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Transcript
Guest Article
Considerable research in Yoga as therapeutic intervention is being done abroad. We are thankful to
Dr. Sat Bir Singh Khalsa to permit us to publish his PowerPoint presentation on Yoga Research which
will be of interest to SM readers – Ed.
Research on Yoga as a Therapeutic Intervention:
Past, Present & Future
Dr. Sat Bir Singh Khalsa*
Brigham & Women’s Hospital
Harvard Medical School
Basic Elements of Yoga Practice
Research on Yoga
as a Therapeutic Intervention:
Past, Present and Future
January 14, 2013
Physical postures/exercises
JBTD Research Centre
Mahatma Gandhi Institute of Medical Sciences
Sevagram
Breathing exercises
Deep Relaxation
Meditation
Sat Bir S. Khalsa, Ph.D.
Assistant Professor of Medicine
Brigham and Women’s Hospital, Harvard Medical School
Director of Research, Kundalini Research Institute
Research Director, Kripalu Center for Yoga and Health
3
“Yoga teaches you the
techniques and awareness
to stay healthy. You gain
strong immune, glandular
and nervous systems. This
foundation gives you
energy and lets you deal
with the mental and
spiritual facets of your life.”
Reasons for Practice
in a Beginners Program
Yogi Bhajan
From: Yoga in the real world: Motivations and patterns of use, Quilty MT, Saper R,
Goldstein R, Khalsa SBS, Global Advances in Health and Medicine (in press) 2012.
4
5
-------------------------------------------------------------------------------------------------------------------------------------*Dr. Sat Bir Singh Khalsa, Ph.D. has been fully engaged in basic and clinical research on the effectiveness of yoga and
meditation practices in improving physical and psychological health for over 10 years. He has also practiced yoga lifestyle for
over 40 years and is a certified Kundalini Yoga instructor. He is the Director of Research for the Kundalini Research Institute,
Research Director of the Kripalu Center for Yoga and Health and Assistant Professor of Medicine at Harvard Medical School at
Brigham and Women's Hospital. He has been involved in efficacy studies of yoga for a number of conditions including chronic
insomnia and anxiety disorders. His current studies include clinical trials of yoga for post-traumatic stress disorder and chronic
stress and ongoing research funded by the Kripalu Center for Yoga and Health evaluating a yoga program within the academic
curriculum of public schools to determine the benefits in mental health characteristics such as perceived stress, resilience,
emotion regulation and anxiety. Dr. Khalsa routinely interacts internationally with other yoga researchers and he is
actively working with the International Association of Yoga Therapists to promote the field of research on yoga
therapy. For over 5 years he has also been teaching elective course at Harvard Medical School in Mind-Body Medicine.
e-Mail: [email protected]
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Yoga Journal Survey 2012
I do yoga in
my suite.
Doctor’s
orders.
9
19
Deep Breathing
Meditation
Yoga
Progressive
Relaxation
From: Complementary and Alternative Medicine Use Among Adults and Children: United
States, 2007, Barnes PM, Bloom B, Nahin R. CDC National Health Statistics Report
#12, 2008.
20
21
24
25
Yoga Research
Das and Gastaut, 1955
Yoga Mimamsa
Swami
Kuvalayananda
and colleagues at
Kaivalyadhama
Laboratory, Lonavla
starting in 1924.
56
papers by
Kuvalayananda from
1924-34 and 1954-73
From: Variations de l’activite electrique du cerveau, du coeur et de muscles squelettiques
au cours de la meditation et de l’extase yogique [Variations in the electrical activity of the
brain, heart, and skeletal muscles during yogic meditation and trance], Das N, Gastaut H,
Electoencephalography and Clinical Neurophysiology, Suppl. 6:211-219, 1955.
26
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29
Green & Green, 1977
Bagchi and Wenger, 1957
“…physiologically
Yogic meditation
represents deep
relaxation of the
autonomic nervous
system without
drowsiness or
sleep …”
From: Electro-physiological correlates of some Yogi exercises, Bagchi BK, Wenger MA,
Electroencephalography and Clinical Neurophysiology, 7 (Suppl):132-149, 1957.
30
FMRI During Meditation
From: Beyond Biofeedback, Green E, Green A, Knoll Publishing Co. Inc., 1977.
31
Long-term Meditation & Cortical Thickness
From: Functional brain mapping of the relaxation response and meditation, Lazar SW, Bush
G, Gollub RL, Fricchione GL, Khalsa G, Benson H, Neuroreport 11:1581-1585, 2000.
32
From: Meditation experience is associated with increased cortical thickness, Lazar SW, Kerr
CE, Wasserman RH, Gray JR, Greve DN, Treadway MT, McGarvey M, Quinn BT, Dusek JA,
Benson H, Rauch SL, Moore CI, Fischl B, Neuroreport 16:1893-1897, 2005.
33
Yoga, Thalamic GABA, Mood & Anxiety
MBSR and Gray Matter Density
L Hippocampus
Posterior Cingulate
Temporo-parietal
Junction
Cerebellum
Brain regions involved in: learning and memory processes, emotion
regulation, self-referential processing, and perspective taking.
From: Mindfulness practice leads to increases in regional brain gray matter density,
Hölzel BK, Carmody J, Vangel M, Congleton C, Yerramsetti SM, Gard T, Lazar SW,
Psychiatry Research Imaging, 191:36-43, 2011.
