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June 22, 2012

Yoga Heals Unseen Injuries: An Interview with Annie Okerlin.

This is the fourth interview in an ongoing series called “At Attention, At Peace”; a conversation among students, teachers and officials in the military about the role of yoga in addressing PTSD. Click here to read parts one, twothree, five and six. To subscribe to the series, email ‘subscribe’ to [email protected] and receive links to a new interview each week

Annie Okerlin, RYT, is the owner of Yogani Studios, Tampa, Florida, and the president and founder of the Exalted Warrior Foundation.

Since March of 2006, Annie and the EWF instructors have implemented an adaptive yoga program throughout major military medical and veterans’ hospital facilities nationwide.

Annie designed the program to support wounded populations, including amputees, burn victims, and those with orthopedic poly-trauma, traumatic brain and spinal-cord injuries, PTSD and depression. She is currently pursuing certification as an iRest® teacher.

In this interview, she shares her experience coordinating with VA hospitals and medical facilities, the hidden structure inside of any healing community and how seemingly debilitating physical wounds can transform the spirit.

Full Interview

Lilly: Can you say a little bit about the process of collaborating with the VA? How did that start and what has that process has been like?

Annie: We started at the Walter Reed Army Medical Center, which is actually no longer, it’s now Bethesda Navy Medical Center. That’s always been our calling card and it’s a big card to pull. Because of our president, who is a Rear Admiral ex-Navy SEAL, we had an extremely strong, supportive military connection. Still, when we approached the James Haley VA here in Tampa, which is the third-largest polytrauma center in the country, they were reticent. So, we asked what we could do to help the staff and the guys. When we described the work we had been doing at Walter Reed and shared some of the research and findings, bit by bit, they came around.

So, what started as one class a week in the transition unit has become four classes a week. We’ve reached the inpatients, the outpatients, and the spinal-cord injury guys, and the psycho-social rehabilitation and reintegration center.

Last Thursday, I had a guy come in from about 45 minutes away, an older gentleman, a Vietnam veteran who doesn’t really associate with other veterans much. I introduced him to another student of ours, a very vocal and involved Vietnam vet and it was like the two of them fell  in love. Since last Thursday this new student has sent me five emails just to tell me what an amazing day he had. He’s just so liberated in the knowledge that he has a community to reach out to.

That’s what it’s all about, is creating that community to help the reintegration process, to welcome them home, and to help pull them out from whatever space they might be stuck in as they re-find their feet. For me, yoga does that. It’s community, it’s support, it’s stability, and I feel very strongly that that sense of community can help anybody, but especially the veterans, wounded or not.

Lilly:  How would you define yoga in terms of its relevance to those returning from war? And has your definition changed in any way since starting this work?

That’s what it’s all about, is creating that community to help the reintegration process, to welcome them home, and to help pull them out from whatever space they might be stuck in as they re-find their feet. For me, yoga does that. It’s community, it’s support, it’s stability, and I feel very strongly that that sense of community can help anybody, but especially the veterans, wounded or not.

Annie: When working with a wounded veteran, (and I bracket that as seen and unseen injuries), if you are giving someone the tools to find and maintain ease in their own body and their mind—that’s yoga.

Lilly: What do you think are some of the biggest barriers right now, cultural, logistical or otherwise, to yoga being more integrated into the military? I understand that you’ve had a really positive relationship with the VA, but what would you like to see more of and what do you see as the main hurdles right now?

Annie: I think that because the ship of military and medical VA facilities is so big, it takes such a long time to turn it. However, I feel strongly that the awareness is there. Nobody I’ve ever met or worked with in these places has said “We want all of these people to be addicted to pain pills and sleep medicine.” People want to help. But I think there’s a stigma of yoga still, in the world and the United States, even though 23 million people do yoga now.

What’s hard is that there are some quacks out there who have messed up the ability for well-meaning, well-trained, well-certified people to come in and say “We’re a community resource, make use of us.” And everybody wants money.  That’s something that we’ve done that kind of come back to bite us occasionally. But we’ve donated our program into the facilities. All of them. Even into the Marine Corps Wounded Warrior detachments that were supposed to be in by the end of 2013. All of them.

We pay the teacher, but we don’t go to the military or the government for the money. That takes all the paperwork, red-tape nightmare out of it for the facility. We just need them to provide assent.

When working with a wounded veteran, (and I bracket that as seen and unseen injuries), if you are giving someone the tools to find and maintain ease in their own body and their mind; that’s yoga.

We were given a donation by a guy in San Antonio who wanted us to harness all of the veteran programming in San Antonio, because they have a huge base and a huge military hospital. They harnessed all of the small groups to form an umbrella group called the Triad Foundation.

