Wednesday, October 6, 2010

Closing Post, Can you measure open-heartedness?

Putting off writing this closing post of SYR has given me time to reflect on what I just experienced. We were asked in the evaluation handout about our preference of a smaller venue for future symposiums such as HI versus a larger venue to accommodate more attendees. [Undoubtedly there is bias in responding to that question. Questionaire data analysts take note!] Everything was fairly perfect for us at the Himalayan Institute.

We were cared for, no, doted on by what seemed like scores of residents. Attendees and residents shared rooms on the same floor, bathrooms, meals, yoga classes, and conversations. They were everywhere (not quite like the constant helpers Americans find themselves surrounded by in India, but getting close). It seemed like there was nothing they would not do for their guests. Monday morning as I left a resident of around 20 years wanted to hold an umbrella over me while I took my stuff to the car. The auditorium, one big screen in front and another half way down one side, was monitored by the AV specialist, and everything went off without a hitch in there. We could all see and hear. My only complaint, as noted previoiusly, was that the internet could be accessed only on the other side of the building and there are lots of steps and corners and long hallways full of spiritual art to get distracted by along the way. I actually have no doubt that this atmosphere is what Sat Bir Khalsa, the progenitor of this symposium, desires. HI is as sattvic a setting for a symposium as I can imagine.

The attendees were not your usual yoga conference crowd, by a long stretch. Judging from a show of hands Probably no more than 30% were yoga therapists. Most were academics or clinicians, doctors, nurses, physical therapists, PhDs in education or psychology, so many areas, most all practicing and believers in the power of yoga. Those present representing yoga/yoga therapy/yoga education, etc but probably not yoga research per se, consistently asked more questions about the yoga aspect of a study, i.e. yoga protocol, who offered the yoga to the subjects, precautions taken, modifications, etc. "Kind" of yoga used for a study and how important that may be was discussed more than once and whether it could be said that the subjects were "really doing yoga" was also acknowledged.

Discussion, in fact, is germane to the presentation of research results. The presenters of the preconference (Sapier, Innes, Cohen, and Khalsa) all (i think) spoke to its importance. That's where the authors really have an opportunity to bring up the challenges, missed opportunities, unforeseen outcomes that could be studies further etc. All good researchers it seems are looking for ideas to propel their work into the next stages of research that will offer proof of the power of yoga and other mindfulness based practices.

Among the many positive effects of yoga we have either personally experienced or learned about from studies, probably the one that I am most thrilled with—largely for personal reasons but also because so many people are affected by this— is yoga’s ability to change the course of Post Traumatic Stress Disorder. Dr. Bessel van der Kolk, a psychologist, shared with us his NCAAM funded study on PTSD.

Van der Kolk’s Saturday keynote came at that time during the symposium when people had fully emerged from their shells. It was after lunch where we’d been happily expressing themselves with one another, and had had a chance to walk outside or mingle in the poster session area. Part of this was actually due to Sat Bir’s planning brain, as he had envisioned this conference based on the Gordon model. This is where a very focused and appropriate group— sometimes even hand-picked delegates who apply for admittance—through the setting and intervals, pauses and pace come into a flow that generates a rhythm of convergence, divergence, crescendos and lulls and the energy and interactions are a bit more electric and unconstrained. There was a high energy in the auditorium even before van der Kolk’s talk began. I think we all felt it.

Van der Kolk is one of those magnetic speakers who command their surrounding space. I don’t know why this occurs and maybe there is a study somewhere on this type of personality. But we were all leaning forward, I noticed, and (I’m really not exaggerating) hanging on his every word.

He opened with a film of a traumatized woman in a chair seated near her psychologist. The psychologist asked the woman to recall the incident that was still traumatizing her. Van der Kolk asked us to notice her body posture, which was slumped and defensive. Apparently she would describe the horrible accident in vivid detail, over and over, and each time that she did her body would respond again to the trauma and she would begin crying. The body keeps reliving the trauma, he told us, and that trauma is an illness of the total organism.

He considered, he told us, how useful is it for a person to keep talking about their trauma again and again when the body just keeps reliving it when they do? First we have thoughts, then the emotions are expressed, and then the body reacts. How do you get people into a mode where it is over?

Showing a slide of a crowd of people running through the streets of NYC during 9/11 I think was brilliant audience manipulation probably unintended that way though. We were now psychologically part of the story he was telling because everyone in the room was sympathetic to the circumstance. But what he told us was new, at least to me: there was virtually no PTSD following 9/11 because people were able to run to a safe place, to home, and that support from around the world poured forth. He concluded that by and large, if you can run to a safe place following a potentially traumatizing event, you don’t get traumatized.

So trauma occurs when the body is unable to take actions it naturally would take. And this trauma remains embedded in the body possibly especially due to continued recounting of the event because the body believes it is back at the source of the trauma again.

As did all of the speakers who shared their research, some background or lead-up to theories was offered from other studies, and not only studies authored by the speaker. Throughout the weekend we witnessed the reliance and respect researchers have on results and insights to be found in the literature that may give them a new spark of insight which will help make their own work a unique contribution. There’s obviously competition for scarce funding dollars, but they are extremely respectful of contributions others are making.

Just as Dr. Shirley Telles is mining the yoga texts for explanations as to how yoga can work and then creatively applying those lessons in today’s world, Dr. van der Kolk had insight from Darwin’s work done back in 1872. Darwin offered that the pneumogastric nerve, as he called it, now called the vagus nerve, was the control center to the emotional body.

He commented that those who are using alcohol or drugs to make themselves feel better (often the case with traumatized people) , more than any other group, through peripheral activation of the vagus nerve is trying to change how they react to past trauma.

Overcoming trauma, then, is to regulate the physiology by learning to get out of flight or flight mode, and for this he used yoga with the woman previously noted (and other subjects who were traumatized). Van der Kolk noted heart rate variability (HRV) differences. Low HRV indicated anxious or depressed states; High HRV indicated resistance to stress. Please go to the Digital Resources Library and look at his slides and graphs, etc.

Recognizing the reality of what yoga does to people, he asked subjects how they Felt about their bodies (mood scale questions). He went to MIT and somebody figured out a way to measure HRV on 8 people at the same and learned that some people remain hyperactice during savasana – they are actually in the fight or flight mode during savasana! The question then arose of how to get them totally, safely relaxed during savasana and he emphasized the importance of qualitative assessment to capture that. There can be no doubt in anyone’s mind after attending this symposium on yoga research, how critical is the information generated from qualitative assessments.

We come then to brain hemispherity and the medial part of the brain. Via the left hemisphere there is no pathway to the emotional brain. Because we know that the left hemisphere is the center for language and logic, we must strongly consider that we can’t talk ourselves out of an emotion that we are feeling. But via the right hemisphere, where symbols help us be the social animals that we are, we can access emotions. And, self-awareness, which is what we have been searching for in our struggle out of this pain, can be touched through the medial part of the brain, the medial prefrontal cortex.
Interestingly, the medial prefrontal cortex is also involved with empathy.

I leave you to study his slides when they are posted on the DRL.

But the upshot of all of this is that when traumatized subjects do yoga, they become consciously in touch with their bodies. A traumatized person is basically out of touch with both body and feelings. With PTSD there’s a breakdown in cortical timing, a messed up default system. When a person is traumatized, different parts of the brain are not working together, there is lack of brain coherence (something that has been studied quite a lot at Maharishi University, but I saw nothing of their work at this symposium). Yoga does something to the brain.

Finally, again we see the woman we were introduced at the beginning of the presentation. She has been practicing yoga. The psychologist asks her about the event. She is sitting up straight, head tilted to one side, and says with perfect assurance and clarity something like: Oh, I don’t know. I’m really not that interested in talking about it right now. I’m tired of talking about it.

Certainly not all yoga teachers or yoga therapists are interested in yoga research, either reading it or participating in it. But for those who are, SYR was a real gift. And for those who aren't, take heart in this question posed by Dr. Cohen: "Can we measure open-heartedness?" The answer, of course, is no. There are some things about yoga that are beyond the reach of science.

In service, Julie Deife

1 comment:

  1. Julie, thanks so much for this last post and the information about van der Kolk's work, which is very important to anyone working with PTSD. I know that when I'm in the yoga teacher role my ability to help people feel safe in savassana is the best thing I can do. I help people feel safe in my psychotherapist role too, but it is the bodily experience that counts.The body experience can be reached in the therapy room too, but I have felt for many years that a good yoga teacher can help us reach back to our core and grow again, on a non-verbal level. The non-verbal process also goes on in therapy. The verbal process helps us make sense in other ways.
    Thank you again for your wonderful reportage.