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Helping Clients Overcome Challenges

Helping Clients Overcome Practice Challenges through Somatic Space

This article was originally published by the International Association of Yoga Therapists, Yoga Therapy Today, Winter 2018, Yoga Therapy in Practice, www.iayt.org 

Increased interoceptive awareness—the deep knowledge of what’s occurring in the physical body, the soma—can be a negative experience for some. Notwithstanding the long-term benefits clients gain through heightened self-awareness, we yoga therapists may find ourselves needing to help clients navigate uncomfortable sensations and emotions that arise from yogic inquiry. Yoga, perhaps initially perceived as a purely physical activity, can move students through the three psychic layers of the gunas (qualities). I use somatic yoga and the pancha kosha (five-sheaths) model to guide people toward sattva (balance); here I offer practical ideas to help others to do the same.

When muscles fail to perform, it is not necessarily because they are strong or weak. Muscle inhibition occurs in athletes and armchair quarterbacks alike. The ability to control muscles comes partly from nervous system communication. Somatic Yoga was developed to increase communication among the nervous system, brain, and pranic body. My eyes opened to the benefits of a regular Somatic Yoga practice as a result of experiencing chronic pain in the sacroiliac joint (nervous system), post-concussion syndrome (brain), and energy-body consciousness (pranic body).

I liken the journey through the somatic space to Joseph Campbell’s The Hero’s Journey; separation, initiation, and return. In yogic terms, The Hero’s Journey translates as the gunas, or subtle basic components of life. Tamas (often translated as “darkness”) is the road of separation—appearing wide and easy, it represents ignorance and inertia. Innumerable people are breathing a lackluster survival breath and walking the black road of tamas without even knowing it. Perhaps they cannot or chose not to be present in the body. Often in the depths of physical or mental despair, they receive the call to action. Rajas (passion) is the winding, uphill road of action/initiation.

Yoga practices, particularly Somatic Yoga, in my experience, can delicately guide clients through rajas when they feel agitated (or, for some, when they feel anything at all) and when they face off with the things they fear the most—the kleshas (obstacles). Students who view this awareness as a negative may be scared, sad, angry, or in denial. They may discontinue the practice and go back to tamas because it is safe and familiar. Initially, rajas requires surrender. With guidance and regular practice, rajas is where we start to see we have control of our lives. Tamas is the victim mentality. The discomfort of rajas is where you learn to love yourSelf, dragons and all, to get to the purity of the sattvic state. Yogic philosophy doesn’t see the journey as acquiring a new strength, as Campbell does; rather, in Somatic Yoga the superpower is something that was always there. Remembering and returning to awareness of the Self is the steady state of sattva.

 

Demystify the Somatic Space

A starting point for somatic inquiry may be to take the mystery out of movement with a brief overview of the nervous system. The somatic system, or voluntary nervous system, includes both sensory and motor neurons, allowing communication to flow freely to and from the muscles, sensory organs, and skin. What we call muscle memory is really one of the jobs of the nervous system. Habitual movement, aging, and trauma (conditioned reflexes) can cause the nervous system to “forget” how to move with fluidity and freedom. We should explain to our students that both physical and emotional trauma can result in the inability to feel ourselves. Psychological trauma is held in the brain, but we also hold trauma in the body in the form of unconscious contractions. Despite being voluntary, much of our somatic movement takes place below the level of conscious awareness; the fact that this does not always have to be so is a tremendous asset that we can use to empower our students.

How do you guide those who encounter difficulty doing what on the surface appears to be a simple practice? Let the goal be to stay present. Teach them that they have the tools within themselves to heal; they need only to listen to their bodies. When physical or mental challenges arise, normalize movement and emotional response. Give such clients veto power. “Veto” means “I forbid” in Latin and can be absolute or limited.

