Report from Haridwar, India
This is a special edition of the LifeForce Yoga for Depression Newsletter. I am writing you from Patanjali University & Yogpeeth in Haridwar, India where we have just concluded “Yoga for Health and Social Transformation-the First International Conference.” I will be summarizing the research presented on Yoga and mental health below, and providing a brief mention of other important findings on the efficacy of Yoga treatment for diabetes, breast cancer survival rates, post-operative recovery from heart surgery, weight loss, and many other disorders.
On the opening night of Conference, the “chief guest” and keynote speaker was the incomparable Mr. B.K.S. Iyengar, who brought Yoga asana practice to the West. At 93, his speech, given without notes, vibrated with energy and clarity. In the brief review of his life, he spoke of how he was brought to Krishnamacharya at age thirteen, sickly and weak, after spending a year in bed with tuberculosis. He said that because breathing deeply exacerbated his condition, Krishnamacharya gave him a practice without pranayama. This has answered an old question I and many others have had about Mr Iyengar’s reluctance to teach pranayama before a student has mastered asana.
During the closing ceremonies, our hosts Swami Ramdev and Acharya Balkrishna addressed the delegates and gave out prizes for award-winning presentations. Swami Sadhguru Jaggi Vasudev, the spiritual leader of the Isha Foundation gave a brief talk and led a resonating chant.
Namaste from Mother India, the Home of Yoga,
RESEARCH: TELLES ON KAPALABHATI AND PTSD
Shirley Telles, Ph.D., Director of the Patanjali Research Foundation and author of over 120 research articles in peer reviewed journals, presented an overview of her current research. I will mention two recent studies, the first still in press.
Dr. Telles began her inquiry with an important question: Would kapalabhati (skull shining breath, characterized by forceful quick exhalations and passive inhalations, bring more blood flow to the brain during practice, putting those with a predisposition at a higher risk for stroke? What she found was that there is actually a reduction in blood volume during the optimum practice, of one exhalation per second, or sixty breaths per minute. Following the practice, the blood flow returns to normal and in fact, hemoglobin (the amount of oxygen in the blood) actually increases. Oxygenating the blood is beneficial to numerous health conditions. In addition, as compared to the control group which practiced breath awareness, perception, motor skills and attention increased in the kapalabhati group. (Psychological Reports)
In a randomized controlled study, PTSD symptoms were reduced, self-esteem increased and heart rate variability (HRV) was elevated in Bihar flood survivors following 45 days of Yoga practice as compared to a wait-listed control group. Biomed Central Psychiatry, 10(1):18
Dr. Telles and her colleagues at the Patanjali Research Foundation have published nearly twenty studies this year, not including another kapalabhati study in press designed by Dr, Telles and researcher Nilkamal Singh. Included in published research are studies on leptin levels after Yoga practice (a factor in obesity), neuroticism, anxiety, and rheumatoid arthritis. [2011, in Press]
RESEARCH: KHALSA ON YOGA IN THE SCHOOLS
Sat Bir Singh Khalsa, Ph.D., Director of Research for the Kundalini Research Institute, Research Director for the Kripalu Center for Yoga and Health, and assistant professor at Harvard Medical School at Brigham and Women’s Hospital, with Dr. Shirley Telles, helped to plan the Conference presentations. Dr. Khalsa reviewed the increase in depression and suicide rates among children, particularly adolescents. He described a number of programs in which Yoga is being implemented in public schools, and the evidence suggesting improved mood, self-esteem, and better emotional regulation. He reviewed his current research at a public high school in Massachusetts where Physical Education students were randomly divided into regular PE classes or Kripalu Yoga classes and attended 2-3 times a week. Over the course of the semester, the control group showed an increase in negative mood states in all measured categories while the Yoga group maintained baseline scores or improved.
