Can Good Posture Help Mental Health?

For many years, due to being unusually tall and thin, yet very shy and awkward, I had chronically poor posture. My shoulders hunched up and my large head dipped down. I had a judgmental first grade gym teacher who assigned children into groups by physical ability; he designated the two gangliest tallest girls, me and another, as basically the worst in the class and gave me the equivalent of near failing grades in gym class, even though I got straight As otherwise. From that point onward, I never felt comfortable in my skin as a physical being. I dreaded gym class for decades and avoided all sports, even though I thankfully had a kind gym teacher in middle school who tried to encourage me and gave me hope that I wasn’t an eternal klutz.

Despite a brief attempt at joining an intramural basketball team in my college dormitory, I still felt generally avoidant of anything athletic. Years of computer screens, reading, studying, and parents nudging me to straighten up didn’t help my chronically hunched neck and back. As an added bonus I battled social anxiety, and the combination of my lack of physical and social confidence made me prone to depression and withdrawal from others.

Shortly after starting psychotherapy during my residency training as a physician, my therapist heard about my anxieties and avoidance of any physical activity. She gently challenged me to start going to the gym in my Manhattan apartment building. It was fortunately a rather nice gym, fully equipped with a wide range of classes and reasonably priced and not overcrowded. I took the plunge and signed up for a membership. Having previously been bored by the monotony of machines or running, I tried an aerobics class. Unfortunately, the level was so intense, and I was so out of shape, that I had to stop midway through to avoid throwing up. Then I had recently heard about the growing yoga and pilates trend and decided to give them both a try.

I took to yoga almost immediately, despite knowing I was the least flexible person on earth. I liked the instructor’s gentle tone and slow pace in contrast to the frenetic ferocity of prior classes. I liked the emphasis on meditation and breathing, an instantly soothing mind-body approach, and the reassurances that the poses were guidelines, not goalposts. I would always feel surprised at how sweaty and sore I would get afterwards because it felt so quiet and gentle otherwise. The class taught me on some level to tolerate frustration and discomfort and quietly strive towards improvement. Pilates was also great for building up the “core” as they always emphasized; strengthening that midsection “corset” of muscles was meant to take pressure off your upper torso, neck, and shoulders so again you could stand taller. And gradually I did improve; I was never able to touch my toes before and got closer and closer. I became less fatigued during each class as my arms strengthened. Best of all, I felt my neck and head pull up more and more towards the ceiling; I felt comfortable standing tall with my heart opened up. I was never able to do fancier poses like the levitating frog or headstand, but that was ok. I could tell that I was less afraid of the world, less in a crouched stance of fear.

Accordingly I felt more comfortable and in sync with others around me, since I no longer felt entangled in my own awkwardness. I was still an introvert, but I didn’t have to assume that everyone saw my tension and shame at first glance.

Various studies have noted the importance of posture in affecting one’s relationship to people and the world. One study (Carney et al, 2010) has postulated that “power poses” lead to increased testosterone and decreased cortisol levels, with these trends being associated with social dominance and decreased threat perception. While other studies have not always been able to replicate the hormonal findings, the increased emotional valence of risk-taking, action orientation, and confidence are consistent trends. Unfortunately a recent small randomized controlled trial by Davis et al. (2017) did not find that power posing reduced public speaking anxiety versus a non-posing group or any detectable hormonal changes although both groups reported improvements in overall anxiety; the effects may still be mild and variable for each individual. For more serious anxiety and depression, physical activity and change may not be enough in and of itself; therapy and/or medication management may also be necessary as indicated by your treatment provider.

Nonetheless, it seems to be common sense that a more open posture and taller stance helps one feel comfortable with being exposed to the world and is associated with presenting greater confidence and ease to others. Many people admire the statuesque postures of ballerinas and dancers and feel orderly around the taut military stance. It seems that through postural posing, you can enact a less anxious stance to others, and this may help trigger your inner emotions to follow suit. The body and mind are often linked, and working on your posture may be an opening step to mental recovery as well.