85 - Fiona Agombar - Yoga Therapy in Recovery from Long Covid

Jackie Baxter  0:00  
Hello and welcome to this episode of the long COVID Podcast. I am delighted to welcome my guest today, Fiona Agombar who is a yoga therapist, author and rest activist who specializes in teaching live online yoga for all fatigue conditions, including MECFS, exhaustion, burnout from stress, and of course, now long COVID. So a very warm welcome to the podcast.

Fiona Agombar  0:23  
Thank you so much, Jackie. Thank you for inviting me.

Jackie Baxter  0:26  
I'm so happy to have you here today. So it to start with, would you mind just saying a little bit more about yourself and what it is that you do?

Fiona Agombar  0:34  
Sure. Well just a bit of background, I had ME for about 15 years myself. And this was in 1990, after I'd been running a very busy public relations business. And I had what I now would say was burnout. And I also had a virus, which was glandular fever, that showed up in a blood test. But basically, at the time, the doctor said, we're not sure what's the matter with you. And we can't really help you and I was left to get on with it. And I got more and more ill. I ended up in a wheelchair. I had myriad symptoms, some which are very similar to long COVID. But my major symptoms were extreme fatigue, insomnia, and brain fog. And at one point, I was hospitalized. And then I very slowly began to recover. 

And I puts parts of my recovery down to the fact that I took up yoga with a wonderful teacher who I met who did what at the time was called remedial yoga. And she focused a lot on breathing and relaxation. And from that, I realized that I had been hyperventilating or breathing too fast most of my life. So I was constantly in the stress response. So learning to rebreathe helped a lot. And also, you know, I learned along the way that yoga is about having a quiet and peaceful mind. And my mind was always very hyper active. So this was very important for me to understand. 

I then was so impressed with the effects yoga had on me that I wrote a book called "Beat fatigue with yoga". So that was in around 1999. I eventually made a full recovery from ME. And then I started running retreats and classes and people who'd read the book started to come and join me. I then went on and did further training in yoga therapy. And then kind of everything ticked along until, of course, the pandemic kicked in - meanwhile I was writing another book. And the book was called "yoga therapy for stress, burnout and chronic fatigue syndrome". And ironically, the book came out around the same time as the pandemic. 

And then I started live online Zoom classes. And to my amazement, the classes were really filling up, because so many people were coming who had long COVID. So that's kind of in a nutshell, a little bit about me and my classes. 

Jackie Baxter  3:00  
Yeah, I love how you have kind of taken sort of what you have learned throughout your experiences, which must have been awful to go through. But you've turned it into this amazingly positive kind of thing to help others who are sort of where you were. So I think that's awesome. 

But you've been working with people with MECFS, and other sort of related conditions since before COVID and long COVID came along, obviously. What are your kind of thoughts on the similarities, or not, between the two conditions?

Fiona Agombar  3:37  
I think in both cases, it's generally post viral fatigue, or, it's a post viral illness. How that manifests, I think, you know, in yoga, we don't label illnesses so much, we're more interested in looking at the whole person. But you know, I think there is a spectrum where you might have somebody who's completely bed bound, or in a wheelchair, or somebody who can maybe manage day to day living, and whether that's from long COVID, or from another virus, the symptoms are quite similar, I think. 

So for example, I run a teacher training course for teachers to teach long COVID so I'm quite regularly looking at the ONS, the Office of National Statistics, and they quote that 70% of people with long COVID say that their main symptom, or most worrying symptom, is fatigue, well, that's the same with ME. So if you wish to draw a chart, the symptoms of long COVID and ME, they are very, very similar. The differences are maybe that with long COVID, people still may have loss of sense or taste. And you know, and that can go on for a long time. And also, maybe the breathing difficulties are more severe. 

But you know, there are other symptoms like PoTS, postural tachycardia syndrome. I mean, people with ME have been complaining about that for years, but nobody's taking that much notice. And then the other thing is mast cell sensitivity. So things like histamine intolerance, which actually I have myself, again, people with ME have had that for a very long time, and nobody's taken any notice. But now the long COVID community, so many people have mast cell problems, that at last, thankfully, doctors are beginning to look at it. So you know, it's great for the ME community. Because I think the research that's been done into long COVID will benefit people with ME. 

But as far as I'm concerned, from my teaching, I just work with got I've got, so I very loosely talk about working with fatigue, because in yoga, we have something called prana, or energy. So we can, one of the definitions of yoga is that it's about helping prana to flow more effectively around the body. And for that we work very much with the breath. So we would do that with any of these kind of post-viral conditions.

