Houseboat

When the government re-imposed the restrictions limiting gatherings in public and dining up until 6 pm, it was expected that the rules would be in place until infection rates stabilised and the vaccine could be easily deployed. Unfortunately the variance in untraceable cases and lack of an authoritative vaccine rollout has meant that these restrictions have been on a rolling extension. Each week since the New Year, the restrictions have been extended for another week, and another week, and another week. The public has been informed that restrictions will remain in place until after the lunar new year. Until then, public premises and venues will remain at 50% capacity, fitness centres will remain closed and restaurants cannot seat parties of more than 2 people per table, or after 6 pm.

Because of this, larger-sized rental properties in Hong Kong, mostly sourced from AirBNB have become a popular weekend option. Most of these rental properties fall under the category of "private premise", which means you can technically host as many people as you want. The one caveat is that there is usually a minimum booking of 2-3 nights, however with most people having access to surplus annual leave a lot of these properties are booked up until the end of February. In an attempt to add variety up the current restrictions, some friends decided to hire a houseboat for the weekend. 

The boat is moored in Aberdeen Marina and can only be accessed through the local Sampan service that brings boat owners from their vessels to the shore. It's a different world out here, there's the eye-watering mega-yachts owned by tycoons, there's the local fishermen and trade boats, there's the various boat hire services and there's also a small community of people who live on houseboats. Then there's us, a group of people who want to have a BBQ and share a meal with more than 2 people and not wear a mask when we're playing cards. We also threw a huge party.

Pretty cool experience, it's definitely a different way to live. The sound of boat engines, sound of horns and seagulls and the gentle, perpetual swaying in the evening. I'm not sure how people live on house boats.

Exercise regime

Some good news for the new year. Ankle stability is slowly (I mean slowly) returning. Have been seeing the physiotherapist regularly for a couple of weeks with a focus on rehab and hands-on therapy and acupuncture. Really trying to avoid the surgery route and there has been deliberate effort on strengthening through the entire range of the hips and stability work through the ankle. Lots of calf-raises, single-leg step ups, pigeons and half-range pistol squats.

Also I have finally been given clearance to start more vigorous training on the ankle. With the view to promote blood flow through the ankle. Putting the roof to good use with light skipping and posterior chain strengthening with a kettlebell. Also, went for a light jog, first time in three months. Ankle feeling a lot better than it did 3 months ago.

Shoulders
- Single arm clean, press (3x 5 each side)
- superset: 20x swings + 8 handstand push-ups (3x)
- Turkish getup (5x 1 each side)
- superset: goblet press + upright row (3x)
- theraband pull aparts (3x 20)

Legs
- superset: lateral lunges + calf raises
- single arm clean, step back lunge
- single leg deadlift
- superset: 20x swings + goblet squats
- front lunges kB carry each side

Back
- superset: 30s swings + 30s push ups (3x)
- single arm row
- superset: good mornings + chin ups
- Turkish getup (5x 1 each side) + bicep curls
- theraband: rear delt flies + band pull aparts

Bhramari Pranayama - Theory Assessment

The word Pranayama, consists of two roots: Prana, which means ‘vital energy’ or ‘life force’ and Yama which means ‘control’, or more specifically, the word Ayama, which means ‘extension’ or ‘expansion’. Pranayama provides the techniques where prana, or life force can be activated and regulated. More specifically, to induce the flow of prana in the nadis, or energy channels. There are four components of pranayama that utilized during breathing: (i) Pooraka, or inhalation, (ii) Rechaka, or exhalation, (iii) Antara kumbhaka, or inhale breath retention, and, (iv) Bahir kumbhaka, or exhale breath retention.

“The breath is the most vital process of the body. Human beings’ breath about 15 times per minute and 21,600 times per day. Respiration fuels the burning of oxygen and glucose, producing energy to power every muscular contraction, glandular secretion and mental process. The breath is intimately linked to all aspects of the human experience.” [1]

Pranayama can be incorporated after shatkarma and asanas practices, but before meditation. It is important to first prepare the body by stabilizing and strengthening the physical body for breathing. This can include lateral stretches, chest expansion, loosening the joints and hips. The use of movements to form a connection with the breath can be performed during asanas; by bringing awareness to the breath. Pranayama techniques such as Ujjayi breathing can be used to create breath awareness, or as a technique to warm the body up before a yoga class. Similarly, Sheetali, or cooling breath can be used at the end of a

yoga class to cool the body to restore a normal temperature. Pranayama can be incorporated at the end of an asana sequence to activate calmness and restore focus. One such technique is known as Bhramari Pranayama.

