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Wellness Strategies
Part of A Practical Guide to Complementary Therapies for People Living With HIV

2004

Medical systems like Ayurveda, homeopathy, naturopathy and TCM offer users a spectrum of treatment options and a philosophical system in which to understand them. Although some PHAs have chosen to learn about these systems of health, others look to complementary therapies to address specific health concerns. In this section, we discuss treatments that might have derived from complete medical systems but are now used as stand-alone therapies. In some cases, these are ancient therapies that are still closely tied to traditional systems. Yoga -- an important component of Ayurveda -- is one example, but many people who use it are not familiar with broader Ayurvedic medical principles. Other therapies in this section are relatively new, like therapeutic touch, which was created by studying a variety of older traditions.


Aromatherapy

Aromatherapy involves essential oils extracted from plants to treat illness and improve overall well-being. These essential oils are usually inhaled or applied to the skin. For example, they can be added to hot water and inhaled as steam or used in a bath or shower. They can also be added to various vegetable oils to create a massage lotion. Essential oils are very concentrated and can burn the skin if not properly diluted. Only a few drops are required for each treatment.

NOTE: Never ingest or swallow an undiluted essential oil unless it has been specially prepared for ingestion. Ingesting essential oils can lead to serious health complications.

Essential oils can be purchased at health food stores. However, an aromatherapist, herbalist or naturopath will work out an individual mixture of essential oils to treat specific concerns. People using aromatherapy may combine several different oils to create a combination that is more powerful than its individual components.

For HIV infection, aromatherapy generally may be used to relieve stress and fatigue or to address specific health concerns. For example, lavender oil can counter stress and fatigue but is also used to treat skin irritations. Peppermint oil is thought to improve circulation and relieve tension headaches.

Aromatherapy relies on our sense of smell. Most people have experienced memories triggered by particular aromas, so it is not surprising that aromas can affect mood, stress level and sense of well-being. For this reason, a person's experience with aromatherapy is highly individual. The emotional impact of different aromas varies from person to person. Although many people enjoy and benefit from aromatherapy, others do not.

People who are allergic to perfumes or other scents may also be allergic to aromatherapies and understandably wary about their use. Many essential oils can be toxic in large doses, and some people may be especially sensitive to their scents. This is particularly true for children as well as pregnant women, who should altogether avoid certain essential oils. Since substances heated for inhalation are spread through the air and rapidly taken into the body, it is important to consider the wishes of other people in your environment when using aromatherapies.

If you plan to buy and mix essential oils without the guidance of an aromatherapist, herbalist or naturopath, you may wish to consult a book on the subject. The Fragrant Pharmacy by Valerie Ann Worwood is an excellent resource.

Aromatherapists are not regulated in any province. The cost of a one-hour session with a qualified practitioner ranges from $60 to $100.


Colour Therapy

Seeing colour affects our senses, state of mind, mood and emotions. Colour can stimulate and energize or calm and sedate. Colour affects the foods we eat, the clothes we wear, the environment we frequent. Colours have different wavelengths and vibrational frequencies. Seeing a rainbow may impart feelings of euphoria, excitement or joy.

Colour is an important element of many complementary therapies. Gem stones used to enhance the energy of the chakras in Ayurvedic medicine are chosen by colour.

Many of the properties of flower essences are determined by the colour of the blossoms from which they derive. Colour therapy is also an important part of nutritional therapies. Nutritionists often suggest that people shop for as many different colours of fruits and vegetables as possible to ensure that they take in a range of vitamins and nutrients. The colour of food, an important part of its appeal, may in turn stimulate appetite. Some people attribute different healing properties to different colours.

Colour and Attributed Properties

Red
Boosts digestion and has a warming effect.
Orange
Provides vitality, mental clarity, joy and emotional expansion.
Yellow
Acts as a motor stimulant, boosts morning energy and facilitates digestion.
Green
Nurtures, calms nerves and reduces tension.
Blue
Cools the body and has strong yin or vata (wind) properties. (See sections of Ayurveda and traditional Chinese medicine for details.)


