Yoga, Mindfulness, & Neuroscience: How Transformation Really Happens Milano ~ 9 Ottobre 2014

Transcription

1 Yoga, Mindfulness, & Neuroscience: How Transformation Really Happens Milano ~ 9 Ottobre 2014 Integrative Yoga Therapeutics with Bo Forbes Bo Forbes, Psy.D., E-RYT500 boforbes.com (website) youtube.com/yoginibf (YouTube Channel) facebook.com/boforbesyoga (Facebook Educational Site)

2 Map of the Mind-Body Network Immune System Pain Modulation Pathways Enteric Nervous System Physical Body Nervous System Emotional Body (Limbic) Mental Body Fascial Web Deep Visceral Body The Eight Primary Research Findings on mindfulness, yoga, anxiety, and depression 1. Yoga as more than exercise: More Effective than Yoga as Exercise for Anxiety (Narasimhan, 2011) Participants in both the integrated and exercise yoga groups experienced decreased depression and stress, an increased sense of hopefulness, and increased flexibility compared to the control group. However, only the integrated yoga group experienced decreased anxiety-related symptoms and decreased salivary cortisol from the beginning to the end of the study. Yoga, practiced in a more integrated form, i.e., with an ethical and spiritual component, may provide additional benefits over yoga practiced as an exercise regimen. 2. Our Yoga Practice Has a Half-Life (Streeter et. al., 2010) Chris Streeter BU Study #2: Iyengar Yoga vs. Walking GABA: a calming neurotransmitter, important in stress resilience (less time in fight-flight-freeze) Stress hormones (cortisol) decrease after yoga, but regular practitioners don t have lower baseline levels. Our practice has a half-life and needs to be taken every day.

3 Yoga may be an important factor in stress resilience, but may require a daily dose Frequency trumps duration of practice 3. Posture Affects Mood, and Vice Versa (Canales, JZ et. al, Brazil, 2010) Over a 10-week period, 34 individuals with depression and 37 healthy volunteers were evaluated, and posture was assessed based on digital photos of the subjects During depressive episodes (in comparison with the post-treatment period), patients showed increased head flexion, increased thoracic kyphosis, a trend toward left pelvic retroversion, and abduction of the left scapula After remission, patient posture was similar to that of the control group 4. Mindfulness Training Alters Neural Expression and Duration of Emotion, Turns off Narrative Mechanism (Farb et. al, 2010) Default Mode Network, or Evaluative Network: self-referential, dwelling in past, concerned about future, comparing present to what you d prefer it to be MBSR: yoga nidra bodyscan and relaxation, gentle breath-centered asana, breathwork, mindfulness meditation, psycho-education re: application to daily life After MBSR, greater activation in experiential network- greater de-activation in evaluative network Can t be trained through explanation: practice decouples narrative mode and experiential mode Concept: learn to feel, breath through feelings without commentary, story-telling, meaning-making Practices that direct non-judgmental attention to sensory, embodied elements of experience promote emotional healing and well-being Restorative Yoga Therapeutics as a way of training ourselves to sit with direct experience 5. Yoga enhances the benefits of mindfulness (Shelov et. al., 2009) In an 8-week study, yoga was found to increase indices of mindfulness Three areas of mindfulness showed significant increase: attention to the present, open and accepting attitudes toward experience, and insightful understanding yoga prevents negative emotional mood states (i.e. anxiety and depression) 6. Restorative Yoga is More Effective than Stretching for Reducing Subcutaneous Fat in Overweight Women (Araneta, Allison, Barrett-Connor, & Kanaya, 2013)Six-month investigation period Both groups lost weight The Restorative Group kept weight off, lost significantly more fat than the stretching group, which eventually began to regain the fat toward the end of the study Possible reductions in cortisol in the Restorative Yoga group implicated 7. Rest is Dynamic (Immordino-Yang, Christodoulou, & Singh, 2012) When body is at rest and mind is awake, this creates a state of Dynamic Internal Reflection This state reduces the activity of the Default Mode (Narrative) Network 8. Self-Compassion Reduces Anxiety & Depression Self-compassion lowers anxiety & depression (meta-analysis of over 22 studies) Reduces cortisol Increases heart-rate variability (an indicator of emotional health) Provides emotional resilience over self-esteem Kristin Neff, 9. Interoception is Powerful as a subset of Mindfulness as well as a stand-alone practice (Farb, 2013) increases plasticity in medial & anterior insula (mindfulness centers) important component of mindfulness breath and meditation

