Yoga as Therapeutics for Aging

Neiman outlines the symptoms of Aging as:

• bone loss
• loss of taste and smell
• declining gastrointestinal function
• loss of visual and auditory functions
• decrease in lean body weight
• osteoporosis
• mental impairment
• decreasing agility
• decreasing ability to metabolize drugs
• increase in chronic disease
• diabetes
• heart disease
• hbp
• stroke
• arthritis
• degradation of neuromuscular response
• reaction to time
• balance
• strength of muscles, tendons & ligaments
• incontinence
• decreased size and function of liver and kidneys
• decrease in heart and lung fitness
• decrease in both physical and mental flexibility and range of motion
• lower levels of gonadal hormones

Harvard:

• Skin:
• Brain:
• Cardiovascular:
• Respiratory:
• Musculoskeletal:
• Digestive:
• Reproductive:
• Excretory:
• Immune:
• Endocrine:
• Sense Organ:

Physical Aging of Bones, Muscles & Connective Tissue:

• Loss of skeletal height
• loss of muscle mass
• muscle fiber changes
• loss of strength
• loss of flexibility
• loss of reflexes
• deterioration of telomeres

Yogasana Sports & aging:

• STUDIES

Women's Life stages: yoga as therapeutic

Therapeutic Baseline Facts:

• Exercise & Estrogen
• vigorous exercise reduces estrogen levels and can lead to scanty periods or loss of periods. This has negative repercussions on the bony structure of the body.
• bone loss and calcification can be reversed or managed by the introduction of a slow, isometric practice like yoga in conjunction with a vigorous athletic regimen.
• During OVULATION there is an increased risk of muscle and connective tissue damage (estrogen is high), and lowest when estrogen is down (period through day 14). This is because women with high levels of estrogen can stretch further, but risk injury. 
• Pregnancy
• Shift in practice should be for the health of baby and mother instead of advancing practice
• First Trimester
• women who have a history of miscarriage, cervical insufficiency should not start yoga practice or should abstain from their normal practice during this period
• estrogen and progesterone balance that may effect practice prescriptions
• progesterone prohibits contraction of the uterus and estrogen increases it. High levels of progesterone in the early stages of pregnancy increase as pregnancy progresses
• Muscles, joints, ligaments and tendons in pregnancy
• relaxin opens the joints and softens the ligaments and tendons
• joints are destabilized
• over-stretching is a constant danger (worst in pregnancy)
• affects FEET the most (falling arches due to relaxin) -caution
• abdominal muscles severely stretched. Asana practice should not encourage this late in pregnancy especially if abdominal wall is diaphanous 
• no contraction of the abdominal wall either.
• Inversions
• no indication that if done safely with consideration of added weight, increased instability and potential for higher blood pressure that these are counter-indicated, despite yoga literature
• Balancing
• as weight increases, standing on one leg should be AVOIDED, since it may result in injury based on lack of stability in joints
• well supported standing postures are indicated  to avoid leg cramps due to lack of calcium.
• Respiratory and cardiovascular systems
• in response to the added pressure that the growing fetus places on the ribs and diaphragm, respiration rate increases
• soft tissues of the nose swell due to increased estrogen making breathing through the nose more difficult
• need to use intercostal muscles MORE as pregnancy progresses 
• slower breathing is beneficial
• mouth breathing may be an appropriate accommodation
• Inferior vena cava
• pressure of growing baby tends to trap blood in the legs and lead to swelling and potentially varicose veins
• inversions can be very beneficial here!
• reduces constipation which can be caused by pressure of the fetus on the intestines as well
• can compress when mother lies on her back for a long period of time, so modifications (right anterior side of the spine) especially after month 5
• lightheaded, nauseus, dizziness (so much blood is taken out of circulation)
• avoid this is asana or savasana even if mother feels no ill affects (may be to fetus)
• Nervous and digestive systems
• progesterone levels increasing and higher levels of relaxin lead to constipation and indigestion
• prescribe postures to do this without deep twisting
• Sciatica
• pressure from baby
• Menopause
• decreasing estrogen: hot flashes, mood swings, night sweats, depression, urinary problems, vaginal dryness, aching joints, reduced libido, weight gain
• adrenal and kidneys can make up much of this estrogen production if they are healthy or unstressed
• twists, and backbending!!!!
• oseoporosis
• decreased through premenapausal practice
• muscle loss reduced with yoga
• hot flashes are an activation of the sympathetic nervous system. Anything that can reduce this will reduce hot flashes
• cooling pranayama
• cooling inversions
• lower heart rate and blood pressure and promote vasodilation
• stabilize hormonal imbalance
• relaxation for sleep disturbance
• disturbed sleep & libido

examples of postural prescriptions:

Hot Flashes:

• cooling and restorative poses. Any gripping or tension in the body can make hot flashes worse, so using props such as bolsters, blankets, and blocks to help support the whole body is a good idea. 
• Placing the head on a bolster or chair during forward bends, for example, helps calm the brain and relax the nerves. Supported reclining poses can also help promote complete relaxation.
• Supta Baddha Konasana and Supta Virasana, for instance, allow the abdomen to soften and any tightness in the chest and belly to release; Ardha Halasana (Half Plow Pose) with the legs resting on a chair calms jittery nerves.

