The way we feel at any time dictates how well or unwell we perceive ourselves and our reality to be. For instance, if you are running at a high blood glucose level, your energy will be different from normal levels or low levels. Within the blood glucose spectrum, there is a difference between 200mg/dL and 400 mg/dL, or 65 mg/dL to 45 mg/dL. You are going to feel different.
Just as there is a difference between when we feel capable with diabetes versus hopeless. There is a thought, but also a feeling in the body.
Our energetic condition governs our mood and emotions. How we feel determines how we see the world and live in relationship to it. Essentially the better we feel, the more vibrant and engaged we will be in our lives and, in turn, our diabetes management. But if we're in a funk, numbers awry, plagued by stress and digestive distress, we're less likely to view the glass as half full.
Our mood is a feeling; it is not a thought. It connects with thought, but mood shows up as a sensation in our body. The problem is that when we feel an uncomfortable mood, we identify with it just as we would identify with a core belief like "I will never control my diabetes."
We feel it, so it must be real.
By learning to link with our feeling/energy body, we can de-link from uncomfortable sensations and link with sources of happiness and devotion, transforming discomfort into ease.
In yoga, this is the energy of bhava shakti - the feeler. We can bring a positive bhav - or feeling into our yoga practice - and then into our diabetes practice. To transform mood is one part mind (intellect) and one part body (nervous system). The most potent and practical tools for transforming mood are self-reflection, intention (sankalpa), breath, and sound.
A Meditation to Transform Mood
1) To begin your practice, any practice take several breaths and reflect on your feeling state - what is your energy like? How does this manifest as emotions and sensations in your body? Where do you feel these sensations? As you reflect, keep the breath smooth and even.
2) Remember a pleasant experience, a time in your life where you felt the freest and effortless. Observe the sensations in the body and where they are most concentrated.
3) Alternate nostril breathing. Lift your right hand, inhale left nostril, breathing into the space of concentrated sensation, hold your inhale for 5-10 seconds in that space. Exhale right nostril. Inhale right nostril, breathing into the same space, hold the inhale for another 5-10 seconds. Exhale left. Repeat 5x.
4) Bring attention to the fact of your natural, effortless breath at the heart center. The feeling of your breath when it is effortless is the feeling of PURE JOY and LIGHT. As the body inhales, experience the joy and light radiating at your heart. When the body exhales, the light is absorbed.
5) Mantra - remaining with the same awareness from #4, mentally chant the mantra SO on inhale and HUM on the exhale. Remain in this effortless space for several minutes. So hum = I AM THAT.
6) Eventually, the mantra will occur spontaneously. Experience the breath, light, and the mantra occurring at the heart center, recognize that the feeling of you is the feeling of THAT - the essential SELF - beyond sorrow, beyond darkness.
7) Before you return, recall that moment of peace, the feeling of real, lasting peace in your body. Recognize that there is no separation between you and lasting peace.
May is mental health awareness month, and it is no secret that mental health + diabetes are intimately connected. Mental and emotional health is essential for overall health with and beyond diabetes. But people with diabetes are up to 50% more likely to develop mental health conditions like anxiety and depression due to immense self-care requirements and physiological changes(blood glucose dysregulation, digestive distress, sleep disruption).
This month, I'm offering yoga psychology tools for transforming thought, mood, and behavior with diabetes.
To start, we're looking at thought and cognition. The ancients described the energy of intelligence and knowledge as jñana shakti. Jñana is to know and possess insight, essential skills for managing diabetes. When the mind and body are disturbed by illness, worry, or obsession, our innate intelligence cannot shine through and inform our decisions.
According to yogic philosophy, we are constantly incurring new impressions from our experiences. Every experience that we have, whether positive or negative, leaves an imprint in our mind, through which we see the world. So, let's consider diabetes, a disease we do not receive a manual for and one that we have to learn through trial and error.
Our minds will hold onto negative experiences more readily than positive ones, forming deep grooves in our subconscious. It is estimated that it takes about five positive experiences to counteract one negative one. Considering this, it is no wonder that we can hold negative perceptions, biases, and thoughts regarding diabetes and our competency in taking care of it.
