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musings on Yoga, Ayurveda and Chinese Medicine

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Stroke (CVA): from Wind Strike to Insight

by Hyoun Bae on 12/11/18

Stroke (CVA): from Wind Strike to Insight

Many of us have viewed Jill Bolte Taylor’s viral TED talk “My Stroke of Insight.” We’ve also witnessed the American spiritual teacher Ram Dass, in his genuine discussion of how he was unprepared for death, urging baby boomers to take a more serious look at age-related diseases.

Stroke is a medical condition that is close to home – one that I have had success in treating, but also has influenced me personally, taking the lives of individuals that influenced my life and work.

In the U.S., some 800,000 individuals have a stroke or cerebral vascular accident, annually. Fortunately, as a leading cause of death, its moving lower down on the ladder – due to stroke awareness and prevention.

For many, stroke is a wake up call. One can have a silent infraction or transient ischemic attack. In other cases, classical symptoms may arise such as dizziness, headache or motor impairment.

From her opening, Jill Bolte Taylor speaks of hemorrhaging – hemorrhagic stroke being one of the two major categories – where an artery leaks or ruptures, as opposed to an artery being blocked, such as with a thrombotic stroke. She also speaks beautifully of her intent toward recovery, wherein a blood clot was removed.

Bolte Taylor discusses some of these signs and symptoms lucidly, with the fading perception of a keen scientist. Her acuity and attention to the process of stroke onset and of hemispheric differences in perception and cognition was a clarion call to the way we live our lives, inhabit our bodies and the social world.

Chinese medicine has treated stroke and its sequelae for thousands of years. Nowadays, especially in China, there are extensive neurobiologically-based and traditional medicine approaches for both acute and chronic/post-stroke care where large patient loads receive the benefit of integrative treatment.

In classical Chinese medicine herbs and acupuncture are employed in emergency conditions, and the understanding that has shaped over two millenia is hardly overshadowed by some of the lifesaving surgical interventions and drugs we now have. Acupuncture can assist even in the most crucial, acute stages of stroke onset.

With stroke, timing and dosage as well appropriate intervention, can mean day and night, in terms of outcome.

Stroke can cause dementia, anxiety, inability to swallow or speak, cause motor weakness and impairment, and impact our memory. It can utterly change our lives and those of our loved ones, as there is often a cost of care and a stroke can also dramatically shift our cognition.

Acupuncture alone can assist in recovery. I know this well firsthand. We now have medications such as Alteplase – the gold standard – and surgical interventions can be administered for hemorrhagic conditions. Acupuncture can create dramatic possibilities, which can be followed with OT, PT or speech therapy.

Moreso, our attention has been focused on prevention. High blood pressure, diabetes, weight, smoking – these, along with other risk factors of age, ethnicity and gender are the context for prevention.
Chinese medicine used to examine environmental influences or interaction. How is this wind penetrating the body, and effecting the brain and the channels of the extremities (causing weakness, balance issues, motor impairment, spasticity and atrophy)? The sequelae of stroke are formulated in terms of a number of discrete presentations, and modern doctors have further differentiated how to effectively treat stroke at every stage.

In more recent eras, blood circulation in the brain was a concept integrated into modern Chinese medicine. TCM has included emotion regulation and lifestyle/behavioral regimens into the fold of stroke prevention.
The esteemed medical thinker, Ye Tian Shi offered to Chinese medicine the notion that this wind – instigating stroke onset was not from without, but was a pathomechanism influencing circulation in the brain, and was precipitated by the state of our qi and blood.

In particular, Chinese thinkers have mentioned the zheng qi – also known as the “upright qi” – underlying our health status and immunity, which can be depleted, setting the stage for stroke.

Jill Bolte Taylor and Ram Dass both speak of stroke as providing insight. Bolte Taylor, uniquely conveys her drifting in the “beautiful space of la-la land” as a reprieve from stress and interaction with the sensory world of information and energy, that our nervous systems register and how it taught her about brain function. Ram Dass has shared over the decade(s) of the reckoning of “being stroked,” as a message to prepare for ageing and death, in our culture.

Both of these marvelous iterations of stroke experience speak to me about shen, or what we translate as ‘spirit’, and the relation to our embodied life, made possible by our brain and nervous system.

Stroke has taught me about relationality, consciousness and connection and about how precious and fleeting this life is.
Like the magical people who have come into my life and been whisked away, stroke touches all of us in an uncontrollable way, mirroring love.
Bolte Taylor ends her talk with a question about choice – not only about prevention and management of stroke – but also about issues of fear, distance, and other left-hemisphere dominance, and rather about connection and our raison d’etre.