Working with a sensation scale rather than a pain scale teaches clients that it is safe to be present in their bodies, even in discomfort. The body communicates through sensation. Discuss pain as a complex communicator that is about structure and emotional response, much of which is attached to previous experience and fear. Don’t make the scale all about difficulty. Encourage them to remember the sensation of pleasure: massage, eating something delicious, petting a furry friend, sexual satisfaction, or a simple hug. The traditional ayurvedic techniques of garshana (gentle dry-brushing of the skin) or abhyanga (warm oil massage) can be intimate gateways to reintroduce the nervous system to the sensation of pleasure through the skin.

What happens when a student discovers structural imbalance or an inability to feel a muscle? For instance, when working with the quadratus lumborum, a client may feel an immediate muscle response on one side of the back and think the muscle doesn’t exist on the other. Similarly, Somatic Yoga is a recommended postpartum practice to reconnect to the pelvic floor and transversus abdominis, but these muscles may be difficult to locate kinetically. Guide the students to bringing their awareness into the area with the intention to visualize it; visual aids such as a photograph of a particular muscle and thoughtfully placed props can accentuate cognitive connection. In the case of movement disorders where there is an inability to move or movement cannot be controlled, guide clients to imagine the experience of the movement.

Give people ample time to “mind their Ps”: pause, present, precious perception. Allow them to experience how much sensation can exist in stillness. When doing asymmetrical movements, take a full minute of inactivity between the two sides. The mind loves to entertain contrast in the body. The first side can communicate the experience to the brain to prepare the second side for the movement. Learn from the experience but don’t anticipate how the second side will respond. When both sides of the body are done, pause again, noticing the similarities and differences.

Ask clients to describe recurring and unfamiliar sensations as fantastically as they can and to label perceptions as something other than “good,” “bad,” or “okay.” Remind them occasionally that you are the DJ choosing the song, but they control the volume knob of bodily sensation.

Work within the Kosha Model

What door would enable a client to enter the body: spanda, shakti or grace?

Spanda: Annamaya Kosha

Spanda is play and spontaneous expression of aliveness! Let the practice be “sloppy yoga.” This often works with those who are more physically oriented, like to overdo movements, and have difficulty stepping away from the bigger, stronger, faster philosophy. Sitting too much, rigidity, and habitual movement patterns are what get us into trouble in the first place, so play! One approach is to ask students to invoke their inner child and do the practice as if just learning to move. Suggest they give themselves permission to approach the movements like their favorite animal would. Ask them to continually notice when bodily sensations move, increase, dull, or subside.

Even when the practice is familiar, invoke the beginner’s mind; don’t just go through the motions. The practice may at times appear uneventful, but fascinating things are happening at the subtle-
body level. Enthusiastically encourage curiosity and amazement. Freedom of expression in the body inspires creative thinking. If it adds to the creative pulse, somatic yoga can be a breath-centered practice. The inhalation deepens the student’s experience of expansion and elongation; the exhalation allows release. As Carl Jung said, “The creation of something new is not accomplished by the intellect but by the play instinct acting from inner necessity.”

Shakti: Pranamaya Kosha

The vital force of prana shakti makes itself tangible though the breath. This approach is for those who are more devotional, spiritual, or who enjoy meditation. A healthy dose of skepticism works, and yoga nidra can be used to develop conscious awareness of the pranic body. A goal of yoga therapy is to create energy and distribute it to all parts of the body. It can be valuable to offer your client a simplified explanation of the subtle body that may include nadis (energetic channels), chakras, vayus (“winds,” or functions of prana), and/or marma points. When the students can sense where their breath originates or can connect to their spiritual heart, they are ready to explore the power of creating energy through awareness and intention. Explain that pain can be thought of as congested energy. Ask them to breathe into the body, noticing where they feel tension or discomfort. Then on the next inhale, breathe into the tension; exhale the energy out. If a specific point in the body needs healing or release, the student can use all their senses to create an active image in their mind and fill the particular part of their body with the image.

