Mind Body Connection: Considering the Evidence

The following video contains a wealth of information on mindbody health with an emphasis on cardiovascular health (the speaker, Dr James Kneller, is a cardiologist).

He explains the electromagnetic impact of the heart on oneself and others and the broken heart syndrome caused by extreme stress. He discusses the placebo effect, the power of Pavlovian conditioning, the impact of optimism on heart health and the negative effect of depression and bi-polar disorder on heart health. He also presents evidence on the effect of ‘awe’ on reducing systemic inflammation, the power of charitable giving on health indices, the positive impact of gratitude and the negative impact of job loss on mental health, and divorce on heart health. He also talks about the importance of harnessing intuition in predisposing one to living a successful life. He also explains how feeling young can help us live longer and the habits of centenarians such as being easy going, outgoing, optimistic and laughing a lot and the importance of each of these in living better for longer.

He also discusses the implications of the presented evidence.
1) The conguency one feels with oneself is vital to good health.
2) Your inner experience shaper your outer world and those around you.
3) Love, gratitude, inpiration, compassion, awe, forgiveness, are all important in maintaining positive health by harnessing the mindbody connection.

The evidence he presents is fascinating and thought provoking. Please watch to learn more.

Cool down with Sheetali Breathing

Many more people practice Kapalabhati, the breath of fire, than Sheetali, the cooling breath. Sheetal means cool and soothing in Sanskrit and that is the effect it has on the mind and body. It is calming and relaxing to the body’s metabolism.

Sheetali breathing is useful in reducing blood pressure, ulcers, acidity or any increase in the fiery ‘pitta’ state which can often translate to inflammation, stress and the fight-flight response. It literally cools the body’s temperature and has a rejuvinating effect on the body’s systems by removing excess heat. It is said to refresh the nervous system by activating the parasympathetic branch of the autonomous neverous system which relaxes the breathing, heart rate and muscular tension. It also refreshes the endocrine system, spleen, bile and even reduce fevers.

How to do Sheetali Breathing?

Start with a crosslegged meditative posture on the ground with your back straight and your body relaxed. Take a few slow deep breaths to further relax your body.

In this type of pranayama the tongue is rolled lengthwise into a tube which sticks out of the mouth. As it so happens, many people can’t roll their tongue in this direction. For these people an alternate horizontal folding of the tongue horizontally can be used. This is often called Sitkari Pranayama.

Inhalation uniquely in this practice, happens through the mouth, and you can feel the air being cooled as it enters through the wetness of your curled tongue. Exhalation is gentle and slow through the nostrils. The general proportion of time in inhalation to exhalation is 4 seconds to 10 seconds if possible. The shorter the inhalation and the longer the exhalation, the more relaxing this exercise will be. But keep in mind as with all Yogic practices, nothing should cause you discomfort. Do not force your breathing to follow any proportion. Just guide it along gently in the direction of the proportion mentioned.

Practice this for five minutes and work your way to ten minutes as you get more practice. Ten minutes will truly relax you and cool all the stress away.

Precautions

Please keep in mind that it may be better to avoid this exercise if you have low BP.as this exercise tends to lower blood pressure. If you are going to try it anyway, please keep an awareness on your body and stop when you feel any discomfort. If you feel dizzy then please stop the practice and continue normal breathing.

Trāṭaka

Meditation is becoming very popular nowadays but it is mainly mindfulness which is getting a lot of the attention. Trāṭaka is a less known type of meditation which appears in stories such as ‘The Monk who Sold his Ferrari’ by Rabin Sharma and ‘The Wonderful Story of Henry Sugar’ by Roald Dahl.

It involves a gaze at what is typically a candle flame. It is important that the gazer is as still as possible, refrains from blinking and movement of the eyes. And equally important is that the candle is not flickering or moving. This fixed gaze develops concentration.

I must say in my practice it has been easier to concentrate than pay attention, so I have found Trāṭaka more easy to do than mindfulness. It is difficult for the mind to wander too far when you have an external point of focus and your eyes are open.

It is difficult though, especially in the beginning, to prevent your eyes from moving. It is the way we see – either an object must move or we must move our eyes to see an object at all. The eyes have movement even during sleep (Rapid Eye Movement during dreams REM sleep). So to consciously stop the eye movement is difficult to do.

Eye movement is also the way we think. This has been studied in NeuroLinguistic Programing. We gaze in different directions to access memories or create a visual or auditory image. There hve even been studies that show abnormal patterns of eye movement in those with schizophrenia, depression, and other psychological illnesses. So keeping the eyes still has interesting effects on the mind. With the stilling of the gaze, the mind stills too. For moments, there is no thought. In order to see the flame, you must be totally present, just looking and doing or thinking nothing else.

This property of the Trāṭaka exercise makes it have potentially big benefits for various phsycological problems. Apart from this, the benefits of the exercise include increased concentration power and improvement in various eye conditions too. As a Yogic exercise it is clubbed with Kriyas, which generally tend to cleanse internally or externally. Trāṭaka is often done till the eyes water or grow tired. The watering of eyes upon resisting blinking may have a cleansing effect on the eyes.

So next time you think of meditating, if you want to try something new, try Trāṭaka.

What’s wrong with the Western Medical System

Western medicine has done wonders for humanity. It plays a very important role in saving lives in emergencies, uses the best technology available to diagnose people’s health issues and bases much of it’s progress on medical and scientific research. However, there are several aspects in which it falls short of helping people feel better. Here I try to explain some of them.

Mind and Body

No other medical system in the world considers the mind and body as separate and unrelated. This false premise underlies the mechanical view of the body and indeed the reductionist approach which Western thinking takes to medicine. It is slow to recognise the interconnections between the systems and the significant influence one’s mental state has on one’s physical state and vice versa. Recent research has started to show how powerfully our thoughts and emotions impact our physical health. Robert Sapolsky, a researcher and lecturer at Stanford, has written a book called ‘Why Zebras don’t get Ulcers‘ in which he explains in a simple and engaging way, the mechanisms by which stress impacts various health conditions; ranging from diabetes to autoimmune disorders, not to mention the obvious ones such as heart disease and hypertension. Research on ‘Blue Zones‘ as well as studies which examine the role of social connection on longevity of those with breast cancer reveal that even psychosocial factors such as having healthy social connections can impact physical outcomes and lifespan. The research on the ‘mind-body connection’ within neuroendocrinology, biochemistry and immunology is growing far too vast to cover in this article, but increasingly shows that the mind and the body are just different aspects of one being that impact each other at every turn. Yet when we visit a physician for any ailment, we are hardly, if ever, asked about our mental. emotional and social lives.

