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TSY 300-hour TT
March 2014
Symptoms
Psoriasis can develop on virtually any part of the skin. Some of the most
uncomfortable and debilitating locations psoriasis can occur include: under
the nails, on the genitals, on the face, on the hands and feet, and on the scalp.
Triggers
Some of the known triggers include stress, strep throat and upper
respiratory infections (especially in the case of guttate psoriasis), injuries to
the skin (known as the Koebner Phenomenon), specific medications (lithium,
antimalarials, Inderal, quinidine, Indomethacine) and cold, dry weather.[8-10]
Among those who are involved with psoriasis, some believe that psoriasis is
strongly linked to diet and allergies but these links are not yet conclusively
proven.[7,8]
Topical Treatments
Some topical treatments are aimed at soothing the skin and reducing the
dryness associated with the condition. These treatments include the use of
Epsom salts baths, mineral oil and other moisturizers. [7,12] Further
treatments include:
Phototherapy
Systemic Medications
An Alternative Approach
In this physical body, the various organs and systems all have their
own functions to carry out, but there should be coordination between
them. If any of the organs or systems of the body are not able to
coordinate with each other, it means that not one but all systems and
organs are unbalanced. Thus, in any sickness, whether physical or
mental, every system is out of coordination.[33]
To rid the skin of psoriasis, the modern holistic view and the
yogic/ayurvedic* views are much the same: the entire body must be cleansed
with emphasis on cleansing and then regulating the digestive system. The
initial cleansing will help to immediately alleviate the toxin toll on the body
and let the organs resume normal functioning. Once balance is restored to
the entire body, the attention can shift to maintaining that balance. The
following sections take a look at determining which yoga and ayurveda
practices are helpful to cleaning the body and keeping psoriasis at bay for the
long-term.
*Yoga and ayurveda are sister systems of understanding the body, both
stemming from the Vedas.[42]
Kriyas
The Hatha Yoga Pradipika and the Gheranda Samhita are two
foundational texts that form the basis of modern-day yoga. In his version of
the Hatha Yoga Pradipika, Swami Muktibodhananda combines the
information from both texts to give a more in-depth explanation of the
practices described in the Hatha Yoga Pradipika. Together the two texts
outline a system of purification practices (kriyas) for almost all diseases in
the body. These practices are designed to purify the doshas, or constitutional
humors of the body.[43] According to the systems of yoga and ayurveda, the
imbalance of these doshas is the root cause of most illnesses. [33] In order to
correct these imbalances, The Hatha Yoga Pradipika outlines a system of six
practices known collectively as shatkarma. Individually, there are: dhauti
(internal cleansing), basti (yogic enema), neti (nasal cleansing), trataka
(concentrated gazing), nauli (abdominal massaging) and kapalabhati (frontal
brain cleansing breath).[33] Some of these practices overlap with the
ayurvedic system of five practices known as panchakarma, which will be
referred to in-depth at the end of the section.[44] Each kriya, whether it is
described as part of shatkarma or panchakarma may have several
contraindications and/or may require pre- or post- procedural care.
Therefore, neither shatkarma nor panchakarma should be practiced without
the guidance of a guru, experienced practitioner or medical professional who
is qualified to prescribe and oversee these practices.
The first practice of shatkarma is dauti. Dhauti consists of the
practices of cleansing the body internally. There are four subcategories of
dhauti: antar dhauti (internal cleansing mainly dealing with the digestive
system), danta dhauti (teeth cleansing), hrid dhauti (cardiac/chest cleansing)
and moola shodhana (rectal cleansing). Each of these categories, in turn,
describes several practices utilizing different tools for cleansing.[33]
Anatar dhauti, for example, consists of vatsara dhatui swallowing air
into the stomach and passing it through the large intestine, varisara dhauti
(shankhaprakshalana) drinking up to sixteen glasses of salty water and
passing it through the digestive system, vahnisara dhauti pushing the
abdomen in and out rapidly, and bahiskrita dahuti standing navel-deep in
clean water, pushing the rectum out of the body and cleaning it physically
with the hands.[33] Among the practices of antar dhauti, varisara dhauti is
considered the easiest and least advanced practice. While varisara dhauti
must still be practiced under the guidance of an experienced practitioner, it is
the most accessible practice to the average, healthy person.
