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

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 Spring 2011 Volume 7, Issue 1 $5 1 Yo g aT h e r a p yToday Spring 2011 Spring 2011 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 Reflections on How We Got Here Yoga Therapists EDITOR IN CHIEF Kelly Birch, RYT-500, PYT ake a moment to ponder why you are GRAPHIC DESIGNER Ken Wilson holding this magazine in your hands. COPYEDITORS Denise Hodges, Corleigh Stixrud T What path brought you to this point Yoga Therapy To d a y is published in the Spring, Summer, and Wi n t e r. in time? Was it a sudden realization, the cul- mination of years of work, a calling? IAYT BOARD & MANAGEMENT I recall many moments in my life that Eleanor Criswell, EdD, President led to my writing this note to you. I re m e m- Matra Raj, OTR, TYC, Treasurer ber as a young girl wondering why people Molly Lannon Kenny, Vice President w e re going to the moon when there was so Clare Collins, RN, PhD Betsy Murphy, BSN, RN, RYT, HN-BC much to discover on earth; as an adolescent, Executive Director John Kepner, MA, MBA becoming aware of the suffering of people Membership Manager Jesse Gonzales a round me and yearning to help them; and as a young woman, Advertising Manager Abby Geyer standing at the frontline of an antiwar demonstration amid pro t e s t- ers full of aggression and divisiveness, experiencing the pro f o u n d MISSION realization that I had to be the change that I wanted to see in the IAYT supports research and education in Yoga, and serves as a professional organization for Yoga teachers and Yoga therapists world. And over the years, the experience of joy and beauty and love worldwide. Our mission is to establish Yoga as a recognized and that came through Yoga was the most exquisite and influential forc e respected therapy. in my life; in many ways it has become my life. If I were a betting woman, I'd wager that most of you re a d i n g MEMBERSHIP this magazine have had similar experiences—noticing the suff e r i n g IAYT membership is open to Yoga practitioners, Yoga teachers, within ourselves and others, seeking solutions, finding them in Yo g a , Yoga therapists, Yoga researchers, and healthcare professionals who utilize Yoga in their practice. and becoming passionate about sharing this open secret with others. I AYT is an expression of our collective heartfelt desire to make MEMBER BENEFITS Yoga an integral, living part of our culture. In this issue, you will • Subscription to the International Journal of Yoga Therapy read about some of the ways in which this is coming to fru i t i o n • Subscription to Yoga Therapy Today worldwide. • Access to IAYT’s research resources and digital library We begin with Members News to bring you up to date on IAY T ' s • Professional recognition through IAYT’s online listings and an IAYT membership certificate events, meetings on standards, and the annual report from our exec- • Discounted registration at IAYT events utive dire c t o r, John Kepner. We are also proud to bring you news of B.K. Bose's Jefferson award for outstanding service. CONTACT Our three featured articles bring news and views on efforts to P. O. Box 12890, Prescott, AZ 86304 advance Yoga as a respected therapy: IAYT's president, Eleanor Phone: 928-541-0004 (M-F, 9AM – 3PM MST) Fax: 928-541-0182 Criswell, presents an interesting and comprehensive report on The www.iayt.org • [email protected] First International Conference on Yoga for Health and Social Tr a n s- formation conference in Haridwar, India, and Angela Wilson and HOW TO SUBMIT TO YOGA THERAPY TODAY Nina Moliver offer two complementary, well-argued articles on how Writers re s e a rch helps to transform our society by effectively communicating Email a query or completed article to: [email protected]. Yoga Yoga's unique contribution. A report by Nancy O'Brien on Steff a n y Therapy Today relies on submissions from the membership. Please Haaz's “Yoga for Arthritis” Te a c h e r- Training Intensive provides an submit reports and articles on training, views and insights relat- example of how a tested re s e a rch protocol is being used to tailor Yo g a ing to the field and profession of Yoga therapy, as well as on integrative practices and business practices. Request writer guide- to a specific population. Jnani Chapman critiques a Yoga and bre a s t lines from editor. Articles are reviewed and accepted on a rolling cancer book that is based on a successful pilot study by its authors. basis and may be submitted at any time. In a new section, Insights, Yoga practitioners and therapists Advertisers s h a re Yogic wisdom from their own lives. J. Brown's thought-pro v o k- Call 928-541-0004 or email [email protected] for advertising ing article examines how a shift in perspective can change one's rates and deadlines. Editorial decisions are made independently understanding of pain and health. Bobbie Brooks reflects on the of advertising arrangements. responsibilities of becoming a Yoga therapist, and Traci Housman REPRINT POLICY tells the story of how Yoga transformed her during the most chaotic IAYT's reprint policy applies to all articles in the International episode of her life. Journal of Yoga Therapy and Yoga Therapy Today. Fee: $5 per copy Also in this issue, we introduce a new column from IAYT's Bob per article. The policy works on the honor system, e.g., if two Butera, who shares skillful, practical advice on how to help our articles are copied for 25 students, please send IAYT a check for clients integrate Yoga more fully into their lives. $50 and note “for reprints” on the check. Requests for reprints of As you reflect on what brought you to this magazine, consider articles should be emailed or phoned to Jesse Gonzales, Member too what more this magazine can bring into your life. Upcoming Services Manager, at [email protected] or 928-541-0004. issues will explore the therapeutic relationship, how to keep the heart of Yoga in Yoga therapy, and how people are bringing Yoga to the ENVIRONMENTAL STATEMENT s t reets, the schools, the workplace—in short, anywhere that there ' s This publication is printed using soy-based inks. The paper contains 30% recycled fiber. It is bleached without using chlorine and the people, there can be Yo g a ! wood pulp is harvested from sustainable fore s t s . Yo u r s , K e l l y

3 Yo g aT h e r a p yToday Spring 2011 Ta b l e O fC o n t e n t s Spring 2011

From the Editor 3 Reflections on How We Got Here 9 Members News 5 2011 Annual Report to Members by John Kepner, MA, MBA 7 Conference Abstract by John Kepner, MA, MBA 7 Update on Standards 8 Events: Update on SYR, Update on SYTAR 8 Niroga in the News 39 IAYT Member Schools 40 IAYT Donors & Sponsors Yoga Therapy for Daily Living 9 How Do We Guide Clients To w a rd a Deeper Level of Intention? by Robert Butera, PhD Insights 11 Evolution of a Yoga Therapist by Bobbie Brooks 15 Thinking About Pain and Health by J. Brown 21 19 Surprised by Peace by Traci Housman Featured Articles 21 The First International Conference on Yoga for Health and Social Transformation: A Report from IAYT's president by Eleanor Criswell, EdD 24 The Transformative Potential of Science: How Research Can Bring Yoga into the World by Angela M. Wilson, MA 27 Yoga Research: Yes, No, or How?— A Contribution to the Dialogue by Nina Moliver, PhD, RYT Interview 30 Richard Panico, MD, Founder and Director of The Athens Regional Mind Body Institute, with Manjula Spears, e-RYT 500, Chief Yoga Therapist. Integrative Medicine and Yoga 30 Therapy in a Community-Based University Hospital Setting by Amadea Morningstar, MA, RPP, RYT-200 Training Report 34 Yoga for Arthritis Teacher-Training Intensive with Steffany Haaz by Nancy O’Brien Reviews 36 Research Review: Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study Reviewed by Dilip Sarkar, MD, FACS, DAyur

Book Review: Yoga and Breast Cancer: A Journey to Health and Healing By Ingrid Kollak, PhD, RN, and Isabell Utz-Billing, MD Reviewed by Jnani Chapman, RN, CYT

Spring 2011 Yo g aT h e r a p yToday 4 MembersNews by John Kepner, Executive Director 2 0 11 Annual Report to Members

010 was a pivotal and re w a rding year P u b l i c a t i o n s c o n f e rences in one month. Check the for IAY T. Several highlights stand out, December 2011 YTT to see if we survived. 2 including the 20th anniversary of the Kelly McGonigal, PhD, IJYT's editor in F o r t u n a t e l y, Debra Krajewski has joined us International Journal of Yoga Therapy ( I J Y T ) chief, brought forth a special perspectives and has rapidly become indispensable as and the landmark First Annual Symposium section in the anniversary issue consisting of our onsite conference manager. Our confer- on Yoga Research. At the beginning of this several articles by veteran members “look- ence management partner is R. Cassidy and y e a r, IAYT had a strong presence and sever- ing backward, looking forward.” Linda Associates. al members made presentations at the First Getz, IAYT's long-term graphics artist, International Conference on Yoga for Health designed a brilliant new cover, consisting of Standards and Social Transformation in Haridwar, h u n d reds of pictures of individuals fro m I AYT conferences, all overlaid with a picture India. This was wonderful recognition of the The IAYT Educational Standards committee of Patanjali. work of IAYT as well as the work of so many continued to work hard on developing stan- Julie Deife delivered three wonderful of our members. Last, but not least, I am d a rds for the training of Yoga therapists, pleased to report that IAYT swung from the new issues of Yoga Therapy To d a y, firmly establishing it as the leading magazine in including meeting in Chicago the week red to the black, a most important metric for b e f o re Christmas. This sort of effort appears any organization. our field. Alas, she is moving on. Fortunate- l y, Kelly Birch, IAYT's longstanding copy to also be of interest to many Indian Yo g a M e m b e r s h i p e d i t o r, an experienced Yoga therapist with a therapy organizations. Indeed, we had a b a c k g round in scientific re s e a rch, is well- brief meeting on this in India, at the Patanjali Yogpeeth, just after their conference. As far The one downside is that individual mem- qualified to take the reins. You are holding as we can tell at this time, we all seem to be bership growth leveled off last year. At year- her first issue in your hands. Abby Geyer in the same ballpark with respect to the need end we had 2,665 members, just a 1 perc e n t became IAYT's new advertising manager in m i d - y e a r, bringing many years of pro f e s- and the length of training. We look forward i n c rease from the year before. In part, this sional experience to our advertising sales. was due to the lack of a general membership to future collaboration in this area. For more She is a Yoga teacher and student of Ay u r v e- c o n f e rence and the excitement that would details, see “Update on Standards” in this da, as well as the advertising manager of the bring. Another probable reason is that IAY T i s s u e . Light on Ayurveda Journal. is simply not very focused on “marketing.” Looking Forward We are busy publishing, putting on confer- C o n f e r e n c e s ences, and working on standards. Finally, we think that many Yoga teachers simply do not Much of our work in 2011 will simply be As mentioned earlier, the First Annual Sym- focused on execution: our two publications, know about IAY T, or they think that they posium on Yoga Research (SYR) was a land- our two conferences, and the standard s have to be a Yoga therapist to join. IAYT is mark event for our field. SYR 2010 sold out work. That is plenty. However, there will be open to anyone professionally interested in two months early at almost 200, about thre e an accomplished set of new board members Yoga therapy. We believe our publications, times our expectations. Much thanks to the c o n f e rences, and other re s o u rces are espe- Himalayan Institute, who were such won- elected in Febru a r y, so I expect some care f u l cially helpful to Yoga teachers considering derful hosts. attention will be paid to long-term planning additional study and training to do more Because of the success of that confer- as well as our operational infrastru c t u re . therapeutic work. So, you can help by telling ence, we are holding a second SYR, Septem- I AYT has incredible opportunities for service a friend who might benefit from member- ber 23-25 at the Kripalu Center for Yoga and to our field, our members, and the public, ship in IAY T. Health in Stockbridge, MA, in part to honor but we have to make sure our capacities School membership increased 38 per- the Kripalu Institute of Extraordinary Living meet our aspirations. If you would like to cent, from 48 to 66 schools at year end. (IEL), the only major Yoga re s e a rch institute help this work by sponsoring one of the key Schools are a key pillar of the future of our in North America and the subject of an arti- p rograms, such as a conference, the stan- field, and IAYT is supporting pro f e s s i o n a l cle in this issue, “The Transformative Poten- d a rds work, or one of our publications, training programs by listing them on our tial of Science: How Research can Bring Yo g a please contact me at website and, of course, by the effort to devel- into the World,” by IEL's assistant dire c t o r, j k e p n e r @ i a y t . o rg . op standards for the training of Yoga thera- Angela Wi l s o n . pists. Watch for a new survey of schools in After a one-year hiatus, we are bringing See you at S Y TA R a n d 2 0 11. A list of current 2011 Member Schools back IAYT's annual membership confere n c e , SYR! YTT is published in this issue and all schools can the Symposium on Yoga Therapy and be found via our “Find a Member School” R e s e a rch (SYTAR), September 1-4, 2011, at In Service, function on the IAYT website. an exceptional site, the rustic and charming J o h n Membership services continues to be Asilomar Conference Grounds on the Mon- led by Jesse Gonzales, our longstanding t e rey Peninsula in California. i n t repid membership manager, who is well We are holding both conferences in Sep- known for her dedicated personal service to tember due to unique opportunities for each members. c o n f e rence. Yes, it is a bit crazy to host two (Member News continued on page 7)

5 Yo g aT h e r a p yToday Spring 2011 Spring 2011 Yo g aT h e r a p yToday 6 MembersNews continued Conference Abstract Update on Standards C redibility and Community: The Role of a Pro f e s s i o n a l John Kepner, IAYT Executive Dire c t o r

Association in Supporting Yoga Therapy as an Emerg i n g very single member of the IAYT Edu- P rofession in the United States cational Standards Committee met in E Evanston, Illinois, the weekend b e f o re Christmas. It was a remarkably har- monious and productive meeting. The main focus was on continuing to refine a profile of c o re competencies for Yoga therapists that should be taught in entry-level Yoga therapist training programs. As previously mentioned, the committee has been using the s t a n d a rds developed by the A u s t r a l i a n Association of Yoga Therapists as a tem- plate, or framework, to start from.

I n h e rent to this issue are many questions of balance, including: • What is the right balance between current educational practices and “ideal” p rograms? • What is the right balance between “academic freedom” and re q u i red content (or between allowing unique approaches and c reating a shared professional identity)?

All of this is guided by several general goals, including: Swami Ramdev hands a presenter's plaque to John Kepner at the First International Conference on Yoga for • Standards should be set at a level that is Health and Social Transformation in Haridwar, India. challenging but attainable and should achieve an appropriate balance of com- John Kepner, MA, MBA. Executive Dire c t o r, with many strong implicit challenges in the peting interests. International Association of Yoga Therapists West, with our heavily regulated healthcare • The school-approval process should be systems, and for the tradition itself, which, of a ff o rdable and manageable. he conference organizers had a speciacol urse, is classically a spiritual practice. This • The timeframe for implementation of i n t e rest in the role of professional associa - p resentation will lay out IAYT's strategy, s t a n d a rds should be re a s o n a b l e . T tions for developing Yoga therapy as a rationale, and challenges in our efforts to cul- p rofession within India. I was privileged to speak tivate Yoga therapy as an emerging pro f e s- Two other key components addressed over on this from the perspective of IAYT and the sion in the United States, and how we sup- the weekend were United States. In a complementary way, Leigh port this movement worldwide. There will • an in-depth definition of Yoga therapy Blashki, secretary to the Australian Association be particular emphasis on professional pub- g rounded in the Yoga tradition. of Yoga Therapists (AAYT), spoke on the history lications, professional conferences (including • broad guidelines for global hours for of Yoga in Australia and the development of the re s e a rch conferences), working with sister training programs, including clinical A AY T, including their pioneering standards for p rofessional associations (such as those for training and pre re q u i s i t e s . Yoga therapists. Leigh is also a member of the Ayurveda), and professional standards, as I AYT Advisory Council and a member of the well the role of a sustainable business model. Nothing has been finalized, and hence there I AYT Educational Standards Committee. I am We are quite cognizant of the fact that the is nothing specific that can be published yet. most pleased to report that there is strong support w o rds “professional,” “business,” “therapy, ” The working plan is for a d r a f t set of stan- for mutual collaboration in this area in the future . and “Yoga” sit together uneasily, and my d a rds to be published on or around A u g u s t H e re is the abstract of my presentation. favorite challenge to the term “Yoga thera- 1, 2011, to allow everyone, especially IAY T I AYT is a professional association serv- py” itself is: “Now, what part of Yoga is not member schools, to preview it before re v i e w ing Yoga teachers and Yoga therapists world- therapeutic?” My personal, but unoff i c i a l , and discussion at the Meeting of Schools on wide. Our mission is to establish Yoga as a slogan for our work at IAYT is “Keep the September 1, just before SYTAR. Wr i t t e n recognized and respected therapy. This mis- Yoga in Yoga therapy.” YTT comments will be accepted before and after sion statement is short and sweet but loaded this meeting, (continued on page 8)