Conservative Nature

You may ask, if research that explores the mind body connection already exists, surely the doctors would know about it and apply it? Here is my second disappointment with the western medical system. It is excessively conservative. This means that many new findings within the research takes years, if not decades, to become incorporated into standard practice. For example, it was found in 1956 that X-rays on pregnant women resulted in higher occurrence of childhood cancer but it took the next 25 years for the medical establishment to stop the practice, despite the findings being freely available. I think about the children who could have lived had the practice incorporated the findings sooner. There are other examples such as the work of Dr Dean Ornish which has for the last thirty plus years been showing repeatedly in different rigorous experimental paradigms the profound effect lifestyle changes can have on those with heart disease, irrespective of age and severity. But these findings still aren’t incporporated into standard medical practice. Patients with heart disease are still only given the options of drugs and surgery which does nothing to address the cause of the problem and thus leads to recurrance of the illness.

Hidden Agendas

The purpose of the medical system should be to serve the wellbeing of the patients who come to them. But in several instances, it seems that other things come first. There are several documentaries about how those in mainstream western medicine are trying to eliminate all other forms of health professionals so that they, and the pharmaceutical companies can monopolise the market. It is undeniable that the ‘big-pharma’ companies weild power over doctors ‘persuading’ them to prescribe certain medications to increase their profits leaving the wellbeing of the patient as a secondary matter. Worse still, many doctors perform unnecessary surgeries, making money for themselves with no concern for the short term pain and long term damage they may have inflicted on the patient. Even though I truly believe that the students who want to study medicine start out with the intent of helping others, somewhere along the way, they start dancing to a different tune.

Fascination for Gadgets

The novelty of the X-ray was in part the reason that the evidence relating it to childhood cancer was so hard to accept for the medical establishment. The medical establishment is simply blinded by all the potential of new technologies that they can’t accept any possible negative aspects of it which flies in the face of what they expect it to do – help save lives.

Fascination with high tech equipment is also the reason that, as technology has grown more prevalant and accessible, the doctors have started to ask patients fewer questions and order more tests. This is not to say the technology is not helpful; it is, very much. But it is not a substitute for the art of medicine which is about observation, connecting experience with research, knowing what questions to ask the patient to get to the bottom of the issue and making the patient feel cared for. What tends to happen nowadays instead, is the passing around of patients from one specialist to another, putting them through innumerable tests, some repeatedly, and labeling them with diagnoses which have no known cause, which is quite meaningless except that it defines a set of symptoms. Patients feel more like lab-rats than like people in this process. Though technology has its uses, it has unfortunately added to the mechanical approach of western medicine. Further, the focus on technology at the cost of the art of medicine is also better for business, benefiting the companies which produce and sell these complex machines.

Not Simple

Some problems have simple causes. Doctors though, tend to assume and consider the worst possibility before examining anything simpler. It’s quite an alarmist reaction and can really scare patients.  If you tell a doctor you have knee pain, the first thing they may say is ‘you may have rheumatoid arthritis’. While this could be true, rather than scaring the patient with such an answer without any basis for this comment, wouldn’t it be more useful to ask about any recent changes in posture, any strains or injuries and other simpler explanations first?

Some problems have simple solutions. But doctors have a tendency to prescribe drugs and recommend surgery even when  a better alternative is possible. Doctors tend to dismiss or ignore wonderful research which shows emperically the beautiful, healthy and powerful effects of changes in  lifestyle such as in diet, exercise, meditation etc. Dean Ornish has been the voice of this approach for decades.

Ineffective for Chronic Problems

When you have a car accident, an injury during sports or any immediately life threatening problem, rush to the hospital or call an ambulance. This is what they do best. But if you have a chronic condition, the western medical system doesn’t offer any real solutions.

Symptoms, not Cause

The approach of the western medical system seems to be focused on suppressing (what they call ‘managing’) the symptoms rather than trying to understand and address the underlying cause of the problem. This relates to the ‘Hidden Agendas’ as well as the ‘Mind and Body’ problem and I consider it a very disturbing pitfall of the system. This outlook turns doctors into technicians who manage prescription dosage for the rest of the patient’s lives, rather than the healers they set out to be. A drug which does not work to solve the problem is not really medicine. A drug which tends to increase in dosage as the years pass certainly is doing nothing to make you healthy again.

Managing the symptoms can be useful until the cause is found, in the short term. It cannot be a solution in and of itself. While the symptoms are being controlled to make the patient more comfortable and able to deal with daily life, all effort must be put to getting to the bottom of what caused the problem and what can be done to resolve it at the root. If such answers can’t be found within their system, the doctor needs to be honest and admit that there is actually no solution to this that they know of. And allow the patient to try other medical systems where with a different approach an answer may be available.

If the focus was on addressing the cause of the health issues, people may not need to come back to a doctor. They may be able to stop all their pills. It seems in the best interest of the pharmaceutical industry to avoid shifting focus away from symptom management because often once a reason is found for the problem, the ways to fix it may not involve the sale of any drugs at all.

Side Effects

The reason that getting to the underlying cause is so important is because many of the long term exposure to drugs can cause such damaging side effects which at times can compound the problem and lead to several other problems resulting in the patient being far less well than they were on first visiting the doctor. All you need to do to be convinced about this is to read the little information sheet which comes with any prescription drug. In those cramped and small fonted letters lies all the possibilities that can occur if you are to take the drug. The doctor may tell you they are unlikely but they occur far more frequently than you may think.