Danta dhauti generally refers to the cleaning of teeth with a stick of
neem or babool. Other types of danta dhauti include jihva dhauti cleaning
the tongue by rubbing it the first finger and thumb joined together in a circle,
karna dhauti cleaning the ears with the middle finger, kapalrandhra dhauti
cleaning the forehead and face, and chakshu dhauti bathing the eyes with
lukewarm saline water.[33, 45-47] All of these practices are simple and many
can even be replaced by modern day practices such as tooth brushing, using a
tongue scraper, and cleaning the ears with a cotton swab.[46] The other
practices can be learned by anyone and all of them can be practiced regularly.
Hrid dhauti consists of danda dhauti inserting a stick (soft banana
stem, turmeric root, sugarcane stick or catheter) into the stomach to clean
the esophagus, vaman dhauti induced vomiting aimed at cleaning out the
stomach, and vastra dhauti swallowing a long, sanitized piece of cloth
followed by practicing nauli (abdominal exercises).[33] The most basic among
these three practices is vaman dhauti.
Lastly, mool shodhana involves inserting a clean middle finger or a
turmeric root into the rectum and rotating both clockwise and anti-
clockwise.[33]
Dhauti practices are used to clean the digestive and respiratory tracts.
They remove toxic waste that has built up in the body, including but not
limited to old bile, mucus buildup, infectious bacteria, excess fatty tissue,
fecal buildup, flatulence, etc. Dhauti helps to restore the bodys optimal
chemical balance, stimulate healing, and regulate digestion. Each practice of
dhauti has its own contraindication and should only be practiced if
prescribed by a qualified expert.[33]
The second practice of shatkarma is basti. Basti is the practice of yogic
enema. There are two main variations of basti: jala basti (with liquid) and
sthala basti (dry, with air). Jala basti is the easier and more common of the
two variations. Traditionally, jala basti was performed by squatting in a river
and using a bamboo tube. These practices are no longer practical for the
most part, and rather, a recommended method is to insert a gently lubricated
catheter or plastic tubing part way up the anus while one squats over a
bucket of water (or sometimes medicated oil) in which rests the other end of
the catheter. By performing uddiyana bandha (abdominal retraction lock)
and/or madhyama nauli (central abdominal contraction) the water should be
sucked up the tube into the anus. The breath should be held in and when it
cannot be held any longer, the tube should be removed and exhalation should
occur while one sits on a toilet. The contents of the anus should be expelled
during this time. After the practice, pashinee mudra, savasana and
bhujangasana should be performed to expel any remaining water and air.
Sthala basti is performed with the practitioner laying on their back and
sucking in air into the rectum.
