Bridge in Spring by Marie Lossky (@Marie.Lossky on Instagram)
Often when we use the toilet, we’re in a hurry and rushing with the attitude of “just get this over with—I have something important waiting” or our minds are elsewhere as we are texting or reading, which distract us from our present intention of the moment: to empty and eliminate.These poor toileting habits could contribute to problems associated with not fully emptying the bowel or bladder, or to issues related to a non-relaxing pelvic floor, where the pelvic floor muscles are over-recruited and not fully relaxing or releasing as they should during voiding. This may potentially lead to or exacerbate a variety of pelvic health issues, such as irritable voiding symptoms, incontinence, chronic constipation, chronic pelvic pain, and low back pain.
Being fully present and aware of our body, breath, mind, and emotions when we use the toilet can potentially help relax the pelvic floor muscles (PFMs), resulting in successfully completing our task. There is even preliminary research suggesting the positive and promising effects of Mindfulness Based Stress Reduction on pelvic health conditions such as urinary urge incontinence (see Baker et al 2014 ), chronic pelvic pain (see Crisp et al 2016 ), and, specifically, interstitial cystitis and bladder pain syndrome (see Kanter et al 2016). We talk about mindfulness during many everyday activities, such as driving, walking, exercising, eating, socializing, and so on, so why not also be mindful while going to the bathroom?
Knowledge of this information, combined with my training and experience of integrating medical therapeutic yoga with my physical therapy practice and working with patients suffering from pelvic floor dysfunctions who had difficulty relaxing during voiding, inspired me to create this toilet meditation.
Patients, yoga students, and pelvic health practitioners that I have shared this with seemed to really enjoy it, found it easy to practice and teach, and reported that it was helpful. It consists of six stages, which I’ve labeled using the acronym AIRBAG to help you remember.
Practicing the Toilet Meditation
If you are sitting on the toilet, it is a good idea to place your feet up on some blocks so that your knees are slightly higher than your hips. This position can help your pelvic floor muscles relax and allow for proper elimination, particularly for bowel movements. If you are standing during urination, you can still perform the six toilet AIRBAG meditation stages.
A = Awareness. Start by becoming present and connected to your body as best as you can. Quickly scan your body from head to toe, simply observing sensations that you may be experiencing, without judgment, both internally (interoceptive awareness) and externally (such as the sensations at the soles of the feet weight bearing on the supporting surface, or sensations at the thighs as they weight bear on the toilet seat, or how you are holding your arms, or any tension in the jaw or shoulders). You may include also awareness of thoughts and emotions, without elaborating on a story or analyzing.
I = Imagine. Next, as you start to empty your bladder and/or bowels, use your visualization skills to imagine your pelvic floor and the general area of attachments of the pelvic floor muscles to the inside of the front, sides and back of your pelvis, tailbone, and sacrum. Visualize where your bladder and bowel are positioned, and imagine them emptying and that the pelvic floor muscles spanning across your pelvic floor are healthy and functioning optimally.
R = Release and Relax. Let go of any tension in your pelvic floor muscles, as best as you can. Releasing and relaxing these muscles can sometimes be difficult for a variety of reasons, and sometimes trying “too hard” to relax and let go creates even more tension. So be patient and compassionate towards yourself if you have trouble with this. Letting go often takes courage, trust, concentration, and practice.
B = Breathe. Allow your natural breath pattern to emerge. Sometimes when we try to breathe, we create more tension, which results in unnatural patterns that do not serve a relaxed state. As you quietly inhale, your belly will naturally protrude outwards or forward and your pelvic floor will descend. As you exhale, your belly and pelvic floor muscles will return to their resting positions. While you are emptying your bladder and/or bowels, see if you can simply allow the quiet rhythm of your abdomino-pelvic diaphragmatic breath to happen on its own without trying to change it.
A = Allow. This stage involves a little more than just releasing and relaxing or allowing your breath to happen on its own. See if you can really give yourself permission to trust that your body knows what to do and when to do it. Perhaps you feel the need to push gently (do not strain) or you feel like you want to take a deep breath, sigh out loud, lean forward, or place your feet in a different position. The more refined your awareness skills are, the more you can trust what feels right, and not always what you think you should do.
G = Gratitude. I think it is a healthy practice to not only be completely present and mindful when toileting, but to also honor this sophisticated and truly complex function that our body does for us on a daily basis without us even asking it to. So each time you complete your toileting practice, I invite you to send a little gratitude to your body and all its incredibly phenomenal parts to end your toilet meditation!
For those of you who are interested in learning more about this, a full guided Toilet Meditation (with music and breathtaking cinematography) is included in my “Creating Pelvic Floor Health with PhysioYoga” practice sessions, which consist of a combination of physical therapy based exercises and yoga methods targeted to optimize pelvic floor health.
Shelly has been integrating yoga into her physical therapy treatments since 1998, addressing a wide variety of conditions including persistent pain. Currently, she travels globally offering specialty PhysioYoga and Life is Now PCY courses, lecturing at medical college programs, instructing at numerous therapeutic yoga programs, and presenting at international conferences. She is dedicated to actively promoting the integration of yoga into healthcare by inspiring, empowering, and educating health professionals, yoga practitioners, students, and people in pain about ways yoga can be used safely and effectively to address a variety of health issues and improve quality of life. Please visit www.physioyoga.ca for more information.
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