I regularly encourage clients to develop a "self-care" plan as a way to manage the challenges and difficulties that life regularly presents to each of us. Self-care can be anything that provides a sense of ease and comfort, and varies depending on each individual. Sometimes we identify things like exercise, meditation, joining social groups, reading, watching movies, aromatherapy, hiking.
Because my personal and professional experience tells me that yoga is an effective tool for self-care, I often encourage clients to try it and sometimes I teach them yoga during our sessions. Likewise, I often hear clients say that they find a sense of peace in the outdoors, I encourage them to go to natural places as regularly as possible, as much as our urban environment here in Dallas allows.
This past week, I came across two articles about these very things.
This article in Medical News Today outlines three new research findings that support the use of yoga as a supplement to treatment for depression. They each followed patients who scored high on depressive symptoms prior to starting a yoga program (Bikram in one study and Hatha in the other two studies) and found significant symptom reduction at the end of the program. In one of the studies, symptom reduction lasted for at least four months after the end of the program.
These study results are no surprise for those who have personal experience with the mental benefits of a regular yoga practice. We are learning more and more that empirical research findings support it as well.
The Japanese call it taking a "nature bath", referring to the practice of fully immersing oneself in the sights, sounds, smells and textures of natural places. What a wonderful way to describe the common feeling of peace that many of us experience when hiking, camping, swimming, and discovering beauty in nature.
This article in Time magazine outlines how connecting to "green space" can improve mood and wellbeing for many of us. It highlights that the quality of greenspace is more important than quantity. For instance, cleanliness, accessibility, and the ease of connecting to others are more important factors than the size of the greenspace. So for those of us that live in urban environments, local parks, walking trails, and tree lined neighborhoods are resources to our mental health.
So... if you're finding your mental health challenged today, if you're feeling down or anxious or stressed or angry... break out that yoga mat and do some downward facing dogs and sun salutations. Take a walk to your local park and circle it a few times. Take some deep breaths of the soft breeze. Watch the birds, and listen to them. Feel your heart beating as you move and know that you are giving yourself a wonderful gift!
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:
What to know before you go:
Here's to finding the best yoga experience to reap the benefits of this ancient practice!
Why Yoga Works for Mental Health
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.
What Research Shows
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
How Yoga and Counseling Are Combined
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 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.
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.
Flourish is Expanding!
Big news has been building, and I think it's time to share! First, Flourish is adding a new counselor to the mix starting in July! Megan Kennedy, LMSW, bio forthcoming, will soon join the practice with expertise in solution-focused, and child and adolescent counseling. Megan is a truly gifted therapist and will bring her unique approach and enthusiasm for helping to every session. I am so happy to have her as a partner!
Second, Flourish will soon have a new, second location! We are hoping to welcome clients in August to our new home at Sync Yoga and Wellbeing, at 1888 Sylvan Ave Ste F-250, Dallas, 75208. We will continue to see clients in Casa Linda as well, but love the opportunity to work at Sync because we'll have more space for yoga and an intensely kind and compassionate community to be a part of.
Here's the first chance, THIS SATURDAY, to check out yoga and counseling in action for our clinically integrative workshops, Yoga for Emotional Health. Fellow yogi counselors, Charles and Julie, and I will be lead participants through yoga postures specific to mental health.
Afterward, we will host an open house to welcome all health professionals in to see the truly healing space being created at Sync. I am so excited!
Yoga In Sanskrit...Week 4
This week we move on to downward facing dog, Adho Mukha Svanasana (pronounced Aw-do Mew-hah Shf-vah-nah-sah- nah... wow that's tricky).
It's the keystone pose of so many sequences in a vinyasa-based practice, and it's great to practice anytime you need a little time-out and energy boost. This pose elongates and releases tension in the entire back of the body, including the calves, ankles, hamstrings, lower back, upper back, neck and top of the head. It is an accessible way to turn yourself upside down, too. Placing the head below the heart keeps the circulatory system toned and running in top form. When the blood flows vigorously, the mind clears, resilience is nurtured, and heavy emotions may lighten. In addition to the back body stretching, downward facing dog allows the mind to behold the world from a new perspective and we see ourselves in a new way.
