Clinical Evidence for Yoga Therapy in Psychosomatic Disorders: Emphasis on Neurobiological Mechanisms and the Biopsychosocial Model

Erfan Shakibi
Holistic Yoga Teacher
Academic Member of the International Holistic Yoga Therapy Institute (IHYTI)
Member of the Psychology and Counseling Organization of Iran
M.A. in Psychology
www.ihyti.com

Abstract
Psychosomatic disorders, characterized by complex interactions between psychological factors and physical symptoms, pose significant diagnostic and therapeutic challenges in contemporary clinical practice. This article synthesizes current evidence regarding the efficacy and mechanisms of yoga as an integrative intervention for psychosomatic disorders. Drawing on systematic reviews, meta-analyses, and randomized controlled clinical trials published between 2024 and 2026, we examine the psychophysiological pathways through which yoga exerts its therapeutic effects, including autonomic nervous system regulation, modulation of the hypothalamic–pituitary–adrenal axis, reduction of inflammatory markers, and enhancement of interoceptive awareness. Meta-analytic evidence demonstrates significant reductions in systolic blood pressure (6.82 mmHg), diastolic blood pressure (2.92 mmHg), and heart rate (2.55 beats per minute) following yoga interventions, accompanied by clinically significant improvements in anxiety, depression, and perceived stress (Maity et al., 2024). Emerging research on somatic yoga for functional neurological disorders and adjunctive yoga therapy for somatoform pain disorders further supports yoga’s role as a safe, feasible, and effective adjunctive treatment. We present an integrative framework positioning yoga within a biopsychosocial model of psychosomatic medicine and addressing both mechanistic pathways and practical considerations for clinical implementation. The article concludes with recommendations for future research, including the need for larger randomized controlled trials, standardized intervention protocols, and examination of yoga’s effects on specific psychosomatic conditions across diverse populations.
Keywords: yoga, meditation, psychosomatic disorders, biopsychosocial model, psychoneuroimmunology, interoception, mind–body medicine

Introduction
Psychosomatic disorders, broadly defined as conditions in which psychological stress disrupts physiological functioning and leads to physical symptoms or exacerbation of existing medical conditions, impose a substantial and growing burden on healthcare systems worldwide (Britannica, 2021). Contemporary neurobiological models conceptualize these disorders as arising from disrupted integration among neural systems supporting emotional processing, bodily awareness (interoception), and cognitive control (Pick et al., 2019; Barnes-Kennedy et al., 2026). The prevalence of psychosomatic manifestations across medical settings, from primary care to specialized neurology and psychiatry clinics, underscores the urgent need for accessible, mechanism-based interventions that address both the psychological and physical dimensions of these conditions (Stone et al., 2010).
Traditional pharmacological approaches, although often effective for symptom management, are commonly limited by adverse effects, incomplete response rates, and an initial focus on symptom suppression rather than the underlying psychophysiological disturbances (Saini and Sharma, 2024). This has led to increasing interest in non-pharmacological and integrative interventions that directly target the mind–body interface. Among these approaches, yoga, an ancient practice originating in South Asian traditions that integrates physical postures (asanas), breath regulation (pranayama), and meditation (dhyana), has emerged as a particularly promising therapeutic modality (Khalsa, 2007; Maity et al., 2024).
Contemporary yoga therapy represents the systematic application of yoga principles and practices for the prevention and treatment of medical and psychological conditions (Yogendra, 1970). Unlike conventional exercise or relaxation techniques, yoga explicitly targets the integration of physiological, cognitive, and emotional processes—precisely the domains implicated in the pathophysiology of psychosomatic disorders (Gard et al., 2014; Barnes-Kennedy et al., 2026).
The practice’s emphasis on mindful attention to present-moment bodily sensations, deliberate modulation of breathing, and gradual exposure to physical postures provides a unique means of addressing altered interoceptive processing, autonomic dysregulation, and difficulties in emotion regulation characteristic of psychosomatic conditions (Mehling et al., 2018; Sinnott et al., 2026).
The past decade has witnessed substantial expansion of the evidence base supporting yoga’s therapeutic potential across a range of psychosomatic conditions, including cardiovascular diseases, autoimmune disorders, chronic pain syndromes, functional neurological disorders, and stress-related somatic complaints (Cramer et al., 2018; Magan and Yadav, 2022; Barnes-Kennedy et al., 2026). Systematic reviews and meta-analyses have documented significant improvements in both physiological parameters, such as blood pressure, heart rate, and inflammatory markers, and psychological outcomes, including anxiety, depression, and stress (Maity et al., 2024; Takemura et al., 2025). Nevertheless, important gaps remain in our understanding of the specific mechanisms through which yoga exerts its effects, optimal intervention parameters for different conditions, and practical considerations for integrating yoga into routine clinical settings.
This article aims to provide a comprehensive synthesis of current evidence on yoga as an integrative intervention for psychosomatic disorders. We first review the conceptual framework linking the core components of yoga to psychophysiological pathways involved in psychosomatic conditions. We then examine empirical evidence from systematic reviews, meta-analyses, and randomized controlled trials published between 2024 and 2026, with particular attention to cardiovascular, autoimmune, functional neurological, and stress-related disorders. Finally, we discuss clinical implications, practical considerations for implementation, and future research directions.

