Monday, October 29, 2018

Interview with Seth Powell, Part 1: Early History of Yoga for People with Disabilities

Ascetics Performing Tapas, South India c. 1820, 
Opaque watercolor on paper, 23.5 x 29 cm., The British Museum.
by Patrice Priya Wagner

While taking an online course “An Introduction to the History and Philosophy of Yoga” with Seth Powell, I became very curious about the origins of yoga instruction for people who weren’t male and from an upper caste in India—the primary demographic we had studied. When, for example, did people with disabilities gain access to the teachings of yoga in India? What about women or other marginalized groups? Despite his busy schedule of teaching, writing a PhD dissertation, and having a family-life with children, Seth Powell agreed to an interview to shed some light on these questions.

Because the final interview was quite long, with detailed and fascinating answers to each question that I asked, I decided to divide it into separate posts, with one question and answer in each post in the series. Here's the first question I asked Seth:

Priya: I’m aware that you're doing extensive research for your PhD on the beginnings of yoga asana practice in India, and I’m curious to know what is the earliest textual evidence we have of people with disabilities gaining access to instruction on asana and meditation practice in India?

Seth: First off, thanks for asking me to do this interview Priya. That is an interesting question. I’m not sure what the earliest textual moment of this would be. To begin to approach this question though, I think it is important to build some historical context, as you know from my online courses, I love to do! From the outset, I think we should be cautious in looking to India’s past for obvious justifications for our contemporary social or political ideals and movements. I believe strongly that we should first try to understand Indian history and philosophy—including the early history of yoga—on its own terms. We may discover things do not always align so easily with our own modern concerns and views today, however, this hermeneutic of curiosity and openness can reveal very different ways of being human, in classical and medieval India.

So where do we begin? Most scholars today maintain that the origins of Indic yoga and meditation practices arose out of the confluence of Brahmanical and Śramana (e.g., Buddhist and Jain) traditions, along the Gangetic plain in northern India, sometime around 2,500-3,000 years ago. I think we need to first ask, who were these early yogis? 

Broadly speaking, they were male ascetics—celibate, renunciates, on the fringes of early Indian civilization. But they were also “counter-culturalists,” in the sense that they were rejecting and reinterpreting the normative religious and social values and expectations placed upon them by the dominant Vedic society of the day. Many seem to have been Brahmin ritualists or warrior class-men (like the Buddha), who were leaving behind their families, jobs, identities, bank accounts, et al., in radical pursuit of what we now call “enlightenment.” They retreated from society into the forests, banded together in groups, and gathered at the feet of exalted gurus, where they exchanged ideas and practices aimed at eradicating human suffering, overcoming the limitations of the mind-body, in pursuit of great powers, and ultimately “release” (mokṣa) from worldly existence. Hardly the yoga and yogis we think of at the urban studio today.

Saiva ascetic devotees, Ellora (c. 7th century)
Photo by Seth Powell
The origins of postural yoga, or āsana, practice are to be found predominantly among these religious ascetics. Still to this day, traditional Indian ascetics utilize the body to cultivate a certain spiritual power or “heat,” known as tapas. By standing on one leg, or holding the arms over head, for an incredibly long period of time (we’re talking 12 years or more!), the ascetic seeks to gain power over the limitations of the mind-body. For many of these ascetics, often the body is mortified in the process. With the loss of blood flow to the arm, for example, it becomes withered, and rendered dis-abled. This is an extreme form of what we might call an elected disability by choice, wherein one goes to such extreme lengths of cultivating “mind over body” that the body is sacrificed in the process. With the sacrifice of the body, however, comes great yogic power and charisma, and these ascetics are highly revered within their communities. Today we can still see images of these body-mortifying ascetics at a Kumbha Mela festival in India, often used for their “shock” value to exoticize notions of the foreign and mystical East. 

In an early Śramana context, the ascetic idea of bodily practice was to completely still the body, in order to no longer produce any karma, which keeps one bound in Samsāra (the cycle of life, death, and rebirth). What better way to cease the production of karma (lit. “action”) than by ceasing to move altogether? We have a famous image of the Jain ascetic Gomateśvara who stood still, stark naked in the forest, for so long that the creeper vines wound up his legs and body, engulfing him entirely as a part of the forest. Elsewhere I have suggested that the much later practice of Tree Pose (vṛkṣāsana), likely develops from this earlier ascetic notion, of “standing like a tree.” The Bhagavad Gītā is famously critical of such an approach, when Krishna tells Arjuna, never for a moment can one not engage in action. Even the renunciation of action is itself a form of action! Standing still like a tree, or sitting like a stone, is still standing and sitting, after all.

