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Part 1 Yoga and Psychotherapy Yoga Practices in A LifeForce Yoga Healing Institute Awakening Your Agenda ~ Part 1 Client’s Inner Pharmacy The Safe Container Part 1 Yogic View of Depression Therapy Training Boston, 2012 Meeting the Mood Yoga Tools Amy Weintraub, MFA, ERYT 500 Author of Yoga for Depression; Yoga Skills in The Evidence Psychotherapy The Practice www.yogafordepression.com How Yoga Skills Enhance Therapy Strengthens the Therapeutic Alliance Yoga and Psychotherapy Helps Client focus Helps Client access feeling states Provides tools for mood regulation Self-Study (Svadhyaya) Provides tools for self-care Compassion (Karuna) Helps in management of Bipolar Disorder & schizophrenia (Visceglia, 2011) “The highest spiritual practice is self- Increases self-efficacy observation with compassion.” Nondual Strategies for working with difficult emotions Provides tools and language to access a larger Self ~Krishnamurti “You are more than your mood, more than your beliefs about yourself and the world.” Yoga Practices in a clinical setting The Safe Container Psychologist and LifeForce Yoga® Practitioner Dr. Deborah Lubetkin with a client, Lotus Mudra “Crying is one of the highest spiritual practices. One who knows crying knows yoga.” ~Swami Kripalu ©2011, rev.2012 Amy Weintraub www.yogafordepression.com 1 LifeForce Yoga Healing Institute Centering with imagery, sound & Therapeutic Bond – Rituals & breath Practices Soothing Image Lighting of a candle Hand gesture A hand gesture (mudra) Inhale through the nostrils for 4 counts A simple yoga breath (pranayama) Hold the breath with the image for 4 A soothing image of sanctuary or peace counts. (bhavana) Exhale with the mantra “so-hum” A soothing universal tone (mantra) Yogic Three-Part Breath A cleansing breath (kriya) Intention Client’s intention reveals itself (sankalpa) Therapeutic Bond Yoga and Psychotherapy Meta-analysis of over 400 manualized 1. Safe Container treatments for depression, the greatest 2. Permission predictor of a beneficial outcome was not 3. Move slowly the therapeutic modality utilized, but the 4. Cue to sensation relationship between client and therapist. 5. Grounding (Wampold, 2001) 6 Yoga in Psychotherapy ~ Safe Container A client who returned said, "When I came before, you helped me understand and get Psychotherapist and LifeForce Yoga® Mentor Joe Walter, LICSW, working with a client, in where I wanted to go. Now you show me “Seated Mountain with Integrity.” Inhale: “I am” yoga practices I use to help myself through the crown; exhale: “Here,” grounding understand and get where I want to go." through the feet. ~Sherry Rubin, LCSW, BCD, LFYP, Downingtown, PA 11 ©2011, rev.2012 Amy Weintraub www.yogafordepression.com 2 LifeForce Yoga Healing Institute Yogic View of Depression Constricted Prana ~ constrictions in all Koshas Duhkha – Mistaken belief of Separation ~ Avidya Suffering ~ (II:3-4) literally means obstructed space Sukha – Happiness ~ literally means unobstructed space There’s a yoga appropriate for every body! Alternate Nostril Breathing Rajasic: In emotional terms, this would be anxiety, anxiety-based depression, mania, hypomania. Meet the rajasic state with vigor, then move to a more calming practice. Meeting the Mood/Constitution ~ Understanding the Gunas ©2011, rev.2012 Amy Weintraub www.yogafordepression.com 3 LifeForce Yoga Healing Institute Bellows Breath – Inhale One Breath per second Bellows Breath - Exhale Alternate Nostril Breathing Vishnu Mudra – Hand in a clinical setting Position for Alternate Nostril Psychologist and LifeForce Yoga Practitioner Dr. Sue Dilsworth leading a client in Alternate Nostril Breathing Opening Occluded Nostrils for Calming Mudras Alternate Nostril Breathing Adhi Mudra ©2011, rev.2012 Amy Weintraub www.yogafordepression.com 4 LifeForce Yoga Healing Institute Calming Mudras Calming Mudras Chin Mudra Dhyana Mudra Tamasic: In emotional terms, this would be dysthymia (mild, Alternate Nostril Breathing chronic depression), lethargy, major depression. Meet the tamasic state with a slow, restorative practice, then build to a more energizing practice. Meeting the Mood/Constitution ~ Understanding the Gunas Energizing Mudras Energizing Mudras Ganesha Mudra Brahma Mudra ©2011, rev.2012 Amy Weintraub www.yogafordepression.com 5 LifeForce Yoga Healing Institute Energizing Mudras Balancing Mudra~ Shiva Lingam Mudra Happy Buddha Yoga Strategies ~ Appropriate Basics of Asana & Pranayama as in Clinical Treatment Treatment Postures are practiced with conscious attention to the Breathing Techniques (Pranayama & kriya) breath and the sensations in the body. Creating Intention/Affirmation (Sankalpa) The following movements are included: forward Using Visual Imagery (Bhavana) bending, back bending, side