Yoga and Pain Management – “Sarah”

Yesterday I was assigned a patient who could not walk more than 6 feet due to a complaint of severe pain in her left hip, back, and buttock.  As the physical therapist worked to transfer her from the bed six feet into the wheelchair, I observed the patient.  She continually held her breath and cried out, despite the therapist's encouragement to take some deep breaths.  I wheeled her down to a quiet space where she could sit in a recliner and gaze out the window at the lake.  Shaminic Dream was playing on the stereo.  She immediately began a monologue that lasted 30 minutes about all the losses in her life – her friend she lost to cancer, another friend she lost to dementia and then death, her cat, her family who began to steal from her.   I finally placed my hand on hers, acknowledged her pain, and expressed that we needed to do some therapy now.  I led her through a body scan and  counting her breaths backwards, and then took her on a journey into her past to a time where she felt happy, healthy, and without pain.  When the meditation was over she announced, "I have no pain."  I quickly went and found the physical therapist, who proceeded to walk the patient 180 feet back to her room!
The results seemed so miraculous that I actually got choked up on the elevator after I left the patient.

The physical therapist was excited to have me work with the patient again today.  Though the patient still tended toward an anxious monologue, I was able to walk her the 180 feet back to our quiet room for another session of meditation.  This time the patient dwelt on paintings she had done of people in the past (she is an artist).  It was as if all her memories were tied to art she had done.  I asked her to bring to mind some of the happiest moments of her life.  She shared that one of the best moments she remembered was when she discovered in a pastel class that she had the ability to paint portraits.  In our session, I took her through the body scan again and then asked her to go back to the time that she discovered she could paint.  I asked her to allow all the joy, the optimism, and the pride of that moment to seep into her bones, her cells, her organs.  When we finished, the physical therapist once again was able to engage her in meaningful therapy.

The case of "Sarah" demonstrates so clearly to me how the physical pain patients experience in the hospital involves so much more than the supposed physical source of the pain.  Patients bring with them to the hospital all the emotional pain, loneliness, and losses they have accumulated in their bodies over a lifetime.  Meditation, especially breathing meditation, in addition to positive guided imagery, allows patients to release some of their accumulated pain while using their minds to tend the garden of the accumulated  good experiences in their lives.  The results can be nothing short of miraculous.

Your Thoughts Have Power

Sent to me by Becky Hartman from a friend…

Achieving Life Balance Through the Mental Practice of Yoga

Most people probably think of physical postures when they hear the word "yoga."  The physical practice is important and is one avenue to freedom and unity between the physical body, the mind, the emotions, the breath, and the spirit.  I was a very physical kid and practiced yoga postures back then via my mom's Lillias yoga cards.  I returned to the practice in1999 to help balance out the physical and mental stresses of life as an occupational therapist in a hospital.  I found the practice so transforming that I went on to achieve my 1000-hour certification with Integrative Yoga Therapy (IYT) and eventually opened Living Room Yoga, a healing center offering yoga classes, yoga therapy, cranial sacral therapy, hypnosis, and yoga teacher training.

Out of my training with IYT, my rehabilitation background, and my desire to help people achieve balance on all levels of being, I developed a style of yoga therapy called Life Balance Yoga Therapy.  At the beginning of each Life Balance Yoga class, students are asked to observe sensations in the body, thoughts moving through the mind, any emotions present, how it is in the breath, and how connected to spirit they feel.  Then they are asked to inquire of the higher self what is most needed from the practice of yoga to enable them to return to peace, bliss, and ease.  In keeping with the teachings of Joseph LePage, founder of Integrative Yoga Therapy, the Life Balance Yoga teacher provides a class to give each student "a little of what they want and a little of what they need."  It is not uncommon for students to express gratitude that the class seemed to be geared especially for them.

