We walk together

02 Thursday Jun 2022

Posted by RichardB in creative arts therapy, Dance Movement Therapy

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Addiction, clients, meditation, movement therapy, Patients, Psychotherapy, recovery, rehab

In my work with clients/patients I sometimes use the written word to help process what they are feeling and what I am feeling about working with them. I worked for years at a residential drug/alcohol rehab center and wrote a short poem about one experience.

1. We walk together
toe to heal
In the way we came here

Youngest to oldest – Male to female –
Opiate to alcohol – Forceps to stone

2. We all
Everyone of us
walk for a reason

3. Up the hill
breathlessly
we reach the top

4. around the pond and into the trees
A shelter – A holding
in the environment

5. Close your eyes
Notice your breath – As you inhale – as you exhale
Feel the wind – notice the smells – the scent of the earth

The sunlight and shadows sway back and forth to the rhythm of the branches moving in the wind

6. Don’t be afraid – shiver- cry out – weep – scream
We are all killers inside
We are all healers inside
Our blood runs through the veins of our ancestors
And is here to stay – an echo of times now gone

A dream of times yet to come

Interpretation

1. Today I took my clients outside to the park. We walked in a pecking order; the client with the most time were in front followed by the others in order of time, drug of choice, sex, finally by age. It was a metaphor for their life journey, of their choices and circumstances thrust on them from birth.

2. In the clients (and us all) our journey is a reflection of who and where we came from. Our personality and our history. Our wants and needs. Our understanding of these things. In this residential rehab clients have come because of an intersection of factors, both internal and external.

3. The walk with the clients took us up a sharp and steep hill, the last little leg of our walk before we reached the park and the pond. The walk of addiction is a mighty hard row to hoe in the discovery of the self

4. The clients were very happy to see the pond and dogs and people, and we headed for the trees to find some sanctuary. This little stand of trees I felt would be a good holding environment to do a movement meditation in a public space.

5. I led the group through a meditation in the environment, giving them a chance to be calm/passive and feel nature, with its enormous power. Like that higher power that 12 step teaches. Also nature has a rhythm that we, as earthlings cannot escape, it is deep inside us, with us since the womb.

6. In the mediation I encouraged the group to go to where it was safe and to go a little beyond safety, to a new place. Being different (clean/sober) in a setting (park) that is familiar is challenging. They will face that challenge when they leave the rehab. As addicts they must accept their dark side, and they must recognize their light side. This killer and healer is the story of being human, told by all cultures since we first lit a fire and huddled together. It is this story telling that teaches us to remember the mistakes so we know what to do if we make them and know how to avoid them.

catas

Meditation and Pain Management

11 Tuesday Jan 2022

Posted by RichardB in Meditation, mindfulness, Uncategorized

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meditation, pain management

Meditation can relieve pain, and it does so by activating multiple brain areas, according to an April 2011 study in the Journal of Neuroscience. Fadel Zeidan of Wake Forest University and his colleagues scanned people’s brains as they received uncomfortably hot touches to the leg. When subjects practiced a mindful meditation technique that encourages detachment from experience while focusing on breathing, they reported less pain than when they simply paid attention to their breathing. Likewise, different patterns of brain activity emerged under the two conditions, with mindful meditating resulting in more activity not only in executive centers that evaluate experiences and regulate emotions but also in lower regions that control the signals coming from the body.

The volunteers learned the meditation technique in only four 20-minute sessions, which means this pill-free analgesia could be a feasible way to help real patients suffering from pain. “People can reap some of the benefits of meditation without extensive training,” Zeidan says.

When I work with patients using mindfulness I start by asking who has experience with any type of meditation, breathing techniques and/or relaxation exercises. We than have a brief explanation and question and answer period and I focus on removing any doubt, fear, or skepticism. I usually than do a 10 to 12 minute body scan moving right into a mindful meditation that focuses on the breath.

With the co-occurring patients I work with this process seems to work the best. The chat in the beginning warms people up, the body scan relaxes which helps the meditators enter into a more meditative state.

