Sat Bir S. Khalsa, PhD, has been practicing a yoga lifestyle since 1971. In addition to living in an ashram, or yoga community, outside the city of Boston and practicing yoga several times per week, Khalsa is a neuroscientist in the Division of Sleep and Circadian Disorders who studies yoga as an intervention for insomnia, anxiety and chronic stress and for promoting mental health in public schools. He even authored a Harvard Medical School e-book on the benefits of yoga and meditation on the brain.
CRN recently spoke with Khalsa to learn more about his passion.
From what discipline do you approach yoga and yoga research?
My academic history is in the field of biological rhythms and sleep research. I came to the Brigham in 1996 to study sleep and human circadian rhythms with Charles Czeisler, PhD, MD, FRCP, chief of the Division of Sleep and Circadian Disorders. I’ve had a longtime passion to study the effects of yoga since the mid-1970s. In 2000, I was fortunate enough to begin doing research on yoga full-time due to funding from the National Center for Complementary and Integrative Health (NCCIH), which is part of the NIH.
Can you describe your earliest studies?
My original studies were tied to my expertise in sleep medicine, so I conducted research on yoga for chronic insomnia. Subsequent to that, I conducted trials on yoga for performance anxiety, PTSD, chronic stress, generalized anxiety disorder and, ultimately, yoga in public schools and for frontline professionals in workplace settings for mental health benefits.
What are you currently working on?
We recently completed a study with middle school students at Boston Latin School addressing the efficacy of yoga for reducing risk factors for substance abuse – funded by the National Institute on Drug Abuse and the Kripalu Center for Yoga & Health. The study’s hypothesis was that, compared to a control group participating in regular physical education classes, students who instead participated in 32 yoga sessions across an academic year would improve in negative internalizing behaviors – a known risk factor for substance use – and self-regulatory skills – a known protective factor for substance use. We also hypothesized that the yoga intervention would reduce both severity of substance use and the degree of substance use initiation. A positive finding was that students in the yoga program showed no increase in willingness to smoke cigarettes, whereas those continuing with PE classes did, supporting our hypothesis of yoga as a preventive strategy.
One of my current research involvements is evaluating the preliminary efficacy of yoga treatment for generalized anxiety disorder. This NCCIH-funded study, which is being conducted at MGH and Boston University, is a three-arm trial comparing Kundalini yoga – a dynamic meditative yoga style that incorporates postures and movement, breathing techniques, and relaxation and meditation practices – with cognitive behavioral therapy (CBT) and a stress management intervention. Another ongoing study is the evaluation of the efficacy of a structured program of Kripalu yoga, a popular traditional yoga style, in addressing distress, burnout and mood disturbance in frontline professionals working in educational, health care and correctional institution settings.
Can you describe some of the physical and mental benefits of yoga?
The findings are pretty convincing in terms of suggesting yoga as a behavioral treatment in a variety of disorders. There are multiple factors and mechanisms by which yoga generally leads to benefits. One is the physical component – the postures, exercises and breathing techniques that improve physical and muscular strength, balance, physical and respiratory fitness, and so on. This is of assistance in many medical conditions, particularly those that have physical components.
Another area in which yoga is very effective is self-regulation, particularly regarding stress and emotion regulation. Stress is a huge contributor to the severity and even genesis of many disorders, so by directly improving stress management and emotion regulation, yoga acts to help with symptom severity in many diseases. It can also improve the quality of life, which is important especially in patients with chronic diseases such as cancer and diabetes.
We also see an improvement in mind-body awareness with yoga. Through the practice of meditation and mindfulness within yoga, one engages the attention networks in the brain. Over time, this leads to enhanced awareness of one’s physical body, emotions, feelings and the content of thoughts, and that awareness can lead to a change in behavior. People tend to gravitate toward positive behaviors because, perhaps after yoga, for the first time, they’re sensitive and aware enough to feel and experience the benefits of those positive behaviors.
What is yoga therapy?
Yoga therapy is different from yoga classes to the general public. It’s used to address the needs of specific patient populations, including both clinical symptoms and underlying causal factors. It safely incorporates appropriate yoga practices based on a person’s physical and emotional limitations so that he or she can get the benefits of the practice. For example, if someone has low-back pain, a yoga therapist would teach him or her specific types of physical exercises and techniques that are safe for their condition and are believed to improve low-back tension. Or a yoga therapist might teach someone with anxiety specific breathing and meditation practices that are believed to be effective for that condition.
Do you see yoga therapy gaining popularity in health care?
Yes, the growth of integrative medicine is moving along quite rapidly. Most major academically affiliated hospitals have an integrative medicine center associated with them, and these offer not only mind-body therapies, which includes yoga, yoga therapy and meditation, but also massage, acupuncture and so on. At BWH, we have the Osher Center for Integrative Medicine, and MGH has the Benson-Henry Institute for Mind Body Medicine.
How has yoga impacted your life personally?
Yoga has made profound changes in my life. When I first started practicing in 1971, I was interested in the whole idea of enhancing life’s meaning and purpose, the experience of deeper transcendental states of consciousness, including the so-called “flow” state. After I started practicing, I started to notice changes in self-regulation of stress and emotion, physical changes in my body, deeper flow states and improvements in my mind-body integration. I moved into a residential yoga community, and I became a certified yoga instructor. Yoga has been my lifelong practice and passion.
I believe I’ve been able to take on more activities without the side effects of stress because of yoga; I’m able to cope with stress more effectively. I’m aware of how I’m feeling and reacting, and it keeps me away from negative behaviors that are counterproductive and motivates me to adopt healthy behaviors. Yoga has also improved my respiratory fitness and kept me flexible. I’m 65 years old and have never been on any medication and don’t foresee any significant need for it in the future.
What do you think people are looking for when they start yoga?
There is a variety of reasons people come to practice yoga: physical fitness, stress management, wellness, spiritual growth, illness prevention and treatment, or simply as a healthy hobby, although its role as a successful stress management strategy is well-known and well-deserved.
Is there something about society today that you think warrants a heightened need for yoga?
Chronic stress is a major risk factor and exacerbator of many of the now highly prevalent preventable lifestyle-related noncommunicable diseases and disorders. Yet, as a modern society, we have few, if any, stress management strategies taught in schools or applied in health care settings. In fact, even many of our teachers and doctors are themselves burned out from chronic stress. Yoga is an excellent strategy for managing it. Not surprisingly, there’s been a remarkable rise in the number of people practicing yoga – 10 percent of the U.S. population in 2012 compared to 5 percent in the decade prior, and it appears to be going up.