By Cornelia Bedford – Yogacampus Yoga Teacher Training Diploma Course

Introduction

Mental health issues such as stress, burnout, depression or anxiety account for 44 per cent of all work-related ill-health cases in Great Britain, and 57 per cent of all working days are lost due to ill health, according to Governments Health and Safety Executive[1]. Having been personally impacted by burnout a few years ago, this topic is close to my heart. The aim of this essay is to explore to what extent yoga therapy, a holistic healing approach, can be applied to restore overall health and wellbeing. Incorporating the knowledge of ancient yogic frameworks allows to understand causes behind physical, mental and emotional imbalances, and provides insights and solutions to return to the body-mind equilibrium and build resilience – creating a life where one does not just survive but thrive.

A Burnout – Physical, Mental & Emotional Imbalances

Burnout – A Personal Story

I never thought I would ever find myself part of the national statistics relating to Stress. Then, in 2016 my life ran off the rails. At that time, life was a continuous loop of juggling responsibilities, however I felt invincible like super-woman and proud of being able to juggle it all. Each moment was filled with something: two young children demanded their fair share of attention, school projects & fairs, assemblies, homework, playtime and play dates. Working in the city in a client-facing Financial Services role four days-a-week (packing in five days) meant deadline driven projects and ad-hoc assignments, commuting, business travel and long-hours behind a desk.  As a family we decided to renovate the house and temporarily moved out due to the amount of work involved, meaning continuous discussions and decisions around design and fittings. Whatever was left of any spare time circled around socializing with other parents, family and friends, keeping the household going and staying up to date on news using various Social Media channels. It did not occur to me that the number of colds, sleep-less nights, feelings of exhaustions, mood swings at home and work increased. I did not notice that my focus, concentration and motivation at work decreased. I did not think that leaving the house on an empty stomach, just with a coffee, eating lunch at 2pm, snacking on chocolates throughout the day and a salad in the evening would further fuel my already un-healthy state of being. I did not see that day in 2016 coming where my world came crushing down. But it did…and it hit me and my family hard.

Initially, I was signed of sick for stress/burnout for two weeks, however I ended up being off work for six months. While I was unsure what had happened to me, I slowly began to piece together how I got to that stage. Stress is generally associated with a negative meaning. There are two types of stress though: positive stress is needed to get us up in the morning and some amount of it is necessary for survival. Positive stress can drive our motivation to complete a task and be associated with feelings of excitement and activity. Negative stress arises from physical, mental or emotional stimulus or situations occurring outside of a perceived normal routine which can cause reactions and feelings of discomfort, unfamiliarity and anxiety. Any reaction or response to stress causes physical reactions in our bodies.

Symptoms and Causes of Burnout

The following will only focus on the effects of negative stress on the human body and mind, going forward referred to as body-mind to emphasize the connection between our physical, mental and emotional being. Our brain communicates with the entire body through the central and peripheral nervous systems.  The central nervous system receives and processes information from all over the body and sends nerve impulses to the peripheral nervous system to request action. This communication happens through nerves and via organs as well as through chemical and hormonal messages. The peripheral nervous system further consists of several sub-divisions of which the autonomous nervous system will be more closely looked at and referenced through this essay. It controls the body’s involuntary functions such as body temperature, heartbeat, blood pressure, breathing, digestion and stress response.  The autonomous nervous is further divided into the sympathetic and parasympathetic nervous system. The sympathetic nervous system springs into action when we need to get active or tackle life threatening circumstances such as avoiding a car accident. It prepares the body for action, increases the heartbeat, raises blood pressure, opens airways to breathe more easily and stimulates thought processes to assess a situation quicker. These reactions also known as ‘fight-flight-or freeze’ trigger a number of hormonal physical and neurological responses, known as the stress response. The length of the stress response depends on the situation. The parasympathetic nervous system is responsible for nourishing, restoring and healing the body and mind. It responds to safe circumstances by activating the relaxation response which results in a decrease in the heart and breath rate as well as blood pressure and leads to optimal functioning of the immune and digestive system. This state of relaxation is generally referred to as the ‘Rest-and-Digest-State’. The desired state of being is when the sympathetic and parasympathetic system work together and an average day consists of balanced activities of stimulation on one hand and activities that are physically and mentally relaxing.