For example let us take oral steroids, prednisone, which is used for several problems where inflammation needs to be controlled or where the immune system needs to be suppressed (allergic disorders, skin conditions, uveitis, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders). Side effects even after just a week of taking them can include aggression, agitation, anxiety, blurred vision, decrease in the amount of urine, dizziness, fast, slow, pounding, or irregular heartbeat or pulse, headache, irritability, mental depression, mood changes, nervousness, noisy, rattling breathing, numbness or tingling in the arms or legs, pounding in the ears, shortness of breath, swelling of the fingers, hands, feet, or lower legs, trouble thinking, speaking, or walking, troubled breathing at rest, weight gain (including what is called moon face). One could also expect abdominal or stomach cramping or burning (severe), abdominal or stomach pain, backache, bloody, black, or tarry stools, cough or hoarseness, darkening of skin, decrease in height, decreased vision, diarrhea, dry mouth, eye pain, eye tearing, facial hair growth in females, fainting, fever or chills, flushed, dry skin, fractures, fruit-like breath odor, full or round face, neck, or trunk, heartburn or indigestion (severe and continuous), increased hunger, increased thirst, increased urination, loss of appetite, loss of sexual desire or ability, lower back or side pain, menstrual irregularities, muscle pain or tenderness, muscle wasting or weakness, nausea, pain in back, ribs, arms, or legs, painful or difficult urination, skin rash, sleeplessness, sweating, trouble healing, trouble sleeping, unexplained weight loss, unusual tiredness or weakness, vision changes, vomiting, vomiting of material that looks like coffee grounds, acne, dry scalp, thinning of the scalp hair, lightening of normal skin color, red face, cataracts, increased ocular pressure, reddish purple lines on the arms, face, legs, trunk, or groin, swelling of the stomach area.

As though this wasn’t enough, when steroids are tapered off (even gradually), there are often steroid withdrawal effects too. Withdrawal symptoms and signs (weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea, abdominal pain and severe muscle and body aches) can mimic many other medical problems. Many doctors try not to use steroids for long term treatment. Instead they attempt a more powerful drug which suppresses and modulates the immune system. The side effects of which can be far more serious than even steroid treatment and can result in liver or pancreatic failure, hospitalisation, surgery and worse.

Even outside the realm of inflammation medication, many effects of combining pills for two different problems are unknown and can compound into a more serious problem than the side effects of either pill alone.

Mechanical Nature

Though I have mentioned this in several of the previous points, I think it is worth outlining why this is a problem. The way we are taught about the human body in Biology is about systems within the body, parts of those systems and more detailed parts of those parts. For example, the urinary system contains the kidneys, ureters, urinary bladder, urethra etc. Then we study more about kidneys, the structure and function of a nephron, and then further inward, which part of the nephron reabsorbs what, what is the role of the Henle’s loop. The reason I was so crazy about biology was because I believed that if you understand every single minute part of the body and what it does, you can know everything there is to know about how it can go wrong and how to fix it. Nowhere are we taught that in a complex system like the human, the ‘whole is more than the sum of the parts’. The body is not a machine. There are interaction effects and emergent properties which simply can’t be explained through the mechanical reductionist approach.

Secondly, the mechanical outlook extends to the interaction between the doctors and the patients. As I mentioned earlier, taking so many tests, and asking fewer questions about the patient’s life makes the patient feel less like a person. The doctors can’t be blamed though because they are alotted too little time with each patient. Even if they were to have seen them regularly for over a year, they would know nothing about their living conditions, nutritional state, psychological, social and monetary state, which all have an impact on their health. Rather, they start to see patients as malfunctioning body parts to fix and monitor. Each of us is a full person with a mind, an environment, certain behaviours, pasts, deep set beliefs, and unique needs. I believe that a full healing process would need to take all aspects of the person’s life into account.

Legal Fears

Much of what doctors do is in fear of being sued. They are often instructed to take the least risky path for the patient, even if it means unnecessary testing and a great deal of discomfort to the patient, to avoid law suits. This fear prevents doctors from being creative at their problem solving and leads to them following a set protocol in their treatment. This too contributes to the loss of the art of medicine.

Failure to Diagnose

There are several examples of people who have gone to the doctor, or several doctors for a serious problem they have had – such as acute chest pain or acute vomiting or diarrhea attacks – and have been subjected to all possible tests under the sun, only to find that everything is ‘normal’. If everything is normal, why do these people still suffer? There are no answers here. Failure to diagnose, or often misdiagnosis can cause immense frustration to patients who are already suffering. This problem shows that the tests and technology though advanced, don’t cover all aspects of a person’s life that could impact their health significantly. A more creative approach which involves listening to the patient, spending more time trying to understand the source of the problem could add insights that purely blood, urine tests and CT scans can’t reveal.

Trial and Error

This follows from the previous point. In the cases where diagnosis is not simple, doctors tend to use trial and error. Frequently they prescribe antibiotics without knowing if there is really an infection present, just to rule it out. If no solution comes from that, they try some other medication. Over-testing is preferable to this because of the various undesirable sideeffects that can result from taking random and unnecessary medications.

Authority

The medical system is designed to give a certain authority to those who have an MD and leaves them with certain rights which others could be worthy of sharing. Midwives who deliver babies don’t have the power to sign off on the birth certificate document. Nurses in the emergency rooms who perform the tests and spend a disproportionaltely longer amount of time with patients compared to the doctors aren’t given the authority to say that the person is okay either. The nurses who sees a woman and her child all through labour will still have to call the doctor when the baby is about to come out. Catch the baby, sew the stitches if any and off they go with one more delivery under their belt. Doctors know far less about the cases and spend less time with patients than the nurses. But they get the final say. Although this line of authority is necessary and useful in complex cases, it can cause inefficiencies and waste a lot of the patient’s time when a simple case can be signed off on by a nurse.

This same authority is something society and law gives an MD. Yoga studios mention in their consent form that permission from a doctor should be sought before engaging in these activities. Several books are required to write a disclaimer which undermines the author’s authority on the subject topic and dismisses the content as ‘opinions’, even if the content is valid and based on scientific knowledge simply because the author is not a doctor. This is surely done for legal reasons leaving the responsibility of the health of the readers or the participants of a yoga studio in the hands of the MD but there is something disturbing about the overreliance on a medical opinion.

