Wednesday, December 15, 2010

Yoga as a Therapeutic Model for Disordered Eating Patterns

Yoga as a Therapeutic Model for Disordered Eating Patterns

Sinéad McCarthy

Laura Douglass

CSOCS 3452

6 December 2010


Yoga as a Therapeutic Model for Disordered Eating Patterns

Introduction

Eating disorders are one of the most prevalent diseases that adolescents suffer in our society, specifically young, white girls (American Academy of Pediatrics, 2003). In the United States, approximately 1% of children and adolescents suffer from anorexia, 90% of these teens are white middle or upper class females. As society puts more pressure on women to fulfill an impossibly perfect image, young girls across the country from various ethnic backgrounds are also developing eating disorders such as anorexia (American Academy of Pediatrics, 2003). Today, eating disorders are listed as the third most common chronic illness among adolescents. From a young age girls are learning poor dieting habits, whether it be from television, peers, or even family members (American Academy of Pediatrics, 2003; Bissell, 2007; Harrison, 2007).

Women across America are starving, binging, purging, exercising excessively, and abusing laxatives all to look like the models on billboards and in magazines (Harrison, 2007). For women who have suffered from trauma or feel as though they are inherently flawed, their internal thought processes focus on their flaws rather than their accomplishments. It is too easy for a person to ignore the achievements they have made in life when he or she has received negative responses throughout much of life. For many, eating disorders such as anorexia and bulimia become a crutch for the person to lean on when other areas of their lives are not as unfolding as initially planned. These negative comments, thought processes, and pressures to be perfect become overwhelming for many women leading to drastic measures (Cook-Cottone, Beck, & Kane 2008). Unfortunately, eating disorders often become the only source of feeling as though they have control in life. Many psychologists, physicians, and nutritionists specialize in this field in order to curb these statistics, and develop a treatment plan that actually works. One treatment that is currently becoming increasingly popular to help curb eating disorder patterns is yoga and meditation (Doulgass, 2009).

Alternative forms of treatment have always been fascinating to me. One day, I hope to become a psychologist who specializes in working with adolescents and young adults. In order to be most effective with all my future clients, I hope to be able to provide each with the best care possible, personalized specifically for each individual’s needs. Working with this age group, I know that I will come across many young women who suffer with body image issues. It is unfortunate, but in our society body image will constantly plague thousands of girls and women throughout their entire lives. Thus, I feel it is incredibly important for me to discover as many treatment methods as possible regarding eating disorders. Unlike many other psychiatric diagnoses, eating disorders are not easily managed simply through talk therapy, and patients can not receive a quick fix via a prescription (Comer, 2009). Instead, the emotions surrounding body image and incessant need for control must be evaluated and the counselor and client must work together to find an alternative manageable and healthy outlet.

Disordered Eating Thought Processes

While many people do not immediately think of yoga when discussing eating disorders, instead many people in a Western society such as America believe that yoga would only hinder a person’s self esteem. In recent studies (Cook-Cottone et al, 2008) the contrary has been proven, psychologists have found that regular practice of yoga may in fact help women become more comfortable in their bodies – when practiced under the appropriate conditions. If a person who suffers from an eating disorder practices yoga it is common for the patient to use the practice as another form of control (Cook-Cottone et al, 2008), which is why it is necessary for any person suffering from an eating disorder to first practice with an instructor who specializes in eating disorders. Practicing yoga does not only provide physical health benefits, but also mental health benefits. People who regularly practice have been found to be more aware of their bodies, mind, habits, and surroundings (Daubenmier, 2005). It is because of this new sense awareness that it is highly suggested as a form of treatment for women suffering from body image issues and eating disorders (Daubenmier, 2005).

Psychologists and nutritionists both agree that one of the contributing factors behind disordered eating patterns are because women have been sexually objectified in the media throughout history in Western societies (Bissell, 2007). Everywhere you look implicit sexual connotations can be found in advertisements, television, film, even Microsoft Clipart, it is no wonder that women feel pressured to obtain irrational bodies (Daubenmier 2005). Women begin to view themselves more as sex objects rather than human beings. By seeing themselves as objects, women are imposing social and psychological issues onto themselves including relationships (romantic and platonic) and how they view themselves in general, which can in turn lead to disordered eating habits.

According to Franzoi (1995), “women learn to view their bodies as objects of others’ attention, or body-as-object” whereas men tend to view themselves in a “body-as-process” manner (Daubenmier, 2005, p. 207). By viewing themselves in such a way, women are socialized to conceive themselves as objects to be evaluated by others causing women to criticize themselves based on the ideals they believe others have set for them. Fixated on fulfilling others’ standards, women may often find themselves battling inner conflicts of “how do I look?” rather than sentiments such as “how do I feel?” (Daubenmier 2005, p. 208). Self-objectification increases one’s feelings of shame and guilt, resulting in restrained eating patterns.

It is because of such thought patterns that many women in Western societies suffer from eating disorders, depression, anxiety, and sexual dysfunction disorders. In hopes to help women with these issues, many psychologists suggest sports participation, physical activity, and other activities to help females “experience their bodies in more direct and positive ways” (Daubenmier, 2005, p. 208). Yoga has been found to be a great form to stop, or at least curve people’s self-objectifications. This is because through practicing yoga, a person is able to experience the body as whole rather than focus on individual functions or portions of the body. When practicing yoga, one has to feel the stretch throughout different sequences of poses. For many people who suffer from eating disorders, it is important to feel the stretch and be able to hold the stretch. To successfully hold the pose, one has to make sure that they are able to recognize the signals the body is releasing, to note that the stretch feels right, not too tight or loose. As Daubenmier (2005) states so eloquently, the “underlying goal is to unify mind and body, by immersing oneself in subtle sensations of the body” (Daubenmier, 2005, p. 208).