What seems difficult for many yoga students is translating what they learn in class to a home practice.  They may not remember the postures or draw a mental blank when they try to practice them at home.  One way to immediately begin to incorporate yoga into your life is a daily practice of observation on all levels of being.  This can be as transforming as a physical practice, and it only takes about 10 minutes.  It  is basically the same practice we do in Life Balance Yoga at the beginning of each class.  Simply

1. Observe sensations in the body.
2. Notice the thoughts that are moving through the mind.
3. Become aware of any emotions present.
4. Notice how you are breathing (shallow, medium deep, hard to inhale?  hard to exhale?).
5. Notice how connected to spirit you feel.

In addition, I add the following to my daily practice:

1. List of gratitudes.
2. List of daily intentions.
3. List of affirmations (a form of self-hypnosis!).

Personally, I have been doing an email gratitude exchange with a friend since 2006, adding daily intentions, affirmations, and observations more recently.  These practices keep me from self-delusion and take away my need to hide through over-eating or over-workng.  Staying completely conscious and aware enables me to address issues while they are still small, allowing me to reside more often in the state of peace, ease, and bliss spoken of in the Yoga Sutras of Patanjali.  I believe in the power of these practices so much that I assign them as homework to my weight-loss clients.

I now invite you to begin these simple yet powerful practices as well.  Whether you record them in a journal, exchange them with a friend, exchange them with me at Stacy@livingroomyoga.biz, or post them on my Heal Yourself, Heal the World Blog, I am confident that you will find them to be a powerful, transforming influence in your life.

Daily Gratitudes

Begin Your Daily Mental Yoga Practice Today!

I have been practicing daily gratitudes, intentions and affirmations for several years now.  It has been such a powerful tool in my life that I have decided to offer a place your you to post yours too as you wish.  Because it is a part of the "homework" for my clients who are releasing extra weight I have added awareness categories as well..  Here are mine for today:

Aug 15

Awareness of body:  Right sided discomfort.  Feel dehydrated.

Emotions:  Hurt and anger about everyone but two people cancelling at the last minute on me (or not bothering to cancel at all).

Thoughts:  I can't believe the people that I changed the date and time for are the people who cancelled at the last mnute.  I am mad at myself for bending over backwards for people I thought cared about getting together as much as me but who obviously didn't.  I wish I didn't have these feelings.

Breath:  Deep

Spirit:  Hard to feel connected when I am feeling hurt and angry.

Gratitudes:

Today I am grateful for Lily, Jennifer, and Aaron who came out last night and for the fun time we had, for Justin who brought me a new drink gratis when I spilled mine, for a Sunday stretching out before me, for dancing.

 Intentions:

To hydrate myself well, to eat healthy and light, to read the paper, to putter around the house.

 Affirmations:

Everything that is happening is what should be happening.

These feelings will pass.

Aug 14

Aug 13

Awareness of body:  Tight calves, slightest discomfort in the right shoulderblade.

Thoughts:  So glad I slept so many hours.  So glad I seem to be getting emails.  I hope the emails that I didn't get yesterday were not crucial.  Man it's hot in here.

Emotions:  Calm.

Breath:  Deep

Spirit:  Connected

Gratitudes:

Today I am grateful for SLEEP, the new computer at work that is super fast, that I seem to be getting emails today, that it is FRIDAY, my message with Melinda later on today, that Greg didn't sort through the filing stuff last night so I do not have to feel obligated to work on it on my day off.

Intentions:

Today I intend to drop stuff off for charity, choose to do activities that refill my cup, enjoy my massage, eat foods that are good for me and contribute to a thin light body.

Affirmations:

Everything that is happpening is what should be happening.

It is safe for me to reside in peace, bliss and ease and allow life to flow as it will.

I am present to each and every moment of my life.

I enjoy life to the fullest

My metabolism and appetite support and strong, lean, healthy body.

Aug 12

Awareness of body:  Slight discomfort in right shoulderblade, right buttock.  Fatigue.

Thoughts:  I wonder why Lynda is not on the schedule.  Feeling tired.  Feel the need to disengage from work.  I resolve to relax tomorrow and disengage from work.

Emotions:  Calm.

Spirit:  Connected.

