YOGA TOWARDS INDEPENDENCE

Franky Lewis

Jenny Fellows, research paper tutor f or the IYTA (N.Z.) Inc.

A most useful paper for yogis, yoga teachers and anyone coming into daily contact with disabled people. It is a reflection of two yoga journeys, Frankys in accepting and working with what is and seeing the potential for more; and Keegans journey of dev eloping awareness and strength. Thank you Franky. You are an awesome yogi!

Franky, this is a beautifully presented paper. It is well thought out, with a logical development of your theme. You have included a lovely programme, with photographs, which will be very useful to many people I am sure.
Anne Scott, course tutor for the IYTA (N.Z.) Inc.

I read your paper, which I really enjoyed. It was beautifully written and described yoga in relation to you and Keegan very nicely. It was very touching really. Not just words and facts but lots of soulful emotion as well. I certainly understand now how much more yoga offers you and Keegan than just physical components like stretching and strengthening solely. Great job, it is an excellent resource and confirms the many benefits of yoga practice.
Colleen Remu s-Bodle, physioth erap ist.

You are such a gifted writer! ... Expressing your views and feelings so exquisitely. How lucky is your son !
Louise Wiggins, AUA, Dip T, IYTA Dip, SAIYT Dip.

You are a tower of inspiration...people will see it ...some just not now ...much love to you...
Pat Armitst ead, Joy olog ist . Beautifully said Franky. Its a quality that bursts forth from you . Adrian Daly, y oga teacher and n ation al presid ent for the IYTA (N.Z .) Inc.

We are all part of an incredib ly vast, majestic and interconnected energy complex. Understanding this and appreciating this! is the basis and foundation of yog a. It is the knowledge required for living the d ivine life.
(Schiffmann, p340)

YOGA TOWARDS INDEPENDENCE

Interdependence is and ought to be as much the ideal of man as self sufficiency. Man is a social being. Without interrelation with society he cannot realise his oneness with the universe or suppress his egotism. His social interdependence enables him to test his faith and to prove himself on the touchstone of reality.
Mahatma Gandhi, 1929
(Cited i n Wikipe dia)

Franky Lewis

Copyright 2006 by Franky L ewis. All rights reserved . No part of this research paper may be reproduced in any manner wh atsoev er with out writt en permission from th e author, ex cept in the case of brief quotation s.

Printed in New Zealand by Divin e Yoga NZ Web: www.d ivin eyoga.net .n z Second ed ition Ju ly 2007. For more informat ion, please contact Franky by email: divin eyoga@orcon.n et.nz

The techn iques describ ed in this paper should not be attempted with out the profession al gu idance of a certified yoga teach er and/or a physioth erap ist.

Cover illustration: Franky and Keegan Lewis buddy walk ing.

ACKNOWLEDGEMENTS

Writing this research pap er has been made possib le f irst and foremost thank s to Keegans precious co -operat ion. Th anks to him, h is patience and willingn ess to particip ate, I am glean ing some v ery priceless learning, wh ich I am eager to share. I am most gratefu l to him for cho osing me as a mother. I am thankful to my husb and Lew for h is pat ience and support, for listen ing to my yoga stuff and for being so understand ing of the many h ours I spend on my yoga mat and in front of the computer. I am also gratefu l to my parents fo r in troducing yoga into my lif e at a young ag e and to all my frien ds who have in their own way, and sometimes unkn owing ly, pointed me in the right direct ion. I would like to ext end my thanks to all the therapists wh o have worked with us for the last ten y ears and who hav e willingly sh ared their wealth of experience with me. Than ks also to all the members of our t eam of helpers, wh o read ily support us and contribute to Keeg ans independ ence. I would also lik e to warmly thank my f riend Philip Pat ston, whose insights on d isab ility are helpin g me to understand Keegan from the p erspectiv e of a disabled person. Finally, I could not have written this paper without the commitment and support of all my yog a teach ers; a special thanks to my friend Trish Dy e, m y tutors Anne Scott and Jenny Fellows, all the tutors of the IYTA Teacher Train ing Course and Debbie Findlay who synchron ist ically made me realise that yoga cou ld be adapted to all lev els of abilities. Franky Lewis September 2006

TABLE OF CONTENTS

PREFACE INTRODUCTION BACK GROUND Prematurity Cerebral Palsy Aspergers Syndrome The New Zealand Disability Strategy Relevance to Yoga YOGIC MANAGEMENT THROUGH PAT ANJALIS EIGHT LIMBS Yamas Niyamas Asanas Understand ing movement Stretching Strengthening Body awaren ess Areas of Keegan s body requiring special attent ion Keegans daily routin e

1 3 5 6 9 10 10 12

13 14 19 24 25 27 30 34 36 39

Pranayama The role of th e breath in our dev elopment Keegans breathing pattern Yogic man agement Pratyahara Dharana Dhyana Samadhi YOGA, AN APPROACH FOR PARENT S CONCLUSION GLOSSARY OF SANSKRIT WORDS APPENDICES Appendix 1: Brain damage in premature babies Appendix 2: Stress for parents of premature babies Appendix 3: Touch Relaxat ion BIBLIOGRAP HY

79 79 80 81 84 87 89 90 92 96 98 101 102 104 106 107

PREFACE

Getting caught into believing that liv in g with a disability needs to be stressfu l and traumatic is an easy trap. When life deals us dif ferent and more challeng ing card s than our neighbours, we suddenly don t fit in the sy stem anymore. We enter the frater n ity of disabled people who have to fight and lobby for the most basic need s and rights: support for p ersonal hygien e, accessib ility to building s, equ ipment for mobility As we engage in ongoing battles, we can find ourselves reinforcing maya 1, the illusion of sep arat ion. We feel that there is them: non-disabled people who h ave no or lit tle understanding of our issu es because of not liv ing wit h them; and us: disab led families wh o live complet ely d ifferent lives but are try ing to adapt to a society designe d for able-bod ied people. I had alway s seen my sons physical impairment as a limitat ion to the practice of yoga rather than a tool to explore his abilit ies. Th is was reinf orced by the fact that, apart from Jesus teach ings on healing 2, the great yoga masters of ou r time h ave not left us a manual of detailed yogic pract ices for impairments. Discovering yoga under the new light of Patanjali s Sutras 3 opened up new horizons for me and sent sh ivers down my spin e when I realised the dormant potential for Keegan. It was then that I decided to learn as mu ch as I could for h is ben efit , but also for the b enef it of other people/ch ildren in a similar situat ion. This d ecision gave
1 2

Sanskrit word. Yogananda, pp329-351 (Healing Power of Thought Transformation). 3 Written in the Sanskrit language approximately 2000 years ago in Northern India by the sage Patanjali, they are a compendium of an ancient pre-existing oral yoga tradition consisting of both practical advice and theoretical context. Divided into four chapters, they consist of 195 sutras (aphorisms or statements), which have been extensively expanded by numerous commentaries ever since.

2 me an elat ed passive pawn going to take also going to feeling of strength: in stead of being a of the trad ition al medical approaches, I was an activ e role in my son s well being. I was empower him to do the same.

Nearly three years have now passed since that decision and I can truly say that therap ist s, friends and family are all amazed at Keeg ans development. He is ten y ears old and opening up to the world like a beautiful f lower. There is n o doubt in my mind that yog a play s a big part in the awak en ing of his potential. For me, learn ing to detach myself f rom the illusion of the m and us and from close-t o-heart issu es enables me to concentrat e my energy on promoting Keeg ans indep en dence in a very posit ive way.

INTRODUCTION

For the purpose of this paper, I have chosen to def in e independ ence as the capacity to freel y make decision s and to act on them. Where society may assume that Keegan will alway s be dependent for all his n eed s, I am trying to teach h im a mean ingful way to find his own independ ence. By act ively support ing and encouraging his mob ility, I am, tog e ther with Keegan and a team of helpers, dev eloping h is ind ependen ce and help ing him to creat e meaningfu l personal int erdepen dence with his environment . Practically, th is means d istilling in him awareness at all lev els: physical, ment al, emot ional, spiritual and social. Calling upon Patan jalis t each ings, my aim is also to show Keegan a way to p eacefully accept the limitations of h is physical body and to control th e agitat ion of h is thoughts in order f or him to sign ificantly d evelop his own person al skills and abilities. I wou ld like to teach him how to detach himself from his f rustration s an d turn them into posit ive exp eriences toward his emot ional and sp iritual freedom. The h igher h is awareness, t he mo re h is spirit will be ab le to st and in it s true id entity and shine through his action s. In this paper, I first set the backgrou n d of Keegans extreme prematurity. I briefly explain his impairment s, and inform y ou on the meaning of th e New Zealand Disability Strat egy in todays Aotearoa 1 and its relevance to Yoga. I then propose to sh ow you how I hav e researched and adapted yogic principles to Keegan s specif ic needs in order to promot e his indep endence. I look in detail at:

Maori word meaning New Zealand.

4 yamas and niyamas (abst inen ces and observ ances) asanas 1(postures) pranayama 2 (expansion of the lif e force) pratyahara (withdrawal from the senses) and relaxation techn iques dharana (concentrat ion). I also cover brief ly: dhyana (med itat ion) samadh i (self-realisat ion). Finally, I share with y ou some personal insight on how yoga help s and support s me, as Keegans mother. I conclude that adapting yogic principles to Keegan s specific n eed s, as described in this paper, is helping him awak en to his potential, and more imp ortan tly is proactiv ely promot ing his journey towards independ ence. The inf ormat ion h as come predominantly from a combin ation of life-long exp erience wit h yoga and the medical knowledge I have gained from Keeg ans therapists. It has been reinf orced by t he rea d ing of numerou s books, web sit es, articles an d informat ion sharing with disab led families and friends. Other sources also include: compact discs, tapes, yog a courses, lectures. Time has now come to share the mod est fruit of my research and bring awaren e ss to the f ore in order to help other peop le awak en to their potential, regardless of their abilities.

According to Patanjali, asana is that position which is comfortable and steady. (Saraswati. sana Pranayama Mudra Bandha, p9). 2 Not to be confused with breathing techniques, which are used to influence the flow of prana in the nadis or energy channels of the pranayama kosha or energy body.

BACKGROUND

1. Prematurity
Born at twenty-six week s of gest ation (fourteen weeks early) and weigh ing sev en hundred an d eighty eight grams, Keegan is one of these miracle babies the press and the medical profession proud ly talk about.

