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The lower back pain secret: Sacroiliac Joint Instability

One Sunday morning, I got up out of bed and felt a groaning ache radiating from my lumbar region, around the hips and down the outside of my left thigh. Fast forward to ten days later, and I am now an ecstatic 90% better! I’m writing this blog post to let you know how I self-diagnosed my problem and learned to heal in only 10 days.

Youtube is an amazing resource for back problems. A heartfelt thank you goes to Dr. Brant Peterson, a sports chiropractor at Positive Motion Chiropratric, for sharing the information that helped me the most to get through this. The bonus was that I was able to help to pass his advice on to my friend Steven who had, coincidentally, been suffering from the same debilitating condition for several months. Months?? I could barely handle a week! But I’m a wimp when it comes to pain and being a bit of a yoga geek, I also love to research problems.

SO WHAT WAS THE PROBLEM?

Turns out I was suffering from an often-undiagnosed condition called SACROILIAC JOINT (SIJ) INSTABILITY. SIJ issues are tricky to diagnose. The problem is often missed on an x-ray, CT scan or MRI even though SIJ issues cause up to 15% of lower back problems. And it is not something that can be fixed with an ‘adjustment’, which will offer temporary relief at best and might well make the condition worse. This is because the problem is not that the joint is too fixed or rigid but that it is TOO UNSTABLE.

There is a (controversial) process of diagnosis that involves injecting an anesthetic into the joint but you obviously need a medical professional for that. Also, there are many other conditions that can mimic the symptoms of SIJ problems such as a herniated disc, spinal stenosis, osteoarthritis or bursitis of the hip. The good news is that this problem responds very quickly to some very simple interventions.

SO WHAT IS THE SACROILIAC JOINT?


I always started to nod off in anatomy class. Nothing like a personal injury to get you fascinated by the subject! The SI joints lie between the sacrum and the ilia (singular: ilium) bones of the pelvis – hence the name sacroiliac joint.

The ilea are basically the hip bones, the large ones that look like the ears of an elephant. The joint we’re talking about connects the elephant ears of the hip bones to the sacrum at the base of the spine. The sacrum is a bony structure that looks like a shield from Game of Thrones. It’s located just above the tail bone at the base of the lumbar vertebrae, which itself is connected to the pelvis. Remember, everything is connected.

These joints carry the entire weight of the body, so the ligaments that connect need to be super strong and stable. In fact, they are the strongest ligaments in the whole body. The joints they attach to act as SHOCK ABSORBERS, protecting from stress on the pelvis and spine, and they are key to LOAD TRANSFER from the upper to lower body when upright.

WHAT IS SACROILIAC JOINT INSTABILITY?

SIJ instability occurs when the ligaments that connect these joints get stretched from overuse or trauma. Dr. Dan Tuttle explains: The joint becomes hyper-mobile. In an attempt to stabilize the joint, the body will activate a multitude of muscles and people will experience this as a multitude of symptoms. Since the SI joints are so key to stabilizing the body, when they are not working properly, the whole system can get out of whack.

WHAT DOES SIJ INSTABILITY FEEL LIKE?

For me it felt like my body was being slowly crushed from both ends. It was a dull, grinding kind of pain. But it’s not always just around lower back. The pain can be felt in the hips, the buttocks, where the hips and thighs meet at the front of the body, down the side of the thighs, even around the shoulders and neck. If left untreated, it can even lead to sciatica. Since there are so many muscles from the rest of the body that attach to the pelvis (being able to run away is of paramount importance to survival) SIJ PAIN CAN TRANSFER ALMOST ANYWHERE, including the neck and shoulders. It can even cause headaches, which it did for me.

Some people can pin-point a very specific area as the central point of the pain region. This is classically on one side of the rear-most point of the pelvic bone above the buttock, a couple of inches to the side of the centre line of the upper sacrum. It can be felt as a small bony protrusion.

Pain sucks our milkshake dry. Leaving us tired, grumpy, restricted, and vulnerable to more injury. The pain of SIJ instability can be dull and throbbing, but it can also be sharp and stabbing. The back can feel tight or stiff. The pain can come on suddenly or creep up over time. Mine was always worse in the mornings and improved throughout the day and then got worse again in the evening.

WHAT CAUSES SIJ INSTABILITY?

Trauma to the area can be caused in several ways, often from a simple motion that combines bending forward, tilting the pelvis and twisting the torso. Steven knows exactly when his trauma occurred. He was on a ladder fixing a roof and he twisted around while carrying some tiles, combing classic SIJ damaging moves.

One common trigger is misjudging a step down and banging the heel heavily causing a sudden, hard impact. Activities where this impact is repetitive, such as tobogganing can also be culprits. SIJ problems can affect women in late-stage pregnancy, where the weight is being carried forward, and people like myself who have one leg a different length to the other are more prone to this problem. (It was due to a motorcycle accident in my more exciting youth). And, like everything, you need to take care of this area more as you get older. I’ve always had a really strong back, but at 58, this was a wake up call to pay more attention.

In my case, I’m pretty sure that I destabilized my SIJ while leaning forward while pouring large plastic bottles of kerosene into my kerosene heater container. I could tell at the time this was not a very smart position and a couple of times my back felt tweaked afterwards, but I didn’t think much of it because the pain didn’t last very long. But this winter, when I was filling my kerosene heater almost every day, it was a step too far. Needless to say, I now use the hand pump when filling the bottles. Takes twice as long, but it’s well worth the wait!

WHAT MAKE SIJ ISSUES WORSE?

Some activities that can feel really bad when you have this condition are: prolonged sitting or standing, walking upstairs, turning in bed, leaning forward, twisting.

YOGA POSES to avoid with SIJ ISSUES

Here’s a red list of yoga poses for SIJ issues. All forward bends, especially asymmetric bends and/or those where the legs are wide like Upavistha Konasana; all side bends. Also problematic: Extended Triangle Pose (Utthita Trikonasana); Extended Side Angle Pose (Utthita Parsvakonasana); all postures that spread the thighs wide apart (abducted poses) such as Warrior II (Virabhadrasana II) and Baddha Konasana; and spinal twists such as Marichyasana III as well as any side bends. Janu Sirasana is one of the worst since it combines all the moves known to aggravate this condition: twisting, abduction, and forward bending. There’s a very informative article in the Yoga Journal that goes into all of this and more.

Many of these red list poses were included in my daily practice. I was doing warrior like it was going out of style as well as lots of forward bends and extended side bends. Looks like I’ll have to create another practice sequence for a while. A good opportunity to change the routine.

YOGA POSES THAT HELP

Many sites that claim to show helpful poses for this condition include poses that actually AGGRAVATED my SIJ instability. The two poses that I CAN recommend without hesitation are: Boat Pose (Navasana) and Bridge Pose (Setu Bandha Sarvangasana). I’d love to hear from anyone who has helpful suggestions based on experience rather than speculation. However, there are a LOT of EXERCISES that CAN help, as you’ll see.

Boat Pose is a good yoga pose for SIJ issues

WHAT ARE THE BEST INTERVENTIONS FOR sij ISSUES?

There are 4 main interventions that worked like a charm for me.

  1. REST
  2. SIJ SPECIFIC EXERCISES
  3. TARGETED COLD WATER THERAPY
  4. SACROILIAC BELT

I also took 400 mg of ibuprofen once a day for the first 3 days. It seemed to help the muscles to relax and be more responsive to the exercises.

REST REST REST

Learn from Wise Rest Dog

As Dr. Dan Tuttle points out, physical therapists tend to think in terms of mobilization for resolving joint and muscle issues, when actually what this joint needs is to be STABILIZED—in other words held together better. This is why REST can be so important. I don’t mean bed rest. But actually, stopping your daily routine for a while – and certainly stopping the movements that could have caused or exacerbated the condition like lifting weight, especially while turning, twisting, bending forward, etc. Rest can be one of the toughest things for bodywork enthusiasts to do, but you need to take time to reset, figure out what you’ve been doing that has caused this problem to arise, and give your body a break from all unnecessary stress. I stopped all yoga and my 1 hour daily walks for a week. Walking on flat ground for up to 15 minutes is fine though. You can start the suggested exercises right away, since they address the problem instead of exacerbating it.

SIJ SPECIFIC EXERCISES

Most importantly of all DON’T’ STRETCH! I know it feels like this is what you need, but it’s not. My friend who didn’t know that he had SIJ instability, kept coming to me for private yoga lessons for his back pain. Sometimes he would get temporary relief, but that was the rub. It was always only temporary. There are specific exercises that can radically improve your SI joint stability, but they do NOT involve stretching. They involve horizontal hip-stacked leg lifts, clamshell exercises, core work and isometrics.

Dr. Brant Pederson of Positive Motion Chiropractic has some very helpful exercises here.

Dr. Joe DeMarco of OcraMed Health has some cool core-building exercises designed especially for people with SI joint issues.

My SI joint healing routine (morning and evening) involved 3 rounds of 10 the horizontal leg lifts, 20 or so clamshells each side, and a couple of isometric exercises. The key to the horizontal leg lifts is to STACK THE HIPS and even to roll the top hip slightly forward. If it’s hard, you’re probably doing it right. Later, I included Dr. Joe DeMarco’s knee-raised crawl which was fun as well as stabilizing. How I love that word – stabilizing.

TARGETED COLD WATER THERAPY

Cold water is a natural pain reliever. Cold water causes the blood vessels to restrict, reducing blood flow and so bringing down swelling and inflammation.