New Awareness:  My giving cup is getting low – time to refill my cup.

Gratitudes:

Today I am grateful for the new computer at work, finding a new computer guy we can count on, new clients and students.

Intentions:

Do the laundry, get groceries, prepare the digestion class, make T's disk, have the computer successfully installed with no glitches,figure out Lynda's appt.

Affirmations:

I listen to my inner voice and honor its wisdom.

I rest when I am tired.

I set and keep healthy boundaries with others.

I do good work and people are happy to pay for it.

I accept the endless flow of good coming to me.

Everything that is happening is what should be happening.

Aug 11

Awareness of body: The slightest discomfort down the right side.

Thoughts:  I look forward to seeing Melinda today.  I have got to get the house straightened before 11:00.  I wonder what the moon people are saying about the cosmos.  Lots of weird internet and other miscommunication going on.  Can't wait for girlz night this Saturday.  With all the weirdness going on in the cosmos I wonder if Henrick will have a tough timie setting up the computer tomorrow.

Emotions:  A tiny bit of melancholy.

Breath:  Deep.

Spirit:  Connected.

Gratitudes:

Today I am grateful for new students last night, the opportunity to "try out" to teach at St. Pete Times, feeling positive about the hypno session yesterday, Greg being so sweet and serving me dinner, Linda offering to send me cinnamon sugar in a bottle!

Intentions:

To straighten the house before 11am, be present and effective with M, R, and T, do my best work, enjoy the wind, eat light and healthy in support of a light healthy body, maintain optimism.

Affirmations:

Everything is going exactly as it should.

I embrace the good that flows to me with open arms and heart.

I channel the good that flows to me and through me to others.

The inspiration to write grows in me and a theme to write on each day in my blog comes to me easily.

Hypnosis, Yoga, and Weight Loss: My Story

We all know that in order to lose weight we must burn more than we take in.  But those of us who have either been heavy all our lives or who have gained and lost weight repeatedly throughout our lives know that other factors are at work that make this simple truth not so simple at all.  Due to the roles food plays in our lives – comforter, emotional fulfiller, an antedote to boredom, a chemical trance, a quasher of emotions - losing weight creates a cascade of internal events that spans our physical, emotional, intellectual, and energetic selves.  This cascade of events often results in our gaining back any weight lost as soon as we stop dieting – and sometimes gaining even more than we lost.  

I know what I am talking about.  I begain dieting in the 5th grade and have lost and gained up to 35 pounds many times in my life.  In 2006 I lost 35 pounds on the Weight Watchers program.  I can be quite focussed and disciplined when I put my mind to something so losing the weight was really not difficult.  I remember just wanting to get the weight off me as quickly as possible nd I excercised like crazy and decreased by calorie intake drastically to do it.  When I reached my goal I remember being scared to death of putting the weight back on.  Since I did nothing to change my relationship to food during that period of weight loss that is exactly what happened.  By February of 2010 I had gained almost 30 pounds back.

I had been contemplating taking weight off again for a few months- even putting it on the vision board that I developed for the Mapping Out the Next Phase of My Life Class that I presented in August of 2009.  However, the stress associated with the recession of 2009 kept me from feeling able to move forward with my goal.  Yes, I definitely used food to cope with stress, worry and unhappiness and I was unwilling to give up my drug during this scary time of financial uncertaintly.  What I did do in early 2009 was obtain my certification in hypnotherapy.  Little did I know how key that decision would be in my own weight loss journey.

I began conducting weight loss hypnosis for clients both in groups and individually as my contemplation regarding my own weight loss continued.  My contemplation included gathering information on what foods help with stabilizing blood sugar and what kind of time would be required for me to fully commit myself to "the project."  I determined that I was unwilling to do the tedious recordkeeping required by the Weightwatchers program and did not have the extra time or energy required to add in hours and hours of exercise on top of the yoga classes I was already teaching.  I engaged in online research on how many calories I would need to take in to lose weight at my current level of exercise and determined it was around 1200 calories.  I also looked into meal replacement plans to help with the time management aspects of dieting.  I continued to be unready to actually undertake my own weight loss until all the sudden I just was.  I sincerely believe that all the hypnosis sessions I did for others was all the while causing shifts in me that brought me to the point of being ready to begin.  Armed with the information I had gathered over the previous three months, I simply began.

