Yoga as Medicine

CHAPTER 3

YOGA FOR STRESS RELIEF

The mind makes a man its slave;

again the same mind liberates him.

—SWAMI SIVANANDA

Stress is not all bad. Being nervous, worried, and on edge has survival value.

As you’ve probably heard many times before, you wouldn’t even be here to read this if your ancestors hadn’t had a well-honed stress response system to survive marauding invaders and hungry predators. Even getting out of bed in the morning demands a surge in blood pressure that wouldn’t occur without your built-in stress response system, which relies on activation of the sympathetic nervous system (SNS) and the release of stress hormones, including adrenaline and cortisol.

When you perceive a threat—anything from a confrontation with an angry motorist to an unexpected tax bill from the IRS—your SNS is activated almost immediately. Your blood pressure goes up and your heart beats harder, bringing extra blood to the large muscles of the legs and arms to allow you to defend yourself or flee from trouble (hence the term fight-or-flight). Blood clots more easily in case you are injured. White blood cells stick to the walls of capillaries, ready to be mobilized if any wounds incurred get infected. Energy sources, including sugar and fats, are mobilized to give you plenty of fuel. If you’ve ever had a near miss—like almost getting hit by a bus—you know that the stress response kicks in almost immediately, then takes a while to wear off.

If your stress response system is functioning well, once the threat has passed, your body shifts into a restorative mode in which the parasympathetic nervous system (PNS) dominates over the SNS. Your blood pressure and heart rate return to normal. Stress hormone levels drop, as do blood sugar levels and measures of blood clotting. In the modern world, most of the “threats” we face are no longer physical. Typical contemporary stressors—worries about relationships, problems at the job, and abstract concerns about money, security, happiness, and fulfillment—tend not to be resolved quickly, so the stress response system either stays activated or is repeatedly reactivated. When that’s the case, your built-in protection system can turn on you and cause disease.

The Link Between Stress and Disease

When someone mentions a stress-related health problem, you might think of an ulcer, trouble falling asleep, or tension headaches. Stress can indeed contribute to these problems, but scientific evidence is showing that stress fuels some of the biggest health problems of our time, including type 2 diabetes, depression, osteoporosis, heart attacks, and strokes, as well as autoimmune diseases like multiple sclerosis (MS) and rheumatoid arthritis. While there isn’t a lot of evidence that stress causes cancer, it appears to increase the odds of dying from the disease. All told, it could be argued that stress is the number one killer in the Western world today.

There has been much reported in recent years about an epidemic of obesity, most tragically among children, who may end up overweight for life. New evidence suggests that the biggest predictor of overweight in children is their stress levels. A study published in the journal Health Psychology found that stressed-out children eat more than twice as much at meals than less-tense classmates, snack more, and make far more unhealthy food choices. They also showed one of the hallmarks of unhealthy eating: skipping breakfast, which sets the stage for overeating later in the day. Overeating may be in part due to the effects of cortisol. Yoga has repeatedly been found to lower levels of this stress hormone.

CORTISOL: A KEY PLAYER IN STRESS-RELATED DISEASE

The elevation in cortisol levels that results from stress undermines health in numerous ways. High cortisol levels have been linked to increased fasting blood sugar, high systolic and diastolic blood pressure, high triglyceride levels, as well as insulin resistance. Each of these is an independent heart attack risk factor, and together they act synergistically to multiply the danger. Cortisol appears to be intimately involved with stress-related eating; high levels are linked with what scientists studying rats call “food-seeking behavior,” and binge eating in humans. If you do overeat, cortisol ensures that the extra calories are converted into fat deposited in the most dangerous place of all from a health standpoint, the abdomen. Excess intra-abdominal fat greatly increases the risk of type 2 diabetes and heart disease, two of society’s biggest killers. But this is only a partial catalog of cortisol’s effects.

Elevated cortisol also lowers bone density, has been linked to depression, and appears to affect immune function. When you respond to an acute crisis with a surge in cortisol you get a temporary boost in immune function. But when cortisol levels remain chronically high, they have a deleterious effect on the body’s built-in defenses. This is no surprise: cortisone and other drugs related to cortisol are used medically to suppress the immune system. Scientists have linked chronic stress with how likely you are to develop a cold if exposed to a virus, and how severe the symptoms will be. High levels of stress are known to reactivate herpes infections and to make your immune system less likely to respond to a vaccine. Cortisol appears to be the major player in this immune suppression.

Cortisol has even been linked to memory loss. One reason that stressful events are so strongly imprinted in the mind is high cortisol levels. Chronically high cortisol levels, however, can undermine memory and lead to permanent changes in the brain. Some studies link the tendency toward stress to the subsequent development of Alzheimer’s disease (although there is no proof of a causal connection). Chronic stress, however, probably does accelerate the decline in mental function in someone who has the disease and may contribute to other forms of dementia.

The list below summarizes the ways stress can undermine health. (Notice that many of these effects are the opposite of the results of yoga, as described in chapter 2.)


