Yoga: dialoguing with Collective Health

Abstracts

The ancient tradition of yoga coming from India provides individuals with self-knowledge regarding their possibilities and limitations, making them more autonomous in the search for well-being, healthier and more conscious. This theoretical essay, based on the literature review, analyzes the repercussion of yoga through some of its implications as a health practice within Western rationality. The appropriation of yoga by the Western culture implies an understanding of the capitalist system regarding the way of producing health in contemporary societies, and in the deepening of discussions about its philosophical and practical benefits in public health. This construction underlies the Brazilian National Health Sytem (SUS), and helped in the consolidation of an expanded concept of health, creating cultural bridges based on tolerance and respect for its tradition.

Yoga; Western world; Mediation; Health care; Collective Health

A tradição indiana milenar do yoga oportuniza o autoconhecimento dos indivíduos em suas possibilidades e limitações, tornando-os mais autônomos na busca de bem-estar, mais saudáveis e conscientes. O ensaio teórico, fundamentado na revisão da literatura, analisa a repercussão do yoga em algumas de suas implicações como prática de saúde na racionalidade ocidental. A apropriação do yoga pela cultura ocídua implica a compreensão do sistema capitalista sobre o modo de produzir saúde nas sociedades contemporâneas e no aprofundamento das discussões acerca de seus benefícios filosóficos e práticos na Saúde Coletiva. Esse aprendizado fundamenta o Sistema Único de Saúde (SUS) e vem consolidando o conceito ampliado de saúde por meio da criação de pontes culturais baseadas na tolerância e no respeito a sua tradição.

Yoga; Ocidente; Mediação; Atenção à saúde; Saúde Coletiva

La tradición hindú milenaria del yoga da oportunidad al autoconocimiento de los individuos en sus posibilidades y limitaciones, haciéndolos más autónomos en la búsqueda de bienestar, más saludables y conscientes. El ensayo teórico, fundamentado en la revisión de la literatura, analiza la repercusión del yoga en algunas de sus implicaciones como práctica de salud en la racionalidad occidental. La apropiación del yoga por la cultura occidua implica la comprensión del sistema capitalista sobre el modo de producir salud en las sociedades contemporáneas y la profundización de las discusiones sobre sus beneficios filosóficos y prácticos en la salud colectiva. Ese aprendizaje fundamenta el Sistema Brasileño de Salud (SUS) y consolida el concepto ampliado de salud, a partir de la creación de puentes culturales basados en la tolerancia y respeto a su tradición.

Yoga; Occidente; Mediación; Atención a la salud; Salud Colectiva

Introduction

The yoga postulates a proposal of knowledge and practices originated in India, to explore the domains of the mind. The insertion of this practice into everyday life allows individuals to develop their natural possibilities and relate harmoniously with their surroundings, as they free themselves from the anxieties that hinder their freedom ¹ .

Patanjali, the mythical person responsible for codifying yoga, organized this system into eight parts: yamas, nyamas, asana, pranayama, pratyahara, dharana, dhyana, and samadhi. Yamas represent the five moral and prohibitive values to be practiced: non-violence, commitment to truth, honesty, continence in sensual pleasures, detachment. Nyamas refer to the five disciplinary and constructive practices: purification, contentment, self-effort, study, consecration to God. Together, yamas and nyamas represent a code of ethical conduct designed to eliminate mental and emotional disturbances from practitioners and to enable them to live virtuously. Asana correspond to a stable and comfortable physical posture, in which the relaxation of effort is gradually worked on. Pranayama consists of breath control. In the sequence, the concepts of pratyahara (emancipation from sensory activity), dharana (concentration) and dhyana (meditation), deepen the development of concentration and internal perception and are enclosed in samadhi (integration), which represents an immersion in the deepest layers of consciousness ² .

The repercussion of yoga on Western rationality took place in the context of a crisis in its rational and ethical thinking, concomitant to the search for values and practices of wellbeing. The appropriation of this and other oriental traditions in another socio-cultural context implies hybridization, the development of new behaviors and a new ethical conscience ³ . Nowadays, the practice of yoga is recognized in the world as a rising traditional therapeutic modality, supporting conventional medicine, aimed to promote health and longevity to individuals ⁴ , ⁵ . The incorporation of this tradition in the Brazilian territory has contributed to the process of “health” resignification and corroborated the comprehensiveness of care, guided by ethical conduct and the use of self-manageable techniques, such as: physical postures, breathing exercises, control of organic perceptions and meditation ⁶ .

