Yoga for Veterans : PTSD, Trauma, Amputations, and Moral Injury

Yoga for Veterans : PTSD, Trauma, Amputations, and Moral Injury

Yoga is a practice that incorporates multiple components, multiple techniques that include not only the physical posture but also physical exercise, breathing techniques, deep relaxation techniques and very importantly the contemplative side which is meditation practice, practice of mindlfulness. The yoga panel is discussing yoga practice and programs that can help veterans through post traumatic stress disorder, dealing with traumatic brain injuries, learning to live with amputated limbs, healing from moral injury and more. 

Panelists

Talk Recorded on Feb. 23, 2017, 5 p.m.   EST 606 10

Hear Talk Audio

Priya Menon Priya Menon

Priya Menon - Good evening and welcome to CureTalks.  This is Priya Menon joining you from India on CureTalks’ 119th episode.  CureTalks is a social initiative with the mission to heal the world through information, discussion, and sharing of knowledge.  We organize online talks by inviting guests from around the world to discuss a wide range of health and wellness issues.  Our diverse group of panelists come from all walks of life.  They are doctors, nutritionists, professors, researchers, patients, parents, caregivers, and health professionals; and today, we are discussing yoga for veterans.  Our episodes on yoga are very popular and have seen us discuss mindfulness, Yoga Nidra or iREST, meditation, and healing through yoga with eminent yoga scientists and teachers like Richard Miller of iREST, Dr. Sat Bir Singh Khalsa from Harvard, among others.  Over the months, we have learned many aspects of yoga which is the practice that incorporates multiple components, multiple techniques that include not only the physical posture but also physical exercise, breathing techniques, deep relaxation techniques, and very importantly, the contemplative side which is meditation practice and practice of mindfulness.

Priya Menon – Today, we have with us a very interesting panel of yoga experts; and we are discussing yoga practice and programs that can help veterans through posttraumatic stress disorder, dealing with traumatic brain injuries, learning to live with amputated limbs, healing from moral injury and more.  First of all, I would like to introduce our panel members.  We are thrilled to have Dr. Carol Horton on CureTalks again.  Carol is Vice-President of the Yoga Service Council.  She is an Author and an Editor of the Yoga and Veterans book.  A certified Forrest Yoga teacher, Carol has taught yoga in Cook County Jail, a homeless shelter, a residential foster care facility, community health centers, and several studios in Chicago.  She was the co-founder of Chicago’s Socially Engaged Yoga Network.  Carol is also my co-host for the show today.  Welcome to CureTalks, Carol.

Dr. Carol Horton - Thank you!  I am so honored to be here.

Priya Menon – Joining Carol on the panel is Pamela Stokes Eggleston, also from Yoga Service Council, and is contributing editor to the Yoga with Veterans book.  She is Founder and CEO of Yoga2Sleep, an organization that uses yoga and wellness services to promote better sleep for the best life and a co-founder of Blue Star Families, a national non-profit that bridges the gap between civilian and military veteran communities and leaders.  With Pamela, we have Judy Weaver who is Director of Yoga South Teacher Training Program in Boca Raton, Florida, and is the Primary Founder and Director of Education for Connected Warriors.  Judy is well recognized for her expertise and knowledge of yoga and other mind and body disciplines.  Judy conducts trauma-conscious yoga trainings, developing curriculum based on the latest scientific and psychological research available for yoga as a healing modality for traumatic stress.  With Judy, we have Annie Okerlin who is Founder of Yogani Studios and Exalted Warrior Foundation which offers adaptive yoga to traumatically wounded veterans and military and veterans hospital.  Exalted Warrior Foundation supports nationwide programs assisting re-integration of the wounded back into civilian life.  Welcome to CureTalks, everyone.  Thank you so very much for being here today.

Priya Menon - What we are going to do is we will start with the discussion with Carol, and then Carol will lead with the panel discussion.  We would like to inform all our listeners that we will be addressing questions sent in via email towards the end of the discussion.  If you want to ask a question, you can press 1 on your keypads and we will bring you on air to ask them live.  You can also email your question to priya@trialx.com or post them on CureTalks’ website.  With that, we can begin with the discussion.  First of all, I would like to congratulate every one of you on the new book, Yoga for Veterans.  Carol, I believe it was a very, very special and unique experience of having compiled this with so much…, such a lot of information, so maybe you could just talk a little bit about the topic and how this book came about so that listeners, you know, can enjoy how this book was actually published and its going to give them a lot of information right now.  So…

Dr. Carol Horton - Yes, of course.  Thank you so much.  So, this book, Best Practices for Yoga with Veterans, is part of a series of Best Practices Books that is being jointly sponsored by the Yoga Service Council and the Omega Institute.  Each of these books is very unique, in that it comes out of a big collaborative process.  So, if you look on the book’s cover, you will see that while I am listed as the editor, we also have five contributing editors listed, which…, one of whom is Pamela, on the program, and another 20 contributors listed who include among others Judy and Annie, also on the program.  In addition to that, if you look on the inside cover, you’ll see that we have another four expert peer reviewers who looked at the entire manuscript before it was published.  So, that’s to say that this book is the collaborative effort of 30 people working together over a year and a half period, during which we came together, everyone but the peer reviewers came together, for a full week at the Omega Institute in New York.  There, we got to know each other as people and as professionals working in all different ways to support the mission of bringing yoga and mindfulness practices to veterans as well as, in some cases, active duty military personnel.

Dr. Carol Horton - Among the contributors, we had not only yoga teachers but doctors, social workers, psychologists, trauma therapists, and many others, so a wide range of expertise including that of, I believe, about eight military veterans and some additional active service military personnel themselves.  So, a very diverse group that was led through an intensive process of what I call collective brain storming where people met in small groups on particular topics and hashed out what could they agree are the best practices, not necessarily their particular way of doing something, but something that everyone could come to terms with as this is the best way to say, connect with the VA to offer yoga program or adapt trauma-informed yoga principle to work with this particular population.  So, it was a very involved process producing pages and pages and pages of detailed notes which are contributing editors, then further refined.  Eventually, those all came to me.  I crafted them into the full book manuscript, which was then reviewed by everyone who came to what we call the symposium, a small gathering, as well as eventually by the peer reviewers.  So, really, this book boils down the wisdom and experience of 30 highly accomplished professionals who have dedicated themselves to offering military veterans in the way that it stays effective and in all ways best to work with this particular population.

