Client has hyper mobility in all joints with pronounced overpronation in the feet and resulting internal rotation of the knees and hips. There is no sign of a pelvic tilt. Client self-reported tightness in trapezius muscle. Client has rapid, irregular, reverse breathing with no history of asthma. There was visible tension throughout the whole body.

Client was visibly excited, with fast breathless talking and difficulty relaxing or sitting still.

Client was clearly anxious and also teared up a few times while talking about emotional/mental abuse history and recent police/arrest-related trauma.

Client does not have a religious interest, but would like to build a spiritual practice and mentioned creating an altar for meditation. She would like to have support to help her process trauma, to relieve internal pressure, and to release negative feelings.

Client demonstrated strong feelings of self-judgement, strong sense of justice (i.e. wrong versus right/good versus bad), and fear of losing control.

I will offer the Yamas and the Niyamas from the Yoga Sutras as a way for the client to begin break the pattern of aversions and attachments and to create some more balanced approaches towards self. This will hopefully help to alleviate some of the anxiety that the client is feeling.

I utilized this study to determine what standing yoga poses might be helpful as interventions for the patellar instability and which to avoid. I will utilize Warrior 1 and Warrior 3, along with tree, but will avoid standing Warrior 2. Liu AM, Chu IH, Lin HT, Liang JM, Hsu HT, Wu WL. Training Benefits and Injury Risks of Standing Yoga Applied in Musculoskeletal Problems: Lower Limb Biomechanical Analysis. Int J Environ Res Public Health. 2021 Aug 9;18(16):8402. doi: 10.3390/ijerph18168402. PMID: 34444151; PMCID: PMC8391656.

This study, while without a control, was helpful to provide some examples of how a well-rounded yoga therapy intervention that includes Hatha Yoga, pranayama, and meditation can assist to reduce the pain the client is experiencing in their shoulders and neck. Sharan D, Manjula M, Urmi D, Ajeesh P. Effect of yoga on the Myofascial Pain Syndrome of neck. Int J Yoga. 2014 Jan;7(1):54-9. doi: 10.4103/0973-6131.123486. PMID: 25035608; PMCID: PMC4097917.

I read this study and found that it was useful to formulate an approach with yoga practices for an individual with generalized anxiety disorder. In particular, it provided some ideas for the importance of repetition and a teaching approach so that the client can incorporate practice more easily at home. More P, Kumar V, Usha Rani MR, Philip M, Manjunatha N, Varambally S, Gangadhar BN. Development, validation, and feasibility of a generic yoga-based intervention for Generalized Anxiety Disorder. Complement Ther Med. 2021 Dec;63:102776. doi: 10.1016/j.ctim.2021.102776. Epub 2021 Sep 25. PMID: 34571143.

How do you recommend I approach the discussion of the arrest if it arises again? This client was peacefully protesting on their former college campus and were one of a group of individuals that was arrested. In intake she said that the location of the arrest was also near the apartment where she had once lived with her abusive ex and that the arrest reactivated a lot of that trauma as well.

• 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.