Cold water is a natural pain reliever

Since cold therapy has several other benefits, I normally take a 3-4 minute cold rinse after my hot shower every morning, so staying in a bit longer to target my SI joints wasn’t a big deal for me. I know that many people have a huge aversion to cold water (as did I before I got used to it) but it has an amazing effect on pain. After my hot shower, I use the spray nozzle for 1 minute I on my front pelvic region, 1 minute each on my hips and 1 minute on my lower back. It is simply AMAZING how good this feels afterwards.

SACROILIAC BELT – MY NEW BEST FRIEND

When I put on my sacroiliac belt my first feeling was – gratitude and relief. It just feels so, so good, like this is EXACTLY what my body needed. “I can finally start to heal” Steven texted after the first day of trying it out. The belt costs about 30 USD. You can run a test by tying a scarf or any long narrow material around your hips. If this feels good, then a sacroiliac belt might be what you need. You can hide the belt under clothes but I tend to wear mine on top. It feels a bit action hero, like it should be hung with high tech weaponry. I might never take it off.

Here’s a video from the wonderful Dr. Brant Pederson on how to wear it, because it’s a bit tricky. It needs to be below worn on the hip to be effective.

OTHER SIJ INTERVENTIONS

There are more extreme interventions such as SI joint fusion – a surgical procedure that involves placing a bone graft over the joint with screws and rods to keep it in place as it grows. There’s only about a 50% success rate though and spinal surgery seems an extreme and risky option.

There are also SUPPLEMENTS that help some people. Dr. Pederson recommends a product called Ligaplex 1. Glucosamine and Chondroitin formulas are also said to help, especially if your SIJ problem is linked to other underlying issues. I encourage you to work with your own chiropractor or health professional for proper diagnosis and resolution.

I hope that you found this helpful and are soon pain free.

And as always, respect yourself, explore yourself.

Putting your yoga foot down

How we stand, and how we engage our feet with the earth informs and responds to our fundamental interior attitude. Do you step into a room tentatively like a you’re worried about intruding? Or do you step like someone with a right to be there? Doit dans ses bottes (right in your boots) as the French saying goes. Do you walk lazily with a lack of direction or do you walk confidently with purpose? This 5 minute exercise will tell you a lot about how you hold yourself in space.

The practice of yoga increases proprioception (also called kineasthesia)‑‑the awareness of position, movement, force, and effort of the body in space. The greater our proprioception, the more we are able to conduct our bodies in ways that keep us injury-free, balanced and resilient. Proprioception is also key to the conservation of energy which lies at the heart of any yoga practice. It is sometimes called ‘the sixth sense’ the implications of which become increasingly apparent as we deepen our practice.

A great place to begin to increase our powers of proprioception is with the feet, since the placement of our feet affects our entire body, from our knees to the pelvis and spine, all the way up to the neck and head. When we wear closed shoes, or even socks, we block our ability to develop this awareness, so I highly recommend that you practice barefoot. First of all, discover your own habitual foot stance with the following exercise.

Stand tall but not stiff, arms relaxed to the sides, with a lifted straight spine. Don’t bend or lock the knees because this turns off the core and hip muscles. Your feet can be together or slightly apart but make sure that the toes of both feet are in line. Bring your awareness to your feet. Roll them a little inwards onto the inner arches and then outwards onto the outer arches a few times. What feels more natural? What do you notice?

Now bring the weight back into your heels as far as you can while keeping the toes on the floor, and then forward towards the balls of the feet keeping your heels down. Again, check what feels more natural to you and what you notice happening in the legs, hips and back. Place most of your weight on the heels and notice how you lose the natural curve of the lumbar spine and the core muscles become disengaged. This is how most people stand.

Now lean forward onto the balls of the feet and notice how the increased pressure on the lumbar forces it to curve more and the core muscles engage. Standing on the inner feet will internally rotate the hips, which can, over time, lead to ‘knock-knees’. Standing more on your outer feet will strain the outer knees and can lead to bowed legs. Place your fingers gently across the hip bones and roll the feet first to the outside and then to the inside and feel the external and internal rotation of the hips as you do so. Notice how even a small adjustment of the feet affects the position of the hips.

Now take a few moments to divide your weight evenly between the heels and the balls, then between the inner and outer arches. Gently spread and then lengthen the metatarsals by spreading and lengthening the toes. Press your toes firmly down and grip them a little. The toe gripping is a temporary step to help you to connect with the next part of the practice.

Now lift up through the inner arches of your feet keeping the three points of the triangle of each foot (the two ends of the transverse arch across the balls of the feet and the heel) on the floor. Feel a suction lifting sensation right in the centre of the foot. You can imagine your feet like two toilet plungers creating a suction on the ground (excuse the image!) Feel how the lift of inner arches travels all the way into the inner ankles. You might notice a subtle lift of the thighs and the backs of the calves as well.

Now, relax the grip of the toes without lose the lift around the central point of the suction. This takes a bit more concentration and effort, but it will be worth your while. Engage the legs and ankles to maintain this lift in the arches. This is pada bandha or ‘foot lock’ in classical yoga. It enables the yogi to draw prana (vital energy) up through the ground.

Now, walk around the room for a minute or two while trying to retain all the following points:

1. The weight of each foot spread evenly between the upside down triangle made by either side of the transverse arch and the heel connected through the inner medial arch and the outer lateral arch.

2. Maintain a lift of the inner medial arch of both feet

3. Spread the toes apart

4. Feel a suction and lift at the very centre of the foot

With a bit of practice you can develop your “Yoga Foot”, heighten the sensory feedback through your entire nervous system, get that prana flowing more freely and learn how to hold your ground. Literally!

Respect yourself, explore yourself.

10 reasons NOT to do yoga today

We all suffer from occasional bouts of procrastination, especially when it comes to something that’s actually good for us. (Go figure).We don’t tend to procrastinate about that third glass of wine, or flopping in front of Netflix for the evening, but we do put off going for a bike ride, changing our diet, or yes, doing our yoga practice. There are still days (though they are becoming fewer and fewer) that I don’t do yoga. And, of course, there is always a great reason. So, this month, I thought I’d make a list of TEN REASONS NOT TO DO YOGA TODAY.



I’m sure many of you will recognize some of these and can add your own favourites to anything that you procrastinate about in your life!

1. I’M TOO TIRED. Yoga gives us energy and vitality. Also, it’s highly unlikely that we will feel less tired as the day goes on. Try it and see.

2. I’M TOO BUSY. I’LL DO IT LATER. Funny how that ‘later’ never seems to happen no matter how well-intentioned we are. Being busy means keeping our priorities straight. We are actually more efficient with the things we have to do when we spend time to do our practice because we feel better while we’re doing them!

3. I HAVE TO CLEAN THE HOUSE. This one’s a personal favourite. Obviously, the house cleaning police are going to ring the doorbell at any moment and demand an on-site inspection! Anyway, if you clean your house after a spot of yoga, you’ll have more energy and enthusiasm for it.  

4. I DON’T HAVE A YOGA ROUTINE. Get one! There are several yoga teachers in the Deux-Sévres who, like me, would be happy to work with you to develop a personal daily practice.

5. I DON’T HAVE SPACE TO DO YOGA. So make one! You only need somewhere the size of your yoga mat. And, as the weather starts improving, consider doing your yoga outside. It is even more beneficial to do yoga in nature.

6. YOGA IS FOR SKINNY PEOPLE. This is one of the biggest misconceptions and is driven in large part by yoga types who emphasize a physical stereotype of the ‘ideal’ yoga practitioner. Actually many of the ancient yogis of India were quite tubby! And in any case, yoga helps to improve your digestion and regulate metabolism which will help to balance your body to keep the weight off.

7. I’M TOO OLD. I began teaching yoga at the age of 53. A yoga teacher recently died at the age of 101. She was teaching almost to the end. End of argument.

8. WHAT IF I HURT MYSELF? You are more likely to hurt yourself cleaning the stairs or leaning over the bathtub without preparing your body fist? Doing yoga under guidance will increase your body-awareness which will, in turn, protect you from injury as you go about your daily routine.

9. I’M NOT FLEXIBLE. No one is flexible at every part of their body. Yoga is not gymnastics. Flexibility is over-emphasized because of the images of extreme yoga postures that we see as examples of the ideal yoga students. Flexibility is just one part of the many benefits of yoga, which include improved strength, endurance, resilience, balance and body awareness.

10. I NEED TO TAKE CARE OF SOMEONE ELSE. Whether a spouse, kids, grand-kids, friend or animals, if you take care of yourself, you will be in such a better state of both mind and body to take care of someone else. Even 15 minutes will make a difference.

FEEL FREE TO ADD: It’s too hot, it’s too cold, my yoga pants are in the wash, and my dog ate my yoga mat!

In truth, we all need a break now and then, even from yoga. But there is a difference between a conscious break and an excuse. Because whatever your reason for not doing yoga today, it will stop making sense the moment you step onto your mat and you remember why you were there in the first place.

Vitamin D and Covid 19: Big Pharma’s worst nightmare


According to a November 28 press release from the Department of Health & Social Care, the UK government is planning to distribute free Vitamin D supplements to 2.7 million of the most vulnerable people in Britain this winter, a move already taken by the Scottish parliament. This is welcome news to the hundreds of researchers and medical professionals who have been urging governments and healthcare bodies since the beginning of the pandemic to pay more attention to the growing body of evidence that Vitamin D reduces the incidence, severity and mortality of Covid 19.