Priya Menon - Oh, that’s such an amazing experience.  So, if I were to buy book right now, I mean read it, what…, can you please tell the listeners, what information does it contain?  I mean are you going to list programs that would help veterans, kind of resources they can access?

Dr. Carol Horton - Okay.  So… Sure.  Since we had people from many different organizations represented and of course there are other organizations out there that might offer yoga to veterans or train people to teach yoga with veterans, we did not deliberately endorse particular organizations, but what we did do was compile information with four key audiences in mind.  So, one audience would be veterans and military personnel.  This book is designed to provide them with this really in-depth understanding of yoga that they would need to really understand on the deep level, how and why it could be beneficial as well as the more general principles by which they could find an appropriate teacher or program to connect with.  Another audience says the book is intended for is yoga teachers.  So, we wanted to provide research for yoga teachers who want to work with veterans with a really in-depth discussion of what they might need to know that’s different from what they would learn in a general yoga teacher training.  So, the book covers issues such as learning military culture and special terminology, how to adapt trauma-informed yoga principles to the military context, specialized issues that one might encounter like working with service dogs or working in the VA and much more.

Dr. Carol Horton - Another audience we addressed the book to is yoga service organizations, that are usually non-profit, not always, organizations that are really specialized in either training teachers to work with this population or offering direct services themselves and offering information about how they might get a program up and running, how to think about staffing issues, how to connect with the VA and more and then finally, we also crafted the book, so it would be interesting to VA administrators and others who are not yoga specialists or teachers but who might be interested in setting up a program or classes for yoga for veterans, wherever they are working, whether its a community center or veterans organization, the VA, so they need to know how to understand yoga credentials, what to looks for if they want to contract with the yoga teacher or yoga service organization and really why this makes sense, why is this something they should invest in, what can they really expect this practice to offer veterans.  So, all of that is contained in the book and more.  Its quite extensive, yeah.

Priya Menon – Very interesting!  Its really interesting.  So, we are definitely not talking about, I believe, any specific age group here, are we?

Dr. Carol Horton – No.  That’s correct.  In fact, one of our chapters is dedicated to yoga for families of veterans.  So, given that, the book could really be relevant to anyone of any age.

Priya Menon - Okay.  Okay.  Just so that we can start off with the yoga for healing talk which you are going to get the panelists to talk on…, maybe generally you can just let our audience know, what are some of the conditions that yoga can help the veterans with?

Dr. Carol Horton - Sure.  So, some of the things discussed in the book are one, just overall quality of life but also posttraumatic stress, military sexual trauma, traumatic brain injuries, amputations, healing with certain commonly used medications and the side effects thereof, and also issues of adapting to civilian life post deployment.

Priya Menon – Thank you, Carol.  That was a nice introduction to the book and how it came about, although we can dive in for the full content and what the listeners can take away from here, from this talk today.  I will hand it over to you now to lead the panelists.

Dr. Carol Horton - Great!  Thank you.  So, let’s start out with Judy Weaver of Connected Warriors.  Judy, Connected Warriors offers yoga both to active duty military members and to veterans.  Could you lead us through a short discussion of whether you think that yoga offers the same benefits to both of these groups or are there any important differences to keep in mind?

Judy Weaver - Hi!  Thank you for having me on this conversation.  So, yes, I think that there are similarities and there are few differences.  What we have seen is our military, they are our active duty population.  They need to be able to shift from their sympathetic nervous system or where they stay in their hypervigilance while they are either deployed or between their missions.  So, when they are back, either between the deployments or between missions, they need to switch that off and what the practice of this trauma-conscious or trauma-informed yoga does, it teaches them to observe the actual state of their nervous system and then they use the tools to help regulate it, where our veterans, they have lived, so many of them for so long, in their sympathetic or the hypervigilance that their body-mind actually believes that that’s their normal state and for them its really hard for them to switch that off and by this practice they are actually able to learn to observe it and to make small incremental changes that actually hold, you know, we call it going to the edge but not going over the waterfall.

Dr. Carol Horton - Great!  So, just for those who are familiar with your organization, Connected Warriors does offer for trauma, informed yoga classes in 20 states around the United States as well as in six countries around overall and enable medical ship and so I am wondering based on that wide diversity of experience, how do you think yoga could help military personnel and veterans either become more resilient in the face of potential traumatic experiences or heal from posttraumatic stress?

Judy Weaver - So, one of our basics what we address is, we also address the families and for those of you who may not understand, our perspective is trauma is anything that overwhelms a person’s ability to cope and PTS or posttraumatic stress is, that’s the actual uncontrollable anxiety that follows a traumatic event and we look at PTS as a side effect of trauma because everyone processes it differently.  They respond in a different way.  So, for us, we have created this community and we find that that is a big piece of their actual healing, so to speak, is having the communities wherever they are going, whether they are state side or whether they are travelling, whether they are in deployment.  So, for us, its really a practice of breath and movement and it creates awareness of where they are and I call that their proprioception, you know, where your body parts are in space and by starting to understand that, that awareness, then they start to understand my heart rate, blood pressure and be able to take a step back and breathe and come into a different perspective and have space maybe between their thoughts.

Dr. Carol Horton - Can you say a little more about how the yoga helps to build community?

