Healing the Whole Person: Teaching Yoga and Mindfulness for Cancer
A cancer diagnosis is no longer a death sentence. Nowadays, 50% of people with a cancer diagnosis will survive for ten years or more and the survival rate has more than doubled in the last 40 years. Increasingly, the approach taken by those in the medical profession and by complementary care-givers is not just to try to extend the life of the person with cancer but to help them to live well. By ‘living well’ we can understand living with a degree of physical and mental ease, in healthy relationship to oneself, to loved ones and to the world.
Yoga can serve as a powerful self-help tool for people coping with the impact of cancer, aiding practitioners to heal the whole person – body, mind, spirit and relationships.
While yoga is not a substitute for medical treatment and should never be considered an alternative, it can provide a way for people affected by cancer to exercise some control over their own physical and mental health. Here, I must say, the assertion that self-help empowers people to affect their own health by no means implies that they are responsible for their disease. There are very many variables in the combined conditions that result in cancer and it is not helpful or reasonable to think of it as being someone’s fault. However, one could say that someone with cancer has a responsibility to their disease, meaning that they can take charge of their own self-care to a greater or lesser degree, depending on their circumstances.
Hatha yoga is known to promote relaxation, enabling the endocrine and parasympathetic nervous systems to bring about homeostasis, which has a positive effect on the immune system. As is also commonly known, it strengthens muscles, improves joint functionality and helps to heal scar tissue. Furthermore, students in my classes have remarked that it has increased their body awareness to such an extent that they feel an ability to self-diagnose, increasing their confidence that they will sense imbalances in the system at an early stage.
Another important benefit of a mindful yoga practice is that it helps people to befriend the body. In our highly body-conscious society this is imperative for anyone seeking self-acceptance, but for those who have had a diagnosis it is common to feel alienated from the body and even betrayed by it. “Defeminised”, “emasculated” and “undesirable” are words I often hear in relation to the body with cancer. Mindfulness and yoga teach us to turn towards the parts we feel cut-off from, to welcome them into our experience and eventually to embrace them as an integral part of our being. We start to trust our inner reference points and learn our own truth instead of placing our sense of self-worth in unrealistic, socially-constructed ideals. In learning to sit with the physical difficulty or discomfort, we are able to cultivate self-compassion which can lead to self-acceptance and contentment.
We can see the physical body as a kind of side door into the mind – rather than taking on the onerous task of grappling with the capricious mind, we start with the body and watch the effects filter through. When the participant becomes skilled at minding the body and the breath, he or she can try the more advanced practices of turning towards emotional discomfort, locating it as a felt sense within the body and then observing the physical sensations whilst being aware of any narrative that arises.
Yogic anatomy gives us the five koshas, a model of our complex design as physical, mental and spiritual energies. The koshas provide us with signposts to follow as we encounter landmarks of the self during practice – they are usually depicted as a “Russian doll” kind of model with the body (annamaya kosha) being the outermost sheath of being and pure bliss being (anandamaya kosha) being the innermost doll at the centre. The division into layers makes the concept easy to comprehend and to communicate, but the real power of yoga is that by affecting one layer, we affect them all as there is no real separation between them. So, when participants engage in therapeutic movement to heal the body, not only does it give them a sense of empowerment and control over their health, but the shift in wellbeing in the body will have its ripple of effect on the mind. Those who feel connected to spirit may perceive a positive change on that level also. People often report feeling more ‘alive’ after doing a yoga practice which suggests that it is more than just a bodily experience.
To summarize the koshas, it is a fluid system with information travelling freely between layers of consciousness. We experience this flow of information either as sensations in the body and movement of the breath, or as emotional fluctuations and thought processes. We do not have language to adequately describe the felt sense indicating disseminated information from higher states of consciousness (higher, or intuitive mind (vijnanamaya kosha) and pure bliss (anandamaya kosha)) as it is a highly subjective experience which is normally beyond the realm of language and intellect. It is often described as a shift in understanding, an expanded awareness, a feeling of interconnectedness and of coming home to oneself.
Alastair Cunningham, in his book The Healing Journey, presents a similar “structural map” of personhood but with the layers radiating out from the body level to include social order/biosphere/ spiritual or existential order. At the heart of Cunningham’s Healing Journey is the need for connection in order for true healing to occur. It is interesting to note here that the word healing comes from the Old English “haelen”, meaning to make whole. For healing to take place there does not have to have been a “cure” – healing is rather an integration and acceptance of all aspects of self. As well as becoming connected to and knowledgeable about one’s own body and mind, Cunningham recognizes the need to be connected to our loved ones and stresses the importance of strengthening relationships and seeking out community when coping with cancer. Becoming connected to body, mind, spirit (or unifying consciousness) and others brings us into full possession of our being and therefore into wholeness.