Impaired Function of the Immune System	Increased Cholesterol
Increased Inflammation	Increased Triglycerides
Decreased Bone Density	Increased Blood Clotting
Problems with Memory	Impaired Wound Healing
Increased Appetite	Poorer Sleep
Weight Gain	Increased Sensations of Pain
Fat Deposited in Abdomen	More Fatigue
Increased Resistance to Insulin	Worsening of Mood
Increased Blood Sugar	Adoption of Less Healthy Habits

Yoga’s Take on Stress

Whatever the external causes, stress is often fueled by your thoughts. The mind can even produce stress worrying about problems that almost certainly won’t occur. Some of Mark Twain’s biggest disappointments, he quipped, never happened.

The good news is that healing and just plain feeling good about your life can also be facilitated by your thoughts. As much as anything, yoga is a technology that teaches you how to stop your mind from working against you. Yoga turns the mind into your ally. In the words of Patanjali, “Yoga slows down the fluctuations of the mind.” By turning down the volume on what I call tape loops—mental samskaras—you can get in touch with a more blissful place inside. At first you may only notice it toward the end of a yoga session, but if you maintain the practice, you become more and more aware of a calm place at your core throughout the course of the day. Over time yoga helps you realize that much of what you routinely get upset about is not that important. That may be the best stress reduction method of all.

One yogic tool that intentionally uses thoughts to change the body and mind is guided imagery. While you relax in either a seated position or lying down, a teacher (in person or on tape) guides you to different places in your imagination. The images can be visual, auditory, tactile, or metaphorical. Try the following exercise, led by Rod Stryker, and see if it affects the way you feel. Don’t move through it too quickly. When Rod teaches it to a class, the pace is leisurely. He pauses frequently between instructions, taking six to eight minutes from beginning to end.

EXPERIENTIAL EXERCISE: GUIDED RELAXATION. As with all relaxation exercises, first turn off any music, television, phones, or anything else likely to distract you. Sit in a comfortable, upright position or lie down. When you are settled, imagine that a wave of relaxation is spreading through your entire body. Let go of any holding in your jaw. Let your lips part and your upper and lower teeth separate slightly. Without changing your facial expression, imagine the feeling of a smile. Grow that radiant, open innocence, the joyousness behind a smile. After a moment, bring the feeling of a smile to your heart and linger there in your imagination. Then feel a smile in both lungs and in the space between your shoulder blades. From there bring the feeling of a smile to your abdominal organs and digestive system, your lower back, your pelvis and reproductive organs, and both legs. Finally feel your whole body as one large, open, radiant smile. Feel yourself as the embodiment of a smile, your whole being renewed, reverberating with the presence of a smile. Every cell is smiling.

Did you notice any changes from doing this exercise? Do you feel more relaxed? Has your breathing slowed down or gotten deeper? Is your mood lighter? It’s possible that you didn’t feel much. People differ in which images work best for them. If you are a more visual person, you might respond better to images of a beautiful scene in nature. Images can also combine sense modalities. An imagined beach scene, for example, might conjure up the sound of the waves, the smell of salt water, and the sensations of warm sun and ocean breeze. If you are interested, you might experiment with various imagery exercises aimed at different senses to see which ones appeal to you most.

Yoga practices like this can be profoundly relaxing, even joyful. The power of yoga, however, goes beyond how you feel while you do it and immediately thereafter. Yoga also holds the possibility of being transformative.

SAMADHI ON THE BEACH

Most people have experienced a feeling of deep calm at the ocean, or in another natural setting. They get so absorbed in the beauty and the power that surrounds them that they lose all self-consciousness. For just a moment, the constant chatter of the mind slows down. Sometimes in a moment like this people find clarity. Maybe they realize that they aren’t happy in their job or in their personal life and need to make a change. It’s not that they make a decision, exactly. It’s more like they recognize a message coming from inside that they couldn’t hear in the din of their everyday lives.

The psychologist Mihaly Csikszentmihalyi has written extensively about a phenomenon he calls flow. Flow is the effortless sense of being in the moment. From a yogic perspective, it’s also a place where healing can occur. It might happen while doing your work, sitting on the beach, listening to a symphony, or if you are very lucky, even in the middle of a traffic jam. If you’ve ever had an experience like this—even if you’ve never done yoga—you’ve already had a glimpse of what the practice of yoga could bring you.

The experience of complete absorption is what the ancient yogis called samadhi, a Sanskrit word meaning “still mind” and the eighth limb of Patanjali’s eight-limbed path. Samadhi, Rod Stryker says, happens when you are completely engaged in what you are doing; there are no thoughts of anything else, and time disappears. Samadhi is a blissful state, beneath words, that yoga teaches is your birthright. It’s built right into your circuitry, though you may need to learn how to access it.

Yoga is a method, or a collection of methods, to get to samadhi. Yogis believe that when you quiet the mind, you come to realizations about what’s true and what’s not true, what’s important and what isn’t. As blissful as samadhi can be, its greatest benefit is not the experience itself: it’s what the experience teaches you about how to live your life. The kind of samadhi in everyday life described above is, from a yogic perspective, only the beginning. Patanjali described several levels of samadhi. Deeper states of samadhi, and the insights that accompany them, yogis believe, come only through the regular practice of meditation. Still, even a moment of samadhi on the beach can change you, and may whet your appetite for more.

