Observation

There are always many sides to an object or issue at hand. If we take a cylindrical can and only observe from the top we will see a circle.  If we only view from the side we see a rectangle. To get a more clear and accurate picture, we must observe from all angles.

Our first featured discussion is on the topic of observation. As yoga therapists, what do you look for when working with your clients/patients/students? We are fortunate to present vantage points from three health professionals each specializing in physical therapy, Ayurveda, and chiropractic.

And because our perceptions are typically a reflection of our own personal experiences, background, and education, we ask that you too share your own views on the topic of observation.

 

Master teachers share their unique views and welcome your feedback

_ObservationAuthors


Observing Observing

by Matthew J. Taylor, PT, PhD, ERYT-500, YTRX

I’m grateful to Larry for the invitation to submit a posting on the topic of observation. In that spirit of gratitude, please bear with me as I offer some thoughts from a somewhat different perspective (he’d be disappointed if I didn’t!).

To begin, let’s “look” at the origin of the word:

      ob•ser•va•tion   [ob-zur-vey-shuh  n]  noun   from L. observationem (nom.
observatio) “a watching over,”: 1.)  an act or instance of noticing or perceiving;
regarding with attention, especially so as to see or learn something.
1

What initially stands out to you in that definition? For me, the very yogic “watching over” or witness perspective leaps out. But with extended “attention” I “see” additional “somethings” that demand more noticing. Sit a moment resting your attention over those words…what do you see or what deeper “learnings” emerge? Allow me to share a few that I suspect may enhance your skills as a yoga therapist.

Three questions came forward for me: a) WHO is watching?; b) WHAT is the intention of the watcher?; and, c) What do we DO with what is learned? Allow me to preface my answers by sharing my bias (i.e. places from where I observe.) As a “recovering” physical therapist, I’ve written passionately about the risks of accidently falling into the western mechanical model as a yoga therapist here in the article titled, A Fork in the Road.  If you’ve been raised in the USA, this paradigmatic black hole almost certainly affects your ability to observe as yoga therapist. Here’s how and what you might do to YRx yourself!

WHO is watching?

If we buy into this unity-stuff, immediately we learn that my ahimsic me observing the ahimsic you is really the same bit o’consciousness discovering his/her-self. And isn’t that the entire point of how YRx is different from other therapeutic approaches? We arrive to remember we’re connected and whole already, NOT broken and separate. Practical Teaching Points: a) As you begin to “observe” first notice the three previously posed questions in that moment as they apply to you; b) How does what you notice in the other apply to YOUR ahimsic self?; and, c) Consider how you will create an environment for the student to safely observe themselves without deepening their story of separateness/brokenness by telling them your observations? Grant them the gift of skillful self-observation.

WHAT is the intention of the watcher?

As the therapist what is your intention as you begin to observe? To find some brokenness? To “fix” the other? To hold yourself and the other in compassion? Feel the visceral difference as you re-read these three options. Ah the game of being in control. If I just study with Swami Salami and learn his techniques, then I will be a great therapist! Really? Sense the slippery slope of intention as you begin to observe. Practical Teaching Points: a) Can I soften my eyes and heart to perceive (not get) all of the koshic layers of myself and those who I might mistake as the other?; b) Can I remain soft as I then watch over to have deeper insight into how to best “be” with the student versus “do to” the student?; and, c) Are those intentions really enough? I’ve learned so many other ways to fix.  Really? Can I trust that emergent property of observation “to see or learn something”? (Yes, you can by the way!)

What do we DO with what is learned?

You know all that stuff we wonderful faculty members have taught you about observation and how you need to know it? Well, spoiler alert, observing weak muscles, high shoulder, and crooked backs and then creating a fixing program based on those observations DOES NOT alleviate the pain or suffering according to the best and more thorough analyses of scientific evidence! WTH(eck)? Yep, read the evidence research (not case studies or low level evidence). Fixing posture doesn’t predictably correct pain. No joke! Now how are you breathing? And you thought you hadn’t fallen under the force of the black hole of control? (This is why Larry pays me the big bucks…) What now? Well, consider these Practical Teaching Points: a) Take these 3 questions into every observation; b) Watch over you and them with deep compassion; and, c) Soak in the bliss of observation as you remember both you and they are the watcher.