Basti cleanses the bowel to remove unsuitable or excess bacteria, old
stool, threadworms, and excessive heat from the lower intestines. It cures
digestive disorders, relieves constipation, stimulates sluggish digestion and
strengthens the solar plexus. Basti also has a positive effect on ones
emotional state. Because of the advanced nature of basti, many practitioners
will use and enema kit to assist in the performance of jala basti.[33,48,49]
Neti is the practice of nasal cleansing. There are two types of neti: jala
neti and sutra neti. Jala neti is the practice of streaming warm saline water
through the nasal passage with the use of a special pot. The spout of the pot
is held up to the right nostril while the practitioner tilts his or her head to left
breathing through the mouth, and the saline water flows up and out the left
nostril. The practitioner then brings their head back up to center, closes off
the left nostril and gently blows out any remaining water. This is then
repeated on the other side. While the use of saline water is standard practice,
warm milk or warm ghee (clarified butter)/oil can also be used. These
practices are called dugdha neti and ghrita neti, respectively.[33] Sutra neti is
the practice of using a special cotton thread or a rubber catheter to cleanse
the nasal passages. In this practice, the head is tilted slightly back while the
thread or catheter is gently pushed up the right nostril until it can be felt in
the back of the throat. The practitioner then puts his first two fingers into the
back of the throat to pull the thread through the mouth. It is recommended
that the string be pulled back and forth through the nostril and mouth,
however this is not necessary. Finally the string is pulled completely out
through the mouth. This is repeated for the left nostril. To aid in this process,
the thread or catheter can be either dipped in saline water or coated gently in
ghee. It is recommended that sutra neti follow jala neti, and that both are
followed by pranayama to completely dry the nasal passage.[33]
The neti practices are said to create resistance to certain diseases of
the eyes, ears, nose and throat. These include but are not limited to myopia,
eyestrain, glue ear, middle ear infections, nasal polyps, and inflammation of
the adenoids. Neti is also said to increase memory, concentration, creativity,
intuition and youthfulness of complexion and it is said to be beneficial for
those suffering from anxiety, depression, epilepsy and hysteria. But most
importantly to the psoriatic, neti is said to bring balance to the entire central
nervous system as well as to the systems governing respiratory, circulatory,
digestive and excretory functions.[33]
Trataka is the fourth practice of shatkarma. It is the practice of
concentrated gazing. There are two varieties of trataka, the simplest of which
is known as bahiranga trataka or external gazing. The practice involves
steadfastly gazing at an external object with full concentration, clearing the
mind of any other thoughts, for at least 5 to 10 minutes while blinking as
little as possible. While any object or symbol can be used, the easiest and
most common is a candle flame (one that is steady and not disturbed by
drafts, movements, etc.) because it lends itself to the goal of the practice: an
internalization of the image so that one can practice antaranga trataka or
internal gazing. In this second practice, the practitioner focuses on a clear
and stable internal visualization with closed eyes.[33]
Trataka is beneficial not only to the eyes, but also to psychological and
mental functions. It is useful in the treatment of depression and anxiety
something psoriasis patients can be overcome by. Trataka is a powerful tool
in a spiritual sense because it is said to cause the brain to withdraw from
external stimuli while keeping awareness alert. Over time, this translates into
a spiritual awakening that can give one the feeling of a connection to a
higher spirit.[33] From the psoriatics point-of-view, a spiritual connection can
be beneficial in overcoming anxiety and depression as mentioned previously,
but also in ridding the mind of negative thoughts and emotions: an effect that
can have proven repercussions on the physical body, especially in the case of
psoriasis.[38, 50-53]
The next practice of shatkarma is nauli, or abdominal massaging. It
can more accurately be described as the art of abdominal muscle isolation,
namely the rectus abdominis with the help of the external oblique and
traverse abdominis. Nauli can be practiced in two variations: muscles
contracted in a circular pattern (vama nauli is clockwise in motion while
dakshina nauli is counterclockwise in motion) and central abdominal
contraction. The circular version of nauli is typically mastered before moving
onto central abdominal contraction. The action of abdominal muscle isolation
in this manner gives a massage to the central internal organs. In turn, the
massage of the organs gives rise to many benefits: it stimulates digestion;
tones the abdominal muscles, nerves, intestines, reproductive, excretory and
urinary organs; generates energy, especially in the digestive and excretory
systems; generates heat in the body; balances the endocrine system,
balancing hormones and mood; and can help to strengthen ones
willpower.[33] These benefits are especially relevant to a psoriatic who is:
experiencing constipation or malabsorpbtion due to leaky gut syndrome,
having trouble losing extra weight, having negative thoughts or associated
depression, dealing with a weakened immune response and/or experiencing
lack or willpower or a feeling of helplessness.
