by Shanti Shanti Kaur Khalsa, Ph.D.

On a cool Tuesday morning in January 1990, Jonathan called. I had been teaching yoga to people living with serious illness for about five years in Los Angeles.

“I’m calling to let you know I may not make it to class on Friday, ” Jonathan began in his soft British accent. “I’ve gone to the doctor this morning and he told me I have just three days to live. Mind you, I am not actually canceling. If the doctor is right, my partner David will give you a ring.

If the doctor is wrong, I’ll be in class, in my usual spot.” Jonathan spoke with ease and calm. From the time he had first started classes in Kundalini Yoga for people living with HIV, he took to heart the yogic perspective on living and dying. He used this time to explore his life.

What was he afraid of? What was holding him back from fully enjoying the gift of his life? Jonathan used the practice of meditation to help him become aware of his feelings, beliefs, decisions, words, and actions and to transform them.

He then made a conscious choice to live in a way that honored the sacredness of his life. He was 39 years old. When it came time for death, he was prepared. It was with this fearless depth that Jonathan heard the doctor’s prognosis.
In the early evening on that same Tuesday, David called to let me know that Jonathan had passed away peacefully in their home.

When I first started to teach Kundalini Yoga to people with HIV, cancer, and other life-threatening illness, a renowned health care leader told me bluntly, “Death is a medical failure. We don’t want our patients to die, so when it looks as though they will, we start to pull away. We turn our attention to the patients where we can win.”

At that point, there was nothing in my life experience that had taught me how to serve people facing death, and I was seeking the wisdom of those in the field. I stood in front of a leading representative of modern medical health care, astounded.

So, I thought, this is how medical people are trained away from a dying person. How would a yogi respond? Simple. Move closer. Closer to the dying person, and especially move closer to the realization and acceptance of one’s own death.

Yogi Bhajan says that to know how to live, we must know how to die. To a person following a yogic way of living, life is a conscious preparation for death. When we remember in life that we are to die, our awareness does not allow us to do a wrong act. We remember the preciousness of our life and choose right action.

Roger’s Story

Roger was a chemical engineer and a methodical man. For him, everything had to have a reason, an explanation, and it had to make sense. When he received a diagnosis of stage IV colon cancer, he approached his treatment with the same one-step-at-a-time system that he used in his lab at work. When his oncologist told Roger there was no further treatment he could give him, Roger said, “I’ll just keep turning over more stones, until I find a solution.”

His efforts led him to meditation and yoga practice and the inner work of facing death and finding new life.

“I have discovered a world beyond my intellect and this has been an extraordinary experience. Now, to me every place is an altar, every experience is a blessing. Life has become magical, even though I am doing the same routine.” Roger encouraged his family, friends, and colleagues to explore this process with him. He made new friends along the way and continued undaunted, even when others around him did not share his enthusiasm for addressing death.

” I was an old guy, 68, when I was diagnosed. I didn’t think there was anything more I could learn about life. I never thought spirituality or religion had any value. I was mistaken. After I reached the limits of medical treatment, I learned to see and to serve the purity and piety in all. Shocked the hell out of me and everyone who knew me.”

“Facing my death has been the most important work I have done in my life. I believe death needs to be more openly discussed and planned for in families, the same way that education of the children, retirement, and buying a home are discussed and planned for. Understanding death has such an impact on living life that we need to give it more attention.”

Roger lived four years longer than his doctors foresaw, and at the time of his passing he was surrounded by loved ones who were at peace with his death, and who could support him calmly. His wife, Melinda, described his last moments. “His breathing became difficult for a minute or two, then calm and even again until it stopped altogether. I noticed he had a slight smile on his face. Though I was right next to him, it was clear that he was not smiling at me.”

What happens when we die? According to the yogis, at the time of death, each of the nine gates close, one at a time, until the energy of spirit is consolidated at the crown chakra. The soul is carried with the subtle body through the tenth gate. The person exhales, the soul is released. There is no next inhalation. Stillness follows.

Divine Grinding

At the time of the passing of the soul from the body, each of us experiences 30 seconds of “divine grinding.” This divine grinding comes in three stages. During the first 10 seconds you face the entire panorama of your life. The next 10 seconds, you judge yourself. During the final 10 seconds you take your last breath, your last exhalation, and your soul and subtle body pass.