CALMING THE MONKEY MIND

In contrast to the inner quiet of complete absorption in the moment is the more usual state in which the mind’s tape loops just won’t stop. In most people the mind constantly roams from topic to topic, provides a running commentary on how things are going, interspersed with a seemingly random stream of thoughts: worries, to-do lists, snatches of song lyrics, sexual fantasies, images from the media, and assorted memories. This is what yogis call the monkey mind. It’s kind of like a hyperactive kid, flitting from thought to thought, never concentrating on any one thing for very long. Much of what fills the monkey mind are mental samskaras: repetitive, automatic thoughts about what you fear, desire, or hate. The monkey mind rarely attends to the present moment. It would much rather obsess about past resentments, relive old glories, worry about the future, or fantasize about how life could be different.

When you spend all of your time listening to your internal tape loops, you can’t fully attend to the present. You don’t hear what your spouse just said. You don’t fully taste your food. You quite literally don’t smell the roses. Since many people have never experienced anything else, they think a constant inner dialogue is normal. Others may not be consciously aware of how often they are lost in their internal world of thought. To further explore this idea, please try this simple meditation exercise.

EXPERIENTIAL EXERCISE: MEDITATION ON THE BREATH. Sit up straight, either on the floor or in a chair. If sitting is not possible, lie on your back. Gently close your eyes and begin to follow the breath, but don’t make any effort to change it. Try not to drift into sleep. Bring your attention to the sound of the breath flowing in and out. Notice the air as it brushes the inside of your nose. Pay attention to the entire inhalation right up until it ends and the exhalation starts. Tune in to the exact moment of transition. Focus on the fine details of how the breath feels in your nostrils and listen to the sound it makes. Notice if the in breath and out breath are equally smooth and of similar length. If you notice that your attention has wavered, simply return your focus to the breath once again. Stay with the practice for two to five minutes.

After you’ve finished, think about how the exercise went. Were you able to keep your focus on the breath? Did your thoughts tend to wander? Were you thinking about a pain in your back or an itch on your nose? Did your mind jump to what you need to do later today or tomorrow? Were you judging yourself?

If your mind was all over the place in this exercise, don’t worry. You are in very good company. Almost everybody’s mind is like that almost all the time. It’s only when you sit in one place, close your eyes, and try to focus that you begin to see it clearly. Very few people can maintain one-pointed concentration for the duration of even a single breath. Part of the usefulness of this meditation exercise is that when you try to be quiet, you can clearly see how busy your mind is.

Modern humans spend almost all of their waking life in the land of words and concepts. These are important, of course, but through yoga you learn that you shouldn’t spend all of your time there. Yoga teaches that the real you lies beyond that endless verbal stream. It’s not that you want to abandon rational thought. You just want to be able to turn it off for brief periods, so that you can tune in to direct experience and the unselfconscious self that lies beneath the surface. What the ancient yogis invented were a series of techniques to lessen the distraction of the nonstop verbal parade so that the mind can become clearer and more perceptive.

From a health standpoint, besides distracting you and sometimes making you miserable, the monkey mind tends to keep the SNS activated, which is just the opposite of what most people in the modern world need. The feelings of calm, connection, and meaning we experience when we fully occupy the present tend to shift the balance toward the PNS, potentially undoing some of the damage.

STRESS AND THE BREATH

Breath is perhaps the most important tool in yoga practice. The ancient yogis discovered that the breath, which is normally automatic, has profound effects on the nervous system if consciously controlled, with the potential either to increase activation or to promote relaxation, depending on the practice. Through yoga practice, you come to realize how your breath affects how you feel and how you can use it to alter your state of being. Much of the focus in yoga is on slowing and deepening the breath, but it’s also about making the inhalation and exhalation as smooth as possible with no major bumps or hiccups. Controlling the fluctuations of the breath, yogic lore teaches, helps calm the fluctuations of the mind (see box on Chapter 3).

Feeling stressed can have a number of effects on the breath, most of them not good. From a yogic perspective, breathing in dysfunctional ways can be both a consequence and a cause of stress; you may breathe erratically when you feel stress, and choppy, inefficient breathing causes tension and unease. Just slowing the breath down and making it more regular begins to lessen feelings of stress within seconds. This wisdom is reflected in the common injunction to someone on the verge of losing self-control: “Take a deep breath.”

SLOW, DEEP BREATH

RELAXED NERVOUS SYSTEM

CALM MIND

In yoga, the breath is used to relax the nervous system, which in turn calms the mind. When the mind is still, yoga teaches, you have access to deeper wisdom from within, and both creativity and healing are facilitated.

DIAPHRAGMATIC BREATHING

Crucial to understanding yogic breathing is appreciating the role of the diaphragm, the most important of the muscles that help move air in and out of the lungs. The top part of this large, thin muscle is shaped something like the dome of an umbrella, and separates the chest from the abdomen. The heart and lungs sit right on top of it and the liver, stomach, and other abdominal organs just below it. Its top part connects to the inside of the lower ribs in both the front and back. On the diaphragm’s underside, a thick tendon connects it to the lower spine. When the diaphragm contracts to initiate the in breath, its dome moves downward. If your abdomen is relaxed, the pressure will make the belly gently expand outward and the lower regions of the lungs expand downward. If you tune in, you may notice a subtle sensation of pressure between the navel and the breastbone when you inhale, which resolves as you breathe out. You may also notice a subtle flaring of the lower ribs on inhalation, also facilitated by diaphragmatic movement, that allows you to take in more air.

