National Ayurvedic Medical Association 2021 Annual Conference Report

by Baba Lou Haber

The 17th Annual Conference of the National Ayurvedic Medical Association (NAMA) brought together online 45 experts whose presentations centered on Ayurveda as evidenced-based and integrative medicine. The conference demonstrated how practitioners are harnessing scientific research to validate classical Ayurvedic approaches, growing expertise in disciplines of emerging importance such as microbiome research and genomics, and building bridges with Western medicine.

Integrative Medicine Defined

Among the first presenters was Victoria Maizes, MD, executive director and professor of medicine at the University of Arizona Andrew Weil Center for Integrative Medicine. Maizes offered a definition of integrative medicine as “healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle” and “emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.”

An internationally recognized leader in integrative medicine, Maizes began with an alarming statistic from JAMA: Even though 70% of deaths in the United States are due to behavioral and environmental factors, only 1%–3% of healthcare dollars are spent on disease prevention, compared to 97%–99% spent on medical care and biomedical research. She emphasized how “something is missing from our healthcare systems, and we believe that we can do a better job taking care of our patients through integrative medicine.”

Innovative Integrative Approaches

That spirit of advancing a better way to improve healthcare and foster wellness was abundantly evident throughout the NAMA conference. Presentation topics included evidenced-based approaches to healing leaky-gut syndrome (in which an unhealthy gut lining allows undigested food and toxins to leak into the bloodstream); innovative therapies to address gastrointestinal tumors; Ayurvedic approaches to mitochondrial diseases and disorders (which occur when mitochondria fail to produce sufficient energy for the body to properly function); and Ayurvedic prevention and treatment of gynecological disorders.

Among the presenters on yoga were Susan Bass, AP- and AYT-NAMA, E-RYT 500, C-IAYT, a certified Ayurvedic practitioner and Ayurvedic yoga therapist who founded the Sarasvati Institute of Ayurveda & Yoga Therapy and the Sarasvati Mission. “Ayurveda excels at digestion and detoxification, so it is about improving the quality of blood,” noted Bass. “That’s why Ayurveda and yoga are exponentially more effective when practiced together, because who cares if you have the blood moving around the body when it is of poor quality and does not nourish the cells and the organs?”

Bass led two sessions. The first examined the beneficial role of yoga in reducing stress and improving mental health. In her second presentation, Bass brought together asana, pranayama, mudra (gestures), and marma (vital body junction points) therapy to address vishama agni (irregular/weak metabolism), the type of digestive imbalance caused by excess vata (air/wind).

A Deeper Understanding of “Evidence”

Bhushan Patwardhan, PhD, national research professor at the Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, provided an overview of Ayurveda as an evidenced-based science. He emphasized that Ayurveda and yoga require a different approach to research and a fresh look at what constitutes evidence, given that they have an entirely different framework than Western medicine.

According to Patwardhan, the integration of Ayurveda and modern medicine will entail an “epistemological transformation process” in which Ayurveda as a holistic, experiential, and natural approach will need to be more fully appreciated and understood by medical practitioners and the medical research community.

A New Paradigm to Foster and Sustain Health and Wellness

In her presentation “Biodiversity Is Health; Biodiversity Is Sustainability,” Vandana Shiva, PhD, likewise emphasized the critical importance of a paradigm shift—one to a more holistic understanding of health that includes our interconnectedness with all species and the entire planet.

“The paradigm we have today is one that doesn’t work with whole systems,” said Shiva, a researcher and eco-feminist food-sovereignty activist who founded the Research Foundation for Science, Technology, and Ecology in Dehradun, India. In contrast, Shiva noted, Ayurveda teaches us that health is about balance. “The body is not little fragments and parts; the body is a non-separable whole interacting non-separably with the world and the biodiversity around us,” she said.

Shiva ended her talk with a call to action. “If there is one thing we can take forward from ecology, from biodiversity, from Ayurveda, it is our interconnectedness,” she said. “We are one, and we can be interconnected through health and regeneration, or through disease and degeneration. [E]ach of us should cultivate the will and determination and the hope that the regeneration part is what we will evolve.”

A Look at COVID-19

NAMA additionally offered a post conference event providing perspectives from conventional medicine and Ayurveda on COVID-19. The presentation, by Dhaval Dhru, MD, and Mimi Guarneri, MD, included a survey of preliminary research looking at promising results of both integrative and Ayurvedic treatments of the virus.

Throughout the conference, NAMA encouraged attendee donations to help the people of India during the country’s COVID-19 crisis through such organizations as Sewa International USA (www.sewausa.org).

Mark Your Calendars

Planning is already underway for NAMA’s next annual conference. The 2022 gathering will be a special event where participants will hopefully again meet in person. The theme of the conference, to be held in Tucson, Arizona, April 22–24, is “Ayurveda for Family Health.”

Originally published in Yoga Therapy Today, a publication of the International Association of Yoga Therapists (www.iayt.org). Shared with permission.

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About the Author

Baba Lou Haber has written for CBS News, served as a communications executive for several companies and public agencies, and is a Cicero Award–winning speechwriter. He is currently studying to be an Ayurvedic Health Counselor. Baba Lou also serves as a member of NAMA’s Communications Committee.

The Dangers of Self-Medicating with Herbs

by Manju Kolli

Before I had the joy of becoming an Ayurvedic Practitioner, I trained and served as a clinical pharmacist. My experience in pharmacy, spanning more than 15 years, has both informed and enriched my perspective on the Ayurvedic practice I have built.   

As a pharmacist, one of the most alarming and challenging trends I have witnessed is the surge in sales of over-the-counter (OTC) drugs, particularly those designed to alleviate symptoms of a range of increasingly common chronic illnesses. The growing use of OTC medications has been further fueled by their affordability, as well as by a rise in the number of prescription drugs that are now available over the counter.   

Abuse and overuse of OTC medications can have serious consequences. The dangers from misuse of certain OTC painkillers, cough medicines, antihistamines, antacids, and laxatives, for example, are well documented within the medical community, and there is growing public awareness of the perils as well. 

We are now seeing rising sales of herbal supplements, the market for which is currently valued in the multibillion dollar range and continuing to grow as increasing numbers of consumers seek natural remedies, both to prevent disease and to address chronic conditions. Additionally, the COVID-19 crisis is prompting many wellness consumers to look to supplements, including herbs, to boost their immune system.