Once the soul passes from the body, it enters a “cylinder,” the tunnel of white light described by so many who have had near-death experiences. As it moves along in this space, the soul may sense the passing of other souls. At the end of the tunnel, there is a choice.

The left side is hot; the right side is snowy cold. On both sides are your relatives, calling you.

The message of the yogis is, “Go toward the snow.”

At 17 days after death, the soul chooses to stay in the electromagnetic field of the earth, or to cross through the electromagnetic field, into the blue ethers. Most souls remain in the first level of blue ether for a period of time before entering the next life.

In the process of death, it is important to keep connection with the neutral mind. This is the time to be deep in our identification with the infinite, undying self. Yogi Bhajan says, “You and your mastery must come through at the moment of death.” We develop mastery when we wake up during the early morning hours, take a cold shower, and meditate before the sun rises.

In the darkness, in the resistance of that time of the day, meditation practice gives us skill to penetrate the mind with the light of the soul. This ability is necessary during the divine grinding just before the soul leaves the body.

It is also said that chanting Wahe Guru or the pran sutra, Nanak too lehna too hai, guru amar too vicharia, (You are Nanak, Guru Angad, and Guru Amar Das) at the time of death helps to connect us with the neutral mind, and release the soul.

Long Ek Ong Kars

The chanting of Long Ek Ong Kars, for example, is part of the Aquarian Sadhana and is an excellent means to command freedom within one’s self, increase vitality, and break through blocks. Yogis recommend practice of it to allow ease and vitality into the process of dying.

Also called the Morning Call, this is the 2 and 1/2 cycle mantra of Ek Ong Kar available on most sadhana CDs from Ancient Healing Ways

Yogi Bhajan describes death as “a process where your consciousness does not exist within the control of your ego.” This means that we must have a relationship of trust with the unknown, the unseen, in order to die peacefully. Much of yogic life practice is to deepen this trust.

Nam Simran, the repetition of the sound current, such as a mantra, with each breath develops such trust. The practice of the one-minute breath can have this benefit as well. The practice of giving to the unknown, such as in charitable giving, and the practice of taking right action without attachment to outcome, are examples of deepening the relationship of trust with the unknown.

Instead of judging oneself and others, practice blessing and forgiving so you can bless and forgive all that you see in the panorama stage. Practice releasing all attachment to what happened or did not happen during the course of your day and forgiving and blessing every person and every event.

Roger found that this practice became his greatest power in life. “My best achievement is that I can bless all, forgive all. It has brought boundless joy to my life.” And a peaceful, transcendent death.
The poetic words of Guru Nanak convey the feeling of vastness, joy, and deep calm that is the movement of the soul from life into death.

The nine gates are closed by the True Lord’s Command and the Soul Swan takes flight into the skies.

Be at peace.

by Shanti Shanti K. Khalsa, Ph.D.
IAYT Advisory Council; Guru Ram Das Center for Medicine & Humanology, Espanola, NM

The day before I started to write this article I sat with eleven other Yoga teachers, each representing a member school of the International Association of Yoga Therapists, each a steward of their Yogic lineage and tradition, each a pioneer in bringing Yoga as a therapy into Western medicine. We met as a standards committee intended to create minimum requirements for Yoga therapist training. Under the skillful facilitation of Dan Seitz and John Kepner, we sorted through such concepts as scope of practice, knowledge base, clinical experience requirements, and core competencies— areas few of us considered when our first Yoga student with a health condition came to class. What a difference twenty years makes!

When I was trained as a Kundalini Yoga teacher in 1971, the focus was on teaching healthy people. Sure, people came to class to increase their flexibility and energy, to reduce stress or improve sleep, but these were not considered people with health conditions. Fifteen years later, students came to my class on La Cienega Boulevard in Los Angeles with fevers that had no known cause. Many had orange fungus growing in the creases of their skin or long white filaments growing from their tongue. They were in late-stage HIV disease. This was out of my realm; I had no medical background and had no idea how or even what to teach these students. Fortunately, my spiritual teacher Yogi Bhajan lived in the same city and was available to train me to teach Kundalini Yoga to people with health conditions. Though I did not recognize it at the time, nor label it so, it was under his direct guidance that I moved from being a “Yoga teacher” to becoming a “Yoga therapist.”