In a normal, healthy breath, the abdomen tends to puff out as you inhale. As the diaphragm moves down to allow more room for the lungs to fill, the abdominal organs get gently compressed and the belly tends to move out. Then when you exhale, the diaphragm relaxes and moves back up and the belly tends to move in a bit. One type of inefficient breathing that can be a marker of stress is what yogis call reverse, or paradoxical, breathing. Instead of using the diaphragm to take in air in the most efficient manner, paradoxical breathers work against themselves, contracting this large muscle when they should be relaxing it and vice versa. Reverse breathers pull in the abdomen when they breathe in and let it out when they exhale. The breath tends to be short and staccato, with a quick lift of the rib cage on inhalation. If you try it, you may notice that this type of breathing is similar to the sudden breath you take when you are startled. The effect on the nervous system of habitually breathing this way is a bit like getting startled thousands of times a day.

EXPERIENTIAL EXERCISE: BREATHING ASSESSMENT. You can assess whether you are a normal or a reverse breather either sitting in a chair or lying on your back. If you lie down, you may want to bend your knees and put a pillow beneath your head for comfort. Place one hand on your abdomen and the other over your lower ribs. As you gently inhale and exhale, notice which way your hands are moving. Don’t try to change anything right now, just notice. In normal breathing, the abdomen puffs out gently with the inhalation and moves back in as you exhale, while the rib cage doesn’t move as much. In reverse breathing, the belly moves in on the inhalation and out on the exhalation, and there is more movement occurring in the upper rib cage.

If it turns out you are a reverse breather, don’t worry. This is something you can change over time. Better still, if you’re a reverse breather who suffers from anxiety, insomnia, high levels of stress, or any other condition made worse by stress, you may have just discovered something you can change that could significantly lower your stress levels. Bringing more awareness to the breath and learning some simple yogic breathing techniques, such as the one that follows, could start to help you almost immediately.

EXPERIENTIAL EXERCISE: BELLY BREATHING. If you’re able, lie on your back for this exercise. First observe a few natural breaths. Then inhale, and on the next exhalation gently contract your abdominal muscles, bringing your navel in the direction of your spine. With little or no muscular effort, let your abdomen gently lift as you inhale. Breathe this way for a minute or so, then pause to observe any changes in your mind or body. Most people find themselves feeling much more relaxed. You can try this exercise in a sitting position, too. If the seated belly breath works for you, you can use it anytime you wish—at your desk at work, at a stoplight when stuck in traffic, or in an airplane flying through turbulent weather.

SENSORY OVERLOAD AND STRESS

Yoga teaches that just as what you eat has a tremendous effect on the health of your body, what you take in through your sense organs feeds your mind. Until the twentieth century, people generally had to slow down when it got dark in the early evening and remain that way until early the next morning. With the invention of electric light all that changed. Now computers, TVs, beepers, PDAs, cell phones, neon lights, and car alarms, to name a few, bring an avalanche of sights and sounds that may be much more jarring to the nervous system than most people assume. Studies suggest that noisy workplaces—even when workers believe they aren’t bothered by the sounds—can activate the body’s stress response system. Thus sensory overload is likely to be exacerbating already sky-high stress levels in the modern world. No wonder it’s so hard for most people to concentrate.

Pratyahara, the fifth limb of yoga’s eight-limbed path, is the turning inward of the senses. By selectively increasing your attention to internal phenomena like the breath, you can learn to tune out external phenomena. You still hear outside sounds, but like the din of voices in a crowded cafeteria, they become sensations you can allow to fade into the background. Rod Stryker says, “One of the reasons that we experience so much fatigue is that the senses are just overwhelmed with too many stimuli. The more we can turn our awareness inward, turn the senses internally, the more they are replenished and rejuvenated. That internalization of attention is also the bridge to the healing power of yoga.”

Try this exercise that can facilitate pratyahara.

EXPERIENTIAL EXERCISE: PALMING EXERCISE. Sit in any comfortable seated position, with your spine in an upright position. Begin by rubbing your palms together to generate heat for fifteen to twenty seconds. Then place your palms over your closed eyes. Do not put any pressure on the eyeballs themselves, which are sensitive structures. Instead, press on your brow and on the cheeks outside the bony rims of your eye sockets. Continue to keep your chest upright but allow your head to gently tip forward (figure 3.1). Start to tune in to the breath. Notice the color and texture of any visual patterns beneath your hands. Allow those visual images to fade to black as the muscles of your face let go. Stay for one to five minutes. When you stop, notice whether you feel any more relaxed and are able to see with less tension in your eyes.

It is also possible to learn to bring relaxation to your eyes using awareness and imagery. If you notice yourself staring during your yoga practice or at any other time, simply try to soften your focus. Tune in to any tension in the muscles surrounding the eyes and try to let it go. The following imagery exercise is based on something I learned from B. K. S. Iyengar’s son Prashant.

