Entry TypeAssessment
Client/GroupWK
Entry CategoryIntended Case Study
Select your mentorBrahmi Romero
Intake
Assessment
Proposed number of sessions8
Location of sessionsVirtual
Planned time per session90 minutes
Presenting ProblemClient has intrusive thoughts and ruminates and she wants to be able to manage that.
Physical

Client’s is generally in good physical health.

Client experiences a disconnection with her body. Her mind does not know how to process feelings of being approached by males who show interest in her – her body freezes and she does not know how to process the moment and experiences aversion and sometimes anger.

I contacted the client and informed her that I wanted to observe her while she is breathing. After a short centering period, I observed the client breathing, I could see that she breaths into the upper chest, I see the chest rise and fall every time. When I asked her to describe how she breaths to me, she said mostly into her chest. After a while, the client noticed that she was also breathing shallowly into the abdomen. I could not see that she was breathing into the abdomen – I think because it was shallow. I understand this to be reverse breathing, thus client is a reverse breather.

This client recently got certified as 200 hour Hatha Yoga teacher in January 2024. Client continued to practice for a few weeks and then stopped.

In the 200 hour Hatha Yoga certification class, she learned various breathing practices, she described clenching her teeth and breathing in and out, and rolling the tongue and breath in through the mount and out through the nose. I am unfamiliar with most of the practices she described. The only ones I know are Kapalabhati and Brahmi.

Client speaks a little incoherently at times. She’ll jump from one thing to another, or not be sufficiently clear about what she is trying to say.

Client/Group goalsHaving a better relationship with herself. Allow herself to feel the feelings she is feeling. Process feelings going through her body instead of cutting feelings off.
Energetic

I find client’s energy to be Tamasic -Rajasic, active, incoherent, negative, desire based. She distorts her awareness without knowing it.

Emotional

At age four, client was in the same bed with her mother and father while her father was having sex with her mother, when she turned to look at what was going on, her father said to her “what are you looking at” this made her feel shame as if she did something wrong. She turned away but could still hear them.

It almost seems that as a result of this experience at age four, the client’s mind separated itself from it’s body.

Also at age four, she lost her little brother, he died and she did not understand where he went and her parents did not talk to her about it – she felt emotionally frozen and has carried this emotional pattern until now.

Additionally, she was neglected emotionally by her parents because they were grieving for the loss of their son.

I find client’s emotional energy to be tamasic-rajasic: downward moving, with fear and avoidance. Currently, client experiences depression at times and her mind ruminates.

I find client to be lonely. Due to abuse and dysfunctional behavior from her mother and sister, client has blocked them from reaching her. Client’s father died during COVID 11/2020, and she is still grieving although less than before.

Client is currently angry over a friendship with a man that didn’t meet her expectations. This was not a romantic relationship, although at one time he was interested in her, she rejected that interest. When this happened, she was triggered with loss and abandonment because he left without telling her - triggering the same feelings of “feeling frozen” that she felt at age 4 when she lost her little brother, and these feelings have been triggered all of her life, particularly in relationships with men.

Client was raped around age 28 by someone she knew, but she didn’t understand it as rape until recently when she was watching something on TV and the person spoke about being raped. When this happened, it took her back to when she was four when her father was in bed with her mother, as mentioned above. Client said that when she realized that she was raped around the age of 28, she felt a dissociation, she experienced PTSD and vomited, and she was unable to breath through her nose. This is why the client says “she finds it important to connect with her breath.” By this she means just being conscious of her breath, and “she needs to have slow deep breath into her stomach.” She is trying to calm herself down.

Recently, client has been trying to help herself, she is aware that something is not right - she has been taking swimming since May twice a week for 45 min – 1 hr. Then core exercises and stretches, followed with Kriya yoga meditation. This takes her about 1 hour to do. These activities help her feel better.

Spiritual orientation and needs

Client is all over the place spiritually, digging holes in different places. Client is trying to find her way through the maze of spiritual offerings but it seems she does not know how to decide on one path.