Yoga as a Form of Treatment

Several studies have been complied in recent years to determine if there is actually any correlation between practicing yoga and developing a new sense of self-awareness. Researchers have already compiled information regarding the correlations between anxiety and yoga (Godfrey, 2006; Netz & Lidor, 2003), which is a good stepping point for work with eating disorder clients. Many people diagnosed with eating disorders often have anxiety issue as well (Comer, 2009). According to Godfrey’s discussion with Eva Selhub (2006), “[y]oga reduces anxiety, promotes well-being, and improves quality of life among the women who practice it regularly” (Godfrey, 2006, p. 1113). Knowing that yoga is an accepted form of treatment for anxiety, it is interesting to learn how people have redeveloped the practice to treat eating disorders.

Indra Singh discusses her own battles with anorexia and how yoga helped her come to terms with her body image in her 2010 Natural Life article. Throughout the article she discusses how she was first introduced to yoga at the age of seventeen. Prior to taking any yoga classes she was only sixty-three pounds. She had no energy. She could barely make it through a day, she has “lost all control” of her life (Singh, 2010). Shortly after beginning yoga, Singh could see and feel the positive affects of the exercises, “[w]ith various pranayama techniques, meditations, and relaxation skills, I was steadily on the road to recovery” (Singh, 2010). She goes on to explain the importance of these relaxation techniques and how one is given “permission to live, to relax, to let go” (Singh, 2010). Letting go is not something that most people with eating disorders are able to do because of the constant pressures and anxieties they tend to put on themselves. According to Singh, both her personal experiences and work as yoga instructor, has taught her that when these practices are completed daily, “these skills help transform the mind and allow you to gain back your own personal power” (Singh, 2010).

Rani and Rao conducted a three-month study to see if participants had any change in feelings of self-objectification. As hypothesized, the women who participated regularly in yoga classes for the allotted time felt a greater sense of “awareness of bodily processes” (Daubenmier, 2005, p. 208). In similar studies, researchers found that these results are not limited to females (Daubenmier, 2005). In fact, in a two-month study of undergraduate students, both male and female students had increased levels of body satisfaction after practicing consistently. A third study conducted with children’s yoga groups found that only after four weeks children experienced greater body acceptance and awareness. With evidence such as this it is no wonder psychologists have contacted yoga centers to create specified classes to work with eating disorder clients.

Further research has even discussed additional health benefits yoga provides if practiced routinely and accurately. One form of yoga as a therapeutic tool to treat clients with disordered eating habits is Attunement of Mind, Body, and Relationship (AMBR). Attunement in this model “is defined as a reciprocal process of mutual influence and coregulation” (Cook-Cottone et al, 2008, p. 66). In order to successfully attain attunement, one must be able to define how his or her social interactions (i.e. environment, family members, peers, etcetera) affect them individually. According to Cook-Cottone et al (2008), “representational self is the constructed self that is presented to the external system” (Cook-Cottone et al, 2008, p. 68).

Through this process, clinicians use a combination of cognitive and dialectic behavioral therapy processes in order to have clients gain an acceptance for her body. This model has shown great results because “the model posits that the etiology of eating disordered behavior is a developmental trajectory influenced by a complex interaction of individual, relational, and cultural variables” (Cook-Cottone et al, 2008, p. 66). Unlike other psychotherapies mentioned previously, AMBR tries to bring in all the variables known to attribute to eating disorders in hopes to reframe the client’s worldview and view of self. From the data collected thus far, it has been found that this treatment works best in group settings where clients are able to discuss personal opinions with others’ to gain a greater understanding of the world.

These group sessions are extremely structured, and each week follows the same general model as the previous week. Typically a session “followed the same predictable sequence of activities designed to provide practice in mind–body integration (i.e., a body, mind, and mind–body sequence)” (Cook-Cottone et al, 2008, p. 70). Sessions consist of a ten-minute review of the previous weeks work before about a one-hour yoga practice (Cook-Cottone et al, p. 70). This process enables clients to work towards inner attunement. Over the course of treatment, a successful candidate will begin to realize the negative cognitive defenses they have created internally and externally are at fault for their eating disorder. As previously stated, it is common for many people to develop eating disorders because they can only see imperfections in themselves. Feeling as though they lack control, people who are susceptible to disordered eating spend much of their time comparing their own appearance to that of others and images projected in society because “the body present a more accessible, measurable object of conflict” than what the initial issue may be in some cases (Cook-Cottone et al 2008, p. 67).

Many professionals believe that through the use of the body and mind, yoga allows people to maintain healthier eating patterns in general (Daubenmier, 2005). It is believed that these habits are enforced by “gaining sensitivity and responsiveness to bodily cues, including those of hunger and satiety” in turn allowing people to realize that they do not have to eat whenever they are faced with an emotional or situational circumstance, but instead because they are truly hungry (Daubenmier, 2005, p. 209). Many studies surrounding this realization have been conducted with clients who suffer from binge eating disorders, and the results are overall successful among all clients while in the program. Kristeller and Hallett conducted a six-week intervention program for women suffering from binge eating in 1999, concluding that women who participated in the program had a dramatic decrease in amount and severity of their binges during and after. This can be credited to the fact that through yoga practice, one is able to understand their bodily sensations more freely. In many eating disordered patients, the physical feelings of hunger are not easily recognizable because people develop the ability to ignore the cues the body associates with hunger.

Conclusion

After conducting the research for this paper, the benefits of yoga on a person’s overall well-being are too obvious to ignore. It is through this enhanced awareness that people are able to reassess their feelings of self, enacting an awareness of and responsiveness to the body’s functions that was previous ignored or non-existent. These new thoughts toward the body often cause people to gain a greater appreciation for “autonomic processes and physical abilities, thereby diminishing the importance of physical appearance to one’s physical self-concept and overall sense of self” (Daubenmier, 2005, p. 208). These new abilities often allow people to improve their entire view toward their physical appearance, lower the need to control or change their appearances in harmful ways.

