Perspectives on Yoga Therapy, Health & Wellbeing
Below are some perspectives on yoga therapy, traditional Thai bodywork, health, and wellness which we have written about, highlighted on our website, or been asked about by clients, students, and colleagues. Please respect our copyright © by not plagiarizing our materials or website content, and directly citing the source if you cite our writing. Some articles below require specific consent for use, in any form, including linking.
Yoga Therapy – Selected Articles
Yoga Therapy Today (YTT) - Publication of the International Association of Yoga Therapists (IAYT)
Yoga Therapy's Role in Long-term Care: Broadening Our Approach to Working with Neuromuscular Conditions
Yoga Therapy in Neuropalliative Care: Specialization and Considerations
Yoga Therapy and Physical Therapy: A Difference in Perspective
YogaTherapy.Health – IAYT Education / Awareness Site
Yoga Therapy's Potential for Long-term Support of Neurological Conditions
Yoga Therapy in Neurosupportive Care: Providing Person-centered Support
Yoga Therapy – Mind Over Matter
Krishnamacharya was adamant about only practicing yoga as was appropriate, referencing age and stage of life, ability, knowledge / level of practice, and also recommended that one not practice yoga without proper intention or if one was not in right-mind (focused, introspective, calm). The primary guidelines given by Krishnamacharya for the practice of yoga were using the breath as a guideline, sequencing appropriately, and listening to the body and mind so that they could act as one: "Cultivate inner or subtle-body awareness gradually, with the breathing." Krishnamacharya's outlook on teaching and practicing yoga: "Practice without right knowledge of theory is blind. This is also because without right knowledge, one can mindfully do a wrong practice." [Commenting on the tendency in modern times to assume that any yoga, done in any way, taught by anyone, is beneficial. In effect, he is stressing the very important fact that there is a world of difference not only between a 'mindless' and 'mindful' yoga practice, but the correct use, practice, and application of yoga] “Taking into account the structure of the body and the distortions in the body, one should do the appropriate asana. However, only an expert can guide a student." "Fast movements will distort both blood circulation and the respiration. This results in crookedness of the body and injury to the different parts of the body. Slow practice of asanas with proper respiration will not only remove the defects in the body but result in [directing and concentrating one's focus]." "Watch the breath mindfully. Choose the sequence wisely. Still the mind attentively. Else, do not do yoga."
Being Fit... or Being Well? Yoga for Health
We receive inquiries regarding yoga therapy which sometimes begin along the lines of “I want to be fit and I think yoga can do that for me." The response we give is not expected, however it is as simple and straightforward as possible: Do you wish to be fit...or well? An Olympic athlete can be seen as 'fit,' yet they may not be well. It is a known fact that competitive athletes push the body to the limit in order to gain results, however that level of pushing is in fact a stressor on the entire body. Many female athletes are anemic or have low bone density, and male athletes may have abnormally low testosterone levels leading to decreased muscle strength. Mood disturbances, adrenal insufficiency and immune system suppression are common with overtraining. Why might yoga be a step toward health and wellness? Yoga has been shown to reduce perceived stress and anxiety, in turn modulating stress response systems (reducing heart rate, lowering blood pressure, easing respiration). There is also evidence that a regular yoga practice helps increase heart rate variability, an indicator of the body's ability to respond to stress more flexibly. The conclusion of a comparison study printed in The Journal of Alternative and Complementary Medicine states: Studies comparing the effects of yoga and exercise seem to indicate that, in both healthy and diseased populations, yoga may be as effective or better than exercise at improving a variety of health-related outcome measures including HRV [heart-rate variability], blood glucose, blood lipids, salivary cortisol, and oxidative stress. Furthermore, yoga appears to improve subjective measures of fatigue, pain and sleep in healthy and ill populations. Svastha is a Sanskrit word meaning being oneself or in one's natural state—being well, sound, and healthy in body and mind. Perhaps this is yoga's gift, and a lesson to be learned.
Chair Yoga – When a Chair Becomes a Crutch
Some time ago we startled a fellow yoga therapist by telling them we avoid using chairs in yoga therapy sessions if at all possible. Eyes wide they said, "But, I don't understand. You said you work with MS and Parkinson's, right?" This is a very telling reaction, indicative of the reliance on outside objects and a false sense of security in order to attain a desired yoga pose or position in someone who is elderly, inflexible, injured, or has a disability. Props such as wedges, bolsters, blocks, and straps distract the mind (and quite often confuse it!), taking away the two primary and essential tools yoga practitioners / yoga students / yoga therapy clients should have at their disposal at all times—awareness and focus. This can be awareness of external influences such as the support of the floor (rather than an outside object such as a chair) or internal awareness of ones breath or state of mind, outward focus on an object or point in space to maintain balance, or inward focus to calm racing thoughts or avoid reacting to every inconvenience or discomfort. If a yoga teacher or yoga therapist assumes that a student or client who is elderly, injured or disabled must always be tethered to a prop or chair in order to practice yoga, something has been lost in translation. More often than not, working slowly, carefully, and with moderation, a chair or props are not needed, or their use may be delayed for years. Props may serve to facilitate, but facilitate what: finding a means, any means, to get into a pose? Permit the student or yoga therapy client to internalize and absorb the effects of yoga on their body and gradually ease into a pose over time with simpler poses or modifications… if and when they are able. It is not the pose which is of essence, it is the effect of the practice—the awareness of doing, the observation of breathing, the process of learning and healing.