Given my overlapping backgrounds in pharmacy and Ayurveda, I am acutely aware of the dangers of potential misuse of herbal supplements by consumers who may be self-medicating. This concern is shared by Ayurvedic and allopathic doctors alike. A friend who is a nephrologist even made a personal appeal to me to help save people’s kidneys by warning them of the dangers that lie in the misuse of herbal supplements.

The Science of Herbs

Although those of Indian origin tend to see Ayurveda as grandma’s wisdom-infused medicine, the reality is that Ayurveda is highly scientific in its approach to health and wellness. The well-developed rationales and principles underlying this approach and the logical treatment protocols it comprises have withstood the test of time. 

Foundational to Ayurveda is the understanding that we all have a distinct blueprint at birth. As we mature, age, and go through life’s varied experiences and challenges, the natural balance of our original constitution (prakruti) changes and can be pushed out of balance. This imbalanced state (vikruti) is heavily influenced by our dietary and lifestyle choices. 

Since a person responds to external triggers according to their particular prakruti, one person’s medicine can be another’s poison. This insight is true for most herbs just as it is true for most drugs.

Also essential to the proper use of herbs is a clear understanding of the Ayurvedic principle Karya Karana Bhava, which holds that no event occurs in creation without a cause. Simply put, there is a cause behind each and every disease. Ayurveda’s wisdom is used to address that cause in order to maintain health, prevent disease, and restore balance. 

Let us look at the common problem of indigestion. One study cited by the National Institute of Health estimates that one in four Americans suffers from it. 

There are many causes of indigestion. I have grouped together some common causes according to the dosha they can aggravate:

1. Excessive or high-impact physical activity or insufficient food consumption, aggravating vata

2. Spicy, salty, or sour foods, or excessive anger, aggravating pitta

3. An extremely sedentary lifestyle or consumption of too many sweet and heavy foods, aggravating kapha 

Trikatu (which comprises dry ginger, black pepper, and pippali) can be very helpful in curing indigestion, as well as the bloating it can cause; however, it is only truly applicable to one of the three scenarios listed above.

In the first scenario, indigestion is likely to have resulted from insufficient digestive fire because of a loss of tissue strength, with the influence of vata’s predominantly dry and light properties. Trikatu will increase these depleting qualities, due to its own inherent dry and light properties, which, in turn, will aggravate the indigestion.

In the second scenario, indigestion results from excessive pitta, and trikatu will likewise aggravate indigestion and pitta due to its hot potency.

In the third scenario, however, trikatu is indicated as an appropriate pacifying remedy. 

Here are some other examples of commonly available herbs that are subject to misuse: 

Tulsi is known for helping with cold and cough symptoms. If, however, a cough is due to depletion, and it is dry, tulsi will increase the dryness and depletion and could aggravate the cough.

Ashwagandha is frequently used to treat depression, help with fertility, and increase muscle mass. If a client’s symptoms are due to excess accumulation of ama (undigested food in the body), however, ashwagandha will only worsen the condition. 

Triphala is definitely an amazingly versatile herbal medicine that can help in many scenarios, but long-term use of it can create a harmful dryness in mucosal linings. 

Neem can help with diabetes by removing excess accumulation of mucus. Yet if neem is overused after it achieves the desired action, vata gets aggravated, creating an imbalance.

Even ghee, one of the most widely advocated superfoods in Ayurveda, can be misused. If a person is suffering from insufficient digestive fire (mandagni) and excessive mucus, ghee can further dampen digestion and exacerbate the problem. 

These are but a few examples of why it is essential to understand the nature of both the prakruti and the vikruti of clients, as well as the pathological road map of their disease manifestation, before prescribing herbal treatments. It is also important to use the optimal delivery method, including the Karya Karana Bhava, that will efficiently and effectively deliver the right herb to the right site and body system. 

As these examples illustrate, well-meaning friends can naively advocate for an herb that has worked very well for them but can be harmful for someone else. In contrast, a knowledgeable Ayurvedic Practitioner can help clients find and correctly use herbal supplements that are right for them.

Our Role in Educating the Public

As Ayurvedic Practitioners, we play a critical role in protecting public health. Here are three suggestions for increasing awareness of the benefits of herbal supplements and the dangers of self-medicating:

1. Ask your clients to reach out to you with any questions rather than try to self-medicate based on advice from friends or information they find on the internet.

2. Offer free talks in public venues, such as virtual or live forums hosted by local libraries.

3. Author articles for local newspapers to educate your community.

The increasing popularity of herbal supplements and remedies represents a potential turning point in public awareness and medical community acceptance of Ayurveda as a credible pathway to health and wellness. It is up to us as practitioners and students of Ayurveda to help people understand that herbs and herbal supplements must be used appropriately.

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About the Author

Manju Kolli is an Ayurvedic Practitioner based in California’s Bay Area, where she is the founding director of Ayurhitam, an Ayurvedic wellness clinic. Manju has more than 15 years of experience serving as an allopathic clinical pharmacist at the long-term care pharmacy PharMerica. A NAMA-recognized Ayurvedic Practitioner, she also teaches Ayurveda and has expertise in women’s and children’s health, gut problems, skin conditions, mental health, and allergies.

Healing from Disasters by Getting to the Root Cause

By Madison Madden, AD

The word Ayurveda translates to the “science of life.” While its chief objective is to preserve health and prevent disease, Ayurveda also offers sophisticated healing and curative practices informed by an understanding of the laws of nature and the symbiotic relationship between human health and our environment. 

This ancient wisdom is waiting for us to seize it at a time when we are wrestling with global health crises, climate-related catastrophes, and many other challenges. Ayurveda understands all of these hardships as symptoms states of dis-ease. The Charaka Samhita,[1] one of Ayurveda’s four main texts, uses the term Jana Pada Udwansa, translated as a “disaster of a community of people,” to characterize four such states of dis-ease:

1. When a region gets denatured (Desha)

2. When water becomes toxic (Jala)

3. When air becomes polluted (Vayu)

4. When cycles of time become irregular (Kala)

When we look at the realities of our day, we see that we are not just experiencing one or two of these phenomena, but all four at once. 

Animal habitats have been denatured by urban encroachment. Water in parts of both the developing and developed world has become toxic. This past fall, the U.S. West Coast had the worst air quality in the world, and on a typical day in Delhi, the sun is not even visible. Cycles of seasons are changing around the globe due to rising temperatures and extreme weather patterns. These climate changes pose great danger: A landmark 2019 UN Climate Report estimates that about one million animal and plant species are threatened with extinction, more than ever before in human history.