Readers may also be interested to note that in order to sit in a seated posture for a prolonged period of time, ancient yogis and ascetics often employed cloth yoga straps! That’s right. This was known as the yogapaṭṭa in Sanskrit. As I’ve shown in a recent online article, it turns out, the history of the yoga strap is just about as old as the discipline of yoga itself. For more than two thousand years, we might say that yogis have been utilizing “props” to assist their practice (see The Ancient Yoga Strap: A Brief History of the Yogapaṭṭa).

Okay, but back to your question. While certainly not the earliest textual evidence, one very interesting example that comes to mind of someone with physical disabilities being taught yoga, is the story of Caurangi Nāth. The Nāth yogis were an important Śaiva order associated with the development of bodily-oriented Haṭha Yoga during the medieval period, who trace their lineage to the first two great Nāth (“lords”) Matsyendranāth and his disciple Gorakhnāth. A fourteenth-century text from Andhra Pradesh in Telugu called the Navanāthacaritramu, “The Tales of the Nine Nāths,” is perhaps the first text to narrate the legendary stories, or hagiographies, of nine of these great Nāth adepts (siddha). 

Editor’s Note: This interview contains a mythological story with gruesome physical violence that we suggest is to be taken as a metaphor (as we see in the Grimms' Fairy Tales, for example). 

The story begins with a young prince named Sāranghadhara who is playing with his pet pigeon while his father, the king, is off hunting in the forest. The bird is enticed by a beautiful parrot and flies off into the private quarters of the prince’s stepmother (one of the king’s many wives). When Sāranghadhara goes to retrieve his prized bird, his stepmother welcomes him and propositions the young prince with sexual advances. He politely declines and leaves, after which his stepmother feels angered and humiliated. Seeking revenge, when the king returns home from his hunt, she falsely accuses the young prince of rape. The enraged king decides that mutilation is the proper punishment for his son, and sends two of his ministers to take the prince to the forest, where they proceed to dismember his arms and legs from his torso. It is a violent, bloody, and unjust scene. 

The great yogi Matsyendranāth, who is wandering in the forest, hears the agonizing cries of pain of the prince who was left for dead. Out of compassion, he brings the mutilated prince back to his yogic cave where he nourishes him with milk and care. He then proceeds to instruct the prince in the tradition of Rāja Yoga, through which the prince is able to grow back his limbs, and ultimately attain a “perfected body” (siddha-deha). The prince is thus given the new yogic name, Caurangi, “Four Limbs.” 

While there are many disturbing aspects of this violent tale for modern readers, it is interesting to note that the guru teaches the disabled student Rāja Yoga, not Haṭha Yoga. With no arms or legs, the prince simply could not have engaged in the demanding bodily practices of traditional Haṭha Yoga, including āsana, mudrā, and bandha, because it was beyond his physical capacities. Instead, Matsyendranāth teaches according to the inner needs of his student. He instructs the prince in the more contemplative Rāja Yoga, which requires no bodily limbs, but rather through meditation, leads to the spontaneous inner awakening of Samādhi. 

Seth Powell is a longtime practitioner of yoga and a scholar of Indian religions, Sanskrit, and yoga traditions, and is the founder of Yogic Studies. He is currently a PhD Candidate in South Asian Religions at Harvard University, where he is writing his dissertation on the history, theory, and practice of medieval and early modern yoga traditions. Seth also holds degrees in the study of religion from the University of Washington (MA) and Humboldt State University (BA). He has taught and lectured for numerous university courses on the religions and literature of India, Hinduism, Buddhism, and yoga traditions, and presents his research regularly at international conferences. Seth conducts online courses and teaches regularly on the history and philosophy of yoga at studios, teacher trainings, and universities around the country. You can find him online at www.yogicstudies.com.

This post was edited by Patrice Priya Wagner, co-editor of Accessible Yoga blog and member of the Board of Directors.