4 Therapeutic Infrastructure Interventions in the Integrative Yoga Therapeutics Practice The Yoga Practice Lab Helps build inner awareness, helps practitioners get to know their mind-body network Helps empower practitioner/client to take an active role in their own healing Hawthorne Effect: by simply measuring something, we change it Pratyahara (Internal Awareness) Involution of the Senses Outer sight transitions to inner sight, or insight and outer hearing to a deep, internal listening Awareness itself is therapeutic; it is neutral and not organically anxious, depressed, angry, etc. Pranayama (Not just breath control, but regulation (and lengthening) of life force ) Breath impacts the nervous system very rapidly o hyper-ventilating can put the nervous system into overdrive o slow, regulated breathing can balance the nervous system and also quiets the mind The Bandhas: Mula (Root), Uddiyana (Upward Flying/Navel), and Pada (Foot) Bandha Grounding, stabilizing, and energizing A vehicle for inner awareness Help support the spine and align the body Foundation of core body strength Pada Bandha, three main benefits: lightens you (good for depression), grounding (good for anxiety), protects knees and also expands shower curtain rod of the sacral spine Slow Transitions Transitions become an active part of the practice: where we need to anchor Transitions are a liminal (in-between) space; we prefer well-defined spaces both on and off the mat Bringing awareness to transitions, treating them with the same care we treat actual poses, and bringing the core body into play during them, is tremendously helpful to our practice. Lymph Drainage Helps release toxins Strengthens the immune system, which then helps nervous system and emotional body balance Postural Adjustments: Foundational alignment work Gateway to Prana (pec/neck/shoulder/head axis) Going Up the Stairs Backwards Posture affects Mood, and Mood affects Posture Micro-Alignment Creates a channel for breath Helps with injury prevention Helps awaken sleeping (tight/unaware) spaces in the body, helps hypermobile spaces rest, stabilize Fascial Reintegration Alignment of the entire fascial web The fascial web is sentient, and intelligent, and tied into the nervous system We are moving from the concept of neuro-muscular reintegration to neuro-fascial reintegration Therapeutic blockwork poses for fascial release Restorative Yoga Calming to the mind and nervous system (new nervous system set-point) Helps emotional body move from narrative mode to direct experience, and tolerate experience Creates magical combination of relaxed body, alert but calm mind that helps access deeper wisdom

5 Self-Care Pillar: Mindfulness and Self-Compassion Mindfulness: MBSR (Jon Kabat-Zinn s work) Includes meditation, body scan, breath-based movement, yoga nidra Impressive body of research linking mindfulness to many areas of physical and emotional health Helps uncouple Default Mode Network and Experiential Mode Reflect-and-redirect that we find in Restorative Yoga Restorative Yoga: an incubator for difficult emotional experiences Self-Compassion: self-kindness common humanity mindfulness Self-Compassion: lowers anxiety & depression (meta-analysis) reduces cortisol increases heart-rate variability provides emotional resilience over self-esteem Self-Compassion Break: This is a moment of suffering All people feel suffering at times What do I need at this time? Interoception: Attention to momentary bodily sensations increases plasticity in medial & anterior insula (mindfulness centers) important component of mindfulness breath and meditation Mindfulness Training Alters the Neural Expression and Duration of Emotion and Turns off Our Narrative Mechanism (Farb et. al, 2010) Default Mode Network, or Evaluative Network: self-referential, dwelling in past, concerned about future, comparing present to what you d prefer it to be MBSR: yoga nidra bodyscan and relaxation, gentle breath-centered asana, breathwork, mindfulness meditation, psycho-education re: application to daily life After MBSR, greater activation in experiential network- greater de-activation in evaluative network Can t be trained through explanation: practice decouples narrative and experiential modes Concept: learn to feel, breath through feelings without commentary, story-telling, meaning-making Practices that direct non-judgmental attention to sensory, embodied elements of experience promote emotional healing and well-being Restorative Yoga Therapeutics as a way of training ourselves to sit with direct experience

6 Immunity via the Enteric Nervous System Research on Immune System/Enteric Nervous System Interactions: Anxiety can make the stomach more acidic People with a history of trauma are more likely to develop disorders of the gut The converse is also true: people with irritable bowel syndrome (IBS) have a higher incidence of childhood trauma than people whose belly brains behave more normally Serotonin (a neurotransmitter long implicated in depression) is an enteric neurotransmitter The gut s complex serotonin system includes no fewer than seven types of receptors Transmitters released by terminals of enteric neurons in mucosa influence immune-related cells Intestinal mucosa cells release active substances, including cytokines and mast cell tryptase, that act on enteric neurons Two-thirds of the body s defenses reside in the gastro-intestinal tract: your immune system first kicks into alert mode in your digestive tract Enteric Nervous System (ENS): Our Belly Brain Housed in sheaths of tissue in the esophagus, stomach, small intestine, and colon the only part of the peripheral nervous system whose extensive neural circuits are capable of local, autonomous function Extensive and reciprocal communication with nervous system Two-way communication between ENS and immune system, as well Enteric Nervous System (ENS): contains 100 million neurons more neurons than spinal cord makes its own hormones, neurotransmitters, peptides makes endorphins (natural opiates) Functions of ENS: Control of motility Regulation of fluid exchange (water and electrolytes) in digestive tract Defense reactions of the gut Regulation of gastrointestinal endocrine cells (serotonin system) Primary Infrastructure Interventions: Pratyahara Pranayama Bandha and Core work Slow Transitions with Micro-Alignment Lymphatic Drainage Fascial Reintegration Restorative Yoga Therapeutics Prana in the Belly occurs when we cultivate a combination of four things in the core: Awareness (i.e. is there chronic holding? Laxity? Do we alternate between the two? What other messages (read: gnosis) does the core have for us? Strength (of the deep intrinsic abdominals and psoas- this should happen without shortening) Flexibility (i.e. in backbends) that works in concert with strength The capacity to release (voluntarily and through RYT)

