Sunday, March 15, 2015

Yoga Culture and the Biomedical Centric Narrative

Having just completed this long response to a Facebook thread about yoga, the use of pharmaceuticals by yoga teachers, alternative medicine, and the problematic nature of "New Agey" responses to health and wellness issues, I decided it was worthy of a blog post. The original post by a yoga teacher who was shocked to learn of two long time yoga teachers that used meds to treat their depression was, after an apparent fluffy of negative responses, taken down. It was replaced by this apology, while the original piece was responded to by several yoga bloggers, including Matthew Remski and Charlotte Bell. While I appreciate many of the points both Matthew and Charlotte offer, I was struck by what I'd label a biomedical centric quality to their responses. Something that I also found in the discussion that ensued on Matthew's FB page, and which I feel needs to be unpacked in detail to avoid falling into an all too easy "good and evil" binary. Below is my attempt to do a bit of that unpacking.


I've been following this discussion for a few days now, trying to figure out if I should say anything or not. I didn't get to read the original post, so I don't know what kind of claims the author made about pharmaceutical medications or Western bio-medicine in general. One thing I do find curious is - in this depression saturated continent of ours, where medications is a commonplace solution - how the author was "shocked" or even "surprised" that some yoga teachers are using pharmaceuticals to address depression or similar challenges. I honestly don't get the wow factor there.

One tendency I have noticed whenever these discussions about medicine come up is that the power and demands of the biomedical point of view are not often made explicit. For example, there's rarely any direct dialogue about the societal position of biomedicine as orthodox and state sanctioned. And how that positioning allows proponents to dismiss anything else at will without any damage to their credibility or standing. Taking a stand in favor of pharmaceutical intervention has little of the social risk that taking a stand in favor of an energy medicine approach to anxiety or depression does, for example. Or that the same positioning means that the terms of engagement will default to biomedicine's unless deliberate effort is made to question and open space for differing worldviews.

Here, I see many appeals to "experts" and a need for "expertise" and "evidence," without naming the fact that behind this is a demand for whatever is being considered medicine to give deference to biomedicine's criteria for determining validity. That the definition of depression, for example, needs to fall in line with how biomedicine sees it, and/or that any treatments being offered must be backed by scientific "proof," or be explainable using the language and structures of biomedicine. And that anyone who offers some potential treatment option needs to demonstrate a certain level of "competency" - as biomedicine defines competency - or else they'll be lopped off as New Age flakes or charlatans.

Again, I didn't get to read the original post before the author took it down, so I don't know if she made a lot of universalized claims against drug therapies in particular, or solely in favor of alternative approaches. Personally, while I'm not a fan of pharmaceuticals, I think all options should be available for people to choose from. And I wouldn't offer anything with a blanket statement that "THIS IS IT." So, if the author of the original post was operating from that attitude, then I totally get why so many folks reacted so strongly against her post.

At the same time, what I have witnessed over and over again in these kinds of conversations is a tendency for everything to slide under the control of a biomedical narrative. That those who question biomedical interventions are suspect until they prove otherwise. And that "alternative" medical modalities are only valid if at least some of what they offer can be explained or demonstratable under the biomedicine framework.

Along these lines, I actually would argue that the plethora of ill informed yoga folks who knee jerk reject all forms of biomedicine and biomedical approaches, and offer yogic soundbytes and superficial elements of other medicine systems in response to issues like depression are actually a product of this same narrative of inquiry. It takes a lot of effort, strength and persistence to nurture and offer a medicine worldview that isn't biomedicine in this society. Far easier is the path of least resistance, where you know you don't resonate with the dominant model, but make little or no effort to learn and then practice a different one.

Finally, I'm guessing that to some degree or another, the hostility towards folks like the yoga teacher who wrote the original blog isn't really about medicine at all. But about expressed entitlement. Namely, that because person X was at some point anointed a teacher via teaching certificate or some other flimsy method of approval, that they feel "empowered" to "help others" with any problem or issue that arises. That said "yoga teacher" thinks they understand enough to do so, solely or mostly because they've finished some basic course of study, or read a book or whatever. To me, this sense of specialness - that being a yoga teacher means that you have some great level of wisdom and knowledge to "share" - is really the crux of many of the so called controversies in "yoga culture" today.


Anonymous said...