So, what insight does Ayurveda offer regarding these afflictions, our planetary dis-eases? Ayurveda teaches us that a root cause of our societal problems is a disconnection from nature.

To put it simply, human beings on the whole attempt to dominate nature rather than live in harmony with it. Failure to adequately care for and protect our planet, unsustainable practices, and overconsumption are contributing to the breakdown of ecosystems and the extinction of species. 

In our systemic disconnection from nature, we have lost touch with ways of living with and caring for the natural world that were passed down generation after generation in societies and cultures around the globe. This ancient wisdom is invaluable in navigating our way back to a life that dwells within the bounds and bounties of nature. 

Cultivating Sattva

 According to Ayurveda, the remedy to our global crises is sattva, one of the three gunas, the prime qualities of nature. Sattva embodies harmony, wholesomeness, and virtue. 

 The other two gunas, rajas, often translated as action or agitation, and tamas, commonly translated as inertia, are also natural aspects of life. Disease, however, manifests only in rajasic and tamasic states. 

For example, constantly competing with others, which leads to stress, is a form of rajas. Overconsumption of heavily processed foods results in tamas. Both can contribute to chronic disease. 

Healing occurs primarily through sattva, which is why Ayurveda practitioners emphasize sattvic lifestyles. Just as nature expresses itself differently in various parts of the world, each individual must learn to live in harmony with their own nature and local surroundings. Such lifestyles comprise practices and diets that calm the mind, nourish rather than deplete or toxify the body and the environment, and recognize the interdependence between the individual and community. 

Moving Clients toward Sattva 

Here are five examples of how you can help your clients live a more sattvic lifestyle. 

1. Introduce them to the concept of matching their nature to Nature. Point out the similarities between the cycles of their bodies to the cycles of nature, and help them to live in greater connection. Examples include rising and setting with the sun, eating to the rhythm of agni (digestive fire), adjusting routines in keeping with the change of seasons, and easing into new stages of life. The wheel of the doshas (kapha, pitta, and vata) can be seen in all of nature. This is a wonderful way of teaching clients about the doshas without overwhelming them.  

2. Encourage them to discover a sense of purpose. Help your clients widen their gaze beyond the stresses of their individual circumstances and look toward how they can find ways to serve others. Help them connect with what brings light to their lives and what gifts they may have silenced. Finding purpose opens a pathway out of rajasticand tamasic dis-ease patterns. 

3. Teach them how to reduce stress and nourish their minds and bodies through their breath. Guide your clients to experience how the quality of their breath can transform their mindset, improve health, and increase their ability to respond meaningfully to others. 

4. Help them embrace a sattvic diet. Teach them about the impact of their food choices. Help them transition to more plant-based and seasonal diets, as well as foods and beverages that are suited to their particular constitution. Suggest solutions to their cravings for sugar and simple carbohydrate comfort foods that honor their rituals but replace tamasic choices with sattvic ones.  

5. Educate them about the benefits of panchakarma. Charaka notes that panchakarma detoxification therapy is an outstanding method for a person afflicted with the four forms of Jana Pada Udwansa. Panchakarma can lead to a true paradigm shift in mind and body. 

Looking Inward at Your Own Practice: Three Questions to Ask Yourself

Teaching and healing by example are fundamental qualities of a revered Ayurvedic practitioner. I urge you to ask yourself three difficult but vital questions: 

• How can I live a more sattvic lifestyle? 

• Where do I sacrifice sattva for short-term or material gains? 

• How can I help create more sustainable, local, and seasonal resources for my practice and community? 

Listen carefully to your answers. Our inward gaze can help us move from blaming others and finger pointing to cultivating the sattva we need to help ourselves and others heal from the Jana Pada Udwansa, the disaster of a community of people. 

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About the Author

Madison is a NAMA-recognized Ayurvedic Doctor, Writer, Environmental Educator, and Activist. She is the Co-founder of Pacific Coast Ayurveda and the International Institute of Tantric and Vedic Sciences, as well as a founding member of Mendonoma Climate Action Group, who hosted the largest regional event for Global Climate Strike Day in September 2019. Passionate about the vital intersection of health and environment, she can be found at livewiseheal.com.

[1] See Chapter 3, Vimanastana.

Sanskrit: The Language of Ayurveda

THE IMPORTANCE OF SANSKRIT IN PRACTICING AYURVEDA IN THE U.S. 

by Maria Radloff

Like yoga, Ayurveda exists within the language of the gods—Sanskrit. Rooted in poetic Sanskrit verses, Ayurveda had been passed down solely through the memorization of these sacred scriptures until only recently when Ayurveda began its journey beyond the borders of India.

Unlike yoga, whose language and culture have been completely Americanized in this country, Ayurveda has maintained more of its traditional Indian character. It is almost impossible to study Ayurveda in the U.S. without using some Sanskrit terminology. Everyone understands vāta, pitta, and kapha, even if they’re not pronounced properly.

The meaning of so many Ayurvedic concepts is so deeply embedded in the language, that it would be nearly impossible to teach Ayurveda without using Sanskrit. Imagine replacing the word pañcakārma with “cleansing process” every time you refer to this Ayurvedic procedure. The English term hardly does justice to the treatment’s complexities. Likewise, how would you refer to the process of upaśaya without having that word in your Sanskrit vocabulary? Sanskrit words don’t always translate neatly into English because they often convey concepts whose meanings are deeper and more nuanced than their literal definitions suggest. Some of these Sanskrit concepts don't exist in Western culture, so translating them is impossible; you have to explain them instead, which can be arduous. Without the Sanskrit terms, you have to resort to lengthy explanations or deficient English replacements to speak about Ayurvedic principles and practices.

One of the beautiful things about Ayurvedic terminology is that once you understand the root words, you can decipher and understand many of the Ayurvedic terms more clearly by breaking them into their original parts. For example, it’s easy to figure out that hrdroga refers to heart disease once you know that hrd means “heart” and roga means “disease.” This approach gets a little trickier with words like grdhrasi (the Ayurvedic term for sciatica). In this case, the root grdhra, which means vulture, refers to a characteristic sign of the condition—an ungainly vulture-like walk.

As someone who learned Sanskrit in the U.S. through yoga, I had an advantage in understanding the language of Ayurveda through these root words. For example, prasara, which means “spread,” is used in Ayurveda to refer to the third stage of disease, when it spreads from its original site to other locations in the body. This word is familiar to yogis from the frequently mispronounced name of the popular pose prasārita pādottānāsana, or wide spread intense extended leg posture. Because yoga and Ayurveda were born from the same philosophy, Sanskrit is equally interwoven into both sciences, so understanding one will help a student understand the other.

