How does Yoga Therapy work to heal pain?
Yoga is a positive psychology that needs the power of our mind to help heal conditions or ailments that we may be suffering from. Thought power is very important in healing pain, and is often referred to in the medical communities as the mind-body connection, or Psychoneuroimmunology.
Psychoneuroimmunology interprets disease processes through the interaction of psychological, neural and immunological processes. Recent research discoveries in the field, have helped to confirm the philosophy illuminated in the ancient yoga texts and to generate credibility for the notion of mind-body medicine within the scientific and medical community. Therefore, the beneficial practices of yoga asana, pranayama and meditation are gaining more respect as the practices are interpreted through the perspective of psychoneuroimmunology, leading to proposed recommendations for yoga-based promotion of health and management of chronic conditions.
Yogic therapy can provide patients with the skills and the motivation to change age old, debilitating habits into new healthy habits that enhance well-being and reduce physical and psychological suffering. Regardless of age, those who live by Yogic Science as a mind-body medicine can dramatically boost the immune system, facilitating clarity of thought, helping focus attention, increase energy and productivity, enhance problem solving capabilities and also have strong and healing relationships. As part of a complete daily wellness program, meditation, diaphragmatic breathing and a gentle yoga therapy can improve mental, emotional and physical well-being offering clients the necessary skills to become an active partner with us as physicians in maintaining health and vitality.
Yoga as a positive psychology
Yoga is a positive psychology and so it is important that we always use positive mental intention to create change. Intention has the power to change neural pathways in our brain through both synaptic pruning and functional neuroplasticity. Our positive intentions reduce stress and conditions that are derived from such. The use of sankalpas in Yoga therapy is an excellent way to overcome the negative thinking that causes detrimental effects in both the nervous and immune systems. A Sankalpa is the intention to heal conditions of the body and mind, creating a new bodily and mental pattern.
- New Body Pattern: Nava Sharira Samskara
- New Mental Pattern: Nava Manas Samskara
A sankalpa must be something of immense importance to you or the patient to achieve a lasting neurological change. In the science of brain neuroplasticity we call this one pointed practice “synaptic pruning” or “structural neuroplasticity”, where we may record a change in the neural pathways of the brain, even the body.
Synaptic Pruning: This process of elimination and strengthening of synapses is referred to as synaptic pruning. The connections of those neurons which are used frequently become stronger, while the connections of those neurons that remain unused die. Synaptic pruning is the method of the brain to adapt to changing circumstances and environment.
Structural Plasticity: It refers to the ability of the brain to bring about an actual change in its physical structure in response to learning new things.
As we know, in reference to the above, the powerful healing science of yoga has known this for a very long time.
To see this change in your patient, you must guide them towards their goal, teaching them one-pointed attention, so they detach from negative samksaras or patterns, physical, mental and emotional. They must focus only on that which is positive, but also achievable. This concept is referred to in Patanjali’s yoga Sutras as practice Abhyasa and detachment, Vairggya, meaning that when we practice moving towards our goal, we naturally detach from that which is no longer helpful to us.
Forming a Sankalpa: positive change
Resolves are always short, positive sentences of moral significance to be embedded in the subconscious such as ‘I resolve to more compassionate to myself.’ This autosuggestion is very powerful, and must be repeated with true conviction. Sankalpas must be based in present tense, and so we must as practitioners treat the patient as if their sankalpa is already unfolding from the moment they come into contact with us. Our intention also heals.
Affirm their faith in themselves by offering encouraging words and ask them to choose their personal goal or sankalpa in positive present tense: ‘I am moving towards functional movement of the spine….”
There are four stages of Sankalpa that we may choose from, particularly in helping our patients deal with pain or illness:
- The reforming of bad habits that may lead to chronic pain, and the creation of good habits
- Improving the quality of life and living, reducing physical and emotional pain
- Creating a real change within our personality, compassion, having better relationships (positive relationships are proven to work by reducing, stress, inflammation, and pain)
- Realizing what we are trying to achieve in this life – This keeps us mentally health and satisfied
Faith based on personal experience, shraddha
Our patients also need to see that the practice is working for them and have some faith in their achievements, based on personal experience. Personal reflection or evaluation with the therapist through continuity of care is very important in yoga therapy. This leads a patient to see their achievements as they move towards their goal in stages, so this faith should be unfolding and personal, not based on blind belief or dogma. This type of experiential faith is called shraddha in the yoga sutras.
In fact, we know that faith works to heal. Researchers have been studying how spiritual attitudes and faith affect health. In a recent study on people with human immunodeficiency virus (HIV), for example, those who had faith in a presence beyond, or compassion toward others, or a sense of inner peace, and were of spiritual inclination and discipline had a better chance of surviving for a long time with acquired immune deficiency syndrome (AIDS) than those who did not have such faith or practices. Research suggests that qualities like faith, hope, and forgiveness, and using positive prayer and inaction, including social support, have a noticeable effect on health and healing.