Conceptual Framework: Yoga and the Biopsychosocial Model of Psychosomatic Disorders

The Biopsychosocial Basis of Psychosomatic Disorders
Contemporary psychosomatic medicine conceptualizes psychosomatic disorders as phenomena arising from dynamic interactions among biological, psychological, and social factors (Engel, 1977; Pick et al., 2019). At the biological level, chronic psychological stress activates the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system, resulting in sustained elevations of cortisol, catecholamines, and inflammatory cytokines that can contribute to tissue damage, immune dysregulation, and symptom generation (Hegberg et al., 2019; Magan and Yadav, 2022). At the psychological level, maladaptive cognitive and emotional processing patterns—including catastrophizing, avoidance, and emotional dysregulation—maintain and exacerbate symptom experiences (Bennett, 2022). At the social level, environmental stressors, interpersonal conflicts, and limited social support contribute to allostatic load and symptom exacerbation (McEwen, 1998).
Importantly, these analytical levels are not independent but mutually reinforce one another. Altered interoceptive processing—the perception and interpretation of internal bodily signals has been identified as a key transdiagnostic mechanism linking psychological and physical processes in psychosomatic disorders (Millman et al., 2023; Pick et al., 2020). Individuals with psychosomatic conditions often exhibit reduced interoceptive accuracy alongside increased interoceptive sensibility, producing a pattern of heightened attention to bodily sensations accompanied by difficulty accurately interpreting those sensations (Millman et al., 2023). This interoceptive disturbance is associated with altered activation of key brain regions, including the insula, anterior cingulate cortex, and amygdala—structures central to emotional processing, bodily awareness, and cognitive control (Perez et al., 2021; Pick et al., 2019).

Therapeutic Mechanisms of Yoga

The therapeutic effects of yoga in psychosomatic disorders can be understood through multiple interconnected mechanisms that directly target the biopsychosocial pathways described above.

Autonomic Nervous System Regulation
A primary mechanism through which yoga exerts its effects is modulation of autonomic nervous system activity. Breathing-based practices (pranayama) and sustained meditative attention activate the parasympathetic nervous system, reduce sympathetic arousal, and promote a physiological state of rest and recovery (Zaccaro et al., 2018; Sullivan et al., 2018). Meta-analytic evidence has documented significant increases in heart rate variability, a marker of parasympathetic tone and cardiac autonomic regulation, following yoga interventions (Zou et al., 2018). This autonomic shift is particularly relevant to psychosomatic conditions characterized by chronic hyperarousal, including cardiovascular diseases, functional neurological disorders, and stress-related somatic complaints (Kelly et al., 2018; Streeter et al., 2012).

HPA Axis Modulation and Stress Regulation
Yoga practice has been shown to modulate HPA-axis activity, reduce cortisol levels, and improve stress reactivity (Raghavendra et al., 2013; Pascoe and Bauer, 2015). A randomized controlled trial comparing meditation, yoga, and stress-management education found differential effects on markers of allostatic load, suggesting that yoga may exert unique effects on stress-related physiological pathways (Psychological assessments, 2025). Reduced stress-related neuroendocrine activation has direct implications for psychosomatic conditions, given the well-established role of chronic stress in exacerbating symptoms across multiple organ systems (Magan and Yadav, 2022).

Reduction of Inflammatory Markers
Emerging evidence suggests that yoga interventions can reduce systemic inflammation, a key pathway linking psychological stress to physical disease. A 12-week yoga and mindfulness meditation program in middle-aged obese women demonstrated significant reductions in erythrocyte sedimentation rate (26.7%) and high-sensitivity C-reactive protein (31.5%), accompanied by improvements in psychological stress and sleep quality. Systematic reviews have documented yoga’s ability to reduce inflammatory markers including interleukin-6, tumor necrosis factor-alpha, and C-reactive protein in diverse populations (Estevao, 2022; Bhagel and Saha, 2021). These anti-inflammatory effects may be particularly relevant to psychosomatic conditions with inflammatory components, including autoimmune disorders, cardiovascular diseases, and chronic pain syndromes (Gautam et al., 2020; Magan and Yadav, 2022).

Enhancement of Interoceptive Awareness
Yoga’s emphasis on sustained, non-judgmental attention to bodily sensations directly targets interoceptive disturbances observed in psychosomatic disorders. Systematic reviews have documented improvements in body awareness following yoga interventions, with emerging evidence suggesting that these changes may be mediated by increased activation of the insula and prefrontal cortex (Garnsey et al., 2025; Barnes-Kennedy et al., 2026). The Multidimensional Assessment of Interoceptive Awareness (MAIA) has been used to document significant improvements in attention, body listening, and attention regulation following yoga interventions (Mehling et al., 2018; Barnes-Kennedy et al., 2026). These interoceptive improvements may facilitate more accurate perception of bodily signals, reduced symptom-focused anxiety, and improved autonomic regulation of physiological states.