One of the biggest obstacles to learning Sanskrit is the variety of ways that words are spelled. There is the Americanized version of Sanskrit that spells words phonetically, such as moola, dosha, and sheeta. This is helpful for those unfamiliar with the Sanskrit alphabet, but creates a quandary for those with a little bit of Sanskrit knowledge, since some of the sounds are lost or unclear.

Then there is the IAST convention of writing that uses special markings on characters. This system indicates exactly how each sound should be pronounced, but is altogether confusing to anyone without Sanskrit training, not to mention scary!

And the final obstacle is that Sanskrit is downright hard! In the Sanskrit classes I take, everyone, including the teacher, is always looking up terms, and we frequently have to correct our study guides and handouts. I always tell my own Sanskrit students that they just need to let go of trying to “get it”—that Sanskrit can't be “gotten” in the usual way. I explain that I will make mistakes, and they will make mistakes and that's just how it goes. Sometimes the hardest part is just being okay with that.

If you’re studying Ayurveda in the U.S., I believe you’ll find that most schools use at least some Sanskrit vocabulary, even if it’s just the most basic, Americanized form. Here are several key reasons why I believe it is important for anyone studying Ayurveda (and yoga) to learn Sanskrit, along with the sounds of its alphabet.

Reason 1: Lineage

Ayurveda always has been, and still is, handed down via Sanskrit ślokas and sūtras. As an Ayurvedic student, I’ve found that almost every class I attend is taught by a traditional Ayurvedic Doctor from India who was required to learn not only Sanskrit, but also the classic Ayurvedic texts. Not a class goes by where we don’t hear a verse from Aṣṭānga Hrdayam or Caraka Samhitā. My teachers sometimes need to recall a memorized verse from a Sanskrit text to answer a question correctly.

Reason 2: Communication

For Ayurvedic professionals to understand one another, they must share a common language. I have met people from many different countries and cultures who practice Ayurveda, and regardless of their native language, they all share the common language of Ayurveda. While I don't think it's important to know Sanskrit when communicating with rogis, as most of them won't apprehend the nomenclature, it is important when working or learning around other Ayurvedic professionals, researching topics in this field, or reading Ayurvedic texts. Without knowing Sanskrit, one will be locked out of understanding many books and other resources.

Reason 3: Understanding

The principles of Ayurveda remain the same whether they’re conveyed in English or Sanskrit, but when you learn them in English, your understanding of them will only be as deep as the translator’s. There is deeper wisdom held in the language of Ayurveda, as many of the Sanskrit words don't translate into English. This is due to the fact that the concepts the words are expressing don’t exist in the American culture. To understand the philosophies underlying Ayurveda, we must connect with the words that embody these unfamiliar ideas. Ayurveda has been learned through chanting and sound for millennia, so the true meaning of Ayurveda resides in its native language.

Reason 4: Purify the Mind

One of the most efficient ways to purifymanas is to use Sanskrit and chanting. Spoken out loud or even internally in the mind, Sanskrit can purify the mind and create a more sattvic state. To use Vedic chants or mantras for these types of practices, knowledge of the Sanskrit alphabet and the sounds associated with it is vital.

Reason 5: Sound

In Sanskrit, the meaning of a word is considered inseparable from its sound, so when words are mispronounced, their meaning is lost. For example, if you say ananda with only one measure of sound on the first a, you’re actually saying “no bliss.” To tap into bliss, you need to pronounce aananda (ānanda) with two beats on that first a sound. For example, I always explain to my yoga teacher-training students that there are no wrong pose names, just new poses; for example, mispronouncing nāvāsana as navāsana turns boat pose into number nine pose. So to properly use Sanskrit as a healing tool, you must understand the sounds of Sanskrit.

Reason 6: Accuracy

If you’re going to work with Sanskrit words, why not do it right? There is no extra effort involved in saying ka-pha than there is in saying ka-ffa (i.e.,a breathy “p” sound versus an “f” sound). For someone new to Ayurveda, it is just as easy to  learn the correct pronunciation of a word as it is to learn an incorrect one. Therefore, I think it is exponentially more important for a teacher of Ayurveda to know how to pronounce Sanskrit words than it is for the student. The students will echo the teacher’s pronunciation. To learn Sanskrit properly they need an authentic learning experience, where the teacher is well versed in speaking the Sanskrit sounds. One of the things I appreciate most about my teachers is their precise pronunciation. Even though there are words they Americanize for students, I hear all of the authentic Sanskrit sounds that make up the words when they speak—the retroflexes, the aspirates, the nasal sounds. Hearing these sounds is so helpful. Since I understand the nuances of the Sanskrit alphabet, I can usually grasp the meaning of words more fully when the sounds of the Sanskrit characters that the words are rendered in are spoken exactly as the phonetic rules of the language dictate. So why not incorporate proper Sanskrit pronunciation into Ayurvedic education? The price of the education will remain the same, but it will provide far greater benefits.

Reason 7: Standardization

As Latin is to the Western medical industry, so is Sanskrit to Ayurveda. Most industries have their own languages. As a web designer, I need to be able to speak in HTML and CSS, which are computer languages. Architects, engineers, lawyers all speak a unique language that conveys the principles and concepts that inform their day-to-day work. Why should our industry be any different? Sanskrit is the precise way to communicate the meaning of Ayurvedic terms. Imagine trying to explain Ayurvedic concepts or use your own everyday language rather than standard-industry terms when discussing a case. The lack of a common language would significantly increase the potential for errors and miscommunications that could undermine the effectiveness of traditional Ayurvedic protocols.

Reason 8: Truth

Without knowing the language of Ayurveda, there will always be a barrier between the truth and you. Sanskrit embeds universal truths within it, and since Ayurveda and yoga constantly invoke the Self and the discovery of those truths, it can serve as a conduit to that magical ah-ha moment in your journey. Sanskrit is not an old, abandoned language; it is the living language of the Divine that lives deeply within us all, that unites us, and provides language for the deepest wisdom we could ever touch upon.

In Conclusion

Although I love that Ayurveda continues to spread (prasara) around the world, adapting to an endless number of languages and cultures, I will always believe that there is just a bit more truth and understanding conveyed when the Sanskrit language is used. The principles of Ayurveda are powerful whether described in English, Spanish, or Hindi, but the true master of Ayurveda that will use this divine language and really know Ayurveda in its deepest sense.

