Yoga and Exercise: The Benefits of Yoga Above and Beyond that of Common Forms of Exercise.

Yoga is a spiritual discipline with its roots in India. The word ‘yoga’ is found in India’s earliest known scripts, the Vedas, which date from the Vedic period which began in 1500 BCE. Composed in Sanskrit, the Vedas are the oldest writings of Hinduism.

The word ‘yoga’ is most commonly translated as meaning ‘to yoke’ or ‘to bind’. For many years, yoga was more of a notion of meditation and a religious practice as opposed to the postures (asanas) we typically associated with it in current Western society. It was around the 5th century that yoga became an established practice among Hindus, Buddhists, and Jains. Importantly, these ancient versions of yoga were spiritual practices with the primary aim of yoga asana being to prepare the body for an extended period of meditation. During the medieval period (500-1500AD), different schools of yoga emerged. Hatha yoga appeared in Buddhist texts around the 8th century; a combination of asana, breathing and meditation and possibly the closest to what we, in the Western world, most commonly associate with yoga today.

Much more could be written about the origins of Yoga – we haven’t even mentioned Patanjali, Swami Vivekananda or the eight limbs of yoga… perhaps a deeper exploration is warranted within another blog post at another time. For now, suffice to say that yoga itself absolutely and undeniably sprang from roots of an intensely spiritual nature. We shall bear in mind yoga’s roots as a spiritual discipline as we explore its physical and emotional benefits above and beyond exercise in this blog post.

A systematic review due for release next month (Larson-Meyer, August 2016) has looked at the energy cost and metabolic intensity of yoga. Seventeen studies were reviewed, concluding that few yoga sequences/poses, including Surya Namaskar, meet the criteria for moderate to vigorous-intensity activity in accordance with the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) physical activity guidelines. Our fear here at the Minded Institute is that these results may inhibit medical professionals from recommending yoga to their patients, which could certainly be the case if yoga is viewed in a one-dimensional way as an exercise practice aimed at achieving the daily recommendations for moderate- or vigorous-intensity physical activity. As we hope will become clear as we move through this article, yoga as a physical, psychological, and spiritual discipline is so very much more that this and has a wealth of benefits above metabolic intensity to offer.

A growing body of research suggests that yoga has the potential to improve both physical and mental health through a range of mechanisms, including the down-regulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic (‘fight or flight’) nervous system (SNS). Physical and/or psychological stressors trigger the HPA axis and SNS resulting in a range of physiological, behavioural, emotional, and psychological effects, primarily as a result of the release of stress-related hormones including cortisol. Such a response leads to the classic ‘fight or flight’ response which, over time when repeatedly stimulated, can cause a state of hypervigilance leading to a dysregulation of the system and, ultimately, health challenges including anxiety, depression, diabetes, autoimmune disorders, and cardiovascular disease to name just a few. It is also particularly worthy of note that yoga has been found to increase brain GABA levels, which are associated with improved mood and decreased anxiety. In research by Chris Streeter and colleagues in 2010, for example, a 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise.

Given yoga’s clear benefits to physical and psychological health, it is perhaps unsurprising that it is often viewed purely as an exercise practice by people in the Western world. Indeed, some yoga classes in gyms do not allow the spiritual elements of yoga to be part of the programme, forbidding elements such as chanting. Interestingly, in research involving the health benefits of yoga, exercise is the most common intervention used as a comparison. Ross and Thomas (2010) conducted a review of studies on yoga and exercise and found twelve studies comparing the effects of yoga and exercise, nine of which focused on adults and three on seniors. 597 of the 873 subjects who participated in the twelve studies were women. Exercises used as a comparison included aerobics, walking, running, dancing and cycling. Overall, in these reviewed studies, yoga was found to be equal or superior to exercise in relieving symptoms associated with diabetes, multiple sclerosis, menopause, and kidney disease. Yoga was found to have beneficial effects on blood glucose levels in people with diabetes and other chronic health conditions, on oxidative stress, and on cholesterol. Furthermore, yoga was found to be relieve the symptoms of mental illness including depression, anxiety, obsessive-compulsive disorder, and schizophrenia. Comparing yoga and exercise groups, yoga groups often score significantly better than exercise groups on social and occupational functioning, and psychological, social and environmental measures of quality of life, suggesting that yoga has something to offer above and beyond exercise. In research exclusively on healthy individuals, yoga has been shown to be as effective as or superior to exercise on nearly every outcome measured

