Yoga in Quarantine: Tips for Cultivating a Home Practice

“Yogas chitta vritti nirodah,” the second of Pantajali’s Yoga Sutras, is likely the verse most recognizable to yogis of any level of experience.  A seminal tenet of yoga philosophy, it literally translates to “Yoga is the stilling of the fluctuations of the mind.” A more modern, colloquial interpretation might be, “Yoga quiets the mind chatter,” and I bet I speak for all of us when I say that at this moment, I really need to spend some time each day quieting the chatter in my mind.  We are living in a historical moment unprecedented in our lifetimes, and it is all too easy, shut up in our homes and consuming the news, to allow atmospheric anxiety and personal worry to escalate into the full abandon of panic.  Over the past week, in my non-yoga life as a university instructor, I probably wrote the phrase “Don’t freak out” over and over again in upwards of sixty emails.  And yet, last night when a server crashed, I freaked out, my students totally freaked out, and my husband, at loose ends with his workplace closed, stayed up all night fretting and then drank a beer at 1:00 pm today and lay down for what he referred to as a “stress nap.” Right now, just when we all need yoga in our lives more than ever, our studios are closed and the governor is telling us to stay in our homes. 

The governor is right: we do need to practice radical social distancing as much as we possibly can in order to gain control of this crisis.  But we don’t have to give up our yoga practices just because we’re holed up at home.  With that in mind, here are five tips for creating and maintaining a home practice. 

1.     Create a dedicated container for your practice.  It’s wonderful to be able to have a designated space—even a room!—for your home asana practice, but most New Yorkers don’t have that luxury.  However, anywhere you have space to roll out your mat can be a sacred space if you make it so.  Create a bit of ritual around your practice: light a candle, compose a dedicated playlist on Spotify, do something to establish an intentional boundary around your physical practice, even if you’re in the living room one day and the bedroom the next.  Devoting a time of day to your practice can also be a way of creating sacred space. 

2.     Take it easy. If you are used to practicing in class with a teacher observing, be especially careful when working at home.  Don’t cut corners: take care to warm up fully, and make sure the room is at the temperature you’re accustomed to when practicing.  If you can’t get your apartment as warm as the studio, add layers, especially around your joints.

Don’t test your limits—there’s no teacher to stop you from hyper-extending or “hanging out” in your joints.  So be mindful of your hips, knees, spine (particularly your neck) and shoulders. If you’re used to being cued in and out of poses, transition slowly and mindfully, and be especially mindful of alignment.  If you feel any pain or discomfort, stop. A home practice during an epidemic is neither the time nor the place to push boundaries in your asana practice.

3.     Try practicing online.  If you’re missing class and instruction, there are plenty of options for you to practice at home with others, both in real time and asynchronously.  Prema Yoga Institute is offering live classes every day via Facebook, on a donation basis.  In addition, online yoga platforms offer a tremendous variety of options for a home practice.  PYI’s own Dana Slamp teaches via Yoga Anytime, and there’s a fifteen day free trial for their subscription service.

4.     Remember that yoga is more than asana. Just as important as maintaining a physical practice is keeping yoga alive in your mind and heart.  If you don’t have an altar in your house, now is a good time to set one up. An altar doesn’t need to be religious—it can simply be a space dedicated to cultivating mindfulness. Mine sits on top of a tiny cabinet in the corner of my bedroom and holds a salt lamp, a candle, a box with my mala, a few precious stones, and copies of The Pocket Pema Chodron and Tosha Silver’s Change Me Prayers. I sit in sukhasana every night before bed to read, breathe, and chant.

5.     Just practice.  As my teacher says, the best yoga practice is the one you do. If you’re homeschooling the kids, working online all day, taking care of loved ones, or just generally climbing the walls and can only devote ten minutes a day to your practice, then practice for ten minutes. But fire up that tapas and commit to an ongoing practice.  As the extremely prolific novelist Anthony Trollope once said, “A small daily task, if it be really daily, will beat the labors of a spasmodic Hercules.”

During this period of intense mental stress and danger to our physical health, a steady at-home yoga practice is not only possible, it may well be a major component in keeping us mentally and physically well.  Yogic practices are proven to down-regulate the nervous system and boost immunity, and yoga in general keeps us in touch with our bodies, our breathing (!) and our bodhichitta (soft-heartedness).  A home yoga practice not only helps  us to keep functioning, it helps us to marshal our resources to support others.  So here’s a new mantra to carry into the coming weeks: keep inside, keep well, and keep practicing.