7 Yo g aT h e r a p yToday Spring 2011 MembersNews continued N i roga In The News with a goal for a final initial set of standard s N i roga Institute Founder Bidyut Bose to be published in the fall of 2011. Events Receives Jefferson Award Many fundamental questions, such as OAKLAND, CA h o w, when, and by whom this will be Update on SYR By Kelly Birc h a d m i n i s t e red, are yet to be addre s s e d … a n d Planning for IAYT’s Symposium on Yo g a that's okay. The focus is not on forcing a set R e s e a rch, September 23–25, 2011, at the I AYT member Bidyut Kripalu Center for Yoga and Health, con- Bose has been award e d of standards to be imposed immediately, a Bay A rea Regional Jef- tinues to go well. Our partner, Kripalu’s but on working for a reasonable consensus ferson Aw a rd for his on what it really means to be a Yoga thera- Institute for Extraordinary Living, is pro- outstanding work as pist—as defined by a broad set of core com- viding extraordinary support. IAY T Executive Director of petencies, not curriculum hours. Not every- applied for an R-13 grant from the the Niroga Institute, an thing will be addressed. Some important National Center for Complementary and Oakland-based non- Alternative Medicine (NCCAM) to sup- p rofit that teaches issues, such as faculty qualifications and port this scientific meeting. We re c e i v e d Transformative Life Skills (TLS), a multi- specialty programs, are unlikely to be a good score, but competition is very modality intervention including Yo g a , a d d ressed in this initial effort. s t rong and we will not hear until Febru- b reathing techniques, and meditation to at- a r y, or even March, 2011. Such a grant risk youth and other vulnerable populations, including seniors, cancer survivors, Thoughts to keep in mind: would allow us to provide international and recovering addicts. • Creating any set of standards where none travel support and more support for existed previously usually has the eff e c t The Jefferson Aw a rds for Public Service graduate students, but otherwise the w e re cofounded in 1972 by Jacqueline of raising overall quality. c o n f e rence is not dependent on govern- Kennedy Onassis and others to honor vol- • We are creating a working document to ment funding. Special interest gro u p unteerism and community outre a c h serve as a basis for a broader conversa- meetings at the symposium are alre a d y t h roughout the United States and are pre- tion with the school community; there being organized. The first is for those sented on two levels: national and re g i o n a l . will inevitably be a need for changes. i n t e rested in re s e a rch for Yoga for the Bose's receipt of a regional Jefferson Aw a rd • We are creating a process that will be Military and Veterans, in cooperation was the subject of a segment on CBS’s E y e - 1 refined again and again over the course with the Samueli Institute. If you are witness News on December 1, 2010. Bose responded to the announcement of time. i n t e rested in organizing another, please by saying, "This honor is not only a tribute contact John Kepner at [email protected] . to the tremendous commitment and dedica- Another key question is, “What are the tion of all Niroga staff and teachers, it is also short-term and the long-term roles of IAY T Update on SYTA R an acknowledgment that the management in all of this?” Associations are not the best We had a positive, almost overwhelming of chronic stress and the development of long-term place to house the institutions response to IAYT's first “Call for Pre s e n- emotional self-regulation are powerful cata- lysts that can transform our communities." that maintain standards, but they are often tations” for our forthcoming member- Bose left a successful career as a scientist the place to start. I personally do not want to ship conference, the Symposium on and technology executive in Silicon Valley to turn IAYT into a bureaucracy! YTT Yoga Therapy and Research (SYTA R ) , launch the Niroga Institute in 2005 as a vehi- September 1-4 at the Asilomar Confer- cle to bring TLS to at-risk youth and other ence Grounds on the Monterey Peninsu- underserved populations. Curre n t l y, Niro g a ' s la in California. We received over 160 Yoga Corps teachers are reaching more than IAYT's Reprint Policy p roposals for sixteen sessions. Most 2,000 students a week in local public and w e re strong, professional, and attractive. alternative schools, juvenile court place- We are delighted when members use The Psychological track received the ments, drug and alcohol rehab programs, and IAYT articles for their teacher and ther- most proposals (35%); the Spiritual other settings where these skills are needed most and have the greatest impact. apist training programs and workshops. track, the least (11%). The selection Independent re s e a rchers have shown Well-written and well-edited articles are p rocess is going to be very difficult. that youth who practiced TLS experienced our stock in trade, so we have a simple N o w, watch for the “Call for CIC less stress and displayed better self-contro l and economical reprint policy. Fee: $1 P resentations” coming in March. These than their peers who did not practice them. per copy per article. For example, if two a re shorter, 15- to 20-minute pre s e n t a- The implications of these results are quite sig- articles are copied for 25 students, tions that will allow you to share your nificant. Niroga's programs are incre a s i n g l y please send IAYT a check for $50 and work and connect with your peers in the being viewed as a cost-effective, powerful note “reprints” on the check. Alternative- Common Interest Community sessions. catalyst for positive child and youth develop- ly, you can make a $50 donation via Also watch for the “Call for Spon- ment impacting education and mental health IAYT's “Make a donation” link on IAYT's sors.” Conference sponsorship pro v i d e s and as a frontline prevention and intervention strategy for violence reduction. YTT home page, again noting “reprints” in one year's recognition on IAYT's website, 1. CBS San Francisco. (2010, December 1). J e f f e r s o n the comment section. This policy works over and above exhibition space at the Aw a r d s : Teaching yoga’s healing virtues to ease Bay on the honor system. c o n f e rence. YTT A rea’s pain. Retrieved from http://sanfrancisco.cbslo- c a l . c o m / 2 0 1 0 / 1 2 / 0 1 / j e ff e r s o n - a w a rd s - t e a c h i n g - y o g a s - h e a l i n g - v i r t u e s - t o - e a s e - b a y - a re a s - p a i n .

Spring 2011 Yo g aT h e r a p yToday 8 Yo g aT h e r a p yf o rD a i l y L i v i n g by Robert Butera, PhD How Do We Guide Clients To w a rd a Deeper Level of Intention?

s Yoga therapists, we are T h e re is intention behind every often charged with guiding action that we take in life, and it can Aour clients toward finding a either be beneficial or damaging to meaningful and individualized path our wellbeing. This is certainly tru e of health and healing. At times, in Yoga. Think for a moment about clients come to us with a superficial what might happen to a student reason for their goals, mostly because whose intention in doing a Yo g a they haven’t been encouraged to pose is to look good and impre s s uncover the deeper levels of motiva- others. The student is inclined to tion for practice. If the therapist is push beyond his physical limitations able to guide clients to transform and potentially injure himself. In their original reason for coming to contrast, a student whose intention Yoga therapy sessions into a spiritual is to appreciate the body will likely intention, clients may have a gre a t e r be finely attuned to her capabilities chance of meeting their goals. The and will have a deeper physical, insights that they gain in their thera- emotional, and spiritual experience py sessions are imbued with a sense in her Yoga practice. of deeper purpose and a level of understanding that can be applied to Types of Intention tasks outside of the therapy session. Understanding intention is fun- Let’s explore the three types of inten- damental to life, not just Yoga. A s tion to get a sense of how they aff e c t clients learn to cultivate pure inten- daily life: tion in Yoga practice, they may start to do the same in their daily actions. 1. Active intentions ( r a j a s i c ) : a c t i v e , Many people live disconnected fro m excited, obsessive, hyper, competi- their intention for doing things, tive, fast-paced, clinging, attached, whether in work, relationships, or infatuated, ego-boosting. These are some other area of life. How can students To better understand intention, we can intentions that serve to boost the ego: how embody their most inspired self if they are n ’ t consider the three basic qualities of nature , can I work harder to look better, be more clear on the reasons behind their actions? the gunas, from Yoga philosophy. The g u n a s fit, and improve my external self so that A commitment to spiritual healing originate from Samkhya, one of the six other people like or respect me more? This means renewing deep-seated intentions schools of classical Indian philosophy. In intention is mirro red by many of the cul- every day. Connecting clients to something Samkhya philosophy, the gunas are thre e tural values that society reflects fro m l a rger than themselves while doing Yo g a “tendencies”: rajas, tamas, and s a t t v a. In sim- childhood to adulthood—study more ; poses will impact their entire lives, including ple terms, we can think of r a j a s as activity, compete in work/school; make more their physical health. When performing t a m a s as inactivity, and s a t t v a as purity or money; be stro n g e r, faster, more physical- Yoga poses, a married person might think, equilibrium. Clients can probably identify ly attractive; and stay busy at all times! A “ Today is another day to consider how to with all three states of being, whether they capitalist society promotes speed, pro f i t , better love my spouse.” Or an individual a re feeling energetic and obsessive ( r a j a s i c ), p o w e r, pro g ress, stress, and materialism. might say, “Today is another day for me to dull and depressed ( t a m a s i c ) or calm, clear, The idea of continually seeking out “more renew my commitment to a healthy and focused ( s a t t v i c ). The Yoga therapist and better” is like an animal chasing its lifestyle”; “Today I’m going to think of my seeks to offer practices that will magnify the tail, never finding the happiness that gets job in terms of its larger purpose in life and client’s pure s a t t v i c state of being because it put off to “someday.” This type of attitude I’m going to feel inspired at work, even if I best facilitates the path of self-realization. In in a Yoga practice continues the fast pace, feel my job is somewhat mundane”; or, most practice, this means cultivating an intention with no chance to rest or feel, and pro- i m p o r t a n t l y, “I’m going to renew my com- that matches the lucidity and luminosity of hibits the slow-paced awareness re q u i re d mitment to spiritual gro w t h . ” consciousness itself. for self-understanding and healing. R a j a s i c

9 Yo g aT h e r a p yToday Spring 2011 intentions can have short-term positive ful here—see if the client can ask why— the inexplicable mystery of spiritual connec- outcomes but if they are not connected to “Why do I want to lose a few pounds?” The tion to fill the cup. Encourage them to think something deeper, they often lead an indi- first answer might be an inactive re s p o n s e of the intention as a focus for receiving and vidual to a level of attachment that can based on fear: “I want to lose weight enriching their perception of the experience. further his or her suff e r i n g . because people will like me more.” Or “I’m This visualization exercise can help the prac- afraid of having a heart attack.” In their titioner internalize in a highly personal man- 2. Inactive intentions ( t a m a s i c ) : i n a c t i v e , essence, the desires are not bad; they just ner the potential of the lessons learned fro m dull, depressed, fearful, confused, lethar- need to be connected to a deeper intention. the practice of intention. gic, helpless, self-doubting, disorg a n i z e d , T h e re’s nothing wrong with wanting to look Although I suggest that students arrive l a z y. These are intentions that stem fro m good or be healthy. The problem is when the at one intention and use it for a period of fear and confusion and may cause a per- d e s i re becomes the intention. time, know that they can always change son to practice Yoga simply because a doc- The next level of inquiry might be “Why intentions. If they’re feeling weak one day, tor or friend said to. Laziness leads to an do I want to look good?” Let’s suppose that they might adjust the intention to having intention of wanting instant results with- the deeper desire is to improve the client’s courage to practice Yoga. Or if they’re filled out putting forth the effort re q u i red to love life. The spiritual aspect of this desire is with a deep sense of gratitude, they might really change habits and perc e p t i o n s . love. Encourage clients to follow the inten- hold the intention of offering gratitude to the Many people start Yoga and quit early in tion of love and their Yoga practice becomes world through each Yoga pose. The most the process because they are not ready for c e n t e red on the giving and receiving of love. important thing to keep in mind in using the big changes and challenges associated With the example of wanting to lose weight intention is that it is heartfelt and sincere. If with personal gro w t h . in order to be healthier, again ask “Why?” the intention doesn’t fit their mood, there ’ s P e rhaps they want to live longer and be there no point in setting that intention because it’s 3. Pure intentions ( s a t t v i c ) : balanced, clear, when their children grow older. The re a s o n not going to serve them in practice. p u re, calm, peaceful, content, illuminat- for losing weight is now a virtue: to help oth- The guidelines for cultivating positive ing. Freedom from suffering (physical, ers. The intention of their Yoga practice is to intention also apply to how students live their psychological, and spiritual) happens become a strong and healthy person in ord e r lives. Whether they recognize them or not, the with the cultivation of pure intention— to serve other people. underlying intention in all activities and bright, calm, clear, immaculate, illuminat- All that is re q u i red to be successful in set- thoughts determines the result. Seen in this ing, and balanced—and learning how to ting a deep intention is a little time for the w a y, daily life is like a Yoga pose. And, vice practice these states of mind, body, and client, along with some patient guidance on versa, Yoga poses embody life in that spirit. The intention for Yoga poses the Yoga therapist’s part. Keep on asking moment. Rather than avoiding the deepest becomes a virtue, such as “compassion” them “why” until a virtue is reached. Some and perhaps most difficult parts of life, we or “courage,” changing with each day, common examples of virtues would be love, can guide clients to tune in and listen to their depending on what is relevant for living compassion, peace, joy, service, balance, faith, inner guidance. The spirit’s healing potential well. A new perspective helps us to deal t rust, hope, acceptance, forgiveness, patience, is allowed to come through and change what with stress and transform attitudes and devotion. Intentions are not limited to needs to be changed. Practicing Yoga means t o w a rd daily interactions. We discover the these virtues, but these are good examples. continually working toward a pure appro a c h t rue source of pain, learn how to take As clients pro g ress, everything they learn of awareness and acceptance. There is no per- re s p o n s i b i l i t y, and become who we want should help them integrate the essence of the fection, just the ever-evolving journey. YTT to be. In this space, a Yoga practice offers a newly uncovered intention into practice as fuller sense of self-awareness and facili- well as daily tasks. The intention may evolve Robert Butera, M.Div, tates the greatest healing. or change as they continue to study Yoga. PhD is the founder and d i rector of The Yo g a L i f e Institute in Devon, PA , Steps for Guiding Clients To w a r d Applying Intention to Yoga Pose w h e re he leads the Deeper Levels of Intention P r a c t i c e C o m p rehensive Yo g a Therapy Program; pub - Advise clients to outline two or three per- Many students arrive at their intention with lisher of Yoga Living Magazine; and author sonal goals. Let’s say they’d like to impro v e g reat precision, but wonder how to apply o f The Pure Heart of their health, relationships, and spirituality. this intention to Yoga poses. To help stu- Yo g a (Llewellyn, Sep - Investigate the deeper purpose for the inten- dents apply intention in practice, offer them t e m b e r, 2009). Bob has tion in these particular areas. For health, per- the image of a chalice, a holy cup, and ask been teaching Yoga and meditation for over haps they think happiness equals losing a lit- them to name this chalice with their inten- twenty years. Bob was originally trained by pio - neers in the field of Yoga therapy at The Yo g a tle weight, a very common health concern. tion. Let the lessons and experiences of the Institute of Mumbai, India, and has a PhD in Be very careful to recognize that such a spe- Yoga therapy session fill the cup. A l l o w the field of Yoga Therapy from The California cific physical goal is not the most eff e c t i v e insights related to the intention to fill the Institute of Integral Studies. Learn more at intention. Self-inquiry becomes really help- cup; the deep feeling of peace fill the cup; Yo g a l i f e i n s t i t u t e . c o m .

Spring 2011 Yo g aT h e r a p yToday 1 0 I n s i g h t s by Bobbie Brooks Evolution of a Yoga Therapist What does it take to be a Yoga therapist? One practitioner describes her journey of discovery. y introduction to IAYT came I joined IAYT . . . to continue I attended the 2008 SYTAR confere n c e , t h rough its website as I sought my education and be part of a w h e re I soaked up additional knowledge M l i t e r a t u re on how to teach a Yo g a and began to see where my 25 years in engi- student who was a senior with osteoporo s i s . community of pro f e s s i o n a l s neering re s e a rch and development could I was teaching Yoga at a fitness center then willing to dive deeper into the transfer over to the Yoga world. I bro u g h t and wanted to keep my student safe by pro- therapeutic aspects of Yo g a . some of the conference discussions back to viding appropriate modifications, teach with the Directors of the Nosara Yoga Institute i n t e g r i t y, and educate myself further on the This was something that and convinced them that it was important to specific pathology. At the time, the IAY T integrity-wise I knew I had to participate in IAYT as a Member School. In website was the only re s o u rce that I could do, since people were begin- 2009, I once again attended SYTAR and this find documenting any Yoga re s e a rch, and it ning to seek me out for re f e r- time I also sat on the IAYT Council of Schools led me to previously published re s e a rch arti- as my Yoga school's re p resentative. IAYT has cles on osteoporosis from the I n t e r n a t i o n a l ral for “hard cases,”. . . been a great catalyst for me to “up my Journal of Yoga Therapy. These were invalu- game,” and since joining, I've increased my able and allowed me to approach my stu- s e i z u res that began after he “pulled the personal studies in anatomy and physiology dent in an informed way, which gre a t l y plug” on his brother's life support. For me, as well as psychology and neuroscience and aided in building the trust between us. She the case of the latter client was the tipping have taken additional Yoga therapeutic knew that I had taken the time to conduct point at which I decided further education in trainings with former IAYT board members. the re s e a rch, digest the information, and Yoga therapy was needed. After extensive Discussions with other members on the develop an understanding that would help rounds of testing, the best neurologists in the I AYT Council of Schools and side conversa- us to have an intelligent dialogue about her Southeast told him that his issue was psy- tions at the 2009 SYTAR conference were a unique needs. Together we were able to cre- chosomatic and not neurological. I intuitive- catalyst to increasing my education. On the ate a s a n a modifications that worked for her ly knew that his seizures were linked to the one hand, I found out that I knew more than in the context of a group class and that fell functioning of his nervous system, and I sus- I thought, but on the other, that I had a lot to within the guidelines presented by her pected that he would seize when we moved learn, and this deepened my hunger for fur- physician and physical therapist. At this into s a v a s a n a or any form of deep re l a x a t i o n ther knowledge. Little did they know, but point, I had 300 hours in Yoga training fro m (which indeed was the case). But I really did- my decision to pursue an advanced degre e the Nosara Yoga Institute, whose curriculum n't know where to go from there. I wanted to was greatly shaped by a lunch conversation s t resses the therapeutic aspects of Yo g a understand more re g a rding the neuro b i o l o- with Bo Forbes re g a rding the lymphatic and ( t h rough Self-Awakening Yoga and one-on- gy of what was occurring so that I would nervous system; a brief exchange with one Pranassage® training). The experience have more options on how to proceed. As it Eleanor Criswell, who encouraged me by with my client showed me the benefit of was, I had limited success in helping him to a ffirming some of the points I was raising in deepening my education in Yoga therapy. relieve the symptoms that were functionally the Council of Schools meeting; and a I joined IAYT shortly after this experi- debilitating. Some of the areas where I need- lengthy conversation with J. Brown at one of ence to continue my education and be part ed further knowledge included (1) how to the keynotes, where he and I discussed the of a community of professionals willing to help him work his developmental edge need to keep the inquiry alive in lieu of re l y- dive deeper into the therapeutic aspects of without retraumatizing him, (2) understanding solely on a protocol in a therapeutic ses- Yoga. This was something that integrity- ing what might be contraindicated given the sion. I wanted to have more therapeutic tools wise I knew I had to do, since people were medicines he was taking (antidepre s s a n t s to help my clients and also strengthen the beginning to seek me out for referral for and a host of others), and (3) how the psyche voice within IAYT for those who believe that “ h a rd cases,” such as a client with diabetes was connected to the soma physiologically, we can still hold on to the systemic benefits who had phantom pain from an amputation, the interdependencies between psyche and that Yoga yields without mimicking the a physician who was recovering from a soma, and what methods I could use to We s tern medical model. brain tumor operation, and a client with access the psyche through the soma. (continued on page 13)

11 Yo g aT h e r a p yToday Spring 2010 Spring 2010 Yo g aT h e r a p yToday 1 2 Insights c o n t i n u e d

Since then, I began a PhD program in clinical psychology with a somatic specialty at the Santa Barbara Graduate Institute (SBGI). SBGI is the only place in the world c u r rently offering a PhD in Somatic Psychol- o g y. This acceleration of my evolution as a Yoga therapist has occurred over a re l a t i v e l y short time span, and I attribute much of it to the high caliber of IAYT members that I have met both at SYTAR and through the honor of working with the Council of Schools. I am so grateful for the interaction with IAYT members, and I am thankful for my growing re l a- tionship with IAY T. As Yoga therapists/educators in a growing and maturing industry, I believe there is a call for us to increase our education, either by taking small, measure d steps or great leaps.

