Recovery: Yoga and Addiction by Miranda Hope, SCHYS Student

RECOVERY: YOGA AND ADDICTION

“The opposite of addiction is not sobriety, it’s connection.” (1) ~ Johann Hari

“Every addiction arises from an unconscious refusal to face and move through your own pain. Every addiction starts with pain and ends with pain.” (2) ~Eckhart Tolle

Addict. The word conjures an image of a wild-eyed desperate soul, far from the rails of a productive and healthy life. I’ve known a few. I’ve been one: a teenager, looking at my world in which most everyone seemed disconnected from themselves, happiness, and me, muttering we’re doing it wrong we’re doing it wrong, as I chain-smoked by day, drank to excess most nights and tried every drug I could. I was desperate to feel less discomfort, more freedom. To find connection, love and acceptance. My cravings – especially for alcohol and nicotine -- felt at first like a great solution and then, like an eagle had wrapped its talons around my spine. Craving was at the wheel of my life, the rest of me slouched in the shotgun seat, and both of us (my addiction and me) riding atop a rattling axle cracked by “an inability to connect in healthy ways with other human beings,” (3) and the loneliness, insecurity, arrogance and fear that resulted from it. An addict can be hard to love, all that abysmal, destructive, self-centered behavior. Surely there must be a way out.

A DISEASE OF CHOICE

The human relationship to mind-altering substances is as old as human culture. Recovering heroin addict and journalist Maia Svalovitz writes, “Whatever the evolutionary precursors of drug use are, a permanently “drug-free” human culture has yet to be discovered. Like music, language, art, and tool use, the pursuit of altered states of consciousness is a human universal.” (4) That state when use feels no longer optional must be just as old.

David McCauley, M.D. asks whether addiction is a disease or choice in his film, Pleasure Unwoven, and answers: “It is a disease of choice.” He explains that addicts may have the choice temporarily not to use, but without a structured recovery program, they do not have the choice to be free of their involuntary, unmanageable cravings. Psychologist Alice Miller asks, “What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.” (5) Profound self-centeredness is an SOS signal? Yes, it is.

SUBSTANCE ABUSE DISORDER

Addiction – now called “Substance Abuse Disorder” in the DSM-V (2013) – is a complex brain disease marked by cravings so intense that the person is unable to stop using despite the desire to stop. Doctors initially assumed that addiction was attributable to a defect in the brain’s prefrontal cortex, the part of the brain responsible for executive functioning (what is bad, good, better and best), social and emotional control, and decision-making. Those in the throes of active addiction are uniquely horrible at these tasks, so it made sense to locate the aberration there. But according to Dr. McCauley, addiction is a flaw in the mid-brain, which operates under the level of consciousness and is dedicated to sight, pleasure seeking (such as eat, defend, have sex, all of which are programmed to be pleasurable) and surviving the next 15 seconds. For various reasons, the neurotransmitter dopamine – which drives pleasure-seeking more than pleasure-feeling – has hijacked the brain of the addict, ordering her to obtain her drug as though her life depended on it. (6)

Hijacked. It is the nightmare of the eagle with its talons in the addict’s spine. What was once a balm, an emotional anesthetic, is now a source of more pain. As Eckhardt Tolle writes, “Every addiction starts with pain and ends with pain.” (7)

According to the CDC, between 1999 and 2017, more than 700,000 people died in the United States from drug overdoses, 400,000 of those deaths attributable to opioid painkillers. (8) 22 million Americans struggle with substance dependence or abuse. Relapse rates are higher than 40%. (9) These alarming statistics do not take into account the reality that so many chemical addictions – caffeine, sugar, alcohol, tobacco, marijuana, prescription medications -- are socially acceptable and encouraged while many behavioral addictions are normalized and celebrated even while causing harm -- food (too much, too little), sex, shopping/spending, gambling, excessive working, screens, social media, information intake, and video games to name nine. They all cause the surges in dopamine of more vilified addictions.