Flower Essences and Other Essence Therapies

Essence therapies rely on the idea that plants, gems and crystals have a vital energy that can have a healing effect. Most essence therapies focus on a person's emotions and spiritual well-being rather than on physical healing. Essences are created when flowers or gems are placed in pure water and exposed to sunlight. Because the energy of the flower or gem is seen to be vibrational, it spreads through the water. Thus, the vibrational pattern becomes part of the water. Just as in homeopathic remedies, the pattern is enhanced when the water is diluted. (See section on homeopathy for details.) Drinking a few drops of the remedy in water, tea or fresh juice allows the body to take in this vibrational energy.

Flower essences are the most common essence therapies. Each flower is used for its specific vibrational energy, which in turn has an effect on a person's emotions. The properties of a flower essence are based on the flower's colour, on where and when the flower is grown and sometimes on the medicinal properties associated with the plant itself. There are several groups of flower essences from plants that grow in different parts of the world. The best known system of flower essences is Bach remedies.

Bach remedies focus on healing a person's emotional state and creating a positive impact on the whole person. Created by Doctor Edward Bach in the late 1800s, this system classifies 38 negative states of mind and offers remedies for each state. Each remedy derives from the flowering part of a specific plant. These essences are sometimes combined to deal with a host of emotions. For example, Rescue Remedy (probably the best known Bach remedy) contains star of Bethlehem, cherry plum, clematis, impatiens, rock rose and crab apple. It is intended for use in times of crisis and acute stress. Bach flower remedies come in small dropper bottles; the flower essence is dissolved in grape alcohol. Preparation involves dissolving a few drops of a remedy in another liquid. Genuine remedies are marked Bach Flower Remedies and include the address of the manufacturer in the United Kingdom (the only place they are made).

In gem essences, the liquid takes on the vibrational properties of one or more gems. Magnetic fields and pyramidal energies are sometimes used instead of sunlight to distribute the gem's energy throughout the liquid. The therapeutic properties attributed to each gem depend on the stone's colour, molecular structure, chemical composition and the area where the gem is found. Gem stones are often used to enhance the chakras. (See section on Ayurvedic medicine.) Gem essences may also be used to balance the chakras to promote physical, spiritual and emotional well-being.

Flower and gem essences can be combined to create vibrational essences that suit individual needs. Some combinations are thought to have a synergistic effect, which means each essence increases the effectiveness of the others. The names of some commonly combined vibrational essences are Sanskrit, an ancient Indo-Aryan language, and are chosen to best describe that for which the essences are meant.

Some people wear different types and colours of crystals and gems to promote healing. In the same way that people may share the vibrational energy of a gem or flower by drinking its essence, they may benefit from the energy of a crystal worn regularly. Also, the forms of touch therapy described later in this guide rely on the belief that people can share their vital energy to provide healing for others.


Herbal Therapies

Herbal therapies are medically active substances harvested from plants. They may come from any part of the plant but are most commonly made from leaves, roots, seeds or flowers. They are eaten, drunk, smoked, inhaled or applied to the skin.

Herbal therapies are part of virtually every medical system. Many drugs now used by conventional Western doctors originated as herbal medicines. Practitioners involved in the medical systems discussed in the first half of this guide use herbs extensively. So do herbalists, who practise outside these systems. A European healing tradition, sometimes called the "wise woman" tradition, also focuses primarily on herbal healing.

Herbal medicines are often viewed as a balanced and moderate approach to healing. Pharmaceutical drugs derived from plants are made by isolating the chemicals that have a medical effect and concentrating them in the medication. Herbal therapies, on the other hand, contain all the chemical components of a plant, as they occur naturally. This important part of herbal medicine may explain why some herbs -- used by experienced practitioners for centuries -- have not performed well in modern clinical trials when their active chemicals were isolated from the rest of the plant.

Herbal therapies are available at herbal and health food stores and, increasingly, are being sold in drugstores and grocery stores. Buyers' clubs are another option for buying herbs and other nutritional and complementary therapy products. These clubs allow people to pool their money to obtain bulk products at lower wholesale costs. Then members purchase products through the club at a reduced rate, often through the mail. Although buyers' clubs have flourished in the United States, they are less common in Canada. Joining a U.S.-based buyers' club may involve hassles when importing treatments across the border.