EXPERIENTIAL EXERCISE: EYES ON THE SIDES OF YOUR HEAD. Stand in Mountain pose (Tadasana). Balance effort with relaxation as you press your feet into the floor and lift your chest (figure 3.2). Keep your breath smooth and release any gripping in your shoulders and neck. Look straight ahead. After a few seconds, imagine that you have eyes on your temples that can see out to the sides. As you breathe, try to perceive what those eyes would be seeing. Don’t pull the images toward you, just let them passively seep in. If you feel a wave of relaxation come over you with this exercise, it’s likely you’re holding tension in your eyes and facial muscles all day long.

Yoga Practices for Stress

ASANA

The regular practice of yogic postures can be a fabulous way to lower stress when you feel overwhelmed, and as preventive medicine. Besides changing the balance of the nervous system, asana reduces muscle tension. From a yogic perspective, stress can cause muscle spasms and the reverse is also true: tight muscles can raise your stress levels. Thus a varied asana program is an effective way to gradually lessen this chronic source of stress, even if some of the postures don’t necessarily feel relaxing while you are doing them.

The practices that follow, on the other hand, can bring a sense of profound relaxation, sometimes almost immediately. If your nervous system is too aroused from stress or over-stimulation, however, you may not be able to settle into relaxation right away. In that case, yogic postures can be a wonderful prelude, allowing you to burn off steam, setting the stage for deep relaxation.

SAVASANA: YOGIC DEEP RELAXATION

Savasana, Sanskrit for Corpse pose, is sometimes called Deep Relaxation (figure 3.3). It’s typically the last posture of a yoga class. While it looks easy, yogis insist Savasana is the most difficult pose to do well—and the most important. Savasana is nothing like taking a nap or lying around on the couch. Those activities tend to bring dullness to the mind, what yogis refer to as a tamasic state. In Savasana, you are not spacing out, you are tuning in with evermore subtlety to what is going on. This is a sattvic, or clear, state of mind. As Swami Vivekananda put it, “A fool enters into sleep and comes out as a fool while a fool enters into samadhi and comes out as a wise man. One is unconsciousness and the other is super-consciousness.”

The position of the head is crucial in Savasana and other relaxing poses. If your chin is elevated relative to the forehead (see figure 3.4a), the position tends to be stimulating. If your chin is even with the forehead or slightly lower, it’s easier to relax.

a) The position of the chin is higher than the forehead, undermining some of the relaxing effects of Savasana.
b) In order to correct the problem, it may be necessary to elevate the head with a pillow or folded blanket.

EXPERIENTIAL EXERCISE: RELAXATION (Savasana). Lie flat on your back. Allow your arms and legs to gently splay out from your body symmetrically. Let your palms face the ceiling and your feet roll out to the sides. If you have any back discomfort, bend your knees and place a blanket or pillow under them. (If you are pregnant and beyond the first trimester, please see Chapter 5 for advice on how to modify the pose.) After thirty seconds or so, make any final adjustments you need to be comfortable; after that try to stay absolutely motionless, as any movement can interfere with deep relaxation. Allow your eyes to gently close. Imagine that your body is getting heavier, sinking more deeply into the floor. Feel the heaviness of your hip bones, the backs of your heels, and your shoulders. Imagine that the surface below you is made of soft rubber and that at all points of contact your body is actually sinking an inch or two into the floor. Try to relax your jaw completely so there is a slight space between your upper and lower teeth. Your tongue, where most people unknowingly hold a lot of tension, should completely relax, to its root. When the tongue is tense it bunches up. Allow your tongue to feel as flat as a dog’s, so that there is a feeling of space between the bottom and top of your mouth. Because old habits die hard, it’s useful to return your awareness to your tongue again and again during the course of relaxation to see whether you’ve gone back to tensing up. See, too, if letting go in your tongue helps you relax your throat, and whether that in turn helps you find any release in the chest. Stay in the pose for five to fifteen minutes (the longer, the more beneficial). As you relax into the posture try to simply notice your breath. Don’t try to control it, just follow it in your mind. If you can learn to let go, you may discover that your breath becomes a little shallower as you ease into relaxation. It will still be regular but not as deep as when you first began. Ideally, you should not fall asleep in Relaxation pose. The goal is a state of relaxed awareness. If you do fall asleep, it’s a sign you are sleep deprived. Sleeping in Relaxation pose isn’t yoga but the sleep may be useful.

If the room is at all cool, be sure to dress warmly or cover yourself with a blanket. When you relax deeply, your body temperature tends to drop slightly. Feeling cold, however, can activate the SNS, which constricts the arteries in the feet and hands to retain body heat, but also counteracts the mental relaxation you’re looking for.

How you come out of Relaxation pose is crucial. Despite being instructed to the contrary, many students abruptly sit up as soon as the teacher says come out of the pose. Doing so can negate some of the benefits. If you’ve just spent fifteen minutes coaxing your nervous system into a state of relaxation, coming out abruptly can give you a jolt of adrenaline, leaving you considerably less relaxed. The proper technique involves bending the knees toward your chest, then rolling onto your right side (figure 3.5a). If possible, keep your eyes closed at this stage, as it tends to keep your senses directed inward. Stay on your side for a minute or so, and when ready, use your arms—not the muscles of your back—to slowly push yourself to a sitting position, bringing your head up last (figure 3.5b).