Cognitive and Emotional Regulation
Yoga cultivates mindfulness—the capacity to attend to present-moment experiences with openness, curiosity, and non-judgment—which has consistently been associated with improved emotional regulation and reduced psychological distress (Bishop et al., 2004; Gaiswinkler and Unterrainer, 2016). Through repeated practice, individuals develop greater capacity to observe thoughts, emotions, and bodily sensations without becoming overwhelmed or reactive, disrupting cycles of catastrophizing, avoidance, and symptom amplification that maintain psychosomatic conditions (Bennett, 2022; Cramer et al., 2018). In addition, yoga has been associated with improvements in attentional control and working memory, which may further support adaptive coping with physical symptoms (Mrazek et al., 2013; De Castilho and Campelo, 2023).

Empirical Evidence for Yoga in Psychosomatic Disorders

Cardiovascular and Metabolic Outcomes

The strongest evidence base for yoga’s efficacy in psychosomatic conditions concerns cardiovascular risk factors and metabolic parameters. A systematic review and meta-analysis of yoga interventions among medical and dental students—a population at high risk for stress-related cardiovascular changes—documented significant improvements in both physiological and psychological outcomes (Maity et al., 2024). Across five studies with more than 300 participants, yoga interventions reduced systolic blood pressure by 6.82 mmHg (p = 0.002, z = 3.06) and diastolic blood pressure by 2.99 mmHg (p = 0.03, z = 2.22). Heart rate decreased by 2.55 beats per minute across six studies (p = 0.06, z = 2.77). These effect sizes are clinically meaningful, given that a 3-mmHg reduction in systolic blood pressure has been estimated to reduce stroke mortality by 8% and coronary heart disease incidence by 5% (Stamler et al., 1989; Appel, 2003).
The mechanisms underlying these cardiovascular improvements appear to be multifaceted and include parasympathetic activation, stress reduction, and increased baroreflex sensitivity (Pal et al., 2014; Chu et al., 2016). Specific pranayama techniques, such as Bhramari pranayama, have been associated with particularly notable effects on blood pressure and heart rate, consistent with their emphasis on parasympathetic activation (Musto and Vallerand, 2023; Shukla et al., 2020). These findings have important implications for psychosomatic cardiovascular conditions, in which psychological stress contributes to hypertension, arrhythmias, and other cardiac manifestations (Yusuf et al., 2014).

Autoimmune and Inflammatory Conditions
Yoga’s anti-inflammatory effects have generated interest in its therapeutic potential for psychosomatic autoimmune and inflammatory conditions. A randomized controlled trial of an 8-week yoga-based lifestyle intervention in patients with rheumatoid arthritis documented improvements in disease activity, psychoneuroimmune-axis markers, and quality of life (Gautam et al., 2020). Transcriptomic profiling analyses have demonstrated differential expression of genes related to immunity, cellular signaling, and metabolic processes following meditation interventions, suggesting that mind–body practices may influence gene-expression patterns related to inflammatory and immune function (Abomoleak et al., 2022).
A systematic review and meta-analysis of yoga-based mind–body interventions in inflammatory bowel disease identified benefits in conditions with overlapping pathophysiology, including reduced systemic inflammation in rheumatoid arthritis, improved autonomic regulation in hypertension, and increased psychological resilience. These findings support conceptualizing yoga as an intervention targeting shared psychophysiological pathways across diverse psychosomatic conditions rather than disease-specific mechanisms.

Functional Neurological Disorders
Functional neurological disorder (FND), characterized by motor, sensory, and/or seizure symptoms that are incompatible with identifiable neurological disease, represents a prototypical psychosomatic condition in which psychological and neurological processes intersect (American Psychiatric Association, 2013). Contemporary models emphasize the role of altered emotional and autonomic regulation, interoceptive processing, and neural integration in the pathophysiology of FND (Pick et al., 2019; Barnes-Kennedy et al., 2026).
A 2026 randomized controlled feasibility trial evaluated a 6-week somatic yoga intervention for adults with FND and compared it with a music-based relaxation control (Barnes-Kennedy et al., 2026). The trial met recruitment and retention targets and had a 100% retention rate in the yoga group. No intervention-related adverse events were observed. Exploratory analyses demonstrated large effect sizes for improvements in self-reported FND symptoms and interoceptive awareness in the yoga group, with effects maintained at 3-month follow-up. These findings extend previous uncontrolled case series demonstrating benefits of individualized yoga interventions for functional seizures (Kipnis et al., 2018, 2019) and represent the first randomized evaluation of yoga in a broader FND population.

