 Welcome to Shrinkwrap, Hawaii. My name is Steven Phillip Katz. I'm a marriage and family therapist here in Hawaii and it gives me a lot of pleasure to tell you that sitting next to me today is Dr. Tomas Cummings, his third trip to the show here and today we're going to talk about yoga and mental health. Welcome Tomas. Thank you Aloha. Thanks for coming on again. Good to be here again. Yeah. Yeah. So first let's have a little definition of terms. Okay. Everybody thinks they know what yoga is but what is yoga? Well of course it's evolved through the years but those of us who are a little more purists you know it goes back to ancient India and a long time ago a person by the name of Patanjali wrote down these sutras or truths you know ultimate truths about the way the world is and how to be in the world and then they developed the practice of yoga that most people think of when they think of yoga that involve positions we take with our body that we call asanas and often it's very connected to the breath and you do a flow of one position or one asana to the next asana. And there are classes all over it's grown in popularity exponentially over the past decade. And so the types of yoga have kind of become a diaspora become Americanized like this hot yoga that people like. It's not traditionally based you know in India it's very hot but they recommend in the writings that you practice in the early morning in the evening when it's cool. So it's pretty much an American thing to do the hot yoga. The very essence of yoga as it was developed and evolved through the years is a system of personal development to prepare you then and the poses are to prepare you for meditation. So in a healthy kind of form of yoga that I'm going to talk about today that's good for mental health. It involves practicing the asanas the forms of positions and the meditation at the end of it. So I'm guessing that I didn't realize what asana asana means breath. So no it means a form a position that you take with your body the asana is that that must be related. It's related but not it's not it's related and it sounds alike because that's a kind of yoga. No vipassana is a type of meditation. Different. Yeah it's very it's very it's the traditional type of Buddhist meditation that's most closely aligned with this western mindfulness scientifically based meditation. Like the Jon Kabat-Sin and vipassana style of meditation are quite similar. I see so most of the ones that we see at the yoga studios here are hatha yoga. Yeah hatha yoga means taking the form in your body taking the positions and in most classes you go through a series of forms or positions of varying levels of difficulty depending on the class that you took and most yoga studios will have three levels right. And then at the end you lie down on your back and sometimes use some props under your knees or blanket over you and you meditate for 15 minutes. That's the corpse pose. That's the corpse pose yeah yeah shavasana and from what you're saying that's the most important part. I think that's the most important part that it's the mindfulness part of it and the healthy connecting of mind and body that occurs during yoga that's so healthy for you. A good yoga teacher like Brigitte one of my favorites or Martin at Aloha Yoga Kula they will throughout the class keep saying good things like this is not a competition just go to your edge wherever you are and breathe and relax or they might say see that pose is a little difficult and you might hear your mind just starting to chatter a little more chitabrita they call it chattering mind oh I can't do this oh I'm so out of shape oh I can't stand and they will tell you just just tell that mind to be quiet just breathe just relax in the breath because it's really about going to your edge say in a forward fold where you feel this pain initially and your hamstrings and you breathe and relax with it. It's very good training for the mind so it will transfer to day to day life when it gets a little intense say with your partner over an argument you're having and you just kind of relax you know how to relax in the face of some physical stimulation or pain can transfer to emotional pain so the stress in your hamstring you can take that to this emotional stress and you can transfer with that I can deal with it. It's not a logical thing you're going to do it's just this continuing to reside in the breath as they say to relax with this intensity going on okay something about my voice. No that's very it's like when you're talking about just relax and I don't know if it's because you are a yoga teacher or a therapist or both you have this very calming voice and every time you say something relax I just want to take a breath and relax. Good good it means did you work on that? No it's just I've been doing this for a few decades and I've led a lot of groups in conscious relaxation which is kind of like a deep relaxation process it's akin to meditation. Way back when I was in grad school people say oh your voice is so calming it's so relaxing. I have to spice it up when I'm a professor in talking. Don't want to be a human barbiturate in class. Do you teach also? I've taught a lot yeah. But it's hypnotic so I mean that must also be good as a therapist. It can be when I'm trying to get a person very relaxed in an anxiety disorder treatment we teach our patients the skills of self-regulation we call it. Regulating yourself to stay calm to stay cool and calm so that you make wise decisions based on your values and your goals rather than based on the heat of the moment you know anger or something. So in any anxiety management or anger management treatment I teach the patient how to relax I guide them through relaxation and meditation exercises. I give them handouts they can go to my website and have me guide them with the recording on my website. Oh that's cool. I recommend apps and then they practice practice they come back they talk to me about the practice. They keep a log of their meditation. Yeah so they can talk to me about struggles they're having with it. Let me know how they're progressing even in some times the therapy is talking about why we didn't practice you know so but yeah it's very