Keegan at birth

7 What is litt le known, because resuscitation of micro babies 1 is still in its infan cy, are the lon g -term eff ects on children as they dev elop through ch ildhood and adolescence. Observ ing and supportin g Keegan since birth has made me realise that there is indeed no miracle but an ongoing discovery of physical, mental and emotional challenges which are undou btedly due to his extreme prematurity. He was resu scitated at birth with a poor Apgar score 2 of 4 at 1 and 7 at 5 minutes, had a possible brain h aemorrhag e, respiratory distress syndrome (RDS), pu lmon ary haemorrh ag e, feeding difficu lties prevent ing him from suck in g, inguinal hernias, irritability , slow growth , cognit ive d evelopment issues and other signif icant condit ions n ot relev an t to this paper which I wish to keep privat e. He was diagnosed with cerebral palsy eight month s after his b irth and with epilepsy three years lat er. We are cu rrently in the process of investigat ing Asperg ers Syn drome (h igh function ing autism) as an other possible diagnosis. An EEG 3 and MRI 4 we did at the ag e of f ive sh ow that the white m atter of h is brain is underdev eloped, which is consistent with a v ery premature birth, accord ing to David Jamison, h is paediat rician and head of Starships Neurolog ical Dep artment at th e time.

Babies born under 1000g. The Apgar score was developed in 1952 by an anaesthesiologist named Virginia Apgar. It is designed to quickly evaluate a newborn's physical condition after delivery and to determine any immediate need for extra medical or emergency care. Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2: heart rate (pulse), breathing (rate and effort), activity and muscle tone, grimace response (medically known as "reflex irritability"), appearance (skin coloration). These five factors are added together to calculate the Apgar score. Scores obtainable are between 10 and 0, with 10 being the highest possible score. (Kids Health for Parents. www.kidshealth.org/parent/pregnancy_newborn/pregnancy/apgar) 3 Electro encephalogram. 4 Magnetic Resonance Imaging.
2

8 Recent studies hav e found a link between damage to the white m atter of the brain , the myelin at ion process 1, cerebral palsy , a whole array of other conditions and preterm birth. 2 According to research conducted by the National Institut e of Child Health and Human Development , 25 percent of extremely premature babies have neu rological prob lems at 18 to 22 months, and 17 percent will dev elop cerebral palsy. 4 Another study on prematurity of ch ildren born between t wenty -six and thirty-three week s suggest s that by the age of f ifteen, forty percent will have some type of n eurological impairment 3: behaviour and cogn itiv e problems oft en accomp anied by sensory and physical impairments. As the brain, along with the spin al cord, is on e of the main const ituents of the Central Nerv ous System (CNS ), any damage to it will affect th e bodys ability to manag e the other sy stems. Th e eff erent sy stem, which regulates muscles and glands, struggles to communicat e. Th is affect s the control the body has on it s muscu lo -skelet al system (muscles and bon es) but it also has an eff ect on the endocrine syst em (glands), which could exp lain an array of endocrinal issu es such as: diabetes-type symptoms like fainting if not eating at a regular time slow growth poor sleep pattern constant dehydration with difficu lty to control body temperature weak immune syst em epilepsy high tolerance to pain psychological issues (anx iet ies, mood swings) challeng ing cognit ive development: constant need for reassurance of how he f eels physically, mentally and emotionally .
1

The myelin is the insulating sheath surrounding nerve fibres in the brain and spinal cord. 2 See Appendix 1. 3 Impairment originating in the brain.

9 Hence the importance of estab lish ing and maint aining good blood flow around vital organ s (including the brain and the spin al cord), in order to opt imise sy stemic commun icat ion.

2. Cerebral Palsy
Cerebral Palsy is a condit ion resu lting from brain damage (usually around the t ime of b irth) cau sing physi cal disord ers and problems with motor con trol and posture, such as increased muscle tone and inv oluntary muscle movements. As explain ed hitherto, I discovered that the physical aspect s of Keegan s impairments were not limited to h is physical body, as the m edical prof ession seems to believe through their symptomat ic approach, b ut also have profound effects on h is mental, emot ional, social and spiritual personality. As act ions, int en tions and thoughts are gen erat ed in the brain, bringing them to fruit ion for Keegan inv ariably creat es sp ast icity 1, prevent ing smooth energy f low throughout his body. Cerebral Palsy s main characterist ic f irst appeared to me as muscular tension . As yoga is about letting go of tensions, it seemed log ical to use this approach to help Keegan.

Spasticity has been defined as an increase in muscle tone due to hyperexcitability of the stretch reflex and is characterized by a velocity-dependent increase in tonic stretch reflexes (Lance, 1980). (eMedecine from WebMD. www.emedicine.com/NEURO/topic706)

10

3. Aspergers Syndrome
At the time of writ ing the first edit ion of this paper, I was exploring this syndrome, as many clues seemed to indicate that it was affect ing Keegan. Now I feel that a diagnosis would on ly st igmat ise him with anothe r label; so in stead , I have chosen to celebrat e his diff erences and encourage him to cult ivat e them as his very own and special contribution s to human evolut ion. The self esteem he n eeds in order to d evelop his full potential and accomp lish his Lif e Purpo se depends on positive messages he receiv es from his env ironment. At the crucial age of his teenage y ears, it is t ime to break f ree from the constant y ou cant do this b ecau se you are disabled attitudes th at the medical and educat ional models unconsciou sly drum in to us through th eir thought less viewp oint s and policies.

4. The New Zealand Disability Strategy

The New Zealand Disability Strategy 1 states that Disability is not someth ing ind ividuals have. What indiv iduals hav e are impairments. Th ey may be physical, sensory, n eurological, psych iatric, intellectual or oth er impairment s. Disab ility is the process which happens when one group of peo ple create barriers by designing a world on ly for th eir way of liv ing, takin g no account of the impairments other people hav e. We are eith er born with an impairment (due to genetic factors like Down Syndrome or due to perinat al brain damage lik e Cerebral Palsy) or acquire one (loss of a limb in a car accident or a strok e).

Office for Disability Issues. The New Zealand Disability Strategy. www.odi.govt.nz/nzds, p7.

11 A majority of imp airments are located in the brain and have very different impacts dep ending on the part(s) of the brain that is (are) affected. We commonly see impairments as physica l (aff ect ing the body), mental (mental illn ess) or intellectual (aff ecting the intellect, ou r reason ing sk ills). What is import ant to underst and is that impairments h ave an impact on h ow an indiv idual relates to his/h er environment . We learn and grow thr ough experiences, no matter how th ese take place. A person who is not able to walk will obv iou sly hav e a dif ferent ex perience to a person wh o walks. This doesnt mean that his/h er experience is any less than that of any one else. The perception of our en vironment is ju st different. Th is perception is sometimes exacerbat ed, leading to hypersensitiv ity, wh ich occurs wh en on e (or more) of th e five senses is ov er -stimulated. Another important ch alleng e that a disabled person may face is fru strat ion: barrier s such as accessib ility, being heard and understood are very tough lesson s indeed, quite often misjudged by our own ignorance. The New Zealand Disability Strategy was written in support of the one -in -five New Zealan ders who ident ify that they have a long -t erm impairment . Underpinn ing the New Zealand Disability Strategy is a vision of a fully inclu siv e society. New Zealand will be inclusive wh en peop le with impairments can say they live in: A society that high ly values our lives and continu ally enhances ou r full participat ion. Achieving this vision will involve ensuring that disab led peop le hav e a mean ingful partnersh ip with Government, commun ities and support agencies, based on respect and equality. D isabled people will be integrat ed into comm un ity life on t heir own terms,

12 their ab ilities will be v alu ed, their diversity and interdep endence will be recognised, an d their human rights will be protected. 1

5. Relevance to Yoga
The New Zealand Disability Strategy is showing us how to open our minds and understand that we are all human beings instead of being categorised as either disabled, Maori, f emale or gay or. a combinat ion of these We all hav e many v ery diff erent n eeds. Being able to demonstrate love and compassion, to use our listen ing skills and to put ourselv es into someon e elses skin will help us to bett er understand the needs of a wide v ariety of people, more part icularly those of u s who, at a sou l lev el, have ch osen this lif etime as a hu ge learning opportunity for the human race. We can learn to become in clu siv e and support each other, as a community , thanks to th e creation of interdep endent link s. We can also learn to value everyones cont ribution to society and celebrate th e diversity of lif e, Div ersity within Un ity. In doing so we all contribute to enhance the overall experience of our human race.

Ibid. p7.

13

YOGIC MANAGEMENT THROUGH PATANJALIS EIGHT LIMBS

This is the teaching of yog a. Yoga is the cessation of the turnings of thought. When thought ceases, the spirit stand s in its true identity as observer of the world . Otherwise, the observer identifies with the turnings of thought.
(Stoler Miller, p29)

14 Yamas and Niyamas Moral princip les ( yamas ) and social ob serv ances ( niyamas ) are the first two yoga practices wh ich, accord ing to Patanjali, can h elp us d etach ourselves from the misident ificat ion between un lib erat ed spirit and phenomen al world (th e sou rce of our pain). The applicat ion of the yamas and niyamas int o Keegans lif e is slowly taking the sha pe of a strong and positiv e base, which h e will be able to use, I hope, as a platf orm when time comes to leap gracefu lly an d happily into adulthood. The five yamas or moral qualities Ahimsa non-violence

Sutra II.35: When we are firmly established in non-violence, all beings around us cease to feel hostility. 1
Some stud ies have shown that parenting stress is a risk factor for lat er behav ioural problems in both preterm and other ch ildren. 2 The stress created in try ing to cope with everyday lif e for the parent of a d isab led ch ild is a fact or that undoubtedly affect s all disabled families. Parents b ecome the buffers between a non-und erstanding society and a child who function s diff erent ly but who has so many talents, wh ich are not oft en recognised by society . For examp le, it tak es Keeg an two hours to get ready to go to school ev ery morn ing. A last minut e event , like hav ing to change his clothes, in ev itably add s an extra 15 minut es to our routin e. As we hav e been threatened not to be
1 2

Cited in Lawson, p7. See Appendix 2.

15 able to u se the t ax i service to go to school if we are more than five minutes late, ou r morn ings h ave become v ery tense. In these in stances, and because th e consequen ces are significant (how would Keegan go to school? ), it is very easy to become frustrated and display impa tient behaviours. Applying ourselves to demon strat e non -violent and patient attitudes toward Keeg an is contributin g to create a lov ing and caring at mosph ere within our family unit. Feeling peacef ul and respected, Keeg an can ex press h imself in a mean ingful manner, with out the need t o mimic pattern s of impatience.

Ahimsa is also relevant to Keeg ans ph ysical practice;

wanting to push h is body too far cou ld be tempting but damaging.

