Exploring Mind-Body Modalities

When you think of mind-body exercise, which of the following activities come to mind: yoga, Pilates, step aerobics, Nia, weight training, soccer, tai chi, running, karate? Now think about why you may have ruled out some of these modalities: What criteria did you use to determine that one of these exercise formats was mind-body and another was not?

Chances are, your answers were informed by your personal perspective as to what constitutes “mind-body” exercise. Problem is, if you asked 10 other fitness professionals for their definitions of mind-body modalities, you would probably get 10 different answers. Knowing what makes any particular activity “mind-body” first requires an understanding of what is meant by the term.

In addition to defining that term, this article highlights the psychological benefits of mind-body exercise, as documented in the scientific body of research. Our review of the literature involved an analysis of mind-body approaches within the fitness world and beyond. This review underscored the confusion even in the research as to what constitutes mind-body exercise. For example, we noted an implicit bias that physical activities that are Eastern in origin, such as yoga and tai chi, are more likely than Western forms of exercise to be classified as mind-body. While it is true that disciplines like yoga have been practiced for more than 4,000 years, we doubt that every yoga class creates a more mindful experience than pumping iron or dancing joyously in a group fitness class!

Let’s see what our experts and our research review revealed.

Mindful, Mind-Body, Body-Mind: What’s in a Name?

We asked a number of fitness experts what they thought mind-body exercise meant. After hearing their answers, we got further away from the idea that the line in the sand that defines mind-body corresponds to an East-West split.

Some experts emphasized an integrated mind-body experience, while others focused on internal bodily sensations. Engaging all thought processes was the main criterion for one expert, intention and consciousness formed the criteria for another, and a profound inwardly directed mental focus was the crucial aspect for a third. One expert even said that the mind-body moniker was too narrow and the term needed to be widened to include the spiritual aspect of exercise.

Most interestingly, even though the majority of our experts were involved
in a specific discipline, such as Nia or qigong, none felt that the term mind-body exercise should be limited to a
specific group of activities. One expert preferred the designation mindful over the more customary term mind-body, in that the former captures more of the “cognitive process involved.”

Ralph La Forge, MS, is the managing director of the Duke University Lipid Clinic and Disease Management Preceptorship Program at Duke University Medical Center in North Carolina, and a research editor for IDEA publications. As the former chairperson of IDEA’s mind-body fitness committee, he has heard many definitions of mindful exercise. Here are five likely criteria that La Forge says can help determine whether an activity is mindful, or mind-body, in nature:

1. The activity contains a self-reflective, present-moment and nonjudgmental sensory awareness.

2. It includes a perception of movement and spatial orientation.

3. There is a focus on breathing and breath sounds.

4. Attention is paid to anatomical alignment.

5. The activity has a quality of being “energycentric,” or involves an awareness of the movement and flow of one’s intrinsic energy (chi or prana).

For more opinions from our group of experts, see “Defining the Mind-Body Experience” on page 61.

Mind-Body in the
Fitness Industry

Although activities such as yoga and tai chi have been around for centuries, it is only in the last decade that they have become popular in the modern fitness scene. Why now?

Research has shown that there is a close association between how we feel in our bodies and what we think about ourselves (Harter 1993). In this regard, exercise should be something that makes us feel better about ourselves—and as a rule, it does (Penedo & Dahn 2005). Yet, the message that fitness is all about sculpting the body into socially valued shapes and sizes has kept many people away from exercise programs in clubs (Daubenmier 2003). Consumers are demanding fitness programs that focus less on the body and more on the mind and spirit. To attract a wider range of clients, the fitness industry has responded to this demand by offering mind-body programming with more meaning for people’s everyday lives.

Perhaps the distinction between mind-body and more body-oriented activities partly relates to the degree to which participants’ objectives are tied to the outcome rather than the process of exercising. Engaging in exercise for weight loss or body shaping represents a focus on outcome, whereas emphasizing the exercise experience has more to do with process (Collins 1998; Franzoi 1995; Kern 1995). Another theory is that the body is an intelligent organism, with a mind that is oriented to listening and responding to body signals (Kabat-Zinn 1990). Disruptions of the mind-body connection create dysfunction, which, in the fitness world, can lead to poor adherence, physical imbalances and exercise-related injuries.

