Yogic Intervention in Rehabilitation Communities for Drug Addicts

Swami Ishananda Saraswati (Italy)

A. Teaching yoga to drug addicts in prison

After several unsuccessful attempts, a proposal to organize yoga classes in Turin's prisons was accepted. I was asked to begin in the section housing drug addicts, many of them HIV seropositive or with AIDS (Acquired Immune Deficiency Disease). I had no experience in this field and doubted my ability to cope with the combined problems of imprisonment and the drugs often connected with AIDS. In the past, when I had asked Paramahamsa Satyananda about the most useful yoga practices for physically and mentally handicapped people, he had said that I would discover them by myself while practising and being in contact with those people. That advice, like all Paramahamsaji's other advice, consolidated into a successful and enriching experience.

The group consisted of fifteen male prisoners, aged between twenty and fifty. Most were physically very weak, their percentage of lymphocytes being at the minimum level established by the Italian Justice Department for obtaining release from prison in favour of hospitalization. The proposed program would last for four months and consist of a yoga class of one and a half hours twice a week. At the first meeting I realized that the participants would not be able to manage more than an hour of class and, therefore, the whole program had to be revised.

Pawanmuktasana

I decided to have the group practise the pawanmuktasana part 1 (anti-rheumatic) series, first of all because these practices require a minimum of physical strength, and also because I remembered Swami Niranjan saying that he usually made his disciples practise pawanmuktasana for a long time, even if, as a result, some happened to run away. However, as nobody could escape from jail, I thought I could run the risk!

Kirlian photographs show that a large quantity of mucus develops and accumulates in the aura and nadis of drug addicts and people with serious diseases such as AIDS and cancer. This mucus can be removed by the practice of pawanmuktasana, which can restore a fluid and correct pranic circulation. Moreover, the pawanmuktasana series helps to eliminateama(the toxic waste material produced by the body's internal combustion and metabolism) through the lymphatic system. As lymphocytes can also enter the bloodstream through the lymphatic system, these practices can, therefore, strengthen the immune response.

Relaxation and the immune system

Apart from damaging the central nervous system, drugs also suppress the immune response, probably because of the hyperstimulation of the glands of the adrenal cortex. This problem, which is accentuated by prolonged conditions of stress and depression, tends to further suppress killer cells and to accelerate atrophy of the thymus gland. Situations of stress and continuous reactions of the fight or flight mechanism bring about excessive production of adrenalin and noradrenalin hormones and reduced production of corticosteroid hormones. As a result, favourable conditions are created for the development of many infectious pathologies.

In 'The Neuroimmunitary Way', Dr. Felten suggests that the immune system can be conditioned and also reinforced without pharmacological intervention by creating visualizations in which you are stimulating the thymus gland. He also says that just one session of relaxation, combined with regular physical exercise, can increase the production of killer cells and of endogenous opioides.

Therefore, relaxation practices and yoga nidra were utilized frequently. Shavasana was also utilized much more often than in normal classes, not just to let the participants rest, but also to provide the opportunity to recreate a physical self-image through rotation of consciousness around the body. I also noticed that movement of the abdominal muscles hardly existed due to somatization of tensions in this region. Therefore, I first tried to make the group aware of the natural breathing process and then introduced useful asanas. The aim was not only to develop a state of relaxation, but also to relieve many problems of the digestive system such as constipation.

Nadi shodhana

After the abdominal block was released, nadi shodhana pranayama was introduced. A person who has used psychoactive substances for a long time, and is hit by serious diseases like AIDS, experiences imbalance of the physiological rhythms, circadian and ultradian, which has deleterious consequences for the main physical and mental functions.

In India, yogis throughout the ages have understood the connection between ultradian rhythms and the flow of the breath, while western medicine only started research in this field in 1982. Results indicate that the activities of the two cerebral hemispheres, the sympathetic and parasympathetic nervous system, and the curve 'Activity-Maximum performance-Rest-Recharging' are connected with the passage of breath through the nostrils and with the dominance of the flow in one compared to the other, continuously alternating every 90 to 120 minutes.

