Yoga Therapy UPMASA 33 rd Annual Grand Convention Hilton Union Square, San Francisco, CA Enrico G. Camara M.D. FAPM UPCM ‘81
DISCLOSURE: I’m on the shy side.
Learning Objectives 1. To describe and explain the history, principles and practice of yoga in the USA. 2. To recognize the major benefits and risks of yoga therapy. 3. Integrate the use of yoga, where applicable, into a treatment plan for patient care.
2016 Yoga in America Study • 36 million practitioners (up from 20.4 million in 2012) • 14-M > 50 yo. 28% male. • Reasons cited include flexibility, stress relief and fitness • 34% of Americans are somewhat or very likely to practice yoga in the next 12 months • Practitioners are 20% more likely to say things like “I have a good sense of balance,” “good dexterity,” “good range of motion,” or “give back to the community” than non - practitioners.
Yo - G o a t
Kaba yo-ga
Definition of Yoga
Yoga = “yoke” “union” Body GOD = small self (ego) (SELF) Realization Mind
Yoga Definition (psycho-physiology) Five Sheaths/ Levels of Five Disruptors (Stressors): Existence: Ignorance (of true Self) Bliss (Balance) Knowledge Strong Desire (attachments) SELF Mental Strong Aversions Sense of separateness (ego) Energy Fear (especially of Death) Physical Symptoms: mental pain, anguish, turmoil, despair, tremors, irregular breathing, general nervousness, and anxiety
Prescription: 8 Limbs • Abstentions • Observances • Postures • Breath (Life-Force) Control • Sense-withdrawal • Concentration • Meditation • Contemplation – Bliss • Definition of Yoga includes all 8 Limbs.
Yoga Therapy • Yoga therapy is the process of empowering individuals to progress toward improved health and well-being through the application of the philosophy and practice of yoga. • - IAYT
Yoga Therapy • Yoga as integrative practice: body, mind, spirit: to prevent and treat dis-ease • Different from just taking a yoga class; but a yoga class can be therapeutic • Can be used for a variety of physical and mental conditions • Provides a supportive role to modern medicine and integrates spiritual aspects
History of Yoga in the USA
Key Historical Events Yoga in USA • 1893: Vivekananda (disciple of Sri Ramakrishna) gave speech at World’s Fair in Chicago with the central message of commonality in humanity, a vision of global unity • 1920: Yogananda comes with same message to speak at Congress for Religious Liberals in Boston: “ religion is universal and one” and that everyone shares the aspiration of attaining happiness (bliss).
Limitations from Immigration Acts • Immigration Act of 1917: essentially barred immigration from the Asia-Pacific region • Exclusions added based on challenges and needs of states (laborers for rail, iron, plantations) • Immigration Act of 1924: established quotas (e.g. 100 in 1925 for East Indians) • Luce- Celler Act of 1946: quota of 100 Filipinos and 100 East Indians (allowed Filipinos to naturalize) • Immigration and Nationality Act of 1965: beginning of liberalization and non-discrimination against non- northern Europeans
History Yoga Therapy USA • 1925: Yogananda relocates to LA • 1928: Lecturing in Florida : banned “due to complaints from husbands .” he was considered a ‘colored man’ acting in capacity of a teacher to white women. He returns to India dis-illusioned. • 1930s: Columbia University: epicenter of hatha yoga in the USA: Dr. Josephine Rathbone: PE Dept professor: techniques of progressive relaxation using yoga • 1936: Yogananda relocates back to USA • 1940s up: American students return after studying yoga in India • 1960s up: Other established yoga teachers from different traditions/ lineages
History of Yoga as Therapy
Patanjali Sutras • 196 aphorisms: first codification of yoga practice • Date unknown: 500 BCE to 300 BCE • Main message: inner balance by identifying with Self as Spirit (Divinity/ Pure Consciousness) via control of the mind • Began more as a spiritual, meditative practiced passed on through a lineage of teachers
Buddha Bose
Yoga Therapy Benefits and Risks