RESEARCH: BERNARDI ON BREATH AND DIABETES
Luciano Bernardi, M.D. of the University of Pavia, Italy and currently visiting professor at the University of Helsinki Finland, whose research on the effects of manta chanting I included in Yoga for Depression, provided an overview of efficient breathing practice during exercise before reporting on his most current research on diabetes. Shortness of breath is deconditioning and worsens heart failure. Training to breathe slowly at rest, as Yoga practice encourages, improves shortness of breath during exercise and therefore improves the symptoms of heart failure. Thus training in slow oga breathing, as demonstrated in his now-famous 2006 study of climbers scaling Everest who showed fewer effects from altitude sickness when compared to untrained climbers, supports higher blood oxygen content, autonomic nervous system regulation and posture.
Because patients suffering from diabetes-I have lower levels of oxygen in the blood and Yoga increases oxygenation, he wondered if pranayama would benefit diabetics. His research showed that indeed, the diabetes group practicing Yoga breathing improved oxygenation, postural control and parasympathetic response.
RESEARCH: ANAND ON SUDHARSHAN KRIYA, PRANA-YOGA AND NEW MEASUREMENT TECHNOLOGY
Sneh Anand, Ph.D., of the Indian Institute of Technology (the MIT of India) reported on the neuro-cardio pulmonary efficacy of both Prana Yoga and Sudharshan Kriya, using ECG and other objective measurements, as well as subjective psychosocial self-reporting measures. Both groups showed a shift in frequency and higher gamma power in frontal, central and some temporal regions of the brain, indicative of higher cognitive functioning. Both groups also showed higher cardiac autonomic tone, but only the the Sudharshan Kriya group showed statistically significant reduction on subjective measurements of anger, depression and a significant increase in life style and stress management skills.
As an engineer, Dr. Anand is developing new measurement tools to track blood flow and other parameters. For example, she has a simple headset that may replace all the attachment points of ECG. She spoke informally of her experiments, and says that she is finding that blood flow increases to the pineal gland area with the practice of ajna chakra meditation (imagining light at the brow point). While this is exciting to contemplate-does this mean meditating on vissudhi chakra (throat) might increase blood flow to the thyroid? Meditating on anahat (heart) chakra could increase blood flow to the thymus gland?-the measurements have not yet been corroborated.
RESEARCH: SAPER ON LOW BACK PAIN
Robert Saper, M.D., M.P.H., Director of the Integrative Medicine program at the Boston Medical Center and a professor at Boston University, presented evidence for the efficacy of Yoga for low back pain. There were several aspects of this study that addressed the psychological dimensions of low back pain. People suffering from the condition often exhibit fear/avoidance behaviors, limiting their movements, which can make the condition worse. In remaining sedentary, muscles can atrophy and weight gain can place additional stress on the area of pain. Untreated low back pain reduces GABA levels, a neurotransmitter (when low) implicated in depression.
One aspect of the study that I found especially interesting was the way in which Dr. Saper developed the Yoga protocol so as to make it consistent and replicable. He and his colleagues reviewed all the literature on Yoga and back pain and then convened a panel of Yoga experts from Iyengar, Anusara, Kripalu and Hatha traditions who also reviewed the literature before designing the Yoga classes.
The second aspect of his study that was commendable was that he targeted an underserved minority population that would not otherwise have access to Yoga. The outcome was favorable in that the Yoga group showed a significant reduction in back pain, a decreased reliance on pain medication along with positive mood changes.
Finally, a third aspect of his future research that I find noteworthy is the care he is exhibiting for his subjects. He has funds to expand the study and to this time conduct a one year follow-up. He became aware that after the study was completed, a number of study participants had no access to Yoga in their communities and so most had stopped practicing. In the next round, he will make community classes available on a weekly basis to study participants after the completion of the study. This added element can potentially provide follow-up longitudinal data on this underserved population.
RESEARCH: INNES ON WOMEN’S HEALTH
Epidemiologist Kim Innes, MSPH, Ph.D., associate professor at West Virginia University and the University of Virginia, has completed seven studies, funded by a NIHCCAM grant that looked at the effects of Yoga for as an intervention for the prevention and treatment of cardiovascular disease, diabetes, Parkinson’s disease and other conditions in postmenopausal women and older adults. She’s also investigating the application and usefulness of Yoga for adults with cognitive impairment (and their caregivers), osteoarthritis, and other related diseases. Although she was testing for other improvements like balance and gait, she included psycho-social measurements in her studies and in all cases, she found improvements in mood and sleep and a reduction of stress.