Holding the Opposites I have been in a unique position to watch the tug-of-war between the various Yoga therapy “camps” without necessarily being polar- ized to either. My Yoga and Yoga therapy training through the Nosara Yoga Institute is experiential with an inquiry-based method- o l o g y, so I very much believe in the exploration of the multidimensional self and finding your own inner guidance. But my years of involvement with scientific exploration in p rograms that are nearly as complex as the human body also allow me to see the need between what he called the Pre v e n t a t i v e ring within our own Yoga therapy commu- for higher standards of education in Yo g a C a re Yoga Professional (PCYP) and the Clin- nity is a healthy, normal process of a life therapeutics. There is a place for specialty ical Application Yoga Professional (CAY P ) 3 cycle. I am encouraged by our dialogue as knowledge, especially within the construct of P e r s o n a l l y, I blend various techniques fro m we stretch, pull, and make Yoga therapeutic an inquiry-based application. So in my per- Yoga, Somatics, Pilates, somatic psychothera- “ t a ff y.” There is a place for all of us to re s i d e sonal experience as a Yoga therapist, I am p y, even exercise physiology when practi- in this process. I am grateful for you all. YTT pulling from both schools of thought. Last cal—but they are all lovingly wrapped and y e a r, I found a quote in a Yoga Therapy in Prac - supported within the construct of an inquiry- R e f e r e n c e s 1. McGonigal, K. (2007). From the editor. I AYT Yo g a t i c e editorial by Kelly McGonigal, PhD, that I based model. As I facilitate and we co-cre a t e Therapy in Practice. 3(2), 2. taped on my bathroom mirro r. In the morn- t o g e t h e r, my clients are empowered to find 2. Rothenberg, R. (2009). A case for collaboration. I n t e r - ings as I arise, I am reminded that “account- their own healing, instead of them relying on national Journal of Yoga Therapy, 19, 9. 3. Brown, J. (2009). Therapy is not Yoga. I n t e r n a t i o n a l ability and soul is not about finding a single me as their source of empowerment. I am not Journal of Yoga Therapy, 19, 25-26. n a r row path that excludes many, but about a Yoga purist in the classical Yoga tradition; I finding a practical way to 'hold the oppo- believe that Yoga is continually evolving. A s i t e s . ' ”1 I have been looking for this practical modern example of this evolution includes Bobbie Brooks's Yo g a way to “hold the opposites” as I evolve as a Iyengar's introduction of props that he used therapy certifications Yoga therapist and as I participate in and to enable his own healing. include Pranassage ® observe the IAYT discussions. I re s o n a t e d In general, people respond to what and Yoga of the Heart ®. with Robin Rothenberg's statement in a works for them. This is what I am intere s t e d She lives split-based recent issue of International Journal of Yo g a in, and the more I increase and educate between Huntsville, T h e r a p y that she had discovered that her myself in various modalities, the more tools Alabama, and Nosara, Yoga therapy “protocol is an amalgam of var- I have to address a client's needs. How won- Costa Rica, where she ious therapeutic techniques.”2 I also clearly derful is that? I believe that the pull between consults for the Nosara understood J. Brown's thoughtful distinction d i ff e rent theories and camps that is occur- Yoga Institute.

13 Yo g aT h e r a p yToday Spring 2011 Spring 2011 Yo g aT h e r a p yToday 1 4 I n s i g h t s by J. Brown Thinking About Pain and Health

any people are coming to Yo g a because they have pain and want M relief. What they don't always bar- gain for is that addressing pain thro u g h Yoga practice entails more than just stre t c h- ing their bodies. At the workshop on the Fundamentals of Therapeutic Yoga that I taught at Kripalu this past summer, I worked with a diverse g roup of nine participants from across the United States. They had spinal fusions, rheumatoid arthritis, Crohn's disease, sciatica, and the usual aches and pains that come in the course of life. Most of them had been to plenty of doc- tors, followed the course of re c o m m e n d e d t reatments, and were still left wanting. They w e re resorting to Yoga because they had reached the limitations of Western science. Ye t , conventional notions of health are deeply ingrained and linked to an allopathic ideology that is difficult to escape, especially without a model or an alternative frame of re f e rence. All of the participants assumed that J. Brown and his daughter, Roslyn Bro w n . “therapeutic Yoga” meant they would tell me their symptoms and I would pre s c r i b e That a certain amount of pain is re q u i red for humans to grow teeth them poses. While therapeutic Yoga is helpful in easing pain and facilitating health, in so we can eat and be nourished is evidence of how integral pain is my experience, poses do not work like pills. to our existence. A therapeutic orientation in Yoga practice does not necessarily mean viewing heal- The alluring suggestion that some spe- I shared with the group that I was able ing through a scientific lens. One participant cial, more intricate variation of twist would to make my body strong and flexible, learn challenged me by citing a re s e a rch study she somehow be more potent than a simpler, p recise a s a n a alignment and knowledge of read that showed how doing twists aids m o re enjoyable one or that a teacher with anatomy and physiology, and still have lots digestion; she suggested that knowledge of m o re extensive knowledge of anatomy and of pain and be miserable in life all the same. anatomy and physiology is the key to mak- physiology would have the power to cure M o re than anything else, the key to making ing Yoga therapeutic. people with poses are examples of an my practice genuinely therapeutic hinged on I pointed out that Yoga practice has been e n t renched mindset. If it were just a matter a shift in my perspective. helping people since long before there were of assessing anatomical or physiological In reconciling within myself the death any scientific studies on the subject. The poses o c c u r rences and applying a corre s p o n d i n g of my mother and in cultivating a sense of have no inherent curative power of their own; c o r rective manipulation then, sure l y, science- life's inherent worth, my reason for practic- they are vehicles for a source of healing that based medicine would have already estab- ing Yoga changed. I discovered that the how comes from within and is inherent to life. lished effective pro t o c o l s . and why of my practice is what influences The group was skeptical. They came for We continued our practice and discus- the effectiveness of the techniques. some empirical answers and I was not off e r- sion over several days and began to identify O ffering the details of my personal ing any. I explained that there are, essential- ways in which breathing and moving exer- inquiry into Yoga emboldened the partici- l y, four actions we engage with our bodies in cises can be utilized to establish useful pat- pants to do the same and, as our time togeth- Yoga practice: forward bending, back bend- terns of thought and behavior. The focus er came to a close, tears were shed and new ing, side bending, and twisting. If your prac- shifted from the technicalities of poses to the outlooks forg e d . tice contains these actions and they are experience of practice and an awareness of When I returned home from my time in engaged appropriately then you will poten- how we felt. Emphasis was placed on a re g- Massachusetts, I discovered that my six- tially receive all the benefits of practice, ulation of breath (ujjayi pranayama) and find- month-old daughter had begun exhibiting including better digestion. Whether we ana- ing a measured amount of effort that could signs of teething. Witnessing her in such dis- lyze it through a scientific lens or not, the be supported and enjoyed. Individual modi- comfort without any way to help her was, to outcome is the same. fications were employed where necessary. say the least, difficult. (continued on page 17)

15 Yo g aT h e r a p yToday Spring 2011 Spring 2011 Yo g aT h e r a p yToday 1 6 Insights c o n t i n u e d

More than anything else, the turing sentiment. Too easily, pain makes an key to making my practice enemy of our bodies. One of my teachers suggests that pain is genuinely therapeutic hinged healing. If we accept this premise then per- on a shift in my perspective. sistent pain might indicate that healing is It got me thinking about pain and how I utilize taking place even under continued adverse my practice to address it in my own body. conditions. By this logic, healing comes to S p e c i f i c a l l y, I was thinking about my right hip. f ruition and pain diminishes when condi- My early years of practice, filled with tions are favorable. Thus, the sentiments youthful overexuberance and misguided e x p ressed by Dr. Dean Ornish in his key i n s t ruction, have re n d e red me hypermobile a d d ress at SYR 2010 when he spoke of how and prone to inflammation. Sometimes it small lifestyle changes make a huge impact seems to originate at my sacroiliac joint; on our health. sometimes I think it may be due to worn T h e re is a commonly held misconception connective tissue in my hip socket. When it that health amounts to having no pain. Not f l a res up, the pain can extend all the way t rue. Certainly, it is possible to be in a terrible down my leg and into my foot and be quite situation, filled with pain, and still be dealing d e b i l i t a t i n g . with the circumstances in a healthy way. My I have considered talking to a doctor daughter is perfectly healthy and yet she still about this pain but never have. At the time of experiences pain. That a certain amount of my last physical, it had not been bothering pain is re q u i red for humans to grow teeth so me much and the doctor seemed so we can eat and be nourished is evidence of i m p ressed with me as an example of good how integral pain is to our existence. health that I didn't bother to mention it. Given the often fickle turn of events and I already have a good sense of what undeniable realities of our lives, some tests he would likely have run and am fairly amount of pain is unavoidable. There f o re, I confident they would have provided no have come to think of my health as the definitive answers. MRIs cannot undo the p rocess by which I manage the pain that life p rolonged mistreatment of my body in the i n h e rently brings. The better I am able to name of achieving alignment and becoming manage it, the healthier I am. Bringing care- s e l f - realized; nor can they do anything to ful attention to an engagement of my bre a t h a d d ress the unrelenting demands of being and body as a means of easing physical dis- the sole proprietor of a Yoga center and a comfort and establishing constructive pat- newly anointed dad. terns of thought and behavior is immensely I can't help but think that were I to have helpful in this re g a rd . enough time and re s o u rces to tend to myself M o re than simply alleviating symptoms in an ideal way, my hip would heal and the with poses or any scientific explanation for pain could be minimized if not done away how poses might address issues in our bod- with entire l y. But unless a magical suitcase of ies, therapeutic Yoga involves having a re v e r- money falls from the sky, there is no way to ence for the human body's innate intelligence tell. and capacity to heal. Our ability to receive the What I do know is that when I am therapeutic benefits of Yoga practice is contin- YTT fatigued and the pain is persistent, I begin to gent on this fundamental concept. question whether my body can heal on its own and wonder if I need an outside intervention to “fix” me. The emotional impact of chro n i c pain will cause doubts in even the strongest of constitutions. What a terrible irony that one of J. Brown is a Yo g a the by-products of pain is a tearing down of teacher/therapist, writer, the mentality so vital to healing. and founder of Abhyasa My only recourse in these instances is to Yoga Center in Bro o k l y n , make an honest assessment of the circ u m- N Y. stances surrounding my discomfort, take a b h y a s a Yo g a c e n t e r. c o m . any seeable actions to ease the situation and, above all else, meet the difficulty with a nur-

17 Yo g aT h e r a p yToday Spring 2011 Spring 2011 Yo g aT h e r a p yToday 1 8 Insight by Traci Housman Surprised by Peace A moving account of finding stillness amid the chaos of incarcerated life.

hen I met Nancy I was in a very each time, Nancy was able to meet dark and transitional place in my everyone where they were at. Several Wlife. women entered the class feeling like it I had left my life behind to move to a would be unattainable, that they were new town, where I married my teenage not equipped to reap the benefits of sweetheart. A year later, I found myself in Yoga; but through her kind words and jail, not understanding how I let my life get thoughtful training, I watched self- so out of control. I was mourning my hus- esteem and self-worth blossom before band and still trying to understand what my eyes. For so long, I had believed had happened that night. I was broken and that Yoga practice was for those privi- disconnected. I was lost and searching for leged few…not for me. But Nancy meaning, trying to find a purpose in every- i n t roduced us to the idea that Yo g a thing that was happening. As I began to was something that everyone accept that I was in captivity, I reached out deserved to have in their life. for answers. To w a rd the end of my nine months The jail off e red several groups and of incarceration, I began to discover classes that inmates could sign up to attend. the fitness benefits of Yoga. I had A few of the older ladies in the jail had been always done regular exercise and con- attending a class called “Relaxation Te c h- s i d e red myself to have a strong body. I niques.” I asked about it and was told it was soon learned that Yoga off e red a level basically a Yoga class. I had never done of fitness that I had never explore d . Yoga, but I had always been curious about it. Once, after being given more specific T h e re was a class limit of five people; I put feedback on the technique of the my name on the waiting list and soon found poses, I found myself breaking a sweat myself in my first Yoga class. within ten seconds of a pose. Bre a t h- That was when I first met Nancy. ly pulled back into the never-ending drama ing was again taught to help keep me We all sat on Yoga mats in a circle on the of jail life. focused on my body. It was truly like being f l o o r. We took turns telling how we were For several months I continued to attend able to take a vacation inside of my own feeling at the moment and letting Nancy the weekly class. I enjoyed the physical b o d y. I could be surrounded by aggre s s i o n know if we had any injuries to be aware of. e ffects on my body. I had a back injury that and chaos and yet be in a safe, calm place She began talking about m e t t a, lovingkind- had plagued me for fourteen years that within myself. ness. Each lady had her own story and level seemed unnoticeable to me after the class. It is amazing for me to look back and see of stress, pain, and ability. Nancy started us The stretches were intense, but when paire d how I have been so privileged to have met o ff lying on our backs and doing some exer- with the focus on breathing that was prac- Nancy at such a difficult time in my life. The cises that worked our abs. I was surprised at ticed during the stretches, I found my mus- focus that I was able to attain during such a how quickly my muscles were being activat- cles were able to relax more into the stre t c h traumatic period was impressive. The ability ed. I was used to crunches and sit-ups, but and I received much-needed relief (especial- to simply "let go," when so many times in my these seemed much more effective. Next, we ly considering the uncomfortable metal beds life that was easier said than done, just started doing some poses. They were all for- at the jail). I also focused on the metta teach- became automatic at times. I had a new- eign to me, but her directions were clear ings. These were practices that kept my heart found practice of slowing everything down enough that I could fumble into each one. in the right place. Too many people in the jail inside of myself so that I could process what Everyone was laughing as we stumbled become bitter and angry and even aggre s- it was that I was feeling, and tune into a con- a round trying to find our balance. But sive. It was very difficult to be in such close nection with everything around me that I t h roughout the class, she always re m i n d e d quarters with so many people going thro u g h was not aware of before. us that there were modifications to the poses so much stress, but the techniques taught in In addition to my own experience, I that would allow anyone to gain benefit. the classes allowed me to interact with peo- observed so many women experience diff e r- At the end of the class, everyone comple and accept their behaviors without feel- ent levels of their own growth. I watched mented on how much more relaxed they felt. ing triggered myself. I was able to find a people who have never known another way How their bodies felt healthier. Some were place of peace within myself. of thinking, consider new possibilities and able to maintain that feeling once back in the T h e re were times when a completely try new ideas. I watched them open to some- main jail area, while others were immediate- new group of women attended the class, and thing diff e rent. I watched women who had

19 Yo g aT h e r a p yToday Spring 2011 For so long, I had believed that Yoga practice was for those Nancy Candea, CYT, E-RY T, CPT, is the privileged few…not for me. But Nancy introduced us to the d i rector of Yoga Impact. Information about Nancy can be found at yogaimpact.org & idea that Yoga was something that everyone deserved to have nancycandea.com. She can be contacted in their life. at [email protected]. insecurities about their weight find pride in this knowledge with people who desperate- course. And I am learning about the physiol- themselves for the energy that they exerted ly need it in their lives. These people are n ' t ogy of Yoga poses in connection with the in class. I watched girls who would re s p o n d even aware of how much they could benefit anatomy of the body. The most exciting part to stress with aggression, simply choose to f rom the teachings, just like I didn't know. about it is the realization that I will always let go of a situation. As I have said, it is amaz- N o w, nine months since my release, I have more to learn, further to reach, and ing to look back and see what Nancy continue to be amazed at the pro g ress that deeper to go into every doorway that Yo g a b rought to the enviro n m e n t . takes place in me. Sometimes it is a trickle, practice has opened inside of me. For as crip- Once I had been released and started and other times I am flooded with it. At times, pling as some of the moments were that the next chapter in my life, with its own set it is a physical pro g ress. All of a sudden my b rought me to where I am now, I can't help but of challenges, I could feel that I was drifting body finally understands how to coord i n a t e be grateful for every moment of my life. YTT away from that place inside of myself that the muscles and I just “get it.” Sometimes, it is found connection. Fortunately, I re c o n n e c t e d on a more connected level. Spiritual, if you with Nancy on the outside of those walls and will. I can be struggling with emotions, or an At 38 years old, Tr a c i was invited into her instructor program. I am interaction for whatever reason, and some- Housman's new goal is to learning more about the concepts and tech- thing inside my heart just opens up to the big s h a re the connection to niques that held me in dark times, and am p i c t u re of it all, and for a moment, I am able to compassion and peace that excited that I will be able to bring this to peo- step outside of my own protective walls and was shared with her during ple in the future. I am deeply grateful for the simply accept what is. I cherish every a time of chaos in her life. opportunity to have met Nancy, to be learn- moment that I am given. I journal it each day, ing from her, and to have the chance to share which is a part of the instructor training

Spring 2011 Yo g aT h e r a p yToday 2 0 The First International Conference on Yoga for Health and Social Transformation A report from IAYT's president, Eleanor Criswell, EdD

he First International Conference on Yoga for Health and Social The conference was inclusive of all the Yoga traditions and many Transformation, organized by the University of Patanjali and w e re re p resented. There were re p resentatives from most of the Tthe Patanjali Research Foundation, Haridwar, India, was held leading Yoga institutes of India. Some, though invited, were not January 2-5, 2011. The University of Patanjali and the Patanjali able to attend. Many swamis and sages came to bless the confere n c e R e s e a rch Foundation are divisions of Patanjali Yogpeeth under the both in the opening and closing ceremonies. The conference began d i rection of Swami Ramdev and Acharya Balkrishna. Shirley Telles, a with a four-hour inaugural cere m o n y, in which I was honored to w o r l d - renowned Yoga re s e a rc h e r, was chair of the scientific pro g r a m re p resent IAY T. Many gurus and prominent teachers participated, committee and moderated the entire conference. Dr. Telles spoke at such as Swami Ramdev, Acharya Balkrishna, Swami Veda Bharati, I AYT's last SYTAR in 2009 and the first Symposium for Yoga Researc h Swami Chidanand Saraswati, and Sri B.K.S. Iyengar, who was the (SYR) last fall. The conference was closed at 1,500 participants. chief and most-honored guest. Among his sage comments, he The International Association of Yoga Therapists (IAYT) was noted that the interest in Yoga in the West helped spur a re s u rg e n c e well recognized by the Uni- of interest in Yoga in India. versity of Patanjali. John Kep- R e p resentatives from most n e r, executive dire c t o r, and I, of the Indian re s e a rch and Eleanor Criswell, pre s i d e n t , teaching institutions and w e re invited to re p re s e n t associations spoke briefly. I AYT at the conference. A These organizations include number of people from IAY T the Association of either presented at or attend- Himalayan Yoga Medita- ed the conference. For exam- tion Societies International, ple, Sat Bir Khalsa was on the the Central Council for scientific program committee R e s e a rch in Yoga & Natur- for the conference as well as a o p a t h y, Dev Sanskriti Vi s h- panel presenter; Leigh Blash- wavidyalaya, the Isha ki, Kim Innes, Robin Monro , Foundation, Kaivalyad- and Amy Weintraub were hama, the National Institute p resenters. Loren Fishman of Naturo p a t h y, Parmarth was a poster pre s e n t e r, for Niketan Ashram and the which he won an award. Sev- India Heritage Researc h eral re s e a rch scientists who Foundation, SDM College have presented at IAYT con- and Hospital, Swami f e rences also presented here , Vivekananda Yoga A n u - including Luciano Bernali, Swami Ramdev, Ashwini Setya, MD, Eleanor Criswell, EdD sandhana Samsthana, and University of Pavia, Italy; The Yoga Institute (the old- Ginger Carrieri-Kohlman, School of Nursing, University of Califor- est Yoga institute in India and the world). Two-minute video clips nia, San Francisco; Lorenzo Cohen of the MD Anderson Cancer Cen- enabled the audience to experience the nature of the ashrams and t e r, Houston; Loren Fishman, Columbia College of Physicians and institutes. It was a single-track conference that included a number S u rgeons, New York; and Robert Saper, Boston Medical Center, of panel presentations, a poster session, and a paper session. Con- Department of Family Medicine, Boston. John Kepner and I chaire d f e rence themes included Yoga and Health, Yoga as Therapy, and panel sessions. John Kepner's presentation, “Credibility and Commu- Yoga and Society. Morning Yoga classes in the University of Patan- nity: The Role of a Professional Association in Supporting Yoga Ther- jali's large auditorium (capacity: 10,000!) conducted by Swami apy as an Emerging Profession in the United States,” led to discus- Ramdev for at least one and a half hours were broadcast around the sions with many delegates about the role of professional associations world via satellite television. Millions of people were able to expe- in developing the field. rience the conference via Aastha TV and other channels. For exam- The conference was conducted in the Indian tradition with a ple, an advisor to the IAYT board, Dilip Sarkar, who at the last combination of spiritual, re s e a rch, and application sessions. Much of minute could not attend the conference, watched it from Norfolk, the conference was guru - c e n t e red. In India there is a strong tradition Vi rginia, and gave us feedback on his impressions via the Internet. of following the guidance of a guru. The guru is a teacher in the During the meal and tea breaks, presenters and attendees were able l a rgest sense of the word and is, ideally, Self -realized. This confere n c e to meet together to discuss Yoga re s e a rch, Yoga education, and was organized following that tradition. There are many Yogas and other topics and to form many valuable connections. Julie Deife Yoga lineages in India that are guru - c e n t e red. In the United States and was pleased to have the opportunity to interview Swami Ramdev other countries many of the Yoga traditions are not guru - c e n t e re d . and Acharya Balkrishna.