If Savasana is hard for you, be patient. Even relaxation expert Judith Hanson Lasater admits, “I couldn’t do Savasana at first.” She finally figured out that Savasana is not something you do. “It’s a noticing practice,” an exercise in mindfulness. You notice your hand is tense, your jaw, your belly, “and then, as you become aware of it, of course, it dissipates.”

LEFT/RIGHT BREATHING

Using their heightened awareness, ancient yogis detected what scientists now refer to as the nasal cycle. Humans (and other animals) cycle alternately from breathing through one nostril to breathing through the other, for periods ranging from a few minutes to a few hours. This pattern continues even during sleep. In one area of investigation, yogis compared the effects of left-nostril breathing, right-nostril breathing, and breathing through both simultaneously. One reason for turning to the right as you come out of Savasana is that lying on your right side promotes breathing through the left nostril, which encourages relaxation.

According to ancient yogic teachings, the left nostril is connected to ida, a hypothesized energy pathway, or nadi, which travels alongside the spine, and is cooling, restorative, and feminine in nature. It more or less corresponds to yin in traditional Chinese medicine. The right nostril is governed by pingala, a complementary nadi, which is warming, energizing, and masculine, roughly equivalent to yang. More and more scientific research is supporting the notion that breathing through different nostrils has very different effects on the body.


RIGHT-NOSTRIL BREATHING	LEFT-NOSTRIL BREATHING
Stimulates Sympathetic Nervous	Stimulates Parasympathetic
System (Fight or Flight)	Nervous System (Relaxation Response)
Stimulates Left Hemisphere of Brain	Stimulates Right Hemisphere of Brain
Increases Verbal Performance	Increases Spatial Performance
Increases Blood Sugar Levels	Lowers Blood Sugar Levels
Increases Rate of Blinking	Reduces Rate of Blinking
Decreases Intraocular (Eye) Pressure	Increases Intraocular Pressure
Increases Heart Rate	Decreases Heart Rate
Inflates Right Lung Preferentially	Inflates Left Lung Preferentially

A yogic practice that is believed to balance the sympathetic and parasympathetic branches of the autonomic nervous system is Nadi Shodhana, alternate nostril breathing—out and then in through one nostril, then out and in through the other, repeating this pattern for the duration of the practice (see Chapter 16). Masters believe that during meditation the breath should flow evenly through the two nostrils, and Nadi Shodhana, because of its balancing effects, is considered the perfect prelude to meditation.

RESTORATIVE YOGA: SUPPORTED SAVASANA

A number of restorative yoga postures invented by B. K. S. Iyengar are among the most powerful and effective ways to relax. You position your body in a yoga pose but various props, such as bolsters, blankets, blocks, and straps, do most of the work for you. Your job is to simply settle into the pose, draw your senses inward, and, as always in yoga, keep your focus clear but soft.

Judith Hanson Lasater became a specialist in restorative yoga after suffering a personal tragedy that left her unable to do her normal yoga practice. She had learned supported poses working with Iyengar and used to teach them. “Then my twin brother got very sick, and eventually died. During that whole year period I was so distraught, all I did was restorative.”

Even the pose Savasana can be done in a more supported fashion by lying back over a bolster (figure 3.6). By letting the prop hold you in the posture, the rib cage expands naturally. You tend to breathe more deeply, slowly, and regularly. Yogis find the pose to be energizing, due to the effects of the slight backbend, but also restful, since you’re lying down and it requires so little effort to stay in the pose.

Some people who are too sick to do regular asana can do restorative postures. If you are bedridden, rather than just lie there, why not prop yourself into a supported Savasana or other pose once or twice a day? I highly recommend that anyone with chronic disease incorporate it into their treatment plan, no matter what other measures or other style of yoga they are practicing.

Although you can improvise with pillows and blankets at home, I think anyone with a serious medical condition should consider buying a few high-quality props for restorative yoga. One I particularly recommend is a cylindrical bolster like the one shown in Supported Savasana. I prefer ones that have a firm stuffing such as cotton batting as opposed to those filled with foam. The number of uses you will find for this prop is amazing.

Supported Savasana

RESTORATIVE YOGA: LEGS-UP-THE-WALL POSE (VIPARITA KARANI)

One of my favorite restorative poses is Viparita Karani, also sometimes called “Legs-Up the-Wall,” which elicits the relaxation response, a form of resting while you are awake, that is a different physiological state from sleep. If you feel tired in the afternoon, try this pose. Viparita Karani and other restorative poses generally won’t leave you feeling groggy and won’t interfere with falling asleep at night (unless you fall asleep in the pose) which naps unfortunately can do. Legs-Up-the-Wall can be done with the hips on the floor, but for an even greater effect, try the Iyengar practice of elevating the pelvis on a bolster or a stack of folded blankets.

