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Jivana Heyman, founder of non-profit organization Accessible Yoga, gives readers a gentle nudge to step into a safe yoga practice that fits the needs of any person in his book, Accessible Yoga: Poses and Practices for Every Body. With compassion and years of experience, we are guided into an accessible yoga practice, literally for every body. Yoga Editor for NY YOGA LIFE magazine, Lauren Cap had an opportunity to chat with Jivana right before the pandemic in early 2020, and shares her interview below.
I first want to thank you for creating Accessible Yoga to make yoga available to all communities with various physical abilities. It’s important to have information like this at our fingertips to remind everyone that yoga is most importantly about feeling good, not looking good.
Thank you for your interest in Accessible Yoga, and for your awareness that yoga is really about feeling good, not about how you look or what kind of poses you can do. It’s unfortunate that the image of yoga in the media is so limiting when the benefits of yoga are so powerful and are available for everyone. In fact, I often think of how it’s those of us who are struggling the most who can really benefit from yoga.
I came to yoga to help me deal with the pain and stress in my life, and I’m so grateful for how yoga has given me tools to help me with the challenges of being human. I feel like I owe a debt of gratitude to give back in some way, and my mission is to challenge those limited ideas we hold on to about what yoga is and how it works.
The most important thing for people to understand about yoga is that it is primarily a mental practice – working with the mind to reduce stress and connect with the essence of who we are. I often say, “Yoga isn’t about having a flexible body, it’s about having a flexible mind.” With that deeper understanding of the practice, it’s easy to find ways to make all the practices of yoga accessible, whether we’re talking about the poses, breathing practices, relaxation techniques or meditation.
The use of pose orientation in this book is very creative as we are able to maintain the elements of the traditional practice while offering an accessible way to receive the healing benefits of yoga. How do you empower practitioners to look beyond their physical limitations and feel confident in their Accessible Yoga practice?
I think knowledge is power, and one of the challenges in yoga is that there’s this feeling that the classical poses can’t be adapted or somehow they lose their power. Most of the poses we’re practicing these days evolved over the past few hundred years. It’s really the philosophy, meditation and breathing practices that are most ancient. The more people understand the underlying benefits of individual poses, the more they can find those benefits in different variations. That’s the way I’ve organized my book – trying to help people look beyond the superficial appearance of a pose and consider why they’re doing it. The “why” of a practice is the key to adaptation and accessibility.
What are some challenges you’ve witnessed from students who may be reluctant to a practice that doesn’t resemble what they see on social media or magazines? How do you work with your students to identify those needs to create a safe space of acceptance?
Safety and acceptance are the two most important elements of a yoga class. I want people to feel like they belong in the space, and that they will be safe – physically and emotionally. In order to do so, I often directly address the misrepresentation of yoga in the media. I try to teach my students about what yoga is – working with the mind to connect with the heart.
The main challenge that comes out of the misrepresentation of yoga within yoga classes is the idea that more is better. I constantly see students straining and potentially injuring themselves. It can take experience to learn about how far to go into poses and how long to hold them. I worry that with the competitive nature of our Western culture, many people are getting hurt in yoga. I also worry about the emotional suffering that people experience in yoga classes – feelings of not being good enough, or that they don’t belong.
There’s a common phrase, “The students are our teachers.” Along with your extensive training and experience, do many of these sequences and alternative practices come from practitioner feedback?
Yes, pretty much everything I teach comes from collaborating with my students and from other teachers who have inspired me. A key element of accessible yoga is collaboration, which is based on the idea of seeing the student as your equal and lifting them up. The traditional teacher/student hierarchy can be disempowering and lead to many problems, including much of the abuse we are seeing in the yoga world.
Collaboration is a key element in my teaching because it asks the student to step into their inner wisdom and sharpen their awareness. It can help them take on their yoga practice in a more profound way. In many ways, my goal is to make the students independent yoga practitioners who aren’t reliant on me. The more they feel that they have their own practice the more yoga will become an important part of their lives.
How has your personal practice changed over the years from when you first started?
I’ve been practicing yoga intently since I was in my early twenties, and now I’m in my early fifties, so a lot has changed. As my body ages, I try to find a practice that is supportive of my wellbeing in every way. When I was younger I would push myself into some of the more gymnastic poses, but after a lot of injuries, I’ve finally learned my lesson.
Nowadays, I don’t plan what I’m going to do when I get on the mat. I like to take a moment to notice how I’m feeling and consider what will be most supportive of my body and my mind in the moment. In fact, my mental state may be the most compelling part of my daily practice. I ask myself, do I need a more inward, slow, gentle practice with restorative poses and longer pranayama? Or do I need a faster, fun practice with music? Is there a part of my body that needs to be protected, strengthened, or stretched? Each day is a new adventure.
