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''I Am a Nice Person When I Do Yoga!!!'': A Qualitative Analysis of How Yoga Affects Relationships
Alyson Ross, Margaret Bevans, Erika Friedmann, Laurie Williams and Sue Thomas
J Holist Nurs published online 28 October 2013
DOI: 10.1177/0898010113508466
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“I Am a Nice Person When I Do Yoga!!!”
A Qualitative Analysis of How Yoga Affects Relationships Journal of Holistic Nursing
American Holistic Nurses Association
Volume XX Number X
Alyson Ross, PhD, RN Month XXXX xx-xx
University of Maryland School of Nursing 10.1177/0898010113508466
http://jhn.sagepub.com
Margaret Bevans, PhD, RN
National Institutes of Health Clinical Center
Erika Friedmann, PhD
University of Maryland School of Nursing
Laurie Williams, MA
Casey Health Institute
Sue Thomas, PhD, RN, FAAN
University of Maryland School of Nursing
Purpose: To develop a better understanding of how yoga practice affects one’s interpersonal relation-
ships. Design: Qualitative. Method: Content analysis was used to qualitatively analyze written com-
ments (n = 171) made regarding yoga improving interpersonal relationships in a large cross-sectional
survey of yoga practitioners (N = 1,067). Findings: Four themes were identified: Yoga practice leads to
personal transformation, increases social interaction, provides coping mechanisms to weather relation-
ship losses and difficulties, and leads to spiritual transcendence. Practitioners believed that their inter-
personal relationships improved because their attitude and perspective had changed, making them
more patient, kind, mindful, and self-aware. They expressed an aspect of community that was both
practical (they met new friends) and spiritual (they felt they belonged). They thought they could better
weather difficulties such as divorce and death. A number discussed feeling a sense of purpose and that
their practice contributed to a greater good. Conclusions: There appears to be an aspect of community
associated with yoga practice that may be beneficial to one’s social and spiritual health. Yoga could be
beneficial for populations at risk for social isolation, such as those who are elderly, bereaved, and
depressed, as well as individuals undergoing interpersonal crises.
Background and Significance extended period of time with his teacher (Bryant,
2009). Classically, only males participated in yoga
More than 13 million Americans practice yoga
study. A great deal has changed over the past 100
(Ross, Friedmann, Bevans, & Thomas, 2013), and
years as yoga migrated West from India. The disci-
many believe yoga improves their health (Author,
pline has been opened to women, and the current
YYYY). For centuries, the discipline, consisting of
format of teaching typically involves group instruc-
eight limbs (universal ethical principles, individual
tion in yoga classes.
self-restraint, physical poses, breath work, quieting
of the senses, concentration, meditation, and self-
absorption or emancipation), was passed down from Authors’ Note: Please address correspondence to Alyson Ross,
University of Maryland School of Nursing, 7719 Tomlinson
guru (teacher) to sisya (pupil), typically via one-on- Avenue, Cabin John, MD 20818, USA; e-mail: Alyross1@
one tutorials, usually while the pupil resided for an verizon.net.
2 Journal of Holistic Nursing / Vol. XX, No. X, Month XXXX
The physical, mental, and emotional health ben- Although social relationships are clearly impor-
efits of yoga have been studied extensively over the tant to one’s health and the practice of yoga histori-
past several decades, and yoga has been shown to cally has revolved around an intense relationship
improve a number of health conditions including with one’s teacher and more recently with one’s
cardiometabolic conditions such as cardiovascular peers in class settings, the authors could find no
disease and type 2 diabetes (Innes, Bourguignon, & published articles discussing the therapeutic bene-
Taylor, 2005), cancer (Culos-Reed et al., 2012), fits of the social aspects of yoga. In a recent national
arthritis (Büssing, Ostermann, Lüdtke, & Michalsen, survey of Iyengar yoga practitioners that we con-
2012), asthma (Posadzki & Ernst, 2011), and psy- ducted at the University of Maryland School of
chiatric conditions such as depression (Uebelacker Nursing, 67% of participants, regardless of race,
et al., 2010), anxiety (Kirkwood, Rampes, Tuffrey, gender, or education, agreed or strongly agreed that
Richardson, & Pilkington, 2005), and posttraumatic yoga helped improve their interpersonal relation-
stress disorder (Meyer et al., 2012; Telles, Singh, & ships (Ross, Friedmann, Bevans, & Thomas, 2013);
Balkrishna, 2012). Yoga is thought to elicit physical individuals with chronic health conditions were
and mental health benefits by down-regulating the even more likely to agree that yoga improved their
hypothalamic-pituitary-adrenal axis and the sympa- relationships. Participants in the study were invited
thetic nervous system response to stress (Ross & to express their thoughts or comments about the
Thomas, 2010). Although the evidence supporting impact of their yoga practice on their lives and inter-
the health benefits of yoga is substantial, almost all personal relationships; the purpose of this article is
of the research has focused on the practice of phys- to analyze these comments in order to develop a bet-
ical poses (asana), breath work (pranayama), and/or ter understanding of how yoga practice affects one’s
meditation. No published studies have examined interpersonal relationships and social health.