Happy Observations!

Namaste,  Matt

Submitted by Matthew J. Taylor, PT, PhD, ERYT-500, past president of IAYT and www.drofyoga.com .

1. observation. (n.d.). Online Etymology Dictionary. Retrieved May 03, 2013, from Dictionary.com website: http://dictionary.reference.com/browse/observation


Observation—An Ayurvedic Perspective

By Felicia Tomasko RN, E-RYT 500, YTRX

The slump of one shoulder, patterns of lines on the face, cuticles stripped of skin, fuzzy coating on the tongue, the rapid analysis of a problem, or the rambling storytelling that flits from topic to topic. These are only a few of the observations I may make in the first moments of sitting with someone, whether in a therapeutic setting or even during a lunch with friends.

Within the philosophy and practice of Ayurveda, literally everything about a person tells us something that we may need to know. It provides us information that clues us in on a person’s constitution (their prakriti or “true nature”) as well as their current state of balance and imbalance. We may observe the sound of their voice, the clarity and color of the eyes, the complexion of the skin, the patterns of lines, a sunburn, a curl of the hair, leaning on one hip while sitting, or one foot while standing. The information is endless. We can certainly filter for the details that are important and the signatures that stand out to compile a meaningful story that may help us facilitate transformation, feel ease in the body, and to pursue optimal health and well-being.

Observation is like a muscle, I was taught in my studies of Ayurveda. It requires attention, flexion, and participation. We were instructed in how to encourage people to stick out their tongue and to read what is written there—hints to the functioning of the digestive system, the state of the spine, or even information about what the body may be holding.
I practice these skills just about every day, whether I’m having lunch with a friend, meeting with a client, or teaching a group class. Before I share any observations, I ask for permission as I don’t want my suggestions or thoughts to seem intrusive.

These skills are honed from learning the systems and recognizing patterns. They are acquired from sitting in my teacher’s clinic, spending hours in the company of other students, comparing and contrasting notes, and confirming hunches by asking questions.

Recently, I’ve talked to a friend after a meeting about the tale of not doing enough to balance the constant travels that was told in his hands. I’ve gently suggested to someone with drawn lips to consume more oil, someone with a coated tongue to drink more hot water, someone with a wavering voice to find ways to become more grounded, and someone with twisted/rotated hips to examine their posture while driving and notice if they tend to lean to one side, favoring or slouching into one part of the body.

As yoga therapists, we may look for askew knees, rigid joints, hiked up shoulders, tense neck, etc. When we widen our gaze and peer through the lens of Ayurveda, we can see an entire universe of information.
Since the practice of Ayurveda has become embedded in my life, I apply it to myself often. I begin the day by examining my tongue in front of the mirror to take stock of the current situation and then use that information to decide what to eat for breakfast, what to drink, and how to adjust my practice to release the tension that my tongue may confirm to me that I feel. It’s validation for intuition and this vision provides me the permission to make adjustments in my routine.
One of my favorite arts that I’ve learned from the study of Ayurveda is this powerful and potent art of observation. It offers the encouragement to look deeply into the form, the eyes, and the very being of another person to discern energetic patterns and to gain insight into the ever-elusive and playful means of maintaining balance in the maelstrom of everyday life. The constantly changing cycles that make up this world mean that we must always be flowing in motion with the energetic shifts and patterns. Pausing and observing allows us to move forward with clarity.

Felicia Tomasko, RN, E-RYT 500 teaches on the faculty of Loyola Marymount University’s Yoga Therapy RX Program. She is the editor in chief at the Bliss Network producing LA YOGA Ayurveda and Health and Find Bliss Magazines. Felicia serves on the board of directors of the National Ayurvedic Medical Association.


Observation

By Rick Morris DC, CYT, YTRX

Ms. Brenson, your 10o’clock yoga therapy patient, arrives 20 minutes late, seems harried and chatters with little focus as you take her case history.

