Blog o1 - Yoga & CSBD

Vanessa Beaulieu

Vanessa (she/her) is a second-year student in psychology and the  lab coordinator. She holds a Bachelor's degree in Film Studies from the University of Montreal (2012), a Yoga Alliance-issued teaching certification in Yoga instruction (2020), and a Graduate Diploma in Mental Health from the Téluq University (2022). She is keenly interested in the use of yoga as a complementary tool in the treatment of certain psychopathologies and physical and sexual traumas.

In light of increased mental health issues and challenges of accessing mental health care, many individuals are exploring alternative methods to alleviate their distress [23]. Meanwhile, those already receiving mental health support are seeking supplementary approaches to reduce their symptoms alongside psychotherapy and medication[7]. Yoga is emerging as one such tool.
 
Several studies[A] have investigated the efficacy of yoga as a complementary tool for various mental health issues. It has demonstrated potential in reducing symptoms associated with conditions like schizophrenia[19], post-traumatic stress disorder[6-16], depressive disorders[7-16], anxiety disorders[7-16], and eating disorders[14-16].
 
However, research on the potential effects of yoga on sexuality-related disorders is currently limited. These studies are often pilot studies with small and specific samples (e.g., small male sample  [9-11-22]), limiting our knowledge and the generalizability of these findings to other populations. Nonetheless, the majority of these studies underscore the need for further investigation, as they have observed reductions in the symptoms examined in their research.

Yoga, originating from India, is an ancient discipline with roots dating back approximately 10,000 years, intertwined with tantra [20]. Passed down from teacher to student for centuries, the Yoga Sutra of Patanjali, written around 2,500 years ago[25], is one of the foundational texts of this practice.
 
Yoga, which means "union" in Sanskrit[20-25], aims to establish a balance between the body, mind, and emotions. This balance is achieved through the practice of asanas (postures), pranayama (breathing techniques), and meditation (dhyana)[20]. This discipline promotes personal development across various aspects of life, including the physical, intellectual, emotional, spiritual, ethical, and interpersonal realms[18-25].
 
A key aspect of yoga is the cultivation of the ability to observe life's changes without judgment, enabling better stress management and self-realization[24]. Moreover, yoga can serve as a healing and relapse-prevention tool for individuals living with a mental illness[27]. Yoga is based on the eight limbs of yoga, including asanas, pranayama, and dhyana, which guide practitioners toward realizing their full potential[25]. Yoga also fosters self-awareness, stress management, and improved emotional responses, making it a beneficial practice for mental health[26]. Studies have shown that when combined with cognitive-behavioral therapy (CBT), yoga can help prevent relapses of anxiety and depressive disorders, thereby reducing long-term mental health needs[7].

Compulsive Sexual Behavior Disorder (CSBD), also known as sex addiction in the general population, is now recognized as a new diagnosis in the International Classification of Diseases[27] since 2022. It involves repetitive, poorly controlled sexual behaviors that cause distress and impair daily life. To receive a CSBD diagnosis, these behaviors should lead to significant distress, neglect of responsibilities, interests, and health, and result in substantial impairment in various aspects of daily life[4].
 
‘’ Individuals with Compulsive Sexual Behaviour Disorder often engage in sexual behaviour in response to feelings of depression, anxiety, boredom, loneliness, or other negative affective states[10]. ‘’

There is still an ongoing debate regarding whether CSBD should be classified as an addiction, obsessive-compulsive disorder (OCD), or an impulse control disorder5. To the best of our knowledge, there are no studies directly linking yoga to CSBD. However, there have been some studies linking mindfulness meditation to CSBD[3-9-22]. Moreover, considering the shared symptoms among CSBD, OCD, addiction disorders (AD), and Impulse control disorders (ICDs) (e.g., intermittent explosive disorder, kleptomania)[5], as well as existing research on the benefits of yoga for OCD[1-2-21], addiction[8-22], and ICDs[11-17], it would be worth exploring whether the symptoms common to these conditions could be alleviated through yoga practice.

Based on these observations, it appears that yoga could offer a valuable complementary approach to the treatment of CSBD. However, to further explore this possibility, there is a need for a comprehensive literature review, the development of validated tools covering all three core aspects of yoga (beyond just mindfulness meditation), and the undertaking of pertinent scientific studies. 
Disclaimer: Please note that this blog article only provides an overview of yoga and its association with different mental health issues based on the current state of the scientific literature. This blog article does not endorse any treatments for CSBD or any other mental health issues. If you are interested in exploring the practice of yoga, we recommend consulting with your primary healthcare provider. Seeking their guidance will ensure that you make informed decisions regarding your well-being.

[A] It is important to acknowledge that the diversity of yoga methods and schools, unlike standardized mindfulness programs such as Mindfulness-Bases Stress Reduction (MBSR) and Mindfulness-Bases Cognitive Therapy (MBCT), complicates the comparison and interpretation of study results.

References

[1] Bhat, S. G. S., Arasappa, R., Jagannathan, A., & Varambally, S. (2021). Yoga therapy for obsessive compulsive disorder (OCD): A case series from India. Asian Journal of Psychiatry, 62, 102739. https://doi.org/10.1016/j.ajp.2021.102739
 
[2] Bhat, S., Varambally, S., Karmani, S., Govindaraj, R., & Gangadhar, B. N. (2016). Designing and validation of a yoga-based intervention for obsessive compulsive disorder. International Review of Psychiatry, 28(3), 327–333. https://doi.org/10.3109/09540261.2016.1170001
 
3] Blycker, G. R., & Potenza, M. N. (2018). A mindful model of sexual health: A review and implications of the model for the treatment of individuals with compulsive sexual behavior disorder. Journal of Behavioral Addictions, 7(4), 917–929. https://doi.org/10.1556/2006.7.2018.127
 