EXPERIENTIAL EXERCISE: LEGS-UP-THE-WALL POSE (Viparita Karani). Set up for the pose by placing a bolster or a stack of folded blankets parallel to the wall and approximately six inches away from it (if your hamstring muscles at the backs of your thighs are tight, you may need to move the prop farther from the wall). To come into the pose, sidle up to a wall and sit on and to one side of the bolster or blankets (figure 3.7a). Place your hands on either side of the bolster and swing your legs up the wall (figure 3.7b). If you are on a bolster, your tailbone should rest just over the front edge of the bolster so that your sacrum, the triangular bone at the base of your spine, angles down toward the floor. This maintains the normal inward curve in your lower spine and makes the pose more relaxing. Place your arms in “cactus” position as show in figure 3.7c, or palms up alongside you, as in Savasana. Rest in this pose for five to fifteen minutes. If you start to lose circulation to your feet, come down earlier or simply cross your legs, keeping your hips where they are. To come down from the bolster, bend your knees and use your feet to push off the wall to bring your buttocks to the floor in front of the bolster. From there, use your arms to help you sit up.

How to Get into Supported Viparita Karani

A SEQUENCE OF RESTORATIVE POSES WITH CUMULATIVE EFFECTS

As powerful as individual poses are, the cumulative effects of doing a well-designed sequence of these postures can be even more profound. This restorative sequence was designed by Patricia Walden. In Supported Downward-Facing Dog pose (Adho Mukha Svanasana) and in Half-Standing Forward Bend (Ardha Uttanasana), the head is supported to increase the calming effect. In Supported Bridge pose (Setu Bandha) and Legs-Up-the-Wall pose (Viparita Karani), Patricia recommends belting the thighs with a yoga strap for added relaxation (not shown). Similarly, the strap looped around the legs, and the yoga blocks or folded blankets placed under the thighs in Supine Cobbler’s pose (Supta Baddha Konasana) allow the hips to release tension.

a) Supported Dog pose (Adho Mukha Svanasana)
b) Supported Half-Standing Forward Bend(Ardha Uttanasana)
c) Supine Cobbler’s pose (Supta Baddha Konasana)
d) Supine Cross-Legged pose (Supta Svastikasana)
e) Supported Bridge pose (Setu Bandha)
f) Legs-Up-the-Wall pose (Viparita Karani)
g) Relaxation pose (Savasana)

It pays to learn restorative yoga from a teacher who has experience working with props. Subtle individualized differences in the setup can make a huge difference in the effects. For example, in supported Savasana, some people need an extra folded blanket under the head and neck, or something under the knees if the back hurts. If the arrangement is good, you should feel a progressive calmness after a few minutes in the pose. Any restlessness or irritation may be a sign that something isn’t set up right for you.

If time allows, Patricia suggests adding two variations to Legs-Up-the-Wall pose for even deeper relaxation. After lying with your legs up the wall for five minutes, unbuckle your belt, and leaving your hips on the bolster, cross your legs against the wall (figure 3.9a) as if you were in a seated position. After a minute or two, switch the cross of your legs and stay there an equal amount of time. Then uncross your legs, and push your feet into the wall to shimmy your buttocks just over the edge of the bolster and onto the floor. From that position, cross your legs and rest them on the bolster (figure 3.9b), stay a while, then cross your legs the other way. This sequence is known as Viparita Karani with cycle.

If you do this or another restorative sequence, try to maintain any calmness you achieved in one pose during the transition to the next. At first you may only want to stay a minute or two in each pose, gradually building up to as much as fifteen minutes in subsequent sessions. Some people buy timers so that they know when to move to the next pose. If you do this be sure to get one with an alarm that won’t be jarring (which could potentially undo some of the restorative benefits).

YOGA NIDRA

Yoga Nidra, Sanskrit for yogic sleep, is an intricate form of guided relaxation, taking you on a journey through dozens of different visualizations, normally while you lie in Savasana. A teacher or a recorded voice guides you through the practice, which can run anywhere from a few minutes to more than three-quarters of an hour. Because you attend to the voice and bring attention to the different areas of the body and different images as you’re directed, your mind stays occupied. This is a particular advantage for people who tend to brood or get anxious if they try to relax without guidance. Since Yoga Nidra requires very little effort, it is a practice that is suitable for almost anyone, including those who are seriously ill and who may not have the energy for asana or even seated meditation.

Yoga Nidra, Rod Stryker says, gives the benefits of the deepest sleep without the dullness of being unconscious. A lot of what most people think of as relaxation, he says, is only partial. Yoga Nidra involves not just relaxing the body and mind, but also the nervous system and the subconscious mind in a systematic fashion. “Different tools were developed over the millennia for achieving this state,” according to Rod, “and what we have today is a compilation of the different types of techniques that have been used.” Rod is currently involved in two research projects in which scientists are evaluating the healing potential of the practice. The best way to do Yoga Nidra is in a class setting or at home along with one of the several CDs available (see appendix 2).

MEDITATION

In many forms of meditation, you attempt to fix your concentration on one thing, what the yogis call one-pointed attention. The thing you concentrate on could be your breath, a sound or a phrase (mantra), a candle, a geometric design (yantra), an image of a deity or guru, or of a light emanating from the center of your body. Simply choose something that has a resonance for you and try to stick with it throughout a sitting. Flitting back and forth between different focal points is less likely to result in a meditative state.