Anxiety, Irritability, and Insomnia:

When a person is under stress, the sympathetic nervous system responds by accelerating the heart rate, slowing down the muscles of the digestive tract, and increasing blood circulation to the brain to fight the stressor.

Once the stress dissipates, the parasympathetic nervous system responds by doing just the opposite-slowing the heart rate back to normal, stimulating the smooth muscles of the digestive tract, and bringing the body’s systems back into balance.

When the body is under continual stress, the sympathetic nervous system and the adrenals-which manufacture stress—fighting hormones along with the male hormones that get converted into estrogen—can get stuck in overdrive.

• Uttanasana (Standing Forward Bend) and Prasarita Padottanasana (Wide-Legged Standing Forward Bend)—in both cases with the head resting on a bolster or blankets—can help reduce irritability and mental tension, because bending forward and shutting out external distractions and stimuli can soothe the mind and reduce the effects of stress. 
• The nervous system then receives the signal that all is well, and the adrenals and sympathetic nervous system stop working so hard.

If insomnia is a problem, inversions can sometimes help, because they ground the body’s energy and burn off excess anxiety. When followed by restorative postures, they encourage a deep state of rest.

Fatigue:

Of all the symptoms women complain about during perimenopause, fatigue is second only to hot flashes. Plunging progesterone could be the culprit, especially if the fatigue is coupled with depression and lethargy; if a woman feels inexplicably weary for days or weeks on end, depleted adrenal glands could be part of the problem.

• gentle supported backbends, because they encourage the chest and the heart to open and often bring renewed energy, determination, and joy.
• Supta Baddha Konasana. A deeply restorative posture, it can instill feelings of safety and nourishment. It also opens the chest, improves respiration and circulation, and helps lift the spirits while completely supporting the body.

Depression and Mood Swings:

• specific poses create a mental state that positively affects the mind. 
• “Backbends, especially if supported, allow a sense of lightness into the body,” she says. “They stimulate the adrenals and massage them into action, the heart and lungs open 
• Chest-expanding poses energize the body by improving respiration and circulation, and thus counter feelings of depression. 
• inversions, such as Sarvangasana, can help improve a depressed mood. 

Memory:

• The same postures that counter depression, such as backbends, chest openers, and inversions, can help collect fragmented thoughts
• Adho Mukha Svanasana (Downward-Facing Dog Pose) sends blood to the brain and encourages deep, focused breathing, which can improve mental alertness. 
• Savasana (Corpse Pose) soothes the nerves, calms the mind, and puts the body into a state of repose.

summary of yoga and menopause studies

Ayurveda: Yoga's Sister Science

Ayurveda is a 5,000-year-old system of natural healing that has its origins in the Vedic culture of India. It is one of the seven sister sciences (along with yoga). Although suppressed during years of foreign occupation and British colonial rule, Ayurveda has been enjoying a major resurgence in both its native land and throughout the world. Tibetan medicine and Traditional Chinese Medicine both have their roots in Ayurveda. Early Greek medicine also embraced many concepts originally described in the classical ayurvedic medical texts dating back thousands of years.

More than a mere system of treating illness, Ayurveda is a science of life (Ayur = life,Veda = science or knowledge). 

• It offers a body of wisdom designed to help people stay vital while realizing their full human potential. 
• Providing guidelines on ideal daily and seasonal routines, 
• diet, 
• behavior and 
• the proper use of our senses

Ayurveda reminds us that health is the balanced and dynamic integration between our environment, body, mind, and spirit. There is no standard therapy as in Western (allopathic) medicine, so that the only limitations are those of the physician.

Recognizing that human beings are part of nature, Ayurveda describes three fundamental energies that govern our inner and outer environments: movement, transformation, and structure. Known in Sanskrit as:

•  Vata (Wind), 
•  Pitta (Fire), and
•  Kapha (Earth)

these primary forces are responsible for the characteristics of our mind and body. Each of us has a unique proportion of these three forces that shapes our "constitution" (nature).

• If Vata is dominant in our system, we tend to be thin, light, enthusiastic, energetic, and changeable. 
• If Pitta predominates in our nature, we tend to be intense, intelligent, and goal-oriented and we have a strong appetite for life. 
• When Kapha prevails, we tend to be easy-going, methodical, and nurturing. 

Although each of us has all three forces, most people have one or two elements that predominate.

For each element, there is a balanced and imbalance expression. 

• When Vata is balanced, a person is lively and creative, but when there is too much movement in the system, a person tends to experience anxiety, insomnia, dry skin, constipation, and difficulty focusing. 
• When Pitta is functioning in a balanced manner, a person is warm, friendly, disciplined, a good leader, and a good speaker. When Pitta is out of balance, a person tends to be compulsive and irritable and may suffer from indigestion or an inflammatory condition.
•  When Kapha is balanced, a person is sweet, supportive, and stable but when Kapha is out of balance, a person may experience sluggishness, weight gain, and sinus congestion.

An important goal of Ayurveda is to identify a person’s ideal state of balance, determine where they are out of balance, and offer interventions using diet, herbs, aromatherapy, massage treatments, music, and meditation to reestablish balance.