whether the relationships one develops with one’s
yoga teacher and peers provide health benefits above
Conceptual Framework: Yoga and the
and beyond the benefits derived from the physical
practice of yoga. Biopsychosocial Model of Health
It is important to study the social aspects of yoga The biopsychosocial model of health first pro-
practice, because the quality of one’s social relation- posed by Engel (1977) provides a comprehensive
ships and quantity of one’s social support are known framework for understanding health and disease
to be important predictors of health (Umberson & that is less reductionistic and more interactive than
Montez, 2010). Social isolation has such a profound the traditional biomedical model. Whereas the tradi-
psychological impact that it is frequently used as a tional biomedical model views health and illness as
form of punishment or torture. Indeed, the stress of linear, dualistic in nature, and a product of cause
social isolation is associated with negative cardiovas- and effect relationships, the biopsychosocial model
cular outcomes (Brummett et al., 2001; Grant, views health as far more complex and holistic.
Hamer, & Steptoe, 2009), as well as increased Instead of disease being due to a particular causative
inflammation and impaired immune system function factor, it is viewed as a dynamic process involving
(Kiecolt-Glaser et al., 2003; Kiecolt-Glaser, Gouin, the interplay of several factors from the biological,
& Hantsoo, 2010). In 148 studies examining the psychological, and sociocultural realms (Molina,
impact of social relationships on mortality, strong 1983). According to the biopsychosocial model of
social relationships consistently increased one’s odds health, numerous biological, psychological, and
of survival, regardless of one’s age, gender, or cause social factors interact and affect health outcomes in
of death (Holt-Lundstad, Smith, & Layton, 2010). either a positive or a negative manner (Hoffman &
Not only do close personal relationships make people Driscoll, 2000). Biological factors include age, race/
healthier, they make them happier as well. Individuals ethnicity, gender, and preexisting health conditions.
in committed relationships or partnerships report Psychological factors refer to emotional status,
greater subjective well-being, a measure of emotional including depression, anxiety, reactions toward
health or happiness, than those in casual relation- stress, and psychological and emotional well-being.
ships, and individuals in happy relationships report Social factors focus on socioeconomic status and
higher subjective well-being than those in unhappy social ties, including friends and family as well as
relationships (Dush & Amato, 2005). ties to one’s community and society. These three
Qualitative Analysis of How Yoga Affects Relationships / Ross et al. 3
mous online survey asking detailed questions about 1998). The researchers focused primarily on the
their yoga practice and their health. Of the 1,167 who latent meaning underlying the communications but
responded to the survey link, a final sample of 1,045 used the exact words or phrases of subjects whenever
was acquired. A detailed description of the sampling possible, particularly when those words or phrases
process used in this study has been described else- were used repeatedly. Because little has been pub-
where (Ross, Friedmann, Bevans, & Thomas, 2012). lished about the impact of yoga on one’s interper-
Despite 60% reporting at least one chronic or serious sonal relationships, the researcher focused on an
health condition (including 24.8% with depression), inductive versus a deductive approach to analysis
yoga practitioners in this study reported lower levels of (Kondracki, Wellman, & Amundson, 2002). This
obesity (4.9%) and smoking (2%), higher consumption approach allows descriptions, categories, and themes
of fruits and vegetables, and higher levels of happiness to arise from the data, as opposed to allowing precon-
compared with national norms (Ross, Friedmann, ceived ideas or theories to drive data analysis.