This overreliance encourages people to depend on a doctor for much more than they did a couple of decades ago. And it encourages an outsourcing of responsibilities about one’s health and disempowers the individual. For example, if a person has a persistent cough, they can easily figure out whether it is a dry or a wet cough, and under the possible reasons for a dry cough they can eliminate and deduce the reason to be acidity. And also keep a watch on what they are eating and the postures in which it gets worse and start to modify their dietary intake and behaviour to mitigate the problem. This only requires that they pay attention to their own bodies. If instead they disempower themselves and go to the doctor about it, the doctor can rule out more serious possibilities and can go so far as to say that it appears to be a dry cough. Without the patient telling them that it gets worse when they eat XYZ and better when they drink ABC, they won’t have a method to figure out that it is acidity, and they can only give you a generalised list of foods that exacerbate the problem. This list of foods is not absolute fact though. Some people with acid-cough are fine with lemons and cooked tomatoes but not with raw cherry tomatoes. This is something the patient has to figure out through observing themselves. Similarly in many cases where there is a simple problem such as a first degree burn from scalding hot water, knowledge of the best way to act immediately serves the patient better than relying on a doctor. Washing with cold water immediately and consistently and keeping the skin cool with a cloth covered ice pack for the following hour or so (and applying aloe vera) helps infinitely more than rushing oneself to urgent care where one has to wait to see the doctor and the damage to the skin has worsened by that point.

Another aspect of authority of a doctor which I find disturbing is that in some parts of the world, many doctors simply dictate what is to be done and expect no questions from patients. When asked for an explaination to understand what is going on better, the doctor often responds with a haughty, I’m the doctor, you’re the patient, just do what I say.

While this problem may be far less common in the US, it is very common in India and can result in the public taking the doctor’s word at face value and never being given the opportunity to learn enough to help themselves. A dialogue should be possible between doctor and patient and the aura of power and magic that surrounds a doctor and medical jargon needs to be dispelled. The D-R is not what makes a doctor worthy of respect. The magic of a doctor is in how well informed she is on the latest research, how caring she is in handling her patients, and how creative she can be in finding the best solutions for those who seek her help.  The conversations need to be informative in a way that patients understand what is going on without feeling fearful unnecessarily, blindly impressed, or scared by terms they have never heard before. A doctor is not better if he prescribes fancy medication. A truly great doctor is one who knows when not to prescribe anything. A great doctor will not feel threatened by questions, but rather feel encouraged that the patient wants to take an active role in their own health. Such a doctor will feel free to share whatever information is available to make the patient feel empowered to evaluate the information given to them. A patient should feel able to understand the basics of what the risks and rewards are and make their own decisions in partnership with a qualified professional.

It will take quite a lot to overcome these shortcomings. I hope the medical system can work towards the ideal. In the mean time, the challenge I face is to provide what the doctors don’t.

  • The need exists for someone who is willing to reach into the latest research and try something that could work. When someone is suffering, if well established answers aren’t easing their pain, new options need to be given a chance. That is how new discoveries are validated – by replication. When someone is suffering, what matters is easing their pain. Any method that can offer that possibility must be tried.
  • The need exists for someone who is curious and open to learning about other approaches which see the mind and body differently and applying any beneficial insights for the benefit of their clients.
  • The need exists for someone who can afford the time to talk and work in active partnership with a client explaining what is happening without throwing jargon at them.
  • There is a need for someone who looks for accessible solutions which are available to the client which result in the education and empowerment of the client.
  • There is a need for someone who will care about the client as a whole person and help them put together input from various specialists and the context of their mental, emotional, social lives.

The Dr in front of my name is from a PhD, not an MD. I’m a scientist by training and that is the approach I take; One of curiosity, not unilateral authority. I won’t shy away from admitting what is unknown. But I won’t stop there and give up either. I will comb through the literature until I find something that could help you. My only agenda is to help you Rise.

 

Introduction to Pranayama

Prana can be translated to mean breath, though in subtle terms it is also associated with ‘life force’, ‘vital energy’. Ayama means control. Together, Pranayama means control of breath. It is a vital part of Yogic practise consisting of breathing exercises which can have profound effects on the body and the mind.

The breath is automatic and occurs as a bodily process even when we are unconscious of it but it can also be consciously controlled when we will it with our minds. This is why the breath is claimed to be the bridge between the mind and the body. You may have also observed how the breath changes based not only on physical exertion and rest, but also based on different emotions. The corrolary then is that physical and emotional states can also be controlled through the control of the breath.

Traditionally, the mastery of Pranayama is arrived after the mastery over Asana – posture. But in practice, some Pranayama exercises are integrated into a Yoga class. The breath is central to the practise of Yoga. Asanas without attention to breath are simply empty movement with far less benefits.

LungVolume

Here I introduce a few common and simple breathing exercises.

Keep in mind that before doing any Pranayama

  • You should feel light and comfortable in terms of your body (read; a light stomach and done with all ablutions) and clothes.
  • The body should stay relaxed with the spine erect and centered, and eyes closed.
  • A meditative posture such as Padmasana or Vajrasana is recommended though the simple cross legged Sukhasana is also fine.
  • There should not be any strain during these exercises. Breath should not be retained longer than comfortable. Normal breathing is sufficient.
  • Those with loose motions should take a break from Pranayama. Those with heart complaints, high blood pressure, slip disc or spondylosis, or those who are menstruating or pregnant should avoid Kapalabhati and Bhastrika (not covered in this post).
  • Pranayama should leave you feeling fresh. Do not overdo your practice all in one go. Try to maintain a regular practice
  • Perform the exercises in a place with fresh air, no dust or insect disturbances.

 

Yogic breathing

The diagram above illustrates different aspects of our total lung capacity. Automatic breathing, when we are not particularly aware of our breath, nor controlling it in anyway, is illustrated by Tidal Volume. This can give you then an idea of how much of lung capacity we don’t actually utilise.