___________________________________________________________________________________

Molly Goforth is a yoga and meditation teacher and a student at Prema Yoga Institute. She specializes in accessibility and trauma-informed yoga teaching and practice.

Yoga Therapy for the Heart: Interview with Sonja Rzepski, C-IAYT

Sonja Rzepski is an IAYT-certified yoga therapist and graduate of Prema Yoga Institute’s Yoga Therapy Program. Sonja received her initial yoga teacher certification in the inaugural teacher training of Samahita Centered Yoga Institute in 1999, and originally studied Ashtanga yoga under Eddie Stern. Sonja teaches the Yoga Therapy for Cardiac Care course for PYI; in addition, she was the lead yoga therapist for the Northwell Lenox Hill Cardiac Care Yoga program, whose work was chronicled in a recent study published in the Annals of Clinical Cardiology entitled The Yoga Meditation Heart Connection—A Pilot Study Looking to Improve Women’s Heart Health, which demonstrated a meaningful connection between yoga and meditation practices and improved well-being and decreased depression rates in female cardiac patients, as well as other benefits.

I recently had the opportunity to sit down with Sonja and ask her about her work with cardiac patients as well as about yoga and heart health in general.  What follows are excerpts from that conversation.

____________________________________________________________

Molly Goforth: Can you talk a bit about how you came to your specialization in cardiac care? 

Sonja Rzepski: It honestly goes way back, because of my mom's experience of having a heart attack, and also my family history of heart disease.  I hadn’t been seeing my parents on a regular basis because I was living in New York City, and they were living upstate when my mother got a job opportunity in the city and I started seeing her regularly.  I noticed that she was looking sort of grey, that she had gained a significant amount of weight, and that she got short of breath easily, just walking down the block. I knew my grandfather had had a heart attack, and that my mother had a significant history of heart disease in her immediate family, as I mentioned.  So I asked her if she had been to the doctor, and she quite casually told me that she had seen her doctor recently and he had said that women couldn’t have heart attacks before menopause.  I asked her if he had done any tests, and she said no. My mother is an extremely upbeat, positive person, but her energy was low, and even though she was having chest pains, her doctor didn’t run any tests and put her on anti-depressants. He just didn’t consider heart disease to be a possibility for a pre-menopausal woman.

MG: I would say that’s unbelievable, but sadly, it’s not.

SR:  No, it’s not.  There is so much information regarding women and cardiac health, and how to prevent heart disease in women.  But regarding my mother, she was told it was indigestion, it was depression, it was anything but her heart.  The only reason she ended up getting an accurate diagnosis is that she happened to go to lecture given by a specialist in heart disease in women at NYU, and she found that she was checking all the boxes, so to speak, regarding her symptoms.  After the lecture she spoke to the doctor, and she ended up becoming a patient, but it took her months to get an appointment. By the time she was finally seen, she actually had a heart attack in the hospital, on the table.

MG: Oh, my God.

SR: She had 92% blockage at that point, and of course the anxiety of it all likely contributed to the cardiac event.

MG: Of course.

SR: Thank goodness she was in the right place.  I was flabbergasted, because it was my own mother and she had been so misdiagnosed for so long.  It became very educational for me; I started to go with her to appointments and I started to become fascinated at the work her doctor, Dr. Steinfeld, was doing.  I wanted to learn more and more, and I started to get more in depth and to apply what I was learning to my yoga teaching.

MG: And how did that progress?

SR: I worked with Dr. Rachel Bond and Dr. DeJesus, and I started working with their support group. They had a women's support group for heart disease and I started basically mentoring with a cardiologist and working with their patients. And thank goodness the doctors were very open-minded and generous.  I mean, I was getting amazing training right there in the hospital. So then it just grew and grew and we started a formal outpatient cardiac class at the hospital.  Our patients had had cardiac events or suffered from heart disease and were seeing the cardiologists, but were not in the hospital at that time. They would return for classes, and that's how this study came about. And then, through Prema, we were able to bring in Yoga Therapy students as mentees, to support the work and even eventually to teach.

