Healing the causes of suffering – A four-step model for healing

Yoga Therapy, Healing the causes of suffering

Yoga Therapy as a Healing Modality

Offerings like “Yoga for Back Pain” and “Yoga for Stress Relief” are common, and seemingly increasing every day. But the truth is that no one set of tools or approach works to resolve any diagnosis or problem.

Yoga therapy works best when it is personalized. This means that rather than a set of exercises or a protocol for, say, arthritis, yoga therapy looks beyond the diagnosis—and sometimes even beyond the symptoms—to find the underlying cause of someone’s suffering. The goal of yoga therapy is to help someone move from vyutthana, or suffering, to nirodhah, its cessation.

Because everyone is unique, individualizing a yoga practice means more than changing up postures or giving modifications; it means looking at the whole person. When developed with this approach, a personalized practice will look different for each person—even when they experience similar symptoms or diagnoses.

A four-step model for healing

Patanjali’s Yoga Sutras outline a four-step model of healing called vyuha. This model helps us to identify the underlying cause of each symptom. What we uncover acts as a guide as we set our compass in the direction of healing.

Yoga therapy clients certainly don’t need to know these steps, but understanding a bit about the model can also be a pointer toward wellness.

1. Heyam: The symptoms

Suffering comes in all shapes and sizes. With heyam, we start by making a list of everything going on, no matter how momentous or trivial symptoms may seem. Yoga therapists will typically work with clients over time to understand the full picture of how suffering is arising for them.

2. Hetu: The cause

Causes of suffering can manifest in many ways. Two people with the same diagnosis, such as migraine headache, may have similar symptoms with different root causes; likewise, a single symptom can point to different issues within the same person.

Underlying all suffering is avidya, a misperception or a disconnect from one’s true Self—we suffer because we can’t differentiate between the Self and everything else. However, yoga therapists don’t need to know the immediate cause of someone’s suffering to begin working with them. Often, they begin by focusing on reducing symptoms, and the process itself brings the primary causes to the surface.

3. Hanam: The goal

Yoga therapy often has multiple goals. The long-term aim, however, is to help calm the mind, clear perception, and create connection with the spirit (however the client conceives of this). Connection with one’s inner Self is liberating—what a relief to understand that we are more than our disease or circumstance, especially when dealing with a life-threatening or chronic illness! When connected with our spiritual selves, we are not easily knocked off balance.

four-step model for healing

The short-term goal is to feel better and to reduce uncomfortable symptoms, a path the yoga therapist will choose carefully alongside the client. There are many ways to travel from Los Angeles to New York; we change the plan as needed and work first with the symptoms that will have the biggest impact.

4. Upayam: The tools

Yoga therapy also has many tools, all aimed at alleviating suffering and helping us return to our center. Asana, or physical postures, are probably the most well-known in the west. The physical work is a great tool, but asana does not always have the biggest impact, and it may not be suitable for clients for a variety of reasons. Other tools include pranayama (breath-based practices), bhavana (visualization), mantra (sound and chanting), other kinds of meditation, pratyahara (looking inward), and more.

Anything that reduces suffering and increases peace and clarity of mind, body, or spirit can be considered a tool of yoga. Choosing and combining appropriate tools is an art. Personal practices can and should be changed and rearranged as the person experiences deeper connection with themselves.


Yoga therapy often involves slow, step-by-step change. The methods are informed by long tradition and rich practices like the vyuha model, but all clients really need to know is that this kind of sustainable transformation can bring great relief.

Annie Jones, C-IAYT, E-RYT 500, CYT is a yoga therapist in the lineage of T. K. V. Desikachar, a Vedic chanting instructor, and a clinical herbalist. 

This post originally appeared on yogatherapy.health, published by the International Association of Yoga Therapists. Used with permission.


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