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Yoga for people suffering from Trauma with David Emerson from JRI

David Emerson from Justice Resource Institute talks about yoga for people suffering from trauma with yoga teachers and experts, Dashama, Micheline Toussaint, and Marcela Clavijo.

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Talk Recorded on Jun 13, 2013, 06:00 pm EST </> Embed
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Priya Menon Priya Menon

Priya :  Hello, everyone, and welcome to the Cure Panel Talk Show on yoga.  I am Priya Menon, Scientific Media Editor at Cure Talk, and on behalf of the Cure Talk Cure Panel team of Sharib Khan and Chintan Patel, I welcome all of you this evening to a discussion on yoga.  We will be moderating the call and bringing people live on the show.  Cure Panel Talk Show is organized by Cure Talk, the blog of trialx.com, an online platform to connect patients to clinical trials of new treatments.  For more information on clinical trials for all conditions, please visit trialx.com/ask.  This is the 15th episode of Cure Panel Talk Show and the second Cure Panel discussion on yoga.  Our first show on yoga featured Dr. Satbir Khalsa from Harvard University and today we have with us David Emerson of the Justice Resource Institute.  David Emerson will be talking on yoga for trauma.  Today’s show has been selected to be featured live on Blog Talk Radio. The panel is co-hosted by co-founder of Trialx and yoga enthusiast, Sharib Khan.  On the panel we have Marcela Clavijo, Dashama, and Micheline Toussaint.  On behalf of the Cure Panel Talk Show, I welcome all of you to the show.  We will be taking in calls from our listeners towards the end of the show.  Callers can let us know by pressing 1 on their keypads and we will bring them live on air to ask their questions.  Sharib will now introduce us to the experts.  Sharib, you are on. Sharib!  Sharib, can you hear me?

Sharib Khan : Yes, I am on air now.  So, thank you, Priya, for the introduction and I am so excited to be here on the panel and have such an esteemed expert and panelists to have on discussion today.  So, let me quickly introduce our expert today, David Emerson, who is the Director of Yoga Services at the Trauma Center of Justice Resource Institute in Brookline, Massachusetts, and he is an accomplished yoga instructor and co-author of the book, Overcoming Trauma Through Yoga, and founder of the Black Lotus Yoga Project, a non-profit organization dedicated to the teaching of yoga to individuals with posttraumatic stress disorder.  He is also on the advisory board of Mandala House and he joined the Trauma Center in 2006 and helped develop the Trauma Center at the Justice Resource Institute and in a while we will ask him to tell us a little bit about the Justice Resource Institute and also a lot of work that he is doing there.  As the coordinator of the Yoga Services Program at the Justice Resource Institute, he has been responsible for the implementation, supervision, and oversight of the yoga intervention component and which is part of an NIH Foundation Study to assess the utility and the feasibility of yoga intervention for traumatized adults with PTSD.  He has extensive experience in the instruction of yoga for patients with posttraumatic stress disorder and he has worked with various populations and has also developed and conducted yoga training session for rape crisis centers, domestic violence programs, residential programs for youth, and military bases, and the veteran affairs.  So, we are very excited to have David today and with that I will let David get on air and quickly introduce himself a little bit and talk about the Justice Resource Institute and then we will dive in to discuss his work at the trauma center there.  David, you are on air.

David Emerson : Very excited, everybody.  Thanks so much for having me on.  A quick introduction to the trauma center itself would be, it was started about 30 years ago by Bessel van der Kolk and its really a treatment and research institute focused on PTSD and complex trauma and over the years we have done a number of important studies in the field of trauma and you can add yoga to the list at this point.  So, at some point if people are interested, I can talk a little bit about recent people studies and we have been working for about 10 years now and done thousands of classes and three studies, so that’s quick introduction.  Let me know if you want more.

Sharib Khan : Oh, yes.  That’s helpful.  Actually, let me ask you to tell us a little bit about how you got started with this work at the trauma center and what exactly is your work in treating people with PTSD and how are you applying yoga to address trauma in patients with PTSD and other situations?

David Emerson : Okay.  How I got started, I was a social worker for about 10 years and went back to school to become a therapist and clinical social worker and nearly found that the talk therapy wasn’t very comfortable for me and meanwhile just had my own yoga practice that I did enjoy quite a bit.  So, I went into that full time and became a yoga teacher.  During the course of a couple years, I heard about Bessel van der Kolk and the work at the trauma center just in general.  They are working in yoga, but they treat trauma and I found it to be quite a good fit and tried to bring yoga into the mix. So, the plan for us when we started was we were always going to study what we do, whether we could develop as clear a picture as possible about what works and what doesn’t work for trauma and so that was really the project and what I would say in terms of just a quick overview about what we do with yoga is the focus is helping people feel what they feel in their body (audio unclear) the body is carrying in different forms and noticing what it feels like and then starting to practice making about what you do with your body.  So, its about really taking control and ownership of your body through this process called introception where you are just beginning to notice what if feels like to have a body you like and so that’s essentially what we do, using yoga (audio unclear) …practice having a body and try just making choices.