This seems to bring us full circle. Mind-body exercise may currently be thought of as a “programming stream” within fitness facilities. But many experts project that mindful exercise will probably become an integral feature of all programming in the future. Connecting people solely to an exercise outcome can negatively affect long-term adherence. Once the pounds are off or the health risk is reduced, why would any clients continue doing something that they don’t enjoy, that doesn’t have intrinsic meaning or that makes them feel disconnected?

Revealing Our Findings

So, what did we find as a result of our review of the existing literature on the psychological experiences and outcomes of mind-body exercise? (For details on how we conducted our review, see “Our Research Methodology” on page 62.)

For the most part, it’s good news. Few studies of classical mind-body fitness programs cast doubt on the merits of such activities; in fact, most were highly supportive. First, let’s look at yoga, since the greatest number of studies we identified examined this particular activity.

What Yoga Yields

Analyzing the effects of ashtanga yoga, generally seen as a more demanding form of yoga, one study reported clear benefits from a 6-week program (done twice a week), after which yoga participants reported better gains in positive mood, quality of life, energy levels, sleep quality, concentration and short-term memory than the control group (Casden 2005). A similar type of study explored the effects on regular exercisers who added a weekly yoga class to their routines over an 8-week period. This exercise-plus-yoga group showed greater gains in positive moods and less stress than exercisers who did not perform yoga; the exercise-plus-yoga group also experienced more immediate positive emotions from yoga than from cardiovascular or resistance training (Baldwin 1999). Interestingly, a study that compared novice and advanced hatha yoga students found only marginally higher scores in terms of life satisfaction and positive feeling in the more advanced group (Lee 2004).

Yoga’s impact on stress is a frequently discussed topic in the literature. One study we reviewed indicated that the practice of yoga did not decrease daily stress levels in yoga practitioners versus a control group; however, the yoga group did have more varied coping skills during periods of stress (Oleshansky 2004).

A number of studies considered the impact of more intensive or prolonged yoga training. For example, participants in a 10-day yoga workshop reported increased concentration and stamina and lower levels of anxiety (Sharma, Yadava & Hooda 2005). Another report found that individuals who practiced 1 hour of yoga five times a week shifted their personality profiles more in the direction of self-actualization (Malathi et al. 1999). Other effects of long-term training in yoga included greater congruence between measures of participants’ ideal and actual self-
perceptions (Rani & Rao 1994) and an increased sense of body awareness. While these findings are intriguing, no control groups were involved, and the question arises as to whether any type of long-term physical training would have had similar or even greater effects.

Reports of yoga’s benefits for a variety of medical conditions were also common. A 12-week yoga program helped women who were being treated with chemotherapy or hormonal therapy for breast cancer by significantly reducing anger-hostility scores (Patel 2005).Yoga was also found to help in the treatment of individuals recovering from alcohol and drug dependency (Holthaus 2005; Lohman 1999). Yoga was shown to improve mood states in psychiatric inpatients (Lavey et al. 2005). Lastly, yoga practice resulted in reductions in pain, fatigue and anxiety for women suffering from fibromyalgia (Holmer 2004).

Finally, an intriguing study of how yoga can help psychotherapists prevent career burnout revealed useful clues about unique qualities of this mind-body exercise (Valente & Marotta 2005). Analysis indicated that the therapists’ practice of yoga fostered greater control over self-thoughts and emotional reactivity; helped balance their lives; and resulted in greater acceptance of the therapists’ own needs and those of their clients.

Comparisons of Yoga
With Other Modalities

Studies that compared “nonstrenuous” yoga programs with more traditional strenuous exercise forms, such as step aerobics, often focused on the resultant mood changes. One trial compared the effects of five different exercise forms (yoga, stretching, tai chi, Nia and aerobics) (Kawano 1999). Tai chi was found to produce mood improvements closest to those generated by more intense cardio training. Yoga and stretching worked better than the other programs in reducing anxiety and generally improving mood. The most impressive finding was that nonstrenuous exercise increased body awareness more than it did mood, whereas traditional strenuous exercises had little effect on body awareness. This effect seems to be a key difference between mind-body and other forms of exercise.