Why is yoga able to offer additional benefits to exercise such as aerobics, walking and jogging? The answer is both simple and clear. Yoga is an embodied practice of mindful movement, incorporating movement with the breath. By bringing attention to and coordinating the breath with the movement of the body, a profound sense of embodiment can be fostered which can facilitate improved emotional health and a transcendent sense of self. In Patanjali’s yoga sutras, asana is described as ‘Sthiram Sukham Asanam’, meaning that which gives steadiness, stability and joy. Yoga is a practice for unifying body, mind and spirit. Meditation, which is a limb of yoga, also provides additional spiritual, physical and psychological benefits which have been highlighted extensively in the mindfulness literature in particular.

From a physical perspective, exercise stimulates the SNS, raising plasma levels of ‘stress’ hormones such epinephrine and norepinephrine. Yoga on the other hand, has been shown to lower sympathetic stimulation, significantly lowering levels of plasma norepinephrine and epinephrine. Given its linkage to the breath, yoga can also be thought of as a ‘training ground’ for the nervous system; whilst the sympathetic nervous system may be stimulated by the asanas (particularly in more arousing forms of yoga like Vinyasa or Kundalini), balance can then be restored by marrying the movement with long, deep, mindful breathing. In this way, yoga can teach us how to regulate the nervous system in a way that other forms of exercise cannot.

It is undeniable that exercise can have profound benefits for physical and emotional health. This is without question and not the argument being presented here. Rather, the desire is to highlight the additional benefits that yoga can have for both mental and physical health over and above what exercise can offer us, whilst keeping in mind that yoga is not, at its core, an exercise practice but a spiritual discipline. It is important to educate medical professionals about the additional benefits of yoga, who may otherwise simply view it as a practice synonymous with typical exercise and fail, therefore, to make a particular recommendation of yoga to their patients.

We would additionally like to highlight that people uninterested or even adverse to the spiritual facets of yoga can indeed engage in yoga as a purely physical practice should this be their desire at the current time. It is also worthy of mention that people sometimes come to the spiritual aspects of yoga ‘through the back door’ so to speak, perhaps signing up to their first yoga class in order to increase flexibility or decrease body mass, only to find so very much more. Here at the Minded Institute, we meet every person at the stage of their journey they are at, whether their desire be to improve their physical, psychological, emotional, or spiritual health or, in our opinion, optimally, all of these.

References

Larson-Meyer, D. (2016). A systematic review of the energy cost and metabolic intensity of yoga. Medical Science Sports Exercise, 48(8), 1558-1569.

Ross, A. &, Thomas, S. (2010). The Health Benefits of Yoga and Exercise: A Review of Comparison Studies. The Journal of Alternative and Complimentary Medicine, 16(1), 3-12.

Streeter, C. et al. (2010). The effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomised controlled MRS study. Journal of Alternative and Complementary Medicine, 16(11), 1145-1152.

Heather Mason’s Speech at the House of Commons on 27th June to Discuss Yoga in the NHS

Yesterday evening, Heather Mason addressed the House of Commons, where over 100 other leaders in yoga, health, and politics and the community were present to discuss yoga’s inclusion in the NHS. The Early Day Motion recently passed was also discussed. Below follows Heather’s impassioned speech:

– – – – – – – – – – – –

Good evening everyone,  I am deeply honoured that you are all here tonight to celebrate yoga’s contribution to humanity and to underline how its integration into the NHS will foster greater well-being to many while reducing the economic burden associated with non-communicable diseases:  According to the department of health England, 70 percent of the NHS’s budget is spent on these chronic conditions, many of which are preventable and are partially or totally ameliorated through improved lifestyle choices.

As someone who healed from years of depression and Post traumatic stress as a result of combined yoga and mindfulness practice, I have long wanted these modalities to be readily available. I think it’s often part of healing, the desire for others to also find relief. When I first came to the UK 13 years ago and then established the Minded institute, I didn’t even dream of what we are discussing tonight.  There was not enough interest and not enough evidence. 