How meditation can change your life and mind | Sam Harris, Jon Kabat-Zinn & more | Big Think

17 Thursday Dec 2020

Posted by RichardB in Meditation, mindfulness

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There are a lot of misconceptions when it comes to what mindfulness is and what meditation can do for those who practice it. In this video, professors, neuroscientists, psychologists, composers, authors, and a former Buddhist monk share their experiences, explain the science behind meditation, and discuss the benefits of learning to be in the moment. “Mindfulness allows us to shift our relationship to our experience,” explains psychologist Daniel Goleman. The science shows that long-term meditators have higher levels of gamma waves in their brains even when they are not meditating. The effect of this altered response is yet unknown, though it shows that there are lasting cognitive effects. “I think we’re looking at meditation as the next big public health revolution,” says ABC News anchor Dan Harris. “Meditation is going to join the pantheon of no-brainers like exercise, brushing your teeth and taking the meds that your doctor prescribes to you.” Closing out the video is a guided meditation experience led by author Damien Echols that can be practiced anywhere and repeated as many times as you’d like.

Mindfulness: how to be present in the moment

20 Tuesday Oct 2020

Posted by RichardB in grounding, Health, Meditation, mindfulness, Wellness

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meditation, mindfulness

UC San Diego Center for Mindfulness joins William Mobley, MD, PhD for a discussion of how to be present in the moment and leverage the practice of mindfulness to stay engaged, focused, and fulfilled

Evidence based Yoga 2

01 Thursday Oct 2020

Posted by RichardB in Health, Wellness, Yoga

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Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. Part two of evidence based Yoga:

Fitness and Health

Carpal tunnel syndrome A randomized, single-blind controlled trial of 42 patients with carpal tunnel syndrome assigned subjects to either a yoga treatment group or a wrist splint group, each 8 weeks in duration. Twice a week, the yoga group practiced postures specifically designed to strengthen and stretch each joint in the upper body. Yoga participants showed improvement in grip strength, pain levels, and Phalen’s sign when compared to the wrist splint group. Nerve conduction studies were not performed.¹⁵ A Cochrane review of 21 trials that evaluated the clinical outcome of nonsurgical treatment of carpal tunnel syndrome reported that 8 weeks of yoga practice significantly reduced pain as compared to wrist splinting. The yoga was described as having a “significant short-term benefit,” though the duration of this benefit is unknown.¹⁶

Depression A 2004 review of five RCTs that evaluated yoga-based interventions for depression and depressive disorders showed some positive outcomes and no adverse effects on patients’ mild to severe depressive disorders. However, poor study design and incomplete methodologic reporting makes this interpretation preliminary.¹⁷ An RCT studying 7 weeks of yoga training in a group of breast cancer survivors showed positive changes in emotional function, depression, and mood disturbance.¹⁸ “Yoga and stress management” (in the online version of this article) provides more information on this study and others involving the effects of yoga on stress.

Irritable bowel syndrome In an RCT, treatment with loperamide (Imodium) was compared to treatment with a series of 12 yoga postures practiced twice a day for 2 months in a small sample of patients with clinically diagnosed irritable bowel syndrome. Patients underwent measurement of surface electrogastrography, and trait and state anxiety tests were administered before, during, and up to 2 months after treatment. Both intervention groups demonstrated a decrease in bowel symptoms and state anxiety.¹⁹

Menopausal symptoms In a recent pilot study, 14 postmenopausal women reported via interview and questionnaire a decrease in the severity and frequency of hot flushes after 8 weeks of 90-minute “restorative yoga” classes. Although this initial finding sounds encouraging, this trial had no control group or objective parameter measurements.²⁰ An RCT studying postmenopausal sleep quality divided 164 women into groups who participated in either 4 months of low-intensity yoga, a moderate-intensity walking program, or a wait-list control group. This study reported no statistically significant interventional effects of any treatment on total sleep quality or on any individual sleep quality domain.²¹

Multiple sclerosis An RCT of 57 subjects with clinically defined multiple sclerosis were assigned to weekly Iyengar yoga class plus home practice, a cycling program, or a wait-list control group for 6 months. Results showed that both active interventions produced significant improvement in perceived levels of energy and reduced fatigue; however, the specific effects of the yoga practice were not isolated.²² Osteoarthritis In a pilot study, 11 deconditioned, yoga naive subjects with a clinical diagnosis of knee osteoarthritis showed improvements in pain and knee stiffness after 8 weeks of yoga training. The group performed modified Iyengar yoga sessions once a week.²³

