Introduce workday self-care techniques based upon the Relaxation Response teaching using a set of customized practices intended to provide parasympathetic activation & mindfulness techniques that offer in-the-moment relief / results to chronic stress and anxiety. SOURCE: IYI SMTT Manual 2020: pp. 37-39

Chair Yoga 10 - 15 min, weekdays - 5 asanas to introduce movement & mitigate sedentary working conditions while offering screen-time breaks. Meditation (5 min in AM to start) with focus on breath, body awareness & create time/space for herself - daily check-ins - for mindful awareness. Practice for 2 weeks, review next session.

RP - 58 y-o female - inactive, HBP, overweight, pre-diabetic, 2 knee replacements and long-COVID symptoms. Currently working remotely at home full-time - facing chronic stress and anxiety with 74 y-o husband who has Parkinson’s.

My intention was to help the client overcome any potential resistance to ‘adding one more thing’ to her daily tasks. I prefaced the care plan by asking that she hold this as an experiment and invited her to be open and playful - and speak up regarding her experience as she tried the chair asana and meditation. I made a clear request that she be fully transparent re her experience no matter what. I added that by doing so we’d be able to adjust her plan, as needed, to ensure that we were honing these practices to be of maximum benefit to her.
I framed these practices as a means for daily self-care - reconnecting with, supporting and nurturing herself.

Raja: I used the principles of Ahimsa and Satya. Ahimsa as a tool for non-violence - I.e. letting go of harsh criticism, self-judgement as she worked with these practices. Satya was offered as a means for her to be truthful with herself and me as well.
Pranayama: used to self-regulate when experiencing stress - Dhirga Swasam. I also offered Brahmari Breath as a means for Pratyahara - ‘sense-withdrawal’ to shift her focus when feeling overwhelmed.
We discussed Dharana as an entry-point for meditation - a weekly goal of 3 to 4 5-minute sessions. If she didn’t meet this goal to consider it an observation, not a failure.
We discussed the concept of Pratipaksha Bhavana. Reframing staying open to other possibilities for interpreting results.
Bhakti Yoga: client is a passionate music lover. I asked her to select some of her favorite performers and listen to their music when driving.

She was very open and grateful although it was obvious she couldn’t fully envision herself sticking with these practices. Her daily obligations - work and caring for husband with Parkinson’s leave her in an ongoing state of exhaustion.
She was engaged when we worked together.

I emphasized the principles of Ahimsa and Pratipaksha Bhavana. Do what she can and let that be enough for the day - Santosha.
Santosha: I encouraged her to be open to finding some moments throughout the day where she can experience some joy and pleasure - listening to her favorite music, watching birds outside her office window. Be open to what other possibilities that might show up too. Anything that gives her a sense of Ahhh, connection and well-being.

I did apply the intended plan. She was especially grateful for the chair asanas practice and the Bhakti suggestion. Overall I think the goal was achieved to offer her some practices and awareness regarding self-care - see how that unfolds over time.
We strategized about finding time for practices that were beneficial to her throughout her day - even if was for just 5 minutes. One example, setting 2 or 3 alarms throughout her workday to just take a couple of deep breaths and/or do some asanas. This approach helped remove the pressure of success and only one way to do it well.

I had some letting go to do. I found myself wanting her to fully embrace these practices and take them on with discipline and enthusiasm. I realized it’s ok to want her to realize the many benefits available to her - but to be realistic in my own expectations for where she’s at and what she’s capable of doing giving the many demands of her life.
I also realized that it’s important for me to trust myself - my intuition - to speak up and offer suggestions that might take her out of her comfort zone - even when I sense I’ll face some resistance. I’m offering ideas, options, practices as possibilities - and learning to be open to her response and let go of the outcome.

If faced with the same / similar situation again, I believe I would take the same approach - knowing there’s always more for me to learn. I see that it’s best to minimize assumptions about the client and instead practice active listening as we work on a treatment plan together. I learned the importance of trusting that the client is the expert on themselves and their experience and to not push too hard - do my best to ensure they’re comfortable with the agreed-upon goals.
I’ll continue to research health conditions and challenges that the client is facing prior to our intake meeting. I found it especially beneficial to take some time researching Parkinson’s, which her husband is facing. It was really helpful as I was able to offer my rudimentary understanding of this condition as a means of empathy as well as my intention to have the fullest awareness of all that she’s facing.
One other thing I plan to consider is the notion of accountability. How can I challenge / encourage a client to apply the practices we’ve agreed upon without it seeming like pressure or creating resistance or withholding if something isn’t working, etc. Initial thought is to encourage transparency.