Ayurveda: the science of health PP 

Click here for power point presentation

TAKE YOUR DOSHA TEST HERE

Video about Dosahas HERE 

DOCUMENTARY ON AYURVEDA: watch!

Systems: Viniyoga

Gary Kraftsow & Claire Collins

Based on the teachings of TKV Deskishar and Krishnamacharya out of Chennai India

Viniyoga ™ is a comprehensive and authentic transmission of the teachings of yoga including asana, pranayama, bandha, sound, chanting, meditation, personal ritual and study of texts. Viniyoga ™ (prefixes vi and ni plus yoga) is an ancient Sanskrit term that implies differentiation, adaptation, and appropriate application.

The American Viniyoga™ Institute uses the term Viniyoga™ to refer to an approach to Yoga that adapts the various means and methods of practice to the unique condition, needs and interests of each individual - giving each practitioner the tools to individualize and actualize the process of self-discovery and personal transformation.

The practices of Yoga provide the means to bring out the best in each practitioner. This requires an understanding of a person's present condition, personal potential, appropriate goals and the means available. Just as every person is different, these aspects will vary with each individual.

Principles of practice:

• repeat and stay
• The use of repetition into and out of postures in addition to holding postures
• function over form
• The emphasis on function rather than form in asana practice, and the science of adapting the forms of the postures to achieve different results
• breath and adaptation
• The emphasis on breath as the medium for movement in asana, and the science of adapting the pattern of breathing in asana to produce different effects
• art and science of sequencing
• The refined art and science of combination which allows teachers to create sequences of different orientation, length, and intensity to suit the intention and context of each practice.

Yoga Therapy:

• long term goals
• reduce symptoms of suffering
• manage symptoms that cannot be reduced
• root out causes where possible
• improve life function
• shift attitude and perspective in relationship to life's challenges
• Empowewrment:
• self-observation
• behavioral modification
• adaption of methods of practice

• Multidimensional approach
• Persona
• behavior
• thoughts
• mood
• physiology
• anatomy
• family
• society
• environment
• cosmos

Technique:

• breath science teaches proper breathing
• this breathing is matched with proper targeted movements
• posture move with the breath and are broken down into kramas
• precision is based on functional anatomy

Systems: Svastha Yoga Therapy

Ayurveda/Yoga & wellbeing

translated as "stay in one's self"
disease is a principle barrier on the path of yoga
principle methods of simple healing identified by Krishnamacharya:

• moving arms, legs and neck with appropriate inhalation and exhalation
• following appropriate diet
• avoiding inappropriate travel

CIKITSA means treatment in sanskrit, treatment requires PRACTICE (it is not a passive activity)

Holistic approach considers practice in the following areas:

1. body
2. breath
3. mind
4. diet
5. lifestyle
6. environment

Function oriented approach to the body

1. start in a position of minimal pain and discomfort
2. build awareness of posture and move toward the neutral spine
3. strengthen targeted muscles and move toward gentle extension
4. engage core stabilization, particularly using exhalation
5. initially avoid flexion, especially flexion and rotation movements
6. attention always on strengthening and stabilization first

Lifestyle/Mind/Ayurveda

important components of healing.

Psychological Tools of Yoga:

• embodiment
• minding the mind and mindfulness
• opposing negative thoughts
• creating positive thoughts & emotions
• mantra meditation/chanting
• rituals and sacrednes

Ayurveda determines actual course of practice (menstruation is pitta, i.e.)

Systems: Kundalini Yoga

Yoga is considered a scared science. It is a system based on the movement of prana by the pranji (person). The sacredness of the person is awakened through the practice.

Kriyas

• rhythmic, targeted movement 
• means completed action
• predetermined series of one or more exercises or postures in combination with PRAMAYAMA and MANTRA to affect various nerves, glands, or organs with an outcome greater than the sum of the parts. 
• combine breath, posture, bandha, mudra, dristi & mantra and has a SPECIFIC EFFECT on the physical structure and physiology of a person
• these kriyas affect the subtle anatomy of the body
• prana vayus
• nadis 
• chakras
• tattawas

Principles

• teach to the student, not the diagnosis
• start with what is right and you will never go wrong
• match the yoga to the student, not the student to the yoga
• do not teach by formula, never apply the general to the specific, or the specific to the general
• teach to relax
• raise vitality (first task in healing)
• start from where the student is; accept the student as they are in each moment

Adaptive confidence: the ability to respond to changing challenges inherent in getting well. 

• self-efficiency
• resilience
• the ability to manage setbacks
• flexibility
• endurance
• felt connection to inner guidance
• support for change

Group or individual settings with the same or mixed illnesses

The "Special Six" (students that you learn from)

Conscious interviewing leading to mindful assessment:

1. breath and posture
2. strengths and limitations of the student: physical, mental and emotional
3. flexibility & range of motion
4. medically diagnosed condition and course of disease progression
5. co-occuring conditions and cofactors
6. contraindications for the condition and for the particular person with the condition
7. stage level of illness or condition, if appropriate
8. side effects of medical treatment
9. person's personal experience of the condition
10. persons personal objectives and comfort level
11. social and family support

Tools and Methods:

• awareness
• acceptance

Limitations to ones healing potential

• not every problem has to be resolved
• recovery is slow as we discover students inner conflicts
• a little bit goes a long way
• doing something is better than doing nothing

Tuning in

• adi mantra: Om namu guru dev namah at least three times, tuning in to the divine teacher/healer within
• provides a protective link for the teacher
• do this sitting with a straight spine and jalandara bandha
• 20-30 seconds of silence follow

Happy healthy holy breath

Mantra

pauri kriya (concentrative meditation)

one minute breath (sa ta na ma)

SKY

has been studied extensively and shown to impact many illnesses and their course toward recovery

Systems: Structural Yoga Therapy

A systematic approach to feeling normal ROM, reestablishing muscle tone and alleviating joint pain. It appears to be centered on the physical body but it has far reaching implications for the subtle body as well

Assessment: Body Reading

• intuitive/instinctive
• looking for "perfect posture"
• if it isnt broke dont fix it
• look for hyper-mobility as well as restrictions
• skeletal shape
• male/female
• long/short waisted
• limb length
• carrying angle
• etc

Asana guidelines:

• adjust your body for comfort
• always extend your spine
• calm the physical and psychic effort required to hold a posture
• scan the body and relax the areas of unnecessary tension
• maintain steady, rhythmic, natural breath through the nose and an awareness in the changes in your breath movement patterns
• distinguish the feelings of contraction and pain from those of simply stretching
• coordinate your movements into and out of postures coordinated with your breath
• move with awareness of the position of your body without visual cues and develope pratyahara (withdraw senses from external objects)
• isolate the movements of major muscles with minimum effort

ROM and MT (range of motion and muscle tension) assessment and balancing is at the core of this therapy

Yoga therapies for each dosha

Systems: Iyengar Yoga

Health equals the following:

• spiritual welfare
• social welfare
• physical welfare
• resource welfare
• community welfare
• moral welfare
• psychological welfare
• political welfare
• ecological welfare
• cultural welfare

Individualized therapeutic protocols, centering on the practice of ASANA (physical postures) in a precise and therapeutic way, intersecting with a modern, biomedical perspective.---health and sickness result from SCIENTIFICALLY EXPLAINABLE BIOLOGICAL PROCESSES.

Health is defined as complete physical, mental and social well-being. 

HEALTH IS MORE THAN NOT BEING SICK.

Traditional Foundations:

• (yoga sutras): 
• wholeness consisting of a complete grasp and command over the processes of being and becoming aware.
• human being is a part of prakriti (nature) and purusha (pure spirit)
• first step is to seek SAMADHI
• (BG) acting according to ones true nature, or dharma (individuals are all different)
• (tantra/HYP) asana is perfect firmness of the body, steadiness of intelligence, and benevolence of spirit.

Principles which distinguish Iyengar Yoga Therapy

1. alignment of the body with effort to develop a technique that always hits the right note, and common using the instruments of props ...which were invented and pioneered by BKS Iyengar, to provide better support for the joints and body in yoga asana.
2. an appropriate SEQUENCE of poses to make entire and healthful melodious phrases that gradually harmonize the body
3. a timing or recommended interval that each pose should be held in the same way that it is both the length of the notes and and the intervals between them that makes each melody distinct

Role of the therapist

• help patients with their specialized knowledge on how to use alignment and props within posture to eliminate suffering.
• health is the ability to to find an abundant and profound joy in the face of our ultimate extinction, and requires that the therapist help the patient understand more about existence, both personal and cosmic
• iyengar yoga uses the body's fund of physical welfare to persuade the consciousness to align itself with all the other welfares that extend beyond the mortal frame. (extend to manifest divinity)

Removing Suffering:

• the essence of yoga therapy is VAIRAGYA (detachment)  and the insistence that the impact of pains and discomforts can be persuaded to recede in consciousness- cease to drain overall energy

Regimens are outlined in LOY

and in Yoga Kurunta (rope wall)

Systems:Yoga Rx

Inspired by TKV Deskishar, yoga Rx was founded at Loyola Marymount University. It combines yoga therapy directly with integrative medicine.  (Le Page)

Principles:

• yoga is a practice that optimizes the health of the body and quiets the mind
• stands on the belief of the vital integration of mind, body and spirit to heal a whole person
• synthesis of the ageless wisdom of the East with the most recent knowledge in complementary healthcare in the West.
• replaces old bad habits with new better ones
• advocates a change in lifestyle
• adapts yoga practice to the needs of the individuals with specific or persistent health problems that are not usually addressed in a a group format.

training based on:

• knowledge of musculoskeletal system
• knowledge of internal workings of human body (circulation, hormonal, etc)
• clinical experience through practicum immersion in a healthcare setting
• intern in clinical practice immersion, as KARMA (not paid)

8 steps to wellness

1. mind-set
• practices habits that encourage a positive state of mind-visualizations, laughter, spending time in nature, social support, meditation, goal setting
2. biomedical re-education
• work habits, walking style, sleep environment & postions, etc (OT)
3. personalized asana routine
• 10-20 minutes once or twice a day
4. journaling
• daily log
5. food choices
• healthy diet
6. adequate hydration
• 6-8 glasses of water daily
7. breathing breaks
• short pranyama routines daily
8. adequate rest
• encouraged and techniques taught