Satya truthfulness

Sutra II.36: When we are firmly established in truthfulness, action accomplishes the desired end.1
Society often assu mes th at disabled people cannot express themselves or peop le f ind it easier and less time consuming to talk to th e person accompanying the disab led person. Peop le oft en forg et to talk to the ch ild; instead they speak about h im to the p arents, right in front of him and somet imes for long p eriods of time in th e case of specialist appointment s. With Keegan , we are somet imes quick to make assu mption s which reinforce the dif ferent aspects o f h is disab ility and wh ich are therefore disrespectfu l, lik e for example telling him to concentrate bet ter while buddy
1

Ibid. p7.

16 walk ing 2 wh en it is actu ally us (th e person helping him) who is n ot supporting h im properly Observing Keegan when sub ject ed to such situ ation s is quite rev ealing; he eith er looks uncomfortable and becomes ag itated or h e switches off and removes h imself from the situat ion (h e is phy sically there but his mind is elsewh ere). Allowing him to express th e purity of who he truly is, is an import ant key to his emotion al and spiritual development. Letting him be part of th e conversation, as he requ est s often, is giv ing him the opportunity to feel included in h is environment and to learn how to posit ively interact with others.

Asteya non-stealing

Sutra II.37: When we are firmly established in integrity, all riches present themselves freely. 1
For the last ten y ears, we have concen trated all our efforts on Keegans phy sical well being . This mean s that some other areas of his dev elopment n o w need to be addressed, lik e learn ing about his iden tity and property. Keegan expresses h is uncertainty by ongoing quest ions such as: Are you my mother? Or Is this min e? Even though these questions come across as a constant n eed for reassu rance, they could also indicate that Keegan is affirming himself and learning about what belong s to whom. Once h e underst ands this concept, and possib ly in th e same process, he will comprehend the mean ing of non stealing .

2 1

Supported walking as pictured on the front cover. Ibid. p8.

17 Patient ly taking the t ime to respond to his numerous questions is imp ortant in order for him to understand this concept and find his place in society.

Brahmacharya continence

Sutra II.38: When we are firmly established in our search to know God, subtle potency is generated.1
As the term ch ast ity does not apply to Keegan (and to most of us), the application of this yama need s to be taken to it s wid er meaning. As Keegans sen ses tend to be easily over stimulated, h is react ion s sometimes seem to be out of control and out of proportion . Teac hing him moderation and how to detach himself from his senses will en hance his perception of the world and enable him to liv e life to th e full with out becoming addicted to the pursuit of pleasure or the avoidance of pain.

Ibid. p8.

18 Aparigraha non- possessivenes s

Sutra II.39: When we are established in non-attachment, the nature and purpose of existence is understood. 1
Detachment from the sen ses also ext ends to material things. As we, Keeg an and his support team, are reliant on material things such as eq uipment f or his mobility, we may come to ident ify with them and believe that we cou ld not exist without them. With non -attachment comes the realisat ion and the grat efuln ess that we are v ery lu cky to have the support of such wonderfu l technology, and the appreciation that happin ess is in our in ner self rath er than in anyth ing extern al.

Ibid. p9.

19 The five niyamas or personal observances Saucha physical and mental purit y

Sutra II.40: Physical purity destroys identification with the body and brings freedom from contact with other bodies. 1
Illn ess and attachment to persistent, incessant thoughts and emotions creat e pain , preventing the whole body from relax ing. Physical purity for Keegan involves learning about his person al hyg ien e, proper d iet and suff icie nt sleep, an appropriat e ex ercise regimen in clud ing yoga postures and keeping h is en vironment clean and tid y.

Sutra II.41: From mental purity arises cheerfulness, mastery of the senses, one-pointedness and fitness for the vision of the Self. 2
Mental purity is lett ing go of those worrisome thoughts and emotions. The assistan ce that he receiv es in his daily life needs to be respectful of h is desire to learn how to achieve th ese different asp ects of purity with out assuming that he is not able to. Creat in g awaren ess at this level empowers him to make decision s with regard s to his physical and mental health.

1 2

Ibid. p9. Ibid. p9.

20 Santosha contentment

Sutra II.42: From contentment, unsurpassed happiness is gained.1

Constant mental agitat ion renders cont entment quit e difficu lt to experience and could be a sign that Keegan is trying to find a way to connect with h is inf init e nature. At times, it seems to me that , ever sin ce he was born, Keegan has b een discont ented with ev erything around him. I sometimes wonder wh ether it is his spiritual way of sharing with u s the refu sal of his present k armic life or maybe just a ref lect ion of my own discontentment . Qualit ies such as love, pat ien ce and compassion can break through this sh ield of unhappin ess by creating posit ive thoughts on how to be at peace with any situat ion at h and. This is reinforced through teach ing him that resist ing an experience actually reinforces th e realisat ion of that exp erience. Paxton Robey reminds u s of Jesus words Resist no Evil: If it is tru e that reality is created by thoughts held in mind and emot ion s held in the body, what is creat ed by being anti -war? 2 When we accept that we choose our ex periences at a soul lev el and that the u ltimate school (earth school) giv es them to us as part of our karmic cycle, we learn to feel serene about th em. On ly then can we reach a state of happiness and peace. This dimension is very challenging but goes hand in hand with detach men t ( aparigraha ) and non-violence ( ahimsa ) on the path to supreme bliss.

1 2

Ibid. p9. Robey, p20.

21 Tapas austerity

Sutra II.43: Through fiery aspiration and through the removal of all impurities, comes the perfecting of the bodily powers and of the senses.1
This niyama is an important paramet er in the shap ing of Keegans personality and strength of char act er. In this context, au sterity is seen as the discip lin e that is necessary to work toward and achieve independ ence. By drumming repetit ion into his daily routine in a gent le and caring but con sistent mann er, Keegan is learning to develop the courage an d the f ire n eed ed to push himself toward his personal goals no matter what they are. As this powerfu l burn ing process is a gift from me to him, I need to carefu lly en sure to inclu de temperan ce in my teach ings to him. Combin ed with d harana and balanc ed by santosha , it becomes a valuable tool to teach Keegan equilibrium bet ween his driv in g and steadying forces. Once count erbalanced, these f orces will clear h is way toward courag e, wisdom, integrity and straightforwardness.

Cited in Lawson, p10.

22 Swadhyana self-study

Sutra II.44: Self-study results in contact with the soul (or divine One).1
Even though self -study inv olv es the reading of sacred scriptures, for wh ich Keegan is too you ng yet, it also mean s the cult ivat ion of th e ability to read en ergy patterns in the self and others, to discriminat e between the not-I and the transcendent Self ( Atman ). For Keegan , it means discov ering these energy patt erns within h is body, mind and emotion s an d how these f orces interact with each oth er. Through his daily y oga rout ine , Keegan is learn ing to feel mov ement s and shift s of en ergy within h imself more import antly , but also with in his surround ings. He is learning to observ e these changes and adapt to them. Th is awareness is slowly bearing fruit as he is now spontan eou sly st arting to apply his y ogic experimental knowledge when required , for examp le to gauge peoples thoughts or emot ion s. This niyama works toward reinforcing t he asteya yama ; learning more about h imself h elp s him find his ident ity within h is environment .

Ibid. p11.

23 Ishwara pranidhana self -surrender

Sutra II.45: From surrender to the Lord, the state of samadhi is perfected.1
Surrendering to God or Brahman is the culmin ation of our yoga practice. It is the reminder that, as we ch oose our experiences at a sou l level, we n eed to trust that these were ch osen in fu ll awareness of our H igher Selv es, for the best of human kind ev olut ion. For Keegan , this translat es int o the ch allenge of accepting things as they are and learn ing to cop e with fru strat ion. It also mean s learn ing to live in th e present moment and enjoy ing what that present moment has to offer. As Epicureans u sed to say: Carp e Diem 2. For his family and support network, it first involves accept ing him as he is, but also supporting and encouraging him. Beyond that, it invit es us to acknowledge th e beauty of h is soul. Going a step further, we can all ch oose to transcend the karma that gen erat ed his b irth by opting for happiness in every moment. Wh en choosing happin ess, we discard the guilt attached to karma , we become free to surrender to God and attain s amadhi . When we surrender to God, we acknowledge our div inity . We underst and that every part of our body, ev ery plant , animal, object are expression s of God. We b ecome All encompassing, we become On e, reunit ed with our Creat or.

1 2

Ibid. p11. Latin expression meaning seize the day.

24

1. Asanas
Sutra II.46-48: The posture of yoga is steady and easy. It is realized by relaxing ones effort and resting like the cosmic serpent on the waters of infinity. Then one is unconstrained by opposing dualities.1
A few years ago, when I st arted researching the benefit s of yoga for Keeg an, he already had a p hysioth erapy program, wh ich I had comp iled into a book, comp l et e with pictures and which was being carried out by his team of helpers. Like most parent s, I was act ively looking for alternatives that may further support Keegan towards maint ain ing and developing his physical cond ition . Physioth erapy was a great tool but its main focu s was physiolog ical; exercises main ly concentrat ed on stretching and strengthen ing muscles. Yogasanas , like physioth erapy, also focus on stretching and strengthen ing muscles. Nevertheless, other aspects, lik e for ex ample body awaren ess, a ttracted my curiosity and I soon became con vinced that a y ogic approach wou ld add value to Keegans ex ercise reg imen.

Stoler Miller, p56.

25 Understanding movement At this point , I need to clarify how movement s are generat ed, and how th e process of movement aff ect s people with Cerebral Palsy: When we sign al ou r brain of the int en tion to perform a particu lar activ ity, th e control centre instant aneou sly computes wh ich joint s need to move, in which ord er and sequen ce, and by how much, at th e same time, of course, mak ing all the other adju stmen ts necessary to maintain our body in balance Our muscles work in patterns and the brain responds to our intent ion by mak ing groups of muscles, not single muscles, work Normal postural tone prov ides the background on which mov ement is based, h igh enoug h to withstand gravity, but low enough for easy mov ement. 1 The main charact eristic of Cerebral Palsy lies in the damage to the n ervou s syst em: commu nicat ion between parts of the nervou s centres and its motor pathway s is compromised, aff ecting postural control and the performance of particu lar act ivit ies. Practically this translat es to th e following challenges: increased muscle ton e (spast icity): in stead of a particular group of muscles working together to achieve a task, lik e stand in g up for examp le, all muscles cont ract to try to contribute to th e task . anti-gravity f lexor tone: react ions to master gravity. Th ey can be eith er lacking or absent.

Finnie, pp47-50.

