Find a direction
Choose where a person is starting, what needs attention, and the time of day. The planner answers with the direction Kraftsow’s method would point toward: whether to build or to calm, where to begin, how to breathe, which adaptations to reach for, and when to send someone to a clinician first.
A first practice: spine and breath
Kraftsow’s general rule is to begin every therapeutic practice with the spine and the breath, because linking breath to movement links the mind to the body and makes the movement conscious. This short sequence follows that rule and suits almost any starting point. We move in and out of each shape with the breath several times before staying.
- Arrive lying on the back, knees bent, feet on the floor. For six breaths we simply notice where each inhale begins and where each exhale ends.
- Arms overhead on the inhale, back down on the exhale, six times. The inhale widens the chest from the top down; the arms follow the breath.
- Apanasana (knees to chest) Hands on the knees, we draw the knees toward the chest on the exhale, gently firming the belly from the pubic bone up toward the navel, and let them move away on the inhale. Six times.
- Cakravakasana (the table top family), on hands and knees. On the exhale we fold back toward the heels, rounding the back; on the inhale we come forward and lift the chest. Six times, slowly, with the breath leading.
- Rest on the back for several breaths, letting the exhale grow a little longer than the inhale.
Function over form
Gary Kraftsow began studying with T.K.V. Desikachar in India in 1974 and founded the American Viniyoga Institute in 1999, the year Penguin published Yoga for Wellness. The book sets down the therapeutic side of the Viniyoga tradition that Desikachar carried from his father, Tirumalai Krishnamacharya, the same teacher at the root of the lineage tree.
The book rests on one idea. In Kraftsow’s reading of the tradition, the way each person did a posture was worked out between teacher and student, and
“the transformational value of a posture was always seen in relation to its function, not to its form.”Gary Kraftsow, Yoga for Wellness (1999), Introduction
A posture has value for what it does in a particular body, and so the form is free to change. That idea turns a set of fixed shapes into a set of tools, and it is the ground of everything below. Kraftsow ties it to samskara, the conditioning that repetition lays into how we move and react. Habit keeps us functioning and also limits us. Turning attention inward, and moving with awareness led by the breath, is how new patterns begin to replace old ones.
The same idea runs through the adaptation principles I learned in my September 2026 training, set out in Adapting the pose on the sequencing page. Reading Kraftsow showed me the lineage those principles come from.
Six steps of a therapeutic practice
Kraftsow presents therapy as a process between two people more than a menu of poses for conditions. I read his method as six steps, each drawn from his own chapters. The sequences in his book are, in his words, “descriptive rather than prescriptive”: models of an approach, meant to be adapted again for each person.
1Meet the whole person
Kraftsow maps a person in five dimensions, the pancamaya, or five sheaths, of the Taittiriya Upanishad: the physical body, the breath and vital energy, the mind, the deeper layer of understanding, values, and past patterns (vijnana maya), and the heart, our sense of joy and what we cherish (ananda maya). A condition in one dimension reaches all the others, so long-term back pain can bring fatigue and low mood, and low self-worth can end in joint pain. The first work is listening across all five.
He places the relationship ahead of the technique: “the technology of practice is secondary to, and emerges out of, the relationship that develops in the environment of the session between the teacher and the student.” The tradition’s word for right association is sat sangha.
2Screen before practice
For the neck, shoulders, and back, Kraftsow names the signs that call for a professional diagnosis before any yoga: numbness or tingling in the arms, hands, legs, or feet; sharp, electric, or immobilizing pain; sharp pain in the shoulder. In those conditions, he writes, yoga may assist healing, and the wrong practice may make matters worse. For persistent anxiety, panic, obsessive-compulsive disorder, post-traumatic stress, or deep depression, he recommends professional psychiatric care, with yoga as a companion to it.
3Choose a direction
Every therapeutic practice leans one of two ways, described in the pair of cards below. Kraftsow adds a third lens from the three gunas: agitation (rajas), as in anger and anxiety, calls for calming; dullness (tamas), as in depression, calls for awakening interest and energy; and the aim of both is clarity and balance (sattva). The two directions often mix. For a person with chronic fatigue, his sequence begins gently building to raise energy and ends gently calming, because too much heat would leave her exhausted. For anxiety he meets the person where the mind is: first movement strong enough to match the agitation, then a gradual slowing, deep slow breathing, sound, and finally meditation or prayer.