Separating ourselves from the pain
To educate others to rise above the experience of the pain or condition is important, so that they do not identify with the disease, and become either overwhelmed or obsessed by their condition. Patients must be able to step back and be reminded that they are awareness itself: simply aware of their thoughts, feelings and sensations, but they are not THE PAIN. In yoga therapy we actually look to accept our experience as it arises, rather than chasing something beyond, or even some exotic experience through yoga.
How to manage pain with yoga therapy
Yoga therapy in combination with mindfulness based meditation has profound effects on pain and its management. We can categorise pain in two ways. Acute Pains may defined as a sharp pain lasting for a short time, usually less than 12 weeks, whereas chronic pain is pain that lasts for more than 12 weeks, and which modern medicine may have difficulty in treating.
In America statistics show that at least 80 percent of Americans seek professional help for back pain at some point in their lives and it is only second to the common cold in illness related absences from work. Yoga therapy helps people in the chronic or rehabilitation stage of their pain management, after their acute stage has passed. It is often used in conjunction with medical care, chiropractic or physiotherapy. Acute pain patients must be under medical care. Yoga therapy can also be helpful in knee and hip problems, arthritis and carpel tunnel syndrome. Insomnia, painful menses, menopausal symptoms, headaches, and diseases such as Parkinson’s or multiple sclerosis can all be helped through yoga therapy. The mind-body connection is paramount, and can help improve the quality of life for those experiencing serious chronic and progressive conditions.
The World Health Organisation or WHO found that people with chronic pain struggle to exercise, enjoy a normal sleep pattern, engage socially, drive a vehicle or have normal sexual relations. Findings show that those who completed an eight week mindfulness programme found that their levels of pain reduced. With mindfulness we actually go to the place where it hurts in the body and allow the sensation to be there rather than fight with the pain itself. When we practice Yoga asana we do the same. We enter deeply into the body and breath. One might expect a patient to experience more pain when facing it, but seemingly not. There is clearly a difference between pain and suffering.
Both Yoga and Buddhism are philosophies that essentially seek to help us find a way out of suffering. Pain is inevitable, but suffering is optional. The education of people on the differences between pain and suffering is important. We all experience pain from time to time and it is a very useful sensation so we do not harm ourselves in everyday life. Yet, suffering is clearly different. It is a complete resistance to the moment or what we believe is happening to “us”, and it is something that we can take responsibility for. Rather than waking up with back pain and attributing blame to ourselves, even others, regretting the past and fearing the future of the pain, just the sensation can be experienced. This negates the emotional suffering and pain such as loneliness, grief, anger, or anxiety. Teaching your patient to be curious about these emotions will tend to result in less suffering if they do not resist them.
You don’t need to teach people to tolerate the pain, because even if they stop tolerating pain, the pain may still exist. Tolerating is still a state of unnecessary tension. If they actually try breathing into the pain, resistance will ease around the pain. The truth is that the pain only exists from one moment to the next, and when they notice and let go of the desire for the back or shoulder pain to go away, suffering is reduced. They become present, truly engaged in this moment, which is all there is.
This is how to practice mindfulness when teaching someone to cope with a painful sensation. To become curious, but not try to get rid of sensation, as it may intensify their neural connection to the pain.
Avoidance strategies will not make the pain go away either; they may just numb the pain for the time being. This can be a coping mechanism that works for some short term, but through avoidance, pain is often sustained or enhanced. Teaching someone to really look intricately into the thoughts and feelings they may experience around pain works. Turning towards the painful experience with a true awareness and positive intention begins to turn the experience away from suffering. Pain is physical and suffering is mental. Beyond the mind itself, there is no suffering. Whilst pain helps us to survive, and is essential to life, nothing can compel us to suffer. Suffering is our own clinging and resistance, our unwillingness to enter into a state of flow with life, or our unwillingness to move on.
Coping with pain
How to help our patients with pain:
- Pain only exists in the present moment. By concerning ourselves with an experience beyond this moment, we begin to suffer
- Tension increases pain. Breath increases blood flow and relaxes skeletal muscle. Breathe into the area of pain, tension will naturally release to some degree and may reduce pain, but if it remains, acceptance of the sensation is truly key
- Trying hard to reduce pain may not work, in a similar way to trying to relax can create more tension. Acknowledging and accepting pain may change the patient’s experience for the better
- If patients find it difficult to stay with the pain as a sensation, create a different and positive neural pathway with their positive sankalpa. This sankalpa may have little to do with the negative pain
How breathing assists in the therapeutic application of yoga
Breathing itself is a science that is truly amazing and powerful in its healing application. Breathing uses muscles that improve posture, reducing the stiffness and curvature of the spine that may indeed lead to reduced blood flow and lack of oxygen to the brain. This slumped posture may lead to depression or anxiety, as the breath is constricted causing blood flow and oxygen to be reduced in the patient.