The cancer yoga class serves as a kind of sangha (community) where before and after class, participants can speak and express emotions freely, listen to each other’s stories and discuss their treatment. There is evidence to suggest that people who attend support groups for cancer are likely to survive longer, which indicates the positive effects of being able to communicate to others what you are going through. In a yoga class the group is bound together by the experience of doing the practice, which gives people a sense of commonality aside from cancer. It is not unusual for long-lasting friendships to grow out of these groups, and for those who do not engage much with other participants, it is still a source of tacit support. Participants in my classes are always encouraged to do what they have to in order to make sure their needs are met, whether that means lying down and relaxing, breaking wind, leaving the room, sighing, laughing or crying. It is a space where they can be authentically themselves and where everything is welcome.
As a new and very green Yoga for Cancer teacher at Penny Brohn Cancer Care, simple questions such as “How are you?” seemed taboo. I thought that I had confronted my preconceptions about cancer during my training but in reality, I had barely scratched the surface. It had not occurred to me that people could feel good and be coping with cancer, or that they might want to talk about not feeling good, or just have a moan about their job or tell me about their new grandchild. My own imaginings about their condition crippled me. The first woman to bare her head in my class, having got rid of her wig, was incredibly beautiful to behold. She exuded a potent mixture of bravery, feminine power and vulnerability. I “tactfully” didn’t mention it. It wasn’t until she was heartily celebrated and complimented by the other women that I realized I had been bordering on rude by ignoring her new style, once again lamed by my own prejudice and fear. That, and similar, is what most people with cancer put up with every single day.
Western cultures banish any threat to life from real consideration, preferring to juxtapose death against life as its opposite. The mindset is something like this: I am here, therefore life is here. Death is over there, thankfully. This attitude makes us awkward and overwhelmed in the presence of people who are going through cancer and other illnesses, and when we or a loved one receives a diagnosis of life-threatening illness we are faced with a huge leap into the unknown – or more denial. Woody Allen famously quipped, “It’s not that I’m afraid to die, I just don’t want to be there when it happens!”, which reflects the attitude favoured in Western cultures. We would rather ignore it than have to deal with it. The irony though, is that in accepting death, we can fully accept life. I will always be grateful to the clients at Penny Brohn for teaching me to take my first steps into that unchartered territory.
“Death exists, not as the opposite but as part of life” – Haruki Murakami
A diagnosis marks a separation – from the person you thought you were and were going to be, and from loved ones. Sometimes referred to as the Hero’s Journey, those who choose to explore their relationship with their own mortality go through a subsequent adjustment which is a process of separation (from former life and identity), initiation (into a different understanding) and return (as a changed person – the hero). For this reason, a diagnosis can mean a sense of isolation, as the person with cancer feels as if they have been cast away from the familiar shore, suddenly distant from others and having to navigate foreign waters alone.
An essential part of yoga practice is to “let go” which seems contradictory to the discipline and focus required to maintain sadhana (practice). It’s true that we need to exert some willpower and determination in making our practice happen, but on the mat, the effects of asana, pranayama and meditation are to be observed without expectation or judgment. We paradoxically endeavor to surrender to whatever arises, having put the conditions in place for awareness to unfold. The goal in each moment of this surrender, is to “die” to the ego itself and to make the act of practice its own reward rather than investing in the superficial “achievements” inevitable as practice becomes more advanced.
Dying to the ego means letting go of who we think we are. Fixed ideas of identity prevent us from experiencing things as they really are and act as a barrier to authentic relationship with self and others. By teaching us to die to the ego, yoga and mindfulness practice help to prepare us for death itself. There is a popular Zen saying, ‘Die before you die’, the wisdom of which directs us to accept the ephemeral and subjective nature of our existence in order to live and die well. This is not to deny the validity and uniqueness of each embodied life and of our own individual experience, but to recognize that life, the mind and the body are a process. Truth is a process, and what we think of as our fixed identity in this world changes moment by moment, but most radically with a life-changing event like cancer. To attain true wisdom, we have to let go of knowledge and cultivate an open and ready mind – sometimes this is referred to in Buddhism as “Beginner’s Mind”, pointing to the fact that we are new in every moment, and to respond authentically to life, we have to actively not know and trust in the process.
Yoga and mindfulness teach us to charter the unknown ocean of consciousness while grounding the awareness in the here and now. Anchored to the breath, the yogi can explore her greater consciousness without getting capsized by the power of who she really is. By opening to the unknown, we open to the fullness of life. Maria Rilke Rainer puts it this way:
“Let everything happen to you: beauty and terror.
Just keep going. No feeling is final.”
– Go to the Limits of your Longing
Working with people on the cancer journey, I have experienced my deepest heartbreak and I have witnessed the highest courage, creativity and inspiration. I am privileged to have worked at the outposts of human experience and alongside real heroes.