Research Limitations • No study has incorporated all 8 Limbs/ Parts of a Yoga Practice • Limited to Postures and/or Breathing Exercises and/ or “Meditation” • More concentration exercises or relaxation vs. meditation • Use of self-selected populations and/ or inappropriate control groups • Large variation of levels of experience and teaching ability of yoga teachers; • No double-blind studies • Yoga interventions not described in detail in order to be replicated • Use of only self-report measures • Large variation in “dosing”
Yoga Practices (Postures-Relaxation, Breathing, Meditation) Physical Fitness Mind-Body Awareness Self-Regulation Flexibility Mindfulness Emotional Regulation Strength Attention Stress Regulation Balance Concentration/ Cognition Resilience Cardiovascular Self/Social awareness Equanimity Respiratory Function Psychological Self-efficacy Physical Self-efficacy Improved Physical and Mental Health, Performance, Behaviors Mood, Well-being, Psychological Disorders, Substance Use Disorders, Positive Behaviors, Relationships, Cognitive-Academic Performance, Quality of Life
Yoga vs. Exercise • SNS dominates • PNS dominates • rapid forceful movements • Slow dynamic and static movements • higher risk of injury • Low risk of injuring muscles and ligaments • • Fatiguing Energizing • • imbalanced activity of muscle Balanced activity of opposing muscle groups groups • • competitive, goal-oriented Noncompetitive, process-oriented • • Cortical region of brain dominates Subcortical regions of brain dominate • Internal awareness predominates • External awareness predominates
Yoga Practices (Postures-Relaxation, Breathing, Meditation) Physical Fitness Mind-Body Awareness Self-Regulation Flexibility Mindfulness Emotional Regulation Strength Attention Stress Regulation Balance Concentration/ Cognition Resilience Cardiovascular Self/Social awareness Equanimity Respiratory Function Psychological Self-efficacy Physical Self-efficacy Improved Physical and Mental Health, Performance, Behaviors Mood, Well-being, Psychological Disorders, Substance Use Disorders, Positive Behaviors, Relationships, Cognitive-Academic Performance, Quality of Life
Activities that Stimulate PNS/ Vagus N. • Singing, Chanting • Slow, deep breathing • Yoga • Meditation and prayer • Positive social relationships • Laughter • Probiotics • Massage • Intermittent Fasting • Laying on R side • Gargling, chewing
Touch Therapies • Increases weight of premature babies by 47 % • Reduces depression in patients with Alzheimer's disease • Doubles likelihood children will speak in class • Enhances attentiveness • Reduces pain • Reduces stress hormones • Improves immune function
Vagal Nerve Stimulation Activities Can Help • Anxiety disorders including OCD • Depression • Alzheimers • Fibromyalgia • Obesity • Tinnitus • Addiction • Autism • Metabolic syndromes • CVS disease/ heart failure • Irritable Bowel
Yoga Practices (Postures- Relaxation , Breathing, Meditation) Physical Fitness Mind-Body Self-Regulation Flexibility Emotional Regulation Awareness Strength Stress Regulation Mindfulness Balance Resilience Attention Cardiovascular Equanimity Concentration/ Respiratory Function Psychological Self-efficacy Cognition Physical Self-efficacy Self/Social awareness Improved Physical and Mental Health, Performance, Behaviors Mood, Well-being, Psychological Disorders, Substance Use Disorders, Positive Behaviors, Relationships, Cognitive-Academic Performance, Quality of Life
Mind-Body Awareness • Three major senses through which we learn: visually, auditorily, and kinesthetically (musculoskeletal system and viscera) • Body awareness involves an attentional focus on and awareness of internal body sensations including propioception and interoception • It can be modified by mental processes including attention, interpretation, appraisal, beliefs, memories, attitudes, affect • Enhancing body awareness and non-judgmental mindfulness thought to be key for all mind-body therapies (yoga, tai chi, etc.)
Body-Mind Awareness Meditation Can Help • Anxiety disorders including OCD • Depression • Attention-Deficit • Fibromyalgia • Obesity • Tinnitus • Addiction • Autism • Metabolic syndromes • CVS disease/ heart failure • Irritable Bowel • Asthma, COPD, • etc
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