Benefits of Integrating Yoga Into Postgraduate Mental Health Curriculums

As we find ourselves in a bit of a lull in the Covid-19 outbreak here in southern California, I have found my way back to teaching yoga in-person in a local yoga studio. My heart is full as I have greatly missed the opportunity to bring this healing modality back in-person to a larger audience. Yoga, including all of its contemplative practices, has been the largest tool in my self-care tool kit, even becoming my way of life over the years, and it is truly what kept me grounded in gratitude through the pain and chaos of the past two years. Although I may not have found myself on my yoga mat regularly, especially for those yummy 90-minute classes that include an extra long savasana shape at the end, I know how important these practices are for supporting our mind-body-spirit health. And, as a mental health provider, I know it is mission critical to prioritize our self-care practices in order to be fully present and prevent burnout. With increasing rates of burnout in mental health providers during the pandemic, the question becomes is it possible to integrate yoga into postgraduate curriculums for mental health providers to ensure the long-term wellbeing of such providers?

A recent research study took a look at including yoga into the curriculum for first-year mental health students to test the feasibility of such a proposal. Introducing such tools to all students in this setting ensures all mental health providers would have the first-hand knowledge and experience of the impact on their well-being before actually moving into the space of providing services to clients, where the stress level of the role only increases. Although the results of this research advocates for such a change to the curriculum, it only provided a brief, 15-day offering. It is my belief that offering longer curriculum based yogic interventions would not only provide more sustained self-care tools to the mental health provider but it would also equip the mental health provider with the skills to bring such self-care tools to their clients.

Yoga for helping health professionals during a pandemic

As a helping health professional (HHP), I rely on my yoga practices to maintain mind-body health, work-life balance, and healthy boundaries with my clients.  When colleagues share that they are challenged to maintain these things and ask me what I might do, my first response is all things YOGA.  The responses I get range from a smile to a rolling of the eyes.  Which got me thinking . . . since HHPs are among the highest risk occupational groups for mental and physical health challenges, is my self-care go-to  (yoga) experience unique to me or might these tools really have a more across-the-board impact on such a group of professionals?

When I first started to practice yoga movement, I noticed how it relieved my low back pain that came from a herniated disc.  It was due to practicing yoga movement on a regular basis that I did not require any physical therapy or back surgery then or now (although I did integrate regular chiropractor adjustments into my self-care practices since).  As my back pain went away and I continued to add additional yoga practices to my activities of daily living, I discovered how much calmer and centered I felt mentally and emotionally.  It was these cumulative positive experiences that motivated me to pursue becoming a yoga teacher and then a yoga teacher trainer!

One of the most powerful yoga practices that has served me well is Svadhyaya.  It is one of the five Niyamas, or sacred habits for healthy living, of yoga.  It is often translated simply as self-study within a larger connotation of introspection.  Most of my yoga practices now occur off the mat, but finding the mat for the movement practice certainly reduced the symptoms of anxiety enough to open the door to the practices that actually become a way of life.  That is why I am so passionate about recommending all things yoga to everyone!

So what does the research say about yoga as a tool to support those in the helping health profession overall, beyond me?  Well, recent research took a look at that exact question.  A systematic review that included 25 research articles around the effectiveness of yoga interventions among HHPs and students found that implementing yoga interventions in this population brings mental and physical benefits across a variety of settings and backgrounds, including a reduction in stress, anxiety, depression and musculoskeletal pain.

If you are interested in reading more, click the link below.  If you are a helping health professional or student, consider sharing this link with those that might be in a position to support the implementation of such practices in the workplace or school.

Might Yoga Help Prevent Teacher Burnout?

The pandemic caught most of us off guard and added significant stress to our lives, asking us at times to think out of the box to come up with creative ways to do what we did in the past differently.  In a flash, life went virtual!  Teachers, in particular, who, as a profession rank high amongst those helping professions that are predisposed to mental health challenges due to stress on the job, were asked to convert in-person curriculums to remote learning overnight.  Teachers were already at risk of burnout before the pandemic, with a significant percentage of teachers leaving the profession within the first 5 years.  The pandemic has simply added salt to an already open wound.