In September, the evidence was amplified when David Meltzer, an internist and economist at the University of Chicago, and his colleagues, published the results of the first analysis of Vitamin D deficiency with testing positive for Covid-19. The results found people low in Vitamin D to be “at substantially higher risk of testing positive for Covid-19”. In study after study (40+ at the last count) researchers the world over have been discovering significant correlations between Vitamin D supplementation and reduced severity of Covid-19 symptoms, including fewer deaths.

So why did it take the UK government so long to begin talking seriously about Vitamin D? And why is the messaging still so muted?

Although the supplement distribution is a welcome move, with all the evidence now amassed and health professionals in such vigorous agreement as to its significance, what we should be seeing is a massive public health campaign around Vitamin D, with state funding of large-scale clinical trials. Hopefully, this is just around the corner since the government has announced a reviewal of the evidence. And yet, disappointingly, the media is not holding the government to account. In their article announcing the planned free distribution of supplements, the BBC claimed that ‘there is limited evidence that vitamin D protects against or treats Covid-19’. This echoes the statement of Health Secretary, Matt Hancock, who said in a parliamentary session in September that government-led research did not ‘appear to have any impact’ on the virus, when in fact, officials admitted that no such trials have been conducted. Whether this was a genuine mistake on the part of the Health Secretary or an intentional obfuscation is anyone’s guess.

Some of the confusion about what constitutes reliable evidence lies in the difference between observational studies and controlled clinical trials. Clinical trials are the gold standard for medical research, and include a control group (or placebo group) and an experimental group; the one that receives the intervention. However, when the resources are not available for control studies, well-designed observational studies, particularly of larger populations, can be extremely valuable in determining associations between specific exposures and results. Whereas it is true that a few of the studies have not demonstrated a statistically significant link between Vitamin D supplementation and improved Covid-19 patient outcomes, the findings of dozens of peer-reviewed, randomized, double-blind, observational studies suggest otherwise.

As far back as May, Joanne. E. Manson, Prof. of Medicine at Harvard Medical School described the evidence as being “quite compelling” that Vitamin D offers protection against infection and complications from Covid 19, ”particularly against the severe reaction cytokine storm.” Rose Anne Kenney, from Trinity College Dublin called the evidence, “very strong.” And in his letter to the British Medical Journal on October 5, Australian GP, Peter J. Lewis echoed these and other voices, when he referred to the evidence from research studies as “overwhelming”.

Large scale controlled clinical trials require serious funding, organization and human resources, which is why, especially when there is no drug company behind the intervention, they more often require governmental support. For the past several months, doctors, scientists and healthcare professionals have been calling for such trials to be conducted into Vitamin D and Covid-19 on the strength of the results of the numerous observational studies. This issue has been raised in several BMJ Rapid Responses and can be read in the conclusions of many of the researchers themselves, often in quite urgent terms.

Thankfully, (although apparently unbeknownst to the Health Secretary or the BBC) we now have two, albeit quite small, controlled clinical studies on Vitamin D and Vitamin D analogues in the treatment of Covid-19. The most recent was carried out in India and was published in Nature on 19 November 2020. This study concluded that Vitamin D deficiency not only markedly increases the chance of having severe disease after infection with SARS Cov-2, but that Vitamin D deficiency translates to increased mortality.

The first randomized clinical trial in the world on Vitamin D and Covid-19 was conducted at the Reina Sofía University Hospital in Spain and the results were published August 29 in The Journal of Steroid Biochemistry and Molecular Biology. The results were clear. Vitamin D supplementation improved outcomes for Covid-19 patients, reduced the chances for ending up in intensive care, and reduced mortality. The researchers are now extending the study throughout hospitals in Spain.

These two clinical studies support a number of the findings of the other 40 or so observational studies on Covid-19 and Vitamin D:

  • There is a greater incidence of Covid-19 in Vitamin D deficient patients and Vitamin D deficient people are more likely to test positive for the virus.
  • Covid-19 patients with low Vitamin D levels are more likely to be hospitalized.
  • Vitamin D supplementation reduces the likelihood of a Covid-19 patient going to intensive care.
  • Vitamin D offers a protective effect both in terms of symptoms and survival in those who take it as a regular supplement before contracting the virus.
  • Supplementing with Vitamin D, or exposure to UVB radiation that forms Vitamin D through the skin, reduces Covid-19 fatalities.
  • The most gains are experienced in patients who are more severely Vitamin D deficient.
  • Moderate doses are more effective than high doses.

You can read all the studies here with a helpful summary here.

Vitamin D deficiency is a global problem but its safety and usage is well-established and understood. Vitamin D toxicity is extremely rare and there are no nasty side effects at the doses being recommended. We can source it from fatty fish, cheese, eggs, and beef liver, but we get most of it from sunshine. Healthcare professionals have long advised supplementation of Vitamin D in the Winter, since the the lack of sun leads many, particularly the elderly, to become deficient. Vitamin D has been found to enhance innate immunity and suppress the expression of pro-inflammatory cytokines. The link between strong Vitamin D levels and resistance to respiratory infections has also long been known. And now we have persuasive evidence that Vitamin D can play an important part in any treatment program for the coronavirus.

You would think that in light of this, international and government health agencies would be lining up to conduct the kind of clinical trials that would remove doubt once and for all. Yet there have been none so far, neither by the World Health Organization as evidenced by their International Clinical Trials Registry Platform (WHO ICTRP), the CDC, nor the National Institutes of Health. In fact there are currently no federally funded clinical trials of the effects of Vitamin D on Covid-19 at all. One can’t help but wonder, if we were we talking about a new or redeveloped drug that could be marketed to giant profits and reputational acclaim, whether the enthusiasm would be greater. After all, the discovery that hundreds of others have already made that an ordinary Vitamin (actually a hormone, but let’s not nit pick) that anyone can get reading the newspaper in their back garden on a sunny day and costs pennies to produce commercially can help Covid-19 patients is not exciting to those driven by such motivations.

As Robert A. Brown, Chair and researcher at the McCarrison Society, a nutrition-based think tank, writes in the BMJ, ‘…if the depth of information, and number of studies on ‘D’, consistently pointing in the same direction, related to a new COVID-19 ‘drug’, with minimal side-effects, it would have been front-page-news. Additional clinical research would have been prioritised with determination and alacrity, and ‘D’ by now, licensed as a standard-treatment-protocol.’

Fortunately, institutions are now taking it upon themselves to forge ahead with clinical trials of Vitamin D and Covid-19. There are currently 59 such trials either planned or already underway around the world, including several in the United States and a large trial in planning by Queen Mary University of London funded by Barts Charity.

Such large scale clinical trials could easily have been supported by the likes of the Gates Foundation that has made Covid-19 a central focus of their current work. In May, the Gates Foundation joined forces with Wellcome and Mastercard to the tune of 125 million dollars to ‘identify potential treatments for COVID-19, accelerate their development, and prepare for the manufacture of millions of doses for use worldwide.’ This initiative is being coordinated by the Covid-19 Therapeutics Accelerator which is seeking international investment of ‘at least’ 11.6 billion USD over the next year. Back in March, the Therapeutics Accelerator donors announced grants of $20 million to three institutions—the University of Washington, University of Oxford, and La Jolla Institute for Immunology—to fund clinical trials in order to identify highly potent immunotherapies for the current pandemic. None of these institutions are engaging in clinical trials of Vitamin D in treatment of the disease.

Currently, the only FDA-approved Covid treatment drug is remdesivir, produced by the biopharma giant Gilead Sciences and sold under the brand name Veklury. Remdesivir was also the first Covid treatment drug to receive a conditional marketing authorization in Europe. Surprisingly, the WHO recommends against its use, having stated that there is no evidence that it improves survival or helps people stay off ventilators. Last month, Therapeutics Accelerator, granted 500,000 USD to Almac to develop production of a drug for the treatment of Covid-19. That drug was remdesivir.

From a business point of view, remdesivir kicks Vitamin D out of the park. While remdesivir costs over 3000 dollars for a 5-day course, a one month supply of Vitamin D3 will set you back around 4 dollars. Vitamin D is not and cannot be patented. It can be made very cheaply in huge amounts with production not confined to a single country or region.

The reluctance to invest in clinical trials or to promote the robust body of evidence for a cheap and easily scalable intervention for Covid-19, raises many questions about the influence of the pharmaceutical industry and their backers and lobbyists on government health ministries and public health policy. How these relationships might be impacting the interests of public health should be cause for concern. Hopefully, the full force of scientific inquiry and the integrity of thousands of researchers and health professionals who genuinely seek to improve the outcomes for people affected by this disease will prevail. Fortunately in this case, if our institutions fail us, we need go no further than our local chemist, or – weather permitting – our own back yard.

What the body wants: the muscle of survival and why it deserves your attention

Psoas_Tenderpoint

One of my first introductions to the power of the mind-body connection was through a set of muscles called the ‘psoas’. These are the muscles that attach our lumbar spine to the legs. They’re often called the ‘fight or flight muscles’ since they are a first responder to conditions of threat, allowing us to high kick, bring our knee towards our stomach in defense–or run.

Several years ago, I was in a traumatic relationship with a man with all the traits of narcissistic personality disorder. Although the relationship only lasted a few months, the experience had left me terribly depressed and anxious and my self-confidence in tatters.