Judy Weaver - I’ll give you a quick story.  When we started the organization, I had 20 people coming to the classes and they were wearing…, military members, they were wearing their branch of service shirt and we got a few dollars.  So, we bought t-shirts for Connected Warriors and prior to the t-shirts, it would be like high school and you have the clicks of each military branch.  You would have the army, then air force, the one air force guy, we’d have the marines, and we’d have the navy and there was not a lot of conversation amongst the different branches of service.  When we passed out these t-shirts, they took off their branch of service, they put the Connected Warrior shirt on and they started to talk and what it is, when especially when they separate from the military, they have been part of a unit, they have been part of a mission, they are very purpose oriented and they are part of this huge military community.  You know, we have 21 million veterans in the US and of this community, now they are kind of out there on their own.  So, what we have found is just the fact of having these t-shirts create this new uniform for them and its part of this new community that they belong to and we are seeing it more and more with active duty also.

Dr. Carol Horton – Yeah.  That’s…, that’s fascinating.  Thank you!

Judy Weaver - Welcome!

Dr. Carol Horton - Moving back to the question of PTS or posttraumatic stress, I am wondering if you are familiar with the concept of moral injury and could explain that briefly to our listeners and then whether you think its a useful concept and how it compares with, if it does at all, to PTS?

Judy Weaver - Right.  So, moral injury…., there’s a movie out recently, its actually nominated, Hacksaw Ridge, and what that movie is…  Its about a conscientious observer in World War 2 and this young man, he knew where his edge was and he knew he wanted to serve, but he knew that he couldn’t do it with a weapon and so he became a corpsman and that is a medical doctor, so to speak, on the battlefield and what this young man, his moral line in the sand was very clear.  So, what moral injury would be is if you would cross that line in the sand and doing your job and not being able to reconcile with that and I come back to what trauma is.  Trauma is anything that overwhelms your ability to cope.  So, if you cross that line from that perspective, that would be the moral injury.  Now, how is that related to PTS?  To me, its just one of many incidences or events or situations that cause that traumatic event that creates the side effect of PTS.  So, its…, its similar in my mind to survivor’s guilt.  Does it matter what the reason is, right; at the end of the day, they had something occur that overwhelms their ability to cope.  Now, does that turn into PTS?  Not necessarily.  Not everybody who has a traumatic event will actually have those side effects.

Dr. Carol Horton - Okay.  Thank you!

Judy Weaver - You’re welcome!

Dr. Carol Horton - And then could you, final question before we move on to Pamela, could you please explain to us the difference between healing posttraumatic stress and engaging in posttraumatic growth and little bit about how yoga could help with each?

Judy Weaver - So, I think that that whenever anybody who has PTS engages in any of, there’s many now, available modalities which help them move towards healing, there’s conversation that can it be truly healed or not.  I think that it all, whatever these modalities may be that somebody may embark upon, they will all help them learn to manage these side effects from trauma.  Now, yoga specifically, my belief is, we are energetic beings and our body responds and receives communication electrically and chemically and we know that mindfulness practices actually increase that communication system and yoga specifically taught, my belief is that synchronization of the breath and the movement in a mindful manner can actually create that healing process, which to me is the posttraumatic growth.  You know, once somebody actually moves toward a healing modality, they are doing that is how I look at that.

Dr. Carol Horton - Great!  Thank you, Judy.

Judy Weaver - You’re welcome!

Dr. Carol Horton - We’ll open up things for questions after we discuss little more about the work of Pam and Annie.  So, we’ll hear more from Judy then.  Pamela Stokes Eggleston…, Pamela is the Founder and Director of Yoga2Sleep, an organization that again uses yoga and wellness services to promote better sleep for the best life.  So, Pam, can you explain to us what made you decide to make sleep the primary focus of your work?

Pamela Stokes Eggleston - Sure, Carol.  Well…, and thanks for having me on the show.  I, first and foremost, love naps, so that’s why I wanted to make sleep an important part of what I do with Yoga2Sleep and that’s the truth, but also when my husband returned from serving in Operation Iraqi Freedom, he had posttraumatic stress disorder.  One of the symptoms of that is having trouble sleeping and so as he was having trouble sleeping, I had trouble sleeping naturally.  So, I turned to Ambien and as a Wounded Warrior caregiver, I let go of things that I knew in my soul would help me through this arduous times, yoga, my practice, gardening, I let that go and I wasn’t feeling like myself.  So, I returned to what I knew instinctively was helping me, which was yoga and I used it to help me get better sleep for the best life.  I think one-third of the United States is sleep deprived and so sleep is so critical to hormone balance, disease prevention.  As Judy mentioned, the sympathetic nervous system, trying to make that shift from sympathetic to parasympathetic, yoga helps us do that and it subsequently helps folks get sleep and so that’s why I made that my primary focus.

Dr. Carol Horton – Thank you and I know that you also focus quite intensively on therapeutic yoga to veteran and military families.  Could you tell us a little bit about what that looks like?

Pamela Stokes Eggleston - Yeah.  Now, just before I answer that question, I would like to say that I am a military family member and it took me a while to wrap my brain around that.  So, my grandfather served in World War 2 in the army, in a segregated army.  My Dad is an air force veteran and my husband is an army Purple Heart veteran who was injured in combat and so it took me a while to kind of receive that role or title of military family member and as I progressed in my yoga journey, was getting training and working with civilians, I wanted to be of yoga service and give back in the way that I felt compelled to do and so I began teaching yoga for veterans classes.  I took classes on trauma training and I really got connected with veterans and initially in particular with women veterans who, as you mentioned earlier, Carol, have issues with MST and some anti-PST and some other issues and that kind of resonated with me because I co-founded a non-profit working with military families and as a military family member, I gravitated towards that.  Because I am a Wounded Warrior caregiver, I gravitated towards working with providing therapeutic yoga for caregivers of Wounded Warriors and their families.  So, I think its really important to understand that 1% of the United States population serves in the military but also families serve too and I think a lot of people forget that that the families are serving right along with the service members.  The families are really a critical piece in holding that service member up and maybe even in bringing them to therapeutic yoga session or doing these types of practices.  So, that’s how I became involved.  I am immersed as a family member, but then it kind of drew me to that.