Past research has looked at the benefits of bringing yoga into the schools for the students.  This research has shown the positive effects on the developing minds of children, including but not limited to reducing stress and anxiety, improving memory and attention span, enhancing coping skills, and increasing self-confidence and self-esteem.  By building yoga into the students’ curriculum, it was accessible to everyone and was not designated as an optional, after-school activity.  By supporting students in this way, it certainly indirectly helps the teachers.  However, with such a high burnout rate in this profession, it is just as important to look at what might prevent such teacher burnout more directly.

More recent research is now looking at bringing yoga to the teachers at school.  One such recent quasi-experimental study looked at the connection between improving the mental and emotional well-being of teachers through a twice-a-week yoga class, including gentle meditation exercises, and a reduction in burnout.  Yoga, and is contemplative practices, was considered for this research because it is a discipline that has been shown to enhance body awareness and encourages equanimity in the mind.  The design of this research included concern for the need to adapt to the working environment, so that no particular setting would be required, making it easy to replicate.

The research was able to identify a significant, positive effect of yoga on the psycho-physical well-being and resilience response on the job of the teachers.  The program was short, only 8 weeks, and did not identify any risks.  The conclusion suggests that schools would benefit by offering yoga to the teachers to reduce burnout.

If you are interested in reading the full article, click the link below.  If you are a teacher or know a teacher, consider sharing this article with those that might benefit, including the principal of your school.

Can yoga influence the gene expression of your DNA?

I believe so as I personally dove into all of the mind-body interventions yoga had to offer to prevent one of the most important risk factors for cardiovascular disease, which is the leading cause of mortality. Both of my parents were diagnosed with hypertension, with my mother getting the diagnosis in her 30s, and both went on to develop cardiovascular disease that is managed by multiple prescription medications.  When I turned 40, my physician informed me that I was pre-hypertensive, which sent me on a journey that not only reversed this diagnosis, but changed my life in so many other ways!  Different life experiences can influence your genes and cause subconscious behavioral patterns that are passed on over generations, including trauma.  And now we might be discovering how yoga and all of its contemplative practices can change and perhaps undo the damage of such life experiences.

There is a newer focus of research that is digging deeper into how the contemplative, mind-body practices of yoga impact our genes, especially in relation to the stress response and inflammation.  This body of research is looking at the autonomic nervous system’s response to stressful events, specifically the pro-inflammatory gene expression pattern.  The human body’s autonomic nervous system is made up of two main branches, the sympathetic and the parasympathetic.  When presented with signals and sensations, the autonomic nervous system responds and takes one of three pathways through these two main branches to keep us safe.  The oldest route from an evolutionary development perspective leads to immobilization (think freeze/faint) through the parasympathetic dorsal vagal nerve branch.  The next pathway to develop led to the mobilization response (think fight/flight) through the sympathetic nervous system branch.  The final one to evolve led to social engagement (think safe and social) through the parasympathetic ventral vagal nerve branch, which is unique to mammals.

When danger is sensed, the human body’s autonomic nervous system travels backwards through the sympathetic nervous system’s fight/flight response and then perhaps, if we feel trapped, to the parasympathetic dorsal vagal nervous system’s freeze/faint response.  When the body arrives in the space of immobilization for survival, it can be a long and painful journey back to the space of feeling safe and social.  So anything that might make this journey shorter and less painful is welcome!  That is where understanding how yoga can support such intentions is vital.