Yogic breathing is a method by which to take fuller breaths. Often this practice starts with sectional breathing consisting of belly breathing, chest breathing and clavicular breathing.

comparative-anatomy-respiratory-system-12-638.

Belly Breathing

One of the most crucial exercises to build awareness of a full and relaxed breath is Belly Breathing.

  1. Sit relaxed with your back straight, preferably in a meditative posture and eyes closed
  2. Place your hands over your belly on either side of your bellybutton with your fingers loosely interlaced
  3. Breathe slowly and fully into your belly in a way that it rises and expands and the interlace of your fingers come apart
  4. Breathe slowly and fully out in a way that your belly falls and contracts back inwards and fingers will interlace back together
  5. Repeat slowly five to ten times

This may feel awkward or counterintuitive at first since many people are used to breathing into their chest and sucking in their belly. Practising belly breathing can be it itself very relaxing. The method becomes clear when we watch how people breathe when they sleep.

In Belly Breathing you are gaining lung capacity by expanding and contracting the diaphragm at the base of the lungs.

Chest Breathing

  1. Slide your interlaced fingers upwards to the centre of your chest
  2. Breathe slowly and fully into your chest, keeping your belly as uninvolved as possible. The rise and expansion of the chest will be felt in the interlaced fingers.
  3. Breathe slowly and fully out and let your chest fall inwards. The fingers will interlace more closely.
  4. Repeat slowly five to ten times

In Chest Breathing you are gaining lung capacity by expanding and contracting the intercostal muscles located between each of the ribs.

Clavicular Breathing

  1. Slide your interlaced fingers further up until they are on your clavicle between your shoulders
  2. Breathe slowly and fully into your the top of your chest raising your shoulders and collar bones. Keep your belly and chest as uninvolved as possible. The rise and expansion of the clavicle will be felt in the interlaced fingers. The expansion will be fairly small relative to the belly and chest.
  3. Breathe slowly and fully out and let your shoulders drop. The fingers will interlace more closely.
  4. Repeat slowly five to ten times

In Clavicular Breathing you are becoming aware of the expansion possible from the shoulder and collar bones area. It corresponds to the uppermost lobes of the lungs. It is the shallowest form of breathing.

After the sectional breathing, the capacity by the expansions of different parts of the respiratory system becomes clear. Now full Yogic Breathing becomes simple.

  1. Inhale and expand the belly, chest and then the clavicles in sequence as the breath reaches full capacity
  2. Exhale and drop the belly, chest and then the clavicles in sequence, pulling them all inward as much as possible until all the air is expelled

The inhalation and exhalation happens first by expanding or contracting the belly so it acts almost like a fulcrum. Remember, the positioning of the hands on the belly, chest and clavicles are only to get a sense of the expansion in the right areas as you start out. Once you develop the awareness of each section and the expansion possible in them, it is perfectly fine to do this exercise without the interlaced fingers.

Another thing to keep in mind during this breathing exercise is to keep the breath smooth. It may be difficult to breathe so slowly and fully at first as you may not be used to using this much of your total lung capacity but with practise you will find that it gets easier.

Note – the residual lung capacity cannot be exhaled as it is what keeps the alveoli and the delicate lung structurally stable.

Kapalabhati

This second exercise is a form of cleansing as it removes stale air pockets not normally circulated during shallow breathing. Typically a Yoga session can start with this kriya as another method to open the lung capacity and refresh the lungs and body. It is an especially useful exercise to feel fresh and alert in the mornings.

  1. Sit relaxed with your back straight in a meditative posture and eyes closed
  2. Keep face and jaw relaxed
  3. Take a deep breath and exhale slowly and fully
  4. From this state of exhalation (the lower limit of Tidal Volume) begin a forceful and fast exhalation by sharply drawing the belly inward. (You are clearing out as much of the Expiratory Reserve Volume as you can with each exhalation and creating enough circulation that even the Residual Volume is refreshed)
  5. Allow the inhalation to be passive. Do not exert any control over this inhalation.
  6. Follow with active and forceful exhalation again
  7. Continue in a steady rhythm that is comfortable to you
  8. To start with, 20 is a good count. As you get more comfortable, build it up to around 80 or 100 at a time.
  9. Once you are done, keep still and observe the changes in your heart rate and breath. Often you may not feel like taking an inhalation for a few moments. Once you do, take a few full breaths and return to normal breathing.

There are several variations within Kapalabhati such as done in different postures, or using only one nostril, or alternating nostrils between the breaths or after each breath. Each of these have the basic benefits of Kapalabhati and some extra uses.

Nadi Shuddhi

My guru always stressed Nadi Shuddhi as one of the most important exercises you could ever learn. She said if you do nine rounds of it six times a day you will never get sick.

Take your finger horizontally under your nostrils and feel for which nostril is more active. The right one is associated with surya, the Sun – higher metabolic processes and the sympathetic nervous system whereas the left nostril is associated with chandra, the Moon – calmer, more relaxed state and the parasympathetic nervous system. The body automatically alernates the primary nostril every few hours or based on the environmental or psychological state one is in. The body needs to have a balance between these two types of processes. Sickness can result from an imbalance in this alternation.

Nadi Shuddhi brings the body back to a balance through this connection between the breathing patterns of the nostril and our metabolic states. The aim is to have balanced breath betwen the two nostrils, slowed down and with heightened awareness. It can have a very profound effect when done around 20 cycles or more in one stretch. It simultaneously relaxes and refreshes the body and the mind. The minimum though is nine cycles in one go. It is usually done towards the end of a Yoga session.

Nasika Mudra

 A fundamental mudra in Pranayama practice is the Nasika Mudra. In your right hand fold in the pointing and middle fingers and keep the ring and little fingers straight along with the thumb. The palm will bend a little into itself. This is ok. In alternate nostril breathing the top of the thumb is used to block the right nostril and the top of the ring finger is used to block the left nostril. The fingers should not press into the nostrils such that the nose bends. They should only gently close the nostrils.