21 Yo g aT h e r a p yToday Spring 2011 The conference was confirmation that interest in Yoga therapy and Yoga research is growing rapidly and that the work of IAYT is an important part of a worldwide movement.

(For an account of the presentations and more, see Julie Deife's tice s e v a (service). For example, many people devote at least two hours blog on the conference at yogagoesglobal.com) per day to Yoga practice Swami Ramdev-style, and many have trained The objective of the conference was to “bring together leading as Yoga teachers to give free Yoga classes in their communities. international scientists, re s e a rchers, and academicians to address the Because of his energetic teaching style, the New York Ti m e s called him underlying mechanisms of Yoga and the value of its application in “the Richard Simmons of Yo g a . ” 2 This is clearly the most popular eff o r t health, medicine, and society. ” 1 The goal of Patanjali Yogpeeth is to to promote Yoga as a therapy in the world to date. Yoga therapy has c reate social transformation by enhancing the health and wellbeing been practiced in India since ancient times. Gurus regularly used Yo g a of Indians and everyone worldwide through Yoga. Yoga also con- practices to heal their students ( c h e l a s ) and others in the community. tributes to the efforts to enhance India's sense of its heritage. Patan- Swami Ramdev has made many strong claims about the health bene- jali Yogpeeth has a strong interest in social transformation, Indian fits of Yoga. To back up these claims, he established the well-funded s e l f - reliance, planetary welfare, and human rights. I am in sympathy R e s e a rch Division of Patanjali Yogpeeth in Haridwar under the dire c- with many of the goals of Patanjali Yogpeeth's mission, especially tion of Shirley Telles and the supervision of Acharya Balkrishna. The that of bringing in Yoga for health as the foundation for social trans- newly formed Patanjali Research Foundation will sponsor extensive formation. The agenda for Patanjali Yogpeeth and the Bharat Swab- re s e a rch in the future . himan movement is a classic one. You can find it in the writings of At the conference there was a strong emphasis on Yo g a g u rus of the past as well as contemporary gurus. What is diff e rent in re s e a rch. Yoga re s e a rch is very important for increasing the accept- this case is Swami Ramdev's extraordinary charisma, Acharya Bal- ance of Yoga worldwide and enhancing the health of everyone. krishna's amazing organizational skills, and the extensive use of tel- When people are healthy and actualizing their potential they func- evision and other media to spread Swamiji's teachings. He has tion happily within their families, communities, and nations and i n s p i red millions of people in and out of India to transform their lives can participate as world citizens. and the lives of others through Yoga, which he calls Yo g, and to prac- (continued on page 23)

Spring 2011 Yo g aT h e r a p yToday 2 2 ConferenceReport c o n t i n u e d

The outcomes of history and the world. the conference benefit During the confere n c e , all of us—you, me, and I was able to thank I AY T. It was very aff i r m- India for the gift of ing to me and the work I Yoga to the world. We have done over the past a re deeply grateful to 40 years, the things I Swami Ramdev and have taught my stu- Acharya Balkrishna for dents, and to IAY T ' s bringing Yoga more potential. It was very deeply into the lives of inspiring. We have contemporary Indians many new colleagues as and to the world at a result of the confer- l a rge; for example, ence. John and I were Swami Ramdev's class- able to meet and talk es are shown world- with many well-known wide via satellite televi- Yoga re s e a rchers and sion and there are educators. Debra Kra- Patanjali Yog centers in jewski, assistant to the the United Kingdom, executive director of the United States, and I AY T, coordinated IAY T ' s Nepal. The 94-acre booth in the exhibit are a Patanjali Yoga & Herbal and assisted in many R e s e a rch Center is cur- networking activities. rently being developed Many contacts and collaborations were established or stre n g t h e n e d . in Rosenberg, Texas, a suburb of Houston. The re s e a rch sponsored by After the conference, presenters toured the Yoga re s e a rch labora- the University of Patanjali under the direction of Shirley Telles and the tories of the Patanjali Yogpeeth's Research Division—Emphasizing work of the conference presenters is deeply important for the accept- Yoga. The four laboratories feature oxygen consumption and meta- ance of Yoga in many contexts in contemporary society and for the bolic testing, autonomic function testing, clinical neuro p h y s i o l o g y, refinement of the practice of Yoga and Yoga therapy. and perceptual and motor skill testing. Next we visited the Patanjali The cooperation and collaboration that is possible when gre a t Food and Herbal Park, the manufacturing and distribution facility for souls and minds come together for the common good could be seen Patanjali Yogpeeth's Ayurvedic medicines, spices, personal care pro d- in this conference. It is thrilling to me to envision what is possible. ucts, and so forth. Construction began on January 5, 2010, and the The ripples from this conference will continue to be felt for some facility was up and running in less than a year. Currently sitting on time. I want to thank Swami Ramdev, Acharya Balkrishna, and 125 acres and soon to double in size, it is a large-scale operation. Its Shirley Telles for IAYT's opportunity to participate in the confere n c e . purpose is to support small farmers and organic farming, to pro v i d e I wish the Patanjali Yogpeeth well on its continued growth and better marketing for farmers and lower prices to consumers, and to development and the achievement of its goals in peace and in the encourage healthy living. The next day John Kepner, Leigh Blashki spirit of Yoga. YTT (Australian Association of Yoga Therapists), and I met with A c h a r y a Balkrishna, Shirley Telles, and others re g a rding the proposed Indian For more information about Swami Ramdev, Acharya Balkrishna, and Association for Yoga Therapists. We also met with others thro u g h o u t Patanjali Yogpeeth see divyaYo g a . c o m . the conference re g a rding associations in India and other countries. The following day John, Debra, and I went to Rishikesh, which is about an hour away from Haridwar. There we visited the Sivanan- R e f e r e n c e s 1. Patanjali Yogpeeth - Divya Yog Mandir (Trust) (2011). Yoga for health and social da Ashram (Divine Life Society). Swami Sivananda was the guru for transformation: First International Conference, January 2-5, 2011. Retrieved January Swami Vishnudevenanda, Swami Satchitananda, and Swami Chi- 2 0 11 from divyaYo g a . c o m . dananda, all of whom trained many Yoga teachers in the United 2. Polgreen, L. (2010, April 19). Indian who built yoga empire works on politics. States and worldwide. We also visited the Sadhana Mandir Trust, an Retrieved from nytimes.com/2010/04/19/world/asia/19swami.html?_r=1. ashram founded by Swami Rama in 1966; Swami Veda Bharati's ashram (Swami Rama Sadhaka Grama) and its Meditation Researc h Institute, which is under the direction of Manuel Fernandez (I was delighted to see that biofeedback/neurofeedback is being off e red to Eleanor Criswell, Ed.D., is emeritus professor of ashram residents and guests and that psychophysiological re c o rd i n g s p s y c h o l o g y, Sonoma State University, director of a re being used in their re s e a rch); and Swami Chidanand Saraswati's the Novato Institute for Somatic Research and ashram (Parmath Niketan Ashram) on the banks of the Ganges. Training, and president of the International The conference was confirmation that interest in Yoga therapy and Association of Yoga Therapists. Yoga re s e a rch is growing rapidly and that the work of IAYT is an important part of a worldwide movement. John, Debra, and I met delegates from many places in the world. We are still processing this e x t r a o rdinary opportunity to immerse ourselves in Yoga throughout its

23 Yo g aT h e r a p yToday Spring 2011 The Tr a n s f o rmative Potential of Science How Research can Bring Yoga into the World —by Angela M. Wilson, MA

or many of us who practice Yoga, validating the scientific ben- Standardized protocols . . . also empower efits of the practice seems unnecessary. We know that Yo g a F enhances wellbeing and improves our lives, and most of us researchers to deepen their scientific who practice do not need a scientific study to demonstrate this re a l- inquiries from “Does this practice work?” to i t y. Yet most of us would like to see Yoga become more central to our c u l t u re. What if Yoga were acknowledged more broadly for its abil- “What are the underlying mechanisms by ity to transform our educational system or influence our healthcare which it works?” policies and prescriptions? What if it were an essential part of our w o r k d a y ? Has Begun but Needs Continued Support At the Institute for Extraordinary Living (IEL), we believe that Yoga re s e a rch is on the brink of becoming a formidable field of study Large NIH grants. Pilot data can place an intervention on the scientif- and as such has the potential to bring Yoga deep into the heart of our ic radar but more serious buy-in from healthcare providers, educa- cultural institutions. The National Institutes of Health (NIH) and the tors, and employers comes from the kinds of studies that only larg e r National Center for Complementary and Alternative Medicine funding can provide. Larger grants, and the rigorous studies they (NCCAM) are both actively seeking proposals for Yoga interven- enable, very clearly enhance the credibility of the intervention itself. tions. NCCAM's five-year plan clearly states a need to encourage the Yoga re s e a rchers have just begun to receive large grants: Dr. Chris development of mind/body interventions such as meditation, mas- S t re e t e r, for her work on Yoga and the brain; Dr. Lorenzo Cohen, for sage, and Yoga and to study these interventions for clinical eff e c t i v e- his work with cancer patients; and Dr. Sat Bir Khalsa, for his study on ness, safety, and eff i c a c y.1 Although funding remains an issue for traumatized military veterans. re s e a rchers no matter what the field of study, this recent call for Yo g a re s e a rch is a clear indication of a cultural shift in healthcare needs. Yoga Research Conferences and Collaborations. One reason that a T h e re are many other pieces in place that would support the contemplative intervention such as Mindfulness-Based Stress Reduc- expansion of Yoga re s e a rch at this particular time. These include a tion (MBSR) has proliferated is due to its prestigious annual confer- h e a l t h c a re system that is in serious need of re-visioning, a surprising ence, hosted by The Center for Mindfulness. Conferences such as number of well-respected scientists who are already studying Yo g a , these are necessary forums for meditation teachers and scientists to and a society that is beginning to wake up to the call for pre v e n t a- come together and talk about the relevant clinical and scientific top- tive healthcare and a cultural cry for a more balanced world. ics. Over time, conferences can create a strong platform for teachers So, with all these pieces in place, what are the obstacles that and scientists to tap each other's re s o u rces and to build community. remain? What are the steps that are needed for Yoga re s e a rch to S i m i l a r l y, one of the reasons Yoga re s e a rch has expanded in the obtain a larger share of public grant funding? And what develop- last several decades is because of the various Yoga re s e a rch confer- ments will move Yoga from being perceived as anecdotally benefi- ences that have been established. These conferences allow Yo g a cial to being accepted as scientifically valid? At IEL, we have begun re s e a rchers to come together to discuss their work and share ideas to to address these questions. c reate a truly collaborative effort. H o w e v e r, many of these conferences have been held in countries What's in Place outside the United States. Given the growing number of Yo g a re s e a rchers in this country, it was a strategic move on the part of IAY T Cutting-edge researchers involved in Yoga research. In order for a to host its First Annual Symposium on Yoga Research (SYR) last fall new field to successfully emerge, a formidable group of re s e a rc h e r s in Honesdale, PA, in addition to its Symposium of Yoga Therapy and needs to turn its scientific skills to the challenge. Yoga practice has R e s e a rch (SYTAR), which began in 2007. More of these forums are been quite successful in securing the interest of highly leveraged needed so that Yoga re s e a rchers can continue a creative dialogue re s e a rchers. Dr. Lorenzo Cohen, from MD Anderson; Dr. Chris about Yoga re s e a rc h . S t re e t e r, from Boston University's School of Medicine; Dr. Bessel van de Kolk, from the Trauma Center; and Dr. Sat Bir Khalsa, fro m What's Sorely Needed Brigham and Women's Hospital and Harvard Medical School, were all highly valued re s e a rchers in their particular field of study even before Standardization of Yoga Protocols. A c o m p rehensive discussion on they began their re s e a rch on Yoga. As a result, Yoga re s e a rch has gar- s t a n d a rdization of Yoga protocols is beyond the scope of this article. n e red increased scientific recognition, prominence, and pre s t i g e . H o w e v e r, standardization is an important scientific tool, particularly in the “gold standard” of randomized controlled trials. When Abundance of preliminary data. Most re s e a rchers can tell you that someone says “I practice Yoga,” what does that mean? Is it Power even the smaller NIH grants now re q u i re scientists to provide pre- Yoga or Hatha Yoga, Kundalini Yoga or Kripalu Yoga? Does it mean liminary data. Pilot data are essential if a re s e a rcher is to obtain a s a n a or p r a n a y a m a? Which is it—in what combination and for how l a rg e r, more influential grants. Fortunately, we have achieved this long? For a re s e a rcher who is intending to implement rigoro u s step. There are now hundreds of studies that provide pre l i m i n a r y re s e a rch methodologies, lack of specificity or standardization is a lim- data. We know Yoga works and we know it works for a number of iting factor in the attainment of larger grant funding. d i ff e rent populations.2 (continued on page 25)

Spring 2011 Yo g aT h e r a p yToday 2 4 Transformative c o n t i n u e d

essential tools of Yoga and to develop evidenced-based Yoga curricula founded on these tools. We aspire to continually refine these curricula in order to best address the major mental and physical diseases of our time. The second, parallel, mission is to conduct a thorough study of the impact of Yoga curricula on the full spectrum of human functioning, to scientifically understand Yoga's capacity to attenuate states of physical and mental suffering, and to enhance optimal states of human functioning. We aspire to communicate and re p o r t this knowledge through conference presentations, scientific publications, and media articles. The IEL has undertaken the following strategic initiatives to begin to fulfill its mission to bring Yoga into the world and to study its impact on health and wellness. These include initiatives in curriculum development and rigorous re s e a rc h .

Curriculum Development Kripalu guests enjoy a Yoga class on the front lawn. Standardized Yoga Curriculum: The process of creating a core cur- Although there are now hundreds of studies on Yoga, Yo g a riculum has involved an in-depth discussion with senior Yoga teach- re s e a rch has been criticized for the lack of standardization in its pro- ers about the key ingredients of a “standardized Yoga curriculum.” t o c o l s ,3 and we believe that this is the main reason Yoga re s e a rc h e r s Our eight-week curriculum consists of both “on-” and “off - t h e - m a t ” have had difficulty obtaining larger grant funding. MBSR, developed techniques, combining a s a n a practice with accessible Yoga philoso- by John Kabat-Zinn, has enjoyed the success that it has because it is a p h y. The focus is on supporting students in developing a gre a t e r s t a n d a rdized intervention. MBSR is now off e red in over 200 medical capacity to be mindful responders to their experience and to practice centers, hospitals, and clinics around the world,4 l a rgely as a result of and cultivate greater states of equanimity, compassion, and skillful NIH funding. action. This curriculum was designed to be accessible to a wide In addition to grant funding, standardization allows mental range of populations and conditions. Although the core curriculum health workers and physicians to have a clearer sense of what they is focused on nonmedical populations, we are already in the pro c e s s a re recommending to their patients. It's one thing to tell a patient to of creating iterations of this program for obese women and second- “give meditation a try”—it's quite another to prescribe a meditation ary school children. course that has been repeatedly validated by science.5 Our long-term vision for this initiative is to create a curriculum This isn't to say that we should only have one Yoga intervention. that can be off e red in various venues, including workplace, academ- We will need diff e rent standardized protocols for diff e rent conditions ic, and healthcare settings. It is also our intention that this curricu- and ultimately for diff e rent constitutions. But, in order to most eff e c- lum will offer Yoga teachers an opportunity to expand their own tively interface with the scientific model of investigation, we need to tools for teaching, and thus create a more sustainable livelihood for start with a select few interventions to build on. teachers. S t a n d a rdized protocols allow for a deeper understanding of what practices are most effective—for whom, and for what re a s o n s . They enable replication and, there f o re, validated outcomes. They also empower re s e a rchers to deepen their scientific inquiries from “Does this practice work?” to “What are the underlying mechanisms by which it works?” If each scientist or Yoga practitioner creates his or her own idiosyncratic intervention, it makes it challenging to build on that work. One of the IEL's primary missions is to create standard i z e d curricula in order to enhance our funding potential and to expand the impact of Yoga on our culture.

