Client is a 47-year-old Asian female living in the USA for three years. She speaks fluent Cantonese and English. She moved her to marry her American husband whom she met in Singapore through work. She wishes to increase her stamina, lose weight, reduce stiffness, and balance her emotions. She wants to move more and practice mindfulness, be more aware and connected.

She has no experience in practicing yoga and thus has no routine. She thinks she will prefer gentle and chair yoga. She does meditate but “not often”.

KTS lives in a nonviolent way, mostly truthful, prefers living with purity by eating clean healthy foods, living and keeping a clean home. She is introspective, quiet, avoids too much stimulation, and aspires to a life of concentrated awareness. She’s familiar with and sometimes practices guided imagery and relaxation, body scans, tense and release which she learned through the cancer program at the hospital.

She wishes to experience a connection to the greater whole, to feel complete.

She has a PCP and sees a few specialists as well. She struggles with allergies, menopause, and has weight concerns. On July 7, 2022, she had a hysterectomy due to uterine cancer. She is up to date on her physical, dental, and vision exams. She takes a few supplements but didn’t list any prescribed medication.

KTS notes that she can’t kneel for long, has lower back and ankle pain and is prone to strains, and her balance is poor. She awakens between 6 and 7am, uses an alarm; is in bed between 10:30-11pm. She falls asleep easily and isn’t tired when she awakens.
When working, the Client sits approximately 6 hours per day. She has work-related restlessness, and doesn’t enjoy long periods of sitting. She has every possible cushion, wedge, etc for her chair, computer and floor in an attempt to sit comfortably at her home work station. She feels stiff when sitting for prolonged periods of time. She works from home and in an office. Her home space isn’t ideal, not only is it uncomfortable, it’s also cramped and cluttered.

Client does upper and lower body toning twice per week for 20 minutes; and cardio once a week for 20 minutes. She eats healthy, clean food, likes to snack once a day, drinks 16 oz of water daily, a cup of tea or coffee daily, and a glass or two of alcohol every 2-3 days.

She describes herself as outgoing and easy going. She is experiencing mood swings from menopause and takes Estroven. No other medication for menopause is prescribed due to her cancer. She has “mad spikes”, the estrovan seems to help.

She breathes easily but not deeply. She learned some breathing techniques post-surgery and may implement them from time to time but no consistently.

She isn’t fearful, anxious or depressed. Situational episodes push KTS to feel overwhelmed. For example, traveling with her ‘stepson’ recently was very overwhelming for her. The Client shared that when he is in the small condo with them every other week, she is anxious, and stressed by his behaviors.

Her family lives in Malaysia and Singapore. Her husband’s family is in Virginia. Her ‘step-daughter’ chooses not to meet her; the first wife doesn’t acknowledge her. Her ‘stepson’ has disabilities and recently announced his acceptance of her.

Her biological family doesn’t discuss issues. This bothers her.

KTS’ mom died last year in Malaysia. She was there prior to her passing and at her service. She is grieving still. One year ago, she sought help through the cancer network. She did well with the first therapist where she learned how to reframe her thoughts. Since her issue was a ‘grief issue’ related to her mom and not her post-cancer situation, she was required to switch therapists. The second one wasn’t very helpful, she stated.

As for coping, the Client described it as ‘so-so’. She walks when stressed though not enough, and doesn’t feel motivated to do anything. She states that she is, “not mindful enough”.

She has no spiritual or religious beliefs. She has no history of this either. The statement in the intake was, "I embrace strong spiritual/religious beliefs, ethic and morals. " She selected, Never. I explained during intake that Yogic Philosophy resembled living the live values she listed: gratitude, compassion, responsibility, etc. I said I'd refer to these and others throughout the practice. I would be sharing the Yamas and Niyamas, which are "right living with others" and "right living with our inner minds and thoughts". And asked for permission to do so. KTS said, yes.

KTS has a bachelor’s degree in mass communication and is employed full-time for an international non-profit as a manager doing administration and operations. She worked for them in Singapore and landed a job with them in DC after having been here for a year so she’s worked for them for 5 years total. The job is mostly sedentary unless they’re traveling and running programs elsewhere.