  1. Sit with spine erect in a relaxed comfortable posture, preferably a meditative posture
  2. With the Nasika Mudra on the right hand, bring it up to the nose
  3. Take a deep breath and release
  4. Now, block gently the right nostril as you inhale from the left nostril
  5. Block the left nostril and exhale through your right nostril
  6. Keeping the left nostril blocked, inhale through the right nostril
  7. Switch to block the right nostril and exhale through the left nostril
  8. This completes one cycle. Repeat at least nine times in one session.

Ensure that the breath is smooth and does not feel forced. There may be an imbalance in the length of each inhalation and exhalation in the two nostrils. Just be aware of this and how it may change as you continue to practice. As you continue with each cycle, the depth of the breath may increase and the overall pace of breath may slow down. Pay attention to your posture and keep a count of the breath cycles.

 

That brings us to the final section of this post:

The Scientific studies that have been done related to Pranayama. Unlike Meditation, Pranayama has not been studied by as many people. Here is a very brief taster of the studies out there.

The most studied exercise is Nadi Shuddhi, also called Nadi Shodhana or Alternate Nostril breathing. One study explores the effect of three types of nostril breathing to try and isolate the effect of each nostril on metabolism as indicated by relative oxygen consumption and galvanic skin response. Another study investigated the effect of nadi shuddhi on cardiorespiratory functioning and found that after four weeks of practice of only fifteen minutes a day in the morning, significant decreases occures in pulse rate, respiratory rate and diastolic blood pressure, promoting parasympathetic activity. Forced alternate nostril breathing has been studied with EEG and found to have balancing effects on the function of both hemispheres of the brain. Yogic breathing seems to have beneficial effects on spatial memory. A study also showed  that blood pressure decreased significanlty following alternate breathing.

There are some studies also done on Kapalabhati exploring cardiovascular and respiratory changes, heart rate variablility, and the effect of this exercise on blood urea, creatinine and tyrosine.

Though the studies are fascinating, experiencing the effects of these breathing exercises first hand is quite another thing. And all you need is your breath!

REFERENCES

Desai, B. P., & Gharote, M. L. (1990). Effect of Kapalabhati on blood urea, creatinine and tyrosine. Activitas nervosa superior, 32(2), 95-98.
Naveen, K. V., Nagendra, R. N. H., & Telles, S. (1997). Yoga breathing through a particular nostril increases spatial memory scores without lateralized effects. Psychological reports, 81(2), 555-561.
Raghuraj, P., Ramakrishnan, A. G., Nagendra, H. R., & Telles, S. (1998). Effect of two selected yogic breathing techniques on heart rate variability. Indian Journal of physiology and pharmacology, 42, 467-472.
Stančák, A., & Kuna, M. (1994). EEG changes during forced alternate nostril breathing. International journal of psychophysiology, 18(1), 75-79.
Stancak Jr, A., Kuna, M., Vishnudevananda, S., & Dostalek, C. (1990). Kapalabhati–yogic cleansing exercise. I. Cardiovascular and respiratory changes. Homeostasis in health and disease: international journal devoted to integrative brain functions and homeostatic systems, 33(3), 126-134.
Telles, S., Nagarathna, R., & Nagendra, H. R. (1994). Breathing through a particular nostril can alter metabolism and autonomic activities. Indian journal of physiology and pharmacology, 38, 133-133.
Telles, S., Yadav, A., Kumar, N., Sharma, S., Visweshwaraiah, N. K., & Balkrishna, A. (2013). Blood pressure and purdue pegboard scores in individuals with hypertension after alternate nostril breathing, breath awareness, and no intervention. Medical science monitor, 19, 61-66.
Upadhyay Dhungel, K., Malhotra, V., Sarkar, D., & Prajapati, R. (2008). Effect of alternate nostril breathing exercise on cardiorespiratory functions.

The Benefits of Meditation

The claim that meditation is good for you and can help improve or enhance one’s mental and physical health is quite a remarkable claim. How can sitting still and paying attention to one’s breath have such an enormous impact on so many conditions we suffer from?

There are many people now, a growing number, who are beginning to accept at a conceptual level that meditation must be good to do because they may have heard an increase in mention of its benefits in popular culture. For example, they may have heard that companies such as Apple and Google encourage their employees to learn and practice meditation regularly to improve their productivity. There are many who may talk about it but would not have ever practiced it.

And then there are those who have experienced it to various degrees and know, not just conceptually, how much difference even ten minutes a day can make to one’s life.

No matter what level of experience one has had, the piling evidence from the scientific community which quantifies its effectivity cannot be denied. Rigorous studies which use standardised psychological and physical parameters show the significant impact of meditation on various psychological and physical conditions.

In this article, I cite some examples from such scientific literature to provide a broad picture of the benefits of this exercise. By no means is it possible to be comprehensive,  as the literature in each of the following subtopics is very vast. (There are review articles (e.g., Grossman et al., 2004, Abbott et al., 2014, Marchand, 2012) which compare many studies on a similar topic). And I must mention that the subtopics I mention here are not the only areas that have been studied with respect to the impact of meditation. Nevertheless I hope this write-up will encourage readers to explore this topic in more detail themselves.

meditation-by-the-lake-55721299753723Ly4

Psychological

There are several studies that investigate the effectivity of meditation in its various forms on psychological problems. Here I present a small glimpse of the research that explores its effect on some common disorders; depression and anxiety, eating disorders, ADHD and PTSD.

Depression and Anxiety

A review by Chiesa et al. (2010) compared studies on the neural mechanisms behind mindfulness meditation, psychotherapy, pharmacotherapy and placebo and found that long-term mindful meditation practice allows a more flexible emotional regulation by engaging frontal cortical structures to dampen automatic amygdala activation. This mechanism is similar to psychotherapy and placebo neurally and works in a top-down direction in contrast to pharmacotherapy which works in a bottom-up direction.

DeBerry et al. (1989) showed that compared to cognitive restructuring and pseudo-treatment controls, regular practice of meditative relaxation is a significantly more effective modality for reducing state anxiety in the anxious elderly.