 

Bhramari is the word for the Indian Black Bumble Bee, the name Bhramari also refers to the Hindu Goddess, an incarnation of the Goddess Parvati. Her name, Bhramari refers to the ‘Goddess of Bees’ or the ‘Goddess of Black bees’ and is commonly associated with all-things bees, hornets and wasps. The technique of Bhramari Pranayama is more affectionately known as the ‘Black Bee Humming”, or the “Female honey bee'' pranayama. The Bhramari Pranayama breathing technique refers to the sound that is created during the exhalation of this technique; the sound most resembles the humming, or the buzzing noise of a bee.

 

The noise of the Bhramari humming can be a useful tool for removing the constant chatter and inner activity that can often enslave our thoughts and mind. In addition, the gentle vibrations created by the Bhramari buzzing can also help relax and stabilize the physical body. Like most pranayama techniques, Bhramari stimulates the Autonomous Nervous System and directly activates the parasympathetic nervous system which has a natural

calming effect on the body, and mind. The technique is easy-to-learn and time-efficient making it useful for those who find meditation challenging or have the excuse of being “too busy” to create time for themselves. The simplicity of Bhramari pranayama allows practitioners to employ this technique as a quick and effective method for the reduction of anxiety or for the reduction of stress with only a few breaths.

To perform the technique of Bhramari, first find a comfortable seated position - Regardless of being seated on the floor or in a chair, ensure that you are evenly seated on your sit-bones; Your pelvis should be neutral (exhibiting neither an anterior, nor a posterior tilt). If seated in a chair, ensure that both your feet are equally planted on the ground. 

 

Next, close your eyes and take a deep inhalation – the inhale and exhale breath should be through the nose, but may be adjusted if there are blockages of the nose or sinus. Create a seal of your ear canals using (i) the index finger of each hand. Taking your right index finger press against the right-hand side cartilage at the opening of your right ear blocking sound to

the right-hand side, then taking the left index finger press against the left-hand side cartilage at the opening of your left ear block sound to the left-hand side. 

 

Note, do not press too hard. Your fingers should not be directly in the ear canals. Alternatively, if you have difficulty creating a seal with your index fingers, you can (ii) gently press the entire palm of your hand against your ear to create the seal with your hand. Again, do not press too hard.

 

Simultaneously while blocking your ears, breath out through your nose and generate a humming noise through pursed lips. To create the humming noise, the lips should be closed without tension, ensuring that the teeth are not touching, with the jaws relaxed. The sound should be high-pitched, even, and continuous for the duration of the exhalation. The sound will be soft and gentle creating a soft vibration through the head, the skull, the teeth, the sinus, and the tongue. Continue to keep your eyes closed, if you like, you may focus on the third eye chakra, Anja. Repeat the inhale and exhale process for 5-10 rounds. For the last two rounds, you can practice using a silent Bhramari, where no sound is made on the exhale, the practice here is to be able to sense the reverberations on each exhale, in silence.

 

One variation for Bhramari is to perform the pranayama technique using Shanmukhi Mudra, or the ‘closing of the seven gates’ mudra. The Shanmukhi Mudra requires blocking off the sensory inputs by closing the seven sensory outlets: sight, the two eyes; sound, the two ears; smell, the two nostrils; and taste, the mouth. To perform Shanmukhi Mudra, raise the arms up beside your head so that the elbows are pointing out towards the side. Next, close the ears with the thumbs, close the eyes with the index fingers, close the nostrils with the middle fingers. To close the mouth, use the ring fingers above the lips and the little fingers below the lips. Again, do not press too hard. Perform Bhramari pranayama with Shanmukhi Mudra using the same inhale and exhale patterns.

 

For more advanced practitioners the incorporation of Kumbhaka, or Bandhas can be included with the practice of Bhramari.  Kumbhaka, or breath retention pranayama techniques are useful for stimulating oxygen and carbon dioxide production which promotes more efficient cycling of oxygen throughout the body. Antara Kumbhaka, or inhale retention and Bahir Kumbhaka, or exhale retention can be added to Bhramari at the end of each inhale and exhale. Add Kumbhaka by performing retention, or holding the breath for 3-5 seconds on each side of the inhale and the exhale.

 

When breath retention is comfortable, the practitioner can take this one step further with the use of a Bandha, or lock. The Sanskrit word bandha means to ‘hold’, ‘tighten’ or ‘lock’. The bandhas aim to lock the pranas in particular areas and redirect their flow into sushumna nadi for spiritual awakening [1]. A bandha can be incorporated during the retention period. The inclusion of Jalandhara Bandha, or throat lock invigorates the Vishuddha, or the Throat

Chakra. The inclusion of the Mula Bandha, or the root lock invigorates the Muladhara, or the root chakra. Both Jalandhara and Mula Bandha can be applied during the retention period of Bhramari.