Sharib Khan : It was very interesting to read from your work that looking at PTSD and treating it more as a… or getting the body to start feeling and moving and not just thinking about the mind which is frozen and in the past experience and can you elaborate a little bit more on that and how did that insight come and where did… and what research showed that this is where we need to focus on, rather than just the mental aspect of it and how you have seen this actually being applied and produce results?

David Emerson : Yes.  Great question.  I think from my perspective and our perspective at the trauma center, neuroscience is really the key insight over the past 15 years or so and encouraged changes in the field.  So, the brain pictures are really important.  What we are seeing is parts of the brain that are involved in cognition, self-reflection, and the ability to verbalize internal (unclear audio) those parts of the brain adversely affected by trauma exposure.  So, if you ask people to articulate what their feeling is, in many cases, especially if they were traumatized, its really impossible and if anything, it could be re-traumatizing for people because you can’t feel yourself and you can’t articulate what you can’t feel, so its pretty much a futile process.  Meanwhile, you see parts of the brain that are involved with self-reflection and introception and we start to wonder are there ways that we can engage those parts of the brain through the body.  The first research that was really important for us was the meditation research, the passion of meditation research that people like Jon Kabat-Zinn and Richard Davidson (audio unclear) meditation where you focus internally can have an effect on the parts of the brain, so you could start by really rebuild some connectivity there.  The thing with trauma is that if we just ask people to sit and meditate its also overwhelming.  You have to have a pretty healthy frontal lobe to be able to organize all those thoughts that come up when you meditate.  So, people would move around, if they were just asked to sit still, but the beauty of the hatha yoga is you get to move.  You get to move and really start to feel your body and then you also get to do the mindfulness sort of introceptive practice at the same time.  So, that was the underpinning  neuroscience, some of the meditation research and I guess that’s where we started from.

Sharib Khan : That’s such a fascinating piece of information that you provided because, you know, in western medicine until very recent…, I mean even now for a majority of people and physicians, there’s always been a mind-body disconnect and this is a great example of how we can show the body actually can influence the mind and in turn the mind is then influencing the body and, you know, again, as Dr. Khalsa had pointed out in his research actually when we were having him on the Cure Talk Panel Show last time, that there are, you know what you are saying that, there are actually immediate changes in the neuronal circuit that are immediate as well as short term and long term through the practice of yoga and its exciting to know that actual research is showing these things more, you know, objectively, what has always been believed and what has also been held as a strong therapeutic focus in eastern medicine in the mind-body connection.  So, with that, can you talk a little bit about exactly what the interventions entail like, what happens when a patient with PTSD comes into the trauma center and then what’s the assessment of the severity of it and then how do you plan the intervention and what does an intervention actually entail?

David Emerson : Yes.  Great!  Absolutely.  So, first distinction I think is probably useful for us to make is we really don’t treat PTSD.  We are treating complex trauma.  So, you should make that distinction.  PTSD is symptomatology and in order to qualify for it, you have to have certain symptoms that you can find in a physician’s desk reference, okay and so you have a…, let’s say you have a traumatic event and one month later you have a certain set of symptoms, then you fall back to PTSD.  Complex trauma is (unclear audio ).  So, traumatic experiences that happen all the time, so we are re-exposed and if you think that children who grow up in an abusive home,  for example or even if soldiers who agree to go into the war zones repeatedly.  That’s the kind of thing that we are focused on.  That’s the sort of brain science that I am talking about.  So, those of where you see the changes in because introceptive pathways in the brain is complex, repeated exposure and naturally where our yoga program is focused.  Other things we know about complex trauma is, often times there is a developmental component, so a lot of it is taking place in the context of relationships and particularly primary relationships, your home.  So, if like…, there’s a relational component to what we are doing with yoga, its actually really important if you think about…  If you look at trauma, experts like Judith Herman, she has been talking about the primacy of relationships for 20 years in terms of moving trauma that has to take place in the context of relationship.  So, we are focused on particularly the relationship that one has to oneself and there’s another way actually to describe introception.  We feel like if we can help people start to feel themselves, for example, it could be as simple as wherever you are right now, notice where the ground is, notice where you are making contact with the surface underneath you, that’s one example.  More complexity there would be muscular dynamics.