Basically, all of the smaller groups could focus on their work instead of five different organizations trying to figure out how to afford a secretary. It was such a brilliant idea, and I’ve talked to a bunch of the guys down here and suggested that we do something like that. I think people really want to protect their niche, and I think coming at it from a yogi’s perspective I say “No! It’s community we need, let’s start creating community for our veterans to come back to!”

The other big thing that we’re working with, is getting the Military Mind-Body Health Consortium together, where we create a clearing-house certification board where the military or the VA can call us and request a yoga teacher, and we will have vetted these people or they will have done a training that we agree with. That’s the hope.

Lilly: Currently how many facilities is the Exalted Warrior Foundation bringing programs into?

Annie: We’re in nine different facilities, and up to about 20 classes a week throughout them all.

Lilly: So where are all of the facilities?

Nobody I’ve ever met or worked with in these places has said “We want all of these people to be addicted to pain pills and sleep medicine.” People want to help.

Annie– We’ve got four classes in Tampa. There are more classes in Bethesda. We have one class a week at the Brooklyn VA and we are supporting 2 classes a week with a teacher in San Diego. Last year, we were mandated by the Marine Corps to be in all of the Wounded Warrior detachments in the country. We’re also in Portsmouth Naval Hospital in Virginia Beach.
Lilly: How has the mission statement of Exalted Warriors changed since you’ve started?

Annie: Our mission statement has pretty much remained the same: bringing adaptive yoga to wounded military members, veterans who suffer from both seen and unseen injuries. What’s kind of morphed is our idea of who we can consider a wounded soldier, a wounded veteran. The population is becoming so vast.

A lot of what we do is incorporate the caregiver into the class by giving them a period of time for their own practice, as well as giving them time to work with their patient. So they have more tools in their tool belt. It’s very important because some of these people are going to be with these patients on wards for the rest of their lives.

In Tampa we’re really mixed, mostly because we have the resources. We have guys that vary from never going to get out of their wheelchair, very limited communicative skills, to, say, a guy with a brain injury, still in the hospital, just getting stabilized, maybe preparing for more surgery, compared to a guy in transition unit, preparing to live by himself.

Lilly: Are you structuring the classes differently for each population? What varies and what remains the same?

Annie: It’s consistently a regular yoga class that we’re teaching. It’s a gentle yoga class but I amp it up a bit, because most of these guys are young and strong, or they were strong prior to injury, so they like to feel the challenge. That’s what brings them back. Usually they expect yoga to be boring. They’ll be like, “Excuse me, ma’am, I don’t mean to be rude, but yoga is for sissies.” So, I’m like, “Come in and do the Marine Corps abdominal championships like we do at Walter Reed and then tell me how sissy this is!”

Because it’s important for me to develop the relationships not only with the participants but with the therapists as well, we’ll generally have a doctor or psychologist in the room with us. I go in early and shake hands and hang out, and if there are students who are not shaking hands or if they’re not maintaining eye-contact, I will check in with the therapist and ask what’s going on.

A lot of the time she’ll say that they haven’t done brain scans yet, they’re assuming at that stage that if there is PTSD, there is probably a traumatic brain injury, so if we could test thing like the vestibular system, namely balance, it would be helpful.

A lot of things the guys can cheat their way around on, but balance is huge. So, keeping them in the chair, we stand up, we do a couple of balance poses. Doing tree pose you can make a grown man fall over in 10 seconds. So I work really closely with the therapists, asking what they need to see, what can I do, what do I need to know going in. It’s a really nice relationship.

Our mission statement has pretty much remained the same: bringing adaptive yoga to wounded military members, veterans who suffer from both seen and unseen injuries. What’s kind of morphed is our idea of who we can consider a wounded soldier, a wounded veteran. The population is becoming so vast.

 On Wednesday, we have the PRRC, which is the Psycho-Social Rehabilitation and Reintegration Center. These are all veterans, out of the military, from all different wars. We have a Korean war vet, all the way to a guy who’s been home for three months. The whole gamut. A lot of guys have been sent to this day-clinic. There’s a lot of heaviness and a lot of psychological issues, PTSD not necessarily being the only one. We do the regular gentle class, but I end it early and we do a long yoga nidra, a long deep-relaxation meditation. We talk a lot about why yoga is great for understanding your habit patterns. If you see yourself coming into a behavior which is not conducive or not necessary, you find your breath, you do the best you can to ride through it with the least destructive behavior.

Lilly: What is the essential value of yoga, in your opinion?