She feels she works somewhat too much; enjoys her work quite a bit; and, it’s somewhat stressful ("The department is getting split up. People are sniping and worrying, unsure of the future." She described it as a slow-burn mental stress.). The job does leave enough family time. Her spouse contracts with the same organization so they often have the opportunity to travel together.

She and her spouse own the condo; it’s nice, she says, and the neighborhood is quiet. She has no socioeconomic challenges nor does she face any sociopolitical or legal circumstances that one would consider to be of concern.

As for her cultural and familial experiences, she sometimes feels that she belongs to the community. She’s recently connected with a group of overseas Chinese from Singapore, a women’s group. She said she doesn’t know any of them very well yet. She intends to continue meeting up with them. She has experienced rejection (immediate spousal family), sometimes in the community as well; prejudice and bias because of her culture; as well as intergenerational trauma.

She feels strong ties to her spouse, immediate biological family, often to her extended family – all of whom often share the same values and beliefs. The client lists authenticity, loyalty, responsibility, gratitude and compassion as her most important life values which she’s developed throughout her life.

KTS notes that she doesn’t yet feel that she has a community or cultural group to which she connects. She feels that she has to make an effort to keep up with regular activities. She does enjoy walking, hiking, sightseeing (museums etc.), window shopping, cooking, and eating. A sense of togetherness and shared interests are important to her. As for her immediate family, she likes that they care for each other through acts of service, filial piety, and self-sacrifice.

When asked, the Client wrote that sees herself through other people’s eyes. She wants to give herself more credit and not beat herself up so much.

The following question was, "What else should I know about you?" She wrote, “Post cancer: I am more emotional and my short term memory is not as good as before. I am keen to find a new normal where I am living fit and healthy with menopause in my life.”

1. Seelig, Pamela, Threads of Yoga, Boulder, CO: Shambhala Publications, 2021.
a. Since the Client has stated that she doesn’t rely on spiritual or religious precepts, I’m using this book’s contents to help me with the interpretation of broader yogic themes, relying on the wisdom presented in its strategies to bring yogic concepts into the yoga therapy sessions. For example, the client wishes to improve present moment awareness. I'll speak to practicing mindfulness in small doses, like when she's walking to the store. I plan to introduce Morning Mindfulness as an Om Practice. This book offers everyday situations and applies yogic philosophy .

1. Jenson Price, Jennifer Brunet, Adults diagnosed with gynecologic cancer and their relationship with their body: A study on the supportive role of yoga using interpretative phenomenological analysis, Body Image, Volume 49, 2024,
101705, ISSN 1740-1445, https://doi.org/10.1016/j.bodyim.2024.101705.
a. KTS doesn’t talk much about her cancer, surgery, or post-cancer experience. I do know she believes she needs to lose weight. This manuscript addresses how people may experience changes in body image. The Client also shared how she shouldn’t beat herself or worry what other’s think. I hope to present to her the benefits of Yoga and how it can provide opportunities for body empowerment and improvement. I was also reminded when reading this that, “Yoga can elicit negative self-perceptions when personal expectations are not met.” I want to ensure that her Yoga Therapy experience is a positive one that she will choose to continue.
2. Danhauer SC, Addington EL, Cohen L, Sohl SJ, Van Puymbroeck M, Albinati NK, Culos-Reed SN. Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer. 2019 Jun 15;125(12):1979-1989. doi: 10.1002/cncr.31979. Epub 2019 Apr 1. PMID: 30933317; PMCID: PMC6541520.
a. KTS is post-treatment for cancer. She came to me not talking about cancer but her stamina, stiffness, poor balance and emotional imbalance. This manuscript supports the statement that a consistent yoga practice improves fatigue, sleep, and multiple QOL domains, as well as a number of biomarkers. That physical fitness/functional ability outcomes were positive as well will help me when citing the benefits of yoga. The post-treatment studies didn't have a substantial focus on psychosocial well-being. Often this data, if measured, falls under QOL. KTS doesn't speak of depression but based on her input and affect, I believe it is present.

We spoke last week about me using the term, "post-cancer". I met with the client and brought up how she would like me to refer to it. I call her by her name and usually don't use the diagnosis as a descriptor.
She told me that she doesn't think about it. She hasn't chosen a term (it's been two years since her surgery). She said she accepted that she had cancer and went through the process in neutral, coming out of it on the other end.

• 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.