To me as a yoga therapist, the most important part of my work is how I ask questions.  Everyone has been to a medical or wellness provider-allopathic, holistic, whatever-that either doesn’t pay attention to your answers after a question has been posed or just doesn’t bother to ask you anything in the first place. 

Everyone hates that!  

• Feeling like you are not being seen and heard
• Feeling like just another number instead of a human-being
• Feeling like you are just $$ in the bank for the practitioner and they have no real interest in your well-being

What does this all lead to?  You not going back to that practitioner. You not following through with the recommendations, guidance, needed medical attention, etc.  All of which is not in your best interest.

…Because why bother!  They don’t care. They didn’t hear a word I said. They just wanted my money. They are in cahoots with big pharma. ETC. ETC.  We have all had this conversation in our minds.

My goal as a yoga therapist is for my clients never to feel this way.  I want them to feel heard.  Truly listening and hearing someone=Empathy!  
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Specifically in Yoga Therapy, we use the Panchamaya Kosha Model.  The Panchamaya Kosha Model suggests that the human system is interconnected and functions optimally when there is a state of balance between the Koshas (layers). The five Koshas (layers) are physical, energy/breath, mental/emotional, wisdom/intuition and bliss layers. 

By applying this model, a yoga therapist can provide support for a client’s physical, emotional and mental well-being. I intentionally frame the conversation with my clients around the Koshas so that they feel heard, seen and partnered with.

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Some Examples of my Questions:
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Annamaya (Physical)
1. On your intake, you mention tightness in your shoulders.  Can you describe what you are feeling?
2. On a pain scale of 1-10, how are your knees feeling today? 
3. Compared to the average day, is your pain better or worse (scale of 1-10) today?
4. Does the range of motion in your shoulder impact your daily activities? How? What are those limitations?
5. As a yogi, are there any asana(s) that cause you pain? What are those poses and where is the pain?
6. How does your arthritis affect your knees? Stiffness, range of motion limited, etc.?
7. Do you notice certain things trigger tightness in your shoulders and neck? Stress, overexertion, etc.?
8. Does your pain or discomfort prevent you from certain life activities? What kind? Do you use work arounds, just don’t do the activity, have someone else do it for you, etc.?
9. When you are standing in tree pose, do you notice anything about the posture? How does your standing leg feel? Your shoulders? Etc.?
10. When you are in plank pose, do you feel the muscle in your back activating? Where?

Pranayama (Energy/Breath)
1. Where do you feel the breath? In your chest, ribs, abdomen, all?
2. How restful is your sleep?  Do you wake throughout the night or sleep the entire time?
3. Do you feel rested when you wake up? All the time, sometimes, never. Does it affect the rest of the day?
4. Do you ever experience the afternoon slump? How often? What do you do to remedy it (such as coffee, etc.)?
5. How would you rate your stress levels (scale of 1-10)?
6. What causes you stress?  What are your triggers? How does the stress make you feel (anxious, lethargic, etc.)?
7.  Do you have any go-to activities for helping with stress? What are they?  How often do you do them?
8. On the average, how would you describe your energy level? How does that compare to today’s energy level?
9. When you stated you had difficulty starting certain activities, can you describe to me what that means to you? 
10. How would you describe the quality of your breathing?

Manomaya (Mental/Emotional)
1. You mentioned poor concentration, how would you describe it? When does it occur?
2. When do you feel anxious?  What are some of the things that create anxiety for you?
3.  What does “overwhelm” feel like to you? Does it have a color, texture, etc.?
4.  Where in your body do you experience anxiety?
5.  In your intake you mention poor memory, how has that manifested in your daily activities?
6. When you have difficulty making decisions, how does that impact you?
7. How does stress manifest in your body or breath? Do you notice it in certain parts of the body?
8.  What do you do to relive stress and anxiety? How often?
9. How do you show yourself self-compassion?  What do you do to nurture emotional health? 
10. How would you describe the quality of your support network?  How satisfied are you with the quality of your relationships? 