Annie: I would say self-awareness. And from the yoga-Nidra perspective—learning the self. The idea of allowance is also very important. One of the reasons we were so successful at Walter Reed was that we were offering an alternative workout with no goal orientation. So when you’re trying to rehab someone’s leg or a residual limb if you’re working with an amputee, there’s all these goals that have to be met and it’s always about the next step. But my goal is just for them to feel good, to feel better than when they came in. They don’t necessarily know what it feels like to feel good. I’ll have someone who has been in a wheelchair for six months try backbends using a block for support, or someone who has had his legs amputated at the knee try hip-flexors with sandbags. So, I think, no matter who you are, yoga is comfort self-awareness and ease.

Usually they expect yoga to be boring. They’ll be like, “Excuse me, ma’am, I don’t mean to be rude, but yoga is for sissies.” So, I’m like, “Come in and do the Marine Corps abdominal championships like we do at Walter Reed and then tell me how sissy this is!

Lilly: Do you have one student in particular who sticks out in your mind?

Annie: One, named Joell Trivera, who is considered the third most traumatically injured soldier yet. He was stepping into a humvee, covering a shift for one of his friends. He got a really bad feeling and looked down the street to see an RPG coming right at the vehicle. The vehicle was blown up. He was thrown, his right leg was taken off, and the three other guys in the vehicle were killed instantly. He had third-degree burns over 60 percent of his body. He lost his eyes, his eyelids, and most of the skin on his face. His jaw was cracked and shattered. He had massive skull penetration, meaning that it was blown off. Thankfully, there’s no indication of even a minor brain injury, which is unbelievable.

Joel in Warrior I

He’s blind, he’s an amputee, he’s lost most of the fingers on the one hand, and is probably going to lose the fingers on the other hand. He’s had 36 surgeries, has at least another 20 more to go. He needed a new skull plate, to round out the shape of his head. He had eyelids sewn in, so he could blink. And he’s the lightest, most vibrantly alive, positive person I’ve ever met. He now lives in Tampa. He travels a lot. He’s a motivational speaker, and he really embodies what I realized early on in this process. I don’t think I would be graceful as these guys. He is the triumph of the human spirit.

So when you’re trying to rehab someone’s leg or a residual limb if you’re working with an amputee, there’s all these goals that have to be met and it’s always about the next step. But my goal is just for them to feel good, to feel better than when they came in. 

Another friend of mine is a double above-the-knee amputee, about 33 and a Navy SEAL. He is now the top two or three seed in the world for adaptive Nordic skiing. He’s going to the Olympics in Russia. He’s just a badass. There’s a young gentleman at the Balboa program, I think a double below-the-knee amputee, he’s training to climb Kilimanjaro. And there are thousands and thousands of stories like that.

Lilly: What would you like to see in a book about yoga and veterans? What would be interesting or useful both within this tight-knit community of veterans and people in the military, and outside, such as yoga practitioners who might have never met a veteran?

Annie: There’s a lot of judgment with war, and I think people are looking at it as just thats- war- and overlooking the human beings who fought it.

I want to see more people, everybody, not just the yoga community, really aware that healing doesn’t have to be through yoga, or playing guitar, or poetry, or anything specific like that. It can be knowing that your community is there for you. As a culture I think we’ve gotten very far away from that.

There’s a lot of judgment with war, and I think people are looking at it as just that, war, and overlooking the human beings who fought it. 

~

Editor: Kate Bartolotta

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*Yoga Organizations Serving Veterans

*Adaptive Sports Foundation: an organization bringing sports to disabled youth and is the recent founder of the Warriors in Motion program which works to provide veterans with a basic knowledge and practice of wellness. http://www.adaptivesportsfoundation.org

*Yoga for Vets: Yoga for vets maintains a list of studios, gyms and teachers that offer at least four free classes to war or conflict veterans that served, or are currently serving, in the United States Military. http://www.yogaforvets.org/

*Warriors At Ease: Trains yoga and meditation teachers to teach in military settings. http://warriorsatease.com/

*Wounded Warrior Project: An organization that seeks to raise public awareness, assist injured service members and provide programs to meet the needs of men and women returning home. http://www.woundedwarriorproject.org/mission.aspx

*Healing Combat Trauma: Provides resources for and about healing combat trauma with a focus on providing medical, psychological and legal care for veterans and their families. http://www.healingcombattrauma.com/

*There and Back Again: Provides reintegration support services to veterans of all conflicts. http://thereandback-again.org/

*The Veterans Yoga Project: Brings together information and resources for anyone interested in the use of Yoga as a therapeutic practice for Veterans. http://www.veteransyogaproject.org/

*Connected Warriors: works to maintain and establish nationwide free yoga classes for service members, veterans, and their families. http://theconnectedwarriors.org/locations.html or [email protected]

*Yoga for Vets NYC- Offers Bi-weekly Yoga classes to Veterans at the Integral Yoga Institute http://yogaforvetsnyc.org/

*Yoga Basics: Provides free online support and information for those seeking to establish or maintain a yoga practice. http://www.yogabasics.com/

*Yogadownload.com: Offers online customized yoga classes for anyone seeking to establish or maintain a yoga practice. http://www.yogadownload.com/

*Yogis Anonymous: Provides both online and in person classes in a safe, non-judgmental atmosphere. http://yogisanonymous.com/

*War Retreat: Yoga & wellness events, resources, and articles for those who go through wars, conflicts and disasters. Formerly The War Photographers’ Retreat.

