• 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.

Legs up the wall/chair or with pillows in bed depending on physical limitations for 15 minutes at the end of each day to calm the mind and alleviate tension in the body.

Pursed lip breathing at the end of the day before bedtime to elicit a parasympathetic nervous system response and help to prepare for bedtime. Visualization of breathing in healing and breathing out pain/dis-ease

Reducing feelings of attachment to the body/mind by repeating “I am not the body, I am not the mind, I am the (Truth Absolute/True Self or something else that the client can identity like the Atman.) The client should repeat this at least three times in a row at the start of each day and again when he feels himself connecting to the pain and other disturbances of the body or mind.

Add OM chanting for three rolling rounds before meditation practice.

Check In
Guided awareness centering with emphasis on lovingkindness in areas of pain
Joint Freeing Series while seated in comfortable chair
Discussion of Abhinivesha as a cause of suffering because the client has been strongly identifying with the body and with the parts of the body where he is feeling physical pain. We talked about Tapas in a prior session.
Contract and Release using the Mitchell Method
Guided Meditation with visualization of placing emotions on leaves and letting them float by, including sensations like pain
Pursed lip breathing with visualization of breathing in healing and breathing out pain/dis-ease
Rolling Om chanting

This client has responded well to yoga therapy and is applying the practices. During the period that we have been seeing each other, the client took my recommendations to request physical therapy for the foot that was impacted by the bunionectomy surgeries. He has also been seeing his therapist more regularly since we’ve been doing yoga therapy.

He developed a perianal abscess two weeks ago and was hospitalized to drain the abscess. As a result, we’ve had to pare back some of the physical asanas that he is doing and we’ve been doing his deep relaxation while lying in prone position because he says that’s most comfortable. His surgeon encouraged him in follow up to start to do legs to chest while lying down, rocking back and forth, to help the tissue in that area release. This is a pose that I taught the client previously to help with back tension, so he was excited that he already knew how to do the pose.

PT assessment took place this week and the client brought the assigned exercises to me for the foot. I’ll incorporate a few into our next session. The PT will see him twice a month for the next two months.

This client has said that our sessions are one of the only things he feels like he does for himself. I have been working to ensure that he sees his daily practice as the same. He came in last week very angry about the hospital stay and the fact that he was unwell and those emotions were such a change from how he normally presents that I led a centering earlier than I normally might to give him a chance to decompress, but also to give myself an extra chance to center.

I have learned with this client, as well as others, that life happens and I have to adjust the care plan based on how the client shows up. My flexibility benefits the client, so I’ve become less attached with each session to “sticking to the plan” which is really helping me think on my feet and grow as a yoga therapist.

Centering/Guided Awareness
Joint Freeing while seated in a comfortable chair, incorporating toe extension from PT
Adapted sun salutations while seated
Mountain pose with proprioception
Foot ankle rocker mobility standing with a chair or by a wall for balance
Theraband plantarflexion while seated on floor (if body can tolerate this) or lying down with legs up against wall
Knees to chest while lying supine, gentle rocking to release tension in back and lower body
Rectangle breathing to help extend exhalation
Contract and Release using the Mitchell Method
RAIN (Recognize Allow Investigate Non Identification) Meditation to help the client learn to ease emotional suffering and confusion, as well as to release some of his identification with the body-mind
Rolling Om chanting