A big obstacle to meditation is that many people feel intimidated by the concept of meditation or what they consider their failed attempts to do it. Their minds are so busy that they conclude they are wasting their time. In fact, tuning in to the fluctuations of the mind is the first step toward actually meditating, and can be a form of meditation itself, as in mindfulness practice. Remember that from a yogic perspective, to effect change you first need to see clearly what is. And for most people, what is, is that they can’t fix their attention on any one thing for more than a few seconds. Thoughts butt in like intrusive neighbors. But that’s how everyone feels at first, and even experienced meditators find their minds wandering again and again.

Part of learning to meditate is to notice all the judging in your mind. I’m no good at this. This isn’t working. I can’t meditate. Those are all just fluctuations of the mind, the chatter that keeps you away from direct experience. If it’s cropping up in your meditation practice, it’s undoubtedly happening in the rest of your life, and recognizing that is one of the fruits of the practice. Meditation is like playing a musical instrument. If you spend your whole time on the violin thinking about how lousy you are, your experience will be torturous. Your internal monologue will distract you from what’s actually going on and you will miss the opportunity to really hear what you are doing. But play your scales over and over in spite of your doubts and you may discover an ease coming to your practice that had formerly eluded you.

Studies suggest that many of the physiologic benefits of meditation—lowering blood pressure, heart rate, stress hormone levels, and the like—accrue even to those who don’t think they are doing it well. In his research, Jon Kabat-Zinn has found that a program which includes mindfulness meditation along with some asanas seems to help people independent of their medical or psychiatric diagnosis. “We work with people with a wide range of different kinds of conditions, all mixed up in the same room,” he says. “Whether it’s headaches, or high blood pressure, or irritable bowel syndrome, or trying to get back in shape after coronary bypass surgery, or cancers, many different kinds of cancers, the mind-body response is—in terms of symptom reduction, in terms of attitudinal change—the same.”

Here’s an ancient meditation technique based on the sound of the breath. To yogis the breath itself can be a mantra. They hear in the in breath the sound so and in the out breath ham, pronounced hum. In Sanskrit, the words so ham mean “I am that,” reminding them of their connection via the breath to the entire universe.

EXPERIENTIAL EXERCISE: SO HAM MEDITATION. Sit in a comfortable upright position or, if necessary, lie down. Close your eyes and start to tune in to the sound of your breath. Imagine that the in breath makes the sound so and that the out breath makes the sound hum. As the breath comes into your nose, hear in your mind soooooo for the entire duration of the inhalation, and hummmmm for the entire exhalation. If your attention wavers, don’t judge yourself but simply return your focus to the sound of the breath. To deepen the practice, you could also try to maintain your internal focus at the third eye, located in the middle of the brain behind the spot on the forehead where many Indian women place a decorative bindi. Stay for five minutes or longer (any amount is good but many yogis believe that the deeper benefits of the practice come with daily sessions of at least twenty minutes).

Meditation may seem like work at first and not as relaxing as many of the other practices mentioned in this chapter. But if you stick with it and practice—even if you have doubts and even when you don’t feel like it—over the long run, meditation can be the most powerful stress-reduction technique of all. Shanti Shanti Kaur Khalsa points out that there is a “difference between the sensations you have during something and the outcome. You can not enjoy meditation but be transformed by it.” Or, as most people who hang in eventually discover, you can be transformed by meditation and enjoy it immensely. And if you believe the ancient sages, meditation is the key to transformation.

Making Time to Relax

Some readers, particularly those from the United States—the most overworked nation in the world—may say, “That’s all well and good but where am I supposed to find the time to relax?” The only way it will happen is if you make it a priority. In the last thirty years, US productivity has doubled. Part of that has come from the almost two hundred additional hours the average person now works annually. Unless individuals and society are willing to examine some of the assumptions that foster this inherently stress-provoking way of life, they are unlikely to solve their problems with stress and stress-related disease. It requires tapas—yogic discipline—to schedule and make time for relaxation, especially if your samskara, your habit, is to always do more and go faster.

Periodically getting away from it all is another vitally important way to cut stress that’s too often neglected. Many Westerners, including more Europeans of late, rarely if ever take vacations. If they do, they bring along work, cell phones, and laptops that ensure they can’t really let go. Although it’s not one of the commonly cited risk factors for heart attack, failing to take vacations may be more dangerous than smoking or high cholesterol. In the famous Framingham Heart Study, women who skipped vacations for six years in a row were eight to sixteen times more likely to develop heart disease. Add yoga to your vacations, of course, and you’d only increase the benefit.

Making time for relaxation could be as simple as fitting it into the cracks in your day or substituting one habit for another. Could you lie for five to fifteen minutes in Savasana once a day rather than watching TV, reading the paper, or talking on the phone? Could you close the door to your office and put your legs up the wall when you feel sleepy in the afternoon instead of taking a coffee break? Nischala Joy Devi says a few minutes of deep relaxation a day can remind you that even when you’re busy on the outside, there’s a quiet place within. Do the practice as if your life depends on it, she tells her students, “because it does.”