Nadi shodhana pranayama can restore the balance of ultradian rhythms and consequently of the physiological rhythms. It can also integrate and harmonize the different tendencies, complementary and antagonistic, of the human being. In this case, nadi shodhana pranayama is particularly useful because psychoactive substances stimulate the activity of ida nadi abnormally and in a regressive way and inhibit the activity of pingala nadi.

Yoga nidra

The practice of yoga nidra is very delicate and presenting it to those who have been drug dependent requires care and caution. Therefore, I proceeded very gradually, initially introducing short sessions of breath awareness, breath counting and rotation of consciousness around the body, so that I was able to evaluate the reactions to the practice and to proceed systematically and cautiously. As the classes progressed, I introduced the sensations of hot/cold, heavy/light, leaving out those of pain/pleasure. Then simple visualizations were added that contained self-recovery images linked with a sankalpa (resolve) that had been previously agreed to by the whole group, and was directed towards an improvement in physical balance.

Results

After the first month almost all the prisoners attending yoga classes reported that they were feeling better, with more physical energy, improved digestion and sleep, and a reduced level of anxiety. During this period no one was admitted to hospital because of an immuno-compromise state. Unfortunately we were unable to involve either the medical or psychological teams in the project. A proposal to have the prisoners fill in a health questionnaire was not accepted. As a result, confirmation of the benefits could not be officially recognized, although the Italian Justice Department wrote a letter thanking and congratulating us on our work.

Towards the end of the four months, the prisoners who had been practising yoga organized a revolt in protest at the indifferent, inadequate and harsh treatment that the prison management was reserving for AIDS afflicted persons. During the revolt all the non-prisoners present in that section of the prison, including some doctors, nurses, educators, a lawyer and myself, were shut inside the corridor leading to the cells. When the director of the prison arrived, the prisoners' spokesman explained the uncomfortable conditions and how little was being done to alleviate their suffering. He also said that the only, and disinterested, help they had received had been during the yoga classes.

This first experience with drug addicts was not easy, but it was very important because, as a result, the entire section has been reorganized and the director replaced. The new director asked us to continue with the yoga classes in the isolation section.

B. Teaching yoga in drug rehabilitation communities

In Italy, therapeutic communities for the rehabilitation of drug addicts are mostly managed by private institutions receiving state or local funds. The staff must be professionally qualified as doctors, psychologists, educators or nurses. One percent of the staff can be made up of former drug addicts who have completed the rehabilitation program and a specific training course.

Yoga can be included only as a voluntary activity and as social support intervention, not as a rehabilitation instrument, unless those who propose it belong to one of the above categories. In these communities, yoga programs can be more diversified compared to the prison program. This is mainly because only a few people are HIV positive and, therefore, usually in quite good health. One works with male groups and/or mixed groups aged from eighteen to forty and over.

The yoga class lasts for one and a half hours, once a week, for a period of eight months. The course is open to drug addicts who have already overcome the crisis of abstinence, and in whom the psychologist has seen the integrity of some parts of the ego and the willingness to attend yoga classes.

The yoga teacher must spend some time observing all the members of the group in order to establish a global profile of the drug-addicted personality, to discover blocks and physical rigidities, breathing quality and to be informed of past and present pathologies. An introductory meeting attended by the social workers is necessary to explain the meaning of yoga and its benefits. It is also very important to remove prejudices and to clarify misunderstandings regarding comparisons made due to misconceptions about yoga and psychoactive substances.

The Vedic tradition mentions a herbal mixture that can modify the structure of consciousness. Its meaning is known only to a few gurus who keep it secret because it is to be utilized only for purposes prescribed in the ancient texts, under their direct guidance and only with disciples who are spiritually prepared. So, in today's society, drugs lead to experiences that cannot be considered purely spiritual; they do not produce any change in the level and quality of consciousness and they interfere with the individual's natural process of evolution. Drugs also eliminate the natural barriers which prevent the passage of repressed psychic material from the unconscious to conscious level of mind, thus eliminating the automatic defence mechanism. This eventually leads to psychic imbalance and confusion, and regressive and aggressive tendencies.

