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February 10, 2012 | 10:36 AM
By Rachel Zimmerman
wbur.org | Common Health

Ben Tannenbaum, a wiry first-year medical student, is under pressure.

His typical day involves about five hours of lectures and test prep — physiology, genetics and histology on a recent weekday; a mad dash off to a clinic to practice as a doctor learning physical exams and basic medical history-taking; and then, after getting home around 8:30 pm, a few more hours of work reviewing the day’s material before it all starts again the next morning.

“And that isn’t including elective courses, student organizations, research, volunteer work, or extracurricular activities that almost everyone is trying to find time for as well,” says Tannenbaum, a-24-year-old student at Boston University School of Medicine.

But on Tuesday night, the perpetual motion of Tannenbaum’s life stopped. He entered a packed classroom, rolled out his blue yoga mat and plopped down on the floor. Alongside 25 other barefoot medical students, Tannenbaum listened to a half-hour talk on “the relaxation response” and how the technique — a simple type of meditation that reduces the activity of the autonomic nervous system — can alleviate stress-related maladies, from migraines to depression. Then everyone took a deep breath and stretched into downward-facing dog. The yoga part of the medical school’s weekly yoga course had begun.

As everyone knows, medical students are a singularly stressed-out lot. “More than 20 percent end up with depression, more than half suffer from burnout, and in any given year, as many as 11 percent contemplate suicide,” Dr. Pauline Chen writes in a New York Times report on the “toxic” nature of the medical education process. So it makes sense to offer these overwhelmed kids de-stressors like yoga and meditation. But here, at the BU medical school’s first-ever yoga elective the aim is even broader: The faculty and instructors who launched the class hope these future doctors will be able to exploit their knowledge of yoga and its research-based benefits to someday help patients and to feel as comfortable prescribing yoga as they do Prozac.

 “I’m leaning toward primary care,” said Tannenbaum, the med student, speaking after class. “And it’s so important to acknowledge that there are many paths to health and wellness. It’s one thing to sort of know about yoga and other alternatives to pills and medications, but with the lecture component here, to really understand how it works and be able to talk about it with patients, I think that will be be very helpful.”

So in these weekly, hour-and-forty-five minute classes, lead instructor Heather Mason — who designed the course — and members of the BU faculty introduce students to the research behind various elements of yoga. The focus is mainly neuroscience, but there’s also psychology, mind-body medicine, anatomy, and beyond. The class syllabus includes clinical studies on how the nervous system benefits through an elongated exhale, the mechanics of neuroplasticity, increasing heart-rate variability and alleviating lower back pain through postures.

“The unique thing about this class is that the students are getting this extra neuroscience component, so it’s more than just experiential,” says Dr. Rob Saper,  the Director of Integrative Medicine at BU School of Medicine, who envisioned the course with Mason after the two met at a yoga research conference in India last year. Saper adds: “In 1988 At Harvard Medical School [where he was a student] a yoga class that included lectures on neuroscience would have been untenable, a total nonstarter.”

In fact, Saper, as a burnt-out medical student, took a year off to study at Kripalu, the yoga retreat in western, Mass. which, he says, inspired him to “try to change medical education and medical care in a way that’s more wholistic” and to make self-care a priority. “To the degree a medical student or health care professional can promote their own wellness — whether it’s yoga, running, whatever — that person will be better able to provide outstanding health care and avoid burnout, which has been shown to negatively impact medical care.”

It’s worth noting that under the fluorescent lights here at the BU yoga class there are no fashionable Lululemon outfits nor orders to “push to your edge” with complex, increasingly  controversial, poses.

Indeed, in Tuesday’s class Mason, complained that she had no blocks to use for props; when there was a shortage of mats, some students were clearly unsettled by the prospect of practicing on the maroon-colored carpet badly in need of a shampoo. “Who is familiar with the relaxation response?” asked Mason, who is also finishing up a master’s degree in neuroscience, at the start of her lecture. One young woman raises her hand. The others shook their heads. “Well, if you want to use this in your clinical practice, you can teach someone in an hour and it can have a huge impact,” Mason said.

