At the time of this photograph, senior monk Tharpa Tashi had been confined to the Tongsa Dzong ("Tongsa Fortress") watchtower for six years. He was to remain there for four more years, when he was to retire at 60.
Like distance from your subject, the angle you shoot from has also probably become a habit. Get low, get high. Get overhead. Stand on a chair or a bed. You'll be amazed how just changing your angle can dramatically alter your photos.