Herbal medicines are often promoted as a gentle and non-toxic approach to good health. This does not mean herbal therapies never cause side effects or never interact with other pharmaceutical and herbal treatments. Learn enough about any herbal therapy to ensure that the dose is safe and effective. Learn about possible side effects and watch for signs of drug interactions. It is also important to inform your doctor, pharmacist and complementary therapist about all of the medications and health products you are taking -- prescription and non-prescription -- including herbs and supplements.

A Practical Guide to Herbal Therapies for People Living With HIV provides more information on the use of different types of herbs. CATIE also publishes fact sheets on specific herbs that are commonly used by PHAs. Although we hope that our herbal guide and fact sheets will be a useful starting point for people interested in exploring herbal therapies, we encourage you to get as much detailed information as you can about any treatment that you're considering. Think about consulting a qualified herbalist who has experience working with HIV-positive people.

Herbalists are not regulated in any province, but some are registered as naturopaths, and others are accredited through professional societies for TCM practitioners. The Canadian Association of Herbal Practitioners requires its members to complete three years of full-time study. Some institutions and associations differentiate between clinical herbal therapists and consultant herbal therapists: the former generally have more years of training and experience. An introductory session with a qualified herbalist costs about $60 to $100. Follow-up visits are around $40 to $70.


Iridology

Iridology studies the eye and the area around the eye, particularly the markings of the iris -- the coloured portion of the eye. Every organ is connected to the iris through the nervous system. In the first stages of fetal development, the eye is actually part of the brain. As the embryo forms, the eye slowly separates yet maintains thousands of connections to the nervous system. Other nerves in the body receive impulses from the optic nerve, the optic thalamus and the sympathetic and parasympathetic nervous systems. Iridologists believe that illnesses, including the location of a disease, its history and the possibility for progression, are identified by reading the iris. Iridology is a non-invasive way to study a person's physical and mental health.

Each person's iris has a unique pattern, and iridologists keep detailed records of each one. They carefully examine the integrity of the iris's tissue. Tissue integrity is the structure, colour and density of the iris fibres. By examining the individual fibres within the iris, iridologists discover inherent genetic traits. Close-knit fibres and loose fibres suggest different health outcomes.

Iridology does NOT reveal specific diseases or infections, since many diseases cause similar changes in body tissue. Instead, according to iridologists, the iris reflects the condition of these tissues and pinpoints areas of toxicity, congestion or other types of imbalance. Modern iridologists often use a chart outlining the relationships between portions of the eye and various body systems.

Identifying the body's inherent strengths and weaknesses allows a person to do what's necessary for the weaker areas before the symptoms of disease cause further destruction. This may be useful for HIV-positive people whose weakened immune system enables illness to manifest quickly. Ayurvedic treatments are often used in conjunction with iridology to maintain and restore weaker areas of the body.

The effectiveness of iridology is a subject of controversy. A recent review of the medical literature found that controlled trials to date have not demonstrated any clinical benefit to iridology. The cost of an initial session can range from $60 to $150. Iridologists are not regulated anywhere in Canada.


Juicing

Juicing creates liquid foods, which the body can easily assimilate and absorb. It allows the vitamins and other nutrients in fresh fruits and vegetables to be easily consumed -- even by people who have no appetite. Raw foods provide abundant energy. They supply the body with optimum nutrition in the form of vitamins, food enzymes and fibre. Juicing is often used if a PHA's health is compromised by weak digestion or malabsorption and if a person has difficulty chewing.

Most fruits have a cleansing effect on the body's system. Their high water content flushes the digestive tract and kidneys. Juicing is used to flush the kidney, liver and gastrointestinal system of toxins. For PHAs dealing with the side effects of antiretrovirals, juicing may assist in removing the toxic by-products of the drugs. These enzymes are naturally present in fruits and vegetables. Proponents of juicing believe that enzymes are destroyed when food is processed or heated. Our own bodies produce enzymes that digest food and incorporate it into the cells of our bodies. Juicing allows us to ingest the enzymes of fruits and vegetables, which may make digestion easier.

The freshest produce will give you the most enzymes. So choose fruits that are in season. To avoid ingesting pesticides, peel the skin of the fruit or vegetable and do not ingest the pulp. Fresh juices are a concentrated form of food. Be moderate in your consumption. Fruit juices are high in fruit sugar.

