Yoga as a form of support for women following breast cancer
Shelley Robinson
My first experience of the benefits of yoga for cancer occurred when I taught a general hatha yoga class at a local school. A young mother attending this class reported a wide range of progress over a period of time. Her first comment was about the relief of physical tension, caused by stress and overwhelming thought processes, through her practise of relaxation. On another occasion she mentioned how breath awareness and simple meditation techniques were helping her deal with a life changing situation. The young mother went on to report that her consultant was impressed with the improvement of mobility in her arm and shoulder following surgery and treatment which she attributed to the combination of movement and relaxation practised in the yoga class. It was only at this point that she disclosed that she was recovering from cancer. Over the following months the young woman went on to report that following radiotherapy her respiration had been restricted which she was able to improve through yoga breathing techniques. She was also relieved that she could control her recurring lymphoedema through yoga asana, especially pawanmuktanasana 1. The young woman’s experiences inspired me to invite a small group of women to a ten-week yoga course to further explore any possible benefits of yoga after the diagnosis of cancer. The participants described what they learned in Yoga as a Form of Support for Women following Breast Cancer.1 Some of their experiences may resonate with others going through periods of ill-health.
A sudden shift from health to illness, as is often the case with cancer, provides individuals with little former experience of appropriate coping strategies to draw upon. Coping skills are accessed in an effort to ‘self regulate’ back to the former state of well-being. An individual’s demographic, personal, cultural, social, environmental and illness related factors are variables which help determine the choice of coping mechanisms.2 Health Psychology suggests that coping strategies often require a process of cognitive restructuring. The process is particularly applicable in serious illness, where a re-evaluation of life is often reported. One participant described how her changing perspectives following treatment were supported through her yoga practice:
It’s made me like a chameleon. Yoga has made me really think about my adaptation to the depths and widths of my experience. It made me take stock. I don’t over extend myself now, as I would before. I do what I can within my own capacity. I’m at peace with myself. Life’s for now.
In recognition of the mental, emotional and physical changes that impact on individuals following the diagnosis and treatment of cancer it is recommended that psychological, social and practical support is available at all stages of the illness. On a personal level, the exploration of different ways of understanding the body and self care are often described by individuals as part of their overall coping strategy following the diagnosis of cancer. The French historian and philosopher, Foucault, described the biomedical view of the solid visible body predominantly held in the West as only one way, neither the first nor most fundamental, to understand disease.3 Conversely, many Eastern traditions hold common themes in their understanding of health and illness. They are holistic, and so recognise the interrelatedness and pervading subtle energy of all things. They are also relativistic, focusing on the illusory nature of time and form. Further Eastern tradition, as in shamanism, views all sentient beings as sharing the continuum of physical, mental, emotional and spiritual aspects.4 In these traditions homeostasis is reached by bringing the interrelatedness of existence into direct experience through breathing, postural adjustment, meditation, diet and relationships with others.5 Friedeberger stresses that care is required when oversimplifying causes of illness, as well as the success or failure of overcoming illness, as this can be unhelpful for the person trying to cope with the health problem. For example, she goes on to suggest that simple explanations of illness in terms of the law of karma can sometimes be used to account for sickness of the body and mind. However, karma refers to a complete Eastern philosophy in which yoga is embedded and can be widely misunderstood. Simplistic theorising may: Enthrone the individual at the absolute centre of the universe, whilst ignoring everyone else in it, as well as the enormous variety of factors that affect our lives over which we have no control.6 A broader perspective of the factors underlying health and illness engenders respect of individuals’ own choices of self care and treatment whilst reserving judgement on the causes of ill-health.
During the ten-week yoga course the ladies practised simple yoga asana including pawanmuktanasana part 1; relaxation and yoga nidra; simple pranayama and breath awareness including meditative techniques. Through these practices, the ladies confirmed learning about managing fatigue; improving mobility to the arm and shoulder following surgery and treatment; help with pain and insomnia; improved self esteem; a sense of being more in control of their body and mind and ways of managing mental and emotional challenges. Additionally they experienced social support from attending a group which did not focus on their illness. Some of the women’s own experiences follow.
Fatigue, as a result of the illness and a side-effect of treatment, was reported as having a significant impact on participants’ lives ranging from changes in their work commitments to the inability to climb stairs without having to rest halfway. All of the ladies reported some benefit from yoga practices in their personal effort to combat fatigue. One lady explained:
I have noticed a difference. I definitely feel better. I am finding that I can walk up hills with ease. I can walk up without having to struggle to breathe.
