Yoga Therapy for Parkinson's Disease and Multiple Sclerosis. Jean Danford
chronic and prolonged, more determination is needed to overcome distractions.
Distractions are listed in Sutra 1.30 – they are obstacles to progress. Vyahhi styana samshaya pramada alasya avirati bhranti-darshana alabdha-bhumikatva anavasthitatva chitta vikshepa te antarayah – vyahhi, disease is the first obstacle, followed by dullness, carelessness, laziness, sensuality, false perception, failure to reach firm ground, and slipping back from progress made, complete the list.
In Sutra 1.31, duhkha daurmanasya angam-ejayatva shvasa prashvasah vikshepa sahabhuva, distress, despair, trembling of the body and disturbed breathing are identified.
All of these would be easily identifiable in a person with Parkinson’s or MS. The disease can overtake life completely so that the idea of a true self existing and being able to connect with that part is left far behind. Although there is desire to ease or even overcome some of the physical symptoms of the disease, there is also a need for the individual to be preserved and not lost in the disease process. Woven into yoga sessions should be the underpinning philosophy that the self dwells within and can be nurtured, recognised and present. Thus the quality of life is enhanced.
Patanjali goes on to say that focused practice is the best way to overcome distractions. Perseverance, practice and focus can all be encouraged within the yoga practices planned. We need to motivate, encourage, educate and inform, so that students feel supported in moving forward. It is in this area that we can offer practice sheets, describing 10–20 minute sessions to be done at home, to engage regular practice.
In Sutra 1.33, Maitri karuna mudita upekshanam sukha duhka punya apunya vishayanam bhavanatah chitta prasadanam, Patanjali states that by being friendly and compassionate and not focusing on the negatives, the mind is able to become calm.
In recent years we have seen studies in the field of neurophysiology that show that these attitudes help in healing stress and trauma, the part of the nervous system responsive to the social environment and relationships. The vagus nerve and the enteric nervous system respond to friendliness, compassion, warmth and love, which bring about positive changes in health, and the human being can move towards homeostasis (Porges 2011).
It is important to encourage this attitude both as a leader of a group and among the group members themselves. My observation in working with small groups, especially those connected to a charitable network where there is social interaction as well as education, is that by care, consideration and inclusiveness, one can bring about a sense of belonging and wellbeing that supports the progress made in other areas of yoga practice.
Patanjali goes on to offer breathing, awareness/mindfulness and meditation as practices that lessen the power of negative, hurtful, traumatic memories and experiences, and lead to a better quality of life.
In the second part of Patanjali’s Sutras, 2.3–9, the five obstacles – kleshas – are described, and we are reminded that they are ever-present. These are ignorance, egoism, attachment, hatred and clinging to bodily life. Ignorance in this instance is not just a lack of knowledge or education, but not being able to see the truth. When we are caught up in suffering, our ability to recognise what is real diminishes.
Do our students want to engage in this search for the truth? As with yoga itself, and in life in general, some people are drawn to be seekers and others follow a different path. If this concept is at the heart of our teaching, I believe the quality and vibration of that message will get through. In many people, illness causes introspection and leads them to question the things in life of real value, to prioritise differently, to value life experiences differently. This, in its essence, is therapeutic.
As yoga teachers, we are encouraged to offer a spread of practices following the guidelines set by Patanjali, known commonly as ‘The Eight Limbs of Yoga’: Yama, Niyama, Asana, Pranayama, Prtyahara, Dharana, Dhyana and Samadhi. In planning a balanced yoga session, these offer a framework of underpinning ethics, moral standpoint, practices and progression.
Patanjali’s ‘Eight Limbs’ offer the model defining yoga practice in working towards the goal of a healthy contented life.
Yama and Niyama underpin our teaching and guide our conduct and attitudes.
Yama is usually translated as restraints, which govern our conduct towards both ourselves and towards others:
•Ahimsa is the refusal of violence, or non-harming.
•Asteya is the refusal of stealing.
•Aparigraha is the refusal of covetousness.
•Satya is truthfulness.
•Brahmacharya is continence.
This group of rules guides us to respect and honour ourselves and others, to show our acknowledgment that there is a oneness in life, doing unto others as you would have done to yourself.
Niyama translates as observances:
•Saucha is purity.
•Tapas is austerity.
•Samtosa is contentment.
•Svadhyaya is self-study.
•Isvara pranidhana is devotion to the divine.
This group of rules offers guidance on how to conduct oneself and one’s thoughts to promote balance and happiness.
Asana offers a range of postures that are specifically tailored to the needs of the student and their capabilities. In asana practice we can improve balance, strengthen muscles and joint mobility, improve circulation and build overall confidence.
Pranayama offers suitable practices that improve oxygen intake and the efficiency and health of the lungs, thus keeping away infections.
Pratyahara is a key practice in aiding physical relaxation and offering an opportunity for inner awareness and inner stillness, bringing an experience of the self, with senses withdrawn.
Dharana offers training to focus concentration and to make progress towards meditation, which is helpful in daily living as we engage the nervous system and brain function.
Dyana is meditation. Although there may not be an opportunity to offer this as a practice within the time allowed in a Yoga Therapy group, students can be encouraged to go to a specialist practice group or to practise at home.
Samadhi is a personal experience that would be beyond the remit of the average therapy class.
Guidance for dealing with negative thinking is given in 2.33 and 2.34. When negative thoughts are troubling, think the opposite way – Pratipaksha Bhavana. We can engage with this in therapeutic yoga by offering positive ideas and thinking even in a small way.
Parkinson’s disease, multiple sclerosis and the chakra system
There is a point of view that the pranic flow is the origin of health, and when that flow becomes disturbed, ill health follows. The disturbance of energy may begin long before the disease is identified. Many yoga teachers are familiar with the subtle energy system of the chakras, and if we consider what is happening at the subtle energy level, we can see the way that Parkinson’s disease and similarly MS show energy imbalance.
The chakras are distribution centres, sending energy out to all the different kosha (levels), through the nervous system, endocrine system and organs of the body, giving us a 3D model. In yoga terminology this happens through the nadis and vayus. We can see how this would impact on the functioning of the whole if it is out of balance.
Just how disturbance manifests in Parkinson’s or MS is summarised over the next few pages. This is a projected general analysis as each individual has their own unique pattern.
The root chakra: Muladhara
What we can observe in Parkinson’s and MS is that communication between the brain and body is not functioning. As this affects mobility and ability to control movements, we can expect a severe disruption in Muladhara chakra. So we have instability, loss of balance and disrupted function