My Foster Hair, the Sequel

Five years ago, I cut my hair off and donated it. I wrote a post called My Foster Hair, that described my feelings of attachment and nurturing before, during and after the process.

This week, I did the same thing. It took me a while to decide to do this again. Originally, I wanted my hair to be longer than it was before I cut it, but the opportunity to do this came up in such an obvious way that I couldn't ignore it.

Our attachment to hair is a funny thing. I spent years receiving compliments for my long, healthy straight hair, only to mumble how much I wished it was longer, or shorter, or curlier, or thicker, or lighter or something-er. The grass is always greener, and someone else's hair always better, in some way. About a year ago, I came to the conclusion that I really didn't appreciate the hair on my head, and perhaps it was time to grow it out and give it to someone who would.

Before

After

I remember fielding a call from a potential student when beginning my Tuesday yoga class for cancer survivorship; she wanted to know if the class was all women, and if they had hair. At the time, I thought it was an unusual question, and that she would be better off asking me more about the class itself, but it turns out that this is not an unusual question.

Hair makes a strong statement. We even have the expression, "having a bad hair day," which acknowledges how much we are influenced by our follicles.

Some women I know chose to shave their heads as an empowering act as soon as chemo began to take its toll. They tell me it helps when it's on their own terms. It's bold and emotional to let go of all the hair on our heads, even though, technically, the visible hair shaft is considered "dead".

This time around, I donated my hair to an organization called Wigs for Kids. They operate via donations and are committed to offering hairpieces to children free of charge. If you are interested, you need to follow their guidelines and can mail in your hair at any time.

Letting go of your hair certainly leads to a lightening of your load, especially if you consider how much it may help others!

Namaste.

Announcements

• Next yoga teacher training event is Saturday, August 3: Effective Yoga Teaching Strategies After Cancer Treatment; see events page for more details.
• Beginning September 4, Lorien will be teaching 2 classes for the Stanford Cancer Supportive Care Program! Wednesday's classes will be gentle movement and relaxation, and Thursday's classes will be empowering alignment, balance and strength building; both classes will meet 1:30-2:45pm at Samyama Yoga Center in Palo Alto. The Stanford CSCP are generously offered to patients, survivors and caregivers free of charge, thanks to generous donations.

Reflections on Teaching Yoga in a Chronic Pain Program

Artwork from:
http://criticalscience.com/chronic-pain-
psychosocial-interventions.html

This population is really limited... Some of them are addicted to prescription narcotics... Some of them have mental health challenges... They could be in a pain flare.

Do you think you can help?

The questions made me pause. Could I help? As I had been taught to do in yoga, I took a deep breath and checked in. I knew I wanted to help, but did I feel like I could be of service? The answer that came back was yes, so I laid out ideas and plans, and my interviewers glanced at each other and smiled at my enthusiasm. I was in a room filled with medical professionals who were redesigning their pain management program and wanted yoga, among other healing modalities, on the menu. I mentioned my own experiences with chronic pain, dating back to when I was a pre-teen, and how yoga had helped me. I was so full of idealism in that interview, and I was totally underprepared for what I was about to undertake. I’m grateful for that idealism, because I might have been scared off if not for it.

On my first day, there were 8-10 people in the room, and their pain was as diverse as them. Some could sit in chairs, and some could only sit for a few minutes; some preferred being on the ground, and some turned green at the thought of getting to the floor and back up again. We had chairs, a few padded mats, a few bolsters and some foam blocks. I had planned a yin yoga sequence, but realized quickly that this was not going to work. I started to worry,

what could I ask these people to do that wouldn’t hurt them?

I went through my yogic toolkit, and realized that all of these people could help themselves through pranayama. Good thing yoga isn’t solely about the body!

What they each had in common was that their nervous systems were stuck in a fight-or-flight mode because of their pain. As Dr. Palermo wrote in her post, pain triggers the stress response, and continual pain leaves the switch to the stress response fixed in the “on” position. My tool for the nervous system is always the breath. They might not all be able to get to the floor, or stand, or sit up, but they could all breathe. So, we started there.

