Virtual Mentor. September 2003, Volume 5, Number 9.
A Physician's Guide to Balance
A physician describes how practicing and teaching yoga helps him to maintain work-life balance and emotional well-being.
Steven Landau, MD
I couldn't practice medicine without doing meditation and yoga.
I began doing yoga at the age of 10. I thought to myself, "This will save the world!" after finishing a brief rest in the corpse pose. Then the second thought came, "If only people will do it." (Aye, there's the rub.) Then I stopped doing it.
I started doing meditation regularly in Harvard in my senior year of undergraduate training. It helped calm my mind, and I've been doing it ever since, with the Ananda Marga Yoga Society. Now I teach classes in prisons, battered women's shelters, and my own Johnston Memorial Hospital. I even have a straight scientific talk I do for CME on Medical Aspects of Yoga and Meditation. And you're probably wondering what all those initials mean after my MD. The FAAFP is a symbol of family practice, the primary holistic discipline in mainstream medicine. The ABHM is the sign of the even more holistic discipline in non-mainstream medicine, the American Board of Holistic Medicine. The RYT stands for Registered Yoga Teacher.
I was asked to do this article because of my association with the Yoga Alliance, a non-profit group of idealistic and practical yoga teachers who also want to save the world through yoga. They've set up minimum standards of training in this art and science that was previously almost totally unregulated, and is still usually taught from master to disciple.
Have you noticed how much I've used the word "I" so far? That's a little like the practice of meditation. First you get the "I" trash out, and after a while it all gets handled nicely. Then, as your selfish concerns wear off, you start getting the larger picture and transcend into the realm of bliss.
Ashtanga (8-limbed) yoga incorporates the multiple elements used to put out the trash and keep it out. It has parallels to medicine, as follows:
2. NIYAMA (extro-internal observances)
Yoga requires balance in the mind, body, and spirit. But where do emotions come in? Emotions are just thoughts with enough power to stimulate hormonal and physiologic reactions. Yoga deals with these directly. Here's how:
1. Asanas balance out the hormones. Don't ask me how—you just have to experience it. There's been no convincing scientific data that I've seen to show that cortisol or thyroid levels go anywhere predictably. That's probably partly because people doing different studies use different techniques and yoga postures, of which there are thousands. One way that asanas work is by pressing on chakras. These are psycho-physical plexi corresponding to various points in the body. Known for thousands of years, they also correspond to conjunctions of voluntary and involuntary sphincters, sympathetic and parasympathetic nervous plexi, and major endocrine glands. The yogic description of the chakras and nervous system also looks just like a common rendition of the caduceus (see diagrams 1, 2).
2. Muscles get stretched out and utilized in a way that tones them and doesn't fatigue them terribly much. An overall sense of euphoria develops. Stretched muscles work better and with less effort. The day flows smoother.
3. Self-massage following asana practice causes release of immune modulators from the skin. Feels great, too.
4. Corpse pose, everybody's favorite, allows total release from stress, and is the basis for the Jacobson desensitization technique. You can do it at lunch for a few minutes after you've been on call the night before. Works well.
PRANAYAMA—Breath and energy control
PRATYAHARA—Withdrawal of the attention from the sense-objects
Having said and done all that, there's still a need to achieve and maintain balance in the society. So, here's a tip from Tony Robbins: make a wheel, with spokes, each arc of which represents a segment of your life. Then fill them up to the level at which each segment is functioning at this very moment in time. Are they equal? Then your wheel of life is going smoothly, and can go around very fast. Are they unequal? Then your wheel of life is going to go bump-bump-bump down the road and be very uncomfortable. So now you know which portions of your life you need to concentrate on and improve (see diagram 3).
Another critical point: How do you know when to use intuition and when to use intellect? When do you listen to that "still, small voice"? The answer is that you listen to it all the time, and obey it when you can. You learn to combine its wisdom with the practicality of the intellect and science that you've been taught, and you'll find that it works wonderfully well.
Last point: Always see the bright side of everything, and focus on it. By worrying constantly about bad outcomes, you'll bring them about. By focusing on the good outcomes and how you'll make them happen, you'll discover ways of bringing that about, too. You always have the choice. And as my guru, Shrii Shrii Anandamurti, told me, "Forget all past mistakes. Live your life afresh from this very moment. Do something concrete for the suffering humanity. And smile a little bit!" And with that, he took his hands and made my lips smile a little bit. And so you do, too.
With love and best wishes,
Steven Landau, MD, is an attending physician with Johnston Memorial Hospital in Smithfield, NC, and employed at a rural family health clinic, Johnston Family Care Center, in Kenly, NC. He also holds positions as adjunct instructor at both the University of North Carolina-Chapel Hill's School of Medicine and School of Nursing.
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