RESEARCH: COHEN ON CANCER
Based on his previous research, Lorenzo Cohen, Ph.D., professor and Director of the Integrative Medicine Program at the MD Anderson Cancer Center in Houston, TX, Distinguished professor at Fudan University Cancer Hospital in Shanghai, and grandson of Yoga luminary Vanda Scarvelli, has received a 4.5 million dollar grant from NIH to fund a large randomized controlled Yoga study with women with cancer. His current research has been based on the evidence that psychological stress is a predictor of mortality in breast cancer patients. In animal studies, mice injected with tumors fared better when given propanol to block the stress hormone norepinephrine as compared to mice without the block whose tumors metastasized. Based on the theory that Yoga also reduces norepinephrine and therefore strengthens immunity to stress, Dr. Cohen and his team used various Yoga styles, including Tibetan Yoga and protocols developed in collaboration with the Vivekananda Kendra in Bangalore. The findings validate his thesis. A decrease in depressive symptoms impacts long term survival rate in breast cancer.
His 2004 study used the Tibetan Yoga protocol with lymphoma patients and found improvement in sleep disturbances, a reduction in dark thoughts and symptom reduction, post treatment. His 2010 study, in collaboration with Vivekananda Kendra, found a reduction in the stress hormone cortisol and an increase in “finding meaning in life” three months after the Yoga intervention. What is illuminating about this increase in “meaning” is that those who measured highest in “finding meaning in life” at three months, showed a higher incidence of intrusive thoughts at one month. This could indicate that Yoga allows and cultivates a welcoming attitude to all that’s arising, including negative and intrusive thoughts. Might it be possible that In the process of bringing the sludge to the surface, Yoga also encourages qualities of acceptance, balance and even joy? Could it be that those who remain in denial of their fears and fight to keep negative thoughts at bay may be contributing to their own psychological stress, which as stated above is a predictor of mortality among breast cancer patients?
RESEARCH: GANGADHAR ON SCHIZOPHRENIA
B.N. Gangadhar, M.B.B.S., M.D., professor of psychiatry and Medical Superintendent of the National Institute of Mental Health and Neurosciences (NIMHANS) spoke about the efficacy of yoga in better management of schizophrenia. Citing three randomized controlled studies he and his colleagues have done, two of which used exercise and a do-nothing group as controls, in all three studies the yoga group fared better. Negative symptoms dropped after yoga therapy far more than the group that practiced physical exercise. Yoga helped improve depression, social dysfunction and quality of life more than those who practiced exercise.
OTHER INTERESTING RESEARCH
Elisa Harumi Kozasa, Ph.D., a psychobiologist and senior meditation researcher at the Universidade federal de San Paolo, Brazil, presented on the effect of training the mind in attention through meditation. She demonstrated how experienced meditators can pay sharp attention to a single object, and when doing so, they keep their brain-waves stabilized for a long time, when compared to non-meditators.
Senior research and clinical dermatologist Terrance Ryan, D.M.,FRCP, emeritus at Oxford University, and Honorary President of the International Society of Dermatology, with over 600 publications to his credit, presented an astounding paper on the use of Ayurvedic treatment combined with Yoga to ameliorate the symptoms of lymphedema, a mosquito-borne disease affecting millions of people in India. Through gentle movements, pranayama and Ayurvedic herb soaks, the huge swelling of the legs (commonly known as elephantitis) is brought down to near normal proportions without surgical intervention, which can be severely disfiguring. Although Ayurveda addresses specific conditions, the whole mind/body/spirit of the individual is considered when developing treatment. In this case, the herb treatments prescribed were based on dosha type (Vata, pitta, kapha), and therefore varied. Yet despite variation, they all worked to reduce the extreme swelling of the lower extremities of the body.