But look at us now!  We stand on the precipice of possibility knowing the time is right for the UK to set an international example – to become the first nation to fully embed yoga into the healthcare system. 

Simon Stevens, chief executive of NHS England, has backed a £450 staff well-being drive and explicitly included yoga. Yoga is spreading throughout the nation and Kantar media group reported that in 2015 2.4 people practiced regularly. Research evidence is burgeoning, convincing, and increasingly rigorous. A bibliometric analysis looking at trials conducted from 2003-2013 found that there was a 1000 percent increase in this time frame compared to the previous 36 years combined. In the US, NIH repeatedly finds yoga to be the most popular mind-body practice used in complementary health.  Further review papers reveal those who practice possess better lifestyle choices, are happier, healthier, and use the health services less. I am excited to hear Ned Harfiel present his research on a how yoga intervention led to cost savings in the NHS later on this evening.

What is clear is that yoga is good for us, that UK is broadly open to yoga, and that by bringing yoga into the NHS we could alleviate some financial pressure.

 The Mindful Nation report published by the APPG expounded a strategy for bringing mindfulness into healthcare estimated that £15 would be saved for every pound spent. These figures were calculated based on the expense associated with using mindfulness to treat depression and chronic pain.  Yoga delivers similar health benefits to these two patient groups while also addressing other chronic conditions in a manner that mindfulness cannot such as cardiovascular disease, diabetes, obesity, respiratory conditions, and muscular-skeletal conditions to name just a few. Like mindfulness, yoga improves mood and, as a result, practitioners reap the benefits of stress reduction.  However as yoga also involves breath regulation and postures it has wider ranging and more pronounced physiological effects.

Further, reviews comparing yoga to various forms of exercise overwhelming report yoga engenders superior health outcomes and is safer for many clinical groups. 

Accordingly, in the USA it is a yoga based program and not a mindfulness one nor an exercise regime that is covered by Medicare for those with heart disease.  This is a result of a revolutionary finding that a complete yogic lifestyle can reverse heart disease.  The program is economical, imparts wellness in all aspects of a person’s life, and helps patients to play an active role in their own health and healing. 

Succinctly, yoga is a comprehensive health strategy of empowerment.  And people of all ages, in all walks of life, with or without any health condition can benefit.

This year on International Yoga Day, Ban Ki Moon implored us to consider how yoga can help the world to achieve its health and well-being goals for the 2030 Agenda for Sustainable Development.  The UN and the WHO recognise what yoga can bring to the world.  Let the UK be the bastion of light reflecting this reality to the rest of the nations.  Already we have an Early Day Motion passed through the Grace of MP Bob Blackman, and as of last Wednesday, through our collective energy—10 percent of all MPS were contacted by their constituents to sign the motion. Let us continue to mutually spearhead this effort. 

I look forward to hearing from all of you, researchers, community leaders, healthcare leaders, and yogis.  Thank you for coming, Namaste!

Big UK Yoga Survey Now Live!

We have wonderfully exciting news to share with you! The Big UK Yoga Survey is now live…and eagerly awaiting your unique participation.

A survey such as this is long overdue in the UK. Similar such surveys have been carried out in the United States and Australia amongst others, thus giving a picture of the reasons people might practice yoga, the benefits they notice/have noticed in the short and long term, other lifestyle changes that may have occurred as a result of their yoga practice and experiences of yoga-based mindfulness, spirituality and a sense of connection with others.

If you have practised yoga or attended yoga classes in the past year you are eligible to take part in the survey and are very warmly invited to do so. The survey is being carried out by researchers at the University of Westminster, headed by Dr. Karen Pilkington and Dr. Tina Cartwright, two leading researchers in the field of yoga for physical and mental health. We know that more and more people are taking up yoga in the UK and this survey, in part, aims to elucidate why. The hope is that the results of the Big UK Yoga Survey will suggest what is most beneficial emotionally, physically, psychologically and spiritually about the practice of yoga and highlight areas of research to be explored in the future. In many ways, the deeper desire is to share scientifically that which we already know experientially; that yoga has tremendous benefits to offer us in terms of health and wellbeing and should, therefore, be made available to all people regardless of age or health status. Yoga is for every body and everybody.

