My client is a 52 year old female, coping with PTSD symptoms, shallow breath, jaw, neck, and shoulder tightness.
Her PTSD is due to childhood trauma of losing a brother at the age of 4.
This trauma got triggered a year ago and put her in a freeze mode.
She expresses that she was unaware of breathing while in the freeze mode.
She described herself as "a walking mummy" or "a robot".
She lost her father in 2020 and was mourning for about 3 years and then this trauma got triggered.
She was not allowed to cry or not taught how to handle her emotions as a child and told "to shut up and do the chores".
She has stressful relationship with her mother which made her to feel frustrated and angry.
She describes that her mother used her as a tool and a caretaker of her sister.
Her sister was not appreciative of her.
The client took care of her sister with driving, bringing food for her when she was diagnosed with bipolar disorder and hospitalized.
She doesn't know much about her older brothers.
She is not talking to her mother or sister because it puts her in anxious mode.

Shallow breath, can breath deeply when done consciously now,
Unaware of her breath when she was in freeze mode.
Lack of energy during the midday.
Sleeps late around 2 to 3am for the past week.
Quality of sleep is good.

Has trouble focusing.
Tends to overthink when something bothers her.
Goes to talk therapy/occupational therapy to talk about grief, PTSD detachment style,
She had a feeling of loss or lost something for all these years. Now, she discovered what she lost which is the loss of her brother
Never allowed or taught how to deal with emotions as a child.
Had a hard time expressing her emotions.
Always told to shut up and get back to work
Now wants to mourn for the loss, wants to comfort herself by saying it is ok to cry, feel angry or sad
Wants to sit with the loss instead of suppressing it, denying it, tolerate it instead wants to sit with it and comfort herself
Wants to say she loves her brother and wants to hear her brother saying he loves her.
Mental fog
Inertia
Stressful relationship with mom and sister and don’t know much about her older brother
Work related stress - no permanent job, doing odd jobs for living and gets assignments as paralegal writer. Wants to stabilize herself to start a career
Financial stress - no retirement fund, keeps expense minimal
Stress about future
Occasional feeling of anxiety, depression, anger.
Doesn’t like to go out
Doesn’t want to see anyone (including family member)
Doesn’t want to get into any relationship

Loss of connection with body, breath and mind in freeze mode
Attends SRF (Self Realization Fellowship)
Does kriya yoga and meditation
Feels connected when journaling, doing spiritual practices, nature and family
Wants to connect with her mom in a meaningful way but feels that her mother thinks that she is visiting her to get some food or get her inheritance.

Lack of ambition, motivation, planning, setting goal, achieving it
Wants to learn about yoga philosophy, writing, music, dance, and arts
Likes problem solving and making the situation better
Finds interest in watching YouTube videos about bible, ethiopian bible, how chinese language incorporated the story of the creation into the chinese language itself

What is stress:
1)Stress response
2)Relaxation response
3)How to relieve from stress
4)How to cope with stress
5)How to build stress resilience
6)Practice and non-attachment (Abyasa and Vairagya)

Centering:
Managing triggers and panic attacks based centering practice
3-3-3 Rescue Technique
Chanting “Om” X 3
Setting sankalpa
Smiling at palms
Asana:
Netra vyayamam - Draw circles with eyeballs
Warmup full body - Lying down JAPA Yoga Joint Exercises
Back bend - Cobra (Sympathetic activation)
Forward bend - Wind relieving pose (Parasympathetic activation)
Twist - Lying spinal twist (Cleansing)
Inversion - Bridge pose (Calming)
Relaxation:
Basic IY deep relaxation, with all elements ( Helps to relax the tight body from freeze mode)
Breathing Practices:
Breath awareness + Extended Exhalation
Deep, 3-part breathing (Calming)
Meditation
Kriya Yoga meditation or Repeating affirmations - “I am safe”, “I am loved”, “I am worthy”
Closing:
Chanting “OM”
Lokha …
Dedicating practice
Smiling at palms
Research Studies:
Yoga for Adult Women with Chronic PTSD: A Long-Term Follow-Up Study: https://pubmed.ncbi.nlm.nih.gov/26863321/
Yoga as an adjunctive treatment for posttraumatic stress disorder: a randomized controlled trial : https://pubmed.ncbi.nlm.nih.gov/25004196/
Mechanistic pathways of mindfulness meditation in combat veterans : https://pmc.ncbi.nlm.nih.gov/articles/PMC4803530/

I chose doing asana practice in the bed (bed yoga) to motivate the client doing the asana practice. Is it a good approach?

• 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.