26 equilibrium reactions: th eir funct ion is an automat ic response to loss of balance, help ing us to both maint ain and regain our balance, thus making free and indepen dent movements of the h ead and limbs possible in all positions. 1 These can be lacking or completely absent. sav ing react ion s: automatic postural react ion s to protect ourselv es du ring v ery sudden or unexpected loss of balance, lik e thrusting out our arms with straight elbows to place our open hands on a supporting surface. Th ese can either be absent, incomp let e or exagg erated . The unusu al forces forming the patterns of spasticity are applied over some joint s and the in creased ton e of some muscle groups mean s that those muscles are nev er stretch ed or elongat ed by their antag onists 2 and a stat e of imbalance is created. Ov er a period of time, those muscles and their t endons wh ich a re h ypertonic (spastic) lose their elasticity, as indeed does the tissue surround ing the joint ov er wh ich they work. 3 We are now ab le to understand the importance of stretch ing the agon ist (contracting) muscles and supporting the ant agonist muscles in t h eir strengthen ing task. As this hyp erton ic act ivity is at work t wenty -fours a day , in most movements and intentions of movement (thoughts and emotions), count eract ing it s effect s in terms of potential muscle contractures wou ld n eed to occu r for the same length of t ime, which is practically impossible if Keegan is to have any quality of lif e.
1 2

Ibid. p51. Antagonist muscles are muscles that oppose movements; agonist muscles are active muscles that contract and shorten. 3 Ibid. pp257-258.

27 The yogic manag ement of Keegans h ealth therefore involves a comb inat ion of carefu lly chosen asanas in order to stretch and st rengthen specific muscles, applied with the specific goal of creating body awareness at all lev els (physical, ment al, emot ional). Stretching Stretching can eith er be passive or act ive, th e act ive action b eing more eff ect ive than the p assive. Nev ertheless, as activ e stret ches are f or Keegan very difficu lt to perf orm, the f irst approach of yogic management concentrat es on passiv e stretches. As reduced mob ility st iffen s muscles and joints, which in turn further reduce mov ement s, a gent le daily stretch ing program pract ised first thing in the mo rning is paramount in order to maint ain f lex ibility in his joints wh ile carefu lly stretch ing and relax ing his mu scles. It is through my own pract ice of the p awanmuktasana series as described by Swami Satyan an da Saraswat i in his book Asana Pran ayama Mudra Bandh a 1 that I realised the potential ben efit s of su ch exercises for Keegan . Until then, Keegans stretch ing rout ine main ly focu sed on his muscles. So it is with Keegans lev el of abilities in mind that I designed h is personalised program 2, based on the pawanmuktasana series , which focuses on joints as well as muscles. Pawan means wind or prana ; mukta means release and asana means pose. Therefore pawanmuktasana means a group of asanas that remove any block ages which prevent the free f low of en ergy in the body and mind. 3 The result s showed quit e quick ly; it on ly took a couple of week s of daily practice to notice that h is arms and legs had gained more rang e of mov ement s.
Saraswati, Asana Pranayama Mudra Bandha, pp21-73. See p42. 3 Ibid. pp23-24.
1 2

28 Active stretches are also part of Keegans daily routine, but they are more subtly included in h is program. Ev ery movement that Keegan makes toward s his mob ility can be used to act ively stretch, lik e for ex amp le bend ing over to pick up a toy will activ ely stretch h is h amstrings.

In this forward bend, a helper h olds Keegans pelv is into posit ion, aiming at facilitat ing: - straight legs - sitting bon es facing upwards - feet flat on the floor - knees above ankles

29

Coming out of h is st anding frame is a good opportunity to stretch Keeg ans hip f lexors. In this stret ch, Keegan completely lies back on the helpers leg, who can move h is/her th igh forward to deepen the stretch .

30 Strengthening The stretching action of muscles needs to be balanced by some strengthening of diff erent groups of muscles in order for Keegan to be ab le to hold his posture, build his balance and maintain equ ilibriu m with in his body. The muscles in need of strength ening are t he muscles antagonist to those wh ich are hypertonic. Th is mean s that these mu scles help and promote t he stretch ing act i on of the muscles in n eed of stretch ing and relax ing.

Side st epping strength ens the g luteal muscles (gluteu s mediu s and min imus), helping the adductors to stretch.

31 Exercises are a combinat ion of yogasanas, supported by props if need be, swimming and horse -riding therapy.

Lying prone on a wedge helps: - strengthen back and shou lders, - open up the chest (b enef icial to clear t he lungs of mucu s aft er a lung infect ion), - stretch h ip flex ors, - facilit ate perist alsis.

32

The gentle and rhythmic mov ement s of the horse encourage muscle relax ation .

33

In the water, Keegans mov ements are less aff ected by gravity, giving him more f reed om and ability to independ ently stretch and strengthen his mu scles. Swimming is paramount for Keegan an d complements well Yoga therapy with variou s advantag es such as promoting hip flex ibility (th rough pelvic t ilt s and counter -/nutat ion movements) and build ing up of cardiov ascu lar stamina.

34 Body awareness The development of body awaren ess is an integral part of Keegans ind ependen ce. We have all h eard mov e it or loose it. Restriction of movements f or Keeg an entails limited awareness of the parts of h is b ody that he is not able to move or move with diff icu lty. Subsequent ly limited awarene ss of these body part s engenders less mobility. According to Michael Reed Gach, body awareness includes intuit ion , mental attitud es, physical awareness, centering med itation, balancing pain and the emotions through the breath and awareness in daily life. 1 Bring ing awaren ess into Keegans lif e is certain ly the most rewarding asp ect of my teaching . It requires presen ce, caring and pat ien ce. Physical awareness is, at th is st age of his physical growth, a very import an t part of creat ing awareness, as posture and correct alig nment are paramount for the int egrity of h is sp in e and the prevent ion of def ormit ies. In order to develop this awareness, Keegan is learn ing his body parts, where they are, th eir fun ction and how to centre h imself . It may be tempting to move h is legs or arms for h im wh ile transf erring from one p lace to anoth er but, as Keegan is getting bigger and heavier, it is in fact a dis serv ice. In the quest for h is independen ce, lett ing him participat e in meet ing his own needs and in itiate h is mobility is central and respectful of th e autonomous adult he will be on e day. As Keegan is not ab le to activ ely perform his daily pawanmuktasan a rout ine, I pract ise them for him, tak ing him through the mov ements wh ile trying to create awareness and part icipation at a physical and mental lev el. To ach iev e this, I combin e talking him through the
1

Gach, p30.

35 practice and touch ing the parts of his body that n eed to move, strateg ically placing my hands and fingers on acupressure point s to encourage d eep er awaren ess and release of ten sion. Helping Keeg an towards body awareness also encompasses teaching him to get in touch with his inn er self and to tru st his f e elings, wheth er physical, mental or emotional . Learn ing to commun icat e with his teach er within is a valuab le source of const ant information and wisdom for kn owing h imself and for letting go of rigid ity and negat ivity of thoughts. As Keegans awareness grows, h e is learning to ext end and include his awaren ess into h is daily lif e. He is often seen breath ing in deep ly in order to achiev e mobility , to open his airway s when wh eezy or to relax. The next st age of his awaren ess is to slowly turn some of his passive st retch es into act ive on es.

36 Areas of Keegans body requiring particular attention 1) As the spine is the f oundation of our body, I pay particu lar attention to its f lex ibility . The nerv es th at go to all parts of ou r body and to all our intern al organs bran ch out from the spin al cord. When any vertebra is out of position , it aff ects th e nerv es and muscles in the local area, and also the internal organs associated with it through the related nerves and merid ian s. Muscu lar ten sion will collect ar ound the imbalanced area, and can ultimately cause back pain, and more severe back prob lems. 1 Being less mobile than an able -bodied person , Keegan does not get to in volu ntarily massage his intern al organs as we do during the course of t he day. So by systematically stretch ing his spin e in all direct ion s, I can help him release ten sion s and keep it properly aligned. As the neck and head are exten sions of the spine, neck stretches are vital and form part of Keegans daily routin e. By freeing tight areas, th ey promote better flexib ility, control and balan ce of his head. 2) The pelvis conn ects th e upper and lower body. It provides for a great range of body movement, with the overall posture of the body being determined by the posit ion of th e pelv is. Therefore, when the pelvis is pulled out of p lace or st agnated by tension, the whole body is affect ed. Conv ersely , if the posture of another part of the body is poor, the p elv is cannot properly do its job of d istributing the body weight, and muscle strain and joint ten sion in the pelv ic region can result . Approximat ely 36 muscles att ach to the pelv is; they act together to stabilize the pelv ic girdle in relat ion to the spine. 2

1 2

Ibid. p34. Ibid. p206.

37 Within th e pelv is lie the hip s, wh ich are const antly being put under strain due to the unu sual forces mentioned before. Th e hip joint is a ball -and-socket joint. Th e socket (acet abulum) lies in the pelv ic bone and is f latter in sh ape during in fancy . It only truly becomes a socket as the ch ild beg ins t o take weight through the joint . At the age of ten, Keegan has already undergone major h ip surgery as well as two int erv ention s of Botox 1 inject ion s, in order to prot ect his hips and prevent dislocat ion. So, ensuring flexibility of his hips through the prevent ion and the remov al of blockag es is v ital f or his mobility . Develop ing strong hips is achieved through as m uch weight bearing as possible (buddy walk ing as seen on th e front cover of this paper, walk ing frame and stand ing frame). At a psychic lev el, as th e sacral chakra 2 ( swadhisthana chakra ) dwells with in th e pelv is, learning to manage the f low of energy around it wou ld enhance the not ion of self -acceptan ce attached to this chakra and help him deal with t ightness or blockage in that area.

Botox is injected in a muscle as a relaxant; the effect lasts about three months, during which rehabilitation takes place. In children with Cerebral Palsy, it is not cosmetic but a way to stretch some particular muscles and therefore prevent or delay surgery. 2 In yogic context, chakras are vortices of pranic energy at specific areas in the body which control the circulation of prana permeating the entire human structure. Each chakra is a switch which turns on or opens up specific areas of the brain. (Saraswati, p513). Chakras are connected to the functions of the physical body primarily through the endocrine glands and the spinal system. They mediate the energy within and without the body through the various spinal contacts. Distribution (of energy) occurs throughout the body by means of the nerve pathways and the circulatory system. In this way all of the organs, tissues and cells receive the energy for their various uses. (Andrews, p37)

38 3) The more a muscle is involv ed in mov ement, the more it contracts and as a result , the more it becomes susceptible to develop contractures. Particu larly at risk are: biceps, h amstrings, gastrocnemius, quadriceps and adductors. Keep ing these mu scles flex ible is a never -end ing challenge, which is addressed through act ive and passiv e stretch ing, strengthen ing of antag onist muscles and correct posit ion ing in equ ipment.

