B.K.S. Iyengar, India’s most venerated yogi at 92, is not exactly known for passionate outbursts. His dismissal, earlier this week on a visit to China, of the Baba Ramdev school of yoga as “selling Kapalbhati" as “a short cut", is indicative of the dangers of the TV-yoga craze.

Kapalbhati, a complex form of Pranayam (there are many gentler forms of this age-old breathing technique), the fourth stage of Ashtanga yoga, is primarily an advanced spiritual and yogic tool and not the quick-fix, six-pack abs formula or the cure-all it is often marketed as by practitioners such as Ramdev.

A verse in the Sama Veda cautions, “Yatha sinho gaja vyadho, bhavedvashya shanaiha shanaiha. Thartheva sevitho vayurnyartha hanthi sadhakam" (Just like an elephant, a lion or a tiger can be tamed slowly and gradually, in the same way a practitioner should try to tame his breath slowly, slowly or else it kills the practitioner himself).

In the cross hairs: Baba Ramdev and his yogic practices have come under the scanner. Ranjeet Kumar/The Hindu

In 2008, the Asian Heart Institute (AHI) in Mumbai linked 31 cases of heart attack to reckless practice of Kapalbhati. Vijay D’Silva, medical director of the AHI, confirms: “An independent yoga instructor affiliated to our cardiac rehabilitation department had conducted a study correlating 31 cases of heart ailments with improper practice of yoga. While we have not continued the study, we have found a 100% correlation between ‘unsupervised exercise’ and cardiac failure." Most experts say that recklessly practising Kapalbhati can at the very least make you seriously ill.

Kapalbhati is de rigueur in many Indian households among people of all ages—and its practice a common sight in parks. Revolutionized by Ramdev through yoga camps and television, it is a shrewdly marketed capsule form of yoga in its place of origin long after it became one of the more successful exports to the West in the early 1960s. It is claimed that Kapalbhati can cure cancer, blood pressure disorders, heart ailments, baldness, impotence—even homosexuality, as Ramdev famously declared in 2009. It may have been the subject of parody in Raju Hirani’s 2009 blockbuster 3 Idiots, but thousands of Indians today consider Kapalbhati a panacea for all ills, forgetting its complexity as a yogic tool, and the possible adverse effects in the hands of those with less experience.

Ramnavami, a senior teacher at the Sivananda Yoga Mumbai Centre for 25 years, trained at the Bihar School of Yoga. She suffers from epilepsy. In 1987, her guru, Swami Satyananda, forbade her from performing Kapalbhati. She does not teach it to her students. “The benefits are not important, it is the contraindications that are important. It can lead to heart problems, high blood pressure, vertigo, hernia, epilepsy and related brain problems. If students insist they want to learn, we teach them to do it gently, for 20-30 counts. These 200-1,000 count sessions are not advisable," she says.

Ashwini Gokhale, who has been a teacher of the Iyengar school of yoga for over 12 years and a student of it for over 20 years, says she has performed Kapalbhati “only once". That was when Geeta Iyengar, Iyengar’s daughter, was conducting a session at the Pune Institute on a cold December morning. “Everyone was coughing, so she asked us to perform it in a controlled manner, to clear our nasal passages. As a teacher of mine put it, it is like a dose of strong antibiotics—you would not take it every day and only ever under a doctor’s prescription. Today, Kapalbhati is a quick-fix pill. It’s like those tablets people buy to lose weight. It’s a lazy man’s yoga," says Gokhale.

The Internet is filled with quiet pleas of desperation: “I bleed every time I perform Kapalbhati, why?" asks Deepa. “I had excruciating pain when I masturbated. I practise Kapalbhati regularly," says Subhash. “I have a deviated nasal septum, is that why I am nauseated every time I do Kapalbhati?" wonders yet another.

S. Rao, a 40-year-old software executive, used to be an alcoholic. “I kept trying to quit, but just couldn’t," he says. Then someone told him about Kapalbhati. “I switched on the TV and did it every morning. Within 10 days, I was drinking more, was agitated, irritable and had developed migraines." Doctors and medication did little to stem the decline. Then he met a guru, who told him to stop Kapalbhati immediately. “I was taught the correct form through basics: Puraka, Rechaka, Kumbhaka. In three months, I was fine," he says.

Some years ago, G. Khairnar, a former deputy commissioner of the Bombay Municipal Corporation, famously had to be rushed to hospital after he overdid Kapalbhati, and industrialist Vijay Mallya reportedly stopped practising it when it aggravated an existing ailment.

What are its merits?