 

Finally, the practise of Bhramari Pranayama should be performed in the morning and preferably on an empty stomach.

 

References

[1] S Saraswati (1969)

Asana Pranayama Mudra Bandha

 

Meditation for the treatment of depression: Theory Assessment

Meditation and mindfulness have garnered in popularity in recent times - Amidst our busy and stressful lives, individuals are plagued with societal expectations and stresses, the ability to find some quiet and some space has become a valuable tool in the 21st century. The simplicity and effectiveness of medication is part of the appeal, in addition, the non-invasive administration compared to other medications and traditional therapies. The application of meditation as a tool for the treatment of depression has gained popularity amongst practitioners and professionals who deal with patients suffering from psychiatric alignments. Two research papers that look at the efficacy of meditation techniques are examined below.

The first research paper titled “Mindfulness Based Interventions in psychiatry” [1] investigates the effectiveness of Mindfulness Based Interventions (MBI) for the treatment of psychiatric disorders. 

The research primarily looks at Mindfulness Based Interventions, or MBI in the form of Mindfulness-based Cognitive Therapy (MBCT). MBCT programs are designed to be 120-150 minutes per week, for the duration of 8 weeks. MBCT focuses on two main components: (i) formal meditation practices which includes seated meditation sessions, mindful movement (example: walking, yoga) and the body scan method, a technique used to bring attention to bodily sensations starting at the feet and progressively moving up towards the head and neck. (ii) informal meditation practices whose objective is to incorporate mindful awareness in everyday activities such as mindful eating, or mindful brushing of the teeth.

The application of MBCT has been shown to reduce the risk of depression relapse via cognitive, psychological, and neural mechanisms. Stressful life events or other triggers in everyday life can lead to recurrent negative thought patterns such as depressive rumination, judgment and anxiety which may lead to depressive relapse or other psychiatric symptoms. Mindfulness places emphasis on identifying these thinking patterns as they arise and viewing as temporary thoughts that are not facts or realities to be identified with or reacted to. The ability to accept without judgment and adopt a non-reactive attitude is one of the key mechanisms for the reduction of negative thinking patterns.

The paper provides evidence supporting the use of MBCT for the reduction of depressive relapse and includes a meta-analysis that cites four randomized controlled trials of patients with at least three depressive episodes. The evidence found that MBCT reduces the risk of relapse compared with ‘Treatment as usual’ (TAU) or placebo control groups. The MBCT+TAU patient group showed a 32% relapse rate, compared to the TAU, control group of 60%. There is strong evidence to suggest that MBCT is effective as a maintenance antidepressant medication in prevention of major depressive relapse.  One caveat of the research shows that MBCT studies that include active-control groups result in mixed findings, as MBCT may not be the most effective tool for preventing relapse, especially compared to other active psychosocial interventions.

Following MBCT treatment, participants self-reported improvements in mindfulness, reduced rumination, reduced worry, improved meta-awareness, increased self-compassion and reduced emotional reactivity. MBI also helps train the individual to develop a different relationship with their thoughts by developing the skills to notice one’s thoughts, separating the perspective of the self, and creating self-awareness.

Finally, the mechanism for enhancing emotion regulation strategies, through repeated meditation, allows participants to develop body awareness through self-regulation and emotion regulation. In addition, cultivating the nonjudgmental state increases the participants ability to respond and manage stressful events.

In summary: “Despite this relative short history, MBIs have garnered considerable support for their efficacy to treat psychiatric disorders. Numerous research investigations have shown that MBIs are efficacious for reducing depression relapse and treating depression symptoms.

In addition, these interventions reduce symptoms across psychiatric disorders with mounting support for anxiety disorders, bipolar disorder, eating disorders, and substance use disorders.” [1]

The second research paper titled “Meditation Programs for Psychological Stress and Well-being: A Systematic review and Meta-analysis” [2] investigates the effectiveness of meditation programs for improving stress-related outcomes. This piece of research aggregates the results from studies dating up until June 2013 with Meditation as the primary tool. 

The research looks at studies with the following criteria: Adult population (18

years or older) exhibiting medical (heart disease, cancer, diabetes, hypertension and HIV) or psychiatric (anxiety, depression, stress and insomnia) condition, ignoring healthy individuals.

Various types of meditation techniques are cited, including: (i) Mindfulness-based (MBSR, MBCT, Vipassana, Zen, other), (ii) Mantra-based (eg: Transcendental Meditation, other) and (ii) other forms of meditation. A total of 18,753 unique citations including 47 trails with 3,320 participants met the above criteria.