Considering this legacy in its millenary greatness and implications to the field of health both in Brazil and in the world, we conducted a theoretical essay based on literature review. Our objective is to discuss the repercussion of yoga in some of its implications as a health practice within Western rationality.

Insertion of yoga as a health practice of Brazilian National Health System (SUS)

Any discussion regarding health as interdisciplinary knowledge, built in the last decades, cannot avoid the need of understanding the influence of the dynamics of capitalism on the values of society. Since then, these dynamics influence the way of understanding “health” and allocate the usefulness of their practices within the rules and rationales of the market. Arouca ⁷ , by establishing relationships between the rules of preventive medicine discourse and the capitalist mode of production, highlights the contradictions based on the fragmented, assistance-based and capitalistic health model, marked by the strengthening of individual medical actions through value exchanges.

Faced with the needs established by capitalism upon the culture of health - whose logic proposes the prioritization of illness in order to have more patients, more consultations and exams, and more profits - it is inevitable that the health system is insufficient to cure them. This incapacity consists in the commitment of assistance, and consequently, in the resolubility and humanization of care, which become proportional to the time available for consultation ⁸ .

Over the decades, new conceptions have brought progress in counteracting the obsession for profit by a greater concern with wellbeing, quality of life and social improvements ⁸ . Thus, the insertion of yoga meets the ideals proposed by important theorists in the construction of a broader vision in health. Campos ⁹ portrays this situation, reinforcing the need for a broader understanding of the health-disease process while building comprehensive approaches in the re-dimensioning of health management in light of the Paideia method. This proposal demands the sharing of knowledge and powers with the purpose of producing health, and it is materialized as it allows the empowerment of individuals to intervene in the world, aware of their own desires and interests, of their relationship with the dominant culture and organizations; and able to incorporate interventions on themselves or on the collectivity.

Yoga integrates the set of therapeutic systems that began to be available from the 60’s, in the midst of the medical and sanitary crisis, configuring a scenario of rejection to the proposed health model. Based on the counter-culture movement, these systems based on holistic-integrative conceptions represented an alternative to attenuate the individualism attributed to the hegemonic patterns. The search for these therapies has influenced the process of health resignification, disease, treatment and cure ¹⁰ , ¹¹ . In discussing this paradigm change, Campbell ¹² affirms the adherence to these systems as a gradual process, translated by the wide acceptance of beliefs long established and confined to an influential minority encompassed by the counter-culture movement.

In Brazil, this movement took place during the most critical phase of the military dictatorship, which contributed to the fragmentation of these ideologies into camps separated by the oppressive regime. The therapies that constituted it were less invasive and less iatrogenic than the predominant medical model, and were often disdainfully associated with the hippie movement ¹³ . Despite the propension to marginalize this movement, there was widespread dissemination of these practices and the consequent affirmation of a new paradigm to counter the hegemonic medical model. The proposal of this alternative pattern is based on the valorization of health, the repositioning of the individual (patient) as a center of investigation and therapeutic practice, the doctor-patient relationship as an essential strategy of therapy, the search for simpler and less costly therapeutic means, with equal or greater efficacy in terms of healing in situations of illness; and the autonomy of individuals ¹⁰ .

Since the 1980s, with the reestablishment of democracy and the conquest of social rights, such as the implementation of the Brazilian National Health System (SUS), these alternative therapeutic proposals became more and more widespread, and in 2006 they were categorized as Integrative and Complementary Practices (ICPs) of the SUS ¹⁴ . The proper regulation of yoga in this category is very recent, through ordinance 849, on March 27, 2017 ¹⁵ .