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About the Author

Maria Radloff is an Ayurvedic Wellness Practitioner student at Kerala Academy. She begrudgingly began studying Sanskrit and Vedic chant when she became an ashtanga student of Dave and Cheryl Oliver in Scottsdale, Arizona. Her studies quickly unlocked the magic of Sanskrit, and soon she was devoting more energy to the language than to the asanas—in effect, the language became her yoga. Maria teaches Sanskrit for yogis and Ayurveda students and professionals.

Editor Note: I used “American” Sanskrit in a normal font, such as Ayurveda and Yoga. Words that are meant to be in pure Sanskrit are in italics with IAST.

The Value of the NAMACB Certification Board Exam

By Paula A. Witt-Enderby, Ph.D., CAHC
 
When new graduates think about preparing for the National Ayurvedic Medical Association Certification Board (NAMACB) exam, they probably become nervous as I was when I was getting ready for mine. We dread studying. We have doubts about our mastery of the subject matter. We wonder why we’re doing this.   
 
It’s perfectly normal to feel this way. When nearing the end of my health counselor training in May 2017 at the Kripalu School of Ayurveda, I wondered if I was prepared enough to pass the boards. I wasn’t sure when I should take the boards—I didn’t want to take them before I had studied sufficiently, but I also didn’t want to wait too long for fear that I would have trouble recalling all that I learned during my training.  
 
Nevertheless, I took the boards soon after graduating because I recognized their importance. The NAMACB boards play a critical role in standardizing training from the different schools of Ayurveda, lending credibility to our field, and ensuring that each of us emerges from our respective training programs as a truly competent Ayurvedic professional. 
 
From everything I now know after a year and a half in practice, I can say without a doubt that preparing for and taking the boards has given me confidence in my counseling skills and lent credibility to my services as a certified Ayurvedic health counselor. I proudly display my NAMACB-recognized Ayurvedic health counselor insignia on my business cards, on my website, and in any informational brochures or presentations that accompany my workshops.  
 
Getting ready for the boards by reviewing the study guides prepared by NAMACB and posted on its website helped me untangle many of the complexities of our field: I gained a clearer understanding of how to place the philosophy and history of Ayurveda in the proper context, what the 25 principles of samkhyaare and how they form the entire basis of Ayurveda, and how to differentiate between interrelated yet distinct Ayurvedic concepts such as the following:

1. The goals of Ayurveda (maintain the health of the healthy and cure the sick) 

2. The three pillars of Ayurveda (diet [ahara], lifestyle [vihara], and herbs [auśadha]) 

3. The three pillars of health (diet [ahara], sleep [nidra], and energy conservation [bramacharya]) 

4. Ayus(body, mind, senses, soul) 

5. The three causes of disease (misuse of the senses [asatmyendriyartha samyoga], crime of the intellect [prajnaparadha], and temporal factors [parinama])  

 
The study guides helped not only clarify the six schools of philosophy and their main principles—areas that I had trouble synthesizing during my training—but also deepened my understanding of the characteristics and symptoms associated with amaand low ojasby dosha(vata, pitta, kapha) and by system (digestive, musculoskeletal, nervous, general) as they relate to imbalances in the mind and body.  
 
Equally important, studying these guides helped realize what I didn’t know, sending me back to my class notes, training handbooks, or Dr. Lad’s textbooks to fill the gaps in my knowledge. The preparation process also forced me to memorize all the relevant details about herbs—their Sanskrit name, classification by genus and species, indications, contraindications, qualities, etc.  
 
As a professor for 23 years in a pharmacy school and coming from a discipline where testing, certification, and licensure are routine steps to a successful career as a healthcare professional, I want to reassure every examinee that the high quality of our Ayurvedic training ensures that we gain the competence required  to complete  a similar path to professional credibility.  
 
No doubt your training was as rigorous as mine and your teachers, like mine, did a brilliant job of infusing your training with the essence of Ayurveda as it was conceived in classic texts and passed down  in words, mantras, songs, and writing exercises and presented you with enough case scenarios from their diverse backgrounds and broad and deep experience to enable you to not only pass the boards but also achieve excellence as Ayurvedic professionals. 
 
We were led to Ayurveda for a reason. We are lucky to have been given this ancient wisdom. May we all trust in ourselves as our teachers and the Ayurvedic community trust in us!

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About the Author

Dr. Paula Witt-Enderby, Ph.D., CAHC is a Professor of Pharmacology and Toxicology, NIH-funded melatonin research scientist and Board Certified Ayurvedic Health Counselor. She blends Western and Eastern medicine into her research on bone and breast cancer.

State Licensure For Ayurveda Legitimacy and Recognition

By David T. McConaghay, AD

State licensure will grant Ayurveda the legitimacy and official recognition it needs to realize its full potential to positively impact the lives of millions of people.
 
Licensure is a state-level function. As the pre-eminent national Ayurvedic organization, NAMA is busy doing everything in its power to facilitate the pursuit of licensure. These foundational efforts include the establishment of scopes of practice, national board exams www.namacb.org for three levels of Ayurvedic professionals, as well as a council to accredit Ayurveda schools (NAMA Accreditation Council, NAMAAC).
 
NAMA, however, can only do so much. Therefore, if we are to perform our role as modern-day stewards of the vidya that is Ayurveda, those of us invested in properly protecting and promoting its study and practice must organize ourselves at the local level.
 
There is already a great deal of ongoing activity in this arena. Formal state associations currently exist in California, Colorado, Florida, and Minnesota, and there are groups currently forming in many other states, including but not limited to Connecticut, Massachusetts, New Jersey, New York, Pennsylvania, and Texas. Leaders from these groups meet monthly to share best practices and inspire each other.
 
State organizations serve as a focal point for local Ayurveda communities. They offer membership benefits, send informational newsletters, host educational events, and hold regular leadership meetings to serve the needs of Ayurvedic professionals in their state.
 
In addition to cultivating community solidarity, these state groups will serve as the avenues through which the Ayurvedic profession will achieve the official recognition it needs to reach a mass audience in America.
 
While each state organization is inherently independent, we see immense benefit to maintaining general alignment and open channels of communication between states and with NAMA. Look for updates in 2019 detailing more about the precise structure of the relationship between NAMA and the state organizations.
 
If you are curious about what’s happening in your state or want to make something happen in your state, please contact us jolynne@ayurvedanama.org, and we’ll get you connected!