A meta-analysis done by Hoffman et al. (2010) analysed 39 studies with a total of 1140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges’s g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effects remained robust irrespective of number of treatment sessions, and were maintained over follow-up.

Eating Disorders

Kristeller and Hallett (1999) showed that eating based mindfulness meditation significantly reduced scores on the Binge Eating Scale (BES) as well as the Beck’s Depression Inventory (BDI) in 18 obese women. They experienced an increased sense of control and their binge eating reduced in frequency and in severity. This was an exploratory study.

A more recent study (Bush et al., 2014) examined problematic eating behaviours and body image satisfaction and in 124 women using a ten week mindfulness and intuitive eating program as an intervention. Using a Body Appreciation Scale, Five-Facet Mindfulness Questionnaire and Questionnaire for Eating Disorder Diagnoses, they also found that it was effective as a treatment strategy for problematic eating and increased body image satisfaction.

ADHD

Zylowska et al. (2008) studied the effect of meditation in an 8 week program on the symptoms of ADHD. In 24 adults and eight adolescents who were diagnosed with ADHD, mindfulness was found to be a feasible treatment method in reducing the self-reported symptoms and performance on attention based tests. Improvements in symptoms of depression and anxiety were also noted in this study. Meditation was shown to improve behavioral and neurocognitive impairments.

Harrison et al. (2014) investigated Sahaja Yoga Meditation as a family treatment method for children with ADHD. Parents and children participated in a 6-week programme which consisted of twice-weekly clinic sessions and regular meditation at home. Results showed improvements in children’s ADHD behaviour, self-esteem and relationship quality. Children described benefits such as better sleep patterns and less anxiety at home and better concentration and less conflict at school. Parents also reported being able to manage the childrens’ behaviour more easily, feeling happier and less stressed.

PTSD

In a study in 1985 (Brooks and Scarano, 1985) Transcendental Meditation was used over a three month period as a treatment modality for individuals with PTSD from the Vietnam war. Another group simultaneously received psychotherapy. The participants were measured on 9 symptoms (independent variables) of PTSD including insomnia, depression, outbursts of anger, somatisation, emotional numbness, anxiety, substance abuse, difficulty holding a job, and problems in interpersonal relationships. Whereas Transcendental Meditation showed significant improvement on eight of the nine variables, therapy showed no significant improvement on any measure.

A review by Lang et al. (2012) looked into three types of meditation based interventions applied to address PTSD; mindfulness, mantra, and compassion meditation. They found all three to be effective in reducing the symptoms and improving the quality of life. The review goes further to present the mechanisms by which the three types of meditation may work.

Physical

Many of the traditions that the various types of meditation come from do not treat the mind and body as separate entities. Instead, they speak of them as merely different and equal aspects of one’s full entity. Scientists have found great physical benefits to meditation though it can be considered a mental exercise. Here are some examples.

Inflammation 

Psychological stress is a major contributor to symptom exacerbation across many chronic inflammatory conditions. It can provoke acute increases in inflammation in healthy individuals. In a recent study (Rosenkranz et al., 2016) experienced meditators (9000+ lifetime hours) were found to have a reduced stress (in the Trier Social Stress Test) and inflammatory response (a neurogenic inflammatory response was produced using topical application of capsaicin cream to forearm skin) compared to a matched control group.

Kox et al. (2014) compared those who were given meditation and breath control training for ten days with those who received no such training when exposed to experimental endotoxemia. In the intervention group plasma levels of the anti-inflammatory cytokine IL-10 increased more rapidly after endotoxin administration, the levels of proinflammatory mediators TNF-α, IL-6, and IL-8 were lower and flu-like symptoms were also lower.

Chronic pain

Kaplan et al. (1993) studied the effectiveness of a meditation-based stress reduction program on fibromyalgia using 77 patients in a ten week program. Parameters measured included global well-being, pain, sleep, fatigue, and feeling refreshed in the morning. Patients also completed a medical symptom checklist, SCL-90-R, Coping Strategies Questionnaire, Fibromyalgia Impact Questionnaire, and the Fibromyalgia Attitude Index. The mean scores of all those who completed the course showed improvement, with 51% of them showing moderate to marked improvement.

J Kabat-Zinn (1982, 1985, 1986) has published highly cited work on this topic. In his 1982 study, 51 chronic pain patients who had not improved with traditional medical care were given mindfulness meditation training in a 10-week Stress Reduction and Relaxation Program to train chronic pain patients in self-regulation. At the end of the program, 65% showed  from 35-50% reduction in mean total Pain Rating Index (Melzack). Other pain indices and in the number of medical symptoms reported also showed similar decreases. In the study published in 1985, Kabat-Zinn et al. reported decreases in measures of present-moment pain, negative body image, inhibition of activity by pain, as well as psychological parameters such as anxiety and depression for 90 pain patients. Improvement was found regardless of type of pain and were sustained even 15 months after the study on all parameters except present-moment pain. These effects were absent in the control group of pain patients. Similar effects, both physical and psychological, were found in the 1986 study which included 225 patients. The patients were followed up to evaluate the long-term benefits up to 48 months after their participation in the program.

Hypertension

Seer and Raeburn (1980) studied the effect of Transcendental Meditation on hypertension. Modest reductions in blood pressure were seen in both meditation groups with significant diastolic percentage reductions while no change was seen in the control group.

Patel (1977) reviewed several controlled studies which have used systematic relaxation training and seen significant and lasting reductions systolic and diastolic pressures. When exposed to laboratory stressors, pressures return to baseline levels. Patel suggests a continuation of this practice in everyday life is necessary to continue to maintain the benefits long-term.

Cardiovascular Disease

A review by Ray et al. (2014) showed that multiple studies from the past few decades have demonstrated the beneficial effects of meditation on various cardiovascular risk factors. In addition to decreasing cardiovascular mortality, meditation has also been shown to improve conditions such as hypertension, type 2 diabetes mellitus, dyslipidemia, and high cortisol levels. This review discusses possible biological mechanisms underlying such findings.