So, the first one is sensory awareness and then you get into, you know, what’s happening in this forum?  What muscles do you feel stretching?  What muscles do you feel strengthening?  So, we are focused on that kind of relationship, a relationship with the self, which is also taking place in the context of a relationship with somebody else who at least will be able to teach her.  So, I would say what we are doing is focus on introception, but the yoga teacher is very specifically not ordering people to do things.  So, if you were to hear a session at the trauma center, you wouldn’t hear commands.  So, we don’t tell people to lift their arm.  We are inviting people to lift their arm if they like.  So, the whole organization is around is this what you feel and notice what you want to do with these options.  So, if you really try to investigate developmental and sort of interfamilial trauma, I would argue – all that I say is my opinion now if you would – that if you are not ordering people around, you are inviting them to experiment with things, you are starting to rebuild relational dynamics, giving people a chance a new kind of relationship with somebody in  power.  So, we are really, we are really serious about not ordering people around and being respectful of people’s choices and actions and so that’s pretty much it, but it sounds simple in a way but to stay focused on that kind of practice for months and years which is what we do with people and it takes a lot of, I guess, discipline on the part of the teacher.  Sometimes it seems like its easy to tell people what to do, you will get it done quick, but in this treatment of trauma, that would be the (unclear audio) really want to back off and be patient so people have time to feel what they feel and make choices.

Sharib Khan : That’s very helpful.  That’s really helpful and we are very interested to actually observe one of these sessions.  So with that quick introduction about what you are doing at the Justice Resource Institute and some details on the work itself, I will move on and introduce our first panelist who actually also happens to be my yoga teacher and I have been taking Marcela Clavijo’s classes at the Iyengar Yoga Institute in New York for quite a few years now and I am so honored and delighted that she was able to take some time out to be with us on the panel today.  So, its a real honor and privilege to have her here and she is junior intermediate certified yoga teacher of the Iyengar yoga lineage and she has done her yoga training including various trips to India where  she studied with the Iyengar family in Pune and also trained with Patricia Walden and Manuoso Manos who are senior Iyengar yoga teachers.  She is an ordained Tibetan Buddhist nun in this higher tradition and has conducted many retreats at places like Menla Mountain in Phoenicia, New York, upstate New York, has done retreat`s in other parts of the country and also teaches in the city at the Iyengar Institute and the Yoga Works and places in Washington Heights.  With that, I will bring Marcela online and would love to have her introduce herself a little bit, talk about her work as a yoga teacher and also then ask David some questions about his work.  Marcela, you are on air.

Marcela Clavijo : Oh, yes, I am.  Thank you, Sharib.  First of all, I would like to thank you and Priya for inviting me to be on this show.  I am very happy to do this and its an honor and a pleasure for me to be able to participate in this with you and also I would like to say hello to David and to thank you for your introduction and also to the other panelists, to Dashama and to Micheline, hello everybody.  I am here in New York City and its nice to know that we are all connecting all over the country and all over the world.  I think this is magnificent.

David Emerson : Thank you. So, what I…  The first thing would be just I am a little picky and my actual title as a typical Iyengar yoga teacher, we are kind of a little bit fussy about the details and I am a certified, I am an Iyengar teacher and its junior intermediate 1.  There are various levels of junior intermediate certification and I am just at the beginning of that.  So, there’s I think three of them and I am a junior intermediate 1, just for listeners who are interested in these kinds of details.  Its not a big deal, but details are also important and basically what that means is that as a practitioner of Iyengar yoga, we have a handle on the complete system of yoga in terms of the effects and the practices as well as the asana practices, the pranayamas and meditation practices.  As far as being a teacher at that level, we begin to present the deeper organic presentation of the asanas to the students who have been practicing and are a little bit more familiar with, say, the sequencing and the physical aspect of the asanas, the more structural aspects of the asanas.  We also give them a deeper comprehension of the evolution of the asanas, principles of alignment, principles of function and movement.  The asanas themselves, they are deeper, especially hip movement, pelvic movement is presented at this stage as well as more complex integrated movements of balancing, of weightbearing and combining that with all sorts of shoulder and hip and spinal movement as far as, you know, what I am teaching.  I mean I also teach beginners and a little bit more advanced beginners, what we call level 2, and at the Iyengar Yoga School, I have been there for about 15 years or so.  I am very happy to say and I am proud to say that I am still teaching there and the Iyengar’s I think…  First of all, they are still alive, which to me is a really important factor, where they modify their teaching based on what they see right in front of them.  So, we as an Iyengar student and teacher, I can go right to the source and present a situation, present a problem or a situation I might be having with a student and they assess and they come up with very innovative and practical solutions based on what they see in front of them and that means that its great, but at the same time its always changing.  For example, a few years back, some postures, we were cautioned to not present some postures to students, but then later on we have seen that and we have been told that some postures based on what they have seen with their students in their medical classes in India are actually beneficial.  So, it keeps us, Iyengar teachers, very much in the present moment.  We are kind of encouraged to not think about any posture or any sequence or anything that we might present to the student that it will always be this way, written in stone.  We are encouraged to be creative and to always watch our students and help them to recognize just as you were saying, David, to recognize, help them to recognize their own experience to feel what its like to be embodied and to recognize and handle their own physical experience and guide them through that as well and that helps us also to guide the students.  (Pause)  So, that’s as far as I would like to say right now.