Kripalu's Institute for Extraordinary Living

The IEL a s p i res to create a world in which Yoga is scientifically and experientially validated as a practice that can awaken the human being's innate capacity for self-healing and awareness. We envision a world in which Yoga sits as a leading evidenced-based holistic intervention for physical, mental, and spiritual wellbeing. A world in which, as a result of this scientific validation, all people, re g a rdless of age, economic status, or ethnicity, will have unmitigated access to Yoga—in their schools, in their work environments, and in their h e a l t h c a re choices. Janna Delgado teaching Yoga to girls at Monument Mountain Region High The IEL has two primary missions: The first is to articulate the School in Great Barrington, MA, as part of IEL's research on Yoga in schools.

25 Yo g aT h e r a p yToday Spring 2011 The IEL aspires to create a world in which Yoga is scientifically and experientially validated as a practice that can awaken the human being's innate capacity for self-healing and aware n e s s . . ..A world in which all people have unmitigated access to Yoga—in their schools, in their work e n v i ronments, and in their healthcare choices. R e s e a r c h D r. Conboy has recently paired with nationally recognized obesity re s e a rcher Dr. David Ludwig, from Children's Hospital in Boston, Yoga in Education: In collaboration with our director of re s e a rc h , and together they continue to investigate how Yoga facilitates weight D r. Sat Bir Khalsa, we have initiated a collection of studies on Yo g a loss in women. and secondary school children. These studies focus primarily on the impact of Yoga on mood, cognitive control, and academic perform- Yoga and the Brain: Cognitive science re s e a rc h e r, Dr. Sara Lazar, fro m ance. A brief account of results indicates that students who partici- Massachusetts General Hospital, is currently analyzing data on a study pate in bi-weekly Yoga classes through a school semester re p o r t investigating the impact of long-term Yoga practice on brain stru c t u re higher states of wellbeing and mental stability than control subjects and function. Utilizing state-of-the-art MRI technology, Dr. Lazar is who received physical education classes alone, suggesting that Yo g a investigating whether Yoga practice can change the actual stru c t u re of acts as a buffer against academic and social stre s s . 6 In collaboration the brain. This study will also evaluate changes on attention, fluid intel- with Harvard alcohol re s e a rc h e r, Dr. Howard Schafer, the IEL ligence, and enhanced emotional and cognitive functioning. intends to utilize this pilot data to apply for a grant through the National Institute of Drug Abuse early next year. Bringing the vision to fruition

It is clear that momentum is building nationwide with pioneer scientists, promising pilot data, development of standardized Yoga curricula, and IAYT's publications and conferences. Yoga re s e a rch, in general, is on the edge of proliferating. How can we as a professional field continue to support this momentum? N o w, more than ever, we need to tap the power of collaboration and communication. This fall, the Second Annual Symposium on Yoga Research (SYR) will be held at Kripalu Center. The confere n c e will serve as a meeting place for Yoga re s e a rchers and practitioners to unite and discuss the latest topics facing our field. Collaborations will form, and the deepening of scientific inquiry will no doubt occur. Science offers a framework and a language that, if properly utilized, can bring Yoga practice to thousands of people who would not otherwise have access to its benefits. Science is the epistemology of our time, and it is through science, not in spite of it, that we as a community have an opportunity to transform our society—to impact its Jennifer Johnston, Yoga teacher for IEL's Yoga and PTSD study, teaches Yoga values, its relationships, and its view of life itself. It is through science Warrior I to a veteran. that we can bring Yoga more fully into the world. YTT

Yoga and Posttraumatic Stress Disorder in Ve t e r a n s : In 2008, the R e f e r e n c e s 1. National Center for Complementary and Alternative Medicine. (2010). Exploring the Department of Defense awarded Dr. Sat Bir Khalsa a $300,000 grant science of complementary and alternative medicine: Third Strategic Plan: 2011-2015. R e t r i e v e d to study the effects of Yoga on post-traumatic stress disorder (PTSD) F e b ruary 2, 2011, from http://nccam.nih.gov/about/plans/2011 . 2. Khalsa, S. B. S. (2004). Yoga as a therapeutic intervention: A bibliometric analysis of in veterans. Dr. Khalsa has since been given an additional $300,000 published re s e a rch studies. Indian Journal of Physiology and Pharmacology, 48(3), 269-285. to add a control group to the study. In collaboration with trauma and 3. Salmon, P., Lush, E., Jablonski, M., & Sephton, S. (2009). Yoga and mindfulness: Clini- Yoga experts, the IEL has developed a comprehensive “on-the-mat” cal aspects of an ancient mind/body practice. Cognitive and Behavioral Practice, 16(1), 59- 72. Yoga program specifically designed to relieve symptoms of trauma. 4. Mindful Living Programs: What is Mindfulness-Based Stress Reduction? (n.d) During the 10-week study, veterans will attend two 90-minute Yo g a Retrieved February 6, 2011, from mindfullivingpro g r a m s . c o m / w h a t M B S R . p h p . classes each week and practice at home every day for 15 minutes. 5. Praissman, S. (2008). Mindfulness-based stress reduction: A l i t e r a t u re review and clin- ician's guide. Journal of American Academic Nurse Practitioners, 20(4), 212-6. The primary goals of this study are to reduce PTSD severity and 6. Khalsa, S., Schultz, L., Cohen, D., Steinder, N., & Cope, S. (in press). Evaluation of the symptoms and decrease nervous system arousal. mental health benefits of Yoga in a secondary school; a preliminary randomized con- t rolled trial. Journal of School Psychology. Yoga for Weight Loss: The IEL's Yoga for Weight Loss study will e x p l o re how practices such as a s a n a, p r a n a y a m a, and mindfulness can help women lose weight and improve physical and psychologi- Angela M. Wilson, MA, is assistant director of cal wellbeing. This pilot study considers the effects of regular Yo g a the Institute for Extraordinary Living. Her back - practice on weight loss and associated parameters of physical and g round includes re s e a rch on spirituality, medita - psychological wellbeing. The scientific evaluation of this work is tion, and Yoga. She has a master's in mental being done in collaboration with Dr. Lisa Conboy, social epidemiol- health counseling, is a Kripalu Yoga teacher, and ogist at the Osher Institute, Harvard Medical School. Utilizing the has completed 250 hours of training in Ay u r v e d a . key components of our “core” curriculum, this pilot study will m e a s u re the effects of Yoga on subjective health, psychological wellbeing, and objective biomarkers in overweight and obese women.

Spring 2011 Yo g aT h e r a p yToday 2 6 Yoga Research: Yes, No, or How? A Contribution to the Dialogue —by Nina Moliver, PhD, RY T

any of us who listened to Dr. Tim McCall's keynote When we take the longer view—the view of speech, “To w a rd a More Blissful Union of Yoga and Sci- external validity, or the “real world”—obser- M ence,” at the 2009 SYTA R 1 knew that we were hearing some words of truth. Yet in a response to Dr. McCall in this publica- vational designs will actually give us results tion, Dr. Marshall Hagins2 voiced the concern that Dr. McCall may that are more accurate and more likely to have unfairly been giving science a “black eye.” I'd like to take a closer look at what Dr. McCall said in his speech, and I'd like to reflect what happens when Yoga is actually show that far from giving science a “public drubbing,” Dr. McCall practiced. That's a finding of science. was inviting the scientific community to broaden its vision of what As Dr. Laurence so correctly stated, we need not turn our backs on science can contribute to the understanding of Yo g a . Yoga re s e a rch to address the defects of the randomized, contro l l e d D r. McCall has cited several specific problems with scientific trial. There is a middle way known as the observational design, also studies of Yoga. First, double-blinding a Yoga experiment is not pos- called the outcome-based study or the effectiveness study. sible. Second, experiments are performed with standardized pro t o- In an observational study, participants live and practice in their cols, but Yoga in the real world is not practiced according to stan- natural settings. Ty p i c a l l y, they answer questions about their feelings d a rdized protocols. Third, experiments are expensive—and the or behavior in the setting where they live or work, often by complet- sponsors of experimental studies are often responsible for biasing ing a survey. Usually they answer these questions only in re t ro s p e c t . and corrupting the results. Fourth, Yoga studies tend to involve Participants are not told what to do, where to do it, or with whom or fixed protocols, whereas Yoga instructions are normally based on an how often or when or for how long. interactive response to empirical observation. Fifth, Yoga studies tend to involve exclusion criteria, whereas in normal Yoga instru c- The Validity of the Observational Design tion, every person is welcome to practice, and it is the job of the How valid are studies using observational designs? Researc h e r s i n s t ructor to adapt the practice so that it is comfortable and safe for a rgue that with an observational design, we cannot determine cause the individual. Finally, the evaluation of short-term changes is usu- and effect. For example, if a re s e a rcher didn't randomly assign the ally most effectively accomplished by studying beginners. Thus, the participants, it is not possible to know if Yoga practitioners are hap- re s e a rch tends systematically to underestimate the long-term poten- pier because they practiced Yoga, or if people who were happier tial of Yoga. All of these issues are issues not with science, but with w e re naturally attracted to starting a Yoga practice. Thus, any num- randomized, controlled trials. ber of untallied factors could be confounding the results. T h e re are ways to address this argument—for example, support What Kind of Yoga Research? f rom prior re s e a rch, a multiplicity of studies, proof of biological plau- The randomized, controlled trial (also known as the clinical trial, the s i b i l i t y, and (in scientific parlance) a dose-response eff e c t .1 7 As Leslie e fficacy study, or the experiment) was introduced by the pharma- K a m i n o ff1 8 pointed out, Yoga doesn't cause wellness—it re m o v e s ceutical industry in 1948 to test new dru g s .3 The clinical trial is pro p- obstacles to it. Most importantly, however, the argument against the erly suited to interventions where experts select the tre a t m e n t , observational design has to be weighed against the many risks that w h e re the treatment is essentially forced on the body, and where the D r. McCall and others have pointed out in designing an experiment. role of consciousness plays little or no role in the outcome. When we The next step, then, is to weigh these two tradeoffs, in what Dr. want to test other kinds of interventions, or treatments, or behav- Hagins has identified as the internal/external validity issue-an issue iors, we may need to use other kinds of scientific tools. well-known in the scientific literature . D r. McCall is by no means the first scholar to raise these issues Conventional wisdom in medical science is that the random- with re g a rd to the scientific investigation of a complex, self-chosen, ized, controlled trial is the “gold standard,” superior to an observa- whole-health wellness practice, which is what Yoga is. Dr. McCall tional study. However, empirical evidence substantiating this claim has echoed re s e a rchers in many fields-including psychotherapy,4 is surprisingly absent.3 , 1 0 , 2 0 , 2 1 E m p i r i c a l l y, results from observational a c u p u n c t u re , 5 n u t r i t i o n ,6 , 7 h o m e o p a t h y,8 , 9 n u r s i n g ,1 0 h e r b a l i s m ,11 a n d studies within the field of medicine have proved more accurate than even the biological and social sciences,1 2 , 1 3—who have argued that those from clinical trials. In randomized, controlled trials, inconsis- applying the methods of the clinical trial to complex, nonpharma- tent and contradictory findings have been found in almost all topics ceutical interventions will create unreliable results, particularly false s t u d i e d .7 , 2 2 , 2 3 , 2 4 The same cannot be said of observational studies. negatives. Dr. Martin Seligman1 4 d e c l a red that the randomized, con- Thus, we return to the issue of tradeoffs. Dr. McCall accurately t rolled trial was simply “the wrong method” for evaluating a prac- identified the tradeoff issue when he asked, “Who says that a statisti- tice when crucial elements of the practice in a real-world setting are cally accurate and clean look at plastic Yoga, that nobody in the re a l omitted, and that random assignment was not desirable for study- world does, is more valid than a statistically muddier look at what ing complex behaviors in the field. More re c e n t l y, Dr. Bo Forbes1 5 real Yoga therapists actually do?” This question was n o t an attack on and Dr. Scott Laure n c e 1 6 have expressed similar concerns about science. It was a focus on the tradeoff issue—a healthy discussion using evidence-based medicine for Yoga, because evidence-based within the scope of scientific inquiry. Observational designs are statis- medicine is based on a reductionist, analytical, short-term, expert- tically muddier from the point of view of isolating variables and pro v- c e n t e red model, which is not the model on which the Yoga appro a c h ing causation. But when we take the longer view—the view of exter- is designed or claimed to work. nal validity, or the “real world”—observational designs will actually Quantitative re s e a rch has much to offer us for studying give us results that are more accurate and more likely to reflect what patterns involving groups of people, instead of just individuals. happens when Yoga is actually practiced. That's a finding of science.

27 Yo g aT h e r a p yToday Spring 2011 Using a clinical trial to study the outcomes of experiments have included between 10 and 20 participants. It is easy to miss significant findings with such a small group. In contrast, a long-term Yoga practice is like putting a observational designs can include thousands of participants. More square peg into a round hole. And making this participants give more robust, reliable results. All of this points to the possibility that the observational design should be given a much statement doesn't give science a black eye. s t ronger place in Yoga re s e a rch than it has been given so far. I argue that by using an observational design, we can gather good data about a complex, long-term Yoga practice, which operates out- Using a Randomized, Controlled Trial to Study side of the rules of linearity and causality. With an observational study, We l l n e s s we do not need to trace the mechanisms or sort through the impossi- ble complexities of whole lives. We focus on the outcomes. That is why A Yoga experiment rarely lasts more than three to six months, per- the observational study is also called an outcome study. In complexity haps with follow-up questions a few months or years later. A n y- and systems re s e a rch, the complex system is re g a rded as a black box. thing more is usually too expensive—it re q u i res more grant money We don't know what happens inside of the black box—we ask only and professional re s e a rchers, and grant funders are reluctant to what went into it, and what came out of it. Despite the infinite com- give money for studies not designed in the drug paradigm. We plexity of each person's life, at the end of the day, many of the diff e r- can't realistically extend many experiments much longer—certain- ences between subjects will iron out, and we will be able to ask, “Do ly not for decades. Many Yoga experiments have lasted a few the statistics suggest that Yoga may have made a diff e re n c e ? ” weeks or even a few days. In my study, they did. I distributed a one-time survey to hun- Learning what Yoga can accomplish in the immediate term is a d reds of older women, many of whom had Yoga practices extending worthwhile and admirable endeavor. What these experiments fail to back as far as 50 years. The longer and the more often these women do, however, is to investigate what happens additively and cumula- had practiced Yoga, the more those low levels of psychological and tively with a committed Yoga practice, when synergistic outcomes physical well-being dissolved from my spreadsheets. There was no begin to emerge. And, as Dr. McCall noted in Yoga as Medicine,2 5 e v e n plateau. Results held true after correcting for a range of other lifestyle six months is a drop in the bucket for a Yoga practice. By privileging factors. Diff e rences among the diff e rent yoga traditions were not sig- short-term studies and standardized protocols, we are fore v e r nificant. Low scores kept getting higher with more time and practice. studying beginners, we are systematically underestimating the heal- I never could have discovered this pattern with an experiment—cer- ing potential of Yoga in our re s e a rch, and we are systematically tainly not in a reasonable timeframe, with a reasonable budget, and excluding an understanding of these synergistic and cumulative with hundreds of long-term Yoga practitioners. e ffects of the practice. In short, we are shortchanging the potential of What about all those confounding variables? I argue that the con- our scientific inquiries. founders confuse the re s e a rc h e r, but not the y o g i or the y o g i n i. For the Using a clinical trial to study the outcomes of a long-term Yo g a Yoga practitioner, these so-called confounders-a healthier diet, a sim- practice is like putting a square peg into a round hole. And making pler lifestyle, more time outdoors, more kindness and compassion, this statement doesn't give science a black eye. We do not under- m o re loving relationships, more bike-riding, a better path to right mine science when we insist that re s e a rchers use the most appro p r i- l i v e l i h o o d — a re not confusing. They are mutually enhancing and ate scientific method for the problem at hand. We undermine sci- re i n f o rcing. These so-called confounders act synerg i s t i c a l l y, c o p ro d u c - ence when we clip its wings and narrow our topics to fit a pre c o n- i n g the outcomes: wellness, joy, sere n i t y, and self-actualization. ceived paradigm. As Dr. McCall so accurately stated, Yoga will Long-term y o g i s and y o g i n i s have been largely invisible to Yo g a always come up short when measured with a pharmaceutical yard- re s e a rchers. I argue that this gap has occurred because Yoga re s e a rc h e r s stick. We there f o re need to examine our scientific tools and use the have unevenly focused on performing artificially constructed experi- tools that are the best fit for studying what we want to study. ments with beginners. Nothing I say here is meant to demean the value of these experimental contributions. On the contrary, these experi- The Observational Study: Making the Marriage ments have been invaluable to Yoga re s e a rchers, and I have endlessly of Science and Yoga Wo r k drawn on them for all of the teachings they have given us. These experiments help us interpret our long-term, observational studies and support our contentions that Yoga is behind all of these improvements for D r. McCall pointed the way forward in his address when he made which we have been unable to prove causation. two recommendations for future scientific Yoga studies: (a) study My argument is simply that short-term Yoga studies have inher- Yoga over a longer time frame, and (b) do more outcome studies. ent limitations and can there f o re give us only one side of the story. Outcome studies offer a number of advantages that cannot be re a l- We need to balance the picture with observational designs. And we ized in brief trials. The subjects in an observational study typically need to elevate the importance and the legitimacy of the observation- re p resent the target population more closely than do the subjects in al design in Yoga re s e a rch, putting it on a par with the clinical trial in an experiment.2 6 , 2 7 Medical re s e a rchers acknowledge that observa- giving us the type of information we need. YTT tional designs play an important role in investigating treatment outcomes in large, heterogeneous populations with complex, chro n i c c o n d i t i o n s .2 1 In an observational study of wellbeing, we can meas- u re long-term personality changes that are deeper and more endur- ing than are changes in mood. Nina Moliver, PhD, RY T, is a re s e a rch consultant in Observational studies cost much less money than experiments Boston, Massachusetts. She has experience as a Yo g a do. An impecunious graduate student like me was able to conduct teacher and a mental health counselor. Her Yo g a an observational study over the Internet, without renting space or re s e a rch study won the Dissertation of the Ye a r hiring a teacher. This means that many more studies can be conduct- award at Northcentral University. ed under the radar of the pharmaceutical industry, its largesse, and its expectations. In addition, an observational study can include many more participants. Finding even 100 participants for a Yo g a experiment is a substantial, and costly, accomplishment. Many Yo g a (References on page 29)

