THE INTERNAT I O N A L A S S O C I ATION OF Y O G A T H E R A P I S T S YYoo gg aa TT hh ee rr aa pp yy TToo dd aa yy March 2010 Volume 6, Issue 1

ReachSing eoutr vhel pes t.o heal.

Ayurveda, Yoga, Embracing Yoga and Annual Report and Pregnancy Balanced Regulation Eating Disorders to Members 1 Yo g aT h e r a p yToday M a rch 2010 Ta b l e O fC o n t e n t s March 2010

Service Heals. Illustrated through a story by Cyndi Kershner of a community care group designed to assist a chronically ill patient and that of Katie Tandon who discovered 19 how service moved her patients toward recovery, these two Yoga therapists teach us that the role of service, or s e v a , is fundamental to the practice and the profession of Yoga therapy.

19 Community Care and How Yoga Serves the Chronically Ill by Cyndi Terry Kershner 22 Seva as Saving Grace by Katie Tandon onRegulation 7 Embracing Balanced Regulation by Scott Laurence 9 InterView 9 Mary Cardinal, Yoga Therapy Program Coordinator by John Kepner onPractice 12 Insights on Pregnancy from Yoga and Ayurveda by Margo Bachman

15 Yoga as the Missing Link in Eating Disorder Recovery by Beverly Price

24 Magic Carpet or Life Raft 12 by Jennie Lee onMedia 31 Books: Yoga for A n x i e t y, reviewed by Bo Forbes Yoga for Osteoporosis, reviewed by Patricia Brabender Inside Chronic Pain, reviewed by Neil Pearson onBusiness 29 How a Business is Like a Yoga Practice by Susi Hately 24 onMembers 31 Annual Report to Members by John Kepner IAYT Member Schools 2009 IAYT Donors N A M A Annual Conference Coming Soon

M a rch 2010 Yo g aT h e r a p yToday 2 Yo g aT h e r a p yTo d a y from the Editor

PUBLISHER International Association of Our Nature to Serve Yoga Therapists EDITOR-IN-CHIEF Julie Deife s I write this short message, the GRAPHIC DESIGNER Ken Wilson COPY EDITORS Kelly Birch, Denise Hodges people of Haiti have just seen 35 A days pass since the earthquake that Yoga Therapy Today is published in March, June, and December. killed over 230,000 people. Soon after it IAYT BOARD & MANAGEMENT s t ruck, volunteers from all over the world Eleanor Criswell, EdD rushed in as fast as they could while the Matra Raj, OTR, TYC world watched—literally moment-by-mo- Molly Lannon Kenny ment—as special-force's teams comprised of Clare Collins, RN, PhD Betsy Murphy, BSN, RN, RYT, HN-BC medical personnel, searc h - a n d - rescue spe- Executive Director John Kepner, MA, MBA cialists, and peacekeepers arrived. They Member Services/ Jesse Gonzales saved hearts and lives. In times like these, Office Manager Advertising Manager Madeline Groves the world knows that we are all one—otherwise could we be so touched by feelings of pain and loss in others? To the people suff e r- MISSION ing this tragic event, there are probably few among us who were IAYT supports research and education in Yoga, and serves as a unable to feel compassion and find ways to offer help. professional organization for Yoga teachers and Yoga therapists worldwide. Our mission is to establish Yoga as a recognized and But it doesn't take mind-numbing events like the 2010 Haitian respected therapy. earthquake (or Hurricane Katrina, or the 2004 Asian tsunami, or 9/11 ) to instigate empathic responses for our fellow humans. We are wire d MEMBERSHIP IAYT membership is open to Yoga practitioners, Yoga teachers, for empathy and compassion and we know instinctively that helping Yoga therapists, Yoga researchers, and healthcare professionals others comes naturally. Even as we mourn with Haiti, we honor a who utilize Yoga in their practice. g reat gift that we as humans have. As Jeremy Rifkin writes in his new MEMBER BENEFITS book The Empathic Civilization: “It is the empathetic moments in one's • Subscription to the International Journal of Yoga Therapy life that are the most powerful memories and the experiences that • Subscription to Yoga Therapy Today comfort and give a sense of connection, participation, and meaning to • Access to IAYT’s research resources and digital library one's sojourn.” And we in Yoga also have a foundation that embodies • Professional recognition through IAYT’s online listings and an IAYT membership certificate empathy in our practice—s e v a, or selfless service. • Discounted registration at IAYT events That is why I selected articles for this issue's feature section f rom two Yoga therapists that bring home the message of s e v a. CONTACT P. O. Box 12890, Prescott, AZ 86304 “Community Care and how Yoga serves the Chronically Ill” by Phone: 928-541-0004 (M-F, 9AM – 3PM MST) Cyndi Terry Kershner is rich not only with information that includes Fax: 928-541-0182 the Yoga therapy program she developed and implemented to fulfill www.iayt.org • [email protected] her role as part of a volunteer team organized around the needs of a HOW TO SUBMIT TO YOGA THERAPY TODAY man at the end-stage of Lou Gehrig's disease, but also with the Authors power of a healing web spun by caring people offering whatever Email a query or completed article to: [email protected]. Yoga Therapy services they could. In a smaller way than that of a gigantic re l i e f Today relies on submissions from the membership. Please submit e ffort, Cyndi and others served, bringing together an entire healing reports and articles on training, business,practice, views and insights of the field and profession of Yoga therapy. Brief articles c o m m u n i t y. Service is also what Katie Tandon writes about in “Seva should be 800–1000 words; feature articles should be 1500–2500 as Saving Grace,” although hers is a diff e rent approach in that she words. Articles are reviewed and accepted on a rolling basis and has successfully guided patients, through her work as a clinical psy- may be submitted at any time. You may also contact Julie Deife, editor, by mail at: chologist, to adopt s e v a as a therapy in resolving their own serious P.O. Box 867, Corrales, NM, 87048. conditions that re q u i re emotional healing. Both of these women help Advertisers us remember that while healing may sometimes come as a result of Call 928-541-0004 or email [email protected] for advertising using specific techniques appropriate to the individual and his or rates and deadlines. Editorial decisions are made independently her conditions, that without empathy and conscious selfless interac- of advertising arrangements. tion with others the healing for either the giver or receiver would not REPRINT POLICY be complete. IAYT's reprint policy applies to all articles in the International Understanding that to see oneself in others and to experience Journal of Yoga Therapy and Yoga Therapy Today. Fee: $1 per copy another's plight or condition is part of the very fabric of the healing per article. The policy works on the honor system, e.g., if you copy two articles for 25 students, please send IAYT a check for paradigm. As Yoga therapy finds its expression in what could be the $50 and note “for reprints” on the check. Requests for reprints of unfolding of a new era of healing, we are ready to claim our place as articles should be emailed or phoned to Jesse Gonzales, Member Yogis and embrace that which we “know” to be true. Service heals Services Manager, at [email protected] or 928-541-0004. is one truth of our practice and our culture of Yoga is one that can help heal the world. ENVIRONMENTAL STATEMENT This publication is printed using soy-based inks. The paper contains 30% recycled fiber. It is bleached without using chlorine and the In Service, wood pulp is harvested from sustainable fore s t s . Julie Deife

3 Yo g aT h e r a p yToday M a rch 2010 M a rch 2010 Yo g aT h e r a p yToday 4 L e t t e r st o T h e E d i t o r

eaders speak about articles in the Decem- P Ts are recognized and respected as the pro- ber 2009 issue of Yoga Therapy To d a y. T h e fession that evaluates and diagnoses movement R “letters to the editor” section will appear challenges. They have achieved that status in future issues as your letters are received. Send t h rough a pro g ressive process of development them directly to [email protected]. Get involved by that includes a scope of practice, standards, and sharing your thoughts with other members of tests of competency. Germane to Yoga therapy I AYT! —JD and to Dr. Riley's intended point, each pro f e s s i o n must determine what it does and how it will be determined that someone qualifies To the Editor, P Ts go through an arduous pre p a r a t i o n p rocess. For instance, in Yoga therapy there is dis- I agree with, and applaud, Leslie Kaminoff ' s cussion about 500-1000-hour- a n d - m o re training "Declaration of Independence for Yoga Educa- p rograms. It is important to note that this means tors" in the December issue of Yoga Therapy To d a y. hours of contact, not semester hours. Consider by The state (take your pick) will put you in a strait- contrast that the average candidate for physical jacket of rules and re q u i rements and suck all the therapy (i.e., who hasn't even started school yet) j o y, compassion, and creativity out of whatever has 8 semester hours of biology (240 contact gift you are bringing to the world. I speak fro m hours), 120 contact hours of human anatomy and personal experience of 15 years "in the system" as a counselor. p h y s i o l o g y, 90 hours of human movement, 120 hours of physics (in In the same issue of Yoga Therapy To d a y, I was inspired to re a d p reparation for biomechanics), and so forth. Those are the pre re q u i- "Dick's Story" by Robin Rothenberg. It never, ever, could have hap- sites to start training! School then includes 960-1280 additional clinical pened in the world of government regulation. If the recent public internship hours of clinical training and testing, following the class- debate about the healthcare industry—all state regulated—tells you room instruction. Also included are classes and testing to be able to anything, it is to stay as far away from it as is possible. read, evaluate, and use re s e a rch as a professional later in ones care e r. I would also like to never hear the words "evidence-based" These are standards by which professions judge other pro f e s- again. Whether we are teaching a class or working with a client indi- sions. Obviously the system is not perfect, but as we move forward v i d u a l l y, we are client-based. As Robin Rothenberg said, "Rather t o w a rd our collective mission of becoming a respected and re c o g- than concerning myself with the condition, I focused all my atten- nized profession, I urge each of us to participate in the larger conver- tion on being present with Dick and letting him guide and instru c t sation taking place. It is only through the many voices of our pro f e s- me as to what he needed." sion that we might find the best way forward. Fortunately, we have this fine publication and our journal that allow us to stay informed Susan Sullivan PRY T, RY T and contribute. N a r ro w s b u rg, NY. 8 s u e s u l @ f ro n t i e r n e t . n e t Thank you. Matthew J. Ta y l o r, PT, PhD Past president, IAYT Board of Directors, 2008-2009 To the Editor,

Thank you for the important interview with David Riley, MD, about To the Editor, Yoga therapy and standards. Dr. Riley is a valued friend and sup- porter of our organization, having been an important part of the first I'm sending this letter in praise of the beautiful article written by S Y TAR in 2007. I am writing to correct a misstatement he made Nicolai Bachmann. His words ring true for me, especially his com- about the professional qualifications of physical therapists (PTs) on ments concerning use of the English word "mind”. When training page 28 of Yoga Therapy To d a y, Vol. 5, Issue 3: “Physical therapy is a to become a teacher, I often found it confusing when I tried to post-graduate program with some minimal science re q u i re m e n t s — remember concepts and asanas in English. When I remembered you don't have to be an MD or an RN.” and utilized the Sanskrit terms things took on a whole different Allow me to state the correction and then the significance to the meaning and the true beauty of all that is Yoga began to open l a rger question around standards. within. I make it a practice to teach in Sanskrit first, transliterating Physical therapists generally have the same science re q u i re- to English when needed. ments as physicians, with the exception of organic chemistry and Thank you for publishing Nicolai's article. It served as a reaf- m i c ro b i o l o g y. Most physical therapy schools re q u i re biology, chem- firmation to me of the importance of the practice of using Sanskrit i s t r y, physics, calculus, anatomy, and so on, taken side by side with in all that is Yoga. p remed students. Further, presently 142 of the physical therapy pro- grams are now doctorate-level degrees, and the profession will be Most sincerely, fully doctorate level by 2020. Those are the current facts, but more Deborah Gullo important to our discussion as Yoga therapists, is why are PTs YogaCrossroads allowed to diagnose and what can they diagnose? Placitas, NM

5 Yo g aT h e r a p yToday M a rch 2010 M a rch 2010 Yo g aT h e r a p yToday 6 o nR e g u l a t i o n by Scott Laurence Embracing Balanced Regulation

he regulation of Yoga therapy, Yo g a conflicts by accepting the shallowness of and regulated by external and internal con- schools, and Yoga education is a wel- the way Yoga has been presented to the trols. “IAYT's mission is: to establish Yoga T come recognition of our pro f e s s i o n ' s public, going our own way as Yoga thera- as a recognized and respected therapy.” g rowing influence and status in Western cul- pists, and not interfering with “the system.” Having established the goal of making t u re. Regulation provides many benefits for But once we begin to compete for the ther- Yoga therapy a profession, now is not the people who want to enter the profession and apeutic dollar, the ru b b e r, as it were, begins time to retreat under the fear of regulatory for clients or patients who want or need to to meet the road. dominance or control. By embracing regu- avail themselves of this therapy. For the pro- We in Yoga therapy are at a cro s s ro a d s lation, we can be a positive force for influ- fession itself and for its practitioners, we in the development of an infant pro f e s s i o n a l encing the dynamic tension between the must ensure that regulation has an appro p r i- arm of Yoga. Proposed changes in the U.S. regulators and the profession. ate payoff that makes the sacrifice in time, h e a l t h c a re system support a shift toward m o n e y, and freedom worth the eff o r t . re w a rding preventative care or, “wellness,” It is tempting to see regulation and and provide an opportunity for Yoga thera- The Value of Regulation associated issues of commercial and pro f e s- p y, with its attendant underlying philoso- sional certification and licensing as all about phies, to achieve greater influence within the The most valued of professions are the most the costs and benefits, but we can take integrative healthcare model. By adopting heavily regulated, and their schools are sub- actions to ensure that the cost-benefit ratio is the term “therapy,” which carries with it cul- ject to the most rigorous of oversight and acceptable. Of course it is onerous and tural, ethical, and business implications a c c reditation. They are the most heavily re g- expensive to earn an education, pay pro f e s- related to healing, we embrace the world of ulated because their potential for harm sional fees, and be subject to rules set by oth- the professional. And professions are re g u- reflects the underlying power and persua- ers. But outside pre s s u re also serves a noble lated—as are the schools that train those pro- sion of their stature, the power of their meth- purpose by placing boundaries on low stan- fessionals. By claiming not only to heal the ods and the depth of their alliance with the d a rds, unregulated power, and complacen- measurable external but also the ineff a b l e fundamental values and practices of the cul- c y —the natural tendency for any established and private internal, we invite—nearly t u re. Members of these professions are gen- p rofession to resist change. d e m a n d — t h i rd-party oversight. erally well paid, carry influence, and are To date, Yoga's reach in the West has To gain influence, regulation will play respected. All professions fight control and been more broad than deep. Much of Yo g a ' s an important and supportive role in this regulation, but they are also supported and g rowth has been crassly commerc i a l — e v e n change. Without a focused partnership with validated by it. As long as regulated institu- f requently based on celebrity or fashion regulatory agencies at all levels, the essential tions and practitioners act within the guide- appeal; yet curiously, it also parallels an values and methods of Yoga therapy stand lines set, there are relatively few re s t r i c t i o n s u n p recedented interest in health and well- in danger of being co-opted and diluted by on what they can actually do. If a pro f e s s i o n ness by Westerners that reaches far beyond existing dominant models such as standard focuses on good outcomes, it is re l a t i v e l y conventional biomedical approaches or medical practices, chiropractic, physical f ree from restrictions on process and content. interventions. Many traditional Yogis are t h e r a p y, massage, exercise science, and men- But beware: if the medical doctor or hospital o ffended less by the inevitable development tal health counseling. causes physical harm, if the lawyer perverts of regulation by outsiders than by the pro l i f- Yoga embodies the standard of essen- the law, or if the financial institution causes eration of highly secularized and market- tial union of body, mind, and spirit. For others to lose money and jobs, then the re g- driven Yoga centers or copyrighted books example, Yogic therapies treat the “men- ulatory agencies will respond with more and lectures that are pale reflections of tal” through somatic approaches; we are c o n t rol over the way that profession does ancient, profound, and freely available prac- t h e re f o re the bridge between the medical business. Sometimes regulations overre a c h , tices. If there exists a freedom to create one's and psychological sciences. But what this a re irrational, or are driven by political or own brand or blend of Yoga, then a corre- also does is imply acceptance of a higher economic aims; that is the price a pro f e s s i o n sponding obligation to adhere to other d e g ree of professionalism, including more , pays for ignoring its own internal standard s re q u i rements of the social marketplace, rather than less, comprehensive training and values. including regulation, logically exists. and supervision than practiced by other For Yoga therapy, there are two funda- Yoga has both core and advanced ele- p rofessions. mental defenses against overregulation. If ments that are at odds with fundamental Yoga therapy alone can integrate and the profession fears overregulation, our operations, values, and goals of the curre n t synthesize existing healthcare alternatives p roactive position is to attain a high degre e medico-industrial complex. So far, our by extending its essentially innovative and of internal oversight based on ethical p ro g ress has been relatively easy in spite of flexible approach to change to how our actions. Secondly, we must focus on estab- this, and we have succeeded in avoiding profession is registered, certified, licensed, lishing good comparative outcomes, based

