By most measures, Sat Bir Khalsa's life resembles that of many a scientist with a PhD in neurophysiology. The 58-year-old spends his days interpreting data and writing grant proposals, teaching a weekly seminar, contacting study volunteers, and traveling the globe on speaking engagements. It's the usual stuff you'd expect from someone who is assistant professor of medicine at
Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School.
But what drives Khalsa is anything but typical for a man in his position: The centerpiece of his life and work is yoga. Each morning, he practices two-and-a-half hours of Kundalini Yoga, mantra meditation, and chanting, all in the tradition of Yogi Bhajan. In fact, his decision to take the position at Harvard was not the result of a burning drive to join the Ivy League; rather, it came from his desire to be near New England's largest Kundalini Yoga center, the Guru Ram Das Ashram in Millis, Massachusetts. Almost everything in his personal and professional lives revolves around yoga and his quest to document the modern therapeutic potential of this ancient practice.
Ask Khalsa why he devotes so much energy to proving the benefits he's already convinced of (he's practiced Kundalini Yoga for more than 35 years, after all), and he will tell you that he can't afford not to. "This is not a job; it's my life's mission," he explains.
"People want a cure for the health care system, and yoga is an important possible cure. The American lifestyle generates an enormous number of sick people, and there's a huge cost to repair them. We're constantly looking for high-tech solutions—a new magic pill, a new surgical procedure. But what if we went low tech instead, giving people yoga strategies? It would be the biggest bang for the buck in terms of making an impact on the world."
Building a Case for Yoga
In Khalsa's vision of the future, yoga will be a routine offering in schools, hospitals, and the military. To ensure that his vision comes to fruition, he is focused on getting tangible results by conducting studies. "The Western health care model looks at evidence-based medicine," says Kelly McGonigal, a yoga teacher and health psychologist at the School of Medicine at Stanford University and editor in chief of the International Journal of Yoga Therapy. "If you don't have peer-reviewed studies, people think that the modality must not work."
It is research, this argument contends, that will make yoga a credible and reimbursable part of our health care system. And that's what Khalsa has set out to provide: a sizable body of hard evidence that will enable yoga to become the preferred "medicine" of America—prescribed by doctors and paid for by health insurance. "We know this: Yoga makes people better on many different levels," he says. "So why not get it to more people?"
Khalsa compares yoga to a ubiquitous household wellness tool—a toothbrush for body and mind. "I think of this as hygiene. We have dental hygiene, which is a well-accepted part of American culture. Schools teach it, doctors recommend it, parents reinforce it. Imagine if people didn't routinely brush their teeth. That would be unheard of in this country! But what about mind-body hygiene? We have nothing for that."
If we'd use yoga as regularly as our toothbrushes, he says, if schools taught it, doctors recommended it, and parents reinforced it, people would be physically and emotionally healthier. In Khalsa's mind, a generation of people would have a tool that reduces their stress, or at the very least manages it, while building self-awareness.
With several published studies under his belt and more in the works, Khalsa is well known in the yoga world as a champion of yoga research. But that doesn't necessarily make him a hero. Some yogis view the scientific scrutiny as blasphemous, a trampling on the sacredness of the practice. Others question whether the way yoga is taught for research
purposes properly reflects the practice, because researchers use a standardized, one-size-fits-all protocol in their studies, rather than the traditional methods of yoga therapists, who tailor their approach to each individual patient. "The group-teaching approach with a standardized set of tools is not consistent with yoga's fundamental approach," notes Kausthub Desikachar, executive trustee of the Krishnamacharya Yoga Mandiram in Chennai, India.
In addition, a lot of yoga research, as it's currently constructed, focuses on the short term, with trials often lasting only 8 to 12 weeks. "Yoga is a powerful intervention, but a gradual one," explains Dr. Timothy McCall, a board-certified specialist in internal medicine, a longtime yogi, and the medical editor of Yoga Journal. "So examining it for that amount of time won't capture more than a fraction of what it can do."
Still, McCall would rather see yoga studied than not. "Will studying yoga show the scope of what it's capable of? Not at all," he says. "But is it helpful? Absolutely. It allows us to make the case to skeptical physicians, policymakers, and others that yoga can be a promising treatment modality for people with specific health conditions."
Studies of yoga's benefits have been taking place for decades, with visionaries such as Herbert Benson, founder of the renowned Mind/Body Medical Institute in Boston, and Maharishi Mahesh Yogi, founder of Transcendental Meditation, attempting to document its therapeutic effects in the 1960s and '70s. The chronicling of yoga's benefits continued throughout the '80s. When Larry Payne and Richard Miller founded the International Association of Yoga Therapists in 1989, the discipline finally had a home. In recent years, the National Institutes of Health have funded studies of Integral Yoga for managing hot flashes, Iyengar Yoga for easing recovery from breast cancer, and Tibetan Yoga for helping to overcome sleep problems and fatigue.
But among scientists, bias against yoga persists. "There's a common perception in the minds of conventional scientists: Yoga is either trivialized as something for cosmetic purposes to slim your butt, or it's perceived as a goofy, New Agey, 'out there' kind of practice," Khalsa says. In his experience, it is more difficult to get research funding for, say, an insomnia study when the protocol is yoga than when it's some other form of treatment.
"If you can find a pill that fixes something, that's golden. Everybody wants that," he says. "What's not sexy is the stuff that makes the most sense—lifestyle research. And yoga is really all about changing your lifestyle." Although progress is being made, he says, it is slow. Of the 46,000 large projects currently funded by the National Institutes of Health, fewer than 10 involve yoga.