Somatics, Embodiment and Body Therapy

by Hyoun Bae on 10/27/18

Somatics, Embodiment and Body Therapy
One of the key facets of our work is somatics, often regarded as a field of disciplines that engage methods of inquiry and discourse that mediate ways of knowing(and healing, through the body. These include bodywork, the expressive arts, approaches to manual and movement therapy that populate the healing grounds of science, philosophy, psychology, medicine and even spirituality.

Within somatic inquiry we can also chart the sociopolitical mapping of the body, anthropological concerns regarding what the body is and means, and meaning itself that is forged through the body. There’s the fitness and wellness domain, that of the performing arts and the emotional body, with its internal schemas.

These all form the broader enterprise of embodiment, not only its practices but also their manifold expressions. Embodiment frames each of our own coming to identity, health and healing.

Body Talk: Ways of Seeing
I’m currently working on a database or anthology of somatics, for clinicians, to complement one on Asian mindbody therapies I’ve slowly been growing, over the last two decades.

There are many ways to frame the discourse of somatics. An insightful and concise work by Sandra Reeve entitled “Nine Ways of Seeing a Body.” discusses the body as an object, a subject, as well as phenomenology. The first personal exploration of our embodied experience is also the realm of mindfulness.

Both mindfulness and healing can be extended to any of these “nine ways” of viewing bodies and embodiment. This short tract and its mapping of the somatic terrain, is well worth the read and I invite dialogues.
I’d preferably label myself an interdisciplinary “body thinker” meaning I locate my views in experience, and experience enriched through somatic practices. It began for me through martial arts training from the age of three, then through the arts, and finding the richness of Eastern mindbody disciplines and art history/anthropology.

For many, whether involved in dance or art, the body becomes a space to carve out understanding – where one returns. Where one gains trust and finds their answers.

Art, in different eras – just as medicine – invariably reflects notions of how we conceive of the body, embodiment.

For example, the relationship between Asian temple art and architecture, or landscape painting (ecology and relationships with the environment) also conveys this shifting sense. Whether its Korean embroidered folk art, or Chinese or Japanese landscape painting, I've always enjoyed how smaller scenes might depict the frivolity of daily life amidst natural environs, and the scales of human life in relation to the immensity of a mountain range, or a waterfall in the backdrop.

The abstract and symbolic are just as potent descriptors as the linear and anatomic – referencing the subjective and objective. One might find in Sandra Reeve’s “Nine Ways” a conceptual road map for exploring issues through art, movement or any embodiment discipline.

The First Principle of Somatics: Knowing and Learning Through the Body

There are many ways to talk about a body, but bodily practices enrich our ways of knowing and attending to experience.

They are about immersion, rather than abstract theorizing.

I locate a few such mindful creatures across a variety of disciplines. For example, Jaida Kim Samudra’s notion of “thick participation” speaks of deeply entering into mindbody disciplines, unearthing body knowledge that is fundamentally tacit. Her work was on White Crane Silat.
A body thinker is first, one who is engrossed and enchanted by the sensual wisdom that is encountered through bodily practice. Indian, Chinese, Japanese and Tibetan mindbody practices have influenced my particular methodological orientations. Contemporary psychology, somatics and the humanities have helped me see beyond these rich, and often binding, cultural frames.
Narratives of Embodiment
Each of us carries one or many somatic narratives. Understanding them is a key to health and healing.
A perennial favorite – author and editor – Don Hanlon Johnson, has published a new title (Diverse Bodies, Diverse Practices, 2018) and as I dove in, I had some preconceptions shattered.

I was initially confronted by the switch up – the interdisciplinary shift in this new discourse of embodiment. I found it to be bold. While at first acknowledging my own conditioned notion of somatics and embodiment, it was a breath of fresh air as I settled into what was being offered.

My appetite in the somatic realm includes discussions of cutting edge movement and manual disciplines, and their crossover in somatic psychology. This new work shares different “narratives of embodiment,” ones that challenge and specify more discrete socio-cultural issues.

In medicine, we speak of bodies and embodiment in ways that place them in a clinical or therapeutic framework, and often less in terms of the lives and stories we encounter. This work speaks from the place of real issues identity and social experience, rather than medicalized bodies, unconscious of context.

Before sharing my takeaways, I wanted to direct some of you to the chapter by Nick Walker on “Somatics and Autistic Embodiment.” Walker is an Aikido instructor and professor, who discusses the notion of neurodiversity and his autistic experience and embodiment.

