• 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.

With the participants sometimes being with me more than one session, and at times changing weekly, I've learned how to arrive with a toolbox of practices - wisdom teachings from raja, asana, pranayama, pratyahara, dharana and dhyana from hatha - and then depending on the individuals, how they present, being mindful of possible psychotropic drug interactions - adjust the session accordingly. Also really honoring ahimsa during my time with them, as well as embodying satya - truly being present and authentic with them.

I do feel like each session offered the opportunity for the clients to move towards sattva, which is the ultimate goal of their inpatient stay. Continued practice of pranayama and applying wisdom teachings after discharge will provide the most long-lasting benefits.

With each session clients reported low physical energy as well as areas of discomfort in their bodies at check in, and at the end of practice reported feeling more ease in their bodies. Offering standing asanas with the support of the chair allowed for more stability and range of motion with asana such as Surya Namaskar and Virabhadrasana II.

All clients have challenges with taking a deep diaphragmatic breath. In every class as I encouraged them to pay attention to their breathing and guided pranayama - dirga swasam with finger compressions and brahmari especially - I saw an increase in abdominal movement on inhale, and a lengthening of the exhale. Clients who presented rajasic (often very talkative), would present more towards sattvic by the end of practice. Clients who presented tamasic would present more towards sattvic and be more engaged with me and other participants through eye contact, facial expression and verbal responses.

I think of Austin, who would present rajasic, very talkative and emotional about his feeling "trapped" and "against his will" in being in the hospital at check in, but would be more steady in his emotions at the end of practice. Clients were able to engage with the pratyahara of brahmari breath and shavasana practice.

From the final session it really stood out when Ray responded at the end that he felt "more like me." His response did not seem to come from a place of asmita, but of being more connected to his true nature, and less under the negative effects of psychotropic medication.

Overall I believe clients were able to connect with, and sometimes find a few minutes of rest in the vijnanamaya kosha, even though I was not able to offer a full-length yoga nidra. Clients who presented at check in as very rajasic and talkative were more sattvic and reflective at the end of each session. Clients who presented at check in as tamasic were more sattvic, seen in smiling, a change in their countenance/facial expressions, and verbally expressing appreciation for the practice.

It was challenging to assess this kosha. I'm not sure how many participants have been able to connect with awareness of the anandamaya kosha as there is so much movement and disease through the others during their stay. In sharing the simple chant of 3 OMs with them, and how we can all share in the sound and vibration together, I felt that was an accessible practice to at least introduce the idea that we are more connected than separate, and offer insight to a deeper connection to God/Higher Power/Source.

I have not received any negative feedback from a client or provider/medical staff on the floor. Clients share at the end that they feel "relaxed," "calm," "ready for a nap" sometimes, and my favorite piece of feedback which I mentioned earlier - when Ray shared he felt "more like me."

Really the only homework I give is I ask, "What is one thing you practiced that you can continue to use?" Whatever they mention - an asana, a mudra, a pranayama - I tell them "homework" is to do the practice at least once per day.

Just endeavor to stay present and flexible with each moment. Continue to keep a balance between offering enough silence at times for them to tune into what they are experiencing, as well as encourage dialogue for them to share with me. I feel I am getting better at reading the shifts in behavior that can accompany medications "kicking in" so to speak that can impact their presentation and practice.

Perhaps ways to touch upon the anandamaya kosha more with them?

Yes. Every week is an honor to be able to serve whoever comes to the session. I definitely feel a little drained after this session, but have a 15 minute break before going downstairs to 3N where I can ground, do some pranayama, and collect my thoughts.