Yoga and Meditation – Avoiding Rumination
Mainstream yoga regularly emphasizes physicality and increased flexibility, coupled with music, heated rooms, and an array of props—rather than establishing a calm, focused mind, stable body, and quiet space to rest the senses and reduce the barrage of extra-sensory input we are subjected to by the modern world. There are, most certainly, efforts by some yoga instructors and yoga therapists to achieve a balance by offering meditation, yet there exists a common misconception—and lack of understanding—of the essential difference between meditation, and rumination. As a yoga therapist and instructor, client and student questions regarding meditation have led to long conversations in an effort to elucidate this point. Meditation, reflection, contemplation... Each is distinct, yet are all too often aggregated under the rubric of meditation. First and foremost, one must be aware that meditation is a practice, not simply a technique. There are indeed techniques which can lead us to master the practice of meditation, commonly overshadowed by numerous techniques taught and presented as meditation. Meditation is a lifelong practice, guided by reflection—note that the verb reflection suggests a 'mirroring' of the true Self— and contemplation, an observance of the true Self. More often than not, the aim of meditation is presented as a Jungian pursuit of self-focus, rather than a study of the higher Self. In today's yoga practice, there is a blurring between the introverted practice of citta ekagrata (mental focus) through meditation, and the extroverted practice of rumination, the 'monkey-mind' permitted to cavort freely without guidance or tether. This said, meditation is a double-edged sword. If learned correctly and wielded properly, it is a tool for cutting through Māyā and the obfuscation of truth. If left dull though lack of practice or proper guidance, it becomes a dangerous and unruly weapon, delving deep into unknown depths with no restraint or clear purpose. The result of the former is clarity and understanding, whereas the latter brings confusion and unhappiness. Meditation is defined as engaging in mental exercise for the purpose of reaching a heightened level of spiritual awareness. Meditation should be learned from someone who has the ability to guide one both deeply into, and safely out of, a meditation or meditative state. Such a person has themselves been highly trained, either by a spiritual guide or master-teacher, and is able to distinguish between (and teach a student to distinguish) between stream of consciousness or rumination—and true meditation. Such training does not occur over a week, but over years, if not decades, of tutelage and introspection. For most of us who do not seek an ascetic life, meditation can be a goal; however, first learning the most basic techniques and methods which might allow one to sit comfortably for extended periods of time, or calm the mind enough to even begin to focus on a single concept or visualization... are an arduous task! First learning mindfulness of the mind and its fluctuations, as well as awareness of the body, can be lifetime pursuits.
Yoga and Alcohol – Dulling the Mind and Senses
Alcohol, in any form, dulls the senses and slows the functions of the mind. Yoga is a practice intended to create awareness and increased consciousness, and clarity of mind, thinking, perspective. At the purely physical or physiological level, it is practiced for self-care, injury prevention, and general health and wellbeing. Alcohol impairs balance and coordination, affects judgement and emotional control, causes muscle cramps or weakness, reduces circulation, and dehydrates the body. These are merely short-term effects: long-term effects range from brain shrinkage and liver toxicity, to permanent damage to the nervous system, cardiovascular system, and endocrine system, as well as severe malnutrition. And what of consuming alcohol directly after practicing yoga? Given that yoga is regularly touted as reducing anxiety, lowering blood sugar, eliminating toxins, increasing balance and proprioception, and bringing clarity of mind, we would suggest that alcohol—which causes anxiety, raises blood-sugar levels, creates extra work for the liver to clear out toxins and metabolites, reduces the ability to balance and coordinate, and impairs function of the mind/brain—is not compatible with a practice which seeks to create balance and communication between mind and body, and stability and control of the physical / external body and mental / inward body. The trend of mixing yoga with alcohol consumption in workshops or get-togethers is a negation of a primary tenet of yoga: Pratyahara. The term is derived from two Sanskrit words: prati and ahara, ahara meaning food or anything taken in (ingested, sensory, mental, emotional), and prati meaning away or against. Together these mean control of ahara— control over external influences and distractions. Although the interpretation is often taken to mean absolute control, or mastery, over external influences and their effect on us, it is actually the repeated and persistent practice of Pratyahara which one aims for: absolute deprivation of the senses results in outright rebellion and over-indulgence, or extreme avoidance (Buddha, in his attempts to survive on one grain of rice per day, discovered that this path is not tenable). Within this ongoing practice of Pratyahara, or avoidance of those things which we may identify in our life as being distractions from right action, right speech, right thought, alcohol has no place. It defies common sense to dedicate oneself to a practice in the pursuit of awareness, balance, health and wellbeing, only to put oneself in harm's way. Is it not logical to avoid alcohol if and when possible—but particularly in conjunction with a yoga practice?