Picking up the theme of body awareness as an important outcome of mind-body exercise, female hatha yoga participants were compared with women who regularly took part in aerobic dance and also with a control group (Daubenmier 2003; 2005). Yoga participants reported the highest level of body awareness and trust, both during exercise and in daily life. They also showed the least amount of self-objectification, the lowest internalization of the feminine thinness ideal, the least tendency to compare their bodies with those of others, the smallest discrepancies between their ideal and their actual physical attributes, and the most body satisfaction. Compared with the aerobic dance group, the hatha yoga participants also reported significantly fewer eating problems (Daubenmier 2003; 2005).

Another comparative investigation examined the effects of single exercise sessions of aerobic dance, weight training, martial arts, tai chi and yoga; a music appreciation group served as controls (Szabo et al. 1998). The yoga and tai chi participants reported higher levels of tranquillity than all other exercise groups and showed lower psychological distress, fatigue and exhaustion than those who did martial arts. The aerobic dance group was not significantly different from any of the other groups in its effects, while the nonexercise music appreciation group showed the most positive affect.

In a comparison of African dance and hatha yoga, both forms of exercise resulted in significant declines in perceived stress and negative feelings, compared with a control group that saw no changes (West et al. 2004). When a physiological measure of stress was added and examined, greater levels of stress were noted in the African dance group compared with the hatha yoga group. This study adds to our understanding of yoga benefits and, at the same time, cautions us that psychological indices of activity benefits may differ from physiological ones.

Yoga was also found to decrease stress levels in students taking final exams and was as effective as meditation in decreasing immediate states of anxiety (Moss 2004). When compared with a mental relaxation approach, yoga had a slight edge over the other approach in calming the students’ test anxiety (Broota & Sanghvi 1994).

Several studies contrasted yoga with other anxiety management or stress reduction techniques. A comparison of yoga with imagery training and a standard relaxation technique found that brief imagery training resulted in greater reductions in negative feelings than did a short yoga session (Khasky & Smith 1999). A similar result was noted when extended yoga practice was compared with relaxation techniques practiced over an extended period of time (Ghoncheh & Smith 2004). This conclusion led the study authors to note that doing a mind-body activity, such as yoga, is no guarantee that you are, in fact, being mindful when exercising.

Manifestations
of Martial Arts

Martial arts differ widely in terms of what is mind-body and what is not. Most would agree, for instance, that aikido as commonly practiced in North America is a mind-body exercise, while its competitive form, judo, may not seem much different from intercollegiate wrestling. As illustrated in the movie classic The Karate Kid, the mindfulness of martial arts may be as much a function of the teacher as of the practice itself.

Martial arts studies have relied on psychological measures similar to those used in other exercise psychology research. For instance, tae kwon do practitioners have been found to reap stress reduction effects comparable to those derived from running and meditation (Kim 2003). Compared with the experience of riding on a stationary bicycle, a martial arts class offered clinically depressed participants greater positive feeling, reductions in negative feelings and anxiety, and increased self-efficacy (Bodin & Martinson 2004).

Moving beyond the traditional scope of exercise psychology, an intensive study of teenage aikido students revealed intriguing positive ways in which this activity affected them (Ingalls 2003). The benefits included a greater sense of peace and community, and learning to avoid or redirect aggressive attacks in daily life. Similarly, a study of both new and highly experienced martial artists suggested that their mind-body disciplines helped them deal more effectively with life’s frustrations and conflicts; their self-control also improved, which in turn reduced anxiety and fear in social settings (Overchuk 2002).

A recurring theme in martial arts research is whether such training helps reduce aggressiveness in participants. The evidence is mixed, although many studies suggest that martial arts may have a cathartic effect in terms of reducing aggression (Mastrostefano-Curran 2004).

For example, the question of whether martial arts training could help in the treatment of type A (aggressive, hostile, time-pressured) behavior patterns was addressed in a study that compared a 10-week aikido course with 10 weeks of aerobic training (Jasnoski et al. 1987). Only the aerobic training appeared to reduce type A patterns in relation to the control group in this study; aikido had no impact.

A study that tracked children examined whether their aggressiveness was impacted by training in judo or karate and also found no significant changes (Reynes & Lorant 2004). Another study comparing at-risk youth who participated in either martial arts or team sports (or served as controls) showed no changes in aggression in either of the active groups—although the study author did note that the karate group had the highest level of aggression scores throughout the study period (Anderson 1999).

