Monday, March 25, 2019

Yoga and Advanced Aging, Part 3: Reconsidering the Breath

Music, Dorrit Black, 1928
By Carey Sims

Carey will be presenting a workshop “Yoga and Advanced Aging: Teaching in Assisted Living, Skilled Nursing, and Memory Care Spaces” at the Accessible Yoga Conference in St. Louis, May 31-June 2, 2019.

Part Three: Reconsidering the Breath

Many of us have discovered that connecting with our breath is where the rubber meets the road in our practice. But some of the breath techniques we find effective in the general population may not always apply to adaptive and senior students. In this article we will rethink how we cue the breath and explore the challenges our students may be facing when we ask them to breathe in certain ways.

How many times have we been encouraged to take a deep breath in a yoga class? Probably more than we can count. But for some students with advanced aging, a “deep” breath can feel invasive and even violent. I often kid that handing out a cough drop or a cup of water counts as an assist in my classes because breath work inevitably ignites a coughing spell.

I have found that replacing the word “deep” with “gentle” allows for a full inhale, but invites softness into the breathing experience. Students are less likely to overexert, grip, and become tense. Example: “Take a gentle breath in and a slow breath out.”

I also give students the freedom to breathe from their nose and/or mouth. Usually most students inhale through the nose and exhale through the mouth, but not always. As teachers, we must constantly ask what we are trying to achieve with a particular cue or technique and allow ourselves to be creative in achieving that goal. Connection to the breath is what matters to me; I don’t get dogmatic about methods.

When teaching movement, consider the breath as a layer of experience. Matthew Sanford has a saying, “Prana follows consciousness more than it follows breath.” This is one of the cornerstones of my teaching. I come from a vinyasa background and this was initially hard to wrap my head around, but once I stopped leading with breath, I began to tangibly see the results in my students’ ability to connect with their bodies. Why would this be?

Students with advanced aging and/or dementia often struggle with left/right discrimination and moving in two directions at once. Managing these types of movements and coordinating breath at the same time is extremely challenging and often causes frustration. I know that linking breath with movement is powerful, but my solution is to explore movement first and layer in the breath after we have connected with the body.

A simple change in my cueing order creates the necessary rhythm, connection, and space for the breath to benefit rather than impede my students. For example, “Lift your arms up toward the ceiling and lower them back down by your sides. Do this a few times and notice how that feels. Now we are going to move with our breath. Breathe in and lift your arms up and breathe out and lower your arms down.” I don’t want my students to feel like they are doing something wrong and become frustrated. If that happens, they may quit participating or decide not to come to yoga the next time. I am not their Physical Therapist or Occupational Therapist— I want them to feel good during our time together.

Another way to teach breath awareness is by exploring function. When we understand the utility of a technique or pattern, we can shift our relationship to it both as teachers and practitioners. Take holding the breath for example. This is natural reaction to being over stimulated. It’s like the brain knows we need to hit pause and regroup for a second or two. The next time you are focusing really hard on a new or complicated task, observe your breathing. If you find that you are holding your breath, don’t admonish yourself; instead be amazed at your body’s brilliance at problem solving.

When I work with my senior students on a new sequence, I often ask them to check in and notice if they are holding their breath. We usually laugh and smile at this recognition. I tell them it’s okay, explain why it’s happening, and ask them to let their body catch up to the posture or movement. From there we breathe out slowly. We simply need to create space for the breath to sort itself out and trust that our bodies know what to do once we get out of the way.

As we just explored, holding the breath is a brilliant stabilizing mechanism for the mind, but I’ve witnessed many times that the body also intuitively supports the spine through breath suspension or retention. Think of an instance where you picked up something a little too heavy and grunted or held your breath for a second. Your body intuitively knew it needed stability and used a pause in the breath to create it. Understanding this function helps me appreciate why some students are breathing the way they are. For many of my students, a movement like lifting the arms overhead is strong. These students often instinctively hold the breath as a means to recruit strength. Recognizing this, I will work with what is naturally happening and layer in a slow exhalation as we lower the arms.

Elongating the breath has a similar stabilizing function to breath retention, but introduces the sensation of ease inside of effort. I may refine the last example further by asking students not to drop their chest as they lower their arms. As we continue we might focus on decelerating the downward momentum of our limbs as we exhale. Example: “Lift your arms up toward the ceiling, keep your chest lifted and slowly lower the arms down as you exhale.”

A friend of mine said something beautifully powerful to me recently. “Carey you are helping your students connect with their bodies before they leave them.” I never really thought of it that way, but it’s true. Many, if not most, of my students’ bodies are steadily declining. I have lost a lot of students over the past few years. This is all the more reason to let our time together become a place of playful exploration. My students don’t need to be concerned about getting things “right,” especially their breathing. Imperfections are welcome.


Carey Sims, RYT500, E-RYT200 lives in Charlotte, NC, where he teaches at NoDa Yoga and offers Chair Yoga at various senior living centers in the Charlotte area. He is a student of Adaptive Yoga pioneer Matthew Sanford (Mind Body Solutions, St. Louis Park, MN.) His mission is to use Yoga to help students explore their bodies in an accepting and non-judgmental way. 

This article is part of a series exploring the practical application of yoga in Assisted Living, Skilled Nursing, and Memory Care spaces. Carey shares some of the challenges he has encountered teaching in these environments and offer practical techniques that he has found useful in sharing yoga with this population.


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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