For the first time doing what needed to be done to lose weight has felt easy.  I am not hungry.  I am satisfied with small portions.  No matter what is going on, who I am with, or how I am feeling, I am content with sticking to my eating plan.  Furthermore, I am able to clearly see in the moment those times that I would normally binge myself into a food trance and simply choose another way to cope.  I believe all these factors are directly related to hypnosis as these are common suggestions I make in hypnosis sessions.  Even when two weeks go by and I do not lose weight I feel ok about it because  I am not rushing to the end of the diet.  I am practicing a relationship to food that I fully intend to maintain for the rest of my life.  I eat to live.  And I know the extra weight will come off.  How could it not?

I give so much credit to self-hypnosis for the ease in which I have been able to release the extra weight.  However, I know that other practices have greatly contributed as well.  Integrating the philosophy and pracitice of yoga over the past 10 years has led to waves of internal shifts that have helped me overcome periods of great anxiety and depression.  A daily gratitude, intention, and affirmation practice (which is essentially self-hypnosis) has been transformative as well.  So far I have released 22 pounds.  I am confident the practices of hypnosis and yoga will enable the rest to be released in good time so that I may enjoy looking, feeling, and being my best self for the rest of my life.

Out of my experiences I am developing a program that I believe will help others permanently release their excess weight.  This program is geared toward changing clients' relationship to food and to themselves utilizing the tools of yoga, yoga lifestyle coaching, and hypnosis.  Click here to read more about the Change Your Mind, Change Your Weight Program. 

Tuning Into Internal Cues in the Moment

I have been reporting on Facebook lately on how much I have been enjoying the Hypnosummit.  I have two more weeks to listen to the lectures and have been trying to listen two hours per day to get the most value for my money.  Today I was listening to a subject that I deal with regularly in my practice hoping for new insight to help my clients achieve lasting change.  I wanted to hear it, learn it, and integrate it but found myself feeling more and more agitated the more I listened.  I heard myself saying to myself … "Just hang in there, you can get through this."  But I got more and more agitated the more I listened to this man.  Why?  I have no idea.  He wasn't the best speaker.  The sound quality wasn't great.  But the level of agitation seemed to go beyond either of these issues.  I finally decided it didn't matter why I was agitated.  What mattered is that he was agitating me.  I then stopped listening and moved on to a different lecture.  Was I meant to listen to this other lecture?  Am I meant to use the techniques from this other lectures with my clients tonight?  I don't know.  All I know is that I FINALLY listened to my inner self and stopped listening.  That is the important thing.

Standing Up to My Doctor Lead to Greater Health

I just returned from getting my annual physical with my medical doctor, Aparna Asher.  She said, "Your labs are perfect.  I don't know how you changed your low thyroid but it's perfect now."  I told her I changed my labs through preventative care of acupuncture, chiropractics, and a change of attitude.  Here is the story of how I stood up for my health…

Just a year and a half ago I had a very unpleasant experience with Dr. X.  I had just "given birth" to my first group of 200-hour level teachers and I was feeling depleted physically and energetically.  In addition, the economy was heading into the toilet and I was fraught with worry about the future of the yoga studio.  This coupled with PMS left me feeling pretty depressed just before my period.  My labs indicated slightly low thyroid as well.  Before choosing Dr X I had called his office and explained that I was a "natural girl" and did not like taking medication.  I was assured that Dr. X used natural means first before prescribing medication.  With two visits this doctor insisted on putting me on two powerful drugs, Levothyroxin and the antidepressant medication Zoloft (despite my symptoms only being prementstrual).  When I protested he looked at me and said, "Think of your poor husband."  He went on to tell me how it was for me instead of asking me how it was for me.  Not being in the best state of mind to stand up for myself, I acquiesed and took the pills – a very low dose mind you. 