Post-Traumatic Stress Disorder and Trauma-Related Conditions
Post-traumatic stress disorder (PTSD) is often accompanied by prominent physical symptoms, including hyperarousal, sleep disturbances, and chronic pain—features that substantially overlap with psychosomatic manifestations. A 2026 systematic review and meta-analysis of randomized controlled trials examined yoga’s effects on PTSD symptom clusters, including intrusions, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity (Sinnott et al., 2026). Across nine studies, yoga produced small-to-moderate reductions in intrusion symptoms (p = 0.027, d = 0.31) and overall PTSD symptoms (p = 0.030, d = 0.29). When age was entered as a moderator, yoga also significantly improved avoidance and arousal/reactivity symptoms.
The authors proposed that yoga’s emphasis on present-moment mindfulness may permit attentional awareness that protects against intrusions, while its physiological effects on autonomic regulation may directly target arousal and reactivity symptoms (Sinnott et al., 2026). These findings are consistent with broader evidence that exercise, including yoga, reduces overall PTSD symptoms (Bjorkman and Ekblom, 2022; Nejadghaderi et al., 2024), while extending this evidence to examination of cluster-specific effects.

Somatoform Disorders and Somatic Symptoms
Somatoform disorders, conditions characterized by persistent physical symptoms that are not fully explained by medical disease, represent a core domain of psychosomatic medicine. A 2025 open-label controlled trial examined the effects of 24 weeks of adjunctive yoga therapy in patients with somatoform pain disorders. Adding yoga therapy to standard treatment improved pain, anxiety, depression, somatic symptoms, and physical health-related quality-of-life scores compared with standard treatment alone. These findings are consistent with broader evidence indicating that mind–body therapies reduce somatic symptom severity in bodily distress disorders.

Stress, Anxiety, and Depression
In psychosomatic conditions, stress, anxiety, and depression represent both contributing factors and important therapeutic targets. A 2025 meta-analysis of yoga interventions in cancer patients also demonstrated significant reductions in anxiety and depression, accompanied by improvements in spiritual and emotional well-being (Takemura et al., 2025).
The mechanisms underlying these psychological benefits appear to involve both cognitive/emotional and biological pathways. Cognitive mechanisms include enhanced mindfulness, self-awareness, and emotional regulation, enabling individuals to observe thoughts and emotions without judgment and reduce reactivity to stressful situations (Bishop et al., 2004; Uebelacker and Broughton, 2016). Biological mechanisms include modulation of HPA-axis activity, reduction of inflammatory markers, and increased autonomic balance (Streeter et al., 2010; Li and Goldsmith, 2012). Importantly, yoga has been associated with increased gamma-aminobutyric acid (GABA) levels and changes in neurotransmitter systems including serotonin, norepinephrine, and dopamine—changes that may directly address the neurochemical substrates of depression and anxiety (Streeter et al., 2010, 2017).

Integration into Clinical Practice
Practical Considerations
Translating yoga research into clinical practice requires attention to several practical considerations. First, intervention parameters, including frequency, duration, and type of yoga, vary substantially across studies, making standardized protocols difficult to establish. The meta-analysis by Maity et al. (2024) documented interventions ranging from 2 to 24 weeks, with weekly sessions varying from 15 to 90 minutes. The 2026 FND somatic yoga trial used six weekly 60-minute sessions plus recommended home practice three to five times per week (Barnes-Kennedy et al., 2026). Although this variability complicates direct comparisons, it also suggests that yoga may be adaptable to diverse clinical settings and patient populations.
Second, the importance of individualized and participatory approaches has been emphasized across several studies. Yoga interventions tailored to individual capacity, emphasizing safety and regulation rather than performance, and allowing choice and agency, appear to maintain engagement even during periods of stress or symptom exacerbation (Barnes-Kennedy et al., 2026). Trauma-sensitive yoga practices, which emphasize patient agency and choice, have been specifically developed for populations with trauma histories and may be particularly relevant to psychosomatic conditions in which bodily awareness can provoke distress (Kelly et al., 2021; Nguyen-Feng et al., 2020).
Third, the question of whether yoga should be offered as a stand-alone treatment or as an adjunct to usual care requires careful consideration. Current evidence suggests that yoga is most appropriately positioned as a complementary intervention rather than a replacement for standard medical care (Saini and Sharma, 2024; Barnes-Kennedy et al., 2026). The 2025 trial of adjunctive yoga therapy for somatoform pain disorders demonstrated that yoga provides additional benefits when combined with standard treatment, supporting an adjunctive role.

Training and Competence
Effective implementation of yoga therapy in clinical settings requires attention to therapist training and competence. While some studies have used certified yoga therapists with specialized training in clinical applications (Barnes-Kennedy et al., 2026; Mitchell et al., 2014), others have used yoga instructors with varying levels of clinical experience. Establishing training standards, certification requirements, and continuing-education programs for yoga therapists represents an important priority for the field (Khalsa, 2007; Ciezar-Andersen et al., 2021).
In addition, healthcare professionals who refer patients to yoga programs or incorporate yoga principles into their practice require foundational knowledge of yoga’s mechanisms, evidence base, and safety considerations. Integrating yoga education into medical and health-science curricula has been proposed as a strategy to address this gap, with evidence indicating that medical students participating in yoga programs report improved well-being and are more likely to recommend yoga to future patients (Horiuchi et al., 2022; Maity et al., 2024).