As in other ICP modalities, the understanding of yoga as a health practice within Western rationality is no exception to the need to consider the concept of health in a holistic way, in all aspects of human life. With the intention of exploring the perceptions of influential yoga leaders in the city of São Paulo about the contributions of this practical philosophy to the Health System, Siegel and Barros ¹⁶ identified extensions in which it was perceived as relevant to make important contributions synthesized in the following aspects: totality, consciousness, virtues and spirituality. The concept of totality refers to the integration of body-mind-soul-universe and corresponds to the scope of health care. The cultivation of the consciousness, whether bodily, emotional, mental or spiritual, does not have a direct correspondence with the principles of the national system, but the consequences of its construction reinforce values such as: autonomy, leadership, co-responsibility, rationalization, control and participation. The practice of virtues - truth, honesty, culture of peace, fraternity, tolerance, abstention from whatever is not beneficial, discipline, universality of concepts, integration of ethnic groups, genders and cultures - which is based on the yamas and nyamas, was aimed as a value in changing paradigms in health from the counter-culture movements, and served as an orientation for building symbols and values of the current health policy. Finally, spiritual awareness - corresponding to harmony, connection and purification - although not explicitly represented into health policy, is already understood as important by some health professionals engaged in creating strategies for its applicability. In this way, yoga can be understood as a set of physical, social and philosophical practices useful for the health field.

There is a growing scientific effort to publish studies that recognize physical and psychological benefits from yoga practice or its isolated techniques in individuals with different health conditions ¹⁷ , ¹⁸ . However, despite evidence of positive therapeutic changes, the assimilation of its techniques differs among individuals, groups and societies. Investigations should take these differences into account without losing sight of the subjective and social complexity of human potentialities. This field is still emerging, especially in Brazil, and needs to be explored more systematically in different groups in association with other sciences ¹⁹ , ²⁰ .

Ancient India in the globalized context

The intercultural dialogue that characterizes the globalized world is originated, among other factors, from the economic, political, scientific, industrial and communications development around the world. Freedom of expression and opinion and the advancement of the media have offered people the opportunity to reinvent their ways of life and produce heterogeneous cultures based on an exchange dialogue with multiple cultural references. Being that so, individuals have become less restricted to the impositions of their traditions and organizations, as well as more autonomous to criticize and recreate values and customs ²¹ , ²² .

India, is home to such ancient civilizational trajectories, and currently is characterized as a territory of great contrasts and social disparities, as a true kaleidoscope. Throughout its history it has assimilated the most diverse cultures that culminated in a landscape of cultural, social and religious heterogeneity, and strengthened the liberal democratic regime. Its great scientific advances have made possible greater technological development and configured it as an emerging economic power at the global level. This extensive territory, on the other hand, is in constant conflict and geopolitical disputes, added to the caste system, impacting economic and social development ²³ - ²⁵ .

This understanding is in contrast with the product sold by tourism to the Western imaginary, portraying repertoires of spirituality, exoticism and wellbeing, which place India on a timeless and idyllic setting of an East created for and by the West, or even to meet the invention of the East by the East itself. In this territory, the practice of yoga is presented as welfare and gains singular connotation by being conveyed with Indian authenticity, while irreproducible elsewhere ²⁶ .

In his analysis of cultural differences, Zimmer ²⁷ clarifies that Indians in their historical and philosophical perception, as well as individuals incurring in Western rationality, all have their own psychological, ethical, physical and metaphysical disciplines; and that for this reason India also benefits

[...] from the structure and measurable powers of the psyche, it analyzes the intellectual faculties of man and the operations of his mind, evaluates the theories of human understanding, establishes the methods and laws of logic, classifies the senses, and studies the processes by which we learn, assimilate, understand and interpret experiences ²⁷ . (p. 21)

However, while Western rationality, in its critical thinking, points to information as an object of interest for the progress of rational sciences, ancient India points to transformation as the basis for radical change in human nature, in the understanding of the world and of existence itself ²⁷ .

Eliade ²⁸ , in discussing the human condition, ponders that the logic of Western thought characterizes humans as being conditioned, the fruit of their temporality and historicity. In the Indian thinking, this conception corresponds to “existence in Maya”, that is, in a world of appearances, illusory and transitory. The path of discovery of what is legitimate is through self-knowledge, through the exploration of the unconscious. Such access allows practitioners to know the limit of human conditioning, as well as to master it in the field of understanding human life. Yoga, in turn, has the technology destined to this purpose.