Bevans, & Thomas, 2013). Subjects who practiced To enhance the validity and reliability of the find-
yoga more frequently exhibited more favorable levels ings, two investigators independently analyzed the
of mindfulness, happiness, body mass index, fruit and data, and then they compared their findings. The
vegetable consumption, vegetarian status, fatigue, and investigators separately read through all of the com-
sleep than those who practiced less often (Ross, ments several times, immersing themselves in the
Friedmann, Bevans, & Thomas, 2013). data. While reading through the statements, research-
As part of the survey, participants were asked ers made numerous notes in the margins. Often,
how much they agreed or disagreed that yoga exact quotes (words or phrases) were pulled from
improved a number of aspects of health. Participants their statements. Notes that captured the essence of
agreed that yoga improved happiness (86.5%), energy the person’s experience were placed on coding sheets,
(84.5%), sleep (68.5%), social relationships (67%), after which researchers began to abstract categories
and body weight (57.3%). Subjects were invited to from these codes. The names of the categories would
post comments following each of these questions. emerge that captured the underlying meaning of the
For this analysis, the researchers used comments category. Occasionally, a number of codes would be
posted to the question: “How much do you agree or closely related but not necessarily identical. In these
disagree with the following statement: My relation- instances, subcategories or variations within a cate-
ships are better because of yoga.” Of the 1,045 indi- gory would emerge. For example, one category that
viduals in the original study sample, 700 (67%) emerged was that subjects reported having more
agreed or strongly agreed that yoga improved their positive characteristics after starting yoga. Four sub-
relationships, and 171 posted comments to this categories of this category included being more
question and are included in this study. insightful, happy, and tolerant, in addition to feeling
better. Finally, the researchers worked together to
group the categories into overriding themes.
Data Analysis Graneheim and Lundman (2004) define themes as
interpretations of the underlying meaning of an indi-
Processes and Procedures vidual category or group of categories.
The investigators abstracted similar categories,
Data were analyzed using qualitative content although the number of categories differed (7 and 10,
analysis. A number of methodological considerations respectively). The investigators discussed their differ-
were taken into account prior to data analysis. The ences and came to a consensus on 10 categories, with
researchers first identified the unit of analysis or the 8 subcategories that fell under four major themes. As
content area to be studied, which in this case con- recommended by Elo and Kyngas (2008), the
sisted of subject’s open-ended comments to the researchers identified authentic citations that served
statement, “My relationships are better because of as exemplary examples of the category or subcategory.
yoga.” The researchers had to determine the study’s
criteria, particularly whether the analysis would
focus on the literal words in the text as written Credibility and Legitimacy
(manifest data) or on their underlying meaning One reasonably could argue that open-ended
implied within the text (latent data), or both (Berg, comments made in an anonymous survey might not
Qualitative Analysis of How Yoga Affects Relationships / Ross et al. 5
adequately reflect the reality of one’s experience, as Table 1. Characteristics of Study Sample (N = 171)
only those individuals able to articulate their experi- Variables M (SD) Range
ence would respond or the investigators might mis-
Age 55.0 (11.3) 23-80
interpret those experiences. However, Geer (1988) Length of yoga practice 12.0 (7.6) 0-25+
found that open-ended questions used in surveys (in years)
adequately capture individual’s experiences, and the
Frequency %
anonymity of online surveys may lead to more hon-
est responses (Erickson & Kaplan, 2000). Gender
One problem confronted by the researchers was Male 24 14
Female 147 86
that because the surveys were anonymous, there was Race
no opportunity for the researchers to validate the White 157 91.8
findings with participants. For this reason, two Othera 14 8.2
investigators conducted independent data analysis Marital status
to validate the findings. As suggested by Graneheim Married/lives with partner 113 66.1
and Lundman (2004), the researchers had an open Singleb/widowed/separated/ 55 32.2
divorced
dialogue to discuss and define the categories. Other 3 1.7
Authentic quotes were used to increase trustworthi- Employment
ness (Elo & Kyngas, 2008). The researchers explored Full-time 73 42.6
other sources of information to further validate find- Part-time 49 28.7
ings, including the findings in the ancient yogic text Not employed 49 28.7
Education
Yoga Sutras of Patanjali as interpreted by B. K. S.
High school/GED/trade/ 7 4.1
Iyengar, one of the world’s foremost yoga teachers
vocational school/other
and author of numerous texts on yoga practice and Some college 14 8.2
philosophy. College graduate 66 38.6
Master’s degree 66 38.6
Doctoral degree 18 10.5
Findings a = Multiracial (n = 5; 2.9%), Asian (n = 3; 1.8%), African
American (n = 3; 1.8%), Other (n = 3; 1.8%).