Feeling even more terrible than before after a week on the medication I pulled out the side effectsI for Zoloft and discovered I had all the side effects listed (racing heart and mind, insomnia, and anxeity).  I called Doctor X's office and told his wife that I was having terrible side effects and wanted to go off the pills.  She told me sternly that I would need to come in to the office and switch to a different medication.  Having basically no medical insurance at the time I told her that I could not afford to keep running into the office to try this and that medication that I I did not want to be on in the first place.  Then she said actually said, "Haven't you seen the commercial about how much depression hurts?"  My mouth actually dropped open that she quote a TV commercial to me- I told her that yes I have seen it but that wasn't me.  I finally got her to agree to just have the doctor call me.   When he did call me and I told him about the side effects  he told me that the list of side effects "was only for the lawyers"  basically insinuating I was not truly experiencing them.  Now I was really mad.  When I told him I was unwilling to go on another medication he insisted that I wean off the medication over the next two weeks and agree to see a psychotherapist.  To get him off my back, I agreed.  I stopped after three days (I am not recommending this – this is just what I chose to do being that I was on a very very low dose in the first place).  I felt terrific.  I slept, my heart stopped racing, and my anxiety level went way down.  Since I was not longer in PMS, I was not longer depressed either.  I did not seek pyschotherapy – I became my own therapist.

I walked around feeling really pissed off for about two weeks.  I am a strong person who in a weak moment got bullied by a doctor - someone who was supposed to be a healer.  He had completely dismissed my own self-awareness and perceptions, something I try never to do with my own clients.  If I was able to be bullied by him, what about someone who was not as strong as me?  I knew I had to speak up for myself and for the sake of others.  I began to research Zoloft and Levothyroxin to find out that others had very similar side effects to me.  I also found out that once on these powerful drugs for awhile the body becomes dependent on them, becoming even less able to produce the natural chemicals needed for stability and health.  Armed with research I wrote the doctor a letter.  Here it is with some personal information withheld:

Dear Dr. X,

I am writing you to let you know how I am doing.  I began weaning off the Zoloft after speaking to you.  After three days, I stopped altogether.  I had no negative effects from weaning off.  I slept great that night and since.  I suspect as I head into my period again next month, I will experience mood and sleep disruption again; this has been my pattern over the last several months.

My mood lifted in correspondence to my starting my period.  When I told you that I did not always feel depressed, you looked at me with a look I interpreted as “Yeah, right” and followed up with , “Think of your poor husband.”  This felt very dismissive and condescending to me – I felt like as soon as you labeled me as “a depressed person” you dismissed my perspective completely.   You had only met me twice….   

Despite my feelings about your response, I decided to find out how I was affecting others.  I talked to my husband and asked him if I had been hard to live with lately.  He replied, “I would not even know anything is wrong if you had not told me….”  I also asked my manager at the studio for her honesty.  She replied that I was harder on myself than on anyone else.  She also added, “Hey, I think if you are gonna have the spunk, you’ve gotta have the funk.” 

Her last statement reminded me of when I was on Celexa in the past.  I remember feeling a real dampening down of my personality during that time.  I did not feel as creative and I felt sleepy a lot of the time.  I also gained 35 pounds and my husband expressed that I did not seem to laugh very much when I was on the drug.  No funk, but no spunk either.

You kept telling me that I needed to talk to someone to unearth my deep psychological issues.  Well, just to let you know, I have done that work.  I felt like you assumed I had not done enough work on my emotional issues; I assure you, I have.

I am not the sort of person who wants to treat symptoms instead of the root cause.    When I first called your office, I told the person answering the telephone that I am not a medication person and asked if you were the sort of person who quickly resorted to medication.  I was assured that you were not.  Yet, within two visits you had me on two medications.  And when I told you I had side effects from Zoloft you told me not to look at the side effect sheet saying, “That’s only for the lawyers!”  I was appalled that you were dismissing my experience as not being real.  This did not inspire my trust at all.