7 Yo g aT h e r a p yToday M a rch 2010 on solid anecdotal and, especially, empirical, be regulated as a therapy. Its graduated grative approach. evidence from the consumer. The funda- teachers will eventually strive for individual For many of us, it is a valid goal to get mental tenets of Yoga are so inhere n t l y certification or licensing in order to earn government and third-party payers to re i m- bound to ethical and moral behavior that if enough to pay for the instruction and contin- burse for Yoga and Yoga therapy. But that we set up good internal standards and con- uing education credits re q u i red and to cannot possibly happen if we do not agree to t rols, regulatory agencies will focus on col- c h a rge for services that reflect the true bene- regulatory oversight and if our teachers and lecting fees and handling state-level certifi- fits they provide. healers are not recognized as licensed or cer- cations through existing boards. The tenden- Grants and loans are available for the tified providers of healthcare services. cy for regulators to interfere with course study of cosmetology and mechanics, but If Yoga instructors and therapists do not content or with individual practices would one generally must self-pay to be a Yo g a guide regulation, then others will fill that be lessened. i n s t ru c t o r. Failure to embrace re g u l a t i o n void and Yoga itself will suff e r. denies Yoga therapy and professional Yo g a Without licensed schools, without pro- education to many in need. Not everyone fessional recognition of Yoga therapy, and Who Wants Regulation, and Who has the money or freedom to take paid class- without the status that comes from being a B e n e f i t s ? es without loans or scholarships, or to pay qualified Yoga teacher, thousands of patients for training that provides no diploma or and clients are denied access to the transfor- P re s s u re for regulation and licensing comes license. Is this good for Yoga? mational possibilities of Yoga. If this re q u i re s often from competitors such as other schools Is fear of regulation not just about loss of putting up with regulation, then I am all for and professions that are regulated and are f reedom, but also a fear that the availability of it. YTT subject to fees and oversight; they want a level Yoga to an expanded group of teachers thre a t- playing field. Do Yoga schools or therapists ens our special status and our income? Sacri- expect competitive owners and operators to fice can be freeing, too, and not just in teach- Scott Laurence, MEd, f o rever tolerate unlicensed Yoga schools and ing but in action. Being a citizen has rights— Phd, RY T-500, is a teachers, who are often much more intimate and we love to talk about our granted rights private practitioner with their clients and who claim greater bene- to freedom in all forms—but this corre s p o n d s and staff member at a fits, including life-altering changes? to duties and responsibilities as well. local, private addic- tion and co-occurring Having established the goal of making Yoga therapy a profes- disorder clinic where sion, now is not the time to re t reat under the fear of re g u l a t o ry he uses Yoga to tre a t dominance or control. c h ronic pain. He received his PhD in Physiological Psychology The greater pre s s u re comes from con- Opening the Doors with a focus on recovery of function. He is a sumers—certainly from those who were licensed mental health counselor (LMHC) in the cheated or hurt by an unregulated school or A few years ago, I co-facilitated the health state of Florida. He has practiced Yoga since teacher; those seeking third-party re i m- and wellness program in a private addic- 1968. [email protected] bursement for healthcare expenses; and tion and co-occurring disorder treatment f rom aspiring therapists who wish that their center. We taught and led eight classes a chosen profession were regulated and re c o g- day on Yoga, mindfulness, and other allied nized so that they may derive a living fro m activities to over 120 patients. They loved it. Many wary consumers will accept thera- it. We collected their written feedback and pies only if they are regulated and demon- routinely they told us our classes and activ- strate adherence to high professional stan- ities were the best part of their treatment. d a rds, or if they can get reimbursed for the The program disbanded after one year services provided. because what we did was not approved as If I embrace freedom from regulation, I treatment or therapy by insurance carriers must embrace the choice of pro f e s s i o n a l i s m and there were no state guidelines for doc- and licensing as well. Yoga education (as umentation. Therefore the institution car- opposed to Yoga therapy) might escape re g- ried us as an expense but could not get ulation if it provides only dire c t i o n s , reimbursed for what we did. We existed as descriptions, and information directly to recreation and relief from the “real treat- consumers. But, once it teaches others how ment.” If the patient saw a psychiatrist and to directly influence or manipulate the phys- received a prescription, that was re i m- ical body, once it aims to treat common men- bursable even if the patient did not ask for tal or emotional problems such as depre s- that treatment, even when the patient sion and anxiety—especially for pay—it will showed more progress with the more inte-

M a rch 2010 Yo g aT h e r a p yToday 8 Interview by John Kepner Mary Cardinal, Yoga Therapy Program Coord i n a t o r

Mary Cardinal is the coordinator of the Yoga ther- early to pick up the voicemail from the apy program at the Total Health Center at the biofeedback specialist as well as read the Himalayan Institute (HI) Headquarters near notes on what they did. That is essential, Honesdale, Pennsylvania. She has a “dream job” because our biofeedback specialist is very as a Yoga therapist, practicing within an integra- skilled in giving short practices that the client tive health center, with her colleagues in medicine, can do two to three times per day, and the c h i ropractic, massage, and biofeedback just down Yoga therapist really wants to incorporate the hall from her. Her teaching space used to be a those practices that the biofeedback specialist small nun's chapel, and the room still radiates worked out and found to be useful for that some of that subtle energ y. In this interview, I client. So, that is important information to me. especially wanted to bring out what it is like to The other thing that comes up is the var- work in such an integrated environment and how ious ailments that clients have. One example that might benefit both her and her students. of how it works is, say, if we have a client with a specific type of muscular dystro p h y that we are unfamiliar with, the doctor JK: Tell us how you came to be a Yoga ther- spends time getting the staff up-to-date and apist at the Total Health Center here at HI. p rovides at least a summary of what that par- mani Tigunait. He closed us up in a class- ticular type of muscular dystrophy means for Mary Cardinal: I came to the Himalayan Insti- room and spent a week with us so that he the client. That takes additional time, but she tute in 1993 as a schoolteacher and I taught in could train us specifically as to how he want- makes sure to do it even if it may mean a pri- our children's school for a number of years. ed us to approach Ayurveda with our vate conversation that happens on a short During that time I took my Yoga teacher train- clients—not just in the Yoga therapy setting walk together, a visit in the office, or right ing and then began teaching Yoga and work- but also in the massage and physician set- b e f o re the session. For instance, you saw me ing with a nurse who was working with our ting, so that we would be approaching our this afternoon where I saw the doctor on my medical doctor, Carrie Demers. The nurse had clients in an integrated manner, sharing the way in, and she said, “Don't go to your two been drawn to my style of teaching and felt it same types of information, and giving our o'clock without seeing me,” and we slipped would be a good fit for our therapeutic clients, own experiences of Ayurveda. The latter is into her office for a brief meeting that gave who have one-on-one sessions and small important because we all had diff e rent con- me crucial information about how to g roup classes. She asked me to work with Dr. stitutions. a p p roach the client that I had scheduled for Carrie so that Dr. Carrie could experience my the next hour. style of Yoga in one-on-one sessions. That was JK: Common training is very beneficial. the beginning of our relationship as doctor JK: What are some of the most common and Yoga therapist. Mary Cardinal: Right; and we often refer to issues that you work with here? that particular training even though it was JK: What was it about your style that inter- years ago, about 1999. Mary Cardinal: We see a lot of low-back ested her? H e re's a general example of our integra- issues. We see a lot of hip issues. There are tive approach to care, using our experiences people doing lengthy meditations here. We Mary Cardinal: I think it was that I related to with rejuvenation clients. It's quite common. see a lot of sitting posture challenges, folks beginners very well and I was drawn to Rejuvenation clients spend between three and that have been sitting in their meditation adapting poses so that anyone who was ten days here having treatments of biofeed- p o s t u re for a number of years and need s t ruggling could experience the benefits of a back, massage therapy, and Yoga therapy, some assistance because something new has pose in an adaptive version using props such along with their doctor visits. We have staff come up for them, such as an ankle or a knee as blankets, cushions, etc.; but, sometimes it meetings where we discuss diff e rent aspects p roblem. There are a lot of knee issues was with changing the pose altogether. It of what is going on with the client and share because people are not just practicing medi- was important to me that each student be how we intend to approach treatment or how tation but Yoga as well, so structural issues able to have an experience in a pose, rather we experienced things in our sessions. There a re common. than feeling as if a pose was beyond them. is breathing that happens in massage, in O r, there are often structural issues biofeedback, in Yoga therapy, and a doctor along with a major ailment. For instance, JK: Please tell us more about this environ- gets in there and educates the patient as well. someone is struggling with a hip or uncom- ment and the integrative approach off e r e d We want to be aware of overlapping and we fortable sacroiliac joint, but they are also in at HI. also want to complement what others are the process of figuring out their path in allo- doing. These meetings are quite formal. Then pathic medicine for treating their cancer. We Mary Cardinal: Let me answer that by first in between these meetings, diff e rent thera- don't ignore one and work with the other; sharing a bit about Ayurveda and how we pists talk to one another. For instance, I might r a t h e r, we address both simultaneously. If we incorporate it into our program. Our entire see a client at 2:00 that the biofeedback spe- a re dealing with someone who has gastro i n- s t a ff was trained in Ayurveda by Pandit Raj- cialist saw at 9:00, so I will make sure to get in testinal cancer for instance, a lot of the things

9 Yo g aT h e r a p yToday M a rch 2010 that we are going to do for their low back and Mary Cardinal: Stick to the science of Yo g a . focused on breathing practices in response to hip will create space and relaxation for the The science of Yoga is to come back to your your question here, but I use a s a n a as well in abdominal and the pelvic cavity. classical practices that ground and soothe the p r a c t i c e . nervous system. So, alternate nostril bre a t h- JK: What are some of your most common ing is a practice you will see used fre q u e n t l y JK: What about prayer and m a n t r a m e d i t a- issues in physiological systems? h e re at the Himalayan Institute and taught t i o n ? c l a s s i c a l l y. Likewise, diaphragmatic bre a t h- Mary Cardinal: GI and digestion is a com- ing is a foundation for our work here . Mary Cardinal: A b s o l u t e l y. One of the best mon one. Respiratory ailments come up, not referrals I can offer is to make a client aware as commonly, but they come up fre q u e n t l y. JK: Have you worked with people in situa- that a personal m a n t r a is available to them Autoimmune comes up. Also multiple scle- tions where they are actively undergoing t h rough the Himalayan tradition and the lin- rosis and fibromyalgia. chemotherapy and they don't know what is eage. going to happen? JK: What about the mental and emotional JK: Referral, how so? realms, such as depression or anxiety. Do Mary Cardinal: A b s o l u t e l y. One of the most you ever work with people in those areas? important things that I believe I have to off e r Mary Cardinal: I refer them to Dr. Rolf Sovik the client in the midst of treatment is support, or Pandit Rajmani Tigunait, and that is avail- Mary Cardinal: Absolutely; depression and and that support may come in my manner able here on campus for a seeking person. We anxiety are two sides of the same coin. They and tone. But what really comes through is do use the practice of so ham and that is our come up quite frequently and they come the support that they gain from feeling methodology of teaching meditation, so I along with ailments and they also come g rounded and enabled in calming their own o ffer that m a n t r a . But I also encourage clients along with structural issues. nervous systems. That may mean a deep hip to continue with what has grounded them s t retch, working with crocodile and dia- thus far. I support any use of prayer and JK: One of the concerns in our field that we phragmatic breathing, or coming to an meditation that they have experienced, and I hear from psychologists is about Yoga ther- upright position and sitting—just witnessing also try and take it to, not so much the next apists who may not be very well-trained in their own breath or perhaps using the prac- level, but bringing them towards a little bit psychotherapy and who are working with tice of u j j a y i to slow their breath and addre s s m o re traditional use of meditation. I often people who have mental health problems. their nervous system. Those are some of the find folks practicing relaxation in the corpse What would you say about that? ways that I would support someone who pose and thinking that what they are doing is needs to really relax deeply. I have sort of meditation, who have (continued on page 11 )

M a rch 2010 Yo g aT h e r a p yToday 1 0 Interview c o n t i n u e d

a whole new experience when I bring them JK: What about the chiropractor? up to a supported or a lifted seated position and they are then able to practice meditation Mary Cardinal: That is one of our newer with their head, neck, and trunk in alignment. additions and I have found that working It is taking someone from where he or she with the chiropractor has been really help- c u r rently is at and supporting him or her to ful. She is able to tell me, because her spe- go further. cialty is applied kinesiology, that, say, the gluteus maximus needs strengthening on JK: Are you also training other Yoga thera- the right side, and I am able to apply that to p i s t s ? the poses that I am doing. I am able to very quickly look at how a person is stabilizing Mary Cardinal: I have off e red formal training him- or herself in various poses and hone in Yoga therapy with a sequence that is pri- right in on that area when I have that infor- marily focused on structural issues but is also mation from her. an extension of the program where I work The nice thing about a team approach is with teachers to increase their confidence in we can share a hunch and work to either understanding of the science of Yoga. So the p rove or disprove that hunch and see what is training is in increasing their awareness of really going on. More gross physical infor- how they understand classes of poses and mation is just extremely helpful in keeping what those poses have to offer the body as things efficient and giving clients more of well as their understanding of postural align- what they need in that one-hour session and ment and alignment in general so that they in their sequence of sessions. can support a body in a restorative pose, for example. JK: Is there anything else you would like to I have worked with teachers in a rather share with us? formal way; this pose is good for this, that type of thing. I have also worked with them Mary Cardinal: I think of my IAYT publica- so that they have a chance to do private ses- tions as some of the best re f e rence materials I sions with one another and that has been re a l- could have. What I enjoy most about them is ly interesting work for me. We are in the the exposure that I get to the other schools of p rocess of re s t ructuring that pro g r a m . Yoga. I am steeped in this tradition here, and I enjoy that very much, and as you said, this is an ideal scenario. However, the full JK: There is so much here that is a good b readth of Yoga that is shared when a teacher example of what IAYT is trying to support, f rom another tradition comes and share s that is, bridging Yoga and other healing time with us has been very useful in my prac- practices within the broad spectrum of tice of Yoga therapy. h e a l t h c a r e . The other thing that I want to say a little bit more about is the doctor experience. My Mary Cardinal: I spoke about my connection relationship with the doctor has been pro b a- with the biofeedback specialist and I spoke bly the single most powerful force in my about my connection with the doctor. The practice as a Yoga therapist. Our doctor, who other connection that is extremely important practices Yoga and supports what happens in to me is with the massage therapist. I want to the Yoga therapy room, has been able to give know that my massage therapist knows how me information about all diff e rent types of to work with releasing particular muscles, ailments and challenges that is much more working with the piriformis and working subtle and accessible for me as a Yoga thera- with the psoas, because when I see these pist because she is coming in with her own issues come up so strongly in a s a n a s, then practice and her own ideas about what might some manual work to relax the body as a be helpful and that is the arrow that points whole and also to release those particular me in a direction. YTT a reas is essential. Clients will feel a tre m e n- dous amount of improvement because of both. Acommon statement from our clients as John Kepner is the executive director of the they go through our program is, “I'm not sure International Association of Yoga Therapists. if it is the Yoga or if it's the massage.” When Reach him at [email protected] . we have a good integration between our serv- ices, then that is a very positive statement.