Safety and Contraindications
Yoga is generally considered safe when performed with appropriate precautions, although attention to individual contraindications is essential. In the 2026 FND trial, no intervention-related adverse events were observed, despite participants experiencing symptom exacerbations and health complications expected in this population (Barnes-Kennedy et al., 2026). However, some studies have reported high dropout rates, with possible explanations including the time commitment required, group format, and increased anxiety resulting from awareness of physiological sensations during practice (Davis et al., 2020; Reinhardt et al., 2018).
Specific precautions may be necessary for individuals with particular conditions. For example, individuals with severe cardiovascular disease should avoid strenuous physical postures, and those who have recently undergone surgery or sustained musculoskeletal injuries require modified practice. Trauma-informed approaches that emphasize patient choice and avoid triggering sensations or physical postures are recommended for individuals with trauma histories (Kelly et al., 2021). As with any therapeutic intervention, the benefits and risks of yoga should be considered individually, with appropriate screening and monitoring.

Future Directions and Research Priorities
Despite significant progress, important gaps remain in the evidence base for yoga in psychosomatic disorders. Several research priorities emerge from the present review.
First, larger, adequately powered randomized controlled trials are needed to confirm promising findings from feasibility and pilot studies. Although the 2026 FND somatic yoga trial demonstrated feasibility and acceptability, its sample size (n = 30) was insufficient for a definitive efficacy test (Barnes-Kennedy et al., 2026). Similarly, the open-label design of the somatoform pain-disorder trial limits causal inference. Larger blinded and placebo-controlled trials with appropriate active comparators are needed to establish efficacy and identify optimal intervention parameters.
Second, examining yoga’s effects on specific psychosomatic symptom clusters, rather than overall symptom severity, may provide more precise understanding of mechanisms and clinical applications. The 2026 PTSD meta-analysis by Sinnott et al. demonstrated that yoga effects differ across symptom clusters, with the strongest effects observed for intrusion symptoms (p = 0.027, d = 0.31). Examining cluster-specific effects in other psychosomatic conditions may similarly clarify the specific pathways through which yoga produces its benefits.
Third, mechanistic studies using neuroimaging, biomarker assessment, and genetic analyses are needed to elucidate the biological pathways underlying yoga’s therapeutic effects. The 2025 randomized controlled trial comparing meditation, yoga, and stress education with a broad set of outcomes—including self-reported psychosocial variables, allostatic-load markers, and gene-expression measures—provides an important model for such research. Transcriptomic profiling studies have already identified differential expression of genes related to immunity, cellular signaling, and metabolic processes following meditation interventions (Abomoleak et al., 2022), and similar approaches in yoga research may reveal novel mechanistic insights.
Fourth, the question of optimal intervention parameters—including type of yoga, frequency, duration, and delivery method—requires systematic investigation. The 2026 FND trial demonstrated the feasibility of remote delivery alongside in-person sessions (Barnes-Kennedy et al., 2026), suggesting that hybrid models may improve access and adherence. However, the comparative effectiveness of different delivery formats, intervention lengths, and practice intensities remains largely unknown.
Fifth, examination of yoga’s effects in diverse populations and cultural contexts is needed to establish generalizability. Most yoga research has been conducted in Western, educated, industrialized, rich, and democratic populations, limiting the applicability of findings to other cultural contexts. Integrating traditional yoga knowledge systems with contemporary research methods may provide insights that transcend cultural boundaries and increase the global relevance of yoga interventions.
Finally, implementation-science research is needed to address practical barriers to integrating yoga into routine clinical settings. These barriers include limited insurance coverage, lack of referral pathways, inadequate provider training, and patient-access issues (O’Keeffe et al., 2021). Research on effective implementation strategies, including provider training, referral networks, and reimbursement models, will be essential for translating evidence into practice.

Conclusion
The accumulated evidence reviewed in this article supports conceptualizing yoga as a safe, feasible, and effective integrative intervention for psychosomatic disorders. Yoga’s therapeutic effects appear to operate through multiple interconnected pathways that directly target biopsychosocial mechanisms involved in psychosomatic conditions, including autonomic nervous system regulation, HPA-axis modulation, reduction of inflammatory markers, enhancement of interoceptive awareness, and improvement of cognitive and emotional regulation.
Meta-analytic evidence demonstrates significant improvements in cardiovascular parameters, with clinically meaningful reductions in systolic blood pressure, diastolic blood pressure, and heart rate following yoga interventions (Maity et al., 2024). Psychological outcomes including stress, anxiety, and depression also demonstrate significant improvement, with effect sizes comparable to or exceeding those of conventional psychological interventions (Maity et al., 2024; Takemura et al., 2025). Emerging evidence from randomized controlled trials supports yoga’s efficacy in specific psychosomatic conditions, including functional neurological disorders (Barnes-Kennedy et al., 2026), post-traumatic stress disorder (Sinnott et al., 2026), and somatoform pain disorders.
Integrating yoga into clinical practice for psychosomatic disorders holds considerable promise and offers a low-cost, accessible, and acceptable intervention that addresses both the psychological and physical dimensions of these conditions. However, realizing this promise requires continued investment in research, including larger randomized controlled trials, mechanistic studies, and implementation-science research. As the evidence base continues to grow, yoga may increasingly find its place alongside conventional treatments as a valuable component of comprehensive psychosomatic care.
The convergence of ancient yogic wisdom with contemporary psychosomatic medicine presents an opportunity to develop more holistic and patient-centered approaches to conditions that have challenged conventional biomedical models. By addressing mind–body integration—the foundational insight shared by both yogic traditions and modern psychosomatic medicine—yoga offers a therapeutic pathway that is at once ancient and urgently contemporary.

