Client is a Yoga Teacher and teaches up to twice a week. She also takes two Yoga classes and a Pilates class every week.

Client has a number of physical issues and health issues:
o Client works very hard physically on weekends and after work.
o Upper back pain between shoulder blades and upper neck for this she is seeing a chiropractor and she takes two yoga classes per week which help the pain.
o Surgery for left hamstring tear, and right quadricep strain.
o Arthritis in her thumb.
o She is getting headaches from grinding her teeth since she lost her mouth guard.
o Pre-diabetic.
o Pre-high cholesterol.
o Eye strain.
o Due to her living situation, client is unable to sit at a desk when she works which creates poor posture.

Evaluating Client’s Breath: Client was observed breathing for 9-10 minutes. In the beginning of the observation, client was breathing into the upper chest/reverse breathing. After observing the client for almost two to three minutes, client’s breathing began to slow down and her belly began to expand she was breathing into the belly from then on. After another few minutes, I asked client to put her hand on her belly and asked her to tell me where she was breathing into, she said the belly. I also observed her lying down for 5 minutes and I saw that she was breathing into the belly. She confirmed it.

Client currently has a very chaotic life situation which creates stress. She lives in a home that is being renovated and was supposed to be finished by now. Client lives with her aged mother. Client also has a full time job. Client owns a bar/restaurant at which she is constantly putting out fires and where she often has to be present. Client also has a Yoga business and this too causes stress. When client is highly stressed and her days and nights are non-stop and most of the time she is running from one thing to the next - client breaths into the upper chest first – reverse breathing.

Client has high stress due to having a strained relationship with her mother, their communication is difficult, her mother is impatient, complains a lot, and has ways of talking that irritates her and client reacts; in addition, client is having her house renovated is anxious over the contractor who is doing the work because it is taking too much time and is costing double the amount of what she expected. They have not had a kitchen since July 3rd so client has not been able to eat well on a regular basis. She is eating out a lot and is eating lots of sandwiches. Additionally, for a while she did not have a bathroom in her new home and had to use a potty. This level of high stress, poor eating, and difficult living situation has been going on for months.

Client has aversion and anger to her mother’s impatience, the complaining, and the way her mother speaks to her.
Client gets angry with the Contractor.
Client gets angry and has aversion to one of her employees at the restaurant because the employee is constantly complaining.

This client is chronically stressed and overloaded.

Client is constantly putting out fires with her businesses and at her home, and at work. For example, the other day she was scheduled to have a colonoscopy on a day that she usually teaches a yoga class – she asked one of the teachers that she employes to substitute for her, the teacher agreed. Then before the colonoscopy the teacher informed her she couldn’t sub for her. Client had the colonoscopy and wound up teaching that night as well.

Client does not have a spiritual practice. Currently client does not have the wherewithal to begin a meditation practice. Client is not in a position to dedicate time to consciously develop spiritually. Yoga has been important for this client. She trusts that Yoga Therapy will help her and this is where she is at now.

Client says that her meditation practice is to walk her dog. She walks her dog four times a day for 15 to 30 minutes each time.

Client feels bad because of her lack of patience because she snaps at her mother who is an elder and she may not be around for long. Client also snaps at the contractor and this also causes her to feel bad. Client owns a restaurant and is also snapping at one of her employees there.

Client is a Yoga teacher and has a Yoga business and employs other Yoga teachers to work in her business. She does not snap that them, but she has stress from the paperwork she has to do for this business. Additionally, she has a full time job as a Communications person for an information technology company.

Client will be taught Stress Response education, and how conditioned internal stressors create much of the stress we experience, especially long-term stress. Client will be guided to identify her major inner stress. This will help her understand that stress that is internal is something she is able to have the control over and to change.

The Yoga Sutras of Patanjali, Translation and Commentary by Sri Swami Satchidananda

Sutra II.8 – Aversion/Dveshah – Aversion is that which follows identification with painful experiences.

Sutra I.2: The restraint of the modifications of the mind-stuff is Yoga.

Sutra I.3: Then the Seer [Self] abides in His own nature.

Sutra I.4: At other times [the Self appears to] assume the forms of the mental modifications.

Sutra I.5: There are five kinds of mental modifications which are either painful or painless.

Sutra I.33 – By cultivating attitudes of friendliness toward the happy, compassion for the unhappy, delight in the virtuous, and disregard toward the wicked, the mind-stuff retains its undisturbed calmness.

Include exercise guidelines and/or contraindications and cite properly 2000 max characters.

The information in these studies are ideal for my client with pre-diabetes and pre-high cholesterol, and chronic stress.

The studies show that yoga can turn down the HPA axis, pranayama stimulates the Parasympathetic Nervous System, the pancreas to secret insulin, and pranayama and meditation can help with the emotional aspect of pain. And, the metabolic benefits from Mindfulness Based Stress Reduction observed that LDL and total cholesterol was a decrease by 15% and 10% respectively. “Study shows that greater parasympathetic activity correlated with greater decreases in triglyceride levels (cholesterol); and that more minutes practiced per week correlated with decreases in total cholesterol.

(Arkiath Veettil Raveendran, Anjali Deshpandae, Shashank R. Joshi: Therapeutic Role of Yoga in Type 2 Diabetes, EnM Endocrinology and Metabolism. March 2018:3
Therapeutic Role of Yoga in Type 2 Diabetes - PubMed (nih.gov)

Gerritsen RJS, Band GPH. Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Front Hum Neurosci. 2018 Oct 9;12:397. doi: 10.3389/fnhum.2018.00397. PMID: 30356789; PMCID: PMC6189422.
Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity - PMC (nih.gov)

Gentile, C., Starnino, L., Dupuis, G., & D’Antono, B. (2021). Mindfulness-Based Stress Reduction in Older Adults at Risk for Coronary Artery Disease: A Pilot Randomized Trial. Clinical Gerontologist, 45(2), 272–286. https://doi.org/10.1080/07317115.2021.1887421

What is a sacral assessment.

• 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.