4Start where the person is
Kraftsow pictures health on a scale from minus one, a very serious condition, to ten, optimal health, and starts each person at a different point on it. For serious illness the practice begins lying on a bed or seated in a chair, with awareness of the breath. From there, the practice starts with simple movements of the spine linked to breath, and adds techniques as the person is ready.
5Adapt and sequence
This is the craft at the center of the book: changing posture, breath, sound, and props to fit the person, then ordering the practice so that each part prepares for the next and the body returns to neutral at the end. The toolkit and the sequencing principles have their own sections below.
6Practice, watch, and revise
“Without practice, there will be no results,” Kraftsow writes, and the practice has to change as the person changes. His teacher Krishnamacharya had a name for any practice that helps one part of us while harming another: anga bhanga sadhana, literally a limb-harming practice. His example was running (“Running is for horses!”), good for the heart and lungs and hard on many ankles, knees, and hips. Any practice, a yoga practice included, can become one when it is wrongly applied, so part of the ongoing work is watching whether a practice still serves the person doing it.
Building
For weakness, low energy, specific debilities, lack of confidence, and recovery after illness. The techniques are the inhale, holding after the inhale, backbends, and shoulderstand, and chanting, visualization, and meditation can be shaped the same way. Building practice generally raises heat and energy.
Reducing
For conditions of excess such as hyperactivity or anxiety. The techniques are the exhale, a short hold after the exhale, forward bends, some twists, and headstand. Reducing practice is generally cooling and conserves energy, and Kraftsow notes it can also serve as prevention.
Ways to adapt a practice
Kraftsow gives three reasons to adapt: to keep practice from becoming mechanical, to meet conditions that change from day to day, and to work with long-term problems. Adaptation is also how we emphasize different effects of the same pose. His tools fall into four groups.
The form of the posture
Arms
One arm instead of two lightens the load, eases the neck and shoulders, and works each side on its own. Sweeping arms do the same, and paired with head movements they stretch and strengthen the neck. Bending and straightening the arms brings awareness to the upper back and helps it flatten. Using the arms as levers takes us deeper, with more risk to the joints.
Legs
Bent knees in standing poses lower the center of gravity and let the low back stretch; in seated poses they can help or limit the pelvis tipping forward. Wider feet increase the stretch in standing and seated poses, and ask more of the hip muscles on the back and belly. Shifting one knee back deepens the stretch on that side of the back.
Props
A wall, table, chair, blocks, cushions, straps, and light weights, used when movement is restricted or to intensify work in one area. Kraftsow shows a twist on a chair, a kneeling pose against a wall, and a book under the hips in a forward bend.
The movement into and out of it
Origin
Where a movement begins shapes its effect. Beginning a standing forward bend from the belly limits the forward tip of the pelvis; beginning it from the hips invites it.
Direction
Coming up into Ardha Uttanasana helps flatten the upper back, which suits a normal to rounded upper back. Moving down into it rounds the upper back, which suits a flatter one. In Bhujangasana, pushing down through the hands deepens the arch in the low back, while pulling back on the hands and bringing the chest forward deepens it in the upper back.
Range
Going as far as possible is often the wrong aim. A person who drops easily into Upavistha Konasana stretches the low back far more by bending the knees and keeping the sit bones down.
Stages, speed, and staying
Breaking a movement into stages (krama) deepens it. Faster movement energizes and slower movement calms, always paced to a full breath. Moving in and out of a pose several times usually prepares us to stay in it.
Attention
Where we place attention changes the pose. Kraftsow suggests moving into Parsvottanasana four times, attending first to the back heel, then the belly, then the hands, then all three. Holding a quality such as kindness in mind can soften the whole practice.
The breath
In this tradition the breath always begins before the movement and leads it: “first feel the current, and then swim with it.” On the inhale the chest expands from the top down, and on the exhale the belly firms from the pubic bone up toward the navel, which steadies the pelvis and low back. The breath itself can then be adapted, and the breath page holds the fuller practices.