Still, it is important to remember that this method may not work for every person who has disordered eating habits. Some studies have shown that yoga can also be harmful to clients struggling with eating disorders because of the Western perception of yoga (Daubenmier, 2005). Unfortunately, like most modern fads in Western culture, yoga has also strayed from its roots. When first introduced in the United States, yoga was seen as a practice only for the elite (Douglass, 2007). I was first introduced to yoga through tabloid magazines discussing how skinny certain actresses are because they regularly practice yoga. Even yoga magazines published in the United States are filled with unattainable body images. Encouraging people (especially young girls) who are already struggling with body image issues to practice a form of exercise that is strongly associated with thin celebrities can be damaging if not monitored. All the psychologists and yoga instructors must be specifically trained in this area to ensure the best results. If not, there is a strong possibility that the client will not be able to ever recover fully from an eating disorder, but instead develop a form of exercise bulimia.
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Monday, December 13, 2010

Yoga Therapy and Breath Control in the Prevention of Asthma Attacks

By Roxanna Minor

INTRODUCTION

Imagine that you’ve just sprinted down a few blocks to catch a bus. You missed it by a few seconds, you stop running, and stand by the curb, slightly hunched over, panting. Your heart is racing because of the exertion and currently, it is trying to bring your oxygen levels back to equilibrium. Instead of feeling that slight ease when you regain your breath, you continue to breath heavily, drawing in as much air as you can with each breath. Breathing out seems impossible at this point; it almost burns when you try. You’re stuck in this cyclic hyperventilation, unable to speak or make a sound. For me, this is what an asthma attack feels like; something that I experience at least a few times a month.

Asthma is known as an incurable disease that causes the sufferer to slowly asphyxiate due to their bronchioles closing up when exposed to allergens. More than 20 million people in the United States and 300 million in the world have asthma (National Heart Blood and Lung Institute, 2007). In Western culture, exercise is seen as a practice that is of great importance to help prevent disease, manage weight, and improve quality of life, which is the general well-being of an individual in society (Tecco, 1999). Since one of the main triggers of asthma is physical exertion, most asthmatics are overweight, depressed, and cannot get the exercise they need (American Lung Association, 2009). Research has shown that yoga is better suited for asthmatics as an exercise plan because the movements are slower and less strenuous than other forms of working out (Ellis, 2010). This research is presented as a personal guidance for asthmatics as well as a means to expose research that expounds alternative methods of maintaining a healthy and happy lifestyle. Yoga therapy and breath control are important for asthmatics to maintain a symptom-free lifestyle.

Asthma is closely related to a low quality of life, which involves complications with social, emotional, physical, and occupational aspects in everyday life. (Juniper, Guyatt, Ferrie, & Griffith, 2003; Sundberg, Palmqvist, Tunsäter, & Torén, 2009). There are no known causes, although research has led to a theory that our hygienic and sanitary western lifestyle may increase the chances for a child to develop asthma because they are not subjected to infections in early childhood, which affects the way their immune system develops (National Heart Blood and Lung Institute, 2007). There are many known triggers for asthma, including but not limited to: dust mites, pollen, household cleaners, pet dander, cigarette smoke, and pollution (National Heart Blood and Lung Institute, 2007; Planinz, 2010; Singh, 2006). Asthma is controlled through careful planning and medication; asthmatics are prescribed a quick-relief medicine for an immediate relief of symptoms and a long-term control medicine to reduce inflammation of the bronchioles. Although there has been a significant amount of research on this topic, treatment for it has not progressed and there is still no ‘known’ cure.

A Bit of Personal History

Having had asthma since the age of four, I am avidly interested in alternative treatments for respiratory illness. I have taken a wide range of medications that are supposed to help control my asthma. The medications that I take daily are Abuterol, which is my rescue inhaler, and a Long-Acting Beta-2 Agonist, Advair Diskus. The Advair acts to “help prevent symptoms.” My chronic and unstable asthma calls for high doses of each, giving me side effects such as nervousness, sleeplessness, nausea, and, right after taking a dose, tremors. I visit the hospital more frequently than any asthmatic should. When I arrive, I am given doses through a nebulizer every two hours and if it is severe enough, an adrenaline shot. I live with the fear in the back of my mind that I may one day die from this illness.

When I had my first attack in preschool, I was hospitalized for almost three months. My pediatrician informed my parents about the dangers of airborne allergens, dust mites, and pet dander. When I was released from the ICU, my parents donated every stuffed animal my brother and I had and cleaned the apartment thoroughly every two or three days. I was prescribed the Abuterol inhaler, the nebulizer, and Prednisone, which is a corticosteroid that is an anti-inflammatory. I took the inhaler about 6-10 times daily, the nebulizer once or twice, and Prednisone twice daily. Because Prednisone is a steroid, I gradually began to have mood swings and insomnia.

Although I was being treated for my asthma, I continued to have frequent attacks. The nurses at the hospital began to suppose that my parents were abusive because I was under a great deal of stress.

Overtime, my attacks became less frequent, but the severity was constant. I began to sleep through the attacks I had at night because I hated the hospital so much. My doctor and I have stopped talking about ways to lessen my medication and treat my illness. I have made no progress other than infrequent attacks. My last serious one occurred this past September when I came down with Bronchitis. Having an attack is like breathing through a small straw, except you cannot just make it disappear. Personally, I will not accept that I cannot do anything else to keep the attacks to a minimum.

the effects of yoga and breath retention

My knowledge of asthma is based upon what my doctor has shared with me: It is a chronic disease with no cure. Once someone develops asthma, he or she is likely to have it for life. Even if I do not feel any symptoms of asthma, my bronchioles are still inflamed constantly and an attack can flare up at any time. I need to take control of it through constant attention to how I am feeling and use of my medication. Not doing so can cause a trip to the Emergency Room. I must stay away from what triggers my asthma. I may have a chance to improve the frequency of the attacks, but that is solely through the constant use of medication.