Systems: Integrative Yoga Therapy

Founded in Kripalu by Joseph Le Page, IYT is grounded in a 10-step therapeutic process forming a complete healing program

Principles:

• students learn to integrate indepth information through the creative process while using a wide variety of yoga tools
• tool and techniques are used to design yoga programs for specific groups and one on one yoga therapy sessions
• based on the model of the 5 koshas
• serves as a map of the human being for guiding the spiritual journey and as a guide to global health and healing
• exploration and understanding of the five koshas guided by the therapist naturally leads to the recognition of our own true being, whose nature is freedom and unity.
• this recognition has to be integrated into all healing methodologies for yoga therapy to be effective

Qualities of the yoga therapist: 

earned through exploration of a wide range of spiritual states as expressions of our authentic being as core beliefs are relaesed. This creates an understanding of how love and compassion influence physical health and healing.

• creativity: vitality, gratitude, lightness & ease, surrender
• personal practice: study of the self and texts, simplicity, generosity, compassion
• equanimity: integrity, integral vision, witness consciousness, sensitivity & intuition
• tools and techniques: careful listening, skillful speech, patience, enthusiasm
• selfless service: grounding, self healing, body awareness, conscious presence

10-Step Process:

• check-in
• educational theme
• awareness exercise
• sharing
• mudra and affirmation
• breathing exercises
• warm-ups and yoga postures
• yoga nidra (guided rtelaxation)
• meditation
• closing

10-week long therapeutic group programs:

• week 1: visualizing optimal health
• "I visualize a new dawn of perfect health"
• core quality: new possibilities
• week 2: Stress reduction
• "I am completely relaxed and at ease"
• core quality: relaxation
• week 3: Body awareness
• "I trust and honor my body"
• core quality: healthy embodiment
• week 4: correct postural alignment
• "my body and spine are naturally aligned"
• Core quality:optimal alignment
• week 5: optimal breathing
• "my my breath flows freely and easily"
• core quality: breathing completely
• week 6: self nourishment
• "I awaken to my own spring of inner energy"
• core quality: self-nourishment
• week 7: awakening senses
• "I awaken my senses to live each day vibrantly"
• core quality: living more fully
• week 8: gratitude 
• "I treasure each moment of my life as a precious gift"
• core quality: gratitude
• week 9: opening the heart
• "my heart beats in synchrony with the heart of all beings"
• core quality: compassion
• week 10: life's deeper meaning
• "I align with life's deeper meaning"
• core quality: purpose and meaning

Healing: 25 essential principles

• Anan-maya-kosha

1. enhanced body awareness
2. experiential understanding of the systems of the body
3. optimization of posture and release of chronic muscular contraction
4. supporting optimal physiological functioning
5. balance of 5 elements

• prana-maya-kosha

1. experiential knowlwdge of breath
2. balance with subtle body: prana vayus and nadis
3. balance in Chakras
4. integration of body and mind through breath
5. pranic healing

• mano-maya-kosha

1. learning to relax
2. sense of community
3. expression of feelings
4. increased self-confidence
5. reduction of symptoms of anxiety and depression

• vijnana-maya-kosha

1. clearly defined goals for healing
2. releasing core beliefs
3. redefining challenges
4. learning at all levels of being
5. exploring life's deeper meaning

• ananda-maya-kosha

1. cultivating values
2. the body as a source of positive sensations rather than pain
3. integration of all facets of being
4. living in the present
5. awakening spirituality

Mudra and Yoga Therapy:

• allow therapists to sense and explore experientially all facets of yoga philosophy
• in one-on-one yoga sessions allow for infinite range of possibilities for health and healing by directing breath awareness and energy specific areas and systems of the body
• in group sessions: awaken and support the main theme or core quality of the week. mudra used with affirmations repeated throughout class.
• ideal for homework because they can be practiced anywhere
• hand mudras are traditionally prescribed for a wide range of health conditions. 

JOSEPH LEPAGE

Systems: Purna Yoga Therapy

Called "integral yoga" Founded by Aadil Palkhivala (based on teachings of Sri Aurobindo)

Principle:

• all parts of the human being need to be addressed for healing to happen.
• Until the client is ready to connect with the spirit and solve all of his/her own problems, the therapist has many tools to offer from a wide varieties of modalities
• asana from BKS Iyengar lineage
• mediation from Aurobindo (and his wife Savitri)
• philosophy from Hindu major texts
• concepts which are central
• avidya- ignorance
• asmita-ego
• raga-attachment
• dvesha-aversion
• abhinvesha-fear of impermenance
• nutrition from Ayurveda, Chinese medicine, and naturopathy

Role of the Client and Therapist

• client must have the urge to be well
• client must have the willingness to change
• client must be given appropriate and specific guidance for the condition*
• the client must consistently apply or practice the therapeutic guidance
• the client must have patience

*the only responsibility of the therapist

Approach to disease:

• all disease is a manifestation of imbalance in the energy meridians of the body or in the muscular skeletal system. 
• imbalance reflects a disparity between what I think I should be doing and what I am doing
• imbalances occur at all levels of the 5 koshas, and at all chakras
• disease manifests when we do not attend to the signals and signs that have been informing us of these imbalances-indications that we are out of sync with nature, not living our dharma, and not connected with our supreme source.
• fundamental problem is separation from the source-most systems do NOT permenently heal because they do not address this issue.