Without going too deep into the science (click on the button below to read more if interested in a deeper dive), when the human body encounters stress and triggers the sympathetic nervous system, it increases production of chemicals that regulate how genes are expressed, activating genes to produce proteins called cytokines that cause inflammation.  When these higher levels of cytokines persist over time, the human body is put at a higher risk of a whole range of diseases, including cancer and psychiatric disorders.  This newer research is finding that people who practice mind-body interventions such as mindfulness meditations, yoga or Tai Chi, actually reflect the opposite effect, namely a decrease in the production of cytokines, leading to a reversal of the pro-inflammatory gene expression pattern.  One of the more recent studies considered one of these mind-body interventions, specifically meditation, an emotional and attentional regulatory activity that supports a state of inner quiet.  From this inner quiet grows increased self-awareness which has the power to reduce stress-related symptoms.

To read more about the growing evidence that stress can cause changes in gene expression and how intentionally engaging in mind-body practices can transform the genetic effects of stress, click below:

Can yoga change your brain?

What if we could see inside of our brains when we are practicing our deep breathing, sun salutations, and savasana?  Would you want to see/know what parts of your brain are being turned on and off or growing and shrinking?  Well, this might not quite be reality yet, however, with neuroimaging technology what it is today, it is pretty close!  When I started my yoga practice almost 20 years ago, I didn’t know what the practice did to my brain if anything, I just felt relief each time I left class.  Now, all these years later, it excites me to know that it supported my brain’s own natural ability to heal.

Before discovering yoga, I was a workaholic that was in a constant state of flight or fight with the world around me.  I figured I had inherited my mother’s anxiety and there was nothing I could really do about it.  Boy was I wrong!  My first yoga class spoke to me in a way that I had never experienced before, calling me back to the mat that first year 5 to 6 times a week.  I thought it had become my new addiction, yet it changed me so profoundly that I was finally able to find the long sought after balance I craved in my life.

I believed yoga was a huge contributor to my healing journey, although at the time I might not have fully understood how it worked.  Today, with the integration of neuroimaging and neurophysiological techniques into the study of yoga, research has begun to reveal consistent structural and functional changes in the brain.  With the benefit of magnetic resonance imaging (MRI), positron emission tomography (PET) and/or single-photon emission computed tomography (SPECT) scanning, the benefits of yoga are lighting up our brains!

Although the various research studies have looked at different aspects of yoga, such as movement versus meditation as well as styles of yoga, these studies reflect relatively consistent cerebral structural and functional changes.  What this tells me is that you can’t do it wrong!  It doesn’t matter if you practice Iyengar, Yin, Hatha and/or Kundalini yoga, it will help your brain.  It doesn’t matter if you practice movement, breathing techniques, meditation or chant, it will help your brain.  And with all of the different approaches, including Kids and Chair yoga, yoga is available to help our brains throughout the entire life cycle.

Fast forward with the increasing popularity of yoga worldwide, research is still scarce in yogis yet it is expanding with the assistance of neuroimaging.  And this research is showing that yoga effects the brain both structurally and functionally, specifically in areas involving interoception, posture, motivation, and higher executive functions.  Moving forward, more research is needed to reflect the changes in the brain through neuroimaging when the brain is suffering from the effects of anxiety, depression, PTSD and other stress-induced mental health challenges.  I would have loved to see what my brain looked like before discovering yoga and after integrating my practice into my everyday life.  I think the results would have been very validating!

Can yoga – and all of its contemplative practices – contribute to a healthier cognitive aging process?

My husband and I try to remember to laugh when we walk into a room and then have to stand there for a few minutes because we realize we forgot why we were heading there in the first place.  And I think a sense of humor is critical in many circumstances, so applying it to myself as I age is putting a value into action!  However, instead of accepting the gradual decline in the neural circuitry of the brain as we age, what if you were to learn that there was a simple way to preserve the connectivity in our brains that contributes to overall health?  Would you be willing to try it?

Well, with the assistance of brain imaging, research studies can see the impact of contemplative – or attentional – practices on very specific areas of the brain, which opens the door to more rigorous studies that shed light on how such practices can support a healthier cognitive aging process.  These brain imaging techniques have shown that there are changes in the functional connectivity of our neural networks as we age.  Now the idea of ‘before and after’ imaging can be applied more broadly in research, beyond the studies that focus on prescription medications.