As prana is experienced on the subtle level as touch, placement of hands can result in clearer communication. This is different from manual manipulation, which may fall outside the scope of your practice and can be interpreted by the students as “doing it wrong,” “not doing enough,” or that you are fixing them. Use your hands to teach them to use their own hands as feelers for the nervous system, transmitting their own life force from their heart (the seat of prana) through their hands. When finished, have them ask the subtle body if it has any messages.

Grace: Manomaya Kosha

One aspect of grace is the ability to surrender all limiting beliefs and previous experiences. Make the practice about self-acceptance over self-improvement. This is best received by those who feel more emotional, those who present with low self-esteem, or those for whom healing needs to triumph over curing. Two influential words are “allow” and “trust.” You may also want them to start by creating an affirmation or sankalpa (heartfelt intention) and to keep repeating it. Teach them to let go of self-judgment. In a society that rewards “perfection,” teach that it is okay to make mistakes! Stay away from language that leads to what the movement should look or feel like. Offer the understanding that the senses are intended to bring joy. Explain imagery as the language of the mind: it listens to what is outside us through our senses, then speaks in images that can turn into words. We decide to attach a positive or negative association to the words, and therein lies the difference between pain and suffering.

Hold Space: Vijnanamaya Kosha

Always hold space for your clients. We hold sacred space for them by asking for their highest good and offering unconditional love. The greatest gift we give our students is to teach them to cultivate that same sacred space for themselves outside the safety of our guidance and to continually stay present and objective when experiencing signals within the body. Witnessing consciousness of self and experiencing this awakening through yoga gives the client a glimpse of the illumination of pure consciousness.

Sukha: Anandamaya Kosha

Yoga teaches that we need to have sweetness (sukha) in our lives to bring us closer to our Source—bliss. Recognize and praise the joy of small successes with your students. A benefit of a traditional asana practice is that we purposely challenge ourselves, stress the physical body, and consciously watch the mind’s response. In Somatic Yoga, we undo by underdoing; there is personal accountability in recognizing and doing only what makes us feel good. The more we experience joy, the more it becomes our natural state of being.

Somatic Yoga is highly adaptable and achievable, but needs to be structured for the individual. Yoga therapy clients have often tried several modalities before they find you. They are familiar with the failure of checking out mentally and the unfulfilled expectation that someone else would “fix” them. Start with a thorough and thoughtful intake, which may hint at the client’s current level of self-awareness. The intake should include a discussion of any history of physical or emotional trauma, even when the trauma does not have any obvious correlation to the issue the client is presenting with. Ascertain the mental and spiritual state of your client using the qualities of the three gunas. Let the client do the talking with words and body language. To the best of your ability, give the client a voice in creating their yoga therapy plan. Continually adjust the plan based on feedback. Using the kosha model, ask them what door they are most comfortable with: the body, the breath, or the mind. As the client gradually increases her or his awareness of internal body sensations in your presence and in the rest of life, the practice is no longer about overcoming pain or dis-ease, and joy can be developed in the purity of the sattvic state.

Peace and Light,

Megan

Access a printable PDF copy of the article here: YTT_Winter 2018_MacCarthy

Falling, Flying and Wakeful Napping: Healing My Concussion

(This first person perspective was written in July 2010 while 6-20 days post-concussion. The timing of the concussion was incredibly serendipitous; six days later I was scheduled to attend an 11 day Yoga of the Heart training with Nischala Joy Devi at Kripalu Yoga Center. The program is designed for cardiac and cancer therapy, but it was a remarkable recovery option for concussion. This piece was never shared publicly until recently when it was typed up for a 15 page research report on Yoga for Concussion as part of a 300 hour certification with Inner Peace Yoga Therapy.  Thought it was not an official part of the research, it was included as a personal insight into a messed up brain and my continued motivation to study yoga therapy. I still believe the main component of recovery from concussion is patience, but I am hopeful that the standard of care will go beyond rest, limitations and restrictions. As multidisciplinary treatments are more readily understood and used in all areas of medicine, treatment plans that follow the yoga therapy model will continue to be developed for concussion.)

