From a Yogic perspective, heart disease in all its forms manifests not only on the physical level, but also on the energetic, emotional, mental and spiritual levels.  Yoga's healing qualities address heart disease in each of these layers, allowing sufferers to literally open their hearts to total health and well-being.  


A Yoga practice and lifestyle helps each person to become mindful of the factors that contribute to heart disease.  Yoga is certainly not a substitute for conventional medicine, and anyone considering Yoga to assist with healing from heart disease should first discuss it with a health care professional. 


Dr. Dean Ornish M.D. was the first medical professional to publish valid medical research demonstrating that Yoga, as a part of a holistic lifestyle program, can help prevent the progression of heart disease as well as reverse it. His research began in the mid-1980s and the results published in a number of medical journals, including, Journal of the American Medical Association, The Lancet, The American Journal of Cardiology, to name a few.  


They key to the program's success was its focus on the whole person, deriving many of the techniques from the teachings of Yoga.  The program consisted of empowering individuals to make comprehensive lifestyle changes, focusing on diet, stress-management, moderate exercise, smoking cessation, and psychological/emotional support.  The results showed that those who did make the changes reported lower incidences of angina (chest pain) in a short amount of time, and they were able to engage in work and other activities previously too painful to perform.  Within a month, they recorded improved blood flow to the heart, and within a year, 82 percent of participants measured improvements in blocked coronary arteries.  


More Yoga-based rehabilitation programs are becoming available for sufferers of heart disease.  Yoga's benefits penetrate beyond the physical body, to positively impact the energetic, emotional, psychological and intellectual layers of our beings.  These five layers or sheaths of one's being are known as the Five Koshas.  


The Five Koshas

Annamaya Kosha = Physical (or Food) Body

Pranamaya Kosha = Energy Body

Manomaya Kosha = Emotional Body

Vijnanamaya Kosha = Intellectual & Wisdom Body

Anandamaya Kosha = Bliss Body


All these layers are intrinsically connected.  The state of the Physical Body is directly influenced by what goes on with inner Koshas.  Dr. Mala Cunningham, founder and creator of the Cardiac Yoga program - one such Yoga-based rehabilitation program - explains, "From the yogic perspective, disease begins in the energetic and vibratory levels before manifesting in the physical body.  Therefore, if there are negative and harmful vibrations or thoughts in the higher levels of consciousness (i.e. the mind and emotions) then the effect will be registered and felt in the physical body."  When beginning to heal yourself from heart disease, the easiest is to start with the gross, outer-most layers and then work your way inward to the subtler layers.



The Physical Body - Annamaya Kosha


The Annamaya Kosha literally translated means the Body of Food and comprises our physical body of bones, muscle, internal organs and skin.  According to Yogic teachings, the quality of food we consume affects the quality of the body's cells and tissues that the food converts into.  Food is a delicious and exciting component of the modern lifestyle, and it is possible to enjoy it to its fullest without compromising on its wholesomeness.  Dr. Ornish recommends a low-fat vegetarian diet for maximum effectiveness in reversing heart disease. A plant-based diet is encouraged because it expends minimal energy for digestion and absorption, but provides the maximum amount of energy and nutrients to the body and mind.   Ornish does, however realize the challenge of this for many, and has therefore introduced a program called the Spectrum, which individuals can craft to suit their lifestyles.


The physical practice of Yoga postures also falls under the Annamaya Kosha.  The main focus of Yoga postures for heart patients is to reduce environmental stressors.  Most people are not even aware of their bodies until there is discomfort or pain.  When a person learns to relax, he develops awareness of the sensations and events that occur within the body.  With this awareness comes the ability to respond to the body's needs instead of habitually ignoring them.  As the practice develops, Yoga helps remove toxins and waste from the body, strengthening not only the muscles (including the heart) but the internal systems as well.  Patients who have suffered myocardial infarction (MI) or a heart attack need to start with the basics and gradually work their way up.  The following pages show a sequence of Yoga postures based on Dr. Cunningham's Cardiac Medical Yoga program.  



The Energy Body - Pranamaya Kosha


Just beneath our physical body is the Body of Energy, or Prana.  Prana is the vital life force (known as Qi), which is like a current that runs through our bodies, providing us with vital energy to live, breath and heal.  Prana mainly enters our being through the breath but is more than just oxygen.  While most people understand Pranayama to be breathing techniques, its true purpose is for an individual to take control of the Prana in the body and use it to assist the body in healing.  


