Hell-Bent (45 page)

“One only needs to read the title of Alice Miller’s
Drama of the Gifted
Child
…”:
Miller,
The Drama of the Gifted Child: The Search for the True Self
(Revised Edition), 1997.

“All the easier to discard …”:
Discard? Did I really write that? Have I learned nothing? Yoga, with its quest for union, asks for integration—it asks us to assimilate even the imperfect parts of our existence to create a cohesive whole. Discarding Bikram the man, our own ego, competition, or even our former “inadequate” selves simply isn’t part of the operation. As Anna, my friend from Teacher Training with the alcoholic ex-husband and fresh set of brass balls, says, “My yoga practice integrates. Healing is the idea something needs to be fixed. Instead, Bikram Yoga integrated me. I am still me—with all the pathetic parts—only better.” So why “discard”? Partly a crutch of language, but partly to impress the idea that to truly see how something fits into your life, it can be invaluable to step away.

Part VI: All Lies Are Aspirational

“The true opponent, the enfolding boundary, is the player himself. …”:
David Foster Wallace,
Infinite Jest: A Novel,
New York: Little Brown and Company, 1996.

Footnote “Love! And a word about its use herewith … Oxytocin is a neuromodulator. …”:
On Oxytocin and unlearning: Norman Doidge,
The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science,
New York: Penguin, 2007; on hormones released by intense exercise: John J. Ratey,
Spark: The Revolutionary New Science of Exercise and the Brain,
New York: Little Brown and Company, 2008.

“What my favorite teacher, Courtney Mace, calls ‘the battle between the ego and the soul’ “:
“People seems to like that phrase, ‘the battle between the ego and the soul,’ a lot, and I realize I said it so it’s out there, but I
hate it. I hated it the moment the words left my mouth,” Courtney says. “They simply do not express what I mean. Pitting the ‘soul’—a word so ambiguous, I loath to use it—against the ‘ego’ only serves to strengthen the idea that these two aspects are separate. Worse, it suggests that the ego can be vanquished. That is not my goal in yoga. That is not my goal ever. … I’m looking for union, harmony between the ego and the higher self. I hate that I said it’s a battle between the two because that is exactly what the lowest part of me would want to think. In battling, the ego thrives. But it doesn’t need to be eliminated. It needs balance. … We are human. It’s not possible or desirable to abolish an essential part of who we are.”

Part VII: Finding Balance

“He demanded Tony break up with his girlfriend—soon-to-be-wife—Sandy. …”:
This was not an unusual request. According to many early teachers, Bikram took great pleasure both in arranging marriages between his students and, when he felt a couple was poorly matched, demanding they stop dating. In this particular case, there were certainly other issues at play. Tony had recently asked Bikram if he could buy him out of the studio. Bikram incorrectly blamed Tony’s attempts at independence on his new relationship with Sandy—and threatened by that independence, decided to nip the threat in the bud.

“He did a last interview with a reporter from
Self
magazine. …”:
The reporter was calling for comment on the latest yoga sex scandal, celebrity teacher Rodney Yee sleeping with students. A scandal juicy only because Yee was simultaneously publicly exhorting the fact that his yoga practice strengthened his happy marriage. To Tony it was an interview that represented everything he was trying to get away from: the celebrities, the sex, the need to wrap yoga in unrelated wholesome morality, and the hypocrisy that resulted when all those values met in the marketplace.

“When selective serotonin reuptake inhibitors (SSRIs) hit the market …”:
Although seizing on antidepressants as a potent example of the placebo effect had long been decided as my rhetorical strategy, several publications came out during the writing of this book that helped focus this section immensely. Primarily Irving Kirsch’s phenomenal deconstruction of antidepressants—
The Emperor’s New Drugs: Exploding the Antidepressant Myth
—and several of the articles written in response to his arguments, in particular Marcia Angell’s review in
The New York Review of Books,
“The Epidemic of Mental Illness: Why?”