700,000 deaths in less than two decades because people can’t sit with and process their pain? Addiction doctor Gabor Mate, MD asks: “The question is never ‘Why the addiction?’ but ‘Why the pain?” (10)

TRAUMA

Recovering addict and founder of Yoga of 12-Step Recovery (Y12SR), Nikki Myers asserts that “most addictive behaviors are maladaptive responses to trauma.” (11) Similarly, recovering addict and British entertainer Russell Brand writes, “It was a great revelation to learn that my problem was not alcohol, heroin, crack, bulimia or sex but a twisted system of beliefs brought on by my trauma and shame that had become the basis of my unconscious program for living.” (12) Journalist and recovering heroin addict Maia Svalovitz calls trauma “the critical factor that causes the problem” (13) and explains: “If you learn that the world is not a safe and stable place – and that others are unreliable – when you are young, it can shape the trajectory of your emotional learning and the way you cope for the rest of your life.” (14) Trauma creates disconnection, body from mind from spirit, person from others. Trauma expert and Psychiatrist Bessel van der Kolk notes that “people with an ACE (Adverse Childhood Events) (15) score of 4 (out of 10) were seven times more likely to be an alcoholic than adults with a score of zero. For those with an ACE score of six or more, the likelihood of IV drug use was 4,600% greater.” (16) Drug use “is often an attempt to manage stress,” (17) something the traumatized often feel at unbearable levels. This is all just to reiterate that many addicts are not partying pleasure-seekers out to catch a high. They are victims of childhood trauma out to feel normal.

PUNISHMENT

According to the Council for State Governments, 65% of all prisoners meet the criteria for addiction. 11% receive treatment. (18) We currently incarcerate 2.3 million people in this country, 1.5 million of them addicts. Another 458,000 inmates committed drug-related crimes. Together, these two populations make up 85% of the incarcerated population. If addiction can be traced to childhood trauma, then as a nation, at great financial, human, and social cost, we are systematically encaging and further traumatizing the already traumatized by the millions.

Svalovitz makes a compelling point when she explains that addiction is of course immune to punishment since punishment is already hardwired into the experience of addiction. An addict will sacrifice everything and risk death for a drug that may no longer provide a consistently pleasurable high. Incarceration and punishment are more likely to strengthen addiction’s hold. Seattle Police Chief Norm Stamper believes “we pay dearly for a vindictive system that often serves to make matters worse – much worse.” (19)

There is one form of punishment that is highly motivating to keep addicts using: the fear of withdrawal. As Svalovitz describes, it “is the anxiety, the insomnia, and the sense of losing the only thing you have that makes like bearable and worth living, not the puking and the shaking…. Mostly I felt utterly stripped of safety and love [by] the recurring fear that I’d never have lasting comfort or joy again.” (20) For Svalovitz, heroin brought safety, love, comfort, and joy. It made life bearable. Without it, we can assume it was not.

HEALING

If trauma is the root cause of addiction, how do we heal it? In The Body Keeps the Score, van der Kolk explains that the memory of trauma is stored in the muscles, the viscera, the nervous system of the body. He mentions a constellation of activities and therapies that ease the symptoms of trauma, not one of which resembles punishment: safe relationships, relaxation, body awareness, staying in the present moment, yoga, meditation, trauma-informed therapy (including Internal Family Systems therapy), EMDR (21), neurofeedback,(22) and the arts. Trauma rips a person’s awareness out of the body and into the head, sometimes a dissociated state. Van der Kolk leads his clients to draw their awareness inward, encouraging the experience of: “feeling your body. Feeling your substance. Feeling the life inside of yourself.”(23)

A grounded, embodied, autonomous self is also critical for addiction recovery. The addicted need to be taught how to create a foundational self so that they can “observe rather than react” (24) to the events, including the intense cravings, of their lives. Finally, the traumatized and addicted need to learn to leave the past in the past and find peace in the present moment. As Nikki Myers explains, “Anything that is used to escape the present moment as intolerable reality can turn into an addiction.” (25) It’s no coincidence that this grounded, present self is also essential for finding a true connection with others, exactly what the addict has lacked all along.

YOGA AND ADDICTION RECOVERY

In an interview with writer and podcast host Krista Tippet, Bessell van der Kolk spoke specifically of yoga as an essential adjunct therapy in the healing of trauma:

“Yoga turned out to be a very wonderful method for traumatized people to activate exactly the areas of consciousness, the areas of the brain, the areas of your mind that you need to regain ownership over yourself…. yoga in my mind is an important component to an overall healing program. … It resets some critical brain areas that get very disturbed by trauma.” (26)

His words, “regain ownership of yourself,” sound like a perfect antidote to the hijacking nature of addiction, the releasing of the eagle’s talons. “Yoga” is frequently translated as ‘union,’ which by definition makes it a useful therapy for a disease of disconnection. Even a cursory view shows just how thoroughly yoga addresses the most common symptoms of addiction. (See Addendum C) Need embodiment? Asana. Need to come into the present moment? Meditation. Need to manage cravings? Pratyahara. (“Craving and aversions arise when the senses encounter sense-objects.” ~Bhagavad Gita 3.34. (27) Need to relinquish self-centeredness, aggression, theft, lying? Svadyaya, Seva, Ahimsa, Asteya, Satya. To manage stress, anxiety and depression? Asana, Pranayama, Meditation. To surrender to a higher power? Isvara Pranidhana. To recover a deeper, not addicted self? Dharana, Dhyana. Arrive at a mentally altered state? Samadhi.

