Alzheimer’s disease is a degenerative and fatal disease that robs a person of cognitive ability and the ability to understand, have meaningful conversations, and make sense of the once familiar world around him. It leaves the ability to feel emotions and express feelings intact. That is the cruelty of the disease. Our identities are based on our our memories, what we think about, how we process our thoughts, our behaviors and our physical abilities. When all that is stripped away, what remains? Our feelings. Our emotions. Therapeutic yoga connects on a feeling level with people with Alzheimer’s disease to help create balance and mind-body connection and to increase positive emotions. The application of therapeutic yoga could be widespread, potentially reducing medication levels and ameliorating negative behaviors associated with negative moods and anxiety.

Understanding the Disease

René Descartes, in one of the most well known statements in Western Philosophy, wrote “I think, therefore I am,” meaning that if a person questions their own existence then this proves that they must exist. (I wasn’t a philosophy major in college so please have patience if I have glossed over the finer points of this.) A person with Alzheimer’s disease does think, but the process is untamed and disordered. The ability to order thoughts in a logical progression, to sequence steps in a process or to use judgment in order to assess the validity of thoughts is progressively lost. As short-term memory is lost and more recent memories begin to fracture and disappear, the identity retreats back in time to when the memories that still exist enabled the creation of a cohesive identity, usually much younger than the chronological age of the person. Eventually even this is lost at the end stages of the disease. With the container of identity stripped away one becomes a feeling being, rather than a thinking being. For a person with Alzheimer’s disease, the experience is “I feel, therefore I am.”

In order to communicate with a person with Alzheimer’s disease you must access them on the level of feelings appropriate to the age of their identity. Experts have observed and written that in the social model for treatment and habilitation, engaging in activities which trigger pleasant memories can ease anxiety and bring out pleasant memories. Activities such as gardening or baking cookies are examples often cited in literature. A recent article in the Boston Globe described a boating trip to the Charles River by a group of Alzheimer patients. This small group had been ardent boating enthusiasts in the years before Alzheimer’s. This trip helped to trigger memories of previous happy outings and the accompanying pleasant emotions. The key to this treatment is to engage the emotions of the individual through the totality of the experience rather than focusing on executing the task correctly.

The Treatment

A great deal of work has been done in the field of somatic therapy, the use of body movements to access and release deeply held emotions in individuals for whom traditional talk therapy is ineffective or potentially traumatizing. The use of dance, music, art and most recently yoga has been and continues to be studied with therapeutic applications in mind. This model works with body memory to create an experience on the physical level (movement, auditory and/or visual) which helps to access and release emotions on a deep and therapeutic level. While this work has been used extensively in clinical settings with patients dealing with trauma, it can be equally used to access joy and ease. In my ongoing class at Whitney Place Adult Day Health in Natick, MA the staff and I have witnessed this engaging of positive emotions in clients with Alzheimer’s disease through relaxation chair yoga and meditation, resulting in the easing of anxiety and an improved sense of well-being.

The relaxation chair yoga that I lead with this group of students is based on the Structural Yoga Therapy Joint Freeing Series® (JFS) as taught by Mukunda Tom Stiles. According to the yogic view of the body and anatomy, the physical body is only one layer, or sheath, of a being. There is also the breath, or life force body, the mental body, the wisdom body and the bliss body. Each body is considered to be contained within the next, much like Russian nesting dolls.¹ This is a description of the mind-body connection that people experience when doing yoga. Yoga engages all of these layers. The JFS was created to move prana, or life-force energy, through the body in order to bring all these layers into balance. It helps to lubricate all the movable joints of the body, to promote the mind-body connection and to improve coordination along neural pathways. It is highly adaptable and gentle. People can complete the series from a yoga mat, sitting in a chair or reclined in bed and receive all the benefits.

Promising Results

When I began to work with the group, they were as a whole was rather skeptical yet compliant. After a few classes, however, I noticed a change. I kept to the same routine, bringing only a little variation into the practice. I had them focus primarily on coordination of physical movement with their individual breath patterns. If they had a challenge making a particular movement, I encouraged them to use their imaginations to create the movement in their mind so that the nervous system would still receive the benefit of the practice. They began to smile at the end of class and appeared visibly relaxed, even those who didn’t seem to be following along with the physical movements. Many began to thank me for coming. At first the group was very talkative and it took a bit to calm them down and get them to focus. Over a few months, I noticed that the group seemed to take less and less time to settle down once I arrived. Between each movement I would ask them to check in with how they were feeling and to notice how each movement left them with a different feeling. Some would nod in recognition. Then we’d progress to the next movement. I introduced the idea that feelings change and if you’re feeling something that you don’t like, you can use body movements like sighing out loud, deep breathing, or lifting the arms overhead to shift that feeling.

The Marketing Director began commenting that two adults who had been particularly agitated were remarkably soothed by the classes and remained calm for the rest of the day. Other staff echoed these statements. It was also interesting to note that after a few classes, several of the adults were remembering the sequence and anticipating the next movement. The systematic approach seemed to allow the intelligence of the body to take over the practice.

Now, when I go to teach, the group claps at the end of class, thanks me for the yoga and leaves smiling!

What I unknowingly stumbled upon was the power of yoga to engage the feelings of the adult with Alzheimer’s disease and to work on that level to reduce anxiety by releasing energy and emotional blocks and restoring balance. By using certain key word phrases throughout the practice and a systematic approach to working with the body, the adults were quite content to allow the intelligence of the body to take over, to build awareness of the emotional component of body movement, and to have their emotional experience of those poses validated, enjoying the release of negative emotions by replacing them with positive ones. This is great for the adults with Alzheimer’s Disease, great for the staff of the adult day health center, and great for their care partners at home!

To The Reader…

I am currently putting together a research project to quantify and qualify these observed benefits in a larger population of adults with Alzheimer’s disease at different stages of the disease and in different settings as well as the benefits to care partners. If you would like more information on the project, would like to suggest possible resources, or would like to be a part of the project itself please contact me and I’d be happy to give you additional information.

Do you have any anecdotes on yoga and working with special populations by accessing the feeling being? Please share them with me by adding a comment below!

Namaste!