Embodying feelings of support, safety promotes restorative rest by calming the nervous system.

To gain more rest during the day, without taking a nap or disrupting night time sleep.

Male, 68, physically active (swims, bikes, strength training.) Was diagnosed with Parkinson's Disease 8 1/2 years ago, in 2013. Had deep brain stimulation surgery three years ago, in 2018.

I expected after one in-person session, the client would feel acquainted with the sequence and stretches enough to guide himself through the practice several times until our next weekly in-person meeting. Music was incorporated to pace the holds and transitions, and to retain the client’s interest. With the combination of self-guided and in-person practices, I thought the client’s rest might deepen progressively over several weeks as his body became more familiar with the poses and movements.

Raja. Pratyahara, yoga sutras 2.54 & 2.55. Svadhyaya, sutras 2.1, 2.32, and 2.44.
Karma. Reframed. “Optimal conditions for body and mind to most effectively perform tasks. - Feeling physically at ease and energized, free of tension and pain.” SMTT p. 95a

Supporting material.
Parkinson’s and fatigue.
https://www.epda.eu.com/about-parkinsons/symptoms/non-motor-symptoms/fatigue/
Effect of restorative yoga vs. stretching
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174464/

In-person intake. Two more in-person sessions and a third wrap-up meeting.

Through the intake assessment, the client mentioned feeling fatigued, stressed, anxious.

During the 1st session, transitions between resting shapes were effortful and a bit cumbersome, interrupting the calm cultivated during stillness.

Seated cow/cat restricted motion. I suggested cow/cat on hands and knees. This expanded the range of motion and allowed for fuller breathing. Synchronizing breath and understanding the cow/cat motion was a challenge for him. Verbal cues did not convey the motion. Physical touch clarified the intention. After two sessions, the client moved naturally/fluidly with his breath, enjoying the movement. His body was visibly relaxed and quiet in the final relaxation pose, his breathing shifted from heaving to soft.

Music kept client engaged. He practiced twice on his own.

- Continue weekly in-person, at home sessions with me.
- Incorporate the sequence into his other workout routines, possibly after a swim or a run twice a week.
- Make note of how he feels after each practice. Is he rested, calmer, enlivened, more "with it?" Has his mood shifted?

Yes, my initial plan was implemented. Gaining additional rest outside of naps or nighttime sleep was achieved. The goal was partially achieved as the client fell asleep in one in-person session during the final relaxation with legs elevated. After each in-person session the client said he felt calmer, rested, more “with it,” and motivated. He was visibly more at ease after 20 minutes of Therapeutic yoga.

For set-up, I added a bolster in crocodile, making space for inner thigh & groin constriction, softening the low back. We switched cow/cat from seated to hands and knees. I added a few extra props: the pillow in supported crocodile, the neck pillow, and the blanket for over the top of head.

The client better understood my verbal cues when I incorporated light hand touch to the areas of movement. Gentle energetic touch allowed more ease in the body. Permission was granted before any hands-on assist was given.

Lessons learned.

Let go of expectations. Let your client be your teacher. Videos and verbal cues just are not sufficient for some clients. In-person, real time connection may be necessary for the practices to be received and embodied.

I would meet twice a week in-person to start, then move toward the client practicing on his own progressively. This slower approach would provide encouragement and support, more subtly refining the practice to the client’s needs. Suggest client keep notes, reflections. Incorporate reviewing reflections together to invite further client self-inquiry.

The client looked forward to our sessions. He expressed receiving extra rest during the day, relieving feelings of anxiety and hyperactivity, gaining motivation.

Summary
The client presented with feelings of fatigue and anxiety. These feelings are related to a myriad of Parkinson’s Disease symptoms. Through our work together it became clear that the client’s proprioception and interoception abilities are compromised, making in-person sessions the preferred mode of interaction. The client felt calmer and rested with a brighter mood.