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Thursday, October 25, 2018

Video of the Week: Opening of the Europe 2018 Accessible Yoga Conference

For those of you who weren't able to attend our October 2018 conference in Germany, here's a video of the opening session of the conference. We hope you enjoy it.



This post was edited by Nina Zolotow, co-editor of the Accessible Yoga blog and Editor in Chief of Yoga for Healthy Aging.

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Monday, October 22, 2018

The Need for Accessible Prenatal Yoga

by Hersha Chellaram 
When I first found out I was pregnant eleven years ago, I was determined to dedicate to a prenatal yoga practice to stay healthy and prepare for labor and early parenthood. During the first pregnancy, I took my prenatal yoga teacher training and hoped to be that pregnant woman who was able to get into beautiful poses. Reality was a different story. My mobility considerably declined, I frequently experienced bleeding nose and gums, and I had extremely low blood pressure. Although I had no medical risk to my pregnancy, I was apparently experiencing what the medical community referred to as the “common discomforts of pregnancy. “My yoga practice had to adjust to suit my needs and I simply omitted poses that would aggravate symptoms. 

During my second pregnancy my mobility was better, so I practiced prenatal yoga diligently. However, the classes I took never discussed the importance of stabilizing the joints and I ended up with a misaligned pelvis and a terrible pain in my pubic symphysis. I was unable to walk for the final few weeks before baby number two arrived. 

Towards the end of the second pregnancy, my doctor ordered me to stop doing any yoga for a year, even after the baby was born. Being unable to move the way I loved made me gain a considerable amount of weight. That plus being in pain and at home without emotional support caused me to experience a mild case of depression. When my best friend came to visit, I was able to recognize it. And with the help of the teachings of yoga, I was encouraged to become my own yoga therapist and figure out a way to practice. I began to work with my body as if it was a client of mine (I didn’t recognize my body anyway, so that helped). Through this journey, I adapted and adjusted my practice to suit my broken body. This practice consisted of finding new ways to stabilize my joints, strengthen parts of the body that were weak, and stretch out other parts that were misaligned. I researched the anatomical side of these conditions, and I worked with physical therapists and Pilates instructors. Then I found what was common in yoga and adapted my practice. What was paramount was giving myself the space and acceptance to grieve the loss of my old body in order to move forward in my new one. 

Once I was in better shape, I started teaching prenatal yoga and postnatal yoga in Hong Kong. The range of abilities in women who walked in the studio were extreme! For example, one student was 44-year-old biker who never wanted to have a baby and never thought she could have a baby at her age. Before getting pregnant, she had been in a motorcycle accident and had a titanium plate in her left lower leg. She limped all the time and could not sit on the floor. She had never tried yoga before, but the doctor said it would be good for her so she decided to try her first class with me at seven months. I was truly grateful for my past experience teaching people with limited mobility because I was able to accommodate her in my class of younger regulars, without her feeling inferior. She kept returning to class even after her beautiful baby boy was born. 

Over the years, I taught many women who had difficult pregnancies. Many, like me, experienced a serious decline in mobility. Some even had to stop classes to go on bed rest. For a few, delivering a healthy baby meant putting their lives at stake and a couple lost their babies, either through miscarriage or stillbirth. Women experiencing these types of serious health risks need compassion, attention, and, most importantly the general know-how to accommodate them in a class (because it’s not always apparent). Too often, when a woman goes through any of these things, she simply stops class and the teacher never sees her again. But shouldn’t a woman have the right yoga teachings to help her through these experiences? 

For this reason, I created a unique program that covers prenatal yoga in all its glory: the good, the bad, the beautiful and the ugly. Not surprisingly, it’s called Accessible Prenatal Yoga. What makes these classes more accessible is the way in which we deliver the integrated teachings of yoga in each class. The class begins with an open discussion among students. This not only helps students learn from each other, but they have an outlet to express themselves in a non-judgmental environment. Discomforts, issues, and health risks are openly discussed, together with the right guidance from the teacher on how yoga, meditation, and other internal practices can help. Many prenatal classes focus so much on opening up the hips that other important and sometimes uncomfortable subjects, such postnatal depression and the inability to bond with the baby, are topics that are missing. That is why Accessible Prenatal Yoga is designed for students to be able to openly discuss all the uncomfortable things about pregnancy and early parenthood that may occur. This way, if a woman finds herself going through a challenging pregnancy or is learning how to care for a new baby, she already has the awareness, the tools, and the community she needs to get through it. 