Slowly, I eked out a sequence that supported most, if not all, of them. Together we found options for anyone who experienced pain or struggled to breathe during any part of the practice. I used Kelly McGonical’s book, Yoga for Chronic Pain Relief, as a guide, and I asked them to befriend their bodies and establish a relationship that wasn’t based on fear and pain. We joke about being less of a dictator and more of a coach of our bodies. Over and over, we emphasized – together – that the shape of the pose wasn’t the priority; the attitude, breathing, and observing were what really mattered.

When they weren’t doing yoga with me, they were practicing qi gong, walking or chair dancing, learning about their brains, their emotions, their diet and their habits. The team consists of psychologists, physicians, a pharmacist, a nurse, a Traditional Chinese Medical practitioner, a physical therapist, a Feldenkrais teacher and myself… a very well-rounded and holistic combination of providers.

Over the last year I’ve notices some patterns arise in the hundreds of patients that have come through the program. In the first few weeks, the patients are very fixated on their bodies and their sensations. The questions they ask me are indicative of this perspective: Am I doing this right? Is there a yoga pose for this body part / pain situation?

But at some point, the patients realize that 

it’s not about their body or their pain, but their relationship to both. 

For most people, that realization happens during the third week of the program, but some figure it out right away, while others report back months later that they now understand.

Pain and stress are on one side of a coin, with relaxation and service on the other, and emotions running along the edge of it. The tools that we offer them are mindfulness, compassion, presence, perspective and community; we use these tools to flip that coin from one side to the other. Some of the tools are packaged as yoga, and some are not, but the foundation is all the same.

Announcements:

• Sunday, June 23rd: Lorien will be offering restorative yoga demonstrations as part of Kaiser's Seeds of Hope Cancer Survivor Day. See Events page for info.

Lorien's Healing Yoga for Wellness DVD is out! How to get your very own copy:

• Order from Amazon for $27.95, plus tax and shipping 
• Stop in to Breathe Los Gatos and get it today for $30, plus tax
• Buy it directly from Lorien for $27.19 (tax included, no shipping, you must pick it up in class)
• Coming soon to eBay, Kaiser Santa Clara, local yoga studios and many more...

Yoga and Chronic Pain

I teach yoga as part of a chronic pain management and rehabilitation program through Kaiser. I asked one of the psychologists to write me a post that explains how chronic pain occurs. Here is the post from our wonderful Dr. Cassie Palermo:

Artwork by George Camacho

"From the first time that I practiced yoga, I was drawn to it. I appreciated the centering, calming, meditative aspect of it. It provides me with a path back to equilibrium when I lose my way. At times I feel compelled to prove my worth – both to myself and my team, as I judge myself against the more seasoned professionals with whom I work. I also lose balance when I strive for "more" and overdo it in my daily routine, and this imbalance takes me out of the moment. With its emphasis of "keeping my yoga on my own mat," focusing on my breath, and being aware of my body movement, posture, and alignment, I practice what I need to restore my sense of balance.

A year or two after I began incorporating yoga into my own routine, yoga became part of my work, as well. I am a psychologist in a chronic pain program and the program now includes a yoga component. It turns out that yoga, among other smooth and gentle movement practices, is a healing approach for the management of chronic pain.

I say "it turns out," not because this discovery is coincidental, but because I have not always known as much about chronic pain and its management as I do now. What I have learned has come from observing the patients in the pain program and doing my own research.

Chronic pain is essentially a disorder of the central nervous system, 

though it becomes quite complex when looking at all that is involved in the way the brain processes pain. However, we must first understand that pain actually serves a purpose.

We are hardwired to interpret signals – sent by nerve endings – as pain, in order to avoid physical damage and/or death. For example, if we put our hand on a burner we do not initially know is hot, we are able to respond by pulling our hand away before we consciously become aware that the burner will indeed singe our skin. Likewise, when something startles us, our system shows a response before we make sense of what has caused the alarm. Once we realize that a friend has jokingly jumped out to scare us, we then experience our rapid heart rate, our tense muscles, and the surge of adrenaline that is already starting to drain. When we feel this, we are experiencing the sensations related to the "fight or flight" response.

