• 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.

Respond to this week’s journaling prompt: What are the negative messages that your mind commonly repeats?
Please list at least three.
What are some positive responses that you might bring to mind when these negative thoughts arise?
Please list one or two positive responses to each negative thought pattern.

Keep up the Kirtan Kriya regularly, possibly before work as the client suggested for herself.

Return to her affirmation card several times a day.

Continue to practice gentle yoga several times a week, continuing her already established practice.

Our session was virtual, on Zoom rather than in-person as usual. Check in, ground, arrive. Connect with natural breath. Reviewed client’s WHOQOL questionnaire responses in overall terms, looking for themes. Some standing movement: empty coat sleeves, ‘HA’ breath kriya, standing cow/cat, heaven rushing in; seated three part breath with Garuda mudra to access udhana vayu movement of energy upward for positivity.

Pain level, 5. Fatigue level, 6-7. What was the thread, the theme revealed in the quality of life questionnaire? Pretty much negativity across the board except in conditions of her living environment and access to quality healthcare. Negative self-image, body image. Family history of eating disorders: mother, younger sister. Client believes her eating disorder will “be with me until the day I die.” Dissatisfied or very dissatisfied with health, herself, personal relationships, support from friends, energy level. Pain prevents her from doing what she needs to do. Perceives herself as unable to concentrate.

Given these responses, and knowing she has regular visits with her psychiatrist and psychotherapist to go more fully into her entrenched patterns, the practice of pratipaksha bhavana was discussed and suggested. We’ll make this a consistent part of our work together, along with celebrating her successes and affirmations.

The client continues to experience swelling in her left lower leg, was referred to a vascular surgeon, and canceled saying she is not strong enough to go through another surgery. The client will soon be undergoing Axionics therapy for sacral neuromodulation to alleviate an overactive bladder.

She joined a local hiking group, fell on one of the hikes while returning to the trailhead. Thankfully she was not injured and a fellow hiker helped her up. When asked if returning to hiking after her accident caused her any stress or retraumatized her, the client said, “No.” with a shrug.

On the positive side, she is reconnecting with some old friends, getting together in the Poconos for the weekend. She practiced Kirtan Kriya meditation for seven minutes, one minute longer than last week.

The client’s responses to the quality-of-life questionnaire brought to light the persistence of her negative self-talk. It’s important for me to remain accepting and caring with her, celebrating every success. The client is determined to keep her job at Target that is causing her much pain and fatigue. I am going to address this choice by talking about the Gunas and creating more balance in her life. More yoga nidra.

Share responses to the most recent journaling prompt. Return to in-person overall session plan with a longer yoga nidra (resting in a pink cloud of yoga.) Try energetic alternate nostril breathing as the client "hates" closing the nostrils for this breath practice. Allow time for journaling to a new prompt and reflection.