Stability - A Key Foundation in Yoga
Whether referring to the mind, emotions or body, yoga traditionally emphasizes stability. However, stability does not imply inflexibility or rigidity, which lead to stagnation in both mental processes and bodily functions; for example, regular, cyclic changes—such as the seasons, tides, or a woman's menses—are a form of stability. These are in contrast to constant change and variability—rumination, despite being a pattern, is not focused or stable thought, and waking at a different hour every day will disrupt otherwise stable processes / cycles (biorhythms) of the body and functioning of the mind. This is particularly true in the context of neurological conditions, which have both cognitive and physical manifestations. The premise for providing stability is common sense, particularly given the fluctuating symptoms which are a component of a number of neurological conditions such as MS, Parkinson's, Huntington's and others. As a 2,500+ year tradition of mind and body balance attests—yoga cikitsa, or yoga therapy / yoga for healing—neurological conditions are Vata-based, meaning they are inherently categorized in the mind-body state, or dosha*, of the air element: in motion, fleeting, not grounded. As a direct consequence, stability and grounding become the primary foci when considering neurological imbalances or conditions with a neurogenic origin. Shaking and trembling, such as one might experience in stage fright or when in pain, are a reaction of the mind and body, respectively. In practicing yoga, one seeks to calm reactivity, to stabilize the mind and body and thereby restore a balance... not create a reactive state. These physiological actions (shaking, shivering, trembling) all happen in a hyper-reactive state, usually characterized by high anxiety or tension. These are response-based, protective states which are traditionally approached with grounding of the mind and body inasmuch as is possible. To induce instability—such as deliberately provoking shaking or trembling—is therefore counteractive to the traditional (and common sense!) yogic approach (yoga cikitsa / yoga therapy) as well as that of its sister-in-medicine, Ayurveda. Yoga is frequently touted as a means to overcome the loss of flexibility experienced in aging, or perceived stiffness in those who are younger. So-called loss of flexibility is primarily reduced range of motion in a joint. Flexibility, or lack thereof, is far more likely to be a trait than an acquired or lost ability and is directly impacted by laxness of the ligaments which stabilize and hold joints together; lifestyle; diet and nutritional status (deficiencies, malabsorption, excess of a mineral such as calcium); anatomical differences; and the predominant type of muscle we have inherited (fast twitch, slow twitch). To suggest that doing yoga automatically imparts flexibility conjures the now ubiquitous vision of lithe bodies in strained positions rather than in a state of ease (sukha), steadiness and resilience. First and foremost, we want stability and ease in body and mind—always, not just as we age. Rigidity / inflexibility, whether in body and mind, often come in tandem, perhaps with a condition which affects the brain and then the body, or with bodily stiffness and soreness originating from tension and stress, or a rigid, unbending attitude. Would it not be more beneficial to gain a stable yet flexible mind, rather than spending years attempting to achieve bow pose or what has aptly been named 'screaming' pigeon in modern terminology? * For those who practice yoga or yoga therapy: Prescribing of yoga poses and yoga cikitsa (yoga therapy) does not map directly to the doshas, a physical state. However, the tendencies found in the gunas (traits, or attributes) usually correlate to the predominant dosha.
