• 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.

Practice Virabhadrasana II - with the support of a wall and chair per your capacity. Take time to notice the effects of the pose on the first side before continuing to the second side.

Practice the abdominal march with TVA engagement - keeping the knees bent at 90 degrees, and perhaps keeping one hand lightly resting on the lower abdominals to make sure they don't lift up or the lower back arch. See if you are able to perform 5-10 repetitions on each leg, or to your capacity for that day's practice.

Perform abdominal massage every day - not immediately after eating. 8-10 breaths and strokes in each of the six directions. When in doubt, reduce the pressure and go more slowly:

1. Left ASIS to edge of the navel
2. Right ASIS to edge of the navel
3. L & R center pubic bone to edge of the navel
4. Left lower edge of ribs to edge of the navel
5. Right lower edge of ribs to edge of the navel
6. Center below sternum to edge of the navel

Using the same fingers, gently massage clockwise in the spiraling circular motion from around the navel out to the bony landmarks of the massage, then spiral inwardly back towards the navel, still clockwise. Pause after completing the entire massage and notice the effects.

Check In & Homework Review

PSS & PEG assessments

Awareness Practice

Asana: Virabhadrasana II - seated and standing, wall and chair supported

Supine March with TVA engagement

Dirga Swasam

Abdominal Massage

Shavasana and Yoga Nidra

Client presented tamasic but in good spirits, still feeling the effects of Long COVID, which she describes as low physical energy and at times depressed thoughts of "not wanting to be here." She shared at moments during the week she felt very "powerless over life... had feelings but didn't have feelings." She had continued practicing the Awareness Practice for her homework, and had found it helpful in noticing the negative thoughts and emotions - yet remembering that she is more than those thoughts and emotions. She also found gentle movement every day.

Her PSS was 17/40, and PEG was 7/30.

I encouraged her to continue her asana practice of the Fishman poses we had reviewed so far, and as we were going to explore Virabhadrasana II today, I introduced how she can opt to perform the standing asana seated on days where she desires to have movement but feels her energy is too low for standing practice. We also discussed how using the chair does not make the pose "easier" - in fact, it can increase both the challenge to and awareness of several muscle groups by adding stability/reducing the balance demands and allowing her to engage more with the sensations in her body. She did explore Virabhadrasana II standing with her back against the wall and front hand on the chair. After first exploring the pose to the right side, she felt what she described as "increased blood flow and circulation in the pelvis... and gentle massage and stretch - just enough." She also felt engagement in the rhomboids when she took a few breaths with both arms stretch out, still with her back against the wall. After exploring the pose on the left side, she described a "tension, pull of the inner right knee" (possibly the gracilis?), but overall found the pose "more comfortable, more stable" on the left side. She also experienced her eyes watering, feeling "emotion hit out of nowhere," and we discussed again how muscles move and hold emotions.

Next we returned to the mat, and I introduced her to a pelvic floor and deep core strengthening exercise from Leslie Howard's Pelvic Floor Yoga, supine march. After gently engaging the pelvic floor by lifting the perineum, and engaging the TVA, she performed two repetitions on each side before needing to pause. She described it as "hard" but appropriately challenging, and felt the engagement of both her core and pelvic floor in beneficial ways.

Then I encouraged her to find appropriate support, which she did by supporting her lower legs with a bolster, and introduced her to another practice from Pelvic Floor Yoga, the gentle abdominal massage, offering both support for improving digestion as well as interoceptive awareness and mind/body connection. She described her experience with the massage as an opportunity to "love myself," "getting feedback," and "spiritually grounding."

After Shavasana and Yoga Nidra I asked her about emotions she was feeling and thoughts she was having, and at first she paused. Then responded, "You ask me these questions, then the thoughts come," realizing she still at times struggles with allowing herself to explore her thoughts and emotions unsolicited. She then shared she felt the "value of my space...allowing myself space. Space I'm taking up is not resented." She shared she had thought about her late brother Eric, who had been a primary physical abuser during her childhood, remembering times where her parents had left her alone with him, who was jealous and controlling. She spoke of memories coming back to her recollection where "he would take away my space to feel... he didn't allow me space to react." She found herself saying to herself, "I'm taking my space back. It's my space and it belongs to me."

Again I find the need to hold my plan loosely, as she is still healing from COVID, but seems to be embracing the challenge of physically and mentally slowing down. I find I must constantly remind myself that "less is more," and it's not about introducing her to a volume of practices, but finding what practices she can embrace, connect with, and apply in supportive ways.

Check In and Homework Review

PSS and PEG scale

Awareness Practice

Article: What Do I Need to Know About Long-Covid-related Fatigue, Brain Fog, and Mental Health Changes?https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10028338/#:~:text=This%20is%20the%20most%20common,You%20may%20be%20sleepy. - based on the suggestions in this article, revisit the bedtime routine previously established - is it working? If not, what would she like to change? Also based on the recommendations of this article, continue breath awareness and gentle pranayama and asana.

Ayurvedic Dosha Assessment - you had made a suggestion for this around sleeping patterns, and I think it could provide helpful information. We'll discuss it and I'll give it to her as part of her homework following this session.

Asana: review of Fishman poses so far - continue with Parivrtta Trikonasana

Pranayama: review Nadi Shodhana

Shavasana and Yoga Nidra