My experience when I am able to give something my full attention is one in which the memory of the moment is so much richer and stronger, whether it is a conversation with someone or simply sitting outside in nature.  I find that I can more easily recall the details of the experience when reflecting on it, almost as though I am experiencing it again in all of its colors and textures.  So if there is something I can do to help support the health of my ability to maintain my attention, I say ‘sign me up!’

Recent data from studies looking specifically at yoga and other contemplative practices such as meditation suggest that such practices may revert, at least in some part, the effects of aging on the functional connectivity in the brain.  The intention of the research is to look at how using the body and breath as the focus of contemplation helps to preserve cognition and the neural connectivity of those brain areas that typically decline with age.  When we hold the body in one of the shapes of a yoga practice, and bring the mind’s awareness to focus on the experience of the breath in that shape, it supports the parts of the brain that support cognition and brain connectivity.  Sounds pretty good to me for simply moving the body and breathing with intention and attention!

If you are so inclined to read more about the details of a recent research study looking how yoga and other contemplative practices impact specific parts of the brain involved in maintaining a healthier cognitive aging process, click the link below:

Can meditation support your immune system, especially in light of the effects of COVID-19?

As someone that suffered with anxiety for most of my life, I am personally so grateful for my yoga practice, which includes various contemplative practices such as meditation.  (Click here for a great image that reflects the many different types of contemplative practices.)  What I found through the ongoing use of these tools is a consistent way to navigate stress to maintain my body, mind, and soul health.  Stress is still present – and I no longer have any expectations of living a stress-free life – yet it no longer accumulates into an expression of anxiety.

Meditation is a very personal experience.  It is the personal nature of the practice that can make it difficult to try and especially hard to maintain.  There are also many different forms of meditation, so it definitely is not one-size-fits-all.  Yet the intention behind meditation – to slow down the mind and help us detach from our thoughts – creates space.  It is this space that can be scary.  When we encounter stress, one of the most common tools humans go to in order to deal with the freeze/fight/flight response is distraction.  We might distract ourselves by watching shows, eating, drinking, shopping, or one of the many other forms of impulsive behaviors that bring feelings of guilt and remorse along with them.

And yet more and more research is demonstrating the benefits of meditation, including how it can support our immune system functioning, which is vital right now in light of the pandemic.  Meditation, whatever form of it that works best for you, helps to regulate the normal, natural human stress response, reducing the inevitable inflammation effects of that response.  If we can find a form of meditation that we enjoy, then this tool can become the sharpest one in our toolkit and the one we consistently turn to when we feel anxiety building.

One of the more creative methods of meditations I utilize is journaling.  This expressive writing tool has also been shown to reduce anxiety and depression.  Relax Like A Boss, a website dedicated to wellbeing and stress, put together an ultimate guide to meditation journals.  If you might consider this form of meditation, you can link to the guide here for tips on how to get started.

Contemplative practices do not have to be done for long periods of time, unless that works for you.  Another one of my favorites is conscious deep breathing, and I do this several times a day for just a few minutes.  It acts like a reset button for my nervous system.  You might count how long you inhale and how long you exhale or you can include visualizations, such as colored light.  You might add affirmations, such as inhaling peace and exhaling stress, if that helps give the thoughts in the mind the necessary mini vacation.  Simply keep in mind that you cannot do it wrong!

I think what is most exciting is how research is looking at the body-mind connection more and more and not approaching the body and mind separately when working towards health.  One recent review of the research literature focused on the interconnected physiological processes in the body that supports the continued inclusion – and expansion – of meditation in the treatment of diverse medical conditions.  What they looked at more closely is the impact of stress on the gut microbiota and how meditation supports the health of our gut, leading to a healthier mind through the regulation of neurotransmitters.  The research team recommended the integration of meditation into conventional health care and wellness models.  If you would like to read more about this review, click the button below:

Does including music in a yoga class add to the healing benefits?