Seizure disorders In 2000, a systematic review of the published literature revealed that only one study was able to meet the selection criteria for reliable research design. The reviewers concluded that no available evidence pointed to yoga therapy as an efficacious treatment for epilepsy.²⁴

Strength and flexibility In a recent study on the fitness related effects of hatha yoga, 10 yoga-naïve and previously untrained subjects aged 18 to 27 years participated in 85 minutes of pranayama and hatha yoga practice twice a week for 8 weeks. These subjects showed significant improvement in upper and lower body muscular strength, endurance, and flexibility. No statistically significant change in body composition or pulmonary function was observed.¹³
In a partial RCT with a longer time frame, 54 subjects aged 20 to 25 years participated in either 5 months of yoga instruction or no activity. After that time period, both groups practiced yoga for an additional 5 months. The group practicing 10 months of yoga showed significant improvements in shoulder, trunk, hip, and neck flexibility, as well as a reported improved performance during submaximal exercise testing.²⁵
A well-executed study compared subjects who underwent 24 hours of hatha yoga classes over 8 weeks with a control group. The yoga training group showed a 13% to 35% improvement in flexibility, balance, and muscular endurance. The authors concluded that hatha yoga practice has significant effects on balance and flexibility.²⁶

REFERENCES

1. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49.
2. Carrico M. Yoga Journal’s Yoga Basics: The Essential Beginner’s Guide to Yoga for a Lifetime of Health and Fitness. New York, NY: Henry Holt and Company; 1997.
3. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4): 783-798, vi.
4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18(6):491-519.
5. Raub JA. Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797-812.
6. Luskin FM, Newell KA, Griffith M, et al. A review of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6(2): 46-56.
7. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attentiondeficit/ hyperactivity disorder (ADHD). J Atten Disord. 2004;7(4):205-216.
8. Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005;39(12):884-891.
9. Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. Meditation therapy for anxiety disorders. Cochrane Database Syst Rev. 2006;(1):CD004998.
10. Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol. 2005;94(5):543-548.
11. Vendanthan PK, Kesavalu LN, Murthy KC, et al. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 1998;19(1):3-9.
12. Sherman KJ, Cherkin DC, Erro J, et al. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2005;143(12):849-856.
13. Tran MD, Holly RG, Lashbrook J, Amsterdam EA. Effects of Hatha yoga practice on the healthrelated aspects of physical fitness. Prev Cardiol. 2001;4(4):165-170.
14. Clay CC, Lloyd LK, Walker JL, et al. The metabolic cost of Hatha yoga. J Strength Cond Res. 2005;19(3):604-610.
15. Garfinkel MS, Singhal A, Katz WA, et al. Yoga-based intervention for carpal tunnel syndrome: a randomized trial. JAMA. 1998;280(18):1601-1603.
16. O’Connor D, Marshall S, Massy-Westropp N. Nonsurgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003(1):CD003219.
17. Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: the research evidence. J Affect Disord. 2005;89(1-3):13-24.
18. Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S. A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psycho Oncol. 2006;15(10):891-897.
19. Taneja I, Deepak KK, Poojary G, et al. Yogic versus conventional treatment in diarrheapredominant irritable bowel syndrome: a randomized control study. Appl Psychophysiol Biofeedback. 2004;29(1):19-33.
20. Cohen BE, Kanaya AM, Macer JL, et al. Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial. Maturitas. 2007;56(2):198-204.
21. Elavsky S, McAuley E. Lack of perceived sleep improvement after 4-month structured exercise programs. Menopause. 2007;14(3, pt 1):535-540.
22. Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology. 2004;62(11):2058-2064.
23. Kolasinski SL, Garfinkel M, Tsai AG, et al. Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study. J Altern Complement Med. 2005;11(4):689-693.
24. Ramaratnam S, Sridharan K. Yoga for epilepsy. Cochrane Database Syst Rev. 2000(3):CD001524.
25. Ray US, Mukhopadhyaya S, Purkayastha SS, et al. Effect of yogic exercises on physical and mental health of young fellowship course trainees. Indian J Physiol Pharmacol. 2001;45(1):37-53.
26. Boehde D, Porcari JP, Greany J, et al. The physiological effects of 8 weeks of yoga training. J Cardiopulm Rehabil. 2005;25(5):290.

Evidence based Yoga

24 Thursday Sep 2020

Posted by RichardB in Health, Wellness, Yoga

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Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. There are numerous schools of yoga. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes postures (asanas) and breathing exercises (pranayama).