Sharib Khan : Yeah.  I was just summarizing that that’s a great introduction and also, as you mentioned, it fits in so well with what David was saying…that we have to feel our experience and go with the experience as part of the practice.  So, with that, I believe you have a few questions to ask David as to…  So, would you like to go ahead with that?

Marcela Clavijo : Oh, yes.  Very much.  So, thank you again, David.  Thanks for your wonderful introduction and I was really intrigued by what you present in your book, Overcoming Trauma Through Yoga, about the four aspects that you present to the students to experience the present moment, to make choices, to take effective action, and to create rhythm.  The one that I was struck by, that kind of picked my curiosity, was the one about making choices in light of also what you were describing the way that you lead the classes where you don’t command students, you don’t order them or tell them what to do, rather you invite them or suggest to them if you would like to do this and that.  How do you kind of guide them and what sort of factors do you use for considering to guide them toward making the choices that they make?

David Emerson : Umm…  Yes.  Thanks for your introduction as well.  I learned a lot.  Its a great point and in my mind this point I would also consider that practice making choices is kind of a cornerstone… that ahimsa is in many ways the cornerstone of yoga philosophy.  For me, the focus on trauma is so much about not being able to make choices and the impact of that experience on an organism, you know, is not (audio unclear) the idea that I didn’t want bad things to happen to me and they happened anyway.  Its really an organism issue, where your brain, your hormone levels, cortisone, what’s happening inside your tissues and your skin and what’s also happening emotionally and physically, so we try to use yoga as an opportunity for people to begin to make new choices again and so it started off as a semi-theoretical experience and what would it be like to make real choices and as time went on and we started to get feedback from our students we realized how important it was for people and when we did our study, we just finished a big study on part of it was qualitative interviews with people of what happened for you after doing 10 weeks of yoga and one of the key things that kept coming back was choice.  People would practice making choices like how high they wanted to lift their arm (audio unclear) how much energy they wanted to use and, you know, _____ and then they were saying to us that, you know, then I realized I had other choices in my life, there were other choices in my relationships, in my, you know, work life, you know, personal.  So, it seems as though the experience of making choices that are feel-able within your body based on, you know, body feedback is having an impact on people that goes beyond that moment.  So, you know, I am just qualitatively, people seem to be rebuilding their capacity.  They make effective choices that have results they can feel.  You know the other aspect of choice and, you know, its better than anything else is we are trying to tend to the neuroscience what we understand.  So, if you are making choices about what you are doing, especially with us its always based on what you feel, you are starting to engage those intraceptive pathways, parts of the brain as it was kind of stated earlier, connect mind and body.  So, about emphasizing choice, hopefully we have a very preliminary neuroscience to back us up on this.  Our next study is going to be big as fMRI study and it looks like you can start to re-engage those parts of the brain, I think that’s a big part of it, choice and experience.

Marcela Clavijo : Oh, great!  Thank you again.  That’s…

Sharib Khan : That’s very, very interesting.  Thank you, Marcela, for bringing up this question and, David, for highlighting that you have very preliminary neuroscience data that is sort of suggesting that really not, I wouldn’t say complex, but very, very deeply interrelated phenomena of experience choice, choice experience, experience choice, choice experience and… Its, its…  You know, actually I am trained as a physician and I was training to be neurosurgeon, so I have always been very interested in the brain and the anatomy and neuroscience.  So, its exciting to hear that yoga is playing at that level and making those kind of changes happen.  So, Marcela, you have one more question if you can go ahead with that and then we can pull up Dashama and Micheline on the call as well as we are down to the last half hour of the panel.

Marcela Clavijo : Oh, thank you.  Yeah.  Thanks for letting me ask another question. This is the last one that I had which was about if there is a way that you are guiding the students in self-evaluation, in other words about the choices that they are making and creating rhythm in that process.  Is there a way that then…, are you giving them any tool for evaluating anything in progress?

David Emerson : Yeah.  That’s a brilliant question.  You know, I would say the way that our protocol works is everything has happened with present moment oriented. Everybody in our programs are in therapy, so they have a place to talk about and sort of reflect on experience.  Our focus is on the experience itself, so in the moment, you know, if someone makes a choice, for example, and had an impact that they could feel in their body, we will try to highlight that.  You know, I work with a lot of females, for example, so when one of the kids, you know, does something or decides to stop doing it and says now, this is uncomfortable for me, I couldn’t even breathe here, so I am going to stop doing this and I’ll say, wow, that’s great that you noticed that and that you were able to make that choice, you know, to come out of that.  So, I try and try to emphasize the experience that is happening and then sort of build that story as long as we have your people.  So, other than that, we don’t have any experience like thing or story making around the experience itself, but you do that in therapy if it’s helpful, you know. Because its really about what’s happening right now…..and sort of trusting the body, to my perspective, I feel like the body will remember those experiences, you know..If they are imprint kind of genuine, I think that’s the sort of thing that your organism won’t forget and so we try to trust that and stay out of the way as the story making, which we do know its different parts of the brain that will get involved in making stories about things, you know, as opposed to having the experience.

