Cora Wen on Training & Practice in Yoga Therapeutics

Last week, the Yoga Sanctuary hosted a series of workshops with internationally acclaimed yoga therapy expert, Cora Wen.  We caught up with Cora after one of those workshops, Yoga as Therapeutic Healing, and asked her to tell us why yoga is so effective when it comes to working with physical and mental conditions and why it’s a great way to stimulate healing and promote wellness. As it turns out, the key to its efficacy, Cora tells us, involves two things: yoga is doable, and, it’s doable.

The question of yoga’s “do-ability” as a therapeutic and restorative tool is reflective of how it fits into the dual worlds of traditional and medical healing. Its capacity to balance a holistic care model with its pathology-based counterpart is what makes yoga a keystone of developing integrative medical departments. While alternative and complementary treatments are receiving more attention in studies and patient care plans, there is still a great deal of criticism and even hostility to integrative medicine within the conventional medical world. When the newly elected Obama administration opened to discussion the role of science and the field of healthcare back in 2009, top American scientists, for instance, jumped at the chance to advocate for the defunding of the National Center for Complementary and Alternative Medicine, a division of the U.S. National Institutes of Health originally created in 1992. Concerned that the NIH was funding what he called “pseudoscience”, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, disparaged alternative medicine research for its lack of rigorous controls and studies. His colleague, Steven Novella, a neurologist at the Yale School of Medicine, further claimed that the NCCAM was being “used to lend an appearance of legitimacy to treatments that are not legitimate.”

Much of the problem when it comes to integrating complementary interventions with medical ones lies in the fact that it can often be difficult to determine their efficacy because their use is not easily measurable or quantifiable in clinical trial—or, at least, hasn't been tested yet. In a profession that values tangible results, the "illegitimacy" of non-systematically or subjectively tested alternatives means they are often perceived to be placebos, pseudoscience, or remnants of superstitious lore. So, in a society that seeks the cold, hard facts and proof, how does a practice like yoga fare?

According to Cora, yoga is making headway in the medical field largely because its benefits are measurable. Though yoga has long been used therapeutically in eastern practice and in ayurveda therapy, systematic studies are now being completed in the west through clinical trials that seek to determine yoga’s effect upon a variety of conditions and disorders. Scientists, for example, are beginning to more deeply inquire about its implications for healing when it comes to addiction or Post Traumatic Stress Disorder, or in relieving joint pain and arthritis.  Yoga's effects upon the nervous and endocrine systems are indeed being recognized as evidence increasingly indicates that a restorative yoga practice produces tangible results under rigorous investigation that can be interpreted and assessed.

When applied as a therapy, then, yoga has been found to be influential in healing from or improving the quality of life when living with illness, while also encouraging changes to lifestyle that can reduce levels of stress and imbalance and promote vitality. During her workshop, Cora treated us to a demonstration involving a seemingly simple back-bend, but one which offered much in the way of therapeutic benefits. The pose, in fact, utilizes the yogic principles of mindful movement with conscious, restorative posture to foster not only good physical condition, but mental and emotional well-being, too. Physiologically, the pose releases the neck and opens the rib cage, while allowing the practitioner to take advantage of the benefits of an inversion—placing the heart above the head to encourage proper circulation of lymphatic and other bodily fluids.

But what’s more, by opening the throat and inverting the body, the supported back-bend helps release emotional tension while stimulating new perspectives on the world by literally turning it upside down. The pose, Cora demonstrated, can help relieve anxiety by providing supported opportunities to look at worries with a new perspective. On the other hand, Cora advised that the same pose might not be an appropriate option for someone with depression—the reason being that a back-bend can be too stimulating emotionally and therefore potentially taxing for the body and mind of someone within a depressed state. The key to rebalancing the body-mind is not necessarily achieved by complicating one extreme with another, and what may be suitable for healing in one individual, Cora warns, might be ineffectual, or worse, dangerous for another. .

And this is the crux of the other side of the yoga therapy coin: it’s doable not only because it’s measurable, but because it’s patient-centred. Yoga, Cora tells us, is so doable because it provides feasible and achievable options for movement for people who may have limitations or disabilities.  At the same time, yoga has the capacity to be individuated according to the variables that make up each person’s mind and body at a certain point in time. In conjunction with medical and physical evaluations, yoga therapists can determine the goals of each client and develop personalized techniques suitable for that individual.  When healing therapies take into consideration not only the differences in bodies, but the mental, psycho-spiritual, and life circumstances of each person, it becomes “yoga in the present moment; connection!”

Perhaps most importantly, because yoga is doable and because it targets specific needs and conditions, it encourages individuals to reclaim personal responsibility for building overall health and wellness.  It’s an empowering therapy that provides opportunities for self-care and for participating in one’s one healing and health management.  And as a prescription for holistic wellness, yoga fosters an awareness of the multiple ways in which we can nourish and heal ourselves in body, mind, and spirit.

With a flexibility that accommodates individual abilities and conditions within the rigours of an academic research setting, therapeutic yoga is finding great support in medical institutions with new programs in place to provide patients with access to its principles and practice.  And for those of us who are reassured by results and studies, the proof of yoga’s benefits is in the funding of the pudding so to speak. To prepare for our meeting last week, Cora sent me a list of clinical trials currently recruiting or actively being completed this year, and I admit I was taken by surprise when I saw just how many were being done. There are studies being undertaken to determine yoga’s effects upon patients with physiological diseases from heart failure, HIV, breast cancer, and malignant brain tumours, to those with mental or mood disorders such as PTSD, depression, and psychosis.  From a medical perspective, yoga does indeed have measurable value when it comes to treating patients, and not only in encouraging calm and reducing anxiety when it comes to the overstimulation of the sympathetic nervous system, or that which is responsible for our “fight or flight” responses. Evidence also points to restorative yoga’s positive influence upon the parasympathetic nervous system—our system of long-term survival that promotes rest and regeneration over time by maintaining the supportive functions of the internal organs. 

It’s clear that yoga’s tradition of mind-body holistic healing is gaining recognition as an effective therapy in preventing and managing chronic conditions, especially as it continues to be welcomed as a complementary therapy in conventional health care. As I read through the findings of a pilot study done at University of California San Francisco in preparation for the “Practicing Restorative Yoga or Stretching for Metabolic Syndrome”, or the PRYSMS study in which Cora participates, I learn that researchers found that after fifteen 90-minute yoga sessions over a 10-week period, “there was a trend to reduced blood pressure, a significant increase in energy level, and trends to improvement in well-being and stress” among study participants. The best part of these findings, however, is recognizing that these are results that can benefit anyone with any level of fitness or health status. It’s not only the do-ability of yoga that makes it a practical and efficacious tool for health care, but it’s also the fact that its benefits can be extended regardless of body and individual circumstances. As it’s increasingly promoted as an accessible and feasible therapy, it seems that western medicine is finally catching on to what eastern practitioners have long known—yoga is a mind-body practice that can help foster whole health and healing across the medical spectrum and according to the individual.

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