The class then follows a format where postures are adapted to suit individual abilities and the students can practice together, always allowing for decreasing mobility as students’ pregnancies progress. Another important component is offering practices for students to do at home, when lounging or in bed, as a student may suddenly find herself on bedrest. 

Here are some of my recommendations for making prenatal yoga classes more accessible: 

1) Never make assumptions about a woman’s pregnancy. Pregnancy is not always a happy picture. Not every pregnancy is planned or wanted. Some women may even be pregnant due to being violated by a known or unknown partner. For these reasons it’s important to understand the effects of stress on pregnancy and be more trauma informed. 

2) Empower students to own their sensations and make choices based on their feelings. If a yoga teacher puts expectations on students and their performance in a class, he or she takes away the sense of self control. Teachers want to encourage students to tune in to their bodies, their energy, and their needs. Yoga is not about a certain shape or form. It is about an inner experience. 

3) Create a class structure that is consistent and predictable. When a class follows a predictable rhythm, the students know what to expect, which can foster a feeling of security. To avoid being repetitive, teachers can adjust the content to cover different pregnancy topics or class themes. 

4) Adapt, adjust, and accommodate. Brush up on prenatal chair yoga adaptations and have an abundance of extra props ready to go. Be prepared to teach two classes parallel to each other and integrated with one another. Instead of telling students to practice a modified version of a pose, simply offer options for practice and demonstrate these options without saying if one is more “advanced” than the other. 

5) Offer teachings that go beyond the yoga mat and into everyday life. If a woman has to leave your class because she has reached the end of the gestation period or she runs into a health condition, she should have a few tools that she can use to help her through this time. For example, when teaching more subtler practices of yoga in class, such as warm-ups or pranayama, you can discuss how this is beneficial even if a woman goes on bed rest or when the baby is born. 

6) Be a part of a woman’s community. Although prenatal yoga teachers are not midwives, doulas, or counsellors, they can be caring individuals as part of a woman’s community. How far teachers want to take it is an individual choice. One idea is to go for a smoothie or tea after class with students from time to time. If a teacher is not comfortable with this, then simply being available for students to ask questions or share struggles before or after class is another way to make yoga more accessible. 

For more information on the Accessible Prenatal Yoga Course, please visit hershayoga.teachable.com

Hersha Chellaram is a yoga therapist and authorized yoga teacher trainer for Integral Yoga and Accessible Yoga. She offers 200-hour, 500-hour, prenatal, and children’s yoga training programs specializing in the spectrum of ability, often going beyond the physical practice of yoga to include more internal and mindfulness practices (see hershayoga.com). Her prenatal yoga training program educates women and yoga teachers about individualizing yoga’s approach to be inclusive and adaptive to accommodate women of all abilities, health conditions, and pregnancy risks. Post-natal recovery, emotional health and trauma sensitivity are also hallmarks of her training, so that the teachings of yoga can be safely applied to women in difficult circumstances. She is founder of YAMA Foundation, a Hong Kong-based non-profit that brings yoga, arts, and meditation to underserved communities, including those with disabilities, special needs, chronic illnesses, and vulnerabilities.


This post was edited by Nina Zolotow, co-editor of the Accessible Yoga blog and Editor in Chief of Yoga for Healthy Aging.

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Friday, October 19, 2018

Featured Video: Reika Shucart's Wall Sun Salutation

Reika’s Sun Salutation in this video is a simpler version than the one demonstrated by Arturo Peal in our September 14th post and is the one that Jivana Heyman teaches in his Accessible Yoga Trainings.

 

This post was edited by Nina Zolotow, co-editor of the Accessible Yoga blog and Editor in Chief of Yoga for Healthy Aging.

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Tuesday, October 16, 2018

Submitting to Our Blog

by Nina Zolotow
This blog was designed to be a place where we can share information and hear from the many members of the Accessible Yoga community. So, would you be interested in contributing to our blog by writing a post yourself, being interviewed by us, or sending us a video or photograph? We’d be ever so grateful for your contribution!