Yogi Bhajan did not use the terms “Yoga therapy” or “Yoga therapist” and encouraged us not to use this language. We call what we do “bringing Kundalini Yoga into the healthcare field” or “teaching Kundalini Yoga to people with… (name the condition).” He felt that until there is adequate research on the application of Yoga practice to support health outcomes, it is not appropriate to call what we do “therapy” or “therapeutic.”

Other Yoga teachers were in a similar situation, with students who had identifiable conditions and for whom a regular Yoga class did not serve. We found each other. Larry Payne knew Richard Miller; I knew Larry, who introduced me to Sherry Brourman, who influenced my work with the lymphatic system. Lisa Walford was teaching people with HIV; so was I. Eric Small was down the road from me, teaching Yoga to people with MS. Most of us taught specialty populations: just people with cardiovascular conditions, just people with back pain, just women with breast cancer, just people with depression.

Through the centuries Yoga has been taught and practiced as a way for healthy people to reach their excellence. Even though there are Yogic texts on the therapeutic applications of Yoga, it is not historically a therapeutic method or intervention. Fortunately, most of us had a lineage, a Yogic tradition we followed with a living teacher who guided our work.

We helped each other connect with physicians and allied health professionals, supported each other with marketing and outreach, made connections to participate in professional conferences. We formed a tribe of sorts.

Defining what Yoga therapy is and what a Yoga therapist does? Who had time for that? I don’t recall that we even used these terms in 1986. For many of us, it was more than enough to address what was in front of us. In my own situation,

new medical information about HIV and the immune system came out almost daily, requiring me to constantly learn more and modify how, what, and even where (hospital, hospice, home) I taught. Students died almost every week. It was messy, chaotic, enormously demanding, and changing fast. This is a field?

After a few years of this, it started to dawn on us that something bigger was happening than just us teaching Yoga to people with a health condition. Larry hosted a training by A.G. Mohan at Meadowlark. From this we got a glimpse of our range and impact and began to put language to what we were doing: We were pioneers in the West for the therapeutic application of Yoga.

Larry and Richard got reflective, and one day in 1989, Larry called to tell me they were forming the International Association of Yoga Therapists. Would I like to be a charter member? Absolutely. Now our tribe had a name and a home. Were we a field yet? Probably, or at least getting close.

We started training other Yoga teachers to do whatever it is we did, and we began to expand what we offered. My work with the immune system and HIV disease led to courses on the practice of Yoga for people with cancer, for chronic pain, for grief recovery, for support during major life change. This led to work with people with depression, anxiety, heart disease, diabetes, and metabolic conditions. By 2004, we knew we had to offer training not in specialty conditions, but in —dare I say it—the field of Yoga therapy. We need to train Yoga therapists, not just Yoga teachers who can teach to specialty populations.

From this evolution, neither Yoga therapy nor Western medicine is the same. Over the past twenty years, Western medicine has influenced the delivery of our Yoga therapy programs and how we work with clients. In turn, we are influencing Western medicine. There is more widespread acknowledgement of the contribution the practice of Yoga brings to health, and the ability of the body/mind/spirit to restore health. In addition, popular books such as Yoga as Medicine by Timothy McCall, MD, and Meditation as Medicine by Dharma Singh Khalsa, MD, have brought the practice of Yoga and the Yogic way of living as a therapy to a broader audience.

Today, the International Association of Yoga Therapists holds conferences to bring together Yoga therapy practitioners and researchers. We are working to create a unified professional identity. We are creating standards and guidelines for the training of a safe, effective practitioner of Yoga therapy. Faculty qualifications, regulation of the field? Areas we did not dream of twenty years ago are now essential elements of the conversation.

The conversation continues and expands. What do you want to contribute toward the future in the next twenty years?

by Shanti Shanti Kaur Khalsa, Ph.D.

Ruby was an energetic career track executive with a television production company when she was diagnosed with colon cancer at age thirty-four. “Who gets colon cancer at my age? I was devastated.