Results from the USA and Australian International Yoga Surveys were very promising. The 2012 USA study found that 8.7 percent of U.S. adults, or 20.4 million people, practice yoga. Of current non-practitioners, 44.4 percent of Americans call themselves “aspirational yogis”—people who are interested in trying yoga. The study also collected data on age, gender, and other demographic and lifestyle factors. Of the yoga practitioners surveyed:

  • 82.2 percent are women; 17.8 percent are men.
  • The majority of today’s yoga practitioners (62.8 percent) fall within the age range of 18-44.
  • 38.4 percent have practiced yoga for one year or less; 28.9 percent have practiced for one to three years; 32.7 percent have practiced for three years or longer.
  • 44.8 percent consider themselves beginners (22.9 percent are new to yoga; 21.9 percent are beginning to practice yoga after taking some time off); 39.6 percent consider themselves intermediate; 15.6 percent consider themselves expert/advanced.
  • The top five reasons for starting yoga were: flexibility (78.3 percent), general conditioning (62.2 percent), stress relief (59.6 percent), improve overall health (58.5 percent) and physical fitness (55.1 percent).

The findings from the Australian International Survey were equally as fascinating. The typical yoga survey respondent was a 41-year-old, tertiary educated, employed, health-conscious female (85% women). Asana (postures) and vinyasa (sequences of postures) represented 61% of the time spent practicing, with the other 39% devoted to the gentler practices of relaxation, pranayama (breathing techniques), meditation and instruction. Respondents commonly started practicing yoga for health and fitness but often continued practicing for stress management. One in five respondents practiced yoga for a specific health or medical reason which was seen to be improved by yoga practice. Of these, more people used yoga for stress management and anxiety than back, neck or shoulder problems, suggesting that mental health may be the primary health-related motivation for practicing yoga. Healthy lifestyle choices were seen to be more prevalent in respondents with more years of practice. Yoga-related injuries occurring under supervision in the previous 12 months were low at 2.4% of respondents.

Responding to the Big UK Yoga Survey will not only be an interesting journey for yourself personally but will also be offering a great service to our broader understanding of yoga’s applications and benefits. The survey is easily filled out online, takes around fifteen minutes to complete and can be accessed on the following link; https://www.westminster.ac.uk/about-us/faculties/science-and-technology/big-uk-yoga-survey-buys

The Minded Institute have been involved with the set-up of the survey since its inception and are passionate about imploring as many people as possible to take part. Your views and experiences truly can make all the difference.

For more information, or simply to share your thoughts on the survey, please contact Lotte at lottesamuels@gmail.com.

 

Yoga for Refugees, Ourmala Event, Tues 21st June 2016

According to the 1951 United Nations Convention Relating to the Status of Refugees, a refugee is “a person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence as a result of such events, is unable or, owing to such fear, is unwilling to return to it.” A person is officially accepted as a refugee in the UK when they have their claim for asylum accepted by the government.

Under international law, anyone has the right to apply for asylum in any country that has signed the 1951 Convention and to remain there until the authorities have assessed their claim. No country has ever withdrawn from this convention having originally signed up to its edicts.

More than a million migrants and refugees crossed into Europe in 2015, igniting what has been termed by the media as a ‘ refugee crisis’. Indeed, countries struggled to cope with the influx and stark divisions were experienced in the EU over deciding how best to deal with resettling people. Winter did not curb the flow of people; according to the UNHCR, 135,711 people have reached Europe by sea since the start of 2016. Refugees from Syria, displaced by the ongoing conflict there, continue to come in the largest numbers followed by people from Afghanistan, Iraq, Eritrea and Kosovo.

In the UK, the judicial system is highly complex, making it very difficult to be granted asylum. The process is extremely tough and the majority of people’s claims are turned down. Since 2005, people recognised as refugees are only given permission to stay in the UK for five years and can have their case reviewed at any time. Numerous wonderful charities are therefore stepping in to support people and whole families before and during this five year period with Ourmala being one such tremendously vital and pivotal charity.

