Overcoming Asthma by retraining the Breath.

Following an emergency visit to an intensive care unit, yoga teacher Barbara Benagh pledged to beat her asthma. After extensive research, she discovered the key to overcoming asthma is retraining the breath.

By Barbara Benagh

It’s the middle of the night. Suddenly you’re wide awake, suffocating, gasping for air but unable to catch your breath. The whole world seems to be closing in around your throat and chest. The urgency to breathe that woke you in the first place is rapidly giving way to panic. You’re having an asthma attack.

For millions of Americans, this is an all-too-frequent occurrence, a nightmare that can’t be fully appreciated by those without the disorder. That was certainly true for me. Until late 1987 I had never given asthma much thought. Then I had a bout with viral pneumonia. Even after I recovered, a nagging cough lingered. The cough became chronic and, after several months, so did periods of breathlessness. After one particularly anxious episode, I went to the doctor. She diagnosed my problem as asthma.

Asthma comes from the Greek word for “panting.” My doctor described it as a reversible, chronic lung disease characterized by coughing, wheezing, and inflamed airways. Though asthmatics always have some degree of inflammation, an asthma attack or “flare” occurs when some trigger provokes increased swelling, mucus production, coughing, and a tightening of the smooth muscle around the airways. As airways close, breathing becomes shallow, fast, and difficult. Symptoms can be mild, severe, or even fatal. This is the clinical explanation, but it hardly conveys the terror of an experience that leaves even the strongest person feeling out of control and helpless.

Upon my doctor’s diagnosis, I became one of the 17 million asthma sufferers in America. Figures from the U.S. Department of Health and Human Services are sobering: Six percent of children under 5 have asthma (a 160 percent increase since 1980), and older children miss 10 million school days each year. Asthma accounted for nearly 2 million emergency room visits last year; more than $6 billion was spent on asthma care. According to the World Health Organization, the situation isn’t much better throughout the industrialized world. In Australia, for instance, at least one in eight children has asthma. Annually, there are more than 180,000 deaths worldwide from the condition, and asthma seems to have become a more serious disease in recent years. Researchers are scrambling to figure out why.

Pollution is often cited as a cause, and with good reason: Airborne and environmental pollutants can trigger asthma attacks. But studies show pollution can’t bear sole blame for the epidemic. Even where pollution rates are declining, asthma incidence continues its upward climb.

Other scientists theorize that perhaps we are too clean. Researchers at Columbia University are trying to determine if the important sensitization of the immune system that should take place early in life has been reduced by modern hygiene, leading to later hyperactive immune reactions that contribute to the occurrence of asthma.

Especially intriguing is the recent theory that the very drugs that revolutionized asthma care may be partly responsible for the increase in overall incidence, and especially for the growing mortality rate. This hypothesis is particularly compelling since the current epidemic indeed began at about the same time modern asthma drugs went on the market.

Treatments for Better or Worse

Successful treatments for asthma have always been elusive. Remedies changed little through the ages and have included herbal tinctures, relocation to arid climates and, believe it or not, smoking tobacco and cannabis. With the development of bronchodilators or “rescue” inhalers during the 1960s, everything changed. These beta-agonist drugs (the most popular is albuterol) bring rapid relief from the most common symptoms of asthma. Airways quickly reopen, wheezing stops, and mucus clears. This lets the asthmatic relax and breathe more easily. These sprays seemed to be the big breakthrough that would banish asthma forever, but they have a downside. Many asthmatics overuse their inhalers.

Though doctors warn against this, it’s easy to see how such a pattern develops. People are less likely to avoid the situations that trigger asthma attacks if they know a puff or two from an inhaler will magically banish their symptoms. Inhaler overuse can also mask a silent increase in chronic airway inflammation, giving asthmatics a blunted perception of how severe their asthma is, so that they put off getting further treatment until they have a real crisis.

According to the Canadian Respiratory Journal (July/Aug 98), “regular use of short-term beta-agonists as maintenance therapy for chronic asthma is no longer recommended.” Articles in several other prominent medical journals have also documented that even normal use of albuterol eventually worsens asthma. In other words, while inhalers relieve symptoms in the short term, in the long run they contribute to an overall increase in the frequency and severity of attacks.

Doctors now recognize the limits of rescue inhalers and often recommend the use of newer drugs, primarily corticosteroids, which treat an asthmatic’s chronic inflammation. With the development of these anti-inflammatories, medical treatment of asthma has entered a new era. Prednisone, the most popular of these drugs, is now the last line of defense against asthma and has saved many lives, including my own. Regular use can reduce the need for bronchodilators and prevent asthma attacks. However, prednisone is a potent drug with severe adverse effects that can include dependence, hormonal changes, weight gain, glaucoma, and severe bone loss. With long-term use a person can be affected by problems more crippling than asthma itself.

Every Breath You Take

Like 90 percent of diagnosed asthmatics, I relied upon popular medications, using a combination of inhalers and prednisone to prevent and relieve symptoms. I also tried a number of alternative therapies like herbs, acupuncture, and dietary supplements, which were of some help. I was vigilant about avoiding the common triggers of asthma attacks. But none of these strategies provided long-term relief from my symptoms, nor did they free me from drugs and hospital visits, which came to average about five a year.

Most perplexing, the pranayama techniques that I had practiced for years, and that I thought would help me, actually triggered symptoms (especially those exercises which emphasized the inhalation or its retention). Later I would understand why, but at the time I felt helpless. I was afraid to take less medicine, as my situation was deteriorating.

Then, in late 1995, it happened. Two days after coming down with the flu, I went into respiratory failure and spent the next three days unconscious in intensive care on a respirator. Later I was told I nearly died.

During my long recuperation I had ample time to contemplate my predicament. I had to come to terms with the fact that the medicines I had been taking were no longer helping me. I knew my asthma was severe enough to be fatal, and might be unless I took proactive steps to improve my circumstances. I had to find something new.

A question had nagged at me ever since I was first diagnosed. What change had occurred in me that now caused me to react so severely to triggers that, in the past, were harmless? I think this is a relevant question whether one has had asthma a few months or for years. What is going on inside this particular body, right now, that causes me to have asthma?

It is so easy to define asthma by its symptoms. The majority of treatments, in both allopathic and complementary medicine, are designed to alleviate those symptoms. However, symptoms are not the cause of asthma, and I knew from years of practicing and teaching yoga that treating symptoms without considering the whole person seldom solves the underlying problem. So I set out to learn why certain triggers cause the body to react with an asthma attack.

As I read everything I could find about asthma, I was intrigued to discover that several prominent experts on breathing, including Dr. Gay Hendricks, author of Conscious Breathing (Bantam, 1995), and Dr. Konstantin Buteyko, a pioneer in the use of breath retraining for asthmatics, consider the malady to be more a disturbed breathing pattern than a disease. I began to wonder if my breathing patterns had been so thrown out of sync by the stress of coping with pneumonia that the changes had become chronic. Of course, I was acutely aware that my breathing was disturbed when I was having an asthma attack; now I began to consider the possibility that my breathing might be significantly disturbed even when I had no symptoms.

Was it possible that my disordered breathing was actually a cause of my asthma and was perpetuating it? Could it also be that disordered breathing was sabotaging my attempts to help myself through pranayama? Not only did these ideas help me to make sense of my condition, they also gave me hope. If the way I breathed was causing my asthma, then retraining my breath might alleviate my problems. Excited by this prospect, I dived into learning more about how the body breathes.

Breathing Lessons

Respiration, like other essential bodily functions, is involuntary. Our bodies are programmed from birth to perform these functions automatically, without having to think about them. Respiration is unique, however, since it can be voluntarily modified by the average person. This capability is the basis for breathing techniques that have been part of the yoga tradition for thousands of years. For asthmatics, these techniques can be the foundation for a program of breath retraining that can help them manage their disorder.

Breathing is ideally a process of maximum efficiency with minimum effort. Its efficiency depends on the correct functioning of the diaphragm, a strong sheet of muscle that separates the heart and lungs from the abdomen. Each breath starts in response to a message from the respiratory center in the brain which causes the diaphragm to activate. It flattens into a disc, making the lower ribs swing out and thus increasing the volume of the chest cavity. The lungs follow this expansion, creating a partial vacuum that pulls air into the lower lungs, much like a bellows.

When we exhale, the diaphragm simply relaxes. The lungs have a natural recoil that allows them to shrink back to their regular size and expel air. The abdominal muscles and muscles of the rib cage can enhance this process, but it is the release of the diaphragm and the recoil of the lungs that are the crucial elements in the exhalation. After a pause, the breath cycle begins again, a pumping rhythm we can all easily feel. When our breathing apparatus is working efficiently, we breathe six to 14 times per minute at rest. In a healthy person, this rate increases appropriately when the physical needs of the body require it.

Waiting to Exhale

Like other involuntary bodily functions, breathing is usually controlled by the autonomic nervous system, which enables the human organism to run like a well-oiled, self-correcting machine. There are two branches to this system: the parasympathetic and sympathetic. The parasympathetic branch, known as the “relaxation response,” controls resting functions of the body. It slows the heart and breathing rate and activates digestion and elimination.

The sympathetic branch has the opposite effect. It rouses the body and regulates active functions related to emergencies and exercise. When emergencies arise, the sympathetic branch floods the body with adrenaline—the well-known “fight or flight” response. The heart rate goes up and breathing rate increases to supply the body with an infusion of oxygen. If the danger is real, the increased energy is used. If not, the body stays in a state of overstimulation which can become chronic, causing a number of symptoms including anxiety and hyperventilation (overbreathing).

Since few of us are immune to the constant stresses and strains of modern life, the alarm bells of the sympathetic nervous system are constantly being rung. It is a real juggling act to maintain a healthy autonomic balance, a challenge at which asthmatics generally fail.

Although most asthmatics are unaware of it, we tend to chronically breathe at a rate two to three times faster than normal. Paradoxically, instead of providing more oxygen, overbreathing actually robs our cells of this essential fuel. We do take in more oxygen when we overbreathe; but, more importantly, we also breathe out too much carbon dioxide.

Most of us learn in school that when we breathe we expel carbon dioxide as a waste gas, but we don’t learn that expelling just the right amount of CO2 is critical for healthy breathing. If CO2 levels get too low, the hemoglobin that carries oxygen through the blood becomes too “sticky” and doesn’t release sufficient oxygen to the cells.

Eventually, starved for oxygen, the body takes drastic measures to slow breathing so CO2 can build back up to safe levels. These measures produce the classic symptoms of an asthma attack: Smooth muscles tighten around the airways, the body further constricts them by producing mucus and histamine (which causes swelling)—and we’re left gasping for breath.

Catch Your Breath

Once I understood that breaking the cycle of overbreathing is essential to overcoming asthma naturally, I could draw on all my years of experience with pranayama. I experimented with breathing techniques to see what would restore my natural breath rhythm. Over time I settled on a handful of exercises that were both simple and effective at slowing my breath rate and reducing the incidence and severity of my asthma.

There are certain precautions to consider as you embark on this program. Please do not stop taking your medications. The program may ultimately reduce your dependence on medication or enable you to do away with it altogether, but this should not be done hastily or without the approval of a doctor. If you have diabetes, kidney disease, or chronic low blood pressure, have had recent abdominal surgery, or are pregnant, you should consult with your physician before doing these exercises.

I also strongly suggest that asthmatics avoid additional breathing exercises which call for rapid breathing (kapalabhati/bhastrika), retention of the inhalation (antara kumbhaka), or tightening the throat (strong ujjayi). Asthmatics must realize that many breathing exercises which are quite beneficial for a normal breather may have a paradoxical impact on an asthmatic.

Let me stress that patience and perseverance are required in this program. The disrupted breathing patterns common among asthmatics are deeply ingrained and can take a while to change. The truth is, it can seem easier to take a pill or use an inhaler than to spend 15 minutes a day on exercises that confront these stubborn patterns and bring up the fears and emotions that often surround the disease. I know the frustrations firsthand.

But I also know, from my experience, that if you make these behavioral changes a daily regimen, you’ll gain valuable tools for managing your asthma.

Breath Retraining Tips

Here are a number of practical guidelines that will help your efforts be more successful. At first, practice the exercises in order. You may eventually find you prefer a different sequence, and that’s fine. (You may also have other exercises that have helped you in the past. Feel free to include them.) But whatever you do, I recommend you start each session with the Deep Relaxation exercise.

Don’t be too ambitious. Resist the urge to do more even if you feel you are ready. Wait a few months before increasing your efforts.

The exercises work best on an empty stomach, but you should sip water to help keep your airways moist.

For optimal results wear warm, loose-fitting clothing and practice in a comfortable place where you have room to lie down on the floor. In this position, less effort is required for your diaphragm to move well. However, if you are experiencing asthma symptoms, lying down may be uncomfortable. In that case, try sitting on the edge of a chair and leaning forward onto a table. Rest your head on folded arms and turn your head to one side. But you don’t need such ideal conditions to practice; I encourage you to do exercises whenever and wherever they come to mind. I often practice while I am driving.

If you feel anxious, nauseous, or short of breath while doing the following exercises, STOP. Get up and walk around. You are probably hyperventilating and need to burn off some energy. Don’t try to continue your exercises immediately, but come back to them the next day.

Remind yourself often—especially if you get frustrated—that the way you breathe now is making you ill; that it’s learned behavior; and that it can be changed.

Practice the exercises once or twice daily. When you are exhibiting symptoms, exercises 4 and 5 can be done more frequently.

There is one final guideline that may seem like a whole program in itself, since it can be so hard for an asthmatic to do: It is very important to breathe through your nose during all the exercises, even though asthmatics are often chronic mouth breathers. In fact, it is important to breathe through your nose most of the time. Air breathed in through the nose is filtered, warmed, and moistened, making it just right for sensitive airways. Nose breathing also promotes correct diaphragmatic action since it makes hyperventilation more difficult.

You may protest that you have to breathe through your mouth because your nose is always blocked. But did you know that a chronically blocked nose can be a result of poor breathing, instead of the other way around?

Here are a few tips to help unblock that schnozz and keep you breathing through it. After an exhalation, hold your nose and shake your head up and down for a few seconds, stopping when you need to inhale. This can be very effective, especially if you repeat it a few times.If you do Headstand in your asana practice, you may find that it helps, too. Using a mild saline solution to wash out your sinuses is also a great habit to develop. (Neti pots are designed for this purpose.)