All of the participants, with the exception of one, indicated discomfort or limitations with movement of their arm or shoulder following surgery and treatment. Although the ladies had been given exercises by their physiotherapists the motivation to continue the routine at home was sometimes a struggle. They described the physical benefits of attending the class:
Even though I did all the exercises that the physiotherapist told me to do whilst in hospital, I didn’t realise how poor my muscle control was following treatment until I came to the yoga class. You become more aware of your body, what it can do and what it can’t do with yoga.
I was amazed at the gentleness of yoga and the way you were led into it. I was amazed at some of the things I could do that I couldn’t do before.
Relaxation, meditation and breath awareness have been used in clinical situations to help people manage various health conditions. There is strong evidence to suggest that relaxation helps to reduce some side-effects of cancer treatments and pain7 and that meditation and breath awareness help to reduce anxiety and improve mood state.8 The participants observed that it is possible to develop different perspectives on personal cognitive processes when practising awareness of one’s thoughts and emotional responses during the above yoga practices:
Yes, I had a bad day yesterday. I woke up in a lot of pain and I did have a little panic. I thought, ‘What’s happening now?’. Then I decided I would try to relax. So I did try and it does help.
It started off with really trying to get control of my mind with breath awareness, because your mind is just skitting around and to keep it still for a second is wonderful. You can think more clearly.
The meditation surprised me in that I was able to switch off within a short period of time and I could feel the benefit.
There was no pressure for women to disclose personal experiences if they did not wish to do so; the classes focused on helping their own body and mind deal with cancer and its effects. In this relaxed situation an additional benefit of the class was that women chose to share some of their fears and problems with others for the first time. Studies indicate that improved mental and physical well-being can be linked to social support.9 A number of participants referred to coping with a sense of isolation after diagnosis and how the group had helped them:
I think something like relaxation is very, very useful – together with the support. I don’t think there’s anything as bad as feeling isolated in traumatic circumstances. Because what does anyone know about this illness unless they have to live with it or unless they meet it?
You know, I thought that I was the only one that had gone to pieces and that I would panic if anything else happened. But they all do. I was amazed.
It is known that cancer patients need a range of support and practical help in areas where they experience particular difficulties.10 The need for a shift in the approach to care and support for people affected by cancer– to a greater focus on recovery, health and well-being after cancer treatment is recommended in government health policy11. Self-help provides a sense of control in a situation in which many aspects of personal autonomy and dignity may be challenged. The British Medical Journal reported: The successful focus on medicine on specific disease interventions has meant relative neglect of healing and holism, and from this shadow complementary medicine has emerged, with its counterpointing biases. The gap between them is, however, narrowing with the emerging view, backed by the study of placebo and psychoneuroimmunology, that to ignore whole person factors is unscientific and less successful.12. The learning shared by participants in the study Yoga as a Form of Support for Women following Breast Cancer adds to the growing body of evidence that recognises yoga practices can provide practical ways of addressing this gap.
Published in Mandala Yoga Ashram Newsletter 2012
1. Robinson S (2001) Yoga as a Form of Support Following Breast Cancer. BA (Hons) Health Studies. Manchester Metropolitan University.
2. Moos R H and Schaefer J A (1984) The Crisis of Physical Illness : An Overview and Conceptual Approach. In R H Moos Ed Coping with Physical Illness. New Perspectives. 2 3-25 New York : Plenum Press.
3. Foucault M (1973) The Birth of the Clinic : An Archaeology of Medical Practice. New York : Pantheon.
4. Jung C G (1978) Psychology of the East New Jersey : Princeton University Press.
5. Graham H (1998) Complementary Therapies in Context : The Psychology of Healing London : Jessica Kingsley.
6. Friedeberger J (1996) A Visible Wound A Healing Journey Through Breast Cancer. Shaftesbury : Element Books.
7. Department of Health (1997) Guidance for Purchasers. Improving Outcomes in Breast Cancer: The Research Evidence. London : Department of Health.
8. See The Body/Mind Medical Institute at Harvard University www.massgeneral.org/bhi.
9. Spiegal D (1998) Living Beyond Limits : New Hope and Help for Facing Life-Threatening Illness. London : Vermillion.
10. Department of Health (1996) Improving Outcomes in Breast Cancer – The Manual : A Policy Framework for Commissioning Cancer Services – Report of the Expert Advisory Group. EL (96) 15 London : Department of Health.