I was not taught any alternative way for managing my asthma except for a practice called “Belly Breathing” or “Abdominal Breathing” (Rakel & Saunders, 2003). I was taught that once I start feeling some chest tightness, I was to be calm and lay down. I then had to place one hand on my abdomen and another on my chest. While I tried to breathe slowly and deeply, I had to focus on moving only the hand on my abdomen, insuring I was not taking shallow breaths. This breathing practice helped me a number of times when I started feeling anxious and began wheezing or breathing erratically. What I did not learn was that this is a breathing technique similar to the pranayama practice in yoga.

Recent research has deduced that yoga improves asthmatics’ exercise tolerance, histamine tolerance, and quality of life (Adhyatmananda, 2001; American College of Sports Medicine, 2009; Benagh, 2001; Gardner, 2009; Gutfeld, Meyers, & Sangiorgio, 1991; Manocha, Marks, Kenchington, Peters, & Salome, 2002; Nagarathna & Nagendra, 1985; Planinz, 2010; Saffron, 1998; Singh, 2006). Unfortunately, the reason why yoga improves these tolerances as well as quality of life is not fully explained in some research studies. Others point out that the practice of controlled breathing creates a significant drop in resting heart rate and sympathetic reactivity, which is caused by the relaxation of the muscles involved with breathing (Adhyatmananda, 2001; Benagh, 2001; Planinz, 2010; Saffron, 1998; Singh, 2006). These specific sources also point out that asthma is a reversible ailment, not a permanent disease.

The Role of the Breath

Breathing is a natural and involuntary bodily function. It is “a process of maximum efficiency with minimum effort” (Singh, 2006, p. 1). It is controlled by the autonomic nervous system, which is broken down into two sections: parasympathetic and sympathetic systems. The parasympathetic branch directs the resting functions of the body while the sympathetic branch controls the “fight or flight” response (Singh, 2006). If the danger is tangible, the excess adrenaline is used, if not, hyperventilation and anxiety ensues.

This hyperventilation, also known as overbreathing, becomes habitual for asthmatics, making them breathe in for much longer than they breathe out (Neves, 2010). The idea of overbreathing is believed to be the root cause of asthma in research presented by Professor Konstantin Buteyko (Benagh, 2001; Lum 1975; Neves, 2010; Planinz, 2010; Rees-Evans, 2010; Saffron, 1998; Singh, 2006). In his investigation, Buteyko linked hyperventilation to several chronic conditions and sought out to develop a technique to normalize breathing patterns (Reese-Evans, 2010). He created the “Buteyko Breathing Process” to reverse asthma symptoms and lessen the need for medication. A brochure describing the effects of hyperventilation and Buteyko’s research states:

You have asthma because you have been habitually overbreathing more air than

your body requires… Every part of your body, every organ and every system is

affected by over breathing. This disorder has been given many names, but

Chronic Hyperventilation Syndrome (CHVS) describes best the huge complex of

symptoms to which it gives rise (Neves, 2010, p. 3).

His research also describes that overbreathing does not produce more oxygen; it instead flushes carbon dioxide, which is essential for the proper oxygenation of the body’s organs As a result, cells receive less oxygen, causing shortness of breath and panting (Neves, 2010; Rees-Evans, 2010; Lum, 1975; Singh, 2006). This causes a severe biochemical disturbance, creating a malfunctioning immune system that gives rise to an allergic response (Neves, 2010).

Hyperventilation is caused by the same sympathetic branch response that I have discussed earlier. The stress that causes the fight or flight response can create habitual hyperventilation which can result in a chronic shortage of carbon dioxide, producing a long-term inflammation of bronchioles.

Barbara Benagh is a yoga instructor who is currently located in Massachusetts discovered this for herself through her own struggles with asthma. She states, “If the way I breathe was causing my asthma, then retaining my breath might alleviate my problems” (Benagh, 2000). Her experiences with pranayama helped her achieve breath retention. Through some experimentation, she found a handful of exercises that worked and created her own breath retention program.

Physical and Mental Harmony

I have found that I subconsciously hold my breath during the day and over breathe. It is difficult for me to fully exhale, so my inhalations are twice as long as my exhalations. I have not fully grasped the ability to control the way I breathe, but I am attending yoga class twice a week and making a conscious effort to lengthen my exhalations for 15 minutes a day. Whenever I practice and slow my breathing and mind, I feel a sense of relaxation and calmness. This definitely contributes to my lower levels of anxiety and stress.

Yoga’s psychological and physical effect on the mind and body has long been used as a treatment in western culture, even though ‘traditional’ yoga was not developed as a system of therapy (Singh, 2006). Hatha yoga, according to Saraswati Muktibodhananda, is “the science of physical and mental harmony” (Muktibodhananda, S., Saraswati S., & Svātmārāma, 1998, p. 19). Without this harmony, human beings suffer from “psychic and mental diseases” (Muktibodhananda, S., Saraswati S., & Svātmārāma, 1998, p. 19). Controlling the breath means controlling the fluctuations of thought. Through this practice, stress levels are kept at a minimum.

In other eastern texts, such as The Spiritual Roots of Yoga, it is clear that breathing plays an important role in maintaining equilibrium in physical and mental health. This text specifically states, “The quality of breathing in a person is intimately and directly connected with the inner state, as apparent from even a superficial observation of oneself” (Ravindra, R. & Priscilla M., 2006, p. 10). Even the Yoga Sutras of Patanjali suggest that disharmony of breath is linked to a disharmony in mentality. He describes that obstacles such as physical illness, doubt, laziness, etc are connected to mental and physical pain, sadness and frustration, unsteadiness of the body and irregularity of breath (Hartranft, C., 2003).

CONCLUSION

Bio-medical research is beginning to touch upon the healing affects of yoga and breath control. Despite what I have researched and learned for myself, it is not a common practice for pediatricians or doctors to immediately suggest alternative means of treatment for asthma. They instead prescribe medications to alleviate the symptoms of an ailment. Research has found that rescue inhalers and corticosteroids do not fully assist in the treatment and prevention of asthma (Benagh, 2000; Reuters, 2010; Singh 2006). Unfortunately, there is no other medicinal assistance available.

