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Accessible Times Two: When Both Teacher and Students Have Multiple Sclerosis

By Ninazolotow @Yoga4HealthyAge

by Patrice Priya Wagner

Accessible Times Two: When Both Teacher and Students have Multiple Sclerosis

Two Flowers by Melina Meza

One of the benefits of having a chronic illness means that I often enjoy first-hand knowledge of how a pose may affect my students with the same disease. The situation feels somewhat like conducting research for a thesis and finding original source material in my own body and my previous journals of yoga practice. However, as a certified yoga therapist, I also use traditional research methods, often finding results from clinical studies that are similar to my anecdotal ones.
In my case, the chronic disease I have is Multiple Sclerosis (MS). Multiple Sclerosis is a disease of the central nervous system in which information becomes disrupted traveling within the brain and between the brain and body. The cause is not known and symptoms include vision loss, pain, fatigue, impaired coordination, depression, and more. While there is no cure, there are medications available to help with symptoms and slow disease progression.
No two cases of MS are exactly the same, just as no two humans are identical. So the unique combination of symptoms presented by individuals with this “designer disease” can make teaching a class of students with MS a challenge. For example, my current class of people with MS includes students who remain in their folded chairs, some who can stand and get down onto their mats, and others who can stand but don’t get on the mats because they can’t get back up again.
For these students I offer an integrated Accessible Yoga class in which I cue students into and out of a pose together even if their set up is different. To accomplish this, I instruct set up for seated students while others wait and breathe until I give instructions for their set up. Then I follow up with carefully scripted phrases that lead all students simultaneously into and out of the pose. Since fatigue is one of my toughest MS symptoms and cueing set up twice for a pose takes double the energy, I’m glad this type of cueing has become easier for me over time!
Personal experience has shown me that I feel better when in parasympathetic nervous system dominance (the rest-and-digest state). While in this mode, my shoulders relax and tension that I hold in my stomach releases. Since my brain understands there’s no emergency, my blood pressure goes down as well. So my home practice relies heavily on ways to encourage a relaxed state of mind and to interrupt my “worry” reaction when confronted with an unexpected situation.
Bu test-and-digest mode doesn’t come easily to many people with MS—perhaps because the message that there’s no emergency is disrupted while traveling on damaged nerve fibers. Since chronic stress can result from extended periods of sympathetic nervous system dominance (fight-or-flight mode), I teach a variety of yoga practices throughout the yoga session to quiet the nervous system. Awareness of the breath is key for both myself and my students because when our breath becomes become slow and deep, we are able to bring on parasympathetic nervous system dominance in our own bodies. At the start of every session, we do deep, three-part breathing with a hand on our abdomens (then ribcages and lastly collarbones), feeling each part of the body move as we encourage more airflow coming in and going out. Then throughout the session and especially while holding poses, I offer reminders to students to be aware of their breath.
Near the close of the session, I lead the calming practice of Yoga Nidra, a form of guided relaxation. Current neuroimaging technology confirms what many of us know anecdotally that relaxation and quieting the mind puts us in a state that not only feels good but also down-regulates an unhealthy stress response (see Watch 'The Science Behind Yoga at 13:39 in the video).

For Yoga Nidra, I help each student support themself with a variety props to meet their individual needs, whether they remain seated or lay on a mat. I’ve learned several techniques for Yoga Nidra, each a slightly different method to relax the body and mind, and take the best one out of my toolbox for the combination of students with me that day.
Because meditation is another practice that quiets the mind, it should come as no surprise that I include meditation in each session I offer. Days long ago as a student an early experience with meditation gave me a wonderful feeling of peace and joy that I didn’t realize lived inside me. Now I hope to help others with MS find serenity and peace of mind as they go through life with this chronic illness.  
Accessible Times Two: When Both Teacher and Students have Multiple Sclerosis
Patrice Priya Wagner, RYT 500, C-IAYT, trained in Integral Yoga and has taught people with disabilities since 2008. Priya is on the Board of Directors of Accessible Yoga, and assisted or co-presented in Accessible Yoga’s conferences held in New York City and San Francisco in 2017, and in Santa Barbara in 2015 and 2016. She currently offers classes for people with Multiple Sclerosis in Oakland, California, and brings to her teaching a focus on mindfulness and meditation to develop peace of mind inside and out of the studio. 
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