I realize that for a new practitioner that might be too much to take on. In the beginning it’s fine to do the same practice every day and notice how it feels. Gaining sensitivity to what’s happening inside your body. Introspection is an essential skill that comes with practice. Also trying out all different styles is a great way to learn about all the different tools that yoga offers.
What has surprised you the most since founding Accessible Yoga?
I’ve been most surprised by the incredible reaction I’ve gotten, and how much this work resonates with so many people who love yoga deeply. A big part of the mission of Accessible Yoga, the non-profit, is to support yoga teachers who are making yoga accessible. I’ve been amazed by the work that yoga teachers are doing all over the world. These are teachers who are serving day after day to bring yoga to communities that have been disempowered or underserved. They are often serving without recognition, and sometimes without even getting paid!
Wherever I travel, I meet yoga practitioners and teachers who have found the power of yoga and are sharing it with others. Their dedication and service is what propels me to continue to work for greater understanding and to break down barriers to access. All the issues that limit access to wellness also limit access to yoga – racism, sexism, ableism, homophobia, transphobia, etc., are all issues in the yoga world.
Physical adjustments in class has been a hot topic recently. To quote you, “Ongoing consent means that just because a student gives you consent at one point in class doesn’t mean that you have consent to touch at another time…Ongoing consent means that we open up a dialogue with our students during class…you can create an environment where declining touch is accepted and even celebrated, where students are learning to connect with themselves and speak up for what they need.” Do you have any additional comments on this topic?
It’s very important that we have more discussions in the yoga community about the lack of consent for touch that is happening in a lot of classes. Most of us weren’t trained in how to gain consent from our students, and we assume that hands-on adjustments are what the students want. I think we’re just starting to address this issue as a community, and I’m sure we’ll see more policy changes in the coming years to create more clarity around this topic.
The first thing we need is a clear scope of practice for yoga teachers, as well as a thorough code of conduct. We currently don’t have either, and it means that many yoga teachers are offering touch, adjustments and other practices without appropriate training. It also means that as a community we don’t have clear guidelines to follow to keep students safe.
Ironically, the real power of yoga resides in its ability to calm the mind and allow us to turn inward. I think we need to turn to the heart of yoga, which is already accessible, in order to make the practice safer and more effective for all our students.
Learn more: jivanaheyman.com
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With more people working from home due to the COVID-19 pandemic, there have been a few silver lining discoveries for some. Cutting down travel, spending more time at home, avoiding awkward or negative workplace scenarios, and the occasional “wear your sweats to work” dress code are all benefits of the virtual office. But one challenging arena to navigate is finding work-life boundaries. You may have noticed you’ve been working longer hours than usual from the comfort of your home and find yourself taking fewer movement breaks. Maybe those trips to the water cooler weren’t so bad? Periodic movement throughout your workday helps release unwanted tension and unburden your mind.
Here is a gentle and feel-good chair yoga sequence you can do right from your desk that helps counteract those long hours of sitting.
Neck and Spine Relief
Maybe you’ve been leaning into the excitement of your work or slouching into the comfort of your couch. This side bending pose can help you rebalance your spine, release a tense neck and stretch your intercostal muscles to facilitate better breathing.
Start seated in your chair with a neutral spine. Lean your right ear towards your right shoulder and straighten your left arm down alongside your chair seat. Take a few breaths here, sensing the elongation of the side of your neck. Then allow the rest of your spine to follow suit by side bending to the left and reaching your left arm overhead. You can walk your right hand down the side of your chair or support your hand on a block. Take 3 to 5 deep breaths as you observe the movement of your left side ribs. Next, lower your left arm to hang heavily by your left side while you slowly rotate your neck to look down towards your right hand and then up towards the ceiling. Do this for a few cycles. When you are ready to change sides, center your head and bring your torso upright.
Dynamic Twist and Lift
When your back is feeling achy, and your breathing feels off, try this dynamic combo. Begin seated with a neutral spine. Take your right hand to your outer left thigh and support your left hand on the chair seat or chair back (do the one that feels natural in your body to do. Inhale, and as you exhale, turn to the left. Breathe smoothly and steadily rather than forcing a deeper twist. On an exhalation, unwind your twist. Then hold onto the sides of the chair slightly behind your hips, and lift your chest. Stay for a breath or two, then repeat and turn to the right. Do this for as many rounds as you need.
Lunge It Out
Does it feel difficult to stand up after being seated for a while? Give your hip flexors some love with one or both of these supported lunges.