Jackie Baxter  5:55  
Yeah, that's really interesting. So what name you choose to put on the condition is possibly not so important. It's more looking at what your symptoms are, and how you can sort of help them and your body as a whole, I guess?

Fiona Agombar  6:14  
Exactly. Because in yoga, we say we work with the person, not the condition. Having said that, in the last book that I wrote, I wrote a whole chapter on the mitochondria and chronic fatigue. And there's a doctor who I really love, I don't know, if you've come across Dr. Terry wahls, and she cured herself of - she had very severe multiple sclerosis, which she actually cured through diet, and I say cured, she's a professor of medicine. And she has gone on to run controlled trials, which have been published on PubMed. So you know, this isn't just her saying that. But what she talks about the mitochondria, a great deal. And I mean, in her particular model, she says that most disease comes down to problems at cell level, cell being mitochondria. 

And she also states in her book, don't label your disease or don't give too much power to it. Because you know, as you say, we're working on helping the root cause. So in science, that would be mitochondria. In yoga, that would be prana, helping energy to flow more effectively around the body. Because we say that if we can get prana to flow, then any disease can be helped. Not necessarily cured. You know, it depends where you're at, and what you have, but certainly helped a great deal. So that's kind of one of the theories of yoga.

Jackie Baxter  7:42  
That's fascinating, isn't it, and I think I fall into this category as well, there are a lot of people that want everything to be fixed. So you know, you see a little bit of improvement, which is obviously a good thing. But it's almost like every time I see a little bit of improvement, it reminds me how much more improvement I want. So 25% is great. But you know, what about the other 75%? You know, why can't I do that, too? And like, you know, I will but you know, not today. So it's really interesting talking about the sort of incremental improvements that are, you know, really, really important. 

But what you were saying about not giving too much power to your illness, which I thought was very interesting, because I think certainly for me, because long COVID takes over so many parts of your life, you know, you're not working, you're not exercising, you're not doing the chores, it's stopping you from socializing, all of these things, it takes over your entire life. So then you don't think about anything else other than long COVID. And it can be such a kind of overwhelming thing, doesn't it, that it stops you realizing the things that maybe you can do or what you could do to help or the little improvements that you have made. I love the way that you put it - not giving too much power to it, because it does it has too much power, I think a lot of the time.

Fiona Agombar  9:10  
Well, obviously we don't want to deny it either. And I think having great compassion. One of the things I come across in my classes is that people don't have compassion for themselves. So you see, the philosophy of yoga is very much about working much more in the present moment. And I'm not saying that that's easy, but that's certainly what we are aiming to come towards. And if we can come towards ourselves with compassion. I mean, let me first of all, just say that long COVID, as with any of these chronic illnesses, it can be devastating because it threatens or changes our relationships, our work, you know, our ability to maybe we can't live where we - it changes everything. And that's really, really hard. So first of all, I just want to put it out there, but I have great compassion for that, and I understand why we can give power to our diagnosis. 

But if we can, through a system like yoga, it doesn't have to be Yoga, you know, there are other systems out there. But through something like yoga, if we can learn to become more present, what we begin to see is that there are fluctuations of energy and fluctuations of symptoms, including pain. And that in this moment, I might be very exhausted, or in this moment, I might be in pain, or in this moment, my breathing might be difficult. But that doesn't mean that tomorrow or next week, or next month, is going to be like that. Because the tendency of the mind is to go into the future and think, Oh, my goodness, this is always going to be the case. And then that keeps us in a state of fear, and in a state of stress. 

But if we can become very present in our bodies, and accept that this is how it is for now. But I can bring compassion to how I am right now. So even if I'm very exhausted, even if I'm in pain, if I can maybe bring a sense of acceptance to that in this moment, but not dread what might be ahead and not anticipate what might be ahead. And life slowly slowly begins to become easier. So in that sense, we're not giving the power to our diagnosis. So that sense, we're just seeing that there are fluctuations of symptoms, they come and go. And we're not going to anticipate or be too fearful of what might lie ahead.