References
Abomoleak, B., Pragya, S. U., Griswold, A. J., Mehta, N., Uddin, P., Veeramachaneni, P., & Mehta, D. (2022). Preksha Dhyana meditation induces alterations at the transcriptome level in novice and healthy college students. Saudi Journal of Biological Sciences, 29(4), 2299–2305.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Appel, L. J. (2003). Lifestyle modification as a means to prevent and treat high blood pressure. Journal of the American Society of Nephrology, 14, S99–S102.
Bennett, A. (2022). How does yoga practice and therapy yield psychological benefits? A review and model of transdiagnostic processes. Complementary Therapies in Clinical Practice, 46, 101514.
Bhagel, P., & Saha, M. (2021). Effects of yogic intervention on pulmonary function and respiratory muscle strength parameters: A systematic literature review and meta-analysis. Journal of Biosciences, 46(3), 76.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Veltling, D., & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.
Bjorkman, F., & Ekblom, O. (2022). Physical exercise as treatment for PTSD: A systematic review and meta-analysis. Military Medicine, 187(9–10), e1103–e1113.
Editors of Encyclopaedia Britannica. (2021, August 15). Psychosomatic disorder. Encyclopedia Britannica.
Campelo, G., & De Castilho, G. M. (2023). Yoga, explicit, and implicit emotion regulation: Long-term and current yoga practice predicted more attentional focusing and less emotional bias in a go/no-go task. Trends in Psychology. Advance online publication.
Chu, P., Gotink, R. A., Yeh, G. Y., Goldie, S. J., & Hunink, M. G. (2016). The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology, 23(3), 291–307.
Ciezar-Andersen, S. D., Hayden, K. A., & King-Shier, K. M. (2021). A systematic review of yoga interventions for helping health professionals and students. Complementary Therapies in Medicine, 58, 102704.
Cramer, H., Anheyer, D., Saha, F. J., & Dobos, G. (2018). Yoga for posttraumatic stress disorder—a systematic review and meta-analysis. BMC Psychiatry, 18(1), 72.
Davis, L. W., Schmid, A. A., Daggy, J. K., Yang, Z., O’Connor, C. E., Schalk, N., Do, A.-N. L., Maric, D., Lazarick, D., & Knock, H. (2020). Symptoms improve after a yoga program designed for PTSD in a randomized controlled trial with veterans and civilians. Psychological Trauma: Theory, Research, Practice, and Policy, 12(8), 904–912.
Effects of a 12-Week Yoga and Mindfulness Meditation Program on Psychological Stress, Inflammatory Markers, and Sleep Quality in Middle-Aged Obese Women: A Randomized Controlled Trial. (2024). Sport Mont.
Efficacy of Cognitive Behavioral Therapy and Acceptance- and Mindfulness-Based Treatments in Adults with Bodily Distress: A Network Meta-Analysis. (2024).
Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136.
Estevao, C. (2022). The role of yoga in inflammatory markers. Brain, Behavior, & Immunity – Health, 20, 100421.
Gaiswinkler, L., & Unterrainer, H. F. (2016). The relationship between yoga involvement, mindfulness and psychological wellbeing. Complementary Therapies in Medicine, 26, 123–127.
Gard, T., Noggle, J. J., Park, C. L., Vago, D. R., & Wilson, A. (2014). Potential self-regulatory mechanisms of yoga for psychological health. Frontiers in Human Neuroscience, 8, 770.
Garnsey, C. L., Gnall, K. E., Osherow, E. K., & Park, C. L. (2025). Changes in body awareness in yoga interventions: A systematic review. Complementary Therapies in Clinical Practice, 59, 101977.
Gautam, S., Kumar, M., & Kumar, U. (2020). Effect of an 8-week yoga-based lifestyle intervention on psycho-neuro-immune axis, disease activity, and perceived quality of life in rheumatoid arthritis patients: A randomized controlled trial. Frontiers in Psychology, 11, 524025.
Hegberg, N. J., Hayes, J. P., & Hayes, S. M. (2019). Exercise intervention in PTSD: A narrative review and rationale for implementation. Frontiers in Psychiatry, 10, 133.
Horiuchi, S., Flusberg, Y., Peterson, C. T., Mills, P. J., & Cohen, H. W. (2022). Current approaches to yoga in U.S. medical schools: Scoping review of the literature. Journal of Integrative and Complementary Medicine, 28(6), 463–473.
Kelly, U. A., Evans, D. D., Baker, H., & Noggle Taylor, J. (2018). Determining psychoneuroimmunologic markers of yoga as an intervention for persons diagnosed with PTSD: A systematic review. Biological Research for Nursing, 20(3), 343–351.