Assessment of Clients:

• is the patient ready and willing to commit to heal?
• questions are then about the fears and emotional states related to problem (i.e.= a lack of the feeling of control leads to destabilization of the SI joint and the lower back-the muscles between the vertebrae respond to these subconscious thoughts of fear and uncontrollability, looking deeper, the three chakras involved in SI issues are 1-3. These represent stability, creativity and power. the therapist will also ask questions bearing on these issues.)
• therapist probes clients subconscious issues
• next is physical alignment assessment evaluating physical imbalances
• next is diet assessment
• next is lifestyle assessment
• finally, therapist does spiritual assessment

Treatment:

application of the various methods in the "tool kit" to treat the patient individually, and teach them to evolve their skills for living. Spiritual advancement is the key and ultimate goal which will lead the client to healing, but this therapy may have to penetrate many layers to get to this healing.

Systems:Phoenix Rising

An integrated transformational experience aimed at real personal change through the resolution of issues like fear, pain and intimidation which are deeply embedded in one's psyche. Result is deep physical, emotional and spiritual shifs.

Definition:
process based practices that facilitate the unfolding of our true nature.

Process:

• uses presence and focused awareness on several aspects of their immediate experience including:
• breath
• body in asana held at one's edge (therapeutic discomfort)
• the many emotions that arise are an expression of the  5 koshas.
• refined awareness of these koshas allows the client to gain valuable awareness valuable and meaningful information about themselves, ranging from
• insights into samskaras/underlying behavioral tendencies
• vasanas/underlying postural way of being
• witnessing by a practitioner MIRRORING them their VIJNANAMAYA KOSHA (their layer of being that has the capacity to receive all experience free from judgement.-accelerates their ability to access their own deeper layers of wisdom
• GUIDED MEDITATION: final and most important aspect of the session where integration is achieved. 
• process of discernment that guides the client directly to their own source of wisdom, acceptance and truth.
• client accesses highest state of mind-buddhi
• vijnana is directly informed from anandamaya kosha (pur bliss) and and divine consciousness of the soul. 
• allows for meaningful and profound changes in one's life
• based on the work of Carl Rogers and Malcolm Knowles (psychotherapy)
• therapist always provides PROCESS, not CONTENT (does not manipulate or guide experience)

Systems: UZIT

Combines 5 integrative therapies to exponentially increase the efficacy of each. List of contributors reads like a new age healer dinner party invite list, plus Donna Karan. (who gave all the money)

• yoga therapy
• reiki
• essential oil therapy
• nutrition 
• contemplative care

works against PANIC tm --pain, anxiety, nausea, insomnia & constipation ---common symptoms to so many disorders

Yoga Therapy starts with practitioner doing self care before performing care to others. (see page 499) OMG

Program

• in-bed movements
• restorative poses
• breath awareness techniques
• body scan meditations
• reiki
• aromatherapy
• contemplative care
• philosophy
• observing oneself
• developing a formal sitting practice
• bearing witness
• creating a community support system
• nutrition

Self-care integration of modalities...DAILY PRACTICE

CLINICAL ROTATIONS
our practitioners are trained to enter a situation empty of ideas and empty of found observations. it is a blank slate that is the foundation for keen listening and profound observations. before entering a patients room there is an entire protocol to follow to get proper information.

• what is the patients diagnosis
• when was the diagnosis made
• how long has the patient been in the hospital
• do nurses have any specific concerns about the patient
• who is there supporting the patient, staff, family, friends?

mental notes training (no pens!!!!!)

• does the patient have any visitors or a healthcare practitioner with them
• single or suite
• are there flowers or cards, caring?
• general environment of the room, temperature, lighting, smell, sounds?

questions to the patient

• are they asleep/ did they just eat?
• how is their breathing-short, ragged, held, smooth, easy
• what is their body position
• what color is their skin
• how coherent are they

DECIDE WHICH SYMPTOMS of PANICtm, their session will address through this rigorous data collection. (lol). The therapists constant observation and skillful listening lead the way. training oneself to be constantly centered, empty, and receptive is where each therapist's self-practice comes in to play.

therapists learn SEQUENCED, and LAYERED SPECIFIC COURSES OF ACTION to take with each healing art. It is common for a patient to have more than one symptom of PANIC, and a session might morph into a hybrid of practices, finding the intricate balance to a whole solution. It is when the USIT therapist learns to integrate the modalities together within a single session that the true potential of this integrative therapy is realized.