Sitting on a bolster enab les Keegan to play wh ile stretch ing his adductors and strength ening his upper body. His muscles get furth er attent ion as Keegan treat s himself , about once a week, to a deep -tissu e massage (touch adapted to h is needs), performed by a qualif ied massage therapist. It provides a precious opportun ity to address physiological blockag es and ensure that perman ent misalignment and pain do n ot settle.

39 Keegans daily routine I have specif ically adapted and design ed this rout ine f or Keegan from the orig inal Pawanmuktasana series by Swami Satyananda S araswat i 1 and from my own person al practice. We used to practise it rigid ly ev ery day but yogic wisd om has now taught me a gentler way of addressing Keegans needs than ks to the yama of non -violence ( ahimsa 2). As explained bef ore 3, Keegan cou ld ex ercise twenty -f our hours a day in order to meet the physical needs o f stretch ing and strengthen ing his muscles. Yet, Yog a teach es us that finding happin ess in lif e assumes reaching a point of equipoise where all aspect s of our bein g are comf ortably and stead ily balan ced 4. So a daily phy sical practice also n eeds to take into consideration, if not f acilit ate, mental, emotional and spiritu al satisfaction as well as mean ingfu l social interact ion s. Also, as muscle tone and stamina fluctuat e daily, I now try to choose wit h awareness and intuit ion the appropriat e way of best me et ing Keegans needs: stretch ing, strengthen ing, stamina and/or down time. The following pictures will give you an idea of how Yoga can be adapted to individual needs. Ev en though important tip s for Cerebral Palsy are highlighted, on ly practise these techniqu es with the profession al gu idance of a physioth erap ist and/or a certif ied yog a teacher. As physical conditions v ary signif icant ly accord ing to the type of impairment s, so does th e therapy .

1 2

Saraswati, Asana Pranayama Mudra Bandha, pp21-73. See p17. 3 See p29. 4 See Sutra II.46-48 on p27.

40 In all practices, it is essent ial to remember: to keep the body aligned in order to avoid putting pressu re on joint s. Stress can occur on some joint s in the process of stretch ing other areas. to stretch comfort ably, loosely, withou t passing the point of resist ance. Stretch ing a muscle b ey ond its normal range w ill trigger a stret ch ref lex (aut omatic contraction of the muscle in order to prevent furth er stret ching). Further stretch ing could then resu lt in seriou s injury; injury mean s rest unt il fu ll recov ery. to equally stretch both sides of the body. As posit ion ing the body and immob ilising the opposit e limb can be difficu lt, we usually perform all the stretches on the right leg (or arm) bef ore stretch ing the left one. to encourage Keegan to participat e in the movements as this will increase his awareness.

41

Toe bend ing (Padanguli Naman) Tips:

The foot is held in a n eutral position and ankle and knee are supported in a straight lin e with the h ip to protect the kn ee joint. Toes are b ent back and forth 3 to 5 times.

42

Ankle rotation (Goolf Ch akra) Tips:

The ank le is nestled in on e hand and the top of the foot secured in the other with the aim of immobilising the ank le. The ank le is gent ly rotat ed 3 to 5 times first clock wise, then ant iclockwise.

43

Ankle bend ing (Goolf Naman ) Tips:

The ank le, knee and hip lie in a straig ht lin e. The foot is fu lly supported in order to facilit ate a movement originat ing from the ankle. Keegans tonal tenden cy of the foot is plantarf lex ion (movement of the f oot away from the body), so dorsif lex ion (movement of the foot toward the students body) is more ben eficial. The ank le is f lexed 3 to 5 times.

44

Knee rotat ion (Janu Chakra) Tips:

The helper places a hand inside the kn ee to give Keegan th e signal of the mov ement. Lifting of the kn ee is then accomp lished b y both Keeg an and the helper. His leg is immob ilised on the f loor with the use of a cloth wrapped arou nd the knee and tucked under the helper s knee. The upper part of the right leg is immob ilised by holding the leg either above or under the knee. The knee is rotat ed 3 to 5 times f irst clock wise, then ant iclockwise.

45

Knee bending (Janu Naman) Tips:

In the same posit ion and alignment, th e knee is gent ly flexed toward the chest 3 to 5 times. The leg is th en straighten ed and slight ly pulled into full ext ension (h eel cupped in the help ers hand) to release pressu re on the knee.

46

Cycling (Pada Sanch alanasana) Tips:

In the same posit ion and alignment, cy cling movements are perf ormed 3 to 5 times forward and then in rev erse. The heel is gent ly pulled away from th e body to encourag e full exten sion of th e knee.

47

Raised legs pose (Utthanpadasana) Tips:

The knee is immobilised in a neutral posit ion by apply ing soft pressu re on t op of the kneecap with on e hand and by cup ping the heel with th e other. The leg is th en raised and lowered 3 to 5 times. Altern ativ ely , his hamst ring can also b e stretch ed by immobilising his th igh wit h hip at 90 and raising the lower leg toward knee ext ension.

48

Leg rotation (Chakra Padasana) Tips: In the same posit ion and alignment, with the help ers hand s in the same p laces, the same leg is rot ated 3 to 5 t imes first clock wise, then ant iclockwise.

49

Hip rotation (Shroni Chakra) Tips:

In the same posit ion and alignment, th e flex ed leg is rot at ed 3 to 5 times f irst clock wise, then ant iclockwise. If needed, the h elper can f irst hold an kle and knee and perf orm some side movements as a preparation exercise.

50

Half butterf ly (Ardha Titali Asana) Tips:

With one leg immobilised, the opposite leg is bent and the ankle is rest ing on the helpers leg. The opposite h ip is immob ilised. A roll placed across the h ips can be used to avoid undue pressure on th e hipbon es. The mov ement is perf ormed up to 20 times.

51

Full butterfly (Poorna Titali Asan a) Tips:

Crossing arms and hand s and immobilising the feet between h is/her kn ees, the helper gently applies external pressure on Keegans knees.

52

Leg lock pose (Supta Pawanmukt asana) Tips:

With one leg immobilised on the floor, Keegan is encouraged and h elped to h old onto his leg below th e knee and pull it toward himself. He aims at placing h is nose on h is kn ee up to 3 times. His focu s is on unrolling his spin e back onto the floor, without sudden ly dropping his head. Breath awaren ess: breath ing in the lying posit ion, holding wh ile pressing the kn ee on the chest and exhaling wh ile lowering down.

53

Dynamic spin al twist (Supta Udarakarsh anasana) Tips:

Feet are held slightly apart on the f loor while the kn ees are gent ly mov ed from one side to th e other. Up to 10 times. It is an important preparation for the static spinal twist.

54

Universal (st atic) spin al twist (Shava Udarakarshan asana) Tips:

The legs are flexed on the ch est , then rolled first on Keeg ans right side. Th e left leg is positioned and align ed direct ly on top of the right and the pelvis is perpend icular to the floor. Legs and pelv is are immob ilised between the helper s leg s. Shoulders and arms are gently pressed onto the floor. Keegan is encouraged to tak e 5 deep abdomin al breaths.

55

Rocking and rolling (Jhulan a Lurhak asana) Tips: Placing both hands on knees, Keegan practises the leg lock pose with both legs. He first rolls h is body side to side up t o 10 times. He then rolls backward and forward up to 10 times, focu sing on keeping h is head tucked in.

56

Sacral massage Tips:

Releasing his lower back on the f loor, he holds ont o his leg s and is h elp ed to perform small circle movements with his leg s, up to 10 times clockwise and anticlockwise.

57

Spine stretch Tips:

Gent ly unfold ing his leg s, his heels are then cupped in the helpers h ands, with legs slightly rot ated externally . The heels are soft ly pulled toward the helper in ord er to stretch the sp ine.

58

Spine extension Tips:

In a sitting posit ion, a small bolst er is placed between the legs and a sandbag on the knees. The helper posit ion s his/her f orearms t o gently lock the elbows into extension . The helper u ses his/her body to softly push the upper body forward . When Keegan breathes in , the helper lightly helps Keegan stretch his arms up; when he breathes out, he let s them come down into the shou lder socket s.

59

Seated forward fold (Pasch imottan asana) Tips:

In the same posit ion and alignment, Keegan is helped to bend forward and reach for his toes. Knees are slight ly bent to allow for tig ht hamstrings. No pulling is ex erted on elbow and wrist joint s.

60

Wrist rotation (Manibandha Chakra) Tips: With one h and hold ing Keegans wrist , the helper uses his/h er other h and to cover Keegans hand. Keegans thumb is tucked in sid e his h and. The wrist is then gent ly rotat ed 3 to 5 times first clockwise, then ant iclock wise.

61

Wrist bend ing (Manibandh a Naman) Tips:

In the same posit ion and alignment, th e wrist is gent ly flexed forward and up. This movement is repeated 3 to 5 t imes.

62

Elbow rot ation (Kehun i Chakra) Tips:

The helper places on e hand to cup the elbow in order to immobilise the upper arm while using the other hand to hold the wrist. The lower arm is gently rotated 3 to 5 times first clockwise, then ant iclock wise.

63

Elbow bend ing (Kehun i Naman ) Tips:

In the same posit ion and alignment, th e arm is straighten ed and bent 3 to 5 times.

64

Shoulder rotat ion (Skandha Ch akra) Tips:

In the same posit ion and alignment, with Keegans back still supported by the helper, the elbow is flex ed; fingers are touch ing the shou lders. Holding the arm bent with both hand s, the helper gently rotates the arm in a larg e circle 3 to 5 times, clockwise f irst then anticlock wise.

65

Neck movements (Greeva S anchalan a) Stage 1 Back and forward Tips:

In the same posit ion and alignment, with Keegans back being support ed, the helper places his/h er hands on the sides of Keegans head and arms on his shou ld ers. The helper f acilitates Keegans h ead movement first forward, then back ward, 3 to 5 times. These mov ement s are focused on freeing any tension rather than stretch ing in order to avoid damage to his neck .

66

Neck movements Stage 2 Chin right to left Tips: In the same posit ion and alignment, with Keegans back being support ed, the helper places his/h er hands on the top of Keegans head and facilitat es turn ing his h ead first to the right, then to the left , 3 to 5 times. With his head on th e sid e, Keegan is encouraged to do some yes and no movements with his head. These mov ement s are focused on freeing any tension rather than stretch ing in order to avoid damage to his neck .

67

Neck movements Stage 3 Ear touch ing shou lder Tips: In the same posit ion and alignment, with Keegans back being support ed, the helper places his/h er hands on the sides of Keegans head and help s him reach h is right shou lder with his right ear. Adjusting his/h er hands as needed, th e helper then facilitat es the same mov ement to the left . Each mov ement is repeat ed 3 to 5 times. These mov ement s are focused on freeing any tension rather than stretch ing in order to avoid damage to his neck .

