OT and Yoga, An Amazing Alliance
Katie Schroeder-Smith, MOT, OTR/L has practiced occupational therapy for over 13 years after studying psychology at UNC Chapel Hill and receiving her Masters in OT at Nova Southeastern University. Katie is certified in sensory integration (SIPT) and has received advanced training in pediatric and therapeutic yoga, handwriting, and Therapeutic Listening. She has diverse experience with all ages from infants to adults in home-based, school-based, and clinic-based settings, as well as hospital and nursing homes. Katie sees patients for Baker Rehab Group as an independent contractor, which allows her to work for a number of different providers in a variety of settings. Her contribution to the BRG OT network has been invaluable.
What do occupational therapy (OT) and yoga have in common?
First of all, to define occupational therapy, it is helpful to know that the “occupation” part actually comes from the verb: to occupy oneself, purposefully, meaningfully, and driven by ones own motivation and goals. Dysfunction, occupationally speaking, could occur in any aspect of one’s purposeful life.
There’s physical dysfunction (perhaps a person is limited by chronic back pain, arthritis, a heart condition or a broken bone) and psychological dysfunction (depression, anxiety, dementia, autism, ADHD).
Dysfunction may even occur at a deeper level, where a person has lost motivation and goal oriented activity, or has perhaps been enabled by learned helplessness or perceived inability. Dysfunction may result from a mismatch between a person and his/her environment. Think of an elderly individual with severe arthritis and osteoporosis who lives in a 3-story row home with narrow doorways, or how about a child with ADHD who lives in a disorganized house without family support who frequently loses his homework.
Dysfunction can present itself in activities of daily living—think again of the arthritic woman who can no longer dress herself or carry things up and down the stairs, or the child with ADHD who cannot sequence his morning routine. It can present in work related tasks– the woman who has poor balance in standing to cook a meal for her family, the child who struggles to sit still or write a sentence in school; or in leisure tasks- the woman who cannot perform her favorite hobbies of needlepoint and gardening, the child who has difficulty participating in organized sports.
However, as the American Association of Occupational Therapy (AOTA, www.aota.org) points out, OTs ask a client “what matters to you?” rather than “what’s the matter with you?”
When a person is not well for whatever reason, he/she often experiences a disintegration of body, mind and spirit, and what matters to that individual is not always readily apparent to even that person. The individual who suffered a stroke must now learn to function inside a body where he can only control one arm and one leg, struggling with basic skills such as rolling over in bed, using the toilet and brushing his teeth. Ask that person what matters to him now, and it’s not yet golf or returning to work; it’s simply walking, talking, and eating.
Yoga can be defined simply as “unity”. Unity of body, mind and spirit. As an OT, I can’t help but extrapolate that to unity of person and environment, unity of person and task, unity of person and person. Yoga is a discipline, traditionally based in eastern philosophy. Occupational therapy, using principles, strategies and poses from this ancient holistic perspective, merges beautifully with the foundations on which the profession of occupational therapy was built. Looking at a person holistically, the OT with a yoga perspective will consider the following 5 tenets of yoga: relaxation, exercise, breathing, eating and positive thinking.
Relaxation, noticeably important in cases of anxiety or stress, is also very significant to recovering from a physical injury. I haven’t met a person with an orthopedic injury who doesn’t tense up or compensate with other muscles. Yoga can help develop body awareness and coping strategies to relax the muscles that don’t need to work, and focus on working the ones that need it. Yoga can also help a child or adult with self-regulation, or learning how to find that calm alert state for optimal attention, focus, and social skills.
Exercise is perhaps the most obvious similarity between yoga and OT as a rehabilitation profession. What is special to yoga however is even the most basic poses require the use of core muscles, those abdominal and spinal muscles that provide stability and alignment for all of life’s activities and movements. Yoga, as a form of exercise, can also be easily adapted to all ages, from infancy to the oldest of adults, and can be graded to the individual’s needs and abilities.
Perhaps one of the most significant contributions of yoga is its focus on breathing. Learning proper breathing methods is critical to those with cardiovascular and respiratory conditions, of course, but it is also crucial for both relaxation and exercise to properly occur. Focusing on the breath allows one to be in the present moment, engaging in an occupation of choice. Breathing techniques are also one of the most effective strategies for self calming, an area that many kids on the autism spectrum or with sensory sensitivities struggle with.
Eating, as a vital activity of daily living is an area that OT traditionally focuses on with regard to independence, adaptation, meal preparation, or oral motor skills/ swallowing. Using a holistic yoga perspective, which foods a person eats and how they regulate their eating patterns also becomes important.
Lastly, positive thinking seems like a no- brainer, for any professional looking to help and heal others. Through the principle of non-judgment and use of strategies such as meditation and positive affirmations, yoga is a wonderful adjunct to OT as a client deals with frustration and patiently works towards his/her goals.
OTs use occupation as both and ends and a means. Simply stated, not only is the person working on a goal in one or more areas of his occupation (I.e. Putting a shirt on independently) but as a means of achieving that goal.
One of my favorite quotes about OT comes from a renowned OT, Mary Reilly: “Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.”
There is more to occupations than activities, purpose, and meaning. Occupations affect our health. What we choose to do, or not do, to occupy our time, profoundly influences our health. Occupations change and evolve over our lifetime, and are most definitely influenced by illnesses, traumatic events, or injuries that occur along the way.
My father was always an avid skier until he had a bad fall and broke his leg. Physically he could have returned easily to the sport after recovering, but his motivation to engage in this was severely changed by his traumatic experience. Luckily, he found other healthy occupations to replace this one.
Yoga can be a healthy, doable replacement for occupations that were unhealthy, impractical, or no longer enjoyable. Yoga can also be a therapeutic means in which to reach another occupational goal, for example improving posture to be able to sit upright to feed oneself, or to optimize focus in the classroom. Last but not least, yoga can be a lifestyle change, in which it is integrated into daily life routines to positively influence health, decrease stress, and improve performance of occupations throughout the life span.
I did not even mention all of the research pointing to the benefits of yoga for health, various medical conditions, and in school age children, to name a few. Look for another post in the near future!