The fact that breathing is an automatic function makes it an act that is taken for granted. Western culture is so heavily filled with distractions that the breath is forgotten most of the time, unlike Eastern cultures who make conscious breathing a part of their lives and have done so since ancient times. This disregard contributes to an asthmatic’s Chronic Hyperventilation Syndrome. Training the breath to return to a normal state has been proven to help alleviate symptoms and greatly lesson the amount of asthma attacks. Consequently, breath control and yoga therapy can be used to reverse inflammation in bronchioles, lessen the need for medication, and improve quality of life. With proper research and testing, breath retention practices can lead to a natural treatment of asthma devoid of side effects.

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Liz Shear--Yoga in the treatment of PTSD

Abstract

Great advances have been made in the study of yoga as medicine, now including the area of psychiatric cases. Yoga has shown much success in the treatment of Post-Traumatic Stress Disorder (PTSD) and even the depression that it is often accompanied by. Studies specifically target military war veterans, the survivors of the 2004 South-Asia tsunami, and children from abusive home environments. The question of how best to treat patients with PTSD is still unanswered. The resources primarily utilized at this point are drugs and talk therapy, both with reputable results, but failing to treat the mental and physical side effects of PTSD as a whole. Yoga has proven to be and adequate resource to those suffering from PTSD because of its ability to treat both these ailments simultaneously. Yoga in the treatment of PTSD has shown nothing but positive results and is still the subject of discussion amongst the medical world.

Yoga in the Treatment of PTSD

As yoga practice popularizes in America, the advertised positive effects of a regular practice are expanding beyond the physical. Psychiatrists have begun turning towards yoga practices to treat psychological disorders, more recently PTSD and the depression which often accompanies it. PTSD is a rising concern, especially in the United States, due to the war in Iraq and its returning soldiers often being affected; however studies on other situations where people are put under an extreme amount of stress are also beginning to be studied. Although the studies for yoga as therapy are only just beginning to surface, already notable success has been proven. Yoga’s meditative qualities, controlled breathing techniques, and physical exercise are shown to cumulate into a wonderful solution for a group of people who have an illness that is difficult to treat. So just how effective can yoga be in the treatment of Post Traumatic Stress disorder, and related depression symptoms? The following research will test any previous beliefs about the treatment of these disorders you may have previously had and yoga’s power in psychological health.

PTSD AND ITS ASSOCIATED SYMPTOMS

Studies on PTSD first appeared on the medical radar when large quantities of soldiers returning from the Franco-Prussian war began showing similar symptoms of exhaustion, anxiety, heart palpitations, chest pain, trembling, and disorientation (Rosalyn M. Bertram, 2008). In Rosalyn M. Bertramand Jennifer L. Dartt’s study of PTSD in children from violent and impoverished communities, they go on to explain the history of PTSD. At first when the soldiers were retuning from war with these symptoms, doctors speculated that when soldiers with a traumatic childhood entered the battlefield, the trauma would resurface. At the time, the only medical solution was basically just to wait it out—the symptoms would go away on their own. Modern studies of PTSD describe it as a result of situations where people experience severe “feelings of fear, helplessness, or horror” (Patricia A. Resick, 2009) and not in any particular relation to a violent childhood, but rather about the things that actually took place immediately at the time the symptoms were noticed. The description of the symptoms associated with the disease has also changed to include mental issues, and not only ones that physically manifest. This includes difficulty regulating affect and impulse, flashbacks, or nightmares, relation difficulties, as well as low self-esteem and self-efficiency (Rosalyn M. Bertram, 2008). Although it is a subject mostly studied for its effects on soldiers who have been to war (Rosalyn M. Bertram, 2008), it has recently been studied on victims of natural disasters (Richard P. Brown, 2005) and children who have experienced particularly horrible situations, such as abuse physically and sexually (Rosalyn M. Bertram, 2008).

HOW TO TREAT PTSD

The best treatment for PTSD is still a highly debated subject amongst those in the psychology field. Medicine has been a suggested solution, in the form of antidepressants, anti antipsychotics, or anti-anxiety pills, but these are only treatments for some of the symptoms PTSD patients endure (McAllister, 2009). Therapy in the form of cognitive and trauma therapy have also been arguable solutions since the diseases discovery (Bruce E. Wampold, 2010). Research by Patricia Gerbarg M.D and her husband, Richard P Brown M.D. (2005), is proving there may be alternative solutions, which they claim to be equally effective. Their work began with Tsunami victims the 2004 Tsunami in South Asia. After the devastating natural disaster, a wave of depression and PTSD swept over the countries populace. The couple began using yogic breathing to treat patients, the results both pleasing and surprising (Richard P. Brown, 2005).

THE GERBARG AND BROWN STUDY

One might ask how the couple came to the conclusion that yoga seemed like a possible solution to their patients PTSD symptoms—why yoga of all the complementary medical possibilities? Perhaps one may find this answer in and interview with Bessel van der Kolk, MD—a renowned authority in the study of PTSD (2009). He describes PTSD as a “residue of imprints left behind in peoples sensory and hormonal systems.” Based on his studies, he claims “most trauma-sensitive people need some sort of body-oriented psychotherapy or body work to regain a sense of safety in their bodies” something which is lost post-traumatic experience. With this knowledge, Gerbarg and Brown (2005) tested a group of patients with PTSD. One group of sixty took a four day yogic breathing course, another group of sixty took the yogic breathing course in conjunction with psychiatric counseling, the third group was a control. As a result, all participants taking the yogic breathing course benefitted more than those who did not, and even more surprisingly the counseling seemed to have no additional positive effect (Richard P. Brown, 2005).