As I gradually gained the strength to end the relationship, something very strange happened to the tops of my inner thighs. They began to throb with a kind of pain I had never before experienced. I hadn’t done any demanding exercise to explain it, but it felt as if these muscles had been massively over-worked. It felt incredibly uncomfortable, like a cry for help that I didn’t understand. It was particularly concentrated in the dip below my hips, half a finger length towards the pubic bone, which later, when I became more familiar with anatomy, I learned was exactly where the psoas muscles connect with the tops of the thighs across the hips. No matter whether I was sitting, walking or lying down, this part of my body kept on screaming as if for attention. The feeling was like being trapped in burning building without begin able to find the EXIT. I listened to calming music on Youtube, tried to meditate (impossible!) and went for walks by the sea. Probably the latter helped more than anything else, but what I actually needed was not so much to calm down but to RELEASE the huge stores of built-up tension as I had continually ignored my body’s signals to remove myself from the abuse.

What I didn’t know then was that my psoas muscles had become trapped in a chronic sympathetic nervous system response. They were communicating something very important to me. GET AWAY. Had I known then what I know now, I would have been able to release this trauma response much more effectively and saved myself days of agony. (Literally running would also have helped but I’m a lousy runner and I generally end up injuring myself).

The psoas muscles are engaging when our legs quiver or shake during an episode that we experience as threatening. Those of us who have had to work to overcome a fear of public speaking know what it’s like to stand with fight or flight neurohormones flooding our system with a neuro-chemical scream of “run!! while we are forced through external pressures to continue to stand still. The audience members may not look like saber-toothed tigers, but this is how our nervous system is experiencing them. Our psoas muscles tense, sending neural signals to our brain to gear us up for a motivated response to a threat to our safety. Our brain responds by sending cortisol and adrenalin to help us to mobilize away from the threat (flight) or towards it (fight).

When we don’t move in response to the brain’s SOS signals our legs can begin to shake uncontrollably, because our bodies are trying to discharge excess energy that is not being discharged through mobility. Although this can feel embarrassing, it is actually our body’s way of protecting us. What happens this protection protocol fails i.e., when faced with a perceive threat we can’t expel this urge for motility, this energy becomes trapped as emotional tension. The psoas muscles are a prime target for this tension to reside since it is the psoas muscles that recruit the movement that signals to the nervous system that we are responding to the perceived threat. When the nervous system doesn’t receive this message, it continues to put out a cocktail of sympathetic system chemicals that keeps our body’s on high alert. This becomes quickly exhausting, physically and mentally, since we will certainly sense this tension psychologically as a dis-ease, a relentless and deeply embedded anxiety.

I wish I had known two things while lying in bed with my psoas muscle chain on red alert but without much of a clue how to calm myself. One is TRE or Trauma Release Exercises and the other is what Marlysa Sullivan, assistant professor at Maryland University of Integrative Health calls “constructive rest”. It’s a term first introduced by Mabel Todd in 1937 in her book, The Thinking Body. Sullivan describes constructive rest as ‘…a position of complete rest in which the spine is relieved of the weight of the arms and legs, and the major joints are free to release into gravity and fall into rest. The goal is to distribute the weight of the body so that no work is required in order to maintain equilibrium.’

If we feel tension in our psoas muscles, it’s logical to think that we need to stretch it more, but this isn’t necessarily helpful and can cause a counter-tension to occur. Sometimes we need to encourage the psoas to relax and release by creating an open resting space around it. Lying on the back with a folded blanket under the shoulders, legs elevated, perhaps up on a couch, a couple of bolsters or a deep-seated chair is one such position.

TRE followed by a position of constructive rest is a very effective way to relieve tension.

I like Charlie Maginness’ explanation but your can run a search and find a session that works for your temperament. Some people call it Tension Release Exercises because not everyone identifies with the word ‘trauma’. It looks far more dramatic than it feels. Most people find that TRE feels very natural and is not frightening at all. On the contrary, it feels oddly soothing. Having said that, it is of course possible that someone might experience anxiety with this practice, so take it slowly and stop and take breaks if you need to. Or if it seems like too much right now, simply put it aside for another time. I would recommend watching this video a couple of times before trying it yourself. One thing that Charlie Maginness leave out is the TRE ‘break’ which allows you to stop the tension release shaking by straightening your legs and pointing your toes. I will be doing my own video on this topic soon, but in the meantime if you’re feeling stable and curious I recommend you give it a go. Just be gentle with yourself and don’t overdo it.

You might find, like me, that you want to lie down for a while afterwards in bed or on a couch. When I’m going through a period of restless sleep, I find it helpful to do these exercises just before bedtime.

My dehydration story – don’t let this happen to you


If you’re suffering from a significant number of the following: constant fatigue, muscle soreness, weakness and lethargy, unexplained headaches, insomnia, irregular or fast heartbeat, low blood pressure, brain fog, dizziness, memory loss, attention deficit, confusion, clumsiness, unexplained mood changes, skin ‘tenting’ (skin staying erect for more than 2 seconds when you pinch it), pruney or wrinkly fingers, sudden appearance of face wrinkles, bad breath, dry mouth, dry or flaky skin, inability to sweat, dark urine with strong odour and decreased urination, sweet cravings, sluggish bowels, nausea, blurred vision, extreme thirst and reduced physical endurance-(phew!)-then chronic dehydration may be your problem.

Of course, these are also symptoms of many other health conditions, but it is worth to consider chronic dehydration as a possible cause if you have been exposed to long-term fluid-depriving conditions. Why? Because if left untreated chronic dehydration can require hospitalization and can even be fatal. And secondly, it is really easy to treat. You just have to not make the same mistakes I did. It seems counter-intuitive but it turns out that chronic dehydration, although initially the result of not taking in enough fluids, can actually be made worse by consuming large quantities of water, as I was about to discover.

I had returned home to France three weeks earlier, after spending six months in North India, much of it over the monsoon season. In monsoon, the humidity can remain as high as 85% with temperatures hovering in the upper 30s to mid 40s. In between the downpours, it is uncomfortable to stay outside for longer than a few minutes. Even a brief walk is exhausting. The high humidity + high temperatures is a perfect recipe for dehydration. I was not unfamiliar with the Indian monsoon, and at the time I thought I was drinking enough water. Looking back, I now realize that some of the symptoms of mild dehydration had already begun to set in.

Once back in France I drank less water initially, thinking I didn’t need as much now I was out of the extreme weather conditions of the subcontinent. When my symptoms worsened, I gradually increased my fluid intake. The often recommended water intake is 8 x 8oz glasses of water per day (about two litres) plus 12 ounces for every 30 minutes that you work out. But there are widely differing schools of thought. Water intake needs differ from person to person and depend on several factors such as age, sex, weight, activity levels, climate, etc. I was drinking over two litres of water daily, being careful to pace myself since I’d read somewhere that it’s better to drink slowly throughout the day rather than glugging half litres at a time, but I just felt worse and worse. After three weeks, I had almost every single one of the symptoms mentioned above and I woke up each morning feeling like I’d been hit by a truck.

I would begin to feel a bit better as the morning wore on, but I usually had to lie down by lunch time and would be a zombie by around 5 pm. No matter how much I lay down, I never felt properly rested. The nights were especially difficult. I woke up often, my heart thumping out of my chest. Some days were better than others but mostly I wasn’t good for much more than Netflix and fitful dozing. My symptoms were similar to the early onset of dengue fever (which I had contracted in 2014 in Delhi). Had I been so unlucky as to get it twice, and out of the season for it as well? Maybe I had succumbed to Covid-19 (which has similar symptoms to dengue in the early phases) even though my nasal swab test at the airport in Paris had come back negative. I’d read that false negatives from molecular tests such as RT-PCR were unlikely but not unheard of. Was it chronic fatigue syndrome? Or something even worse? My mind was entertaining all kinds of unpleasant scenarios trying to make sense of it all and my mood was teetering on the edge of depression–a condition with which I am quite familiar. Then I had a brainwave–or so I thought.

I would fast for three days and “reset” my system. Now, I’m not an avid faster. I intend to fast more than I actually do. But I had done several three day fasts over the past couple of years with very positive results. I would only drink water, I decided, and lots of it. It turns out that in my condition the fast was a terrible idea. And this is why.

Longterm exposure to the monsoon climate in India combined with improper and inadequate water consumption while eating a diet low in electrolytes had resulted in my body becoming dehydrated. This condition had become exacerbated after my return to Europe where the temperatures were still in the 20-30 celsius range; certainly not helped by the couple of glasses of wine I was enjoying two to three times a week, flushing water out of my system more rapidly than normal. We are more prone to dehydration as we age, and being in my mid-50s was also a factor.

What I didn’t realize was that the two litres of water I was drinking a day was now exacerbating the condition. My body was crying out for electrolytes more than water; sodium, chloride, magnesium, and potassium, which we need to deliver fluids to our cells. It was like taking packages to the Post Office when there were no postmen to deliver them. Even though I was taking in fluids it wasn’t getting to its destination. Then on top of this, I stopped eating for three days, increasing my water intake to three litres per day, thus removing all sources of electrolytes from my diet both liquid and solid.

Fasting while suffering from chronic dehydration turned out to be a magnificently bad idea. And all that extra water was simply leaching the few stores of electrolytes that my body had left.

