Bright and early a few days ago, I had the fantastic opportunity to teach a workshop about yoga to counselors from across our state at the Texas Counseling Association annual conference in Dallas. It was a great time! I shared a presentation, then led the group through a yoga practice so they could experience it for themselves. We ended our morning circling up for discussion.

In the session, we talked about the ancient roots and philosophy of yoga, the different types of yoga classes found in many communities today, and how specific approaches have been developed to use yoga for trauma recovery and mental health. You can learn more about all of these ideas in the complete Powerpoint presentation.

Here are a few key slides that may be very helpful when considering starting a yoga practice. First, a description of some of the terms used to describe types of classes.​

Then some findings of researchers. There's a lot of data that points to the benefits of yoga.

But yoga is not to be used without caution. Here's my advice for choosing the right yoga class:

1. ​Know what type of class you are best suited for, and seek that out. Know the class descriptions above and search for those in your community. If you can't find a class, try yogaglo.com for online streaming.
2. If you are a trauma survivor, be especially selective about your yoga class. Choose a class that is "trauma-sensitive" if you are just beginning to process your traumatic experiences. Know that some teachers provide "physical assists" or adjustments that involve them touching you. If you do not want to be touched, communicate that to your teacher prior to class.
3. Hot yoga (100 degrees +) can be counter-productive if you are overwhelmed by heat or have medical conditions. You should have an established practice of good hydration before you attend hot yoga classes. As an alternative, many vinyasa classes offer a warm room (85 degrees +).
4. Look for teachers that offer modifications of difficult poses and encourage acceptance of your body as it is today.
   

What to know before you go:

1. ​Yoga is usually practiced barefoot.
2. It's best to practice on a mostly empty stomach. You will be more comfortable with heat, vigorous sequencing, or twisting if you haven't just eaten a meal.
3. Some studios will have mats to borrow, or you can bring your own. For sweaty classes, a towel placed over your mat keeps you from slipping. You can use a towel from home, or there are special ones made to go on top of yoga mats.
4. Most studios have a place for your belongings outside of the yoga room. They are usually secured by the teacher locking the outside door before class begins.
5. Studios have differing policies about talking inside the yoga room. Some observe silence and others welcome chatting before class.​

​Here's to finding the best yoga experience to reap the benefits of this ancient practice!

Yoga is an ancient practice that originated far away. It has made its way around the globe in a wave of both physical healing and spiritual awakening, while simultaneously becoming a multi-billion dollar industry in the US.  Some of the yoga teaching in the west has been simplified to a mostly physical practice by this commercialization and popularization, however yoga's philosophical foundation as a way to live a good life endures as well. These days, yoga is practiced not just in affluent studios, but also in schools, prisons, hospitals, and apparently on aircraft carriers (love this picture.)

Thanks to modern science and research, we also know much more about how yoga impacts physical and mental health than ever before. Let's explore some things we know about how yoga helps, and then describe how this knowledge can be incorporated into a traditional talk therapy session. 

From Ross, A., & Thomas, S. (2010). The health benefits of yoga and exercise: A review of comparison studies. Journal of Alternative & Complementary Medicine, 16(1), 3-12. doi:10.1089/acm.2009.0044 

Physical Effects

• Powers down the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) stress response which leads to disease
• Decreases cortisol, blood sugar levels, heart rate, blood pressure, inflammation
• Increases immunoglobulin A and immune response
• Decreases sleep disturbance
• Increases strength and flexibility
• Depending on type of yoga, may or may not improve physical fitness

Emotional Effects

• Decreases symptoms associated with anxiety, depression, schizophrenia
• Increases sense of well-being
• Decreases fatigue and experience of physical pain

Psychosocial Effects

• Increases social and occupational functioning
• Increases quality of life

Here's a description of how I combine yoga and counseling. Other therapists/yoga teachers may do it differently, and chances are, my own style will keep evolving the more I learn from my clients what works best.

Individual Sessions

Individual counseling sessions can include yoga, if and only if, the client thinks it will be helpful. Yoga in session can range from simple seated stretches, to intentional work with the breath, to standing and seated poses on the floor. In the intake and beginning phases of counseling, personal goals are identified, and as we explore these goals through talk therapy, I will be thinking about how certain yoga postures or sequences may be helpful. We will talk about using yoga in this way, then plan a time to incorporate it, or go ahead and use it at that moment. The way that yoga is used in counseling is always up to the client, and my suggestions as counselor are just that... suggestions.

For instance, a client who is struggling with self-image may be asked to try a yoga sequence that feels familiar and accessible, and notice their self-talk during the movement. How compassionate are their thoughts toward self? Are thoughts about self-image coming up? Are they critical? Then the client may be cued to work through a more challenging sequence and notice how the self-talk changes. After a few minutes of yoga (usually 15-30 minutes during an hour counseling session), I will sit with the client either on our yoga mats in an adjacent studio or back in the counseling office to discuss their experience, share what internal self-talk arose, describe how their physical or emotional state changed in response to the movement, and so on. 