11 Yo g aT h e r a p yToday M a rch 2010 onPractice by Margo Bachman Insights on Pregnancy from Yoga and Ay u r v e d a uring pregnancy the expectant A c c o rding to my orientation to Yoga, the mother is fulfilling an inhere n t general rule for the first trimester is that if D dharma that exists for females of all someone has not practiced Yoga, then it is species. Throughout the globe, pregnancy is p rudent to wait three months before begin- seen as a rite of passage that will fore v e r ning a traditional a s a n a practice. Women who change a woman's existence. While pre g n a n- have been practicing Yoga can usually con- cy has the potential to be a wondrous expe- tinue their pre-pregnancy practice, but rience, many women are laden with ail- should avoid extreme forward bends and ments and feel uncomfortable in their bodies twists, jumping v i n y a s a s, extreme back arc h- for nine months. Yoga and Ayurveda pro- es, and very strenuous or heating sequences.1 vide a wealth of knowledge about how to Simple a s a n a s in the first trimester might c a re for women during this extraord i n a r y include tadasana (mountain pose), c h a k r a - time to alleviate many common discomforts vakasana ( ruddy goose pose), d w i p a d a p i t h a m and create a joyful, healthy pre g n a n c y. (two-leg posture), and urdhva prasarita pada- As a Yoga practitioner for over 20 years, s a n a (supine staff pose). Now is an excellent I am steeped in the teachings of T. K . V. of a woman's p r a k r u t i (psychosomatic biolog- time to introduce the concept of b h a v a n a: an D e s i k a c h a r, which align with the science of ical constitution determined at birth) and attitude, idea, or intention one would like to Ayurveda. Both Yoga and Ayurveda have an vikruti ( c u r rent imbalanced state of health) cultivate. This can be very personal and is a o v e r a rching view that everything is specific p rovides a crucial framework for designing good starting place for designing a practice. to the individual—from the foods we eat to practices and treatment plans that are appro- the a s a n a we practice. Pregnancy is a time priate for each individual. In each session I that calls for an even greater “tailor- m a d e ” educate women about the basics of the d o s h a s Case Study, First Tr i m e s t e r a p p roach to health. In addition to her unique as they relate to each client individually. A s constitution, each woman may have specific T. K . V. Desikachar says, “The object of medi- Sara is a 37-year-old p i t t a- p re d o m i n a n t health challenges, varying states of mind, tation for the teacher is the student in front of woman who had a strong a s a n a p r a c t i c e and family or relational issues. These are col- them.” Creating appropriate practices is like b e f o re she became pregnant. However, she o red by her stage of pregnancy and how she putting together a big puzzle, as each session had extreme nausea and every forward is adjusting to it. The foundation for this unfolds and a relationship evolves. movement, standing, sitting, or kneeling p remise lies in my background of study in exacerbated her nausea. She discovered that Yoga and Ayurveda, my experience working brisk walking gave her considerable re l i e f . with women in pre g n a n c y, and my own First Tr i m e s t e r Sara also recently had a miscarriage and was p re g n a n c y. concerned about having another one. When Yogic practices that include a s a n a , During the first three months of pre g n a n c y, Nausea and vomiting of pre g n a n c y p r a n a y a m a , meditation, and chanting are all the major organs and the central nervous (NVP) occurs in 50-90% of all pre g n a n c i e s .2 incorporated with diet and lifestyle practices system are forming within the fetus. Brain While this condition can happen in all d o s h i c specific to pregnancy and each woman, our cells are growing rapidly, and the face, eyes, types (vata, pitta, or k a p h a), it is more com- work as Yoga therapists becomes more com- ears, and mouth begin to develop. This time mon among p i t t a individuals. This may be p rehensive and effective. Then we find that is a big adjustment for many women; some possibly due to the rise in hormones during Yoga therapy more truly expresses the inten- feel overjoyed to be pregnant while others p regnancy that circulate in the blood and tions set forth in the classical texts: integra- may be ambivalent. The first trimester, when trigger p i t t a in the stomach, resulting in tion of the general principles of Ay u r v e d a , the pregnancy is establishing itself, can be a i n c reased acid secre t i o n s .3 Yoga's sister science, with Yoga. delicate time, especially if there is a history I created a protocol that would not Combining the principles of Ay u r v e d a of miscarriage or other obstetrical complica- aggravate her p i t t a in body, breath, or mind and Yoga, I continually observe and assess tions. It is also a time of surging hormones, f rom an understanding of her p r a k r u t i a n d my clients. I notice how they walk when which can create additional changes in the v i k r u t i. they come in the door, the feeling in their physical body, digestion, and emotions. The b h a v a n a for Sara was to feel pro t e c t- voice, and the look in their eyes. I evaluate Women may need to adjust their diet to ed and strengthened in the first trimester their physical appearance and utilize the tra- include essential nutrients for pre g n a n c y while feeling physically comfortable. I sug- ditional assessment tools of face, pulse, and and lifestyle to honor the new journey of gested she stop a s a n a for now but continue tongue diagnosis. Having an understanding p re g n a n c y. the brisk walks and (continued on page 13)

M a rch 2010 Yo g aT h e r a p yToday 1 2 onPractice, continued

follow them with shitali pranayama ( k n o w n 20 weeks, but by end the fifth month, s h i r - for its cooling effects on the body and mind) s h a s a n a (headstand) and sarvangasana ( s h o u l- and a short meditation visualizing her body derstand) should be avoided according to Sri and energetic field sealed and protected. Nathamuni's Yogarahasya, a widely utilized Yogic text.6 P r a n a y a m a can be practiced with- Creating appropriate prac- out holding any b a n d h a s, but k a p a l a b h a t i a n d tices is like putting together b h a s t r i k a should be avoided completely.7 It is very important that women don't contract a big puzzle, as each session the abdomen upon exhale. General b h a v a n a s unfolds and a relationship in the second trimester can include whatever evolves. visions the pregnant woman wishes for her- self, her growing baby, and evolving family. She was instructed to follow a p i t t a - reducing diet. I advised her to eat small meals throughout the day, especially first Case Study, Second Tr i m e s t e r thing in the morning and before bedtime, to p revent acidic secretions from irritating the Rebecca is a 29-year-old woman who came stomach, and to use fresh ginger root ( Z i n - to see me in the fifth month of her first pre g- gibar officinalis), which has been clinically n a n c y. She was in much discomfort fro m p roven effective and safe for NVP.4 I chose constipation, fatigue/low energ y, pain in the f resh ginger root over dried because fre s h lower back and hips, and insomnia. She is a does not aggravate p i t t a, whereas dried does. p i t t a - k a p h a type. These are all very common F i n a l l y, I recommended the herb shatavari complaints in pregnancy that respond well (Asparagus racemosis) to settle her stomach to diet and lifestyle changes along with Yo g a due to its demulcent qualities. It has been practices. used historically to nourish the mother and Rebecca had the underlying stre n g t h fetus and exhibits anti-oxytocin activity to and stamina typical of p i t t a - k a p h a types but p rotect against threatened miscarriage.5 was depleted from her stressful job and After two weeks had passed Sara felt lifestyle. Through understanding her p r a k r u t i better overall, even though the nausea had I knew that her o j a s (deep energy reserve of not completely disappeared. She was also the body) would increase through simple able to function much better in her work, changes and she would benefit tre m e n d o u s l y home, and social life. f rom increasing circulation, which can tend to become stagnant when k a p h a is involved. I suggested gentle a s a n a s to increase cir- Second Tr i m e s t e r culation and alleviate pre s s u re on the lower back and open the hips such as c h a k r a - Most women begin to feel better overall in vakasana, adhomukha shvanasana ( d o w n w a rd the second trimester. The pregnancy is more facing dog), u p a v i s h t a k o n a s a n a (seated angle established; NVP typically goes away by the p o s t u re), and d w i p a d a p i t h a m , all modified for fourth month, and energy increases. Howev- p regnancy by making the legs wider than e r, it is still important to begin each session the hips. assessing the d o s h a s along with current men- She was instructed to incorporate cer- tal and emotional states through observa- tain foods into her diet known to incre a s e tion, questioning, and feeling the pulse so o j a s, such as almonds and dates, and to that practices and recommendations can be i n c rease fresh vegetables and fruits (which adjusted to ensure their appropriateness. w e re lacking in her diet). I advised her to In the second trimester and beyond, drink one cup of warm spiced milk before women should avoid all a s a n a s that put pre s- bed with 1 teaspoon of ghee added to re l i e v e s u re on the abdomen. The most benefit will constipation, and to take a warm evening come from a s a n a s that focus on opening the bath with Epson salts and a few drops of pelvis and hips, such as baddhakonasana lavender oil to relieve her low back pain and (bound angle posture) and u p a v i s h t a k o n a s a n a induce a sound sleep. (seated angle posture). If women re g u l a r l y After two weeks she felt like a diff e re n t practiced inversions they can continue until woman. She was sleeping much better, had

13 Yo g aT h e r a p yToday M a rch 2010 m o re energy during the day, and had re g u- bound angle posture) daily, extending the lar bowel movements. She was bothered by exhalation to relax the nervous system while her back only at the very end of the day, my body softened and I visualized a smooth when she then did her Yoga practice, which l a b o r. Within a few weeks my anxiety dimin- gave her re l i e f . ished significantly, as I felt more gro u n d e d and pre p a red for what lay ahead. Yoga and Ayurveda provide the insight Third Tr i m e s t e r and wisdom through their tailor- m a d e a p p roach to health. We can begin by cre a t i n g The third trimester can be an exciting and a p p ropriate Yoga practices that honor each anxious time as pregnancy is coming to an trimester and the various mental and emo- end. While a s a n a practices generally should tional states of each woman. When we add be mild, we also want to ensure that women the tools for continuous balance and moni- a re maintaining their strength, which they toring of the d o s h a s, encourage our students will need when they go into labor. Standing and clients to make simple changes, and poses are excellent to increase energ y. A s a n a s incorporate nourishing practices into their that bring strength and flexibility to the lives, they are more likely to feel the benefits spine are invaluable to support the extra of a healthy, joyful pre g n a n c y. YTT weight of the baby and help pre p a re for l a b o r. Modified versions of uttkatasana ( f i e rc e E n d n o t e s p o s t u re) and janu shirshasana ( h e a d - t o - k n e e 1. Frawley D, Kozak S. Yoga for Your Ty p e . Tw i n pose) may be appropriate. Supported a s a n a s Lakes, WI: Lotus Press; 2001:196. such as s u p t a b a d d h a k o n a s a n a , (supine bound 2. Romm A. Botanical Medicine for Women's Health. angle pose) are also very helpful now and St. Louis, MO: Churchill Livingstone Elsevier; add an element of conscious relaxation. 2 0 1 0 : 3 5 3 . Chanting is another wonderful practice 3. Lad V. The Complete Book of Ayurvedic Home to incorporate throughout pregnancy and R e m e d i e s . New York: Harmony Books; 1998:225. especially to help pre p a re for labor when 4. Willettts KE, Ekangaki A, Eden JA. Effect of a women need to work with the strength of ginger extract on pregnancy-induced nausea: A their breath and keep the mind keenly randomised controlled trial. Aust N Z J Obstet focused on the process. It can add another G y n a e c o l . 2003; 43(2):139-144. dimension to one's practice and encourage 5. Goyal RK, Singh J, Lal H. Asparagus racemo- the breath to lengthen naturally and incre a s e sus-an update. Indian J Med Sci 2003; 57:408. its capacity while the mind focuses on the 6. Krishnamacharya T. Sri Nathamuni's Yo g a r a - s o u n d s . h a s y a . Chennai, India: Krishnamacharya Yo g a Mandiram; 1988:133. 7. Ibid, p. 134. Case Study, Third Tr i m e s t e r

When I was pregnant with my daughter, in M a rgo Bachman, MA, RYT500, is a NAMA the eighth month I began to feel anxious (National Ayurvedic Medical Association)-certi - about becoming a new mother and the fied Ayurvedic practi - unknown of giving birth. This nervousness tioner and KHYF and anxiety is characteristic of vata dosha. My ( K r i s h n a m a c h a r y a teacher taught me a chant to honor diff e re n t Healing and Yo g a gods and goddesses to invoke the qualities F o u n d a t i o n ) - c e r t i f i e d of each one in my growing baby. Thro u g h Yoga teacher. She is a chanting slowly and calmly I began to feel consultant, teacher, very relaxed in my body and mind. I fol- and writer specializ - lowed a basic v a t a- reducing program of ing in women and warming, well-cooked and spiced foods; I c h i l d ren's health. received plenty of rest and spent time sever- w w w. h e a r t o f w e l l n e s s . c o m al days a week swimming and massaging warm sesame oil all over my very pre g n a n t b o d y. I practiced suptabaddhakonasana, ( s u p i n e