To understand the assimilation of yoga in the contemporary world, it is necessary to understand people as a product of the cultural transformations influenced by capitalism, constituted by passive subjects, whose values are focused on consumption activities, immediate pleasure and dominion of nature. Such activities, even in their most decadent and destructive types, are easily confused with autonomy, freedom and liberation of desires, and these societies pay this price in de-structuring of human beings and excess of violence against the environment and people ²⁹ , ³⁰ . Individuals under the influence of this system have their lifestyle based on false ethical premises and a deep emptiness: they deny, conceal and alienate the need to be and to elaborate their own uniqueness ³¹ .

Among the different descriptions of the causes of this cultural decadence, Santos ³² describes this process in Western modernity by characterizing the forms of knowledge as regulated, where ignorance is idealized as chaos and knowledge as order; or as emancipated, where ignorance is idealized as colonialism and knowledge as solidarity.

In this configuration, faced with the globalization and capitalist hegemony background, regulated knowledge prevailed over emancipated knowledge and converted the understanding of solidarity as a form of chaos, ignorance and colonialism as a form of knowledge, and, consequently, as order ³² . From this perspective, modern Western positivist science, on one hand, has ideologically become a powerful source of technological progress and capitalist development, but, on the other, it has marginalized other sciences, taken selectively as “alternatives,” a process designated as epistemicide ³³ .

Although such negative consequences cannot be ignored, this crisis favors a greater acceptance of customs, experiences and lore that are distinct to this society, allowing an increasing plasticity of cultural identities. An understanding is then created that every phenomenon is complex, every concept is controversial, and every field of knowledge is disciplinary ⁹ . From this point of view, these corrupted societies seek a change in the paradigms that characterize them, something that enables individuals to seek to reconcile their dichotomies, to relate in harmony with themselves and with their surroundings ³¹ .

Regarding the change of paradigms, Campbell ¹² describes the process of “orientalization” that permeates the West, aided by the diffusion of ideas, products, practices, or religious systems from ancient Eastern traditions, and reinforces that the introduction of these elements to this culture does not necessarily modify its basic nature:

[...] the most common pattern is the transformation of the imported elements, and not of the societies that import them, as a consequence of their transplantation into an environment different from the one where they were produced ¹² . (p. 6)

To substantiate this statement, the author points out some indicators of the change in the theodicy of Western culture: the decline in belief in a creative and personal God - characteristic of Jewish and Christian conceptions; the growth of belief in some kind of spirit or vital force and in reincarnation, and the decline in the belief in heaven and hell. There is a mystical and immanent awakening in which the divine is present in everything and is part of the world, in counterpoint to the materialistic and transcendent vision, where the divine is superior and separate from the world. Instead of the Christian idea of salvation, in this new perspective individuals strive for self-improvement and respect all forms of belief that lead to it ¹² .

Health is then understood as a non-linear object of imprecise limits and integrated with values such as solidarity, equity and justice. Such paradigms consolidate a praxis that incorporates interdisciplinary practices and takes people’s social health needs as an object ³⁴ . There is an important effort to highlight the quest for comprehensiveness in health and the multiplicity of actions that are involved in this concept. Such actions are aimed at permanently building autonomous individuals, producers of new meanings to live the individual and the collective in an attitude of solidarity and equality, effectively committed to life in its many forms of expression ³⁵ .

Yoga presents a wide proposal of self-knowledge that encompasses moral, physical, spiritual, social aspects, i.e., it comprehends the being in all its potentialities. More than something to be occasionally used, this practice is presented through the integration of the being with the universe, being a constitutive factor of human action in the world. Its ethical principles - such as non-violence, non-consumerism and non-possessiveness - represent a critique of the contemporary consumerist and competitive lifestyle, considered to be the cause of anguish and affliction ³⁶ .

The West, not being able to absorb this complexity, tends to fragment this conception and emphasize the specialization of knowledge. Arouca ⁷ criticizes this inability of Western science to respond to the needs of its objects, and mentions the buffer-disciplines as alternatives to solve such needs. As the West hardly grants scientific status to yoga, which in its essence resists the characteristically Western fragmentation, it frames it in two structures that represent the institutionalization of a concrete practice of the specified relationships between science and knowledge. On the one hand, yoga could represent one more buffer-discipline of medicine in order to propose healing in a holistic way. On the other hand, it could be understood as a science of self-knowledge and liberation that needs buffer-disciplines to be understood, such as Medicine, Physiology, Psychology, Philosophy, among others. In both cases, yoga is not understood from its own point of view.