Student wellness and self-care programs aren’t new. Increasingly, they’re sprouting up at medical schools across the country, says Dr. Benjamin Kligler,  Vice Chair and Research Director of Beth Israel Medical Center’s Department of Integrative Medicine in New York. But the shift has truly started to take hold in recent years: Kligler cites the rapid growth of the Consortium of Academic Health Centers for Integrative Medicine (he chairs the group) which started with eight medical school in the late 1990s and now has over 50.

“Many of these schools incorporate into their curriculum an experiential approach, in which students actually participate in some type of “alternative” therapy — yoga, meditation, acupuncture for example — and then also learn about the evidence for and against effectiveness for these therapies as well as the clinical situations in which they tend to be used,” Kligler says. But naysayers remain. “There are still conservative pockets out there,” Kligler says. “People who feel there isn’t enough evidence yet for us to incorporate some of these alternative practices into the medical school curriculum. But one counter argument is, if patients are doing it, it’s something doctors should know about.” Indeed, with an estimated 20 million Americans doing yoga, it makes sense for doctors to at least have some understanding of what all the buzz is about.

Dr. Chris Streeter, an Associate Professor of Psychiatry and Neurology at BU School of Medicine practices yoga and conducts research on its effects. She recently gave a Power Point presentation to the BU yoga students on how yoga impacts levels of Gamma-Aminobutyric Acid (GABA), a key neurotransmitter in the brain.

Streeter’s latest research, published in The Journal of Alternative and Complementary Medicine in 2010, and done in collaboration with doctors at McLean Hospital in Belmont, Mass. compared two groups of exercisers: people doing yoga and people walking. The bottom line findings: After 12-weeks, the folks in the yoga group showed greater improvements in their mood and anxiety levels compared to the walkers, and there was a positive correlation between increased GABA levels, measured through brain imaging, and improved mood.

At the end of Tuesday’s class — a series of sun salutations, warriors and pigeons — Mason turned out all the lights and led students through a short meditation. She had them relax various body parts and then repeat a simple, calming word with each inhale and exhale for about 10 minutes.

As Carolyn Smith-Lin, another first year medical student, packed up to leave, she explained the main reason she started attending the class: “It’s good for my own mental health.” But now, she says: “I can see how it could be part of an evidence-based practice.” She’s even started prescribing it, albeit informally: “I’m encouraging my mother to do yoga or tai chi,” she says, “for the health benefits.”

Click here to read the Terry Gross interview with William Board, author of The Science of Yoga. Or click below to download the Mp3 file. Air date Feb 7, 2012.

Thank you all for coming to the birthday party and participating in the free classes.  Thirty five people participated in the free yoga classes and cupcakes.  It was a lot of fun all day long.  We look forward to our next party which will be the 20th anniversary of Charlotte's first Yoga Center in 2013! 

_ Jan 11 2012  “How Yoga Can Wreck Your Body” in the Jan. 8 issue of the New York Times Sunday Magazine contained errors and a negative slant. In consultation with Senior teachers, IYNAUS sent this letter to the Times; we hope it will be published to correct some of the errors. IYNAUS takes seriously its mission of disseminating the teaching of Sri B. K. S. Iyengar and of promoting Iyengar Yoga teachers in the U.S. and around the world.

Let us know what you think. Post your comments below and write your own letter to letters@nytimes.com

8 January 2012

To the New York Times Editor: If yoga hurts, it is not yoga. A student’s overreaching ego, a teacher’s ignorance –many causes may lead to injury while doing yoga, but yoga itself cannot be blamed. Nor can B. K. S. Iyengar, who more than any figure in modern yoga has made yoga safe, accessible and transformative for all.