Kelly, U. A., Haywood, T., Segell, E., & Higgins, M. (2021). Trauma-sensitive yoga for post-traumatic stress disorder in women veterans who experienced military sexual trauma: Interim results from a randomized controlled trial. Journal of Alternative and Complementary Medicine, 27(S1), S45–S59.
Kennedy-Barnes, E., Millman, L. S. M., Basamh, Y., Duarte, A., Pacelli, J., Hodsoll, J., & Pick, S. (2026). Somatic yoga therapy for functional neurological disorder: Feasibility randomised controlled trial. BJPsych Open, 12(4), e151.
Khalsa, S. B. (2007). Yoga as a therapeutic intervention. In Principles and Practice of Stress Management (3rd ed., pp. 449–462).
Kipnis, D., Leung, S., Schreier, A. R., Kwei, K., Shah, H., & Quinn, L. (2018). An individualized yoga intervention for people with functional seizures: Case series. International Journal of Yoga Therapy, 28, 93–101.
Kipnis, D., Leung, S., Schreier, A. R., Kwei, K., Shah, H., & Quinn, L. (2019). Yoga for functional seizures: Follow-up case series. International Journal of Yoga Therapy, 29, 73–80.
Li, A. W., & Goldsmith, C.-A. W. (2012). The effects of yoga on anxiety and stress. Alternative Medicine Review: A Journal of Clinical Therapeutics, 17(1), 21–35.
Magan, D., & Yadav, R. K. (2022). Psychoneuroimmunology of meditation. Annals of Neurosciences, 29(2–3), 170–176.
Maity, S., Abbaspour, R., Bandelow, S., Pahwa, S., Alahdadi, T., Shah, S., Chhetri, P., Jha, A. K., Nauhria, S., Nath, R., Nayak, N., & Nauhria, S. (2024). The psychosomatic impact of yoga in medical education: A systematic review and meta-analysis. Medical Education Online, 29(1), 2364486.
McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840(1), 33–44.
Mehling, W. E., Acree, M., Stewart, A., Silas, J., & Jones, A. (2018). The multidimensional assessment of interoceptive awareness, version 2 (MAIA-2). PLOS ONE, 13(12), e0208034.
Meta-analysis of yoga-based mind-body interventions in the management of inflammatory bowel disease. (2025). ScienceDirect.
Millman, L. S. M., Short, E., Stanton, B., Winston, J. S., Nicholson, T. R., Mehta, M. A., & Pick, S. (2023). Interoception in functional motor symptoms and functional seizures: Preliminary evidence of intact accuracy alongside reduced insight and altered sensibility. Behaviour Research and Therapy, 168, 104379.
Mitchell, K. S., Dick, A. M., DiMartino, D. M., Smith, B. N., Niles, B., Koenen, K. C., & Street, A. (2014). A pilot study of a randomized controlled trial of yoga as an intervention for PTSD symptoms in women. Journal of Traumatic Stress, 27(2), 121–128.
Mrazek, M. D., Franklin, M. S., Phillips, D. T., Baird, B., & Schooler, J. W. (2013). Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychological Science, 24(5), 776–781.
Musto, S., & Hazard Vallerand, A. (2023). Exploring the uses of yoga nidra: An integrative review. Journal of Nursing Scholarship, 2023(6), 1164–1178.
Nejadghaderi, S. A., Mousavi, S. E., Fazlollahi, A., Motlagh Asghari, K., & Garfin, D. R. (2024). Efficacy of yoga for posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Research, 340, 116098.
Nguyen-Feng, V. N., Hodgdon, H., Emerson, D., Silverberg, R., & Clark, C. J. (2020). Moderators of treatment efficacy in a randomized controlled trial of trauma-sensitive yoga as an adjunctive treatment for posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 12(8), 836–846.
O’Keeffe, S., Chowdhury, I., Sinanaj, A., Ewang, I., Blain, C., Teodoro, T., & Edwards, M. J. (2021). A service evaluation of the experiences of patients with functional neurological disorders within the NHS. Frontiers in Neurology, 12, 656466.
Pal, G. K., Agarwal, A., Karthik, S., & Pal, P. (2014). Slow yogic breathing through right and left nostril influences sympathovagal balance, heart rate variability, and cardiovascular risks in young adults. North American Journal of Medical Sciences, 6(3), 145–151.
Pascoe, M. C., & Bauer, I. E. (2015). A systematic review of randomized control trials on the effects of yoga on stress measures and mood. Journal of Psychiatric Research, 68, 270–282.
Perez, D. L., Nicholson, T. R., Asadi-Pooya, A. A., Bègue, I., Butler, M., Carson, A. J., … & Aybek, S. (2021). Neuroimaging in functional neurological disorder: State of the field and research agenda. NeuroImage: Clinical, 30, 102623.