Jackie Baxter  11:29  
Yeah, of course, because I think we all know, from I think, experiencing it ourselves, how kind of undulating, how up and down these conditions can be. So you know, you might have a few hours or a few days or a few weeks maybe, where you're doing a lot better. And then you know, things might take a bit of a dip. And I always find that  bit of a dip. It's so awful, you know, and I certainly find myself kind of falling into that, oh, my goodness, this is awful. This is completely terrible. And yeah, it is. But to try and remind myself that Well, yesterday was good. So today is not so good. But that doesn't mean that every day afterwards is going to be not so good. You know, I will have more good days, it's just not today. But you know, it's very, very difficult to sort of stop yourself falling into the sort of "everything's terrible" kind of feeling, isn't it? I certainly find it is anyway.

Fiona Agombar  12:26  
But I think, you know, sometimes I had this myself, the symptoms can be absolutely terrifying. And actually, because of that, I put a meditation on my YouTube channel, which is free, which is how to deal with fear. And it's just a 10 minute meditation so that, you know, when we're really overwhelmed by our symptoms and our fear, I'm trying to draw people through it - the way I do it is a very kind of Buddhist approach, which is to actually turn towards, because what we tend to do, when we are frightened and you know, our symptoms can be very frightening, it can be overwhelming, of course, we contract and we push away and we resist, which is understandable. 

But you know what kind of in yoga we're doing, and if I can use that term spiritual, what we're doing, is doing our best to turn towards, to allow and to embrace. And when we start to soften towards things, and to allow everything to be as it is, it actually becomes easier because the heart starts to open and we can just begin to relax, and allow all this stuff. While not denying how, you know, very frightening and overwhelming our symptoms can be. 

Jackie Baxter  13:40  
Yeah, it's interesting, what you're saying about things just being so terrifying. Because I think that is a big part of it. You know, certainly I've found a lot of my symptoms to be, you know, even when I've been doing slightly better, or symptom will sort of pop up and go, Oh, hello. And it's straight back, isn't it? It's like, Oh, my goodness, you know, you get that drop in your stomach or your and one of the scariest ones for me has been chest pain, because you know, we're kind of hardwired to be scared of that, aren't we? For a lot of obvious reasons. So yeah, it's it's very, very scary. And I think there's there's a lot of kind of trauma tied up and all of that isn't there, which I've kind of come to realize, over time. I think I wouldn't have thought it at the start. But now I'm looking back on it and thinking Oh, my goodness, this has just been like three years of trauma.

Fiona Agombar  14:27  
I think there's a lot of trauma. And actually in the book I wrote, I spent a whole chapter talking about trauma. Although, you know, that was before long COVID. But But I think in any chronic illness, trauma is part of the picture on two levels. Firstly, because there - I mean, I think all of us in Western society have trauma to an extent, but many of us have got some kind of trauma that's happened historically, which can lock us back into the fight and flight scenario or the freeze scenario. But also I think having an illness, any chronic illness, but you know, something like long COVID is traumatic for on many levels. Firstly, we didn't know what it was, secondly, fear was pushed at us, because, you know, the government wanted to keep us inside and to behave. Thirdly, if you actually were hospitalized with it, and in some cases, put it on a ventilator, then that itself was very traumatic. So you know, there's all this unknown going along with long COVID. 

So if you have any understanding of the central nervous system, you would say, of course, it's traumatic. And if you have, you know, an understanding of the stress response, it's going to either put you into fight and flight or shut you down into freeze. And whenever you have a reminder of that, you know, as you explained, like a symptom, your body's gonna remember that and go back into that pattern. So that is a trauma response. You know, and again, working in yoga therapy, we're doing our best to unlock that trauma response, and to bring somebody very gently out of that, and it can take time, and it takes a lot of self compassion and trust and releasing and acknowledging that, you know, maybe, yes, I have had trauma, but to maybe not see myself as a victim. But this is something, if I find the right therapist, that I can work with.

Jackie Baxter  16:13  
Yeah, that's very interesting, actually. Because, like I just said, like, I didn't realize what I had experienced was trauma, until quite a long way through, you know, you kind of think as trauma being something that, you know, war veterans have experienced, for example, or people who've been in a horrendous accident or something, you know, that's trauma. I've just been sick. That's not traumatic. But it is. But it took me a long time before I even realized that. And then I could go, oh, oh, okay. At least now, I know, that's a thing. 

Fiona Agombar  16:47  
Well, it's traumatic for all the reasons I said previously, but it's also traumatic because it brings great change into your life. So life is not the same as it was before. And that I mean, trauma is a matter of perception. For some people, they that's not traumatic, for others it is. But I mean, I also see illnesses like long COVID as traumatic because our society doesn't necessarily accept the idea of not being able to work. And we live in a society where everything is about achievement. And you are, you know, what you produce, and there's a lot of push and drive going on. And if you suddenly drop out of that, on many levels, people find that unacceptable, which is why some people, you know, many doctors are very sympathetic, but some not. 

