July 30, 2007
Teaser Appetizer: Sally Does Yoga
I buttoned my white coat, adjusted the stethoscope around my neck, opened the door and entered the examination room.
I hadn’t seen Sally for a few years.
On this day, what I remembered of her was: a high-strung person with recalcitrant belly pains, which I had not been able to palliate, in spite of all available drugs. She suffered from irritable bowel syndrome of unusual severity, which responded neither to neglect nor therapy.
There she was: sitting on the examination table wearing a bright orange shirt, smiling under the bight fluorescent light.
I extended my hand. “How are you, Sally? How long has it been?”
Seven or eight years” she said, shaking my hand
“ Nice to see you again.” I said.
Looking at her medical chart, the last entry eight years ago showed she took four different kinds of drugs for intestinal colic relief.
“What medicines are you taking now?”
“None” She replied
“How come?” I was surprised.
“You told me to meditate and I did. My pain got better and I stopped taking pills.”
My jaw would have dropped at this miracle, if I hadn’t learned the Marcus Welby technique of suppressing astonishment.
I had not written ‘meditation’ in her chart but I had no reason to disbelieve her.
I recalled having told her to meditate, not out of conviction, but out of sheer frustration, as she had responded to none of the chemicals that I had loaded her with.
And meditation had worked! She told me that she wanted to help others and wanted to know the opportunities in the field. “Surely” she said, “ some aspect of meditation has not been exploited yet.”
Before I talk any further about Sally’s visit, I will summarize what we know about ‘meditation.’
‘Meditation’ is but one of the many steps in Yoga, a metaphysical technique developed over thousands of years in ancient India. Patanjali, a sage, who probably lived around 200 BC, compressed all that was practiced and known at his time into 195 aphorisms - known as Yoga Sutra. Nothing much has changed in the essence of this philosophy and all the variations of Yoga and meditation that are popular now emanate from this original source.
Yoga philosophy says, mind exists in four states: awake, sleep, dream and a state called ‘Thuriya’ - a Sanskrit word - which simply translates into “fourth’ state, where the mind is a pure ‘consciousness and bliss’ and devoid of thoughts. The aim of Yoga - which means ‘to unite’- is to reach this fourth state of mind and be one with the ‘ultimate reality’ which they called ‘Brahman.” The practice is hard, takes many years and only a few succeed.
Patanjali describes eight steps to calm and discipline the mind to arrive at the ‘fourth state’. The commercial ‘ gurus’ emphasize usually just one of the eight steps to create their own brand of ‘Yoga’ and differentiate themselves form other competing ‘gurus.’ The eight steps are:
1. ‘Yama’ (Sanskrit): Abstain from violence, covetousness, sexual indulgence and greed. The first two steps are not different from the teachings of other religious systems, but in Yoga, this is just a prelude, a beginner’s exercise to calm the mind, which prepares the novice for next steps.
2. ‘Niyama’: Practice purity, contentment, austerity, introspection and devotion. These two steps are the most important but least popular. They also have no commercial value for entrepreneurs - no customer pays for advice to abstain from sex and greed.
3. ‘Asana’: Posture exercises to make the supple and flexible. Also called ‘Hatha Yoga’ -- this is the money making venture for the Yoga entrepreneurs. The contorted bodies of leotard hugging figures makes it a visual treat on an advertisement poster. The gyms, strip mall Yoga centers and unemployed celebrities have popularized this step for weight reduction, beauty enhancement and muscle toning.
4. ‘Pranayama’: Control of breath and breathing techniques. In yoga system breath is akin to the basic life source and perfect breathing technique can restore health. Nose is the primary inlet - outlet and abdominal muscles are superior to chest muscles to for breathing action. This step is also popular with the entrepreneurs, who use variations in breathing technique to establish their superior value. Faster breathing, slower breathing, exhaling against a closed glottis (Valsalva maneuver) and use of only abdominal muscles are some of the branded methods. These techniques may have immediate perceptible effects like slowing the heart rate by Valsalva maneuver or dizziness due to hyperventilation, which may impress the gullible customer.