M a rch 2010 Yo g aT h e r a p yToday 1 4 onPractice by Beverly Price, RD, MA, E-RYT Yoga as the Missing Link in Eating D i s o rder Recovery or someone with an eating disord e r, but she had never adhered to treatment re c- the benefits of Yoga can be a powerful ommendations for any length of time. She F tool to uncover underlying causes and qualified as a candidate for inpatient re s i d e n- move individuals toward awareness and tial treatment, but refused this type of inten- re c o v e r y. sive treatment whenever it was re c o m m e n d- The South Carolina Department of Men- ed. Brittany also suff e red from depre s s i o n , tal Health estimated in 2006 that eight mil- a n x i e t y, and OCD. In addition, Brittany had lion Americans exhibited eating disord e r s — c o m p romised lung function due to a history seven million women and one million men,1 of a collapsed lung associated with her star- but that number may be even higher now. vation. She also had severe osteoporo s i s . Given the high prevalence of eating disor- Although we were reluctant to accept ders in this country, undoubtedly many indi- Brittany into our program, her referring psy- viduals affected will ultimately reveal them- chiatrist and psychologist encouraged us to selves as students in the classes of Yo g a work with her. Our licensed therapists teachers. Yoga therapy is an opportunity for focused on addressing her anxiety, depre s- Yoga teachers to bring their skills into the sion, and OCD by integrating individual and lives of individuals who struggle with eating g roup psychotherapy with Yoga and cre a t i v e d i s o rders, sometimes to see them pro g re s s o rders, are consistently found in individuals arts therapy. t o w a rd recovery and sometimes only to re a l- with eating disorders and Obsessive-Com- Our team worked with Brittany on ize that they are not yet ready for the help a pulsive Disorder (OCD). Further information modifying poses and taking care of herself as Yoga recovery program can off e r. on the diagnoses and classifications of eating she tended to overdo and push herself, The case studies that follow are based on d i s o rders, along with co-occurring disord e r s , which was part of her disease. We were con- my clinical training as a re g i s t e red dietitian, may be found in the Diagnostic and Statistical cerned about Brittany injuring herself, specif- e x e rcise physiologist, and experienced Yo g a Manual of Mental Disorders (DSM) IV- T R . 2 ically breaking bones due to her fragile state, teacher specializing in eating disorders for along with compromising her heart muscle over 25 years. I have worked with individuals f rom the extra effort needed because of her who have eating disorders and related addic- Brittany's Story diminished lung function. While Brittany tions both in my private practice and in a was stronger than her skin and bones Yoga-based eating disorder treatment pro- Brittany was 34 years old, 5'7”, and appro x i- appearance might lead one to believe, she gram. Prior to completing my Yoga teacher mately 80 pounds when she was re f e r red to was also preoccupied with attaining perfec- training, I felt that there was a missing link in my Reconnect with Food® Yoga-based day tion in the poses. eating disorder re c o v e r y. Subsequent Yo g a t reatment program. This program offers Yo g a The philosophy of my Yoga teacher training enhanced the way I practice as a cli- along with group and individual psychother- training was to provide increased access to nician. These case studies illustrate the con- a p y, mindful eating, and creative arts therapy Yoga while looking inward as well as to tinuum of eating disorders, how a student led by licensed mental health providers, a move away from intellectualization of pos- might present in the classroom, and ways in psychiatrist, an internist, re g i s t e red Yo g a t u res that in this case, would perpetuate the which a Yoga teacher can identify and guide teachers, creative arts therapists, and a re g i s- perfectionism which fuels this disease. We his or her students who have eating disorders. t e red dietitian. Some of the mental health gave Brittany permission to simply sit on her practitioners are also Yoga teachers. A m e r i- mat and meditate. We also took her thro u g h can Psychological Association guidelines3 Yin Yoga practices, designed to take one Defining Eating Disorders recommend that in order to participate in an deeply inside through the use of long holds outpatient program, such as a partial hospi- and deep stretches that reach deep in the con- Eating disorders are considered a spectru m talization (day treatment) program or inten- nective tissues and the joints. These are the d i s o rder ranging from anorexia nervosa, to sive outpatient program such as Reconnect deep yin tissues of the body, relative to the bulimia nervosa, to binge eating disord e r. with Food, individuals should be at 80% of m o re superficial yang tissues of muscles and Eating disorders are symptoms of depre s s i o n their ideal body weight and medically stable. skin. Yin Yoga opens up these deep, dense, and anxiety, along with a host of other psy- Brittany had struggled with an eating r a rely touched areas. This type of a s a n a p r a c- chological issues, including mental health d i s o rder since high school. She had sought tice is beneficial to cultivate stillness of the conditions resulting from trauma. Depre s- t reatment previously on an outpatient basis mind, which can be more mentally than sion and anxiety, along with personality dis- t h rough individual therapy and sporadically, physically challenging to an individual with

15 Yo g aT h e r a p yToday M a rch 2010 an eating disord e r-including Brittany, who this student practicing at the respective stu- l a rge quantities of food, followed by purg i n g became very rigid in these postures and dio. A student with severe medical issues or restricting her food intake. She had a his- could not remain still. p resents a serious liability to the Yoga teacher tory of drug and alcohol abuse prior to After two weeks in our program, partic- and/or studio owner. Teachers and studios developing her food-related issues. Heather ipating in Yoga, group psychotherapy, indi- can address their concerns with a student also tended to be sexually promiscuous. vidual psychotherapy, nutritional therapy, like Brittany, but should keep in mind this Heather resonated with our pro g r a m . and creative arts therapy, Brittany was student may be in denial and never return to She was particularly attracted to our Hatha re f e r red to a higher level of care since her the studio once confro n t e d . Yoga sessions that off e red long holds and malnourished state, along with underlying challenging poses, while weaving in the s e v e re psychiatric and medical issues, war- eight-fold path along with the c h a k r a i n s t ru c- ranted inpatient/residential treatment. Her Heather's Story tion and practices in relation to what she was distorted thinking made it impossible to do experiencing physically, emotionally, and e ffective psychotherapy, while her edema- Heather traveled from the other end of the spiritually in her addictive process. She tous ankles were potentially indicative of country to access our day treatment pro g r a m enjoyed the v i n y a s a “ f ree flows” we added to kidney or heart failure . in the Midwest, as she was specifically look- our mix of postures because she loved to ing for a Yoga-based program to help in work out and loved “the burn.” In the studio L e s s o n : Yoga does not cure everything and a d d ressing her bulimia and related impul- w h e re I trained, students are given a series of not all students with severe malnutrition sive disord e r. poses to experience in the beginning of the and/or psychiatric issues are able to tap into Heather is a tall, beautiful, and outgo- class session, and then left to “flow on their their innate wisdom to know what is best for ing young woman in her 20s. Most individ- own.” Students can add or delete poses of them. It is important that individuals like uals would judge her as having a beautiful their choosing. They move at their own pace, Brittany have the support of a qualified tre a t- and toned body and would not think any- generally to music, to tap into their bre a t h ment team with experience in eating disor- thing was wrong or unusual about her. But and feel the movement of their bodies on a ders, if working in conjunction with Yoga as what most people would not understand is much deeper level. This type of free flow can a tool. A Yoga teacher who finds a student what is really going on in Heather's head: also be very empowering. In addition, we like Brittany in class should inform the studio Heather loathed her body, herself, and her w e re trained to continuously develop and owner if he or she is not comfortable with life. Her bulimia consisted of bingeing on implement new or (continued on page 17)

M a rch 2010 Yo g aT h e r a p yToday 1 6 onPractice, continued updated flows from class to class and as time f rom these difficult emotions. She was also being sexually abused (raped) as a teenager p ro g ressed, allowing students to continually able to notice when she was crossing bound- by her uncle. In a study by Brewerton et al. open new areas of the body. This style of aries with others and to observe this behavior. ( 2 0 0 0 ) , 6 it was reported that compared with Yoga helps individuals with eating disord e r s Heather began to appreciate her body for the general population, individuals with begin to break free from the rigidity that is what it “could do” versus how she curre n t l y PTSD had a 50% higher history of rape than normally an inhibitive trait they manifest. defined it. the general population. Bulimic women with The treatment goal for Heather was to PTSD were five times more likely to have a focus on her Borderline Personality Disord e r L e s s o n : Yoga can help delay impulses in peo- history of rape compared with women in the and impulsive behavior, which is common in ple with bulimia. Through a regular Yo g a general population who did not have bulimia. p u re bulimics. Binge eating is usually includ- practice, individuals may find themselves in ed in the impulsive behavior criterion for p o s t u res that are difficult or awkward. Learn- It is often the Yoga teacher in B o rderline Personality Disord e r, along with ing to stay within the poses and work whom the student will con- sexual promiscuity and substance abuse. t h rough them can help an individual who fide—based on the re l a t i o n- Individuals with personality disorders feels an urge to binge or practice unhealthy exhibit feelings of ineffectiveness; a stro n g food behaviors delay acting on this urge. In s h i p — b e f o re turning to other need to control one's environment; inflexible our society there is a tendency to want to qualified, professional help. thinking; limited social spontaneity; perfec- escape anything that causes psychological or tionism; and overly restrained initiative and physical discomfort. People frequently tend When Larissa entered our day tre a t m e n t emotional expression. to escape by overeating, working too much, p rogram, she had a hard time moving and Individuals with bulimia also tend to getting caught up in unhealthy re l a t i o n s h i p s , getting into many poses that re q u i red com- abuse alcohol and other drugs more fre- or by drug and alcohol use. In Yoga, individ- p ressing her knees into her chest such as quently than the general population. In a uals are encouraged to observe rather than pigeon, shoulder stand, and seated forward study of students by Stewart et al. (2000), 30- react to their discomfort by breathing and lis- folds. She had difficulty sitting on the floor 35% of individuals diagnosed with eating tening carefully for what their body/minds for periods of time longer than five to ten d i s o rders also abused alcohol and other illic- a re conveying. minutes. In talking with her, she continually it drugs compared with 9% of the general Yoga teachers can be helpful by empha- put up barriers as to why she could not move p o p u l a t i o n . 4 sizing breath and movement, along with tak- f o r w a rd in her life. These barriers included A re s e a rch study by Boudette (2006)5 ing care of one's self. An effective teacher her weight, being the mother of a special elucidated some of the characteristics communicates a healing theme in his or her needs child, and an emotionally unavailable Heather exhibited and was helpful in our class dialogue that empowers students rather husband. By way of emotional soothing she work with her. Boudette taught Yoga in a than using extensive and complicated dia- turned to food. Larissa also did not like to be class designed specifically for eating disor- logue about getting into a pose or by foster- touched or adjusted in postures and was fear- ders and discovered that bulimics and com- ing competition by using another as a ro l e ful and anxious about lying in s a v a s a n a pulsive eaters find a deep sense of peace and model for an ideal as to what “one should (corpse pose). f reedom, integrate positive coping strategies, look like in a pose.” Larissa was able to work toward achiev- and connect with their physical bodies ing her weight goals over the course of our t h rough the practice of Yoga. She concluded p rogram with a slow-moving Hatha Yo g a that Yoga offers a non-verbal, experiential Larissa's Story flow incorporating long holds and many chal- adjunct to talking therapy and also discussed lenging poses. Like Heather, Larissa learned the importance of goal setting in a Yoga prac- Larissa was 45 years old, 5'4”, and over 250 how to use various Yoga poses as metaphors tice designed for eating disorder re c o v e r y. pounds when she began to see me privately for tolerating uncomfortable emotional states The same treatment team and goal-set- for nutrition counseling. She had underg o n e without running toward food for comfort. ting strategy was implemented with Heather bariatric surgery a number of years pre v i o u s While in various Yoga poses, she was taught to as had been done with Brittany. Over the to our meeting and lost close to 100 pounds; hold postures for a certain length of time while course of treatment in our program, Heather h o w e v e r, over time she began to consume maintaining the breath. Larissa learned the reported that her bulimic behavior dimin- small amounts of calorically dense foods, discipline of holding these postures as a ished as she learned to use Yoga to help delay resulting in her gaining all of her weight metaphor for feeling and accepting uncom- her impulses. She learned to explore more back, and then some. At the time she came to fortable emotions instead of resorting to com- deeply when she found herself in posture s us, she was bingeing for several days straight, pulsive eating and other impulsive behaviors. that were difficult or awkward. Learning to followed by restricting food for a given Larissa was also able to tune in to her stay present with the poses and to work amount of time. She was also quite sedentary. body's signals of hunger and satiety and to through challenging postures helped Larissa had a history of purging, but had not t rust her body. Often, standard nutritional Heather delay acting on urges to binge and been active in this behavior for over 10 years. t reatment of eating disorders implements yet p u rge, while listening carefully for what her Larissa was diagnosed with post-trau- another food plan, which solidifies the rigid- body/mind was conveying versus ru n n i n g matic stress disorder (PTSD) as a result of ity of eating disorders that we are trying to

17 Yo g aT h e r a p yToday M a rch 2010 move away from rather than moving instead whom the student will confide—based on t o w a rd intuitive eating found in pro g re s s i v e the re l a t i o n s h i p — b e f o re turning to other t reatment centers. The Reconnect with Food qualified, professional help. Yoga teachers p rogram incorporates various concepts of and studio owners need to cultivate their mindful and conscious eating in daily eating intuition to determine when it is clearly a lia- and is tied into the Yoga practice, which bility to have a severely medically and emo- helps individuals with eating disorders tionally compromised student in their classes. b reak free from “diets” and become empow- YTT e red to make food choices for their highest good. Larissa also learned to enjoy new foods R e f e r e n c e s o ff e red through mindful eating by experienc- 1. South Carolina Department of Mental Health. Eating Disorder Statistics. 2 0 0 6 . ing the taste, texture, and other sensual qual- h t t p : / / w w w. s t a t e . s c . u s / d m h / a n o re x i a / s t a t i s- ities of food along with paying attention to t i c s . h t m . how much she was eating. 2. American Psychiatric Association. D i a g n o s t i c and Statistical Manual of Mental Disorders ( D S M ) Lesson: Yoga teachers often suggest v i n y a s a I V-TR. Washington, DC: A PA ; 2 0 0 0 : 5 8 4 - 5 8 5 . 3. American Psychiatric Association. P r a c t i c e or more cardio-intensive Yoga for weight Guideline for the Treatment of Patients with Eating loss. Someone who struggles with an exces- D i s o r d e r s . 3d ed. Washington, DC: A PA; 2006. sive amount of weight may find similar ben- 4. Stewart SH, Angelopoulos M, Baker JM, Boland efits in a challenging, slow-flow Hatha Yo g a FJ. Quantity and frequency of alcohol consump- class. Yoga is a practice that helps individuals tion in restrained eaters. Psychology of Addictive B e h a v i o r s. 2000;14(1):77-82. to actually experience what it is like to be 5. Boudette R. Question & answer: yoga in the mindful rather than merely talking about t reatment of disord e red eating and body image being mindful in pro g ressive, traditional disturbance: how can the practice of yoga be t h e r a p y. Experiencing mindfulness can help helpful in recovery from an eating disorder? E a t - individuals transfer skills such as learning ing Disorders. 2 0 0 6 ; 1 4 ( 2 ) : 1 6 7 - 1 7 0 . 6. Brewerton TD, Ralston E, Dean M, Hand LD. how to eat when hungry and how to stop D i s o rd e red eating in children with alleged mal- when full, into daily life. t reatment. P rogram and Abstracts from the 153rd Teachers should also be aware of Annual American Psychiatric Association Meeting. whether students want to be touched or Chicago, IL; May 13-18, 2000:Abstract 75B. adjusted in Yoga class, especially if they have a history of sexual abuse, as touching or adjustments may trigger a trauma re s p o n s e . Beverly Price, RD, Some studios have a “no touch” policy, MA, E-RY T, com - which should be honored for the sake of the pleted her Yo g a student's emotional well-being and for the teacher training with eventual successful outcome of the tre a t m e n t Jonny Kest, Center p rogram. for Yoga, Birming - ham, Michigan. She has guidance and It is helpful to work closely with the inspiration from her t reatment team (which may include the med- m e n t o r, Gretchen Rose Newmark, RD, RY T, ical doctor, psychiatrist, psychotherapist, re g- re g i s t e red dietitian, re g i s t e red Yoga teacher, i s t e red dietitian, and the Yoga teacher) in and spiritual dire c t o r. o rder to discuss what type of Yoga practice b e v @ re c o n n e c t w i t h f o o d . c o m would be most suitable for the individual with an eating disord e r. This means keeping an open line of communication and consent by the patient/student. The protocols dis- cussed here may present an opportunity for the Yoga teacher to become involved as a sig- nificant member of the eating disorder tre a t- ment team in an outpatient setting or open doors to involvement in a residential tre a t- ment program. It is often the Yoga teacher in