She records her pain level as a 12, out of a 0-10 pain scale.  When describing her areas of pain, she leaves few places unmentioned, and most are above 7.

You notice the incongruence as she easily gets up from the chair, walks at full speed and comfortably bends and twists.  The observation portion of your examination has already started.

Observation is an essential examination tool that improves with experience and attention.  Since Yoga Therapists emphasize the mind, body and breath, let’s see how our observation skills might apply.

The Mind

You probably observed that Ms. Brenson doesn’t seem very peaceful or focused.  She arrives late, chatters with little purpose and her subjective factors (e.g. pain scale) don’t seem to match her objective findings (e.g. ability to stand, move and walk).

While these factors may be congruent, we should look deeper into her elements of well-being.

Many with “Subjective-Objective Incongruence” incorrectly assume the client just wants the attention that a physical illness will bring. While this may be true, in my experience, it’s more likely brought on by the fear of their condition or its effects (e.g. inability to support themselves, find love or the dread of aging).  Excessive fear can turn tolerable annoyances into overwhelming mental obsessions.

Denial is also a serious problem that needs to be addressed.  In fact, some clients may choose to see you over a doctor just to avoid thinking of their problem as serious. These clients describe their pain levels unrealistically low while grimacing during minimal activities (e.g. getting out of a chair, walking or performing simple postures), and minimizing its effect on their lives.  They’ll need to be correctly assessed and referred to the right doctor, while helping them center their minds and handle their fears.

Other clients may have anger issues that greatly affect their relationships and overall health.  They often show significant objective improvements over the course of treatments, yet they constantly complain otherwise.  And showing the pre and post treatment results rarely deter them.

The Dartmouth-Coop Test in The Morris-Payne Yoga Therapy Exam

is a very effective tool in measuring your client’s state of well being and forging a real partnership in finding some solutions together.

The Body

Yoga therapists and chiropractors know well the association between structure and function.  In this article, we will discuss observation of the spine.

The Neck

The ears should be over the center of the shoulders.  An anterior head posture strains the posterior neck muscles as it requires greater strength supporting the head, shortens the neck extensor muscles and compresses the cervical-cranial junction.  A rounded thoracic spine and low computer monitor are common culprits.

The Middle Back

Our chest should be pointing straight ahead.  Aging, large breasts, low computer monitors and lanky torsos all lead to excessive thoracic rounding (kyphosis).  This leads to thoracic compression fractures, cervical, thoracic and occipital pain.

The Low Back

The low back can be excessively arched, flattened or rotated as can the rest of the spine but this is especially notable in the lumbar region).

Excessive arching or lordosis can “jam” the spine together and compress the facets and nerves.  Not only is it visible, but bending the client backwards at the waist will often increase their low back or leg symptoms.  Weak abdominal or constricted low back muscles can accentuate it. Postures that increase the curvature (e.g. the cobra and locust poses) may be counterproductive.

Flattening of the low back curve occurs often in disc herniations, excessive sitting (with poor low back support) and tight hamstrings.  If it’s a problem, forward bends and strenuous flexion postures may be irritating.

Correcting these postural faults with awareness and yoga postures is a natural fit.

Frontal Inspection

The shoulders, iliac crests and gluteal folds should be level.  This can be observed by watching the patient from the front and the back, standing and bending forward.  Leg length discrepancies, spinal anatomical abnormalities and biomechanical faults from poor posture or injuries are the usual causes.  You may want to correlate this with a standing x-ray.  A heel lift may be necessary as are stretches that correct the asymmetry (e.g. spinal twist with posteriorly rotated side down to help correct the rotation).

Breath

Breathing should normally be relaxed, without notable wheezing, visible diaphragmatic expansion on inspiration and a slightly longer expiration.   Note if the neck muscles stay relaxed and unengaged.   The rate will vary at rest, but 6-15 breaths per minute is desirable.

The Ohm Test, in The Morris-Payne Yoga Therapy Exam, can be used to measure before and after lung capacity.

StdEvalDVD2

Yoga Therapy is the assessment and improvement of mind, body and breath. Although tests give important results, it’s what you observe during and between the tests that complete the story.

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