Pick, S., Goldstein, L. H., Perez, D. L., & Nicholson, T. R. (2019). Emotional processing in functional neurological disorder: A review, biopsychosocial model and research agenda. Journal of Neurology, Neurosurgery & Psychiatry, 90(6), 704–711.
Pick, S., Rojas-Aguiluz, M., Butler, M., Mulrenan, H., Nicholson, T. R., & Goldstein, L. H. (2020). Dissociation and interoception in functional neurological disorder. Cognitive Neuropsychiatry, 25(4), 294–311.
Psychological assessments, allostatic load and gene expression analyses in a randomized controlled trial comparing meditation, yoga, and stress education. (2025). PubMed.
Raghavendra, B., Telles, S., Manjunath, N., & D’Souza, D. (2013). Voluntary heart rate reduction following yoga using different strategies. International Journal of Yoga, 6(1), 26–30.
Reinhardt, K. M., Noggle Taylor, J. J., Johnston, J., Zameer, A., Cheema, S., & Khalsa, S. B. S. (2018). Kripalu yoga for military veterans with PTSD: A randomized trial. Journal of Clinical Psychology, 74(1), 93–108.
Saini, V. P., & Sharma, D. (2024). Integrating yoga and meditation into clinical practice: Strategies for addressing psychosomatic health disorders. IDEAL, 12(2).
Shukla, M., Chauhan, D., & Raj, R. (2020). Breathing exercises and pranayamas to decrease perceived exertion during breath-holding while locked-down due to COVID-19 online randomized study. Complementary Therapies in Clinical Practice, 41, 101248.
Sinnott, S. M., Laumann, L. E., Gnall, K. E., Park, C. L., Wu, Y., Raja, M., Khawand, A., & Pescatello, L. S. (2026). The impact of yoga on posttraumatic stress disorder symptom clusters: A systematic review and meta-analysis of randomized controlled trials. Journal of Traumatic Stress, 39, 188–201.
Stamler, J., Rose, G., Stamler, R., Elliott, P., Dyer, A., & Marmot, M. (1989). INTERSALT study findings: Public health and medical care implications. Hypertension, 14(5), 570–577.
Stone, J., Carson, A., Duncan, R., Roberts, R., Warlow, C., Hibberd, C., … & Sharpe, M. (2010). Who is referred to neurology clinics? The diagnoses made in 3781 new patients. Clinical Neurology and Neurosurgery, 112(9), 747–751.
Streeter, C. C., Gerbarg, P. L., Saper, R. B., Ciraulo, D. A., & Brown, R. P. (2012). Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical Hypotheses, 78(5), 571–579.
Streeter, C. C., Gerbarg, P. L., Whitfield, T. H., Owen, L., Johnston, J., & Jensen, J. E. (2017). Treatment of major depressive disorder with Iyengar yoga and coherent breathing: A randomized controlled dosing study. Alternative and Complementary Therapies, 23(6), 236–243.
Streeter, C. C., Whitfield, T. H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A., … & Jensen, J. E. (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA levels: A randomized controlled MRS study. Journal of Alternative and Complementary Medicine, 16(11), 1145–1152.
Sullivan, M. B., Erb, M., Schmalzl, L., Moonaz, S., Taylor, J. N., & Porges, S. W. (2018). Yoga therapy and polyvagal theory: The convergence of traditional wisdom and contemporary neuroscience for self-regulation and resilience. Frontiers in Human Neuroscience, 12, 67.
Takemura, N., et al. (2025). Effect of yoga on psychological and spiritual outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials with meta-regression. Psychotherapy and Psychosomatics, 94(4).
The efficacy of add-on yoga intervention in somatoform pain disorders: An open-label controlled trial. (2025). PubMed.
Uebelacker, L. A., & Broughton, M. K. (2016). Yoga for depression and anxiety: A review of published research and implications for healthcare providers. Rhode Island Medical Journal, 99(3), 20–22.
Yogendra, J. (1970). Medical research in yoga. Journal of the Yoga Institute, 16, 67–71.
Yusuf, S., Rangarajan, S., Teo, K., Islam, S., Li, W., Liu, L., … & Dagenais, G. (2014). Cardiovascular risk and events in 17 low-, middle-, and high-income countries. New England Journal of Medicine, 371(9), 818–827.
Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353.
Zou, L., Sasaki, J. E., Wei, G.-X., Huang, T., Yeung, A. S., Neto, O. B., Chen, K. W., & Hui, S. S. (2018). Effects of mind-body exercises (tai chi/yoga) on heart rate variability parameters and perceived stress: A systematic review with meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 7(11), 404.