By the morning of the third day of fasting I had to call in the army corps of engineers just to get to the bathroom. I could even feel a cavity forming in an upper tooth, that made it excruciating to brush my teeth (I was able to completely sort this by using a time-honored Ayurvedic technique of ‘pulling’ which I’ll blog about another time). I started racking what was left of my brains since the mental fog was so thick I was having trouble stringing rational thoughts together. Had I felt like this before, other than when I had dengue? Yes. Yes, I had. When I had been dehydrated. I looked up the symptoms and they all ticked off like a perfect mark. One word hovered over all else with rays of sunlight streaming from it and harp music (well, I was practically hallucinating by then)–electrolytes. I dragged myself to the supermarket and bought a packet of powdered electrolytes and electrolyte-containing foods (avocados, bananas, Greek yoghurt, olives, pumpkin seeds, miso soup, chocolate milk, turkey, etc.). Less than half and hour after dosing up with electrolytes, I felt a small improvement. I ate the foods gradually at 15 minute intervals. I continued to drink water (though much less) with electrolytes added throughout the day and I actually managed to stay up until 9 o’clock. The following morning I felt what it was like to wake up refreshed. And so the healing began…

Now, two days later I’m back to normal. I feel incredibly grateful to have my health back and will never take my new best friend for granted again. Electrolytes. Don’t leave home without them.

  1. https://www.webmd.com/women/news/20120120/even-mild-dehydration-may-cause-emotional-physical-problems#1
  2. https://www.sciencealert.com/here-s-what-happens-to-your-body-when-you-re-dehydrated
  3. https://journals.lww.com/acsm-msse/Fulltext/2018/11000/Dehydration_Impairs_Cognitive_Performance__A.21.aspx
  4. https://www.healthline.com/health/chronic-dehydration#causes
  5. https://www.bustle.com/p/7-reasons-youre-still-dehydrated-after-drinking-lots-of-water-15727442
  6. https://www.menshealth.com/nutrition/g19705799/electrolyte-foods/
  7. https://www.healthline.com/health/fitness-nutrition/electrolytes-food
  8. https://www.health.harvard.edu/staying-healthy/how-much-water-should-you-drink
  9. https://www.healthline.com/health/does-alcohol-dehydrate-you#causes
  10. https://www.healthline.com/health/overhydration#types
  11. https://www.healthline.com/health/fitness-nutrition/electrolytes-food

What kind of Yoga is right for you?

I am often asked what kind of yoga I teach. My answer is Hatha Yoga with an
Iyengar influence. But what does that mean? The word ‘yoga’ is often translated
simply as ‘union’, referring to the union of body and mind. Hatha in its simplest
definition means ‘force’ since it is involved in breaking habits of the body through a
certain level of exertion but the word also refers to the power behind the force itself.
Hatha is the general system of yoga poses (asanas) and breathing techniques
(pranayama) from which all modern yoga schools stem, and is made up of word
roots reflecting the union of opposites.

Ha – signifies the sun, the right side of the body, the masculine principle and energy.
Tha – signifies the moon, the left side of the body, the feminine principle and
relaxation.

Hatha yoga is included within the 8 branches of Ashtanga Yoga, an ancient system
of practices that was compiled and elucidated by the Indian sage, Patanjali, in the
Yoga Sutras in the early fifth century CE. All forms of yoga today originated as part
of this comprehensive system that includes ethical discipline, somatic purification
practices, textual study and meditation.

Over the centuries, the postural and breathing techniques of Hatha Yoga began to
gain popularity among the laity outside of the ashrams, and eventually it emerged as
its own discipline. Even today, in India, when someone says they are doing yoga this
is generally what they mean. It wasn’t until the 20th century, that yoga began to sub-
divide into the different schools that we see today.

Swami Sivananda (1887-1963) and Krishnamacharya (1888-1989) both contributed enormously to reviving interest in yoga in India that had waned after a peak in the middle ages. Swami Satyananda (1923-2009) founded the Bihar School of Yoga, the lineage in which my own teacher, Sri Surinder Singh, was trained. Around the same time, K. Pattabhi Jois developed a modern version of classical yoga, called Ashtanga Vinyasa Yoga.

YehudiMenuhin
The violinist, Yehudi Menuhin doing yoga with B.K.S. Iyengar. Menuhin suffered from severe muscular pain which he claimed was cured through yoga. Photo: 1952

But it was B.K.S. Iyengar who perhaps had the greatest influence in bringing yoga to
the West. He founded his own yoga school in the 1950s, emphasizing precision
alignment and the use of props such as blocks, blankets and belts. One of his most
famous students was Yehudi Menuhin who was so convinced that yoga improved his
musical abilities that he liked to refer to B.K.S. Iyengar as “my favourite violin
teacher”.

Today, there are numerous other yoga schools, and some are controversial, so it’s
good to do some research beforehand. There is Bikram Yoga (sometimes called ‘hot
yoga’ because it’s performed in a room at temperatures up to 40 Celsius), Anusara
School of Hatha Yoga, Integral Yoga, even Kundalini Yoga that claims to awaken the
dormant energies at the base of the spine. And with the West’s love of endless
categorizations, more yoga schools seem to be popping up all the time. Lately, I have been incorporating more Somatic Yoga into my classes (see DSM’s September
issue) with gentle flow through movements that work to reprogram muscle memory.

What type of yoga you end up doing will be based on a number of factors, including
accessibility and your own personal motivations. The best way is always to get a
recommendation from someone you know and trust and don’t be afraid to try out
difference classes. There are a number of yoga teachers in the Deux-Sèvres so you
might find one down the road! And it’s worth remembering that not all types of yoga
will suit everyone. Find the style that works for your own body and mind. If you feel
happy when you leave the class, that’s the best indicator!

For information email: lavieenyoga@gmail.com
https://www.facebook.com/groups/lavieenyoga/

Respect yourself, explore yourself

Rebecca

5 myths about cold water exposure



Cold showers. Being on an army base comes to mind, or possibly prison. Either way, cold showers tends to conjure up a punitive element. People who take cold showers willingly when they actually have access to hot water? Well, they must be masochists, or else oddly inured to ordinary human sensation. Or a bit mad.

But science is proving something that humans (and probably lots of animals) too have known since time immemorial; that cold water is an amazing tonic for the body and mind, and yes, you can get yourself to the point where not only do you no longer mind the cold, you actually look forward to it.

Understanding how to recruit the Vagus Nerve is a significant step towards calming the sympathetic fight and flight response and engaging the tend and befriend response of the parasympathetic pathway. The science on the subject is growing fast, and we now have several to reference that demonstrate cold exposure to improve ‘vagal tone’, a key metric of a healthy and responsive nervous system and is adaptive and resilient to stressors.

Vagal tone is measured through the physiological phenomenon of heart-rate variability (HRV). HRV refers to the differences in length of time between our heart beats. A healthy heart does not keep perfect military band rhythm. Surprising as it may seem, it is actually healthier to have slight differences in the interval lengths of your heartbeat. The interval between beats becomes shorter when we breathe in and longer when we breathe out, for example, a feature called respiratory sinus arrhythmia (RSA). HRV is largely influenced by Vagus Nerve activity; and cold exposure is one bottom up (body-first) approach to engaging the Vagus Nerve. This is why cold showers in moderation can be good for the heart among many other things.

Various research has shown that regular cold water exposure:

  • improves mood, even combating serious depression
  • increases alertness and concentration
  • boosts the immune response
  • reduces inflammation
  • improves insulin sensitivity thus reducing the risk of diabetes
  • improves cardiovascular health
  • helps to combat stress
  • helps to burn fat
  • increases circulation
  • improves the condition of the skin
  • promotes healing of muscle injuries

But there are several myths about cold water exposure. As someone who took A LOT of convincing to even try cold water exposure, I know how these myths stood in the way of taking the plunge and reaping the many benefits that this simple, cheap and effective intervention has to offer.

Myth 1: The whole shower must be cold.

I never take a cold shower. But I regularly take cold ‘rinses’. This means that I take a hot shower first to wash and scrub and then I turn the dial to cold and use the nozzle for very targeted exposure on certain parts of my body. This is very different and far more tolerable than stepping directly into cold water.

Myth 2: You need to be shivering cold

No, you don’t. I never go so far as to shiver because it is not necessary for the water to be freezing cold. Science has shown that you don’t need to go under 68 F/20 C to reap many of the benefits discussed here. This is equivalent to cold pool water. You can start with a warm rinse, and then each day adjust to go just a little bit colder. I never measure the temperature of my cold rinses, I just turn the dial to the cold. Strangely, I find it easier to take cold showers in the winter rather than the summer. Maybe this is because I have the heat on in the bathroom.

Myth 3: You need stay under for several minutes.

Even two or three minutes is enough. One study in the journal Medical Hypotheses found that participants who took regular two-to-three minute cold showers of 68 degrees over a two-week period found that their mood measurably improved.

Myth 4: You need to stand under the water

I was very resistant to taking cold showers, even as ‘rinses’ in the beginning. I had a particular aversion to the idea of putting my head under the cold water. I was happy to learn that this is actually not necessary, and in fact, targeted cold-water exposure with a shower nozzle can be even more effective than immersing yourself completely.

The ‘targeting’ part turns out to be key. Cold water exposure increases blood flow to deep tissue and so can help to repair damaged muscles because your blood contains nutrients that heal. Focus the spray on the area that’s aching or giving you trouble. This technique helped me enormously while I was healing from a sacroiliac joint problem that was giving me pain in the hips and lower back.