However, before you apply to write a post, be interviewed, or send us a video or photograph, we have some things we want you to know. Depending on the type of post you want to contribute, we have certain qualifications you need to meet. So check How to Submit to Our Blog to see if you have the necessary qualifications and to find out more about the types of articles we're looking for. Then, if you do, we want you to send us a short bio of yourself, including your yoga training, teaching experience (if applicable), and any other qualifications along with a brief pitch explaining the kind of thing you want to do or say. Send it all in an email to Priya at priyaw@accessibleyoga.org. Looking forward to hearing from you!

This post was written by Nina Zolotow, co-editor of the Accessible Yoga blog and Editor in Chief of Yoga for Healthy Aging.

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Friday, October 12, 2018

Featured Video: Maria Kirsten's Chair Alternatives for Kneeling Poses



Maria Kirsten is a yoga teacher, yoga therapist, and occupational therapist. She specializes in making yoga accessible for students of all ages and levels of experience and ability. She uses her understanding of anatomy and functional movement to empower and educate students to modify and individualize their yoga. Maria’s special interests are in yoga for older grownups, yoga to support mental health, and yoga therapeutics. Maria’s teaching style is unconventional, practical, and fun, with lots of “real life” application and a big-picture approach to yoga practice. Maria thinks that being a yoga teacher is the best job in the world, and she loves to share all her experience and learning to empower others to teach yoga in a safe, accessible, empowering way. For more information, see yogaforgrownups.com

This post was edited by Nina Zolotow, co-editor of the Accessible Yoga blog and Editor in Chief of Yoga for Healthy Aging.

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Tuesday, October 9, 2018

Interview with Virginia Knowlton Marcus on Yoga for People with Disabilities


Accessible Yoga Blog: Where do you teach? Who is the population?

Virginia: Because I just completed a cross-country move from Sacramento, CA to Raleigh, NC, I am on hiatus from teaching a regular yoga class, but am maintaining a regular practice. I have taught yoga in Baltimore, MD and Sacramento, CA. I have taught in studios, gyms, community centers, work places, homes, over Skype and on the telephone. I have facilitated yoga practice for people with and without disabilities of all kinds.


Accessible Yoga Blog: Can you share an experience that stands out?

Virginia: I really loved leading a seated yoga class for my colleagues at Disability Rights California as part of that organization’s wellness campaign. I was a little nervous because I wanted the yoga class to be well received, and was going to have participants not only in the room with me, but also in various locations around the state participating via Skype. However, I was not going to be able to see everyone over Skype, so I would not have that ongoing feedback.

Over 50 staff from around California joined in this practice in the middle of their busy workday. This confirmed for me the tremendous interest in yoga generally, and within the disability rights community specifically. From this experience, I was reminded how happy people are just to have the opportunity to engage in yoga practice, and that it is okay to just jump in! With some good prep work and attention to cueing, it went very well, and not only did we have this wonderful experience together as colleagues, afterward I learned that some people were continuing to do some of the yoga they learned in our class in their offices. This made me so glad I ventured to offer the class, despite being less than 100% confident.

Accessible Yoga Blog: Why do you teach this group or this population? What made you choose this specific group?

Virginia: I have worked for 25 years as a disability rights advocate and have invisible disabilities.When I found my way to yoga, the benefits were profound, and I recognized that more people with disabilities could also realize significant benefits from yoga practice. Yet I did not know other disabled people who practiced yoga – though many expressed interest when I asked – and I never saw anyone with a visible disability in yoga class.

When I took yoga teacher training, it was not even suggested that we should acquire skills to accommodate people with disabilities, nor older persons, young persons, disenfranchised persons, even non-athletes. The training was targeted to a narrow segment of the population — those who enjoy and benefit from a vigorous yoga practice — rather than diverse populations. I found this very disappointing. Not only was there no part of the training dedicated to assisting yogis with any kind of disability, no sensibility was even created that it would be a worthwhile aspiration to do so. When I shared with classmates my desire to make yoga classes more inclusive, they were supportive but clearly saw this as just “Virginia’s thing.” I literally found my Accessible Yoga tribe by entering “accessible yoga” in a Google search box in a quest to find like-minded people. I am so happy to have found dedicated, experienced yogis who are paving this way!