The final practice of shatkarma is kapalabhati. Kapalabhati is a
practice of forceful exhalation and passive inhalation. It is performed while
sitting in a comfortable position with the spine erect. The abdominal muscles
are then contracted into the body to exhale the lungs completely. Inhalation
is a result of the exhalation and occurs spontaneously and passively.[33] It is
advised to begin the practice of kapalabhati by exhaling one breath per
second for 10 breaths. This can gradually be increased to two breaths per
second and the amount of breaths can be increased by 10 until eventually
120 breaths are reached in one sitting. If any dizziness occurs, the practice
should be stopped and then resumed with more awareness and less
exertion.[54]
Kapalabhati cleanses the respiratory system, nasal passages, and rids
the body of a greater amount of gaseous toxins (carbon dioxide along with
methanol, acetone, ethanol, other alcohols, ketones, and some hydrocarbons
to name a few). [33,54, 55] It allows the tissues and cells absorb a greater
amount of oxygen. It massages the internal organs and helps to relieve
constipation. It also helps to increase metabolic rate and regulate weight
imbalances. [55] All of these benefits are relevant to a patient of psoriasis who
is experiencing greater toxicity in the body.
Asanas
(1) Tadasana, (2) Urdhva Hastasana, (3) Uttanasana, (4) Anjaneyasana, (5)
Adho Mukha Svanasana, (6) Kumbhakasana, (7) Ashtanga Namaskara, (8)
Bhujangasana, (9) Adho Mukha Svanasana, (10) Anjaneyasana, (11)
Uttanasana, (12) Urdhva Hastasana, (13) Tadasana. [77]
It also circulates blood and lymph throughout the entire system, helping to
energize the digestive system and helps relieve constipation.[76,77]
(1) Uttanasana, (2) Adho Mukha Svanasana, (3) Uttanasana, (4) Adho Mukha
Svanasana, (5) Ardha Chandrasana, (6) Baddhakonasana, (7) Upvasita
Konasana, (8) Sirsasana, (9) Viparita Dandasana, (10) Supta
Baddhakonasana, (11) Sarvangasana, (12) Halasana, (13) Supta
Padagusthasana I, (14) Supta Padagusthasana II, (15) Paschimotanasana,
(16) Janu Sirsasana, (17) Setubandha Sarvangasana, (17) Viparita Karani,
(18) Savasana, (19) Ujjayi Breath (see Pranayama).
In yoga, the connection between the mind and body has long been
established. The mind is the middle layer of the five sheaths or koshas that
make up the Self,* and it has the capability to affect our energy and our
physical body. By controlling our mind, we can control our body and let our
inner perfection or bliss show in our bodies. For this reason, meditation is
considered one of, if not the most important practice of yoga.
While in yoga it is accepted as fact that our thoughts affect our
emotional well-being as well as our physical well-being, this concept is
slowly finding scientific backing. For example, scientists have found that
meditation is associated with sensitivity to positive emotion and can have a
positive impact on mood.[78,79] Another study found changes in
neurochemistry that suggest a positive mental impact for the subjects in the
study.[80] And perhaps most profoundly, studies have confirmed both the
placebo and nocebo effects.[52, 81-83] What this means is there is scientific
evidence backing the notion that if you think positive thoughts, you can help
your body heal and conversely, if you think negative thoughts, you can
contribute to your own state of poor health.
For a psoriasis patient this is a powerful notion as it means that
accepting the condition and choosing to think positive thoughts can have a
significant impact on healing the condition. In fact, one study concludes that
mindfulness meditation can help patients clear their psoriasis.[84]
So how does one actually meditate? There are a plethora of
meditation methods to choose from, but these suggestions might be among
the most helpful for patients of psoriasis:
* From inner to outer they are anandamaya kosha (bliss sheath a.k.a. the pure
soul), vijanamaya kosha (knowledge sheath), manomaya kosha (mind
sheath), pranamaya (energy sheath), and annamaya kosha (physical body
sheath).[88]
Pranayama
Diet
Where all the diets recommended for psoriasis agree are in the following
areas:
Conclusions
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