You can locate a youtube video entitled: Autistic Identity and the Neurodiversity Paradigm.
I found Walker’s article one of the most articulate and eye-opening pieces I’ve come across, in some time – acutely of benefit to those working in the fields of mindbody practice and medicine.
Johnson, Don Hanlon, ed. (2018). Diverse Bodies, Diverse Practices. Berkeley: North Atlantic Books.  
Reeve, Sandra (2011). Nine Ways of Seeing a Body. Devon: Triarchy Press.
Samudra, Jaida Kim. (2008) Memory in Our Body: Thick Participation and the Translation of Kinesthetic Experience. American Ethnologist, Vol. 35. NO. 4

Empathy: Establishing Connection

by Hyoun Bae on 10/11/18

 World Mental Health Day

Mindfulness and Beyond: How Meditation can Improve Relationships

Neuroscientist Richard Davidson and science writer Daniel Goleman provided a sweeping review of the field of contemplative neuroscience in their recent work Altered Traits. They established the question of what amounts to meditative development, and how practice over time might begin to shape our experience, bringing about positive trait changes.

They locate these shifts in actual structural changes in the brain.

The acknowledgement of neuroplasticity has extended to other human capacities taken up by the field of the social neurosciences. These domains of scientific research and scrutiny intersect with work in the affective realm, employing data from both animal and human studies to better understand how we have evolved and various roles for cooperation and communication.

Meditation is often looked upon as a practice of contemplative inquiry, to help one look deeply within.

The notion of empathy, though, is often translated as ‘entering into the experience’ of another. Tania Singer, noted social neuroscientist and empathy researcher, continues to unpack this vast arena of human development.

Singer and her various colleagues have helped define and distinguish the various shades of empathic relationship that has continued to inform medical and therapeutic care, and also inspired contemplative researchers to look directly at their own traditions for the types of practices that cultivate care and awareness of others.

Demon Miso (Halloween post, 2016) : Drain the Epigastrium formula/Xie Xin tang

by Hyoun Bae on 09/15/18

Demon Miso, Liminal fox spirits and other Haunted tales
There's a type of miso to make when the neighbors are away. Fermented fresh soy beans, a Korean makjang or miso - bearing a stench and taste so incongruous, one might wonder if you’re preparing a noxious feast for non-human entities.
Hakuin, the enigmatic Zen master and calligrapher of the eighteenth century, offers a wonderful teaching through his painting, Demon Miso, wherein he employs the image of Shoki, known to have the ability to cast out demons after exorcising his own. 
Imbued with great compassion, the bulging eyed, ornately-robed character gazes upwards, while brandishing a pestle akin to a sword (of wisdom perhaps), mashing demons in a pestle - making his own special miso-as an enthusiastic young onlooker chimes, "Papa, I can't wait to have a taste!". Hakuin has Shoki, mouthing in the inscription, "Tenuous it is, mashing one's demons into miso. You have to be ruthless (paraphrase). (Yoshizawa, Katsuhiro, 2009).
Demon slayers and shape-shifting spirits are all part of the premodern religious landscape of Japan. Not all spirits are considered evil. Some are powerful and reflect the notion of liminality in the human realm, where desire and belief obscure and that perhaps the full round of existence can be experienced in our own complexity. Many of these shape shifters and human spirits live at the borderland, thresholds of experience where dream and reality, ignorance and conscience, fade ominously.
One record, of a famed koan known as the 'Wild Fox,' recounts the story of a priest whose unkindly acts landed him the bondage of a life as a fox spirit, neither man nor beast, but as a fei-jen, disembodied and haunting as it were, the temple he once served at. In this incarnation, disguised as a monk, with his fox tail protruding from the back of his robe, he approaches the present abbot, and confesses to Pai Chung of his past, whereupon he is met with incisive words that wake him up from his dreamy state. The koan itself is a tool for looking beyond the narratives that construct our experience.
This type of exorcism portrayed in the literary record is more of a transmission, a parable of retribution and awakening. The fox spirit is cast under a stone behind the monastery, and a proper funeral held, indicative of a new lease on life.
The analogy is clear and resonant, and with a somatic meaning as well. 
In my study of herbal medicine, the fox-spirit (Heine, Steven, 1999), cast as a liminal and wily creature was also alluded to with regards to a certain line of prescriptions that could ease epigastric focal distension - that area just below the sternum at the fundus of the stomach, known classically as the reflex area of the heart. 
Most of us get an uncomfortable feeling here, when our emotions get stuck. The area, the opening of the stomach is also a pivot between yin and yang, marked laterally by the threshold of the diaphragm. Breath, emotions, mind and qi reflect an interplay between conscious and unconscious - unspoken elements. The fox spirit becomes a medical metaphor for 'xie xin' - or that which drains the heart of its virtue, the drain of emotional life, when our afflictions and limited beliefs obscure and exhaust a heart/mind radiant and bright, in its natural condition.
The xie xin tang series of herbal presriptions deal with everything from digestive to emotional distress.
Our final interlude invokes Tengu, and the Demon's Sermon (2012), wherein a half-vulture/half-human instructs in the martial arts, on health and of the essence of the spiritual life, based in the wisdom known to the author of these parables, a swordsman at home in Buddhist, Taoist and Shinto religion and the mountain environs where ascetics, spirits and gods roamed freely.
This supernatural twist of motifs has the tengu discoursing to other animals, known as they are to teach human swordsman as well, on the central ways of qi, mind-training and self-cultivation. Returning these earthly lessons, a 'spirit' instructs that the heart and essence of health cultivation is in learning the relationship between mind and vital energy, and that to train in qi is to understand desire, as if to know well our demons, to release the sources of inner conflict that dissipate.
In the opening parable, a sparrow and butterfly wax poetic about the life that was and the life that is - how they've each changed over time and the fallacy of lamenting the past, in favor of accepting things as they are. 
Following this tale is a story about a grandiose and self-assured hawk, in conversation with a timid, self-doubting owl, who questions his odd appearance, not seeing himself as a gorgeous bird of flight. After speaking to other birds, the owl realizes his own gift of seeing at night, and begins to deliberate the relativity of his existence - both its upsides and downsides -and comes to acknowledge that all being are interrelated, and perception are relative and concludes that a compassionate existence is what is warranted.
Ghostly apparitions, spirited guides and stealthy demons retain their power like the unconscious. They inform us not unlike memories, intuitions and beliefs do - in their nature, sources of fragmentation or of wisdom. From Hakuin, we realize our own demon mash is the most savory. From the fox spirit, that redemption is in reckoning and disclosure, and the tengu, or vulture spirit, our demons are our teachers and that to rectify the qi is to look deeply into the essence of our own mind.
And, if that all is ineffectual, the legendary Sun Simiao noted 13 Ghost Points- acupuncture to let the ghosts out!