Perhaps the rishis created yoga to heal a universal longing to feel connected, both internally and externally, the lack of which can create addiction. But what is the source of the disconnection behind this longing? Loss of tribe? Loss of the connection to body? It used to be that much of work and life was physical, that cultures farmed and built and danced together, not this sedentary and intellectual life that many of us lead today. Loss of connection to the earth and the seasons? Loss of purposeful activities like hunting, weaving, and growing, preparing, preserving, and food? Loss of rituals for collectively managing birth and grief and death? Our culture’s rituals seem to have evolved towards the shallow and materialistic. Loss of a sense of Spirit that was once woven into the fabric of a day and the fabric of a being?

Many of us now live disconnected from body, mind, spirit, and each other in ways for which we are not designed. Perhaps the addicts are holding down one end of a long spectrum of disconnectedness and suffering-soothing upon which most of us lie. Could it be that the addict’s behavior is abhorrent to us because we see their alienation and recognize it as our own? Gabor Mate cautions, “No society can understand itself without looking at its shadow side.” (28) Alternatively, in the healing of addicts might we heal us all?

SELF

Around 400 BC, the sage and scholar Patanjali compiled the Yoga Sutras, 196 short aphorisms that serve as a path out of suffering. He explains that pleasure frequently leads to pain because we cling to it, crave it when it is gone and create disruptive thoughts in an attempt to regain it.

YS II.15 To one of discrimination, everything is painful indeed, due to its consequences: the anxiety and fear over losing what is gained; the resulting impressions left in the mind to create renewed cravings; and the constant conflict among the three gunas (29) which control the mind. (30)

It’s the story of addiction: we pursue pleasure to run from pain and thereby run straight into more pain. The next sutra reads: “Pain that has not yet come is avoidable.” (II.16) This suggests that we can take the reins of our pleasure cravings and design a life that avoids suffering, or in the case of addicts, relapse. (31) Next, Patanjali identifies the source: “The cause of that avoidable pain is the union of the Seer (Purusa) and the Seen (Prakriti or Nature)” (II.17) (32)

Here in II.17, Patanjali suggests that we have a foundational misapprehension, a kind of amnesia, that causes our suffering: we’ve merged with the outer world and believe that our discomforts will be soothed by the temporary balms of the external world. If we have never looked inwards, there is nowhere else to seek comfort, but this out-sourced awareness only leads to craving and more pain. Meanwhile, because there is no separation between the Seer and the Seen, when a craving arrives, there is no space and therefore no choice but to submit to the craving’s demand, to be hijacked by the craving because, in this amnesiac state, the craving is the craver, they are one.

Sixteen hundred years after Patanjali compiled the Sutras, Russell Brand wrote this about addiction recovery: “fame, luxury items and glamour are not real and cannot solve you … They are just passing clouds of imaginary pleasure.” (33) And, “the instinct that drives the compulsion [of addiction] is universal. It is an attempt to solve the problem of disconnection, alienation and tepid despair, because the problem is ultimately ‘being human’ in an environment that is curiously ill-equipped to deal with the challenges that entails. We are all on the addiction scale.” (34) Finally, he writes, “That is why we call this process Recovery; we recover the ‘you’ that you were meant to be.” (35) Here Brand summarizes the problem and the goal of Recovery for addicts and yogis and humans alike. The modern world is ‘curiously ill-equipped’ to manage human suffering; external pleasures will never heal the internal disconnection of the addict’s pleasure-craving self from its truest Self, the one we are all meant to be. Only coming into the body and the present moment can accomplish that connection.