If the sympathetic system is on constant alert due to ongoing stressfully perceived situations, our body-mind is in a continuous state of ‘fight or flight’, unable to relax and replenish the resources needed to bring ourselves back into balance. This inevitably leads to chronic stress which is defined as long-term stress experienced over weeks, months or sometimes years. In the 11th Revision of the International Classification of Diseases (ICD-11) the World Health Organization links burnout to chronic stress and classifies it as an ‘occupational phenomenon’ rather than a ‘medical condition[2]. Their definition of burnout is mainly centred around ‘chronic workplace stress that has not been successfully managed’. While I agree with this definition to some extent. I think it is too narrow and only takes one aspect of a human being’s life into account. Having been personally impacted by chronic stress and burnout the symptoms cover a wider range of symptoms: (1) physical and emotional exhaustion (including increased illness, loss of appetite, anxiety, depression, anger (2) cynicism and detachment (including loss of enjoyment, isolation, pessimism and (3) Ineffectiveness and lack of accomplishments (including increased irritability, feelings of hopelessness, lack of productivity. Looking back, I experienced many of these symptoms not just in an office environment while dealing with clients and colleagues but also in my personal life. In today’s fast-paced society an enormous amount of pressure and unhealthy expectations rest on everyone. The speed of development of technology has also contributed to human beings unable to switch off from work, media and news. The constant stream of information and availability also contribute to higher stress levels. This phenomenon is relatively new and generations before us were not exposed to a frequent state of ‘being switched on’. After hitting rock bottom, I wanted to understand the reasons and causes that led to ‘burning the candle on both ends’. I began to learn about burnout and started to understand that burnout is a multi-layered problem that required multi-layered solutions. Germany’s leading expert, author and business coach in the area of stress management, anxiety and depression points out six major areas that form the foundation to our wellbeing: (1) Career, (2) Family/Friends, (3) Health, (4) Social Network, (5) Hobbies, (6) Spirituality/Faith/Values[3]. Dr. Priess argues that human beings strive to create a balance in their lives, to ‘feel at home’ in their skin. This model is also referred to as ‘beetle model’. The more of these aforementioned areas or ‘legs’ are not filled with satisfaction, purpose, content, the more people struggle to be in dialogue with themselves, or in other words have lost their identity which is a major contributor to burnout. Applying this model now to my own life back then, I noticed that over time, more and more of these areas scored badly or had unsatisfactory or no meaning. Burnout does definitely not appear within a few weeks. It slowly starts taking over more areas in a person’s life over several months or years. The more of these ‘legs’ start breaking away, the less stable and resilient people become to withstand life’s challenges. Additionally, Dr. Priess made also another point about the relationship we have with ourselves: people suffering from burnout have not only lost the ability to clearly articulate their own needs but also their identity.

The Impact of Chronic Stress on Health

As described in the previous chapter, stress is a natural physical and mental response to life’s experiences.  For short periods of time stress can be beneficial, however if the stress response stays longer than needed for survival and the body is unable to return to a balanced state, then it can take a toll on our health.

As illustrated, the central nervous system is in charge of the ‘fight or flight’ response. The hypothalamus, located at the base of the brain, sends information via the sympathetic nerves to the endocrine system, in particular the adrenal glands to release the stress hormones adrenalin and cortisol into the blood stream which in turn lead to blood rushing to areas required for ‘emergency reactions’ such as the muscles, heart, lungs and other important organs. If the perceived risk is gone the body should return to normal. Under chronic stress the body is on constant alert and the stress response will continue. Inevitably, the stress hormones will also affect the cardio-vascular and respiratory system: the breath becomes faster in an effort to circulate oxygen-rich blood around the body. With the blood flooded with stress hormones, the heart pumps faster raising the heart rate and blood pressure, damaging blood vessels and arteries which can increase the risk for heart diseases such as a stroke or heart attack. A constant rush of stress hormones can also upset the digestive system.  Under stress the liver produces extra blood sugar (glucose) to provide more energy, increasing the risk of developing type 2 diabetes, stomach ache and heartburn. The continual elevation of cortisol into the blood stream increases inflammation in the body leading to a weakened immune system and restricting its ability to fight off infections.  Additionally, muscles tend to tense up causing headaches, back and shoulder pain. Alongside the illustrated impacts on the physical body, the mental state also suffers from prolonged periods of negative stress. Poor decision-making, brain fog, the inability to cope with the effects of stress, symptoms of anxiety and depression as well as sleeping problems. Subsequently, chronic exposure to stress can affect our body, our thoughts and feelings, and our behaviour.