Ayurveda and Yoga Therapy: Personal Success Story.

by Hyoun Bae on 08/19/18

Dr. Dilip Sarkar, retired vascular surgeon and President of the Board of Directors of IAYT, has an interesting story.

In 2001, a busy surgeon, he suffered from a heart attack. Other than a history of IBS and insomnia, he did not fit the bill.

All of his medical numbers were within range. He apparently showed no signs, nor noted any relevant risk factors or family history.

Four years after his open-heart surgery he was able to stave off medications, concerned about their complex side effects.

He turned to yoga and Ayurvedicmedicine, transforming his life through their practices and daily regimens. And, he was able to reverse his heart disease, and practically overcome IBS.

For Sarkar, his journey - which including needing to leave behind his successful surgical career and adopting a role in the health and wellness industry - was precisely that, parsing what he deems as true health in relation to medical models focused upon disease.

Dr. Sarkar's conclusion is that biomedical or conventional "Western" medicine is aimed at the absence of disease - particularly effective at acute strategies of care, emergency intervention, surgeries and treatment through prescription medicine. As far as preventative care strategies based in a life of wellness, yoga and Ayurvedic medicine offered just that.

Chronic diseases could be best be approached through a lifestyle of wellness, rooted in dinacharya or daily life regimens augmented towards one's personal health, their constitution, and in relation to the seasons.

From his own experience, he was conditioned to look at disease or its absence as the marker of health. Positive states of health and vitality were not measured and agency was not placed upon the patient, or the individual in a healthcare system.

Sarkar travels nationally and internationally promoting what he deems as a comprehensive understanding of yoga and its therapeutic tools, not only the physical asanas, but breathwork, meditation and the ethical underpinnings which contextualize its aims.

Perhaps the overarching import of his offering is to take back agency and locate resources of health within. Our overdependence upon medications and medical assumptions may reflect an impoverished state of health and health knowledge. Endogenous causes of disease are much of our own responsibility, some rooted in stress and endocrine regulation. 

Like many, he locates these "adjuvant" modalities within the umbrella of "Western Medicine." You can benefit from your annual checkups and routine care, while making the most of dietary therapies and lifestyle regimens.

Sarkar (2017). Ayurveda, Yoga Therapy and Western Medicine.

Traditional Medicine Research Database