Being a GP gives me the very special privilege of being a fellow traveler for a time in people’s lives. This perspective has allowed me to reflect on the diversity of joy and challenge that life may bring, and that if we choose, there is a place for yoga in all facets of our personal journeys. I may see you in my consulting room to manage minor ailments, or in your own home when you are brewing appendicitis. In previous incarnations as a junior doctor I will have seen you in hospital clinics to optimize your diabetes and on the wards while you were having dialysis. I have delivered babies and had afternoon tea in nursing homes. When the time comes I may be invited to be there in your final hours. All these places invite yoga. Sometimes it may be the jumpy invigorating energetic kind. Oftentimes it is the more reflective mindful aspect that fits the situation. Nevertheless every health related encounter strikes me as having elements where a perspective of yoga can help. So this last week, with my patients, I have found myself inquiring “have you considered yoga to help with that?” This line of questioning wasn’t planned. I wondered if asking would seem contrived, but so many situations cried out for the question to be asked. The answers I got have reinforced for me the concept that whether we know it or not, yoga can and should be part of all of our lives. Among many, I asked the question to these people. The new mum wanting her pelvic floor back and seeking an hours respite from the constant demands of a newborn. The surgeon in training who is constantly striving to achieve more yet wonders why he feels anxious. In addition he struggles with poor posture and gets back pain when standing for long period in the operating theatre. The retired university lecturer who has just been diagnosed with a rare blood cancer and is looking for a strategy to help with her sadness and navigate the uncertainties ahead. If allowed and embraced, yoga can be a constant presence in our lives. The practice itself being resilient to the passage of time, yet subtly changing emphasis depending on the needs of the individual. For me this yoga practice is my time machine. In my younger days the physicality of the postures was to the fore, freeing up my stiff body. Currently the same yoga gives me endurance and commitment to keep me in good shape for the years to come. It is also introducing me to a mindful way of being. I hope that this time machine in the future will have helped to preserve my joints and strength yet also will have given me clarity of thinking when the mind otherwise begins to dim. The health of the nation is in everyone’s thoughts. The NHS is taking a battering and we are all rightly worried about whether we can afford the looming medical bill as the nation ages. There are always new medical advances to help with particular illnesses. But sometimes the old ways are the best. Yoga can play the role of prevention and alleviation. It is not problem specific, indeed there doesn’t even need to be anything to fix. Yoga can just be a companion, cradle to grave should we choose. Many of you know this about yoga already. If so share the message. Bring a friend to class, encourage family members to try yoga, or revisit your own practice if it has slipped a little. There is nothing to lose and so much to gain.    
Movement is good for you. It releases endorphins, promotes serotonin, the happy chemical in the brain, and is the prime contributor to an efficient body. But I haven’t told you anything new, we know this, we have read the countless headlines detailing the health benefits of movement, perhaps even watched the TED talk detailing movement is the raison d etre for the brain. So if we know all of this, why do we struggle to pull on the trainers, step on the mat, or slip the swimsuit on? Motivation. Motivation is literally the motivator of human endeavour, the red thread that connects Albert Einstein, the Buddha, David Beckham, Krishnamachyra, Ido Portal, and everyone of us that actually wants to discover and sustain the quest for discovery. Irrespective of whether it’s quantum physics, perfecting a free kick, or enlightenment, every discovery entails change, movement - if something stops, it will eventually cease to exist, with the body a mini reflection of this cosmic truth: perpetual motion sustains the circle of life. In many respects, our technological advances are working against motion: technology seems to be advancing at the expense of human movement. Everything is at our fingertips and our motivation to complete what were once the most simplest of tasks is being sapped as priorities shift to maintaining a productive day. Sadly, a productive day largely consists of what is of quantifiable value, with a fraction only earmarked for that which nourishes us. The need to move has been labelled ‘exercise’, a series of repetitive movements that we do in the hope of improving our health, and is synonymous with dusty gym membership cards and failed intentions. In his wonderful Beautiful Practice book, Frank Forencich writes: “Today we know that it’s movement, not exercise, that keeps us healthy…When it comes to maintaining health, exercise is optional, but movement is essential. No one ever died from lack of exercise, but lack of physical movement is absolutely dangerous to health.” Kindling the flame of motivation requires the recognition that our body is equal to our brain, we are physical beings that need to be physical otherwise we will slowly deteriorate past the point of no return. Imagining ourselves unable to perform the most simplest of human actions due to inactivity may be enough to spark the flame, and once sparked, we then turn the attention to the activity that excites us. The gym memberships that gather dust belong to those cardholders who found exercise boring, which it is. Rather, it is the activity that we imagine ourselves finding freedom in that will add fuel to the flame, which can be running through the hills, cycling across the Pennines, holding handstand, or street dancing to Beyonce. When we can imagine ourselves participating in these physical feats, able to see and hear the desire of our body intelligence, the motivation seed has been sown. Acknowledging that our physicality matters is hard when in a society that either values intellectual accomplishments or the body beautiful which is a skewered, almost perverse one dimensional perception of our multi-dimensional bodies. Increasingly though, the astonishing abilities of athletes is being recognised (think Under Armour) in the mainstream media and we’re getting a taste of our bodies’ capabilities when at their peak. But of course it’s horses for causes. We certainly do not have to be an elite athlete to feel good, we only need the motivation to achieve our endeavour to yield the results relative to us. We shy away from those activities solely driven by quantifiable measurements, and look to the quality of the experience. Athletes and practitioners of any discipline all practice for that moment of heightened awareness and direct contact with the now. In being motivated, we are finding the activity that has less to do with quantifiable measurements as these will quickly work against the best intentions when something goes awry and we’re fed the stick and not the carrot. Rather, we step on the mat, set forth across the Pennines, or jog through the parks because we yearn for the quality of experience, the attention in the moment, and discovering something we didn’t know about ourselves which can be the extra mile, beautiful backbend, or mounting that hill. Trusting the communication of the body and acting is the greatest gift we can offer ourselves for in doing so we are more empowered and connected to the perpetual movement of life and we are truly alive.