Marcela Clavijo : Yeah.  Great!  Thank you so much.

Sharib Khan : We will have some time to have Marcela back with anymore questions.  I do believe you have a few more things to discuss.  I will bring up Dashama now.  She has been having difficulty getting on the call.  Actually, she is dialing in from Bali and she lost her phone in the ocean, I believe, and she is trying to dial up through Skype and before we lose her and we are not able to bring her experience and reality into this conversation, I will bring her on and Dashama is a yoga and fitness expert with 10+ years in the industry, training, coaching, and consulting with people and companies.  She is a multimedia producer as well.  She has made books, videos, and DVDs that have been featured on ophrah.com, Wal-Mart and are available in Barnes & Noble, Target, and other places and she has a very popular yoga channel on YouTube, which has grown to have more than 8 million viewers, so we are very, very excited to have Dashama on air.  Dashama, can you hear us?

Dashama : I am here.  Can you hear me?

Sharib Khan : Yes.

Sharib Khan : Glad to have you.  I know you…  Yes, we can hear you and we are glad to have you on the show despite all the technical troubles you had in dialing in.

Dashama : Yeah.  Thank you.  Its actually 6 a.m. here in Bali and so glad that I got on.

Sharib Khan : So, please tell us a little bit about your experience and background as a yoga instructor and teacher and then you can ask David and discuss the topic with David with any questions you have in mind.

Dashama : Thank you.  Yeah, well, its interesting because part of my journey as a yoga teacher has dealt a lot with trauma and part of that reason is because I had a lot of my own trauma.  I was in several car accidents when I was young in high school as well as in college and so it was interesting because I then realized that when I got hit by a car this one time on my bicycle, it actually really damaged my cervical spine and I didn’t think about it because I was very stubborn at the time, so I thought it was going to be okay and then several years later is when I started to develop a lot of stiffness and tension in my upper back and my neck and my shoulders especially and so that was when I decided to go through the yoga teacher training and I learned all sorts of things about my body that nothing else had really been able to teach me.  So, basically…  At first, doctors had only told me that you couldn’t really help to get the cervical curve back in your spine with anything really.  You will just have to, you know, deal with it and then when I learned through yoga teachers that you can in effect really realign your spine and get it back to its natural curvature, then that gave me a lot of hope.  So, that was my early journey and it was interesting because then I (audio unclear) also needed healing as there was also their own trauma.  So, I traveled around the world and studied with a lot of different healers and masters to develop this very comprehensive lifestyle and healing coaching program and certification program to teach teachers how to also be healers and that’s what we are doing here in Bali.  So, that’s kind of in a nutshell, I guess, an extension of that is on the video that I produced, so 11 DVDs and the 30-day yoga challenge on my productions in TV that I am creating in the book.  That’s all been an extension of just getting the message out I feel about, you know, what this has done for myself and also the capacity that I have to really help others to heal and to learn that you can be self-empowered and you can take matters into your own hands, but, you know, apply some very specific strategies to be able to heal whether its from a physical trauma or from something more on the emotional side which I have dealt with that in great detail as well and everything in between, even mental and then all sorts of, types of trauma that people go through and so we really look for the root cause and then that’s where we deal with it from there.  So, hope that kind of gives you a little background.

Sharib Khan :  Yeah.  Thank you for sharing that personal story and journey and its really very inspiring to see that how you are taking that as a motivation and to not just delve into the practice but also now in a mission to actually make it acceptable to so many other people all over the world.  So, please and if you have any questions for David, specifically about his practice and what his research is showing with relation to healing patients with trauma, please go ahead.

Dashama : Yeah, absolutely.  I have a number of (audio unclear) part of my teaching and in my journey I have studied a lot about the psychosomatic connection between trauma or injury and then physical and then journey, the soul journey, so I was wondering.  I had researched and studied, do you deal anything on that level as far as the psychosomatic connection to get, you know, rid of it or do you mostly deal with just, you know, healing the trauma from this point in time forward?

David Emerson : Hmm…  No, I think our key theoretical….First of all, its really cool to be talking to you in Bali.  What an awesome world! Our key theoretical underpinning of neuroscience, so we are really focused on the shift dealing with neuroscience, that is shift us a little bit away from cognitive treatments, so things like cognitive behavioral therapy or prolonged exposure for trauma, even psychodynamic psychotherapy which is thought based.  Because of the insights of neuroscience, we had to start to think a little bit differently about trauma, so the impact on neurophysiology does that.  The other thing I think about from your question is the newest research that I am aware of is epigenetics research which is starting to demonstrate some gene mutations related to trauma exposure, so there appears to be some impact on genes that we can then pass on so that the story of trauma becomes more and more complex, I think the better our research tools get.