CONCLUSION: PEACE AND POWER

T.K.V. Desikachar, in The Heart of Yoga, wrote: “[T]he purpose of yoga is to reduce disturbance and return an individual to his or her inherent peace and power.” (36) Reduced disturbance and inherent peace and power is a succinct description of what many addicts both sought from their drug use and seek from recovery. So it was for me in my late twenties when I started taking yoga classes. I came into my body. I sat with discomfort. I watched my thoughts. I stretched and breathe and relaxed into myself. The eagle of craving released its talons. Over the course of the next two decades, as a yoga student and teacher, the reduction in disturbance and the growth in peace and power have continued and more and more, as I look at my life, I do have a sense that I am closer to doing it right.

Addendum A: Adverse Childhood Experiences (ACEs)

The original Adverse Childhood Experiences Study was conducted in San Diego (1995-7) 17,000 HMO members of Kaiser Permanente completed confidential health exams and surveys to attempt to correlate adverse childhood events and adult health concerns. The demographic of participants was a population with good health insurance, primarily white (74.8%), over 50 (66.3%), with some college or a college degree (75.2%). (Retrieved from: https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html)

The 10 ACEs in the survey:

Prior to your 18th birthday:

1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?

2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?

3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?

4. Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?

5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

6. Were your parents ever separated or divorced?

7. Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

9. Was a household member depressed or mentally ill, or did a household member attempt suicide?

10. Did a household member go to prison?

When children are overloaded with stress hormones, they’re in flight, fright or freeze mode. They can’t learn in school. They often have difficulty trusting adults or developing healthy relationships with peers (i.e., they become loners). To relieve their anxiety, depression, guilt, shame, and/or inability to focus, they turn to easily available biochemical solutions — nicotine, alcohol, marijuana, methamphetamine — or activities in which they can escape their problems — high-risk sports, proliferation of sex partners, and work/overachievement. (Nicotine reduces anger, increases focus and relieves depression. Alcohol relieves stress.)

Fortunately, brains and lives are somewhat plastic. Resilience research shows that the appropriate integration of resilience factors — such as asking for help, developing trusting relationships, forming a positive attitude, listening to feelings — can help people improve their lives. (Retrieved from: https://acestoohigh.com/gotyour-ace-score/)

Addendum B: 12 Steps and Serenity Prayer

12-Steps

1. We admitted that we were powerless over addiction and that our lives had become unmanageable.

2. We came to believe that a power greater than ourselves could restore us to sanity

3. We made a decision to turn our will and our lives over to the care of God as we understand God.

4. We made a searching and fearless moral inventory of ourselves

5. We admitted to God, ourselves and another human being the exact nature of our wrongs

6. We were entirely ready to have God remove all of these defects of character

7. We humbly asked God to remove our shortcomings.

8. We made a list of all the people that we had harmed and became willing to make amends to them all.

9. We made direct amends whenever possible except when to do so would injure them or others.

10. We continued to take personal inventory and when we were wrong promptly admitted to it.

11. We sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God’s will for us and the power to carry it out.

12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to those that still suffer and to practice these principles in all of our affairs.

Serenity Prayer (as used in AA, NA etc.) Reinhold Neibuhr 1892 – 1971

God grant me the serenity to accept the things I cannot change,

The courage to change the things I can,

And the wisdom to know the difference.

Addendum C: Addiction Symptoms, Tools of Recovery, and Yoga Philosophy and Practice

Comparison of

Addiction Symptom 12-Steps / Serenity Prayer (SP) and Recovery slogans / Yoga Concept or Practice

Self-involvement, Selfishness, Ego, Narcissism and also, paradoxically, low self-esteem. / We admit that we are “powerless,” over our addiction. (Step 1) We made a decision to turn our will and our lives over to the care of God as we understand God. (Step 3) Outside solutions can’t solve inside problems. (Step 1) “Grant me the serenity to accept the things I cannot change. (SP) “My way aint workin’.” / Asmita (Ego, one of the kleshas); Samsaya (an antaraya, self-doubt); Svadyaya (self study) Knowledge of witness, true Self (Purusha), practice of Seva (service), Loving kindness meditation to self and others, meditation, surrender, Isvara Pranidhana (surrendering to a higher power.)

Fleeing discomfort / / Asana and meditation – learning to sit with discomfort.

Theft, Dishonesty, Denial, Delusion / “Stinkin’ Thinkin’” (misperception) / Asteya, Dvesa (a klesha: Denial); Satya (Truthfulness); Bhranti-darsana (an antaraya: erroneous seeing.)