Research carried out by the Institute for Health and Behaviour at the University of Luxembourg found that cold exposure specifically targeting the sides of the neck and the cheeks of the face was effective in stimulating Vagus Nerve activity as measure by heart rate variability.

Myth 5: You will feel colder when you get out

Actually, you will feel warmer. Try it for yourself and see. Take a normal shower, and notice your body temperature before you step into the shower stall, and again when you get out. The next day, add a cold rinse to your routine and again pay attention to your body temperature. You will notice that you feel warmer after the shower than when you went it. And this increased warmth can stay with you for hours. The reason you feel warmer after a cold shower is because cold increases our core temperature through increased circulation. Increased circulation is one of the top reasons experts recommend cold showers. As cold water hits your body, it constricts circulation on the skin surface. This causes blood in your deeper tissues to circulate at faster rates to maintain ideal body temperature.

Below are links to several studies on more benefits of cold exposure:

Improved mood

Cold water swimming has been shown to combat major depressive disorder

Improved insulin sensitivity

Cold exposure reduces insulin resistance, and so reduces the risk of diabetes

Combating stress

A study found that participants who swam in ice-cold water on the regular showed an increased tolerance to stress—all thanks to their bodies adapting to the repeat exposure.

Improving the condition of the skin

Hot water actually strips natural oils from the skin and dries it out. Cold water helps to condition the skin. It constricts blood vessels which tightens pores, protecting against pollution and helping to maintain the skin’s firmness and hydration.

Burning fat

Cold showers jumpstart your metabolism and may help with weight loss by increasing the activity of brown fat, a special type of fat that produces heat and burns calories when the body gets cold.

Boosting the immune system

There are many studies on the connection between cold exposure and an enhanced immune system. Taking a cold shower increases the number of white blood cells in your body, the cells that protect you against diseases.

A fascinating clinical trial in the Netherlands found that cold showers led to a 29% reduction in people calling off sick from work.

Another study connected cold showers to improved cancer survival.

So, in short there are many reasons to be bold with cold. And you will feel like a superhero, I promise you!

Recruiting the Vagus Nerve 4: the practice of gratitude


Did you know that the simple act of counting your blessings is actually powerful medicine. that can make measurable changes to your body? The practice of gratitude has been scientifically proven to not only positively affect our psychological health but also improve numerous physiological markers.

This series is about showcasing all the methods I’ve learned that have been proven by science to target the Vagus Nerve, many of which have been practiced for millennia by practitioners of different spiritual and philosophical traditions. What all of these practices do is to improve what neuroscientists call ‘vagal tone’ – that is, our ability to adapt and shift our nervous system responses in a way that is appropriate to the actual level of threat or safety in the environment. Poor vagal tone results in us under-estimating or over-estimating a particular threat and thus generating a nervous system response that is either too passive or too active.

There are both ‘bottom up’ and ‘top down’ approaches to recruiting the Vagus Nerve to improve vagal tone. Bottom up approaches are those that directly work on the body. Top down approaches start with the mind. Both can be effective because the fibres of the VN are both efferent and afferent, meaning that they send information from the brain to the body and to the brain from the body.

Practicing gratitude is a top-down practice that has been proven to improve vagal tone. This may seem surprising, since gratitude is thought of as simply an emotion, but if neuroscience is teaching us anything it is that the mind/body system is reciprocal. Remember that the Vagus Nerve is the connection pathway that comes into play when the nervous system receives signals that the body is safe. When we experience the feeling of gratitude, we feel safe, because gratitude is a feeling of abundance, that counteracts feelings of lack or scarcity. In fact, we cannot truly feel gratitude unless we feel safe to some degree because gratitude is an emotion that requires a certain openness and relaxation. It is a connected emotion – that calibrates us to our less egocentric Self and tunes us in more with the people and environment around us.

Dr. Stephen Porges, who developed the Polyvagal Theory that I discuss in this series, says that practicing gratitude actually generates all kinds of neurochemical changes that signal the brain that you are safe and therefore available to vagal activity. And so gratitude is protective in the sense that it protects us from falling into negative states that are anxiety or fear-driven.

THE SCIENCE OF GRATITUDE

A practice of gratitude has been shown to reduce doctor’s visits, improve cardiac function, improve sleep and decrease inflammation while also lifting mood, alleviating depression, and increasing optimism and an overall sense of well-being. Scientists have discovered that the more you practice gratitude, the more you can maintain a positive outlook.­­ In a study conducted by Harvard Medical School, after only two weeks of a daily gratitude practice, participants reported feeling more hopeful, that they appreciated their life more, and could deal better with everyday challenges.

Another study followed the reports of participants who kept a daily gratitude journal. They reported feeling 15% more optimistic, experienced a 25% improvement in sleep quality and were overall 10% happier, which apparently is the same increase in happiness you get from doubling your income.

The National Institute of Health in the US performed a study using MRIs to show that subjects who focused on gratitude had an increase in blood flow to the hypothalamus-the almond-size part of your brain just above your brainstem that controls stress and sleep. Enhanced activity in this part of the brain inhibits the stress hormone, cortisol, known to increase heart rate and blood pressure. Expressing gratitude to your partner has also been shown in a study to improve communication and good feelings between you.

So every time you focus on gratitude, you are helping to combat the blues, anxiety and insomnia – and improve your relationships!

Sounds too simple to be true? Why not try it and see for yourself?

How to DO MAKE GRATITUDE A PRACTICE

One way that is very simple and effective is to keep a journal by your bedside and every evening or morning depending on your preference, write down 3 things that you’re grateful for. It can be something as fundamental as sunshine. It can be a specific person in your life. A food you love, or a book that has inspired you. Really, anything at all. After you’ve written your three things, spend a few minutes contemplating each one, and allowing the feelings around that to arise and just be with that. Keep this journal for 10 days. If you run out of things to write down, you can always repeat some. The point is the practice itself, not the details.

Personally, I have found a gratitude practice to be a sure-fire way to shift my mood. Within only a few minutes, I experience more spaciousness and more heart-centred awareness. And interestingly, while going through some grieving for lost loved ones, a gratitude practice around my relationship with them has allowed me to replace the sadness and loss with a sense of abundance and appreciation for having had that person in my life and sharing those moments together.

The science behind a daily gratitude practice

A social-cognitive model of trait and state levels of gratitude

Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life

Examining pathways between Gratitude and Self-Rated Physical Health Across Adulthood http

A pilot randomized study of a gratitude journaling intervention on HRV and inflammatory biomarkers in Stage B heart failure patients

Recruiting the Vagus Nerve – Take a step back

This is the second in the series Recruiting the Vagus Nerve: the best friend you didn’t know you had.

Self-distancing is a powerful intervention – some people call them hacks or manoeuvres – to recruit the Vagus Nerve, that wonderful friendly nerve that controls the relaxation response of our Autonomic Nervous System. This is the tend and befriend ground or circuit of safety and connection. When we activate the vagal pathways of the Parasympathetic System, we reduce stress, anxiety and anger, as well as reducing lethargy, low motivation, and inflammation. We improve immune response, breathing, cardiac health, digestion, and lots more. The activity of the Vagus Nerve is measured as vagal tone, so the better we get at recruiting the Vagus Nerve the more we improve what our ‘vagal tone’. You can think of it as a singer toning the voice.

These interventions that target the Vagus Nerve also do something quite remarkable and unexpected – they reduce egocentric bias, that is, the tendency to over-emphasize our own personal view and experience at the expense of a broader perspective. Vagus Nerve activity reduces our tendency to over-analyze and ruminate on our emotions and reactions, hopes and fears. The Vagus Nerve helps us to be less self-conscious, which is always a liberating trend.

A number of scientific research studies have shown that techniques that involve a practice called self-distancing actually reduce this egocentric bias and improve vagal tone – our ability to self-regulate through recruiting the Vagus Nerve.

What is ‘self-distancing’? Self-distancing is developing an observer part of our consciousness. It’s getting out of our story – of predictions or fantasies about the future, if I do this then this might happen. Equally, it releases us from raking over the past which often keeps us trapped in negative thought-loops or obsessive nostalgia. Self-distancing is the opposite of self-immersion. Self-immersion always keeps us from experiencing the present moment because it involves thinking about the self instead of being the self.

According to research, when people adopt a self-distanced perspective while discussing a past difficult event or imagining a difficult future event, they make better sense of their reactions, experience less emotional distress, and display fewer physiological signs of stress, which is reflected in healthier cardiovascular activity. They also experience reduced reactivity when remembering the same problematic event weeks or months later, and they are less vulnerable to recurring thoughts (or rumination).

You can do this consciously, but this tendency can also begin to emerge as a side-effect of mindfulness and yoga techniques which train us to practice observing the body.

TECHNIQUES FOR SELF DISTANCING:

In one study, participants were put into one of three groups. One group performed a traditional “expressive writing” task, with instructions to wear their heart on their sleeve and write freely about their “strongest and deepest emotions.” Another group was told to engage in “narrative expressive writing”, in which they created a “coherent and organized narrative” of their marital separation with a storyline arc with a beginning, middle, and end. The third group given an emotionally neutral writing task. Participants assigned to the “narrative expressive writing” group showed the greatest reduction in cardiovascular markers for stress as well as an increase in heart rate variability (HRV). They found that people who had the best results used the question what instead of why did because why questions encourage a lot of fantasizing.