B Yoga Therapy – A Holistic Approach

Over a period of six months off work, I did get the chance to reflect on my life and myself. Following conversations with an Occupational Health Therapist which revealed I had higher than normal levels of anxiety and depression I was advised to see a psychotherapist. It was also recommended to book physiotherapy sessions for my neck, shoulder and back pain. While I could certainly see the benefits of physiotherapy, I – somewhat reluctantly – made an appointment with a psychotherapist. Over the course of four to six physiotherapy sessions (mainly massages and exercises) I felt physically better but also experienced unfamiliar ‘side effects’ after the sessions: I felt emotional and the urge to ‘let it all out’. I discussed my observations with the psychotherapist was informed that it is the body’s way of letting go of long-held, memorized, emotions in muscles, tissues and fascia. It started to dawn on me what I had been doing to myself over all those months and years. I finally, consciously, made time to re-connect with yoga – which up to that point was for me ‘just’ a form of pure physical exercise. My experienced yoga teacher was very nurturing and planted the seed to a deeper journey – back to myself. In addition to feeling the positive effects of certain postures, the philosophical side of the ancient tradition that yoga is started to interest me. As Donna Fahri states: ‘Yoga is a technology for arriving in this present moment. It is a means of waking up from our spiritual amnesia, so that we can remember all that we already know.’[4] The word Yoga is derived from the Sanskrit root to ‘yoke’, translated as ‘to unite’ and describes the union of body, mind and soul. Yoga originated in India and its teaching is deeply grounded in traditional texts. The sage Patanjali, author of the Yoga Sutras, defines an eight-limbed path by consolidating 196 ‘threads’ or aphorisms that form the framework and accumulated knowledge of a yoga practice. While yoga is traditionally geared towards enlightenment (samadhi), ‘yoga therapy is the process of empowering individuals to progress toward improved health and wellbeing through the application of the teachings and practices of yoga’ [5]. Georg Feuerstein further defines yoga therapy as ‘…holistic treatment of various kinds of psychological or somatic dysfunctions ranging from back problems to emotional distress.’  He acknowledges that both (yoga and yoga therapy) ‘…share an understanding of the human being as an integrated body-mind system, which can function optimally only when there is a state of dynamic balance.’[6] For the purpose of this essay, I will be focussing on ‘yoga therapy’ to provide a holistic, integrated solution in order to regain health and wellbeing after burnout.

Eight Limbs of Yoga – An ancient framework for Modern Life

Patanjali’s ancient Eight Limbs of Yoga still constitute today a framework for practicing yoga and living a life filled with peace and satisfaction. In its essence yoga is the ‘restraint of the fluctuations of the mind’ (Yoga Sutra I.2)[7]. The section below provides insights into the eight limbs of yoga and their relevance to yoga therapy for building resilience in the context of burnout:

Yamas and Niyamas: ten ethical codes of living, about the choices we make and actions we take. The yamas also express our relationship to others in society and nature. The niyamas describe the relationship we have with ourselves in the context of finding physical and mental balance through a balanced lifestyle, instead of striving further for success and achievement but rather by practising patience and finding content.

Asana: translates into ‘posture’ or ‘comfortable seat’. The focus on the physical body through the practice of mindful movement creates an inner awareness and consciousness to build strength and flexibility. The mind’s attention on/in the body brings a renewed perception of the body-mind union and strengthens the nervous system.

Pranayama: breathing practices relating to the movement of prana (life force) through the body to create balancing, grounding or energizing impact for the purpose of optimising energy management throughout the day.

The first four limbs are considered to be the outer limbs and build the foundation for strong, solid and flexible bodies and resilient minds.

Pratyahara: ‘withdrawal of the senses’ and drawing attention towards silence/the inner world without losing contact with the external world. In our society full of information overload multi-tasking has long been associated with higher performance and success, however just contributing to further over-stimulation and exhaustion. Being in the middle of a stimulating environment and choosing not to react but rather to respond is at the heart of mindful living.

Pratyahara as fifth limbs is thought of a the ‘bridge’ linking the outer (first four) and the inner (last three) limbs together.

Dharana: Focussed attention and concentration of the mind. Contrary to multi-tasking sharp, mental focus on one object or task is considered to be more effective and creates mental strength and resilience. The mind is less prone to wandering due to high absorption and concentration.