Ourmala exists to help refugees and asylum-seekers recover from the atrocities they have experienced and rebuild their lives. They stand for compassion, interconnection and social justice. Their mission is to provide immediate and lasting change for refugees and asylum-seekers through therapeutic care, educational services and access to critical resources. One of the key services offered by Ourmala is that of yoga, with ‘mala’ itself meaning garland in Sanskrit, the ancient Indian language in which yoga’s seminal texts are written. All of Ourmala’s services are free and they even refund the cost of travel, without which many of the people availing of their services would be unable to attend. They provide therapeutic yoga classes, hot meals, English classes, access to basic-needs services, access to educational services and a safe space for asylum seekers and refugees to simply breathe and be. Ourmala is truly a place of acceptance, kindness, solidarity and love.

This coming Tuesday, 21st June on the eve of midsummer and the official U.N. International Yoga Day, Ourmala is holding their ‘Yoga for Refugees’ Event in London to raise money to support 250 women and children in our local community. Taking place in Lindley Hall in the Royal Horticultural Halls in Everton Street, South West London, ‘Yoga for Refugees’ will include an extended yoga class in the Jivamukti style to a specially created soundscape by Amir Amor of Rudimental, short talks, special guests, goody bags, a raffle and plenty of opportunity for networking and deep connection with compassionate souls. All proceeds from this unique and spectacular evening will be spent directly on supporting women and children in crisis. Doors open at the stunning Lindley Hall at 5.30pm on 21st June 2016 for a 6.30pm start. For more information, visit Ourmala’s event page at http://www.ourmala.com/yogaforrefugees/ . Tickets can be purchased via Eventbrite at https://www.eventbrite.co.uk/e/yoga-for-refugees-fundraising-evening-with-rudimentals-amir-amor-soundscape-emma-henry-yoga-and-tickets-23794486951?ref=ebtnebtckt . You can also make a kind donation at https://localgiving.org/donation/yoga.

The Minded Institute are proud to be sponsors of this pioneering and compassion-focused ‘Yoga for Refugees’ Event and support the work of Emily Brett and her forward-thinking charity whole-heartedly. We hope to see as many as possible of you there supporting this deeply worthwhile and critical cause.

https://www.facebook.com/events/608361469314822/638291159655186/?notif_t=plan_mall_activity&notif_id=1466252494007889

Yoga Therapy for Diabetes

Diabetes is a chronic, lifelong condition. There are 2.5 million people diagnosed with diabetes in the UK alone with over 500,000 people suffering from the condition without even knowing it. The hormone insulin, produced by the pancreas, is used by the body to stimulate cells into absorbing nutrients and keeping blood glucose levels stable. In diabetes, the pancreas either produces no insulin at all or not enough to keep these levels stable thus causing dangerously high blood glucose levels. This can lead to weight loss, electrolyte imbalance, blindness, poor circulation and even death. Fortunately for sufferers the discovery in 1921 that purified insulin from dogs could be used in humans has since meant that diabetes is no longer eventually fatal but a manageable condition. Depending on the type and severity (Type 1 is commonly known as insulin dependent diabetes and Type 2 as non-insulin dependent), the condition may necessitate insulin injections (Type 1) and/or Metformin and dietary amendments (Type 2). It is to be remembered that no two people will suffer from diabetes in the same way and unstable blood glucose levels will affect each person in very different ways.

Diabetics may seek yoga therapy for a plethora of reasons including the balancing of blood-glucose levels, stress reduction (stress is known to affect blood glucose levels), weight management, the desire to come to terms with suffering from a long-term chronic condition, and help with the fear of injections to name just a few.

In a number of studies, yogic practices have produced an increase in the lean body mass and decrease in the body fat percent. This typically leads to an improvement in insulin sensitivity and reduction in insulin resistance. Insulin resistance, in fact, is the major abnormality in type 2 diabetes and precedes the development of overt diabetes by several years.

Stress is known to have an adverse effect on blood glucose levels. Stress induces the release of cortisol, the ‘fight or flight’ hormone, which increases heart rate, raises blood pressure and stimulates the release of glucose into the bloodstream. In people with diabetes, insulin is not always available to let the extra energy into the cells causing a build-up of glucose in the blood stream. The resulting high blood glucose levels are dangerous to the body, making stress reduction an important element of diabetes care. Yoga therapy may initially aim to address the triggers for stress with an attempt to understand its particular manifestations for the client (i.e. how stress is noticed in the body). The aim could be both to uncover the reasons for the stress-triggers and to find ways of diminishing the experienced stress. It may also be worth finding out if the stressors are accompanied by fear and if physical symptoms, aside from the poorly controlled sugar levels, are taking place (i.e. panic attacks). It would also be beneficial to determine if the stress experienced is eustress, chronic stress, episodic acute stress or traumatic stress. Trauma-sensitive yoga therapy can be utilised if the stress is, indeed, of a trauma-based nature.