  1. TAKE THE PERSPECTIVE OF AN OBSERVER: It’s hard to stop this mental chatter altogether, so a technique that people have found useful is to imagine a stressful future or past event like a fly on the wall. This is a step towards developing what is called ‘witness consciousness’ in yogic traditions or ‘observer consciousness’. A number of studies have shown that people feel less anxious when they imagine a future stressful event – like public speaking or an upcoming interview – as an outside observer.
  2. USE THE THIRD PERSON WHEN SELF-REFERENCING: Saying your name out loud, or even in your head, when self-referencing can have the effect of encouraging a less emotional response to events. If you’re have a tough day getting motivated, you can talk yourself through the steps you need to take – like getting in the shower, making breakfast, and so on as if you are your own coach. You can even give yourself encouragement, like “Don’t worry, you can do this.” Positive self-talk in the third person can help to transform negative thoughtform loops by replacing self-criticism with self-care. In other words, we talk to ourselves the way we would talk to a friend.
  3. NARRATIVE EXPRESSIVE JOURNALING Research shows that just 20 minutes of “narrative expressive writing” over a three day period can trigger a physiological chain reaction that was found to improve Heart Rate Variability (HRV), which is the measurement of variations within beat-to-beat intervals that indicates cardiovascular health and is how vagal tone is measured.

Self-distancing helps us to maintain that BIG PICTURE – viewing our prospects from a third-person perspective helps us to notice things that we might easily miss when we’re all tangled up with it. We miss the wood for the trees, as it were. Self-distancing helps us to be MORE OBJECTIVE which in turn, helps us to take things less personally. And perhaps the greatest gift of self-distancing is the effect of SELF-FRIENDING. Developing this observer self brings in a kinder and less judgmental point of view. It is often easier to have a calm and wise perspective on a friend’s problems but less easy to have that same perspective towards our own.

With the gentle art of self-distancing, we can finally be that friend to ourselves that we try to be for others.

Featured photo by: Angela Hogg

1. The art of self-distancing https://www.psychologytoday.com/us/articles/201901/the-art-self-distancing

2. Regarding stressful events as an observer https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0019205

3. Third person self-referencing. https://www.psychologytoday.com/au/blog/the-athletes-way/201705/self-talk-using-third-person-pronouns-hacks-your-vagus-nerve

4. Narrative expressive journaling as a tool for self-distancing https://www.psychologytoday.com/intl/blog/the-athletes-way/201705/narrative-expressive-journaling-could-help-your-vagus-nerve

Don’t get bored with peace

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Boredom is a topic you don’t hear a lot about in the context of a spiritual path. You hear a lot about discipline, effort and perseverance; you hear about attachment and distractions; you hear about spiritual bypassing and spiritual materialism, but boredom? Not so much. And yet, for me, and I suspect for others, since as we know there are no others in the truest sense, boredom did become a ‘thing’ – and has been one of the most challenging of all the obstacles that I have encountered on this journey of awakening.

I am not talking so much about those fallow periods, when the energy and inspiration gauges dip so low they don’t even register any more, and you worry that you might never ‘do’ anything productive again. Yes, boredom is part of that adaptation to the acceptance that there are natural cycles of production and non-production and that trying to force production out of a state of non-production is likely to be, well – non-productive. I am more speaking to a finer weave in the fabric, when we have already settled down to a large extent, having given up on the notion of being the ‘doer’ of anything. It is after this period of surrender, that it is quite possible, though I am sure not inevitable, that boredom might set in. Because once you have seen through the majority of the programming and have back-engineered substantial stacks of conditioning, something quite miraculous happens – a sense of peace comes over you, that is so deep that it goes beyond any notion you have about an emotion or feeling, or even of an experience. It feels like Grace. And that is the only word that seems to work.

After weeks and months of Grace, and it is quite possible (although again, not inevitable) that the Ego begins to kick a little against all this peace business. The Ego is used to drama, it wants a project, it wants, I-dentification, and Grace is quietly eroding what is left of your I-dentification after all those deconstruction projects of the thoughts systems that had become rooted into an idea of a ‘self’ as constructed from all these beliefs and styles and angles, rather than just dressed up in them.

The Ego is not a fan of Peace. Peace is a threat to the Ego’s very existence. Peace is all-pervasive and non-discriminatory. The Ego likes separations and distinctions.

When this boredom began to kick in for me, it emerged as a subtle restlessness. The Winter had crushed me into a quiet stubborn lump of flesh in front of the fireplace. I had resisted all the usual tugs to take my eye off the ball of startling crystalline stillness. The boredom manifested as an inability to continue to sit still. I seemed no longer able to meditate for long periods. I felt the stirrings of rebellion against everything being always the same.

I did not expect this boredom – which was the only word I could find to describe it. A sort of – is this it then? The ever-changing weather-scapes of the spiritual adventure had been tough, exhausting, but this – this continuity of no ‘thingness’, this interminable continuity was simultaneously profoundly beautiful and frighteningly predatory.

“This peace is going to eat me whole,” groaned the Ego. Egos prefer to be the eater, not the eaten; the devourer, not the devoured.

I flipped through my copy of I am That to see if Maharaj Nisargadatta had anything to say on the topic. I found only one reference to boredom, but it was all I needed.

Once the mind is quiet keep it quiet. Don’t get bored with peace. Be in it, go deeper into it.”

The fact that Nisargadatta had even acknowledged the possibility of getting bored with peace, was a bit of a relief. Go deeper into it. That was what I had to do. Stop circling around it like a skittish horse around a scorpion. Stop this jitterbug effect. Again, it was fear I think, that I had interpreted as boredom. It was the fear of getting engulfed, swallowed up by the whale, stung by the scorpion. Annihilated. Death. Not physical death, but death of the I-dentified self. As long as there was an ‘I’ that was experiencing all of this, the Ego felt secure. But this? This was getting serious. I felt suddenly far, far from home – and yet I knew that my real home was in the opposite direction to where my fear was calling me. Across that murky misty mountain range, so imposing and unforgiving. I no longer could tell where the Shire ended and the Adventure began. Everywhere had become the same.

Later, Nisargadatta talks about the significance of the repetition of struggling on and on with endurance and perseverance, despite the boredom and even despite despair. Because there is something behind it that will always serve as the Saving Grace in every conundrum – and that is the sincere urge towards liberation – what he often refers to as a spiritual earnestness.

Go into it. That’s good advice. It’s how I’m responding to everything that arises now. Instead of trying to avoid discomfort, I lean into it.

The peace as threat scenario is well known to trauma therapists. It is why, some children and even some adults who have suffered trauma and are then guided to lay down their defenses in therapeutic settings – go home and have massive panic attacks. Traumatic responses had been recruited as protective strategies to deal with the initial trauma – and so giving up these strategies can feel threatening and can even reproduce the emotional imprint of previous traumatic events.

The Ego also sees itself as protective. It can even – and usually does – divide itself into various ‘parts’ with distinct roles. Dr. Richard Schwartz labels these parts as the ‘managers’ the ‘firefighter’ the ‘critic’ the ‘exiles’ and so on. But it isn’t necessary to have a history of trauma to get the jitterbug effect during a period of long-term mental peace. It is very normal, and I now realize that it is really simply a matter of settling in and adapting to this as a new normal – it may feel like another level of ‘letting go’ – for me it felt more like submerging into a body of dark water.

It is a strange thing, this aversion to peace. So contradictory. In many ways, the periods of fighting off demons and phantoms were easier. Perhaps not easier, but more satisfying. The Ego can handle being the protagonist of its own spiritual drama. In fact, it was born to play that role. I sat in peace and the restlessness began to stir, and I found myself eyeing the bow and arrow on the door. The Call to Adventure. I felt like Bilbo Baggins. Armed with all this peace, surely I could take on the Orcs of Mordor. You have spiritual currency now. What else to do but spend it?

The Ego wants to ‘do’ something with the peace. It wants a project. It wants a cause. You can’t just sit with it. You find yourself Googling Ashrams in Costa Rica, or a noble-looking NGO – or somewhere with a cave, the further away the better. This is not to say that you shouldn’t join an ashram or work for a noble NGO, or go off into a cave in Tibet. You have to do something with the ‘experience’. You can’t go deeper into it. Anything but that. Because that smells like a kind of death.

The peace doesn’t feel completely safe. Another interesting contradiction. And in all honesty, we’re right. The peace is NOT safe – not for our Ego mind. It WILL destroy us, it will devour us. This is why all those gods and goddesses often look so monstrous and terrifying. You don’t get out of here alive, and awakening requires a ‘death in life’.

So this is Bilbo Baggins feeling suddenly out of his depth on high spine of adventure and announcing to the dwarves that he’s going back home to the Shire to drink a proper cup of tea. But he stays because he realizes that home IS the adventure – we’re already on it. Adventure is an inside job.

You might feel this boredom as inertia – it’s a tamas state. It’s scary because it feels like quicksand, and anyone who has had more than a passing blow with depression knows this fear of getting sucked down somewhere against your will. Rajas is the jitterbug mind that kicks against the inertia. Rajas is looking up flights to Costa Rica. Rajas is checking the quivers in the bow. Rajas is measuring out the cave. There is a constant tension between tamas and raja. But the reality of Sattva – Truth – is neither of these. It is completely beyond these kinds of definitions.

Don’t get bored with peace. What a line.

Because it is if and when we get bored with peace, we are in danger of prolonging the game, of just unnecessarily lengthening the journey. Because it takes us back to our old tricks. It may seem like new tricks, but it’s really the old tricks dressed up in spiritual finery.