DONNA KARAN

Systems: the Breathing Project

Based on the teachings of TKS Deskishar

Focused on making sure that people are breathing. In the process of breathing, one connects to the inherent bliss in oneself. (the ananda -not the suffering/duhkha)

• we learn new ways of breathing in asana, so that we can unlearn old ways of breathing, usisng our bodies, and mind.
• when we combine breath and asana, we are employing some of our most powerful tools for transformation

Principles:

• if a person is breathing, can move their body, and can focus their attention, they can practice yoga
• yoga practice teaches us how to uncover and resolve obstructions to prana
• yoga is not about doing asanas. it is about undoing what's in the way of asanas
• the maximum benefits of yoga practice are derived from the simplest things that we teach, not the most complex
• the simplest thing yoga students are taught is to coordinate long, slow movements of the body with long, slow, movements of the breath.
• when you learn a new way of breathing and moving, you are unlearning an old way of breathing and moving
• the first task with any student is to help them fully inhabit their physical body by drawing their prana inward. if they cannot feel what is happening inside, they need to recognize that.
• healthy movement is well-distributed movement-a little bit from a lot of places
• unhealthy movement is too much movement coming from too few places too many times
• there are no straight lines in the body. All movement exists as 3 dimensional spirals moving through 3 dimensional space
• there are no parts in the body. Everything is connected to everything else
• we can find pathways of connection in an infinite variety of ways
• changing breathing by definition changes posture, and visa versa
• to get something unusual to move, you must get usual movements to be still
• support starts from the ground up
• breath starts from the top down
• for every movement in the body, there is an opposing movement that travels in the opposite direction.
• initiating the action of exhaling from the bottom upward can help to ground the feet, legs and pelvis
• initiating the action of inhaling from the top downward, can help to generate lift and support of the upper spine, rib cage and shoulder girdle
• as important as the details of technique may be in determining outcomes, far more powerful is the quality of the relationship between student and teacher

The teaching relationship

• a good teacher is a catalyst for experience and learning
• a good teacher sees each student as an individual and studies them and honors their many differences
• the student is eventually integrated with the teacher's being through his cumulative (teacher's) knowledge
• goal is for student to embody their own experience

Terminology

• prefer YOGA EDUCATOR to YOGA THERAPIST

Systems: Yoga Nidra (meditation)

Transformative practice derived from TANTRIC teaching of meditation (considered "ancient").

• Characteristics
• secular in nature
• ancient techniques of the Tantrica
• adapting to individual needs
• respecting changes in modern culture
• research proven
• standalone practice or as a complimentary supportive program

• Claims
• Decreases: 
• depression 
• anxiety 
• stress* 
• PTSD
• insomnia
• perception of chronic or acute pain*
• Increases
• ability to have restful and restorative sleep
• well-being & serenity*
• joy, vitality, purpose & meaning in life*
• interpersonal, peer and marital relationships*
• comfort in ability handling situtaion that they can not control*
• perceived control over their lives*
• ability to handle chronic issues such as PTSD, pain & stress*

*these are culture-bound affective indicators which are difficulty to define or measure with any certainty. In almost all cases, these are measurements of clients "perception" of effectiveness

• Goal: 
• To restore the body mind and senses to their natural functioning, allowing for our natural experience of interconnectedness (nondualistic goal). 
• This sense of interconnectedness in our daily lived routines allows us to welcome, explore & transcend levels of identification which uphold our perception of separation & suffering
• Moving through levels or "sheaths" of the body (koshas)
• does not entail assessment, diagnosis or treatment (same for everyone)
• Underlying principles
• We are all part of a larger energetic principle=suffering come from perception of lack of existing connection to this (purusha)
• We have a subject/object duality. we see our separate selves and other objects as separate and in opposition to our selves
• We pass through 10 stages of inquiry (not fixed) which allow us to "uncondition" the mind to remove these false perceptions
• Stages of iRest Inquiry
• Heartfelt Mission
• affirming what gives value, purpose andmeaning to your life
• Intention
• affirming vows that support actualizing our heartfelt mission
• Inner Resource
• affirming an inner sanctuary of security, resiliency, and well-being
• BodySensing
• welcoming physical sensations
• messengers
• physical senssations seen as mesengers of other deeper meanings
• awaken ability to read body's subtle cues (mindfulness)
• BreathSensing
• welcoming natural rhythmsof breathing and energy
• mindfulness
• Feelings & Emotions
• welcoming opposites of feeling emotion
• recognize rather than react to them
• Thoughts
• welcoming opposites of thoughts and beliefs
• law of opposites: pair them instead of focusing on one of the pair which is never separate
• Joy
• welcoming happiness, joy, equanimity & love
• discovering inherent joy, independent of changingstates of conciousness
• joy as good medicine (relieves stress)
• true joy: not just conditional although that may be the initial experience of joy
• Wholeness
• recognizing our unitive wholeness
• separation: relaxing into "being", our innate nature is purusha-unchanging, unconditional, and spontaneously arising.
• Integration
• integrating iRest into all aspects of daily life

YOGA NIDRA with AMRIT DESAI

YOGA NIDRA with RICHARD MILLER

Diverse Populations

• Factors 

(these are not mutually exclusive and may be affected by "intersectionality"-the way that these factors interact with each other in a single individual or a group).

• age
• childhood
• adolscence
• adulthood
• seniors
• life stage
• pregnancy/postpartum
• puberty/menstruation
• injuries
• athletic/training
• repetitive motion (OT)
• lifestyle
• accidental/physical trauma
• chronic conditions (may be reversible)
• diabetes
• post-polio syndrome
• arthritis
• high blood pressure
• scoliosis
• dysplasia/asymmetrical dysplasia
• progressive or acute disorders (non-reversible)
• autoimmune
• RA
• MS
• Lupus
• Scleroderma
• Cancer (& post-treatment)
• mental, emotional & spiritual state
• anxiety/depression
• trauma
• stress
• cultural/sociological
• ethnicity
• religion
• deafness
• gender
• socioeconomic status (education, occupation, income)

• Interventions

(Interventions may occur in the context of group classes or as individual designs. 