See the two pictures below for an example of positioning in this pose.
Physical Cues: There are lots of ways to get into downward facing dog, but here's my favorite. Come into Uttansana, standing forward fold. Check out the Week 2 blog for specifics on how to get into it. Bend the knees as deep as you need to place the hands flat on the ground and step both feet back until you are in the shape of an upside down V, usually about 3-4 feet depending on your height. The hands press down firmly into the mat, spreading out through all ten fingers. The head is in line with the biceps, and the neck is relaxed. The shoulder blades press flat against the back and together slightly, to engage the upper arms. The hips lift high toward the sky while the heels search toward the floor. Your heels most likely will not reach the floor yet, and it's ok! The calves and Achilles tendons will open more over time. Take at least 4-5 long inhales and exhales, and feel the back body stretch and open. To come out, I love to set the knees down on the floor, then set the hips to the heels, bringing the upper body to rest on the thighs and forehead toward the ground (Child's Pose). But you can also walk the feet back up to Uttansana, or just come to seated. Lots of options!
Mental Benefits: Have you ever felt stuck in a rut, moving through life in a way that is familiar but unexciting? Maybe you've also had the experience of shaking things up, trying something new, and challenging yourself in a way that brought back energy and excitement in your life? This energy may come from a new job, a new relationship, a new home, a new project, a new daily routine, a new hobby, or anything else that is "new" to you. I liken downward facing dog to that sense of "newness" that brings fresh energy into our lives. This pose gets the circulation flowing, so that fresh energy is carried throughout the body, especially to the brain. Turning ourselves upside down, we literally see the world differently and feel differently about it. We may be able to shift a mood of indifference to interest, or from anger to tolerance. Also, this pose wakes up our physical foundation, the back body. Think about how the back body is intricately engaged in all movements you make throughout the day, whether it's walking, running, resting, or sitting. Your back constantly holds you up and allows you to carry out the tasks required in your daily life. Taking time to invert, stretch, lengthen, and nurture the back also encourages this fresh new mental energy to emerge.
So there we go, downward facing dog. It's a beautiful shape to take!
Next week, let's move on to down dog's complimentary and opposite pose, upward facing dog, or Urdvha Mukha Svanasana.
Yoga in Sanskrit...Week 3
Happy Wednesday, all! Here's your pose for the week, Utkatasana (Ewt-kah-tah-sah-nah), or chair pose. It's a staple of most yoga practices. As the name implies, the action is sitting down into an imaginary chair. Chairs, of course, are a symbol of comfort, rest, relaxation, and ease. And in this pose, we learn to balance ease with effort.
You may get so overwhelmed you shut down and say nothing. You may say "I don't know." You may leave the room in a panic. You may get angry at them for asking and go on a rant about something else. You may try to answer without making sense. You may feel awful about yourself. You may tell yourself you failed.
Or...before saying or doing anything else, you may remind yourself to breathe. You might take a deep breath and repeat the question to be sure you understand. You might breathe some more, and find that your shoulders relax. You might notice that your breath nurtures you, and the panic might subside. You might suggest further action to take. You might remind yourself that you are worthy, you are prepared, and that it's ok not to know all the answers. You might engage collaboratively with those around you to work toward a common goal.
Utkatasana makes me think of business meetings and how terribly uncomfortable we can sometimes be in chairs! This pose allows us to practice becoming comfortable in an uncomfortable situation. Becoming and transforming are the important actions. Breathing with awareness is what transforms the situation, whether your situation is a tense meeting or is simply standing in Utkatasana.
Stand tall in mountain pose. Find strength in the belly by tucking the tail bone under. Slowly bend the knees, moving the tail bone down toward the floor. Keep tucking the tailbone, and engaging the belly. If you'd like, raise the arms above the head with the palms facing one another, while keeping the shoulders relaxed down away from the ears. If your shoulders are tense and uncomfortable, keep the hands at your chest, palms together. Sit as low as you can, while keeping the chest upright, with crown of the head and spine reaching toward the ceiling, rather than forward. Stay for as many breaths as you can breathe calmly. Then straighten the legs for a few breaths, maybe take a standing forward bend (last week's pose, Uttansana), and repeat if desired.