Spring 2011 Yo g aT h e r a p yToday 2 8 Yoga Research c o n t i n u e d

R e f e r e n c e s 13. Ho, Mae-Wan. (1998). Evolution. In G. Gre e n b e rg and M. M. Haraway (Eds.), Com- 1. McCall, T. (2009, March 7). To w a rd a more blissful union of Yoga and science. Pre- parative Psychology, a Handbook (pp. 107-119). New York, NY: Garland Publishing. sented at Symposium on Yoga Therapy and Research. Los Angeles, CA. 14. Seligman, M. (1995). The effectiveness of psychotherapy: The Consumer Reports 2. Hagins, M. (2009, June). Yoga and the evidence-based medicine debate: A re s p o n s e s t u d y. American Psychologist, 50, 965-974. doi: 10.1037/0003-066X.50.12.965 to Dr. Timothy McCall's keynote address. Yoga Therapy To d a y, 21-23. 15. Forbes, B. (2010). Yoga and managed care: A cautionary tale. International Journal of 3. Concato, J., Shah, N., & Horwitz, R. I. (2000). Randomized, controlled trials, obser- Yoga Therapy, 20, 22-26. vational studies, and the hierarchy of re s e a rch designs. New England Journal of Med- 16. Laurence, S. (2010). The role of outcome-based standards in Yoga therapy. Interna- icine, 342, 1887-1892. tional Journal of Yoga Therapy, 20, 42-51. 4. Seligman, M. (1995). The effectiveness of psychotherapy: The Consumer Reports 17. Heaney, R. P. (2003). Long-latency deficiency disease: Insights from calcium and s t u d y. American Psychologist, 50, 965-974. doi: 10.1037/0003-066X.50.12.965 vitamin D. American Journal of Clinical Nutrition, 78, 912-919. 5. Paterson, C., & Dieppe, P. (2005). Characteristic and incidental (placebo) effects in 18. Kaminoff, L. (2008). I'm not a Yoga therapist anymore! International Journal of Yo g a complex interventions such as acupuncture. British Medical Journal, 330, 1202-1205. T h e r a p y, 18, 17-19. doi: 10.11 3 6 / b m j . 3 3 0 . 7 5 0 1 . 1 2 0 2 19. Concato, J. (2004). Observational versus experimental studies: What's the evidence 6. Ballentine, R. (1999). Radical healing: Integrating the world's great therapeutic tra- for a hierarchy? NeuroRx, 1, 341-347. doi:10.1602/neuro r x . 1 . 3 . 3 4 1 ditions to create a new transformative medicine. New York, NY: Three Rivers Pre s s . 20. Levine, R., & Fink, M. (2006). The case against evidence-based principles in psychia- 7. Colbin, A. (2002). Wholistic nutrition: From biochemistry to chaos, complexity and t r y. Medical Hypotheses, 67, 401-410. quantum physics - applying some concepts from contemporary science to a new 21. Ligthelm, R. J., Borzi, V., Gumprecht, J., Kawamori, R., Wenying, Y., & Valensi, P. understanding of how food affects health. Dissertation Abstracts International, 63(06), (2007). Importance of observational studies in clinical practice. Clinical Therapeutics, 2791. 29. doi: 10.1016/j.clinthera.2007.07.004 8. Bell, I. R. (2005). All evidence is equal, but some evidence is more equal than others: 22. Benson, K., & Hartz, A. J. (2000). A comparison of observational studies and ran- Can logic prevail over emotion in the homeopathy debate? The Journal of A l t e r n a t i v e domized, controlled trials. New England Journal of Medicine, 342, 1858-1876. doi: and Complementary Medicine, 11, 763-769. doi: 10.1089/acm.2005.11 . 7 6 3 1 0 . 1 0 5 6 / N E J M 2 0 0 0 0 6 2 2 3 4 2 2 5 0 6 9. Bell, I. R., & Koithan, M. (2006). Models for the study of whole systems. Integrative 23. Concato, J., & Horwitz, R. I. (2004). Beyond randomised versus observational stud- Cancer Therapies, 5, 293-307. doi: 10.11 7 7 / 1 5 3 4 7 3 5 4 0 6 2 9 5 2 9 3 ies. The Lancet, 363, 1660-1661. doi:10.1016/S0140-6736(04)16285-5 10. Quinn, J. F., Smith, M., Ritenbaugh, C., Swanson, K., & Watson, M. J. (2003). 24. Horwitz, R. I. (1987). Complexity and contradiction in clinical trial re s e a rch. The R e s e a rch guidelines for assessing the impact of the healing relationship in clinical American Journal of Medicine, 82, 498-509. doi: 10.1016/0002-9343(87)90450-5 nursing. Alternative Therapies in Health and Medicine, Supplement 9(3), A 6 5 - A 7 9 . 25. McCall, T. (2007). Yoga as medicine: The yogic prescription for health and healing. 11. Mason, S., To v e y, P., & Long, A. F. (2002). Evaluating complementary medicine: New York, NY: Bantam Books. Methodological challenges of randomised controlled trials. British Medical Journal, 26. La Caze, A. (2009). Evidence-based medicine must be…. Journal of Medicine and 325, 832-834. P h i l o s o p h y, 34, 509-527. doi: 10.1093/jmp/jhp034 12. Capra, F. (1996). The web of life: A new scientific understanding of living systems. 27. Silverman, S. L. (2009). From randomized controlled trials to observational studies. New York, NY: Doubleday. American Journal of Medicine, 122, 114-120. doi: 10.1016/j.amjmed.2008.09.030

29 Yo g aT h e r a p yToday Spring 2011 Interview by Amadea Morningstar, MA, RPP, RYT 200 R i c h a rd Panico, MD Founder and Director of The Athens Regional Mind Body Institute, with Manjula Spears, e-RYT 500, Chief Yoga Therapist Integrative Medicine and Yoga Therapy in a Community-Based University Hospital Setting

Los Angeles about the successes of The Athens AM: What is your experience as the pri- Regional Mind Body Institute. The pre s e n t a t i o n mary Yoga therapist at the Mind Body was warmly received. We follow up here with I n s t i t u t e ? this key pioneer in the integrative medicine movement. MS: As the first Yoga therapist at the Mind In a wide-ranging phone conversation last Body Institute and in the hospital in general, D e c e m b e r, Dr. Panico described to me how the I think about how far we have come. When I Mind Body Institute came into being and how it first started teaching, there was no space that operates now as a key provider of integrative was set up for Yoga—the first MBI classro o m health care in Athens, Georgia. One of MBI's was in the diabetes education department in chief Yoga therapists, Manjula Spears, e-RY T a gym full of exercise equipment. I bro u g h t 500, generously added input via email. in mats and cushions and lights to create an a t m o s p h e re for Yoga. It was cold because the AM: How did the Mind Body Institute t e m p e r a t u re was set for people working out b e g i n ? on machines. The floor was hard and I b rought in padded exercise mats to go under RP: At the time I was approached by the hos- the Yoga mats so people would be comfort- pital, I was medical director of A d v a n t a g e able to lie down. Behavioral Health Systems, a large mental The Mind Body Institute now has two “Physicians in the community health system covering a ten-county catch- big, beautiful rooms designed specifically a re very positive in their feed- ment in Northeast Georgia. I was more than for Yoga and meditation with all the trim- a little reluctant and said, “Let me talk with mings: soft lights, carpeted floors, pillows, back. What they have said is, the 400 physicians involved with the A t h e n s pads, straps, and so on. The space can make ... “It has re t u rned the art to Regional medical center.” I created a two- teaching so much easier. year exploration around this. We off e red one In the beginning I was the only Yo g a m e d i c i n e . ” ” talk per month on CAM subjects, inviting teacher that taught for MBI, Health Educa- physicians, lawmakers, naturopaths, basic tion, and the Cancer Center. We now have n 1999, Dr. Richard Panico, division chief osfcience re s e a rchers, and other experienced eleven Yoga teachers, and many of the class- psychiatry at Athens Regional Medical Cen - h e a l t h c a re professionals to talk about diff e r- es from other places in the hospital have I t e r, was approached by the chief medical officer ent aspects of CAM. At the end of the year, folded into the MBI. and the executive board of the hospital with a new we asked the physicians informally, “Do you idea. They were interested in having a comple - want an integrative medicine center as part AM: Dr. Panico, you as medical director mentary and alternative medicine (CAM) venue of the hospital?” The answer was yes, as long work with Yoga therapists, acupuncturists, as part of the hospital. They wanted it to be physi - a physician runs it, and it's evidence based, psychotherapists, mindfulness teachers, cian directed and evidence based. At first, Dr. and it is in the hospital. nutritionists, massage therapists, and Ta i Panico was a little surprised. He didn't consider Still quite reluctant, I said, “Let me do Chi teachers at MBI. How is integrative that his focus on health rather than disease and m o re re s e a rch on the need and community medicine used? his emphasis on exercise, nutrition, and individ - support for this. We dedicated an entire year ual self-efficacy were CAM per se. It was simply of community re s e a rch, with 14,000 surveys RP: When someone is re f e r red to me, I do a medicine as he knew it. The hospital executive and 100 stru c t u red interviews with other two-hour assessment. We, the patient and I, board was familiar with Dr. Panico's work on CAM venues in community-based hospitals, mutually create a treatment plan, the most mindfulness and with implementing Herbert then focus groups and site visits.1 T h e clinically efficacious path to re - a c q u i r i n g Benson's mind/body programs. They were also response to this survey was extraord i n a r y. and maintaining health. We sequence the cognizant of the fact that Western medicine wasn't We had a green light to move forward. interventions and create referrals to doing that well in responding effectively to chro n - Because it's a small pro g ressive commu- re s o u rces both within MBI and to outside ic disease, an increasingly large percentage of n i t y, it was able to happen. There's better com- practitioners. When I refer someone to one their consumer base's needs. munication among healthcare providers and of MBI's practitioners, I relate the goals of the Ten years later, Dr. Panico spoke to IAY T ' s consumers, and a high amount of interest. t reatment plan. There are too many patients Symposium on Yoga Therapy and Research in (continued on page 31) Spring 2011 Yo g aT h e r a p yToday 3 0 Interview continued

moving through the MBI and now too many p e rhaps 60 percent, of our patients have no making more time in their practices to pro- practitioners to be able to formally sit down prior experience with Yoga and have a con- vide integrative approaches. Athens has an and discuss every individual case. There ' s servative worldview. i n c redible physician population. one chart for each patient. Each practitioner, Classes are designed in several tracts: with the exception of the Yoga therapists, m o b i l i t y, developmentally, disease specific, AM: You are acting as a bridge in family writes pro g ress notes that are filed into the and gender specific. For example, to addre s s and community interactions? chart, along with my follow-up sessions issues of mobility we offer chair Yoga adapt- with patients. I can track pro g ress with each ed for people in wheelchairs and with oxy- RP: Yes, over time the MBI is more and more visit in this way. gen bottles; to take a gentle Yoga class, you about community interventions. MBI is part- have to be able to get up and down off the nering with the Clarke County School Sys- AM: Why not the Yoga therapists? f l o o r. There are special classes for people tem. We are offering stress reduction (mind- with neurodegenerative diseases or chro n i c fulness practices based in Yoga) in after- RP: It's not practical for them to be able to pain [disease specific]. One example of a school programs, with teachers and pro f e s- make notes on each class participant in a g e n d e r-sp ecific class is “Yoga for the sional support staff in a variety of settings. A g roup setting. Unbendable Man.” Here we make available local poverty initiative and the MBI have a Yoga class for active aging males intimidat- p a r t n e red to provide nutritional and mind- AM: Does each unit have a team? ed by studio courses populated with young fulness interventions with parents, childre n , flexible practitioners. Classes designed and staff in vulnerable neighborhoods. The RP: Rather than teams, we have cre a t e d a round the human developmental cycle and MBI/community interaction has seemed to interactive communities of practitioners. that are gender-specific include pre n a t a l become a kind of b o d h i c i t t a ( “ a w a k e n e d The Yoga therapists all make time to meet Yoga, mama-baby Yoga, Yoga for breast can- heart”) of its own. I'm just hanging on for together monthly at the least, and often c e r, and Yoga for bone health. We also have dear life. every two weeks in a venue called “aro u n d classes for caretakers, post-cancer tre a t m e n t the mat.” They have ongoing training and recovery issues, and of course laugh-a-Yo g a . AM: What are some of MBI's biggest suc- mentoring time with me, Manjula Spears, or Lately something happened unexpectedly in c e s s e s ? Robin Bewley. This is very, very important. this class—fathers and daughters began to They are a vibrant group and I admire their attend together. This surprising phenome- RP: The biggest successes are the clinical suc- excitement and relentless study of Yoga. A s non fills me with joy! cesses: we did outcome studies with the part of the farm s a n g h a [community] I meet question, “If somebody completes our pro- with many of them two or three times a grams, what are their results?” We used the week, so there are many opportunities to AM: When is meditation part of the treat- Beck Depression Inventory, the Beck A n x i e t y talk about individual clinical issues, theory, ment plan? I n v e n t o r y, and the SF-36. In the SF-36 in par- and so on. Likewise the massage therapists t i c u l a r, statistically significant impro v e - a re very communal and communicative RP: Always. It is part of Patanjali's Yoga. I'm ments were noted in all categories. In 2003, about shared patients. The psychotherapists i n t e rested in everyone getting meditation when we started, there was a 40 perc e n t come in at diff e rent times, yet they attend training, whether through Yoga classes, or in d ropout rate in our classes. Now it's aro u n d the “Explorations of Mindfulness” gro u p s other contexts such as MBSR or mindful- 5 perc e n t . that I conduct with advanced practitioners ness-based psychotherapy sessions. Mind- and continuing education gatherings. A f t e r- fulness meditation is effective and defensi- Manjula Spears MS: Of course the most w a rd the therapists, mindfulness teachers, ble. It is well studied and in the news every- re w a rding thing is to and individuals from the community at d a y. see those patients that l a rge and I discuss the class and create teach- stay with the pro g r a m ing points. I can't tell you how much fun this AM: How far-reaching has the integrative incorporate the prac- is, based in a kind of attentive, loving, com- concept there become? tices into their life and munal play. The word “play” is not a slowly (and sometimes diminutive; we get an enormous amount of RP: Many of the other departments in the not so slowly) get pro- high-quality training done. hospital are now offering similar health- g ressively better. I also based approaches, in terms of classes and love seeing those AM: When would Yoga be part of a treat- therapies. patients that will soon be leaving this life ment plan? Physicians in the community are very enjoying more fully the time they are here . positive in their feedback. What they have Because most of the patients that I work with RP: Yoga is always a part of the tre a t m e n t said is, “It's effective, and I can refer to have suff e red so much, their gratitude is plan. We define Yoga broadly; we keep in them,” [and] “It has returned the art to med- enormous. sight the ultimate goal of liberation, and we icine.” Repeated positive results get commu- My favorite is the way that Yoga can base classes in the Yoga of Patanjali. We nicated among MDs effectively; and this has heal lives unexpectedly. A student's chro n i c a d d ress and cultivate s a n g h a, teach Yo g a been happening for eight years now. back pain goes away and they become inter- nidra, pranayama, pratyahara, and of course We've also found that how we practice ested in spiritual study. A student with dra- the inner limbs concerning meditation. We medicine influences the practice outside of matic surgical asymmetries in the body try to address all limbs in some way in an the MBI, in the community. Many MDs in becomes balanced and their diet becomes integrated, culturally sensitive way. Many, town have shared with me that they are h e a l t h i e r. Someone with a terminal illness

31 Yo g aT h e r a p yToday Spring 2011 Interview continued who feels they have little to live for becomes AM: What are some of MBI's greatest chal- keeping with the conservative fiscal policies i n t e rested in using their remaining life to l e n g e s ? and the nonprofit status of the hospital, we serve others. These seemingly unre l a t e d do not have allowance for things like dis- happenings illustrate the surprising expre s- MS: Many of the patients I work with are counting classes or selling re c o rded practice sion and power of Yoga. It is always intere s t- faced with life-threatening illnesses leading media. None of the services at MBI are ing to see where Yoga's healing will lead a them to their transition out of this life. Oth- a p p roved by medical insurance, so all cost is student when they simply trust Yo g a . ers that come through our clinic have tried out of pocket and we can lose patients A big part of the classes that I teach in every medical route available and have because of the expense. the hospital concerns holding the space for landed at MBI as a last resort. When they people to connect with one another. I feel this reach me they are in pain, usually depre s s e d , RP: Financially, the challenge is how to make is such an important part of the healing and left hopeless after a long, hard road of it viable. When I first re s e a rched this aspect, p rocess. For so long many of our patients disappointments. One of my biggest chal- t h e re were almost 200 integrative medical have felt isolated and alone. They can come lenges is to give them back their hope and centers nationwide, and only 5 percent of to the MBI and reach out to other people who i n s p i re them to use the practices and have them were making money. In this economy, know what they have gone through and who faith that over time their bodies and mental we can't expand our overhead in spite of have experienced some of the same stru g- outlook will move again in a more positive g rowth. Insurance doesn't pay for our serv- gles. It is also re w a rding to see them begin to d i rection. Without instant relief and after so ices. We need to charge what the market will open up and to connect with each other out- many unsuccessful tries it can be a real chal- b e a r, a bit more than what a Yoga studio in side of class. The Yoga class becomes a way lenge to keep them inspired to practice. town would charge. The overhead in the for them to reintegrate into the world. In the cases where students are suff e r- hospital is very large; we can't avoid being a ing from a fatal neurodegenerative disease part of that. RP: Another unexpected positive occurre n c e or cancer, our work together centers aro u n d The hospital sees MBI as a very positive came from medical training programs. I relieving despair and improving their quali- f o rce; the hospital itself is transforming how teach at two medical schools, and I offer a ty of life. We practice in order to be pre s e n t it practices medicine. For example, people in one-month-long elective course for medical and live in the moment. the OR are doing healing touch; Oncology students in Mind Body Medicine here at the It can also be challenging to give the Services is offering health-based interven- hospital. patients the tools they need through MBI. In tions for its patients. We come up in the re d (continued on page 33)