For the first variation, begin seated and turn your body to the left so that your left shoulder faces the chair back and your feet are on the floor. If they are not, try using blocks under your feet. Lean your torso forward as you step your right foot back, maintaining your left hip and back of your thigh on the chair. Straighten your right leg and take a few breaths. Then bring your torso upright and bend your right knee so that the feeling remains in the front of your right hip. Stay here, or lean your torso to the left as you support your left hand on the chair and lift your right arm overhead. Stay for a few breaths, then release your right arm, lean over your left thigh to step your right foot forward, and come upright to sit. Swivel around to change sides.
The second variation is done standing. Stand behind the right side of the chair and place your left foot in the center of the chair seat. Take your hands to the chair and walk your right foot back some. You can keep the ball of your right foot on the floor or drop the heel to the floor for more balance. Steady your legs, and when you’re ready, lift your torso and reach your arms overhead. Stay here or take your left hand to the chair back and side bend to the left with your right arm overhead. Take a few deep breaths as you press the ball of your right foot into the floor and observe the sensation along the front of your right hip. To come out, lift your torso upright, take your hands to the chair seat to step your right foot forward, and then step off the chair. Stand in tadasana for a few moments before changing to the other side.
Soothing Forward Fold
The chaos of the day usually catches up at some point, so having a few moments of quiet can go a long way. This forward bend can help soothe your nervous system by decreasing the stimulation of your senses.
Begin seated with a neutral spine and your feet wider than your chair. Press your palms into the tops of your thighs as you elongate your spine. On an exhalation, tip your pelvis forward and then round your spine. Support your forearms on blocks on the floor or thighs. Use a blanket for additional support. Close your eyes or soften your gaze and sink into that sweet feeling of release.
Working from home carries the incognito weight of defining clear boundaries between work and rest. As you take on that challenge, these poses can serve as a reminder that small increments of activity can reduce stress and tension while taking care of your body and mind while you work.
Learn more: allisonrayjeraci.com
By LouLou Piscatore
photo credit: Chas Kimbrell
LIFESTYLE
What is functional medicine? How is it different than standard care? And what are the kinds of things that you treat?
In functional medicine, we say that we want to work on root cause resolution. This depends wildly on the human sitting in front of me asking for help and the entire constellation of their being.
My formal training is as a general practitioner. If someone came in with high blood pressure, there are specific definitions…there is a bit of nutrition counseling, and of course, a lot of medications. We had tools, but we also had a certain time allotment in which to use those tools. And what I saw happening, which made me incredibly sad, was that if the tools weren’t working, there started to be almost a dread of that patient – you wanted to solve that problem, but you didn’t want to be in the room with a patient who had a problem you could not solve within five or ten minutes. I watched kind of the unraveling of the sacredness, the beauty, or the joy that could be in a provider-patient relationship.
That’s standard care.
Yes, that is the standard of care and it’s incredible that we know what we know. It comes from a depth of study and understanding of the body. But sometimes someone would come into my office and they would have diabetes, hypertension, high cholesterol, but they would also not feel well and not feel themselves. I could give them the medications and they’d say, “But Doc, I still don’t feel well…is there anything I can do other than the medications you have prescribed?” I wanted to be able to meet the requests of these humans who were not feeling well, who were vulnerable and who were asking me for help.
It’s more intuitive to explain functional medicine through the lens of a human being and the problem, and what I call a 360-degree wraparound plan of care. But it wouldn’t just be a laundry list of things that might just be good for you to do. It would be based on that person’s biology.
For example, during my residency in the Bronx, there was a lack of access to fresh foods. And so sometimes my therapeutic plan of care would be sussing out the farmers market schedule, how they would get there, did they have transportation, etc. And then if they were able to buy those fresh foods, how would they cook them and I would Google recipes and print them out.
So it is a 360-degree approach to the entire person. What is going on in their life, what their lifestyle choices are, what they are eating, what their stress levels are, And personalizing care for that person?
Right, what their genetics are, what their environmental exposures are, and every human who is struggling with a health imbalance will have antecedents -–those could be myriad. We think of it as the functional medicine matrix. We look at all of the factors influencing a person’s health, including social, cultural, life circumstances, everything.