From my perspective, we are dealing with primarily interfamilial relational trauma.  So, you know, what does that do to an organism when you are brought into the world and you are not loved and you are actually harmed, harmed by the people who are supposed to love you and what do you do?  I mean what does that do to you and then how do we heal from that?  How do you approach that from a healing perspective?  So, that’s really where we are focused, is, you mean, help people sort of reestablish an effective organism, a body that can move through the world and be successful and be in love and be loved, to touch and be touched by your loved ones and have that be safe and maybe even enjoyable.  So, that’s the kind of (audio unclear) for and the data we have…  We have really three studies that are most recent as a PTSD study which, I know I said we don’t do yoga for PTSD but in order to get funded by NIH we have to look at PTSD data.  Then, we go to small fMRI code word and then we also go to a couple of large qualitative interviews.  They are individual interviews with people in our studies.  So, I think when we combine what we have learned from those three, we are starting to get a picture about what yoga can do or in treatment and what it looks like what we have is a clinically significant reduction in PTSD symptoms after 10 weeks of yoga, that’s 33% reduction in symptomatology.  That’s really significant.  We have fMRI data in a small group that shows changes to intraceptive pathways after 20 weeks of yoga and we have these interviews that yoga story if you start to take them all together, people having body experiences where they feel affected and they make choices and then beginning to feel like their organism is effective and then making change in their life.  For example, people saying after 10 weeks of yoga, I can let my children touch me and its not a trigger.  I can let my children touch me and its actually enjoyable, its soothing, you know, and that’s a huge shift.  That’s not trauma if you can be touched by your kids and that can be, you know, like a (audio unclear) that’s not trauma anymore in that moment.  So, that’s where we are coming from.

Dashama :  Okay.  Thank you.  Yeah.  Another question I had (audio unclear) really focus a lot on (audio unclear)  the visualization meditation and enough…

David Emerson : I am afraid I didn’t hear that question.  I heard almost none of it.  (Pause)

Sharib Khan :  I think we lost Dashama there.  Micheline, would you like to introduce yourself and go ahead?

Micheline Toussaint : Can you hear…  Can your hear me?

Sharib Khan : Yes, yes, Micheline, loud and clear.

Micheline Toussaint : Okay.  Yeah.

Sharib Khan : You can introduce yourself and…

Micheline Toussaint : Sure.  My name is Micheline Toussaint.  I am coming to you from a much less exotic location.  I am in a suburb of Washington DC and I am a clinical psychotherapist that works with a lot of people individually with complex trauma using somatic methodology as well and then I also teach yoga with cancer patients and that’s sort of a perspective that I am coming to you from today and, David, I just wanted to thank you for your work.  Its been so helpful.  I sort of language my classes and sequence them and just wanted to say a couple of things about how I use some of your four major areas, your idea about really grounding people in their present moment experience.  It has been really helpful working with people who have chronic pain.  A lot of the cancer patients in my classes have chronic pain and when I am asking them or inviting them to sort of notice their experience, there is a sort of habit of noticing the pains predominantly and so what I have noticed is I sort of have to go a little further and then what else..  What else is there?  What else is there?  So, there is sort of a layered part to that question because I think there is almost a habitual way with my pain when I heal my body if that makes any sense.  That’s been sort of one of my learnings, I think, its just invite them to the next level.  There is the obvious thing you feel and then what else?  Then what else?  And then your idea of the practice of making choices has been lovely too, not only just, you know, how much you extend your arm or how much you choose to do this, but even we began to talk about even their participation in a yoga practice as being a choice they are making to participate in their healing and, you know, they don’t have to do this.  This is one of the choices they have.  So much of what happens to a person in their cancer journey feels like not a choice, but this is a choice they are making to participate and that seems very powerful for people to feel that yeah, this is the choice they are making.  I had a question.  A lot of the cancer patients I work with also have multiple traumas in their lives before this, so this is one more traumatic thing that’s happened to them.  What feels different about this for them or maybe for me is that they haven’t yet reached the other side of it, that they are not yet assured of safety, so they are still in the process of getting regular CT scans and still there is sort of a (unclear audio) and I just wondered if you had any other thoughts, you know, I use primarily the ideas instead of grounding them in present moment and not getting ahead of themselves too much wondering about their next scan, but I just wondered if you had any other perspectives or thoughts on that?