68

Eye mov ement s Tips:

In the same posit ion and alignment, with Keegans back being support ed, the helper immob ilises Keegans head and uses a favourite to toy to creat e eye movements. Movement s: up and down, sid eway s, diagonal, rotational and near -distant.

69

Cat stretch pose (Marjari asan a) Tips:

Keegan spend s 30 minutes ev ery day playing on h is pron e wedg e in ord er to stretch h is h ip flexors and st rengthen his back and shou lders. From prone, Keegan is helped into the pose by the helper p lacing one leg between Keegans legs and by then pulling h is hips toward his heels. This pose is practised in combin ation with the Camel and Ch ild poses (see following pages) to loosen up any ten sion in the hips and lower back.

70

Camel pose (Ushtrasan a) Tips:

From the prev iou s pose, Keegan is h elpe d to push himself up and sit on the h elp ers knee. The helper u ses his/her leg to control and facilit ate forward and back ward mov ements of his pelv is in order to st retch Keegan s hip flex ors and quadriceps. The helper places his/h er hands on Keegans torso to help him op en up his chest.

71

Childs pose Tips:

From Camel pose, Keegan places his h ands back on the wedge and walk them as f ar up as possib le. With the helper s hands on h is h ips an d his/h er knee between h is, Keegan endeav ours to sit on h is heels.

72 While the prev iou s pract ices are usu ally performed as a routin e, some oth er pract ices are integ rated in Keeg ans daily activ ities. The following pictures will giv e you a few ideas on how to include Yoga in the daily lif e of a disab led person.

Tadasana and side stretch ing Sitting in h is wh eelchair causes Keeg ans hips to be immob ilised in a f lexed posit ion. So Keegan ben efit s from stretch ing up and sideway s. The h elp er can use the pressu re on h is/h er leg on Keegan s buttocks to ease h im into a gent le back ward bend. With arms down, h e can also lift his legs sideway s in a parallel plane, in order to reinforce his gluteals med ius.

73

Floor stret ch Whenev er possib le, Keegan st retch es on the floor, where he is less af fect ed by gravity.

74

Bridg ing Getting dressed is a good opportun ity to practise the bridge pose. It tones the lumbar sp in e and the gluteals and stretch es the quadriceps. The full butterf ly 1 is pract ised at th e same time, as it loosen s up Keegans in ner thigh s.

See p54.

75

Shaking ten sion Lying in sup ine on th e floor, the h elper holds Keeg ans hands and sends a wave -like mov emen t through his hands, arms and sh ould ers. Keegans part icip ation implies letting g o of any tension . We call it flapping the ch ick en wings.

76

Lateral stretch When ly ing in sup ine on th e floor, Keegan is en couraged to slide on e leg at the t ime sid eway s. The emph asis is on st abilising h is hip s parallel to the f loor and on his kn ees point ing toward the ceiling. This movement promot es the stretch of his side f lexors (trunk) and adductors while strength ening his g luteals mediu s.

77

Sphinx asana Spending time on the floor promotes Keegans mobility. He is also encourag es to stretch, roll and prop up on his elbows int o the Sphinx. The use of an imal names attracts Keegan to move into the poses.

78

Shoulder opener on bolster

In order to alleviate kyphosis (rounded should ers), Keegan spend s a few minutes each day lying sup ine on a bolst er. He first sit s at one edge of the bolster, then the helper helps lower him down by fully supporting his upper body. Keegan rolls off the bolster when f inished practising.

79

2. Pranayama
Sutra II.49: Next come the breathing exercises which suspend the flow of breath and increase life energy.1 Sutra I.34: The peace of the citta is also brougt about by the regulation of the prana or life breath.1
The role of the breath in our development 2 Resp iratory development is fundament al to the development of structure, function and cerebral metabolism in ch ildren. After birth the intern al pressures from the babys breathing beg ins a lif elong process of muscle strengthen ing and the establishment and mainten ance of neurological connections between the brain and the bodys tissu es. Increasing resp iratory strength dev elop s the muscu lar skeletal infrastructure of our trunk, wh ich in turn supports each stag e of funct ional ability. Th e strength of the respiratory muscles creates increasingly strong pressures on the pre -capillary sphincter mu scles. This increases capilla ry blood flow, st rengthening mu scle tissu e and improving their electrical connection in the brain. Respiratory mu scle pressu re du ring breath ing develops and support s blood flow to trunkal and connect ive t issues between the bones. Bef ore and aft er birth an d throughout infancy indiv idual muscles and co-ordinat ing groups of muscles are stimu lat ed in stag es by gentle pressures from th e extern al forces that surround them. Th is external st imu lation enhances blood flow to the muscles. Increased blood flow creat es an enhanced electrical current like a louder voice that can be picked up by the brain. Only wh en the
1 2

Cited in Lawson, p12. Information collected on the website of the Institute for Advanced Neuromotor Rehabilitation. www.advancecentre.org.uk/index.

80 brain can ident ify the muscles ex ist en ce and whereab outs can a command signal b e sent from the brain and receiv ed by the muscle. Keegans breathing pattern Children with neurolog ical imp airments do not learn to breathe normally and this affect s the complex metabolic feedback syst ems between th e body tissues, the bon es, the resp irat ory sy stem and the brain. Keegans breathing is superficial and shall ow, located in the upper lobes of h is lung s, as if the tightness around the abdomin al area 1 is squeezing the air out of his lungs, exaggerat ing the ov erall t ightness of h is body. Th is is called paradoxical breath ing; the abdominal wall moves in rather than out during inhalat ion and moves back out during exhalat ion. Some peop le breathe lik e this all the time, unaware that its purpose is to prepare for f ight or flight. For example, we may su ck our st omach in if we hop in a cold shower expecting the water to be warm. Paradoxical breathing gives u s an immed iate jolt of adrenalin e. Breath ing lik e this keeps our sympath etic system con tinuously act ivat ed. It puts undue stress on the support ive systems of ou r body (digest ion, circu lat ion , endocrine, immun e) an d creat es anx iety . Thoughts and emotions aggrav ate th is pattern, as well as illnesses, which interest ingly most ly seem to sett le in Keegans lung s.

Due to unusual forces of the numerous pelvic muscles.

81 Yogic management Establish ing healthy complete (fu ll) breathing is fundamental and comp lementary to Keegans physical program. Expanding his breathing to t he central and lower lobes of h is lungs init iates the d evelopment of stronger resp iratory muscles. Strong er respiratory muscles strength en the conn ectiv e tissues between the spinal vert ebrae and the sh oulder and pelv ic gird les which then respond increasing ly to sign als from the central nervou s syst em. Fortunately, apart from th e most basic reflexiv e breathing , breath ing is a learnt behaviour. The first st ep is for Keegan to become aware of the muscle tone affecting his mouth muscles, t ightening and protracting his upper lip, rendering full lip closure tricky. This process is being help ed through massaging, posit ive reinf orcement wh ile eating and games (blowing or playing the recorder). The second st ep is to creat e awaren ess of his breath in his abdomen in order to dev elop a good habit of the complete yoga breath. Th is is achieved by teaching him to observ e my own breathing , listen to my explanat ion s and by the touch of my hand on his ab domen and hi s hand on my abdomen . This way, Keegan is learning to feel the mov ement s of his breath up and down his lung s. Being able to direct his breath wh ere t ensions are empowers Keeg an to have more control over h is mu scles. He can relax them eith er to facilit at e h is mob ility or to induce pure relaxat ion in resp onse to physical, mental or emotional tension bu ild -up s. Thanks to abdomin al breathing , Keegan is learn ing to increase his lung s capacity. Th is in tu rn has a posit ive effect on th e movements of the vari ou s pranas with in his body (for examp le: it relieves const ipation).

82

Regulating the breath also increases oxygenation of the brain cells, which strength ens the cent ral nervou s syst em and builds up his immune sy stem, mak ing him more resilient to illnesses. Keegan is currently learning kapalbhati and bhastrika pranayama 1. They are both highly energising and strengthen th e abdomen . Kapalbhati clears and en erg ises the mind and prepares it for med itat ion. It clean ses the lungs (u sefu l in the treatment of asth ma and bronch itis) and balan ces and strength ens the n erv ous sy stem. It tones the d igest ive organs. Bhastrika also clean ses the lungs by alleviating inf lammat ion in th e throat and accumu lat ion of phlegm, but its main action is to stimu lat e the metab olic r at e through increased oxygenation, producing heat and flush ing out wastes and toxins. It saturates the lu ngs and blood with fresh oxygenated air, strength ens the diaphragm and increases circu lat ion. I am also progressively int roducing him to viloma pranayama 2. This practice cult ivat es greater lung capacity and elast icity and promot es extension of the breath. Th is is ach ieved through the interruption of the flow of th e inh alat ion and/or the exhalation . I have tried to teach h im ujjayi pranayama 3 for its calming eff ect but it seems too challen ging at this st age. As for most teach ing, repetit ion is the key. I have no doubt that Keegan will manage to learn this breath if he feels the n eed for it. When sick, Keegan often get s asthma. To help h im calm down and regulate h is breathing, h e blows on a candle with the aim of not blowing it out, as seen in th e picture
1 2 3

Bandha , pp394-400.

For more information on these practices, read Saraswati, Asana Pranayama Mudra

For more information on viloma pranayama, read Somerville, p52. For more information on ujjayi pranayama, read Saraswati, Asana Pranayama Mudra Bandha, pp392-393.

83 below. This has the eff ect of lengthen ing his exhalation, which helps th e expelling of carb on dioxide out of h is lungs (as well as mu cus), there fore also easing his inhalat ion.

Sutra II.52: Then the cloud that obscures the light melts away. Sutra II.53: And the mind is prepared for concentrated meditation. 1

Cited in Lawson, p12.

84

3. Pratyahara
Some old yoga texts refer to the mind as a cage full of excited monkeys. The conscious regulation of the mind stuff, as illumined by the soul, is the real work of Yoga. 1
Keegan has come a long way in learnin g to cope with the over-stimulation of his sen ses. He used to hyper -extend when going out in the brightness of the sun or cry wh en listen ing to classical mu sic. High -p itch ed voices or sudden sound s wou ld make h im jump, frighten and unsettle him. This sen sib ility is still apparent through the expression of his emotions, which bears a con siderable imp act on his management of ext ernal st imuli. Interesting ly, David Coult er ment ions th e existen ce of the enteric nervou s system and the possib ility of conn ect ions between this system and our emotion s. 2 So, strength ening h is nervous syst em through a daily yoga practice has a def init e and positive inf luence on reducing the sen sib ility of his sensory receptors, bu ild ing a strong base for h im to learn to det ach himself from his senses when needed. It is a challenge that he is progressiv ely overcoming, thanks to h is increased body awareness.