Spring 2011 Yo g aT h e r a p yToday 3 2 Interview continued every year, and I seem to be the only one Another essential qualification is that the Reference b o t h e red by that. To date the administra- teachers and practitioners here possess an 1. Cameron, K. A., McCormick, L. K., Panico, R. A., Jenkins, L., & Cook, E. P. (2002,November). Can we tion has been pro t e c t i v e . ability to tolerate the bureaucracy of the sys- integrate complementary and alternative medicine with a tem. conventional medical system? Presented at the 130th AM: Do you have any advice for physi- Annual Meeting of the American Public Health Asso- cian-run, evidence-based centers on this? AM: Is there anything you'd like to say in ciation, Athens, GA. Abstract retrieved from s u m m a r y ? http://apha.confex.com/apha/130am/techpro- gram/paper_43174.htm. RP: Nail down contracts with third - p a r t y payers before opening the doors, if you can. MS: It is an experience of real personal In our case, it would have pushed us back g rowth for me to serve as an educator in the Amadea Morningstar, another couple of years. Know your own world of Yoga therapy at MBI. I learn so MA, RPP, RYT 200, political and financial landscapes; work out much about the strength and endurance of has been working in partnering upfront if possible. the human spirit. the field of integrative Ayurvedic education AM: What qualifications does one need to RP: It is very gratifying work. These are since 1985. She is the do Yoga therapy at MBI? e x t r a o rdinary interventions that are not founder of the Ay u r v e d a financially viable yet in contemporary bio- Polarity and Yo g a RP: The Yoga teachers are all RYT 500s. We medicine. The need for clinical re s e a rch and Therapy Institute utilize primarily Integral Yoga in the thera- c o s t - o ffset data is essential. In eight years, (APYTI) in Santa Fe, peutic training. But since Integral Yoga is MBI has had no significant adverse out- NM. APYTI does not well… integral, other honored traditions are comes, a minimalist side-effect profile. This yet offer Yoga therapy; it is our intention to do utilized fre e l y. We provide yearly training kind of efficacy and safety is unheard of in so when our community base is strong enough events for our teachers and the community. contemporary biomedicine. to provide it. Our teachers have also worked with Jnani I really want to validate the re s e a rc h Ay u r v e d a P o l a r i t y Yo g a . c o m Chapman, Gary Kraftsow, Nischala Devi, e fforts of IAY T. It is absolutely the right way and Kausthub Desikachar. The bottom line to go. I really have enjoyed talking with is that they are individuals who strive for a you, and I appreciate having a voice in the deeper and deeper skill set continuously. journal. YTT

33 Yo g aT h e r a p yToday Spring 2010 TrainingReport by Nancy O’Brien Yoga for Arthritis Te a c h e r- Training Intensive with Steffany Haaz

ith a long-held dream to become many re s e a rch studies to have a positive “the Dean Ornish of arthritis” e ffect on quality of life. It's an effect that, as W and seven years of rigoro u s Haaz points out, extends beyond Yoga class- re s e a rch under her belt, Steffany Haaz, PhD, es and takes hold in people's lives. “People RYT 500, convened her first Yoga for A r t h r i- with arthritis may enjoy Yoga more than tra- tis Te a c h e r- Training Intensive last fall in Bal- ditional forms of exercise, and . . . are more t i m o re. Over three days, she would pro v i d e likely to continue,” Haaz says. her first seven participants with a solid For the 50 million adults in the United States g rounding in sixteen evidenced-based class- with arthritis, or any of its 100 related condi- es, tailored to safely and effectively impart Participant and Baltimore Yoga teacher Janet Indre s a n o tions such as Crohn's disease and gout, Yoga's benefits to people living with arthritis relaxes in a supported wide-angle forward bend. symptoms can range widely from day to day and its related conditions. p resent. However, OA, which affects 21 mil- and year to year. Yoga's compassionate The foundation of this teacher- t r a i n i n g lion people, cannot be cured. Safe movement a p p roach in meeting each individual with intensive was the sixteen-class, eight-week and exercise such as Yoga and stress re d u c- full acceptance in each moment is well-suit- Yoga for Arthritis series: the protocol used tion are often recommended by health-care ed to this variability. during seven years of re s e a rch conducted at p roviders to address symptoms. Johns Hopkins University. The intensive The second major form of the disease, THE INTENSIVE entitles the participants, upon successful rheumatoid arthritis (RA), is an autoimmune completion, to use these sixteen sequential condition affecting 1.2 million people in the O v e r v i e w classes to teach this series, using a manual United States. Its symptoms, such as severe Each day of the intensive in the well- that covers the material contained in those fatigue and pain, commonly flare up and equipped and serene yama studio (Yo g a , c l a s s e s . abate, with stress seen as a major factor. Ayurveda & Meditation Arts) began with a Joining Haaz in the training were two Recent advancements in medical tre a t m e n t Yoga class taught by Haaz in a spirit of self- guest speakers: Heather Keller, RN, BSN, 500 have resulted in some effective medications c a re that was a re c u r rent theme of the train- E - RY T, who taught two eight-week series as for helping to manage the disease; but again, ing. This set the tone as the days moved on, part of the study; and Marina To m p k i n s , safe movement and stre s s - reduction strate- with lectures and group discussions backed d i rector of an adult day program, who has gies are recommended by health-care by PowerPoint presentations and handouts. rheumatoid arthritis and was a student in p roviders to help people deal with their Topics covered included anatomy, the caus- one of Haaz's Yoga for Arthritis series. arthritis self-care . es and symptoms of arthritis, re s e a rc h The training re q u i red a minimum Yo g a results, how specific yogic practices and Alliance registration of RY T-200, and the Haaz and the re s e a rch team at Johns Hop- principles relate to the conditions common participants were all committed Yoga teach- kins University found that the specific bene- to the disease, and how to reach the arthritis ers, from 30-somethings to 50-somethings, fits of this sixteen-class Yoga series for those c o m m u n i t y. steeped in various Yoga traditions and orien- with arthritis included: The main focus throughout the inten- tations, including Integral Yoga, therapeutic sive was hands-on exposure to the Yoga for and restorative Yoga, Iyengar Yoga, and • A statistically significant improvement in Arthritis series so that participants were Bihar School of Yo g a . overall physical health, flexibility, and bal- equipped to bring it back to their communi- a n c e . ties after completion. The first ten classes of • A significant reduction in symptoms of the series offer a basic stru c t u re that begins B A C K G R O U N D d e p ression and improvement in positive with discussion and ten minutes of warm- a ffect (more joy and happiness). ups tailored to individual needs, followed Arthritis, which includes 100 diff e rent condi- • A significant improvement in pain symp- by fifteen to twenty minutes of a s a n a p r a c- tions under its umbrella, is currently the toms and, for those with RA, a significant tice, gradually introducing standing (when nation's leading cause of disability, aff e c t i n g d i ff e rence in the number of tender and possible) and sitting postures with any about 50 percent of Americans, with incre a s- swollen joints when compared with con- p rops and modifications needed; ten min- es projected over the next 30 years as baby t rol subjects receiving the usual medical utes of s a v a s a n a ( relaxation pose); and five boomers age. There is a growing need for c a re . minutes of a closing that includes intro d u c- Yoga teachers with training to serve this tions to various awareness and meditation p o p u l a t i o n . (Study results are included in an article enti- practices. Key to adapting each of the a s a n a, Medication, surg e r y, and other pro c e- tled “Yoga for Arthritis: A Scoping Review, ” relaxation, and meditation practices includ- d u res can reduce symptoms in the most c o - a u t h o red by Haaz and S. J. Bartlett)1 ed in these classes is the broad range of re c- common form of the disease, osteoarthritis ommended modifications, often with pro p s , (OA), which is usually caused by wear and P e rhaps most important for those living with that are demonstrated, illustrated, and, tear on the joints, often with inflammation these conditions, Yoga has been shown by most importantly, (continued on page 35)

Spring 2010 Yo g aT h e r a p yToday 3 4 TrainingReport continued experienced during this intensive. The adap- experiences. Do a Facebook search for “Yo g a tations address specific conditions such as for Arthritis” and see what the intensive's wrist pain (a padded wedge) or overall participants are off e r i n g . weakness (chair and one-on-one support). The remaining six classes use the same basic FUTURE DIRECTIONS s t ru c t u re but focus on some specific topics and concerns. There is a class on sciatica, for Haaz will be teaching a five-day Yoga for instance, and one that explores using a wall Arthritis Teacher Training Intensive at Yo g a v- for those who need the support in such poses ille, Integral Yoga's Satchidananda Ashram in as half-moon or a seated twist. Another class Buckingham, VA, in June of 2011. Plans are is stru c t u red to pre p a re teachers offering the A wedge beneath the mat can mean more support and cushioning and less pain for a person with arthritis. also in the works for a three-day intensive at series to give their students the opportunity Integral Yoga Institute in New York City. (I to lead a session. Each of the sixteen classes g roundwork for deeper understanding of am planning to assist at both intensives.) includes recommended homework for the how to teach to this population. As Haaz Both trainings qualify those who suc- yoga teachers' students, with suggested arti- says, “This population has knowledge. Yo u r cessfully complete it for 30 hours of cre d i t cles included in the teacher and student man- role is not to fix them, but to provide a posi- with the Yoga Alliance. Student manuals uals on topics such as meditation and cre a t- tive experience in a safe way, to allow the and the use of the logo are also available ing a personal practice. pain to be.” With arthritis, often, pain is the when participants present their own Yo g a fact, the truth of an individual's experience. for Arthritis series. D a y - b y - D a y This day also featured the ultimate in The initial seven years of this re s e a rc h Day One: The first day laid the foundation, the intensive's multiplatform, multisensory was funded in part by the Arthritis Founda- with one of the first assignments—practice p resentations. Starting in small groups, then tion and the National Center for Complemen- classes—adding the incentive of perform- reuniting for each group's report and a tary and Alternative Medicine. The next step ance evaluation to the training. Each partici- w h o l e - g roup discussion, we explored the to further validate the re s e a rch findings is for pant, as a re q u i rement for course comple- dramatic web-based comics documenting another re s e a rcher or re s e a rchers to conduct tion, was to practice-teach one of the sixteen author Sara Nash's experiences with Yo g a additional trials on how these sixteen classes, Yoga for Arthritis classes outlined and illus- and RA.2 which were presented in a medical institu- trated in the teachers' manual, sometimes tion, translate into a community setting. with a partner. The rest of us, as “students,” Day Three: This day gave real meaning to To any interested re s e a rchers, Haaz would ro l e - p l a y, taking on the symptoms the word i n t e n s i v e, with emotions, informa- says, “Email me!” ([email protected]). and challenges we would learn about in tion, and experience all heightened by the As therapeutic Yoga steadily makes other parts of the intensive. a w a reness that this was the final day of our i n roads toward bringing Yoga to individuals The day continued with explorations on training. After the morning Yoga class, fea- who, re s e a rch shows, stand to benefit so pro- why Yoga works with arthritis, a re f resher on turing some background Beatles music, the f o u n d l y, the prospect of a growing number a n a t o m y, and a detailed rundown on the day included discussions on teaching strate- of Yoga teachers equipped to safely teach re s e a rch behind the series that allowed the gies for classes of mixed abilities, two more some of the millions with arthritis is indeed n o n re s e a rch types among us to be able to practice classes, evaluations, a beautiful clos- h a rd-won pro g ress to be celebrated. YTT understand the charts and statistics and pro- ing ritual, and, on top of all that, guest-speak- fessionally communicate the results in health- er Tompkins, who shared her moving story R e f e r e n c e s c a re settings. Guest speaker Keller told of the of finally being correctly diagnosed after 1. Haaz, S., & Bartlett, S. J. (2011). Yoga for arthritis: A scoping re v i e w. Rheumatic Disease Clinics of North initially daunting prospect-and ultimately years of struggling with the knock-you-to- America, 37(1), 33-46. Abstract retrieved fro m life-transforming satisfaction-of working y o u r-knees condition of RA—a story of the n c b i . n l m . n i h . g o v / p u b m e d / 2 1 2 2 0 0 8 4 . with people living with these conditions. gratitude one young woman feels having 2. Nash, S. (N.D.) Single in the city with rh e u m a t o i d found her path of transformation in one of arthritis . . .Hello Baltimore! (J. Samborski, illus.). the re s e a rch study's Yoga for Arthritis series. HealthCentral. Retrieved December, 2010, from Day Two: The second day included the first h e a l t h c e n t r a l . c o m / rh e u m a t o i d - a r t h r i t i s / s a r a - n a s h - two practice classes that each of the partici- Tompkins's story, and her powerful per- c o m i c s - b a l t i m o re . h t m l . pants had been assigned to present; a discus- sonal presence on that last day, allowed us as sion on the difficulties faced by those living Yoga teachers to clearly see the value of Nancy O'Brien (nancy - with RA; and a brainstorming session on learning as much about arthritis as we can. o b r i e n Yoga.com), a how to reach and serve this community that “ You need to have an instructor who meets Yoga teacher and well - included re c o rd-keeping, questionnaire s , you where you are,” Tompkins said. “Yo u ness writer, editor, and and outcome-measure strategies. need to have someone who is asking, 'Is speaker who specializes The day continued with one of the t h e re a pain here?' Someone who says, 'We ' re in mind-body practices training's most illuminating segments: all in diff e rent places; there's never any ru s h for elders and those “Application of Yogic Principles.” The pre s- for anything.' That's important.” dealing with health entation used the stru c t u re of the eight limbs By the closing cere m o n y, a sangha ( c o m- challenges, last wro t e of Yoga to present issues likely to arise in munity) had formed. The bond led to the for this publication teaching this series. Looking at arthritis in c reation of a Facebook group where partici- “Our Best Defense,” about Bethesda Naval the context of a h i m s a (nonharming) or s a t y a pants and future trainees can share informa- Hospital's plans to bring a full-time Yoga thera - ( t ruthfulness), for example, created the tion, marketing materials, photos, links, and pist on staff at a primary-care clinic. 35 Yo g aT h e r a p yToday Spring 2011 Reviews

R e s e a rch Review: Domenic A. Ciraulo, MD, Division of Healthy subjects were re c ruited from the E ffects of Yoga Versus P s y c h i a t r y, Boston University School of Medicine community by newspaper ads, flyers, and the J. Eric Jensen, PhD, Department of Psychiatry, Internet. 200 volunteers were assessed for eli- Walking on Mood, A n x i e t y, Harvard University gibility; 71 failed to meet criteria due to taking and Brain GABA levels: A G A B A medication, having a significant med- Randomized Contro l l e d minobutyric acid (GABA) is a neuro- ical or psychiatric disord e r, or recent history transmitter (a chemical that transmits of current mind/body practice. 91 consented MRS Study signals across a synapse) that incre a s- and after strict inclusion criteria, subjects Review by Dilip Sarkar, MD, A es significantly in the brain immediately after w e re randomized to Iyengar Yoga or a meta- FACS, DAy u r a Yoga session. This was reported by the same bolically matched walking intervention for 60 authors in a previous study. The increase in minutes, 3 times a week for 12 weeks. 19 com- S o u r c e : The Journal of Alternative and G A B A levels was in the thalamic area of the pleted the Yoga intervention and 15 complet- Complementary Medicine (2010). 16(11 ) , brain, and for the Yoga practitioners it may be ed the walking intervention and were includ- 11 4 5 - 1152. due to an increase in the parasympathetic ed in the analysis. All subjects had three MRS A u t h o r s : Chris C. Stre e t e r, MD, Division of nervous system activity by stimulation of the scans. The first was performed at baseline; the P s y c h i a t r y, Boston University School of Medicine T h e o d o re H. Whitfield, ScD, Division of vagal nerve. The brain GABAlevel was meas- second scan was performed after their 12 Actuarial Science, Boston University u red by magnetic resonance spectro s c o p y weeks of intervention and was immediately Liz Owen, BArch, Liz Owen Yoga, Arlington, (MRS), a specialized technique similar to followed by 60 minutes of Yoga or the walk- M A magnetic resonance imaging (MRI) to study ing intervention (depending on assignment), Tasha Rein BA, Division of Psychiatry, Boston metabolic changes in the brain. after which the third scan was done. University School of Medicine The previous study also demonstrated T h e re was no significant diff e re n c e Surya K. Karri, MD, MPH, Department of that Yoga and exercise have beneficial eff e c t s between the Yoga and the walking group for N e u ro s u rg e r y, Harvard University on mood and anxiety. GABA level in the demographic or descriptive variables. The Aleksandra Yakhkind, MS, H e m a t o l o g y - brain is reduced in mood and anxiety disor- changes in mood and anxiety scores for each O n c o l o g y, Childre n ’s Hospital, Boston ders. The present study addresses the ques- g roup were analyzed at weeks 0, 4, 8, and 12. Ruth Perlmutter, MA, School of Medicine, tion of whether changes in mood, anxiety, G A B A levels were assessed by subtracting University of Massachusetts, Boston and brain GABA levels are specific to Yo g a Scan 1 from Scan 2 values. Correlations of A n d rew Prescot, PhD, Department of or related to physical activity in general. This mood and anxiety scores were analyzed with R a d i o l o g y, University of Utah study was discussed extensively at the G A B A levels for each scan. The Yoga inter- Perry F. Renshaw, MD, PhD, Department of recent Symposium on Yoga Research and at vention was associated with greater P s y c h i a t r y, University of Utah other Yoga therapy re s e a rch confere n c e s . (continued on page 37)