much an integral part of any treatment for any anxiety disorder including PTSD panic disorder generalized anxiety disorder any of the phobias see a lot of people now with social phobia so they're so used to texting and stuff and they don't do a lot of face-to-face work. Yeah what do you do about that like I struggle with that in my practice like somebody that comes in with their cell phone on do you tell them to shut it off? Oh yeah. Oh yeah. You just say that's the rules ping-pong. Yeah I say we got it we have to talk with each other. It's not uncommon it's not uncommon that they'll show me a text argument ahead with their friend. That's okay it helps me understand what he's experiencing because he's just showing me you know rather than I might not remember it correctly here's what she wrote and here's what I wrote like this one woman she and her partner her girlfriend was really giving her a hard time and she showed me the text exchange and I just kind of deduced that this woman's partner was just itching for an argument because you know my patient was being real cool and just saying I'll tell you later not right now I'm very sleepy I need a rest let's talk about this kept saying that and the other one kept on. So sometimes it's helpful. Yes it is. You know like a patient will bring in a letter they'll bring in an email. But at any rate getting back to yoga there's been quite a bit of research done on it started way back in the 60s with people who did yoga a lot like masters in India showed one of the things they would do is wire them up their brain up to an EEG and then have them get in a meditative state then put their hands in ice water and they could keep their hands in ice water for 45 minutes and keep the alpha wave activity going in their brain alpha is a sign we're relaxing as we fall asleep we go through an alpha state we're meditating we go into an alpha state. So they can do that despite this intense pain right. You may just make the alpha thing reminded me a colleague of ours Jim Spira yeah yeah he has this little I forget what's called this little thing you put on your head that measures your brain waves yeah like as they're happening yeah and so you meditate and they and when you get to the alpha you hear these little like seagulls making nice noises. Yeah it's like a little neurofeedback. Yeah it's exactly those but mine's a computer and you don't you don't put on a you put on kind of a clown like that yeah yeah yeah yeah and you can put on even more if you want sensors and stuff neurofeedback you get feedback how you're doing right so you go okay that's what alpha state feel yeah you know what when I tried it what happened every time I got to the seagulls I would be aware oh I did it and then they go away yeah that's kind of like because now you're kind of looking in on it and remarking on it rather than just being there right yeah and when we meditate we train our mind to stay in these states you know. So some people talking about meditation and yoga kind of meditation is that different than say mindfulness meditation? Yes it is in fact in the traditional mindfulness protocol mindfulness based stress reduction in BSR it's an eight week class you can weekly for three hours a class and then a six hour session and part an integral part of the MBSR program is light yoga and they say light because MBSR mindfulness based stress reduction is about reaching the average Joe and Mary right so they don't want to make it too intense yeah and so there's there's gentle yoga that's an integral part of it in these classes they'll be doing doing yoga they'll ask you to practice at home. So what's different between yoga and sitting meditation is with yoga you are taking poses that can be a little intense so you're challenging your body mind your body mind your mind starts that chattering oh this hurts oh I'm so stiff oh I'm so out of shape and you learn to calm that mind the same thing you're doing in meditation we're saying not now let's focus on the breath just focus on the breath now you're getting this kind of challenge of intense sensations stretching okay what's also good about yoga though is it in a way there's a harboring of anxiety in the body in the muscles you know and we don't even know this is happening yeah it's like because we're ramping up the part of our nervous system it's part of the autonomic nervous system it's running all the time without our control our heart our breath our heart rate our breath our muscle tension our blood pressure it has a strong influence on that and there's this fight or flight system we always talk about and it's it's an old system designed to prepare us to fight or run from sabertooth tiger right but now we don't have sabertooth tigers we have deadlines we have stresses parenting our kids and trouble again in our teenager mouthing off and in distance from our partner and existential stress and traffic and so we have different stressors same systems activated so it creates tension on our body that is there long after the stressors gone right you take it out now cardio exercise is very good for that too think about yoga as you go right to that edge and you feel that tension and you consciously breathe and relax you are working that mind body connection then from mind to body and then when you sit into a pose and you kind of get over that edge you're really relaxing into the pose and in the breath who knows what direction it's body to mind mind the body whatever it is it's good increases your awareness increases your ability to calm yourself the self-regulate it's the ultimate goal of much of our therapy the self-regulation with especially with any interpersonal problems or any anxiety related problems and as I said earlier before we were on the air anxiety gone untreated for too long often morphs into depression right so they're very linked sometimes people have both of them right yeah we'll get right back more to how yoga can decrease that right after we take a break from our sponsor to our sponsor from the show don't touch the mass we'll be right back this is think tech Hawaii raising public awareness oh I am John why he the long time host of talk story with John why he think tech Hawaii is