But if you have long COVID - it's the same with ME, and there's this kind of prejudice of society against you, that in itself is traumatic, because there's the whole gaslighting thing that goes on that so many people with long COVID experience. And, yes, you know, to some people, that is going to be traumatic, because suddenly you're not belonging anymore in society. And we're hard wired to belong, we're hardwired to be part of a peer group. So you know, that in itself, that's another trauma. 

So, yeah, you know, this is why in yoga, or certainly yoga therapy, we are trying to approach a trauma response as well, because we're aware that that's part of the picture. And I am very glad that in my book that, you know, I did research it myself. I researched it, because I've had trauma myself, and you know, it helps when you learning about yourself, and then you can look back and help others too. So, you know, I think that was quite a valuable part of the book. And hopefully, if people are listening to this, and they realize that they might have had trauma, they can reach out and get help for it, because there is an awful lot of help these days out there. Luckily.

Jackie Baxter  18:42  
Yeah, it's interesting, what you were saying about the sort of effects of being gaslit or dismissed or not believed. And yeah, it's very dismissive, isn't it? Oh, you look fine. Or you're too young to be ill, or, you know, all of these things that, you know, a lot of people will have been told, and, you know, Oh, you know, you're really fit, you can't be ill. It's like, well, that's not really the point. It's like, listen to what I'm telling you, and if someone won't listen to what they're being told, especially if you're being dismissed by somebody who's supposed to be helping you. I'm wondering if that's a whole extra layer of something on top maybe.

Fiona Agombar  19:26  
Well, I to this day, how members of my family who have denied or been less than sympathetic to my own experience, and it is as you say, it's, you know, your very experience is being denied. And I've come to a place of being able to forgive that because I realized that they are - people are merely responding to what's the so called normal of our society. 

There's a brilliant book I don't know if you know that Jackie, which I can recommend which is the "myth of normal," by Dr. Gabor Mate - it's his latest book on trauma. And I love the title, the myth of normal, because he's actually saying that our society isn't normal, but we all think it is. But you know, that is why there is this denial and gaslighting of people who are not fitting into the so-called paradigm. And this is why maybe, you know, we are able to form groups and get support from other people who have a similar experience. 

But you know, I know before you started recording, we were talking you and I about being kind of - this can be a positive thing in as much as it helps us to maybe see through the things about society which are not so good. And although it's very painful for us to be ill, and chronically ill, and not be able to engage in that kind of society, it also gives us the opportunity to say, Well, when I get better, do I still want to go back to how I was before, you know, is that actually a healthy society? Or if we're having a society where, you know, a large percentage of people anyway are on antidepressants, or are struggling to pay their mortgages, or, you know, food banks are becoming more and more common. Or, you know, it's frowned on to not be working, is that the kind of society I want to continue to engender? So, you know, there is an opportunity for some kind of growth, I think, when we're ill, because it gives us the time to maybe contemplate these questions.

Jackie Baxter  21:26  
Yeah, you do see things through a very different lens, I think. I mean, that's what experience does doesn't take, you know, every experience is sort of going to change how you see things. But I guess, you know, something like a very big experience, such as, you know, your health, sort of going down the plug hole. It's a whole - I mean, I certainly noticed that I do see things a lot of things differently. And I definitely realize that maybe things that I would have valued beforehand, are not necessarily all of the same things that I feel like I value now. And I guess, you know, that's going through experiences, it's going through trauma, that's, you know, you have a lot of time to think, don't you, which I certainly find is not always helpful, because of my tendency is to overthink, but you do have a lot of time to think.

Fiona Agombar  22:17  
I mean, like you, I have a tendency to overthink, which is why yoga was the right route for me, because it's all about calming the mind. But drawing on your point about you change your priorities - I think before I got sick, I was very much somebody who valued things like, you know, could I buy a bigger house? Did I have the right foreign holidays? And was I hanging out with the right people who were smart enough or rich enough? I mean, I'm maybe being a bit harsh on myself. But you know, there was that element of things. 

Whereas now, I value a peaceful life, I value friendships from the heart, I value nature. And you know, my priorities are very, very different. And you know, I'm much more in the moment. So I value simple pleasures, which might be just sitting in the garden having a cup of tea. So all the kinds of things of status have fallen away, because I realized we can't take it with us anyway. And things are always changing. And these things actually are quite shallow and meaningless. And that doesn't mean I don't, you know, enjoy them sometimes. But overall, my priorities are completely different. 