Aggression/Harm / Making amends for harm done / Ahimsa (Do no harm)

Laziness, sloth, apathy, fatigue / “Faith without works is dead.” “It works if you work it.” / Tapas, Asana, Styana and Alasya (antarayas – apathy and fatigue); Tamas (1 of 3 gunas)

Inability to change habits, emotional overwhelm in the face of change. / “Grant me the courage to change the things I can.” (Serenity Prayer) “Keep it simple, stupid.” “Nothing changes if nothing changes” “First things first.” “If you do what you’ve always done, you’ll get what you’ve always got.” / Samskaras, Tapas, Asana (Removal of Energetic blocks and obstacles); Antarayas (impediments to growth), emphasis on “be where you are” and gradual change. Dharana and Dhyana to see Samskaras clearly.

Cravings, Sensory Obsessions / “Surf the Urge” / Raga (a klesha: attachment to pleasure, craving); Pratyhara, Meditation; Avirati (an antaraya: sensory preoccupations); “Craving and aversions arise when the senses encounter sense-objects.” (Bhagavad Gita 3.34)

Controlling tendencies. / “Let go and let God” / Aparigraha (non-hoarding, non-grasping)

Perfectionism / “Progress not Perfection” / /

Isolation / 12-Step meetings, community / Yoga community, sangha

Toxicity/Intoxication/Disease of the body / Detoxification of body, mind, and emotions / Saucha, Asana to cleanse the body, Annamaya kosha, Pramada and Vyahi (antarayas, intoxication and disease.)

Stress, Physical, Mental, Emotional, Insomnia / “Easy Does It” / Asana, Pranayama, Savasana, Yoga Nidra, Meditation

Fear, terror, trauma, ungroundedness / / Abhinivesa (a klesha: Fear) Chakra 1 healing, Alabdhabhumikatva (an antaraya: groundlessness)

Guilt, Shame, Don’t feel what you feel / Make amends (12 Steps) / Chakra 2, 3 healing; loving kindness.

Grief / / Chakra 4 healing

Voicelessness, Don’t speak what you know / / Chakra 5 healing

Doubt, denial “Don’t see what you see,” Dissociation / / Chakra 6 healing, meditation

Lack of spiritual connection, aloneness / “God, grant me the serenity ….” 12 Steps: 7 of the 12 mention God or a higher power and Step 11 requires: “Prayer or meditation to improve our conscious contact with God.” “Let go and let God.” / Chakra 7 healing, meditation, Isvara Pranidhana

Anxiety, overwhelm, racing thoughts, worry about the future….despondency / “One day at a time” “Just for today.” / Rajas (1 of 3 Gunas). Manomaya kosha. Asana, Pranayama (longer exhale), Meditation (to ground in present moment), Arjuna - “despondent” about future battle.

Depression, rumination on past / “One day at a time” “Just for today.” / Tamas (1 of 3 Gunas). Manomaya kosha. Asana, Pranayama (longer hold after inhale), Meditation to ground in present moment (rather than past rumination);

Relapse / / Anavasthitatva (an antaraya: instability in practice that can lead to backsliding)

Imbalance, disconnection from self, other, spirit, separateness, brokenness / “The opposite of addiction is connection.” (37) / Sattvic. Balance, Integration, Union, Wholeness – the definition of “yoga”

* Some of the items in this chart overlap with ideas from Nikki Myers excellent course on Yoga of 12-Step Recovery (Y12SR)

References

Brand, Russell. Freedom from our Addictions. Kindle ed., Picador, 2017.

Desikachar, T.K.V. The Heart of Yoga. Developing a Personal Practice. Inner Traditions International, 1995.

Mate, Gabor, M.D. In the Realm of Hungry Ghosts. Close Encounters with Addiction. Kindle ed., Berkeley, CA: North Atlantic Books, 2010.

McCauley, Kevin T., M.D. Pleasure Unwoven. A Personal Journey About Addiction. Institute for Addiction Study, 2012. (Study Guide and Film)

Mitchell, Stephen (trans.). Bhagavad Gita: A New Translation. Kindle Edition. Harmony Books, 2000.

Myers, Nikki. Yoga of 12-Step Recovery. Online Intensive Course. https://y12sr.com/trainingresources/y12sr-certification/

Satchidananda, Sri Swami (translator and commentary). The Yoga Sutras of Patanjali. Kindle ed., Integral Yoga Publications, 1978 (Orig printing) 2012 (Rev. Ed.)

Svalovitz, Maia. Unbroken Brain. A Revolutionary Way of Understanding Addiction. Kindle ed., St. Martin’s Press, 2016.