“Over the next two decades, that number increased sixfold. …”:
Or 4.5 million Americans taking antidepressants in 1987, 13.3 million in 1996, and 27 million in 2005. Sharon Begley, “The Depressing News about Anti-Depressants,”
Newsweek,
January 2010.

“So that by 2007, approximately a full 10 percent of Americans over the age of six years old were regularly taking an antidepressant …”:
Marcia Angell, “The Epidemic of Mental Illness: Why?”
The New York Review of Books,
June 2011.

“The SSRI-driven antidepressant market grew into a 19 billion dollar per year …”:
Irving Kirsch,
The Emperor’s New Drugs: Exploding the Antidepressant Myth,
New York: Basic Books, 2010.

“Doctors long wary of the growing influence of the pharmaceutical industry were won over by the powerful results. …”:
Marcia Angell, “The Epidemic of Mental Illness: Why?”
The New York Review of Books,
June 2011.

“The Hamilton Rating Scale for Depression rates a patient’s mood. …”:
Kirsch,
The Emperor’s New Drugs: Exploding the Antidepressant Myth,
2010.

“As early as 1995, Guy Sapirstein and Irving Kirsch decided to pool the results of previous studies on antidepressants. What they found shocked them. …”:
Irving Kirsch and Guy Sapperstein, “Listening to Prozac but Hearing Placebo: A Meta Analysis of Antidepressant Medication,”
Prevention and Treatment,
1998.

“Similarly in nine studies in which active placebos were used …”:
Kirsch,
The Emperor’s New Drugs: Exploding the Antidepressant Myth
, 2010.

“My point here is not to argue one way or another about the usefulness of antidepressants”:
Even if extremely marginal, the additional benefit an SSRI provides over a placebo might be a critical percent for many patients. Just as a baby may be a critical 5 percent of the volume of a bathtub, the overwhelming presence of the placebo effect is no reason to throw the antidepressant out with the bathwater just yet.

“The effect is 100 percent real. And it works on people. …”:
This section on the placebo effect could not have been written without the works of Fabrizio Benedetti (
Placebo Effects: Understanding the Mechanisms in Health and Disease,
Oxford: Oxford University Press, 2009); Grant W. Thompson (
The Placebo Effect and Health: Combining Science and Compassionate Care,
Amherst: Prometheus Books, 2005); Irving Kirsch (
The Emperor’s New Drugs: Exploding the Antidepressant Myth,
New York: Basic Books, 2010).

“In 2005, Dr. Jon-Kar Zubieta examined the brain scans of men as they underwent a painful injection in their jaw. …”:
Jon-Kar Zubieta et al, “Placebo Effects Mediated by Endogenous Opioid Activity on u-Opioid Receptors,”
The Journal of Neuroscience,
2005.

“The effects go far beyond depression and pain. …”:
Benedetti,
Placebo Effects: Understanding the Mechanisms in Health and Disease,
2009; the number forty-five in the text comes from an informal canvassing of peer-reviewed studies in the literature. Placebo effect on herpes: Benson, Friedman, “Harnessing the power of the placebo effect and renaming it ‘remembered wellness,’”
Annual Review of Medicine,
1996; placebo effect on Parkinson’s: Goetz, Leurgans, Raman,
Stebbins, “Objective changes in motor function during placebo treatment in Parkinson’s Disease,”
Neurology,
2000; placebo effect on ulcers: Enck and Klosterhalfen, “The placebo response in functional bowel disorders: perspectives and putative mechanisms,”
Neurogastroenterology and Motility,
2005.

“Placebos triggering immune responses”:
Pacheco-Lopez, Engler, Niemi, and Schedlowski, “Expectations and associations that heal: Immunomodulatory placebo effects and its neurobiology,”
Brain, Behavior, and Immunity,
2006.

“Lowering heart rates …”:
Bienfenfeld, Frishman, and Glasser, “The placebo effect in cardiovascular disease,”
American Heart Journal,
1996.

“Raising energy levels …”:
Beedie, Stuart, Coleman, and Foad, “Placebo effects of caffeine on cycling performance,”
Medical Sciences and Sports and Exercise,
2006.

