Entry TypeAssessment
Client/GroupKana A
Entry CategoryIntended Case Study
Select your mentorBrahmi Romero
Intake
Assessment
Proposed number of sessions3
Location of sessionsKana's fitness center
Planned time per session90
Presenting Problem"emotional dishonesty with myself and others," stress management
Physical

Client presented with no mobility restrictions. The occasional sharp upper back pain followed an incident in 2016 where she felt/heard a "pop" - flares up every few months, starting with an intensity of 6/10, then gradually reduces over several days.

Client was very athletic in high school, playing several sports. Now does not want intense physical activity, but open to an asana practice.

Client/Group goalsStress management. Find peace amid changing circumstances (marriage, career). Reconnect with her yoga practice - in particular her meditation practice, as well as pranayama and hatha
Energetic

Tamasic - physically and mentally. With client's self-described high stress due to instability in marriage, occasional insomnia, and struggling to rest/give herself downtime, she is in survival mode. During breath assessment saw no signs of reverse breathing, but little abdominal movement. Client feels she used to breathe more deeply when in regular practice, but being under high stress her breath is more shallow.

Emotional

On intake client described herself as a "master of emotional dishonesty with myself and others." Seems to have disconnected from the manomaya kosha as a means to cope, survive day to day as opposed to finding freedom and ease. Kleshas present: dvesha - not wanting to face the possible dissolution of the marriage, and the practical challenges that might come with that; raga - attachments to routine?

Spiritual orientation and needs

On intake client shared, "for me the sacred is the same as the mundane. There's not separation outside of our disconnected perception." Client has awareness of her true self, but is distracted by daily demands of life. Finds purpose in the impact she has on the lives of those around her - son, father, sisters, team she leads at work.

Intellectual / Sense of self

Client felt that "yoga changed my life" when she learned vipassana meditation - but was told that, unless she practiced it two hours per day (two one-hour sessions), she "might as well not even do it." I have to say, this to me sounds like whoever was her teacher/guide violated ahimsa, making her feel guilty and like a failure if she could not meditate for those prescribed session lengths. Feel like the client has disconnected from the vijnanamaya kosha - partly do to feeling overwhelmed and discouraged by that feedback, but very much wants to reconnect with the subtle practices. Client also shared her need to "have it under control" (raga).

Yoga philosophy/wisdom research reference(s)

Sutra 1.33 - the locks and keys - thinking of her relationship with herself, as well as her husband. Learning to find steadiness in not allowing anyone to disturb her peace, regardless of their actions and intentions.

Sutra 1.12 - practice and non-attachment. Learning to let go of the need for control, and invest in her own practices and self-care as a priority.

Scientific research reference(s), why chosen, how you plan to incorporate 1-3

Netra Vyayamam - to address tension in the head and neck, as well as relieve tension and strengthen the muscles of the eyes. Will support vision, both physically (sense of sight) and subtly (perspective). A couple of resources:

https://www.healthline.com/health/eye-health/eye-yoga#eye-exercises - highlights the studied benefits and clarifies what has not shown scientific evidence.

https://yogauonline.com/yoga-health-benefits/yoga-for-stress-relief/the-vagus-nerve-and-eye-movements/ - this article highlights the connection of the eyes with the vagus nerve, and the impact of eye movements on stress relief

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937872/ - this study highlights the effects in reducing fatigue following a 6-week protocol of 10 yoga eye movements and practices.

Pranayama: calming practices to balance the ANS - brahmari, waterfall breath, extended exhalation -

https://www.healthline.com/health/breathing-exercise#pursed-lip-breathing - this article highlights many traditional pranayama practices

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137615/ - overview of benefits of pranayama and breathing practices

Hatha: Inversions - to change the lens through which she sees the world, on the physical and subtle levels: balasana, viparita karani, setu bandha sarvangasana, adho mukha svanasana -

https://www.healthline.com/nutrition/yoga-inversion#benefits - overview of benefits of inversions on many systems

https://ssihi.uci.edu/news-and-media/blog/3-yoga-inversion-postures-for-mental-health-mood-stabilization/#:~:text=Inversion%20postures%20can%20be%20helpful,the%20pineal%20and%20pituitary%20glands. - brief recommendation on 3 asanas

Approval Notice
Your care plan should be approved by your mentor, with any amendments they suggested, prior to your remaining Yoga Therapy sessions.
Questions for Mentor

I do not want to discourage her vipassana practice, with which I am totally unfamiliar, but I would love to show her that she can begin a new meditation practice with just a few minutes a day. Wondering about mantra meditation - maybe "so hum" as a starting point?

With client's desire to have an impact on the lives of those around her, I feel she would engage with karma yoga practices. But her challenge is also taking care of others at the expense of herself. Would karma practices/opportunities be helpful to get her out of tamas, or should I focus on the other limbs of Integral?

Care PlanOutline should be a practice adapted to the needs of that client/group, including:
  • Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
  • balanced pranayama considering contraindications, meditation/centering.
  • Please include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client/group.
  • Over time, we want to see something from each branch, selected, adapted and re-framed appropriately. Tools from each module should be used (not on each client/group – but overall)
The outline should show the sequence of practices as you plan to offer them.
Your care plan proposal should be approved by the mentor before session 2 if possible, or 3 if approval is delayed by mentor.
Session
Session Instructions (Not Mentoring)Your session outline should be a practice adapted to the needs of that client, including:
  • 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.
Over time, we want to see something from each branch, selected, adapted and re-framed appropriately.
Tools from each module should be used (not on each client – but overall)
Final Client/Group ReportAfter seeing your client/group (for at least 4 sessions including interactive intake)
Please remember practicum is a learning experience. You’ll learn more from sharing what’s accurate than from what might “look good”. Things you did well, not so well, problems and questions are all valid and useful tools to teach you. We can’t serve you to become the best clinician you can be if you don’t share your challenges and mistakes. Success is anything from which you learn. You can continue to add Session entries after submitting this Final Client/Group Report.
Report briefly on each Kosha belowProgress toward wellness or worsening reported by the client/group or that you observed in the following areas
Additional Information
Personal reflection from doing client/group.
Notify Mentor?Notify Mentor of Updates/Completion