stretching, twists, inversions. Hand Gestures (Mudra) Yogic breathing exercises are practiced that deepen the Mantra Chanting (Nada) breath, increasing lung capacity, energizing the solar Nondual Strategies to balance the plexus and the cerebral cortex, increasing HRV (a flow between sympathetic and parasympathetic) oppositesCommunity (sangha) The practice is regular (minimum of 4-5 times a week.) Yogic Strategies ~ Overview of Biochemical & Appropriate in Treatment Physiological Changes Yoga Nidra Decrease in cortisol levels (stress hormone) Intention/resolve (sankapla) Increase in GABA levels (primary inhibitory Inner Sanctuary neurotransmitter) Body Scan (annamaya kosha) Increase in HRV (heart rate variability) Breath Awareness (pranamaya kosha) Feeling & Balancing the Opposites (manomaya kosha Increase in BDNF (neuroplasticity, genetic & vijnanamaya kosha) expression) Awareness of Self (anandamaya kosha) Demonstrated improvement in memory, Suggestion: Self-acceptance, Gratitude cognitive functioning, perceptual motor skills, Intention/resolve (sankapla) visual perception 36 ©2011, rev.2012 Amy Weintraub www.yogafordepression.com 6 LifeForce Yoga Healing Institute Overview of Biochemical & LifeForce Yoga® for Mood Physiological Changes Disturbance Study Relaxes chronic muscle tension ® Restores natural diaphragmatic breathing Between times one (before the LifeForce Yoga Improves oxygen absorption and carbon dioxide program) and two (two weeks after learning it), elimination participants reported: Increases alpha and theta waves • 64% decrease in total mood disturbance (POMS) Regulates hypothalamus at an optimum level • 53% decrease in average depression scores (BDI) Certain techniques stimulate vagal nerve activity Bioavailability of oxygen and glucose, building blocks • At two months, overall mood disturbance for the production of neurotransmitters continued to drop. Calms sympathetic nervous system while activating Bennett, S., Weintraub, A., Khalsa, S.B., “Initial evaluation of the parasympathetic system LifeForce Yoga® program as a therapeutic intervention for depression,” Intern. Jour Yoga Therapy, 2008. http://www.yogafordepression.com/IJYT-2008-Bennett.pdf 38 UCLA Iyengar Depression Study Yoga Outshines Walking for Mood Of the 17 completers, all diagnosed with unipolar depression In a randomized controlled MRS study, researchers at in partial remission, who took 20 Iyengar yoga classes, 11 were in complete remission after the intervention. Significant Boston University compared study participants who reductions were shown for depression, anger, anxiety, and walked three times a week for exercise to a group neurotic symptoms. assigned to three weekly Yoga classes over a period of twelve weeks. The authors state that the overall remission rate of 65% GABA levels were significantly elevated in the Yoga “compares favorably with other CAM interventions: 43% Sam-e; 20% Omega-3 fatty acids; 19% folic acid; 25% aerobic practitioners. exercise.” More mood improvements in the Yoga group on standard psycho-social measurements. Evidence Based Complementary & Alternative Medicine, 2007 “Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels,” J. Complement Med. 2010, Nov. 16 (11). 39 Mood Improvement for Young Self-Efficacy in Battered Women Adults with Vinyasa Yoga In this first controlled study to examine the effects of pranayama breathing on self-efficacy Young adults with depressive symptoms in a the researchers found that the greatest effect on five-week Vinyasa yoga intervention showed self-efficacy for the battered women in the significant improvements in both self-reported study was derived from the combined & observer-rated depressive symptoms, somatic Testimony/Breathing condition. symptoms & sleep quality. * (2007) Alliant International University [email protected] “Efficacy in Battered Women,” International Journal of Yoga Therapy, (16), 2006. [email protected] 41 ©2011, rev.2012 Amy Weintraub www.yogafordepression.com 7 LifeForce Yoga Healing Institute LifeForce Yoga & Mood Studies in Yoga in Psychotherapy Progress Psychologist and LifeForce University of North Texas, Mandy Jordan, PhD Yoga® Practitioner Dr. Deborah University of Virginia, Patricia Kinszer, MA Lubetkin teaching an anxious Brown University/Butler Hospital, Lisa Uebelacker, client suffering from anorexia the PhD (NIH) Shanmuki Mudra that accompanies Bee Breath Current yoga and mental research summaries available: (Brahmari) to calm her racing http://yogafordepression.com/research-and-news/ thoughts and focus her mind for the transition into therapy. 44 Yoga in Psychotherapy Yoga in Psychotherapy Working with Children: Meeting Negative Self-Talk Psychotherapist and LifeForce Psychotherapist and LifeForce Yoga® Yoga® Practitioner Laura
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