[4] Bőthe, B. et al. (2023). Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools. Journal of Behavioral Addictions, 1-15. https://doi.org/10.1556/2006.2023.00028
 
5Bőthe, B., Koós, M., & Demetrovics, Z. (2022). Contradicting classification, nomenclature, and diagnostic criteria of compulsive sexual behavior disorder and future directions – Commentary to the debate: “Behavioral addictions in the ICD-11”. Journal of Behavioral Addictions, 11(2), 204-209. https://akjournals.com/view/journals/2006/11/2/article-p204.xml
 
[6] Cabral, P., Meyer, H. B., & Ames, D. (2011). Effectiveness of yoga therapy as a complementary treatment for major psychiatric disorders: a meta-analysis. The primary care companion for CNS disorders, 13(4), PCC.10r01068. https://doi.org/10.4088/PCC.10r01068
 
[7] Capon, H., O'Shea, M., Evans, S., & McIver, S. (2021). Yoga complements cognitive behaviour therapy as an adjunct treatment for anxiety and depression: Qualitative findings from a mixed-methods study. Psychology and psychotherapy, 94(4), 1015–1035. https://doi.org/10.1111/papt.12343
 
[8] Hallgren, M., Romberg, K., Bakshi, A.-S., & Andréasson, S. (2014). Yoga as an adjunct treatment for alcohol dependence: A pilot study. Complementary Therapies in Medicine, 22(3), 441–445. https://doi.org/10.1016/j.ctim.2014.03.003
 
[9] Holas, P., Draps, M., Kowalewska, E., Lewczuk, K., & Gola, M. (2021). A pilot study of mindfulness-based relapse prevention for compulsive sexual behaviour disorder. Journal of Behavioral Addictions, 9(4), 1088–1092. https://doi.org/10.1556/2006.2020.00075
 
[10] Iyengar, B. K. S. (2019). Light on pranayama: the definitive guide to the art of breating. Harper Element.
 
[11] Kerekes, N., Fielding, C., & Apelqvist, S. (2017). Yoga in Correctional Settings: A Randomized Controlled Study. Frontiers in Psychiatry, 8. https://doi.org/10.3389/fpsyt.2017.00204
 
[12] Khalsa, S. B. S., Khalsa, G. S., Khalsa, H. K., & Khalsa, M. K. (2008). Evaluation of a Residential Kundalini Yoga Lifestyle Pilot Program for Addiction in India. Journal of Ethnicity in Substance Abuse, 7(1), 67–79. https://doi.org/10.1080/15332640802081968
 
[13] Lupien, S. (2020). Par amour du stress. Éditions Va Savoir.
 
[14] Moscone, A., Leconte, P. & Le Scanff, C. (2015). Rôle du yoga adapté dans le traitement thérapeutique de l’anorexie mentale. Corps, 13, 187-195. https://doi.org/10.3917/corp1.013.0187
 
[15] Ngô, T-L. (2013). Revue des effets de la méditation de pleine conscience sur la santé mentale et physique et sur ses mécanismes d’action. Santé mentale Québec. 38 (2), 19-34. https://doi.org/10.7202/1023988ar
 
[16] Park, L. C et Slattery. M. J. (2021). Yoga as an integrative therapy for mental health concerns: an overview of current research evidence. Psychiatry international, 2, 386-401. https://doi.org/10.3390/psychiatryint2040030
 
[17] Petrofes, C. E., Oberle, C. D., & Middleton, A. (2021). A Preliminary Study Investigating the Effects of Yoga Therapy on Impulsivity in Children Diagnosed with a Psychiatric Condition. Child & Family Behavior Therapy, 43(4), 278–286. https://doi.org/10.1080/07317107.2021.1965764
 
[18] Rama, S., Ballentine, R. et Ajaya, A. (1976). Yoga and psychotherapy – The evolution of consciousness. Honesdale : Himalayan Institute.
 
[19] Sathyanarayanan, G., Vengadavaradan, A., & Bharadwaj, B. (2019). Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review. International journal of yoga, 12(1), 3–28. https://doi.org/10.4103/ijoy.IJOY_65_17
 
[20] Satyananda Saraswadi, S. (2012). Asana Pranayama Mundra Bandha. Bihar : 2013 Golden Jubilee edition.
 
[21] Shannahoff-Khalsa, D. S., Ray, L. E., Levine, S., Gallen, C. C., Schwartz, B. J., & Sidorowich, J. J. (1999). Randomized Controlled Trial of Yogic Meditation Techniques for Patients With Obsessive-Compulsive Disorder. CNS Spectrums, 4(12), 34–47. https://doi.org/10.1017/S1092852900006805
 
[22] Shorey, R. C., Elmquist, J., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016). The Relationship Between Mindfulness and Compulsive Sexual Behavior in a Sample of Men in Treatment for Substance Use Disorders. Mindfulness, 7(4), 866–873. https://doi.org/10.1007/s12671-016-0525-9
 
[23] Simon, N. M., Hofmann, S. G., Rosenfield, D., Hoeppner, S. S., Hoge, E. A., Bui, E., & Khalsa, S. B. S. (2021). Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder: A Randomized Clinical Trial. JAMA psychiatry, 78(1), 13–20. https://doi.org/10.1001/jamapsychiatry.2020.2496
 
[24] Swanson, A. (2020). La science du yoga : comprendre les postures pour optimiser leurs bienfaits. Québec Amérique.
 
[25] Vivekananda, R. (2012). Practical yoga psychologie. Bihar : 2013 Golden Jubilee edition.
 
[26] Woodyard C. (2011). Exploring the therapeutic effects of yoga and its ability to increase quality of life. International journal of yoga, 4(2), 49–54. https://doi.org/10.4103/0973-6131.85485
 
[27] World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.).