So after my last blog ‘The Supreme Ashtanga Yoga’ my wife asked me the question, ‘So why do you practice Ashtanga ?’ Her emphasis was on the ‘why’ and to be honest she knows 100 % why I do Yoga. But her point I guess was that I often write about how amazing Ashtanga Yoga is and how I always bang on about its many physical and mental attributes but I’ve never really gone into too much detail about exactly why I practice. Yes I’ve mentioned I’ve struggled in the past with anxiety and stuff which led me to the mat but I’ve never been so open about what those anxieties were exactly. So here goes. In my late teens I used to do this very strange thing of starring at myself in a mirror- for long period of times. Now yes you might think that the words teenager, mirror and long periods of time is not strange at all but perfectly normal. Except I wasn’t checking my hair out or how many spots I had or even pretending to be Johnny Marr. I was ‘freaking’ myself out – literally going ‘through the looking glass’ and finding myself in the most strangest of head spaces where I no longer felt normal or real or even like a human being- just for kicks (man!) These sensations only lasted momentarily but long enough to scare the shit out of myself, and the only way to get back to ‘normal’ again I had to go and play the guitar or watch TV – I had to distract myself out of the weirdness. I never talked to anyone about why I did this or what exactly was going on when I did do it. I used to refer to it as my mirror feelings. Fast forward a couple of years to my early twenties – I was living the night-life in Glasgow (that’s a whole other story that you don’t need to know about) I would be out every weekend living it up (I’m not going to go into too much detail about living it up , if you’re unsure what I’m talking about here google house music culture early nineties ) On the back of one particular heavy night I can only describe what happened to me as a minor panic attack. Now the minor panic attack whilst being extremely unpleasant at the time, turned out to be a walk in the park as to what was to follow. Over the following weeks I started to feel more and more strange, weird – detached from everyone including myself. Yes it was the exact same symptoms as the mirror feelings, but this time it wasn’t going away and the weirdness got worse, and worse and well before long I was in a state of complete and utter terror. Now unless you’ve ever had a panic attack or similar or perhaps a bad trip (man) then you probably have no idea what I’m talking about or can get a sense of this state of mind. This went on and on and on for weeks then months until I ended up having to move back to Manchester. I saw more psychiatrists and psychologists than you can shake a stick at – I was prescribed like a million different types of medication that did NOTHING! I even spent 3 days in the psychiatric department at Stepping Hill Hospital – no kidding – the doctors were at a loss what to do with me so they admitted me for ‘observation’. The only good thing that came out of this ‘observation’ was that I observed that I wasn’t as nuts as some people! Oh and one other thing I finally had a name for the condition I had.. it was called ‘depersonalisation’ (DP). No-one in the medical profession really knew exactly what depersonalisation was. There wasn’t any particular reason to why one person gets it and one doesn’t. A troubled childhood probably contributed to why I got it – and ‘dabbling’ with recreational illegal medicines (ok drugs!) didn’t help either. Depersonalisation Google will tell you is ‘a state in which one's thoughts and feelings seem unreal or not to belong to oneself, or in which one loses all sense of identity’. But to be honest, that doesn’t do it justice. It is pure and simple ‘hell on earth’ I kid you not – ask any of my family or close friends. The philosopher Sartre wrote a book about it – aptly called The Filth , Hollywood made a film about it , Numb* starring Matthew Perry. If you’ve got half an hour to spare read this for the low down. So thus began a pretty awful part of my life battling with my mind. Apart from traditional western medicine I tried pretty much most eastern ones too. Acupuncture, homeopathy even drinking rain water that had been taking from Stone Circles – I kid you not. If someone had said to me ‘Hey Matt, stick these hot pins in your eyes it will help you’ I would have not even questioned it I’d be writing this blog with an eye patch. I got to the age of 30 with no clear signs of progress with either therapy or treatment when a friend suggested I try Yoga. This is absolutely true – I had no idea what Yoga was, but given that I was up for trying anything, Yoga was to be my next hopeful attempt at achieving some kind of sanity. My first class with my very first Ashtanga teacher Mike Nevitt nearly broke me – I have no idea what made me go back to be honest. Well apart from that I noticed a very small change of perspective. I think initially it was the pure physicality of the practice that helped. Depersonalisation is neither depression nor anxiety, but the utter terror it created made it a bit of both. You feel completely unreal which was very anxiety inducing which made it worse and in turn created more anxiety – a vicious circle. I remember talking to one rather patronising doctor who was asking me if I was a little depressed to which I replied ‘The only reason I’m depressed Doctor is because I’m feeling fxxking unreal’ ( Apologies for expletive but I wanted to make the quote exact). The physical nature of Ashtanga would literally wear me out, so that the anxiety had nothing to feed on. Over