Yoga therapy for motor neurone disease
My experience as a yoga therapist working with motor neurone disease (MND). By Rachel Bilski
Today, I have felt as if I haven’t got a disease.” These poignant words were shared with me by Gaynor, my yoga therapy client of well over a year. In April 2021, Gaynor was diagnosed with motor neurone disease (MND), a rapidly progressive condition with no known cause or cure.
Gaynor’s bravery in the face of such an utterly heart-breaking diagnosis is a constant source of inspiration, and feedback like this has long galvanised me to explore yoga therapy’s potential as an intervention for MND.
MND is the collective term used to refer to a group of progressive, neurodegenerative disorders which attack motor neurons, the nerve cells that control skeletal muscle activity. Over time, individuals with MND may lose the ability to walk, speak, swallow and breathe, with mortality most commonly attributed to respiratory failure. Coping with a terminal diagnosis whilst facing a steep decline in physical function, emotional lability and deteriorating speech has a major impact on quality of life for MND patients. Given that there is currently no cure, treatment approaches focus on life-prolonging measures, symptom management, improving quality of life and palliative care.
Unlike the piecemeal nature of most treatments for MND, yoga therapy offers a uniquely integrative pathway, bringing together many existing management strategies in a single, client-centred intervention. In yoga therapy, health conditions are viewed through the five-part kosha model, incorporating body, breath, mind, intuition, and connection. Working with Gaynor, it was abundantly clear that MND pervades all aspects of her being, and effective treatment therefore needed to address all these layers simultaneously.
Whilst range of motion exercises, passive stretching and joint mobilisation movements are already well-established components of physical therapy for MND, yoga therapy amplifies these interventions with breathing techniques, guided relaxation, mindfulness and the inherent patience, acceptance, and self-compassion these practices cultivate. This whole-person approach provides a particularly potent prescription, worthy of research as extensive as the impact of this cruel condition.
The yoga therapy toolbox is truly a Tardis, but of all the avenues Gaynor and I have explored together, breathing practices are most striking. Particularly prominent for MND are: Dirga, a three-part breathing technique used to improve respiratory strength, vital for those facing the terrifying prospect of respiratory failure; and Lion’s breath, a playful release for the facial muscles, which are often some of the first to succumb to stiffness in MND.
In a powerful lightbulb moment for both of us, Gaynor once said: “Even if I can’t use my body, I’ll always have my breath.” These words will stay with me forever, and they remind me that the wisdom these practices are infused with makes yoga therapy stand out. Guided by the therapeutic process, Gaynor has been able to use her breath to move beyond the physical body, to access the more subtle aspects of her being and enter peaceful states of mind.
As a trainee yoga therapist with The Minded Institute at the time I met Gaynor, I was initially daunted by her case. Although I was permitted to work with health conditions by that point of the training, I had zero experience of MND and was accustomed to working with clients where the goal was to ‘get better.’ Both Gaynor and yoga therapy have taught me that healing and cure are not one and the same; accepting the devastating impact of MND to focus on quality of life was a turning point in the way I work, and has changed my understanding of what it means to be a yoga therapist.
A graduate of The Minded Institute’s internationally-renowned Professional Diploma in Yoga Therapy, Rachel Bilski is a yoga therapist working with a range of physical and mental health conditions. Unique areas include MND, refugees and adolescents with learning difficulties. Rachel’s therapeutic offering is deeply influenced by Buddhist teachings and in particular, mindfulness. Rachel is now both a lecturer and a supervisor for The Minded Institute, where she also works on outreach projects to help facilitate the integration of yoga into healthcare settings. At the time of writing, Rachel is developing a research collaboration with the Royal Stoke University Hospital on yoga therapy for MND.