Entry TypeIndividual Yoga Therapy Session
Client/GroupRuth C
Entry CategoryCase Study
Select your mentorBrahmi Romero
Intake
Assessment
Approval Notice
Your care plan should be approved by your mentor, with any amendments they suggested, prior to your remaining Yoga Therapy sessions.
Care PlanOutline should be a practice adapted to the needs of that client/group, including:
  • Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
  • balanced pranayama considering contraindications, meditation/centering.
  • Please include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client/group.
  • Over time, we want to see something from each branch, selected, adapted and re-framed appropriately. Tools from each module should be used (not on each client/group – but overall)
The outline should show the sequence of practices as you plan to offer them.
Your care plan proposal should be approved by the mentor before session 2 if possible, or 3 if approval is delayed by mentor.
Session
Session Instructions (Not Mentoring)Your session outline should be a practice adapted to the needs of that client, including:
  • 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.
Over time, we want to see something from each branch, selected, adapted and re-framed appropriately.
Tools from each module should be used (not on each client – but overall)
Session Date02/05/2024
Session Number1
Total Session Minutes90
Homework assignment to client/group

Read:

Pratipaksha Bhavana, Sutras 2.33-2.34
The Yoga Sutras of Patanjali, Translation by Sri Swami Satchidananda, p. 127-129
Inside the Yoga Sutras, p. 141-144
Inside Patanjali’s Words, p. 198-203
https://integralyogamagazine.org/patanjalis-words-pratipaksha-bhavana/

Philippians 4:6-8 MSG (Message Translation)
Don't fret or worry. Instead of worrying, pray. Let petitions and praises shape your worries into
prayers, letting God know your concerns. Before you know it, a sense of God's wholeness,
everything coming together for good, will come and settle you down. It's wonderful what
happens when Christ displaces worry at the center of your life. Summing it all up, friends, I'd say
you'll do best by filling your minds and meditating on things true, noble, reputable, authentic,
compelling, gracious - the best, not the worst; the beautiful, not the ugly; things to praise, not
things to curse.

Matthew 11:28-30 MSG
“Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you’ll
recover your life. I’ll show you how to take a real rest. Walk with me and work with me—watch
how I do it. Learn the unforced rhythms of grace. I won’t lay anything heavy or ill-fitting on you.
Keep company with me and you’ll learn to live freely and lightly.”

Practice: Awareness Practice

You can take as much or as little time as you like with this practice. Feel free to explore it differently every day: seated, standing, supine. Even try it “in motion” during an outdoor walk. The goal is to pause and notice, without judgement or trying to “fix” whatever sensations arise.

Physical layer: From the crown of the head down to the soles of the feet, check in with the different areas of your body. Notice areas of tension and discomfort, allowing them to be as they are. Notice the areas that feel good, and if that is a challenge for the current practice, see if you can find an area that feels neutral.

Emotional layer: What emotions are present? How subtle or strong? Are there conflicting emotions present today? Allow whatever you discover to have space.

Intellectual layer: Notice what thoughts are present. Be a curious outside observer to them. Are there themes to the thoughts? Allow them to move freely.

Energetic layer: Recognizing that your energy is constantly moving and adjusting along a vast spectrum - from empty/exhausted/depleted to overflowing/electric/hyperactive.. Where is your energy at this moment? Is it a blend/mix of states - like “tired and wired”? Again, allow it to be whatever it is, no judgements or efforts to change.
Guide your awareness back to your breath. Simply notice. Follow the exhalation to the pause. Follow the flow of the inhale to the pause - how expansive is the movement in your body? Observe the natural rhythm of your breathing. Enjoy it as long as you like, and when you’re ready, return to attention to the present.

Practice: Asana

Eye Movements: Up/Down, Side to Side, Circles: Counter, Clockwise

JAPA: Joint Activation Practices for All
Neck: flex/extend, rotate side to side, tilt ear towards shoulder
Scapula: up/down, pro/retract, “chicken wings”, shoulder circles
Spine: flex/extend (cat/cows), rotate side to side, side bend/flex

Sun Salutation: Pause. Notice. How should I support my practice today?