M a rch 2010 Yo g aT h e r a p yToday 1 8 Service Heals. Community Care And How Yoga Serves the Chronically Il l By Cyndi Terry Kershner

ommunity care is a concept that had its introduction experienced as his ability to breathe comfortably decreased. I with the book Share the Care, by Cappy Capossela committed to working with him a minimum of once a week, C and Sheila Wa r n o c k . 1 In it, the authors advocate an and often twice a week, which I have done for one and a half approach for caring for seriously and chronically ill individuals years. Our sessions always take place on the bed and are by setting up teams of volunteer professionals and laypeople generally an hour and a half long, including transfers to and who can provide many of the services needed to protect and from bed. maintain quality of life. This “community care” approach, as it As Yoga therapists we advocate for a holistic and client- has come to be called, also aims to take pressure off the pri- centered approach to health care that addresses a client's mary caregiver and reduce isolation of both the patient and needs across the spectrum of all the k o s h a s—five layers, or c a r e g i v e r. sheaths, that range from the dense physical body to the more Community care is rich with possibilities. Community care subtle levels of emotions, mind, and spirit. According to the groups, based on the Share the Care model proposed in k o s h a system in Yogic philosophy, the nature of being human Capossela and Warnock's book, perform a wide variety of encompasses physical and psychological aspects that func- tasks, depending on what the particular groups' talents are. In tion as one holistic system. The k o s h a system refers to these my client Fred's case, a number of professionals volunteered d i fferent aspects as layers of subjective experience. As part of for the group who brought skill sets such as Yoga therapy, Fred's comprehensive health care plan, I designed his Yo g a counseling, nursing, and massage. Fred also has volunteers therapy program with the intention of addressing all five who take him to and from appointments, do laundry, and k o s h a s—his whole being. assist him twice daily in transferring from bed to wheelchair. Other volunteers troubleshoot issues with his motorized chair Annamaya kosha, the food-apparent sheath and help him develop new adaptive approaches in his home when needed. Other community care groups will have diff e r- The k o s h a system works from the level of gross to subtle, ent skill bases to draw from depending on who is able to vol- beginning with the annamaya kosha. I began Fred's Yo g a unteer time and expertise, and those who are able to do so therapy program addressing the annamaya kosha. To relieve are the heart of community care services for each patient. pain in his hips and buttocks from sitting in a wheelchair As part of the community care group I joined, I donated throughout the day, I used Thai massage techniques to pro- Yoga therapy services to Fred, who is at the end-stage with vide deep pressure through compression. To help release and amyotrophic lateral sclerosis (ALS), also known as Lou stretch his spine, I helped him perform passive twists, both in Gehrig's disease. ALS is a progressive disease of the nerve his chair and in bed, by applying traction to his legs and neck. cells in the brain and spinal cord, which control voluntary mus- In working with his upper body, passive range-of-motion activ- cle movements. ALS patients experience a gradual loss of ities designed to stretch his shoulders, arms, and hands, muscle strength and coordination in their muscular systems, along with basic massage on his shoulders to relieve the mus- with breathing and swallowing often affected first. Because culature pain associated with slouching forward in his chair, ALS typically progresses quickly, patients with ALS lose the were employed. ability to care for themselves fairly rapidly and require exten- sive help with the tasks of daily living. The average life Pranamaya kosha, the air-apparent sheath expectancy after being diagnosed with ALS is 3-5 years. Fred was not able to do any breathing practices due to the deterioration of his breathing. In sessions, he would lie in bed Yoga Therapy Program while using a Bi-level Positive Airway Pressure (BIPA P ) machine, a breathing apparatus that helps push air into his Fred was seeking help in maximizing his remaining function- lungs. I found other ways to assist his energy in moving such a l i t y. He asked for assistance with the pain he experienced in as Thai techniques, range of motion exercises, and massage. his joints and muscles as a result of confinement to a wheel- He told me that the energy in his body felt much better after chair and the inability to stretch his own limbs. He was also we worked together with these techniques; he reported feel- looking for help in dealing with the generalized anxiety he

19 Yo g aT h e r a p yToday M a rch 2010 ing more clear-headed, and with the pain and tension in his with this meditation for about four months, and according to body reduced, he felt more vigorous and energetic. His face Fred it helped decrease his anxiety level over time. color usually looked healthier as well after we finished this segment of his therapy. Vijnanamaya kosha, the wisdom-apparent sheath This same meditation on the breath also assisted Fred's abil- Manomaya kosha, mind-stuff-apparent sheath ity to cultivate vijnanamaya kosha by helping him step outside With serious chronic illness, and in this case terminal illness, his usual reaction pattern of anxiety and cultivate some co-morbid depression is frequent. Caregivers also typically detachment during the act of breathing. Through the course experience burnout, and the effect of the illness on the of Fred's therapy I have seen his ability to engage with this dynamics of the family system and its functioning is profound. k o s h a grow exponentially; he has deepened his meditation In considering manomaya kosha I noted that Fred had not practice through starting a meditation group, and his level of experienced the onset of depression, and his primary caregiver overall anxiety has decreased markedly as he is able to go had not experienced a significant period of burnout. I believe deeply inside and connect with his wisdom body. this is due to his caregiver designing and implementing an It is also important for the therapist to connect strongly e ffective community care team very early in his illness. with vijnanamaya kosha while engaged in a session. Many Still, emotional well-being resides in the manomaya kosha. times throughout our sessions Fred would experience anxiety During each session, I offered him emotional support by cre- over various things: sometimes he would start coughing and ating a space where feelings about the progression of his ill- not be able to stop; sometimes the wheelchair would malfunc- ness could be discussed. I wanted to make it clear to him that tion; at other times we might have difficulty getting his BIPA P our sessions were a time where he could express his feelings device to work properly. These occasions were stressful for if he wanted to. We would talk for a short time at the begin- both of us, and sometimes it felt like I was working in a hospi- ning of each session about how things were going that week tal ward with all the different high-tech gadgets that he used. and if he had lost any functioning. Whatever came up, I would Whenever we ran into one of these difficulties, I remembered ask about his feelings toward it; sometimes he would want to to engage my witness consciousness so that I would not be talk about his feelings, and at other times he did not. emotionally reactive to the situation. I could not have acted as As a way to connect more deeply with Fred on the level Fred's Yoga therapist if I had not been able to do this. of manomaya kosha, I used therapeutic touch, an energy medicine technique whereby the therapist uses her hands to Anandamaya kosha, bliss-apparent-sheath direct the flow of chi or p r a n a to induce healing in the patient. At the time of his diagnosis, Fred already had a long-standing In Fred's case this simply involved the laying on of hands with meditation practice, which was obvious to me in watching the very gentle pressure to his forehead while I sent healing way he accepted his illness and adapted his life around it. Fred thoughts and prayers to him. I noticed his face and body visi- is my neighbor and I have had the opportunity to see him bly relax when I did this. almost daily in the two years since he has been diagnosed with Fred was expressing a lot of anxiety, however, especially ALS. During this time he has only become more loving, more over the decreased ability to breathe, and this became a ther- compassionate, and more peaceful. It is clear that his spiritual apeutic focus. With each session we worked with a meditation practice helped him immensely in coming to terms with his on the breath from Stephen Levine's book, Healing into Life ALS and that anandamaya kosha was flowering in Fred. and Death. The meditation focused on letting the breath be just as it is and accepting exactly what's there. We worked (continued on page 21)

M a rch 2010 Yo g aT h e r a p yToday 2 0 Community Care continued As the Yoga therapist on his community care team, it has themselves, and his larger community has gotten the oppor- been a joy to be one among a large group of folks who are tunity to get to know Fred in a deep and meaningful context. each taking on different roles to help Fred while also making As a Yoga therapist I have been impressed with the contri- his primary caregiver's life much easier. A leadership group bution that community care can make in encouraging a truly meets monthly to assess his changing needs, troubleshoot holistic and life-affirming path for the seriously or terminally ill challenges, and schedule his sessions with us, though I have patient and their caregivers. I encourage any Yoga therapist not been a part of that group. The larger group of the commu- who works with this population to learn more about it so they nity care team does not meet because there are so many of us, can assist their clients' care providers in setting up an eff e c t i v e but when we do run into each other there is the sense that we community care program. share a common purpose and are part of a team. This is Yoga therapists often have a unique opportunity to observe encouraging to us in our work with Fred and his caregiver. at a deeper level what is going on with our clients, their families, Over the past two years I have been touched watching and caregivers. This ability to look deeper, on the levels of all the Fred's community care program unfold and in seeing the eff e c t k o s h a s , is a strength of Yoga as a healing art. It lends itself to it has had on his quality of life and that of his family. Because his facilitating the type of community care which, as in Fred's case, wife Nancy, who is his primary care provider, invited just about normalized first the experience of serious illness and now the everyone they knew into their journey through ALS together, transition from life to death. Community care created meaning- Fred has had a near constant stream of regular visitors to keep ful experiences for Fred, his family, and his caregivers. YTT him connected to the world and mentally stimulated. The result of the constant support and involvement is that R e f e r e n c e s his illness has unfolded within the support of a strong commu- 1. Capossela C, Warnock S. Share the Care. 2d edition. New York: Fireside Press; 2004. n i t y. Instead of the segregation and fearfulness that typically surround a terminally ill person, Fred's illness has been nor- Cyndi Terry Kershner, RY T-500, is a certified malized and viewed as simply another stage in life that needs Integrated Movement Therapist practicing in to be responded to with compassion, sensitivity, and care. Both Bothell, Washington. Her practice is currently his primary caregiver and immediate family have been focused on neurologically-based movement released from the crushing burden of trying to care for him by disorders. [email protected]

21 Yo g aT h e r a p yToday M a rch 2010 Service Heals. S e v a as Saving G r a c e By Katie Tandon

e v a is the ancient practice of Karma Yoga in its most after she began teaching her friends relaxation and emotional outward expression. It means to be with the self that freedom techniques that she had learned in our therapy ses- S we define as God, human nature, and consciousness. sions. Her action was self-inspired, and I was delighted. Seva has been called “the Holy Spirit in work clothes.” It is the What I have found that so many of my clients have in com- natural manifestation of creative, harmonious, and positive mon is a positive response to therapy that inspires them to energy through compassionate action. learn to love themselves by giving to others. They have taken Through the practice of seva to self and others, suff e r i n g up compassionate actions that have included teaching or can be lessened. One eventually reaches the experience of coaching, volunteering their help at the YMCA, giving to the u n i t y, wherein the heart begins to open and blossom and our p o o r, cooking for the Salvation A r m y, bringing soup to an ailing connectedness to life as a whole is felt rather than merely intel- n e i g h b o r, even working for human rights or environmental heal- lectualized. Then the personality takes on more of the charac- ing. In doing so, they have come ineluctably to several realities: teristic of selflessness and a predisposition develops towards that there are many untapped resources within awaiting expo- altruistic action. This feeling begins to define our sense of sure; that through the practice of s e v a, we come to know the meaning and purpose, and as we engage in s e v a we work to underlying truth of humanity's interconnectedness and are heal self and society from the inside out. therefore never alone; and finally that we are innately valuable. We can create a formidable therapeutic tool around s e v a Rollo May in The Discovery of Being wrote that society was that, through example and instruction, can inspire others to becoming increasingly schizoid in type—tending toward symp- embrace service. S e v a then proves to be both a personal and toms of isolation and alienation like a person whose sense of a social saving grace. relatedness had become broken; that we were increasingly In my counseling practice with those who are depressed marked by a detachment from one another, a sense of unre- or marked by ennui, dysthymia, disconnectedness, or a sense latedness, lack of affect, and depersonalization that we tended of meaninglessness in life, the recommendation to pursue giv- to cover up through a startling propensity for intellectualization ing has proved greatly healing. Sometimes it begins simply and technical formulations. with loved ones. Many married couples have benefited by Whether we see the bestowing of kindness, the giving of being reminded that love is more about tolerance and surren- love, or the formation of empathy as spiritual, psychological, or der and sacrifice than it is about getting one's own needs met. just what mother would approve of is immaterial. The s e v a t h a t It is gratifying when these clients agree to look outside of them- we perform, whatever the context, benefits everyone. Not just selves and join the community or church in assisting those less via whatever acts we perform to the benefit of others, but also fortunate, and then see them come away with a new sense of via the enormous benefit to ourselves in actively countering meaning to their lives and improved self-esteem. the loneliness, listlessness, and isolation that threatens to Through the exercise of s e v a, we learn that singular self- engulf our age. interest is a trap that keeps us isolated. But in making connec- I seek to share personal learning of the immense joy of tions and in giving, we learn to identify goodness as our essence. giving through such actions as offering free classes or extra I have treated many clients plagued by addiction who time to clients, feeling heart connection to others in Sufi heal- have found meaning by helping others through programs ing circles, knowing the deep joy of bestowing peace and a based on the Twelve Steps of Recovery. These programs sense of connectedness to students of meditation, or assisting were conceived to foster emotional healing by connecting to a child's healing through empathy. one's capacity for compassion, first toward oneself and there- In my clinical practice I have often experienced the sudden fore toward others, and by guiding those less far along on the insight that marks intuitive knowing, and suddenly the real path. One client finally turned a corner with alcohol addiction problem is clear. Then the healing routes blazed by the and stopped relapsing after he agreed to become a peer coun- Humanist schools open naturally: empathy as the path to self- selor to my other clients in need. Another client, a young child acceptance and the drive toward self-actualization. with an intractable phobia, really only started making progress These approaches have much in common with Yoga psy- c h o l o g y, something that has been p(rcoopnotuinnudeedd ofno rp age s2 3in)

M a rch 2010 Yo g aT h e r a p yToday 2 2 Seva as Saving Grace continued yogic scriptures for pursuit of equipoise—mental ease and balance. Part of the pursuit of equipoise exists in the practice of s e v a. Yogic philosophy teaches that through s e v a, we begin to wipe away a lifetime or lifetimes of accumulated s a m s k a r a s—the unconscious mental images, fears, and old wounds that hold us back from evolv- ing easily. Thus to help our clients evolve, we have the choice to teach the use of s e v a in our therapeutic practices. Perhaps as our clients grow, and through them and their children, society begins to right itself from the inside out. It is a graceful tool we create when we teach both the personal and social benefits of tolerance, kindness, and peacefulness to the harbingers of our future societies. This would indeed constitute grace, and a saving one. YTT

Katie Tandon, RY T, has been a certified Yoga teacher since 1983. She is also a Dance Instructor, Certified Massage Thera - pist, Licensed Counselor, Certified Employ - ee Assistance Professional, Certified Child and Adolescent Psychotherapist, and Certi - fied Addictions Counselor Diplomate. In pri - vate practice she incorporates Yoga Psy - c h o l o g y. She has received initiation in mys - tical schools of Yoga, Buddhism, and Sufism. [email protected]