As I described above, Utkatasana offers us a reflection of how we handle static, tense, anxiety- provoking situations. When we are anxious but confined, like in that business meeting (or in traffic, in class, etc), panic can set in. When you practice Utkatasana, challenge yourself to stay in the pose to the point of discomfort just momentarily. Then, take note of your emotional reaction to your discomfort. Using the breath to manage that emotional reaction prepares you for life outside your yoga practice, off the mat. Your next business meeting or traffic jam is fertile ground to apply your breath and emotional awareness.
Namaste! Next week, let's talk about arguably the most widely known yoga pose, downward facing dog. In Sanskrit, it's Adho Mukha Svanasana (say that three times fast! :)
Yoga in sanskrit...Week 1
Do you have goals for 2015? Resolutions? Are you rethinking your approach to an important area of your life? Chances are good that you are, because what better time to realign ourselves than at the beginning of a whole new year.
I have many goals for the new year, and I'm excited to share this one. Over the years as a practicing yogi, I've learned lots of poses, or asanas. I've learned both how to shape my body into them, how to teach others these shapes, and what these shapes are called ...in English. Because my teacher training program encouraged the use of English names only in order to make the poses more accessible to Americans, I have so far learned very few in Sanskrit. Various teachers at various studios I've attended used Sanskrit names repeatedly in class, and through that repetition, I picked up some. But I want to learn more, so...
My goal for this year is to learn a new pose in Sanskrit each week, and use the Sanskrit name in my practice and my teaching. Each week I will focus on a new pose, tell you the Sanskrit and English names, describe the physical shape and the mental benefits.
Why take on this task? Is it important to learn these poses in Sanskrit? Well, this is a question I've asked myself lots of times over the years, and obviously my answer until now has been "no, not really, not important enough." But I've changed my mind for one simple reason. Using Sanskrit honors the antiquity and wisdom of the practice. Honoring the practice is an important way to keep ourselves balanced within it.
So here's the first pose I will present in Sanskrit, as I get a head start on the new year! And I get a two-for-one because this pose has two names.
In this pose, stand balanced on your two feet together or hips-width distance apart, depending on which version allows the most stability and focus. Feel the four corners of each foot grounded into the earth. Engage the thigh muscles and turn them inward. Tuck the pelvis, and feel the abdominals engage. Lift the spine toward the sky, and pull the shoulders back slightly and allow the shoulder blades glide down the back. Relax the neck and forehead, and gaze forward.
Tadasana tests our ability to engage only as much as necessary, and focus on the simplicity of standing upright. It may help you understand when your desires are out of balance. For instance, if you stand in tadasana and find yourself wanting to move out of it immediately, ask yourself what would you rather be doing right now? If you'd rather be doing a push up or a headstand, you may over-desire movement. If you'd rather be sitting or lying down, you might tend to over-desire stillness. If you'd rather be checking items off your to do list, you might over-desire work. And so on. Tadasana teaches us to be here now in lightly engaged stillness.
I feel like there's a racetrack in my house sometimes. We have a sort-of circular floor plan, and if I counted the times I've rushed from my dining room through my bedroom through my office into the kitchen and around again, I'd be in the tens of thousands I bet. Sometimes I feel exhausted with all the rushing and the to-do list that seems to only get longer.
I've noticed I'm usually rushing because of a need to move something, provide something, respond to something, or take a break from something.
Move, provide, respond, take a break...isn't that what's entailed in a busy life? Let's explore more.
There are lots of demands for movement at some point most days, right? Gotta roll out of bed in the morning, stretch the legs, shower up, walk out the door to the car or bus or train...GET SOMEWHERE. For those of us that work a lot at home, especially with kids, we may have instant demands to start moving, especially when they are kicking us in the bed or crying at 5am.