Pos
Description
Mantra
Chakra
1
Exhale - Palms in the prayer position
Om mitraya namaha
Anahata (heart)
2
Inhale - Stretch the arms out, up and back
Om ravaye namaha
Vishuddhi (throat)
3
Exhale - bending forward from the hips
Om Suryaye Namaha
Swadisthana (pelvic)
4
Inhale - left leg all the way back, looking up
Om Bhanave Namaha
Ajna (third eye)
5
Exhale - right leg back (downward facing dog)
Om Khagaya Namaha
Vishuddhi (throat)
6
Hold - knees, chest and chin to the floor
Om Pushne Namaha
Manipura (navel)
7
Inhale- lift the head, neck and chest (cobra pose)
Om Hiranyagarbhaye Namaha
Swadhisthana (pelvic)
8
Exhale - push back into downward facing dog
Om Marichaye Namaha
Vishuddhi (throat)
9
Inhale - left foot forward between the palms, look up
Om Adityaya Namah
Ajna (third eye)
10
Exhale - right foot forward, knees straight, bending forward
Om Savitre Namaha
Swadhisthana (pelvic)
11
Inhale - stretch arms out, up and back
Om Arkaya Namaha
Vishuddhi (throat)
12
Exhale - straighten up, palms in the prayer position, release the arms
Om Bhaskaraya Namaha
Anahata (heart)

Practice: Pranayama

Three-Part Deep Breathing (or “filling the pitcher”)

To begin this practice, first take slow natural deep breaths. Let the breath be full but
relaxed. Do not push it out or pull it in. Let it come and go naturally, at an even, steady
pace. Let it be full but relaxed. As you relax, the muscles will be able to expand and
contract as the breath comes and goes. It can feel full but should not feel forced. Be
gentle. Relax into it.

When you are relaxed you can begin the first part of the three-part breath by expanding the
belly out like a balloon as you inhale. This actually contracts the diaphragm muscle and
expands the capacity of the lungs to take in air. Expanding the abdominal muscles with the
incoming breath helps one gain control of the diaphragm. Let the belly expand out as the
breath comes in. Practice this first part until it feels comfortable before proceeding to the
second part. If you notice any light-headedness or dizziness, refrain from the practice until
normal breathing resumes.

The second part of this breath is done by allowing the breath to move up into the rib cage.
The ribs expand out sideways and front-ways as the lungs fill with air, and they contract
down and in as the air is released on the exhalation. As the belly expands the breath fills
the higher parts of the lungs. This should not cause any strain or discomfort. If either is
experienced at all, the practice should be discontinued until equilibrium is again attained.
Such discomfort might be caused by tensing muscles or by trying to breathe deeper than
your natural capacity.

Again, practice gently with evenness and steadiness until you feel the muscles relaxing and
moving freely in their expansion and contraction. Again, do not push or force either the
inhalation or the exhalation. And, again, if any discomfort is experienced, the practice
should be discontinued until normal breathing resumes.

The third part of the breath is done by allowing the inhalation to fill the chest completely to
the top up into the apex of the lungs. Feel the muscles relaxing and moving freely as they expand and contract. Again, do not push or force either the inhalation or exhalation. Do not try so hard.

