Brigham & Women’s Hospital Harvard Medical School Yoga for Health, Well-Being and Education: The Science and the Research Evidence July 13, 2015 INSTILL Conference 2015 Yoga, Education and Wellbeing London Sat Bir S. Khalsa, Ph.D. Assistant Professor of Medicine, Harvard Medical School Director of Research, Kundalini Research Institute Research Director, Kripalu Center for Yoga and Health Editor in Chief, International Journal of Yoga Therapy Research Associate, Benson Henry Institute for Mind Body Medicine
Psychophysiology of Yoga
Bagchi and Wenger, 1957 “…physiologically Yogic meditation represents deep relaxation of the autonomic nervous system without drowsiness or sleep …” From: Electro-physiological correlates of some Yogi exercises, Bagchi BK, Wenger MA, Electroencephalography and Clinical Neurophysiology, 7 (Suppl):132-149, 1957.
“…enhanced expression of genes associated with energy metabolism, mitochondrial function, insulin secretion and telomere maintenance, and reduced expression of genes linked to inflammatory response and stress- related pathways.”
“… suppressing expression of inflammation -related genes and up-regulating expression of genes involved in antiviral and immunoglobulin responses …”
Yoga Meditation and Cerebral Blood Flow Non-meditators Meditators …prefrontal cortex, parietal cortex, thalamus, putamen, caudate, and midbrain…The observed changes…appear in structures that underlie the attention network and also those that relate to emotion and autonomic function. From: Cerebral blood flow differences between long-term meditators and non- meditators, Newberg AB, Wintering N, Waldman MR, Amen D, Khalsa DS, Alavi A. Conscious Cognition, 19:899-905, 2010.
Yoga, Brain Structure and Pain From: Insular Cortex Mediates Increased Pain Tolerance in Yoga Practitioners, Villemure C, Ceko M, Cotton VA, Bushnell MC, Cerebral Cortex (in press), 2013.
Yoga and Fluid Intelligence Fluid intelligence is the general ability to think abstractly, reason, identify patterns, solve problems, and discern relationships. “These findings reveal the possibility to increase resilience and to slow the decline of fluid intelligence and brain functional architecture and suggest that mindfulness plays a mechanistic role in this preservation .” From: Fluid intelligence and brain functional organization in aging yoga and meditation practitioners, Gard T, Taquet M, Dixit R, Hölzel BK, de Montjoye YA, Brach N, Salat DH, Dickerson BC, Gray JR, Lazar SW, Frontiers in Aging Neuroscience, 6:76, 2014.
…people’s minds wandered frequently, regardless of what they were doing …people were less happy when their minds were wandering than when they were not
Meditation & the Default Mode Network dorsolateral prefrontal cortex default network mode regions From: Mind wandering and attention during focused meditation: A fine-grained temporal analysis of fluctuating cognitive states, Hasenkamp W, Wilson-Mendenhall CD, Duncan E, Barsalou LW, Neuroimage, 59:750-60, 2012.
Reasons for Practice in a Beginners Program From: Yoga in the real world: Perceptions, motivators, barriers, and patterns of use, Quilty MT, Saper RB, Goldstein R, Khalsa SBS, Global Advances in Health and Medicine, 2:44-49, 2013.
Yoga Practices (postures, breathing, relaxation, meditation) Mind-Body Self-Regulation Physical Fitness Awareness ↑Emotion Regulation ↑Flexibility ↑Stress Regulation ↑Strength ↑Mindfulness ↑Resilience ↑Balance ↑Attention ↑Equanimity ↑Respiratory Function ↑Concentration/Cognition ↑Psychological Self -Efficacy ↑Physical Self -Efficacy ↑Self/social Awareness Behaviors, Mental State, Health & Performance ↑Mood , ↑Well -Being, ↓P sychological Disorders, ↑Positive Behaviors, ↓Negative Behaviors, ↑Physical Health, ↑Cognitive/Academic Performance, ↑Relationships, ↑Quality of Life
Temporal Changes in Yoga Practice Arousal reduction, physical/mental well-being Mind/body awareness, resilience, self-regulation Psychological / philosophical transformation
Yoga for Children/Adolescents
Majority of seriously impairing and persistent conditions have child- adolescent onsets and high comorbidity Need for treatment of largely untreated child-adolescent disorders
Adolescent / School Mental Health Challenges 7.5% adolescent prevalence for one or more DSM-IV disorders The most consistent factors involve indicators of stress Personal resources (e.g. mastery) enhance resilience to onset From: One-year incidence of psychiatric disorders and associated risk factors among adolescents in the community. Roberts RE, Roberts CR, Chan W., Journal of Child Psychology and Psychiatry. 50:405-15, 2009.