And for that was the gift of illness to me. So for that, I am actually quite grateful. I'm very grateful. Although it's been a horrendous, cruel, difficult journey, you know, and there's times when I felt almost suicidal with it. And I know people listening to this will have had the same, I am still grateful that it's helped me to see life in a very different way and to wake me up on a more spiritual basis, if I can say that.

Jackie Baxter  23:51  
Yeah, yeah, definitely. I remember - people listening might have heard this story before, or even the episode itself, one of my relatively early interviews was with somebody who had recovered and, and she said something along the lines of, I'm glad this has happened. It's a silver lining, because, you know, it's made me more healthy, or, you know, it's given me an opportunity to, you know, look at things that I didn't realize I needed to look at, you know, so she was like, Yeah, I'm glad it happened. 

And at the time, I was, I was doing awfully, I hadn't really found things that helped, you know, we're constantly bouncing from, you know, trying to do too much to, you know, completely crashing, and I just wanted to punch her, because I just thought How can you possibly say that? 

And, you know, looking back on it. I don't feel like I'm glad it happened. But I definitely feel like it's given me an opportunity to make some changes that I didn't realize needed to happen. So I definitely have that like how on earth can you possibly say that and I kind of know what that feels like. From sort of feeling like it on a bad day kind of thing. So it's amazing how your perception of things can change, I think as things maybe improve, and you're able to look back on things or, I don't know...

Fiona Agombar  25:13  
I mean, likewise, I have to be, I'm on a podcast being interviewed and I just said it, but I'm usually very careful about who I say that you know that the illness can be a blessing, because I appreciate that it's so hard and people might want to punch you and I would have been the same as you at the beginning of my own illness. But you know, there are over a million people in the UK, I think it's 1.5 million with long COVID was the last statistic I read, there's a lot of people. And although we know that this was a frightening virus, which has created this initially, I still think there are questions to be asked in the advent of a post viral situation, which is how are we living? And is life actually conducive to recovery. And as a society, could we be doing things differently? 

And I don't remember actually, but in my mother's generation, if somebody was ill with an illness, like, for example, tuberculosis, they were sent off to convalesce for up to a year, but we've forgotten the idea of convalescence, we've forgotten the idea of resting and pacing. But these are key things, not just to recovery, if you have long COVID. But to living a normal life, even if you're ostensibly a healthy person, we need to be bringing more rest periods, more meditation, and, you know, more relaxation, slowing down back into our society, because we are just burning out and it's going crazy. And I don't believe we can carry on like this.

Jackie Baxter  26:52  
Yes, I was having a, I'm gonna say slightly fraught discussion with my partner the other day, and around about this kind of thing where we don't really do self care, until we have to, you know, if someone had said to me three and a half years ago, Oh, you should do yoga, because you know, it's good for you, and it'll keep you healthy. And, you know, breathing is important, and you know, all of these things, I would have kind of looked at them and gone. Yeah, but that sounds boring. And I don't need to. 

And I guess this is kind of like a, you know, a sort of a cultural thing, you know, we don't build rest into our days, into our lives, because we don't need to. We you know, we just keep going and going and going. And I certainly did this before, you know, every single second was full of something, I had deadlines. You know, there was always something, you know, and if someone had said to me, you should sit down and rest I would have been like, I don't have time to do that. But also, I don't need to because, you know, why would I need to rest. 

It's this kind of thing we're actually looking at this from, I don't know about the other side. But you know, from a slightly different perspective, we should all be learning to breathe properly, we should all be building in things like yoga, or meditation or rest into our lives, we should all be trying to eat as well as we can, we should all be doing these things just anyway, because they would keep us more healthy. But it's taken me to go through this horrendous experience to kind of realize this. So you know, I can then understand why I'm then talking to my partner. And he's just like, Yeah, I don't want to eat well, because I don't need to. And I'm like, Well, you know, you're wrong. But also, I know why you're thinking that because, you know, three years ago, I was the same.

Fiona Agombar  28:38  
I think what's interesting is - everything you say is absolutely right. The problem is society is giving us the opposite messages. So society is saying Eat this food, it's really delicious. It's full of sugar and carbohydrate, and very little nutrition, but it's really delicious. So eat this. And then you become addicted to it. Or society is saying you have to keep doing all the time. And if you're not doing then at least you know, drink or watch Netflix or keep yourself distracted. And society is saying if you're resting or taking time out, unless that's for an official holiday, you are perhaps perceived as lazy because you should be doing all the time. So all the messages from our society are saying the opposite of what is healthy for us. 