From: Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a
randomized controlled MRS study, Streeter CC, Whitfield TH, Owen L, Rein T, Karri
SK, Yakhkind A, Perlmutter R, Prescot A, Renshaw PF, Ciraulo DA, Jensen JE.
Journal of Alternative and Complementary Medicine, 16:1145-52, 2010.
34
35
Yoga Meditation on Telomerase
From: A pilot study of yogic meditation for family dementia caregivers with depressive
symptoms: effects on mental health, cognition, and telomerase activity, Lavretsky H,
Epel ES, Siddarth P, Nazarian N, St. Cyr N, Khalsa DS, Lin J, Blackburn E, Irwin MR,
International Journal of Geriatric Psychiatry, (2012).
37
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38
Stress in Occupational Setting
Annapurna Upanishad
III-5. …this mind of mine is extremely restless’.
III-6. It wanders from a cloth to a pot and thence to a big cart.
The mind wanders among objects as a monkey does from tree
to tree.
Katha Upanishad
1-III-8. But whoso is possessed of a discriminating intellect and
a restrained mind, and is ever pure, attains that goal from
which he is not born again.
From: Vedanta Spiritual Library http://www.celextel.org/
From: Yoga for reducing perceived stress and back pain at work, Hartfiel N, Burton
C, Rycroft-Malone J, Clarke G, Havenhand J, Khalsa SB, Edwards RT,
Occupational Medicine (under review).
40
Meditation
and the
Default
Mode
Network
From: Mind wandering
and attention during
focused meditation: A
fine-grained temporal
analysis of fluctuating
cognitive states,
Hasenkamp W,
Wilson-Mendenhall
CD, Duncan E,
Barsalou LW,
Neuroimage, 59:75060, 2012.
42
dorsal anterior cingulate cortex and frontoinsular cortex
lateral PFC and posterior parietal regions
Attention,
Stress &
Mood
dorsolateral prefrontal cortex
default network mode regions
43
From: Short-term meditation training improves attention and self-regulation, Tang Y,
Ma Y, Wang J, Fan Y, Feng S, Lu Q, Yu Q, Sui D, Rothbart MK, Fan M, Posner MI,
Proceedings of the National Academy of Sciences, 104:17152–17156, 2007.
44
Yoga Meditation on Telomerase
Models and
Mechanisms for
Yoga Therapy
From: A pilot study of yogic meditation for family dementia caregivers with depressive
symptoms: effects on mental health, cognition, and telomerase activity, Lavretsky H,
Epel ES, Siddarth P, Nazarian N, St. Cyr N, Khalsa DS, Lin J, Blackburn E, Irwin MR,
International Journal of Geriatric Psychiatry, (2012).
45
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46
Disorder
Stress
-
+
Disorder
+
Yoga
Stress
Fitness
Fitness
47
48
Mechanisms in Yoga Practice
Changes in GABA, ANS, HPA Axis
From: Effects of Yoga on the Autonomic Nervous System, Gamma-Aminobutyric-Acid,
and Allostasis in Epilepsy, Depression, and Post-traumatic Stress Disorder, Streeter CC,
Gerbarg PL, Saper RB, Ciraulo DA, Brown RP, Medical Hypotheses, (in press) 2012.
Control of attentional networks
Reduction of Default Mode Network activity
Reduction of rumination and dysfunctional thoughts
Induction of the psychophysiological “relaxation response”
Structural brain changes in cortex and limbic system
Mind-body effects, e.g. self-efficacy, belief, expectation
Induction of contemplative states and self-identity changes
Vagal afferent activity from pranayama and asanas
Physical fitness, e.g. flexibility, endurance, respiratory
Direct organ/tissue effects
Subtle energy mechanisms, e.g. prana, qi
49
50
Temporal Changes in Yoga Practice
Arousal
Yoga Therapy
Research
reduction, physical/mental well-being
Mind/body awareness, resilience, self-regulation
Psychological / philosophical transformation
51
A Review of Yoga Therapy Research
52
Publication Source – Non-Yoga Journals
http://www.ijpp.com/vol48_3/vol48_no3_spl_invt_art.pdf
53
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54
Disorders – Non-Yoga Journals
Chronology of Yoga Therapy Research
50
45
40
35
30
25
20
15
10
5
0
1963- 1969- 1974- 19791968
1973
1978
1983
1984- 1989- 1994- 19991988
1993
1998
2003
20042008
55
56
Yoga Treatment of Depression
From: Initial evaluation of the LifeForce Yoga Program as a therapeutic intervention for
depression, Bennett SM, Weintraub A, Khalsa SBS, International Journal of Yoga Therapy
18:49-57, 2008
59
Yoga for
Prevention
68
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Yoga in High School Students
Worsening
Improvement
Social Stress
Attitude to School
Anger
Resilience
Negative Affect
Anxiety
Anger Expression
70
Qualitative Evaluation – Self-Regulation
Future Directions
• “… if I was stressed or angry I would then do the
breathing to calm me down and I will probably continue
to do this…I was less anxious about school in general...”
• “Before you’re taking a test… relax and breathe and
you don’t get as nervous or as tense.”
• “In the beginning I didn’t like [yoga], but over time, in
the middle I started to notice results… I began to like it
because it started to work…”
• “Friends who are doing yoga with me are kinder…if
they are mad or annoyed they breathe before
talking…My relationships with people are getting
stronger.”
New Disorders
Neuroimaging
Genomic Expression
Specificity of Practices
Cost-effectiveness
Prevention
Positive Psychology
71
72
73
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Kripalu | center for yoga & health
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