Body & Yoga Therapy
By: Matthew Taylor, M.P.T., R.Y.T.

Supporting a student who has experienced a significant burn represents both a challenge and an opportunity for the yoga therapist. The transformative nature of the "tapas" of a burn sears not only the flesh, but can potentially affect all aspects of the individual as they endeavor to integrate the experience into their being. A bit of background information for context, followed by special considerations of supporting students with burns (note the people-first language vs. "burned students") may enable the therapist to offer a more comprehensive environment.

The skin, or "integument" as it is known in traditional medicine, is the largest organ of the body. Skin serves multiple functions to include a natural barrier to foreign bodies, a sensory organ, a thermal regulatory system, and most importantly in our culture, a visual identity. Each of these functions is affected based on both the severity and location of the burns.
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Translations

Skin is classically described as having seven layers, ranging from the sloughing superficial layer of cells to the intimate, deepest level of the dermis that is literally interwoven with the fascia and neurovascular systems of the physical body. Burns are categorized by the number of layers destroyed and the percent of surface area affected. A partial thickness burn has the capacity to regenerate epidermis on its own, though scarring may be significant, while full thickness burns destroy the capacity for local regeneration and require grafting or secondary scar tissue for coverage. The physical body varies in thickness as well, from the thin skin of the backs of the hands/feet to the thicker skin of the legs and back.

Rehabilitation (to make habitable or fit to live in) is challenging and rewarding. Literally in a single instant the person's life is transformed forever. Physical healing can take from 6 weeks to years. Scar tissue is very aggressive and persistent in its mission to cover and fill in deficits in the integument. The scar is like an iceberg, with its visible superficial layers and potential for visual deformity (note Hollywood utilizes the misshapen irregularities of such flesh for its most gruesome beasts). Beneath the surface, threads of web-like tissue spread out in multiple directions, later shortening to create all manner of restrictions and limitations to normal movement and function. Often the student has to wear bulky, unsightly garments for long periods of time to guide and direct the scar tissue formation.

All of these first kosha challenges of the student's must be a reminder to the therapist of the additional traumas and healing that exists on subtler levels. The table below lists just a few of these energetic, psychic, and spiritual layers that are also consumed in the moment of the physical burn. Without attending to and addressing these concerns, the yoga therapist falls short of offering the full benefits of yoga therapy to the student.

Sanskrit
Common Name
Descrpition
Anna-maya-kosha Body
Food Sheath
In addition to the skin, there can be fascial, tendonous, ligamentous, and muscular destruction. Direct communication with the student's physician or physical therapist is critical as damaged or weakened tissue can make certain asanas dangerous or completely contraindicated.
Mano-maya-kosha Mind
Thought/Primitive Mind Sheath
In addition to the horrific physical pain of the burn and rehab, of course there is the psychic and spiritual pain. This can include guilt if others were burned, if the student is a sole survivor amongst others, if the individual is responsible for the fire, or anger at those that are responsible. All of these issues are layered over whatever emotional imbalances may have existed pre-burn.
Vijnana-maya-kosha Mind
Wisdom/Higher Mind Sheath
How does the individual foresee life, make a creative option out of the experience, and return to their routine if that is even possible? Can the witness mind integrate the lower sensory input and surrender all of the necessary attachments burn recovery demands? Is the individual even aware of these issues and has anyone supported them in working through such needs?
Ananda-maya-kosha Spirit
Bliss Sheath
Burns have a way of asking very directly the big spiritual questions: Who am I? What am I? What am I to do/be now? Literally stripped of the superficial layers, the student is thrust into either addressing or repressing these spiritual quandaries.

The challenges posed by the above list are equaled by the rewards of assisting a student in reintegrating their lives post-burn. A therapist is privileged to walk with such a person in their journey of recovery. As a yoga therapist, you cannot sit with the open, wounded heart of a student with burns, without also looking into your own heart. The work is demanding and requires a commitment far beyond dealing with the "aches & pains" of daily living in a standard yoga class. Volunteering at a local burn unit or center is a wonderful way to gain a deeper level of understanding of the special needs and issues of burn rehabilitation. Knowledge is power and experience in such an environment as a burn center or ward will be powerful. Surrender any temptations of the ego to just "jump in" to this work without proper preparation. The students with burns both literally and figuratively have every nerve and fiber exposed, demanding the compassionate and knowledgeable support of the power of yoga. The seva of service at such a center may lead you into the purifying fires of transformation in your own journey as you paradoxically serve others in their transformation.

DISCLAIMER
Copyright Burn Survivors Throughout The World, Inc.