Asanas

Many rehabilitation communities are in the countryside, in quiet surroundings, and offer the opportunity of outdoor work. However, others are being created more and more frequently in towns where there are fewer opportunities for physical exercise. Therefore, especially in the latter case, it is very useful to begin with more dynamic practices, also because the reduced quantity of negative ions present in the polluted air of towns tends to increase the tendency to apathy and depression that is already so marked in people who have been taking drugs.

We begin, therefore, with pawanmuktasana part 1 (anti-rheumatic) and 2 (anti-gastric) and the shakti bandhas (energy block removers), and we soon introduce surya namaskara, which we ask to be practised quickly. As a vegetarian diet is not followed in any of these communities and as drug addicts are allowed to smoke cigarettes as a substitute for the non-consumption of drugs, we increase the number of rounds of surya namaskara gradually, to avoid a too rapid release of toxins which would cause bouts of fever or troublesome rashes.

In all drug addicts, the liver, kidneys and spleen have been damaged by drugs. Most have been infected with one or more types of hepatitis. Therefore, all asanas that can improve the function of these three organs such as paschimottanasana, ardha matsyendrasana, halasana, ushtrasana and merudandasana have been included in the program.

Many women who are drug addicts suffer from amenorrhoea (absence of menstruation). Some specific asanas acting on the reproductive system, such as kandharasana, sarvangasana and vipareeta karani asana, if performed regularly outside the weekly session, have led to the re-establishment of a regular menstrual flow.

During the performance of asanas, practitioners are continually requested to keep their attention on the movements they perform and on what is happening in their physical body. This focusing of the mind on the `here and now' prevents any escape from reality. It also develops awareness of the physical body and the bodily sensations, a capacity that drug addicts have lost, especially during their numerous abstinence crises. Moreover, as each movement is a consciously performed action, the willpower is automatically trained and progressively strengthened.

Shatkarmas

Shatkarmas, the purification practices of hatha yoga, are not easily accepted. Drug addicts generally tend to draw back each time they face a problem, however small. In our experience we have succeeded in having kunjal practised only a few times, by persons suffering from asthmatic crises and who therefore had strong reasons for seeking relief from their ailment.

Although constipation is a frequent problem, mainly caused by consumption of psychoactive substances but also increased by wrong diet and sedentary lifestyle, most of the drug addicts refused to practise laghoo shankhaprakshalana. The few who expressed interest in the beginning gave up the idea after being influenced by the others in the group. Thus we fell back on the sequence of asanas used for this practice, suggesting they drink unsalted water. Of course, the result was not quite the same, but they did have some benefit from the practice. On the other hand, neti was almost always accepted and for those who had sniffed cocaine for a long time it proved particularly useful in recovering the sense of smell.

Pranayama

Beside abdominal breathing and nadi shodhana, we introduced other pranayamas. Kapalbhati proved useful in reducing the quantity of recurrent obsessive thoughts; sheetali in preventing and reducing the intensity of panic attacks experienced by some; bhastrika in continuing the process of purification from toxins; and bhramari and ujjayi for relaxation.

Yoga nidra

Experts in rehabilitation of drug addicts agree that it is relatively easy to eliminate chemical addiction to a substance from the cells of the physical body, whereas it is not so easy to eliminate psychological addiction. In traditional rehabilitation programs, intervention of a psychoanalytic type has proved difficult to apply. However, the practice of yoga nidra, which is a simple and indirect method to contact the preconscious and unconscious mind, has turned out to be practical and easily applicable.

In yoga, samskaras are defined as one's cellular memory, the store of sensory impressions a human being receives at a conscious as well as a non-conscious level, and also from each life experience. These samskaras influence and condition a person's behaviour without him/her being aware of it. Through the practice of yoga nidra, it is possible to bring the preconscious and unconscious material to the surface of the mind, without having to analyze or elaborate on it. Yoga nidra can lead to the release of energy imprisoned in the mind in order to hold conflicts, frustrations, sense of guilt, etc. in check, and thus repressed.

As the mind is in a state of receptivity during the emission of alpha waves, the suggestions sent to it through the pronunciation of the sankalpa (resolve) find fertile ground and can thus reach the pre-conscious level. From there they are then transferred to the conscious level in the form of willpower. Yoga nidra can become, therefore, a very powerful instrument to facilitate a process of moral restructuring, to train drug addicts to have confidence in their ability to free themselves from their addiction, and to face the difficulties they will meet in their efforts to transform their tendencies and habits.