Our emotions do affect the diaphragm and psychologically people may use this breathing muscle to stifle both anger and fear. Bringing flexibility and function back to the diaphragm for our patients can be life changing. Breathing keeps the lung tissues more elastic, so we can take in more oxygen to nourish all cells, and increase gaseous exchange, making the blood less acidic by nature, and muscles more relaxed. Breath also strengthens immunity. Breath control tones the abdominal area which is often the site of many health problems, with many illnesses beginning in the intestine. Ayurveda as a sister science to yoga agrees with this concept.
While stress is a normal part of daily life, prolonged and high levels of unmanaged stress contribute to an imbalance in the immune system. Over time, this kind of imbalance can result in an overactive immune system, which can contribute to the development of autoimmune disease or a suppressed immune response (Kiecolt-Glaser & Glaser, 1998). Other stress-related problems include increased inflammation, increased pain, and slow healing as well as cell destruction.
Stress is immunosuppressive. Mind body techniques can be used alone or in combination to reduce stress, reduce inflammation, and increase well-being. Research into this pernicious relationship between stress and disease has piqued interest in the ways that contemplative practices might positively influence the immune system. According to a large body of evidence, yoga and meditation appear to have profound effects on immune function in health and disease because of their capacities to reduce stress. This again relates back to the concept of psychoneuroimmunology. Our thoughts can make us nervous and stressed, and stress in turn depletes immunity. This is a cycle that can then lead back to depression or anxiety in an immune suppressed individual, thereby completing a vicious cycle. All our yogic practices can break this cycle and bring about positive change: breath, asana, meditation, and our sankalpa to create a new mental and bodily pattern.
How do positive relationships heal pain?
The Yoga of Healing relationships is simple. Those with positive relationships are said to:
- Have less circulating stress hormones
- Have lower blood pressure
- Improved mood
- Increased pain tolerance
- Lower rates of diseases including cancer and heart failure
- Report positive emotions
- And it may even be that healthy relationships help wounds heal faster!
Most fascinating is this, “Positive relationships proved as beneficial to survival and longevity as quitting smoking and exceeded the benefits of exercise,” says Professor of Psychology Holt-Lundstad.
Teaching our patients about the positive psychology of relationship is crucial. Educating them to be altruistic and compassionate may have great benefit for them and reduce pain, stress and disease.
The yoga of relationships is threefold:
- Cultivating a healthy relationship within, mind body connection and compassion towards self
- Having a strong connection with our natural environment, and healing through nature’s vital elements (Ayurveda)
- Creating strong healthy relationships with those around us as the famous yogi, Desikachar, used to say, ‘yoga is all about our relationships’. This is when we see true change in our practice of yoga, when we see enhancements in all our relationships
How to re-educate clients experiencing pain
First and foremost, improve the functionality of their spine. Re-educate them on biomechanics: sitting, walking, standing, sleeping, lifting, and working. Offer patients a short and achievable daily programme that they can follow easily including breath, meditation and yoga asana. To create a new mental and physical pattern or samskara for patients, we need to train their neural pathways and muscles daily. Even a short yoga therapy programme repeated daily will create change.
Find which educational modality will work best for them; an audio recording, or visual recording, or a written programme. People learn and respond differently.
Teach patients how to relax and change into parasympathetic nervous system activity rather than the sympathetic, flight or fight syndrome. This will relax skeletal muscle and improves blood flow. Yoga Therapy may be considered 80 per cent breath for this reason. Breath is Medicine.
Remind patients of the power of their mind, teaching them about thought power, positive psychology, structural neuroplasticity and psychoneuroimmunology.
Remind them also of the difference between pain and suffering. Learning to accept sensations as they arise rather than resist their sensory experience will create lasting neurological change.
Over time, published research has demonstrated that the practice of yoga asana and meditation can increase brain density, boost connections between neurons, decrease symptoms of depression and anxiety, provide clarity of thought, and increase positive mood endorphins. New research is demonstrating how we can help patients manage chronic pain and depression. Yoga therapy and mindfulness meditation work to heal chronic pain through positive intention, faith, movement, breath science, and structural neuroplasticity. Moment to moment we can create new positive mental and bodily samskaras. As therapists, showing our patients how this is achieved is crucial.
Statistics for complementary and alternative medicine use
What are the main three reasons people use complementary and alternative medicine?
- Back pain
- Neck pain
- Joint pain
What are the main therapies used?
- Natural products
As yoga therapists, we understand that breath and meditation are considered yoga therapy.
Yoga and Integrative Medicine Institute
Celia Roberts has been involved in complementary health education for over 14 years, using an integrated approach combining Yoga, Biomedical Science, Nutrition & Dietetics and Psychosomatics. Celia has taught Yoga, Meditation & Ayurveda world-wide, successfully integrating her background in Western BioMedicine with the Ancient practices of Yoga & Ayurveda. Celia is an advocate for the integration of yoga into the community via accessible media and very influential in bringing yoga to the mainstream. Celia is the founder of the Brookfield Retreat, and co-founder of the Yoga and Integrative Medicine Institute. Celia also created the “Grass Roots Yoga Movement”, a community run yoga by donation program. Celia lives with her family in Brisbane, and cultivates in her own life the values of Simplicity, Compassion and Mindful living.
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