Using medical studies and the science of the biology of belief to improve chronic pain outcomes.

The goal is to improve chronic pain outcomes using yoga therapy and the power of belief. We will measure progress using a pain journal; pain will be tracked daily. Our aim is to have positive self-reports of decreased daily pain within 30 days.

Female, 28 years old, acromioclavicular joint tear from a car accident. Chronic pain in her shoulder and back since the car accident.

I envisioned sitting down with her and reviewing some of the medical studies that prove that "mind over matter" is a scientific fact and not just a statement of opinion. After the client understands the power of belief, we would review a study related to chronic pain that would help her to understand that pain can be amplified in the body through negative beliefs in the mind. Then, we would proceed with the yoga therapy plan as outlined.

https://pubmed.ncbi.nlm.nih.gov/21574706/ ; Mind over milkshakes: mindsets, not just nutrients, determine ghrelin response

https://pubmed.ncbi.nlm.nih.gov/17425538/ ; Mind-set matters: exercise and the placebo effect

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530716/ ; Chronic Pain: Where the Body Meets the Brain

I utilized the branches of Jnana Yoga (reviewing the medical studies to lead us towards understanding the omnipotence of Spirit/Mind), Raja Yoga (asana, pranayama, meditation), and Hatha Yoga (physical postures). The Jnana Yoga was a necessary component for this science-minded client; she had to come to an understanding of herself as not the body and not the mind but that which eternally witnesses both the body and the mind. Adapting this mindset could reduce her experience of chronic pain.

The Raja Yoga would be the instrument that gathers the rays of the mind so that they may become one-pointed and therefore maximally powerful, like a magnifying glass that gathers the rays of the sunlight so that they may burn. A powerful mind is necessary to overcome the pain of the body.

Hatha Yoga was of much interest to the client. Consciously strengthening the body will reduce pain.

This client was very excited to receive the yoga therapy, and was very engaged by the medical studies. She asked a lot of questions which I really appreciated. The physical yoga wound up being longer than I anticipated as the client was asking for modifications and more movements i.e. in child's pose. The client very much took to the pranayama and seemed to be very interested in the idea of increasing cortical willpower through pranayama.

I wound up giving her a list of the asanas and variations that we went through and some notes on pranayama practice. I recommended she continue to practice yoga every day. Because she was so interested in the philosophy, I recommended that she purchase a copy of the Hatha Yoga Pradipika with a commentary by Swami Muktibodhananda, who was also a student of Dr./Swami Sivananda. I also told her I wanted to glance at her pain journal once a week to make sure she was using it.

I did apply the intended plan, and I do believe the goal was achieved, although the session wound up taking the greater part of two and a half hours. After a month of follow up, the client did report significantly lower levels of chronic pain. She acknowledged that much of the improvement might be in her mind, but then laughed and said something to the effect of "everything is in the mind".

I did have to adapt to her continual requests for more scientific information, more asana variations, and deeper explanations of the pranayama. I am continuing to learn that I need to find a way to be less long-winded. I get very excited and the time tends to pass more quickly than I realize. In this particular instance, the client was also very excited. This was great, and the session was quite enjoyable, but from a professional standpoint it isn't feasible for each of my one hour sessions to become two and a half hour sessions.

I would approach it in the same way, I think that beginning with the medical studies was very convincing and can engage the subconscious mind in a way that will support the yoga therapy process. I do think that perhaps medical studies wouldn't be the best fit for every client, but I do believe that beginning the process with each client with some kind of hard information that proves the efficacy of yoga therapy as a healing modality would be useful.

I also think the pain journal was very useful and motivational for the client and will recommend that each client keep a journal even if they have no chronic conditions. Introspective writing seems to be a great adjunct to yoga therapy and the witness consciousness it endears.

I need to emphasize to myself the need to find a way to make the teachings more concise and structured, I have noticed I tend to be all over the place when I get going on particular topics. I just want everybody to know all the benefits of yoga, but I can imagine how some clients would be overwhelmed or feel that I am "overselling" the yoga practice.