Poorly controlled blood glucose levels are also known to make weight management difficult and being overweight can be a contributory factor to acquiring diabetes in the first place, particularly in the case of Type 2 diabetes. A diabetic client may come to yoga therapy with their main aim being to manage their weight or it may be that the weight is a side-issue which nevertheless needs addressing. Excess weight carried around the midriff in particular is known to make the control of blood glucose levels difficult; weight and glucose levels have an effect on one another, interplaying in a complex manner akin to a negative feedback loop. Common feelings related to food and diabetes include feeling deprived and unable to enjoy desired foods. Such feelings of deprivation certainly necessitate validation and therapeutic holding.

A diagnosis of diabetes may bring with it a form of bereavement with the client lamenting the life they had and expected to continue having. Any life change necessitates the need for acceptance. Diabetics need to change their lifestyles, quite dramatically in some cases, and may also have to come to terms with injecting themselves multiple times a day. Add to this the hospital visits, the accompanying physical discomforts, degenerating eyesight and so on and it is perhaps not difficult to see why people with diabetes, particularly those who have been recently diagnosed, can experience disbelief, depression and difficulty in accepting their condition. Depression itself may be a primary reason for a person with diabetes to seek yoga therapy. Yoga asanas to address depression and anxiety may, therefore, also be useful for this population.

For some people, the fear of needles is a very real and tangible phobia. Other phobias related to diabetes may include fear of hospitals, fear of blood tests, fear of gaining weight, and fear of fainting (related to hypoglycemia). Yoga therapy can alleviate the stress and anxiety related to phobias such as these. It is to be noted that some individuals with a pathological fear of gaining weight may adjust their dosage of insulin to prevent such an occurrence, an extremely dangerous practice which can lead to coma and even death. Taking a detailed history during the initial consultation for yoga therapy may alert the therapist to potential insulin abuse, particularly if the client has suffered with an eating disorder in the past, was diagnosed in their teens, or is particularly interested in sport (insulin abuse is also known to take place among athletes and body builders in particular). The involvement of other professionals should, of course, be encouraged as appropriate.

Diabetes is a complex condition with factors such as unstable blood glucose levels, weight management, stress, fears and phobias, depression and physical degeneration among others inter-playing in a multitude of ways. A client may seek out yoga therapy with very clear goals such as weight or dietary management or simply come because their condition feels overwhelming. Other professionals may be taking care of their physical needs but the emotional difficulties related to their diabetes may not have yet been addressed and explored. The use of yoga therapy for diabetes is now becoming more commonplace but there is still much to be done regarding a clear acknowledgement of the immense amount of emotional distress a person with diabetes can go through, particularly if they are newly diagnosed. Yoga therapy can be a profoundly efficacious way of addressing these deeper emotional responses to diabetes whilst also promoting multiple physical benefits such as better blood sugar control, reduced insulin resistance, the reduction of free fatty acids, diminished lipotoxicity and beneficial effects related to beta cell function. It is also reasonable to postulate that the beneficial effect of yogic asanas on the insulin kinetics and the lipid metabolism prevents the beta cell exhaustion and the development of a beta-cell secretory defect, thereby potentially preventing the development of type 2 diabetes in the first place.

Schizophrenia, Trauma-Sensitive Yoga and Embodied Healing

We appear to  have gone wrong somewhere in Western society in our treatment of people diagnosed with schizophrenia, which is characterised in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by hallucinations, delusions, disorganised thinking (speech), significantly disorganised or abnormal motor behaviour (including catatonia), and negative symptoms. Despite conventional treatment in the modern age, many people diagnosed with schizophrenia have poor outcomes. U.S. data on outcomes from severe mental illness such as schizophrenia show that there is greater psychiatric disability today than in the 1940s. People diagnosed with schizophrenia also have higher suicide rates today and the utilisation of hospital beds for this population has not improved. Data also indicates that outcomes for people diagnosed with schizophrenia are at least as good, and in many cases better, in the developing world than in the West. Where have we gone wrong?

