Ha Breath to lift client’s mood – a mood buster to break through stress.
Re-framed Raja Yoga as affirmations – to address cognitive aspects of stress.
With Chair Yoga – to shift energy and relieve client’s shoulder pain.

Goals: Lift client’s mood; relief of shoulder pain. Meet with the client once a week for 4 weeks, Senior Citizen Center. First session 45 minutes, then 15 minutes thereafter. Client will receive Intake, Survey, talk on Understanding Stress, 20 Minutes of recorded session with instructions. Client practices 20 minutes daily. 4 weeks to attain goals.

Female Client Age 71 The client has type II Diabetes which she says “is emotive.” Client has pain in the shoulders. She is slightly bent over and is currently going to the chiropractor twice that helps her with this condition. Client suffers from a difficult emotionally abusive relationship with her husband. Client’s husband is currently very sick. Client has a young grandson that is currently very sick.

Meet once a week for 4 weeks. Prior to first session Client will take a full Stress Management Yoga class.
The following Practice will be given to the Client:
• Brief discussion on stress, stress response, and relaxation response;
• Few minutes of guided Centering;
• 10-15 minutes of selected stretching yoga poses;
• Teaching of the Ha Ha Ha breath.
Brief survey will be given at the first session and at the last session to see if there is any change.

CY and RY were used. The key teaching of using the breath to cope with stress and to bring the awareness to present began with a centering practice, and reminders were given throughout. RY came in the form of discussions with the client, for example, the Client suffered mentally from an altercation she had with a shipping company that she paid to have some boxes delivered. The ‘incident’ was so stressful that she would not get out of bed nor eat for 3 days and this issue had become all consuming. This happened in the last week of our sessions. Prior to this she had been making progress and she was regular with the Practice. Reframed Praktipaksh Bhavana was discussed - the effort to think of things in her life that bring her joy such as seeing her grandchildren, planning for her upcoming trip, and by changing her environment. She received written instructions on how to do a 20 min mmb.

Session 1 (S1): Client reported feeling less pain in the shoulders and less depression because husband was not disturbing her.
S2: Reporting no pain in the shoulders and no depression, and has been doing the Practice daily. Client was taught the Ha breath, and provided with information on the Therapeutic Role of Yoga in Type 2 Diabetes.
S3: Client reported she cannot do the Ha Breath. Client was taught additional progressive CY stretching. Client seemed genuinely happier and she continued to feel good.
S4: The ‘incident’ prior to last session was extremely stressful. Client received mmb via text. At session, she reported that the mmb practice had made all of the difference - she got up from bed, stayed up and was eating the next day. The mmb practice has been working and it seems that she developed ‘faith’ in it because of the experiential experience she had. She resumed CY Practice.

Suggestion for the Client are as follows: It was suggested to cultivate the Practice she has been given by doing the Practice daily for 20 minutes and for the rest of her life (always paying attention to the body). Additionally, to add a 5 minute mmb that she learned to her daily Practice. In a re-framed discussion, it was suggested that Client practice Praktipaksh Bhavana, thinking positive thoughts when disturbed by negative thoughts. To turn her attention away from troubling situations by focusing on what brings her peace and love. To stay away or ignore people that cause her stress.

The Client was given a translated copy (in Spanish) of the centering and Chair Yoga Practice.

Yes, the plan was applied as outlined. The goal was achieved and Client reports that she was developing a daily Practice and she was more at ease and felt no pain. The ‘incident’ during the last week served to show Client how conscious attention towards the breath relieves stress through the use of mindfulness meditation on the breath.

Additionally, the Client was very response to scientific studies presented to her on effects of Yoga on Diabetes Type 2 in an article titled Therapeutic Role of Yoga in Type 2 Diabetes, . As a result, she said that “she wants to do more yoga.”

I had to adapt our last meetings in the last week (on the phone and in person) and focus on helping Client to snap out of the constant negative thought pattern she had fallen into as a result of feeling harassed by the shipping company. I had to think about how to help her because she had shut down and been in bed and was not eating for 3 days – I felt I had to give her something simple that she could do in this state of mind. Giving her the mindfulness meditation on the breath worked and she restarted her Practice and she started eating. She is now doing the Practice with more commitment, because she wants to be well and she wants to be stronger.

I learned to be flexible, opened minded and to stay calm, that things do not always work out how they are planned.

Yes, I would approach it the same way. I would do things in the same way. And I will also practice to be even more calm next time when things happen in Client’s lives (or mine). As Session 4 rolled around, the focus had changed due to the Client’s state of mind as a result of the ‘incident’ discussed above, the approached taken then worked well for the Client, the mindfulness meditation on the breath was simple and she could do it in bed. She opened up a lot to the Practice and she developed ‘faith’ in the power of the breath. The Client felt well at the last session, the ‘incident’ was behind her. She talked about how she received good news from her husband. She said she appreciates the yoga stretches. (She asked me if I would come to her home to give her yoga classes.)