Accessible Yoga Blog: What are you excited to do next with your students?

Virginia: I am excited that I can bring yoga to my new home. I’ve begun reaching out to kindred spirits in North Carolina and will eventually get back to teaching after I am acclimated in my new job at Disability Rights NC. Until that time, I love being a student myself and soaking up knowledge others have developed. In the past year, I have attended an Accessible Yoga (AY) conference and taken Jivana Heyman’s AY training, which had been on my “must-do” list since I first learned about it. The more I can absorb, the more I can offer, and it is not too difficult to create opportunities to share yoga. I look forward to what comes next in that regard!


Virginia Knowlton Marcus, RYT 200, began teaching yoga in January 2016 and is a nationally recognized disability rights attorney who has been advocating for disability rights at the local, state, federal, and international levels for 25 years. Her professional positions have included Executive Director at Disability Rights Maryland, Director of Legal Advocacy and Director of Public Policy at Disability Rights California, and Executive Director of the Joseph P. Kennedy, Jr. Foundation in DC. Her volunteer work has included leadership positions on the Board of the National Disability Rights Network. She earned her J.D. and B.A at the University of California, Davis. She began her current position as Executive Director at Disability Rights North Carolina in September 2018.

This post was edited by Patrice Priya Wagner, co-editor of the Accessible Yoga Blog and a member of Accessible Yoga’s Board of Directors.
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Friday, October 5, 2018

Featured Photo: Jivana Heyman and the Skeleton

by Patrice Priya Wagner


Let’s play a game today! Here is a photo that Jivana Heyman shared on Facebook. Below are some of the possible captions we enjoyed. How would you caption this photo? Leave your suggestions in the comments.

“Me and future me.” (Jivana Heyman)

“When restorative yoga goes wrong…because it’s waaay too relaxing.” (Helen Purdy)

“Your back and alignment look much better than his! He is a bit floppy!” (Sumi Komo)

“Advanced yoga…” (Durgha Hanlon)

“Impermanence.” (Amber Coss Gelwicks)


This post was created by Patrice Priya Wagner, co-editor of the Accessible Yoga Blog and a member of Accessible Yoga’s Board of Directors.

° FOLLOW Accessible Yoga on Facebook, Twitter, Instagram, and YouTube. ° REGISTER here for our next conference. ° DONATE here to help us bring yoga to people who don’t have access or have been underserved, such as people with disabilities, chronic illnesses, children with special needs, and anyone who doesn’t feel comfortable in a regular yoga class.

Tuesday, October 2, 2018

Teaching Yoga in a Hospital Setting

by Lia Akhilanda
I have the honor of teaching yoga in an inpatient hospital to patients with blood cancer. This offering has been a meaningful addition to the care of our patients, and our patients often share after class how practicing caused them to feel a deep sense of calm and gave them a break from the worries and constant activity that comes with a hospital stay. For me, it has been a heart-opening opportunity to connect with our patients and to invite their healing to occur on all levels—mind, body and spirit.

The class is a diverse group of usually 4-8 patients, from all across society and who have a wide range of functional abilities. Patients are at different stages of their treatment: awaiting, receiving or recovering from chemo, stem cell transplants, or immunotherapy, or waiting for the results of a crucial biopsies, etc., sometimes within month-long hospitalizations. All are immunocompromised and often have extensive weakness, fatigue, nausea, GI symptoms, pain, stress, and anxiety. Patients leave their hospital rooms to come to our group room. Some also bring a loved one with them to our class, though all come with their other close companion, their IV pole, which may be actively transfusing chemotherapy or blood products.

Leading this group demonstrates the importance of Krishnamacharya’s core teaching of adapting to the individual because every patient is so vastly different in their life experiences, diagnosis, treatment, and side effects. And often cancer treatment regimens may cause a patient to feel strong and energized one day but completely weak and fatigued on the next day. This class is also a constant reminder of the importance of detaching from outcomes and choosing to be present in relationship with ourselves—mind, body and spirit—and in relationship with those around us. Many of the patients are consciously and subconsciously affected by grief related to being diagnosed and being unable to function as well as they did before their diagnosis. Encouraging patients to increase their awareness of their bodies provides them with a rare opportunity to quietly check in with themselves, an essential first step in making a yoga practice therapeutic.