For example, not being able to get fresh produce in the Bronx…
Right. That might be an antecedent because it puts you at risk for vitamin and mineral imbalances, or blood sugar imbalances. And then there are triggers – where your body is maintaining a certain balance and then something pushes you over the edge. Maybe it’s a big life stressor, maybe it’s getting an acute illness, or taking a course of antibiotics, which can begin a kind of a snowball. Maybe someone says, “Well, my digestion wasn’t good but then my husband filed for divorce and ever since then I’m so bloated, and I look like I’m pregnant.” So, there might have been an antecedent, but there’s also a trigger. And then there are certain things that might perpetuate that imbalance. Once that imbalance is in place, certain foods might be feeding the wrong population of gut flora that are perpetuating bacterial overgrowth, or yeast overgrowth, which could manifest in fatigue, joint pain, and headaches. It might be a seemingly unrelated constellation of symptoms that come from a similar root cause. so, we would think about it in terms of the functional medicine matrix – what is contributing to that health imbalance, what was the trigger, what were the vulnerabilities that allowed that trigger to push them over the edge,and we address as many or all of those pieces of the puzzle as we can to bring the person back into optimal balance.
You take the time to figure all of that out, which separates you from standard care.
When humans come to me, who I call in my mind and in my heart, “partners in healing,” because it really is a healing partnership, they’ve gone to other physicians, sometimes many, who have done their utmost within the scope of their training to advocate, to investigate, and to treat my partner in healing.
But their tools are limited.
The tools are limited. And also the system is limited. What I started seeing happening in my early training and residency, within the time allotment and with the tools we had, we started to experience failure. And I really love and respect my colleagues. However, if all the tools that I acquired with the intention of being of service have not been able to answer the need of a patient, what functional medicine does, is it expands the menu. It’s evidence-based medicine the way I was trained, but expanding the toolkit.
Let’s talk about adrenal fatigue or “burnout”
Our adrenals are little glands that sit like little snow caps on top of our kidneys. Our adrenals are chiefly responsible for making cortisol. And the reason I say chiefly, is because the adrenals also make other wonderful hormones. In medical training, we had a mnemonic for the function of the adrenals; it was sugar, salt, and sex. Sugar is cortisol – cortisol raises blood sugar, and that’s the stress response. We have evolved over millennia to be able to escape from the bear who’s chasing us. We survived because we mounted a stress response, which either gives the energy to climb up a tree or run really fast, or fight. To be standing here today, we had to be able to mount a massive stress response – that is tied to our survival. And that’s cortisol. But there are all these other interesting hormones that the adrenals make. There’s one called aldosterone, which helps us with salt balance, and is part of regulating our blood pressure. And sex hormones. We think of the ovaries or the testes as making our hormones, and that’s true, but the adrenals can also make those hormones. The adrenals make estrogen and progesterone and testosterone. So, if there is something that is causing stress in our body, it affects our adrenals, which essentially affects everything.
This is always an interesting conversation that I have with people, sometimes they say, “But I’m totally relaxed, my life is great, my kids are doing well, I love my job, my partner is supportive.” But that is only one level of stress – there are others. What if your drinking water has lead and you’re amassing a load? That’s stress on your body, You don’t feel it as an emotion, but that’s a huge stress.
So, stress can be physical OR emotional…
We are complex. Every human being is a universe, and is as complex as the universe itself. And in that universe, we have any number of stimuli. It could be light exposure, or exhaust from cars, or a check bouncing and not being able to make rent, or your boss yelling at you, or a food sensitivity. Anything that the body could experience as stress, whether you experience it as an emotion or not, the body will need to respond to with a stress response. Infinite possibilities of stimuli and one response. The body has a finite number of responses. What can the adrenals do? They can make cortisol, or they can make cortisol. Therefore, we have to look at the adrenals with that same 360-degree approach. How will overworked adrenals manifest? When we have a stressor and the adrenals respond, they make more cortisol. But that’s a process and it requires resources. We need our B vitamins, vitamin C, amino acids. If one of our stressors is that we have a chronic gut infection that is starting to affect our ability to assimilate those nutrients, we may be revving up the adrenals, but we’re not able to assimilate the ingredients they need to replenish themselves.
Another way the adrenals replenish themselves is while we rest. Sleep is a huge way that we replenish the adrenals. What if we’re running on empty, and we also have insomnia? We can start to understand how, over time, the adrenals get taxed, and can lose their ability to compensate. That’s usually when people walk through my door.
At first, cortisol is anti-inflammatory. In a stress response, we don’t feel pain – it’s a survival technique. That’s what allows us to fight the bear even if the bear tears open a flesh wound. That’s part of how we survive. But the converse is also true. When we can no longer mount a cortisol response, we’re going to have pain. An extreme version of this is fibromyalgia, which is just total body pain. Or the adrenals are involved in blood pressure regulation. So, someone who says, “when I change positions from sitting to standing, I start getting lightheaded.” That’s the inability of the body to maintain the blood pressure related to aldosterone (adrenal) deficiency. These are all signs, symptoms that our adrenals are depleted.