Dhyana: deeper concentration of the mind, meditation, leading to an experience of merging of the mind with an object. The process of meditation can initiate feelings of inner peace, satisfaction and create a sense of freedom from worries, anxieties and concerns.  

Samadhi: Complete absorption with the present moment (enlightenment) and deep inner peace. It is an impermanent state of consciousness without judgement, possessions and comparisons.    In its essence true human nature is blissful, clear consciousness. At any moment, human beings can experience samadhi – the state of being fully present and whole, without the layers of perception and ego, which we have put on over time.

The Five Koshas – The Layers of Being

Yoga Therapy is a holistic approach to improved health and wellbeing. With that in mind, the ancient philosophy of Vedanta notices that the human being consists of five bodies – five layers of being or self – like the layer of an onion, each contained within the next forming a series of sheaths around the centre. Known as ‘koshas’ these sheaths illustrate (as shown below) that human beings are more than just body and mind but rather represent a map outlining the inward journey from the periphery of the body and arriving at the deepest level of who we truly are:

Annamaya Kosha (physical body): the outermost layer which represents the food body (organs, bones, tissue, blood, body fluids and skin). The senses perceive it as the structure of the physical body which most people can relate to when they begin an asana practice as it directly effects flexibility, strength and balance. What we eat and how we relate to the environment is also included here.

For the application of healing from chronic stress it is important to identify where in the body physical tension and imbalances are stored to target them with a specific yoga practice. Additionally, eating and sleeping habits should be looked at to enable holistic recovery.

Pranamaya kosha (energy body): Sheathed by the physical layer, the energetic body (or subtle body) is the life force prana. Any imbalances or blockages directly impact the overall function of the physical body: nervous system, breath and circulation.

The relationship between how we breathe and how we feel is illustrated by the power of the nerve communication between the body and the brain. Prana is closely related to the breath and has the ability to either create a state of calm (stimulating the parasympathetic system) or foster alertness (stimulating the sympathetic system). Asana and pranayama practices impact the pranamaya kosha.

Manomaya kosha (mental body): corresponds to the mind, emotions and nervous system – expressed as thoughts, feelings, sensations. This sheath is full of mental activity processing signals from the five senses which directly impact the nervous system. Stress originates from the thinking mind (manas), repetitive cycles of thinking and worrying about the past or future and is considered to be the root of all dis-ease (imbalances).

In today’s over-stimulating society, the ability to ‘switch off’ is largely impacted not only by worries and fears but also by technology screens that disturb our brain activity and sleeping patterns. Mindfulness techniques or journaling may be tools to take control of an overactive mind.

Vijnanamaya kosha (wisdom body): beneath the constant stream of thoughts, feelings and sensations lies an inner knowing and intelligence which consists of intuition and conscious, reflective processes. Through this sheath we experience the more subtle level and notice that perspectives begin to shift: the physical body returns to harmony and balance, the energy body releases blockages, the mental body releases fears and heals.

Moving through the first three koshas into feelings like love and compassion to ourselves and others, our relationships change for the better and we perceive us as part of a bigger picture. The ego-driven intellect, controlled by past memories and impressions (samskaras) can lead to actions that cause suffering and pain. Actions driven by intuition-driven intellect lead to happiness and satisfaction. Through meditation, yoga nidra and psychotherapy enable ways to shift perspectives.

Anandamaya kosha (bliss body): transcending through the layers described above, the deepest layer of being – pure joy – is the core of our existence. A sense of balance, harmony and connectedness to our true nature brings optimal health and wellbeing as well as life’s purpose.

All five layers of being are interconnected and depend on one another. If the body is tense, the breath is shallow, the mind is irritated, and wisdom and joy are absent. The integration of a yoga practice into our everyday life help bring all the koshas—body, breath, mind, wisdom, and spirit—into harmony, promoting overall health.

The Seven Chakras – A Human’s Energy Centres

According to yogic tradition, a human’s vital energies (life force) flow through the energy channels (nadis) of the subtle body (pranamaya kosha). Chakras can be thought of as spinning energy wheels. Breathing with awareness and yoga postures to stretch and tone the physical body influence and stimulate the connecting energy channels. The following describes each chakra in more detail and illustrates the human system as more holistic and integrated ‘concept’ to re-instate balance and wellbeing.

Muladhara (root chakra):   Located at the base of the spine, this chakra relates to the element Earth, colour red, and is associated with our sense of safety, stability and belonging. As it forms our foundation (connected to legs and feet), any imbalances can show up as low self-esteem, self-destructive behaviours or a need to over-compensate by acquiring possessions.