Length and ratio
Fix the length of the inhale or exhale, set a ratio between them, or lengthen both while keeping the ratio. Kraftsow notes that the exhale is commonly longer than the inhale, and only rarely the reverse.
Holds
Holding after the inhale extends the inhale’s effect and suits poses that emphasize the inhale. Holding after the exhale extends the exhale’s effect. Both intensify a posture.
Technique and pattern
If the upper back and neck are stiff, focusing the inhale at the solar plexus can ease tension. A movement usually done on the inhale can be done on the exhale, and the breath can be taken in segments (krama breathing), pausing between each third.
Sound
Humming, chanting single syllables, phrases with meaning, or whole songs and prayers focus attention and lengthen the exhale. Kraftsow reports broad agreement that higher-pitched sounds resonate higher in the body and energize, lower sounds resonate lower and calm, louder sounds turn attention outward, and softer sounds turn it inward. He also invites us to test this in our own bodies.
Preparing and counteracting
Two principles order every part of a Viniyoga practice. Vinyasa, “arranging” or “placing,” moves from the gross to the subtle, the external to the internal, the simple to the complex, the easy to the difficult: asana prepares the breath for pranayama, and pranayama prepares the mind for meditation. Pratikriya, “counteracting,” returns the body, breath, and mind to neutral by moving the other way.
The counterpose depends on the person and the day. After a deep backbend one person needs the low back and hips settled first, another the upper back, neck, and shoulders. The same posture, placed after different preparations, also does different work: Kraftsow prepares for Pascimatanasana with forward bends for someone with tight hips, and with backbends for someone whose hips and low back are loose.
Seven principles for designing a sequence
Intention: set a goal for the practice. Efficiency: keep the number of poses and adaptations small and purposeful; too many dilute the effect. Breath: let the breath link attention to the spine, and use holds on purpose. Transition: take time to arrive, and use kneeling poses to move between standing and lying down. Cumulative stress: compensate for strain gathering in the neck, shoulders, hips, and knees. Risk: place riskier postures later, after preparation, followed by simple counterposes. Rest: rest when the breath grows unsteady, after hard poses, when changing direction, and at length at the end.
Forward bends as the hub
In Kraftsow’s account, forward bending is the hub of the wheel and backbends, twists, and side bends are its spokes, so a forward bend carries the practice from one direction to the next. Standing and kneeling poses warm the body, poses on the back relax and prepare for inversions, headstand and shoulderstand sit between half and two thirds of the way through, poses on the stomach strengthen the back, and seated poses come near the end, preparing for pranayama and meditation.
Shaped to the day
A practice should fit the day around it. Someone tired in the morning might begin lying down, rise through the knees to standing, and end resting on a chair before work. Someone wound up in the evening might begin standing and travel down through the knees to lying on the back before sleep. Physical work calls for a practice that restores balance; desk work calls for one that moves the body and clears the mind.
Three kinds of condition
The therapeutic half of the book applies this method in three chapters, each with case studies from Kraftsow’s own students and the practices he built for them.
Common aches and pains
The skeletal and muscular systems, then the neck and shoulders; the upper and lower back; and the sacrum, hips, and knees.
Chronic disease
Digestion, the respiratory, cardiovascular, lymphatic and immune, endocrine, and nervous systems, and the urinary and reproductive systems, each read as conditions of excess or deficiency.
Emotional health
Anger and anxiety as states of overarousal, depression as a state of underarousal, and the practices of breath, sound, reframing (pratipaksha bhavana), and meditation that meet each.
An example: the neck and shoulders
Kraftsow reads most neck and shoulder problems as a poor working relationship among the head, neck, shoulders, arms, rib cage, and upper back, and he works the neck by changing that relationship. Our habit is for the head and shoulders to turn together. We can instead keep the shoulders still while the head turns, or turn the shoulders one way and the head the other, which stretches the muscles on the side opposite the turn more strongly. Turning back and forth alternately contracts and lengthens both sides of the neck, bringing circulation, strength, and relaxation. He names habits that feed the problem: lifting the head as we bend forward, raising the shoulders toward the ears under stress, cradling a phone against the shoulder, and pulling the spine with the head when moving into backbends and out of forward bends. On the sequencing page, the regional notes carry the same principle into Triangle, Side Angle, and twists.