Dr. Carol Horton - On that subject, I wonder if you could say a little more about yoga as part of a larger practice of caring for caregivers and just how important that is?

Pamela Stokes Eggleston - Absolutely!  So, its interesting you say that, Carol, because tomorrow I am going to do a workshop with caregivers with a non-profit, The Hope for the Warriors, and they do these caregiver wellness workshops and what’s happened is I’ve just kind of fallen into it because I think its comfortable for these Wounded Warrior caregivers, as some people call them Hidden Heroes, to feel connected to somebody just like them, to understand what they are going through, so their caregiver journey could be right at the beginning of it where someone just got medically retired out or it could be someone like myself who has been dealing with My Veteran for about 10 years now, we are at a different place in the caregiving journey.  To be able to resonate with me and ask questions and feel themselves being in a space, that phase, for them to express themselves through a therapeutic yoga practice and for them to take time for themselves because so often and I visit too.  I would tell anybody as a caregiver, I did what you guys should not be doing, which is not take care of myself and so I really impress upon caregivers that its really important for you to be able to give your service member, your veteran, a 100% that you give yourself a 100% you know initially and they love yoga.  I mean, I am…, I am getting so much positive feedback with yoga.  I use Yoga Nidra and I know Annie will talk about that later and I have also used mindfulness and meditation techniques that are really helping the caregivers say, okay, I can take just 2 minutes of my day to center and meditate even if I have to take my service number veteran to the VA for several appointments for the day.  So, its just an awareness of what the myriad spectrum of caregiving really means in the military and veteran community.

Dr. Carol Horton - Thank you!  So, I hear you are again picking up that theme of the importance of community and how that can tie into the yoga practice.  I am wondering if you could say a little bit more for people who might be wondering, well, how would yoga that’s designed for the family members of military personnel and veterans be different from the yoga class that I might just go to that is just at some random studio or gym down the street?

Pamela Stokes Eggleston - Sure and I think that that’s really a valid question, right, because I think, you know, a lot of time civilians don’t understand the nuances, the myriad differences of, for instance the caregiver or a military child in the various ages of a military child growing up in the military family.  I think its important to have empathy and understanding the impacts of military life on family and not sort of the superficial, above the flail understanding of, “Oh, I saw this on the news,” but to really maybe befriend someone in your neighborhood or someone around the block from you or somebody on your job that you know has a son that’s deployed to really understand and empathize but not sort of with just crying, sort of outpouring of emotion but really understanding subsequent impacts of trauma, the nuances of combat stress, PTSD, and the impacts of military life on families and to stay on top of that knowledge and learning and empathy and compassion.  I have done that myself.  I am a caregiver, but I also feel like I can learn from other caregivers, military family members, I do everyday, veteran service members, employees on basis and at Walter Reed.  I continue to get feedback and learn from this and I think it is distinctive to understand that a lot of these families have moved from base to base, they, you know, putting down loops may be hard for somebody’s military families and now its the veteran family, they are finding it hard to fit in and so understanding a transition that of service member to veteran and understanding that process would also be helpful in bringing knowledge to the overarching theme of yoga and therapeutic yoga.  So, the yoga teachers would have that deeper understanding and that would impact how they offer classes and this sort of ability to form supportive relationships with their students and that sort of thing.

Dr. Carol Horton – Absolutely!  I think and if I can just tell you this one tit bit.  I have a friend who works to Walter Reed and she loves our book, Best Practice for Yoga with Veterans, and she is like, I am going to make all of my teachers read this, but what happened and we discussed this only on Omega at the symposium, there’s a lot of people who want to come in and teach military service members and veterans, but they don’t have anyone in their family that’s a veteran or military.  They haven’t interacted in any way.  They haven’t even volunteered for instance as one example and with Walter Reed or on base or even at an American Legion Lodge or anything like that, like they…, its not in their life, but they see these things on the news and they are like, oh, I want to help.  So, I think educating yourself and I think a great beginning is to get the Best Practices Book for Veterans and then knowing, trying to give in to the community and the space so you can learn about the population that you want to serve, so your heart can be in the right place, but I think you need to dive a little bit more into what the impacts are on military life.

Pamela Stokes Eggleston - Right.  Thank you and I would add that yoga teachers who might be listening in and interested in serving this population should be aware, if they are not, that there are some wonderful organizations out there, like Judy’s Connected Warriors and others that do offer specialized training to, yeah, really solidly ground civilians…

Dr. Carol Horton – Absolutely!

Pamela Stokes Eggleston - …and a deeper understanding of these issues and many more.

Dr. Carol Horton – Absolutely.  So, I think in the interest of time, we should move on to speaking with Annie Okerlin and again we’ll have time to hear more from Pam while we move to open Q&A.  So, again, Annie is the Founder and Director of the Exalted Warrior Foundation which offers adaptive yoga instruction to wounded warriors in the active military and veteran hospital facilities and to veterans within communities around the country.  So, Annie, could you explain to our audience what adaptive yoga is and what does it offer these warriors?

Annie Okerlin – Sure.  Thanks, Carol.  So, adaptive yoga, it sounds funny to put the adaptive in front of it, but I think its a good way.  Its honestly probably just a good marketing lingo because yoga as we know, is adapted anyway and really the idea that all of us do as instructors is we are meeting people right where they are.  So, for example, the idea of an adaptive yoga class for an amputee is if, you know, the…, if the student doesn’t have a hand, we are not going to do stuff on our hand and the idea is that we work with what we have and again meet the students where they are.  So, we have, I really think sometimes there should be awareness yoga because it, specifically in the military population that we work in, we are meeting all of these different injuries and I think the idea is more that we know how to support someone that maybe has an amputation or has a brain injury and we have the awareness as in the subtleties of getting them into a posture that is therapeutic in nature, but we are also equally working with the nervous system as everyone’s spoken of, you know, Judy and Pam were talking about, sympathetic versus parasympathetic and most of what we are needing is this awareness of everyone’s jeffed up in their sympathetic nervous system, even the teacher if the traffic looks bad on the way in and we all need this coming down and raising of the parasympathetic nervous system and I think its really, really important to know as a teacher how do you modify a posture for someone with a bad back.  While we do that pretty much in any yoga class, how do I deal with the residual whim of someone with an amputation, maybe we use more props, maybe there is more discussion and education of the way the brain is wired for dealing with phantom pain and why breathing techniques work in this situation.