Svadisthana (sacral chakra):   Located in the lower abdomen, lower back and sexual organs, it relates to the element Water, colour orange, and is associated with emotions, fluidity, creativity and fertility. It represents our connection to others, our role in human society. If out of balance, a person may become too emotional, distressed or addicted to substances, pleasures or people.

Manipura (navel chakra):   Located in the solar plexus, it relates to the element Fire, colour yellow, and is associated with energy, our sense of personal power, will and autonomy. If unbalanced or blocked, low self-esteem, lack of energy, incl. burnout and lethargy on one side as well as overconfidence and inflated egos on the opposite side can be experienced.

Anahata (heart chakra):   Located over the sternum, it relates to the element Air, colour green, and is associated with unconditional love through compassion, forgiveness and acceptance. It is concerned with relationships. If unbalanced, a person may become possessive and engage in dysfunctional relationships or does not recognize boundaries.

Vishudda (throat chakra):   Located in the throat (incl. the thyroid), it relates to the element Ether, colour blue, and is associated with all aspects of communication (listening and speaking) and the expression (of truth). Imbalance may create feelings of anxiety, insecurity and shyness and can also be experienced as physical pain the neck, head and throat.

Ajna (brow chakra):   Located in the forehead by the third eye centre, it relates to the element Light, colour indigo, and is associated with our intuition, sixth sense and inner wisdom to handle life’s challenges. If unbalanced, a person tends to lose perspective, becomes narrow-minded and fixated on stresses, unable to think clearly to make informed decisions. 

Sahasrara (crown chakra):   Located at the very top of the head, it relates to the element of Thought[8], colour white or violet, is associated with spiritual understanding and brings about a broader perspective on life – the ‘knowledge’ about inter-connectedness within a larger universe. Imbalance can lead to ruminations about one’s life purpose and seeking happiness from outside sources.

The lower chakras (1 -3) relate to aspects of physical stability, relationship and will, while the upper chakras relate to love, expression, insight and spiritual connection. When energy becomes blocked in any chakra, it triggers physical, mental, or emotional imbalances. A well-tuned asana practice can free up energy and stimulate an imbalanced chakra.  

C Physical, Mental and Emotional Recovery – Restoring the Body-Mind Equilibrium

Recovering from chronic stress or burnout is a slow and painful process – undoing months and years of physical, mental and emotional distress take time. There is no instant cure or general ‘manual’ that restores balance. Coming back into one’s own body, seeking external help and advice as well as re-establishing a relationship with the ‘Self’ are key to restoring health and building resilience for the future. Relating the recovery process to my own experiences, Yoga Therapy -a holistic concept – addresses the human being as integrated body-mind system, rather than treating individual symptoms.

Like an onion, working through several layers addresses imbalances and returns body and mind to an equilibrium. During the first few weeks of exiting the hamster wheel, I felt so physically and emotionally tired, I slept hours during the day and slowly paid off my sleep deficit. Sleep is the most important cure to get back on track and also to stay healthy. But sleep does not come easy. Physical and muscular tension are still present and ‘memorised’ across the physical body. Exercise – generally dropped first – due to depleted energy levels also holds the key recovering physically, with care. Yoga can address and alleviate some of the physical pains, tensions and misalignments. Yoga postures, stretches and breath practices can have energizing, restoring and rejuvenating effects on the whole body-mind system. In particular, postures that open up tight areas in the neck, shoulders, hips and lower back can be very beneficial and subsequently support the body’s energy needs at different times of the day, decrease stress levels while leaving the body’s natural sleep pattern intact. Further details about an energizing morning yoga practice optimizing energy reserves throughout the day[9] and a calming, grounding evening practice preparing the body for sleep[10], can be found in Lisa Sanfilippo’s Yoga Therapy book. The stress hormone Cortisol also influences eating habits. With the body craving more sugary, salty and fatty foods its metabolism and ability to regulate blood sugar are impacted. While some tend to over-eat, others, including me, stopped eating regularly, depriving the body of much needed nourishing foods and drinks, further affecting the body’s ability to regulate emotions. Caffeine, in particular, further effects the stress hormones adrenalin and cortisol further interfering with the body blood-sugar balance. The circadian rhythm[11] plays a key role in balancing the stress response with a nutritious and balanced diet throughout the day.

