Every individual brings a unique constellation of physical, emotional, and spiritual needs and abilities to the yoga practice—a truth that was highlighted as we began teaching yoga in medical settings nearly two decades ago.
A typical class at Duke University’s Health and Fitness Center, for example, might include a twenty-year-old soccer player, a seventy-year-old heart attack survivor, a thirty-five-year-old with chronic back pain, a sixty-year-old with advanced cancer, and a forty-five-year-old competitive swimmer. As a hospital-based wellness center, the facility attracted older adults with heart conditions and other ailments who felt safer in this environment than in a typical gym. But it also drew fit underclassmen and professors, plus athletes of all ages. Beginners stood next to experienced practitioners, fit folks alongside deconditioned ones, grandmothers by college students.
Facing this array of diversity was a humbling and deeply educational experience, and creating a yoga class that met the needs of this varied group was ultimately extremely rewarding. It forced us to dig deep into the heart of the teachings and to let go of preconceived and commonly held notions of what a yoga practice entails so that we could open up to the joyful creativity and vast potential inherent in the experience of yoga. It also led us to realize that we were navigating uncharted territory. While yoga is an ancient wisdom tradition, the modern yoga class is a relatively new phenomenon. Back when the yogic practices evolved, there weren’t large communities of people ages sixty and up. And ancient yoga teachers didn’t have students with artificial joints or implanted defibrillators, or who were taking numerous prescription medications.
This experience led us to search for further training so that we could learn how to best ensure the safety of our more vulnerable students. But we could find no programs that would help us understand the various health problems our more mature students faced and teach us the movement considerations that are essential to making the posture practices both safe and effective. Nor could we find educational opportunities that would help us better understand the existential concerns that often become highlighted later in life.
In 2007, we began our partnership with faculty from the Duke University Health System by launching our first professional training, “Teaching Yoga to Seniors.” This weekend workshop was held at Duke Integrative Medicine, which had just opened its doors as a state-of-the-art facility providing patient-centered health care that integrates conventional medicine with evidence-based complementary practices such as mindfulness, acupuncture, massage, and yoga. We hoped other yoga teachers would be interested in this three-day workshop featuring talks by Duke medical experts along with interactive sessions on how to adapt the yogic practices to comply with any contraindications and concerns raised by our Duke colleagues. The workshop quickly filled and was extremely successful—but clearly it was too short.
The following year we experimented with a five-day program, then in 2009 we settled on an eight-day version called “Therapeutic Yoga for Seniors” that featured presentations from internationally recognized physicians, physical therapists, and health psychologists geared to providing yoga teachers with the essential fundamentals to work safely and effectively with older adults.
In addition to what we refer to as the “Master Program” at Duke, we also offer some abridged programs held at the Kripalu Center for Yoga and Health, in Massachusetts, as well as at several other locations. We launched a website, Yoga4Seniors.com , with a mission to advance the art and science of adapting the yoga practice to older bodies, minds, and spirits. More than seven hundred yoga teachers from around the world have attended our trainings, and it is our experience that—as pioneers charting this new territory—we are all teaching each other as well as teaching our students.
Relax into Yoga for Seniors is a collaborative effort, and we each bring special talents to the program we have built. We have traveled very different paths to arrive at this place together. Here are our stories.
When I was a small girl, my grandmother was the adult with whom I felt best. She was a most generous and funny soul, and I always felt loved and fully seen by her sweet gaze. Her commitment to and love for me was unwavering, and this experience instilled in me a deep wish to support our elders.
In my early twenties I stumbled into a 6:00 a.m. yoga class held at the only wellness center in town. Trying to relate to so many parts of myself in new and engaging ways was beyond intriguing. It wasn’t long before I experienced what might be called an awakening, or moment of clarity, in which a fundamental but previously unrecognized aspect of myself—a steady and ever-present observer, right at my core—made itself known to me. It was almost as if the yoga practice had woken me up to a powerful part of myself that I had always taken for granted and simply overlooked. From that point on, I immersed myself in the teachings and practices of the yoga tradition, which have helped me cultivate emotional intelligence and relate differently to my inner processes.
While working toward my master’s degree in public health, I had a surprising and profound deepening into the yoga tradition through the meeting of my future husband, Jim Carson. Before returning to graduate school in his forties, Jim had lived for twenty-two years as a swami (a monk in the yoga tradition) and had taught the philosophy and practices of yoga around the world. As we fell in love and began weaving our lives together, our home became an ongoing immersion in the teachings and practices of yoga.
After earning my master’s, I taught yoga classes and mindfulness-based stress reduction at the Duke Health and Fitness Center for more than a decade. Through teaching these classes of mostly older adults, my students became some of my greatest teachers. They helped me better understand their strengths and limitations, as well as what aspects of the yoga practice were most valuable to them. Rather than pursuing accelerated levels of fitness or achieving contortionist postures, functional health was very important: students wanted to enjoy their families, participate in their communities, and find ease in their bodies. In service of optimal function, students reported that the ability to relax, to be steady in the moment, and to deepen their awareness of themselves were also compelling aspects of the practice.
After completing his doctorate in clinical health psychology from the University of North Carolina–Chapel Hill, Jim completed his postdoctoral fellowship in psychiatry and behavioral sciences at Duke, where we collaborated on research evaluating the effects of loving-kindness meditation on chronic low-back pain. While we were there, we became involved with an extraordinary group of clinicians who embarked on a path that explored how to scientifically study the efficacy of the yoga and mindfulness practices, especially for people struggling with medical challenges.