Other studies offer more positive evidence. Martial arts training did appear to reduce aggressiveness in adolescent study participants, while also improving frustration tolerance (Adler 2003). Another study involving adolescents in martial arts training revealed significant positive effects on factors related to violence, aggression, behavior problems and delinquency (Zivin et al. 2001). A study of karate students determined that levels of aggression seemed to decline with length of time in training (Nosanchuk 1981), while similar findings were reported with judo students (Lamarre & Nosanchuk 1999).

Tai Chi and Nia

A number of reports on tai chi’s beneficial effects for mind and body have appeared over the years. While this exercise form has not been found to necessarily improve aerobic fitness, it does seem to influence psychological well-being (Sandlund & Norlander 2000). In one tai chi program for elderly participants, for example, gains in global self-esteem, physical self-worth and perceived body attractiveness were noted, along with actual physical improvements (Li et al. 2002). In the absence of a control group, this study unfortunately doesn’t rule out the possibility that any form of exercise could have had similar impacts on these older adults.

When individuals who practiced tai chi exercises were compared with those training on stationary cycles, tai chi was found to be superior in suppressing negative moods (Liu et al. 2005). However, both exercise forms did appear to increase positive emotions.

Partly based in the martial arts, Nia (also known as Neuromuscular Integrative Action) training was compared with a typical aerobics class, with participants exercising over a 7-week period (Kern 1995). During the study period, there were no differences between the groups on standard measures of self-esteem, physical self-esteem or state anxiety. However, at the end of the study period, the Nia participants showed significantly lower anxiety states and had better coping skills than those in the aerobics group. This study suggests that longer periods of mindful training may offer participants more lasting benefits.

Lessons Learned

Some writings on the benefits of mind-body exercise boast extraordinary mental, physical and spiritual healing well beyond the scientific evidence. By contrast, certain traditional Western exercise forms, such as step aerobics, have occasionally been portrayed as being mindless and meaningless. The truth may be found not so much in the exercise forms themselves but rather in the way they are practiced.

Another thing to keep in mind is that existing Western science methods are not entirely up to the task of assessing all the psychological, social and spiritual experiences that people have when they engage in a physical activity, especially one that intentionally fosters mindfulness. Nonetheless, this scientific shortcoming doesn’t allow us to argue the case that mindful programs produce better or different results than traditional forms of exercise.

It is our belief that different exercise forms may indeed foster different psychological, social and even spiritual experiences. So, too, different teachers or instructors may lead you more toward body consciousness or spiritual transcendence. In personal practice, one can get as enlightened from running a marathon as from an intensive yoga session. And weight training can be as much a mind-body experience as tai chi, depending on how each is practiced.

The best we can say right now is that activities like yoga, tai chi, martial arts, Pilates and Nia are quite likely to have wonderful psychological benefits for participants. Whether mind-body modalities are better or even different from other exercise experiences depends on a number of factors, including participants’ inclination to direct their mental activities in a nonevaluative and connected way while training.

One significant area in which reliable differences have been noted between exercise forms is in their ability to foster body awareness. Participants in experiences such as yoga and tai chi may develop greater sensitivity to their bodies than those who do more traditional forms of exercise. Moreover, greater body acceptance and satisfaction have been noted with mind-body forms, and other unique benefits may include the development of compassion and a greater transfer of training principles to daily life.

Looking Forward

From our review, we recognize that there is a tendency to idealize mind-body fitness. We need to see that opportunities for individuals to be more mindful exist in virtually all activity. And we need to learn how to foster this quality because it does seem to have important benefits.

Overall, our review did not find any evidence to suggest that a certain type of mind-body exercise represents a panacea for our problems or is even superior to any other form of exercise. It is our belief that becoming more mindful while training can help fitness professionals in their own lives and, in turn, enable you to pass on your wisdom to your clients.

To help define what is meant by the term mind-body exercise, we asked a group of noted experts for their definitions. Here is a sampling of what they had to say:

Ralph La Forge, MS, managing director of the Duke University Lipid Clinic and Disease Management Preceptorship Program at Duke University Medical Center in North Carolina, and research editor for IDEA publications: “Mindful exercise (sometimes referred to as ‘mind-body exercise’) in its most simple form can be defined as low- to moderate-level physical activity performed with a meditative or proprioceptive or sensory awareness component. Although there remains no universal consensus definition, mindful exercise can also be simply described as physical exercise executed with a profound inwardly directed mental focus.”