Falling, Flying and Wakeful Napping: Healing My Concussion

Being on a plane on a clear day is so amazing. It is a form of humility to feel so small as a city as big as Chicago shrinks down to something resembling an H scale train set. In years of flying, why haven’t I noticed this before? Comfortably connected, but without boundaries or motives; differences and judgement disappear from this height and my reality is tested.

This connection comes after going through the airport with a mixed sense of awe and fright at the number of people all scurrying along their own path. Winding my way through O’Hare is baby steps. I’m cautiously hesitant and extremely overstimulated. Living in the moment and being fully aware of my immediate surroundings is the only shield of protection, (that and a pair of dark sunglasses to hide my deep black eyes from inquisition). The words “please don’t touch me” repeatedly roll through my brain like an unchosen mantra. Resourceful with my energy, or lack there of, I allow myself to see everything without being there; unable and unwilling to join the party or react.

Oddly enough, an airport has never felt so peaceful. At the same time, I recognize that my brain is trying to chew through its leash and do what it wants. My movements are awkwardly unpredictable, like a blind drunkard. When I attempt to order a smoothie, my mind plays a game of Mad Libs with the sentences. Thank you understanding smoothie maker dude for your patience. I think you know the secret of my shattered brain.

Writing this now from the plane feels therapeutic because I have time to think and correct. This is perfect. My brain needs a challenge, but on my terms. Getting the thoughts from my head to the pencil to the paper takes time. And lots of erasing. When I go back to read the scribble, it is as if someone else wrote it.

It is likely that my desire to move in slow motion and watch the rat race in O’Hare as opposed to joining it is an innate, medical necessity. Six days ago, I was knocked unconscious when a pole of flying metal three inches in diameter hit me in the right temple, sending me to the ER with a concussion. With little memory of what happened, I know the best thing I can do is be present and forgiving of myself. My brain needs a healing, nurturing environment with limited stimulation. What could be more healing than yoga in the Berkshire mountains?

So I am on my way to Kripalu to do an 11 day “Yoga of the Heart” training to learn to teach yoga to heart and cancer patients. The irony is that I am now the one that needs serious recharging. After doctor recommendations, discussions with others who had concussions and reading all the gore the internet has to offer (in between much-needed naps), I have come to accept that it may be awhile before I no longer feel like a sea-sick sailor. At least I know my humor portion of the brain is still there as I seemingly inappropriately laugh out loud in my plane seat like a crazy person after writing the words “sick sailor”; the reality is that I was taken out by a sailboat boom.

Understanding this is a time to listen to and honor my body, I’m optimistic the word salad will settle as my brain finds balance. Mentally, I have made a list of the things I probably should not do: sailing (don’t really want to,) water skiing, any fast movement or contact, anything that raises my blood pressure or makes me sweat, and definitely no yoga inversions. That is a hard bit of reality when you love yoga, have 3 fun kids, live on a lake, the month of August is approaching and your nickname is the Energizer Bunny.

I keep coming back to one thought though: I believe in the healing power of yoga.

When I signed up for this training months ago, the ultimate goal was to empower others who also believe in their own healing power. The other day, frustrated and scared, I found myself doubting that same holistic approach to healing. Then I looked back at what brought me to yoga over 20 years ago – a desire and BELIEF that I could manage my panic attacks through breathing and meditation. After a double vision re-reading of Dr. Jill Bolte Taylor’s “90 Second Rule”, I promise to give myself 90 seconds of circuitry freedom to flush the brain no matter what flies out of my mouth. With courage and searching for the appropriate-emotion-meter in my brain, I am considering an additional purpose for this training. My hit to the head was taking one for the team – only I got hit with the bat instead of the ball. I will approach this as a research participant trying to study the benefits of yoga therapy for Post Concussion Syndrome. More to come…