The results of their studies with Tsunami victims lead to more in depth studies of yoga’s effects on various different types of psychological disorders. They tested a specific type of yoga regimen called Sydarshan Kriya Yoga (SKY) on patients suffering from moderate to severe depression which often accompanies PTSD patients many other symptoms. SKY sessions incorporate pranayama (breathing), asanas (postures), meditation, group processes and basic yogic knowledge. Their three-month study of persons with dysthymia and major depression proved reductions on both the Hamilton Rating Scales for depression and Beck Depression Inventory Scores after one week of SKY instruction and three weeks of practice. In private practice most patients with mild to moderate depression responded rapidly to SKY courses often feeling better in as little as five days. Many can discontinue medication with out remission through daily practice (Richard P. Brown, 2005).

YOGA VERSES MEDICINE AND TALK THERAPY

The possibility that a regular yoga practice could replace medicine opened up to additional studies on disorders more stubborn to treat through medical means, such as insomnia, addictions, and phobias (Richard P. Brown, 2005). The success varied, but in general a specific yoga regimen could be found for each disorder based on the patients needs. Gerbarg and Brown’s (2005) Studies concluded that when a specific yoga style was found, the general consensus was success. They even went as far to say that yoga could replace medicine for patients with moderate to severe symptoms of depression and anxiety related to PTSD. Dr. Swami Vivekananda Saraswati (1995), a doctor trained in allopathic medicine, writes at length about yoga’s undeniable abilities in the treatment of mental illness, but does not deny medicines place in this process. His studies focus mainly on four types of mental illness (epilepsy, schizophrenia, manic depression and bipolar affective disorder, and endogenous depression) and although PTSD is not studied directly, the associated depression is, which its patients often suffer from. Thompson agrees that yoga is undeniable a help to his patients, but they must be chemically stabilized before attempting to treat with yoga alone. When stabilized his patients are more mentally fit to integrate a yoga practice into their regimen, “which then will ensure they will get off the drugs quickly” (Saraswati D. S., 1995).

Yoga has proven to be a great compliment to medicine and talk therapy in most cases dealing with PTSD, and overcomes many of the failures of traditional medical procedures. In a study comparing the remission rates of yoga to the remission rates of ECT and imipramine, a popular antidepressant, yoga came out on top (David Shapiro, 2007). Its effect on the body is similar to medicines effect on brain chemicals and receptors in the brain. Gerbarg and Brown have found that Yogic breathing effects the nervous system through the vagus nerve, “the ‘rest and digest,’ or calming, pathway of the autonomic nervous system extending from brain stem to abdomen; when activated, it slows down breathing and heart rate and increases intestinal activity” (Tullis, 2009). Yoga can accomplish the same benefits of medicine without the cornucopia of side effects most anti-depressants have. Dr. Swami Vivekananda Saraswati (1995) mentions that one of yoga’s greatest advantages is its non-addictive or habit-forming nature, one of anxiety pills (like valum) greatest disadvantages. However, the success of medicine on plenty of psychological disorders is undeniable. As Dr. Swami Vivekananda Saraswati (1995) said, it is necessary for a patient to stablize, most likely through allopathic medical needs, before being able to replace medicine with yoga. While yoga is undeniably a great compliment to medicine and talk therapy, it should not be viewed as a replacement.

Where medicine and talk therapy have failed to fully treat this disorder, in the sense that they can only treat symptoms one at a time, yoga has proven to be an undeniable aid. The disorder is a combination of physical and mental disassociation which neither one of the previously mentioned solutions can treat simultaneously. Yoga is successful in the treatment of PTSD because of its specific ability to treat both the physical and mental troubles of patients. Van der Kolk (2009) describes PTSD patients as having a crippling rational mind. The rational mind enables us to “organize feelings and impulses but is not well equipped to abolish emotions thoughts and impulses” (2009). When a soldier returns from war, he cannot erase the disaster and horror he has experienced. He will continue to relive that fear every day because it has been ingrained in him for so long. Children with destructive home environments live their life in fear everyday, so when it stops, they don’t know how else to react to the things around them.

REASSOCIATING THE PHYSICAL AND THE MENTAL PARTS

After being paralyzed at the age of thirteen, Matt Sanford, now an inspirational yoga instructor, has insight to offer about his experience with PTSD and how it affects others. He claims the damage is not the pain you experience at the time of the incident, but that the “real damage is inflicted after the fact, by the ways we attempt to defend ourselves in the short and long term, both physically and mentally” (Utne, 2006). After going through such an experience, PTSD patients fall out of touch with physical sensations because they become overbearing, and have trouble taking care of their bodies. At the same time the “reptilian part [of their brain] is not good at taking care of the mind” (Kolk, 2009) meaning they are subject to uncontrolled thoughts and actions. Swami Ahimsadhara Saraswati (2006) describes PTSD as an “extreme disconnection.” She goes on to say that, “in this muddle we move further from rather than closer to the harmony of body and mind which guides us towards integration and connection with the spirit.”

YOGA IS THE SOLUTION

People who suffer from PTSD have trouble “taking pleasure in the present because their bodies keep replaying the past” (Kolk, 2009). Yoga is an excellent tool to refocus your mind on being in the present moment. When performing asanas (yoga postures) one is fully involved in the stretch they are performing and the balance and concentration involved in holding it. By focusing on ones bodily condition in that moment, PTSD sufferers are allowing relief to their minds reoccurring thoughts of the traumatizing experiences they have gone through. Asanas also offer relief from many of the physical side effects of PTSD on a superficial level. PTSD patients often experience digestive problems, joint pain, hernias, high blood pressure, and more (Saraswati S. A., 2006). Simple and accessible asanas can offer relief from these physical troubles (Saraswati S. A., 2006). PTSD patients also experience the sensation of condemning their bodies because of the physical aliments they face with PTSD. Yoga develops a body that is strong and “feels comfortable” (Kolk, 2009). Yoga also encourages the relief of deep muscle tension through relaxation, and healthy diets to meet these same ends (Saraswati S. A., 2006).