Different juices are thought to have different effects on our bodies. For example, prunes and apricots are used as laxatives, while bananas are recommended to slow diarrhea. It is also important for PHAs to know that grapefruit juice can affect the concentration of protease inhibitors in the blood, possibly making side effects more severe. Although some PHAs have intentionally used grapefruit juice to increase the levels of drugs that the body absorbs poorly, such as saquinavir, people on protease inhibitors should use grapefruit juice with caution, if at all. You can combine juices so that their benefits work together. The potential effects of fruits and vegetables are discussed in the book Juicing For Life, by Cherie Calbom, Jeffrey Bland and Maureen B. Keane.

In addition to the impact of some juices on the digestive system specifically and the body in general, PHAs may also choose juices according to their colour. (See section on colour therapy.)


Massage and Manipulation Techniques

Massage therapy is the movement and stimulation of body tissues by a therapist, such as the manipulation of muscle in Swedish massage or of joints, bones and tendons in chiropractic massage and osteopathy. Most healing traditions use massage. And most PHAs who use massage find it relieves stress and decreases anxiety. Massage may also benefit the immune system.

Swedish Massage

Swedish massage is the form of massage most commonly available in Canada. It aims to stimulate blood circulation and loosen knotted muscles. The kneading, stroking, pressing and stretching can help joints move better and provide relief from pain, stress and fatigue. Swedish massage may also help the immune system work better through relaxation. Studies of the immune benefits associated with massage are mixed. One small study showed an increase in immune system cells with regular massage, while another demonstrated no immune improvements. Benefits have been most dramatically demonstrated in babies. A study of babies born to HIV-positive women determined that those given regular massages gained weight faster and scored better on tests of motor control and alertness. Massage may also help with peripheral neuropathy.

Massage therapists are registered in Ontario and British Columbia, where they must complete a two- to three-year course and pass an examination in order to call themselves registered massage therapists. An hour-long massage session costs $30 to $90. Some massage therapists are covered under the B.C. health plan. (Check that the therapist has opted into the plan.) Some extended health care plans cover massage therapy.

Shiatsu

Shiatsu is a form of Japanese massage that aims to balance the energies in your body. Some HIV-positive people use shiatsu to relieve stress and fatigue. This type of massage may also have immune benefits similar to those suggested for acupuncture, although this claim has not been studied. At least two styles of shiatsu massage are available in Canada, and practitioners may offer one or both. Masunaga shiatsu (or zen shiatsu) is closely related to other eastern Asian medical practices. It focuses on creating balance and harmony in the body by stimulating the flow of Chi or life energy (see section on traditional Chinese medicine) and is closely related to acupressure. The second style of shiatsu is Namikoshi shiatsu, also called original shiatsu. This style combines the Western medical sciences of anatomy and physiology with the Eastern traditions of Masunaga shiatsu. Namikoshi practitioners focus on the pressure points associated with the body's endocrine system, which is a network of glands that distribute hormones throughout the body.

Shiatsu is not regulated in any province, and there is no national organization for shiatsu therapists. Although there is talk of creating a professional organization with a more national scope, only British Columbia and Ontario have professional organizations of shiatsu practitioners.

Reflexology

Reflexology was practised in several ancient medical systems. It aims to influence the health of different parts of the body by applying pressure to "reflex" points on the feet and hands. Each reflex point is associated with a different part of the body. Applying pressure to these points affects the health of the corresponding area of the body. Reflexologists do not use lotions or oils as part of the massage. Nor do they diagnose specific illnesses. Reflexology is used to reduce stress and tension, improve circulation and eliminate toxins. Reflexologists also work on reflex points that may stimulate the immune system.

A session with a reflexologist lasts about 45 to 60 minutes and costs from $30 to $70. Reflexologists are not regulated in any province. To become a member of the Reflexology Association of Canada, practitioners must complete at least 30 hours of classroom training and 60 hours of practical training.