Since the 1020’s researchers have been studying and publishing articles on the results of a Yoga practice. Listed below are some of the research results of Hatha Yoga and specific medical conditions. :

young woman excercising power yoga

ADHD Eighteen boys with diagnosed attention-deficit/hyperactivity disorder (ADHD) were randomly assigned to either a yoga treatment or a cooperative activities group. After 20 sessions of yoga, the boys showed improvement on a variety of indices, including oppositional behavior, emotional lability, and restlessness or impulsivity. The subjects exhibited a dose/ response curve, with those subjects who participated in additional home practice showing a greater response. The control group showed superior scores on measures of hyperactivity, anxiety, and shyness, as well as social function measures.⁷

Anxiety A meta-analysis of the research involving yoga interventions for anxiety and related disorders reviewed eight studies conducted during 2004. Overall, this research reported positive results, especially in cases of obsessive-compulsive disorder. However, the authors were quick to point out a generally poor quality of research techniques, inadequacies in methodology, and difficulty comparing studies.⁸ A Cochrane review of two RCTs that investigated the effectiveness of meditation and yoga on patients with diagnosed anxiety disorders stated that based on the available research, no distinct conclusions can be drawn on the ability of meditation and yoga to be effective for anxiety disorders.⁹

Asthma To determine the efficacy of Iyengar yoga practice on symptoms and perceived quality of life of people living with asthma, 62 patients with mild to moderate asthma were randomized and divided into two groups. The treatment group performed Iyengar yoga for 4 weeks, and the control group enrolled in a “stretching” program. Both groups underwent spirometry testing and recorded their bronchodilator use, symptoms, and quality of life assessments. At no point in the study did the yoga intervention group show a measured benefit in clinical indices.¹⁰Another small RCT divided 17 subjects into a yoga treatment and a control group. The yoga group engaged in relaxation pranayama (mindful breathing) techniques, yoga postures, and meditation 3 times per week for 16 weeks. Spirometry testing showed little difference between the two groups; however, the yoga group showed improved exercise tolerance and reported relaxation as well as a more positive attitude as measured by questionnaire. This study also showed a trend toward less use of short-acting bronchodilator medication in the yoga group.¹¹

Back pain A 12-week RCT compared viniyoga practice with conventional therapeutic back exercises or a self-help book for 101 patients with chronic low back pain. The yoga group met with one instructor for a weekly 75-minute viniyoga practice. Patients were also encouraged to practice at home daily and were given handouts and an audio CD guide. This group showed greater improvement in functional status, decreased activity restriction, and increased general health compared to the conventional exercise group or the self-help book group at 12 weeks. At 26 weeks post treatment, the conventional exercise and yoga therapy group did not show a significant difference in outcome, though at all points in time, viniyoga therapy appeared to be more effective than the self- care book. The viniyoga benefit also lasted for months after the intervention.¹²

Cardiovascular disease A systematic literature review of 70 studies published over the past two decades showed a trend toward beneficial changes in metabolic syndrome risk factors such as insulin resistance, lipid profiles, BP, and anthropomorphic indices. The author noted that by controlling risk factors for metabolic syndrome, a regular yoga practice might possibly reduce the risk of cardiovascular disease (CVD). It is important to note that approximately one-third of the reviewed studies were RCTs and that the majority of the others were uncontrolled or nonrandomized controlled clinical trials.⁴A 2002 comprehensive review of the literature on the psychophysiological effects of hatha yoga concluded that regular hatha yoga practice and a “yoga lifestyle” have the potential to benefit CVD risk indices.⁵

Cardiovascular fitness A 50-minute hatha yoga routine burns 2.2 to 3.6 kcal/min, the equivalent a very slow walk. Except in persons who are very deconditioned, this type of yoga practice alone is unlikely to have a significant training effect on cardiovascular fitness, pulmonary function, body composition, or fat metabolism.¹³ More vigorous forms of power or vinyasa yoga require a higher energy output, depending on the method of teaching and selection of asanas (postures). One recent study demonstrated a 7% increase in VO2 max after previously sedentary subjects practiced 8 weeks of yoga training.¹³However, the general consensus is that yoga does not provide the significant cardiovascular stimulus necessary to enhance cardiovascular function.¹⁴