And then there's the whole fear thing, which has been pummeled into us from mainstream media. And I'm not just talking about COVID - I'm talking about all the other things, you know, it's always negative bad news. Personally, I don't watch the news now because I think it's really bad for my mental health. But all these fear messages are extremely bad for our nervous systems. And we want a lifestyle, which is nervous system friendly. And you know, when we recover from our chronic illness, which if you're listening to to this, you have absolutely very, very good possibility that you will. And you know, we want to learn these lessons and protect our nervous system, protect our mental health, and live in a new way, which we can share with others and not fall back into these really unhealthy patterns. Which society is currently pressing on us. 

So I'm really sorry if that sounds cynical about our current society. But you know, I do despair when I see how children are treated in schools with the pressure of stats, the number of young adults I know on antidepressants, the number of adults I know, on opiates, you know, I just think we have to do things differently. And chronic illness. Yes, it is dreadful. It's very frightening. But it is a way of maybe looking at things and doing things differently. But you know, and as I said, at the beginning, yoga is just one route, there are other routes. But yoga is one way of achieving that by learning to slow down, by learning to breathe, through the nose, from the diaphragm, more slowly, more healthily, you know, and just to live in a way that's more mindful.

Jackie Baxter  31:13  
Yeah, yeah, definitely. And I think, I mean, I'm one of these people that, you know, has to have answers, and likes to have someone to blame. And, you know, it's usually myself that I like to blame. Because, you know, Everything's my fault. But, you know, it's when I sort of think, right, well, you know, I now know that the lifestyle I was living before, is maybe not as healthy as I thought it was. And it should have been, you know, I was too stressed. I was too this. I was too that, I was doing too much. And then I fall into the whole, Oh, well, it's my fault that I got ill, you know, this is all my fault. 

And I think a lot of people find it very hard when they think that they're being blamed for the fact that they got sick. And I think this is a really interesting one, because I do the same thing. I go back and I say, Oh, it was definitely my fault that I got ill. And I'm not sure it is, I think a lot of it as you've just kind of explained is own kind of society and the expectations of us. So it's not that I put all that pressure on myself, actually, a lot of it was, you know, society and the world putting pressure on me. But I also think that maybe it's part of it as possibly taking a bit of responsibility ourselves for our own health as well.

Fiona Agombar  32:27  
I think the whole thing is about self empowerment, self responsibility, not maybe listening so much to external voices, but beginning to trust our own intuition, our own hearts, you know, listening to that inner voice, trusting it. But also, I come from a position where I think it's really wrong and cruel to attribute blame to anyone, especially to ourselves. So this is where compassion comes in. So you know, if we're being compassionate to ourselves, we're never in a state of blame. 

But we can also be compassionate to the world, because maybe the world doesn't know any better. And maybe just by, you know, living more in the present moment, and just doing the best we can within our own small sphere, we can help to radiate out something more positive. But you know, to try not to go into blame or judgment, but to have this attitude of compassion and gratitude as much as we can. And I know that not easy. I'm not trying to say, well, you know, wake up and be an angel, immediately. But, you know, this is just something to aim for. But I think once we come back to the present moment, as much as we can, all this begins to come into place. 

And there's a wonderful quote from one of my favorite philosophers, Eckhart Tolle, and he says, "in this moment, there is nothing to fear. There's only fear if we leave this moment. And that arises as a thought form". So we can maybe start by questioning our thoughts and seeing that our thoughts are not real. So you know, that would be one of my takeaways for the podcast would be to challenge your thinking, particularly if it starts to spiral down. And just come into your body, come into the moment and breathe.

Jackie Baxter  34:10  
Yeah, definitely. Something I thought of when you were speaking earlier, I'd love to talk a little bit about the difference, or similarities maybe, between yoga and yoga therapy, you know, how do the two fit together, or not?

Fiona Agombar  34:25  
Okay, so yoga therapists, like myself, would have started by being a teacher, which means that you work with a group. And as you I'm sure are aware, there's many different variations of traditions and teaching. Yoga therapy, the definition is that we work one to one. So what we say in therapy is that each of us has our own individual patterns. So for example, if I were working with you, Jackie, I would not work in the same way that I might work with a male who was 30 years older than you and had rheumatoid arthritis, for example, because you'd have very different patterns, very different conditions. So it's a very individual approach. 