The two types of interventions have by their nature a very different focus.)

• Whereas the individual prescription is tailored to account for and deal with all aspect of an individual client. 
• The protocol of the group class must be focused on general goals for that population.

• protocols for prevention (optimal health & function)
• protocols for symptoms or treatment of active conditions
• protocols for side effects of treatments
• rehabilitation for injuries (support healing and optimal function)

Contributions:

• Iyengar yoga systems (BKS & Geeta Iyengar)
• anatomy based postural interventions
• Structural Yoga Therapy (Stiles)
• Viniyoga system (Kraftsow via Deskishar)
• anatomy based postural and breath movement interventions
• Kundalini yoga system (Kaur Khalasa)
• pranayama (breathwork) interventions
• Phoenix Rising system (Lee) & Purna system (Palkhivala)
• physio-psychological systems
• Svastha Yoga Therapy
• anatomy based postural and ayurveda (Mohan)
• The Breathing project (Kaminoff)
• anatomy based postural & pranayama
• Other Modern Integrative Yoga Therapies
• Yoga Rx (Payne)
• Urban Zen (Yee & Saidman Yee)
• Yoga Nidra (iRest) (Miller)
• Hatha Yoga systems (traditional texts)
• ayurveda
• diet
• dosha
• lifestyle
• kriyas
• shat karman
• nuali kriya

Syllabus: 6 Weekends

Summary Topics: 60 hours

10/1-10/2           Teaching a Diverse Population

10/15-10/16        Life stages- pregnancy & aging
12/10-12/11        Chronic conditions & autoimmune disorders

2/4-2/5                Special populations: autism, developmental disability, trauma
4/15-4/16            Managing and rehabbing injuries
5/20-5/21            Preventing injuries supporting physical and emotional strength & stability

Useful Resources: (I will

1. Emerson, David. (2015) Trauma Sensitive Yoga Therapy: Bringing the Body into Treatment
2. Robin, Mel. (2009) A Handbook for Yogasana Teachers: The Incorporation of Neuroscience, Physiology and Anatomy into the Practice
3. Lasiter, Judith. (2009)Yoga Body: Anatomy, Kinesiology & Asana
4. Long, Ray. ALL HIS ANATOMY and YOGA books
5. Payne, Larry,Terra Gold & Eden Goldman. (2015) Yoga Therapy & Integrative Medicine: Where Ancient Science Meets Modern Medicine
6. Singh Khalsa, Sat Bir, Lorenzo Cohen, Timothy McCall, & Shirley Telles. (2016) The Principles and Practice of Yoga in Healthcare.
7. Myers, Thomas A. (2014) Anatomy Trains: Myofacial Meridians for Manual & Movement Therapists.
8. Stiles, Mukunda. (2000) Structural Yoga Therapy:Adapting to the Individual.
9. Clark, Bernie. (2016) Your Body, Your Yoga

• Factors 

(these are not mutually exclusive and may be affected by "intersectionality"-the way that these factors interact with each other in a single individual or a group).

• age
• childhood
• adolscencw
• adulthood
• seniors
• life stage
• pregnancy/postpartum
• puberty/menstruation
• injuries
• athletic/training
• repetitive motion (OT)
• lifestyle
• accidental/physical trauma
• chronic conditions (may be reversible)
• diabetes
• post-polio syndrome
• arthritis
• high blood pressure
• scoliosis
• dysplasia/asymmetrical dysplasia
• progressive or acute disorders (non-reversible)
• autoimmune
• RA
• MS
• Lupus
• Scleroderma
• Cancer (& post-treatment)
• mental, emotional & spiritual state
• anxiety/depression
• trauma
• stress
• cultural/sociological
• ethnicity
• religion
• deafness
• gender
• socioeconomic status (education, occupation, income)
• Interventions
• protocols for prevention (optimal health & function)
• protocols for symptoms or treatment of active conditions
• protocols for side effects of treatments
• rehabilitation for injuries (support healing and optimal function

Contributions:

• Iyengar yoga systems (BKS & Geeta Iyengar)
• anatomy based postural interventions
• Structural Yoga Therapy (Stiles)
• Viniyoga system (Kraftsow via Deskishar)
• anatomy based postural and breath movement interventions
• Kundalini yoga system (Kaur Khalasa)
• pranayama (breathwork) interventions
• Phoenix Rising system (Lee) & Purna system (Palkhivala)
• physio-psychological systems
• Svastha Yoga Therapy
• anatomy based postural and ayurveda (Mohan)
• The Breathing project (Kaminoff)
• anatomy based postural & pranayama
• Other Modern Integrative Yoga Therapies
• Yoga Rx (Payne)
• Urban Zen (Yee & Saidman Yee)
• Yoga Nidra (iRest) (Miller)
• Hatha Yoga systems (traditional texts)
• ayurveda
• diet
• dosha
• lifestyle
• kriyas
• shat karman
• nuali kriya