*Vets 4 Vets: A non-partisan organization dedicated to helping Iraq and Afghanistan- era veterans to heal from the psychological injuries of war through the use of peer support.

*Semper Fedelis Health and Wellness: Provides Integrative health and wellness solutions to our nation’s wounded, ill and injured warriors, active duty and reserve military, veterans, first responders, families and caregivers. http://www.semperfidelishealthandwellness.org/

Yoga Teachers Serving Veterans

*James Fox, Founder of the Prison Yoga Project and co author of Finding Peace: A Yoga Guide for Veterans. http://prisonyoga.com/

*David Emerson: Head of the Yoga Program at the Trauma Center in Brookline, MA and co-author of Overcoming Trauma Through Yoga: Reclaiming Your Body. http://www.traumacenter.org/clients/yoga_svcs.php

*Beryl Bender Birch: Director and founder of The Hard and the Soft Yoga Institute, co-founder of The Give Back Yoga Foundation and co-author of Finding Peace: A Yoga Guide for Veterans http://berylbenderbirch.com/

* Patty Townsend, director of Yoga Center Amherst, developer of embodyoga teacher training programs and co-creator of the CD: Deep Relaxation with Yoga Nidra, donated as part of the Give the Gift of Yoga to Vets Campaign: http://www.yogacenteramherst.com/teacher_patty.html

*Rod Stryker, Para Yoga: Founder of Para Yoga, author of the Four Desires, and co-creator of the CD: Deep Relaxation with Yoga Nidra, donated as part of the Give the Gift of Yoga to Vets Campaign: http://www.parayoga.com/

*Suzanne Manafort: serves as a board member of the Give Back Yoga Foundation, co-founder of the Veterans Yoga Project, co-leads trainings for teachers interested in working with veterans and is the creator of the CD: Breathe In, Breathe Out: Quick and Easy Breathing Practices to Help Balance the Nervous System, donated as part of the Give the Gift of Yoga Campaign. http://www.newingtonyogacenter.com/staff/SuzM.htm

Judy Weaver: Co-founder Director of Education of Connected Warriors, a program based in South Florida that co-ordinates veterans and provides free yoga classes.  As well as offering classes that blend the Ashtanga, Anusara, Iyengar and Yin tradition, Judy is currently designing and launching a 200 hour free teacher training program for veterans.

*Daniel Hickman, Nosara Yoga: Creator of For VetsYoga, an introductory yoga dvd for veterans, featuring interviews with vets who have found yoga to be essential for their healing process .https://www.nosarayoga.com/faculty-bios/daniel-e-hickman

*Robin Carnes, Walter Reed Army Medical Center: The yoga and iRest yoga nidra meditation instructor for a multi-disciplinary PTSD treatment program and the CEO of Warriors at Ease. http://yoganidranow.com/

*Karen Soltes, LCSW. Washington DC Veterans Hospital, War Related Illnesses and Injuries Study Center (WRIISC). iREst Yoga Nidra Teacher for several groups of Veterans with a range of challenges, including PTSD, Substance Abuse, and traumatic Brain Injury. Creator of the CD “iREst Yoga Nidra: Easing Into Stillness”

*Dr. Daniel J. Libby- 

a licensed clinical psychologist who conducts clinical research and psychotherapy with Veterans suffering from PTSD and other trauma-related psychiatric disorders in the Connecticut VA Healthcare System. He conducts several weekly mindful yoga therapy groups for Veterans suffering from PTSD and chronic pain as well as co-teaches the Embodyoga teacher trainings with Suzane Manafort. http://veteransyogaproject.org/about-us/

*Sue Lynch- Executive Director of There and Back Again,- Sue began her yoga practice in 2001 in her efforts to manage symptoms of PTSD. Based on her personal experience, Sue is passionate about offering a comprehensive approach to healing to her fellow veterans now, not 10 years from now, so that they too can find relief. Sue works with the Veterans Administration, Vet Centers, Yellow Ribbon Program, Warrior Transition Program and Department of Veteran Services to educate and train staff and veterans on techniques to facilitate self-care.

*Denise Dallas White- works with connected warriors http://www.theconnectedwarriors.org/ to offer free yog clases to all military service persons,veterans &their family members in 11 locations in Florida, and maintins a blog on pininterest about veterans health and PTS http://pinterest.com/ddland/yoga-breath-us-veterans/


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