In addition to Mindfulness-Based Cognitive Therapy (MBCT) the other techniques mentioned include Mindfulness-Based Stress Reduction (MBSR) an eight-week course developed 40 years ago is similar to MBCT but instead of addressing a specific conditions or vulnerabilities provides techniques for “managing negative thoughts”. MBSR can be perceived as a generic technique for combating stress arising from a variety of life events, or a more generalist approach.

Vipassana, the oldest Buddhist meditation practice, is a slightly different form of meditation that focuses the command of non-reaction and freedom from the ego. The practice of Vipassana is used to develop the awareness of the interconnection between what happens in our minds in reaction to what happens to our bodies. Whether an individual experiences boredom, anger, pain or anxiety, training the mind to disconnect and be more patient is at the essence of Vipassana. 

Zen meditation, sometimes known as Zazen, is a deliberate effort to focus on the ‘now’. The focus of the mediation can be on the breath, or on the sensations of sitting, or external sensory input (eg: sounds, tastes, touches, smells) – Zen meditation is to acknowledge the experience without judgement. Example “the purpose of eating dinner, is to eat dinner”.

Another form of meditation discussed is Transcendental Meditation (TM), or mantra-based meditations. TM is a silent, mantra-based form of meditation, where practitioners repeat a manta in the mind and come back to the mantra when thoughts arise. The idea is to force the mantra to transcend the process of thought.

The findings of this research paper are measured by effects on the following categories: Anxiety, depression, stress, overall affect, quality of life, attention, sleep, substance use, pain and weight. Overall, it was shown that the adoption of a mindfulness meditation program demonstrated moderate evidence to improve depression, with an Effect Size (ES) of 0.3 with 95 percent confidence intervals.

In summary: “Mindfulness meditation programs, in particular, show small improvements in anxiety, depression, and pain with moderate evidence, and small improvements in stress/distress and the mental health component of health-related quality of life with low evidence when compared to nonspecific active controls. Mantra meditation programs did not improve any of the outcomes examined, but the strength of this evidence varied from low to insufficient.” [2]

Both studies illustrate the efficacy of a Mindfulness and Meditation practice for the treatment of depression. The ability to disconnect from one’s thoughts and be less reactive to external and internal stimulus can have a positive impact. Due to the wide-ranging benefits and the variety of meditation methods, studies suggest that meditation and mindfulness is a non-invasive and easily administered tool for the improvement of general

well-being and mental health.

References

[1] B. Shapero, J. Greenberg, P. Pedrelli, M. de Jong and G. Desbordes (2018)

Mindfulness-Based Interventions in Psychiatry

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870875/

[2] JAMA Intern Medical - M. Goyal, S Singh, E Subinga, N Gould, et al (2014)

Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142584/

MRI Results

Popped by my Orthopaedic specialist to retrieve results of the MRI on my Left Ankle. "You have completely torn your ATFL". The ATFL, or Anterior talo-fibular ligament is one of the three ligaments supporting the ankle. Not surprisingly, the specialist recommends surgery. My heart drops instantly. It's not the first time a specialist has recommended surgery, my ankle, my shoulder, my ankle again. Ignoring this recommendation, I begin the long and tedious path of physiotherapy and rehab.

Two months since the injury, the swelling is slowly reducing and it no longer hurts to walk. I also have mild scoliosis, where my spine cures slightly to the left. Most likely from poor working at home ergonomics. 2021 is definitely the year for self-care.

2021, come at me

The extension of dining restrictions coupled with the official cancelation of New Year events, meant that all New Year's celebrations would be confined to small gatherings on private premises. Despite the colder-than-usual weather, I decided to take advantage of my rooftop and host New Year's at mine. Equipped with enough meat and blankets to feed and warm a small village we managed to usher in the new year by watching the midnight fireworks in Sydney (at 9 pm HKT) followed by the midnight "virtual" fireworks in Hong Kong. The night was chock full of eating and wine ending up with an intense session of board games (read: Nertz).

Despite only having 6 people over, the combination of grilling, baking, boiling left a solid amount of clean up work. So after the crowd had left, I spent a good solid 45 minutes tidying up, cleaning wine glasses, wiping down the oven and vacuuming up crumbs. The moment of pause, silence and reflection. The post-party clean up reminded me of when my parents would host New Years back in Sydney and we would spend the hour or so after tidying up, drying dishes, wiping down tables, cleaning up the Eski. 

In any case, the year that was 2020, has finally come to a much needed end. I start 2021, with a fridge full of leftovers, a half eaten packet of Tim Tams and boundless expectation. It's time to shine, 2021.