David Emerson : Well, yeah, I know I can relate to a lot of what you are saying and I think the people I work with, you know, when you are traumatized you are always under stress Its not like the trauma has ended, you know.  I mean people may be in therapy and may be in therapy for 10 or 20 years, but the trauma is still there.  That’s when (unclear audio) you know, the project is really, I mean I think you hit the nail on the head, it is to actually have an experience of being present because when you are present in that way that you are not traumatized, you know, and I think your exploration of people is, you know, of what you notice, what you feel and then if people feel overwhelmed with pain, seeing if you can shift, you know, maybe the (unclear audio). There are some small shifts that can be made, but I think that’s what you do.  You know, you explore with people.  You have to kind of accept and you have to accept and respect the amount of pain people are in and then be willing to kind of go into it with an open mind, you know, and maybe its all pain or maybe there isn’t all pain, what if you do this, what if you do that, you know.  So, you know, there are times we may be helpful to even give people maybe a variety of choices if its not overwhelming, you know, things to try, things to experiment with without any expectation or welcome, you know (unclear audio) we don’t feel like we know what’s going to happen.  We don’t know (unclear audio) sort of pretend that we know and then let people have an authentic experience and tell you what they are feeling, what they are noticing, you know, people may be so, so deep in pain that that’s all you know, that’s true, but maybe there will be, you probably had the experience, you know, of working with someone for a while or where they notice something else and then when they do, we can just point it out.  We can just try to.. and highlight it, you know…and then build those experiences as they go, you know, just kind of building on those new experiences.

Sharib Khan : Thank you, Priya, over there for stepping in.  We were trying to bring Dashama back and I wasn’t able to introduce Micheline, but, Micheline, thank you for the introduction and the conversation with David.  If you have anything else, please feel free to add.  I think we might be able to pull in Dashama back into the call despite her terrible internet connection over Skype.  Micheline, if you have anything else, please go ahead.

Micheline Toussaint : No, I think…  Well, I wanted to say to Dashama I will volunteer to come and dive into the ocean in Bali to look for your phone, (laughter) so I just wanted to let her know that.  But, you know, I think the only other thing that I wanted to add and again this is sort of coming out of the yoga tradition, just the importance I have found of the languaging in the final Shavasana, just especially as I work with many people that are towards the end of life even, you know, sort of in a bed where they can’t move at all but just the power of that languaging of just, you know, feel what’s holding you, what’s supporting you literally, whether its the bed or the mat and the floor just evokes a quality of being held in a much larger sense and just working with this population has given me such a kind of understanding of languaging and the power of that and how it can evoke so much more than just the words themselves, if that makes any sense.

David Emerson : Makes sense to me.  I can (unclear audio) saying.  (Pause)  Yes, I mean if you want me to comment at all, I totally understand it.  I think yoga teachers, you know a lot of the language and its incredible how much of language, you know, you use even in 15 minutes and I think we have to pay really close attention to what we say, especially in the context of trauma, you know, or the work you are doing because people are hearing your every word and…..not only hearing but they are taking in and they are taking in into their body and they are interpreting it through their body experience and what we say has a tremendous impact and I think what we say but also like where it comes from in us and what our motivation is and so to be as clear as we can be about that is really…  Its really a big part of the work being like a trauma center yoga teacher.

Micheline Toussaint : Umm…  Well and if I can just share one example of learning for myself that even I had sort of a habit of during a different (unclear audio) and saying something like just can your body for blah, blah, blah and I know just one day I noticed a woman just kind of jerk with the word “can” and I realized, oh, for cancer patients that can be a real trigger word, so just sort of…  So, I try not, you know, I just sort of moved your awareness through, but I feel like I am constantly learning that a word that for me might be fairly benign, might evoke something quite different for people. So I continue to learn now.

Sharib Khan : That’s a brilliant, you know, point that you have shared with us, Micheline, that how the word “can” can be having different interpretations and there I will actually bring on Dashama and Marcela both on air and ask them to add any of their comments on this particular point itself, like how language is interpreted and what they have experienced on their own as a teacher and what they have experienced the effect of language on their children.  So, Marcela, would you like to add something and, Dasham, please add something after Marcela.

Marcela Clavijo : Oh, yeah.  Thank you, Sharib.  Thank you so much, Micheline.  That was really very helpful and thank you for sharing your own experiences and your learning because I think that as teachers and I sometimes even kind of what we joke about in my class is I am the student.  I am the one who is learning from them and my experience has been that as important as language is, its also the tone of voice that you use.  It was something that, David, you were talking about, was watching our own motivation, you know, where we are in relationship to the students, to the group, to the class, to the studio, because that is operating all the time.  We could say the right words, but if the tone isn’t right, if we are not really relating to them as equals in a way and offering to them tools more than orders or instructions to take a shape that’s what they are going to hear and that we are in a very strange way talking to their bodies and they are receiving our energy, how we say the words and how we…, our body language, the expression in our face, if we look at them in the eye, if we don’t look them in the eye.  These things are so crucial that in my experience can enrich the experience with the student or can also undermine my best intentions at getting the perfect sequence or the perfect points or the perfect words, but this other nonverbal aspect is also really important and language is crucial especially in the Iyengar scene where our training is so strongly in guiding students to do things.  I really enjoy giving students the chance to explore, hey, try this.  What does this feel like, do this and trace the results of your action and in a classroom setting also have a conversation so that they are being guided as to what they are doing and what they are feeling and then continuing from there and I find that really, really important.  Also touching students, if we are going to make an adjustment, how we approach them, asking permission to touch them, asking permission to use them as a model in a class or not.  Also, all of these things are so important in class and you are absolutely right, David, we are going to make mistakes and we just have to keep learning from the mistakes and be as humble as we can in our mission to offer what we learn and what we can to help other people. (Pause)