Many of yoga’s healing benefits occur in the mediation aspect of yoga. Because of the rapidly moving minds that PTSD patient’s experience, meditation offers a chance for the all the moving to stop, and for them to focus on what they are feeling in the present moment. During meditation, it is encouraged to allow your thoughts to wonder, not analyze them but allow them to happen. The sensation of one thought ending and another beginning, or even one posture ending and another one beginning, offers PTSD patients hope that what they are currently feeling in their life, especially their fear, will end (Kolk, 2009). Mediation also gives the person meditating the ability to recognize negative thoughts and intercept them. By being more aware of how your thoughts formulate, one is better able to control what thoughts resonate and which thoughts float away. This type of interception is key in overcoming PTSD and depression (Saraswati D. S., 1995).

THE FUTURE OF YOGA TO TREAT PTSD

In 2009 a study was conducted at the Walker Reed Army Medical Center and Veterans Administration hospitals in Miami and Washington, D.C., testing the possibility of yoga nidra (a type of yoga that uses meditation, deep relaxation and breathing and to reduce physical, emotional and mental tension) to help veterans with PTSD. The program was called iRest (Integrated Restoration) and was founded by Richard Miller. The test results were good enough to warrant further testing and consider yoga nidra as a part of deployment readiness training programs.

Although the effectiveness of yoga in the treatment of PTSD is still an unanswered question, the results are stirring up the medical world. In a time where complementary medicine is proving to fill in the gaps medicine and therapy have left open, the legitimacy of these studies is still debated. Yoga is truly a practice that encourages things all people can welcome as healthy steps towards living a better life: relaxation, meditation, being in the moment, positive thinking, and knowing your own body and mind. People who have suffered things worse than any of us can imagine carry a heavy burden in their day-to-day life. Yoga may come as a fundamental relief to people living with this burden as long as our minds remain open to the infinite power and possibilities of peace.

Bibliography

Bruce E. Wampold, Z. E. (2010, June). Determining what works in the treatment of PTSD. Clinical Psychology Review .

David Shapiro, I. A. (2007, February 28). Yoga as a Complementary Treatment of Depression: Effects of Traits and Moods on Treatment Outcome. Advance Access Publication.

Kolk, B. v. (2009). Yoga and Post-Traumatic Stress Disorder: An Interview with Bessel van der Kolk, MD. 12-13. (I. Y. Magazine, Interviewer)

McAllister, T. W. (2009). Psychopharmacological Issues in the Treatment of TBI and PTSD. The Clinical Neuropsychologist , 23, 1338-1367.

Patricia A. Resick, M. W. (2009). Post-Traumatic Stress Disorder: Anxiety or Traumatic Stress Disorder. Journal of Traumatic Stress , 22 (5), 384-390.

Richard P. Brown, M. a. (2005). Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II--Clinical Application and Guidelines. The Journal of Alternative and Complementary Medicine , 11, 711-717.

Rosalyn M. Bertram, J. L. (2008). Post Traumatic Stress Disorder: A Diagnosis for Youth from Violent, Impoverished Communities. J Child Fam Stud , 18, 294-302.

Saraswati, D. S. (1995, July). Yogic Treatment of Mental Illness. Sivananda Math Yoga Magazine .

Saraswati, S. A. (2006, November/December). From War to Peace-Yoga for the Management of Post-Traumatic Stress Disorder. Yoga Magazine .

Tullis, P. (2009, May 01). Yoga: The Strongest Stretch. Retrieved November 14, 2010, from Psychology Today: http://www.psychologytoday.com/articles/200705/yoga-the-strongest-stretch

Utne, N. (2006, July/August). Transcending Trauma. Utne (136), p. 4.

Yoga and Autism

This research paper is about how yoga influences child with autism.

Autism is a developmental disorder that appears in the first 3 years of life, and affects the brain's normal development of social and communication skills. “Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood.” (wikipedia.com) While it is known that the condition is linked to abnormal biology and chemistry in the brain, it is unknown what the exact causes of these abnormalities are. “Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by rare mutations with major effects, or by rare multi-gene interactions of common genetic variants. Complexity arises due to interactions among multiple genes, the environment, and epigenetic factors which do not change DNA but are heritable and influence gene expressions.” (wikipedia.com) There are a number of possibilities that have been suspected, but not proved to be the cause of autism. Some of these include diet, digestive tract changes, mercury poisoning, the body’s inability to properly use vitamins and minerals, and vaccine sensitivity.

The symptoms of Autism can be show as soon as 18 months of a child's life. Parents start to realize that something is wrong in the development of their child. Infants with autism show less attention in social situations, they tend to not smile and look at people as much as a regular child would. Infants also usually do not respond to their own name. Children with autism tend to have difficulty in imagining and pretending the play, they usually have trouble being interactive in social situations, and tend to lack verbal and nonverbal communication. In some cases children with autism lose language and social skills they have gained over the years, after that age of two. This kind of autism is called the regressive type of autism. Around one-third to a half of children with autism never develop enough natural speech to meet their daily communication needs. As the child gets older they could become excessively sensitive to hearing, sight, smell, touch, or taste. They could refuse to wear certain clothing and could become distressed if they are forced to wear them. They become upset with an interruption to their normal routine. They tend to preform repeated body movements. Most of the time the person will become unusually attached to certain objects.

Screening can be done if a parent thinks that there maybe something wrong with there child. Just about half of parents of child who have autism realize that there is something wrong, and not unusual behavior by age 18 months. About four-fifths of parents notice around the age of 24 months. Postponing treatment may affect the child long-term so keeping an eye on the child and knowing the first signs of autism is very important. At this point in time, the US tests all children for autism at the age of 18 months and again at 24 months. They doing this using autism-specific formal screening test.

Here is a list of signs to look for in your child:

-No babbling by 12 months.

-No gesturing (pointing, waving goodbye, etc.) by 12 months.

-No single words by 16 months.

-No two-word spontaneous phrases by 24 months.

-Any loss of any language or social skills, at any age.