11. DH; Macmillan Cancer Support & NHS Improvement (2010) The National Cancer Survivorship Initiative Vision.
12. Reilly D (2001) Enhancing Human Healing. British Medical Journal 322: 120-121, 20 January.
Shelley Robinson
My first experience of the benefits of yoga for cancer occurred when I taught a general hatha yoga class at a local school. A young mother attending this class reported a wide range of progress over a period of time. Her first comment was about the relief of physical tension, caused by stress and overwhelming thought processes, through her practise of relaxation. On another occasion she mentioned how breath awareness and simple meditation techniques were helping her deal with a life changing situation. The young mother went on to report that her consultant was impressed with the improvement of mobility in her arm and shoulder following surgery and treatment which she attributed to the combination of movement and relaxation practised in the yoga class. It was only at this point that she disclosed that she was recovering from cancer. Over the following months the young woman went on to report that following radiotherapy her respiration had been restricted which she was able to improve through yoga breathing techniques. She was also relieved that she could control her recurring lymphoedema through yoga asana, especially pawanmuktanasana 1. The young woman’s experiences inspired me to invite a small group of women to a ten-week yoga course to further explore any possible benefits of yoga after the diagnosis of cancer. The participants described what they learned in Yoga as a Form of Support for Women following Breast Cancer.1 Some of their experiences may resonate with others going through periods of ill-health.
A sudden shift from health to illness, as is often the case with cancer, provides individuals with little former experience of appropriate coping strategies to draw upon. Coping skills are accessed in an effort to ‘self regulate’ back to the former state of well-being. An individual’s demographic, personal, cultural, social, environmental and illness related factors are variables which help determine the choice of coping mechanisms.2 Health Psychology suggests that coping strategies often require a process of cognitive restructuring. The process is particularly applicable in serious illness, where a re-evaluation of life is often reported. One participant described how her changing perspectives following treatment were supported through her yoga practice:
It’s made me like a chameleon. Yoga has made me really think about my adaptation to the depths and widths of my experience. It made me take stock. I don’t over extend myself now, as I would before. I do what I can within my own capacity. I’m at peace with myself. Life’s for now.
In recognition of the mental, emotional and physical changes that impact on individuals following the diagnosis and treatment of cancer it is recommended that psychological, social and practical support is available at all stages of the illness. On a personal level, the exploration of different ways of understanding the body and self care are often described by individuals as part of their overall coping strategy following the diagnosis of cancer. The French historian and philosopher, Foucault, described the biomedical view of the solid visible body predominantly held in the West as only one way, neither the first nor most fundamental, to understand disease.3 Conversely, many Eastern traditions hold common themes in their understanding of health and illness. They are holistic, and so recognise the interrelatedness and pervading subtle energy of all things. They are also relativistic, focusing on the illusory nature of time and form. Further Eastern tradition, as in shamanism, views all sentient beings as sharing the continuum of physical, mental, emotional and spiritual aspects.4 In these traditions homeostasis is reached by bringing the interrelatedness of existence into direct experience through breathing, postural adjustment, meditation, diet and relationships with others.5 Friedeberger stresses that care is required when oversimplifying causes of illness, as well as the success or failure of overcoming illness, as this can be unhelpful for the person trying to cope with the health problem. For example, she goes on to suggest that simple explanations of illness in terms of the law of karma can sometimes be used to account for sickness of the body and mind. However, karma refers to a complete Eastern philosophy in which yoga is embedded and can be widely misunderstood. Simplistic theorising may: Enthrone the individual at the absolute centre of the universe, whilst ignoring everyone else in it, as well as the enormous variety of factors that affect our lives over which we have no control.6 A broader perspective of the factors underlying health and illness engenders respect of individuals’ own choices of self care and treatment whilst reserving judgement on the causes of ill-health.
During the ten-week yoga course the ladies practised simple yoga asana including pawanmuktanasana part 1; relaxation and yoga nidra; simple pranayama and breath awareness including meditative techniques. Through these practices, the ladies confirmed learning about managing fatigue; improving mobility to the arm and shoulder following surgery and treatment; help with pain and insomnia; improved self esteem; a sense of being more in control of their body and mind and ways of managing mental and emotional challenges. Additionally they experienced social support from attending a group which did not focus on their illness. Some of the women’s own experiences follow.
Fatigue, as a result of the illness and a side-effect of treatment, was reported as having a significant impact on participants’ lives ranging from changes in their work commitments to the inability to climb stairs without having to rest halfway. All of the ladies reported some benefit from yoga practices in their personal effort to combat fatigue. One lady explained:
I have noticed a difference. I definitely feel better. I am finding that I can walk up hills with ease. I can walk up without having to struggle to breathe.