In 2014, Client became a member of SRF. She received the lessons but she was too impatience to wait and receive Kriya Yoga from SRF. So she went to Florida to receive kriya yoga from Hari Harnanda. The kriya she received there is different from the Kriya Yoga of SRF. Client says she does kriya she received. [To me, it does not seem to help her. Possibly mainly because she isn’t focused and does not have a spiritual goal.]

Client hinders her meditation, she says she can’t get too deep in meditation or chanting because she never allowed herself to go deep; she says it’s like if she is denying herself because she was never taught and never nurtured properly by her mother.

She goes to the Bhakti Center in NYC because its close to her house, and there she feels some peace.

She also goes to the SRF Temple in NYC to listen to the lectures.

Intellectual / Sense of self

Client is currently seeing a therapist due to the anger over the friendship with the man that didn’t meet her expectations, as mentioned above.

Client’s mind is unclear; tamasic. How she sees things and her understanding of things is not clear.

Its seems to me that even if the client were to read the signal of interest from a man correctly, her trauma stemming back from childhood along with the pattern she has developed (knowing or unknowingly) distort her ability to respond in a healthy way.

Client is currently not working, and it seems she has not been working since the beginning of the year. (I failed to ask more specific questions about this), but is to say that Client seems to lack structure in her life.

Yoga philosophy/wisdom research reference(s)

Client will be taught Stress Response education. We will discuss how conditioned internal stressors create much of the stress we experience, especially long-term stress. Client will be guided to identify her major inner stressors. This will help her understand that stress that is internal is something she is able to have the control over and to change.

The Yoga Sutras of Patanjali, Translation and Commentary by Sri Swami Satchidananda

Sutra I.1: Now the exposition of Yoga is being made.

Sutra I.2: The restraint of the modifications of the mind-stuff is Yoga.

Sutra I.3: Then the Seer [Self] abides in His own nature.

Sutra I.4: At other times [the Self appears to] assume the forms of the mental modifications.

Sutra I.5: There are five kinds of mental modifications which are either painful or painless.

Yama and Niyama Sutras.

Sutra II.8 – Aversion/Dveshah – Aversion is that which follows identification with painful experiences.

Sutra I.33 – By cultivating attitudes of friendliness toward the happy, compassion for the unhappy, delight in the virtuous, and disregard toward the wicked, the mind-stuff retains its undisturbed calmness.

Sutra II.33 - Pratipaksha Bhavana - When disturbed by negative thoughts, opposite-positive thoughts should be thought of.

Scientific research reference(s), why chosen, how you plan to incorporate 1-3

The article below shows that yoga has both short term and long-term positive effects for depression, stress and rumination, and quality of life; and, states that even “simple exposure to a yoga intervention appears to provide sustained benefits to the individual.”

“Participants state that yoga became a “tool in the toolbox”, such that they had gained new skills to use in their everyday lives for managing symptoms of depression and stress. Some of the “tools” they cited including breathing, centering, relaxation, gentle stretching, healthy visualization, and physical movement to “get out of my head and have some control,” “They also stated that their experience with yoga provided them with the “courage to do more”, such as get out of the house, try new things, and even eat more nutritious foods.”

Kinser PA, Elswick RK, Kornstein S. Potential long-term effects of a mind-body intervention for women with major depressive disorder: sustained mental health improvements with a pilot yoga intervention. Arch Psychiatr Nurs. 2014 Dec;28(6):377-83. Doi:10.1016/j.apnu.210.08.014. Epub 2014 Sept 3. PMID: 25457687; PMCID: PMC4254446.

Approval Notice
Your care plan should be approved by your mentor, with any amendments they suggested, prior to your remaining Yoga Therapy sessions.
Questions for Mentor

I met this person/client back in April and I gave her one of my Yoga Therapy brochures and didn’t hear back from her until now.

I informed the client that I would be going away for a few weeks in July and that I probably could do the first session with her (the Intake and Assessment session) before I leave, and when I return, we would be able to start meeting. Client was fine with this because it turns out that she will also be away during the same time period in July.

Do you have any advice for me about the following:
It turns out that we are going to the same event, the SRF Convocation, in LA. We may see each other there. If I do see her, I will greet her, but I feel I should not spend time with her. Like it would be a conflict of interest – something like that.

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)
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.
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.