In this extract from Matthew J. Taylor’s latest book, Yoga Therapy as a Creative Response to Pain, Taylor discusses how yoga therapy can be used to decrease pain and the perception of pain.
How does one teach from the wisdom of pain? And how could yoga therapy be a creative response? My hope is you are starting to see some answers emerge. (Pun intentional and literal.) In this section I will offer some direct implications to make some of this what they used to call “lieutenant-proof” in the army when I was a lieutenant. (Do note later, though, Nora’s caution around giving “direct” instructions.)
We “know,” taken together, the above findings are important because they demonstrate that the neural mechanisms involved in mindfulness- based pain relief are consistent with greater processing of sensory experience and at the same time decreases in pain appraisal (Zeidan et al. 2015). Our familiar practices of paying attention inward and editing narratives. Pain reduction may also occur by fine-tuning the amplification of nociceptive sensory events through top-down control processes of inhibition of incoming nociceptive information and that such pain relief does not reduce pain through one avenue, but rather multiple, unique neural mechanisms. Ah, CDSR. Zeidan and Vago (2016) also cite evidence that mindfulness meditation engages mechanisms that are distinct from placebo to reduce pain and that this could be of critical importance to the millions of chronic pain sufferers seeking a fast-acting non-opioid pain therapy. See the marketing section coming up next for how to use this information. There is a decoupling between “sensory and appraisal-related brain regions,” and similarly, between “sensory and affective pain” to increase coping with the pain that does improve. An alleviation of suffering even if pain is unchanged in intensity? This is the frequently reported decrease in the unpleasantness dimension of pain with respect to pain intensity (Zeidan et al. 2015) plus what we already discussed about yoga also altering the meaning, interpretation, and appraisal of nociceptive information, all of which could be important tools for producing more stable and long-lasting improvements in chronic pain symptoms. Wow! How do we do that?
Just a moment. First a bit more neuroplastics to fuel our imaginations. Did you know skill training in sensing and movement leads to reorganization of the maps (representations: the “R” in CDSR) that involve sensation and movement planning and skillful execution of right actions? These maps get altered with persistent pain, referred to as smudging, as though your GPS system got smeared, limiting detail and accuracy. The same skill training though can also foster “cortical synaptogenesis”: birthing new synapses on the maps. More roads added to a map means more options/creative possibilities. Plus, throw in some regular endurance training when safe to begin and that can stimulate cortical angiogenesis: sprouting new blood supplies in the maps. While strength training (much further along in the progression) leads to spinal synaptogenesis: new synapses in the spinal cord. This entire cascade of neural events is evidence that skills ramp up fast but may not last; the protein responses begin the first days; synapses later around 3–7 days and maps 7–10 days. Break that pattern and no lasting change. Daily practice per Patanjali. Who knew?
There’s a bit more. Plasticity only occurs if the student is paying attention. Yoga has many attention tools. The functions of movement and sensation blur together literally with parallel processes and internal parallel processing of information and the energy of signals rather than stay neatly separate. There are three full body maps in the brain and three hand maps in the primary, secondary, and supplementary movement areas. Maybe there’s some systems effect to those mudras after all? Mudras haven’t been studied yet, but… And there’s also tremendous cross-modal (means of input/jnanendryas processing: visual/audio/ tactile information and energy exchange of mind). That bodes well for a therapeutic practice that includes things like asana, chant, visual feedback, mantra, and props.
But, bad news from Nora Bateson. Do not mistake this long list of relationships with neuroplastics change with a recipe or step-by-step guide for practice. She warns that “delivery from the dilapidated state of the world now” (2017, p.189), and I add, “for the individual pain messes we encounter,” is not something that can be effectively handled by a mechanic. Complex systems yoga therapy declares there are no parts to fix, so we don’t need a mechanic. Therefore, there are no particular manuals to write, or scripts to edit. With spiritual challenges (this yoga is a psychospiritual practice), Rohr (2011) reminds us:
We are the clumsy stewards of our own souls. We are charged to awaken, and much of the work of spirituality is learning how to stay out of the way of this rather natural growing and awakening. We need to unlearn a lot… Yes, transformation is often more about unlearning than learning… (p.x)
So both we and our students will need to unlearn and mutually learn in a learning context rather than follow a recipe.
Recall we are just symmathesies within symmathesies. Our task is going to be to mine together the contexts around the pain and suffering, each of us learning and discovering the related mutual learning that takes place within our respective worlds. Think of it as though we’re trying to make that presenting pain complaint “smarter” or better woven into understanding that is both deep and accurate as a wisdom process. Put another way, the pain being experienced is like an idiot light in an automotive. It means something is wrong or is in an ineffective relationship. It does not mean the person having the pain experience (the driver) is crazy, but that more learning is going to be required to get that light to change. Too often you will hear students recount the former assessment of “crazy” by others that were trying to “fix” them, rather than learn with them.
What do we “do” then? You may be relieved to discover that what you do will often be what you have done before, but the how and why will shift. First, however, you should have practiced and developed some mastery of whatever it is you are going to prescribe so you have more than conceptual knowledge from a book. Experiential knowledge from your own lived experience is critical in order to attune with the experience of the student, plus gain your personal insight into the suffering too. This isn’t their suffering alone, remember.
Speaking of suffering, how am I supposed to not give you instructions while I give you instructions about how to approach all forms of pain and suffering with an open-ended yoga therapy set of skills across not just the individual issues, but institutional and societal suffering? What have I done?
My best effort to resolve this dilemma is to build another framework/skeleton of reference that will be adaptable enough to offer guidance without being prescriptive or directive, but still practical. See if this works.
- Our intention is to teach from the wisdom of pain creatively using yoga therapy.
- Wisdom requires addressing oneself and others.
- Skillful benevolent responsiveness is offered to self and others = compassion.
- There it is. What if there were a system/skeleton of organization that contained yoga therapy-type practices and supported compassionate behavior and the principles of creativity?
Roshi Joan Halifax to the rescue (2012)! Her brilliant article asking whether compassion can be trained is just such a model and I highly advise reading it. It is available free, full text on her website. The short answer to her question is that compassion cannot be trained, but compassionate behavior (action) can be primed by six practice domains of non-compassionate behaviors. This makes sense as there needs to be room to accommodate the emergence of the complex human behavior of compassion, not unlike addressing pain and suffering. Related to our next chapter on creativity, I have made a thorough argument in my textbook that this model is also robust enough to prime for another complex emergent phenomenon, creativity (Taylor 2015b). These domain practices can hold the LB/LE of all the practices of yoga therapy, to give us some organization, but also allow the dynamism of mutual learning and complexity we understand wisdom requires.
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A guide that supports yoga therapists in creating a programme of care for those living with chronic pain, through bringing pain science, creativity and yoga together for the first time. It provides the skills and knowledge to create an environment that restores hope and meaning as well as practical guidance.
Read more here.