Demographic characteristics of the 171 study b = Never married.
participants are shown in Table 1. Subjects ranged
in age from 23 to 80 years (M = 55.0 years, SD = Theme 1: Yoga Leads to Personal
11.3), with the large majority being female (86%)
Transformation
and White (91.8). Most of the subjects were married
or living with a partner (66.1%), and 42.6% were Three categories emerged from the data and
employed full-time. They were well educated, with supported the theme that yoga leads to personal
over 85% having an undergraduate (38.6%), a mas- transformation: Subjects had changed or become “a
ter’s (38.6%), or a doctoral (10.5%) degree. Subjects new person” after starting the practice of yoga; they
reported practicing yoga for less than 1 to more than had more positive traits; and they had fewer negative
25 years (M = 12.0 years, SD = 7.6). traits, all of which made their interpersonal relation-
The researchers abstracted 10 categories, with 8 ships better. Participants believed that yoga had
subcategories that fell under four major themes. transformed their lives, and this transformation
These themes were that yoga practice (a) leads to changed how they relate to others. Said one practi-
personal transformation, (b) increases social inter- tioner, “I have noticed an improvement in my atti-
action, (c) provides coping mechanisms to weather tude, which, of course, makes my relationships with
relationship losses and difficulties, and (d) leads to others much better.” Practitioners reported having
spiritual transcendence. These themes gave a rich “more” of a number of positive psychological traits
description of the experience of how the practice of and characteristics as a result of their yoga practice:
yoga affects the lives of individuals who practice insight, self-awareness, mindfulness, calmness,
yoga. Themes, categories, subcategories, and exem- peacefulness, happiness, compassion, kindness, tol-
plary statements (statements that best illustrate the erance, respect, and compassion. Participants stated
category or subcategory) are shown in Table 2. that yoga puts them in a better frame of mind for
6 Journal of Holistic Nursing / Vol. XX, No. X, Month XXXX
interacting with others: “I feel better able to interact empathetic. This helps me connect with others and
from a generous place after yoga and that usually build strong, trusting and honest relationships.”
lasts a few days.” Simply put by one practitioner, “I Others reported that their new-found self-aware-
am a nice person when I do yoga!!!” ness made them more discriminating in their rela-
Several participants claimed their yoga practice tionships. A number of practitioners said they felt
helped them be more insightful and self-aware, better physically, which in turn led to positive inter-
which made them less reactive and more able to personal experiences. One practitioner explained, “I
respond with compassion in their interpersonal am stronger, calmer, and in less pain so that
relationships. Said one, “I have a greater awareness improves my relationships.”
of my needs and others’ needs so my relationships In addition to experiencing an increase in posi-
are stronger.” “Getting in touch with myself defi- tive attributes, the practitioners wrote about having
nitely helps me get in touch with others,” responded fewer negative traits such as being intolerant, judg-
another. Explained another, “Yoga helps me to be mental, and reactive. As one practitioner stated,
more self-aware, and thus more compassionate and “Yoga engenders a non-reactive nature; this
Qualitative Analysis of How Yoga Affects Relationships / Ross et al. 7
know that yoga is the thing that keeps me feeling as Validation of Findings Through Other
good as I do. Without it I would be sad all of the Sources: The Yoga Sutras of Patanjali
time.
When the researchers looked to the primary text
Another stated the following: of yoga philosophy, The Yoga Sutras of Patanjali, for
validation of our findings, we found the same themes
I was able to care for my dying mother because of expressed by our participants. Thousands of years
my study of yoga. She pointed it out to me and we ago, the yoga sage Patanjali codified yogic philoso-
spoke about it very honestly. I could NOT have phy into 196 aphorisms or “sutras” that detail how
coped or done what I did without being connected yoga practice can be used to overcome life’s obsta-
to my yoga “spirituality.” cles in order to achieve spiritual development. Only
2 of the 196 sutras or aphorisms pertain to the
As one practitioner stated succinctly, “When my physical practice of yoga. The remaining 194 sutras
husband killed himself, yoga helped me face my define and painstakingly detail the practice of yoga
grief and build a new life.” and the effects of the practice on the individual’s
body, mind, and spirit. That yoga provided a tool for
overcoming obstacles and that it leads to spiritual
Theme 4: Yoga Leads to Spiritual
development were themes that emerged in our par-
Transcendence and Connection ticipants’ comments. Just as many of our study par-
The final theme extracted from the comments of ticipants commented on how yoga had changed
participants was that there is a spiritual aspect of their minds for the better, the majority of Patanjali’s
yoga that leads to a transcendence of self and a yoga sutras describe how fluctuations of the mind
sense of connectedness to all mankind. This went lead to suffering and how yoga can be used to con-
beyond making new friends or feeling connected to trol these fluctuations. The second sutra states,
a specific yoga community. The practitioners talked “Yoga is a cessation of the movements in the con-
of feeling a part of something bigger and deeper that sciousness” (Iyengar, 1993, p. 46). After stilling the
transcended individual differences. Said one practi- mind’s endless stream of thoughts, worries, and
tioner, “It takes me to my inner reality and feelings distractions through yoga practice, these negative
of oneness with others.” Said another, “I like honor- states of mind can no longer “distort the true expres-
ing the spirit within me, whether Jew, Christian, sion of the soul” (p. 48).