Trager

Developed by Milton Trager, this form of mind-body medicine uses physical movement to access the healing power of the mind. With Trager, the practitioner guides the patient through a series of gentle movements, which the patient experiences as effortless and freeing. Trager is used to release basic physical and mental patterns and to facilitate deep relaxation, increased physical mobility and mental clarity. It is designed to strengthen a person's autonomy and sense of self. No oils or lotions are used, and the client is dressed, usually in swimwear, briefs or other non-restrictive clothing. Practitioners also teach a series of movements called Mentastics (short for mental gymnastics) People can do these movements on their own to complement the effects of the Trager session. A session with a Trager practitioner usually lasts 60 to 90 minutes and costs $45 to $100. A person must be registered with a national Trager Association to qualify as a practitioner. Training requires a minimum of six months and includes lectures on anatomy and physiology as well as Trager sessions, both given and received. To maintain their registration, practitioners must participate in a three-day training session every year for the first three years, followed by a session at least every third year. Trager practitioners are not regulated in any Canadian province.

Note: Trager and Mentastics are registered trademarks of the Trager Institute.

Chiropractic and Osteopathic Manipulation

Chiropractors assist the body's natural ability to heal by focusing on the skeleton, particularly on the spine and the nerves that run through it. Chiropractors do not use drugs or surgery. By manipulating the spine, they can relieve stress as well as musculoskeletal disorders like headache and back pain. Most of the conditions treated by chiropractors are not associated with HIV, however, PHAs use chiropractors to treat symptoms such as headaches or insomnia. Although their main tool is spinal manipulation, chiropractors also use ultrasound and the application of heat and light. They frequently use X-rays to aid in diagnosis.

Osteopathic doctors use manual manipulation techniques similar to chiropractors but focus more on the body's soft tissues, the muscles and the ligaments. They may be helpful in treating headaches, joint and muscle pain or fatigue. Osteopathic doctors combine osteopathic techniques with conventional medicine and are licensed as physicians in the United States and Britain. In Canada, the practice of Osteopathy is much more restricted. Alberta and British Columbia allow Doctors of Osteopathy to be licensed as physicians but this is not the case in other provinces. Due to these restrictions, osteopathic practitioners are relatively rare in Canada.

Legislation regulates the practice of chiropractic manipulation in all 10 provinces and in the Yukon. In the Northwest Territories and Nunavut, chiropractors are unregulated. The Canadian Memorial Chiropractic College in Toronto is the only accredited school to train chiropractors in Canada. To be admitted to the four-year Doctor of Chiropractic program, students must have completed at least 15 full-credit university courses.

A five-year course at the Université du Québec à Trois-Rivières qualifies graduates to practise in Quebec. Students must have a diploma of collegial studies to be admitted. To be licensed, chiropractors must pass a national board exam and an examination in the province where they want to practise.

Chiropractic services are partially covered by the health-care plans of Alberta, British Columbia, Manitoba, Ontario and Saskatchewan, although user fees may apply. Most private health-care plans cover at least some chiropractic treatments. For those with no coverage, fees are usually $20 to $40 per visit with additional charges for extra services like X-rays.

The Canadian Chiropractic Association does not provide referrals to qualified practitioners, nor do most of the provincial organizations. The regulation of practitioners in most of Canada, however, ensures that those who are certified are qualified to practise. In the Northwest Territories and Nunavut, check the credentials of a chiropractor (with his or her written consent) by writing to the following organization:

Canadian Chiropractic Examining Board
Suite 103, 1144 - 29th Avenue NE
Calgary, Alberta T2E 7P1
www.cceb.ca
(403)230-5997


Mind-Body Medicine

Mind-body medicine uses the power of the mind to promote healing in the body. Some forms of mind-body medicine -- specifically, affirmation and visualization -- are active, using mental exercises to change physical health. Other more indirect forms of mind-body medicine acknowledge that stress and traumatic events have a negative impact on both the immune system and the body in general. These approaches work to control mental and emotional stress. For example, helping people deal with the stress of being HIV positive may benefit their immune function and reduce their risk of illness. Meditation, Tai Chi, yoga and stress management programs are indirect forms of mind-body medicine. An emerging field of conventional medicine, psychoneuroimmunology, studies the links between stress and immune function.