In addition to a balanced physical asana practice, the focus on simple pranayama techniques on and off the mat bring immediate changes to the nervous system through the vagus nerve. Sama Vritti, the breath of equal inhales and exhales, engages the parasympathetic nervous system returning the body-mind to a calmer, more relaxed state. Altering the length of inhale and exhale creates different effects. Increasing the length of the exhale slows down the heart-rate and triggers the relaxation response (such as brahmari pranayama). Lengthening the inhale relative to the exhale gently stimulates the sympathetic nervous system, creating more uplifting and energizing effects.

The holistic yoga therapy approach also addresses habits that compromise ‘mental’ wellbeing. Meditation and guided meditation, such as yoga nidra, and mindfulness techniques (i.e. journaling) can prove useful tools to help ‘still the fluctuations of the mind’[12].  Cognitive Behavioural Therapy (CBT) finds its way as therapeutic approach to reflect on thought patterns and resulting behaviours. Creating awareness and coming back into the present moment rather than ruminating about the past or worrying about the future, can create a sense of calm and confidence into our ability to take back control.

Chronic stress also negatively impacts our moods. When the sympathetic nervous system is overstimulated emotions of anger, frustration, envy and irritability can arise. Constant demands in a materialistic and success-orientated culture create an endless cycle of desire and dissatisfaction, disturbing body-mind balance, impacting the relationship with ourselves and others. Those difficult emotions cause physical tensions and agitation in the nervous system, and need to be released. Psychotherapy, counselling and hypnotherapy can unlock deeply stored emotions and initiate healing.  The concept of contentment is the antidote for stress: “Contentment, or the ability to be comfortable with what we have and what we do not have” (T.K.V. Desikachar, 1998)[13]. According to Dr. Priess’ ‘beetle model’, described earlier, when all six areas in our lives are stable we feel fulfilment and happiness which are key to overall physical, mental and emotional health and wellbeing. Several ancient yogic frameworks delve deeper into the layers of our existence, providing insights and solutions. Yoga Therapy offers a holistic approach to healing by combining contemporary medical health science and the ancient teachings of yoga as ‘scientific system of self-investigation, self-transformation and self-realization’[14].

D Conclusion – A Journey to Resilience and Self-Discovery

Burnout can be a positive force for change, providing the opportunity to reassess nearly everything about one’s life – priorities, goals, hopes, dreams, and work. It is a chance to re-discover oneself and make changes that might otherwise be ignored. These insights gained while experiencing a rather dark phase in my life, gave me the opportunity to heal dysfunctional relationship patterns, relating to others and myself. Re-establishing healthy mechanisms to attend to the neglected areas of myself as human being, rather than as human doing, created the foundation to build more resilience to be able to respond (rather than react) to life’s challenges.

The chakras and multi-layered koshas frameworks can serve as blueprints for our own self-care, and our yoga practice as the architect that makes these blueprints a reality. The effects of a chakra-based yoga practice can have a tangible, empowering ripple effect on our lives. Understanding the different facettes of a human as more than just the parts that add up to a whole lay down the groundwork of providing holistic treatments to illnesses and dis-eases going forward. The Yoga Therapy approach based on ancient yogic philosophies and frameworks appears promising for offering holistic healthcare in the 21^st Century. Raising awareness and creating more acceptance is one step in the right direction – yet there is still a long way to go: “The development of therapeutic, evidence-based yoga is, I believe, an excellent example of how yoga can contribute to health and healing. … I will watch the development of therapeutic yoga in the UK with great interest…” (Charles, The Prince of Wales, 18 February 2019).[15]

Bibliography

Anodea, Judith Ph.D. Wheels of Life. Llewellyn Publications, 1999.

Bell, Baxter, MD and Zolotow, Nina. Yoga for Healthy Aging, Shambala Publications, 2017.

B.K.S. Iyengar. Light on Yoga. Thorsons, 2001

Fahri, Donna. Yoga Mind, Body & Spirit, Gill Books, 2000.

Kleinschmidt, Carola. Burnout – und dann? Kösel Verlag, 2016.

Kraftsow, Gary. Yoga for Wellness, Penguin Compass, 1999.

McCall, Timothy, M.D. Yoga as Medicine, Bantam Books, 2007.

Rountree, Sage and Desiato, Alexandra. Lifelong Yoga. North Atlantic books, 2017.

Priess, Mirriam, Dr. med. Burnout kommt nicht nur vom Stress. Südwest Verlag 2016.