You pointed out I have a serotonin deficiency.  What I want to figure out is why and fix the why.  I do not see my serotonin deficiency as permanent, yet you prescribed a permanent fix.  What I was looking for was a holistic look into what may have led up to this particular episode of depression.  What have you been eating?  Have you been exercising?  How is work?  How is business?  Have you been taking time for yourself?  When was the last time you spent some time feeling the sun on your skin?  Are you doing things that bring you joy?   Are you eating close to bedtime?  Do you feel depressed mostly just before your period?  Are you connecting spiritually?

These questions are based on the research I have done since our last conversation.  In fact, I found a website by physicians that describes all my symptoms and provides articles about what may be behind my particular set of symptoms.  I have included their article on depression with this letter, but their entire website is incredibly helpful.  I have heard that doctors do not like it when their patients look to the internet for answers, but what choice do we really have?  I have talked to doctors about PMS…for years and have never had a doctor address it. 

I believe as a yoga teacher and therapist that the body never lies.  I trust my body to tell me the truth about its needs and I teach my clients to listen to their bodies as well.  When I felt dismissed by you and that you were telling not to trust my own perceptions, I was disappointed, especially because I thought we were on the same wave length.  However, this experience did spur me on in finding an approach more in line with my beliefs and values.  In addition to my internet research I talked with an acupuncturist and herbalist and a chiropractor/kinesiologist.  These approaches support the body’s own self-righting mechanism, unlike medication.  According to the attached article, long-term use of serotonin re-uptake inhibitors may actually decrease your body’s own ability to produce serotonin over time.  No thank you…. 

I realize that you may want to “fire” me as a patient and as a referral source, but I hope you don’t.  I have taken the time to write this letter for several reasons:

• I believe that you were sincerely trying to help me in the best way you knew how

• I want to win you over to my way of thinking – that antidepressants are not the first thing to turn to for mild to moderate episodic depression

• I want you to trust my perceptions and remind me to trust them too

• I want you to ask more questions before prescribing antidepressants

• I respect you enough as a person to give you honest feedback about my experience

• I want you to trust me as a yoga resource for your clients and know that I will always give the best care that I know how, working as closely with you as needed on their plan of care (please be assured that I would never advise anyone to go off their medication, in case you were wondering)

Thank you for your time in reading this letter…. If you would like to discuss anything… please call me at XXX-XXXX.

I did get a call from Doctor X's wife that he had received my letter and understood.  She said he would like to refer me to a particular acupuncturist.  I assured her that I knew several that I trusted and would find one on my own.  I couln't shake the feeling that he still wanted to exert control over every aspect of my decisions – and he had not even bothered to call me himself!   I decided that I could not return to his care.  Ironically, I saw one of Dr. X's patients for occupational therapy when I was covering at Ed White.  It has been several months since all of this happened when he walked into the hospital room.  I introduced myself.  He responsed, "I know who you are."  It may have been my imagination, but I did not detect a friendly tone.  I was doubtful that he had truly taken my feedback to heart whatsoever.   I have heard since that other patients of Doctor X had similar experiences.  He has since closed his private practice.  I can't help wondering if other patients also had the courage to stand up to his bullying or at least left him because of it.

Thankfully one of my yoga students referred me to Dr. Graham.  After having me fill out a survey of my symptoms, he did a hormone saliva test.  What we discovered was that my progesterone levels were so low as to be almost nonexistent!  He prescribed an inexpensive natural progesterone cream taylored to my specific level of depletion.  This has changed EVERYTHING!  I know longer have intense PMS and even my cramps are 80% better indicated by my takng taking about 75% fewer ibuprophen during my period.  Sadly Dr. Graham closed his practice to teach residents and have more time with his growing family.  He referred his patients to Aparna Asher.  So far I like her.  She makes me laugh and is very down to earth.  I think I will feel comfortable with her for the big stuff.  I will stick to acupuncture and chiropractics for most of life's little upsets.