Affirmations

Affirmations are positive statements about health and identity. They are always spoken in the first person and in the present tense. "I am strong and healthy," is an example. PHAs use affirmations to maintain control over their lives. Some people may read them aloud or memorize them for repeated use. Others prefer to listen to them as they are read aloud by a friend or played on a recording device: they find that this method makes it easier for them to concentrate on the words. Hundreds of books and tapes offer affirmations to enhance health and self-esteem. Choose one that is meaningful to you or create your own affirmations. If you are worried about T-cell numbers, you might try an affirmation like, "I am a healthy human being. I am not defined by any T-cell number." Jon Kaiser's book Immune Power offers affirmations specifically for PHAs.

Guided Imagery (Visualization)

Anyone who has salivated over a recipe knows that what is imagined can have a physical effect, such as making you hungry. Guided imagery aims to mobilize the imagination to promote physical and holistic healing. Many PHAs feel powerless in the face of their illness. Guided imagery is used to direct thoughts to an environment where you have total control within your own mind. It is used to relieve the anxiety that accompanies illness and the pain that may be a symptom of illness. Several studies suggest that guided imagery effectively controls anxiety and pain. With some guided imagery, you imagine yourself in a relaxing time or place (your grandmother's kitchen or a sandy beach). Other forms encourage you to visualize your immune system destroying HIV. Guided imagery is used to reinforce the ability of the immune system to resist HIV. Studies have produced mixed results, since the effectiveness of guided imagery may be influenced by such things as receptiveness to hypnosis and the ability to accurately imagine what is happening in the body. Some AIDS service organizations offer guided imagery sessions. Tapes may also be used to guide visualizations. Tapes that focus on HIV or the immune system are available and can be purchased at many bookstores.

Meditation

The art of meditation involves becoming aware of your thoughts, observing them and eventually achieving mastery over them. Meditation means listening to your body and the workings of your own mind and spirit. Many forms of meditation teach awareness of the subconscious act of breathing. When you are in sync with your breathing, you enter a different realm of consciousness. Doing so may help you relax and make you feel more rested than after the deepest sleep. It may also give you a sense of calm, peace, joy and efficiency. Some people use meditation to get a clearer view of reality.

With practice and discipline, meditation is used to cultivate mindfulness. Meditation can be associated with specific spiritual beliefs and is a part of many culture-based approaches to healing, including Ayurveda, First Nations healing traditions and traditional Chinese medicine. Some forms of meditation require that you maintain specific postures or repeat specific sounds or phrases. Other forms are much more casual. Many people meditate when they paint, write or watch a sunset.

PHAs use meditation to help themselves relax and deal with stress and anxiety. Like they use guided imagery, PHAs use meditation to increase feelings of control over their lives. Meditation is also used to strengthen sense of self since it may be understood as a way of listening to your internal voice. At least one study links participation in prayer or meditation to better overall health for PHAs. Many different spiritual traditions teach meditation. Look for one that is meaningful to you. Local AIDS service organizations may offer programs that teach meditation outside specific systems of religious beliefs or they may be able to refer you to an organization that provides such programs.

Stress Management

Stress management programs are used by PHAs to constructively cope with stress. These programs identify the ways you currently cope with stress and teach new mental and emotional techniques for dealing with these issues. Stress management often involves a physical component, such as a breathing exercise, meditation or physical exercise. It may also incorporate counselling sessions or massage work or both. Most PHAs who take advantage of these programs feel the sessions improve their day-to-day life experiences.

A number of small studies confirm that stress management programs lead to relief from anxiety and improvements in quality of life. Since it has been shown that stress has a negative effect on the immune system, many people believe that their immune systems have benefited from stress management programs. But study results have been mixed, partly because the definition of a stress management program varies widely. One study demonstrated an improvement in herpes outbreaks in HIV-positive men after a stress management program. Another showed increases in the number of CD4+ cells.

Many Canadian AIDS service organizations run stress management programs for PHAs, and the programs are usually free. Call your local AIDS service organization (ASO) for more information. If no such workshops are available to you, your local ASO may be able to recommend counsellors or psychotherapists who do this kind of work and are experienced working with PHAs. In some cases, this therapy may be covered by a provincial health plan. Your local organization should be able to tell you more. Further, branches of the Canadian Mental Health Association (CMHA) often run stress management workshops and provide materials about coping with stress. These workshops are not specific to PHAs but they may be sources of useful information. Look up the local branch of the CMHA in the phone book. For individuals, CMHA workshops usually cost around $50.