7 Yoga and Neuroplasticity Neuroplasticity: A Science of Pattern Formation and Pattern Change 1. The Body Feels Emotions, Too a) Mental Processing is slow, and also activates nervous system and emotional regions of brain b) The Body can practice anxiety, depression, chronic pain, etc. c) Even if the mind has insight, the pattern will continue if that insight is not embodied d) The Body is an integral part of changing anxiety and depression 2. Why Change is So Difficult: Neuroplasticity a) Nervous System remains activated b) We Don t Involve the Body in Change (and thus, it replays its patterns) c) We Practice Old Patterns (stories, etc.)* role play d) We go for big interventions such as a rockin physical practice 3. How True Healing Happens a) Instant Healing Doesn t Work- think Slow-Cook Healing b) It s not necessary to process or understand what you are letting go of in order to let it go c) Thoughts can get in the way d) Practicing and Neuroplasticity: subtle, progressive experience that builds over time e) This kind of sustainable practice forges a direct path to optimal functioning 4. Five Ways to Transform Anxiety and Depression a) Balance the Nervous System (parasympathetic) b) Regulate breathing c) Inhabit the body (which creates embodied insight) d) Remain in the present (takes away past and future orientation, builds observation of prakriti e) Creating new narratives (and releasing old ones) 5. How does this translate into our yoga practice? a) We need methods of balancing the nervous system (pranayama, Restorative Yoga) b) Awareness and Breath are the foundations of a transformative practice c) Slowness and embodiment of direct experience in yoga help create positive neuroplasticity d) We need anchors to the present in asana (other than exhortations to breathe! ) e) The mental body needs a makeover that is founded in the physical body s experience 6. Yogic Interventions that work with neuroplasticity principles a) Subtle Practices* repeated regularly over long periods of time (Yoga Sutras) b) Slow, alignment-based practice with micro-transitions for building presence c) Deeper Breathing (Nasal or Ujjayi) d) The Four Bandhas: Pada (Foot), Mula, Uddiyana, Neck/Throat e) Core Work including bandhas and psoas f) Lymphatic Yoga g) Postural work around the neck, chest, shoulder area h) Restorative Yoga as a practice or in Savasana- for a low-energy or high-energy body From Yoga for Emotional Balance: Simple Practices to Help Relieve Anxiety and Depression, by Bo Forbes, Shambhala Publications, 2011.

8 Translating Research into Practice The Skeleton of a Therapeutic Vinyasa Class: The 5 to 45-minute practice PRATYAHARA AND MORE: The 5- to 10-MINUTE PRACTICE Seated Meditation: Bandha & Breath Vinyasa (ENS, NS, IS through lymph, fascial web, and sometimes pain pathways) Opening of Pranic Gateway (neck/shoulder/throat axis) (EB, PB, NS, IS, and more) Intention (thread of awareness that moves through the whole class) PRANAYAMA: 2 ADDITIONAL MINUTES Pranayama: Cooling Pranayama for active minds, balancing pranayama for balanced or slow minds WARMUP: ADDITIONAL MINUTES with FASCIAL WORK FOR POSTURE/MOOD AXIS Standing Frog with other Warmup Therapeutic Sun Salutations, 1-2 on each side, with possible isometrics (all Nine Bodies) STANDING POSTURES: 10 ADDITIONAL MINUTES Basic Standing Poses for Grounding: Revolved Parsvakonasana (Side Angle Pose) and Parsvakonasana (Side Angle Pose) Other Standing Poses Crescendo or Crescendo Therapeutic Pose, if applicable CORE-FOCUSED POSTURES: 5 ADDITIONAL MINUTES Poses like Dandasana Vinyasa, 1/2 Front/Side Plank, Hanging Plank, Core on Block, etc. THERAPEUTIC BLOCKWORK: 5 ADDITIONAL MINUTES Therapeutic Blockwork (with feeling the difference in between or afterward) COUNTERBALANCING: 5 ADDITIONAL MINUTES Counterbalancing Poses: If it was an opening class you can then open the part that was compressed. For example: backbends open the front body and compress the back body; therefore, you want to open the back body without forward bending: Supta Padangusthasana is a great way to do this. If you strengthened something, such as the core body you d then release it. For example, if you strengthen the core body in most of the class, you could then do Purvottanasana (Table), Supported Matsyasana (Fish) with head on block, or Baddha Konasana (Bound Angle). If you released something with intensity, you d want to neutralize or re-balance it. For example, if you do Block on the IT Band, you could balance that by gently stretching it, as in Revolved Supta Padangusthasana, or Simple Supine Twist, or Supine Figure Four 5 to 15 ADDITIONAL MINUTES: Therapeutic Savasana or, if more time, Restorative Yoga (possible incubator for difficult emotions)