They are experiencing multiple physical challenges, what they have in common is they are suffering the pain from arthritis.

Julie:
Previous compound fracture to her left ankle that resulted in a gait disorder, which currently causes left ankle pain rated at 3/10. Her Anamaya kosha is impacted by her gait disorder and left ankle pain, which limits her mobility.

Liliana:
Liliana reports multiple physical issues including arthritis, muscle strain, past injuries to her left ankle, wrist, knees, and shoulders, and current pain in her left heel (rated 5/10). Her arthritis affects her knee joints, also experiencing fingers as well. She plans to start swimming.

Jocelyne
Jocelyne has experienced muscle strains, arthritis, disc problems, osteoporosis, back pain, and shortness of breath. She also deals with chest pain, digestive problems, and hypothyroidism. These physical issues, along with a history of severe back pain and a diagnosis of heart blockage, contribute to her discomfort.

Julie:
As Julie has been practicing yoga for over 20 years, she engages in pranayama, her energy level averages 2.5 /10, and despite getting 8 hours of sleep, she rarely wakes up refreshed, likely due to factors such as chronic pain and hypertension. Her current stress level is low, the primary cause of her stress is atmospheric weather changes, she manages it with resting and the use of topical lotions for pain.

Liliana:
Her energy level is rated 5/10. She feels tired by 10 AM, limiting her ability to attend evening events. She sleeps 8 hours per night but wakes up 3-4 times and does not feel refreshed in the morning.
Her current stress level is 7/10, largely driven by caring for two young children full-time. She has started making lifestyle changes to manage stress, such as walking with her dog and avoiding sweets.
Jocelyne
She reports sleeping only 4 to 6 hours per night and waking up every two hours, which leaves her feeling unrefreshed.

Julie :
Julie feels happy when traveling and smiling, and tends to remain quiet when unhappy, indicating she expresses her emotions internally. She finds joy in the support of her husband and sisters and maintains a positive outlook on life.

Liliana:
Liliana admits to feeling unhappy most of the time, and this leads her to depressed. She finds some joy in completing tasks like French homework and household chores. But she enjoys seeing her brother and sister.

Jocelyne
She shared her worries about her son with MS and she reported her stress level is 7/10.

Julie,
She also finds happiness and support in her family, which indicates she values her connection with others meaningfully.

Liliana:
Liliana did not list any of her spiritual practices. She feels emotionally affected by her physical problems and has a general dissatisfaction with life. However, she is looking to make changes to improve her emotional and spiritual state by swimming and changing her eating habits.

Jocelyne:
Jocelyn did not share her religious orientation, but she reported that she sings at church. Her engagement in singing at church and her connection with the community suggest that she may experience spiritual balance through these activities.

Julie:
Julie’s interests in yoga philosophy, pranayama, and meditation show her active intellectual and spiritual learning engagement. Her practice of various forms of yoga demonstrates her curiosity and desire to apply it to her overall well-being.

Liliana:
Despite her physical and emotional challenges, Liliana remains intellectually engaged. She is learning French taking Happy Joints class via Zoom and is planning to start swimming.

Jocelyne
Jocelyne enjoys reading, watching TV, and visiting with her neighbor, indicating a desire to stay mentally engaged, be active, and keep learning by reading/playing games.

What?
Pratipaksha Bhavana – “When disturbed by negative thoughts, cultivate the opposite positive thoughts.” Yoga Sutra 2.33

Why?
Positive reframing cultivates a mindset of acceptance and resilience, supporting emotional balance.

How?
I would use meditation with positive affirmation to shift their mind from negative to positive. A sample of affirmation is “I am doing my best and I can manage this condition”. This is the opposite thought of “I can’t do it, I am weak”

Joint freeing practice (pawanmuktasana) can help joint flexibility and mobility, enhance circulation and reduce inflammation, and alleviate pain by relaxation.

https://juniperpublishers.com/jcmah/JCMAH.MS.ID.555699.php

• 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.