Those who have been dependent on psychoactive substances have vivid memories of the `fantastic journeys' and troubled mental states caused by these substances. Therefore, the visualization phase in yoga nidra is a very delicate stage. It is necessary to avoid suggesting any visualizations which cause the practitioner to `fly away' and stimulate such memories, and to choose those which relate to reality and are linked with everyday life.

In our yoga sessions, we have used visualizations connected with the sequence of asanas performed, or which were likely to improve the functioning of the physiological systems and organs, i.e. those directed towards the attainment of a definite practical objective. We have avoided those hinting at any dependence or on any external help. We have used those in which it was quite clear that success in anything only depends on one's will and personal efforts in order to improve the internal locus of control, removing any references to transcendental aspects.

A particular form of yoga nidra (which Robert Assagioli called `desensitization technique') can be used with good results, but only after a suitable and specific preparation has been made through the first stages of antar mouna, such as developing and stabilizing the attitude of a neutral witness, with non-involvement and non-identification of the ego.

Psychic centres

In yoga it is explained that the energy of a human being can be expressed in various ways according to one's level of evolution. In a drug user, prana is likely to be crystallized in mooladhara and swadhisthana chakras. It is possible that, when control over the substance is completely lost, the prana is pushed down to even lower levels than mooladhara, which represent evolution in animals. Mooladhara and swadhisthana have tamasic qualities. All the passions, complexes, anguish and desires have their roots there. If the energy of these two chakras is not purified, freed and transformed by passage to the higher chakras, the impulses and experiences which guide a human being will be influenced by the qualities of these two chakras.

Moreover, not only ida nadi but also ajna chakra is stimulated by psychoactive substances in an anomalous way. The ensuing pranic imbalance creates energy fluctuations in the nervous system, which may be the cause of the visual and auditory hallucinations experienced.

After introducing the concept of the psychic energy centres, in order to begin a process of pranic rebalancing in the chakras, students practised the initial stages of nadanusandhana, a practice in which the seven notes of the scale are sung in Sanskrit. Apart from moments of initial embarrassment, due to having to `make their voice heard' in a group, this practice was welcomed. It represents the last stage of yogic intervention in a rehabilitative community and a connection for the possible continuation of a less rehabilitative and more spiritual yogic path, which some persons may choose to follow at the end of the protected period spent in a community.

Conclusion

In conclusion, despite the fact that yoga practices are not officially accepted as a rehabilitative or therapeutic instrument, the teams of psychologists who have followed our projects and their development with some interest have particularly appreciated the yoga practices that release stress and reduce anxiety levels. These techniques have proved to be doubly useful because, besides benefiting those who directly use them, they indirectly make the operator's task easier. As the resistance which develops towards the rehabilitation process is reduced, the subjects become more available for collaboration, and the individual capacity for insight is strengthened, thus speeding up the alleviation of individual problems.

In my experience, those who have been using psychoactive substances have very sensitive, curious and receptive natures, and a great quantity of energy that has been blocked by the use of these substances. The fire of inner search is always alight in them and they want to widen their self-knowledge, to discover the unexpressed potential of the mind, to understand the meaning of existence and of the transcendental and divine aspects.

Therefore, in my opinion many people who have become addicted to psychoactive substances are spiritual researchers. What makes them take one course rather than another probably consists of a complex set of circumstances which western psychology identifies as being due to a family environment that is uninteresting and lacking in values, in deviant friendships and in psychological frailty. All this can be explained by yoga through the concept of karma and through the fact that, at a lower level of evolution, one feels the need to resort to alcohol or drugs and, at a higher level of evolution, to search for divinity. For such persons, yoga might represent the possibility of tripping the switch in the right direction.

I would like to conclude with C.G. Jung's description of an alcoholic patient, in which he compared the insatiable and uncontrollable desire for alcohol to the thirst for and the search after completeness, in other words, to the union with God which certain mystics so eagerly long for.