important to our community because it gives people the opportunity to voice their opinions and to take an active part in our development for the first time think tech Hawaii is participating in an online web based fundraising campaign to raise $40,000 give tanks to think tech will run only during the month of November and you can help please donate what you can so that think tech Hawaii can continue to raise public awareness and promote civic engagement through free programming like mine I've already made my donation and I look forward to your please send in your tax deductible contribution by going to this website thanks with think tech dot cause Vox dot com on behalf of the community enriched by think tech Hawaii's 30 weekly shows mahalo for your generosity welcome back to shrink wrap Hawaii I'm with my guest Tomas Cummings PhD and we were talking about how yoga can help your mental health in general and specifically so when somebody comes to your office and you're being a shrink do you do yoga with them in the office not usually but I will recommend that they begin yoga and it's going to be at their level at their absolute beginners I'm going to recommend that they start at the beginning I'll recommend you to videos different classes in the community or different apps and but I'll give a rationale for it as part of a comprehensive program for managing their anxiety and it's a fact on their body other specific studios you recommend well I mentioned the aloha yoga cool on the windward side in town heard very good things about purple yoga open spaces to locations I know of I'm sure there are many more again the essence is that you want to make sure there's meditation at the end you want to make sure that you attend the class that's appropriate for your level and remember that it's not a competition like I said good teachers will remind you don't compare yourself to others like Brigitte has said more than once you know one yogi says said that the source of all unhappiness is comparison just go to your edge and breathe and relax and you'll find that some days you're more limber than other days but the goal is not to be a pretzel that's one of the rationales for hot yoga you know oh it loosens your muscles but physiologically that's an understanding you know we get to 98.6 as a guy that grew up doing competitive sports I think that's hard to remember that yeah I stopped going to classes because I would see the person next to me with their you know ankle around their neck and I think I can do that and then I hurt my back hurt your leg or something yeah it's not a competitive sport so it's a very different thing it's not really a sport it's a practice right for for self-improvement you know although sports can be a great mechanism for self-improvement it's very different because it's not competitive and so we have to really again we watch our mind with building awareness as we do this and you'll see you get competitive wish I could do that how do you know when you're getting better when you relax more into each pose when you're able to do the ones that are harder for you like pigeon is a hard one for me back bends are really hard for me and and then when you know that you're not avoiding those poses when you practice on your own and when you do get into certain poses it were more difficult for you you're more limber you're getting deeper into them and you're getting a little more into that intense feeling that we might have called pain before yoga but now we're just called intense feelings you know so we're not calling it pain anymore because well you know just like sports doesn't hurt me there's good pain and there's bad pain the good pain isn't sharp like a knee pain like oh it's the good pain you get in your quads when you're running up hills you know just as in yoga poses good pain is it's like it's very alive and it's intense but it's not really really hurting you're not doing any damage okay so you go into the edge breathing and relaxing and then by staying in the pose for some time you relax a little more and you overcome this this is called stretch reflex you stretch a muscle it tends to come back you know when you hit the go the doctor and he hits you just below your kneecapping you're stretching that tendon connected to your quads it reacts by tensing moving your leg up so that's there and if you keep holding the pose and relaxing that reflex gives up and you just relax more and more into it so that's how you're getting better how does that help you in your life with your anxiety or depression or stress just that kind of exercise is very calming in terms of the neurotransmitters it can generate like more serotonin and more relaxing endorphins and cannabinoids so you feel happier yeah you feel happier you feel more relaxed so remember some of stress resides in the body some of stress is generated completely in our mind so the kind that resides in the body can you release it through the poses yes oh yeah no doubt that people come in kind of stressed out from work in the commuting class and they go through a class and they leave a lot mellower a lot more relaxed I notice when I come out of class things look a little more clear the trees in the skies that these things look a little more clear I'm just more aware more present how did you get into yoga a long time ago I was really became a fitness freak way back in the seventies and and I had a neighbor who was she was really into yoga and she started teaching me some yoga and wow this is a great way to recover after intensity and running weight lifting so I started incorporated into regular practice and then I became a triathlete when I moved to Hawaii and most serious triathletes do yoga that the more restorative yoga to prevent injuries and to recover you know when you do this stretching you bring more vascularization into your tendons means blood means blood vessels little microcapillaries growing in deeper into the tendons which means when we tear them as we do an exercise a little bit they repair much quicker so it's good for injury prevention so it's physically good for you not just mentally exactly yeah so getting back to the question some patients I always tell patients look if