MG: What a compelling personal story about how you came to specialize in Cardiac Care. Is you mother doing better now? 

SR: She's doing much better now right. Not only does she lead her own women's support group, she does about 20 to 25 minutes of her own yoga practice every morning.

MG: That’s so great.  Shifting gears a bit, can you speak to working in a hospital setting as a yoga therapist?  What were some of the challenges? 

SR: I think there are actually two great extremes. The cardiologists and the cardiac nurses who saw the results our yoga therapy work was having on their patients were incredibly supportive and bent over backwards to make sure that we had a lovely space to practice in and even supplied water and healthy snacks…they couldn’t have been more supportive. And then the flipside of that is the bureaucracy. Unfortunately, in a hospital setting, even though we're certified yoga therapists, it’s such a new field and with regard to the administration, there's a lot of red tape. When administrative medical professionals don't see the word “licensed” in front of yoga therapy…I’ll just say that there’s still some doubt about the profession, and mistrust, and need for more proof of efficacy. So when studies like ours are done, it’s incredibly important, because anytime you can cite a study it actually brings you that much closer to legitimacy in the eyes of the medical establishment.  Honestly, even to get our study approved took months and months and months, even though we had a bevy of cardiologists supporting it.

MG: That must have been frustrating.

SR: There is a lot of red tape, unfortunately. But our personal experience was always wonderful. Seeing the actual interaction between patients and doctors and nurses and staff on the floor was always fantastic.

MG: Did any of the study’s findings surprise you?

SR: In the upcoming Yoga Therapy for Cardiac Care course at PYI, we will study the Ayurvedic perspective of heart disease and how yoga therapy can address it.  We don’t have the time now to get into a discussion of the complexities of the Ayurvedic concept of doshas and how that relates to cardiac care,  but I can say that the extremely high-functioning, high energy people who would come into the room as patients in our cardiac yoga therapy study…it was often very surprising to me that they were so ready to embrace the practice of yoga and mediation. So one thing that I learned as a yoga therapist working with this population was how important it was to create that safe, sacred space wherever we were.  We would sometimes be in a beautiful room with a fireplace, and other times we would be in the auditorium and they would have to practice… I realized how important was to make the space as consistent and warm as possible, to create that impetus to relax and alter their energy to match the environment.  We tried to incorporate a spiritual element as well, with a singing bowl and playing music before we started, because yes, there was always a lot of energy coming into the room.

I think it was also the weight loss that was actually a surprise to me, as well, because we were doing very, very gentle chair yoga and meditation primarily. But 37.5% of participants lost weight. What the study was really geared toward was dealing with anxiety and depression. And there was a very significant decrease in that, as well. So that was really affirming. It went from a rating of seven to 4.9. 

MG: That's incredible.

SR: Yeah it really is, over a relatively short few months. So that was great. But the weight loss is what really surprised me. And I think part of what made that possible was that the women started to really look forward to coming.  It really became a community, a place where they started to really enjoy talking together and sharing their stories, and the outlook shifted from coming in as a patient and really identifying with their disease to being a part of a support group in a community that was doing healthy, uplifting activity together.  So I really think that we may have had a lot to do with improving other elements of their lives, not simply depression and anxiety but also just their outlook on life: “Hey, I'm going to make more of an effort to get better, because my life matters.”

MG: Speaking of lifestyle changes, are there cultural factors in the U.S. that you feel contribute to heart disease?

SR: Unfortunately, (heart disease) is on the rise and it's the largest killer in the world. And there are quite a few factors cultural factors that contribute. We are becoming less active as a whole. More and more people are waking up, going from their car to work, sitting all day at their job, and going back home and sitting in front of a television. So in general we're becoming less and less active and we don't even realize it. Second, the quality of our food, especially in this country, is just getting worse. There's more and more fast food, but also, even when someone does try to make an effort eat more healthfully, the quality of our meat, the quality of our dairy…and that healthier food is more expensive, all of these factors are truly contributing to declining heart health.

And then there’s a really big one, and it’s stress.  It’s the fact that people are having to work longer and longer hours with worsening health care. And the attendant anxiety this causes, as in,  “Well, I don't want to even go to the doctor because it's going to cost (too much).” There are many contributing factors.

