• 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.

KAPAALABHAATI (SKULL SHINING BREATH)
Note: If at any time you feel dizzy during this practice, return the breath to normal.
Benefits: In scientific articles, Kapaalabhati has been associated with the stimulation of the pancreas to secret insulin, helping to regulate blood sugar levels. Kapalbhati clears the mind and will help with brain fog and increase energy. Kapaalabhati tones the abdominal muscles.

CHECK Your POSTURE. Your back should be straight.

Number of Repetitions: Repeat 5 rounds, 120 strokes/20 strokes per round.

Kapaalabhati is rapid abdominal breathing. To exhale, snap in the abdomen. To inhale, relax the abdomen and the air will return automatically. You can place a hand on the abdomen to check that the abdomen goes in as the air goes out. To start, exhale completely, inhale half way and begin to snap the abdomen in for 20 to 25 expulsions. End by exhaling completely, slowly and with control, inhale fully. Return the breath to normal.

Second round, Exhale fully, inhale part way and begin…... Continue at your own pace without straining, keeping the body steady. Exhale completely,…..Inhale a full breath…. Exhale completely, slowly and with control. Return the breath to normal.
Continue for another three rounds.

NADI SUDI (NERVE PURIFICATION BREATH):

Benefits: Purifies the nervous system; balances the left and right hemispheres if the brain; focuses the mind; is very effective at calming the mind as well as soothing neuropathy, and prepares the mind for meditation.

Number of Repetitions: Try to do it for 5 minutes then build up to ten minutes as you practice. Do as often during the day as you need and do before going to bed.

CHECK Your POSTURE. Your back should be straight.
Naadi Suddhi for nerve purification. Nadi Sudhi is alternate nostril breathing. Please make a gentle fist with the right hand, releasing the thumb and last two fingers. Close off the right nostril with the thumb and exhale slowly through the left. Inhale through the left…. Close with the last two fingers, release the thumb, and exhale slowly through the right. Inhale through the right, close it and exhale slowly through the left. Continue this pattern…. Exhale, Inhale, and change nostrils. Close the eyes and bring your awareness within. Nadi Sudhi purifies the nervous system soothing the nerves, balances the right and left hemispheres of the brain, prepares the mind for meditation. As you do the breath begin to lengthen the inhalations and the exhalations, feel the vital life force pervading the body. If breathing is comfortable practice for 5 minutes. To finish, after the next exhalation though the right nostril, bring the hand back to the lap, sit quietly and feel the benefits of Nadi Sudhi.

Affirmation Note: as we have done, you can add an affirmation when you do Nadi Sudi, you can inhale calmness, and exhale pain. You can add the affirmation for the duration of Nadi Sudi or just for a part of it.

BEE BREATH – (BRAHMARI PRANAYAMA)
Benefits: The humming sound has a natural calming effect on the mind and emotions. This breathing practice soothes the nerves and relaxes the brain and head to lower stress. Brahmari breathing is a pain disrupter, and humming is as well. The vibration soothes.

Number of Repetitions: Do 6 rounds twice or more. Do as often during the day as you need. Do before going to bed.

Instructions for where to place the fingers and how to begin:
o Sit with you back straight, feet flat on the floor.
o With elbows raised to shoulder level, the thumbs and fingers are placed as follows:
o Close off the ears with the thumbs by pressing the tragi (the small protuberance at the entrance of the ears) over the ear-holes.
o Lightly place the index fingers over the lower eye lids so as little pressure as possible is put on the eyes.
o Rest the middle fingers gently on the nostrils. As your Prāṇāyāma practice develops, the nostrils can be pressed to narrow the passages to slow down and lengthen the exhalation.
o Place the ring fingers above and the pinky fingers below the lips.
o With the fingers in place, exhale completely, inhale deeply, and begin the rounds of Brahmarῑ- Bee (humming) breath. See below for further instructions.
● Sit up in a well-ventilated area.
● Close your eyes or lower gaze.
● Place your index fingers as described above.
● Take a deep breath and as you breathe out slowly, press gently on the
cartilage to close the ears.
● Make a strong humming sound, like a bee .
● Repeat 6–10 times.
● Make low, middle, and high notes.
● Focus on the soothing sensation of the hum in the head, throat & chest.
● Notice the different areas that vibrate with different pitches.
● After humming, lower the hands to the lap.
● Sit and enjoy the calm feeling.

Centering

Deep Relaxation (client lying down):
o Full body tensing and releasing (Seegra Savaasana).
o Body Scan – from the head down to the feet and then up again.
o Yoga Nidra.

Breathing practices (client sits up):
o Review of Kapalbhati.
o Nadi Sudi (Alternate Nostril Breath) (6 minutes).
o Bee Breath – Brahmari,

Reframed Yoga Sutras of Patanjali: I.2: The restraint of the modifications of the mind-stuff is Yoga.

Client reported that she has been doing some of the yoga but it's been hard to stay consistent.

I found that client does not sit still. She sways from the left to the right throughout the session or fidgets with her hair. After 2-3 minutes into Nadi Sudi she did stop swaying. She did not sway during Brahmari breath.

I find that the client is not aware of the need to put quality time into her practice. I have stressed that consistency is important for success.

Her neurologist prescribed gabapentin. Client does not have medical insurance now. She said that in one month she will be able to get medical insurance and see a primary care doctor. It seems she is not seeing any medical doctor now.

I suggested that she should meet with a registered dietician as well.

The mind likes to wander away all of the time, and more often than not we are thinking of things that are painful to us, while the ego does not care if we suffer as long as it asserts itself. Painful thoughts and pain in the body can get better if we intervene with a regular practice of Yoga and meditation. Nadi Sudi and Bee Breath (Brahmari) helps to focus the mind. This will help with concentration. As with any practice (and anything), we receive out of it what we put into it, therefore, to receive the most benefit follow the instructions carefully and with consistency to have success.

On July 31, 2024 Client and I had a scheduled session and she did not show. (In previous sessions I found other issues with this client.) Later on client texted me to say that she had a conflict but was unable to alert me. Yesterday, August 5th, I reached out to this client to see how she was doing and to ask if she wanted to meet. Then she told me of the gravity of her pain and how she is looking for relief. I informed her of how Nadi Sudi may help her and she agreed to meet. But, unlike my other clients, it seems to me that this client is either unable or does not put the work in as is needed for success.

This is my fourth session with this client and I will now write up a final report. I will let the client know that I am open to having Yoga Therapy sessions with her whenever she wants and that she should let me know when she needs them. But here after I do not plan to reach out to her.

She agreed to complete the Yoga Therapy Survey for Clients and I forwarded the survey to her. Is there way for me to know if she completed the survey?

Centering

Deep Relaxation (client lying down):
o Full body tensing and releasing (Seegra Savaasana).
o Body Scan – from the head down to the feet and then up again.
o Yoga Nidra.

Breathing practices (client sits up):
o Review of Kapalbhati.

o Nadi Sudi (Alternate Nostril Breath) (6 minutes).

o Bee Breath – Brahmari,

Reframed Yoga Sutras of Patanjali: Sutra I.3: Then the Seer [Self] abides in His own nature.