23 Yo g aT h e r a p yToday M a rch 2010 onPractice by Jennie Lee Magic Carpet or Life Raft A Yoga teacher's journey through dark territory womb. I left the hospital with empty arms to personal transformation through the practice and a shattered heart. Going home to a of Yo g a . baby's room with no baby left me with nothing but stillness. But not the peaceful hen I found out I was pregnant, I kind. I stepped off my mat and into a med- was angry. I had just got my life itation in the cave of human pain. I sat for W working exactly how I wanted it. hours in a rocking chair in her room, hold- A baby meant massive change ahead. ing the tiny little urn of ashes, wondering Immersed in an exciting career in entertain- what practice might make the longing go ment, I was 34 and practicing Yoga for all its a w a y. Nothing did for two long months, physical benefits—extreme flexibility, tight until one night, in the quiet of sitting and abs—and the really hot male instructor I praying, a moment of grace entered on a hoped would adjust me in triangle pose. deep breath. Whether it was her as an Those seemed like the benefits to Yoga. But angel, or God talking, I don't know. But with a basketball in my belly this would all what I heard changed everything. “It is change—and I didn't want change. time to rebuild the spiritual warrior within. For several months, I raged at God and Get up and get present with your son. Tru s t made no modifications in my practice. Then the practice.” one day, feeling the exhaustion of pre g n a n c y, I began to move—basic a s a n a , an u j a y i i I opened my Yoga mat at home, curled up in b reath or two, a few moments of medita- a simple b a l a s a n a, and sobbed. When the My physical strength re t u rn e d tion. Feeling challenged just to get thro u g h tears subsided, I sank into a slow nadi sod - and with each intentional each day, I decided to show up and practice h a n a. Soon a stillness unlike anything I had b reath I became more engaged something, anything. Thinking was over- felt in the steamy, energetically charged Yo g a whelming and sad. But I could practice— studio where I normally practiced descended with daily experience. s i m p l y, unattached, and aware . like a warm blanket around my shoulders. I felt totally disconnected from my With a marriage already on the rocks, a Ashtanga Yoga Practice Manual, since there b o d y. After all, this was the vehicle that c a reer in acting and modeling soon to be w e re no classes in the are a . failed to deliver the baby girl I had carried sidelined, a body that was no longer totally Then at the fifth month, we learned the and loved. But with gentle a s a n a p r a c t i c e , mine, and no idea how I would be as a par- baby was significantly underdeveloped and eventually I stopped hating my physical ent, I just knew—somewhere in the quiet of p robably would not live to be born. Lost self, recognizing that I couldn't be peaceful my being—that everything would be okay. between grief and denial, I returned from the with others if I couldn't begin within. My W h e re had this deep peace come fro m ? ultrasound, rolled out my mat, and collapsed physical strength returned and with each S u rely it was grace. My Yoga mat suddenly into an ocean of tears. My Yoga mat now just intentional breath I became more engaged felt like a magic carpet. felt like a life raft. with daily experience. Although I still In the remaining months of the pre g n a n- missed the child we did not have, I was no c y, I clung to my life raft for sanity and hope, longer wracked with the debilitating emo- Fast forward two years… for faith and strength. Month after month, the tional pain of loss and grief. baby inside of me grew and so did something I left Los Angeles, with all its glamour and deeper from the Yogic teachings that I hadn't opportunity—said goodbye to friends, fam- realized was there—something more lasting Yoga had become my Therapy i l y, care e r, convertible, and hot Yo g a than the thrill of holding a perfect v i r a b - t e a c h e r. Trying to preserve the marriage, I h a d r a s a n a or a spectacular v r k s a s a n a. A s e n s e Depending on the emotional wave of the came to live at a New England board i n g of peace and clarity had come through years d a y, each morning my mat would become school where my husband had taken a job. of practice that even during this most trying either magic carpet or life raft. Move, Nothing and no one was familiar. I was try- time imaginable did not falter. b reathe, focus, turn inward, be still, bliss. ing to be a good mom to our baby and, now Bliss? How could I be feeling bliss after los- p regnant with another, struggling with ing a baby? Bliss or misery. The choice was d e p ression and a severe sense of isolation. U n t i l … mine, and I knew it. Only my Yoga mat felt safe and familiar, I poured myself into the study of and I went to it each morning, teaching At nine-and-half months, only ten days Patanjali's Eight Limbs. Through the y a m a s myself new a s a n a s f rom David Swenson's b e f o re the due date, our baby died in the and n i y a m a s, I felt (continued on page 25)

M a rch 2010 Yo g aT h e r a p yToday 2 4 onPractice, continued

Yoga is not about a destina- In my 30s I learned to understand my emotional energies. Allowing myself to fully tion or accomplishment, but feel but also to let go of feelings, I learned rather the unfolding of experi- that I am more than the ebbing and flowing ence and the ability to re a l i z e tides. Now in my 40s, my practice has oneself as more than that evolved me into someone who can be pre s- e x p e r i e n c e . ent with whatever is occurring, without hav- ing to do anything other than love and be. I lovingly directed on how to reenter life. s h a re this with my students so they will A s a n a and p r a n a y a m a kept me connected to know that Yoga is not about a destination or my body. Practicing pratyahara, dharana, and accomplishment, but rather the unfolding of d h y a n a d i rected my vision toward the one- experience and the ability to realize oneself ness where we all share both pain and hope. as more than that experience. I started to tre a s u re the simple moments of Over the past 15 years, I have survived p a renting my son and realized that I wasn't some of life's most tumultuous waters—loss angry anymore. I was simply grateful. of a child, a marriage, a home, a care e r ; But just a year later, too strained by the s e v e re depression, anxiety, stress, and grief. loss of our second baby, my marriage ended. My practice has found me wherever I am, And yet again I found myself challenged to asked more from me than I thought I could reach even deeper into Yoga for a lifeline, give, and re w a rded me tenfold with something to get me through another mas- s t rength, energ y, and renewed hope. sive change. I never could have imagined this jour- Then the biggest realization of all hit. ney way back in my “hot” Yoga class in Los T h e re was nothing to “get through.” It was Angeles. To say that I feel gratitude for Yo g a e x t r a o rdinarily clear. Every tear, every peal doesn't even come close to describing the of laughter—it is all Yo g a . debt I owe to this tradition. I would not be here I knew I needed to share this with oth- now without it. For this I bow my head and ers who were suffering. I opened a studio whisper om. YTT and began working with people in a pro c e s s that echoes my personal experience and one that I call Transformative Yoga Therapy. Jennie Lee is the Eight years later, I am awed by how this founder of Stillness in practice has met me every step of the way. Motion Yoga & We l l- No matter what waters of emotional circ u m- ness in Newburyport, stance surround me, I know I am safe inside MA. She specializes the practice. No matter how I get to my mat, in Tr a n s f o r m a t i v e with laughter or tears, energy or exhaustion, Yoga Therapy. Wi t h once there, I rest knowing that like a gently over 20 years' experi- rocking raft, my practice holds me as I flow ence, Jennie is com- t h rough the river of life. mitted to sharing Some days I chant with abandon or lux- truth and love through Yoga as a writer and a uriate in feeling my limbs expand in a d h o re t reat and workshop leader internationally. mukha svanasana. Other days I pray not to fall w w w. s t i l l n e s s i n m o t i o n . i n f o o ff my raft into the swirling currents of emo- tional re a c t i v i t y. Standing tall in t a d a s a n a, I ask Spirit to give me something of value to say to those who come to me for inspiration. People say their practice evolves over the years, but over time it is my practice that has evolved me. In my 20s, driven and deter- mined, the practice awakened my physical being into all of its intricate sensations and earthly pleasures.

25 Yo g aT h e r a p yToday M a rch 2010 OnMedia

fies to their inner experience and under- e a s y - t o - read breakdown of Yoga philosophy standing. In addition, their compassion for (the y a m a s and n i y a m a s , the k o s h a s, the k l e s h a s , their own processes of healing, as well as and practices such as p r a t i p a k s a) that is easy to that of their clients and the book's readers, is read and understand. Yet as a clinical psy- one of this book's best features. This self- chologist, Yoga teacher, and Yoga therapist, compassion is one of the hallmarks of the my perception is that the majority of the most text, and it models the self-compassion that helpful exercises in this book could perh a p s is essential-but typically so hard to convey- best be described as cognitive and behavioral. in the process of healing from anxiety. These exercises, such as the well-described The authors offer several thoughtful replacing of negative thoughts with positive and well-designed techniques for develop- ones, and the myriad of ways they offer re a d- ing self-awareness. Some of the highlights ers for compassionate self-touch, which is a include: a compassionate witnessing of one's building block to self-compassion, speak to Yoga for Anxiety inner experience, the generation of self-com- the authors' strengths. There f o re, the book By Mary NurrieStearns and passion, the development of a re l a t i o n s h i p might be better re p resented by a title such as Rick NurrieStearns with silence, linking silence with anxiety, Holistic Practices for Anxiety Relief. New Harbinger Publications and how to direct awareness. They begin Although the Yoga poses off e red in the 2010 these reflection exercises, especially the more book are accompanied by simple, well-pho- complex ones, with basic exercises, re t u r n- tographed images, the authors could also n the beginning pages of Yoga for Anxiety, ing again to the same exercises but adding o ffer modifications for readers with injuries, authors Mary NurrieStearns and Rick m o re complex elements that deepen the or for tighter bodies. Since the model used in I NurrieStearns state, “This book isn't just experience. This user-friendly appro a c h the photos is quite flexible, alternative ver- about anxiety; it's fundamentally about allows the reader to develop skills sequen- sions of postures would help ensure that learning to be calm and contented.” This t i a l l y, which is encouraging to people suff e r- readers are not discouraged or confused by statement underlines the central message of ing from anxiety. i n s t ructions. the book and the primary takeaway message In my opinion, one of the more transfor- Despite this, the cognitive and aware- for its readers. As the authors say, knowing mative passages of the book is the section ness exercises in this book make it a valuable anxiety helps to dispel it. They back up their entitled “Allowing What Is,” in which they and recommended re s o u rce in working with p romise by taking us through a series of per- s t a t e : a n x i e t y. Yoga teachers-in-training, as well as sonal inquiry exercises that help us make Mindfulness involves accepting what is, Yoga therapists, will find a wealth of accessi- sense of our anxiety, unplug from the stimu- and it's through this acceptance that anxi- ble techniques for developing self-aware- lation of the outer world, and get to know ety is reduced. This acceptance includes ness and sitting with anxiety that can be ourselves better. thoughts, emotions, and physical sensa- adapted for group classes and private work The book begins, in its intro d u c t i o n , tions. It's impossible to accept what you (with the caveat, of course, that working with a disarming, empathic personal narra- don't allow yourself to be aware of. Let's with people with debilitating anxiety may tive about the authors' experiences of anxiety apply this to anxiety. “Allow” signifies re q u i re additional training). that immediately put the reader at ease by consenting to, letting it be, and giving Yoga practitioners who have experi- showing that the authors know anxiety yourself permission to feel anxious. We enced the healing impact of Yoga, and inside and out. Mary is a psychotherapist recognize that you don't want to feel anx- would like to augment this with gro w i n g and a Yoga teacher, and Rick is a meditation ious and that you're probably whispering, s e l f - a w a reness, will also find it empowering t e a c h e r. Their combined professional back- “Why would I want to feel anxious?” The and useful. I would also highly re c o m m e n d g round, along with their personal and pro- answer is that doing so empowers you to it for people with anxiety who are underg o- fessional experiences with anxiety, offer a b reathe through your anxiety so that your ing psychotherapy as a means of embodying wealth of wisdom and give context to the resistance doesn't intensify it or cause you the insights gained in their therapy, and also book's exercises, many of which are culled to be paralyzed by it. for psychotherapists who wish to incorpo- f rom the parallel fields of mindfulness med- rate some of the simpler exercises into their itation, psychotherapy, and personal growth. The authors then follow up this valu- therapy practices. YTT The strong influence of the authors' per- able insight with exercises that help the re a d- sonal practices in Yoga and meditation re a d- er sit with, get to know, and accept his or her ily transmits through the pages of this book; a n x i e t y. This is, clinically speaking, one of Bo Forbes, PsyD, is a clinical psychologist, Yo g a they both have clearly committed to the the hardest tasks for people dealing with t e a c h e r, and Yoga therapist in the Boston are a . practices in the book and found them to be a n x i e t y. The authors address this central She is the founder of Elemental Yoga, director of helpful. They demonstrate a clear sense of issue empathically, eloquently, and in a way the Elemental Yoga Mind-Body Teacher Tr a i n- the inner experience of the practices as well that is re a d e r- c e n t e re d . ing Program, and director of the Center for Inte- as potential stumbling blocks (this last is rare Yoga is an integral part of the book's grative Yoga Therapeutics in Boston. in the genre of self-help books). Further- p romise, as seen in its title, Yoga for Anxiety. b o f o r b e s @ a o l . c o m m o re, the intricacy of their instructions testi- The authors offer an effective, eloquent, and

M a rch 2010 Yo g aT h e r a p yToday 2 6 onMedia, continued

Yoga for Osteo- medications used to treat osteoporosis, and porosis, modifications for persons with porosis: The the role of exercise in the prevention and osteopenia, and the classic version of each C o m p l e t e t reatment of bone loss. Evidence is pro v i d e d pose for prevention. Each pose has bullet G u i d e to dispel the notion that osteoporosis is a points detailing the purpose of the pose, By Loren Fishman, woman's disease, and the authors re f u t e including which bones/sections of bones are MD and Ellen another long-held belief that simple weight- being strengthened, contraindications of the S a l t o n s t a l l bearing exercise is an effective way to pose, props needed, and ways to avoid pit- W. W. Norton & i n c rease bone mineral density. They ask the falls of the pose. Photos and straightforward Company reader to ponder why nonweight-bearing i n s t ructions accompany each pose. 2 0 0 9 arm bones are far less likely to fracture than The book's A f t e r w o rd provides informa- weight-bearing bones such as the hip, pelvis, tion for readers who would like to participate o m p rehensive and supremely re l e- and vertebrae. Here they present the crux of in the ongoing re s e a rch on Yoga and bone vant to the profession of Yoga thera- their work: it is not just weight bearing that mass. Research like this is invaluable to the C p y, Loren Fishman, MD, and Ellen s t rengthens bone, but the unconventional integration of Yoga into Western healthcare . Saltonstall's book, Yoga for Osteoporosis, d e l i v- pulling of opposing muscles on that bone. As a physical therapist, I found Yoga for Osteo - ers powerful information that will impact the Yo g a — m o re so than any other form of exer- p o ro s i s to be an extremely valuable re s o u rce. I c a re of the millions of people worldwide with c i s e — p rovides just that: the unconventional have already begun using this information low bone mass. This book is based on the suc- pull of opposing muscles on bones. and the Yoga sequences with patients and cessful initial outcomes of ongoing re s e a rc h The re a d e r, armed with all this knowl- clients. Given the high rates of osteopenia and into Yoga's effect on bone mineral density and edge from the first seven chapters, is ready to o s t e o p o rosis worldwide, this book is a must- is written for Yoga teachers and therapists, examine the Yoga programs created by the have for any healthcare professional, Yo g a h e a l t h c a re providers, and anyone of any age authors. Integrating Iyengar and A n u s a r a t e a c h e r, or Yoga therapist. YTT who wishes to increase their bone mass. methods, three sequences are given in thre e The first several chapters of this book separate chapters: poses for bone stre n g t h , dive into the alarming statistics about osteo- poses for muscle strength, and poses for bal- Trisha Brabender, PT, MS, is a physical therapist p o rosis and related fractures, the physiology ance. Every pose is presented three ways: and Yoga instructor in Lawrence, KS. of bone building and bone breakdown, the with modifications for persons with osteo- i l i v e w e l l @ s u n f l o w e r. c o m

27 Yo g aT h e r a p yToday M a rch 2010 Inside Chronic a r rogant, but I work exclusively with people Pain: An Inti- with chronic pain. I should be good at these mate and Criti- things alre a d y, or so I thought. cal Account After reading the book, I am listening to By Lous Heshusius my students and patients in a new, more cir- Cornell Press cumspect, and even more compassionate 2 0 0 9 w a y. I also find myself choosing diff e re n t w o rds now when explaining pain. These new words relate to both the pain and the p e r s o n . The changes I've experienced also nside Chronic Pain is a rare and powerfulextend into how I am teaching Yoga and book. It is a must-read for anyone who teaching healthcare professionals. After a I considers him- or herself a Yoga thera- recent course for medical doctors, one partic- pist. This engaging patient narrative takes us ipant told me that he had always been pro u d into the world of a person with unre l e n t i n g of treating the pain well, and now he knew pain, forcing us to look deeply into the he needed to treat the person in pain just as human aspects of chronic pain. It also opens much. I would not have been as successful in our eyes to the fact that the words and helping create this new view without the actions of people in pain may not fully wisdom I gained through reading Heshu- reflect either their pain or suffering. Chro n i c sius's narrative. pain is a silent epidemic. I highly recommend this book to all Heshusius makes no mention of a s a n a Yoga teachers, re g a rdless of whether you practice or of using Yoga as part of her pain focus on people in pain. The style of a s a n a management. However, don't let this deter you teach has little to do with the amount of you from reading and learning from such a pain your students may be feeling. As Hes- w e l l - re s e a rched book. The experiences she husius points out, people in pain get tired of describes are common among many with talking about it. We shouldn't assume that c h ronic pain, and she includes information what we see on the outside tells us about f rom many other authors in related thera- internal experience. peutic fields. Inside Chronic Pain will help open our Heshusius opens the book's intro d u c- hearts as much as it will help us question our tion with “How do you put hell on paper?” beliefs and attitudes toward people in pain. This fully sets the tone of this critical, yet not YTT p u rely negative, experience of injury and pain medicine within Western healthcare systems. It is striking how well Heshusius Neil Pearson, RY T-500, is certified in Phoenix describes what most cannot put into word s ; Rising Yoga Therapy. He is a physical therapist her isolation, loneliness, and despair will be working exclusively with people in chronic pain, shocking to many readers. She pro v i d e s a clinical assistant professor at UBC in Va n c o u- views of how well-meaning yet misguided v e r, and founding chair of the Canadian Physio- attitudes and beliefs about pain and people therapy Pain Science Division. Based in Pentic- in pain can actually worsen suffering rather ton, Canada, Neil travels extensively teaching than alleviate it. She also explains in detail pain science, pain management, and therapeutic aspects of the unfortunately few positive Yoga for people with chronic pain. interactions she had with healthcare pro f e s- w w w. l i f e i s n o w. c a sionals in dealing with her chronic pain. Had you asked me before I read this book if I believed I had a good understand- ing of the experiences of people in pain, I would have said yes. Had you asked me whether I thought I needed to change the way I listen to and talk with people in pain, I would have said something like, "Of course, we can always learn to be better, " though I would have wondered how much better I could get at this. I know that sounds