On the bright side, one thing I think is a wonderful value of yoga therapy is that it encourages the client or patient to look at the whole picture of their health, and the more mindful a person becomes, the more they start to care about what they're eating and realize that moving feels good and your life can be strong and healthy. Empowering the agency in their physical form and yet making choices to practice more loving kindness and towards others also highly affects the heart. And this is what I'm very excited about regarding yoga therapy for cardiac care: that we get to bring together all these categories for a healthy life.

MG: Sonja, in your opinion, who is this Yoga For Cardiac Care training for?

SR: First of all, whether you are a personal trainer, a fitness instructor, a yoga teacher or really anyone who is dealing with a population working on their own health, you’re going to obtain such a knowledge base of how not only to recognize the signs and risks of heart disease but also what is effective. Which breathing techniques. Which asana. What languaging is helpful that they can implement and put into their work, whoever they are: acupuncturists, anyone in the wellness field.  And I’d also say that anyone who is supporting a family member or friend with heart disease or anyone who is at risk for heart disease.

MG:
Are there any ways, having worked with women in the study at Lenox Hill, that you think about gender and women when you are thinking about cardiac care in yoga therapy, in addition to how important it is to raise awareness among women about paying attention to their heart health?

SR: You need to have support networks, that is really important to awareness. Because the way heart disease presents in women can be very different from how it presents in men.  So that is number one.
And then I think for women it is really wonderful and important to empower each other. Because very often, for women, it’s easier for them to help a friend rather than to help themselves. So getting them all together allows them to all help one another. And then there is a greater chance that change will happen.

MG: I love that observation: I think that’s a point that should really be amplified. Sonja, I am so looking forward to taking your training, and thank you so much for your time.

SR: You’re very welcome. 

Prema Yoga Institute’s Yoga Therapy For Cardiac Care course, taught by Sonja Rzepski, runs from March 27th-29th at Pure Yoga West. Registration opens February 27th.

___________________________________________________________________________________

Molly Goforth is a yoga and meditation teacher and a student at Prema Yoga Institute. She specializes in accessibility and trauma-informed yoga teaching and practice.

Precautions for Yoga Professionals in the Flu and Viral Season

The physical practice of yoga tends to attract people seeking who are actively seeking to maintain a healthy lifestyle. Unfortunately, like any place where human beings gather, a studio can easily become a breeding ground for pathogens.  The added considerations of heat, perspiration, on-site locker rooms, and shared resources such as mats, blocks, and blankets, further contribute to the challenge of maintaining hygiene while practicing yoga in a public space. 

While most studios are fastidious about cleanliness, there are additional personal precautions yoga teachers and students can take to reduce the risk of infection or transmission.  Below are five tips for protecting yourself and your students in cold season, flu season, or during a state of heightened alarm concerning public health.

1) Wash Your Hands Properly and Often

According to the Centers for Disease Control, hand washing is one of the most effective ways to prevent the transmission of germs, provided it is done properly.  Just as important is when you wash your hands.  The yoga student and the instructor should always wash hands before and after a class, as well as before and after handling any kind of food or drink, or using the lavatory.

Are you washing your hands correctly?  Most of us don’t realize that effective hand-washing requires a full 20-30 seconds of your time.  To truly minimize the transmission of infection, follow these steps from the CDC:

1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.

3. Scrub your hands for at least 20 seconds.  (Tip: hum “Happy Birthday” two times, all the way through.)

4. Rinse your hands well under running water.

5. Dry your hands using a clean towel, or air-dry them.  It’s extremely important to dry your hands completely, as bacteria colonize more readily on moist surfaces.

6. Use a Paper Towel to turn off the sink, as well as to open the door of a lavatory in a public space, then immediately dispose of it in a waste bin.

It’s also important to use hand sanitizer, especially in a yoga studio.  We’ll cover that below.  However, hand-washing hygiene raises and additional, often overlooked point:

2) Avoid Wearing Jewelry To The Yoga Studio, And Keep Fingernails Short

As PYI’s Pain Management and Clinical Yoga Therapy instructor Beret Kirkeby, C-IAYT LmT, points out it’s best to keep jewelry extremely minimal at a yoga class, and to keep nails trimmed short and clean. Jewelry that is not regularly cleaned can have bacteria levels up to ten times higher than those on the skin, even immediately after washing hands.  Jewelry that is not worn on the hands, such as necklaces and earrings, is sanitized even more rarely. Moreover, long nails, both natural and artificial, are breeding grounds for bacteria, and most people do not sufficiently clean their nails when washing their hands.  While they may look attractive, by wearing your nails long, you create more surface area on your hands where pathogens can lurk.