When you’re trying to breathe through your nose, don’t pull the air into the nostrils; instead, open the throat. I do this by imagining my mouth is located at the hollow of my throat.

My last suggestion is an unorthodox but highly effective way to break the mouth-breathing habit. Tape your mouth closed with surgical tape! It’s a bit weird, but it really works—especially at night, when you can’t use other strategies.

Be very patient with your chronically stuffy nose; you will gradually feel improvement.

Exercise 1

Deep Relaxation

This exercise helps you establish a calm state before doing the other exercises. Begin by lying down with a firm pillow or a folded blanket under your head. Bend your knees and rest your feet flat on the floor. If that is not comfortable, place a bolster or rolled blanket under the knees. Feel free to shift your position and stretch if you become uncomfortable. Some people like to play calming music as well. Place your hands on your belly, close your eyes, and turn your attention inward. How do you feel? Are you uneasy, uncomfortable, buzzing, or distracted? Is it difficult to lie still? Is your mind racing? The goal is to let go of all that, which is not always easy. It may take several minutes (or several sessions) to relax deeply. Give yourself time.

With each exhalation, let your belly sink away from your hands and into the back body. After a gentle pause, can you feel the belly rise effortlessly when you inhale? This relaxed action cannot be rushed, so don’t force the movement in any way; an easy rhythm will settle in as your state of relaxation deepens.

Exercise 2

The Wave

I call this exercise “The Wave” because of the soothing movement that ripples up and down the spine when the body settles into your natural breath. This movement helps unlock the diaphragm and massages the abdomen, chest, and spine, releasing tension that can interfere with healthy breathing.

After Deep Relaxation, place your arms on the floor alongside your torso. Close your eyes and turn your attention to the belly and the way it melts into the pelvis each time you exhale. Begin The Wave by gently relaxing the lower back into the floor as you exhale, and then lift it a couple of inches as you inhale. The hips stay on the floor as the lower back rises and falls. This need not be a big movement, and the pace of breathing should be slow and easy. Allow yourself to settle into and slightly amplify this rhythmic wave, and notice if you can feel movement all the way up and down the spine. Repeat this exercise 10 or 15 times before continuing to the next technique.

Poor breathing habits may confuse you and cause you to reverse the coordination of movement and breath, so pay close attention. If you find yourself feeling tense, take a few normal relaxing breaths between cycles.

Exercise 3

Softening the Inhalation

In this exercise you will try to soften the effort you use to inhale, and to decrease the length of your inhalation until it is shorter than the exhalation by as much as half. When you first try this exercise, you may feel an urgent desire to breathe in more. Instead, remember that overbreathing is a habit that perpetuates your asthma.

To identify your basic relaxed breathing rate, begin by counting the length of your exhalation, the pause afterward, and the following inhalation. After several minutes, start to modify your breath rhythm to emphasize the exhalation. Use the baseline length of your exhalation as the gauge for any modifications you make: In other words, don’t struggle to lengthen your exhalation; instead, shorten your inhalation. With practice, this will become easier. In the meantime, take several of your baseline breaths between cycles if you feel anxious or strained.

Exercise 4

Complete Diaphragmatic Exhalations

An inability to exhale fully is a defining symptom of asthma. I practice this exercise frequently whenever I feel short of breath.

Lie on your back with your eyes closed and arms stretched out along your sides. Beginning with an exhalation, purse your lips and blow the breath out in a steady stream. You will feel a strong action in the belly as the abdominal muscles assist the exhalation. Your exhalation should be longer than usual, but it is important not to push this too far. If you do, it will be difficult to pause after exhaling and your subsequent inhalation will be strained.

Pause for a few seconds after your exhalation, relaxing the abdomen. Then, keeping your throat open, allow the inhalation to flow in through the nose. Because of the stronger exhalation, you should be able to feel the inhalation being drawn down effortlessly into the lower chest. Count the length of the exhalation, the pause, and the inhalation. At first, try to make the exhalation at least as long as the inhalation; do this by shortening your inhalation, as in the previous exercise. (Unlike the previous exercise, in which you breathe at your normal resting rate, your breath here will be both longer and stronger.) Eventually, aim to make your exhalation more than twice as long as the inhalation and to make the pause after the exhalation comfortable rather than hurried. Since asthmatics find exhalation difficult, it may help you to imagine the exhalation flowing upward, like a breeze within the rib cage, as the breath leaves the body.

Repeat five to 10 cycles of this exercise. As with all the exercises, I recommend you take several normal breaths between cycles.

Exercise 5

Extended Pause

This exercise is designed to help regulate the CO2 levels in the body. It doesn’t give the same quick fix as an inhaler, but it can turn an asthma attack around if you start it early enough. By pausing before you inhale, you give the body a chance to slow down and build up the level of carbon dioxide. An overbreather may find this to be the hardest exercise of all. At the outset it may be difficult to pause for even a few seconds, but if you keep trying you will notice improvement, perhaps even during a single practice session. Eventually, the pause can extend up to 45 seconds or even longer.

Position yourself as before: on your back, knees bent, with feet flat on the floor. In this exercise I recommend that you consciously shorten your inhalations and exhalations. (Your breath rate should not become rapid, though; the shorter inhalations and exhalations are balanced by the longer extended pause.) Inhale for one or two seconds, exhale for two to four seconds, and then pause. During the pause you may feel an urge to exhale a bit more, which is OK; in fact, the overall feeling of the pause should be like the natural relaxation that occurs as you exhale. You can extend the pause by consciously relaxing wherever you feel specific tensions.

As with all these exercises, patience yields better results than force. Repeat the exercise five to 10 times, and feel free to take normal breaths between cycles.

There are, of course, many other breathing techniques that can be beneficial in the management of asthma, but I can personally vouch for the transformative power of the exercises in this program. I am still an asthmatic, but I haven’t been hospitalized or on prednisone for a very long time.

The results of my efforts have been nothing short of exhilarating. Though I continued to practice yoga throughout my worst asthma years, my practice has become stronger as a result of the breathing exercises, which have helped me develop a greater sensitivity to the role of breath in asana practice. Also, I’ve been able to return to cycling, a favorite pastime I’d given up for a decade. Less than one year after adopting this program, I was able to cycle over Colorado’s Loveland Pass (11,990 feet) and to ride from Boston to New York City in a weekend without taking a single breath through an open mouth!

Although each asthmatic has his or her unique set of circumstances, I hope my story will inspire others to have hope, take active steps to change their respiration, and prevail in finding their own way to breathe free.

Barbara Benagh has practiced yoga for 27 years and taught since 1974. Trained in the Iyengar style and influenced by Angela Farmer, she now offers her own unique approach in workshops worldwide and at her home base, The Yoga Studio, in Boston, Massachusetts.

Significance of the number 108

Significance of the number 108

by Cora Wen – Yoga Bloom on Friday, July 3, 2009Have you ever wondered about the Significance of the number 108? I have looked up many of the symbolgy and would love to hear more….

Mala or Prayer Beads

A japa mala or mala is an eastern rosary with 108 beads. The mala is used both in Hinduism and Buddhism for counting mantras, chants or prayers. 108 has been a sacred number for a long time, and this number is explained in many different ways.

Traditionally, Buddhist have 108 beads, representing the 108 human passions that Avalokiteshvara assumed when telling the beads. This number ensures a repetition of a sacred mantra at least 100 times, the extra beads allowing for any omissions made through absentmindness in counting or for loss or breakage of beads.

Regardless of the meaning of 108, it is important that if a mala is used to count mantras, the mantra be given sincerity, devotion, feeling, and full attention.

108 may be the product of a precise mathematical operation (e.g. 1 power 1 x 2 power 2 x 3 power 3 = 108) which was thought to have special numerological significance.

POWERS of 1, 2 & 3 IN MATH: 1 to 1st power=1; 2 to 2nd power=4 (2×2); 3 to 3rd power=27 (3x3x3). 1x4x27=108

SANSKRIT ALPHABET: There are 54 letters in the Sanskrit alphabet. Each has masculine and feminine, shiva and shakti. 54 times 2 is 108.

HARSHAD NUMBER: 108 is a Harshad number, which is an integer divisible by the sum of its digits (Harshad is from Sanskrit, and means “great joy”)

DESIRES: There are said to be 108 earthly desires in mortals.

LIES: There are said to be 108 lies that humans tell.

DELUSIONS: There are said to be 108 human delusions or forms of ignorance.

9 x 12: Both of these numbers have been said to have spiritual significance in many traditions. 9 times 12 is 108. Also, 1 plus 8 equals 9. That 9 times 12 equals 108.

TIME: Some say there are 108 feelings, with 36 related to the past, 36 related to the present, and 36 related to the future.

ASTROLOGY: There are 12 constellations, and 9 arc segments called namshas or chandrakalas. 9 times 12 equals 108. Chandra is moon, and kalas are the divisions within a whole.

PLANETS AND HOUSES: In astrology, there are 12 houses and 9 planets. 12 times 9 equals 108.
Gopis of Krishna: In the Krishna tradition, there were said to be 108 gopis or maid servants of Krishna.

1, 0, and 8: 1 stands for God or higher Truth, 0 stands for emptiness or completeness in spiritual practice, and 8 stands for infinity or eternity.

SUN AND EARTH: The diameter of the sun is 108 times the diameter of the Earth.

NUMERICAL SCALE: The 1 of 108, and the 8 of 108, when added together equals 9, which is the number of the numerical scale, i.e. 1, 2, 3 … 10, etc., where 0 is not a number.

SMALLER DIVISIONS: 108 is divided, such as in half, third, quarter, or twelfth, so that some malas have 54, 36, 27, or 9 beads.

DANCE: There are 108 forms of dance in the Indian traditions.

PYTHAGOREAN: The nine is the limit of all numbers, all others existing and coming from the same. ie: 0 to 9 is all one needs to make up an infinite amount of numbers.

STAGES OF THE SOUL: Said that Atman, the human soul or center goes through 108 stages on the journey.

SRI YANTRA: On the Sri Yantra there are marmas where three lines intersect, and there are 54 such intersections. Each intersections has masculine and feminine, shiva and shakti qualities. 54 x 2 equals 108. Thus, there are 108 points that define the Sri Yantra as well as the human body.

ANAHATA (HEART) CHAKRA: The chakras are the intersections of energy lines, and there are said to be a total of 108 energy lines converging to form the heart chakra. One of them, sushumna leads to the crown chakra, and is said to be the path to Self-realization.

MARMAS: Marmas or marmastanas are like energy intersections called chakras, except have fewer energy lines converging to form them. There are said to be 108 marmas in the subtle body.

MERU: This is a larger bead, not part of the 108. It is not tied in the sequence of the other beads. It is the quiding bead, the one that marks the beginning and end of the mala.

BUDDHA’S FOOTPRINT: All Buddhists accept the Buddha Footprint with its 108 Auspicious Illustrations. These areas are considered to have been marked on the Buddha’s left foot when his body was discovered.

Monk in Prayer....Meditation.

BUDDHISM: 108 beads on the Hindu maalaa {rosary} 108 Arhats or Holy Ones

HINDUISM: 108 Gopis {consorts} of Lord Krishna 108 Holy places for Vaishnavas 108 beads on the Japa maalaa {rosary} 108 Upanishads 108 Divyadeshes – Divine or Sacred Tirtha throughout India and Nepal 108 sacred water taps in Muktinath – Nepal

ISLAM: The number 108 is used in Islam to refer to God.

JAIN: In the Jain religion, 108 are the combined virtues of five categories of holy ones, including 12, 8, 36, 25, and 27 virtues respectively.

SIKH: The Sikh tradition has a mala of 108 knots tied in a string of wool, rather than beads.
Chinese: The Chinese Buddhists and Taoists use a 108 bead mala, which is called su-chu, and has three dividing beads, so the mala is divided into three parts of 36 each.

SHOSHU BUDDHIST: 108 beads in their malas. They implement the formula: 6 x 3 x 2 x3 = 108 6 senses [sight, sound, smell, taste, touch, thought]
3 aspects of time [past, present, future]
2 condition of heart [pure or impure]
3 possibilties of sentiment [like, dislike, indifference]

TANTRA SHASTRA: 108 Pitha {Sacred Places} The story goes that Lord Shiva was in deep and incessant meditation. His asceticism was creating great heat in the universe. All existence was in peril and Lord Brahma was deeply concerned.

Lord Brahma asked the Mother of the Universe, Maa Shakti, to use Her strength and wile to seduce Lord Shiva. Maa Shakti agreed and was born as Sati, daughter of Shri Daksha. Lord Shiva was so entranced by Sati’s asceticism and extraordinary beauty that he took human form and they were married. Years later, at a feast, Sati’s father insulted Lord Shiva. Sati was so humiliated that she began a deep meditation which led to her immolation.

Lord Shiva was completely heart broken. He reached into the sacrificial fire and pulled out as much of His beloved’s body as he could grab. As He ascended to heaven, bits of Sati’s body fell to earth. 108 bits to be precise! In time, these places were acknowledged and worshipped.

SANATANA DHARMA: In a book by Khurana, the explanation closely mirrors the original Vedic justifications: A circle has 360 degrees, which when multiplied by 60 gives us 21,600 minutes in a circle. 60 comes from the 60 ‘ghatis’ which Sanatana Dharmiks believe in. One ghati is equal to 24 minutes and 60 ghatis come to 24 hours.

One ghati is divided into 60 parts or ‘palas’. So the 60 ghatis multiplied by 60 palasa comes to 3,600. This is further multiplied by 60 (becase a pala contains 60 vipalas) which gives us 21,600. Half of this is for the day, and the other half for the night. So, 21,600 divided by 2 gives us 10,800. For practical purposes, we use 108. Using the number 108 helps us coordinate the rhythm of time and space & we remain in harmony with the spiritual powers of nature.

108 UPANISHADS FROM MUKTIKOPANISHAD: Rigveda(10): Aitareya , Atmabodha, Kaushitaki, Mudgala, Nirvana, Nadabindu, Akshamaya, Tripura, Bahvruka, Saubhagyalakshmi.