M a rch 2010 Yo g aT h e r a p yToday 2 8 onBusiness by Susi Hately How a Business is Like a Yoga Practice

've met a number of Yoga teachers who worked and I had more freedom and more student. The result is the feeling of being s t ruggle with building their Yoga busi- flexibility to teach and build my business. pulled in diff e rent directions and unable to I nesses. They express fears that business A p p a re n t l y, though, there was still more for find your own center. I hear teachers justify- and Yoga are like oil and water and that me to learn. ing their exhaustion with stories like this: making a living teaching Yoga is just not My next lesson would come in a more “When you become a teacher your Yo g a possible. I'd like to offer a diff e rent view, one personal way. My twin sister suddenly practice suffers,” and “When you become a which illustrates that Yoga and business are passed way, and the earth was pulled fro m Yoga studio owner your Yoga practice indeed energetic matches, both requiring an under my feet. I was in a fog for about a year, becomes nonexistent.” I don't agree that it authentic attunement with our deepest self. doing what I could to stay sane, but bare l y has to be this way. Remember the airplane And, when that doesn't exist, either an “on holding on. So I stopped and let go of every- oxygen mask lesson: put the mask on your the mat” Yoga injury or an “off the mat” thing that didn't fully resonate with me. I face first before helping another. business burnout re s u l t s . fine-tuned. It's said that we eventually I understand that there are inherent dis- My Yoga business began in 1999 with become grateful for the rough patches and tractions in life that particularly impact a one Yoga class at a well-known local studio. I'd have to agree. Much like a Yoga practice Yoga teacher. We teach quietness and still- F rom that one class and through the next 11 that becomes smoother after overcoming an ness, yet information pours into our lives years, I would hone my skills in therapeutic obstacle or facing a challenging a s a n a, my and the management of registrations, class Yoga, meditation, and anatomy, while simul- life and business became much more satisfy- plans, bookkeeping, accounting, and build- taneously developing a successful and well- ing and successful from those two lessons: ing a business can be overwhelming. What I respected therapeutic Yoga practice called focusing and letting go, two things we am offering is another way. You don't have Functional Synerg y. I'd publish nine books, would do well to practice every time we step to be run by your business when you find including one translated into Japanese and on the mat. the Yoga within your business. Then you can Chinese, two DVDs, two CDs, and a series of experience a sense of quiet amid the ups, podcasts. I'd create and continue to nurture Whatever it is, identify your downs, and curveballs that come with build- a well-received therapeutic Yoga teacher- priority and give time to it ing and running your business. The key is to training program, as well as create and train every day. get clear on what is important and to re c o g- teachers in the Yoga Thrive: Yoga for Cancer nize that obstacles in business are much like Survivors re s e a rch program that occurred at Let's take a closer look at those two abil- your challenges on the mat. the University of Calgary. ities; focusing and letting go. It helps to be It may seem like quite a bit to have cre- able to identify what is most important in ated since 1999, but I have always believed your life and connect with it, focus on it, Obstacles, Challenges, and Tu r n- that people tend to overestimate what can spend time with it every day. It could be ing Them into Opportunities happen in a year and underestimate what f a m i l y, friends, faith, finances, or fitness. can happen in a decade. Looking back, I Whatever it is, identify your priority and When I think about those challenges on my remember how each step felt so organic, so give time to it every day. When you do, mat, they typically come from not having natural, and in a sense, quite in line with the you'll find the other parts of your life tend to enough of one or more of the following: o rganic and natural rhythm of my own Yo g a work out on their own. s t rength, mobility, stability, stamina, practice. Still, it didn't happen without Letting go. It comes naturally to some patience, or knowledge. It is similar in busi- obstacles. I went through times where I people. When they get sick they take to their ness. When faced with an obstacle it is often chose poor business partners, hired Yo g a bed, ingest their elixirs, and rest-up to well- because the old way is no longer working teachers who didn't work out, and times ness. There are others, however, who don't and one of these qualities is missing. If it is w h e re I worked far too much, and suff e re d - know when to stop; they keep going even because our knowledge is limited—we may what I see as common in our pro f e s s i o n — when they are tired or run down. The more not know Quickbooks or be very technolog- burnout. Twice. w i red or tired they get, the harder they push. ically savvy—these skills need to be learned The first burnout was because I was Anyone who has ever overstretched on the or delegated. Patience becomes a factor handling a full load of teaching in addition mat knows that this will lead to suffering in when we have the skills and we are doing to heading up marketing, overseeing staff , the long run. what needs to be done, but it's feeling like a and keeping the books for my studio. I Distractions of all kinds on or off the slog and we aren't seeing the gains. Much quickly learned that in order to gro w, I need- mat can keep you from both focusing and like the elusive pose that may simply need ed to focus on what I was good at. So, I hire d letting go: obsessive email checking, an time to emerge, if we give ourselves time, if a bookkeeper, an administrative assistant, inability to turn off the cell phone, or the ten- we let go enough, the challenge will soon and a graphic designer. The delegation dency to act immediately on a call from a turn into an opportunity.

29 Yo g aT h e r a p yToday M a rch 2010 In 2005, I had a bustling Yoga studio contract. They accepted the book as it was, Susi Hately trains with five teachers and an office manager, which is virtually unheard of in the publish- Yoga teachers in ther- and during the year prior, I had launched ing world. Soon after, they secured fore i g n apeutic Yoga and my first book, Anatomy and Asana: Pre v e n t i n g rights for the book in Japan and China, and runs a business school Yoga Injuries. I had about 200 books left in I've just found out they are looking into for Yogis twice yearly stock and I needed to do another print run (I K o rea. An obstacle turned into an opportunity, in To ronto and Cal- had self-published my book). But I faced an which, since 2005, has continued to pay me g a r y. To reach Susi obstacle. I had other books I wanted to write g reat dividends every six months. It wasn't visit www. f u n c t i o n a l- and publish, yet I also had a studio to over- just good fortune. I had learned my lesson; I s y n e rg y. c o m . see. I was in a quandary. had let go and had gone on vacation. When I returned, I focused and got to work. I understand that there are Building a business can be fun. Like a inherent distractions in life Yoga practice, some days it feels really good that particularly impact a and other days not so good, but as we prac- Yoga teacher. tice we continue to improve and pro g re s s . We learn more about ourselves, and about So I went on vacation—I had learned what we are doing both on and off the mat. well from my first burnout lesson. It was a We get quieter, and feel how the energ y warm August, and as I sat by the ocean chat- between the practice of Yoga and practice of ting with my nephews, I had one of those business is just a mat away.YTT spontaneous insights: why not sell the first book to a publisher? Brilliant idea! When I got back from vacation I got to work and emailed a publisher I had contacted earlier. My timing was perfect. Within six weeks they had reviewed my book and sent me a

M a rch 2010 Yo g aT h e r a p yToday 3 0 OnMembers by John Kepner, Executive Director Annual Report to Members

009 was a challenging year financially Educational Standards Committee. The pro- our profession to others in Yoga as well as for IAY T, as well as for many of our gram was closed in early 2009 in order to complementary fields. Julie Deife, as editor- 2 members and, of course, most of the focus our work with a fixed set of school in-chief of Y T T, has over ten years of editorial world. We ended up in the red for the first p rogram directors—what might eventually leadership experience with Yoga publications, time since our renewal in 2004. Yet we develop into a Council of Schools. This pro- including the past year with IAY T. accomplished a great deal and we also gram reopened at year-end 2009, with seven Madeline Groves is our advertising added important new services. The way I new members alre a d y, and it remains open manager for both publications. Many of you see it, IAYT is striving to be a full-service at this time. Schools are a key pillar of the know her from her cheerful service, and I am p rofessional association with a small mem- f u t u re of our field, and IAYT is doing all we hoping many more of you will get to know bership base, so we have to provide extraor- can to support schools. A full list of curre n t her too. We have a uniquely focused and dinary service to members and be exception- I AYT Member Schools as of January 2010 experienced audience, so advertising with al financial stewards of our nonprofit org a n- appears on page 34 of this issue of Yoga Ther - I AYT is an economical and efficient way to ization—even entre p reneurial with re s p e c t apy To d a y. All schools can now be found on reach them while supporting your org a n i z a- to financing our services. the new Find a Member School function on tion at the same time. “Full service” means the full set of pro- our website, in large part due to the dedicat- fessional association programs needed to ed work of our long-time webmaster, Jean serve our members, our mission, and the S t o j k o v. The new look on the home page is C o n f e r e n c e s the creative work of our long-time graphic public. In the case of IAY T, our core services I AYT presented our third Symposium on a re professional publications, a pro f e s s i o n a l d e s i g n e r, Linda Getz. Yoga Therapy and Research (SYTAR) in c o n f e rence, and most recently the develop- Membership Services is led by Jesse M a rch 2009, with over 600 attendees, slight- ment of educational standards for the train- Gonzales, our intrepid Membership Manag- ly more than 2008. We owe a tre m e n d o u s e r, and now also supported by Ron Barro n , ing of Yoga therapists. All of these are thanks to Ve ronica and Ivan Zador of Yo g a a n c h o red by membership services. We also who was recently named membership and Developments for their innovative and hard re p resent our field in integrative, comple- operations consultant for technical and qual- work in producing this conference thre e m e n t a r y, and alternative medicine forums. ity improvement. years running. New to SYTAR in 2009 were Let me highlight the accomplishments I AYT's Common Interest Community (CIC) f rom last year in each of these areas and at P u b l i c a t i o n s sessions, which allowed more of our mem- least modestly recognize the people making The 2009 International Journal of Yoga Therapy bers to share their work with peers. A c c e p t- it happen. Where possible, I will provide a ( I J Y T ) was by far our largest issue ever; at ed abstracts from all of the CIC sessions are special focus on how we are financing the 152 pages, this issue was 32 pages longer posted on IAYT's MetaPress site as a special d i ff e rent parts. than the previous year's. The growth in qual- supplement to the I J Y T. Many of the pre s e n- ity and size of this publication is substantial tations are also posted on IAYT's Digital M e m b e r s h i p evidence of the leadership of Kelly McGoni- R e s o u rces Library (DRL). Your association continues to gro w, but gal, PhD, the journal's peer reviewers, and On October 1-3, 2010, IAYT will pre s e n t m o re slowly. As of year-end, we had 2,626 especially the authors. 2010 will be Kelly's our first Symposium on Yoga Research (SYR) c u r rent members, an 8% increase from 2008, fifth year as editor-in-chief, and 2010 is the at the Himalayan Institute, Honesdale, Penn- but slightly down from our membership twentieth anniversary of the I J Y T. sylvania (see announcement page 38). SYR peak of 2,700 in October 2009. With re l u c- All legacy issues of I J Y T w e re posted to will be much smaller than SYTARs of the tance, we raised our base membership fee I AYT's professional journal hosting site, past, but it will also be the first compre h e n- f rom $75 per year to $90 per year last Octo- M e t a P ress, in 2009, due to some truly intre p- sive academic meeting on Yoga therapy b e r, which is still quite low by association id service by Jesse Gonzales. This allows re s e a rch in North America. Of high impor- s t a n d a rds. We also provided a new option, members to search all back issues of the jour- tance is that our initial work on SYR was however: a worldwide digital-only member- nal. (Our service with MetaPress also allows financed by charter sponsors Healing Path- ship at $75 per year that provides all services I AYT to provide libraries with pro f e s s i o n a l ways Medical Clinic and the Yoga Researc h except hard-copy delivery of publications. subscription re s o u rces that include both and Educational Foundation as Gold spon- I AYT's Member Schools Pro g r a m , I J Y T and Yoga Therapy To d a y) . sors; and the Institute for Medical Yoga, the established in 2008 with 48 charter members, Yoga Therapy Today (YTT) was launched Integrative Restoration Institute, and Yo g a recognizes the pioneering schools in our in March of 2009 as a beautiful and expanded Therapy Rx as Silver Sponsors, to all of field and helps students find the right pro- evolution of Yoga Therapy in Practice, and you whom we extend a special thanks. Sat Bir gram for them. School membership fees a re now viewing the first issue of 2010 (Y T T i s Khalsa, PhD, is chairing the scientific com- financed the 2008 Survey of Yoga Therapist published three times per year: March, June, mittee, along with Eleanor Criswell, EdD, Training Programs and the 2009 Meeting and December). In addition to facilitating Kim (Karen) E. Innes, MSPH, PhD, Robert with Schools held along with SYTAR 2009. communication within our membership, Y T T S a p e r, MD, MSPH, and Lynn Waelde, PhD. I Now those fees are financing the work of the is an important way to introduce IAYT and am chairing the administrative side, with

31 Yo g aT h e r a p yToday M a rch 2010 Ms. Traci Childress as conference manager. service. The names of all members of the I AYT is a member of the Academic Con- Thanks also go to those involved at the Educational Standards Committee are also sortium on Complementary and A l t e r n a t i v e Himalayan Institute for their enthusiastic posted on the IAYT website. They are lead- Medicine (ACCAHC), which published a support of SYR, especially their visionary ers in our field who donate considerable landmark book for complementary and alter- executive dire c t o r, Matthew Douzart. time and talent. We are committed to an native medicine late last year, entitled C l i n i - open process on this work, and the minutes cians' and Educators' Desk Reference for the S t a n d a r d s f rom the meetings are posted in IAYT's DRL Licensed Complementary and Alternative Health - The IAYT Educational Standards Committee in the group entitled “Member Schools and c a re Pro f e s s i o n s . Appendices were provided for began holding monthly teleconference meet- the Educational Standards Committee.” a few of the unlicensed disciplines, including a section on Yoga therapy written by yours ings in October 2009 and an initial face-to- face meeting is scheduled for March in A l b u- Of Note t ru l y. This is an excellent book for you and q u e rque, NM. I am quite pleased with the At the North American Research Confere n c e your colleagues who may be involved in inte- p ro g ress so for. We are greatly helped by the on Complementary and Integrative Medi- grative, alternative, and/or complementary medicine programs. All profits go to support exceptional service of Daniel Seitz, JD, EdD, cine in 2009, Sat Bir Khalsa, PhD, chaired the our consultant. Dan provided an excellent symposium “Research on Yoga as a Thera- ACCAHC (see ad in this issue on page 13). overview of the issues at our Meeting with peutic Intervention,” which attracted 100 Schools in March 2009, so IAY T, along with attendees. IAYT supported Sat Bir's work F i n a n c e s the National Ayurvedic Medical A s s o c i a t i o n t h rough the help of Goran Boll of the Insti- I AYT appeared to be heading for financial and the Yoga Alliance, supported the tute for Medical Yoga in Sweden. t rouble in July. But due to the quick, innova- re s e a rch and writing of a formal paper by I AYT made our first appearance at a tive thinking of our then president, Matthew Dan entitled “Regulatory Issues for Yo g a , Yoga Journal c o n f e rence (Estes Park) to sup- Ta y l o r, we issued a special appeal to our Yoga Therapy, and Ayurveda.” The purpose port the conference theme, Healing with Yo g a, membership that received a heartwarming of this paper is to help all of our members w h e re we were re p resented by IAYT board response. All donors as of press time were better understand the complex issues members Betsy Murphy, Matra Raj, and gratefully acknowledged in the 2009 IJYT. involved in the self-regulatory efforts all of Molly Lannon Kenny. Molly also led a panel All subsequent donors, as well as our 2009 us are involved in. This paper will be pub- discussion with Chase Bossart, Bo Forbes, P a t ron and Supporting Members and new lished in the 2010 I J Y T, but it was posted on and Gary Kraftsow on standards for Yo g a Sponsors, are thanked in this issue of Y T T the IAYT website in December as a public therapists. (see page 36). (continued on page 33)