Adolescent / School Challenges Stress (developmental, family, social, academic, societal) Behavior (apathy, violence, social skills, bullying, absenteeism) Mental Health (depression, anxiety, substance abuse, trauma) Attention (ADD, ADHD) Academics (grades, dropouts) Physical Health (obesity, diabetes)
…the striking feature of the present data is...how high the rates of early psychiatric disorders are. Most likely, the lifetime prevalence of psychiatric problems by age 21 well exceeds 80%, suggesting that the From: Cumulative prevalence of psychiatric experience of disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains Study, psychiatric illness is Copeland W, Shanahan L, Costello EJ, Angold A, nearly universal. Journal of the American Academy of Child and Adolescent Psychiatry, 50:252-61, 2011.
Pediatric Physical Therapy. 20:66-80, 2008 Academic Pediatrics, 9:212-220, 2009.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945853/pdf/PE_7_8_20.pdf
Demonstrated Benefits in Children Stress, anxiety, depression Self-concept Cognitive function, memory, perception Flexibility Cardiopulmonary fitness Psychomotor & neuromuscular performance Weight loss
Yoga in Schools
Yoga in Education Swami Vivekananda “The practice of meditation leads to mental concentration. The very essence of education is concentration of mind, not the collection of facts. If I had to do my education once again, I would not study facts at all. I would develop the power of concentration and detachment…” From : Swami Vivekananda, in Education, Compiled from the speeches and writings of Swami Vivekananda, T.S. Avinashilingam,1943.
Yoga in Education William James - 1890 “…the faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgment, character and will. No one is [master of himself] if he have it not. An education which should improve this faculty would be the education par excellence .” From: William James, The Principles of Psychology, 1890.
… the health and welfare of a child will … be regarded as one of as much importance as arithmetic and geography… From: The Hygiene of the School Child, LM Terman, 1914.
From: Using Standards and High-Stakes Testing for Students, Exploiting Power with Critical Pedagogy, Series: Counterpoints - Volume 425, Gorlewski JA, Porfilio BJ, Gorlewski DA (eds.), Peter Lang Publ., NY, Chapter 7, 2012 . School-based yoga programs in the United States: A survey Butzer B, Ebert M, Telles S, Khalsa SBS Advances in Mind-Body Medicine , (in press), 2015. Implementing Yoga within the School Curriculum: A Scientific Rationale for Improving Social-Emotional Learning & Positive Student Outcomes Butzer B, Bury D, Telles S, Khalsa SBS Journal of Children's Services , (in press), 2015.
Published Yoga/School Studies • < 50 studies of yoga in school settings • Most done in elementary schools • Many did not use control/comparison groups • Many were after school programs • Significant # of studies with negative results • Numerous other methodological weaknesses • Funding is the overriding challenge
Published Yoga/School Studies Stress coping Self-regulation Physical and emotional arousal Aggression, hostility, anger Mood, anxiety, depression Rumination, cognitive functioning Self-esteem Mental, social & physical well-being Behavior
Single Session - Yoga vs. PE * * * From: Felver J, Butzer B, Khalsa SBS unpublished data.
Yoga for Youth in a Charter School Perceived Stress Scale Resilience Scale 20 150 Average PSS Score p = 0.17 p = 0.02 Average RS Score 18 140 16 130 14 120 12 110 10 100 Baseline End Program Baseline End Program Positive Affect Negative Affect Average PANAS-C PA Score Average PANAS-C NA Score 34 56 p = 0.07 p = 0.89 32 54 30 52 28 26 50 24 48 22 46 20 Baseline End Program Baseline End Program From: Khalsa, SAK, Khalsa SBS, unpublished data.
Yoga in Public School Research ● 12-week 1-hr Yoga Ed/Kripalu classes 2-3 times/week ● RCT, yoga vs. physical education, N ~ 100 ● Qualitative interviews post-program ● Self-report pre-post mental health questionnaires
Mental Health Outcomes - Yoga Worsening Improvement Social Stress Attitude to School Anger Resilience Negative Affect Anxiety Anger Expression
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