So what a yoga therapist will do is to take somebody's history and work through. And then I specialize in working with fatigue conditions. So as I said at the beginning, I'm concerned with prana, and how we move that. So that's more kind of like an energetic thing, that for that, in the cases of chronic fatigue, I'm looking at tools such as mantra, breathwork, relaxation, and there will be some gentle movement, but it will be extremely gentle. Because hard core physical yoga, would usually be very contraindicated for somebody with long COVID or chronic fatigue. So when you recovered, you might well want to go back to a group class, and you know, enjoy that camaraderie of being in a group. But a yoga therapist will be tailoring a practice one to one. 

And I come from what's called the Vina yoga tradition. So I work differently from yoga therapists from other traditions. So for example, I do tend to work with sound and mantra. And I work with things like the chakras, which will be a different approach from other yoga therapists. But I think all of us have in common that we will be working with breathing, because breath is considered the first source of prana, or energy. And as we know - in any condition, but obviously in long COVID - the breath is a particular place where we would start anyway.

Jackie Baxter  36:29  
Yeah, that's really interesting. And I love what you're saying about breathing, because this is obviously a bit of a rabbit hole that I've gone down myself, it was kind of the first thing that I found that helped me, you know, I was completely flailing, I had no idea what was going on. And then I started working on my breathing. And it was like, Whoa, okay, this is huge. And it's then kind of opened doors to other things that have also helped me, but my breathing was kind of first door that I opened that that helped. And it's just amazing, isn't it? 

And I think what you said about, you know, obviously, long COVID and COVID itself, you know, seems to be affecting the respiratory system, kind of maybe more than a lot of other conditions, illnesses that, you know, contribute to post viral conditions. But yeah, I think maybe for people with long COVID, it's possibly even more important to kind of go in with the breathing, isn't it?

Fiona Agombar  37:00  
Definitely, definitely. Because the breath, I mean, from the yogic perspective, the breath is all about prana, energy. Interestingly, I've just been with my teacher who was over from India on a course. And he was saying that he thinks COVID is a problem with the heart chakra, which is also about space, and the breath. But from the science point of view, of course, the breath is about regulating the nervous system. 

And we were just talking about trauma. So one way to help trauma is with the breath. Although some people who've been traumatized find it hard to follow the breath. But you know, this is something to aim for. So in other words, if we are in fight and flight, we're going to be hyperventilating, maybe breathing through the mouth, maybe breathing from the upper chest, and probably breathing much too fast. So when we begin to regulate the breath, and slow it down, and make it through the nose, not make it, but help to breathe through the nose, help it to be more gentle, and help it should be more from the diaphragm, then we are engaging the parasympathetic nervous system, and that's all about the rest and digest. That's all about healing. And we can't heal unless we are in parasympathetic mode. 

So in order to heal, we really do need to be paying attention to how we're breathing. So most yoga therapists should be working with the breath, you know, that would be key, I would say. And if somebody's listening to this and looking for a yoga therapist, I'd say make sure you work with somebody who understands good breath work and can help.

Jackie Baxter  38:56  
Yeah, and what you were saying about trauma and how some people you might struggle with using the breath. And and we were saying a minute ago about you know, COVID and long COVID being quite a lot on the sort of respiratory side of things, maybe more than other things. And I certainly have a lot of kind of trauma and stuff going back to the not being able to breathe thing, because it was not something I'd ever experienced before. And it was utterly, utterly terrifying. 

So when I then started trying to work on my breath, it absolutely helped. And it was wonderful in a lot of ways. But it also brought up an awful lot of that kind of what I now know is a trauma response where you know, if someone said, right, well, you know, breathe through your nose. Oh, I didn't realize that I wasn't but okay. You know, I tried to breathe through my nose. And once I started getting that very slight air hunger, it took me straight back to when I couldn't breathe at the start. And it took me quite a long time to kind of get over that kind of initial panic, even though I knew that I was fine. I knew I could breathe. So it was almost like it was something that I had to do. And it really, really, really helped. But it was quite difficult to do to start with.

Fiona Agombar  40:10  
Yeah. So before the podcast, you and I were talking about Buteyko, which I think is wonderful. There is part of Buteyko, which we both agree, is maybe not right for long COVID, which is breath holding. So if I'm working with somebody with long COVID, I would not be incorporating any breath holding, or control pauses. Because I think that's too much, for all the reasons you said, certainly not until somebody is nearly recovered. So for me, that one's out - all I'm trying to teach his coherent breathing or in yoga, we call that somana breathing. And if you can't breathe through your nose, then we work up towards that. We work with somebody where they're at. Never going to force anything. 