Dr. Carol Horton - Its amazing work!  I think for those of use who, you know, just don’t have the depth or the expertise, think of adaptive yoga, we think maybe of what kind of physical therapy dimensions and, of course, you have talked about the connection with that to regulating the nervous system, but could you connect the dots a little bit more explicitly between the physical benefits of the practice and what we may call the psychological and emotional benefits and how do I connect and where have I not.

Annie Okerlin - I definitely think they are connected.  So, for example, in the beginning of the practice, I had our community adaptive yoga class this morning where the VAs burst in several different elements of population and so I had active duty service members that have…, are on acute PSTD evaluation.  I had community veterans who are no longer being seen regularly by the VA and I had some veterans who are in a transition unit from major injury and learning to live by themselves again and so people in between and I feel that everybody that walked in that room had some physical discomfort and we know that as we hold this physical discomfort we are creating layer upon layer upon layer of more physical discomfort.  So, addressing the physical discomfort first as well as creating the toolbox base of using the breath, so when we exhale we can start to feel the body begin to soften a little bit and if we dance back and forth between these two things, the psychological piece unfolds on its own and I have felt more and more these days as this workup continued, I think that in this population specifically, everybody, even really traumatically injured service members and veterans, there is a baseline of knowledge because they have been through boot camp.

Annie Okerlin - They know how to move and so kind of like what Pam talks about is this rest piece, this slowing down and giving this sort of spacious awareness idea of stepping back and watching themselves in their body, watching, aah, this felt good and what did that feel like in my body.  Oh, this was a good stretch in my hamstring and oh, wow, my lower back feels better.  Hmm…, that’s interesting and how all of the connection between the physicality, the psychological, the emotional balancing that happens, sometimes without even realizing it.  I always like to say, you know, and I do the same thing, sometimes I roll into a yoga class like a lion ready to just roar to bad traffic, crazy people, whatever, noisy minds and at the end I roll out like a lamb.  Its just aah, and so sort of titrating back and forth between movement, kind of like what Judy was talking about, what is the normal now in the body so especially with an adaptive practice and major injury.  What is the normal experience in your body now?  Well, it may be even more layers of tension and stress than the average person, but that’s okay.  We can continue to welcome that experience and use the tools that we are learning in the yoga practice to then create a new normal as everything begins to settle back down.

Dr. Carol Horton – So, you mentioned there the importance of deep relaxation and the different sorts of benefits that brings which is a nice way too.  Speaking about Yoga Nidra, you offer free Yoga Nidra recordings on your Exalted Warrior Foundation website.  Could you explain to our listeners what Yoga Nidra is and why you offer it and how it works in conjunction with adaptive yoga?

Annie Okerlin - Sure.  So, Yoga Nidra really means yogic sleep or sleep with awareness.  When I first started this work about a decade ago at Walter Reed, I was working in the amputee center and I would say the guys and gals I was working with, you know, hey, are you sleeping well and they would look at me with this disdain like, are you kidding?  Nobody I know sleeps well and I…, and it got me really thinking, like okay, you know, that I feel very blessed that I sleep well.  Obviously, age changes things a little bit sometimes and life experiences, but I think what really engaged me was that this ability to get that spacious awareness we talked about a minute ago to witness my experience; and for me, Yoga Nidra creates this beautifully secure experience without needing to move.  Its ultimately a stillness practice, which if you are uncomfortable in your body and challenged and not at ease in your mind, there is no stillness and stillness is kind of a far off place and the way this specific protocols in all of Yoga Nidra but specifically the iREST practice that I am trained in, it creates the step-by-step experience of finding the comfort in the body, which leads to the ease in the mind and in iREST we use the language of welcoming whatever comes and one of my favorite experiences of teaching Yoga Nidra and iREST specifically was, one of my guys came out of practice and he said, “You know, ma’am, this was like going to the movie theater and just sitting at the back of the movie theater and watching everything happen without any emotional engagement to it, without any physical engagement to it.”  He said, “I saw happy stuff, negative stuff and everything just became stuff.”

Annie Okerlin - One of my favorite quotes in teaching this to service members and their families is, it’s a Pema Chodron quote, and she said, “Don’t be the weather, be the sky” and its getting that spaciousness, that stepping back and watching things happen.  Our minds are noisy by nature.  So, okay, welcome that without the emotional physical attachment and frustration, even the joy of it, just let it…., just witness it, let it happen and ultimately be the peace that you are trying to achieve, be it and then allow it, allow to watch things happen around you and that’s hard for people who were trained to step toward a fight and really get in there, but it ultimately deepens and becomes an awareness of being versus doing and I think that’s…., I think that’s the challenge of being human and then in this population that we are all working in, there are the stressors of PTS and MST and all of these situations of trauma, even just exhaustion level, you know, can really create a situation that’s challenging.  So, when I teach an adaptive yoga class, I use a lot of the languaging from my iREST practice, the spaciousness, the witnessing, the noticing, without judgment, without attaching to the story of what it may be or why, I would say, you know, oh, if your left hip is tight, don’t worry about the story of why necessarily, you know, oh, I fell out of a tree house when I was 8 or whatever the story may be or taking down doors or whatever it may be, welcome the fact that you feel that and notice the breath and let the breath come in and so I use the languaging throughout the practice, yoga practice and then at the end always do a minimum of 18 to 20 minutes of rest.  We don’t rest enough as a culture, I don’t think.