When I first started taking yoga classes years ago back in New Jersey, the teachers did not play music in the background.  There might have been some chanting, as I do remember learning about chanting “Om” and “Shanti” to start and end classes.  However, it wasn’t until I attended a class where the teacher played the quartz crystal singing bowls while we stayed in comfortable, supported shapes that sound caught my attention!  I left that class sensing that something deep inside of me had shifted, although I could not put it in to words at that time.  After moving to California, I noticed that most yoga teachers included music in their classes, whether it was simply nature sounds or straight up rock and roll!  So once I became a yoga teacher, I began to include music in my classes while setting the intention to manifest a set of those singling bowls so I too one day would be able to offer that deeper experience to others.

After a few years, I acquired a set of Tibetan singing bowls which were made out of metal and generated different sound frequencies depending upon their size and thickness.  The belief was that the frequency of each bowl was tuned to the seven major chakras, or energy centers, in the body, causing the human body to begin to vibrate at the same frequency as the bowls, referred to as entrainment.  The process of entrainment of the body’s frequencies to the sound frequencies of the singing bowls was thought to help the body recover and align with its natural, dominant vibration of wellness (versus illness).  At the time, I didn’t have any evidenced-based research to prove such claims, I only had my own personal anecdotal experiences.  Although I think most of us would not argue how music impacts us, research is now starting to show how these specific vibrations from the singing bowls impact mood and Heart Rate Variability, a physiological measure of health.

Now, you have to understand, that although I love music, I do not have any musical talent.  I sing, but not well and only when I am alone and I have no musical instrument training.  I also avoided group exercise classes (before yoga) because I always felt I was a step behind everyone else – yes, I believed I had no rhythm or coordination, instead of knowing I simply vibrate at a different frequency!  It wasn’t until my yoga practice expanded my awareness to the fact that sound, vibration, rhythm, resonance and dissonance permeate the universe.  Those sounds start for us in the womb, where we hear our mother’s heartbeat, pulse and breathing (and entrain with these vibrations) and we remain rhythmic beings until we take our very last breath.  And not only are we rhythmic beings, but all sentient beings vibrate, especially when we allow ourselves to tune into nature.  In fact, if you would like to experiment with some healing sounds of nature, click here to listen to the sounds of birds and sense how stress and anxiety simply melt away!

The intention behind the physical movement and shapes of a yoga practice on the mat is to soften the mind’s activity, by helping it to focus on the body and breath and releasing the tight grip of the thoughts that keep us distracted.  As we practice yoga, the brain waves of the mind change.  The higher frequency brain waves (i.e., Gamma and Beta) begin to slow down.  These higher frequency brain waves are associated with stress, anxiety, and fear.  When the singing bowls are included in the physical practice of yoga, in addition to the physically felt vibrations, the bowls emit measurable waveforms that sound pleasant and soothe the mind and emotions by promoting the slower, more meditative alpha and theta brain wave states.  So, over 15 years later, I couldn’t be happier that I have manifested a beautiful colored set of quartz crystal singing bowls to include in my yoga and meditation classes!

And I’m also excited to learn that therapeutic sound and music is permeating other healing spaces too.  The recent increase in research on the use of music in healing has shown a strong effect on the brain, including rebuilding neural connections, increasing neuroplasticity, balancing brain activity in the emotional centers such as the amygdala and hippocampus, and enhancing reward (e.g., release of dopamine) circuitry, which helps to regulate mental and emotional responses.  The research is compelling enough that music therapy is being integrated in military treatment facilities, such as the Walter Reed Medical Center, to treat combat-related traumatic brain injuries and post-traumatic stress disorder.  So, the next time you are in a movement class and sense the enjoyment of the music, know that the sounds and vibrations are working at a deeper, subconscious level to invite the body to entrain to its natural vibration of health.  Nothing for you to do, simply enjoy!