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ABOUT THE AUTHOR

David T. McConaghay, AD is the Communications Chair of the Colorado Ayurvedic Medical Association (COLORAMA) and is the Chair of the NAMA's State sub-committee, whose mission is to be an organizing force offering support to state-level Ayurveda organizations.

How Applying Ayurvedic Therapeutic Practices in Working with Addiction

By Jessica Ferrol, AD, MHC, CYT, PKS

The Centers for Disease Control and Prevention estimates that at least 72,000 Americans died from drug overdoses in 2017. This number does not include people who died from conditions related to alcohol or cigarettes. The same source asserts that 480,000 Americans die each year from smoking-related illness alone. The National Institute on Alcohol Abuse and Alcoholism estimates that 88,000 die from alcohol- related conditions. It is not known how many Americans suffer from some form of addiction, but these statistics reveal a frightening reality.

Addiction is a disease without a specific cure. Treatment involves managed care. Substance abuse ranks as a leading cause of sickness and death, and addiction itself is now recognized as a chronic disease that causes long-term changes in neuronal activity patterns.

Most addictive substances cause the brain to release hormones that elicit a feeling of pleasure and, at high doses, euphoria. Addiction occurs when an individual has abused a substance or substances to the point that the brain loses the capacity to naturally generate pleasure hormones, leaving the individual to rely on one or more substances to achieve a feeling of normalcy. In fact, nothing about an addicted brain is normal.

Āyurveda, as a holistic healthcare system, provides a complete maintenance approach to supporting sobriety with daily self-care practices and routines that promote physical rejuvenation and mental well-being and restore a normal physical state over time. Āyurvedic theory states that all humans naturally experience kama (“the desire for pleasure”) and that this longing and the wish to avoid pain are basic survival instincts shared by all organisms. Āyurveda also asserts that the attachment to pleasure and the avoidance of pain can lead to disease if pursued at any cost. Addiction is a case in point: The addict will sacrifice nearly everything to feel a high. In the deepest throes of addiction, the addict will sustain a dangerous lifestyle simply to find a feeling of normalcy.

The Āyurvedic practitioner may use the conceptual theory of the five sheaths as a foundation for treatment of addiction. The theoretical understanding of the five sheaths provides a map of how to access body (annamaya kosha), breath (pranamaya kosha), mind (manomaya kosha), intelligence (vijnamaya kosha) and consciousness (anandamaya kosha) as well a way to understand how these parts are connected or can become disconnected.   

Addiction is a disease that takes residence in the body, breath, and mind sheaths and creates a disconnect from the intelligence and consciousness sheaths. Disconnection from intelligence results in an inability to discern reality from illusion, causing the mind to become flooded by irrational, obsessive thoughts. These negatively affect the movement of breath and create a state of hyperarousal (“heightened anxiety, fear, or anger and increased sensitivity to stimuli”) or hypoarousal (a feeling of depression, lethargy, or paralysis) in the physical body.

The addict hopes to achieve a feeling of normalcy by using a drug. In fact, the drug is dangerous, and it works against this end. When the short-term effect of the drug goes away, the addicted mind is once again overwhelmed with irrational, obsessive thoughts. It is in a physically worsened condition, and the cycle of substance abuse begins again. Addicts might instead employ Āyurvedic practices, which may bring stability to the mind and return the body to a well-regulated state.  Over time, these practices may re-establish access to innate intelligence. Connection to innate intelligence is crucial to relapse prevention. 

Proper diet, adequate sleep, and a healthy sensory environment will help minimize cravings. A safe environment is essential in order to deny access to substances that can be abused. Herbs will support the body in detoxifying while also sedating the nervous system. The overall goal is to guide clients to re-inhabit their body, to return home. By cultivating awareness and sensory connection to the physical body, the addicted client ignites activity in the root chakra and circulates a feeling of safety and stability through the mind. This in turn sets the stage for cellular repair to heal the body.

Restoration of the breath involves recovery of the natural, instinctual breath through meditative practices. Life events that are stored as implicit memory affect the natural depth of inhalation and the natural length of exhalation. Recovery of full inhale and full exhale through gentle breathing exercises creates a state of equilibrium in the parasympathetic and sympathetic nervous systems, generating an overall feeling of regulation in the mind and body.

The practitioner must guide the addicted client to the sensation of body through yoga asanas or meditative practices. This will slow the thought process and calm the mind. Trauma often accompanies addiction. Āyurvedic practitioners should be careful not to trigger the client while navigating the terrain of the mind. It might, therefore, be helpful to support this process with one-on-one therapy as well as group therapy, guided by trained mental health counselors.

The following is a method of healing that works with body, breath, and mind: 

Come into a comfortable position that feels supportive for your spine. Feel yourself intentionally withdraw your awareness from the outer environment into the inner terrain. Drop into the body through the breath. Track the movement of breath by feeling the air draw deeply into the nostrils, and follow it to the very end of the exhale. As the body drinks in the air, notice the physical feeling of needs being met. Invite the emotional heart to take in what it needs with the movement of incoming breath. Notice how your body responds to the words “I have all I need in this moment.”  Then, turn your awareness to the sensation of letting go that is present in every exhale. Invite the emotional heart to release that which it no longer needs with the movement of outgoing breath. Notice how the body responds to the words “I belong.”  Make a note of how your body feels at this moment. As you slowly turn your awareness back toward outer environment, stay in contact with inner body sensation. See if you can maintain awareness of inner sensation while you engage with the world around you.

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ABOUT THE AUTHOR

Jessica Ferrol, AD, MHC, CYT, PKS is an Ayurvedic Doctor, Holistic Mental Health Counselor, Herbalist and Certified Yoga Teacher.  She incorporates Ayurvedic practices and psychosomatic therapy in her private practice and an addiction treatment facility.  The purpose of her work is to rekindle the connection to one’s inner source of wisdom.

Belonging to a Professional Association

by Marie-Josephine Royall-Schreck

I am a professional nurse and student of Ayurveda transitioning my career into integrative health coaching through education. It’s one of the most exciting times of my professional life, and, as I’ve learned over and over again in my career, I will need support—the support of a professional association. Wanting nothing less than to be valued for my experience, knowledge, ethics, commitment, and to be credible, one day, my education completed, I will venture out into the world and announce that I am ready to serve in a new way. I don’t expect it to be simple—I don’t know what I don’t know. When deciding to add Ayurveda to my professional life, the first thing I looked for was its professional association. NAMA. 