Greetings and salutations! How do I comment on this current blog? Firstly, I have not read any of the FB accounts that you speak of, but I do have afew things to add...I myself am frustrated with ever increasing amount of yoga teachers with a "flimsy" certificate that are teaching yoga. after studying in India for many years my "teachings "there are not recognized by the current body of the yoga alliance. After looking at their website I see that for a fee of 90.00$ a teacher can then teach others to be a teacher...WHAT!...I personally know students that have practised for 6 months and then become teachers with no exams. As long as they finished the course they are good to go...WHAT?...As I look at the cost of getting my tt2oo hours I find the whole thing incredible and realize that the money in yoga is in pumping out yoga teachers at around $4000.00 a head...I was a ambulance attendant for many years that covered 2 small towns. These towns were crowded with tourists for 5 months of the year. One gets to see many things. One of them is suicide. Depression is a strange thing. I doubt that most of us can relate to someone who is going thru severe depression if we have never been there or seen it. It is not for the faint of heart...Adding more preasure to anyone suffering from this surely involves many of the rules of the yamas.If all things are a manifestation of the Divine, then that means that anti-depressants are too. I , myself , am not a big fan off Big pharma, but I as it is known in the ambulance world..if you are in a head on collision you don't call the reiki practitioner, you call the surgeon...the path to a higher consciousness is prickly. There are many quotes about finding the right teacher. So this too becomes part of the path. a practice of compassion and of gratitude are required to move ahead. Try not to be to hard on the voices of those that are judging. "For they know not what they do".. For each of us a time will come when our ideas about a subject takes a radical shift . From this comes the next stage of our development. Is depression a product of our times? I am grateful that I have not suffered from it...Thus far... the simplest turn of events can alter our lives for ever. In an instance. Therefore, do no harm and live with grace, for we are all walking this path with our coffins under our arms... May this find you well. Namaste', Tracy

Nathan said...

Hi Tracy,

Yoga teacher trainings are a pretty big cash cow at this point. I witnessed plenty of questionable stuff during mine, and it was a decent program compared to some of them out there. Honestly, after going through a program, I wouldn't trust a certificate for anything now. Seeing people with really undeveloped practices being moved into the "teaching" ranks cured all that.

As for depression, I think there are numerous paths towards healing. Anti-depressants being one for some people, but certainly not the only, or even best option for the majority of folks. I can't imagine that depression is a "modern" issue, but it does seem more common today. I'd say that stems, at least to some degree, from the systemic conditions and ways of thinking about life and the world we're subject to these days.

Anonymous said...

Nathan, I've read a lot of your blog posts and you strike me as a very smart dude and a critical thinker.

But I just can't get behind your seeming relativistic attitude towards science and medicine.


I'm not saying that there aren't alternative therapies out there, and some of them might be quite effective, even though the medical establishment hasn't yet embraced them.

The counterpoint to that, is how dangerous some of those alternative therapies and "cures" can be. Faith healers operate and have enormous followings. Do you think faith healers, who pretend to remove cancerous tumors and so forth (but do no such thing) should be considered just as valid as chemotherapy?

Where do we draw the line? What about a guy like Steve Jobs who tried to juice away his cancer?

And he wasn't the first to do so.

Most of us would agree that there is a rush to medicate and overmedicate large segments of our population.

But the way you talk about the narrative strikes me as much more dangerous in some ways.

There is simply too much pseudoscience out there, and much of it leads to charlatans taking advantage of and preying on the most vulnerable people.

That you don't see how incredibly dangerous this is, rather shocks me. The facts appear to be that western medicine has done the heavy lifting when it comes to actually reducing the suffering of afflicted people over the years.

Not "alternative treatments", which, though some might hold promise--simply do not even come close to delivering the results that things like cancer treatments, vaccines, surgery, and other medicines have done for vast segments of the world.

You must know this. You must then see it's important that we develop critical thinking and rationality and not resort to wishful thinking and magical thinking to work our way out of these tough issues.

Nathan said...

Criticism coming in an anonymous form leaves me flat these days.

I could easily lay out long arguments to support my points. You raise juice diets and folks like Steve Jobs; I can raise the tens of thousands of deaths that occur annually from botched surgeries and pharmaceutical interactions. It's really easy to find damaging evidence and then dismiss or greatly diminish.

The reality is more complex. And actually even biomedicine is changing because of more awareness to that complexity, and the need for more diverse approaches.

Anonymous said...

I think dismissing criticism because of "the form" it takes is a bit sad.

My points stand on their own. I didn't write that to rip on you--I gave you credit as being a smart man and a critical thinker.

What I took issue with is your relativistic attitude towards medicine and science.

I think that the botched surgeries, the overmedicating and over reliance on medicine and treating symptoms instead of underlying causes to be disturbing as well as you do.

But that doesn't mean we should encourage belief in things without any proper foundation. As it is, people are too quick to jump to whatever sounds nice rather than what might work or be true.

I think you're better than that, is all.