Vijnanamaya (Wisdom/Intuition)
1. How would you describe your true nature?
2. How could you reframe stress to lessen its impact?
3. How could you transform anxiety so that it works for you?
4. How content are you?  How could you cultivate contentment?
5. What are some tools you use to ground and center yourself?
6. How does reframing stress into something helpful look to you?
7. What brings you discontentment? Why?
8. If you stripped all the layers, what does your true nature “look” like?
9. How does contentment feel in your body? Texture, Sounds, Smells, Visuals, etc.
10. What tools could you utilize to bring the sense of contentment into your daily life? 

 Anandamaya (Bliss)
1. What brings you joy? How?
2. Do you cultivate joy internally? How?
3. How do you cultivate overall well-being?
4. What inspires awe for you? Why?
5. What is an inner resource (memory, visualization, etc.) that connects you to your true nature? How does it appear to you?
6. What is your sankalpa (your intention or vow to yourself)? How can you manifest it in daily life?
7. Do you have a connection to something greater than yourself?  How does that manifest in your life?
8. How do you relate to the word “hope”?  What feelings does it create? 
9. What does “connection” mean for you?
10. What gives you meaning?

What questions would you ask?
How would you feel if a practitioner framed the interaction in this manner?

​I recently learned that Body Fat (Adipose Tissue) is an endocrine organ and actually has more impact on the body than the thyroid gland.  Therefore, too much adipose tissue (obesity) can lead to diabetes.   Obesity increases the risk of developing Type 2 diabetes, high blood pressure, and high cholesterol as well as contributes to the risk for heart attacks and strokes.

So what yoga therapy tools work great for the management of diabetes?

I recommend these 3 yoga therapy tools: 

1. After a few rounds of natural breathing, begin Ujjayi breathing. While your breathing, some food for thought-How Tapas (effort) is balanced with Santosha (contentment). Tapas can bring about change like improved health and lower blood sugar levels. While Santosha brings peace in the current circumstances. Always remember the importance listening to the doctor regarding nutrition and monitoring insulin levels. (5-10 minutes)

2. A short series of asanas to develop an exercise habit that can help with obesity, heart issues, high blood pressure, and metabolic syndrome.  Also , these practices can help lead to improved mood potentially leading to lifestyle changes and improved quality of life. Always watch for any dizziness with the increased movement.  (30 minutes)

Sample Asanas:
• 10 ½ Sun Salutations: The Sun Salutations can be completed as slow as necessary or even use a chair.
• Warrior I:  Warrior I (lower body) with goal post arms. Transition to straight legs and Warrior I (straight) arms.  Repeat 5 times per side with an extended hold at the end (3 counts/breaths). You can also do this posture in a chair if needed. 
• Seated Spinal Twist: Depending on our flexibility, the opposite leg can be bent or straight as well as accomplished with deer legs or from easy pose.   
• Seated Forward Fold: Finally, transition to a seated forward fold to begin the activation of the parasympathetic nervous system.  

3. Savasana: Practice a relaxation pose of choice and begin breathing with an extended exhale.  You can also  use a guided visualization of your peaceful place to continue the activation of the parasympathetic nervous system. (10 minutes)

Yoga can be incorporated into your daily life and have positive impacts on glycemic control.  Studies suggest that yoga has a direct impact on psychoneuro-endocrine and immune mechanisms as well as contributes to parasympathetic activation and anti-stress mechanisms.  This all leads to improvement in overall metabolic and psychological profiles, increases in insulin sensitivity, and improvements in glucose tolerance and lipid metabolism. 

In addition to the practices listed above, yoga practices utilized in the management of diabetes often include cleansing exercises, and the use of bandhas, meditation, relaxation, chanting, Yoga Nidra, or mudras.  These practices can reduce blood glucose levels as well as contribute to the management of co-morbidities.

What yoga practices will you incorporate in your fight against diabetes?