1 2

Dye, p37. The enteric system, part of the autonomous nervous system at the same level as the sympathetic and parasympathetic system, is comprised of the vast system of nerve cells that resides in the wall of the gut (by definition, the entire digestive tube from the oral cavity to the anus). Neuroscientists nowadays know that it is capable of supervising the digestion of food, the propulsion of food through the bowel and the management of all other bowel functions, even when all nerve connections from the brain and spinal cord have been experimentally severed. (Excerpt from Coulter, pp560-561)

85 In order to help h im experience sen se withdrawal, or when over-st imu lated and excit ed, Keegan is en couraged to use his breath to relax body, mind and emotion s. As he experien ces spast icity in all h is mov ement s as well as in his intent ion s of mov ement (th ought) and expression of his emotions, relaxat ion plays an essentially regulat ory role in restoring homeost asis in his body. Touching the parts of his body hold ing tension giv es signal to his brain (through the muscle) to le t go and relax. Thank s to receiv ing numerou s Touch f or Health 1 massages, I have learned to in stin ctiv ely identify or feel these t ensions and apply my hands of light 2 where necessary. Whenev er possib le, and sometimes once a day, Keeg an is taken through a twenty-minute relaxation practice ju st before going to sleep . As Keegans mental agit ation is contin uous, he n eed s his focus to be ch annelled to more peacef ul and calming places. I find music to be th e most ef f ectiv e tool to achieve complete relax ati on. Taking h im through a relaxation session involv es a combin ation of Touch for H ealth massage 3 and soft and transcending music (h is f avourite is listening to a compilat ion of three Ave Marias 4). He usually rest s in advasana , as seen in the picture belo w, with a pillow under his chest . Lying prone is h ighly beneficial for Keegan as it inh ibit s spast icity, promotes open ing of his chest and reliev es stiffn ess in h is neck .

1 2

Type of deep tissue massage promoting lymphatic drainage. For more information on hands of light, read Brennan. 3 See Appendix 4 for an example of Touch Relaxation. 4 See bibliography for reference.

86

Regular touch relax ation session s, besides creating muscle awareness and promoting the release of ten sions, also hav e the benef its of allev iat ing cramps and stimu lat ing the flow of blood throughout the body. It is so relaxing that he somet imes falls asleep When preparing himself to go to sleep, Keeg an alway s listen s to his r elaxat ion compact discs, specif ically design ed for children 1.

See bibliography for references.

87 4. Dharana

Concentration is the fixing of the mind-stuff upon a particular object. 1

Stilling the mind is the goal that is attainab le through concentration. Concentrat ion ex ercises are kn ow n for relaxing the skeletal muscles and for letting the autonomous nervous syst em manag e the internal organ s and tissues of the body without the necessity of consciou s input 2. Concentration is a recognised issu e amongst ex -pret erm babies, probab ly due to the hypersen sitivity mention ed in the previous sect ion ( pratyahara ) and the challenge of being aware of th e different part s of the body. Keegan can be extremely focu sed on some mat ters that are of high interest to h im but he can be ob sessed with them, to the exclu sion of anyth ing else. After repetit ive effort s from his entourage, h e almost relu ctan tly let s go and then tries hard to disconn ect from the obsessive thought. To teach him con centration, I use the ABC techn ique creat ed by my friend Trish Dye: A for alignment, B for breath and C for concentration. It inv olves regu larly remind ing Keegan of h is ABC: stand ing up straight in h is standing frame, breath ing patterns wh ile doing asanas , focusing on what he can do to help his helpers with transf ers between p ieces of equipment (lik e grounding h is legs, correct ing his balan ce), paying attention to the colou r and texture of the food he is eating On the ment al and emotional levels, in creased concentration man ifests it self in th e ability to control his thoughts and emot ion s through detach ing himself from worry ing consequences and to transmu te negativ ity int o
1 2

Bailey, A. Cited in Dye, p38. For more information, read Coulter, p562.

88 creat ive activ ity. Aff irmat ion s and mantras are a great way to break through his circles of n egativ ity. 1

According to Yogananda, concentrat ion of human thought and will acts on the cells of the body: Concentrated human thought touches Div ine Though t; it is that wh ich can heal, not unf ocused fanciful th ought or imag ination. 3

For more on affirmations, read Hay, L. Photo from: www.flickr.com/photos/untitlism. 3 Yogananda, p334.
2

89 5. Dhyana

Sustained concentration (dharana) is meditation (dhyana). 1

The u ltimate aim of the meditat or is to be able to h old steady focus and mental poise under every kind of condition in daily life. 2 This is a challenge in itself , but I find that music therapy is actu ally promoting a pr olonged st ate of concentration in Keegan. On a more pract ical level of his ev eryd ay life, I am try ing to introduce the pract ice of sati 3. This helps h im deal with negat ive thought s and emot ion s through observing an upsetting situat ion without react ing to it. It teaches him to accept and welcome life experiences for what they are, to appreciate th e present moment and to be in the now.

1 2

Bailey, A. Cited in Dye, p41. Dye, p41. 3 Sati consists in the bare noticing of the object of attention, whatever it may be. It is pure Awareness.

90 6. Samadhi

Pure contemplation is achieved when the meditative subject is so absorbed in the object of meditation that the distinction between subject and object disappears. 1
Besides the fact that Keegans impairment makes him stand out in a crowd, h is whole person a attract s people lik e a magn et. His sou l radiates with beauty, origin ality and authenticity. H e has been here b efore some kindred sp irit s say . He is an old sou l and brings to the world exp eriences from his past lives with him. According to Achary a Ram S ivan, th e term samadhi can either ref er to a st ate of being or to th e practice that lead s to it. Techn ically speaking, pratyahara and dharana are pract ices, wh ile dhyana and samadhi happen. 2 Keegans little step s toward self -realisation can truly be seen when he listen s to music. As an indigo child 3, he liv es and f eels mu sic. He seems to disapp ear in anoth er world, entirely absorbed in the melody and merged with the music, syn aesthet ically 4 experiencin g it. His sensit ivity to mu sic is so int ense that he even sen ses disturbing sounds bef ore they occur (e.g. a scratch on a record) and start les t o them as they h appen.

1 2

Stoler Miller, p61. Sivan, p4. 3 Newly evolved child. For more information, read Lee C. 4 Visualising music as it is being played.

91

Keegan performing on stage in a concert organised by his singing teach er Lisa Lorrell - D ecember 2004

92

YOGA AN APPROACH FOR PARENTS

93

Physical well being is inseparable from emotional well being. Happy people are healthy people. The wisdom traditions of the world tell us that happiness does not depend on what you have, but on who you are. 1
As research about parental stress seems to indicate 2, raising a ch ild with a disab ility can gen erate a lot of stress. It cert ain ly did for me (hyperv entilation, depression), unt il I felt myself spiralling out of control. Being the buffer between th e outside world and Keeg ans world was very painfu l and isolat ing as I felt that no one understood our need s and who we had become. Finding equilibrium under these circu mstan ces was almost impossib le Nev ertheless, my re-acquaintance 3 with yoga a few y ears ago clearly made me understand that t he source of my stress was not Keegans impairment but rather the pressu re from the outside to conform t o a society that ruthlessly cat ers for the fitt est and the strongest . Through understanding the y ogic principle of Oneness, I find the courage and strength to let go of the struggle; liv ing with a d isability does not need to be a battle. All these y ears of grieving and unhappiness mad e me overlook th e fact that Keegan is my ch ild before being disab led and that he deserves the righ t to be seen as such. I continu ously seek and discov er in myself the refresh ing and renewed en er gies of caring, love, wisdom and compassion. I finally find a way to accept the reality of our situation and ev en more, I am n ow gratefu l for the
1

Chopra D. Cited in www.images.meadigital.com/users/chopra/namaste_August2006. 2 See Appendix 2. 3 My parents started teaching me yogic principles when I was a toddler. My yogic awareness became dormant during my younger adult years, despite numerous synchronistic events like meeting Swami Satchidananda in 1991, and the same year receiving for my birthday a life-size original picture of Gandhi while I was working in Baghdad, Iraq.

94 richn ess and beauty of ou r experien ce. I would not want my lif e to be any diff erent. Howev er, I still hold on to physical pain, wh ich I create in the process of physically h elp ing Keegan. I deal with it thanks to my regu lar yogasana pract ice and with the support of deep relax ation and medit at ion techn iques. These inv olv e the process of first ackn owledging t he pain and recogn ising which thoughts or emotion s are attach ed to it. Then comes acceptance: being with the pain, feeling it and smiling interiorly at it before ult imately letting go of th e physical tightness at t he same time as all mental and emot ion al ten sions att ached to it. For me, y oga has opened the door to my dormant potential. My daily yoga practice of Patanjalis eight limb s is purify ing my body, mind and soul. It is continuously act ivating my chakras an d is now an integral part of me. Nourish ing myself with ancient text s like the Bh agavad Gita makes walking on the path of self less serv ice an easier matter. I also k eep in mind the teaching s of th e now famous American movie What the Bleep Do we Know 1: reality is a question of personal percep tion. I relat e to Keegan accord ing to my perceiv ed reality, which may not be in full accord ance to h is. I learn everyday to become more perceptive of h is v ision of lif e and ask him for forgiven ess for any misunderstand ing or hurt from my part. As a test imony and encou ragement for the future, Keeg an has been seizure free for ten months, since I start ed to act from my heart rath er than my head 2.

1 2

What The Bleep Do We Know. www.whatthebleep.com. According to L. Hay, the probable cause for epilepsy is: rejection of life; running away from the family or the self, a feeling of great struggle. (Hay, pp 167 and 197).

95 Help carries more healing when it comes from th e heart, as it is the place from wh ich love and compassion freel y flow.

Garden In spiration 1

Learn now that sacrifice of any kind is nothing but a limitation imposed on giving . And by this limitation you have limited acceptance of the gift I offer you. 2

1 2

Author's garden. Et. al., p324.