Having resources and professional support available through NAMA will help my self-confidence, and it will help those who choose to work with me, too. This is where belonging to a professional association has always worked for me.

I’ve been a member of associations throughout my career of more than 30 years, so it feels natural to me to seek out the one association that can make a difference for me as I journey into Ayurveda. Associations have been the hub for many areas of my professional life, becoming the one source I can count on for information surrounding policy, best practices, and what are the issues and concerns of other practitioners in my industry. Below are some of the benefits I’ve realized from belonging to professional associations and ones that I know I can count on as a NAMA member. Here’s how I would rank them: 

Industry News and Newsletters
Continued Education
Ethical Standards
Networking/Friendships
Ability to volunteer and serve
Certification/Credentialing
Events/Conferences
Resources
Advocacy
Techniques and Tools
Collaborate with colleagues

How about you? If you have experience as a member of an association, would you agree with my ranking? Write me and let me know. As a member of NAMA’s Membership Committee, Students Subcommittee, I am part of a team striving to help NAMA serves its future professionals, its future volunteers, its future leaders. Also, if you’d like to share some of your insights regarding membership in an association, send those to me as well, and I’ll do my best to share them with our—your—subcommittee.

If you are a NAMA member now, you’ve made a good choice. If you’re not, consider becoming a member of NAMA today and expose yourself to the many resources available, such as ENEWS, Annual Conference, and Professional Ayurvedic Continuing Education (PACE). Also, consider getting involved through volunteering. As you help others, you will see yourself grow in your own practice and enhance your association in the process. The more you know, the more you grow.

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ABOUT THE AUTHOR

Marie-Joséphine Royall-Schreck is a life-long meditator, yoga practitioner, and learner dedicated to helping individuals understand Integrative Healthcare as a self-care option. Marie-Joséphine is a Professional Registered Nurse, with over 30 years of experience; a Certified Meditation & Mindfulness Instructor, MMI; a Certified Archetypal Consultant, CMED; and Yoga Therapist. Most recently, she and her husband, Jeff, relocated to Sedona, Arizona to explore the west and high-desert living.

Research and Clinical Practice Highlight

with Clayton Bell M.D.

My name is Clayton Bell, and I am an Integrative Medicine physician and Assistant Clinical Professor in the Department of Family Medicine at the University of Tennessee Medical Center.  My current clinical practice as an Integrative Medicine physician combines cutting-edge, evidence-based Orthomolecular-Functional Medicine with the subtle yet powerful healing insights of Ayurveda. 

Personalized wellness plans are created for each patient based on their prakruti, vikruti, and current medical conditions.  Heavy emphasis is placed upon Lifestyle Medicine treatments and “miracles” often abound in the healing response.  Patients and fellow healthcare providers are often amazed to discover what happens when one brings the various aspects of their life (physical, psychological, emotional, spiritual) into balance.  To help expand this clinical knowledge, I am actively teaching Ayurvedic techniques to rotating medical students, residents, and providing Grand Rounds to various medical departments throughout the hospital as well. Combining the science of Western medicine and the wisdom of Eastern medicine creates the highest level of patient care possible.

Ayurveda began capturing my passion and professional curiosity three years ago during my Integrative Medicine Fellowship at the University of Kansas Medical Center. For my fellowship thesis, I wanted to scientifically validate if the various Ayurvedic prakruti (Vata, Pitta, Kapha) were truly biostatistically correlated with Integrative and Western Medicine diagnosis.  Through researching both national and international peer-reviewed journals, many articles began to emerge linking specific prakruti to various biomarkers and genomic patterns.  However, nowhere could I find where any researchers had ever biostatistically validated these most foundational theorems regarding prakruti and various disease states.  

Our research study participants were patients of the KU Integrative Medicine Clinic. Eligibility criteria included adult patients ages 21 and older with no language barriers and the ability to give consent. Approximately 150 participants were screened, 129 were enrolled with 119 successfully completing both the Mind-Body Survey and the Medical History Form. The Mind-Body Survey consisted of 10 self-assessment questions pertaining to specific physical and psychological characteristics. This survey was adapted from The Chopra Center’s Prakruti Patient Intake Form and provided quantitative subscores for each Ayurvedic dosha (Vata, Pitta, Kapha). Participants were also given a Medical History Form to determine active, past, or lack of history for 47 common integrative medicine diagnoses. Biostatistical analysis was analyzed to determine positive and inverse correlations between prakruti and specific disease diagnosis.

Based on our findings, we have discovered multiple statistically significant positive and inverse correlations between prakruti and self-reported medical diagnosis. Vata was associated with anxiety (r = .22, p = .02) and sleep disorders (r = .25, p = .01), whereas Kapha appeared to be protective from anxiety (r = –.31, p = .001) and sleep disorders (r = –.19, p = .04) as well as osteoporosis (r = –.22, p = .02), hyperthyroidism (r = –.24, p = .01) and environmental allergies (r = –.19, p = .04). However, Kapha was statistically associated with obesity (r = .32, p = .001) and overweight (r = .32, p = .001), whereas Vata was protective from obesity (r = –.19, p = .05) and overweight (r = –.39, p < .001). Vata was also statistically correlated with constipation (r = .19, p = .04), depression (r = .22, p = .02), irritable bowel syndrome (r = .26, p = .01), and panic attacks (r = .29, p = .002). Vata was inversely correlated with hypertension (r = –.22, p = .02) and solid organ cancers (r = –.25, p = .01). No statistical associations were found for Pitta.

We were very excited to discover the positive and inverse correlations, which verified the ancient Ayurvedic teachings and our research was published in the Ayurveda Journal of Health—an incredible experience! I learned so much through the entire research and publication process and highly recommend others to do the same.  Our research and many other current publications are validating Ayurveda as an incredibly useful and pragmatic medical system.  To learn more, see the Ayurveda Journal of Health 2017 Summer edition and read our article: Ancient Wisdom: Can Ayurvedic Prakruti Provide Invaluable Insights into Integrative Medicine?

Remember, as a NAMA member you have a subscription discount to the Journal. Check your Member Discounts from the NAMA Member Center.

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ABOUT THE AUTHOR

Dr. Clayton Bell, M.D., is an Integrative Medicine physician and Assistant Clinical at the University of Tennessee Medical Center.  He utilizes evidence-based Orthomolecular Functional Medicine and the ancient wisdom of Ayurveda to create personalized wellness plans for each patient.  