Many teachers and students of Iyengar Yoga were disturbed by the negative tone and outright errors in “How Yoga Can Wreck Your Body” by William J. Broad. Just one example: Broad calls Roger Cole a “reformer” who advocates reducing neck bending in Shoulder Stand by lifting the shoulders on a stack of blankets. But this teaching was devised by Mr. Iyengar – Cole is simply one of many of Mr. Iyengar’s teachers who work this way. Similarly Broad writes that Mr. Iyengar does not address yoga injuries in his seminal book Light on Yoga; any reading will reveal countless instructions on how to perform poses correctly, without harm.

We urge readers to try an Iyengar Yoga class themselves. Iyengar Yoga teachers are held to the most rigorous standards. Only after years of practice and study, and close examination by senior teachers, are they certified. A Certified Iyengar Yoga teacher is a student’s guarantee of a yoga experience which is safe, progressive and personalized to their condition.

During his more than 70 years of practice and teaching, B. K. S. Iyengar has pioneered modern yoga and modern yoga therapeutics. One of his guiding principles – that yoga is for everyone – led him to develop modifications for the yoga asanas (postures) using props which allow them to be performed by practitioners of every age, fitness and skill level.

Iyengar teachers are trained to work even with students with serious limitations and injuries, to recognize when students are ready for certain asanas, and not to ask them to go beyond their readiness. Going to one’s maximum also means not going beyond one’s limits; teachers must help students understand this.

Before undertaking the practice of asana, those who pursue the eight-limbed path of yoga must first practice the guidelines of yama and niyama; first among these is ahimsa – non-violence. For a teacher, this means “do no harm.”

Sincerely,

Christopher Beach, President
The Iyengar Yoga National Association of the United States (IYNAUS) 

21 Harvey Ct., Irvine CA 92617
949-379-4969
Beach59@hotmail.com

We had a great time in Yogaville. We plan to go again in early summer 2012. Stay tuned for updates so you can attend!

_This is a wonderful video about the medical classes in Pune.

New Delhi, India, 20 November 2010 - His Holiness the Dalai Lama today engaged in a conversation with renowned Indian  master Dr. Yogacharya BKS Iyengar on mind training and compassion in a discussion titled Yogic and Buddhist Techniques of Mind Training and Cultivating Compassion at the Convention Center of India Habitat Center in New Delhi.

His Holiness the Dalai Lama with BKS Iyengar and discussion moderator Rajiv Mehrotra at the Indian Habit Center in New Delhi, India, on November 20th, 2010. Photo/Tenzin Choejor/OHHDL His Holiness said happiness is generally understood as deep satisfaction; however, it is important to make a distinction between satisfaction achieved through sensorial level and mental level. The mental level of happiness, he said, can be achieved through spontaneous willingness from within as well as mind training leading to ultimate compassion. For a Buddhist practitioner, His Holiness said the ultimate goal is achieving Buddhahood by cultivating a compassionate mind and the by-product of thus practice is the ability is to achieve a calm and positive mind in one’s day-to-day life.
Dr. Iyengar known for deciphering the code of Patanjali Yoga Sutra in a scientific way and who has practiced Yoga for the last 60 years explained the seven stages in achieving happiness through yoga. He said the moment the intellect of the heart and mind meets through complete understanding of body and mind cleansing, that is when the consciousness of the egoistic self or the “I” is nullified and a practitioner experiences boundless uncolored joy. The aim of yoga, said the sprightly 93-yr-old is to achieve non-colorisation of happiness where remnants of the self is eliminated. He said a yoga practitioner treats negative emotions such as anger as separate entities and thereby brings the mind under control.

His Holiness referred to the various stages of mind as are described in Buddhist texts saying daily meditation coupled with investigation on shunyata or emptiness helps a Buddhist practitioner in achieving happiness. He said the Yoga Mandala practice in Tibetan Buddhism involves the understanding of the concept of emptiness or shunyata. Unless a practitioner has a deep understanding of shunyata, it perpetuates grasping of false realities or perceptions.