11 days have come and gone and the Puja graduation took place tonight; amazement and joy. I’m beginning to remember what it is like to be a whole person in mind and body. Appreciating that there is no control group – I would have been hard pressed on this sacred ground to find someone else who wanted to get hit in the head and NOT practice yoga – I have to believe there is no better way to heal from a concussion than a yoga retreat; specifically the peaceful protection of Kripalu under the leadership of Nishala Joy Devi: veggie diet, no TV, radio, cell phones or overstimulation…not even my computer, which I purposely chose to turn off the past 10 days, (mainly because of the instantaneous high power headaches it caused); surrounded by calm, attentive people taken to a surrealistic level – the Cleaver family in yoga pants smelling like a garden variety of essential oils. Everyone smiling, but the kind of smile your feel in your heart. The environmental factor is huge: it is easier to be peaceful and centered when you are surrounded by it. And unlike in the airport, where I suspected people looking at my black eyes thinking “poor lady, someone beat the shit out of her”, there is no judgment or labeling. We are all here to heal from something, and some of the deepest scars are not visible. This setting is a true Avalon for those in need of quiet personal space and unconditional love.

As for the practical instruction I was blessed to received in the name of learning to teach Deep Relaxation Through the Koshas, I cannot say enough about the healing benefits of this mystical state between wakefulness and sleep. Guided Deep Relaxation through the Koshas, specifically when in the hands of someone as masterful and compassionate as Bhaskar Deva, is a blissful holistic opiate. I looked forward to my daily afternoon “naps” (don’t fall asleep or you will miss the good stuff!) like a kindergartener rolling out their mat after milk and cookies. Only in this case, the “nap” kicked ass on the cookies. The commercial “this is your brain and this is your brain on drugs” where they show the egg frying in the pan met its antithesis. With each Deep Relaxation, my brain took a relaxing trip to the island of tranquility. I imaged my brain as a little superwoman being fed the anti-kryptonite/concussion serum during each relaxation session. It was as if I could feel the neurotransmitters throwing a party inside me as the swelling subsided.

On the down side, listening to, processing and writing notes was a gigantic struggle. As I look back now, it’s as if someone else occupied my body and thoughtfully took notes for me. But this, too, was part of the healing. The exhausting part admittedly. Getting the two hemispheres of my brain to team up again and send the appropriate messages to my hand resulted in lots of cross outs, chicken scratch and frustration. (I would love to blame the poor spelling as well, but that is a genetic flaw.) Too exhausted to do anything but sleep in the evening, I would reread my notes in the quiet morning hours in my dorm room proud and amazed at my ability to focus that long. The first few days, it was as if I was reading all new material. What fairy delivered this information while I was sleeping? Gradually, my brain began to recognize bits and pieces of the material from the day before. The language and thought process made friends with my writing hand too. Since this was an intense 100 hour training, taking notes was necessary. And to some degree, the processing of seemingly endless hours of intellectual information may have aided my recovery. If I were to go on-line today, however, and search out yoga for concussion treatment, I would look for a program with less intensity and more nap time – think retreat not training. But the daily dose of deep relaxation is a must!

As far as the yoga asana goes, my practice was stripped down to about 1/4 of its usual strength and vigor. Delightful! One of the things I thought I would miss the most – the challenge of flow, big backbends and inversions – was replaced with grace; an acceptance of what I could not do and embracing what I could. In the yoga philosophy, this translates as being able to recognize my strengths through self-study (svadhyaya) and surrendering limitations to a higher purpose (ishvara pranidhana). Fortunately, Kripalu style yoga lends itself well to a gentle practice. In the big picture, the physical poses were like being offered desert when I was already satisfied from the meal; not necessary, but a pleasant accompaniment. I also learned to “under-do” – to fill my awareness on less, which is a feeling I will carry with me in my practice.

From a practical standpoint, I don’t hold much hope that football players or wrestlers will retreat to Kripalu after a concussion. But trust me when I tell you, it is their loss.

On to the real world. That’s a whole other story. Can you say relapse?

Peace,

Megan