All this doesn't shake Khalsa's resolve, however. Right now, he's in the midst of conducting a study about teens. He believes that if 40- and 50-year-olds who grapple with insomnia had started practicing yoga and meditation as adolescents, they wouldn't now be facing sleepless nights. Likewise, he says, if adults with type 2 diabetes and obesity had learned yoga in high school, their health outcomes might have been different. A recent study at the Fred Hutchinson Cancer Research Center in Seattle found that people who practiced yoga were more likely to eat mindfully—that is, to be aware of why they ate and to stop eating when full. In fact, the increased body awareness learned through yoga had a greater effect on participants' weight than did the exercise aspect of the practice.
So, Khalsa is hard at work trying to prove that teaching yoga to young people could have a beneficial ripple effect for our entire society. His most recent study involved high school students in rural Massachusetts. His team compared the experience of students who did 12 weeks of yoga with that of another group assigned to a regular PE class. The yoga group had up to three 30- and 40-minute sessions a week, using a modified version of Yoga Ed, a curriculum for school-age students. (They've since switched to a Kripalu Yoga-based curriculum.)
The instruction mirrored adult Kripalu classes, with students learning a full range of breathing exercises (three-part breath, Ujjayi, alternate-nostril, and so on), a gamut of poses (forward bends, backbends, twists, vinyasa sequences), and meditation. "In the long holds of postures, we incorporated the Kripalu emphasis on witness consciousness, or nonjudgmental awareness," explains Iona Brigham, one of the yoga educators in the study. "We also pointed out the connection between breath and movement and encouraged the students to constantly bring the mind back to the present."
At the end of the 12-week program, students filled out questionnaires. Those who had done yoga reported less anger and fatigue and more resilience than the control group. Brigham says, "The kids were so thankful for the strategies they could use to combat stress. They told us where and how they used breathing patterns: to go to sleep, on the athletic field, before a test. Above all, they were thankful to have gained those tools."
By all measures, yoga clearly beat gym class when it came to staying fit and beating stress, Khalsa notes. "As yoga focuses on the integration of breathing, the development of mindfulness, and concentration, it far exceeds regular exercise as a full experience and a way to reduce the stress response," he says. The effect is immediate, he notes, and the capacity to generate the feeling of relaxation on a regular basis increases after weeks and months of practice. "That can't help but benefit us as we face the challenges and health conditions that crop up in later years."
The Waiting Game
If there's a theme to Khalsa's life, it's being ahead of his time. He decided to apply his interest in science to yoga in 1976. But he couldn't find an academic venue in which to pursue it. He went back to school for an advanced degree in neuroscience, with the hope of using it to study yoga. In 1985, with PhD in hand, he looked for a postdoc or fellowship position, but could find nothing related to yoga. Biding his time, he trained his focus on biological rhythms such as the circadian and ultradian cycles.
By 2001 he still wasn't researching yoga. But now, external events worked in his favor: The newly formed National Center for Complementary and Alternative Medicine was offering grants for researchers to train in new areas. "I put together a protocol that matched my skills&mash;yoga for insomnia—and amazingly, it was accepted." Twenty-five years after recognizing an inner pull to study yoga's benefits, his work could finally begin.
Today, the fruits of Khalsa's efforts are increasingly apparent. He has published a half-dozen studies on the effects of yoga for conditions ranging from depression and insomnia to addiction. He has also shown that yoga and meditation techniques can ease performance anxiety in musicians. He brings his expertise to a host of organizations that share a similar mission, serving as the director of research for the Kundalini Research Institute as well as the Kripalu Center for Yoga & Health, and as a member of the editorial board of the International Journal of Yoga Therapy. He has organized symposiums on yoga research and serves as a mentor for many who would follow in his footsteps—meticulously maintaining extensive files on yoga research, categorized by topics such as diabetes, sleep, anxiety, HIV, children, cancer, and so on.
"Sat Bir helps so many around the U.S. and around the world—both established researchers and those just starting out," says John Kepner, executive director of the International Association of Yoga Therapists. "He's just a wonderfully generous man with his time and expertise."
He's also eminently patient waiting for his yoga-is-the-new-toothbrush metaphor to catch on. Certainly, yoga has come a long way in mainstream acceptance. But it still has hurdles to clear before landing where he thinks it can have the most impact: on doctor's prescription pads.
The Future is Yoga
Khalsa may have been ahead of his time, but it seems the world around him is finally starting to catch up. "I've noticed a shift even in the 10 years I've been at Stanford," says McGonigal. "Today, a lot of the younger researchers are interested in yoga and meditation, and they're doing their dissertations on it. That just wasn't the case when I started. "
This newfound interest in yoga from the science world will, Khalsa says, surely boost yoga's credibility as a therapy. "A lot of older, veteran scientists will resist the idea of yoga as a legitimate therapy until the day they die. It's just the nature of bias and belief." (For illustration, he offers the "cigarettes don't cause cancer" die-hards.) "Often it's the next generation that can finally enact a shift."
As more young researchers become interested in yoga, more proposals will be written and accepted; more studies will then appear in peer-reviewed journals. "Once you get hundreds replicating the same outcome in different populations, in different countries, using different styles, then confidence begins to gain. It takes a critical mass of research evidence to ultimately shift the bulk of scientific opinion toward acceptance."
As someone who has waited decades just to receive rejection letters from the NIH, Khalsa is prepared to persevere and bring yoga its due recognition. "My aim is to provide evidence that yoga has a place in regular, everyday life as well as in therapy. And I'll do that by compiling the evidence showing that it works," he says. As author and Kripalu Yoga teacher Stephen Cope explains it, when it comes to the potential of this practice in America, "Sat Bir is holding the 3,000-foot view."
It just may take a while for the world to catch up with him.
Formerly the health editor of Yoga Journal and, most recently, executive editor of Body+Soul, Jennifer Barrett now writes from her home in West Hartford, Connecticut.