Though all have heard of yoga before, for many of the patients this is their first yoga class. I first invite them to think of this class as an entirely new experience. Their imprints of yoga often associate the practice as purely physical and with postures involving strenuous hyperflexibility, which are unlikely to be accessed by most people and potentially harmful for patients with a serious illness. In order to create an environment of comfort and safety, I offer poses that are accessible in an approachable sequence.

My classes are at most an hour long, including about 40 minutes of movement and approximately 10 minutes of guided meditation before and after, depending upon my impression of their interests and abilities. Although I teach alone an RN is present to assist with patient assessment and needs. I generally teach Mukunda Stiles’ Joint Freeing Series, Pavanmuktasana, which focuses on increasing fluidity in the joints and coordinating movement with breath. This series can be done on the floor, in a chair, or in a bed and is easily adapted, approachable, and dynamic. During the ending meditation, I guide patients into stillness and rest, and provide a long period of silence to use the space for sending positive thoughts to themselves or others, sending or saying prayers, breathing, or whatever they feel they need. I thank all members for their willingness to attend and their effort in serving themselves.

Here are a few of the guiding principles I implement:

Medical clearance is essential. In this group, all members are cleared by the medical team and an RN also attends the group to assist in being attentive to their IV pumps and keeping patients safe.

Screen for symptoms at the beginning of class. I specifically ask about weakness, fatigue, nausea, shortness of breath, dizziness, pain, etc. If anyone has these symptoms I consult with the RN before proceeding to make sure the medical team knows and that it is safe to have them participate. I let members know that if any of these symptoms arise during the group, they should rest back in their chair and let us know immediately.

Teach chair sequences to minimize fatigue and increase support. The chair poses I teach increase fluidity and ease in the body and breath and are not intended to build strength.

Give members full permission to take a break, a rest, or leave the class. Sometimes members decide they are too fatigued in the class and the RN supports them in safely returning to their room.

Focus on members building a relationship with their bodies. Cancer and its treatment can be traumatic to this relationship. So, I begin with a meditation based in pratyahara, withdrawing from overwhelming sensory experiences in the hospital and into a sense of inner stillness. Then I provide a guided visualization, starting with the feel of their skin, next feeling skin connecting to muscle, tissue, organs, bones, and then feeling their circulatory system and visualizing their blood energized by their breath. I guide them to rediscover their breath in the moment and pose open-ended reflective internal questions: What does your body feel like right now? What is it like to be with the intimacy of your own breath? Who are you in the body you have now? Where do you feel openness? What is your body seeking?

Sthira sukham asanam. I suggest that members use approximately 70% effort in poses. To illustrate this, I have them flex their arm to 100%, then ask them to flex to only 70%. This prevents over-exertion and stiffness, keeps their body fluid, and helps their minds focus on their relationship with their bodies.

Cautiously and skillfully instruct any pose that lifts the arms above the shoulders or a twist from the midline. This is necessary due to the need to not disturb central venous catheter insertions (PORTs/PICCs/Hickmans), which are internal lines that if displaced can lead to serious health issues or a delay in treatment. I encourage members to keep one line of energy and slowly and gently lift the arm up and down, one side at a time. I have them avoid twists from the midline greater than 45 degrees.

With all of these adaptive considerations, this group has created some of the richest examples of a yogic experience that I have observed. I regularly see that despite experiencing some of life’s greatest challenges, the patients experience a state of interconnectivity with the group and themselves, and often feel a state of inner stillness and contentment with things as they are. Again and again, I bow to their courage.

Lia Akhilanda is an accessible yoga teacher, ayurvedic bodyworker, and nationally certified oncology clinical social worker currently at the University of California San Francisco Medical Center. She has taught in an array of non-traditional spaces, including several non-profit organizations, an LGBTQ+ youth homeless shelter, an inpatient psychiatric facility, and an oncology and bone marrow transplant hospital service. She is inspired by teachings that are accessible, decolonized, socially aware, and full of reverence. She bows to all of her teachers, all who have graciously given her the blessings of sadhana. For more information, see akhilanda.org.


This post was edited by Nina Zolotow, co-editor of the Accessible Yoga blog and Editor in Chief of Yoga for Healthy Aging.

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