towards one’s health while acknowledging the spiritual aspects of one’s
nature” (Woodyard, 2011). Western societies have mostly implemented and adopted only
two of Patanjali’s eight limbs which are the physical poses and the breath work. But the other
remaining limbs/steps are essential in the yoga philosophy as well as in this paper. This yoga
philosophy that is presented here is highly complementary as a holistic therapeutic
mechanism as it addresses all aspects of what it means to be a fully functioning, emotionally
stable, resilient, self-regulated, content, peaceful and healthy individual.
Yoga and meditation teachers may have secularized yoga and meditation practices from its
religious and spiritual roots to further spread these practices throughout the world, but this
14may have had some consequences as to losing core values and ethics of spiritual yoga
practices (Jain, 2014). In the process of secularization, the idea of individual becomes even
more clear. Joseph Alter in his book Yoga in Modern India: The body Between Science and
Philosophy claims that yoga establishes a mystical or spiritual union between the personal
being and existential being, which he articulates as follows:
For the practitioner of yoga, being alone is the structural equivalent of being part of a social
community for which the meta-referent is religion. The yogi sits alone in full and critically
important axiomatic sense of that term as it stands in direct opposition to all other signifiers
that are inherently social – this is the essence of kaivalya (aloneness; Ultimate reality)
(Alter, 2006, p. 768)
This argument by Alter is basically the claim that yoga may act as a substitute for what social
relations are supposed to provide for the individual. Therefore, his observation is important
for this paper because accordingly, yoga can be viewed as a great instrument in situations
where individuals are isolated, in quarantine or simply have weak social connections and
support.
Modern yoga
Understanding the popular perception of yoga and meditative practices in the West is
necessary since it provides good insight as to why yoga and meditation was further
popularized. Theories of individualization and the self, and secularization, are also helpful.
Yoga emerged in the West in the mid- nineteenth century and draws most of its conceptual
models, terminology and imagery from classical Hindu traditions (Michelis, 2004, p. 9). Yoga
became a transnational cultural product (Strauss, 2002) and modern yoga, as we have come
to know it today, is quite different from the more traditional forms of yoga. The ideology in
modern yoga practices is mostly drawn the Yoga Sutras of Patanjali as it contains the practical
and physical techniques of yoga. In the Western world has become understood as more of a
physical, and structural practice as opposed to the traditional and spiritual yoga practice that
is more prominent in the East. Popularized yoga practices are usually in the form of postural
[asanas] yoga combined with various breathing techniques [pranayamas] (Jain, 2014). From
then on, modern yoga has been continually evolving.
15The primary marketing feature of yoga in the West, which portrays yoga as a relaxation
practice with some stretching and postural physical exercises, is missing some of the core
spiritual and religious aspects that is deeply rooted within traditional Eastern yoga and
meditation practices. This secularization process has had the effect that people could interpret
yoga in various ways as it was not connected to spiritual philosophy. This modern portrayal of
yoga in the global marketing of the practices of yoga and meditation as simply an exercise to
improve physical health is to appeal to and attract a broader audience. Yoga is often presented
as a tool for individuals that work in stressful and/or challenging environment to cope with
their daily challenges. Research does indeed support this portrayal of yoga, therefore
contributing to the popularization of yoga in this perspective. It has led to meditative practices
becoming increasingly more popular in modern times and they are currently being integrated
into social institutions, for example in healthcare- and educational institutions but also in the
corporate world.
The practice of yoga and meditation
Practicing meditation involves objectively observing the mind and following the thought
processes. Sociologist Michal Pagis observes that the training of meditation usually takes place
in social, collective spaces although meditation is considered an individualistic practice (Pagis,
2019). A lot of people have the urge to return to social settings - to group meditation - despite
being able to practice meditation in private and this is because practitioners claim that they
experience stronger and deeper connections during collective meditation (Pagis, 2019).
Because people seek to meditate and practice yoga in company of others it is clear that
meditation and yoga may not be described solely as an individualistic practice. Nonetheless,
the health benefits of practicing yoga and meditation alone are still gained even if the practice
is not conducted in a social setting. During such times when people are unable to attend yoga
and meditation with other people in a social setting, digital technologies can be of great value
to allow people to conduct their exercises with other people, under guidance and/or to seek
social connections. What is perhaps most convenient is the fact that the basics of yoga can be
practices with little to no cost and minimal effort as an individual only needs their body for
the practices and enough space around to be able to do the physical positions. As for
16meditation and breathing exercises, they can be carried out anywhere - sitting, standing or
lying down.