The thoughts we have about diabetes, expectations of treatment requirements, and our perceptions of how well we can handle the task will influence our attitudes about diabetes and, ultimately, our engagement in management (1)
There is a positive correlation between improved A1c outcomes, reduced anxiety and depression, and increased quality of life with T1DM and T2DM patients who feel effective at management, even when they make mistakes (2).
But this is not for everyone. The nature of the mind is to grip onto the negative. The ancients knew this, so they devised practices to help us rewire our thoughts, release and transform negative experiences into our strengths.
In both T1DM and T2DM, patients who believed they were worse off because of diabetes reported poorer physical functioning. Lower beliefs in treatment effectiveness yielded the weakest perceptions of health (4).
The silver lining is that beliefs, thoughts, and perceptions are changeable, implying that altering thought patterns could enhance self-management effectiveness and glycemic control.
How to Flip the Switch
To transform thought, we must go deeper than the constant chatter and look at what underlies our thoughts; and these are our core beliefs. Core beliefs are automatic, formed by past experiences, and activated by internal and external triggers. It is essential to recognize that core beliefs are not true; they are learned patterns from past experiences. We perceive them to be accurate, so they become our reality.
A common core belief in diabetes is: "I will never get my diabetes in control".
This core belief could be triggered by an suprise high or low, an undesirable A1c, or a person's comment, "should you really be eating that?"
Having a Conversation with Yourself, About Yourself
We can transform core beliefs through self-inquiry by asking ourselves questions and testing them against reality.
The first step is to identify the core belief - Look for a consistent thought pattern that repeats itself. A common core belief with diabetes is:"I will never get my diabetes in control."
The second step is to test whether the belief is helpful or harmful to your goal. Ask yourself questions like:
The third step is to transform an irrational thought into a helpful one - this is a process in yoga called praktipasha bhavana - or "cultivating the opposite".
Yoga Sutra 2.33 says when we have a conflicted view, we contemplate the situation from another perspective. In psychology, this process is called "benefit-finding." Studies show that teens with type 1 diabetes who can find a lesson in their diabetes management mistakes are more likely to have a better A1c (6).
It is not as simple as saying "serenity now" every time we notice an undesirable thought surfacing. Instead, it becomes an active meditation where we reflect on our thoughts without reactivity—when we see a harmful thought surfacing, we test its validity and then alter it with awareness.
Praktipaksha bhavana does not mean we deny the negative; diabetes is not all skittles and rainbows after all, and life would certainly be a lot easier without diabetes. But it suggests that we hold both the negative and positive together. If it were not for these challenges, I would not be half the person I am today. Because of diabetes, I have a greater understanding of myself and my body. I have more compassion for others and understand what self-discipline means.
(1)Snoek, Frank J., and T. Chas Skinner, editors. Psychology in Diabetes Care. 2nd ed, John Wiley & Sons, 2005, pp 215.
(2) McGonigal, Kelly. The Upside of Stress. 1st ed, Avery, 2015, pp 203.
(3)McGonigal, Kelly. The Upside of Stress. 1st ed, Avery, 2015, pp 202, Harvey, J. N., and V. L. Lawson. “The Importance of Health Belief Models in Determining Self-Care Behaviour in Diabetes.” Diabetic Medicine, vol. 26, no. 1, 2009, pp. 5–13. Wiley Online Library, doi:https://doi.org/10.1111/j.1464-5491.2008.02628.x.
(4) Harvey, J. N., and V. L. Lawson. “The Importance of Health Belief Models in Determining Self-Care Behaviour in Diabetes.” Diabetic Medicine, vol. 26, no. 1, 2009, pp. 5–13. Wiley Online Library, doi:https://doi.org/10.1111/j.1464-5491.2008.02628.x.
(5) Snoek, Frank J., and T. Chas Skinner, editors. Psychology in Diabetes Care. 2nd ed, John Wiley & Sons, 2005, pp 215.
(6) McGonigal, Kelly. The Upside of Stress. 1st ed, Avery, 2015 203
mental health yoga therapy diabetes
Evan Rachel Soroka