Bhakti yoga has been called “love for love's sake” and Karma yoga is the yoga of action or work; specifically, karma yoga is the path of dedicated work

Client would like to work on relaxation, stress reduction, and maintaining her physical status in balance. She describes symptoms that indicate relative weakness in her trunk indicating a need to stretch and strengthen this area.

Client is a 66 year-old female who lives with her husband in Hartsdale, NY. She works as a physical therapist and is currently employed in a nursing home. Client suffers from thoracic scoliosis, she has a c-shaped curvature of the spine on the right side. Her scoliosis dates back to an injury she suffered at the age of 14. She has been diagnosed and in treatment with a physiatrist who worked from a traditional medical approach. Interventions included bracing and doing physical exercises to alleviate the pain. She has never undergone surgery. Her’s is a functional problem that is permanent and it is not unusual for the symptoms to become more severe with advancing age. As a result, it is unlikely for interventions to fully resolve the problem, but they can relieve pain and slow the worsening of the symptoms. Client has been attending weekly yoga classes for the last 4 years and she typically attends private sessions with me roughly 2 times a month. She prefers restorative classes and in savanna she often falls asleep. How do you envision working with the client to incorporate your selected teaching? The major emphasis in the adaptive treatment is work on strengthening and stretching her trunk. I use bolsters and a strap in sessions. Poses focus primarily on the right side as this has been established as the area of primary concern. Interventions will focus on improving the client’s awareness of the problem in order for her to know when the position reflects a more positive alignment. She will then try to maintain that posture for a brief period to strengthen the muscles on both sides of the spinal cord. This will not be done to the extent that she experiences significant additional pain. Pranayama exercises for this condition improve breathing which may be negatively affected by scoliosis. Breathing exercises can lead to a greater awareness of the corrected position and what it feels like to be in the corrected position. What branch(es) of IY will you use? How does each support your goal? Two branches of yoga that I have chosen are bhakti and karma. Bhakti is chosen because this client has a great faith in God. She goes to church every Sunday and she often prays to saints during the day when things she encounters challenges. I chose Karma yoga because of its emphasis in her life on action. Her job as a physical therapist requires her to help others who need compassion in their lives. Short notes on time with client: Client enjoys chanting and also the mantras at the beginning of the classes and the end of the classes. She listens and recites Om and Hari Om, she appears comforted by chanting them. Since she began practicing yoga she reports that her mood has improved. She has also found that her relationships with others have improved. Client doesn't like to be touched in the class, when she is she often says,”don’t touch me” in a manner that suggests considerable anxiety about physical contact when initiated by someone else. Her anxiety is lowered when she is told when contact is to occur. Did you apply your intended goals once you actually met Follow-up suggestions for your client (whether with you or on their own). She doesn't like to be touched by someone else unless she initiates the contact, During sessions she often says,”don’t touch me” in a manner that suggests considerable anxiety about physical contact. Did you apply your intended goals once you actually met? I was able to carry our a hatha yoga class format and she made corrections or did not do the activities that she felt she couldn't she used strap blankets and a bolster to modified the class. Reflection She doesn't like to be touched in the class, when she is she often says,”don’t touch me” in a manner that suggests considerable anxiety about physical contact when initiated by someone else. Did you apply your intended goals once you actually met with the client(s)? Yes. I also inquired how she is feeling, for example, if she is feeling physically depleted or tired, in order to get an idea as to whether she will want to or be able to do a hatha class. Her status on any individual day can affect which goals are addressed. Did you have to adapt anything in your plan? Her training and current work as a physical therapist has contributed to her being familiar with the symptoms which include significant back pain and stiffness. In a sense, all of my sessions with clients are adaptive. My individual classes are constructed on determining what the clients want to work on to address the presenting problem that session. I will make suggestions and then, in most cases, the client will have the final say in the choice of appropriate interventions. Private classes consist primarily of stretching exercises. This is my general approach. This client is knowledgeable regarding human anatomy, she is generally looking for strengthening. With her professional knowledge she has been able to teach me some details about movement and physiology. She has treated the syndrome in others from a more traditional medical rather than a yoga approach, There is a mutual respect that is communicated. Due to the client's hypersensitivity to being touched, an adaptation is required that minimizes physical contact. When I do touch her, I do so after a gentle warning and each time I ask permission. In addition, she can sometimes arrive at the session in an irritated and angry mood. This may sometimes require giving her space to vent before beginning yoga exercises. If you are faced with the same situation again in the future, would you approach it in the same way? yes because I was able to assess her needs and during the session I was able to talk to her and help her as an independent thinker respect that and guided her when needed, Yes, I would do the same thing. The possible exercises and positions are laid out and discussed with the client before they are taught. The treatment and sessions begin with an explanation of what the various alternatives are, together we arrive at a decision on what we will do. The individual treatment is tailored to the client and what they feel comfortable doing.