In this automatic response, the central nervous system receives input that that there is danger and the potential for harm, and takes action to either gear up and fight to protect, or take flight to distance or avoid. Our brain, part of the central nervous system, is wired so we do not have to wait to consciously weigh our options of what to do. Before it's at the conscious level, our brain sends signals to increase heart rate, make our breath more shallow and rapid, decrease blood flow to the extremities so more is available for the vital organs, speed up our thoughts within the primal part of the brain focused on survival, increase adrenaline to delay the sense of pain and provide a surge of energy, and tense our muscles so as to gear up to meet the situation.

This happens with acute pain situations, such as putting your hand on a burner. Unfortunately, this also occurs with chronic issues, such as spinal stenosis, arthritis, degenerative disc disease, and multiple sclerosis

Since the trigger for danger is always present (chronic in nature, i.e. cannot be cured), the signals are continually being sent, translated as pain, and the central nervous system is responding with the fight or flight response. Right idea but wrong situation since, with the above-named issues, we cannot figuratively remove our hand from the burner nor is there necessarily further damage being done.

Chronic pain is the constant signaling of danger, resulting in over activity of the central nervous system and the fight or flight response.

So, what can we do to deal with this automatic response? We actually have more control over our brains than we originally thought, and we can initiate the opposite (parasympathetic) response in our nervous system – and initiate it earlier and earlier, to catch and reverse these survival responses in order to return our system to a calmer, more sustainable state of operation. Practices like yoga, meditation, QiGong, and changing our thinking patterns do just that.

Seeing this transformation among the patients enrolled in the pain management program is profoundly rewarding. Having yoga be a part of that transformation reminds me of my own practice. I'm included in a larger system of change, and that encourages me that my part of the whole is enough; it brings me peace and balance, and makes my job worth doing."

Announcements:

• Sunday, June 23rd: Lorien will be offering restorative yoga demonstrations as part of Kaiser's Seeds of Hope Cancer Survivor Day. See Events page for info.
• Lorien's Healing Yoga for Wellness DVD is out! Go to Amazon to order yours today!

Planning for the End

"She requested only certain people to be in the room with her when she died, but a vast network of friends surround the outside of her home and sang 'Will the Circle Be Unbroken.'"

Photo credit: Cori Maiden

When my friend and colleague described her sister-in-law's passing after a long battle with cancer, I was moved to tears, but it wasn't because I knew her. It was because she passed in such a peaceful and supportive way.

"It was the way she wanted it. It was her plan for the end," my friend told me.

This statement got me thinking about plans.

A few years back, a beloved yoga student of mine told me of his cancer diagnosis and that he had only a few months left. During those few months, he experienced fatigue, nausea and pain. His wife told me: "Although he was ready and wanted to die sooner rather than later, leaving his body turned out to be very hard for him and very hard for me to watch by his side, so helpless to assist.

Mid-wifing [death] is not easy."

30 years ago, I was a part of several end of life plans. My mother worked in a convalescent home and I spent many, many hours there between the ages of 8-12. I was never in the room of anyone's passing, but I held plenty of hands, sang songs ("Indian Love Call" by Nelson Eddy and Jeanette McDonald comes to mind), brushed hair and heard fascinating stories.

20 years ago, my grandmother passed away after a long battle with cancer. Even though she had an end plan, it didn't seem to go very well... but that could have been my perspective: my rock, my anchor and my lighthouse in the storm world was leaving me, and that was all I could think about. There was no holding hands, or singing songs or brushing hair. There were only drugs and arguments and wills. My grandmother chose to leave this life when everyone left the room.

At the time, I was in my junior year of college, earning my mechanical engineering degree from Santa Clara University, just down the street from her house. We had always been close, but after her treatment we grew even closer. When she passed I was very bitter about the way her life ended; I thought, "there has to be a better way than this," and I held on to that judgement to support me during my grief.

2 decades later, I am still searching for that better way. I don't know what it will look like, but I do know that being surrounded by love, holding hands and singing sounds like a great plan.

Breathing, releasing anger, stretching into love and friendliness - as yoga has taught me - is my first step in that plan.

Announcements:

• Next Kaiser Restorative Yoga for Cancer Survivorship 6-week series begins June 12 (ends July 24, no class July 3). Call 408-366-4284 to register.
• Sunday, June 23rd: Lorien will be offering restorative yoga demonstrations as part of Kaiser's Seeds of Hope Cancer Survivor Day. See Events page for info.
• Stay tuned: Lorien's Healing Yoga for Wellness DVD is coming soon!