​Raveendran, A. V., Deshpandae, A., & Joshi, S. R. (2018). Therapeutic Role of Yoga in Type 2 Diabetes. Endocrinology and metabolism (Seoul, Korea), 33(3), 307–317. https://doi.org/10.3803/EnM.2018.33.3.307

I was once hired at a recreation center for a class called “All Levels Hatha Yoga”.  The core group had been taking this class for a year.  I soon realized they had never been taught alignment, pranayama...well, let's just say, they pretty much hadn't really been taught anything "yoga" in the course of the year.  They were also all over 60 years old.  Not surprisingly, I had to teach with a lot of modifications and props.

After nine months, a director (a non-yoga instructor) takes my class (they develop a performance assessment based on one class) for my yearly appraisal.  A week later, we have my performance discussion. 

Director: You do this weird breathing thing that I’ve never seen.
Me:  You mean pranayama?  No other yoga teacher here does pranayama?  So, I then explained what pranayama was and why I have the class do it.

Director:  We advertise this as a Hatha Yoga class.  Why are you not linking breath to movement?
Me: Do you know what Hatha Yoga means? So I explained Hatha, Vinyasa, etc. and the differences between styles.

Director: Why don’t you use modifications like other instructors?
Me: The poses are already "modified" to the level of the students.  I don’t show them the hardest version and then modify down-that’s demoralizing.

Director: You need to make the class harder, so more students come. 
Me: So, the students you have are not important and you would rather I drive them out of the recreation center in order to increase numbers.  It sounds like you want young students and don’t value your older students.  You also understand that if I make it harder-your current students will get hurt, right?

And so the discussion went….which leads me lead this crazzzy concept called ETHICS!

​Over the years, I have noticed there are certain wardrobe faux pas that yoga students (including myself) commit on a regular basis.   So as the self-ordained yoga Blackwell (a long dead super famous fashion critic for those born in the 2000s), I will list them and their remedies.

Booty shorts:  Don't not wear booty shorts to class.  When half the poses I put you in require some variation of spread eagle, I do not want to see your lady bits and know the frequency of your wax appointments.  

Remedy:  Wear shorts/pants at least to the middle thigh.  This ain’t amateur porn hour; it’s a yoga class.

Baggy Shorts:  Likewise, do not wear baggy shorts and no underwear.  I do not need to see your manly bits nor do I need to know that you have never manscaped in your entire life.

Remedy: Wear some flipping underpants, please!!!  Preferably the boxer-brief stye so nothing down there can break free.

The Demi Pushup Bra:  Whaaaaa!!!????  Keep control of the girls!  Demi bras and, I don’t know, INVERSIONS do not mix well.  Another possible test to use--If they pop out when you raise your arms in Warrior I, you are NOT wearing the appropriate bra for said activity.

Remedy:  There’s this new fangled invention called a sports bra.  Try it; you’ll like it.

​Fabio Hair (another pre-2000 reference-Damn, I'm getting old!):  It looks really pretty but I have a hard time teaching Cousin It.  I will break out into “Dah-dah-dah-DUM" and start snapping my fingers.

Remedy: Pull it back, cut it off or let it dread.  Trust me-I'm guilty of this one on a regular basis so I started carrying a supply of hair ties in my mat bag along with extra deodorant (another faux pas we wouldn't cover here but please for the LOVE OF GOD wear some!)

Makeup:  Did you really think Harry Stiles (WOOHOO! A 2021 reference for ya!-we think he is cute, right?) was going to be in class today or something? 

Or is the full makeup (complete with lipstick and false eye lashes) just for me! The average yoga student’s face touches their mat a few times during class--so does a yoga student's feet...and sweaty hands...and plumber’s butt.  Now combine all that bacteria with all that makeup...YUM! 

Remedy:  Buy some makeup wipes.  Your fresh clean zit free face will thank you.

The Mala:  These are beautiful strings of beads to help a practitioner keep count when chanting and meditating.  You may have noticed, I said...Meditating.  Not practicing asana.  By the time I have untangled you from your long strand of Mala beads, you will be unconscious.  That’s not samadhi; that’s brain death.

Remedy:  Leave the Mala at home.  A self induced hallucinogenic bliss can be achieved on your own time--assuming your health insurance covers it.