the next few months I started to practice Ashtanga Yoga more and more, and no it wasn’t all of a sudden life was peachy again, it was more like the feelings were slightly less intense. I remember after 6 months a friend of the family asked me what type of yoga I was doing – I literally had no idea that there were more than one type of yoga. This person had to describe a few different yoga disciplines before they started talking about this form of yoga which require a lot of jumping about – ‘That’s it’, I can remember saying ‘The jumpy one’. Within 12 months of starting Yoga I had my bags packed and was off to Mysore to study with Guruji and the rest they say is history. I wouldn’t say that Ashtanga Yoga was this miracle cure but it wasn’t far off. I still get bouts of the DP now and again but I’m ok with it – I do my practice and it helps to keep the wolf from the door. So I know I bang on a lot about Ashtanga Yoga being Supreme but there you go I think I’ve got very good reason to. That’s why I practice Ashtanga. * The director of this film Harris Goldberg also had chronic Depersonalisation and wanted to draw public attention to this little known disorder he was suffering from. In a very ironic quirk of fate the marketing ads for the film got changed from Matthew Perry (the main character in the film) having depersonalisation to him being chronically depressed as Joe Public could understand what depression was but not depersonalisation.  
One particularly difficult to reach sector of the population, from a health care perspective, are middle aged to older males. We grumpy old men tend to battle on and bottle things up and it is not until things start to go wrong that we pitch up in the doctor’s consulting room. Yoga clearly has lots to offer across the board to all ages and abilities, with both physical and psychological benefits. I think it’s worth exploring how men of a certain age could profit from getting their asanas on a yoga mat and channeling their prana in a more positive direction. It seems to be a rite of passage that happy-go-lucky jokers morph into miserable old codgers soon after the age of 40. On a more serious note, mental health problems such as anxiety and depression in this age group are common and often masked. So this advice applies to half of the population sooner or later…   It is not just the individual in question who will reap the rewards of the cornucopia that yoga provides. Grumpy old men have an uncanny ability to manifest their negative auras as a dirty rain cloud, which can dampen the enthusiasm of those of us with the sunniest dispositions. If there were only some way to shine a little metaphorical sunlight on our grouchy male friends, relatives, colleagues and companions … Well surely the Light of Yoga has something to offer here. Many of you no doubt fear that the power of yoga to bring ultimate serenity to us old codgers may have met its match when pitted against our persistent low level griping. A yoga mat is not a magic carpet after all. However resistant to relinquishing our crotchetiness we grumpy old men may seem, it appears a good yoga session may bring subtle benefits to us as individuals and more importantly to those than surround us.   Dr J’s wife blissfully recounts “the dear old goat has been doing yoga for years. He’s no good at it and has made precious little progress. But I rejoice when he takes to his mat each day because I get an hour and a half of peace and quite which is free of pedantry and undermining sniping.”   Mr E’s colleagues have noticed that, this usually gauche and self-absorbed old gent improves his disposition after a good head-standing session. Some of the common decency and sense of compassion for his fellow human beings that leaks out of his head when he is upright seems to trickle back in during his inversions.   Mr R alarmed his passenger by his deranged ranting at the satnav whilst they were stationary on the motorway. The situation was alleviated by the suggestion that Mr R do some seated twists and pranayama until the traffic began to move again. Thankfully road rage incidents were narrowly avoided and cordial relations with the satnav were restored.   These little case studies just illustrate some of the mental health improvements that yoga can help to bring about. The physical wins for men in their 5th decades onwards are also clear: preserving joint mobility reducing arthritic pain and cardiovascular health improvements to mention but a few. What is important here is the positive impact yoga practice has not only on us grumpy old men but on those around us too. You readers no doubt will have candidates in mind to whom you would like to suggest some yoga. Some pranayama may diminish the patronizing sighs. This supplemented with a good warrior sequence might just attenuate the need for them to launch into battle with everyone they converse with. Get your grumpy old men on a yoga mat. It is for their benefit and yours. But they might need a bit of encouragement.   Matt Joslin
I am proud to be a GP settled in Manchester city centre after having trained and worked in Cambridge, London and Brussels. Being a family doctor is one of the best and most varied jobs. The world with all its problems can walk through my office door and I am invited to collaborate in helping out. In recent years yoga has become an increasingly significant feature of my life. As well as getting me in the best physical shape it has helped me through stresses and depression. I attend several Yoga Manchester classes on a weekly basis. More and more I share my experience of yoga with colleagues and patients. It has become a lifelong friend.