Kapalbhati, one of the Shatakriyas, was considered potent long before Ramdev made it popular. The works of Paramahamsa Yogananda, Swami Rama, Swami Vishnudevananda, Iyengar, Swami Nadabrahmananda and Swami Vivekananda establish this. In 2004, a panel of senior doctors across the country, in association with The Yoga Institute, Santacruz, Mumbai, conducted a project to study the effects of Kapalbhati on a control group. The results were published in the Journal of Association of Physicians of India in April that year.

B.K. Sahai, who was part of that panel, outlines the benefits discovered as a result: “When Kapalbhati was taught under the guidance of medical and yoga experts, benefits were found in controlling diabetes, obesity, asthma, blood pressure." It greatly energizes the mind and fights depression. While each kind of Pranayam has benefits, each also has contraindications.

Shashank Joshi, a consultant endocrinologist with Leelavati Hospital, Mumbai, says: “I have seen a lot of patients come in with problems caused by overdoing or incorrectly doing Kapalbhati. I recently had a patient with a lapsed abdominal wall who developed a hernia. Firstly, yoga is a way of life, not just some generalized exercise. Benefits need to be validated."

Who should learn it?

The very basis of Ashtanga yoga is progressive graduation from asanas to Pranayam, the fourth step of yoga. “Traditionally, yoga required to see if the student could be accepted at all," says Shekhar Ambardekar, a cardiologist affiliated with The Yoga Institute. A guru ensures you can channel the results. “While doing asanas, you cannot just start with exotic poses. It has to build up. Even at a basic level, asanas effect physical and glandular changes," adds Gokhale. The miracle cures being used to sell Kapalbhati only work at a complex, advanced level, say the experts. “And that too, to reverse an ailment or slow it down maybe, but not cure it," explains Ramnavami. She points to the Bihar School of Yoga, which has health management courses for those who use Kapalbhati more regularly for ailments. Such courses provide training in the correct form, method and application for each specific medical diagnosis.

How harmful can it be?

Gokhale seats herself in an incorrect posture, her back arched, and demonstrates how Kapalbhati is done on a daily basis by many. As she draws her breath in and out, her entire upper torso is jerked up and down. “When you jerk your entire body internally, you are giving all your inner organs a jolt. You force the air pressure downwards, exerting extreme force on your uterus. What will be the result if you do that thrice a day?" Common sense?

Shameem Akhtar, a Mumbai-based yogacharya who trained at the Sivananda Yoga Vedanta Centre and has authored two books on yoga, says: “Many people confuse practices. For instance, Kapalabhati is a lighter hyperventilation than Bhastrika; however, sometimes I see people doing Bhastrika, incorrectly. It can cause burnout and nervous system exhaustion." She warns, “Certain Pranayam practices can trigger severe heat in the body that must be channelled. Reckless practice can magnify negatives like anger, irritation, and even illness."

Students flock to yoga institutes and ashrams with ailments that are a result of bad yogic practices. Gokhale says: “As teachers, we often have no empirical evidence. Out of experience, we can see when someone has learnt to do Kapalbhati or is even telling us they are not doing it, but secretly are." Such practices are against the essence of Pranayam. As Gokhale puts it: “Pranayam is not wilfully practised. It happens when you are ready. It is something that just happens when the body is provided the correct circumstances both internally and externally, there is alignment. You can teach someone to create those circumstances. Pranayam is not something you do. It is letting go."

THE COUNTERPOINT

Shirley Telles, head of research, Baba Ramdev’s Patanjali Yogpeeth, on the efficacy of Kapalbhati. Edited excerpts:

Do you have instances of students/patients complaining of health problems after performing Kapalbhati?

So far we have not had any such reports. We have done a random check to check whether persons were hyperventilating or breathing incorrectly and have data using the standardized ‘Nijmegen questionnaire’. This was taken on over 400 people from camps at random and the data are available with us.

What steps do you take to ensure that students perform Kapalbhati in the correct manner?

We mention the obvious contraindications (recent surgery, epilepsy); apart from that we have trained teachers out in the field correcting the practice. We also emphasize the rate as our recent research showed that when a person breathes at this rate, there is no sympathetic activation (which is different from earlier studies where people breathed at 120 strokes/min). An absence of sympathetic activation would reduce the chance of the practice leading to a rise in blood pressure. Hence we place emphasis on doing it slowly (compared to what is usually mentioned) and with no stress/exertion. We also check for other effects—and a very recent paper shows that Kapalbhati practised at the rate we prescribe improves visual perception.

Do you insist on students achieving proficiency in yoga asanas before starting Kapalbhati?

We ask practitioners to learn loosening exercises and diaphragmatic breathing.

Do you hold classes with trained gurus? To what level are these gurus trained in Pranayam and asanas?

The yoga teachers are trained and they have three levels of training. You may get further details from our course office.

Gayatri Jayaraman

gayatri.j@livemint.com

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