why I teach Yoga. Yoga as part of Stroke Recovery.. The Lived Experience

Eastern medicine has always had a more holistic approach, whereas Western medicine  typically focuses on the physical body and disease/illness, sometimes forgetting the emotional influences which can slow recovery-stress, worry, negative self talk and depression. However mind/body interventions are steadily gaining recognition in chronic illnesses and are certainly seen as a way to deal with depression and promote resilience which in turn can encourage a physical healing process. Following the studies over the last ten years, the same themes emerged from all the research, but not all were measured quantitative outcomes. Stroke participants self- reported improvements in their quality of life. A feeling of being calm and aware of sensations and connection to their  bodies, which was leading towards a feeling of greater confidence and self-reliance. Extensive emotional changes were reported such as feeling less anxious, less depressed and less reactive, “ feeling more like their old self”. The participants also perceived physical improvements too in strength, range of movement and balance.

On-going research is still happening and Arlene Schmid, an Occupational Therapist, Yoga therapist and a leading researcher working in the area of stroke rehabilitation at Colorado State University, is confident in the belief that Yoga has an integral and valid part in rehabilitation for stroke and other brain traumas. She concludes from her research and observations in clinical interventions that the practice must include Pranayama, Meditation and Mantras - as well as physical Asana. She says, “ while Yoga is 5000 years old,Yoga and Yoga Therapy are relatively new topics of research, but we have seen improvements in cognitive, emotional and physical changes that commonly occur after a stroke”. In the early days, I sometimes only laid on the mat and wondered ‘what next’, but as my confidence grew I began to explore my breath, physical body and mind, in a safe and absorbing way-still unable to express the changes to anyone else. Why was I feeling better - was my new sense of self a natural progression of time passing or could the Yoga be having some effect…?

These thoughts have led me to read more about Neuroplasticity. For many years the mainstream thought was that brain plasticity stopped in childhood.This is not the case, the brain is able to regenerate throughout our life time and can re-establish and make new neural connections. Nerve cells called neurons signal to each other and those lightning fast connections enable everything from our bodily movements to thoughts and emotions.The more we use a pathway the more it becomes established. However the brain can make new connections, as well as making established ones more efficient. If the brain is challenged with new situations, it can reorganize and restructure itself in order to respond to that situation.The more it is exposed to the challenge then the more the new pathway establishes itself. Our brains are constantly shaped by movement and thoughts-often unknowingly. Within a Yoga practice, if we place our focus and attention on our movements, on our body and on our breath, then our brain and nervous system is thought to rewire itself, according to where we place our focus and awareness. Keeping our focus and attention while in a particular posture and with repetition, creates more neural connections as our brain maps out the body's movement. The more we do something and the more awareness we bring to that movement, the better the brain becomes at noticing the subtlety of what we are doing. Repetition is key to activating Neuroplasticity. Stroke patients often have a side that is hemiplegic - paralysis on one side of the body, a weakness, problems with muscle control or muscle stiffness. Repeat practices on this side result in better outcomes due to new or re-establishing neural reconnections. These practices can be done via visualisation too - imagining limbs or fingers moving.Visualisation can be incredibly powerful and now an accepted psychological practice.Visualisation activates the reticular activating system and the brain responds as though whatever is being visualised, is happening.The Reticular Activating System (RAS), filters the information between the conscious and the unconscious mind. It thinks in pictures not words and cannot tell the difference between reality and imagined reality. The brain creates the same neural connections that tell the muscles what to do whether it is real or imagined. It is also worth mentioning that the RAS also responds to negative thought patterns. A positive approach to recovery and the belief that improvement can be made, however slowly, is vital. The neuroscience saying “ neurons that fire together wire together”, reflects the ancient yogic saying, “ As you think, so you become.”

Meditation is one of the eight limbs of Yoga and an essential component of a Yoga practice.

Studies on Meditation using MRI scans, have shown how, not only are there changes in the way the brain functions, but also changes in the physical structure of the brain. It has been proved that regular meditation increases the grey matter in the brain - the area that is responsible for emotional regulation and attention. In a study in 2013, 20 mins of meditation was added to a stroke rehabilitation programme.The meditation group showed greater improvements in low mood/depression, less fatigue and improved balance, compared with the non-meditating participants.

Mantras can also be used with Meditation as well as embedded in an Asana practice - including using a positive intention or a Sankalpa. Following a stroke there is often a focus on what a patient can no longer do. I remember calling my left side my ‘bad side’, my “bad leg”, “ the side that doesn’t work”- a disconnect from half my body, focusing on the negative. Using positive visualisation ,Mantras and Sankalpas can help heal this disconnect and bring a strength back to mind and body - using intention or  Mantras such as “ I am strong”, “I am whole,” “ I am stable,” “ I am healthy.” The yogic and scientific  idea is that positive thought will embed in the mind and body and become part of the healing process. Instead of focusing on things that hold you back, focus on things that can improve. Instead of imagining doomed scenarios “ this side will never be the same again”, try with positive thought and action and positive mental energy towards improvement - however small.