Another example is a client who is experiencing social anxiety. The client may have a goal of learning new ways to manage anxiety so that it doesn't stop them from going out with friends. The client may notice a tightness in the chest or throat when thinking about going out with friends. So to address it, I might ask a client to imagine that they are about to go out with friends, notice in detail the sense of constriction or tightness they are experiencing in the chest and throat, then use some guided breathwork and throat opening stretches, while seated in the counseling room to work with the sensations. 

Group Sessions

We can also work with yoga in group sessions. My ideal way to combine yoga and counseling in a group is to use a mixture of both physical yoga postures and discussion and/or personal reflection. My experience of vinyasa flow sequences is that often emotional "stuff" will come up as we move the body. As we work into the creaky, rarely accessed parts of our joints and tissues, an emotion may arise. Then from that emotion, a chain of thoughts may arise: memories, anticipations, judgments, regrets, etc. Taking time after a yoga practice to reflect on these emotions and chain of thoughts can help to move through them, put them away, or take more time attending to them. This can be accomplished through internal self-reflection, group discussion, or both. 

​In this upcoming group yoga workshop, we will practice a one hour vinyasa flow class, then we'll take a short break and come back together to process our experiences. I will provide some paper and pencils to help participants process their yoga experience through writing or drawing. I will provide some prompting questions to help participants explore their wellness in several core areas shown below. I like this "Indivisible Self" model because it prompts us to think globally about what impacts wellness. (Myers, J. E., & Sweeney, T. J. (2005). The indivisible self: An evidence-based model of welIness (reprint). Journal of Individual Psychology, 61(3), 269-279. )

After we've processed internally, I'll offer a chance for participants to share and discuss their self-reflections. This part is absolutely optional, as some might prefer to keep their reflections private. A very important component of using yoga with group counseling is that all members agree to keep one another's shared thoughts and feelings confidential.  Maintaining confidentiality is a key guideline and expectation for the participants in this type of group.

In summary, we know that a regular yoga practice is helpful for many different conditions, ranging from chronic illnesses, to mental illnesses, to adjustment-related problems, to general stress and anxiety. We also know that talk therapy is helpful for these conditions. Combining yoga and counseling involves, first and foremost, respect for the client's autonomy and ability to choose the direction of therapy, along with gentle reminders toward self-compassion, self-acceptance, and an attitude of self-exploration in both body and mind. 

-Kambria 

Being mindful is a term used frequently in our society today, and the scientific study of mindfulness is relatively new. From self help articles to blog posts to academic literature, there is a wealth of information available and research to show that creating a mindful attitude can help us deal with many of life's challenges. The seminal work in mindfulness is Jon Kabat-Zinn's 1990 book, Full Catastrophe Living. The "full catastrophe" is the suffering that all humans experience in some way or another, and mindfulness teaches that we can live a full and healthy life even in the midst of the catastrophe. Kabat-Zinn founded the Stress Reduction Clinic at the University of Massachusetts Medical School, where he is also the Executive Director of the Center for Mindfulness in Medicine, Healthcare, and Society. He has created an approach to difficult emotional and physical states called Mindfulness Based Stress Reduction, or MBSR. Since 1979, over 14,000 practitioners have been trained in this method.

So what is mindfulness? There isn't a widely agreed upon definition yet. However here are a few...

"Mindfulness is awareness. It's paying attention, on purpose, in the present moment, non-judgmentally." Jon Kabat-Zinn

"Mindfulness is the practice of knowing what's happening in the mind without getting hijacked by it." -Rick Hanson

So what is your sense of mindfulness from these descriptions? Does it seem like a concept that's hard to wrap your head around? Does it seem far removed from the reality of those days with 1000 things competing for your attention? 

The way I've described mindfulness lately has to do with a train. I've used this metaphor while teaching yoga classes and in therapy. Take a listen to the train meditation here. 

Mindfulness does have to do with meditation and going into the mind, but meditating is not the goal of mindfulness, nor is mindfulness created only through meditation. Meditation provides a place to practice and a window into a mindful state of awareness. This state of of awareness is not a special place you visit while meditating, but rather is just your natural state of being while paying attention to what's happening in the present moment, or "non-meditation."

Kabat-Zinn emphasizes that non-meditation is what we are really after in our everyday life. Because we can't stop, sit, and meditate during the most difficult and busy parts of the day, we need another way to cope with stress. Mindfulness, then, with intentional practice, can be applied as awareness of each present moment as it arises, wherever we are. Learning to be aware of your thoughts, feelings, and bodily sensations in the midst of chaos is really what mindfulness is about. 

I've been hearing a lot about stress and anxiety from clients lately. So I decided to record a guided meditation today with a little intro on the basics of meditation. Enjoy! Please let me know if it's helpful/not helpful, etc. I'd love to hear feedback.