Sanfilippo, Lisa. Yoga Therapy for Insomnia and Sleep Recovery. Singing Dragon, 2019.

T.K.V. Desikachar, Health, Healing, and Beyond. North Point Press, 1998.

The Yoga Sutras of Patanjali, translation and commentary by Sri Swami Satchidananda. Integral Yoga Publications, 2017.

Watts, Charlotte. The De-Stress Effect. Hay House, 2015.

Health and Safety Executive (HSE). Work related stress, depression or anxiety statistics in Great Britain, 2018. http://www.hse.gov.uk/statistics/causdis/stress.pdf

International Association of Yoga Therapists (IAYT). Definition of Yoga Therapy, IAYT, July 2012, Accessed 3/7/2019: https://cdn.ymaws.com/www.iayt.org/resource/resmgr/docs_articles/iaytdef_yogatherapy_ed_stand.pdf

International Association of Yoga Therapists (IAYT). Feuerstein, Georg, Ph.D.: https://www.iayt.org/page/ContemporaryDefiniti

Psychology Today, Circadian Rhythm definition. Accessed 3/7/2019:https://www.psychologytoday.com/us/basics/circadian-rhythm

The Telegraph. Yoga can ease pressure on health service, says Prince Charles. 18 February 2019: https://www.telegraph.co.uk/royal-family/2019/02/18/yoga-can-ease-pressure-health-service-says-prince-charles/

World Health Organization: Burn-out an “occupational phenomenon”: International Classification of Diseases. Accessed 3/7/2019: https://www.who.int/mental_health/evidence/burn-out/en/

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[1] Health and Safety Executive (HSE). Work related stress, depression or anxiety statistics in Great Britain, 2018. Accessed 3/7/2019: http://www.hse.gov.uk/statistics/causdis/stress.pdf

[2] World Health Organization: Burn-out an “occupational phenomenon“: International Classification of Diseases. Accessed 3/7/2019:

https://www.who.int/mental_health/evidence/burn-out/en/

[3] Priess,  Miriam, Dr. med. Burnout kommt nicht nur vom Stress. Südwest, 2016, 51ff.

[4] Fahri, Donna. Yoga Mind, Body & Spirit, Gill Books, 2000, p. 5.

[5] International Association of Yoga Therapists (IAYT). Definition of Yoga Therapy, IAYT, July 2012, p. 4. Accessed 3/7/2019: https://cdn.ymaws.com/www.iayt.org/resource/resmgr/docs_articles/iaytdef_yogatherapy_ed_stand.pdf

[6] International Association of Yoga Therapists (IAYT). Contemporary Definitions of Yoga Therapy. Feuerstein, Georg, Ph.D. Accessed 3/7/2019: https://www.iayt.org/page/ContemporaryDefiniti

[7] The Yoga Sutras of Patanjali, translation and commentary by Sri Swami Satchidananda. Integral Yoga Publications, 2017, p.3.

[8] Anodea, Judith Ph.D. Wheels of Life. Llewellyn Publications, 1999, p. 25.

[9] Sanfilippo, Lisa. Yoga Therapy for Insomnia and Sleep Recovery. Singing Dragon, 2019, page 116-117.

[10] Sanfilippo, Lisa. Yoga Therapy for Insomnia and Sleep Recovery. Singing Dragon, 2019, page 80-81.

[11] Psychology Today, Circadian Rhythm definition: ‘Often referred to as the “body clock,” the circadian rhythm is the 24-hour cycle that tells our bodies when to sleep, rise, and eat—regulating many physiological processes.

Accessed 3/7/2019:https://www.psychologytoday.com/us/basics/circadian-rhythm

[12] The Yoga Sutras of Patanjali, translation and commentary by Sri Swami Satchidananda. Integral Yoga Publications, 2017, page 3.

[13] T.K.V. Desikachar, Health, Healing, and Beyond. North Point Press, 1998, p. 26.

[14] International Association of Yoga Therapists. Definition of Yoga Therapy, IAYT, July 2012, p. 4. Accessed 3/7/2019: https://cdn.ymaws.com/www.iayt.org/resource/resmgr/docs_articles/iaytdef_yogatherapy_ed_stand.pdf

[15] The Telegraph. Yoga can ease pressure on health service, says Prince Charles. 18 February 2019. Accessed 3/7/2019 : https://www.telegraph.co.uk/royal-family/2019/02/18/yoga-can-ease-pressure-health-service-says-prince-charles/