• Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
• Balanced pranayama considering contraindications, meditation/centering.
• Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.

Client reported new diagnosis of Lupus. I assigned the following:

Yoga Therapy can promote balance and harmony between the mind, body, and spirit. Hopefully, these sessions will bring you peace, ease and emotional strength. Honor your body and your mind and as you move through the grieving process.

Be kind to yourself, and be gentle. Keep peace in your soul. Try focused Walking Meditation. Mediation is a way for nourishing and blossoming the divinity within you.” – Amit Ray.

i. Here are two samples on what is walking meditation, the whys and hows:

https://ggia.berkeley.edu/practice/walking_meditation

or for a more philosophical approach:

ii. https://www.lionsroar.com/walking-meditation-thich-nhat-hanh/

Session 2: During this session the client shared that she had a new diagnosis of Lupus which came totally unexpected. The content of the Care Plan was tabled. I listened while MML talked through her emotions providing a safe space for the her to say how she felt and how the condition is affecting her. I implemented Motivational Interviewing asking open-ended questions, making affirmations, using reflections and summarizing. We were able to end with a Yoga Nidra, centering first, then focusing on healing affirmations. Moving forward I will modify the plan based on client’s energy levels and changes in physical ability.

Client appeared distraught and saddened by the new and unexpected diagnosis of Lupus. She seemed to need to talk. I asked her how she was feeling both physically and emotionally; and validated her feelings.

This disease occurs when the body's immune system attacks the body's own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems — including joints, skin, kidneys, blood cells, brain, heart and lungs. (Mayo Clinic)

When I brought up soccer, MML immediately went on the defensive. I explained that she spoke often of fatigue which is a symptom of lupus. My concern was that she also built in rest and recuperation into her day. After this she relaxed.

We practiced Yoga Nidra toward the end of the session.

MML's early response to my question regarding soccer reminded me to tread carefully. I am grateful that I learned motivational interviewing through this program. During the session I used the four guiding principles, represented by the acronym RULE:

Resist the righting reflex;

Understand the patient's own motivations;

Listen with empathy;

Empower the client.

Before the next session I will research and read manuscripts on lupus, and lupus and yoga research. I will refine and revise the Care Plan, focusing more on relaxation techniques and less on strengthening. Lupus flare-ups are a possibility that will need to be asked about at every session.