No one I knew had faced anything like this and many of my friends and family members were more afraid of my being ill than I was. In my field you’re not supposed to get sick.

Looking good is as important as working hard. I was terrified of losing my job or not getting promoted if anyone at work found out.

There were few people I could confide in. I felt so alone and helpless. I attended a meditation class for people with cancer out of sheer desperation.”

Receiving a diagnosis of a chronic or life-threatening illness is one of life’s biggest shocks. Such news stops us right in our tracks and jolts us from the automatic pilot we most often operate from.

Time itself takes on a whole new meaning.

Even with the best medical care, people with illness find they struggle with depression, despair, fear, anxiety, anger, confusion about treatment decisions, and uncertainty about the future.

In addition, clients and their family members tell me that often it seems that the treatment is as destablizing to them as the illness itself.

Practice of Meditation

Meditation practice has long been known to address the emotional aspects of being human, to improve physical health and well being in people with cancer, heart disease and pain patients, to tap our inner strengths, and help us find meaning in our lives.

It makes sense that people with illness find it helpful during medical treatment and recovery.

Ruby continues, “Meditation practice gave me more than the relief from anxiety that I had sought. It awakened in me the understanding that there is something more to be healthy for than just my career.
The cancer diagnosis gave me a kick in the behind, yet it was the meditation practice that woke me up to the true value of my life. I could have just gone through the treatment protocol and removed the cancer.

If I had done only that, then I would still be anxious and depressed and driven to keep measuring my self worth by my career advancements. Instead, practicing meditation unlocked my real gifts, gave me the vitality to create a new future, and helped me garner the inner support to sustain it. It opened in me a deep desire to change how I had been living my life.”

As early as 1964, UCLA researcher Dr. George Solomon found evidence that emotions play an important role in physical disease associated with the immune system. The term psychoneuroimmunology, coined by Dr. Solomon, refers to the psychological influences of experience, stress, emotions, beliefs, traits, and coping on immune function and on the onset and course of a wide variety of diseases.

The relationship between health, psychology, and meditation practice has been of increasing interest among medical researchers over the past forty years and as a result there is in progress a shift in the perspective on the role of meditation practice and health recovery.

Evidence suggests that the health and well being of individuals affected by HIV are not solely dependent on the achievements of the biomedical approach. In the early years of the AIDS epidemic, Doctors George Solomon and Lydia Temoshok found that long term survivors of AIDS had certain psychological traits in common, including what health psychologists call “self-efficacy”, the belief that what you do makes a difference. Later, Dr. Robert Ramien from Columbia University in New York found that long term non-progressors–people living with HIV infection but not showing symptoms–had strong self efficacy profiles. Other researchers have shown that self-efficacy plays a pivotal role in the enhancement of the immune system, in health behavior, and in quality of life in cancer patients.

The good news? The practice of meditation improves self-efficacy. Clinically I have seen evidence of this in hundreds of clients with a variety of medical conditions, and have conducted a study demonstrating meditation practice improves self-efficacy in people living with HIV.

Film maker Carolyn Speranza had been struggling with stress related health problems for years before she started to practice meditation. She found that as her anxiety lessened, her self-efficacy strengthened, and her health improved. Encouraged by her own experiences, she made a film about the effects of meditation called Sight of Stillness which asks the question of meditators, “What do you see when you close your eyes?” For the premier screening of the film she hosted a meditation symposium at the Carnege Science Center in Pittsburgh, Pennsylvania and invited me to share with participants what people with illness see when they meditate. I asked a dozen or more clients how meditation has helped them in recovering from illness and they replied that it gave them….

Hope for a return to health.

A sense of what is possible, from this, I can explore what is available to me.

Connection, support. I know and feel that I am not alone in this.

Peacefulness, freedom from worry or uncertainty about the future.

Joy to be alive right now.

Calm, to just be in the present moment.

Clarity to make decisions.

Confidence to carry them out.

Energy to enjoy life.

Self-efficacy to take action. I believe in myself now.

Self-trust to be comfortable in the face of uncertainty.

Inner guidance to know what is my path.

Sacredness to meet life and death with joy and peace.

What do I see when I close my eyes to meditate? My future.