Parswani et al. (2013) studied the effect of  meditation based stress reduction on coronary heart disease. Significant reduction was observed in symptoms of anxiety and depression, perceived stress, blood pressure and body mass index in patients of the treatment group after the completion of intervention assessment. At three-month follow-up, therapeutic gains were found to be maintained in patients of the treatment group.

Several other physical ailments are also being studied with regard to what effect mental techniques such as meditation training would have on them. The literature is vast but I hope I have provided an interesting glimpse into the evidence on the effects of meditation here.

meditation-1287207_960_720

REFERENCES

Abbott, R. A., Whear, R., Rodgers, L. R., Bethel, A., Coon, J. T., Kuyken, W., … & Dickens, C. (2014). Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta-analysis of randomised controlled trials. Journal of psychosomatic research, 76(5), 341-351.
Brooks, J. S., & Scarano, T. (1985). Transcendental Meditation in the Treatment of Post‐Vietnam Adjustment. Journal of Counseling & Development, 64(3), 212-215.
Bush, H. E., Rossy, L., Mintz, L. B., & Schopp, L. (2014). Eat for life: a work site feasibility study of a novel mindfulness-based intuitive eating intervention. American Journal of Health Promotion, 28(6), 380-388.
Chiesa, A., Brambilla, P., & Serretti, A. (2010). Functional neural correlates of mindfulness meditations in comparison with psychotherapy, pharmacotherapy and placebo effect. Is there a link?. Acta Neuropsychiatrica, 22(3), 104-117.
DeBerry, S., Davis, S., & Reinhard, K. E. (1989). A comparison of meditation-relaxation and cognitive/behavioral techniques for reducing anxiety and depression in a geriatric population. Journal of geriatric psychiatry.
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of psychosomatic research, 57(1), 35-43.
Harrison, L. J., Manocha, R., & Rubia, K. (2004). Sahaja yoga meditation as a family treatment programme for children with attention deficit-hyperactivity disorder. Clinical Child Psychology and Psychiatry, 9(4), 479-497.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General hospital psychiatry, 4(1), 33-47.
Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of behavioral medicine, 8(2), 163-190.
Kabat-Zinn, J., Lipworth, L., Burncy, R., & Sellers, W. (1986). Four-Year Follow-Up of a Meditation-Based Program for the Self-Regulation of Chronic Pain: Treatment Outcomes and Compliance. The Clinical Journal of Pain, 2(3), 159-774.
Kaplan, K. H., Goldenberg, D. L., & Galvin-Nadeau, M. (1993). The impact of a meditation-based stress reduction program on fibromyalgia. General hospital psychiatry, 15(5), 284-289.
Kox, M., van Eijk, L. T., Zwaag, J., van den Wildenberg, J., Sweep, F. C., van der Hoeven, J. G., & Pickkers, P. (2014). Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proceedings of the National Academy of Sciences, 111(20), 7379-7384.
Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of health psychology, 4(3), 357-363.
Lang, A. J., Strauss, J. L., Bomyea, J., Bormann, J. E., Hickman, S. D., Good, R. C., & Essex, M. (2012). The theoretical and empirical basis for meditation as an intervention for PTSD. Behavior modification, 0145445512441200.
Marchand, W. R. (2012). Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. Journal of Psychiatric Practice®, 18(4), 233-252.
Parswani, M. J., Sharma, M. P., & Iyengar, S. S. (2013). Mindfulness-based stress reduction program in coronary heart disease: A randomized control trial. International journal of yoga, 6(2), 111.
Patel, C. H. (1977). Biofeedback-aided relaxation and meditation in the management of hypertension. Biofeedback and Self-Regulation, 2(1), 1-41.
Ray, I. B., Menezes, A. R., Malur, P., Hiltbold, A. E., Reilly, J. P., & Lavie, C. J. (2014). Meditation and coronary heart disease: a review of the current clinical evidence. The Ochsner Journal, 14(4), 696-703.
Rosenkranz, M. A., Lutz, A., Perlman, D. M., Bachhuber, D. R., Schuyler, B. S., MacCoon, D. G., & Davidson, R. J. (2016). Reduced stress and inflammatory responsiveness in experienced meditators compared to a matched healthy control group. Psychoneuroendocrinology, 68, 117-125.
Seer, P., & Raeburn, J. M. (1980). Meditation training and essential hypertension: a methodological study. Journal of Behavioral Medicine, 3(1), 59-71.
Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J. L., Horton, N. L., Hale, T. S., … & Smalley, S. L. (2008). Mindfulness meditation training in adults and adolescents with ADHD a feasibility study. Journal of Attention Disorders, 11(6), 737-746.

What does it mean to be healthy?

When I ask people asked what they think it means to be healthy, I often get responses like:

“It’s when you’re not sick”

“To be fit”

“When all your parts are working properly”

These definitions seem focused on one’s physical body and see health as a state in which going to a doctor is not necessary. But being healthy can be so much more than this. In 1948, The World Health Organisation defined health as

“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

4020982037_62bee53ef3_z
Imagine rising before your alarm every morning feeling fresh and energetic. You feel so productive that you’re able to finish a significant amount of work even before lunch. You’re able to pay better attention, learn new things faster and retain the things you learn. You feel sharp and notice things in detail. You are able to find creative solutions to problems. You feel physically light and you’re able to climb flights of stairs as though gravity is no big deal. Your appetite is healthy and you enjoy every morsel of your food. Your breath is full and relaxed. You feel calm and happy. It feels good to laugh. You have an increased level of patience. You are able to be kinder and more present with the people in your life. You enjoy a deep sense of connection, trust and understanding with your loved ones. You feel confident about who you are and know you are resilient to handle well anything life throws at you. People respect your sharp mind, admire your physical abilities, and can sense an inner lightness within you. Every interaction you have starts to hold meaning and bring out the beauty of those around you. You have a clear vision of your life. Every day feels bright, like a celebration.

To be healthy is to thrive, not just survive. It is to live fully, not just to get by. We are living human beings. Our minds and our bodies are capable of much more than we realise and there are ways to reach for that potential. Why not strive to live as the best version of yourself that you can be?

pexels-photo-38940