The Indian Habitat Center in New Delhi, India, venue for the conversation with His Holiness the Dalai Lama and BKS Iyengar on November 20th, 2010. Photo/Tenzin Choejor/OHHDL Asked by moderator Mr. Rajiv Mehrotra, secretary/trustee of the New Delhi-based Foundation for Universal Responsibility (FUR) if yoga aims at loosening such grasping to avoid maya or false realities, Dr. Iyengar said yoga considers ignorance or mental deficiencies as the cause of all sufferings or dukha in the world. He said living moment to moment without getting caught up in the wheel of past or memories is the path to future. In Patanjali Yoga, he explained, shunyata is known as manolaya or dissolution of the state of mind.

Speaking on the mind and body connection, His Holiness said like yoga practice that stresses on the connection between emotions and physical postures to achieve a state of equilibrium of equanimity, Tibetan Buddhist practice also stresses on the importance of mind and body connection whereby a practitioner when meditating has to focus on the correct body posture such as keeping the spine straight in order to allow the correct flow of energy to provide relaxation during meditation. He then referred to the Vajrayana school of Tibetan Buddhism where connection between right body posture and state of mind are described in detail such as dream state or deep sleep state.

Dr. Iyengar said there are some similarities or closeness between Indian yogic tradition and Tibetan Buddhist approach and suggested both traditions should work together to find a common avenue to benefit the humanity. 
The discussion was attended by Indian and western scientists among them physicists and neuroscientists, scholars, spiritual practitioners and the general public.

Click here to see the Martha Stewart's show featuring Iyengar Yoga. Original air date July 16, 2010.

The following article was originally published at www.mesotheliomasymptoms.com/yoga

_The practice of yoga combines poses, breathing techniques, meditation, and maintains its own distinct philosophy. Yoga is intended to establish a balance of the mind, body, and spirit, resulting in relaxation. Yoga’s origins stem from ancient Indian philosophy, with the earliest written descriptions of the practice appearing in Sanskrit. Yoga is derived from the word “yuj,” meaning union, and it is believed that it could have been put into practice as long as 5,000 years ago. Modern science has endorsed its use in assisting in symptomatic relief of cancer and other chronic diseases. It is a practice endorsed by the National Center for Complementary and Alternative Medicine. Overall, yoga can increase relaxation and physical fitness, with some cancer treatment centers providing yoga classes in addition to standard medical treatments. Due to the benefits of relaxation and physical improvement, yoga may be considered a complementary treatment. Currently, more than 100 different types of yoga are practiced in the United States alone. Most of these practices are based on hatha yoga. Hatha classes usually include gentle stretches, meditation, and restorative poses. Sometimes a mantra, a meaningful word or phrase, is used to focus the mind.

Yoga could assist patients diagnosed with cancers such as mesotheliomaas a complementary treatment. Benefits of yoga stem from the practice’s concentration on ethical standards, dietary choices, physical movements, and meditation. Implementing these practices into daily life could lead to an overall improved sense of well being in those suffering from chronic conditions, cancers, and illnesses. Yoga can be practiced at home or with teachers. Books and videos are available, and regimens can be found on television and the internet. In addition to relaxing the nervous system and improving mood, research indicates that it can lower blood pressure and heart rate, increase metabolism, affect brain waves, and strengthen the immune system. The National Institute of Health links the practice of yoga to symptom relief in: cancer, asthma, diabetes, drug addiction, high blood pressure, heart disease, and migraine headaches. When used with diet and exercise, it may reduce cholesterol levels. Randomized clinical trialsalso show that yoga can help to reduce arthritis pain and to relieve depression and anxiety.

Recent studies point to yoga as a healthy addition to medical treatments in some cancer survivors. Through achieving the balance found in yoga, a better quality of life can be established. Those diagnosed with mesotheliomamay find this especially supportive as they are generally diagnosed in the later stages of cancer. This is due to the long latency periods associated with mesothelioma. Often, the cancer lays dormant, not exhibiting first symptoms until decades after it has formed. Late stage diagnosis is sometimes associated more with palliativecare rather than curative. Complementary therapies, such as yoga, used in conjunction with standard medical treatments, could aid in patient well-being.

References:
American Cancer Society
National Center for Complementary and Alternative Medicine