Activities

I guided her through an Awareness practice, and gave her space to share anything she wanted after. She felt the “connectedness of all her layers.” In particular with the emotional layer… over the weekend she had learned of the passing of a friend, Colleen, whom she had just spoken to the week prior. They had met early on in their respective recoveries, and while she has maintained her sobriety, Colleen had struggled the past two years with addiction. Her passing was alcohol related. She shared that she noticed feeling both the sadness of her friend’s passing and the circumstances around it, yet at the same time felt peaceful. She also shared that the Awareness practice reminded her of a practice she experienced when she was in IOP (intensive outpatient group therapy for addiction), where every session began with participants writing down their answers to the question, “Where am I,” answering in terms of physical, emotional, mental and spiritual terms. We talked for a bit about the similarities between developing awareness in our YCAT sessions and the awareness she was encouraged to cultivate in her addiction recovery. Some other learnings she shared that I really appreciated and hope to incorporate in our sessions:

1. HALT (Hungry, Angry, Lonely, Tired) - she was taught this to use when she was tempted to take a drink, as they represent four states where you’re easily triggered or vulnerable. If hungry, eat something. If angry, pause and check in with yourself or reach out to your sponsor. If lonely, go to a meeting or call your sponsor. If tired, rest.

2. “Move a muscle, change a thought.” This was shared by Ian, one of the counselors in her IOP. It’s been part of her motivation is staying active in both body and mind.

We spent more time talking than I had planned for the session, but I think it was time well spent in building our therapeutic relationship. With her desire to know more about the principles of yoga, I had planned on introducing her to Sutra 2.33-34 on Pratipaksha Bhavana, so for part of her homework I asked her to read those sutras, and shared the article written by Rev. Jaganath Carrera for the Integral Yoga Magazine, letting her know we’ll discuss them next week. I did briefly introduce it, and offered some Biblical scriptures which echo the heart of the practice.

I did want her to move a little bit, and since she had never explored using the wall as a support, I led her through some adaptive sun salutations using the wall. She commented how she felt no discomfort in her neck, back or shoulders where she often holds tension, and instead felt more length and space through her entire posterior chain. (We meet in the small studio space in the fitness center of her condominium building, which has 3 stability balls and some mats.) Due to time constraints I wasn’t able to guide her through yoga nidra or meditation today as I had hoped, but feel I can better organize our time together for next week. I did guide her through a practice of dirga swasam, with which she was familiar from her yoga classes. She found a steady seat, placing one hand on her belly and one on her chest in order to connect more deeply with the movement of the breath in her body. I offered the image of the breath entering and leaving her body much like water being poured into and out of a pitcher. She really enjoyed working with that image during the pranayama practice.

Client/Group progress summary

My goal is to work with the client for a total of 8 sessions, so that I can concurrently complete my YCAT Level 2 internship. As we began I gave her an overview of the 8 weeks, sharing that during our first session our focus will be on Awareness. We began with a check-in, where she shared she was feeling great and her energy was good. She had completed radiation treatment #10 out of 20 that morning, and when she felt herself in a little energy slump, she took a short nap the hour prior to our meeting.

Reflection and self-evaluation

I shared with her that homework I'm giving myself is to get a copy of the Big Book from Alcoholics Anonymous so that I can explore as well the many similarities there seem to be between the teachings from the Big Book and the teachings from the Yoga Sutras. I know I will not be able to invest the time I would like by our next session, but during our time together I would also like to introduce her to the Six Tenets of Yoga of Recovery developed by Durga Leela. I feel these would resonate very much with Ruth and they are not a tool I have previously shared with a client, so we could delve into them together. Initially I believed sharing tools of yoga to support healing from cancer would have the most value, but perhaps sharing tools to continue to support her recovery and her role as a mentor to those also on a recovery journey will be equally supportive.

Final Client/Group ReportAfter seeing your client/group (for at least 4 sessions including interactive intake)
Please remember practicum is a learning experience. You’ll learn more from sharing what’s accurate than from what might “look good”. Things you did well, not so well, problems and questions are all valid and useful tools to teach you. We can’t serve you to become the best clinician you can be if you don’t share your challenges and mistakes. Success is anything from which you learn. You can continue to add Session entries after submitting this Final Client/Group Report.
Plan for next session

Focus on Breathing/Pranayama

Report briefly on each Kosha belowProgress toward wellness or worsening reported by the client/group or that you observed in the following areas
Additional Information
Personal reflection from doing client/group.
Notify Mentor?Notify Mentor of Updates/Completion