Sharib Khan : So, we can make it quick.  I would like to bring some…, any other callers who might want to ask a quick question from David.  So, Dashama, if you have anything to add over the next 30 to 40 seconds and then we can bring callers on air if they have any questions.

Dashama :  Can you hear me?

Sharib Khan : Yes.

Dashama :  Yeah, I was going to ask earlier.  My question was as far as using visualization techniques at that level of meditation practices and yoga practice you feel trauma because (unclear audio) of my work and I wanted to know what kind of research they were doing with that right now?

David Emerson : Yes.  We actually, we don’t use any visualization or…  We don’t even use metaphorical language.  A lot of that is because we know parts of the brain that help you organize metaphors and thoughts and ideas are really, really compromised by trauma exposure.  So, we keep it really focused on concrete visceral, body-oriented, feelable experiences and we know that people are dissociating all the time in our classes and for us, visualization kind of practices or even metaphors would really just enhance dissociation and we are trying to give people like a new experience other than dissociating, what its like to actually be in your body in the present moment.  So, that’s our focus.

Sharib Khan : With that, if any callers would like to ask a question, please press 1 on your phone and we will get to know that you are interested and will bring you on air.  In the meantime, Priya, I believe you have some questions submitted by our listeners in advance and you might want to ask David before we run out of time.  With last couple of minutes, we would like to touch upon at least a question from one of the users.

Priya Menon : Yes. Thank you, Sharib.  I believe one of our participants wanted to know if you have a lot of arthritis and you are not flexible, would yoga benefit you?

David Emerson : Yes, I think so.  I mean I am not very flexible.  (Laughter)  Yeah, I think if you know the (audio unclear) are really secondary to the process and the experience, so you know, it really doesn’t matter at all.  Its much more about what you feel, what you notice, and what you experience in your own body and the choices you make.

Priya : Okay.  There is another question and it is like what are the couple of yoga breath techniques that might be helpful for relaxation.

David Emerson : That’s interesting.  You know, with trauma especially, living with such a big part of trauma exposure, so when we are traumatized we learn to breathe in certain ways to protect ourselves from impulsive body memories.  So, we are very careful about breath.  We do the focus on breath throughout, just noticing your breathing and feeling some of the muscular activity involved with breath, the things we don’t do, we don’t do any breath retention or (audio unclear) or anything aggressive at all because partly because of dissociation and partly because people already know how to retain their breath, you know, and try to keep it moving and very simple.

Sharib Khan : So, we are up with our allowed 60 minutes, but let’s do a quick roundup.  So, Marcela, 10 seconds if you would like to add anything, say anything before we end the show.

Marcela Clavijo : Well, first of all, just to say again, thanks to everybody, Priya and Sharib and David and Dashama and Micheline, its been a real pleasure to meet all of you this way and to hear what all of you have to say about this topic and I am so happy that we are doing all this research and that we are continuing to expand in ways that we can help people through yoga and that’s all I want to say.  I am so happy that this is happening and thank you all for participating.

Sharib Khan : Sorry, we got cut with Marcella, but, Micheline, would you like to wrap up with any concluding thoughts?

Micheline Toussaint : Just again, thank you for being part of this and I agree that this feels like a very exciting time to be a part of yoga and trauma work.  It just feels like just so much happening, that’s being discovered, I am just very grateful for all the work that’s being done in this area.  So, I am really grateful to be a part of this tonight.

Sharib Khan : And I believe we have lost Dashama, but David, again thanks a lot for (yeah) taking the time out and for telling us such important things about, you know, choices and how they influence the mind-body connection and also Marcela and Micheline and Dashama, thanks for sharing your insights.  Its been very helpful.  So, all this is going to be recorded and Priya will send you the link to the recording and you are welcome to share it with folks and we will be having our next panel next month and we will be in touch with you with another expert on the science of yoga.  We will continue the discussion and have more panelists join the discussion.  So, thank you once again.  We are very, very excited to have you all and hope to have you in the next panel going forward.

Thank you. It was a very nice discussion. Thank you very much, Sharib. Thank you. Thanks, Priya.  Thanks, everybody.Good night!


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