Muslim . . .” Numerous practitioners reported feel- Some of the sutras seem to refer specifically to
ing a greater “sense of purpose.” Others expressed how yoga practice changes one’s interpersonal rela-
the idea that their practice benefitted the greater tionships. Sutra 1.33 echoes comments of practi-
good: “Yoga and meditation/pranayama are practices tioners that yoga practice leads to a personal
and ways of living to me that I gain enormous transformation, whereby one becomes more con-
renewal from and hope that my practice in some way tent, more friendly, and less judgmental: “Through
contributes to others well-being as well as my own.” cultivation of friendliness, compassion, joy, and
One woman explained, indifference to pleasure and pain, virtue and vice
respectively, the consciousness becomes favorably
Yoga/meditation puts humans into a “certain state.” disposed, serene, and benevolent” (Iyengar, 1993, p.
That state has been called calm, serene, blissful, etc, 82). A number of sutras refer specifically to how
etc. However, the key point is that in that state, yoga helps one overcome life’s obstacles and afflic-
humans are “better” human beings: less aggressive, tions, leading to a state of Samadhi, described as “an
more flexible, more creative—without any experience where the existence of ‘I’ disappears . . .
indoctrination or imposition of a philosophical system. we truly understand at the core of our being that our
Therefore yoga is universal and context independent. individual soul is part of the Universal Soul” (Iyengar,
2005, p. 215). This sutra parallels the final theme
One final participant echoed the words of many: identified in the study that yoga leads to a tran-
“I’ve often thought and said, if everyone were to scendence of self and a sense of connection with all
practice yoga, perhaps we could attain world peace.” mankind.
Qualitative Analysis of How Yoga Affects Relationships / Ross et al. 9
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yoga practice in general. It also is possible that indi- associated disability: A meta-analysis. Journal of Pain, 13,
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Culos-Reed, S. N., MacKenzie, M. J., Sohl, S. J., Jesse, M.
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T., Zahavich, A. N. R., & Danhauer, S. C. (2012). Yoga &
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cancer interventions: A review of the clinical significance
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model. International Journal of Psychiatry in Medicine,
Margaret Bevans PhD, RN, is a Clinical Nurse Scientist at the
13, 29-36. NIH Clinical Center. The focus of her research is to improve
Patterson, A. C., & Veenstra, G. (2010). Loneliness and risk the psychosocial outcomes of cancer patients and their family
of mortality: A longitudinal investigation in Alameda caregivers.
County, California. Social Science & Medicine, 71,
181-186.
Posadzki, P., & Ernst, E. (2011). Yoga for asthma? A system- Erika Friedmann, PhD is a professor at the University of
atic review of randomized clinical trials. Journal of Asthma, Maryland School of Nursing. Her research addresses the inte-
gration of social, psychological, and physiological contributors
48, 632-639.
to health.
Ross, A., Friedmann, E., Bevans, M., & Thomas, S. (2012).
Frequency of yoga practice predicts health: Results of a
national survey of yoga practitioners. Journal of Evidence Laurie Williams, MA, is a health coach and Director of
Based Complementary and Alternative Medicine, 2012(10), Wellness Programs at the Casey Health Institute, an integrative
doi:10.1155/2012/983258. medicine patient-centered medical home serving the greater
Ross, A., Friedmann, E., Bevans, M., & Thomas, S. (2013). Washington, DC area.
National survey of yoga practitioners: Mental and physi-
cal health benefits. Complementary Therapies in Medicine, Sue Thomas, PhD, RN, FAAN is an expert on psychological
21, 313-323. and social influences affecting health. Her research over the
Ross, A., & Thomas, S. (2010). The health benefits of yoga past 30 years focuses on the effects of depression, anxiety and
and exercise: A review of comparison studies. Journal of social support on cardiovascular health.