There's alot of physical movement required most days, but there's also the moving of things from one place to another. I find myself constantly taking my kids' things from one part of the house back to their room, things I'd just put away the day before! But here they are again... my daughter's hairbrush on my desk, my son's slingshot on my bed, an upturned bag of those tiny rubber bands for making bracelets in the kitchen floor. Ugh! Won't things ever be in their right place, and just stay there? No they won't, because people and things constantly move (and that, in and of itself is not a bad thing.)
So, I could definitely putter around my house all day putting things back where they go, but I'd get nothing truly important done. So I have to be ok with a bit of a mess. I have to be content with things out of place, and without order in every corner of the house. I have to let movement be graceful and come from a true need, rather than an obsessive desire to get somewhere, put things somewhere, or control my environment. I have to find balance between moving and being still. I have to find stillness when the urge to move will distract me from what is really important.
Sometimes the being busy comes from the need to give, to create, to deliver, to provide something. Whether it's a meal, a service, a phone call, a lesson, a document, or anything else, the pull towards giving can easily become unmanageable. Because what happens when you don't live up to a demand to provide something??....GUILT, that's what. It really should be a four letter word, this most tricky emotion!
Here's the mental commentary we may experience:
"I gotta provide what is being asked of me...or what I expect of myself...but I'm exhausted from all this moving and doing...I need a break...if I take a break, I won't be productive...I won't be providing, and how can I possibly live with that?...I can't live with that so I keep giving and providing."
It's a self-defeating cycle of feeling unworthy. So when you feel the need to keep on providing, take a moment of self-awareness to inventory what you've already done. Whether it's doing the laundry, making lunch for a loved one, writing a paper, seeing a client, completing a project, or anything else, acknowledge it and give yourself gratitude. Even if no one else says thanks, you can give thanks to yourself.
Have you gotten those emails yet?
What about those voice mails?
Can you stop what you're doing real quick and answer a question?
The trickiest part of multi-tasking is responding to the needs of others. We not only have to know what's on the to-do list and work on it, we also have to juggle the things that come up in the midst of an already packed day. We have to decipher what is important and what can wait. Who needs immediate attention and who will be ok until later today or tomorrow? And if we do stop and respond, how in the world do we get back where we left off? Especially if we were really in a good flow and accomplishing things. Is it even possible to get the momentum back if I stop and respond?
It's no wonder our brains hurt and we get headaches with all the mental work it takes to handle multiple demands.
When you're multi-tasking, do you even realize you're doing it? Next time you feel overwhelmed, stop everything you're doing and name all the tasks on your mind at that moment. Write them down or make a star next to them on your to-do list. If you have more than two or three, and especially if they are complicated tasks, it's time for a new approach. Otherwise, you'll spend time moving between tasks and not making progress rather than wholly focusing on one or another.
Prioritizing is key. If you don't know what's most important, ask yourself. "If this task isn't done tomorrow, will someone critical in my life be disappointed?" If the answer is no, then it can wait. You can also ask, "Can I accept my efforts today even if this is not done tomorrow?" If the answer is yes, it can wait.
4. Take a break....
Ahhh, that's just what will help when all the moving, providing, and responding becomes too much. Getting away for a quiet moment, taking a walk, gazing out the window, grabbing a snack, locking ourselves in the bathroom for a moment or two...it helps right?
It sure does, but it's hard to get a break most of the time. Sometimes we don't get to choose when to take a break, we just have to snag it when the opportunity arises. It's critical to seize those opportunities and to savor quiet and stillness. Will you allow yourself to be still, even while the to do list looms, the phone rings, the iphone dings, or someone calls your name? Cultivating stillness in the midst of activity is part of what yoga can teach us. That's why I use yoga in counseling, because it helps calm nerves, ease fears, and see the beauty of the moment.
The bottom line is that all of this moving, providing, and responding is important. It's what keeps us connected to the external world, with all of its beauty and all of its chaos. It's what keeps our social connections healthy, and our communities fertile. We just have to learn to be still within all the movement.
Kambria Kennedy-Dominguez, Counselor and yoga teacher specializing in mental health, substance abuse and wellness.