All of the participants, with the exception of one, indicated discomfort or limitations with movement of their arm or shoulder following surgery and treatment. Although the ladies had been given exercises by their physiotherapists the motivation to continue the routine at home was sometimes a struggle. They described the physical benefits of attending the class:
Even though I did all the exercises that the physiotherapist told me to do whilst in hospital, I didn’t realise how poor my muscle control was following treatment until I came to the yoga class. You become more aware of your body, what it can do and what it can’t do with yoga.
I was amazed at the gentleness of yoga and the way you were led into it. I was amazed at some of the things I could do that I couldn’t do before.
Relaxation, meditation and breath awareness have been used in clinical situations to help people manage various health conditions. There is strong evidence to suggest that relaxation helps to reduce some side-effects of cancer treatments and pain7 and that meditation and breath awareness help to reduce anxiety and improve mood state.8 The participants observed that it is possible to develop different perspectives on personal cognitive processes when practising awareness of one’s thoughts and emotional responses during the above yoga practices:
Yes, I had a bad day yesterday. I woke up in a lot of pain and I did have a little panic. I thought, ‘What’s happening now?’. Then I decided I would try to relax. So I did try and it does help.
It started off with really trying to get control of my mind with breath awareness, because your mind is just skitting around and to keep it still for a second is wonderful. You can think more clearly.
The meditation surprised me in that I was able to switch off within a short period of time and I could feel the benefit.
There was no pressure for women to disclose personal experiences if they did not wish to do so; the classes focused on helping their own body and mind deal with cancer and its effects. In this relaxed situation an additional benefit of the class was that women chose to share some of their fears and problems with others for the first time. Studies indicate that improved mental and physical well-being can be linked to social support.9 A number of participants referred to coping with a sense of isolation after diagnosis and how the group had helped them:
I think something like relaxation is very, very useful – together with the support. I don’t think there’s anything as bad as feeling isolated in traumatic circumstances. Because what does anyone know about this illness unless they have to live with it or unless they meet it?
You know, I thought that I was the only one that had gone to pieces and that I would panic if anything else happened. But they all do. I was amazed.
It is known that cancer patients need a range of support and practical help in areas where they experience particular difficulties.10 The need for a shift in the approach to care and support for people affected by cancer– to a greater focus on recovery, health and well-being after cancer treatment is recommended in government health policy11. Self-help provides a sense of control in a situation in which many aspects of personal autonomy and dignity may be challenged. The British Medical Journal reported: The successful focus on medicine on specific disease interventions has meant relative neglect of healing and holism, and from this shadow complementary medicine has emerged, with its counterpointing biases. The gap between them is, however, narrowing with the emerging view, backed by the study of placebo and psychoneuroimmunology, that to ignore whole person factors is unscientific and less successful.12. The learning shared by participants in the study Yoga as a Form of Support for Women following Breast Cancer adds to the growing body of evidence that recognises yoga practices can provide practical ways of addressing this gap.
Published in Mandala Yoga Ashram Newsletter 2012
1. Robinson S (2001) Yoga as a Form of Support Following Breast Cancer. BA (Hons) Health Studies. Manchester Metropolitan University.
2. Moos R H and Schaefer J A (1984) The Crisis of Physical Illness : An Overview and Conceptual Approach. In R H Moos Ed Coping with Physical Illness. New Perspectives. 2 3-25 New York : Plenum Press.
3. Foucault M (1973) The Birth of the Clinic : An Archaeology of Medical Practice. New York : Pantheon.
4. Jung C G (1978) Psychology of the East New Jersey : Princeton University Press.
5. Graham H (1998) Complementary Therapies in Context : The Psychology of Healing London : Jessica Kingsley.
6. Friedeberger J (1996) A Visible Wound A Healing Journey Through Breast Cancer. Shaftesbury : Element Books.
7. Department of Health (1997) Guidance for Purchasers. Improving Outcomes in Breast Cancer: The Research Evidence. London : Department of Health.
8. See The Body/Mind Medical Institute at Harvard University www.massgeneral.org/bhi.
9. Spiegal D (1998) Living Beyond Limits : New Hope and Help for Facing Life-Threatening Illness. London : Vermillion.
10. Department of Health (1996) Improving Outcomes in Breast Cancer – The Manual : A Policy Framework for Commissioning Cancer Services – Report of the Expert Advisory Group. EL (96) 15 London : Department of Health.
11. DH; Macmillan Cancer Support & NHS Improvement (2010) The National Cancer Survivorship Initiative Vision.
12. Reilly D (2001) Enhancing Human Healing. British Medical Journal 322: 120-121, 20 January.