Much of this research is based on the premise that healing can take many forms: more ease, more acceptance, more joy, more forgiveness. It also may result in better physical function and emotional resiliency, even in the face of challenging circumstances. Our research trials have demonstrated that the gentle movements, conscious relaxation, and cultivation of present-moment awareness can reduce the difficult symptoms of pain, fatigue, and emotional distress that occur with many medical conditions.
This experience has reinforced for me not only the utility of these practices for the alleviation of suffering but also the importance of remembering that often the simplest awareness tools can be the most profound. Twenty years of teaching people to pause, notice, and breathe has shown me over and over again that these gestures are often the most powerful yoga practices of all. The power of these gestures has also been invaluable in raising our boy/girl twins. Often what they need most from us as parents is our commitment to pause, breathe, and notice the beauty and vision that they bring to the world. Ultimately, yoga illuminates our relationships—relationship to self, relationships to others—and provides us the ability to clearly see the potential and fullness of life.
Working at the Washington Post in the 1970s and 1980s was a journalist’s dream. I was in my twenties and spent long hours in the newsroom, where our legendary editor, Ben Bradlee, encouraged a competitive atmosphere that he called “creative tension.” While I adored my job, the stress of vying for plum assignments and hammering out stories on deadline led me to develop chronic neck pain. Searching for relief, I turned to yoga.
My weekly yoga class became an oasis of calm in my life, and I loved the exploration of new positions—like handstand—that literally turned my world upside down. Over time I began to realize that yoga offered much more than stress relief and flexibility. Yoga is a journey of self-discovery, and I found that the lessons I learned tackling challenging postures on the yoga mat helped me navigate more skillfully through challenging situations at work and at home.
In 1988 my family and I moved from Washington, D.C., to Chapel Hill, North Carolina, where my husband, Mitchell Krucoff, joined the cardiology faculty of Duke University Medical Center. One of the first things I did was find a yoga class. By then I had two small children and worked as a freelance writer. When my kids took up karate, I studied martial arts with them—earning my black belt at age forty-two—all the while continuing to take a weekly yoga class.
In 1998 I enrolled in a two-year yoga teacher-training program because I wanted to deepen my yoga practice. To earn our certificates, we were required to complete twelve weeks of community service, and I volunteered teaching yoga in a gerontology rehabilitation program at the Durham Veterans Administration Medical Center. Although I’d been teaching yoga for a year by that time, I found myself very uneasy facing a roomful of elderly male veterans—and a few women—with a wide array of health issues.
Uncertain about what would be appropriate to teach them, I observed their calisthenics class and found that many of their floor exercises were similar to yoga poses. I started there, teaching these familiar positions while adding the breath and the yogic approach of balancing effort with surrender. The group loved the class, and I found it an incredibly rewarding experience. I became known as “The Yoga Lady,” and instead of stopping after twelve weeks I continued volunteering for five years.
When Duke Integrative Medicine opened its doors in 2006, I began teaching yoga classes and offering individual yoga sessions in this extraordinary facility. The administrators were open to proposals for programs utilizing this unique environment, and Kimberly and I approached them with our idea of creating a professional training for yoga teachers. In the fall of 2007, we launched “Therapeutic Yoga for Seniors.”
As my body has changed with age, I have come to value the well-known saying “We teach what we need to learn.” Several health crises have given me a personal understanding of yoga’s healing power. Drinking too much water during a marathon in Jamaica in 2003 landed me in a four-day coma from low blood sodium (hyponatremia) and gave me a new appreciation for the deeper practices of yoga. Waking up in Duke’s neurointensive care unit with no idea how I’d gotten there was a surreal experience. While I couldn’t do any yoga postures, I could do breathing practices, meditation, and relaxation, which I found profoundly healing. In 2008, I had open-heart surgery to replace a congenitally abnormal heart valve. Again, my yoga practice was essential in recovering completely to full and vibrant health.
One of yoga’s greatest teachings is that everything changes—except the undying spirit—and throughout my forty years of yoga practice I have been learning to embrace this change. This is not always easy, especially when the change involves illness and loss. Yoga has given me the tools to face whatever arises with equanimity, to be grateful for the gift of breath, and to cherish each day. Distilled to its essence, yoga is love.
While we have traveled different paths on our journey toward our Relax into Yoga approach, we share a common understanding and respect for medical science alongside our deep personal practice of yoga. This has shaped our approach as an integrative program, in line with the emerging arena of integrative medicine . Sometimes confused with “alternative medicine”—which refers to approaches used instead of Western medical care—“integrative medicine” combines mainstream Western medical therapies with complementary therapies for which there is high-quality evidence of safety and effectiveness. It is also a patient-centered approach to care that considers all factors that influence health and wellness—including the physical body, thoughts and emotions, spirituality, nutrition, relationships, and lifestyle.
Similarly, yoga is based on the recognition that all aspects of our being are interconnected, as well as the understanding that the experiences of our bodies, our minds, and our hearts are not separate. In many ways, yoga is ideally suited for those chapters of life when we face issues of aging, illness, and mortality. A central tenet of the practice is this understanding: I am not the physical form I experience today. I am not my thoughts. I am not my feelings. These come and go. I am the awareness that doesn’t change .
Impermanence is a reality of life, and it is an inherent part of the human journey to grow older. Despite misconceptions that yoga is about perfecting a difficult posture or attaining a certain temporary state of profound calm, the practice is more about developing the relationship with all parts of yourself—including the simplest most essential you : presence itself. When the practice begins to cultivate our ability to simply be , pain, grief, and loss can be welcomed with a deeper sense of acceptance and equanimity. In turn, this acceptance and equanimity invite us to relax into life.