3) Use Hand Sanitizer In Addition to Proper Hand-Washing

While washing the hands with soap and water is always indicated at obvious times, such as before and after a class, handling food, or using the lavatory, proper use of hand sanitizer can also qualify as effective hand-washing (or a follow-up to hand-washing), provided that the hands are not visibly soiled, or that you haven’t come into contact with another person’s bodily fluids.

According to Ms. Kirkeby, an alcohol-based rub is the preferred method for hand sanitation.  To sanitize hands properly, ensure that you dispense the recommended amount of product (written on the container) into the palm of one hand.  Rub hands together, making sure to cover the surface area of both hands completely, including the undersides of the fingernails, until hands are dry.  Hand sanitizer can also be used a second step after washing with soap and water.

While some yogis may be resistant to hand-sanitizer because of beliefs that it is “not organic,” contributes to antibiotic resistance, or is ineffective, it is important to note the CDC’s guidelines during flu and virus season. While proper soap and water hand-washing is more effective than hand sanitizer on certain germs, such as norovirus and C. diff, alcohol-based hand sanitizers are the preferred method used by healthcare providers to prevent the spread of disease, provided they are at least 60% alcohol.

During a public health alarm such as an infectious disease outbreak or a flu epidemic, yoga professionals and their clients can wear disposable medical gloves when doing any work with students that requires physical touch, discard the gloves immediately upon completion of the session, then wash hands.  Hands-on adjustments should be avoided in classes of more than one student during periods of concern about contagion or in high-risk settings, as it’s not practical for the instructor to change gloves for every student. 

This excerpt from our Yoga Therapy Certificate course covers the standard precautions yoga professionals should take to print the spread of disease and infection. Yoga Therapists working in clinical conditions may have additional precautions to take to keep clients, coworkers and themselves safe and healthy. Thanks to Beret Kirkeby, C-IAYT, LmT for her content and narration.

4) Consider not Teaching or Attending Class When You Are Sick

Even a minor illness, such as head cold, is a legitimate reason to cancel a class during a period of heightened risk of contagion.  We’re not always aware of the immune health of those around us, and even seemingly healthy people can unwittingly spread infection.  For someone who is immune-suppressed, a minor infection such as a cold can lower the body’s resistance to more serious disease.  It is far better to cancel a class or reschedule an appointment than to risk contracting or transmitting pathogens during a public health alarm.  If you do find yourself teaching or attending class when sick, make sure to follow the guidelines above, and if you need to cough, cough properly: use the vampire cough method, maintain a three-foot barrier between yourselves and others, and wash hands properly immediately after coughing.

5) Avoid Sharing

The yoga community is a generous one, and the average yogi is happy to share: a snack, some essential oil, even a sip from a water bottle!  But this laudable virtue should be curtailed during a public health alarm.  While sipping from the same water bottle is obviously unhygienic, sharing a bag of Pirate’s Booty or passing around a roller of essential oil might seem benign under normal circumstances.  But unless everyone present has undertaken proper hand-sanitizing methods immediately prior, several (or even two) people dipping their hands into a common bag and then touching their mouths is a superb way to spread germs.  Anything applied directly to the skin, such as an essential oil roller or a towel, should ideally not be shared, as many bacteria can live on the skin - including serious pathogens such as MRSA.  As a rule, for everyone’s health, if you love to share, keep individually wrapped candies or bars on hand.  But in general, if it touches your skin or your mouth, keep it to yourself.  This is doubly true in the locker room.

No one enjoys enduring the stress of cold or flu season, or the heightened anxiety of a public health alarm. But with proper preparation and rigorous adherence to some basic hygiene guidelines, we can make considerable strides in the effort to keep ourselves and our students and clients healthy.

___________________________________________________________________________________

Molly Goforth is a yoga and meditation teacher and a student at Prema Yoga Institute. She specializes in accessibility and trauma-informed yoga teaching and practice.