Yajurveda(50): Katha, Taittiriya , Isavasya , Brihadaranyaka, Akshi, Ekakshara, Garbha, Prnagnihotra, Svetasvatara, Sariraka, Sukarahasya, Skanda, Sarvasara, Adhyatma, Niralamba, Paingala, Mantrika, Muktika, Subala, Avadhuta, Katharudra, Brahma, Jabala, Turiyatita, Paramahamsa, Bhikshuka, Yajnavalkya, Satyayani, Amrtanada, Amrtabindu, Kshurika, Tejobindu, Dhyanabindu, Brahmavidya, YogakundalinI, Yogatattva, Yogasikha, Varaha, Advayataraka, Trisikhibrahmana, mandalabrahmana, Hamsa, Kalisantaraaa, Narayana, Tarasara, Kalagnirudra, Dakshinamurti, Pancabrahma, Rudrahrdaya, SarasvatIrahasya.

SamaVeda(16): Kena, Chandogya, Mahat, Maitrayani, Vajrasuci, Savitri, Aruneya, Kundika, Maitreyi, Samnyasa, Jabaladarsana, Yogacudaman, Avyakta, Vasudevai, Jabali, Rudrakshajabala.

Atharvaveda(32): Prasna , Mandukya, Mundaka, Atma, Surya, Narada-Parivrajakas, Parabrahma, Paramahamsa-Parivrajakas, Pasupatha-Brahma, Mahavakya, Sandilya, Krishna, Garuda, Gopalatapani, Tripadavibhuti-mahnarayana, Dattatreya, Kaivalya, NrsimhatapanI, Ramatapani, Ramarahasya, HayagrIva, Atharvasikha, Atharvasira, Ganapati, Brhajjabala, Bhasmajabala, Sarabha, Annapurna, TripuratapanI, Devi, Bhavana, SIta.

YB Travel Mystical Peru

I was in Bali and got an email from my friend Lisa West. She sent all the information about this trip that OAT was offering. It had an amazing itinerary at such an affordable price, it felt like it was meant to be so I decided not to pass it up.

Machu Picchu, also known as “The Lost city of the Incas”, is a mystical, sacred place nestled 7500 feet above sea level in the Andean Mountain Range above the Urumbamba Valley. Touched by the clouds, the ruins are one of the most enigmatic and beautiful ancient ruins in the world. Rediscovered on July 24, 1911 by Yale archaeologist Hiram Bingham, Machu Picchu (meaning ‘Old Peak’ in Quechua, the language spoken by the Incas) was thought to be a sanctuary for the preparation of priestesses and brides for the Inca nobility.

However, no one knows what the real purpose of Machu Picchu was. Some people speculate it was a prison and some say it was a defensive retreat, but the most common belief is that Machu Picchu was the estate of an Inca emperor. The dramatic setting in a remote area of the Peruvian Andes enhances the shroud of mystery even more. An absolute wonder of human heritage, Machu Picchu will touch your heart and soul in many ways.

We were home from our annual six months travel in Asia for just 3 weeks when I was once again boarding a plane to set out on another amazing adventure, albeit without my love, and travel partner. And on a tour not our normal independent travels. But still very exciting! I flew from Tampa to Miami the evening of September 26th to catch the 11:50 flight to Lima. I would have preferred a longer flight so that I could have gotten some sleep, but fortunately the people at OAT Travel took this into consideration. When we arrived in Lima around 4:57 am, they quickly got all of our luggage, got us on the bus and to our hotel (Miraflores district) to sleep until we met up for lunch at noon, and our afternoon tour.

Most of the people (16 max per tour) were on our flight from Miami, but a few had opted for the pre trip to the Amazon and we met them at lunch. After lunch we did our Lima tour including the Archealogical Museum. While many meals were included on the trip, dinner that night we were on our own so Lisa and I, along with TC and Shirley went out with our guide Raul. Sunday was an optional tour or do your own thing so I stayed behind, rested and did my entire Astanga primary series practice, taking my time and staying in each posture for at least 10 breaths. Two hours never passed so quickly. Feeling fresh, rested and that good fatigue feeling, I showered then met up with everyone for our briefing, which included a Pisco Sour (a creamy, frothy, limey cocktail invented in Peru useing a pisco (Peruvian grape brandy) that has a bit of bite). Very yummy. Then we were off to dinner.

Monday we were up at 5:00am, had bags outside the doors for pick up, made our way down to breakfast then our bus to catch our flight to Cusco. Beautiful flight and once we were out of the airport we boarded our bus and headed for an Apalca Shop. They showed us how to tell the difference between baby aplaca, old alpaca, and synthetics being sold as the real thing in the cheap and cheerful markets. But of course they also wanted you to buy from them. They were reputable so if anything were to happen to your item, you could return it. We also had our first cup of coca tea which is suppose to help with altitude sickness.

We had a picnic type lunch on the bus as we made the journey to Pisac which is on the road from Cusco to Ollantaytambo. The place is breathtaking, with a view over the Urubamba Rio and the town, hundreds of meters below !! Some parts of the path leading to the sun temple were quite difficult, especially for those like me that suffer from vertigo, as you have to walk over high cliffs to get there. But the destination is really worth the effort. The most impressive terraces welcome you at the entrance of the site. All 4 sections of the site are magnificient.

Coming from sea level this relatively short, physical walk was a good way to begin acclimating to the higher altitude in preparation for Manchu Picchu. When we came down from the ruins we spent a little time at the market then took our bus to our hotel Urumbamba, also in the Sacred Valley. The place was cozy, clean, comfy and a great place to be based out of for a few days. But we ended up being so busy we had little time to enjoy it. When I come again with Roger, I won’t have to fit everything into such a short time. But I can’t say enough about the way this trip was organized, what we ended up doing, our guide, who was the best, and when I witnessed others, had that validated time, and again.

After our luggage was delivered we got cleaned up and met everyone for dinner. Raul encouraged us to drink lots of water and they provided much of what we drank. But I always drink a lot so ended up buying more. Also, Gatorade, or power ade. I did everything he said, including drinking coca tea which was available at every meal, and only experienced a very mild headache between the eyes for a day.

Day 4 it was back on the bus for our our rafting trip and visit to Ollantaytambo, is a town and an Inca archaeological site in southern Peru some 60 kilometers northwest of the city of Cusco. It is located at an altitude of 2,792 meters (9,160 feet) above sea level in the district of Ollantaytambo. During the Inca Empire, Ollantaytambo was the royal estate of Emperor Pachacuti who conquered the region, built the town and a ceremonial center. At the time of the Spanish conquest of Peru it served as a stronghold for Manco Inca Yupanqui, leader of the Inca resistance. Nowadays it is an important tourist attraction on account of its Inca buildings and as one of the most common starting points for the three-day, four-night hike known as the Inca Trail.

After a visit to these ruins we visited the house of Senora Emma for our lunch. This is part of the “Day in the Life” portion of the trip. Senora Emma and her mother had made lunch for us. We did get to join in preparing a few things and helping serve, then they, including her daughters, sat down and lunch with us. We had been enjoying some really great meals in Peru, but this was one of the best. And that was even without me partaking in the dining experience of eating guinea pig which is a vital source of protein in rural communities, a mainstay of Andean folk medicine and a common religious sacrifice. We had brought gifts for the children and Senora Emma to show our appreciation for their hospitality and these were appreciated, especially the school supplies, tasty treats and bubbles that I added to my list at the last minute. Kids have to play, too!

From here we went to see how Corn Beer was made and to engage in a game of Sopa which was a lot of fun, but few of us were good at. Then they took us to a local well known Artisan to see his ceramics, and how they are made. Yes, a long day and finally we headed back to our hotel in rickshaws, so that those that had never ridden in one before would get a feel for the local transport. Back at the hotel we cleaned up and headed out for another delicious dinner.

Day 5 was finally the day we had been waiting on. We had packed the night before and left our bags outside early that morning. After breakfast we piled into the bus and headed back to Ollantaytambo to catch the train to Manchu Picchu. On the way we stopped at the local Wednesday market in Urumbambo, a place where everything is bought and sold including livestock, and other animals. It was festive, colorful and interesting. Not unlike the markets we go to in Asia. We arrived Aguas Calientes to rain but wasted no time. While our bags were being taken to our hotel, we got on the bus and began our ascent to this magical and mystical place.

Leading a tour is like herding cats but again, throughout this journey, Raul did a wonderful job of keeping us focused and on time, while maintaining a calm demeanor and delightful sense of humor. At the top we disembarked from the bus, went through the turnstill, had our passports stamped and regrouped where we were told. For several hours it would rain a few minutes then stop, then start again. This continued for awhile, and you would get glimpses of the ruins, and the mountains, sometimes hidden, sometimes peeking through, other times totally visible as the clouds kept moving, adding to the spiritual, and mystical feel. But by the end of the afternoon it was totally clear and we experienced Manchu Picchu a completely different way.

We left at closing time and heading back to town and dinner. The town of Aguas Calientes was so picturesque and beautiful, and all the establishments had candles adding to the atmosphere. Raul said it was because the power was out, but it certainly made dinner that night very memorable. As was the food, company, entertainment and fire that was lit in the pit where we ate. I didn’t care much that the power was out except that I couldn’t charge my camera battery, and for the most part everyone ended up being a good sport. Flexibility is important when you travel so why get upset over something you can’t control. After we ate we were all so tired that we could barely walk to the hotel, but we made it back, I downloaded all my photos and we called it an early night.

We were up early the next morning and I didn’t stick around to wait for the group. Me, Robin and Cathy took our tickets for the bus and went up to the 5 star hotel located at the entrance to Manchu Picchu. We sat inside, had a coffee and charged our batteries until our group showed up. Not long enough for a full charge, but enough that I didn’t miss the reason I came. So this fortunately worked out good. Today’s agenda was the Sun Gate which was about an hour and half climb. The sun was shining brightly, and everything was green, and gorgeous. The air so fresh, and clean. Once we were at the top we saw where people come into Manchu Picchu when they hike the Inca Trail. It was a magnificent morning and the walk down just as nice as the walk up, only easier. We left around 11:30 going back to the hotel to pack up and check out, then headed for our lunch before getting on the train, then our bus to Cusco. Another day, another adventure.

We got into Cusco a bit late and had time to shower before meeting everyone for dinner. They were working on the hotel and it was noisey so we ended up checking into another one the next day and were happy, it was even nicer than the one we left. Our hotel was conveniently located, we could walk a lot of places. But this tour we were on included a Cusco City Tour, a tour to Saqsay Waman, a 3000 hectare archaeological complex considered the first of the new seven wonders of the world. This huge construction was planned and built by Andean Man. The Incas called it the House of the Sun and the Spaniards called it a fortress because of its zig-zag shape and the 1536 revolution. The construction, which is made up of three platforms one on top of the other, was one of the most important religious complexes of its time. We partook in a spiritual cleansing by Healer Pedro, had a delicious lunch at a restaurant overlooking Cusco and went a few other places. Another day we had another ‘Day in the Life’ visiting a rural school in Raqchi, and delivering all the goodies we had brought. Other than Manch Picchu this was a highlight of the trip for all of us. We also visited Chinchero where Raul had grown up and he regaled us with stories of his childhood, and we visited a family that continues to practice the ancient art of weaving using natural dyes.

Sunday was our last day in Cusco and we had the option of visiting a local cemetary, and market with Raul. We opted for that then had the rest of the day to wander around and enjoy the city before meeting back up to the hotel for our dinner. The next morning we flew back to Lima, did a tour of the Barranco District then headed to lunch at a beach front restaurant. That afternoon we were on our own so opted to relax a bit in our hotel before we had to leave for the airport around 8:00pm. We caught our 10:50 am flight and made it uneventfully back to Miami, where we had quite a lay over. But by the time you walked from the plane to get through customs, baggage claim and to the domestic gate, we only had about 40 minutes before our plane took off for Tampa. We arrived Tampa safely, with new memories and wonderful new friends. Our group was absolutely terrific, and I am grateful to have had this experience with such amazing people. Fortunately my new friends from India live in Ocala which is very close to me so we can get together in person. For the others email will have to do for now. And I can’t say enough about OAT Travel. The entire way they operate is first class. Their people are amazing. The attention to detail. To REAL customer service, the best. Like it use to be everywhere.

Yoga and Asthma and Pranayama (yoga breathing) for Asthma Relief

Yoga and Asthma

The simple act of breathing is something most of us take for granted. Though our amazing bodies are designed to do this without any conscious thought, this is not the case for those with Asthma. I have been told that when you are having an Asthma attack it is as close to suffocating as you will get.

I cannot think of many things more terrifying, yet for millions of Americans this is a frequent occurrence with symptoms ranging from mild to severe, and in some cases, even fatal results. This can leave even the strongest person feeling out of control, anxious and helpless.

When I was asked to write this article “Yoga Postures for those with Asthma”, I immediately knew that I wanted to take this in the direction of what I have found effective in my classes and workshops; The practice of Pranayama, or yogic breathing. In the Indian Tradition there are 8 limbs of Hatha Yoga. One limb is Yoga the Asana or postures. Then thereis Meditation which usually includes no postures. And Pranayama is yet another separate limb altogether. While there is significant emphasis on the breath in Yoga and Meditation, this is usually limited to one technique. Following in the tradition, I also teach the limbs separately.

Pranayama, or yoga breathing, has been proven in clinical studies to help with many medical conditions. While learning to breathe properly is beneficial to every human being, for those with Asthma it is essential. The breath is the most vital process of the body, the most important aspect of life. Though you can sustain life for a few weeks without food and a few days without water, you cannot live for more than a few minutes without the breath. The breath is linked to all aspect of human experience.

What is Pranayama

Pranayama means the expansion of life force through breath control. Prana=life force. Yama=control, or discipline. Ayam =  expansion.  Asthma comes from the Greek word panting. In a Pranayama practice various breathing techniques are utilized that induce and enhance relaxation, concentration (Dharana), and meditation (Dhyana).

Pranayama is about making the unconscious act of breathing, conscious. It is essential to breathe properly in order to make this process more efficient and to balance the oxygen, carbon dioxide and other soluble gas levels in the blood. Since few of us are immune to the constant stresses and strains of modern life, most of us tend to take short shallow breaths, using only a half to two thirds of our lung capacity. And asthmatics chronically over-breathe, often at a rate two to three times faster than normal which robs the cells of essential fuel versus providing more oxygen.

The more stress, pressure and emotion we experience, the more restricted the breath becomes, as the alarm bells of the sympathetic nervous system are constantly being rung. This perpetuates the cycle of stress, anxiety and shallow breathing. This in turn deprives the body of oxygen and the prana essential to its good health. It takes a lot of practice to develop the real act of consciousness necessary to maintain a healthy autonomic balance.

Asthma is characterized by coughing, wheezing, and inflamed airways. Asthmatics always have some degree of inflammation, but experience increased swelling, mucus production, coughing, and a tightening of the smooth muscle around the airways during an attack, or flare up. As these airways close, breathing becomes shallow, fast, and difficult. The positive news is that Doctors say that is it a reversible chronic lung disease.

Armed with the information from your Doctor, do as much research as possible to find holistic alternatives and treatments to support what your Doctor prescribes. There are many suggested treatments. But as is the case with so many, especially those involving drugs, they usually treat the symptom not the problem. And the additional health risks can make the cure worse than the condition. There are also many myths regarding various treatments, so suffice it to say a proven treatment is elusive. I am no medical expert so cannot speak to this aspect. However, there are experts on breathing that have concluded that poor breathing habits could be the cause of Asthma which supports starting a Pranayama practice to assist with retraining the breath.

How does Pranayama Work

The breath influences the activities of each and every cell. And most importantly, it is intimately linked with the performance of the brain. Human beings breathe about 7-15 times per minute, or 21,600 times per day. Respiration fuels the burning of oxygen and glucose, producing energy to power every muscular contraction, glandular secretion, and mental process.

During respiration the lungs are oxygenated when we inhale. When we exhale we expel carbon dioxide and other waste gases from the blood. This subconscious or autonomic process is known as alveoli. When our breathing is on auto pilot it is not happening in a balanced or efficient manner. All of the air from the lungs is not exhaled, so carbon dioxide remains in the lungs and the windpipe. This reduces the amount of new oxygen available for avioli. By breathing deeply and completely emptying the lungs, far less of this stale air and carbon dioxide remains in the lungs improving the effectiveness of each breath.

A regular Pranayama practice allows you to take control of your breath. This leads to effective, efficient and optimal breathing and up to fifty percent more oxygen transferred into the blood. This is extra nourishment to every muscle and cell. It also forms a bridge between the conscious, and unconscious areas of the mind which results in more  natural, relaxed rhythms of the body, and mind. Through the practice the energy trapped in neurotic, unconscious mental patterns may be released for use in more creative, and joyful activity.

Breathing and Life Span

Slow, deep and rhythmic respiration sublimates, and is stimulated by calm, content, states of the mind. When you breathe incorrectly it disrupts the rhythms of the brain. This leads to physical, emotional, and mental blocks. This in turn leads to inner conflicts, imbalances, personality disorders, destructive lifestyles and disease. By establishing regular breathing patterns through your Pranayama practice, the process is reversed, and negative cycles are broken. In yogic terms this is essential for concentration (Dharana) and meditation (Dhyana). In practical terms this leads to happier, healthier and more balanced states of mind.

In addition to influencing the quality of life, the length, or quantity of life is also dictated by the rhythm of the respiration. The ancient yogis and rishis studied nature in great detail. They noticed that animals with a slow breath rate such as pythons, elephants, and tortoises have long life spans. Where as, those with a fast breathing rate such as birds, dogs, and rabbits, live for only a few years.

From this observation they realized the importance of slow breathing for increasing the human lifespan. Those who breathe in short, quick gasps are likely to have a shorter life span than those who breathe slowly, and deeply. On the physical level, this is because the respiration is directly related to the heart. A slow breathing rate keeps the heart stronger, and better nourished, and contributes to a longer life.

Deep breathing also increases the absorption of energy by the pranamaya kosha, enhancing dynamism, vitality and general wellbeing. Pranayama establishes a healthy body by removing blockages in the pranamaya kosha, enabling an increased absorption of prana. After your practice most people experience a more relaxed tranquil state of min. Many pranayama techniques utilize kumbhaka, or breath retention, to establish control over the flow of prana, calming the mind, and controlling the thought process. Once the mind has been stilled and prana flows freely in the nadis and chakras, the doorway to the evolution of consciousness opens, leading the aspirant into higher dimensions of spiritual experience.

In The Science of Pranayama, Swami Sivananda writes, “There is an intimate connection between the breath, nerve currents, and control of the inner prana, or vital forces. Prana becomes visible on the physical plane as motion, and action, and on the mental plane as thought. Pranayama is the means by which a yogi tries to realize within his individual body, the whole cosmic nature, and attempts to attain perfection by attaining all the powers of the universe.”

The Pranayama Practice 

The practice is based on a 4 part breathing cycle which focuses on:

  • Inhalation (Puraka) – controlling the intake of prana (air) keeping it smooth and efficient
  • Internal retention of prana (antara kumbhaka) – controlling the retention of air within the lungs after an inhalation
  • Exhalation (Recaka) – controlling the expelling of used prana and other wastes  from the lungs
  • External retention (bahya kumbhaka) – controlling the retention of empty lungs after an exhalation.

This may sound simple but it isn’t. Most of us have developed such poor breathing habits that retraining and relearning efficient and effective breathing habits takes time, patience and commitment. Additionally, controlling the breath in this manner requires the use of the mind to resist the natural and automatic impulses and desires of the body to breath, particularly during the internal and external retention of the breath.

Not all Pranayama techniques focus on extending the time for each of these 4 stages of the breathing cycle. On the inhalation this could include developing a long, smooth and steady inhalation with the exhalation matching the inhalation, making sure that the lungs are completely full, or completely empty at the end of each. It also includes extending the length of time the breath is held with the lungs full and the lungs empty to increase the efficiency of the breathing cycle. It is this particular aspect I have found the most important and beneficial.

The benefits of Pranayama

Anatomical, the breathing techniques improve the strength of the diaphragm and the capacity of the lungs to improve the efficiency of the respiratory system, helping to increase fitness and increase the amount of oxygen entering the blood stream per breath. This oxygen helps to provide essential energy for muscle and brain function resulting in:

  • Increased efficiency of each breath
  • Increased lung capacity
  • Increased flow of oxygen to all parts of the body
  • Increase concentration, creativity and cognitive brain functions
  • Increase relaxation and calmness by releasing tension
  • Improved mind and body control, helping control emotions and relieve tension.
  • Improved abdominal and diaphragm control and strength.

Specific conditions that respond to improved breath control include:

  • Asthma,
  • Allergies,
  • High or low blood pressure,
  • Stress-related heart conditions,
  • Hyperactivity,
  • Insomnia,
  • Chronic pain,
  • Some psychological conditions,
  • Metabolic and endocrine imbalances.

How often should I practice Pranayama

There is no exact formula here. But like everything, practice, practice, practice is what produces results. I would like to see people spend at least 15 minutes a day focused on connecting to the breath, working with the 4 cycles of breathing. This can easily be done in the morning before you get out of bed. Or, in the evening before falling asleep, but even with 3 times a week one will see results.

Pranayama Precautions

Pranayama can actually trigger an Asthma attack due to the ongoing fight between the mind and the body around the retention of breath. It is important that Pranayama be done under the guidance of a Yoga or Pranayama Instructor that has specific knowledge, training and experience in this practice. Once you learn the proper techniques if you want to do this on your own it should not be a problem.

Your teacher will help to establish a stable state of mind which is essential to avoid stress, anxiety and other mental imbalances that can occur when the mind and body dance this dance of ‘Who is in charge’. On a more practical level restricting oxygen flow to the brain can lead to faintness, light-headedness or dizziness. Stop the practice, relax and resume your normal breathing should this happen. If this subsides and you feel comfortable resume your Pranayama practice. Be aware of pain or more adverse affects that would require medical attention.

Before you begin your Pranayama Practice

In Pranayama we use nose breathing. This can be the most difficult part of the Pranayama practice for anyone, but especially Asthmatics who are often chronic mouth breathers, which can be the result of poor breathing. This is essential for warming, moistening and filtering the air we are bringing into the body, making it just right for sensitive airways. Nose breathing also promotes correct diaphragmatic action since it makes hyperventilation more difficult.

Being upside down can help open the nasal passages so you may want to do a forward bend. Inhale deeply through the nose and exhale as you are bending. Once you are down hang heavily. Head relaxed, arms relaxed, shoulders relaxed. Gently shake the head back and forth, up and down, synchronizing the breath with the movement. Or, grab the outer edges of the elbows but continue to hand heavily. Use the wall if you want more support, standing with your feet away from the wall as you exhale down, then tipping the weight onto the heels, letting the wall support you.

You can also face the wall inhaling up, exhaling down and once down, leaning into the wall. Find what works for you. Never force the breath. Invite the breath into the body. Take the focus to the throat and imagine you are breathing from here. Do not pull air into the nostrils, relax and flare them while the breath enters the body through the hollow of the throat.

Decide on your practice time and don’t eat at least 1 and a half hours prior to your practice, as Pranayama is best done on an empty stomach. However, it is always good to be hydrated so drink water before, during if you must, and after your practice.

Get your mind and body ready by mentally relaxing and releasing any feelings of anxiety or expectation. Surrender any urge to push your practice. There are no goals. Accept where you are each and every moment, letting your breathe guide your practice. Stop for a few moments if you feel anxious. If this continues stop the practice completely.

Avoid any physical restrictions by wearing loose fitting clothing that allows full expansion of your chest and abdomen.

Choose a quiet place where you won’t be disturbed. Your bed or the floor works well so that you can lie on your back which requires less effort of the diaphragm. If you get frustrated visualize being able to breath smoothly through your nostrils and realize that you are breaking a bad habit and replacing it with a healthy one. This takes time.

There are many breathing techniques available to you. It is always a good idea to experiment to see what happens with each technique. And keep in mind that what may not work today may tomorrow. Be aware and make the effort to observe what is happening, and how it is affecting your body, and your mind.

As with anything new, patience and perseverance is the mantra of the day. Ingrained patterns are stubborn, hard to identify and even more difficult to change. Be kind and loving to your self understanding that it took years to get to where you are today, and that unlearning this will not happen overnight.

Pranayama Technique #1
Finding the Breath

I like to do this technique while lying in bed, or on the floor. Close your eyes. Put the palm of your right hand on your abdomen. Put the palm of your left hand just above your right hand. Gently bring your attention to your breath. Feel the breath enter the body through the warm passages of the nostrils. Without force, draw the breath into the abdomen and fill the hands move as the abdomen begins to expand. Continue drawing the breath up the body from the abdomen into the sternum and feel it rising. With no strain keep drawing the breath up until the collar bones expands. Retain the breath for just a moment, then begin to gently exhale from the collar bone, down to the sternum, and lastly from the abdomen as you feel each area sinking towards the bed, or floor.

Practice this several times until you begin to feel comfortable. Now you can begin to lengthen the breath. As you begin your slow inhalation into the belly, start counting, 1001, 1002, etc.. By the time you have reached the collarbone whatever this number is, use it during the retention of the breath, and on your exhalation. This is your own unique rhythm, gives you a benchmark for your practice, and keeps the mind occupied.  Initially you may only be able to count to 3 or 4. Eventually you could increase your expansion to a count of 6 or 7. With years of practice even more. Depends on where you are starting from.

Again, as you become more comfortable and relaxed you can bring in other aspects. For example: Keeping your awareness on the breath, take your focus to your belly button. Gently engage the muscles, feeling the belly button move towards the spine. As you inhale keep the belly button softly engaged. On the inhalation the breath will hit this wall forcing more air into the lower lung lobes. Continue the inhalation as before, up the body. Notice that the belly no longer inflates but the area just above, or the lower lung lobes, do. This gentle engagement of the belly button is called a Bandha, or energy lock. Try to keep it engaged throughout all the cycles of your practice.

Try to do at least 5, 10 or 15 minutes of these techniques several times a day. Be mindful of staying relaxed, aware, calm and focused on breathing smoothly, deeply, and effortlessly. Once you feel comfortable with the hands on the belly, take the hands and place them alongside the body with the palms facing up. Note any shifts or changes to your breathing.

Cautions: Never force the breath. Stay relaxed and in the present moment. Should the mind begin to wander, bring it back to the breath, reminding yourself that this is the most important thing you can be doing. Focus on filling the body with air like you would a pitcher of water. On the inhalation the breath begins just above the belly button and expands up to the collarbone. On the exhalation the breath leaves the body from the collarbone down to just above the belly button.

Be patient with yourself. Observe. Release any feelings of expectation. Do not analyze, judge or criticize. Simply observe.

Pranayama Practice #2
Convergence of the Breath and the Body

Sit in a comfortable cross legged position. I sometimes like to practice this technique with my back against a wall for extra support. Following the same methods outlined above, bring your focus to the breath and begin your 3 part breathing (filling up the lower, middle and upper lung lobes) using the 3 cycles (inhalation, retention, exhalation). After a 5 or 6 repetitions try adding in the 4th cycle, breath retention at the end of the exhalation. Sit quietly with your eyes closed. Hands can be laying in your lap or anywhere comfortable. Make sure you feel no strain in the neck or shoulders. Chin is parallel to the floor. Chest is lifting and expanding with each breath. But shoulders are not lifting. The crown of the head is lifting towards the sky. The shoulders are not lifting. Stay aware, stay focused. On the breath, the Bandha, where the shoulders are, any stresses or strains in the body.

Try to complete a 15 minute cycle with moving. If the body becomes a distraction ignore it as long as you aren’t in any serious pain. After 15 minutes, or sooner if you need to, while keeping the eyes closed, softly stretch the legs then refold the opposite way and continue the practice.

Retraining the breath takes time. It is a journey with no destination. There are no goals, no where you have to be. The ability to do these two basic practices is all you need, but should you wish to develop an even deeper practice it is wise to start with a strong foundation. These two techniques are a good foundation, and enough for most people.

Deb Bobier is a certified and registered (YA500 level) Yoga Instructor. She is founders of YogaBound.com, a website that focuses on Yoga and Wellbeing from a Holistic perspective. She also hosts Yoga, Meditation and Pranayama classes, workshops and retreats, Nationally and Internationally including retreats in Bali and Thailand. She designs and manufacturers her own line of Yoga Products, and Beachwear.

Debra has extensive training, more than 1000 hours, of Hatha Yoga training in the Ashtanga, and Iyengar styles of Yoga, including intensive training with prominent teachers in the US, Australia, India and other parts of the world. Her interest in Eastern philosophies and homeopathy has directed the many facets her life has taken. In addition to traveling, reading, writing and nature, her interests are in the areas of ‘Wellbeing’ from a holistic approach. She embraces all dimensions of healing using tools, techniques, and philosophies from Yoga, Metaphysics, Holistic Healing, as well as the strengths of Western medicine.

YB Travel Europe

Deb & Roger’s YB Travel Adventures to Europe – many dates going back to ’85 and continuing to the Present

In the late 90’s we were living in England, Germany and Turkey, and traveling around to other countries like Luxemborg, Belgium, Holland, France. I regret that at that time we didn’t have a digital camera so while I have my own personal photos, I have nothing digital to share except for Turkey.

While in England we lived in Nottingham, and spent a week over the Christmas Holiday staying at a friend’s house (we met in Turkey) that lived by Portabello Market in London. Then we visited our friends (Indian man Roger worked with in Turkey) at their home in Leamington Spa.

In Germany we lived in Koln, a small but sophisticated town right on the Rhine River. Holland was a quick train ride away so we were in Amsterdam frequently. And when Roger had time off we would rent a car and drive. In Germany we visited Frankfurt, Freiberg, Heidleberg, Bavaria and the Black Florest.

Once we followed the route of the Battle of the Bulge battle (The Battle of the Bulge, fought over the winter months of 1944 – 1945, was the last major Nazi offensive against the Allies in World War Two. The battle was a last ditch attempt by Hitler to split the Allies in two in their drive towards Germany and destroy their ability to supply themselves) through southern Germany, into Luxemborg, Belgium then back to Germany.

We spent a week once driving from the north, to the south, east and west as we made our way around Holland, nibbling on amazing cheeses, breads and wines. The food all over this region was some of the best I have ever had especially the muscles, cheeses, desserts and chocolates from Belgium.

In the 2000 I worked for a short time in London in South Kensington and lived in East Putney. I made frequent trips to Paris via the train and enjoyed the city, and doing business there. While London was a great experience I am an island person so the tempermental weather never suited me. When this project was over I was happy to leave.

The last time we were in Europe was 2007 where we started in Morocco, made our way up to Spain, over to Turkey, over to Egypt, on to India then Bali before coming home. We spent almost or at least a month in each place and it was truly a trip of a lifetime. I am still disappointed that my external hard drive crashed with all the photos lost, as well as the backup. So unfortunate, and when I think about it I am still wondering what this message was saying.

YB Travel Ancient Turkey

Turkey

Deb & Roger’s YB Travel Adventures to Turkey 1998 – Present

Turkey is located in Western Asia. Starting from the 13th century, the Ottoman beylik united Anatolia and created the largest and most powerful empire of its time, encompassing much of Southeastern Europe, Western Asia and North Africa.

Like most of Asia, Turkey has changed a lot in the last ten years. When we lived there in ’98, it was a lot different, and much less expensive. I am happy we were able to have both experiences. We lived on the Asian side of Istanbul in Acibadem (pronounced Agibadem). This was just across the Bosphorous from old Istanbul located on the European side.

A brief background: In ’97 Roger sold the restaurant he built, Thai Pan Alley, on Indian Rocks Beach. So I decided to leave my career in Broadcasting. Things were dissolving all around us, and I kinda freaked for awhile, then decided to ride the wave where ever it took us.

We spent the next year traveling all over Central America, and as usual, our annual Asia trip. Only this time we could stay longer. Though Roger had been out of the automotive business for over a decade, out of the blue he got this job offer in Istanbul. It wasn’t even a discussion, it was meant to be.

He went ahead of me and I stayed behind to sell all of our possessions, including our condo on the beach, cars, everything. With all that had been happening we wanted to be free to go wherever the wind blew, with no material impediments to drag us down.

I arrived in Istanbul and fell in love with the city. The energy. The differentness, and especially the feeling I go each time I placed my foot on the ground walking in the foot steps of those thousands of years before me.

We had the good fortune of living in a beautiful 3 bedroom condo on the park that the company paid for. In addition to us, there were other engineers from the US so I had their wives to hang out with. And we had regular dinner parties, taking turns at hosting.

But at first I spent a lot of time by myself. I had worked all my life, and it felt strange to have this time. But I enjoyed it. Being able to do what I wanted when I wanted. Having the time to read in leisure which I love. To write. To take my shopping cart up the hill from our apartment to the local outdoor market where everything was fresh, and home made including the cheese, and the filo I bought to make Burek. And negotiating via a calculator neither of us knowing the other’s language.

Then I would go home and cook a beautiful dinner using all my fresh ingredients. Other days I would take the dolmush down to the Bosphorous, hop on a boat, have a cup of tea and enjoy the trip to the other side. Walking and strolling through Taxsim, and other areas.

On the weekends Roger and I explored. And one weekend we flew to Paris. We had a delightful time, and before leaving went to China town to stock up on all the things we needed to make Thai food. One of our suitcases going back was full of condiments, fish sauce, curries. This was when I met Sevim, and Yakup. A beautiful Turkish couple that we have been friends with ever since. When we return to Turkey we stay with them. This November they will come here for a month. We are excited to reciprocate their warm hospitality.

Turkey is often called “the cradle of civilization,” as it has been home to a rich variety of tribes and nations of people since 6500 B.C. Hattis, Hittites, Phrygians, Urartians, Lycians, Lydians, Ionians, Persians, Macedonians, Romans, Byzantines, Seljuks and Ottomans have all held important places in Turkey’s history.

There are ancient sites and ruins throughout the country that attest to each civilization’s unique character. And you can literally feel yourself going back in time as you stroll the ancient streets, witness the whirling dervishes, enjoy a turkish bath and visit places like Topkapi Palace, home (and Harem) of the sultans, Ayasofya (Hagia Sophia): changed the course of Western architecture; greatest church in Christendom for 1000 years, Sultanahmet (Blue) Mosque: Islam’s elegant answer to Ayasofya, with six minarets and blue interior tiles.

Then there’s the Byzantine Hippodrome: the political and recreational heart of Byzantine Constantinople and Ottoman Istanbul, Turkish & Islamic Arts Museum: facing the Blue Mosque on the Hippodrome, a treasure-house of 1000 years of fine art, Basilica Cistern (Yerebatan Sarniçi): an eerie subterranean “sunken palace” of 336 marble columns which could hold 80,000 cubic feet of water in case of drought or siege, Grand Bazaar: the ultimate medieval “shopping center,” with 4000 shops, fun whether you buy or just browse, Egyptian (Spice) Market: food, spices, coffee, snacks and some touristy stuff, Beyoglu: the romance of 19th-century Istanbul, Dolmabahçe Palace: the sultan’s sumptuous new (1856) European-style palace on the Bosphorus.

You don’t have to spend a lot of money for a Bosphorus Cruise: the perfect 90-minute, half-day or full-day Istanbul excursion, up toward the Black Sea past castles, palaces and Ottoman-Victorian villages. And there is Princes’ Islands: get away to islands with Victorian-era towns free of motor vehicles: walk, bicycle, or take a horse-drawn carriage tour.

In 2007 we visited our friends for a month. After a few days in Istanbul we drove south to their seaside home near Bodrum. It is a lovely area and we visited all the small seaside towns, each looking like a painting, they were so charming. At night we would sit on their balcony looking out over the sea to the Greek Island of Kos.

We did an excursion to nearby Ephesus, an ancient Greek city, and later a major Roman city, on the west coast of Asia Minor, near present-day Selçuk, Izmir Province. It was one of the twelve cities of the Ionian League during the Classical Greek era. In the Roman period, it was for many years the second largest city of the Roman Empire; ranking behind Rome, the empire’s capital. Ephesus had a population of more than 250,000 in the 1st century BC, which also made it the second largest city in the world.

Visited Pamakkale. The city contains hot springs and travertines, terraces of carbonate minerals left by the flowing water. People have bathed in its pools for thousands of years. It is located in Turkey’s Inner Aegean region, in the River Menderes valley, which has a temperate climate for most of the year. The ancient Greco-Roman and Byzantine city of Hierapolis was built on top of the white “castle”. As recently as the mid-20th century, hotels were built over the ruins of Heropolis, causing considerable damage. When the area was declared a World Heritage Site, the hotels were demolished and the road removed and replaced with artificial pools. Wearing shoes in the water is prohibited to protect the deposits.

We drove the coastal highway from Bodrum to Antalya and on to Alayna. The views are breath taking and the water the most unbelievable colors of blue and turquoise I have ever seen. Alayna was a nice place to visit for a few days then we were off to Cappadocia stopping along the way at the Mevlana Museum, the mausoleum of Jalal ad-Din Muhammad Rumi, a Sufi mystic also known as Mevlâna or Rumi. It was also the dervish lodge (tekke) of the Mevlevi order, better known as the whirling dervishes.

And nothing can prepare you for the experience of Cappadocia, an ancient region of Anatolia. It is out of this world. Unique, miraculous and a wonder of nature. With a rich history. Headquarter yourself in the inhabited city of Goreme and visit all the sites in the surrounding area. Be sure to take in dinner and belly dancing for a fun, and entertaining evening.

The formation of these chimney rocks happend over tens of thousands of years. In the prehistoric periods (the Bronze Age) the first human settlements began and the humans constructed the underground cities in the volcanic rocks in form of tufa due to protect themselves from the wild animals. They lived for long periods of time in these underground cities. There are many in the Cappadocia area but the biggest is Derinkuyu Underground City. Also, the first Christians escaped from the persecution of the Roman Empire in the 2nd century B.C. and came to Cappadocia finding the underground cities with gates made in a way they couldn’t be easily observed.

Cappadocia lies in eastern Anatolia, in the center of what is now Turkey. The relief consists of a high plateau over 1000 m in altitude that is pierced by volcanic peaks, with Mount Erciyes (ancient Argaeus) near Kayseri (ancient Caesarea) being the tallest at 3916 m.

The boundaries of historical Cappadocia are vague, particularly towards the west. To the south, the Taurus Mountains form the boundary with Cilicia and separate Cappadocia from the Mediterranean Sea. To the west, Cappadocia is bounded by the historical regions of Lycaonia to the southwest, and Galatia to the northwest. The Black Sea coastal ranges separate Cappadocia from Pontus and the Black Sea, while to the east Cappadocia is bounded by the upper Euphrates, before that river bends to the southeast to flow into Mesopotamia, and the Armenian Highland.

This results in an area approximately 400 km (250 mi) east–west and 250 km (160 mi) north–south. Due to its inland location and high altitude, Cappadocia has a markedly continental climate, with hot dry summers and cold snowy winters. Rainfall is sparse and the region is largely semi-arid.

YB Travel Pristine Panama

Panama

Deb & Roger’s YB Travel Adventures to Panama 1997

When we traveled in the ’90’s we also were traveling with an eye towards finding a place to build a healing center. Though we loved Asia Roger’s children live near us in the States and wanted us closer to home. We spent six weeks three separate times in Costa Rica. And though it was beautiful, it was dangerous, especially San Jose. All the expats said that Costa Rica wasn’t what it used to be, and told us that many had already moved to Panama. So we decided to check it out.

We flew into Panama City spending a few days doing exploring the city, visiting the canal and doing a canopy tour through the jungle. There’s an island you can drive to called Casco Viejo that we really liked but it was just starting to be redeveloped and too dangerous to walk around after dark. So that wasn’t an option.

We then flew to Bocas Del Toro, a beautiful province in the Caribbean of Panama. And we thought we had found the place. Tropical, laid back, water everywhere, out of the hurricane belt so we stayed about 3 weeks with a retired Canadian couple that ran a bed and breakfast. They had not had a break in years so we offered to take over for a few days, they accepted and we got a real taste of having no freedom or flexibility. But a great experience.

Bocal Del Toro seemed to be the ideal place for our holistic healing spa which would include fasting, colema’s, fresh, natural high energy food, yoga, massage, horse back rides and more. So we stayed on and continued to do our research. We found out there was a water issue.

While we have no problem with water catcment you have to have water to catch. Running even a small project like we had in mind needed a minimal amount of water. Then there was the issue with who owned the land. The people that worked for Chiquita Banana left the island years ago when the company moved to the mainland. The realtors there (all Western) and others were selling land that didn’t have a clear title. The mayor of the region came to a meeting and said yes you can buy, but if challenged in court you will lose. We said no, while others continued to sell things they had no right to.


If you did find land with a clear title (which apparently doesn’t exist) then you had the issue of squatters. Anyone could set up on your land and 24 hours later it would be their’s. You as a foreigner had no rights, so would have to hire people to secure this and we wanted no part of this kind of living.

Lastly, at the time, there was only one boat a week coming from the mainland. When I saw how few supplies were on the boat and how the few businesses there were fighting for a stalk of broccoli, it was a place we enjoyed, and may visit again (or not, there are sand fleas and they hurt) but there was no way we wanted any part of all the difficulties, and drama. Years later Roger went back, 2003 I believe, and he said it was depressing. Places had closed, people divorced…..adventure, taking risks, putting it out there, all good. But sometimes people want something new or different so badly, or get greedy they don’t take calculated risks.

We left Bocas del Toro knowing we wouldn’t be doing anything in Panama other than enjoying it. We took the ferry boat to the mainland, a beautiful ride. In Chiriqui Grande we got a bus for Boquete. It is one of the top places to retire, with many saying it is reminiscient of the Swiss Alps, but after traveling Asia, with people usually doing the right thing because they believe in Karma, this part of the world is more dangerous. We don’t want to deal with that. We stayed there a few days, and yes, while beautiful, there are so many other places we feel are better. But this was in ’97, and it could be a lot different now.

From there we took a bus to David to catch another one to Guadalupe, then Los Quetzales which is tucked away in the highland cloud forest. It’s a great way to get away from the hustle and bustle of modern living. And just our cup of tea. At 7260 feet above sea level (2,200 meters), the reserve has the highest lodging facilities in the country, and lies inside the primary cloud forest of Volcan Baru National Park, which was established in 1976. The Volcan is adjacent to the 407,000 acre Parque Internacional La Amistad, which straddles Costa Rica and Panama. Their 400 hectare reserve has been protected by the private efforts of its founders in 1970. And is one of the only eco-vacation resorts in Panama or Costa Rica that offers overnight accommodations inside a national park.

The climate varies from 75 degrees F (23 degrees Celcius) during a sunny day to 45 degrees F (7 degrees Celcius). on our chilliest winter night. But the one thing about the ambiance is the absence of biting insects – no mosquitoes, no chiggers, not even a stray no-see-um! Fortunately our area also lacks venomous snake species. They provide access on a rocked road via a 4-wheel drive or horseback. We opted for the latter. You can also walk to the cabin area, a gentle 30 minute climb featuring mountain scenery quilted with small vegetable patches and colorful gardens in the town of 400 inhabitants. Higher up, on the way to the cabins, you’ll walk past simple friendly homes of Guaymi indians.

If you don’t want to go the way we went, you can choose a 50 minute flight from Panama City to David, or San Jose, Costa Rica to David, Chiriqui. From David, the lodge can arrange transportation. The drive to Guadalupe takes about one hour and thirty minutes. This is a great alternative to a hotel in Boquete, a hotel in David or a hotel in Volcan.

YB Travel Multi-Cultural Melbourne

Melbourne

Deb & Roger’s YB Travel Adventures to Melbourne Australia 2011

In 2011 we were visiting my daughter in New Zealand and decided since we were so close that we would visit our friends in Perth on our way to Bali. And on the way we planned to visit Melbourne. In May we left New Zealand and flew Jet Star to Melbourne.

We had an uneventful flight and arrived in Melbourne safe and sound. Their mass transportation system is amazing and we were able to take a bus to the city which dropped us at the train station. From there if you needed a ride to your hotel, they provided it at no charge. But our hotel was within walking distance so off we went.

Winter was already arriving and it was a cloudy day with definite hints of rain, but thankfully the clouds contained themselves until we were safely secure in the comfort of our hotel, the Pension. For the next three days we layered with as many warm things as we had and set out to explore the city. And it is such an easy city to get around, you can walk just about everywhere in the city center. Or, take the free tram that goes around the city. Which also connects with buses and the subway.

Sydney reminded me of a tropical Seattle, and Melbourne of Boston, or another NE city. Sophisticated yet casual with lots do in the way of museums, and the arts. The older architecture mixed with newer more modern buildings. And a really relaxed atmosphere. But it was cold, and rainy the entire time we were there. And while that did not keep us from exploring, it certainly would have been more desirable if it had been warmer. We enjoyed our time there, but looked forward to getting to sunny Perth.

YB Travel Perth, Freemantle, Mandurah & Margaret River

Perth, Freemantle, Mandurah & Margaret River

Deb & Roger’s YB Travel Adventures to Perth, Freemantle, Mandurah & Margaret River Australia 2011

May 11th, 2011 we arrived in Perth via New Zealand and Melbourne. Our friends that we met many many years ago in Bali live in this area. Since we were so close we decided to stop in on our way and visit them for a change instead of always meeting up in Bali.

Karl picked us up from the airport and we headed to their warehouse to pick up Vanessa and Boots (their child/dog). We knew of their business, what they were doing, have seen the website, but the actual product itself is so unbelievably stunning, it literally sells itself. Beautiful, creative….they have (Vanessa is the stylist) done a beautiful job with this business and we were not only impressed, but just so happy for them. Check it out at http://www.villakula.co.nz And if you are interested in this type of business here in the US we are the brokers for this area so send us an email.

We had a glass of wine while we were doing our tour, welcome to Australia! Later Roger rode with Karl, and Vanessa and I and the baby (I mean Boots) took off for their house in Mandurah, a beachside community about an hour from Perth. Soon we were home and I spent the next week shopping and cooking. And it was so much fun to have them come home from work with a healthy and delicious meal waiting. During the weekend we visited Freemantle, and Vanessa’s parents since they live near there. But her Dad wasn’t there so we didn’t get a chance to say hello, and catch up with him. And when they were working we explored Perth, and the Mandurah area where they lived.

Then Karl and Vanessa took off for Bali and generously let us stay at their house, and use their vehicle to go down to Margaret River. If I lived in Australia this is where I would live. It has everything I love. It is laid back, yet sophisticated, woodsy, has some hills so the terrain isn’t so flat, beautiful beaches usually , vineyards, delicious food, home made olive oils, soaps, chocolates and more. It has very few people, gardens, worm beds, composting, kangaroos roaming about, and so much more. There are some places you feel like you have come home to and this was one for me.

We left Margaret River and went back to Mandurah and a few days later headed on to Bali to meet back up with these friends and our mutual friend Norma. We look forward to our next trip there.

Mind Body Medicine – The Dance of Soma and Psyche

Mind Body Medicine – The Dance of Soma and Psyche
By: William Collinge, M.P.H., Ph. D.-Excerpted from The American Holistic Health Associations Complete Guide to Alternative Medicine

The mind steadfastly refuses to behave locally, as contemporary scientific evidence is beginning to show. We now know, for example, that brain like tissue is found throughout the body…. So, even from the conservative perspective of modern neurochemistry, it is difficult if not impossible to follow a strictly local view of the brain.” Larry Dossey, M.D.

In the conduct of medical research, the existence of mind/body interactions has over the years been treated as a sort of hindrance. Such interactions are often lumped under the somewhat disparaging name of the placebo response. “Placebo” is a Latin term whose original meaning is “I shall please,” and it refers to the mysterious and uncharted mechanisms by which the power of suggestion can result in a physiological change.

Ironically, the very scientific methods championed by mainstream medicine in the testing of drugs have provided the greatest scientific support for the existence and power of the mind/body connection. In fact, the mechanisms involved are so formidable that the standard research procedure requires separating out their effects from those of the drug.

Hence the power of mind/body mechanisms has been examined and measured in virtually thousands of drug studies. It is in this sense that they have been verified and acknowledged by medical research to be a real and powerful phenomenon.

In the 1970s and 80s, researchers trained their sights more directly on these mechanisms. Herbert Benson, M.D., and his colleagues at Harvard Medical School led the way with the discovery of the relaxation response. This work has led to a cascade of findings about how mind/body mechanisms can be used for medically significant impact on hypertension, heart disease, cancer, and other conditions.

Today, leading edge programs for both patients and professionals are now conducted at Harvard’s Mind/Body Medical Institute, New England Deaconess Hospital, Boston. And under Benson’s direction, the institute is collaborating in the creation of other such programs at major medical centers around the nation.

In Benson’s perspective, “We are part of mainstream medicine, we are not alternative. You might say that this was considered alternative years ago, but it is now mainstream.”

Taking Center Stage
Indeed he may be right. In early 1993, a widely reported study documented the surprising popularity of alternative medicine this country. Published in The New England Journal of Medicine and led by Harvard researcher David Eisenberg, M.D., the study found that one in three adults had used some form of unconventional medicine. Of the varieties reported, mind/body technique were the most frequently used.

The creation of the Office of Alternative Medicine at the National Institutes of Health followed a few months later. Shortly thereafter, mind/body medicine was brought into the living rooms of millions of Americans by a television series on PBS called Healing and the Mind, hosted by the popular journalist Bill Moyers.

The PBS series symbolized a highly visible milestone in the mainstreaming of what critics had previously considered a form of fringe medicine. Mind/body medicine (also known as behavioral medicine) is of course nothing new. The influence of the mind in healing is addressed in virtually every medical tradition, from the ancient teachings of Ayurveda to modern allopathy. What is new is the legitimization of research in this field to the point of government funding and the incorporation of mind/body programs into the offerings of major medical institutions, many of which are noted for their conservatism and scientific bent.

What is the emerging role of this work? Benson regards it as an integral part of comprehensive health care. He offers the metaphor of a three-legged stool: “One leg is pharmaceuticals, another is surgery, and the third is what you can do for yourself. Mind/body medicine is strengthening the third leg, integrated with the other two legs.

Key Principles, The Biopsychosocial Perspective
In the late 1970s the eminent medical researcher George Engel of the University of Rochester made the bold statement that modern medicine needed a new way of thinking about health and illness.5 He proposed what he called the biopsychosocial model, in which health is the outcome of many factors interacting together. This provides the theoretical framework underpinning mind/body medicine.

In this view, health is not just a matter of “the drugs keeping up with the bugs.” Rather, health is determined by an interaction among our genetic vulnerabilities; environmental inputs such as germs, viruses, or pollutants; psychological factors such as stress, lifestyle, attitudes, and behavior; and social factors such as supportive relationships, economic well-being, access to health care, and family and community patterns of behavior.

Turning Down the Dial on Pain
Jim is a forty-six-year-old assembly line worker who received a disc injury in his neck and developed a chronic pain syndrome involving head, neck, arm, and shoulder pain. He was referred by his physiatrist to Karen Carroll, a biofeedback clinician practicing in Waterloo, Iowa, for pain control.

Carroll used EMG, first for general muscular tension and then for muscular tension around the upper body and neck. Jim was able to discover a direct connection between his thoughts, his level of nervous system arousal, muscular tension, and eventually his pain level.

After eight sessions spaced progressively further apart and accompanied by home practice of breathing exercises and progressive relaxation, his headaches and neck pain completely disappeared. He was then able to use physical therapy to further strengthen his neck and shoulders, and subsequently returned to work. He stated, “I never really knew what it felt like to relax until now.” According to Carroll, this case illustrates the benefits of commitment to self-regulation and daily practice at home for someone who was motivated to avoid medication and surgery if possible.

Engel’s perspective is gradually penetrating the thinking of mainstream medicine. When we look at the big picture of all the factors that influence health, we can see that many are within our direct control. Along with this new way of thinking has come a growing openness and receptivity to the contributing of mind/body approaches.

Mind/Body Communication
Our thoughts and feelings influence the body via two kinds of mechanisms: the nervous system and the circulatory system. These are the pathways of communication between the brain and the rest of the body.

The brain reaches into the body via the nervous system. This allows it to send nerve impulses into all the body’s tissues and influence their behavior. The brain can thus affect the behavior of the immune system with its nerve endings extending into the bone marrow (the birthplace of all white cells), the thymus, the spleen, and the lymph nodes.

It also reaches into all the glands of the endocrine system, all the bones, muscles, all the internal organs, and even the walls of veins and arteries. It can influence the behavior of the heart with its nerves penetrating the heart tissue, affecting heart rate and other aspects of the heart’s functioning. The entire body is literally “wired” by the brain.

The brain is also a gland. It manufactures thousands of different kinds of chemicals and releases them into the bloodstream. These chemicals circulate throughout the body and influence the activity and behavior of all the body’s tissues. The brain could be described as the ultimate apothecary, producing many more drugs than science has ever invented.

The cells of the body have receptors on their surfaces that function somewhat like satellite dishes. These receptors receive the chemical messages being released by the brain and respond accordingly.

Finally, the mind/body connection is a two-way street. In addition to sending messages into the body’s tissues, it also receives feedback, both in the form of nerve impulses and its own receptors that sense what chemicals are being released by other tissues in the body.

Research into how the brain can influence immune responses has given rise to the new field called psycho-neuro-immunology (PNI). Findings in this field have brought great hope to people dealing with such difficult illnesses as cancer, AIDS, CFIDS (chronic fatigue immune dysfunction syndrome), and other immune-related diseases.

It is only a matter of time before similar acronyms are defined for other fields such as psycho-neuro-cardiology (PNC), the study of the mind-heart connection, or psycho-neuro-hematology (PNH), the study of how the mind can influence bloodrelated disorders, such as clotting problems in hemophilia.

The Power of the Mind/Body Connection
One of the most stirring stories about the power of the mind/body connection concerns a man diagnosed with terminal cancer. Reported by Dr. Bruno Klopfer in the Journal of Projective Techniques in 1957, it involved a man with metastatic cancer and tumors that had spread throughout his body. The patient had tried every available form of medicine and his condition had hopelessly deteriorated to the point where he was bedridden and gasping for air.

His doctors agreed that he had only a few days to live. Then the man heard about an experimental drug called Krebiozen, which was in the process of being tested. He insisted on being included in the experimental trials. His doctors, feeling he had nothing to lose and would soon be dead anyway, out of compassion agreed to give him the experimental drug. To their amazement, the man’s tumors soon began to shrink dramatically and he was discharged from the hospital.

Two months later, the man read news accounts of the research on Krebiozen that reported serious doubts with the drug. Within a matter of days, the man’s tumors had returned and were again threatening his life. His doctor cleverly convinced him that new and more potent shipment had been received and proceeded to give him injections of plain water. His tumors once again began to shrink dramatically. He remained healthy for seven more months until another news report declared “Nationwide AMA Tests Show Krebiozen to Be Worthless as a Cancer Treatment.” The man died within two days.

The Stress Response
The stress response is a set of changes in the body that result when the person experiences what they perceive to be a challenging or threatening situation. This matter of perceived threat is important because the effects of the stress response on the body are the same whether the threat is real or just imagined in the mind.
The magnitude of these changes is influenced by how serious the person thinks the situation is and what they think about their ability to handle the threat effectively (their appraisal of their ability to respond). Of course, the more confident the person is in their ability to handle a challenge easily, the less stress is involved. The more the person appraises the challenge as a threat—even at the subconscious level—the more intense will be the stress response.

Commonly called the fight-or-flight reaction, the stress response has the beneficial effect of preparing the body to function at a higher level of efficiency, which of course enhances the likelihood of survival. The physiological changes include:

Increased blood pressure
Increased respiratory rate
Increased heart rate
Increased oxygen consumption (burning of fuel)
Increased blood flow to skeletal muscles
Increased perspiration
Increased muscle tone

While all these changes clearly contribute to one’s ability to fight or flee in an emergency, they also have a downside. If the person is experiencing the stress response regularly and for extended periods of time, these physiological changes have the effect of weakening the body’s resistance to illness and lowering the effectiveness of its mechanisms of self-repair.

The Relaxation Response
Another key principle is the relaxation response, which was discovered and named by Herbert Benson, M.D., and his colleagues in 1974. They were studying a pattern of physiological changes that occurs in people practicing transcendental meditation (TM).

This pattern of changes has been found to represent a very beneficial state, one that is virtually a mirror image of the stress response. The relaxation response includes the following changes:

Reduced blood pressure
Reduced respiratory rate
Reduced heart rate
Reduced oxygen consumption (burning of fuel)
Reduced blood flow to skeletal muscles
Reduced perspiration
Reduced muscle tension

The relaxation response is an antidote to the effects of the stress response and it has also been found to enhance the effectiveness of the body’s defenses and self-repair mechanisms. Regular practice of techniques that elicit this response also brings improved emotional well-being and better handling of stressful life events.

The relaxation response is a physiological state, not a technique as such. As we shall see later, there are many techniques that can be used to produce it and, indeed, learning to do this is at the heart of mind/body medicine.

Coping, Emotions, and Health
Researchers have identified how the ways we cope with emotions and stressful situations—our coping styles—can influence our physical health. Most firmly established are the links between coronary heart disease and the Type A behavior pattern. Type A is a way of coping characterized by constant hurriedness, intense competitiveness, and free-floating hostility.

A more recent concept is the Type C pattern, which in many ways is the polar opposite of Type A. It involves the non-expression of anger and other unpleasant emotions such as fear and sadness, unassertive and overly appeasing behavior in relationships with others, and a preoccupation with meeting the needs of others, often to the point of extreme self-sacrifice. The theory of the Type C pattern was put forward by Lydia Temoshok, Ph.D., a leading health psychologist and PNI researcher. She has found compelling evidence for a link between emotional expressiveness and the progression of cancer.

The middle ground, or Type B. is considered a more balanced way of coping that involves appropriate expression of all emotions and the ability to meet one’s own needs while responding to those of others. People who cope in this more balanced way tend to be less at risk for serious illness. The cultivation of these behaviors is often a goal in mind/body medicine programs, especially for heart disease and cancer.

Lifestyle Change
The use of mind/body medicine takes place within a broader context of changing one’s lifestyle to promote health. Making a daily practice of mind/body techniques is but one of several areas of lifestyle change that work together in a synergistic way. Other areas include proper diet, exercise, and social support.
While the health benefits of diet and exercise are obvious, there is a growing body of research now indicating that supportive interpersonal relationships are strongly associated with better health. They seem to ameliorate or buffer the harmful effects of stress on the body.

Turning Down the Pressure
Alice, suffering from chronic fatigue syndrome (CFS), undertook a two-week intensive treatment of intravenous Acyclovir therapy in the hospital. Acyclovir is a drug that inhibits the reproduction of herpes viruses, a family of viruses thought to be cofactors in CFS. One of the side effects of this therapy is elevated blood pressure, which needs to be closely monitored.

Alice was about halfway through her treatment protocol when she enrolled in a group mind/body medicine program. She brought her stainless steel drip apparatus with her from the hospital and stood it up beside her in the circle with the other patients and their spouses.

The first day involved a series of relaxation and deep breathing exercises. The next day Alice returned to the group bubbling with excitement. She reported that the previous evening her blood pressure had returned to normal. The nursing staff were mystified and wanted to know how she had done it.

Variations: The Many Contexts of Mind/Body Medicine
This field is uniquely cross-disciplinary, which accounts for its wide availability, helping make it the most commonly used form of alternative healing.

Its variety of techniques may be used by medical doctors, nurses, physician’s assistants, naturopaths, osteopaths, practitioners of Chinese medicine and Ayurveda, bodyworkers, homeopaths, and chiropractors. Other human service providers such as psychologists, clinical social workers, marriage and family counselors, ministers, and hypnotherapists also use these tools. And of course there are very specialized applications for midwives, physical therapists, exercise physiologists, respiratory therapists, and others.

Mind/body approaches are generally taught either in office practice via private consultation with a health care provider or in group programs. Hospitals and other institutions offer various kinds of support groups or group therapy programs for people with cancer, heart disease, organ transplantation, and other conditions. Almost all such programs incorporate some use of mind/body techniques, such as relaxation exercises or imagery.

These methods are often taught to patients preparing to undergo surgery or other difficult treatments. Research has found such preparation to speed healing, reduce bleeding and complications, and result in earlier discharge from the hospital.

Procedures and Techniques
The repertoire of mind/body medicine includes all psychological strategies that directly influence physiological states. Following are the most commonly used methods.

Meditation
There are hundreds of varieties of meditation. The most basic approach for facilitating the relaxation response is that described by Herbert Benson. The process should take place in a quiet environment, a setting where one can be quiet, undisturbed, and in a comfortable position for at least fifteen to twenty minutes. Given this setting, there are only two essential steps: the silent repetition of a word, sound, phrase, or prayer and the passive return back to the repetition whenever other thoughts intrude.

Variations on these instructions are at the core of many forms of meditation from diverse spiritual traditions. The simplicity of these instructions, however, makes the approach available to virtually anyone, regardless of their spiritual or religious beliefs. This is because the person can use as their repetitive focus a prayer or any other words that reinforce their beliefs (e.g., “God is love”), thereby adding a further dimension of comfort to the experience.

Mindfulness
This is actually another approach to meditation, which involves the ability to focus completely on only one thing at a time. In other words, in mindfulness the mind is full of whatever is happening right now. This can include walking, cooking, sweeping the floor, dancing, watching a bird, hearing the sound of a river, or any other focus you may choose. Whenever thoughts intrude, you simply return your attention back to the focus. This is a traditional Buddhist approach and has been widely popularized by Jon Kabat-Zinn, Ph.D., in the Stress Reduction Clinic, University of Massachusetts Medical Center, Worcester.

Progressive Relaxation
This is another common approach to eliciting the relaxation response. In this technique the body itself is used as the focus of attention. It may be done either lying down or sitting. They technique involves progressing through the body one muscle group at a time, beginning with the feet, moving up the legs, and so on, spending approximately a minute in each area. For each muscle group, you hold or clench the muscles in the area for a count of ten and then release for a count of ten before moving on to the adjacent area.

The remaining techniques described below, while they also can lead to induction of the relaxation response, are also used for other purposes.

Mental Imagery
This involves using symbols to imagine that the changes you desire in your body are actually happening. For example, you might imagine that pain is melting away and dripping like a warm liquid out of your fingertips. Or you might develop an image of your immune cells actively subduing and preying on cancer cells or viruses, like birds of prey swooping down to engulf field mice in a meadow. This is a highly personalized technique and you would use images that are uniquely exciting and meaningful to you.

Studies of mental imagery have found that people can actually influence their immune functioning as well as significantly reduce pain and tension in the body with this method. But aside from the physiological benefits, which take some practice to achieve, there is also the knowledge that you are doing something to help yourself, channeling your energy into a healing activity. This in itself helps to improve emotional well-being and build a sense of self-efficacy or confidence, which research has found to improve immune functioning.

Autogenic Training
This approach involves using a combination of autosuggestion and imagery. Phrases are used to describe to oneself what changes in the body are desired as if they are happening now. For example, “My legs are warm and heavy,” “All the muscles of my back are softening and melting,” “I am calm,” and “Warm, peaceful relaxation is flowing throughout my body.” These phrases are repeated while maintaining one’s focus on those parts of the body being addressed. Whenever the mind wanders, the attention is gently and passively returned to the focus.

Breath Therapy
A variety of breathing exercises can help one to release tension, anxiety, and pain. They can be used in conjunction with imagery or autosuggestion. They can also be used to encourage fuller breathing in general and give the body a greater supply of energy, which it can use for healing. It takes energy to fuel the body’s self-repair mechanisms including the immune system. Since we take a thousand breaths every hour, each breath is an opportunity to contribute to a healing process.

Some breath therapy techniques use the breath in a calm, peaceful way to induce relaxation, to release pain, or to prepare for imagery. Another variety is Evocative Breath Therapy (EBT), which uses stronger breathing, sometimes accompanied by music, to stimulate emotions and emotional release.

Hypnosis
A simple description of hypnosis is offered by Karen Olness, M.D., of Case Western Reserve University who calls it “a form of self-induced, focused attention that can make it easier for you to relax or learn to control your body’s functions.” It is this experience of extraordinary focus of attention that makes it possible to influence bodily states.

A Hike in the Tetons
Larry was a successful forty-two-year-old architect at the time he developed pancreatic cancer with metastases in 1978. He integrated meditation and imagery into his chemotherapy treatment and though the road was long, he recovered completely, with no further signs of cancer three years later.

He tells the following story about his devotion to doing his imagery practice:
“My girlfriend at the time and I had taken a backpacking trip to the Grand Tetons. This was nine months into my treatment. We’d get out there on the trail and after lunch, which was one of my times, I’d want to sit on the trail or on a rock, or lean against a tree and do my visualization.

This woman was go-go-go, very achievement oriented. She was a very dynamic and pushy and controlling person. ‘We’re going to hike to this point, have lunch . . . by such and such a time we’ll be at the campground,’ and she would get terribly impatient with my after-lunch visualization.

It started leading to more and more friction, but I maintained my ground. I was insistent that this is what I was going to do. By the time the trip was over, we weren’t speaking. We flew back from Wyoming, not even sitting together on the plane, but that was very important for me, because I didn’t often put myself first when it came to her.”

Since his recovery, Larry has remained involved with a cancer self-help program as a lecturer in imagery. His story inspires many others to challenge difficult odds. There is no medical explanation for his recovery. The chemotherapy of the day was not considered curative for his condition, yet somehow he was able to marshall the resources to heal.

When in a hypnotic state, the mind is perfectly aware of the surroundings and the situation, but because it is so highly focused, it is able to concentrate on a task without being easily distracted. This enables the person to use imagery, relaxation, or autogenic suggestions in a richer, more powerful way.

Hypnosis is especially useful for relief from pain, reducing the distress from other symptoms or the side effects of treatment, and establishing a greater sense of control. Hypnotic states can be self-induced or facilitated by a hypnotist or hypnotherapist. Finally, it can help in overcoming one’s resistance to healthful behavior change, such as reducing smoking or changing one’s eating habits.

Biofeedback
Biofeedback uses special instruments attached to the body to give the person information about what is happening in the body. The instruments serve to amplify the signals that the person may not otherwise be able to detect so they can then use this visual or auditory feedback to learn to regulate certain bodily functions. Many people find this form of assistance very helpful for learning to relax.

The most commonly used form is electromyographic (EMG) biofeedback. An EMG sensor is attached to the skin and reveals the amount of electrical activity related to muscle tension in the area of the sensor. This is very useful in helping people learn to relax the muscles, for they have direct feedback—which may be visual readouts, lights, beeps, or tones—as to the degree of tension. This approach is often used for tension headaches and chronic pain conditions.

Other kinds of biofeedback include thermal, sensing the temperature of the skin as an indication of blood flow and relaxation; electrodermal (EDR), measuring subtle changes in amounts of perspiration; finger pulse, for measuring heart rate and force, useful for anxiety or cardiovascular symptoms; and monitoring breathing patterns—rate, volume, rhythm, and location (belly or chest) of each breath.

Biofeedback has many applications, such as headache and migraines, anxiety, chronic pain, teeth grinding and clenching, Raynaud’s disease (vascular disorder causing cold hands and feet), incontinence, asthma, and muscle disorders (including helping people learn to reuse arms or legs that have been traumatized). Essentially any bodily process that can be measured can potentially be controlled or influenced through the help of these techniques.

Scientific Support
There are four areas of research that support mind/body medicine: studies describing the physiology of mind/body interactions, those measuring the effects of mind/body therapy techniques, research on the health outcomes of structured mind/ body programs employing a variety of techniques, and studies of cost effectiveness.

Mind/Body Interactions
The Mind/Heart Connection. Scientists have pieced together how stress affects the heart. This work is well summarized by Cynthia Medich, Ph.D., R.N., a cardiovascular specialist and researcher at the Mind/Body Medical Institute, Harvard Medical School and New England Deaconess Hospital, Boston. What Medich describes as the mind/heart connection involves the release of two kinds of stress hormones into the bloodstream: corticosteroids and catecholamines.
These hormones set off a cascade of changes in the body including increased platelet aggregation (tendency for blood clotting); increased coronary artery tone; a surge in coronary artery pressure; increased blood pressure, glucose levels, and lipid levels; a more rapid and powerful heartbeat; and, paradoxically, a constriction in the coronary arteries. In short, the demands on the heart all increase.11

OAM-Funded Studies
Eight of the initial thirty studies funded by the Office of Alternative Medicine, National Institutes of Health deal with mind/body medicine.

Biofeedback. Angele McGrady of the Medical College of Ohio in Toledo is studying the use of biofeedback-assisted relaxation in reducing the dosage of insulin required in type I insulin-dependent diabetes mellitus. The method is being studied as an alternative to increasing the dosage when the person is under stressful conditions.

Richard Sherman at Fitzsimmons Army Medical Center in Aurora, Colorado, is evaluating biofeedback in treating chronic musculoskeletal low back pain and muscle-related orofacial pain.

Imagery. James Halper of Lenox Hill Hospital in New York City is conducting a controlled study of the benefits of guided imagery for patients with asthma.

Mary Jasnoski of George Washington University, Washington, D.C., is examining the effects of imagery on the immune system, with potential implications for use in cancer and AIDS.

Blair Justice of the University of Texas Health Sciences Center in Houston was funded to conduct a controlled study examining the effects of a group imagery/relaxation process on immune function and quality of life in breast cancer patients.

Hypnosis. Helen Crawford of Virginia Polytechnic Institute and State University in Blacksburg is examining how the use of hypnosis affects the electrophysiology of the brain in patients with low back pain. Carol Ginnandes of McLean Hospital in Belmont, Massachusetts, is studying whether hypnosis can be used to speed the healing of broken bones. Patricia Newton of the Good Samaritan Hospital and Medical Center in Portland, Oregon, is conducting a pilot study of the effects of hypnotic imagery on psychological and immunological factors in breast cancer patients.

With this understanding it is easy to see how individuals who experience stress on a chronic basis are at greater risk for heart diseases. This connection was dramatically illustrated in a study of air traffic controllers, considered to be in a very stressful occupation, who were found to have five times the incidence of hypertension as a comparison group of second-class airmen.

Other research has been able to anticipate who will develop hypertension and heart disease. One study followed 1100 adults for twenty years. Those who had the highest levels of anxiety at the beginning of the study turned out to have the highest rates of hypertension two decades later.

An eight-year study of over three thousand people found that those with the Type A behavior pattern were twice as likely as Type Bs to develop coronary heart disease.

Depression has also been found to affect the heart adversely. A study of patients with a history of heart disease found that those who were also depressed were eight times as likely to develop ventricular tachycardia as the patients who were not depressed. (Ventricular tachycardia is a condition of abnormal and potentially deadly heart rhythms.)

A ten-year study was conducted to follow the mortality rates of people who had experienced stroke. Those who had been diagnosed with either major or minor depression were 3.4 times as likely to have died within the follow-up period. The death rate among depressed patients with few social contacts was especially high: over 90 percent had died.

In a study of 194 heart attack patients, those who reported lower amounts of emotional support in their lives were nearly three times as likely to die within six months as those with higher levels of emotional support.17

The Mind and Immunity. In addition to affecting the heart, the chemistry of the stress response has been found to lower immune functioning. This is illustrated by studies of the effects of exam stress on medical students that have found significant drops in the activity of natural killer (NK) cells as well as in the numbers of NK cells (NK cells are a key in fighting cancer cells and viruses) and a significantly lower percentage of T-helper cells in the blood (the cells that arouse the immune response to fight off an infection).

In a study of recently divorced people, those who wanted the divorce, for whom it brought relief, were found to have better immunity than those who did not want the divorce.

A study of the effects of stress on salivary immunoglobulin A (S-IgA, the antibody that fights infections in the mouth and throat) found that a higher frequency of daily hassles was significantly associated with lower levels of S-IgA. However, the effects were less severe in people who scored higher on a scale measuring sense of humor. This suggests that sense of humor can counter the negative effects of stress on the immune system.

Research has shown that depression can have an adverse effect on immunity. A study that took place in a mental hospital compared natural killer (NK) cell activity in depressed patients, schizophrenic patients, and staff members. The patients with major depressive disorder had significantly lower NK functioning than schizophrenic patients and staff members.

A study involved 132 college students to determine the effects of positive emotions on S-IgA levels. Half watched a morbid documentary about power struggles in World War II, while the other half watched an inspiring film about Mother Teresa, a Roman Catholic nun selflessly serving the poor and sick in Calcutta. The latter group had significantly increased S-IgA concentrations, indicating heightened immune responsiveness.

Mind/body researcher Lydia Temoshok, Ph.D., studied the psychological factors associated with malignant melanoma. Among her findings was the discovery that emotional expressiveness was directly related to the thickness of the patients’ tumors as well as the course of their disease.

Major findings of Temoshok’s research include the following:
Patients who were more emotionally expressive had thinner tumors and more slowly dividing cancer cells.

The more emotionally expressive patients had a much higher number of lymphocytes (immune cells) invading the base of the tumor.

Patients who were less emotionally expressive had thicker tumors and more rapidly dividing cancer cells.

Patients who were less expressive had relatively fewer Lymphocytes invading the base of the tumor.

These findings helped contribute to the formation of the concept of Type C coping.

Can the immune system be trained to respond, like Pavlov’s dog was trained to salivate at the sound of a bell? In a well-designed, controlled study, participants were given a sherbet sweet along with a subcutaneous injection of a chemical known to increase NK cell activity (epinephrine). After several administrations of this regime, the epinephrine was replaced by a useless saline injection. Remarkably, the participants still increased their NK cell activity in response to eating the sherbet accompanied only by the saline injection!

Techniques of Mind/Body Medicine
Some research on techniques has examined their effects on specific bodily functions such as immune responses, blood pressure, and heart rate. Other studies have looked at recovery from surgery, and still others have focused on psychological well-being and the quality of life.

Relaxation Training. This is by far the most widely studied subject in this tradition with hundreds of studies documenting its benefits. A few examples: Patients with ischemic heart disease who practiced the relaxation response daily for four weeks achieved significant reduction in the frequency of preventricular contractions.

Patients with hypertension who took an eight-week (once a week) training program achieved significantly lower blood pressure and the benefits were maintained three years later.

Patients receiving several kinds of elective surgery who were trained in relaxation had less surgical anxiety both before and after surgery. The intensity of their pain and their use of pain medication were both reduced.

Also, a study of patients receiving angioplasty procedures showed significantly less anxiety, pain, and need for medication. In patients receiving heart surgery, those who received the training had significantly lower incidence of postoperative supraventricular tachycardia.

A controlled study of women with premenstrual syndrome (PMS) using the relaxation response twice daily for three months found a 58-percent reduction in the severity of their symptoms.

Two studies found increased NK cell activity as a result of practicing the relaxation response. One, involving geriatric residents in nursing homes, also found indications of lower activity of herpes viruses. In addition, there were significant reductions in symptoms of emotional distress.

Finally, in a study of exam stress in medical students, the more they practiced the relaxation response, the higher the percentage of T-helper cells circulating in their blood.

Meditation. Of many various forms of meditation, TM has led the way in mind/body research. Over five hundred papers have been published in 108 scientific journals, authored by scientists at 211 research institutions and universities, in twenty-three countries worldwide. Studies of TM were instrumental in discovering the relaxation response and its benefits for hypertension. Other studies have found important benefits for such diverse populations as prison inmates, drug addicts, and Vietnam veterans suffering from posttraumatic stress disorders.

In one study, patients with hypertension who practiced TM twice daily for five to six months achieved significantly lower blood pressured. In another, the effects of TM were compared to those of progressive muscle relaxation and usual care in hypertension. For those using TM, the decreases in systolic and diastolic blood pressure were twice as great as those for the subjects in the other groups. As will be seen later, TM has also shown impressive effects in reducing the utilization rates of medical services.

Imagery. Imagery is often used in combination with relaxation and meditation. A controlled study of fifty-five women examined the effects of imagery and relaxation on breast milk production in mothers of infants in a neonatal intensive care unit. They received a twenty-minute audiotape of progressive relaxation followed by guided imagery of pleasant surroundings, milk flowing in the breasts, and the baby’s warm skin against theirs. They produced more than twice as much milk as those receiving only routine care.

In another study, a group of metastatic cancer patients using daily imagery for a year achieved significant improvements in NK cell activity and several other measures of immune functioning.

At Michigan State University, researchers found that students could use guided imagery to improve the functioning of certain white cells called neutrophils, important immune cells in defense against bacterial and fungal infection. They could also decrease, but not increase, white cell counts. At one point in the study, a form of imagery intended to increase neutrophil count unexpectedly caused a drop instead. Subsequently, students were taught imagery explicitly intended to keep the neutrophil count steady, while increasing their effectiveness. Both of these goals were achieved.

Breath Therapy. A study examined the effect of evocative breath therapy (EBT) on salivary immunoglobulin A (S-IgA). EBT involves abdominal breathing accompanied by music and posthypnotic suggestion to promote emotional arousal and release. Forty-five adults in a group therapy program for cancer showed an average 46-percent increase in S-IgA levels after an hour-long EBT experience.

Biofeedback. A controlled study of patients with irritable bowel syndrome found that biofeedback training brought a significant reduction in symptoms. This change was still present six months later. Another controlled study found a 41-percent reduction in migraine headaches in patients using a thermal biofeedback procedure at home.

Multi-strategy Group Programs
Most organized mind/body therapy programs use a regimen of several techniques. Below are described some findings of such multistrategy programs for specific illnesses.

Hypertension. A group program for patients with hypertension included training in the relaxation response, nutrition, exercise, and stress management. Findings included significant reductions in blood pressure, cholesterol, triglycerides, weight, body fat percentage, and psychological symptoms. Importantly, most of the benefits were intact when the patients were checked three to five years later.

Surviving Heart Attacks. Patients recovering from myocardial infarction took a six-hour program of stress management training with mind/body techniques and emotional support. The result was a 50-percent reduction in subsequent rate of cardiac deaths.

Reversing Heart Disease. A controlled study at the Preventive Medicine Research Institute, University of California, San Francisco, examined the effects of a multistrategy program on people with severe coronary heart disease. Patients were randomly assigned to either a usual care group or the experimental program. The latter involved a regimen of dietary changes, exercise, yoga, and group support that included the practice of mind/body techniques. Those in the experimental program almost universally showed reductions in coronary artery blockage, while those with usual care generally showed more blockage.

Benefits for Infertility. A ten-week group program for infertile women included training in the relaxation response with instructions for daily practice and training in stress management, exercise, nutrition, and group support. Results included decreases in anxiety, depression, and fatigue and increased vigor. Also, 34-percent of the women became pregnant within six months of the program.

Reducing Symptoms of AIDS. In a controlled study, patients received group training in biofeedback, guided imagery, and hypnosis. Results included significant decreases in fever, fatigue, pain, headache, nausea, and insomnia. Vigor and hardiness also significantly increased.

Another group program for HIV found significant improvement in emotional expression, sense of control over health, tension, anxiety, fatigue, depression, and total mood disturbance.

Psychological well-being in Cancer. Fifty-nine patients took a ten-day, sixty-hour group program that includes imagery, relaxation training, lifestyle evaluation, emotional release therapies, group support, breath therapy, and exploring the personal meaning of illness. Results included significant improvements in emotional expressiveness, fighting spirit, quality of life, sense of control over health, and optimism–including patients with metastatic disease. These improvements were still present three months after completing the program.

Psychological well-being and Immunity in Cancer. Sixty-six patients with malignant melanoma took a six-week structured group program that included health education, stress management, training in problem solving, and psychological support.

Josephine
Josephine, thirty-six, suffering from headaches, sought help from her physician. Her blood pressure was 150/100, she was twenty pounds overweight, and her cholesterol level was 280 mg/dl. She smoked a pack a day and did not exercise regularly. She was given a betablocker for high blood pressure, a cholesterol drug, and was told to lose weight and stop smoking.

Two months later her blood pressure was 160/102 She had lost no weight, she had not been able to stop smoking, and her cholesterol was 290 mg/dl. When asked why she hadn’t cooperated with the recommendations she broke down in tears. She hadn’t been able to afford the medications ($90/month). Her husband had left her and their two children after a stormy and abusive marriage, so she had been trying to work two jobs, felt depressed, was not sleeping well, and her headaches were now a daily occurrence.

She was referred to the Hypertension Clinic at the New England Deaconess Hospital, Boston, and participated in a twelve-week program of two-hour sessions with ten other participants. The program emphasizes the relaxation response, diet, exercise, and stress management. Her goals in the program were to control her blood pressure, lose weight, and stop smoking.

During the program she regained some of her self-esteem, began to feel more hopeful, started sleeping better, was less irritable with her children, and was able to find assistance for child care and vocational training. She monitored her blood pressure once a day, which dropped to 124/90, and her medication was stopped. She was headache-free. She started walking daily and lost five pounds. Her cholesterol dropped to 220mg/dl. She practiced the relaxation response once a day and signed up for an assertiveness training class at the YWCA.

Before leaving the program, she outlined the situations that might be associated with relapse and developed a plan for action that included returning periodically for the drop-in groups for reinforcement. She also signed up for a SmokeEnders group to start after the program ended.

Six months after the program, there were significantly lower levels of psychological distress and higher levels of positive coping methods in comparison to patients who did not have the program. There were also significant increases in the percentage of NK cells and in their functional effectiveness (cytotoxic activity).

Increasing Survival Time in Malignant Melanoma. The patients who participated in the above study were followed for six years. A startling difference in death rates between the two groups was found. Of those who were in the control group (no group therapy), thirteen of thirty-four had a recurrence of cancer during the six years and ten died. For those who had the group program, only seven of thirty-four had recurrences and only three died.

Increasing Survival Time in Breast Cancer. A ten-year controlled study was conducted with eighty-six women with metastatic breast cancer. Those who had a year of weekly group sessions had nearly double the survival time of those who did not have the group (averaging thirty-six months versus eighteen months). The group provided self-hypnosis and a form of therapy called “supportive-expressive therapy.”

Cost-Effectiveness
Aside from the medical and psychological benefits, one of the most important contributions of mind/body medicine is in reducing the costs of health care by reducing the utilization rates of expensive inpatient and outpatient services.

Dr. Elizabeth Devine of the University of Wisconsin School of Nursing in Milwaukee conducted an analysis of 191 different scientific studies in which surgery patients were taught simple mind/body techniques. She found an average reduction in the length of hospital stay of 1.5 days (12 percent). This of course translates into enormous savings, considering the cost of a day of hospitalization. Results also included faster recovery from surgery, fewer complications, and reduced postsurgical pains.

Other studies have found reduced utilization rates for outpatient medical services. For example, in one study 109 chronic pain patients took a ten-session outpatient group mind/body program. A 36-percent reduction in total monthly clinic visits for pain management was found in the first year after the program.

Another study looked at the medical care utilization rates of two thousand regular practitioners of TM, comparing them with 600,000 other members of the same insurance carrier. For children and young adults the reduction for inpatient services was 50 percent and for older adults it was 69 percent. The reductions for outpatient services were 47 percent for children, 55 percent for young adults, and 74 percent for older adults.

The same pool of TM practitioners were compared to five other health insurance pools, showing 55 percent fewer visits for benign or malignant tumors, 87 percent fewer visits for heart disease, 30 percent fewer visits for infectious diseases, 31 percent fewer visits for mental disorders, and 87 percent fewer visits for diseases of the nervous system.

Strengths and Limitations
The greatest strengths of mind/body medicine are in stress-related conditions and chronic illnesses. It also has a great deal to offer in terms of relief of the symptoms of acute illnesses as well as relief from the side effects of treatment such as surgery, radiation, or chemotherapy in cancer.

This is obviously a complementary form of medicine rather than a primary treatment for major diseases. However, while it is usually thought of as supportive rather than curative, there are illnesses that do not respond to conventional medical treatment and for which mind/body medicine offers a way of gaining some relief and promoting recovery.

One point of controversy that often arises in this tradition is the question of whether its use implies an assumption that one’s illness must hav