Two maps of the same territory
Every teacher is asked some version of why a backbend lifts the mood and why a long forward fold settles it. There are two answers available, and they come from different places. The tradition answers with the chakras, a map of centres along the spine, each with its own emotional theme. Research answers with posture, breath, and the nervous system, and it answers more narrowly than most of us would like. I keep the two apart on this site, so here they are side by side with a line down the middle.
The chakras
The seven centres place qualities of experience along the spine: grounding and safety at the base, creativity and feeling at the sacrum, will and self-worth at the solar plexus, love and grief at the heart, voice and truth at the throat, insight at the brow, and release at the crown. Pose families sit on that map, and the family tree shows which family the tradition files where.
This is a teaching language with real use. It gives a class a theme, it gives a student a place in the body to put attention, and it names experiences people already have. What it is not is a tested claim. I found no peer-reviewed study measuring chakra-specific emotional associations. The scholarly literature that exists is theoretical mapping, such as Chase’s 2018 paper in Medical Acupuncture, which drew a published critical letter from Robinson disputing whether the mapping is justified at all.
Posture, breath, and the nervous system
The honest summary is narrow. Collapsing the body downward reliably dampens mood, and uncollapsing helps. Slow breathing reliably shifts a measure of vagal activity. Yoga helps depressive symptoms in trials that mostly lack a strong control. Beyond that, the field is full of claims that did not survive replication.
Nothing here maps onto a chakra. It maps onto two plainer ideas: the shape we hold changes what we feel, and the breath is the fastest lever we have on the part of the nervous system that handles arousal.
What the research actually shows
Posture: uncollapsing helps, expanding does little
This is the best-evidenced piece, and it is more modest than the version that circulates. Elkjær and colleagues pooled 73 randomised experiments covering 7,038 people in 2022. Expansive posture compared with contractive gave a moderate effect on emotional outcomes, around g = 0.40. The useful detail is where that came from: contractive posture compared with neutral moved people about g = 0.45, while expansive compared with neutral came to g = 0.06 and did not reach significance. Slumping hurts; puffing up does little. Hormonal effects across the same literature were null.
So in practice I cue people out of collapse rather than into display. A chest that is simply not caved, in Mountain, Locust, or a supported chest opener, is doing the part that holds up.
Breath: the fastest measurable lever
Zaccaro and colleagues reviewed fifteen slow-breathing studies covering around 458 people in 2018 and found consistent increases in heart rate variability and respiratory sinus arrhythmia, with reports of greater relaxation and lower anxiety, and some studies finding no mood change at all. Their own caution is the one to carry: no included study estimated the correlation between the physiological change and the psychological one, so the link we assume between calmer numbers and calmer people is still assumed.
Thayer and Lane’s neurovisceral integration model is the usual explanation offered for why vagal tone and emotion regulation travel together. It is a model with correlational support rather than a demonstrated causal chain.
Yoga for low mood and anxiety
Streeter and colleagues gave 32 people with major depression twelve weeks of Iyengar yoga with coherent breathing in 2017. Depression scores fell about eighteen points in both the higher and lower dose groups, with no difference between them, and there was no non-yoga control. Sharma and colleagues ran Sudarshan Kriya breathing against a waitlist for 25 people who had not responded to antidepressants, and found a clear difference, with expectancy uncontrolled. The NIH complementary health centre summarises the field as some evidence of benefit for depressive symptoms, and for anxiety reports a 2018 meta-analysis where possible short-term benefit disappeared once the analysis was restricted to diagnosed anxiety disorders.
Trauma-sensitive yoga
Van der Kolk and colleagues randomised 64 women with chronic, treatment-resistant PTSD in 2014. After ten weekly classes, 52 percent of the yoga group no longer met criteria for PTSD against 21 percent of the comparison group. That trial is the one everyone cites. The pooled picture since is soberer: Nejadghaderi and colleagues combined 20 randomised trials covering 954 people in 2024 and found a moderate improvement in self-reported symptoms immediately after the intervention, no effect at follow-up, no effect on clinician-rated symptoms, and every included trial at high risk of bias.
This is still worth teaching. It is worth teaching as a support alongside care, with the limits named, which is also how Kraftsow frames the emotional-health work above.
