Body Scan with breath awareness to calm an anxious client.

Anxiety scale 1-10 1=calm 5=mild agitated 10 =fully elevated HR, shaking, distress. Scale anxiety at onset, use body scan and breath awareness 10-20 min reevaluate with scale. The goal is to decrease the rating of anxiety with the practice of a short body scan and breath awareness practice.

Client is 24 yr old female with anxiety and overall depression of 2-3 yrs duration. Her depression has been rated by her clinician, at outset it was considered moderate. Her anxiety is generalized and client has 1-3 panic attacks daily.

This client is a friend and she has the ability to call me when she feels in crisis.
My intention was to test the idea of using the body scan and breath awareness in a “crisis”situation. I have found that some people who suffer from extreme anxiety and depression have very little tolerance for a daily practice. My intention was to implement in the crisis and to see if patient became more aware that it was beneficial and might even start using it to prevent crisis moments.

The body scan is primarily dharana
Breath awareness is dharana and pranayama
The goal is overcoming a sympathetic storm caused by thoughts, moods or behaviors that were provoked knowingly or unknowingly.
The breath awareness is pranayama, the guided body scan is a type of distraction from the moments thoughts feelings and behaviors. The distraction if long enough brings a measure of personal control back to the brain to reconnect person and their body in a conscious way enabling them to feel a semblance of control, enough control to hear and move towards next steps, such as elongated exhale, a guided imagery around a safe place, a walk around in house or nature.
Jana yoga is applicable to the changing nature of the mind and the intervention as a way to calm the mind for further exploration perhaps towards hope or faith of Bahkti yoga. A further plan of regular Hatha would be helpful

The client and I conversed on 5 occasions over 2 weeks, each time she was very anxious and unable to really rationally think about much else. I began by spending a lot of time drawing awareness to the feet small parts to larger, one foot then the other. I listened close to her breath and occasionally asked her to be aware of the next breath and attempt to deepen it and breath out through pursed lips. continuing through the scan and ending back on the breath and working with the extending of exhale as she inhaled feeling her belly extend.

My follow up would include a deeper resource for her to use, including regular sessions with a yoga therapist. I would emphasize the relationship to the practice and how she felt after, in order to encourage her to develop a short daily practice. Commitment to going a psychologist for regular appointments.
I would also suggest finding a peer group, mindfulness class, stress management class where she can feel comfortable and learn deeper skills and do some interaction with others.
I would provide references for all of these options for her to explore online or in person.

I did apply the intended plan with my client. It was often challenging to calm her enough initially to implement the plan.
The goal was achieved. I admit the goal is short term but for many people with panic attacks, acute anxiety episodes, acute depressive episodes simple can be effective. Perhaps it can be available to those on crisis hotlines. I do think the effectiveness maybe amplified by the presence of another live person on the line versus a recorded body scan for such a crisis moment.

This situation is not unique in the mental health sphere, what would be unique is applying it on such a personal level.
I had to “talk” to the person to get her calm enough to engage in the practice. This is why it could be beneficial on a crisis hotline. I would add that in doing the breath awareness and the body scan is beneficial for the person in crisis but also the person trying to help. Like a wedge it provides a few minutes for everyone to calm and collect thoughts and move forward to referrals and other great things crisis hotline people do.

I would for all the reasons above. Some people may respond better with starting on a body part and others with watching the breath-it depends on the person.
I learned primarily that the limits of this situation did have a similar real life situation, in crisis hotlines.