The symptoms I would associate with adrenal fatigue are fatigue, first of all, weight gain, hair loss, and depression.
You’re actually naming a lot of the classic signs and symptoms for hypothyroidism. They are related. One of the interesting things that goes beyond laboratory evidence is that when your cortisol is high, it can actually block the function of the thyroid on a cell level. You can have thyroid levels that look kind of within normal range, but you can still have functional hypothyroidism. If you have adrenal imbalances over time, it will affect the thyroid. And of course sex hormones. Sex hormones are the last priority. So, if sex goes, it’s one of the signs that hormones are off, that the body is under stress. When sex comes back it’s a sign that your hormones are reconstituting. There’s a pyramid (for hormones) and the base, the foundation, is adrenals (then thyroid, and then sex on top).
On that note, let’s talk about the importance of rest.
Cortisol follows a circadian rhythm. If cortisol is in balance it should peak within 20 minutes of waking. In fact, in a normal sleep and wake cycle, cortisol should rise as light hits the back of your eyelids. If we’re not mounting that peak, we don’t feel like we’re awake, we don’t feel like we can get out of bed. That’s a cardinal sign of the adrenals burning out. Or someone telling me, “I have a really hard time getting up in the morning, can’t open my eyes until that first cup of coffee.” Some people need a nap at 4pm, but then get a second wind, and are up all night. That’s adrenal imbalance. It’s like waves. The top of the wave should be in the morning and then you have this gradual going down, down, down, and then the bottom of the wave should be the feeling of, I’m ready for bed, I’m going to call it a night. Ideally, we’re hitting that before midnight, and we’re going to lie down, to get that deep, restful sleep, that replenishment. It’s the time when our brain detoxes, our liver detoxes. If instead, we started low in the morning, and we go from low to high instead of high to low, we’re not going to get restful sleep, and that can create a vicious cycle where we’re not getting the rest we need — we’re not replenishing.
Let’s talk about that, because the modern lifestyle changes makes that kind of natural rhythm nearly impossible for most people…people are working 24 hours a day.
Well, now we have technology. I’ll share something that I love from a brilliant functional medicine gynecologist named Bethany Hayes. She asked this question: “How many of you go to sleep when sleepy arrives?” It’s such a simple question. And the answer is we don’t, we push back sleepy, because we have a deadline, or read stories to your kids so that they can go to sleep, and then get things done for tomorrow, and place orders on Amazon Fresh. Oftentimes it involves blue light and the screen,which blocks melatonin. So we are not getting that sleep, we’re not restoring our adrenals. We’re living in that perpetual state of yin deficiency, or parasympathetic deficiency and sympathetic drive, which burns the adrenals out over time. Even if there isn’t something specifically stressing out your system, just the lack of downtime, the lack of rest, of deep, nourishing rest is going to affect your health.
Recently, the World Health Organization recognized burnout as a diagnosable condition. How do you feel about that?
Breaking the silence on burnout is a huge conversation. For example physicians and nurses. There is a great opinion piece, by a physician named Danielle Ofri in the New York Times about the exploitation of doctors and nurses in a system where we have a ratio of 10 administrators to one healthcare provider, and how there’s no more operational efficiency that can be optimized. It’s impossible for a doctor to do the right thing within the 10 or 15 minutes that we’re allotted, so we give of our own time. And so there is burnout. In the physician population, we have the highest rate of suicide of any profession. I’m deeply committed to speaking out about this. I’m very involved in a wonderful organization called the Gold Humanism Honor Society which is trying to cultivate values of humanism in medicine for the humans we are caring for and the humans we are. My antidote to that is the practice of functional medicine, where I get to practice what I signed up for. I get to hold humans in their entirety and care for them in their entirety. There’s a profound insight that grows out of that work. And there is a profound exchange. And we’re able to do impactful work that helps people truly feel better, and function better. It changes your entire, not just health trajectory, but life trajectory. Functional medicine is my antidote to burn-out because it’s about becoming the change we want to see. First, as a human and then as a practitioner practicing the way I believe medicine should be practiced, and caring for others the way I wish I would be cared for. And in fulfilling those things, I have joy, and the wonderful humans I’m so honored to work with have joy, too.
Miriam Rahav, M.D. is a dual board certified physician in the fields of internal medicine and hospice and palliative medicine. Dr. Rahav also has many years of training and clinical experience in integrative medicine and functional medicine. She currently practices medicine in New York City where she is the founder and owner of Rahav Wellness,