Spring 2011 Yo g aT h e r a p yToday 3 6 ResearchReview continued BookReview i m p rovements in mood and decrease in anx- with black-and-white photos of their stu- iety compared to the walking intervention. In dents demonstrating the postures. It was a the Yoga group there were positive corre l a- pilot study and not a randomized contro l l e d tions between improved mood and decre a s e trial. None of their measures and scales is in anxiety and thalamic GABA l e v e l s . This study is important because it clear- reported, nor do they say how many women ly demonstrates that the 12-week Yoga inter- participated in the study. Because of the vention was associated with gre a t e r recent increase in funding for empirical i m p rovements in mood and decrease in anx- re s e a rch studies of Yoga in cancer tre a t m e n t iety than a metabolically matched walking h e re in the United States, I am disappointed e x e rcise, with the implication that Yoga prac- that the authors did not include the details of tices work in some other way than exerc i s e their pilot study. alone, probably through vagal stimulation of the parasympathetic nervous system. The The language the authors use to i n c rease in thalamic GABA levels was also describe the postures is clear and uncompli- associated with improved mood and cated, and the poses are accurately por- d e c reased anxiety, and this is the first study trayed. Sprinkled between the authors' con- to report such a correlation. Yoga practice versation with readers are inspiring quotes caused acute increases in thalamic GABA l e v- f rom class participants—living, bre a t h i n g els and improvements in mood and decre a s e s testimonies from women describing their in anxiety scales. The small sample size in the Yo g a Yoga and Breast Cancer: experience of the practices. One says, “It was g roup, where a significant increase in thala- A Journey to Health helpful to be aware of my body during and mic GABA level was detected, was a limita- and Healing after each [practice]…. I was aware of my tion of this study that was offset by the find- By Ingrid Kollak, PhD, RN, body and forgot about others and appoint- ings of significant increases in thalamic and Isabell Utz-Billing, MD ments and what to do next and tomorro w G A B Alevel with mood and anxiety scores in Demos Health 2010 and next week.” Others say, “I practiced each patient individually. some…at home by myself, especially those We know that in clinical practice, phar- Review by Jnani Chapman maceutical agents that increase thalamic [practices] from the p r a n a y a m a section,” and, G A B A levels are prescribed to impro v e aving taught Yoga to women with “I tried it out and noticed the effect on my mood and decrease anxiety. The pre s e n t b reast cancer for 25 years, I have ability to concentrate and to relax,” and, “I study demonstrated that Yoga can achieve much to say about Ingrid Kollak's loved the freedom to choose from a variety the same effect as these pharmaceuticals by H and Isabell Utz-Billing's new book, Yoga and of Yoga postures. And it impressed me that I d i rectly increasing GABA levels. However, B reast Cancer: A Journey to Health and Healing. was told to practice in accordance with my we cannot definitively conclude from the This book is a good addition to our Yo g a actual fitness.” This also impresses me. study whether the thalamic GABA levels are actually causing the beneficial effects of Yo g a s a n g h a i n t e r n a t i o n a l l y. Breast cancer has the O b v i o u s l y, the authors were able to meet on mood and anxiety. This will need further g reatest number of survivors worldwide their students where they were and help study in the near future. YTT c o m p a red to all other cancers. There are them pro g ress safely, although I wish more many women who will leave breast cancer of that pro g ression was described and pic- behind them to live long and healthy lives, t u red. Full poses are pictured and the varia- D r. Dilip K. Sarkar, MD, FACS, DAy u r, com - and many of them will use Yoga as part of tions are described, but I would prefer to see bines his 40-year experience in conventional the variations pictured as well, since many medicine with his knowl - their healing and re c o v e r y. For them, as well edge of integrative medi - as for the valiant women who do everything who read this book will be new to Yoga and cine, including Ay u r v e d a right and still do not experience remission, I may be dealing with significant physical and Yoga therapy. He is a will mention the blessings, as well as the limitations. For the same reasons, the chap- Certified Ayurvedic Prac - shortcomings, of Yoga and Breast Cancer. ter on standing poses would have been bet- titioner and Yoga teacher F rom April 2008 to August 2009, Ingrid ter placed in the back of the book after the and teaches classes in gentler practices had been detailed. There Yoga therapy, Ay u r v e d i c and Isabell shared a Yoga practice for post- wellness, and integrative operative women with breast cancer. The could also have been more cautions in place medicine. Currently he is p rogram was based on the authors' own when asking students to expend the energ y Executive Dire c t o r, School re s e a rch that included twice-weekly classes of full-body standing a s a n a, such as warrior of Integrative Medicine, Taksha Institute, in for one and a half years. The study found pose. With re g a rd to the gentler practices, Vi rginia. He also serves on several boards, that “Yoga has a positive influence on the the pages on meditation bring the subject including the International Association of Yo g a home with simple suggestions that will Therapists, and is a fellow of the American m o b i l i t y, flexibility, strength, and overall Association of Integrative Medicine. physical fitness of women undergoing tre a t- appeal to many people. ment for breast cancer.” The practices they I applaud the authors for much of the included in their study are shown in the text, content, particularly their soft, go-at your-

37 Yo g aT h e r a p yToday Spring 2010 own-pace approach and many of the pos- “The [practice] helped me overcome my Jnani Chapman, RN, t u res they chose, such as the neck stre t c h e s b l u r red vision, but it was exhausting for my CYT, founded and and the chair and floor poses. If the authors arms.” Some of the side effects of tre a t m e n t directs YCat Yoga or a qualified teacher were able to work with a re mentioned in general, but adaptations Therapy to train Yoga each reader through the book's offerings, I for specific problems are not adequately and other health profes - would trust for every person's safety and included. sionals in adaptive p ro g ress. However, if this book is used with- Another shortcoming with Yoga and Yoga in cancer and out the guidance of a teacher, more cautions B reast Cancer, in my view, is that the authors chronic illness. would need to be included, since most re a d- make promises to the readers: “You will feel She was a founding ers will lack the medical expertise that a the strength of the connection between body clinical specialist at UCSF Cancer Center and qualified teacher can provide. More o v e r, and mind,” “You will grow stronger both Osher Center for Integrative Medicine and is obtaining permission from one's physician physically and mentally,” “You will find that senior staff at Commonweal and Smith Farm to practice Yoga is no guarantee of personal simple Yoga exercises can be as effective as Center cancer help programs in California and s a f e t y. For students who are starting to use receiving a good massage.” While many of WDC. Jnani was executive director of IAYT Yoga for healing while they are re c e i v i n g us can testify that Yoga is greatly beneficial, from 1994–1988; she currently teaches Yoga t reatments like chemotherapy or radiation, a we cannot predict what will happen for for Dean Ornish MD's prostate cancer certain amount of education is essential. This every re a d e r. research group and their spouses and for St. brings me to my biggest complaint—what In spite of these shortcomings, Yoga and Mary’s Medical Center Elder Services Dept. the authors have omitted. B reast Cancer is a good practice text and a in San Francisco. The authors are medical pro f e s s i o n a l s , worthy adjunct for Yoga teachers to accom- and although they counsel the reader to be pany their class instruction for students in gentle and attentive, they do not share active breast cancer treatment. I sincere l y enough of their medical expertise. For exam- hope that the authors—who are obviously ple, there is no discussion of lymphedema skilled Yoga teachers—will publish a second p revention or managing fatigue. Fatigue is edition to add more cautions, contraindica- the number-one side effect of cancer and tions, and qualifications. YTT cancer treatment. One student comments,

Spring 2010 Yo g aT h e r a p yToday 3 8 IAYT Member Schools (as of January 21, 2011)

I AYT School Membership is for schools with Yoga therapist certification programs. The objectives of this program are to support p rofessional Yoga therapist training, to help students find the right Yoga therapist training program for them, and to further our field by supporting the development of educational standards for the training of Yoga therapists. Schools are the future of our field. See the IAY T website for more information. All member schools are invited to the Meeting of Schools, September 1, 2011, held just prior to SYTA R , I AYT's annual membership meeting.

Supporting School Members Atha Yoga & Pilates Integral Yoga S v a roopa Yoga Atha Yoga Therapy Pro f e s s i o n a l I Y Therapeutic Yoga Tr a i n i n g S v a roopa Yoga Therapist 5th Element Yo g a C e r t i f i c a t i o n James Gopal Watkins C e r t i f i c a t i o n 300 Hour Yoga Therapist Sabrina Castaneda and Lakshmi Sutter Donna Criscuolo Training Rachel Hanks Australian Institute of Yoga Integrative Yoga Therapy Svastha Yoga and Ay u r v e d a T h e r a p y P rofessional Yoga Therapy Svastha Yoga Therapist Tr a i n i n g American Viniyoga Institute Graduate Certificate in Yo g a Joseph Le Page AVI Viniyoga Therapist Training T h e r a p y Ganesh Mohan Gary Kraftsow Leigh Blashki Integrative Yoga Therapy Tr a i n i n g C e n t e r The Stress Management Center of Ananda Seva Guru Kula Institute Ayur Yo g a Integrative Yoga Therapy Tr a i n i n g M a r i n Yoga Therapy Certificate Tr a i n i n g Yoga Therapy Pro g r a m Michal Yorkini 200 Hour Teacher Training in Yo g a M a e t reyii Nolan, PhD Remo Rittiner and Tzipi Negev T h e r a p y and Ananda Deviika Ma' Robin Gueth A'cha'rya' MSc. Black Mountain Yo g a KC Fitness Link Yoga Therapy Training Yoga Therapist Training Pro g r a m Tensegrity Yoga Therapy Center Embodied A s a n a Martia Rachman Darryl Olive Post Secondary Education/300 Embodied Asana A d v a n c e d and Brad Rachman Hour Yoga Therapy Internship Training Krishnamacharya Healing Yo g a P ro g r a m Amy Matthews Body Balance Yo g a F o u n d a t i o n Body Balance Yoga Therapy KHYF Yoga Therapy Pro g r a m Sherry Brourman and Leslie Kazadi Heartland Yoga Community Training Kate Holcombe Heartland Yoga Therapy Tr a i n i n g Jenny Otto and Chase Bossart YCat Yoga Therapy in Cancer and Nancy Schalk C h ronic Illness Body Centering Yo g a K u l a - K a m a l a - Yo g a Yoga Therapist Training Pro g r a m Institute for Medical Yo g a Body Centering Yoga Therapy Yoga Te a c h e r / Yoga Therapist Tr a i n- Jnani Chapman Yoga Therapist Training Tr a i n i n g ing Program Goran Boll Nina Be Healing Hearts Through Yoga Yoga Energy Studio C e r t i f i c a t i o n Ayurveda Yoga Therapy Integrative Restoration Institute Centerpoint Yoga Therapy S h a ron A l l i t t C e r t i f i c a t i o n Integrative Restoration (iRest®) School Timothy Ganley Yoga Nidra Anatomy of Yoga Therapy Mount Royal Universities and Sylvie Vasiliki Binga R i c h a rd C. Miller, PhD Leila Stuart Yoga Therapy Certificate Pro g r a m Madeline Kapiczowski L i f e F o rce Yoga Healing Institute College of Purna Yo g a Yoga for Seniors L i f e F o rce Yoga Practitioner Purna Yoga Certificate New England School of Integrative Therapeutic Yoga for Seniors Tr a i n i n g Aadil Palkhivala Yoga Therapeutics Teacher Tr a i n i n g Amy We i n t r a u b and Mirra Palkhivala Integrative Yoga Therapeutics Kimberly Carson Tr a i n i n g and Carol Kru c o ff Phoenix Rising Yoga Therapy The Depths of Yo g a Bo Forbes P RYT Practitioner & Te a c h e r Integrative Yoga Therapy Yoga for the Mind Tr a i n i n g s C e r t i f i c a t i o n Nosara Yoga Institute Yoga Therapy Mindfulness for Elissa Cobb Tzipi Negev S e l f - Awakening Yoga Therapeutics Mental Health Training and Karen Hasskarl Tr a i n i n g Heather Mason Divine School of Yoga Therapy Don and Amba Brahmanand Samarya Center Divine Therapeutic Yo g a S t a p l e t o n Integrated Movement Therapy Gusti Ratliff Yoga Mountain Training Prana Vinyasa Yoga Therapy P rofessional Yoga Therapy Certifi- Molly Lannon Kenny MS, CCC Essential Yoga Therapy Radiant Transitions Therapeutic c a t i o n EYT Therapist Tr a i n i n g Yoga International Tr a i n i n g Gail Wa l s h Yoga Therapy Rx at Loyola Robin Rothenberg Sarasvati Devi Marymount University Yoga Teachers School of Excellence Yoga Therapy Rx Certification Functional Synergy Yoga Pranakriya Yoga Therapy Certified Yoga Therapist Tr a i n i n g Larry Payne, PhD T h e r a p y Pranakriya Yoga Therapy Tr a i n i n g Deborah Perry and Rick Morris, DC, L1; Richard Functional Synergy Therapeutic Marlysa Sullivan and Yo g a n a n d Usatine, MD, L2; David A l l e n , Yoga Tr a i n i n g Michael Carro l l Yoga Therapy Center MD, L3 Susi Hately S t ructural Yoga Therapy & P rofessional Yoga Therapy Studies Ayurvedic Yoga Therapy YogaFit Training Systems Inc. G u ru Ram Das Center for Medi- P rofessional Yoga Therapist Tr a i n- Yoga Therapy & Restorative Yo g a cine and Humanology ing & 5 Clinical Specialty Mukunda Stiles Linda Rowe and Beth Shaw Yoga Therapeutics Teacher C e r t i f i c a t i o n s Tr a i n i n g Ginger Garner MPT, ATC, E-RY T- Yoga Therapy Va n c o u v e r School Members Shanti Shanti Kaur Khalsa 5 0 0 Yoga Therapy Training Maggie Reagh Abhyasa Yoga Center Heaven Wellness & Yoga Insti- P u rusha Yoga School AYC Therapeutic Yoga Tr a i n i n g t u t e P u rusha Yoga Therapy Certification Yoga Tune Up Jason Bro w n Yoga Therapist Tr a i n i n g Joy Ravelli Yoga Tune Up Therapist Training K a ren Claff e y Jill Miller Ajna Yo g a Reconnect with Food® 500 Hour Yoga Therapy Tr a i n i n g Inner Peace Yoga Therapy Yoga Therapy for Eating Disord e r Yogaspirit Studios Jules Payne Inner Peace Yoga Therapy Certi- R e c o v e r y fication Pro g r a m Beverly Price Yogaspirit Therapist Certification Associacao Europeia de Te r a p i a s Michelle Lawre n c e P ro g r a m O r i e n t a i s Salutation Healthcare / B o n e Z e a l Kim Va l e r i Teacher Training with Yoga Ther- Institute of Classical Yoga and Yo g a apy Emphasis T h e r a p y BoneZeal Yoga Cikitsa Therapist Yogatsu Institute Paulo Alexander Hayes Classical Yoga Therapy Tr a i n i n g Yogatsu Institute Yoga Therapy Jiwan Goyal Gerry Sander MS, OTR, E-RY T Alice Strauss and Dr. Alex Rivlin

39 Yo g aT h e r a p yToday Spring 2011 2010 IAYT Donors & Sponsors

I AYT Thanks Our Sponsors, Supporters, Patrons, and Supporting Members

Gold Sponsors and Jan Byrd Libby Kara Stephanie Pearc e other Supporters Sandra Card e n Christian Kaufman Marydale Pecora $5,000 and up Jasmine Chehrazi Hari Kaur Khalsa C o n n i e P i a s e c k i C l a re Collins Elizabeth (Sat Siri Kaur) Kinder Elizabeth Plapinger Healing Pathways Medical Elizabeth Connor James Kirc h h o ff e r Yogacharya Prabhuji C l i n i c Joel Conrad Diane Kistler Judith Pre s t o n Institute for Medical Yo g a Melissa Cre t i n Lillian Koziol Jill Price Neeja Sethi Becky Crigger Monica Kro c k K a ren Prior Yoga Science Foundation Vibhuti J-L d ' A n c o n a Ruta Kulys Shelly Pro s k o Martha Danielson Laura Kupperman Robert Rigamonti New Patron Members, Kasmin Davis Julie Kusiak Dawn Robinson Silver Sponsors, and M a u reen Davis Diana Lakis Barbara Rooney Other Supporters Catherine Deans Jerry Landau Marjorie Rosenfield $1,000-4,999 Janis Desmond Linda Lang Katherine Rosenstein Michelle Dragut M a rguerite Lang Diana Ross American Viniyoga Institute Leigh Drake Emily Larg e M a rg a ret Ruchte Dynamic Therapeutic C a rol Dunaway Judith Hanson Lasater Annie Runkle R e s o u rc e s Linda Dunn Patricia Lebau Peg Rusert Goran Boll Kimberly Eisdorfer Tammy (Satjeet Kaur) Lee R i c h a rd Sabel Institute for Extraordinary Per Ere z Daniel Libby L a u ren Salomon L i v i n g Melanie Farmer Ken Lidden Linda Sandell Integrative Restoration E. Feigenbaum Debra Lister Bonnie Schindler I n s t i t u t e Lara Ferre i r a Lucy Lomax Jayne Shale Paritosh Chocksi Debra Figiel Lisa Long Betsy Grace Shandalov Tushwar Gheewala Diane Finlayson Ada Lusard i Benjamin Shield R i c h a rd Miller Kate Fitzgerald Eunice Ly c k e Stephanie Shorter L. Sukhatankar T h e rese Fleischman Sue Ly n c h Sonia Sierra Wo l f Patricia Tarzian John Fox David Ly n n Eric Small Yoga 4 Classro o m s Ana Franklin Gina Macauley Julie Smallwood YogaSolve Therapeutics Guy Gabriel Tina Madison Diane Speer Amy Gage David Maian Laura Starling Supporting Members Elizabeth Galles Oshalla Dianne Marc u s Mary Steinberg and Other Supporters Kate Hillman Garland K a ren McDaniels Lyndy Sophia Stratbucker $ 1 0 0 - $ 9 9 9 Janice Gates M o rgan McDonald Alice Strauss A n g e l a G a v i n Danielle McGuire Myra Summerlot Kandy A b o u d Becky Gelatt Bob McKinney Elisa Sweigart Jennifer A d a m Merilee Giddings Shannon McMahon Hodges Lisa Ta y l o r P a m e l a A d a m s Louise Goldberg Allie Middleton Anna Te c s o n Kellie A d k i n s J.J. Gormley-Etchells F red Miller Kathryn Te m p l e t o n Nezihe A l i b a b a Lois Gro s s m a n M. Kathleen Miller Olympia Te r r a l R a c h e l A l l y n Mary Guere n a b a r re n a Michael Milversted Kyle Thompson K a ren A r m s t ro n g Beth Hagedorn Nancy Mohler Patty To w n s e n d Melinda A t k i n s Dale Hails Lee Elizabeth Monozon M a rg a ret Tu m e l t y Valeria Balogh Kimberli Harg n e t t Lilia Dianne Mueller Fran Ubertini Linda Baro n Kay Hawkins Cristina Munoz-Gandara Robin Ungar B renda Bazan Terry Henry Kimberly Murphy Stacey Urd a n g Nancy Bolton Beck India Henson Azita Nahai Julia Vinciguerra Quinn R e j e a n Bilodeau ND Mary Hilliker Cindy Naughton Barbara Vo i n a r Mona Bingham Janet Hinkel Suzanne Nuss Don We n i g Mira Binzen Hollie Hirst Teri OConnor Bonnie Wi e s n e r B rent Bloom Jane Houck K a ren O'Donnell Clarke Leslie Wo r r i s Leslie Bogart Ginger Hooven S h a ron Olson Jeannie Wr i g h t s o n Martha Bond Sabrina Huff m a n Marie Opie Wi l l i a m s Christy Wy l e r Jennifer Botka Tracy Hutton Lisa ORourke Yo g a + H e r b s Toni Bradley Dea Jacobson C a roline Owen Ignas Zakarauskas Jo Brill Mary Anna Jansen Dara Papro c k Rebecah Ziegler Anne Buckley-Reen M a retta Jeuland Janeen Paul Mike Zolfo Sarasvati Buhrman Terry Johnson Diane Pavesic Ena Burru d Kathy Jones

Spring 2011 Yo g aT h e r a p yToday 4 0 41 Yo g aT h e r a p yToday Spring 2011 Spring 2011 Yo g aT h e r a p yToday 4 2 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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