By all means go join an ashram, high-tail it to a cave in the Himalayas, or gather up your worldly belongings and give the up to charity – but remember. The best opportunity we ever have is where we are now. In fact, it is the ONLY opportunity. When are we going to take that opportunity? When we book the flight? When we’re on the plane? When we reach the cave? When does it kick in – this plan to spend all this peace we’ve saved up? Are we in danger of squandering it along the way?

I would hazard a guess that if you’ve read this far, you’re ready for the stay – for the quicksand. Perhaps a bit more so, knowing that none of us are really alone. I suspect there are millions of us pondering these things, getting nervy, finding courage in the Call to Awakening, nodding in the direction of a fellow heart.

Wherever we go, eventually we will need to learn to ‘stay’. No experiences lead anywhere ultimately. They seem like they’re going somewhere because there are all these interesting twists and turns and knots and plots, but eventually, they all just curl back upon themselves. Every rabbit hole is simply part of the same warren. You’ll rack up a whole data bank of ‘experiences’. And eventually, you will get tired of it. It will all start to seem like more of the same. If not now, then at some point. You may need to get it out of your system first.

But if you think you might be ready to stay, take it from Nisagardatta. Don’t get bored with peace.

“Stay, stay” I was talking to myself like I was a badly trained dog for months. Stay. Stay. Stay. It was uncomfortable, fascinating and humbling to watch how my Ego wriggled and squirmed under this kind of scrutiny and immobility.

Ram Dass also wrote about boredom.

I remember when I got into my cell in Burma. I spent the day in my cell, the first day of my two months, meditating righteously and getting my sleeping bag right and my food containers, and studying the spider at the window, and all the things you do. Then I realized I had months yet to go, and I was bored. I was really bored.

What Ram Dass did then – because he was Ram Dass – was, he made boredom the object of his meditation. And this is where things began to shift, because he questioned this label ‘boredom’ and began to unpack it. What does it mean? What does it feel like? What the hell is it, this thing called ‘boredom’?’ It’s most probably not what we think it is.

He goes on. ‘It’s interesting to make peace with boredom. Nothing’s happening, nothing’s ever gonna happen again and here we are. It’s fascinating, because when you pull back from a certain level of experiencing life, and see that it’s just more stuff, no matter how fancy the packaging is, it’s just more stuff. You get to the point of realizing that when you are in the here and now, you are here and you’re not going anywhere, and nothing’s ever going to happen.

I had to laugh reading this last part. That’s exactly how I felt over the Winter of 21 to 22. And I would add ‘….and nothing has EVER happened!’

I would be lying if I said that I’m completely out of the boredom woods. I still have moments of the jitters. But they don’t last as long, and I can hold their gaze for longer now. This is how the path works for me. Incrementally. No stone unturned.

So what do I do with the boredom? I increase the exposure, I take a leaf out of the gold-leafed books of Nisargadatta and Ram Dass, and I lean into it. I keep it in my sights. And you know what? It turns, it changes. I’m not going to give away what it turns into….try it and see.

And yes, I do see the irony of writing a blog about not being able to sit still with peace. Well, none of us are perfect – and I can make peace with that as well.

Recruiting the Vagus Nerve: the best friend you didn’t know you had

The Vagus nerve is a master nerve that controls various functions of the heart, lungs, stomach and intestines. Without it we would be in constant fight-or-flight stress mode and we would quite simply keel over and die – probably from a heart attack.

My interest in this work is largely informed by my own past experiences with depression and anxiety forced me to go ever deeper and to seek underlying causes for my condition. When I discovered the work of scientist Dr. Stephen Porges and read about his Polyvagal Theory a thousand lights went off in my head.

In this journey, I have discovered some fundamental practices that can dramatically change how we experience ourselves in the world. These practices bring together eastern wisdom traditions with modern science in very exciting ways that link together physical, mental, emotional and spiritual performance; cardiologists, therapists especially trauma therapists, sports coaches, educators, and yoga teachers, are just some of the professions that are benefiting enormously from these discoveries.

But this information is relevant to all of us. Because what the science of the Vagus Nerve is teaching us that we all have the power to engage with our fundamental states or grounds of being. We can find a greater sense of connection with ourselves and with others, to experience more peace, acceptance, courage, compassion, humour, creativity and playfulness. We will learn why it is important to trust our gut instinct and how to reconnect with that again – and why quality social interaction is so essential and part of what makes us human. We can become more skilled navigators of our social and emotional worlds and understand how our ideas about ourselves sometimes impede our full experience of ourselves.

Understanding the Vagus Nerve will give us insight into what fundamental forces are really driving us as human beings – how simple, powerful, and beautiful they are – and how to work WITH these forces rather than against them.

Leonardo Da Vinci was drawing the Vagus Nerve 500 years ago, but in the past 5 years the subject has exploded with dozens of books on the subject. In this Youtube video I introduce the series with a basic overview of the Vagus Nerve (think learning your way around a car and possibly doing an oil change but not becoming a full mechanic) and why I call it the best friend you never knew you had.

So what is the Vagus Nerve? The Vagus Nerve is the longest and most complex nerve in the body. Most importantly it is the main driver of our parasympathetic nervous system, what is generally called the ‘rest and digest’ mode. But it is much more than this. The Vagus Nerve is actually 2 nerves, the left and the right, but it’s referred to as a singularity. The word ‘vagus’ comes from the Latin for wanderer because this nerve wanders around the body. It’s where we get the word ‘vagabond’ and ‘vagrant’. It looks a bit like a very elongated jellyfish and it goes from the brain down either side of the neck with branches that go to the outer ear, into the muscles of the face, the throat and the larynx, and down into the heart, the lungs and the digestive organs. Understanding where the Vagus Nerve wanders in the body is key to understanding why the interventions that you’ll learn in this series work to foreground this nerve.

What does it mean to recruit the Vagus Nerve?

80% of the nerve fibres which comprise the Vagus Nerve are afferent – meaning that they TAKE information FROM the body TO the BRAIN. This is key to tuning in to this alternative approach to wellbeing that we can call BOTTOM UP, as opposed to TOP DOWN. To RECRUIT the Vagus Nerve means optimizing conditions for this nerve to signal to the higher brain centres that we are safe, that we are not under threat. And when we feel safe, all kinds of wonderful things begin to happen. we can express the parts of ourselves that we have kept hidden, perhaps because we felt too vulnerable to express them: compassion, creativity, courage and curiosity, to name a few. Are you beginning to see how important nervous system literacy can be to our mental and physical wellbeing?

How do we recruit the Vagus Nerve?

This is what I’m going to get into in this series. RECRUITING THE VAGUS NERVE – THE BEST FRIEND YOU DIDN’T KNOW YOU HAD. We’re going to explore together dozens of simple interventions that you can do at home, that don’t require expensive equipment, most of them don’t require anything at all other than a present body and an open mind. I will do my best to post one intervention a week. I’m excited to be on this journey with you. As always, respect yourself, explore yourself.

Powerful 5 minute meditation for re-friending the Self

I love this little meditation. I first learned it from a teacher in Varanasi, India. I love that it is that it is so simple, so universal ,and doesn’t require any philosophical preparation or cultural trappings. The visualization exercise doesn’t require you to be an accomplished meditator or engage in a lot of mental gymnastics. It is very gentle – exactly the gentleness that it encourages in ourselves. You only need a mind and a body and 5 minutes of time. I find that shorter meditations can be very effective, especially for us beginners

This meditation helps us to accept ourselves as we are, without judgement. When we treat ourselves with respect and acceptance, we find that we respect and accept others more easily. It’s a truly magical formula! Tell your inner critic to take a holiday and enjoy this beautiful act of self-friendship.

1. Sit comfortably on a chair or on a cushion on the floor. Take a moment to observe your body and adjust your position if need be. Slow down your rate of breathing a little, extending and refining the inhalation and the exhalation, breathing only through the nose if you can.

2. Mentally scan your body starting from the feet and moving upwards, relaxing any muscles that you discover are tense, all the way up to the head. Feel the connection between your body and what you are sitting on. Relax the stomach and bring the breath more into the stomach, noticing how it rises and falls with each inhalation and exhalation.

3. Close your eyes and imagine that in front of you is a full-length mirror. See your reflection in that mirror, just as you are right now, with the same clothes. Take a minute or so to really stabilize this image of your own reflection in your mind.

4. Mentally offer a greeting to this mirror-self, with a sense of goodwill, understanding and encouragement. Feel these sentiments around your heart, like a warm energy, and continue to offer these positive feelings to your mirror self. Gently lift the corners of your lips into a half smile. Do this for a few minutes, returning to the visualization every time your mind wanders off, which it most probably will! Gently bring your attention back to the visualization (without berating yourself for wandering off to the garden or your plans for the day or wherever it went), and continue to extend these feelings of warmth and good will to your mirror self.

5. Now feel that your mirror self has fully accepted these sentiments with appreciation.

6. Then imagine that the mirror dissolves leaving only the mirror self which then merges into you and dissolves into the area around your heart. Feel that all these sentiments are now operating beautifully inside you. Warmth, goodwill, understand and encouragement. Sit for a while, bathed in all these good feelings.

Move out of the meditation slowly, taking your time, and move through the rest of your day with a more positive outlook.

Contact me for information on individually tailored breath coaching and yoga available online: lavieenyoga@gmail.com

Accept yourself, respect yourself.

Rebecca