Dr. Carol Horton - That’s beautiful!  I love what that analogy of being the sky and watching the weather.  I think in the interest of time we should probably shift things over to Priya so she can open it up to question.

Priya Menon - Thank you, Carol, and it was amazing discussion so far.  To panelists, we have a list of questions which we received via email and some have been posted on our website.  So, we will address them one at a time.  I will ask one of the panel members if anyone else wants to add anything else, they can just jump in and help out.  So, the first question.  Carol, this is for you.  I know you have given me a link for this which I will be posting on the website soon after the session.  The question from our listener is, are there any ongoing clinical trials exploring the effects of yoga on PTSD or brain injuries?

Dr. Carol Horton – So, yeah, I am just pulling up that link right now so I can write up even though I noted it.  Here we go.  Yeah.  So…  I will try to give the exact information quickly.  Why don’t you go on to the next question while I pull that up?

Priya Menon - Yeah.  Okay.  Go ahead.  Judy, maybe you can take this one.  What is the best way to gain access to veterans who are in need so as to provide the proper assistance via yoga?

Judy Weaver - Hello?

Priya Menon - Judy, can you hear…  Yes, Judy.

Judy Weaver – Oh, okay.  Yeah.  Yeah.

Priya Menon - Our question was what is the best way…  You want me to repeat the question?

Judy Weaver - Could you please?

Priya Menon - Yes.  What is the best way to gain access to veterans who are in need so as to provide the proper assistance via yoga?

Judy Weaver - What we have found…  When we originally started, we thought we would bring vets to map, so to speak, and what we had found, we would bring the maps to the veterans and the best way for us has been through the VA Hospital, the vet centers.  You can reach out to the veterans’ fraternal organization, those types of organizations and you are most successful if you align yourself with a non-profit that’s already offering services into the VA because sometimes its difficult to get signed up as a volunteer as an individual.

Priya Menon - Pam, you like to add on to that, something else?

Pamela Stokes Eggleston - Yeah.  I think its what we just touched on the community earlier and that seems to be a thing with what Carol was discussing and how she was leading us into our questions and so I think its a good way to connect with who is in your community, connect with an addition to really what Judy had just mentioned, non-profit to maybe actually working with the VA or other hospitals to connect with them to go connect with bases that may be in your general facility and to connect with non-profits that are doing this work.  So, I think community is really important here to find ways that work and that collective cohesiveness that Judy mentioned earlier.  Right.  There are two other options that we have used which are very effective, its in most major cities.  There is Veterans Community Affairs and you can reach out to them as well as on every college campus, there is a veterans affairs officer.  So, its a nice way to reach out to the younger population, especially.  Yeah?

Priya Menon - Yeah.  Thank you.  Pam, I remember what you talked about how hormones affect your health and how its so important to sleep well for hormone balance.  So, there’s a question from our listener who says, studies show that there are changes in the level of hormones like cortisone as an effect of yoga.  Does this mean that yoga can replace a pill, say if someone was taking a daily pill to reduce stress?

Pamela Stokes Eggleston - I would say it depends on the person because I believe that for me, my cortisone levels were up and I am trying to get my cortisone level decreased, that stress hormone decreased, and get into maybe the DAGA hormone would be more prevalent in the parasympathetic nervous activity.  So, for me, my goal was to not be on Ambien or any kind of psychotropic medications and so I wanted to use yoga to kind of alleviate the need for a pill and so for me, that’s a daily practice and when veterans come to me and when I have worked with veterans that want to work on some of those things, like I don’t want to be on a pill, I don’t want to do this, then I work with them to achieve or to walk towards achieving that goal.  I mean this is something that you want, we’ll try to work that way, but some people, you know, medication has its place.  I am not going to ever say to anyone, you should never take medication or any such thing because I think it has its place, but I think that things can be worked through and as your body…, the body-mind connection in working through these issues is really critical and see what surfaces.

Judy Weaver - I just wanted to add on that is we are actually working with University of Miami’s Miller School of Medicine on a study about opioids and exactly that is, you know, using yoga in this protocol as a replacement for pain management.

Priya Menon - Wow!  That’s nice.

Judy Weaver – Yeah.  Yeah.  Yeah.  And its my…

Priya Menon - Annie, you would like…

Judy Weaver - …in my…

Priya Menon – Yeah.

Judy Weaver – Yeah.

Priya Menon – Yeah, please go ahead, Judy.

Judy Weaver - Oh, I was just going to say, in my experience, we have many, many stories where our veterans who have been on all sorts of medications are telling us that they no longer have to take specific medications, high blood pressure medication, heart medication, and a big…., big amount of sleeping medications.  They are stopping that.

Pamela Stokes Eggleston - I second that, Judy.

Priya Menon - Oh!  Oh, that’s great.

Judy Weaver – Right.  Right, Pam?

Pamela Stokes Eggleston – I agree.  Yeah.  I came…  I mean I came off the Ambien, that’s why I used that example because I did and then a lot of, you know, Judy, we all work with these veterans that are on 20-plus medications and they slowly…

Judy Weaver - Yup.

Pamela Stokes Eggleston - …come off.  You know?

Judy Weaver - I know.  Yeah.  Yeah.

Pamela Stokes Eggleston - Its amazing and nobody wants…  Nobody wants to be on pain meds or sleep meds for the rest of their lives.

Judy Weaver - Right.  Absolutely.

Pamela Stokes Eggleston - And its empowering on greater levels after they do that.

Judy Weaver - Absolutely!  Right.

Judy Weaver - Yes.  I saw a commercial and there is new medication for side effects from the medication that you are taking. I just can’t wrap my head around that. No.  No.  No.

Priya Menon - Okay.

Judy Weaver – Yeah.  That’s crazy.

Priya Menon - So, next question is, like I think all of you can take up, you know, provide your views on it.  It is, do you consider meditation, visualization, and positive self-talk in the same category with yoga?  We’ll start with Judy.