you do yoga incorrectly you'll end up in the ER if you do it correctly it'll keep you out of the ER so like when we do the forward fold uttasana they call all forms are end with asana uttasana is the forward fold where you just bend over and touch your shins or your toes or the floor if you really limber when you do that you want to make sure that you're bending right at the hip crease below your hip bone that you can hit on a counter and it hurts so you're stretching the ham strings and not the lower back in fact good teachers will tell you you know you bend over and then straighten the back so you're at a right angle right and they'll tell you almost kind of arch the back it's like in lordosis like a cat in heat to really really lengthen the side body as we call it in yoga so that you're really lengthening lengthening bending at the hips and not the low back although that happens a little bit and really stretching the hamstrings and opening up the hamstrings and when those hamstrings get more and more loose and limber it relieves back pain oh yeah I had a long bout of back pain and the exercise that the physical therapist gave me were a lot of hamstring stuff yeah yeah yeah keeping that open more yeah doing the pigeon was also good yeah putting the hips yeah exactly and the gluteus yeah yeah I find if I go more than a day without doing my stretching I'm really stiff yeah yeah that's age sets in right a couple apps I'll recommend yoga comm is good you can get the pose every day there's like most steps there's a free level and you can buy into a higher more detail yoga journal has an app and it's a great magazine it's very affordable I get it every month every month there's something in it like great poses for low back pain you know great poses for energizing yourself great poses for sleep you know so and it's a series of anywhere from five to 20 poses that are really helpful for surprising because I find that any kind of exercise usually wakes me up I don't want to do it before I go to sleep but there are some matters yeah yeah for those who know any of the poses the the ones for sleep involve a forward fold but more often there's child's pose ah which is kind of like a fetus here you're on your your shins and your feet are back and you bring your head to the floor and you can do it with your legs nor knees coming out diagonally or right beneath you so there's two ways of doing that yeah there are various poses that are more restorative if there are actually hope classes that are called restorative yoga or Yin yoga that are really conducive to sleep I would assume those are very gentle and very gentle and very slow they'll use props so you set up the props in a certain kind of way then lie back and you just like things that support yeah parts of your body yeah blankets and pads as we call them and so forth and you will just lie and marinate in this pose for three to five minutes with nice relaxing music so you don't have to I mean I think some people have the image also with certain kinds of meditation that you have to sit and it'll load us which would help me yeah no you can do that when you get really good when you practice a lot and get limber but the meditation that occurs is actually as you said earlier the corpse pose Shavasana and you're lying down flat on your back that happens after you do all your stretching a common yoga class might start with a sitting pose just to settle in and set your intention you know might even start with a little home you know just to kind of focus your attention can give me example what might your intention be it's individual the teacher will tell you to take a moment to set your intention and a person might come to class my intention is to let go that work thing that's really bothering me just and just be here now with yoga my intention is to learn to forgive myself for missing that opportunity yesterday my intention will be to calm my mind more and it may be anything personal intention for this session of yoga not for my life it could be a part of your life like I said learn to forgive myself it's individual it brings a certain awareness and focus to your practice then you go through the practice and maybe do some on all fours arching the back these are also good for sleep they call it how where you're arching the back and cat where you're arching at the opposite direction like you ever see a cat stretch and arch his back up and then a cow is like that yeah and that's very that's very calming so you might start with that and then you go into standing poses and then you go into some balance poses which can be pretty intense which you would not do before sleep right so they're energizing their intent and then they bring you back to the floor and then you do more and more floor base poses even on the latter ones you might be on your back with your legs in the air and maybe a strap or just your foot on the toes stretching out the hamstring yeah that's not before and then you'll do some twists you know with the knees looking lying on your back looking to the left and the knees are falling to the right and then the opposite yeah is there anybody that you would not recommend do yoga someone if someone has a serious back problem I would definitely consult your physician on and be very careful how you approach it and there are whole books on yoga for scoliosis yoga for back problems I have scoliosis I'd be a chronic pain patient if it weren't for yoga you know I do yoga regularly and I don't have my pain and you're happier yeah and I have a very crooked back it makes chiropractors shriek or drool depending on their intentions when they look at the x-ray so you could save yourself a lot of pain and money and visits to the doctor by simply doing yoga a few times a week and you went to physical therapy often the physical therapist will be teaching you a series of exercises that are very yoga like that's what they did for me and some of them may be same same yeah well a lot of time once again thank you Tomas thank you so much for coming on and teaching us about yoga today my pleasure and thank you for joining us tune in next time or anytime you want to hit that computer button and watch shrink wrap Hawaii aloha