5. “Pratihara’: Withdrawal of mind from the sensory stimulation. Monks and sages have retreated into monasteries, forests, mountains and holy cities to get away from the mundane distractions of the daily world.
6. ‘Dharana’: Concentration on a single object. Once the practitioner is adept in the in the first five aspects, it is time to practice contemplating on a single object, which could be a sound, breath, a syllable (Mantra) or even a common object like a candle.
7. ‘Dhyana’: The practitioner with a supple body, proper breathing technique, without distractions can now sit quietly in a silent place and contemplate. She tries to ignore the constantly erupting thoughts and concentrate on a single object. With practice the meditation sessions get longer and the mind becomes more thoughtless and she may rarely slip into the next stage of bliss.
In the commercial world, where execution speed is of value, a novice is initiated into this stage without prior preparation. The benefit to the customer is weak but the revenue stream is strong, which propels the Yoga centers oversell “meditation.’
8. ‘Samadhi’: Super conscious fourth state or bliss. A miniscule number of lucky meditators finally arrive at this level. Scientists who have worked on subjects reaching this stage have quoted the feeling of subjects in this stage as rapturous, tremulous and experience unprecedented bliss. Thoughts settle into a state of pure awareness and the observer, observed and the process of observation merge into one. The experience of deep meditation has encouraged articulate writers to give it a spin and compare this state with happenings at the “quantum” level and describe intriguing similarities to the uncertainty principle and even Bell’s theorem.
Does Yoga help health and well-being? Numerous scientific studies in the last 70 years have collected evidence that the practice of Yoga affects the body in many ways. Here is the summary of some salient findings.
--Heart rate slows during peaceful meditation and accelerates in moments of ecstasy. There are stories about the adept yogis stopping the heart in trance. Studies have shown, while the pulse may not be palpable, the EKG continues to show the electric activity.
--Meditation lowers systolic blood pressure in normal or people with mild hypertension, to the extent of 25 mmHg. Combination with other relaxation techniques, like biofeedback is more effective than meditation alone and the effect disappears if meditation is discontinued.
--Many studies have shown that meditators reduce the respiration rate; oxygen consumption, carbon dioxide elimination and can sometimes suspend breathing for longer periods compared to control subjects, without ill effects.
--Muscle tension decreases and the brain electric activity (EEG) show frequent slow high amplitude alpha waves. Experienced meditators and those nearing ecstasy show bursts of faster waves rising from in the front brain. Epileptic like activity without the seizures in the temporal lobe on the side of the brain has prompted speculations that this part of the brain is the seat of religious experience.
--Adrenal hormones, lactate and cholesterol may decrease.
--Pain perception decreases and significant psychological improvements can occur in people suffering from chronic pain.
--Long-term meditators acquire a sense of equanimity, sensory detachment from the outer world and a growing sense of being a witness to their bodies.
--Controversy exists about improvement in memory, intelligence, and short-term concentration, though experienced meditators can control intrusion of irrelevant thoughts.
--Negative effects accompany positive benefits with any intervention and Yoga is no different. In a survey done in 1984 at Stanford, from 4 to 9 % long-term meditators reported adverse effects of anxiety, confusion, depression, emotional instability, frustration, suspiciousness, and withdrawal. In other studies, meditators have reported illusions, hallucinations, relapse of schizophrenia and suicidal thoughts. These effects correlate with the length and depth of mediation. The ancient texts describe Yoga path as “sharp like a razor’s edge.” For serious long-term practitioners, the tradition strongly recommends guidance of an experienced teacher.
Now, I come back to Sally. Meditation had relieved her from constant pain and drug dependence; it had given a freedom from chemical crutches. She had explored various commercial angles and had decided that writing a self – help book would have a larger market. She wanted me to co-author the book. I explained to her that, trained in the ‘scientific’ medicine, we have an acquired contempt for anything ‘eastern’ or ‘herbal” and we do not normally mention or commit such acts - that smack of quackery - in our medical practices.
“But surely you helped me and we could help others. Why would you not help?” She protested.
“It is plain prejudice, euphemistically called bias.” I said.
“ And what will be the title of your book?” I enquired.
“ Meditate, Don’t Medicate.” She announced.
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