The other thing is, if somebody has trauma, which, as you say, if you've had air hunger, that's terrifying, and you can be reminded of that, but equally, I've had people in my classes who've maybe been attacked, or raped and held down. So again, focusing on the breath reminds them of that - it triggers that memory. So we engender something that's called your safe resource. So I would teach somebody to think about something that makes them feel safe. So that might be the softness of their hands, for example, it might be an image of a loved one, or a pet. So that if ever there's a feeling of panic, you go back to that safe resource. 

So for that reason, I would also say if somebody listening to this is looking for a yoga therapist, it's also helpful to look for a therapist who's trauma informed so that they understand these issues as well. Because following the breath is absolutely vital, it's a game changer, like you say. But it also can be very triggering. So you need somebody who understands both those components.

Jackie Baxter  41:57  
Yes, absolutely. And I think that wasn't something I understood, initially. Whereas looking back on it, I'm now going oh, yeah, well, that was trauma. Obviously, that was trauma. How did I not realize that at the time, but you know, obviously, that was because I didn't really think it was a thing. But it's hindsight for you, isn't it? 

Fiona Agombar  42:16  
Wonderful thing!

Jackie Baxter  42:18  
Yeah, definitely. Um, when we were arranging this, I think you mentioned that you're actually in the process of writing a book specifically about long COVID. So I would love to hear a little bit about that. And maybe if there's a couple of takeaways from that?

Fiona Agombar  42:34  
Sure. So I'm writing a book for the same publisher, the previous book was published with which is singing dragon. And I'm writing it with a wonderful yoga therapist called Nadine Mackay, who's had long COVID herself. And we - Nadine is wonderful, we're kind of completely in complete agreement about what we think helps. One of the reasons I wanted to write the book was because when I wrote "yoga therapy for stress, burnout and chronic fatigue", I did some practices at the end of the book, and they were a little bit more dynamic. 

And then when we had the pandemic and I was teaching on Zoom, I really realized I needed to make things much more gentle, much more simple, even than they were in that book. So the book is very much about breathwork. And it's very much about simple mantras, very simple movement. And I also do cover the chakras in that. 

So within the book, which we're still writing, we cover stress, we cover trauma,  Nadine's written two brilliant chapters on breathwork. And then we cover, as I said, prana, the chakras, and we've done quite a lot on self compassion, because we you and I was saying, breath work is a game changer. So is self compassion, because if we're not kind to ourselves, we're going to keep unpicking all the progress we're making. Because we're going to go back to rushing, we're going to go back to maybe putting other people first. We're going to go back to not eating properly or doing too much. Whereas if we can begin to bring in self compassion into our lives, and we give methods of doing that, we can start this journey of being kinder to ourselves, and that's gonna make a huge difference in our recovery. 

So the kind of takeaways from the book are, first and foremost, check in with your breath, three or four times a day, you know, very simple hand on the chest, hand on the belly. Where is my breath? Is it lower down? Is it slow enough? You know, just checking. Don't be unkind to yourself if you're hyperventilating. Just use the hands to say, well, here I am, okay, I can slow it down again. And then I always recommend doing at least one yoga nidra a day, if not two. So that's really important. And just being aware, am I in the stress response? Do I need to stop? Am I in that business of pushing through? Can I take time out? Am I pacing myself properly? So it's those kinds of things. But anybody who wants to know more about energy and chakras, I think would also enjoy the book. So it won't be out this year, it will be out in 2024.

Jackie Baxter  45:15  
Wonderful. Well, I will pop a link to that in the show notes when it does come out. So if anybody is listening to this, and it is now 2024, then it might be worth having a look. And what you were saying about the breath just then - I sat back and I was like, oh, you know what? I think I haven't been focusing on my breath. Because obviously, I've been focusing on what you've been saying. Yeah, it's a good reminder, isn't it? Yes.

Fiona Agombar  45:38  
It's something I check in with myself as well. Yeah.

Jackie Baxter  45:41  
Well, thank you so much for joining me today. It has been so lovely to speak to you and to sort of hear some really positive things, but practical things as well that we can sort of do to help. So thank you so much.

Fiona Agombar  45:54  
Thank you so much for inviting me. I've really enjoyed talking to you. Thank you, Jackie. 

Jackie Baxter  45:59  
It's been a pleasure.

Transcribed by https://otter.ai