Harinder Singh Bedi, M.D., a cardiac surgeon at Christian Medical College and Hospital, Ludhiana, Pujab, India, presented an impressive paper on the effects of a pranayama intervention taught to patients one week before undergoing heart surgery. His presentation included actual film of several heart surgeries, including that of a seven-year-old child. Those who received the daily pranayama training at the hospital were coached to practice upon emerging from anesthesia. The pranayama group recovered faster, had fewer complications and a decreased mortality rate.
Loren Fishman, M.D., of Columbia College of Physicians and Surgeons in New York presented his on-going work, documenting the rotator cuff improvements of over 700 patients who have come to his orthopedic practice, usually expecting surgery. He teaches them an Iyengar headstand, using props where necessary. In one session of headstand, muscles realign so that pain is reduced and range of motion is dramatically increased. In long-term follow-up, the positive change is sustained. Apparently, the headstand teaches the muscles to shift to support better range of motion.
There were other papers, presentations, and posters that covered the pacifying effects of “aum” chanting on infants, Yoga in the management of ischemic heart disease, kapalabhati on heart rate variability and respiration, and many other topics
CONFERENCE NEWS: MUNRO ON LOWER BACK PAIN YOGA TOOL
Robin Munro, Ph.D., Founder and Director of the Yoga Biomedical Trust in England, has been a student of yoga for nearly fifty years and in that time has contributed to the applications of yoga in healthcare, through his trainings and research. His own research has focused on asthma, diabetes and low back pain. He spoke about the importance of assessing low back pain, so as not to exacerbate conditions through an improper application of Yoga asana. To that end, he has developed a computer program n assessment tool that he has made available to yoga teachers and therapists at www.CALBA.net.
CONFERENCE NEWS: AN OVERVIEW OF YOGA THERAPY IN INDIA
Naveen Viswewaraiah, BNYS, Ph.D., is Joint Director of Research at the Center for Advanced Research on Yoga and Neurophysiology. His talk presented an overview of the 14 colleges and 150 hospitals in India that use yoga therapy and naturopathy. He reviewed the programs and research contributed to the field by the Vivekananda Yoga Anusandha Samsthana (VYASA), which since the 1970’s has undertaken applied yoga research. This institution is the first Yoga university to have its publication, International Journal on Yoga indexed on Pubmed. This is also the institution where I first met Dr. Shirley Telles in 1993.
CONFERENCE NEWS: SOCIAL TRANSFORMATION
In addition to research, the Conference gave attention to the application of Yoga to underserved populations. Father Joseph Periera, founding director of the Kripa Foundtion, which for thirty years has treated and supported addicts and those suffering from HIV-AIDS, throughout India and at various treatment centers around the world, spoke of the integration of Iyengar Yoga into the 12-Step recovery program.
James Fox, founding director of the Prison Yoga Project and author of a manual for prisoners available to prisoners free-of-charge throughout the United States, spoke of his work inside the walls of San Quentin Prison in California. Although prison is a violent and dehumanizing place, James talked about the opportunity prisoners “with time on their hands” have for spiritual growth.
Krishna Kaur Khalsa, has been a Kundalini teacher for 40 years and a trainer of teachers for many of those years. As founding director of Y.O.G.A, she trains Yoga teachers and runs a program to serve urban and incarcerated youth. She spoke of the enormous global need to reach disaffected youth.
Leigh Blashki, director of training at the Australian Institute of Yoga and secretary of the Australian Association of Yoga Therapy, spoke of India’s great gifts in the form of Yoga and Ayurveda to the rest of the world and his organizations pioneering efforts in the development of training standards for Yoga teachers and Yoga therapists.
Jon Kepner, executive director of the International Association of Yoga Therapists, spoke of the organization’s mission to establish Yoga as a recognized and respected therapy. He addressed the question of how to keep “Yoga” in the growing business of Yoga Therapy.
I spoke about the integration of seated Yoga practices into psychotherapy in a clinical setting, acknowledging that Indians, with the strong emphasis on family values and tradition, grow up with a greater sense of belonging and a stronger sense of self than do we in the West, and therefore need and seek individual psychotherapy less often. Indians are more likely to seek out the guidance of their guru.