Where emotion is felt in the body
Nummenmaa and colleagues had 701 people in Finland, Sweden, and Taiwan colour in body outlines to show where activity rose or fell for each emotion, and the resulting maps were consistent enough across cultures for a classifier to tell emotions apart. What that shows is agreement about where people say they feel things. It does not show that the bodily events occur, or that they cause the feeling. The nearer physiology is interoception, the sensing of internal state, which Critchley and colleagues tied to activity in the insula. One caution worth passing on: the heartbeat-counting task used to measure interoceptive accuracy in much of this literature has been argued by Zamariola and colleagues to measure beliefs about the heart more than the heart.
Power posing is the cautionary tale. The hormone findings failed to replicate in a larger study by Ranehill and colleagues, and Carney, the first author of the original paper, has since written that she does not believe the effect is real. The pen-in-mouth version of facial feedback failed across seventeen laboratories and 1,894 people in a registered replication led by Wagenmakers, though Coles and the Many Smiles Collaboration later revived the broader idea using posed smiles across 3,878 people. Dose-response in yoga for depression is unsupported: more was no better than less in the Streeter trial. I name these because the body-and-emotion literature is where confident claims go to be quietly withdrawn, and a yoga teacher repeating them inherits the problem.
Teaching with both maps
Here is how I hold them together in a class. The left column is the language the tradition gives, the middle is what I can defend, and the right is where the practice goes. Every pose links to its family on the family tree.
| State | Chakra language | What I can defend | Where the practice goes |
|---|---|---|---|
| Agitation, worry | Vata out of balance; attention scattered above the root | Slow breathing with a long exhale raises vagal measures; meeting the agitation with movement before slowing follows Kraftsow’s own sequence | Active movement first, then Standing Forward Fold, Supine Twist, Child’s Pose, Legs up the Wall, long exhale |
| Heaviness, low drive | Kapha heavy; the solar plexus dim | Uncollapsing the chest is the posture effect that replicates; building practice in the Viniyoga sense favours the inhale and backbends | Cobra, Locust, Bridge, Camel, quicker pace |
| Anger, heat | Pitta sharp; fire at the solar plexus | A lengthened exhale with a short pause is the technique Kraftsow gives, and it is the one slow-breathing research supports for arousal | Forward folds, Gate Pose and other side bends, Seated Twist, cooling breath |
| Grief, holding the chest | Anahata, the heart centre | No evidence ties grief to the chest specifically; what is supported is that a collapsed posture lowers mood and that body maps show people locate feeling consistently | Supported chest openers, Thread the Needle, Puppy Pose, slow breath |
| Unsafe, ungrounded | Muladhara, the root | Trauma-sensitive yoga has one good trial and a weak pooled picture; choice, predictability, and no hands-on are the parts clinicians emphasise | Mountain, Squat, standing poses, Savasana kept short and optional |
What has been tested
Kraftsow’s method has been part of the research on yoga for back pain. His institute reports that he developed the yoga protocol for a National Institutes of Health study of chronic low back pain published in the Annals of Internal Medicine in 2005. A larger trial by Karen Sherman and colleagues, published in 2011, assigned 228 adults with chronic low back pain to Viniyoga-style classes, conventional stretching classes, or a self-care book. After twelve weeks both class groups had better back function and fewer symptoms than the book group, and the gains lasted to six months. Yoga did no better than stretching, which led Sherman to read its benefits as largely physical.
Across the wider field, the National Center for Complementary and Integrative Health summarizes short-term improvements from yoga for chronic low back and neck pain; a 2022 Cochrane review rated the low back gains as small. The emotional-health and chronic-disease chapters rest mostly on case studies and tradition, and I read them as a teacher’s experience, carefully recorded, and as questions still waiting for trials.
Some health claims in the book are stronger than current evidence supports. It describes heart disease as the “direct result” of chronic anger and hostility, where research today treats anger as one risk factor among many, and it uses the language of purification and toxins for reducing practices. I keep those as the book’s claims and leave them apart from the measured findings above.
Yoga therapy is also its own professional field now. The International Association of Yoga Therapists accredits training programs and certifies yoga therapists (C-IAYT), and a teacher trained in adaptations works alongside that field and alongside medical care.