If you would like to read more about how music is being integrated into military treatment facilities for trauma-induced mind-body dysregulation, click on the link below:

Will physicians start prescribing yoga for hypertension soon?

Both of my parents have a diagnosis of hypertension and were put on antihypertensive prescription medication to control it.  I think my mother received the diagnosis in her 30s.  I was turning 40 when I first heard my physician say my blood pressure was “elevated” and wanted it monitored in order to determine if I too would need to be put on some medication.  Boy, am I glad that shortly after that I discovered yoga!

I found yoga while celebrating my 40th birthday in Neversink, NY at the New Age Health Spa.  I recently learned that this place closed down a couple of years ago, which made me a little sad to think that it truly launched me on a path toward holistic health and wasn’t able to sustain itself, unlike the riches the pharmaceutical companies rake it.  The first things I noticed after practicing yoga initially were that my low back pain (from bulging/herniated discs) went away and the chronic tension in my body began to lessen.  The best news though was when I went back to the doctor’s office and was told my blood pressure was back to “normal”.  Now, after many years of practice, my blood pressure is actually considered “low”!

This dramatic change in one of the leading causes of morbidity in my own experience – and one in which prevented the need for a life-long attachment to a prescription medication – was all the motivation I needed to continue to explore the benefits of a yoga practice, eventually leading me to becoming a teacher to offer such healing benefits to others.  Unfortunately, my individual story doesn’t equal proof of a connection, so it has taken many years for the research to show that yoga does have a positive effect on your blood pressure.

In a recent systematic research article review that included 49 clinical trials, the data now show that yoga, when breathing and meditation practices are included, is a viable antihypertensive lifestyle therapy.  It is in moments like these that I would like to say “I told you so”!

If you would like to read more on this recent research, please click the button below:

Might integrating trauma-informed yoga into group psychotherapy be helpful in healing and health?

As a trauma-informed yoga teacher and holistic psychotherapist, I’m always on the outlook for new ways to integrate these two (East meets West) healing modalities, better supporting the alignment of the body, mind and soul (think spirituality).  Research continues to emerge in support of integrating both with positive effects.  As we continue to expand our understanding, we are learning that treating the mind (psychotherapy) separately from the body (yoga) limits the healing benefits.  Just as we are learning that treating the body (medical health) without considering the mind (mental, emotional health) limits healing.  Yet, as I have written about in a previous Blog, there are many yoga style options.

What makes trauma-informed yoga different?  A central tenet of such an approach is choice.  As such, the language used to guide students is specific to creating a choice-based environment and reminds them that they are always in control of their practice.  Certain words are used to empower participants to make choices that feel comfortable and invite a more gentle compassionate approach.  The teacher’s role is to be a supportive and non-judgmental presence.  They are aware of how their own movements and interactions are perceived, demonstrating predictability and consistency to create and maintain safety.  In maintaining such healthy boundaries, they model those boundaries, which includes no physical assisting as such assisting may be triggering to someone recovering from trauma.  Trauma-informed teachers ‘invite’ participants to draw their awareness to the sensations in their bodies to guide them in their choices of shapes and timing of their movements, not ‘tell’ them what to do and when.  Even the guidance around how to breathe in such a class is a suggestion to find a supportive breath that invites comfort.  So no focus on holding the breath is offered.  If you are interested in reading more about trauma-informed yoga, I would suggest checking out Zabie Yamasaki’s website here.

Trauma-informed yoga is new.  In fact, in 2017 the Trauma Center’s trauma sensitive yoga (TCTSY) became the first dedicated yoga program in the world to be listed as an evidence-based program/practice of psychological trauma.  So how excited was I to read the emerging research on integrating trauma-sensitive yoga into group psychotherapy for at-risk groups, such as survivors of intimate partner violence.

What this research suggests is that it may not only have positive effects for clients in Group Therapy, but also for the care providers!  If you would like to read more about this research, click the box below: