Check out my latest original blog for The International Bipolar Foundation!
http://www.ibpf.org/blog/yoga-philosophy-bipolar-disorder-101
The fist of a series of blogs on the Yamas and Niyamas, the “do’s” and “dont’s” of Yoga philosophy.
This one was read by readers in Brazil, New Zealaand, Great Britain, Louisiana USA, France…
It is very exciting. Enjoy!
Photo credit unknown
I have begun my seven-week training on Fundamentals of Bringing Yoga and Meditation into Military Communities.
From my experience sharing Yoga with the young combat veteran and from his recent lashing out and defiant withdrawal from me as coping mechanism, I am even more grateful for the scholarship that I was awarded to attend this training. It is part one of three offered for certification through Warriors At Ease. They have guided me through my work with this troubled and promising young man. Help is needed, Rush Order.
I hope that this program offers me more knowledge and wisdom so that I might become even more successful merging Yoga with trauma recovery and working with vulnerable populations. I know that I did good work with him, with integrity and honesty, yet, naturally, l feel a lack of closure. He up and disappeared! I believe that I exposed his vulnerabilities to him in a way that he wasn’t prepared to integrate, in a moment of insensitivity to his mood, via text. I do not take responsibility for his isolating behavior, however. I am moved by his pain. He has been a phenomenal, inspiring teacher to me. I need to learn more.
I miss working with him. Maybe he’ll come around.
My experience establishing a research program and teaching trauma-informed Yoga for San Luis Obispo County Drug and Alcohol Services through the Adult Treatment Court Collaborative to parolees with dual diagnosis (mental health and substance abuse disorders), a thirteen-week pilot program which ended December 22, 2014, was traumatizing to me.
The program showed, through self-reported questionnaires, improved mental health, mindfulness, breath awareness, quality of life, symptoms and medication compliance and adherence – in other words, we met our therapeutic objectives. I am ever-grateful for the experience, though I find that I am still integrating to the point of quiet introspection. From sex-offenders and threatening gang members to a chaotically disintegrating program and bureaucracy that is resistant and dysfunctional… it was an eye-opening and exhausting experience.
Despite the successful outcome, and though I procured all materials through donations (mats, blankets, a stereo, thirty-six eye bags used as weights hand-sewn by another Yoga student), the County has chosen not to resume offering Yoga to it’s clients due to lack of funding.
The financial glitch is in paying the Yoga teacher, apparently.
No real need to express my disillusionment and disappointment… and I have been galvanized once again to continue forging Yoga programs in agencies and organizations, privately and in groups, for mental health, seemingly against all odds. I remain hopeful, because Yoga works, though I am feeling financially strapped for the time being.
As I recover from these two intense experiences – my sense of dismissal by the veteran and the County – I honor the secondary trauma that I incurred in these contexts by spending time with the traumatized, as well as by my primary trauma – my own responses to personal triggers. I have succumbed to this national flu epidemic and have been spending much time in seclusion. It has been a great retreat, despite the illness.
My new copy of The Body Keeps the Score: Brain, Mind and Body In The Healing of Trauma by Bessel Van der Kolk, MD came in the mail this week. There are numerous passages that I underlined, navigating not by page but by bibliomancy. I will quote some of the mind-bending concepts below.
From The Body Keeps the Score: Brain, Mind and Body In The Healing of Trauma by the good Doctor Bessel Van der Kolk:
…Emotional intelligence starts with labeling your own feelings and attuning to the emotions of people around you… p 354
…Resilience is the product of agency: knowing that what you do can make a difference… p 355
…Disturbing behaviors started out as frustrated attempts to communicate distress and as misguided attempts to survive… p 352
… Identifying the truth of an experience is essential to healing from trauma… Predictability and clarity of expectations are critical; consistency is essential… p 353
…If you are not aware of your body’s needs, you can’t take care of it. If you don’t feel hunger, you can’t nourish yourself. If you mistake anxiety for hunger, you may eat too much. And if you can’t feel when you’re satiated, you’ll keep eating. This is why cultivating sensory awareness is such a critical aspect of trauma recovery. Most traditional therapies downplay or ignore the moment-to-moment shifts in our inner sensory world. These shifts carry the essence of the organism’s responses: the emotional states that are imprinted in the body’s chemical profile, in the viscera, in the contraction of the striated muscles of the face, throat, trunk and limbs. Traumatized people need to learn that they can tolerate their sensations, befriend their inner experiences, and cultivate new action patterns… p 273
…Safe areas can help [traumatized] kids calm down by providing stimulating sensory awareness: the texture of burlap or velvet; shoe boxes filled with soft brushes and flexible toys. When the child is ready to talk again, he is encouraged to tell someone what is going on before he rejoins the group… p 353
On confidence:
…As long as we feel safely held in the hearts and minds of the people who love us, we will climb mountains and cross deserts and stay up all night to finish projects. Children and adults will do anything for people they trust and whose opinion they value… p 350
Most fascinating to me, on the history of trauma recovery and combat veterans:
…Greek drama may have served as a ritual reintegration for combat veterans.At the time Aeschylus wrote the Oresteia trilogy, Athens was at war on six fronts; the cycle of tragedy is set in motion when the returning warrior king Agamemnon is murdered by his wife, Clytemnestra, for having sacrificed their daughter before sailing to the Trojan War. Military service was required of every adult citizen of Athens, so audiences were undoubtedly composed of combat veterans and active-duty soldiers on leave. The performers themselves must have been citizen-soldiers…
…Sophocles was a general officer in Athens’s war against the Persians… his play, Ajax, reads like a description of traumatic stress… p 332
On rhythmic rituals instilling hope and courage:
… Roman general Lycurgus had introduced marching in step to the Roman legions and the historian Plutarch had attributed their invincibility to this practice… This collective ritual not only provided his men with a sense of purpose and solidarity; but also made it possible for them to execute complicated maneuvers…to this day the major services of the U.S. military spend liberally on their marching bands, even though fifes and drums no longer accompany troops into battle… p 334
…Traumatized people are afraid of conflict… p 335
…If you want to give them a sense of control, you have to give them power over their destiny rather than intervene on their behalf… You cannot help, fix, or save the young people you are working with. What you can do is work side by side with them, help them to understand their vision, and realize it with them. By doing that you give them back control… p 342
…Learning to experience and tolerate deep emotions is essential for recovery for trauma. p 344
…Because [Shakespeare in the Courts] is committed to not throwing kids out as much as possible… p 344
…People can learn to control and change their behavior, but only if they feel safe enough to experiment with new solutions. p 349
…Attempts to cope with emotions become unbearable because of lack of adequate contact and support… p 349
…Trauma remains a much larger public health issue, arguably the greatest threat to our national well-being… p 348
…Psychiatry’s obtuse refusal to make connection between psychic suffering and social conditions… p 348
…Rampant prescription of painkillers, which now kill more people each year in the United States than guns or car accidents. p 349
…Trauma devastates the social-engagement system and interferes with cooperation, nurturing, and the ability to function as a productive member of the clan… ‘My humanity is inextricably bound up with yours’… [translation of the Xhosa word and principle of ubuntu]… p 349
On healing, breathing and the importance of heart rate variability:
…To promote reciprocity, we use mirroring exercises, which are the foundation of safe interpersonal communication… imitating facial gestures and sounds and then get up and move in sync. To play well, they have to pay attention to really seeing and hearing one another… trying to keep a beach ball in the air… computer games to help them to focus and improve their heart rate variability … p 354-355
… Heart rate variability measures the relative balance between the sympathetic and the parasympathetic systems. When we inhale, we stimulate the SNS, which results in an increase in heart beats. Exhalations stimulate the PNS, which decreases how fast the heart beats. In health individuals inhalations and exhalations produce steady, rhythmical fluctuations in heart rate: Good heart rate variability is a measure of basic well-being…. p 267
A good yoga teacher will encourage you to just notice any tension while timing what you feel with the flow of your breath: ‘We’ll be holding this position for ten breaths.’ … Awareness that all experience is transitory changes your perspective on yourself… Intense physical sensations unleashed the demons that had been so carefully kept in check by numbing and inattention. This taught us to go slow, often at a snail’s pace. That approach paid off… p 274
On shock:
…People who are… scared can’t think straight, and any demand to perform will only make them shut down further. If you insist, they’ll run away and you’ll never see them again… p 263
…[The] amygdala… had been rewired to interpret certain situations as harbingers of life-threatening danger and it [sends] urgent signals to [the] survival brain to fight, freeze, or flee… p 265
On cultivating interoception:
…In yoga you focus your attention on your breathing and your sensations moment to moment. You begin to notice the connection between your emotions and your body-perhaps how anxiety about doing a pose actually throws you off balance. You begin to experiment with changing the way you feel. Will taking a deep breath relieve that tension in your shoulder? Will focusing on your exhalations produce a sense of calm?… Simply noticing what you feel fosters emotional regulation… Once you start approaching your body with curiosity rather than fear, everything shifts… Trauma makes you feel as if you are stuck forever in a helpless state of horror. In yoga you learn that sensations rise to a peak and then fall… Yoga turn[s] out to be a terrific way to (re)gain a relationship with the interior world and with it a caring, loving, sensual relationship to the self… p 273
At every Yoga conference that I have attended, great attention has been paid to Yoga as therapy for military veterans as treatment for post-traumatic stress disorder (PTSD). I had no point of reference for veterans. I literally turned my body to the side in my seat and resisted the incoming information at these conferences because A) I did not know any veterans and B) I did not care to break my heart over their plight.
Last month, a veteran walked into the Yoga studio.
I want to honor his anonymity and I want to tell his story because it has changed my life. I had seen video of WWI soldiers rattled and lost in their minds, present for Dr. Bessel van der Kolk’s moving demonstration of veterans and trauma-sensitive Yoga http://www.traumacenter.org/, but to meet someone scarred by war, during duty for which he had volunteered, and offered very little by way of compensation by the government that had created this situation… I could not turn away.
First of all, this guy is a handsome devil. Young, mid-twenties. He’s got style and he’s got a sparkle and spunk. I am a sucker for young, handsome men with style. Super bright, fervent, and in need of support. Broke his wrist from hitting a wall. Tinnitus, scoliosis, flat feet from military gear. Still, he came to Yoga. But not to a “regular” Yoga class, because of his discomfort around people – to a private class offered to local volunteers. Anxiety. Depression. Unipolar. Bipolar. Insomnia. Rage. Loss of appetite. Disabled and nearly homeless. Lonely and terrified. Fixated on his story and dying to tell it. Suicidal. Suicidal. Suicidal.
Twenty-two veterans of The Wars on Terror committing suicide per day upon their return home drew the attention of The Armed Forces to Yoga and, in some places, Yoga is available to returning soldiers through the Veteran’s Administration. In our tiny seaside community, however, this kid was struggling without resources to back up his efforts to rehabilitate himself. I knew that I did not personally have the resources to offer this young man everything that he needed and I was scared. My thoughts had become restless over the situation, sensing that it was dire.
So, three days after meeting my first veteran, I found myself making phone calls, from my bed, early one morning. The second number that I dialed actually reached a human being. I was surprised, at 7:30 in the morning on a Tuesday, to talk to a very reasonable, like-minded Yogi and veteran named Gail Francisco. I had, miraculously, reached the outreach coordinator for Warriors At Ease http://warriorsatease.com/ and Gail has become both my lifeline and, through me, the lifeline of my veteran. Just as fervent, Gail has pulled out every possible resource available to this young man. When I wondered out loud if we – if I – were in too deep, she said, “It’s people like you helping one veteran at a time.”
This young man and, I feel now, every veteran, is the bravest of the brave. After serving his country selflessly and offering his life for the United States, upon discharge my veteran expressed subsequent feelings of disillusionment and abandonment, deep grief and haunting flashbacks. Trained to kill, he was never untrained. Fight or flight, without the flight. Fight fight fight fight fight. After six years in the service and reprogramming, beginning at the age of seventeen, he was returned to a culture from which he had been awkwardly separated and to which he no longer belonged, mentally. Taught to endure physical and emotional pain, injury, heat, trauma, cold, homesickness and more, he came home unable to control his temper, socialized in the exclusive ways of the military, uncomfortable in his body, mind and soul. Some of our service people have no one to return home to and enlist to escape brutal abuse and socioeconomic circumstances stateside. This, too, is part of my soldier’s broken heart.
So, on Halloween night, we met at the Yoga studio. I did a medical intake and I let that take one hour to help me to gain his trust, to not rush through, and not be too clinical. I asked the studio owner to stick around because I wasn’t sure of my safety. His physical and psychiatric issues were beyond anything I have ever come across personally or professionally, from traumatic brain injury and tinnitus to not being certain which mental health diagnosis was right. He has been prescribed every gnarly medication there is: opiates for pain, anti-anxiety meds, anti-depressants and more. After our intake, he spent the next hour in supported baddha konasana, where I led him through breathing and visualization. He fell asleep for forty minutes. I was glad, since he had mentioned not sleeping much during the previous week. It began to rain and I opened the door to the outside to finally rouse him. I was afraid to touch him to wake him up. I didn’t want to startle him. I was scared to death of him, while drawn to his vulnerability and need.
That night, on the Yoga mat, my approach was was unconventional for Western standards. He wasn’t paying me and I spent much longer with him than I would have ever projected – four hours total. Intuitively, however, I knew that this kid needed help and that I might be the last person that he might trust before taking his life. I know suicide, and once you know it, you always recognize it. Besides, it was Halloween night, it was raining, I like what I do and, underneath it all, he was very likeable, polite, receptive, willing – exceptional, even.
Over the next six weeks I bought him groceries and dog food, birthday presents and housewares. I brought him Yoga blankets and weight bags so that he could practice at home. I called the Veteran’s Administration and spent hours on the phone learning about services available to him locally and around the state. I took him to court, to the hospital, to the VA in the next county. I took him to the beach and to lunch. Some of those days he was calm, subdued and sweet. Some of those days, though, his moods were so severely unreasonable that I said nothing to avoid exacerbating his PTSD rage. He told me of his plans to kill himself. Some days he could not leave the house or even talk to me on the phone. One day, he refused to wear shoes, and went to his appointment wearing socks, in the rain.
Eventually, though, through the efforts of Gail at Warriors At Ease, myself and my veteran, he ate, slept, got a solid cast on his broken wrist and started the process of enrolling into an inpatient rehabilitation program in northern California, The Pathway Home http://thepathwayhome.org/. There, they have individual and group therapy, service dogs, Yoga, arts and crafts and four months of residential training for twelve veterans at a time. Part of the rehabilitation is to send the warriors into the community to interact with shopkeepers to teach them that not everyone is an enemy. My veteran refused to apply until I told him that he would have his own room, that he could maybe bring his dog, and that it was free.
We have also managed to practice Yoga, in some form, every time we see each other and even over the phone. This young man relaxes faster than anyone I have ever seen in the decade that I have been teaching. He melts. It is so rewarding. He loves it. His body hurts. His body hurts and Yoga helps. It also helps him to feel more clear-headed, less anxious and more present. It helps him to sleep. Sleep is imperative for mood management, be it PTSD or bipolar disorder. Good sleep can dull the blade of anxiety and help to rein in the ferris wheel of mood cycles. It does not matter how good looking or charming you are, you still need a good night’s sleep.
If I could devise some sort of structure for him, a regularity of practice for Yoga and breathing and relaxation, he would benefit greatly. As it is, however, biological rhythms like eating and sleeping are not yet firmly in place and those come first. Yoga is still currently a positive adjunct and every little bit helps. Hit it from all angles, I say: Yoga, sleep, quiet time, good nourishing food, altars everywhere, rosewater spray to reduce anger, frankinscence essential oil to cool your jets, coconut oil on the bottoms of your feet plus socks for sleep, regular exercise, avoiding crazy music, getting out into nature, avoiding spicy foods, wearing soothing colors and natural fibers, practicing trust and faith…
I wish I knew better how to mentor. The mentorship that I could offer was beneficial, but time consuming – necessarily so, and I have no regrets, but would not have been affordable to this young man had I billed him. How do we make therapeutic mentorship care affordable and accessible to those who need it, especially to those with mental health issues? One needs more care than one person can give – it takes a village. Hopefully, my veteran will be admitted into The Pathway Home program soon and begin intensive recovery. His recovery will last a lifetime, as does the recovery for anyone with a lifelong illness. Fortunately, Yoga can be a lifelong practice. I am glad to help wherever I can.
I am pursuing further training through Warriors At Ease so that the next soldier who walks into the Yoga studio can be served with greater expertise. Another warrior will walk through the door. We need all the skills we can gather to support these brave souls to live in peace, and to support ourselves as we do so.
I am so very grateful to this young man for teaching me so much in such a short amount of time.