M a rch 2010 Yo g aT h e r a p yToday 3 2 onMembers, continued

In brief, the financial challenges were T h e re will also be a pre c o n f e rence work- “sponsor an IAYT program page” entitled due to a combination of the general econom- shop: Yoga Research 101-The Basics of Yo g a “Helping IAYT Thrive is Worth the Eff o r t . ” ic recession, the scheduled ending of a sig- R e s e a rch for Therapists, Instructors, and nificant grant, and the continued expansion New Investigators. Our priorities for 2010 are of services that just needed to be done, such Information on SYTAR 2011, our full • the Symposium on Yoga Research (SYR) as putting our journals online and moving association conference, should be forthcom- • enhanced support for our publications ahead with the standards work. Subsequent- ing by fall, 2010. • supporting the standards eff o r t l y, we tightened our belts even more, includ- Much of our work in 2010 will continue • and, as always, supporting our members ing donating our extensive library to the to be on the development of educational who do so much for so many. new Loyola Marymount University library s t a n d a rds for the training of Yoga therapists. in Los Angeles and reducing our off i c e I AYT president Matthew J. Ta y l o r, PT, If IAYT were a private company, I would re q u i rements. We also developed a new PhD, left the board at the end of his term in issue stock. We have a track re c o rd and all sponsorship program (see below). F e b ru a r y, 2010. All of us owe him a debt of the key pillars are now in place to pro v i d e gratitude for his hard work and leadership the professional services re q u i red to support Future Plans over the past three years. Watch for a call for our members, our field, and the public. Of We have two wonderful publications, each nominations from the membership to fill course, we are not a private company; rather with extraordinary editors. One of my per- b o a rd positions. we are a nonprofit public charity. Your con- I AYT provides many services for our tinued support will continue to help us sonal priorities is enhanced support for YTT these publications. Now that we have all e m e rging field, all primarily supported by thrive. issues hosted at MetaPress, we would like to membership fees. This is difficult, however, place more subscriptions with academic for emerging fields with a small membership In service, base, so we have introduced a new, annual J o h n libraries. You can help by contacting your local university library on behalf of IAY T. sponsorship program. This is a way to pro- Please direct questions about this process to vide direct support to the IAYT pro g r a m s me, at [email protected] . most important to you, or to those you believe a re most beneficial to our field as a whole. You can follow the rollout of SYR on our conference website, www. s y t a r. o rg . Sponsors are recognized on IAYT's home Look for registration to open in late spring. page, with additional information on our

33 Yo g aT h e r a p yToday M a rch 2010 IAYT Member Schools

Supporting Members Centerpoint Yoga Therapy Prana Vinyasa Yoga Therapy Anatomy of Yoga Therapy Radiant Transitions Therapeutic Yoga American Viniyoga Institute Lelia Stuart International Training AVI Therapist Training Sarasvati Devi Gary Kraftsow, MA College of Purna Yoga Purna Yoga Certification Prana Yoga & Ayurveda Mandala Ananda Seva Guru Kula Institute Aadil & Mirra Palkhivala Yoga Cikitsa Ananda Seva Mission Hansa Knox Yoga Therapy Certification Training Divine Yoga Center Maetreyii Nolan, PhD & Ananda Deviika Ma' Divine Therapeutic Yoga Training Professional Yoga Therapy Studies Gusti Ratliff Certified Yoga Therapist Training Embodied Asana Ginger Garner MPT, ATC Embodied Asana Advanced Training Essential Yoga Therapy Amy Matthews EYT Therapist Training Purusha Yoga School Robin Rothenberg Purusha Yoga Therapy Heartland Yoga Therapy Joy Ravelli Heartland Yoga Therapy Training Feel Your Best Nancy Schalk FYB Yoga Therapy Training Reidman College - Israel Debra Hennsey Holistic Yoga Therapy Institute for Medical Yoga Rachel Vilojny Yoga Therapist Training Functional Synergy Yoga Therapy Goran Boll FS Yoga Therapy Training Rocky Mountain Institute of Yoga & Ayurveda Susi Hately Yoga Therapy Professional Certification Integrative Restoration Institute Training Integrative Restoration (iRest), Yoga Nidra Gurukul Yoga Holistic Center Sarasvati Buhrman, PhD & Donna Smith Richard Miller, PhD GYHC Yoga Therapist /Teacher's Training Manju and Prashant Joshi Salutation Healthcare/BoneZeal Yoga LifeForce Yoga Healing Institute BoneZeal Yoga Cikitsa LifeForce Yoga Practitioner Training Guru Ram Dass Center Gerry Sander Amy Weintraub Yoga Therapeutics Teacher Training Shanti Shanti Kaur Khalsa Scottsdale Community College Phoenix Rising Yoga Therapy Yoga Therapy Certification PRYT Practitioner & Teacher Trainings Inner Peace Yoga Therapy Carlyn Sikes Elissa Cobb and Karen Hasskarl Yoga Therapy Certification Michelle Lawrence Surya Chandra Healing Yoga School Pranakriya Yoga Therapy Yoga Therapeutics Training Pranakriya Yoga Therapy Training Institute of Classical Yoga & Therapy JJ Gormley-Etchells Marlysa Sullivan and Yoganand Yoga Therapy Training Michael Carroll Jiwan Goyal Svastha Yoga and Ayurveda Svastha Yoga Therapist Training Samarya Center Integral Yoga Ganesh Mohan Integrated Movement Therapy Training IY Therapeutic Yoga Training Molly Lannon Kenny and Stephanie Sisson Lakshmi Sutter Yoga for Seniors Therapeutic Yoga for Seniors Teacher Training Yoga Therapy Rx at LMU Integrative Yoga Therapy Kimberly Carson and Carol Krucoff Yoga Therapy Rx Certification Professional Yoga Therapy Larry Payne, PhD Joseph Le Page Wise Ways Yoga & Movement Arts Professional Therapeutic Teacher Training YogaFit Training Systems Heaven Wellness & Yoga Institute Michele Mangione Yoga Therapy & Restorative Yoga Yoga Therapist Training Chrys Kub, PT Karen Claffey Yoga Mountain Professional Yoga Therapy Certificate KC Fitness Link Gail Walsh Members Yoga Therapist Training Darryl Olive Yoga Teachers School of Excellence Abhyasa Yoga Center Certified Yoga Therapist Training AYC Professional Training Krishnamacharya Healing Yoga Foundation Deborah Perry J. Brown KHYF Yoga Therapy Training Kate Holcombe & Chase Bossart Yoga Therapy Center Atha Yoga & Pilates Structural Yoga Therapy & Atha Yoga Therapy Professional Certification Master Yoga Foundation Ayurvedic Yoga Therapy Sabrina Castaneda Svaroopa® Yoga Therapist Certification Mukunda Stiles Vidyadevi Stillman & Mary Kay LeFevour Australian Institute of Yoga Therapy Yoga Therapy Vancouver Graduate Certificate in Yoga Therapy Mount Royal University Maggie Reagh Leigh Blashki Yoga Therapy Certificate Therapeutic Yoga Training Program Madeline Kapiczowski Ayur Yoga Yogatsu Institute Yoga Therapy Program New England School of Integrative Alice Strauss Remo Rittiner Yoga Therapeutics YI Yoga Therapy Integrative Yoga Therapeutics Body Balance Yoga Bo Forbes YogaSpirit Studios Body Balance Yoga Therapy Training Yoga Spirit Therapist Training Jenny Otto Nosara Yoga Institute Kim Valeri Self-Awakening Yoga Therapeutic Training Amba and Don Brahmanand Stapleton, PhD M a rch 2010 Yo g aT h e r a p yToday 3 4 onMembers, continued NAMA Annual Conference Set for April

he National Ayurvedic Medical Association (NAMA), a non- p rofit professional membership organization of practitioners, T students, Yoga enthusiasts, and people who want to learn m o re about the science of Ayurveda, is hosting its seventh annual c o n f e rence, Ayurveda: Complementary and Global Medicine, in San Mateo, California, April 15-18, 2010. Ayurveda, which means “science of life,” is often described as the sister science of Yoga. Complex yet profound, its teachings off e r ways for all of us to find balance, health, and well-being in a con- stantly shifting and changing world. Twenty educational sessions scheduled include lecture s , practicums, panel discussions, and in-depth opportunities to study with a wide range of Ayurvedic experts. Morning practice sessions (including meditation and asana) allow for integration, and t h roughout the day there are ample opportunities for networking, community-building, and fellowship. I AYT is a partner organization and will be re p resented thro u g h special programs and sessions. To find out more visit www. a y u r v e d a - n a m a . o rg . —by Felicia M.Tomasko, RN

35 Yo g aT h e r a p yToday M a rch 2010 M a rch 2010 Yo g aT h e r a p yToday 3 6 2009 IAYT Donors IAYT THANKS OUR PATRONS, SPONSORS, SUPPORTING MEMBERS, AND NEW APPEAL DONORS

Patron Members and Sharon Cormier Mary Anna Jansen Heena Raikar Sponsors Elisabeth Crim Holiday Johnson David Reed $1,000 and up Laura Crittendon Kathy Jones Karin Reesa Ida Cullen Christine Kamer Diehl Jennifer Riberdy Goran Boll Kaye Cussen Gina Kane Ann Richardson Paul and Linda Copeland Kirdi Dalgliesh Libby Kara Meghann Richko Maryann DiEdwardoYoga Vibhuti Jaya - Lucia d'Ancona John Kepner Lisa Richmond Research & Education Kirti Daryanani James Kirchhoffer Robert Rigamonti Foundation Kasmin Davis Randall Krause Gail Robertiello Matra Majmundar Catherine Deans Julie Kusiak Kathy Robinson Healing Path Medical Clinic Carrie Demers Linda Lang Alecia Roblin Richard Miller Janis Desmond Emily Large Vaz Rogbeck Cindy Dollar James Larkins Marjorie Rosenfield Supporting Members and Michelle Dragut Judith Hanson Lasater Serge Salvador New Appeal Donors Kenneth Dunn Tamara Lau Locana Sansregret $100-$999 Laurie Edwards Mary Lauttamus Bonnie Schindler L. Ella Eilmus Jennie Lee Rhonda Schlesinger Anonymous Amy Elkhoury Kathy Leung Degen Audrey Schoomaker Kandy Aboud Per Erez Libby Levin Kathleen Shannon Kellie Adkins Julia Fay Wendy Lippmann Benjamin Shield Sergey Agapkin Jaunie Federowicz Debra Lister Stephanie Shorter Diane Agnello Ellen Fein Lorena Lobato Sonia Sierra Wolf Barbara Anton Debra Figiel Lucy Lomax Betsy Small Roger Ash Wheeler Diane Finlayson Gina Macauley Eric Small Bodhi Ashburn Alison (Devinder Kaur) Finney Anne Marie Machetto Emily Smith LynnMarie Banas-Petronsky Loren Fishman Tina Madison Diane Speer Ja'net Barchard Trina Ford David Maian Laura Starling Pat Barnes Linda Frank Michelle Maniaci Sharon Steffensen Julie Barton Ana Franklin Christine Marcella Mary Steinberg Anne Basco Agi Jacob Fry Mary Beth Markus Kate Stevely Bree Benjamin Amy Gage Helen McCarthy Alice Strauss Adrienne Benjamin Elizabeth Galles Karen McDaniels Myra Summerlot Corrin Bennett Tiffany Garfinkel Bob McKinney Elisa Sweigart Angela Benton Kate Hillman Garland Shannon McMahon Hodges Matthew Taylor Ross Bergfalk Becky Gelatt Jaymie Meyer Kyle Thompson Rejean Bilodeau Becky Gelatt Beth Meyers Joe Thurmon Mira Binzen Elizabeth Gibbs Allie Middleton Cherie Trice Leslie Bogart Merilee Giddings Michael Milversted Barbara Tudhope Martha Bond Louise Goldberg Nancy Mohler Aria Ungerer Gwen Bonnie Lisa Golde Jenny Mueller Manju Vachher Jennifer Botka JJ Gormley-Etchells Ethne Munden Jennifer Valentine Anie Boudreau Shari Gray Cristina Munoz-Gandara Julia Van Paepeghem Sandra Bowman Mary Guerenabarrena Betsy Murphy Lisa Vandegrift Toni Bradley Ana Gutierrez-Preciado Stephen Nezezon Lanita Varshell Julia Brett Dale Hails Meg Noonan Christina Wadhera Jo Brill Beverly Haines Karen Oberg Phyllis Walker Tina Brisnehan Sherri Hamby Sharon Olson Veronica Waters Mary Bruce Monica Hanson Caroline Owen James Weber Dhaval Buch Kimberli Hargnett Parasuraman Palani Cora Wen Susi Buhmann Albert Marsha Hawk Aadil Palkhivala Diana Westbrook Ena Burrud Margery Hellman Caren Patterson Bonnie Wiesner Jan Byrd Terry Henry Diane Pavesic Michele Wilde Debra Campagna Michele Hensey Jessica Payton Leslie Worris Sandra Carden India Henson Marydale Pecora Raymonde Worsfold Susan Carroll Mary Hilliker Alice Percy-Strauss Jeannie Wrightson Janis Carter Heather Hobbs Cyndy Phillips Karusia Wroblewski Angela Cerkevich Denise Hogan Connie Piasecki Denise Yager Maria Cerniauskas-Upton Ginger Hooven Elizabeth Plapinger Carolyn York Patricia Cieluch Seth Hutton Lauren Ponder Ignas Zakarauskas Karen Claffey Tracy Hutton Mary Powers Paul Zeiger Laura-Jane Clare Sally Ingalls Vimala Nora Pozzi Rebecah Ziegler Margi Clifford Neva Ingalls Yogacharya Prabhuji Mike Zolfo Elissa Cobb Judy/Jothyi Jackson Jillian Pransky Clare Collins Gretchen Jameson Jill Price Joel Conrad Dhan Jangid Shelly Prosko

37 Yo g aT h e r a p yToday M a rch 2010 M a rch 2010 Yo g aT h e r a p yToday 3 8 INTERNATIONAL ASSOCIATION PRESORTED OF YOGA THERAPISTS STANDARD P. O. BOX 12890 U.S. POSTAGE PRESCOTT, AZ 86304 PAID MANSFIELD, OH PERMIT #158 RETURN SERVICE REQUESTED

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