3.2 Yoga research: Evidence of health role and how it
affects the quality of life
A great variety of research studies show number of benefits that yoga interventions and
meditation can have and therefore it is increasingly being implemented in various settings; as
a therapeutic tool, as means to reduce anxiety, depression and other difficult emotions, to
improve happiness and overall well-being and to increase productivity. This includes
institutions such as schools, businesses and corporations, hospitals, prisons and even in
government settings. The purpose of this chapter is to provide a certain understanding of how
modern yoga practice might be a great instrument to implement in communities as means to
improve the public health and wellbeing, as well as the function and the productivity of
individuals. It is especially relevant when communities are experiencing challenging times, for
example during and after hardships such as economic recessions, social disturbances, and
health crises. Yoga as a therapeutic mechanism involves implementing yoga practice as a
treatment for various conditions to prevent and/or reduce structural, physiological, emotional
and spiritual pain, suffering or limitations (Woodyard, 2011). Yoga research shows that
sustained practice of yoga leads to positive outcomes for individuals by chancing their life
perspectives, enhancing life-fulfillment and enjoyment which leads to improvements in
overall happiness and wellbeing (Woodyard, 2011). More importantly, yoga philosophy is a
form of self-help therapy as it focuses the attention and responsibility on the individual,
therefore engaging him in his own healing process. Yoga is recognized as a mind-body
medicine that addresses the spiritual, mental and physical aspects of an individual (Atkinson
& Permuth-Levine, 2009). Yoga and meditation research has increased dramatically over the
last years as health experts and other scholars have become aware of the multiple benefits
that yoga has for the individual and society.
17Psychological benefits
An ethnographic study on Vipassana practice (a specific meditation technique) in the United
States and in Israel conducted by Michal Pagis found that most people use Vipassana
meditation as means to cope with emotions, as a form of stress management or in search for
peacefulness and happiness, which are personal and individualistic goals, although they might
be performed in a social setting (Pagis, 2019). As it helps people in their emotional regulation
and to manage their stress it would be most helpful as an integrated part of any stressful
activity. In the United States for example, mindful meditation is being practiced and
systemized in organizations and institutions such as the army, business corporations, prisons
and schools with little or no reference to Buddha (Pagis, 2019).
A Systematic Review of Yoga Interventions in Incarcerated Setting, published in the Journal of
Sociology and Social Welfare (Wimberly & Xue, 2016), observed 9 yoga studies which showed
positive outcomes by implementing such interventions. This review concludes that yoga
practices (mainly hatha yoga2 but also other interventions with focus on yogic philosophy and
spirituality) were highly beneficial for incarcerated individuals, and positive outcomes in well-
being were clearly evident. Evidently, the most significant decreases in the studies observed
were less aggression, anxiety, and depression. These studies further showed improvements in
self-control and better impulse control. Another study on inmates at Maui Community
Correctional Center in Hawaii revealed interrelations of yoga practice, meditation and chi gung
practice, with increased awareness, better self-esteem, sense of hope and compassion, and
so ultimately increased overall happiness (Duncombe, Kamorosky, Wong-Kim, & Turner). A
study researching the therapeutic effects of regular yoga practice by Behavioral Scientist
Catherine Woodyard (2011) observes that yoga positively effects mental health as it relaxes
the body and mind as it creates a “sense of well-being, feelings of relaxation, improved self-
confidence, improved efficiency, increased attentiveness, lowered irritability, and an
optimistic outlook on life” (Woodyard, p. 51). The result indicate that yoga improves
depression and reduces stress and anxiety.
2 Hatha yoga is mainly physical postures, breathing exercises where the goal is to relax the body and the mind in order to
prepare the individual for a meditative session. It is designed to ‘still the fluctuations of the mind’ and ‘facilitate
meditative absorption’ (Luu & Hall, 2015)
18Physiological benefits
Meditation research has shown that meditation practices have a lot of neurological benefits,
such as reducing anxiety, depression and sadness/loneliness as it fosters more positive
emotions that lead to increased happiness and mental well-being (Sahni, Singh, Sharma, &
Garg, 2021). Borrowing William C. Cockerham (2010) observations in the book The Medical
Sociology, very little is known about the physiological benefits that “patterns of prayer
postures, periods of meditation and contemplation, and regulation of respiration and heart
rate engaged in while singing or praying” (Cockerham, pp. 140-141) may have on individuals.
Only a few studies have been conducted but Cockerham writes that these studies indicate a
lot of positive benefits that come from engaging in religious or spiritual practices such as
singing yoga mantras, rosary prayer or other frequent religious service attendance. These
studies showed a lot of improvements in biological processes such as cardiovascular,
neuroendocrine, and immune function processes (Cockerham, p. 141) and again, this is
associated with spirituality or religiousness. Yoga practices such as postural [asanas] practices,
breathing exercises [pranayamas] and meditation [dhyana] have a strong positive influence
on the immune system as it improves psychological balance and provides a broad-spectrum
immune build up in the body to further resist viruses and other infections (Kluwer, 2020).
The study by Catherine Woodyard (2011) is again relevant as she concluded that yoga
regulates breath and encourages relaxation therefore “shifting the balance from the
sympathetic nervous system and the flight-or-fight response to the parasympathetic system
and the relaxation response” (Woodyard, p. 51) in turn having positive effects on heart rate,
blood pressure, cortisol levels as well as increasing blood flow to the intestines and vital
organs. Woodyard also discusses the positive effects that yoga practice has on the immune
system and how it stimulates pleasure centers in the median forebrain, increases serotonin
levels and other benefits. She observes that restorative postures [asanas], relaxing postures
[savasana], breathing tecniques [pranayamas] and meditation [dhyana] provide “relief from
excess stimulation and the hectic nature of modern life… [and enables] downtime for the
nervous system” (Woodyard, p. 52). Woodyard concludes that yoga enhances the physical,
emotional and spiritual wellbeing, brings about state of peace and fosters acceptance which
is especially important during challenging times.
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