How to Build a Successful Ayurvedic Practice with Education, Legalities and Business Practices

By Felicia Tomasko, RN, C-IAYT, AP

If you’ve embarked on a course of study of Ayurveda, you’ve likely done so out of passion. You may have found some purpose in the teachings or even some measure of healing in your own life. Then, perhaps you decide to put the teachings into practice in a practical way and build a profession from your passion. When it comes to building a successful Ayurvedic business, there are a number of factors to address, from understanding the scope of practice in relation to your education, to knowing the laws you are practicing within, to fully understanding yourself. In addition, even if you didn’t set out with this goal in mind, it’s time to embrace the art of being an entrepreneur. Here are some suggestions for transitioning from Ayurveda as passion to Ayurveda as practice.
 

Know Yourself

While this may seem like a bit of a cliche, taking some time for an inventory of self-awareness is a key component to building any successful career. This is distinct from understanding the scope of your education. Knowing yourself includes understanding something about the ways in which you want to engage with your practice and your business. Where and how do you want to work? For example, do you thrive as part of a team and want to join an integrative medical clinic or group? Do you prefer to set up a solo practice? If so, is there a space at home where you can create a professional office space? Are you looking to make or sell products? Are there specialties within Ayurveda that you feel you want to focus on? Do you visualize a full-time practice or part-time work to accommodate family or other commitments? Try journaling or finding a friend, mentor, or colleague who is willing to brainstorm or heartstorm (as one of my friends says) with you. Know that some of your ideas might change, but it’s helpful to start the process of self-inquiry at the beginning, as it may inform some of your direction and subsequent decisions. As with any business, you’ll be starting where you are in the moment yet making plans to grow a practice and hold an expanded vision.

Embrace Your Education and Scope of Practice

Ayurveda is a vast science and practice. In order to promote clarity in the different educational paths, the National Ayurvedic Medical Association (NAMA) offers separate categories of practitioner types, each with their own course of study, requirements and scope of practice. Of course, Ayurveda is a life-long pursuit, and no matter where you begin there are options available to earn new certifications. In the meantime, understand where you are now and organize your business so that you are operating within the scope of practice appropriate to your educational competencies and certification. Continuing your education is important from the perspective of adhering to ethical guidelines as well as setting yourself up for success.

Commit to Continuing Your Education

Wherever you land in terms of a certification and title, completing continuing education on an annual basis is an important part of staying fresh and current. Even if you are seeing clients daily, nothing substitutes for an ongoing infusion of knowledge and insight from master teachers, clinicians with different experience than your own, and the ongoing wisdom that comes from being a perpetual student. This will continue to expand your skill as a practitioner, clinician, and businessperson, promoting your personal success. Through conferences, classes, and even conference calls and webinars, NAMA offers and refers numerous opportunities for continuing education. Personally, every event or class I attend provides at least one (if not many) a-ha moments that fine-tune or expand my ability to practice successfully.

Know the Laws and Choose a Business Structure

Once you understand the scope of your Ayurvedic specialty, relate that to the laws where you are. This includes understanding the state or regional regulations that apply to the practice of complementary and alternative medicine or therapies. If you have an active medical license, make sure that you are operating within the scope of practice of your Ayurvedic certification as well as your medical license.

Follow the legalities of operating a business in your local area including maintaining a business license and sales tax reporting (if applicable). Look into liability and other insurance policies that relate to both your place of business as well as your practice. Also, create a business structure and accounting system to provide the greatest ease and set yourself up for a long-term successful practice. You may decide to operate as a sole proprietor or to create an LLC or other business corporate structure for liability reasons, for greater clarity, or to facilitate long-term growth if you plan to hire employees or sell products.

Even though you may start small, keep in mind your extended vision. Set up the structures that support your growth. This projected growth may be from one client to five clients or one client to five thousand. The size of the expansion doesn’t matter but having systems in place that create a container for your practice allows you to be the best practitioner you can be. Along the way, utilize the support available for small business owners and budding entrepreneurs. In the US, resources like the Small Business Administration offer free- and low-cost classes as well as opportunities to access mentors.

Ethics Including Confidentiality

Taking an online ethics course is part of maintaining your ongoing professional status with NAMA. Implementing appropriate ethics is essential to maintaining a long-term successful practice. Make sure to implement the appropriate levels of confidentiality surrounding record-keeping and working with clients. Apply this to the systems you set up as well as how you conduct yourself in public. Your clients will notice the care with which you handle sensitive information; it helps to build trust and empowers them to confide in you more freely. This allows you to make appropriate recommendations that set your client up for greater success.
 

Build Your Networks

When it comes to building your networks, think about this from a variety of perspectives. On one level, it relates to building out-bound as well as in-bound referral networks in your community. Who will you call upon when faced with something that is outside your scope of practice? Who will you turn to for advice? Continue to maintain referral relationships with the teachers and mentors from your Ayurvedic programs when you need to discuss (confidentially, of course) a specific case. In addition, develop relationships with people in your community, including providers from other disciplines, for when you are looking for advice or when one of your clients needs services from another system. Get to know acupuncturists, chiropractors, OB/GYNs, massage therapists, energy workers, primary care providers, and more. Find people that you feel sympatico with and would feel comfortable making referrals to. At the same time, develop relationships with people who would be willing to refer clients to you. There may be other providers in your community who are looking for an Ayurvedic specialist whom they can trust. Considering providing some of them a free introductory session so they can get to know you, or offer to give a talk at their office. You may want to host an Ayurvedic tea and chat and invite them for a meet and greet. Developing these relationships in your community is an important aspect of solidifying the success of your own practice.

The other part of building your network is related to growing your group of clients. Start out by connecting to your spheres of influence and being open and communicative about your practice and what you do. You could volunteer at health fairs, donate gift certificates when the opportunity presents itself, encourage (and reward?) referrals from your regular clients. Come back to knowing yourself and your areas of specialty and/or competency. Connect to relevant communities through your areas of expertise. This may include working with kids, women, men, special populations or conditions, areas of interest, and more. As you know yourself, share yourself. As you grow, expand and nurture your networks. Take every opportunity daily to connect your passion to your practice.

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ABOUT THE AUTHOR

Felicia Tomasko, RN, E-RYT-500, combines decades of Ayurvedic study with her background as a registered nurse. Her experience includes working in hospice care, in drug and alcohol recovery, and in biochemical and cognitive neuropsychology research and is the editor in chief of LA YOGA Ayurveda and Health Magazine.