Working with our breath affects how we feel both physically and mentally.  A deep breath instantly provides oxygen and Prana to our body and minds, calming and relaxing both. Our physical heart beats constantly throughout our lifetimes without resting.  The only time the heart rests is between beats.  Pranayama is a practice that slows down the rate of the heart, allowing it to rest and rejuvenate more effectively.  However, stress creates tightness in the physical body, blocking the passageways that allow this energy to flow.  In order to truly benefit from the breathing techniques, we must learn how to relax.


Relaxation of the body opens up the channels within the body to receive Prana.  Only through proper relaxation -- completely switching off the body and mind -- can the body regain the energy it needs.  Yoga Nidra or the Yogic sleep is a recommended daily practice that, similar to sleep, allows the body and mind to experience a completely relaxed state.  The only difference is that you remain aware during the experience.   With regular practice, you start to feel the tension melting away from the body.  As the energy flows and fills the body, the heaviness turns into lightness and relaxation thus becomes the norm for the physical body.  Actual relaxation needs to be learned and patience is required to truly experience the benefits.  



The Emotional Body - Manomaya Kosha


The Manomaya Kosha is the body of senses, emotions and information.  It helps us to function in our daily world but is not responsible for discriminating or analyzing.  This part of the mind is associated with the ego sense, and is usually the part of the mind that gives one thousand excuses why you shouldn't listen to cues from your physical and energy bodies.  This part of the body also receives signals from the Intellectual Wisdom Body, but many times, doesn't respond appropriately.  The result is trapped emotions or feelings, which subsequently affects the outer bodies.


For example, if there is a conflict between our heads and our hearts, the result is often neck pain.  The neck is the physical bridge between our thoughts and our feelings, so any congestion between the two will just cause it to jam.   In the case of heart disease, our chest and lungs can hold on to emotional grief or trauma.  Blocking the expression of the heart's energy can also cause it tighten and become diseased.


According to Dr. Cunningham, "Most people (including heart patients) deal with various psychological issues." Sufferers of heart disease have a lot of emotions to deal with, as with the case of those who have recovered from MI.  They must deal with their whole worlds changing, and most of their friends or family cannot understand the psychological and emotional impact that this has on a person.   She continues, "The practice of Yoga is one avenue for bringing healing back into the emotional heart as well as the physical heart.  Yoga addresses emotional and psychological issues and provides an individual with a framework for exploring and reducing tension and distress internally and externally."



The Intellectual Wisdom Body - Vijnanamaya Kosha


This body is the higher mind, allowing us to make decisions that are based on intelligence, discrimination and intuition, also known as the wisdom of the heart.  Nischala Devi, author of the book The Healing Path of Yoga, and pioneered the yoga programs for Dr. Ornish, says, "It is not unusual to find that when we relax the body and mind, the greater knowledge from within comes to the surface.  Some people have gotten great messages about themselves and their healing from going deep within."


Relaxing the mind to receive these messages takes great practice.  It is not easy to train the mind to be still.  Difficult as though it may seem, it has a profound healing effect on the whole person. Dr. Herbert Benson, Harvard medical cardiologist, who founded the Mind/Body Medical Institute, has spent over 35 years researching the effects of relaxing and stilling the mind.  The "relaxation response," as he terms it, is a physiologic response that rapidly counters the effects of the stress response (fight or flight).  The physical results include lower blood pressure, slower pulse rate, and improved sense of mental and spiritual well-being.  The entire purpose of a Yoga practice is to learn to still the mind, and elicit this relaxation response.  

The Bliss Body - Anandamaya Kosha

In this state of stillness and relaxation comes find a sense of peace and contentment.  This is where we connect with our Bliss Body.  Dr. Cunningham describes this stage as, "the final nebulous stage before consciousness merges with the 'real self' or soul.  This doesn't have anything to do with religion but with living our lives with 'soul' or meaning.  Finding a purpose for your heart gives you a sense of happiness that nourishes you as a whole person, providing unending amounts of energy.  It's the place where the deepest healing occurs.  

These techniques are not only for those who already suffer from severe heart disease, but can be practiced by those at risk for heart disease, who are not yet in need of medical intervention, as prevention is far more effective than cure.  Every human has a connection to all these layers within.  Nurturing yourself as a whole person and not ignoring the signs and signals from other parts of your being allow you to live a life of quality, health and happiness. 

Hersha Chellaram is a certified Cardiac Medical Yoga instructor and Yoga therapist.  She offers yoga workshops for sufferers of heart

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