In the late nineteenth century, Emil Kraepelin concluded, on the basis of symptom and outcome data, that there are three main types of psychosis: schizophrenia (then more commonly referred to as dementia praecox); manic depression; and paranoia. The philosopher-psychiatrist Karl Jaspers then argued that psychotic symptoms can only be explained in terms of aberrant biology and never in terms of the person’s experiences. This was, and is, a very dangerous and reductionist viewpoint which, shockingly, continues to underpin much of the thinking and treatment of schizophrenia today.

The assumption that schizophrenia can be explained only in terms of haywire biology has seemingly encouraged the use of drastic biomedical interventions, discouraged attempts to address people’s emotional and psychological needs, and also denied other systemic factors such as trauma and abuse. In short, it has placed all of the blame on the person’s biology and any potential sense of responsibility and shame, therefore, within the person themselves.

As we have written about elsewhere, diagnoses need to have both reliability and validity in order to stand on any kind of legs at all. To be reliable, any system of categorisation needs to have stable and consistent outcomes. In order to diagnose someone with schizophrenia, however, the medical profession must exercise a great deal of personal judgement and opinion-based reasoning; what might be deemed as a ‘negative symptom’ in one culture may be seen as positive in another. The experience of voice-hearing, for example, is often seen as a sign of spiritual awakening in the African continent but typically seen as a symptom of psychosis in the West.  In order to be valid, any scientific system needs to measure what it says it measures. Since the process of diagnosis relies heavily on opinions and subjective judgements, it is impossible to ascertain if diagnostic labels actually reflect the presence of any actual pathology.

Given the limited reliability and validity, and indeed success, of aetiological research based on biology, some researchers have begun to seek alternatives and to consider other factors such as trauma within the conglomeration of symptoms typically diagnosed as schizophrenia. Indeed the the Hearing Voices approach, and its application of Voice Dialogue, sees the experience of hearing voices not as pathological but, rather, as pointing to deeper experiences and struggles in the person’s psyche that need addressing and assimilating. Other approaches appreciate the aspect of embodiment in schizophrenia, focusing on the presentation of symptoms through the body i.e. auditory hallucinations and other somatic experiences.

A research study conducted this month (Nyboe et al, 2016) looked at physical activity and anomalous bodily experiences in people with first-episode schizophrenia (FES). The purpose of the study was to compare physical activity in patients with FES with controls; to investigate changes in physical activity over one year of follow-up; and to explore the correlations of physical activity and anomalous bodily experiences reported by patients with FES. Physical activity and aerobic fitness were found to be significantly lower in people with FES compared with healthy controls. Over one year of follow-up, people with FES had lower physical activity and aerobic fitness. Those with more severe anomalous bodily experiences had significantly lower physical activity compared with others with fewer such experiences. An obvious conclusion to draw from these findings is that people with FES may benefit from physical activity given that both anomalous bodily experiences and negative symptoms are significantly correlated with low physical activity.

One such form of physical movement, with the additional benefits of the mindfulness, embodiment and interoceptive elements, could be trauma sensitive yoga. Here at the Minded Institute we have found that yoga can have incredible potential benefits to people diagnosed with schizophrenia in a plethora of ways, which is an understanding underpinned by a growing body of compelling research in this area. To explore our trainings in yoga for schizophrenia and psychosis, please visit our CPD page at, http://www.yogaforthemind.info/events-in-the-uk-and-europe/ or contact us as email@themindedinstitute.com. Namaste.

 

Nyboe, L., Moeller, M., Vestergaard, C, Lund, H. &, Videbech, P. (May 2016). Physical activity and anomalous bodily experiences in patients with first-episode schizophrenia. Nord Journal Psychiatry, 5, 1-7.

 

 

 

Clarity Within the Haze: The Benefits of Yoga and Meditation for Alzheimer’s and Other Dementias.

Alzheimer’s UK, the UK’s leading dementia research charity, launched Yoga for Alzheimer’s early this year, an initiative encouraging people to get into their favourite yoga positions while raising money to help find treatments for dementia, which affects 850,000 people nationwide. The initiative will take place at sixteen venues across the UK from Sunday 12th June 2016 until International Yoga Day on Tuesday 21st June 2016.