Tai Chi

Tai Chi is related to qigong (see section on traditional Chinese medicine) and the Chinese martial arts tradition. Like qigong, Tai Chi combines physical movement and meditation. The movements emphasize being aware of your own Chi, or Qi, and the Chi of others. Tai Chi's slow, rhythmic movements have made it a popular form of exercise in Canada, but the mental and physical discipline that it teaches also helps those who practise it to deal with stress. Tai Chi is related to the spiritual teaching of Taoism. There are a number of different forms of Tai Chi, and several are practised in Canada.

Yoga

Yoga is union with the self or divine truth. Although many people think of it primarily as an exercise program, the stated purpose of yoga is liberation: to help an individual achieve longevity, rejuvenation and self-realization. It may also be used to heal and prevent illness.

There is more to yoga than stretches and postures, but these components are usually the first ones that people learn. Yoga contains eight components, which can be incorporated as a person progresses. These eight stages combine mental, emotional and physical aspects. They are yama (abstentions), niyana (observances), asana (postures), paranayama (life force control or breathwork), pratyahara (sense withdrawal), dharana (concentration), dhyana (meditation) and samadhi (contemplation and state of perfect equilibrium).

Yoga is used to establish a sense of relaxation and awareness. It may also increase oxygen consumption and reduce stress. Doing yoga on a regular basis builds muscle strength and flexibility. It is used to manage insomnia too.

Yoga is also said to massage the body internally, stimulating the circulatory and endocrine systems and strengthening the lungs and digestive organs. PHAs who practise yoga have experienced benefits such as improved stamina and reduced fatigue as well as a general feeling of well-being, sometimes referred to as connectedness.

There are many different schools of yoga and many different approaches and techniques. Look for instructors who are registered with a specific school and are experienced at working with PHAs. At least one school has developed a video of postures specific to PHAs. See the resources listed at the back of this guide for details.


Touch Therapies

Touch therapies are based on the belief that people have their own vital energy. This energy field flows through and surrounds the body. Blockages or imbalances in the body cause ill health. This notion is similar to the Chinese concept of Chi. (See section on traditional Chinese medicine.) Touch therapists modify imbalances in the energy field by using their energy to redirect the energy of others.

Therapeutic Touch

Therapeutic touch is based on the idea that "the human body, mind, emotions and intuition form a complex, dynamic energy field." This energy field encompasses the body. When a person is ill, the energy field is out of balance. Therapeutic touch practitioners modify imbalances using their hands but they don't actually touch you. Rather, they believe the energy field extends beyond the body. Although therapeutic touch was derived from the spiritual healing practices of several cultures, practitioners do not require you to hold any particular religious faith. Therapeutic touch is often used by chronic-care nurses to relieve pain and promote relaxation. A small study on the use of therapeutic touch with HIV-positive children found that it effectively reduced anxiety.

Sessions with a therapeutic touch therapist usually last about half an hour and cost between $25 and $50. Some practitioners offer a sliding scale.

Reiki

Reiki means universal life energy. Ki is the Japanese form of Chi, the Chinese word meaning vital energy. (See section on traditional Chinese medicine.) Reiki is similar to therapeutic touch but was developed in Asia. Like therapeutic touch, reiki is based on the belief that living things share life energy. When that life energy is blocked, it creates an imbalance that may appear as illness. Unblocking the energy helps get a person back into balance. During a reiki massage, the practitioner's hands are placed on the body to channel this energy. The client remains fully clothed. Reiki massages generally take 60 to 90 minutes and cost $40 to $60. Reiki practitioners are trained by reiki masters, who are more experienced practitioners. Reiki practitioners are not regulated in Canada and there are no provincial or national associations for Canadian practitioners.

Pranic Healing

Prana is the Ayurvedic word for the life force on which all life depends. (See section on Ayurvedic medicine.) In pranic healing, several methods are used to balance, enhance and increase prana. Pranic healing often involves the intervention of another person, but self-healing techniques are also used. Spiritual healing techniques, such as prayer, visualization and meditation, are used to remove blockages. Like the other touch therapies addressed in this guide, the use of hands is a central component. Breathing techniques, known in yoga as pranayam, are also used to enhance prana.


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