Judy Weaver - I think yes.  I personally think any mindful practice, however, you look at that, is all part of yoga.  Yoga, to me, is union in the very specific definition, I think yoking is bringing together and in my perspective its bringing the body-mind, mind-body all together so that its working as a very functional and efficient machine because we’re just really a bio machine in reality that has emotions and we can think and we have opposable thumbs, but other than that, we’re…, we’re like everybody else.  So, when all those systems are together, which is what yoga is, I think that’s what we’re working towards.

Priya Menon - Pam?

Pamela Stokes Eggleston - I agree.  I think the body-mind connection and we’ve mentioned that throughout our discussion today is really critical with all yoga.  I think moving that, as Judy mentioned earlier, that energy and we’re all energetic beings.  We use that energy and then connect with a mindful practice is absolutely the thing.

Priya Menon - Annie, you want to add something to that?

Annie Okerlin - Sure.  I just…  I agree with everybody.  I take it that the journey of going inwards and really creating a safe place for anyone to experience themselves as whole as peer love, which is ultimately where we’re kind of headed with this and whatever your label on the divine may be.  I think when we begin to rest in our heart again, when we come back to remembering that we are love and peeling off the layers of the things that create the forgetting, I think that being in tune with yourself lends itself to all of these other deeper connections and deepening in our personal relationships and noticing, becoming more aware of how your energy ultimately leads you to being more gentle again back to the human condition because when we can realize it and experience it and be gentle with ourselves, ultimately we’re then able to share that with the people we love and hopefully broader than that and I think that a lot of…, I feel that way I do the work.  I have to do my own work to be able to support anything that comes into the room and if I…., I mean to myself in my practice, then I am not going to be supportive and empathetic, as Pam was talking about earlier, to anyone else.  So, its just constantly welcoming and being gentle, I feel.

Priya Menon - Oh, yeah.  Well….  So, Annie, do you think there are any yoga styles that you suggest are not good or are not best for healing yoga from trauma?

Annie Okerlin - I think that’s a slippery slope.  I think one piece that I have always been very, very mindful of is…  Oh, we can go and play.  Realistically, I felt more and more and more, whatever gets anybody to the mass, whatever gets anybody to its stillness, a gentle movement practice is extraordinarily beneficial.  What I am…  What I try to teach my guys and gals when they come through and they head back out to their home base or wherever they live around the country or even the world is just notice if at any point in the practice did you feel that you are amping up, if you don’t…., if you begin to lose a sense of grounded security, come back to your breath more, maybe lay on your back, do anything that you know in your repertoire to gently come back down, to slow down, be more engaged with your exhale to bring the parasympathetic back up.  So, that in my mind means no Kapalabhati.  Right?  So, no fire breath.  No forceful exhales.  Now, there are times where a very consistent, low, rhythmic Kapalabhati could be great.  If you titrate it back with a deep low Ujjayi lung exhale and you create the situation where someone hasn’t experienced that I am getting…, I am stuck,” great, okay, fine, welcome back now, we settle back down and that’s where the book does great work in explaining, get qualified, if you want to do…, if you want to do this work with this population, do training, do Judy’s trainings with Connected Warriors, do Warriors at Ease training.

Annie Okerlin – We go in depth because ultimately no one wants to create a difficult situation for someone.  Our veterans and our service members have had so many experiences when they try to step out or have an experience and it may not go well, it creates that sense of isolation again.  So, we are welcoming them into a yoga class, a yoga experience where they can create a new pattern of having a successful experience.  If they…, a year, maybe a few months down the road, say, I want to do a hand stand, rock and roll, you know, great, welcome that, but be careful in their early stages of practice because the tools are not as fine tuned yet.  So, I am okay with pretty much any practice.  I just…  I work with so many people who are traumatically injured.  I am always really, really careful of everything.  So, yes, anything that amps you up, be mindful, may be stand back from that for a little while until you feel more comfortable in spreading your wings in your practice.

Priya Menon - Thank you, Annie, for that.  Pam, maybe you can take this one.  Do you believe all trauma is curable?  Do you feel the human mind and consciousness have the potential to release trauma completely with yoga?

Pamela Stokes Eggleston - So, I’ll answer those questions in this way.  I think disease in this country and this is my opinion, is like dis-e, so it just means pretty much you are out of sorts and I think the human mind and consciousness can slowly…  You can practice yoga, give the tools some of which we’ve mentioned to release some of the trauma incurred by PTSD.  I believe that yoga is a complementary therapy.  You can add that to cognitive behavioral training if you are dealing with someone with chronic PTSD or PDI or core chronic disorder and to use yoga to help process through all of that to release this trauma is really, really beneficial.  So, I don’t think…  We always want something to be “curable” when we really need to take a journey in processing through a lot of the issues that are in our tissues, starting with the body, going into the mind, coming from a place of love, like Annie said, and ultimately coming into our spirit.

Priya Menon - Thank you, Pam.  Carol, maybe we just have time for one more question.  Maybe you can take this.  I am a combat-disabled veteran and have seen personally how yoga and iREST have helped me and now I want to give back.  Do you know of any programs that offer help to veterans in getting their yoga instructor certifications?

Dr. Carol Horton - I am aware that Yoga Alliance is now offering scholarships to support people in taking yoga teacher trainings and I know that they are planning to expand the existing program quite a bit in the next year or two.  So, that would be one potential source of financial support.  Otherwise, I am not sure.  Maybe….  Does anyone else know?

Judy Weaver – So, we…  As I mentioned earlier, we started the Elevated Warrior Program and that part of the past, if they become a member and they process through that, at the end of that is a teacher training, a 200-hour trauma-conscious certified teacher training.  So…  I mean, that’s what we offer and right now this year I have 30 Elevated Warriors across the country that will be starting their 200-hour probably at the end of this year and finish up early next year.  So, you know, that’s our program because for us, we want a mix of active duty and veterans.  So, if there are….  For active duty who deploy, they can take that with them and then when they come back, they can maybe wherever their next post is, they may be able to have a class there or bring a class to that place.  So, that’s….  Other than that, its tough out there for that kind of funding right now.