Respecting The Origins of Thai Bodywork
For years we have commented on and written about the misrepresentation of, and misinformation about, Nuad Borarn (Thai bodywork ) on the internet, in print, and in classes and trainings. Comments such as "Thai Massage is an ancient healing method that has been rediscovered in the 21st century," or "Thai massage is a sacred form of yogic healing" are incorrect both in historical context and from the perspective of Thais and their outlook on bodywork's role within Thai medicine. The fact that Thai traditional medical and healing practices have been suppressed in the past, to the point of disappearing from public view, does NOT mean that a tradition has been 'rediscovered' in the 21st century. The current-day renewal of interest in Thai bodywork and resurgence into Thai culture began in the late 60's: to say that it has been rediscovered in the 21st century is an affront to Thai practitioners and teachers (Ajahn), and more importantly to the resilient and enduring legacy of Thai bodywork within the Thai medicine tradition (kept alive by mo'borarn, Thai medicine doctors) throughout the centuries. The terms Thai Yoga, Thai Yoga Massage, Thai Yoga Therapy, and Lazy Man's Yoga are not Thai terms, and are a casualty of westernized marketing, lack of understanding of origin and historical context, and an attempt to draw direct similarities between Hatha yoga and stretches used in Thai bodywork. The current, widespread, and modern emphasis on acrobatics and a rather callisthenic practice are counter to the tradition of reflective, healing sessions as when based in Thai medicine. Thai bodywork, or Nuad Borarn, is in fact based upon and originates from Reusi Dat Ton, a purely Thai tradition with influences possibly predating Hatha yoga. As the internet becomes a resource for information (rather than a solid student-teacher relationship) ambiguity reigns, misunderstanding is created, and false claims are made... This process multiplies, both on websites and in classrooms. Some simple statements may be made regarding Thai bodywork, Hatha Yoga, and Reusi Dat Ton: Thai bodywork in its current, modernized form is a standardized formula put into place by the Thai government. It is not a traditional format, nor does it incorporate the basis of Thai medicine principles or applications. Hatha Yoga is not the basis or origin of Reusi Dat Ton, or of Nuad Borarn. The medicine systems and principles of Ayurveda and Chinese medicine are distinct traditions and cannot be interchanged or applied ad-hoc to Thai medicine or Thai bodywork and therapies. Clearly, there is a lack of distinction between, and respect for these modalities / practices as separate, complete traditions! These traditions (as well as the aforementioned Ayurveda and TCM / Chinese medicine traditions) are not interchangeable. Older practitioners in Thailand dislike the corruption of the ancient methods and are saddened to see them diluted, often meshed with a startling range of unrelated modalities and practices—or taught in pop-up workshops, rather than long-term and focused study with an experienced teacher. Below is a candid commentary on Thai bodywork and the modern trend to somehow mould it into something new or 'better'—or to represent it as something it is not. It is written by a respected scholar and practitioner who grew up in the Kammaṭṭhāna Forest Tradition (Thai Forest Tradition) and studied Thai medicine extensively from deep within, following a lineage based upon traditional teacher-to-student transmission, rather than in a school with a standardized, westernized protocol. It is presented here in hopes that those with a respect and appreciation for Nuad Borarn will read and be informed from the perspective of those who have first listened, learned, and practiced, and only then—after many years—become a practitioner or teacher.. "It is doubtful that anyone who respects the tradition would try to change it. Yet there are many who take a two week course and then decide they have learned all there is to know about Thai Massage and then start adding or changing theory according to their liking. A bit of Reiki, a bit of TCM, a little Yoga... Some people even come up with a new fusion model and stamp a trademark on it because it’s marketable. This is not adaptation this is outright corruption. The only way to allow the medicine to grow is to learn it, understand it, practice it and embody it. Then one does not have to change anything, it will naturally be expressed in the way it’s supposed to be under the given circumstances. This is how Thai Medicine came to be... Think of any other skill or science... As they say, you need to learn the rules in order to bend or even break them. Without knowing them, there is no wisdom, it is just plain carelessness. Nowadays, people learning Thai Massage, writing about Thai Massage and teaching Thai Massage want to find new and interesting ways to make ‘their’ Thai Massage different from the other person. This type of distortion is misleading, ego-driven and is only for the gain of the individual, not the tradition and not society."
Stretching as a Therapy in Thai Bodywork
Appropriate stretches can be intensely therapeutic in Thai bodywork, and are particularly indicated when there is musculoskeletal tension or need for structural alignment. Gentle stretching throughout a therapeutic session is calming to the nervous system while more dynamic stretches are energizing. As in any modality, too much of a good thing is detrimental. Currently most Thai bodywork is practiced, and taught, based upon a fairly modern (1970-80s) protocol, developed for ease and convenience. Classes are attended by healthy, usually young, and flexible students, resulting in the impression that more is better...Not so! Stretching is therapeutic when used sparingly and appropriately. Overstretching is depleting, resulting in muscular pain, aching joints, and increased contracture and stiffness—rather than the ease and flexibility it is intended to restore. This is true for younger and older, flexible or inflexible. Although Thai bodywork certainly has an element of stretching, this is far less prevalent in the Thai bodywork / Thai medicine tradition than is generally taught (or practiced). In fact, Thai bodywork had little to do with stretching until correlations began to be drawn with yoga poses—a recent development, and an unfortunate one. Stretches, when used, focused on nerves (neuropathy, paresthesia, paralysis, entrapment) or were used to remediate a structural misalignment. Thai bodywork should be practiced, and taught, based upon Thai medicine theory, and not merely westernized protocols. Mixing traditional Thai bodywork and medical theory in an arbitrary manner with other modalities is akin to mixing two wonderful scents—nullifying both, and perhaps creating an unpleasant result.
Context & History
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