The benefits of yoga and meditation for Alzheimer’s and dementia are multiple and far-reaching. Whilst there is no cure for Alzheimer’s, research suggests that yoga and meditation may play a role in prevention and improve symptoms and quality of life for patients and their caregivers. In 2014, the first study to suggest that memory loss may be reversed was conducted by Dr. Dale Bredesen of the UCLA Centre for Alzheimer’s Research In this small, novel study, nine out of the ten participants displayed subjective and objective improvement in their memories within three to six months of participating in a 36-point therapeutic program, which included diet changes and exercise.

In another small British study conducted in the same year, a holistic program including yoga and meditation was shown to ease the burden for people with Alzheimer’s and other kinds of dementias and their caregivers. “This is an activity that caregivers and patients can do together,” said study lead author Yvonne J-Lyn Khoo, a researcher with the Health and Social Care Institute at Teesside University in Middlesbrough, U.K. “Because everyone is doing the program together, caregivers have peace of mind to at least allow themselves to ‘let go’.” The study, which received assistance from the U.K. Alzheimer’s Society, was published recently in the Journal of Bodywork and Movement Therapies.

Yoga and meditation may be so efficacious for Alzheimer’s and other forms of dementia as they engage different parts of the brain based on the various components of the practice, which commonly includes pranayama, asana, chanting, and different forms of concentration. Each of these facets can help the brain to form new connections through the stimulation of neuroplasticity. Yoga has also been found repeatedly by multiple studies to soothe and diminish stress, which has been shown to be a strong correlate of Alzheimer’s both for sufferers and their caregivers. Such stress is associated with inflammation in the body and central nervous system, hormone dis-regulation, sympathetic nervous system over-arousal and compromised quality of life. Yoga can reduce stress and inflammatory factors in people with Alzheimer’s and their caregivers and help a person to cope more effectively with the body’s stress response. Meditation has also been shown to improve memory and reduce cognitive decline; adults with mild cognitive impairment who practiced mindfulness, for example, have demonstrated less atrophy in the hippocampus than those who did not meditate. Furthermore, caregivers who practice yoga and are, therefore, less stressed themselves are in a better position to provide optimum care to those they love.

In a study released just this month, the effects of meditation versus listening to music on perceived stress, mood, sleep, and quality of life in adults with early memory loss was studied in the form of a pilot randomised-controlled trial. The effects of two 12-week relaxation programs were assessed within this trial, namely Kirtan Kriya Meditation (KK) and listening to relaxing music. Sixty people were randomised to either group and asked to practice for 12 minutes daily for 12 weeks over the course of three months. Pleasingly, 53 participants (88%) completed the study with participants in both groups showing significant improvements at 12 weeks in psychological wellbeing and in multiple domains of mood and sleep quality. Those assigned to the meditation intervention showed greater gains in perceived stress, mood, psychological wellbeing and quality of life-mental health measures relative to the music intervention.

Yoga and meditation, therefore, may have much to offer people experiencing Alzheimer’s and other dementias and also provide many benefits for their caregivers. In a society which places such value on speed and productivity, the aging population are often marginalised with their self-worth being woefully forgotten. People with Alzheimer’s and other dementias are often undervalued and marginalised to an even greater degree. Bringing yoga and meditation to this population is a much-needed and valuable gift which can provide not only stress relief, improved memory, reduced cognitive decline, diminished depression and soothed hyper-arousal but also covey a powerful message of compassion and valued worth.

Bibliography

Bredesen, D., Easton, M (2014). Reversal of cognitive decline: A novel therapeutic program. Aging, 6(9).

Khoo, Y, van Schaik, P. &, McKenna, J. (2014). The Happy Antics programme: Holistic exercise for people with dementia. Journal of Bodywork and Movement Therapies, 4, 553- 558.

Innes, S., Selfe, T., Khalsa, D. &, Kandati, S. (2016, ahead of print). Effects of Meditation versus Music Listening on Perceived Stress, Mood, Sleep, and Quality of Life in Adults with Early Memory Loss: A Pilot Randomized Controlled Trial. Journal of Alzheimer’s Disease, due for release on 8th April 2016.