Annie Okerlin - Funding is always a dance I think, in the non-profit world anyway, but I know that there is a lot of great stuff happening with Judy’s training and the Warriors at Ease training that we do are going to be online, the first piece is going to be online on Yoga International coming out soon and then we’ve been funded to offer scholarships for veterans to take our training.  I know the young marine that works with me, paid for his 200-hour training themselves.  Going through those, we have things like that, sometimes those things can get very tricky and I know that a lot of the groups at iREST will try to get scholarships for veterans and service members to take the training because there is really no one better to welcome the experience of another veteran than a veteran, and us of course, right?

Dr. Carol Horton - Yeah and there are lot of us and non-profits that are working with military families and service members that will offer scholarships for broadening their horizon.  I mean that’s how I got a lot of my training.

Judy Weaver - And there’s MyCAA for the spouses, MyCAA for spouses, there’s educational benefits up to, I think, 4,000 dollars.  We are working…  We are trying to get through VA and DOD through the education side to get approved as a veteran for training and then there must be funding directly from them to…

Annie – Great!

Judy Weaver – …to get them taught.  So, we’re working towards that goal, to me, everybody, they should pay for their training, yes, to take their training, but I think…there should be funding for that.

Priya Menon – Great!  Great!  So, Carol, yeah, do we have…  Did you get time to check that link out so that I can put it out, Carol, for clinical trials for yoga?  Yeah?

Dr. Carol Horton - Yeah.  So, there is…, just posted this week on the US Department of Veterans Affairs website, news of the most recent and ongoing clinical trial conducted by one Dr. Louanne Davis, a VA psychologist in Indiana, and so that is ongoing and I know that, will post that link.  Annie, I believe you are involved in some sort of ongoing research study as well.  Correct?

Annie Okerlin – We are.  We are working with Warriors at Ease and have contracted Exalted Warriors and several other foundations who are based around the country.  Bob Woodruff Foundation is supporting a study to look at the effects of yoga for post 9/11 veterans and their families and part of what’s exciting is that same training I discussed earlier is that if we find in these classes that there is a military spouse or a veteran that wants to then further their yoga practice to become a teacher, there’s a follow on by offering them to pay for those things.  So, I think there is a lot more activity in the research realm than when the offer started.  Its kind of exciting and I am sure all of the panelists can agree that the detail in there in there is one of the pieces that sometimes makes getting involved with the study quite daunting because we are doing it already and all of that…..and all of that can get very daunting, but its hard because how do you quantify yoga?  How do you quantify?  We all know the great stories and I am sure we can spend days and days, Priya, on your show, talking about the stories that we heard and what we have seen and watching the room begin to settle and soften and jawlines rest and the whole thing and eyes closed, but how do you quantify that?  Do you do that on a pain scale?  Do you do that on a sleep study?  So, there is…  I think there are so many programs out there, research grants right now happening and I know that iREST community has a lot.  You can go to irest.us and look at all their research because that’s Richard Miller’s, very involved in the research department.

Priya Menon - Thank you so much, everyone.  Carol, Pam, Judy, and Annie, it has been an absolute pleasure to listen to you.  I hope your book does really well and helps a lot of people and thank you so much for having shared all this information so generously and patiently with our audience.  The talk will be available on CureTalks’ website for playback, and we will also be loading a transcript for this talk.  We have our next show tomorrow same time with Dr. Robert Orlowski on multiple myeloma.  You can also visit our curetalks.com website for details of our upcoming talks.  Thank you so much, everyone.  Have a great evening.




  • Anonymous User Feb. 23, 2017, 6:05 p.m.  US/Eastern

    There are also a handful of schools around the country that take GI bill as well!

  • Anonymous User Feb. 23, 2017, 5:48 p.m.  US/Eastern

    Do you guys recommend any books, video, or audio on learning more? -In addittion to courses to take.

  • Anonymous User Feb. 22, 2017, 3:59 a.m.  US/Eastern

    I am a combat disabled veteran and have seen personally how yoga and irest has helped me and now I wanna give back. Do you know of any programs that offer help to veterans in getting their yoga instructor certifications?

  • Anonymous User Feb. 21, 2017, 3 a.m.  US/Eastern

    How different is iRest prescribed for PTSD patients from that prescribed to others?

  • Anonymous User Feb. 21, 2017, 2:56 a.m.  US/Eastern

    Do you believe all trauma is curable? Do you feel the human mind and consciousness has the potential to release trauma fully with yoga?

  • Anonymous User Feb. 21, 2017, 2:51 a.m.  US/Eastern

    Are there any yoga styles you suggest which may not be best for healing yoga from trauma?

  • Anonymous User Feb. 21, 2017, 2:50 a.m.  US/Eastern

    Do you consider meditation, visualization and positive self talk in the same category with yoga?

  • Anonymous User Feb. 20, 2017, 10:01 p.m.  US/Eastern

    What is the best way to gain access to Veterans who are in need so as to provide the proper assistance via yoga?

  • Anonymous User Feb. 20, 2017, 7:31 a.m.  US/Eastern

    Studies show that there are changes in the level of hormones like cortisone as an effect of yoga. Does this mean that yoga can replace a pill, say if someone was taking a daily pill to reduce stress.

  • Anonymous User Feb. 20, 2017, 12:25 a.m.  US/Eastern

    Are there any ongoing clinical trials exploring the effects of Yoga on PTSD or brain injuries ?

    Show / Hide Replies

    Priya Menon Feb. 23, 2017, 6:30 p.m.  US/Eastern

    Reply: Hi, pls check out this link: https://www.va.gov/HEALTH/NewsFeatures/2017/February/Can-Yoga-Ease-Your-PTSD-VA-Wants-to-Find-Out.asp