96

CONCLUSION

The main goal of my teaching with Keegan is to help him find a place of st illn ess where he can gain more control over his physical, mental and emot ion al stat es, theref ore encouraging his ind ependence. Th is t each ing involv es patience, discipline and perseverance. It is very subt le and has become an integral part of h is daily lif e. It is my gift to him. A combinat ion of convent ion al and holistic therapies lik e yoga, acupressure, massag es and swimming are approach es that I hav e found very helpful and successful in dealing with the challenges of his impairments (Cerebral Palsy, ep ilepsy, Aspergers S yndrome). More specif ically, the application of yoga through Patanjalis Eight Limb s is play ing a major role in estab lishing a strong developmental foundation, provid ing me with the tools that I need to support Keeg an toward s achieving independ ence. Instead of th e tradit ional medical approach of each symptom an d impairment, yog a enables me to synthesise my previous teach ings to him into a sturdy reference base, wh ich I am continuou sly building on as I explore and discover n ew way s of promoting his ind ependen ce. As Keegan is learning to int egrate th ese ideas (adapted to his ag e), he is dev eloping a sen se of d iscriminat ion as well as creativ e way s of ind ependent ly finding solutions to his person al ch alleng es. Working on remov ing blockages with t he help of asanas and pranayama techn iques, Keeg an has been ab le to maintain range of mov ement s in h is muscles as well as improv e his mobility . Relaxat ion, bett er control of h is breath and the use of aff irmation s hav e strength ened his immune syst em (he is not sick as oft en as he used to be

97 and has been seizure free for almost a year). The development of h is concentration sk ills is mak ing him more aware of his body, mind and emotions, helping him to acquire the n ecessary life sk ills to become more independ ent. Integrating the yamas and niyamas int o our daily life is now bringing a sen se a secu rity, self -confiden ce and equilibrium in ou r family wh ere stress had previously ruled our liv es. We are learn ing to ob ser v e and high light what really matters: awaken ing Keegan to his potent ial in the most loving and compassionat e way. Along with Patanjalis other limb s, they contribute to peace and un ity within our family , and more import antly they proact ively support Keegans journey toward s independence.

98

GLOSSARY OF SANSKRIT WORDS

99 advasana ahimsa aparigraha asan a astey a Atman bhastrik a pranayama brahmach arya Brahman chakra citta dharana dhyana ishwara pranidhan a kapalbh ati pran ayama karma kosha mantra maya nadi niyama prana pranayama pratyahara samadh i reversed corpse pose non-violence non-possessiven ess posture non-st ealing essence, god in us bellows breath contin ence, non-gratif icat ion God in the un iverse (encompassing Atman ) wheel mind concentration meditat ion or pure contemplat ion self-su rrend er cleansing breath effect s of past actions, from this or previou s lifet imes body divin e sacred word or sound Illu sion of sep arat ion energy ch annel observ ance vital energy, life force control of the life f orce withdrawal from the senses meditat ive state of un ion with the Absolut e which we att ain wh en we completely surrender to Brahman self-realisat ion contentment bare attent ion

Santosh a sati

100 satya sauch a sutra swadhyana tapas ujjay i pranay ama viloma pran ayama yama yoga truthfulness purity aphorism self-study austerity, ascetic practice psychic breath breath that goes against the f low Abstinen ce to yoke

101

APPENDICES

102

Appendix 1: Hyaluronan Accumulates in Demyelinated Lesions and Inhibits Oligodendrocyte Progenitor Maturation
NEW RESEARCH OFFERS CLUES TO PREVENT BRAIN DAMAGE IN PREMATURE BABIES

Factors inhibiting the brain' s natural self -healing process identified

Factors that inh ibit the brain's n atural self -healing process and that may offer new insights into h ow t o prevent brain damag e in prematu re babies h ave been ident if ied by a team of research ers supported in part by the March of Dimes. Th e research is publish ed onlin e today in Nature Medicin e. Stephen A. Back, M.D ., Ph.D., an Associat e Professor of Pediatrics and Neurology at the Oregon Health & Science University Sch ool of Medicine, Portland , and colleagues identif ied some of the key f actors that prevent brain damag e repair in premature bab ies and patient s with mu ltiple sclerosis (MS) or cert ain oth er neurological diseases. Th eir findings offer important clues about why the n ervous sy stems fails to repair itself and suggest that some forms of brain damage could be reversed. Dr. Back, who studies dev elopmental brain injury in prematu re infant s, prev iou sly found a lin k between damage to wh ite matter in th e brain associated with premature birth, and damage to immature cells in the brain and spi nal cord , called olig odendrocyte progen itors. Th ese cells normally mature to become oligodendrocytes that make myelin (the insu lat ing sheath surround ing nerv e fibers in th e brain and sp inal cord) throughout life. In some cases, th ese cells f ail to mature a nd cannot rep air damage to the wh ite mat ter of the brain.Th e white matter is mad e up of long nerv e fibers wrapped in myelin. D ifferent kind s of wh ite matt er injury cau se cerebral palsy and learning prob lems in ch ildren born prematurely , and

103 MS in older ch i ldren and adu lts. Dr. Back and his colleagues found that hyaluronic acid (HA) prev en t immature olig odendrocytes from maturing and coating nerv e fib ers with new myelin . Astrocytes, the f irst -responders to nerve damage in the brain, produce HA, which accu mul ates on nerve f ibers where my elin is missing. "Preterm birth can interrupt the normal myelination process. Therefore, this report may help to explain the brain damage seen in premature babies, some of whom have cerebral palsy ," said Michael Katz, M.D., S enior Vice Presid ent for Research and Global Prog rams at the March of Dimes, wh ich is support ing Dr. Back. "Until we find the answers to prevent ing prematurity, research such as this may lead u s to new ways to prev ent brain damage and h as the potential to improve th e lives of thousands of inf ants." Prematurity is th e leading k iller of America's newborns and has in creased 29 percent since 1981. More than 470,000 babies are born prematurely each year in the United Stat es. Premature babies often d ie or suffe r lif elong consequences, includ ing cerebral palsy, mental retardation , chron ic lung disease, blindness, and hearing loss. Accor ding to research conducte d by the National Institute of Child Health and Human Development, 25 percent of extremely premature b abies have neurological problems at 18 to 22 months, and 17 percent will develop cerebral palsy . "Hyaluronan Accumulates in Demyelin ated Lesions and Inhibits Oligodendrocyte Progen itor Maturation " publish ed in the September 2005 issu e of Nature Med icine, volume 11, numb er 9, was a collaborativ e effort of Dr. Back, sen ior researcher Larry Sherman, Ph.D ., an Adjunct Associat e rofessor of Cell and Developmental Biology, OHSU Sch ool of Med icine, and other colleagu es at OHSU, the Nation al Institutes of Health, and the Cleveland Clin ic Found ation . 08/07/05 (Neonatology and Rights of Families, TEMP NAROF Mailing List rcrother@bigpond.net.au, Tue Jun e 6)

104

Appendix 2: Stress for parents of premature babies

NEW YORK (Reuters Health) - An early -intervent ion program can sign ificantly reduce paren ts' stress after the birth of a preterm inf ant, accord ing to a study conducted by research ers in Norway . "Mothers and fathers of preterm infants experience a sustained increase in parenting stress" , Dr. Per Ivar Kaaresen from the Univ ersity of Tromso told Reut ers Health . Kaaresen and colleagu es evaluated the impact of an interv ention program by randomly assigning 146 par ents of preterm infant s to the program or to a comparison 'control' group. The program consist s of several sessions. The f irst is design ed to allow th e parent s to "vent experiences from the hospit al stay and possib ly their feelings of grief." Thereafter, the sessions aim to "enable the parent s to appreciate their infant's un ique ch aracteristics, temperament, and dev elopment al potential." Th e parent s are taught to recognize their infant's signs of distress or stimu lus ov erload or read iness for interaction, a nd to respond appropriat ely . The preterm int ervent ion group had significantly bett er stress scores at 6 and 12 month s comp ared with the preterm control group -- reg ardless of the prematurity of the baby, mothers' and fathers' educat ion or income, or number of older siblings -- the team reports in the journal Pediatrics. "Becau se some stud ies hav e shown th at parenting stress is a risk f actor for lat er behavioral problems in both preterm and oth er ch ildren, the reduct ion in parent ing stress during the infant' s f irst year of life may potentially be an import ant factor in reducing lon g -term behav ioral problems in these infant s," the investigators con clud e. "We think th at reduced parenting st ress is a benef it for the parents by itself, although the effects on chi ldhood

105 development are st ill not clear," Kaaresen said. "We plan to examine the role of early parenting stress on later potential beh avioral problems and the effect s of reduced parenting st ress on later d evelopment ." SOURCE: Pediatrics, Ju ly 2006. (Neonatology and Rights of Families, TEMP NAROF Mailing List rcrother@bigpond.net.au, Thu Jul 13)

106

Appendix 3: Touch Relaxation

Touch Relaxation is a gentle practice that promotes relaxation through creating awareness of tensions held in the body. By scanning and intuitively touching the students body, the practitioner opens the students awareness of where tensions are being held, thereby enabling release of these tensions and an increase in energy flow. Tensions often appear when our mind takes over our body and when we forget to be in our body. In order for the student to reap maximum benefits from the practice, the practitioner will create an atmosphere of trust, peace, nonjudgemental and unconditional acceptance. Have some nice relaxing music playing in the background. Feeling safe, the student will be able to relax and find within him/her the quiet place from where tensions can just be observed. Once attention is gently drawn back into the body, the student will be able to become aware of the tensions, relax on them and let them be. When we let them be, we allow letting them go. This practice can be done in any position, whether sitting in a wheelchair or lying in bed, prone or supine. Below are some suggestions; feel free to use your creativity. Let your intuition and hands do the work! Each movement is repeated three to five times on each side. You can either brush the body with your hands or apply gentle pressure of your fingers on the muscles. Start scanning the body from the top of the head. Position yourself behind your student and using both hands gently brush their brow from the centre to the outside. With students eyes shut, lightly brush across the eyes. Placing your hands on top of the head, brush down around the ears and lightly massage the ear lobes. Starting at the chin, follow the jaw line and up behind the ears. Placing your fingers at the base of the skull, gently let the students head rest in your hands for a few moments. Moving to the right side, move your hand from shoulder to inside of elbow, then from elbow to palm of the hand. Massage palm of the hand and each finger individually, focusing on each knuckle. Grasping each finger, slide your fingers off the end of each of the students finger. Lightly brush down the sternum to the waist on the side you are working on and then over the right hip joint. Move your hands from the right hip joint, over the top of the leg towards the knee. If your student has Cerebral Palsy, you may want to spend extra time on that muscle, very slowly working your finger pressure into the muscle. Move your hands from the inside of the knee towards the back of the ankle. Massage foot and toes similarly to the hand. Move to the left side and repeat the movements. If the student is mobile, she/he can either sit up or roll supine. Move your hands upwards from the lower back to the shoulders on either side of the spine, then to the neck, then brush across the shoulders. Let your student rest.

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