“Enhancing athletic performance …”:
Beedie, Stuart, Coleman, and Foad, “Positive and negative placebo effect resulting from the deceptive administration of an ergogenic aid,”
International Journal of Sport Nutrition, Exercise and Metabolism,
2007.

“Improving sleep …”:
Fratello, Curcio, Ferrara, et al, “Can an inert sleeping pill affect sleep? Effects on polysomnographic, behavioral, and subjective measures,”
Psychopharmacology,
2005.

“Boosting sex drive”:
Bradford and Meston, “Correlates of placebo response in the treatment of sexual dysfunction in women: a preliminary report,”
Journal of Sex Medicine,
2007.

“The placebo effect is shown to grow stronger if the placebo given has side effects or the doctors in question treat the patients with more ‘attention and confidence’. …”:
Benedetti,
Placebo Effects: Understanding the Mechanisms in Health and Disease,
2009.

“Processes we think of as automatic can be brought under something like conscious control. …”:
I have been using the
placebo effect
as a blanket term to describe this ability to link the physical body with willpower/imagination/belief, even though it is an inappropriate use of the term: both because placebo studies typically include statistical phenomenon like regression to the mean, which has nothing to do with unity in mind and body, and because some of the most amazing findings relating to a so-called willpower effect could never be described in terms of placebo. Consider a 1992 study by Guang Yue and Kelly Cole, which found that subjects could strengthen their muscles
just by thinking about them.
In the experiment, subjects were divided into two groups. One group did physical finger exercises, fifteen contractions with a twenty-second rest between each. The second group imagined doing the fifteen contractions and taking the twenty-second rest. At the end of the experiment, subjects who exercised physically had 30 percent gains in strength. The subjects who had only imagined the workout increased their muscular strength 22 percent. They are results simultaneously challenging our notions
of what constitutes a workout, and reinforcing the heretofore exasperating urging of coaches everywhere to focus on intangibles like follow-through and proper form. (Guang Yue and Kelly Cole, “Strength increases from the motor program: Comparison of training with maximal voluntary and imagined muscle contractions,”
Journal of Neurophysiology,
1992.)

“Ernest Shackleton’s declamation that he had ‘pierced the veneer of outside things …’ “:
Ernest Shackleton,
South: The Endurance Expedition,
New York: Signet Press, 1999.

“Jack LaLanne swimming from Alcatraz in the 60-degree San Francisco harbor …”:
A feat repeated twice. The second time at age sixty!

“Cycling of the Gunas …”:
And, of course, my last memory of Bikram, not necessarily chronologically, but more what it all comes down to, the remainder stuck to the frying pan of my brain after I’ve let it soak out for bit: Bikram excited onstage, eyes lit up, telling us a story about Michael Jackson. It’s a story I’ve heard him tell before, maybe five or six times, and like all things Bikram, I have no idea whether it’s true or not, and no idea whether I should let that bother me. But Bikram doesn’t care, he is continuing to tell us all about the King of Pop—both how he introduced the entire Jackson 5 to their first talent agent, and then that, unlike Elvis, even he, Bikram, could not have saved Michael. “He asked for private class. But no,” Bikram says. “It was impossible. The man was a net. His spirit was cut into pieces. I could see that. Too far gone. It is terrible to see a man so beautiful destroyed.” Then, just before I can fall into the somewhat obvious reflection, Bikram does something unexpected. Talking about Michael Jackson has made him want to dance. This instant. And so he yells for the sound guy to put on a disco song he recorded. After some fumbling, a Bollywood-infused techno-disco beat starts thumping, and Bikram’s unmistakable voice hits the sound system. The room starts clapping. Bikram nods his head a few times and then starts dancing with surprisingly fluid, surprisingly choreographed moves. The room goes wild, and several of the Scandinavian women stand up on their chairs and start grinding along with him. At some point, we come back to reality, but in my memory at least, it’s not until the next morning in his hot tent, my face pressed into a sweaty towel, every cell in my body frantic for oxygen, alive and kicking, trying to make it through the next ninety minutes one more time.