Appropriation of yoga in the contemporary world

The appropriation of yoga by other cultures is the result of its popularization and is part of a continuous and gradual process of interpretation regarding its environment. Such a process is based on the logic of a tradition, but is far from being something rigid or immutable. On the contrary, it generates wide interpretations, exceeding the limits of the concrete by allowing different individuals from diverse origins to reach a deeper understanding of the reality around them, and therefore the levels of reality that are reached are proportional to the understanding and commitment of practitioners ³⁷ .

In his pedagogical proposal, based on the respect for the autonomy of individuals, Freire ³⁸ alludes to the question of inconclusion as part of human nature, of the individuals’ need to recognize it in themselves, and to enter into a permanent search: “[...] Unfinished, I know that I am a conditioned being, but, conscious of the unfinished, I know that I can go beyond it” (p. 52-3). The author condemns the absolutization of a point of view and affirms the obligation to have ethics, respect and loyalty in order to criticize the point of view of others.

Based on the crisis of values that our society is facing, there is an urgent need to establish an ethical sense that makes individuals free and sovereign, and contains the spasmatic reproduction of the gestures imposed in the shape of their social and historical field: to earn money, consume and when possible enjoy ²⁹ . Pinto Jesus ³¹ portrays this quest as a need for integration of dichotomies, of men’s reencounter with themselves and with their fellow men:

It is more than a parallelism, in which the West is awakening to points raised thousands of years ago by the East, more than a direct influence. It is not a question of importing the Zen from the Far East, but of understanding what we can learn from it. In this sense, there is an intimate relationship between the Zen vision and the present evolution of Western man’s thought in relation to his body, triggered by the penetration of this new paradigm into our society ³¹ . (p. 96)

In this regard, yoga offers people, in its regular and persistent practice, the necessary tools to reach deeper levels of consciousness. The self-knowledge acquired in this process of searching for its essence, allows the practitioners to reach a larger vision of reality and the state of self-realization without losing sight of the higher ideal ¹ .

In the midst of fads and commercial appeals, the popularization of yoga also favors the distortions of the principles of this tradition. In this sense, this millenary tradition is frequently identified in Western culture as a practice of stress relaxation or sport, which hampers the apprehension of its dichotomous nature, between body and spirit. This society, which idealizes the cult of the body as a central element of social relations, hardly understands yoga as a spiritual practice ³⁹ .

The UNESCO World Report ²¹ , when describing the importance of investing in cultural diversity and dialogue, highlights the weakening of the link between a cultural phenomenon and its geographic circumstance as one of the main effects of globalization. Therefore, caution and epistemological vigilance are indispensable in order not to de-characterize an ancient tradition and denature its principles ⁴⁰ .

Dialogue is the first step towards overcoming the limited and inadequate interpretations of this millenarian eastern practical philosophy. Based on this premise, education helps individuals acquire intercultural skills, allows them to live with -and not despite – the cultural differences, thus contributing to the exercise of citizenship and democracy ²¹ . It is a quest for truth based on different apprehensions of reality. However, this construction presents intangible and unfinished principles, with overlapping opinions ³⁸ making the content richer and more encompassing, and therefore without a final word. Santos ⁴¹ reinforces this idea by proposing the concept of the ecology of knowledges, a movement that recognizes knowledges as heterogeneous, autonomous and articulated among themselves, based on an open system in a constant process of creation and renewal.

Danucalov and Simões ⁴² point out this co-optation of concepts in yoga and meditation, arising from the dialogue with this tradition, as important in the development of humanity.