Tippett, Krista, host. “Bessel van der Kolk with Krista Tippett.” On Being. 26 December, 2019. (originally aired July 2013.) https://www.wnyc.org/story/2fe90c72b8feadf3b8c960a8/

Tolle, Eckhardt. Retrieved from https://twitter.com/eckharttolle/status/1039563073034625026?lang=en

Van der Kolk, Bessell, M.D. The Body Keeps the Score. Brain, Mind, and Body in the Healing of Trauma. Kindle ed., Penguin Books, 2014.

Weiss, Robert, Ph.D, MSW. “The Opposite of Addiction is Connection.” Psychology Today. 30 September, 2015. Retrieved from: https://www.psychologytoday.com/us/blog/love-and-sex-inthe-digital-age/201509/the-opposite-addiction-is-connection

End Notes

1 - Weiss, Robert, Ph.D, MSW. “The Opposite of Addiction is Connection.” Psychology Today. 30 September, 2015. Retrieved from: https://www.psychologytoday.com/us/blog/love-and-sex-in-the-digital-age/201509/theopposite-addiction-is-connection

2 - Tolle, Eckhardt. Retrieved from https://twitter.com/eckharttolle/status/1039563073034625026?lang=en

3 - ibid.

4 - Svalovitz, Maia. Unbroken Brain. A Revolutionary Way of Understanding Addiction. Kindle ed., St. Martin’s Press, 2016.

5 - Mate, Gabor, M.D. In the Realm of Hungry Ghosts. Close Encounters with Addiction. Kindle ed., Berkeley,CA: North Atlantic Books, 2010. Location 203.

6 - McCauley, Pleasure Unwoven. A Personal Story of Addiction. 2012.

7 - Tolle, Eckhardt. Retrieved from https://twitter.com/eckharttolle/status/1039563073034625026?lang=en

8 - Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html

9 - Stukin, Stacie. “Yoga for Addiction Recovery.” Yoga Journal. April 12, 2017.

10 - Mate, Location 792.

11 - Myers, Nikki. Y12SR Online Course, Section 2.2.

12 - Brand, p. 84.

13 - Svalovitz, p. 64

14 -Svalovitz, p. 65.

15 - ACE – Adverse Childhood Event. See Addendum A

16 - Van der Kolk, Bessell, M.D. The Body Keeps the Score. Brain, Mind, and Body in the Healing of Trauma. Kindle ed., Penguin Books, 2014. p. 146.

17 - Svalovitz, p. 67.

18 - “New Casa Report.” February 26, 2010 (Retrieved from https://www.centeronaddiction.org/newsroom/pressreleases/2010-behind-bars-II)

19 - Mate, Location 173.

20 - Svalovitz, p. 33-4.

21 - Eye Movement Desensitization and Reprocessing, a form of psychotherapy that combines talk therapy with directed eye movements that helps to better integrate a traumatic memory.

22 - Neurofeedback is training in self-regulation through the use of an EEG-like computer program that measures brain waves and provides a feedback signal.

23 - Tippett, Krista, host. “Bessel van der Kolk with Krista Tippett.” On Being. 26 December, 2019. (originally aired July 2013.) https://www.wnyc.org/story/2fe90c72b8feadf3b8c960a8/

24 - ibid.

25 - Myers, Nikki. Y12SR Online Course. 2.2

26 - Tippett, Krista, host. “Bessel van der Kolk with Krista Tippett.”

27 - Mitchell, Stephen (trans.). Bhagavad Gita: A New Translation. Kindle Edition. Harmony Books, 2000.

28 - Mate, Location 256.

29 - Briefly, the three gunas are nature’s fundamental forces: sattva (balance, harmony, transparency, what is true and real), rajas (passion, desire, action, pain), and tamas (dullness, ignorance, heaviness, darkness, inaction). Guna means “strand,” suggesting that these three forces are interwoven to make up the known world (Prakriti)

30 - Satchidananda, Sri Swami (trans.) The Yoga Sutras of Patanjali. Kindle Ed. Loc 1793

31 - Nikki Myers uses Sutra II.16 as the foundation of her Y12SR course on relapse prevention.

32 - Satchidananda, Sri Swami (trans.) The Yoga Sutras of Patanjali. Kindle Ed. Loc 1800.

33 - Brand, p. 44.

34 - ibid., p. 4.

35 - ibid., p. 42.

36 - Desikachar, T.K.V. The Heart of Yoga. Developing a Personal Practice. Inner Traditions International, 1995. p. xiii.

37 - Brand, p. 85.