Thinking About Pain and Health

published in the March 2011 issue of Yoga Therapy Today.

Many people are coming to Yoga because they have pain and want relief. What they don't always bargain for is that addressing pain through Yoga practice entails more than just stretching their bodies.

At the workshop on the Fundamentals of Therapeutic Yoga that I taught at Kripalu this past summer, I worked with a diverse group of nine participants from across the United States. They had spinal fusions, rheumatoid arthritis, Crohn's Disease, sciatica, and the usual aches and pains that come in the course of life.

Most of them had been to plenty of doctors, followed the course of recommended treatments, and were still left wanting. They were resorting to Yoga because they had reached the limitations of Western science. Yet, conventional notions of health are deeply ingrained and linked to an allopathic ideology that is difficult to escape, especially without a model or an alternative frame of reference.

All of the participants assumed that "therapeutic Yoga" meant they would tell me their symptoms and I would prescribe them poses. While therapeutic Yoga is helpful in easing pain and facilitating health, in my experience, poses do not work like pills.

A therapeutic orientation in Yoga practice does not necessarily mean viewing healing through a scientific lens. One participant challenged me by citing a research study she read that showed how doing twists aids digestion; she suggested that knowledge of anatomy and physiology is the key to making Yoga therapeutic.

I pointed out that Yoga practice has been helping people since long before there were any scientific studies on the subject. The poses have no inherent curative power of their own; they are vehicles for a source of healing that comes from within and is inherent to life.

The group was skeptical. They came for some empirical answers and I was not offering any. I explained that there are, essentially, four actions we engage with our bodies in Yoga practice: forward bending, back bending, side bending, and twisting. If your practice contains these actions and they are engaged appropriately then you will potentially receive all the benefits of practice, including better digestion. Whether we analyze it through a scientific lens or not, the outcome is the same.

The alluring suggestion that some special, more intricate variation of twist would somehow be more potent than a simpler, more enjoyable one or that a teacher with more extensive knowledge of anatomy and physiology would have the power to cure people with poses are examples of an entrenched mindset. If it were just a matter of assessing anatomical or physiological occurrences and applying a corresponding corrective manipulation then, surely, science-based medicine would have already established effective protocols.

We continued our practice and discussion over several days and began to identify ways in which breathing and moving exercises can be utilized to establish useful patterns of thought and behavior. The focus shifted from the technicalities of poses to the experience of practice and an awareness of how we feel. Emphasis was placed on a regulation of breath (ujjayi pranayama) and finding a measured amount of effort that could be supported and enjoyed. Individual modifications were employed where necessary.

I shared with the group that I was able to make my body strong and flexible, learn precise asana alignment and knowledge of anatomy and physiology, and still have lots of pain and be miserable in life all the same. More than anything else, the key to making my practice genuinely therapeutic hinged on a shift in my perspective.

In reconciling within myself the death of my mother and in cultivating a sense of life's inherent worth, my reason for practicing Yoga changed. I discovered that the how and why of my practice is what influences the effectiveness of the techniques.

Offering the details of my personal inquiry into Yoga emboldened the participants to do the same and, as our time together came to a close, tears were shed and new outlooks forged.

When I returned home from my time in Massachusetts, I discovered that my six-month-old daughter had begun exhibiting signs of teething. Witnessing her in such discomfort without any way to help her was, to say the least, difficult. It got me thinking about pain and how I utilize my practice to address it in my own body. Specifically, I was thinking about my right hip.

My early years of practice, filled with youthful over-exuberance and misguided instruction, have rendered me hypermobile and prone to inflammation. Sometimes it seems to originate at my sacroiliac joint; sometimes I think it may be due to worn connective tissue in my hip socket. When it flares up, the pain can extend all the way down my leg and into my foot and be quite debilitating.

I have considered talking to a doctor about this pain but never have. At the time of my last physical, it had not been bothering me much and the doctor seemed so impressed with me as an example of good health that I didn't bother to mention it.

I already have a good sense of what tests he would likely have run and am fairly confident they would have provided no definitive answers. MRIs cannot undo the prolonged mistreatment of my body in the name of achieving alignment and becoming self-realized; nor can they do anything to address the unrelenting demands of being the sole proprietor of a Yoga center and a newly anointed dad.

I can't help but think that were I to have enough time and resources to tend to myself in an ideal way, my hip would heal and the pain could be minimized if not done away with entirely. But unless a magical suitcase of money falls from the sky, there is no way to tell.

What I do know is that when I am fatigued and the pain is persistent, I begin to question whether my body can heal on its own and wonder if I need an outside intervention to "fix" me. The emotional impact of chronic pain will cause doubts in even the strongest of constitutions. What a terrible irony that one of the by-products of pain is a tearing down of the mentality so vital to healing.

My only recourse in these instances is to make an honest assessment of the circumstances surrounding my discomfort, take any seeable actions to ease the situation and, above all else, meet the difficulty with a nurturing sentiment. Too easily, pain makes an enemy of our bodies.

One of my teachers suggests that pain is healing. If we accept this premise then persistent pain might indicate that healing is taking place even under continued adverse conditions. By this logic, healing comes to fruition and pain diminishes when conditions are favorable. Thus, the sentiments expressed by Dr. Dean Ornish in his key address at SYR 2010 when he spoke of how small lifestyle changes make a huge impact on our health.

There is a commonly held misconception that health amounts to having no pain. Not true. Certainly, it is possible to be in a terrible situation, filled with pain, and still be dealing with the circumstances in a healthy way. My daughter is perfectly healthy and yet she still experiences pain. That a certain amount of pain is required for humans to grow teeth so we can eat and be nourished is evidence of how integral pain is to our existence.

Given the often fickle turn of events and undeniable realities of our lives, some amount of pain is unavoidable. Therefore, I have come to think of my health as the process by which I manage the pain that life inherently brings. The better I am able to manage it, the healthier I am. Bringing careful attention to an engagement of my breath and body as a means of easing physical discomfort and establishing constructive patterns of thought and behavior is immensely helpful in this regard.

More than simply alleviating symptoms with poses or any scientific explanation for how poses might address issues in our bodies, therapeutic Yoga involves having a reverence for the human body's innate intelligence and capacity to heal. Our ability to receive the therapeutic benefits of Yoga practice is contingent on this fundamental concept.