Yoga and meditation seem to be in constant transmutation. Analyzing their evolutionary histories in a coherent perspective, it may be realized that these schools have been undergoing constant transformations and adaptations through the ages. To prevent healthy reinterpretations of the old texts, as well as future adaptations of socio-cultural scope, is to restrict the growth of systems that supposedly were born from the most sincere and intimate investigative need of the human being. To restrict such questions is to impede the advance of science and the continuity of man’s social, cultural and spiritual growth ⁴² . (p. 424)

Transdiciplinarity, in turn, represents an attempt to overcome disciplines in the configuration of knowledge. It offers a more comprehensive understanding of a particular problem to be solved since it allows exchanges of knowledge between so-called scientific knowledge, which follow theoretical methodological rules, as well as inference to more comprehensive and advanced holistic knowledge. This search implies in self-analysis and the identification of humans as part of a larger system ⁴³ . The change that operates allows the reorganization of knowledge, the reestablishment of relationships between the various aspects of reality and the repositioning of complex and contradictory data within a global and hierarchical system, without stable boundaries between disciplines and subjects ⁴⁴ .

From all the diverse aspects of yoga in its ideal of transcendence that are consolidated in transdisciplinary ethics, there is a special remark to the impossibility of describing or formally defining the self-knowledge achieved through practice, since this product refers to something that is built and experienced. On the other hand, yoga does not represent humans’ only means of transcending their reality, a fact that achieves the ideal of recognizing the existence of different levels of reality governed by various logics.

In order to contemporize the knowledge learned, contemporary societies should know to listen. The disregard for the integral conception of the human being and its reduction to minimizing mechanisms, strengthen the hegemonic and authoritarian way of reproducing knowledge. From this understanding, Freire ³⁸ speaking about the knowledge necessary for the practice of autonomy, affirms that a true communication relationship requires the appropriation of the intelligence of the content. The legitimacy of this relationship demands: the recognition of the historicity of knowledge to safeguard the tradition of yoga incorporated into different cultures; openness to the possibility of different points of view; humility in the understanding that there is no relationship of superiority among the knowledges; and tolerance in the recognition of different interpretations as beneficial to individuals, even not reaching the higher ideals of tradition.

Although reality is universally unique, it is reproduced according to the means it reflects. Therefore, it becomes incoherent to apply literally the Indian solutions, that is, the simple imitation of a lifestyle without its assimilation into their emotions and intellect leads people to an inauthentic life, subjected to appearances. The knowledge of listening serves as a lesson that it is possible to use this tradition contextualized to the present day, with our own resources. Therefore, following the path of one’s own experiences allows individuals to find their own answers, to assimilate sufferings and achievements with the peculiarities that belong to their culture ⁴⁵ .

Finally, yoga refers to human connection with the universe from the consciousness of transforming action. This philosophical and practical system presents ample interpretations regarding the means and possibilities to its purpose, and therefore must be “listened to” in its tradition to be correctly reinterpreted in its purpose. Given its expansion in the world and in SUS, the popularization of this practice is intended to arouse interest in its conceptual bases, in order to avoid restricting its complexity to some aspect(s), and be therefore lost from its ideal ³⁶ .

Conclusion

Enjoying the Indian legacy through yoga leads to the development of individuals in all senses of the human personality, allowing them to self-knowledge and approach what is essential to them. This philosophical and practical system makes them more critical and autonomous in the pursuit of their wellbeing, in the improvement of their lives and in the construction of a healthier and more conscious society.

The interpretation of yoga is different among individuals, groups and societies, and in Western rationality, meeting the expanded concept of health built throughout history, which involves: valorization of the subjective component, integrality of the empowerment of individuals, new perspectives of individual and collective reflection and action.

The content offered by the yoga tradition confronts the influence of the values imposed by capitalism in contemporary societies under the logic of consumption, accumulation, individuality and competitiveness. In order to better enjoy this legacy, it is necessary to contextualize and make yoga more flexible, building cultural bridges with contemporaneity, without disfiguring it in its ethical, philosophical and practical principles.

This discussion contributes to the deepening of debates in the field of Collective Health and requires a creative and bold posture in re-signifying health and strengthening the comprehensive proposal underlying the Unified Health System.

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• Translator Félix Héctor Rigoli

Edited by

Editor Antonio Pithon Cyrino

Associated editor Charles Dalcanale Tesser

Publication Dates

• Publication in this collection
  04 Dec 2020
• Date of issue
  2021

History

• Received
  19 July 2020
• Accepted
  21 Sept 2020