Debbie Rosas, co-creator and founder of the Nia technique, which integrates mind-spirit fitness with martial arts, dance arts and healing arts: “In Nia, health, fitness and well-being are a byproduct of the class. We put body first, not mind, because the physical [level] is how people connect to experience. Their perception and recognition that something is happening, things are changing, come from the sensations they feel and the physical changes they see. Their emotional connection connects the body with the mind, and their spirit makes the experience personal—theirs.”

Scott Cole, a mind-body wellness expert who has taught professionals and consumers around the world: “An athlete who is focusing on the task at hand is hopefully experiencing mind-body integration. A skater going for a jump, a boxer [going for] the most powerful punch and a runner easing into a well-earned runner’s high are all experiencing their own form of mind-body exercise. If you are trying to experience mind-body exercise, then chances are, you are not. [Mind-body] is a state of integration that comes with instinct, trust and mental stillness, knowing that the body is there and working for you.”

Justin Price, MA, a San Diego–based personal fitness trainer and co-owner of The
BioMechanics: “I believe that mind-body exercise can be defined as any exercise [in which] the participant is aware of how the brain is ultimately responsible for the success of the movement. A participant who focuses on the control the brain has over the body . . . is always engaged in mind-body exercise. Mind-body exercise is traditionally associated with modalities, such as yoga and Pilates. However, if participants learn to focus on the internal sensations of the body as it performs any movement, then they are, in essence, performing a mind-body exercise.”

Dana Rae Paré, RYT, owner of Infinite Yoga in San Diego: “In my experience, mind and body are inseparable and you really cannot isolate the mind from any form of physical exercise. [Mind-body] . . . is any form of exercise that takes the practitioner to the edge of his or her skill and comfort level, fully engages all thought processes and absorbs the attention completely. During the process of mastery, glimpses of this ultimate meditative state are experienced, which explains both the appeal and the addictive nature of these kinds of activities.”

Roger Cole, PhD, a health psychologist and Iyengar yoga teacher who practices in Del Mar, California: “Mind-body exercise is physical movement (which can include the movements of breathing) practiced consciously, with focused awareness of the actions as they are being performed, and with the intention of bringing about improved well-being of both body and mind. Note that this definition can include common Western exercises, such as skiing, basketball, etc., if practiced consciously.”

Because a more encompassing perspective has not been used to define what is meant by “mind-body exercise,” our study of the existing literature required that we revert to more conventional categorizations of physical activities. This meant that we scoured scientific databases for studies conducted during the past 25 years involving such activities as yoga, Pilates, tai chi, Nia and the martial arts. Our focus was on psychological experiences or outcomes from participating in these classical mind-body programs, not on physical or other benefits, the latter of which were consequently excluded from our review.

We primarily searched the psychological literature through the American Psychological Association’s PsychInfo database, although we also used the Academic Premier Search database to augment our scan. Using a variety of keywords (e.g., “yoga, Pilates, mind-body exercise, mindfulness”), we identified approximately 1,046 abstracts of articles, books and dissertations in PsychInfo and 2,784 in Academic Premier Search.

Certain concerns became evident early in our review. The first concern was that many of the same psychological measures used to evaluate other exercise forms were employed in research on mind-body exercise. An advantage here was that when a study compared mind-body disciplines with other exercise programs, we could discern whether the former offered any special advantages. But most studies we found were not comparative in nature, so that if mood benefits were revealed, we could not say whether the mind-body program was, in fact, superior to other forms of exercise.

A second concern was that there was far more opinion than hard evidence about the benefits of mind-body exercise. Writers with vested interests in a specific form of mind-body exercise (e.g., yoga) would describe what they “witnessed” for that form of exercise or describe their sense of how participants in their favored form had been transformed. Personal opinions simply don’t make it in the science scene. Period.

A final concern was that we would be “throwing out the baby with the bath water.” Available psychological research tools have limited scope. Unique benefits of mind-body exercise may not be easy to measure or there may not be tests to assess the kinds of changes that occur. If our focus had been on the physical benefits of mind-body exercise forms, we might have been satisfied using traditional indices of health and physiological functioning. Given the belief that mind-body exercise impacts spiritual or transcendent qualities, verifying claims using current psychological measures may be difficult, if not impossible.