There are many reasons why parents put their children in yoga classes. For most parents it is important to them that their child has some sort of beneficial outlet. Most parents want to teach their autistic child a way to help them calm down. Parents want children to focus on non distressing things in their lives. Parents also want to help their child block out things that cause the them stress, like noises, certain colors, or disturbing textures. But perhaps the main goal of yoga is to get to children to the point where he or she is able to make steps toward becoming more socially interactive. It is agreed by most teachers and parents that yoga has made a huge improvement in their child's life. Regular yoga classes have been shown to improve listening skills, the stretching in yoga helps relieve stress in their bodies, it challenges them and teaches them not to give up, and deep breathing gives them a tool to help them relax. It also can help slow down overactive children, helps regulate moods, helps the child concentrate, it can help children that are easily exasperated, it helps relax aggressive children, and parents like yoga because if a child has mobility issues, yoga is very accommodating to them.

While doing the research, I found that this new trend of yoga and autism is mostly used in western part of the country where yoga is widely excepted and practiced amongst many non-autistic people. One of the reasons that Yoga with autism is so prevalent here is because Molly Kenny, a speech-language pathologist and an Ashtanga Yoga instructor started a programs in Seattle, Washington called Integrated Movement Therapy or IMT. “Kenny discovered that when she combined touch or movement with verbal exercises, her patients generally experienced more spontaneous speech and improved mood. Such results convinced Kenny that a therapy blending speech-language exercises, self-esteem building, self-calming practices, and yoga postures might address the characteristics associated with autism disorders.” (yogajournal.com) Most families that participate in yoga with their autistic child have the time to dedicate to the practice, have the money to have multiple people in the family take these classes alone with the children, and understand that teaching and practicing yoga with their child is a beneficial and important bonding time for the family and everyone involved in the child’s life. Now, on the West coast, some schools are picking up on this new therapy trend for autistic kids and are incorporating it into their daily school routine. They are finding that is it easier to maintain the children because they are learning tools to help regulate their moods. These programs are taught so that these autistic children become self aware and are able to identify when their mood is escalating into something that could turn upsetting.

For most autistic children, trusting unfamiliar faces is very difficult. The child usually only trusts people in his life that he sees on a daily basis. “Research suggests that autistic children are often withdrawn and relate better to objects instead of people. Many yoga poses simulate objects and animals, such as Mountain, Tree, or Down Dog, that the children may find engaging.” (emaxhealth.com) When emerging a child into the world of yoga, the teacher must form a tight bond with the student. The teacher needs to take the time to become a part of the autistic child's life and become a familiar part of it. Only when this is achieved with the teacher have gained the trust and confidence of the child. Most of the time the teacher uses massage, music, colors, dance, stories, and rhymes to help connect with the student. After the trust and friendship has been gained by the yoga instructor the instructor can slowly incorporate yoga poses in the form of asanas and pranayama or breathing exercises. The combination of asana and pranyama and deep relaxation techniques will help strengthen the child's nervous system, increase overall health, and will facilitate development of the body’s awareness and concentration.

Growing up my best childhood friend was autistic. His name was Joshua. He was and still is such a loving, caring person. From the time I was little until now, I have always been drawn to him. I’ve never met a person so kind and non-judging. He’s very naive about the world, and it just makes realize that there is still good in the world. Joshua’s mother, Martha, was my brownie leader, and an incredible woman. They live in a huge farm house in the middle of no where. Joshua’s mother had adopted about a 9 or 10 autistic children and had a few kids of her own. I remember going over to her house several times a week and witnessing her teaching her children yoga. At the time I had no idea what is was, but it was interesting to me and the fact that the kids loved it made me curious. They would all partake in poses like downward dog, child's pose, and worked on breathing techniques. Even Hannah who was paralyzed from the waist down participated in yoga. I asked Joshua’s mother what she was doing with the kids and she explained to me what autism was and what her children each had and what yoga was. She explained to me how yoga helped all her children relax and de-stress. At the time it was all very confusing to me, but looking back at it I will never forget watching them all do yoga, and now it makes so much sense to me. Joshua was able to take yoga to our school, where his aide would practice with him when he had a temper tantrum. From time to time I drive to see Joshua and his family. He is now 22 and still lives with his parents, as well as all the other adopted autistic children Martha and her husband have. Martha and her kids still practice yoga every day, as a family. Over the years I have become really close with Martha. We talk about how all the kids are doing and how Joshua is maturing and growing and its incredible to see. She explains how hard her life is but how grateful she is. When we talk about yoga and her children, she explains to me that yoga makes her life a bit easier. The kids now have tools that they need to deal with new social situations, new changes in arise in their lives, and how they are now all able to sleep fully through the night, including herself. Martha practices pranayama with her kids, and can see them using it say when they are in the grocery store distracted by the colors and people. Most of the time when I visit, Joshua and I sit on the porch and talk about whats new in his life. I asked him about practicing Yoga when I went to visit their house in Northwood, New Hampshire. Joshua had a big smile on his face. He told me that he loves downward dog. I asked him why and he said because it feels good and it makes him happy. The last time I went over to Martha's she asked me how my yoga class was going and asked the kids and Joshua if I could practice with the family that afternoon. I was nervous that the kids would feel anxious and not want me to practice with then. But once Joshua came over to me and pulled me into the “practice room,” I knew I was welcome. The practice lasted about thirty minutes which seemed perfect because right around twenty-five minutes the kids started to get a little antsy. We did a variety of simplified poses. We did Joshua’s favorite pose, downward dog. We did a few warrior poses, we did child's poses and Martha walked around giving all the kids a little back massage and we ended with some simple breathing activities and a good stretch. At the end of the practice we all sat Indian style, put our hands together, and said, “Namaste!” It was so powerful, and reassured me that I wanted to investigate and write my research paper on this topic.

It is clear to me that Yoga is very beneficial to Autistic children. I think it is important for everyone to have some sort of outlet no matter what are diagnosed with or aren't diagnosed with. It proves to be a bonding experience, a way to become self aware, and is actually beneficial to the body itself. I expect for this trend to really take off and I hope the families with cases of autism continue to explore the vast world of yoga and all it has to offer.



















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