When the body is completely supported by props, a person can hold a pose with little effort or strain, stimulate their relaxation response (through backward bends, forward bends, inversions or gentle twists) and allow the body to move to a place of equanimity.

The goal is to share with the client two 30-min sessions that include a balanced sequence of supported poses (backward bend, forward bend, inversion, twist) to allow the client to release mental and physical tension, elicit a deeper state of relaxation and allow the body to return to its natural state of inner balance and peace. Research shows that people with prehypertension have a higher risk of developing sustained hypertension and cardiovascular disease. Additional risk factors for developing heart disease include a person’s family history of heart disease, and a sedentary lifestyle. https://www.ahajournals.org/doi/10.1161/JAHA.120.016804 Numerous studies have shown that supported yoga poses modulate the stress response (by lowering the cortisol levels in our system) and lead to a significant reductions in blood pressure, which reduces the risk of heart disease. (https://yogainternational.com/article/view/yoga-for-high-blood-pressure; https://www.yogajournal.com/lifestyle/health/hot-blooded/).

The client is a middle-age male with a family history of cardiovascular disease. He suffers from moderate levels of stress and was recently diagnosed with prehypertension. The client uses medication to deal with seasonal allergies. He reported that he has a sedentary lifestyle that involves "a lot of sitting at my desk, with legs crossed." The said that he realizes that he is at risk for developing heart disease. After learning about his elevated blood pressure, he started practicing yoga twice a week. He reported that he "enjoys" stretching and that he moves and stretches his body every day "in some form." The client said that he meditates 10 min every evening "to deal with stress from work". He said he feels “relaxed” while meditating and that it makes him feel “calm.” The client said that he is looking for a personalized program for his sedentary lifestyle. He said that his goal is to learn how to relax and attain a "peace-of-mind.”

The 20-minute teaching segment includes 10 minutes of breathing practices, 10 minutes of deep relaxation with guided meditation.

For this practice I plan to use a variety of props such as bolsters, blankets, and pillows which I would place so that the client’s body feels completely supported, allowing him to deeply relax while in the yoga pose.

Given the client’s experiences of stress and anxiety that show up in his energetic body as shallow breathing, I plan to use a pose that would be suitable for deep relaxation and promote deep breathing.
I considered using the supported corpse pose and bridge pose but chose the Supported Breathing Pose in which a bolster, blankets and pillows are used to raise the chest higher than the heart, which allows the diaphragm to more freely and the breath to go deeply into the lungs.
My plan is to begin the teaching segment with breath awareness to encourage the client to explore his breathing patterns in different part of the body (abdomen awareness, chest and lung awareness, upper chest awareness) and to take note of any long-established breathing patterns that he may not be aware of. I want to encourage the client throughout the practice to take note of any sensations or feelings associated with the breath without judgement.
My plan is to continue the session with deep and slow breathing. I would like to encourage to client to explore long inhalations and exhalations and how his breath patterns affect his body and mind. Deep breathing will allow the client to interrupt the stress cycle and engage the parasympathetic nervous system, initiating the relaxation response. My hope is that this practice will counter the effects of stress and bring the client’s body and mind back to a state of balance. This practice will also slow down the heart rate and stabilize the client’s blood pressure.
My plan is to continue the session with a 10-minute relaxation practice with guided meditation that involves sustained control of attention on a specific word, phrase, or image, encouraging the client to notice thoughts and sensations that arise in a non-judgmental manner. Given the client’s history of chronic PTSD that shows up in his bliss body as a belief in being a separate self, I chose the 10-minute guided meditation (Messenger Meditation) by Richard C. Miller for healing PTSD. This meditation is designed to allow the client to reconnect to his basic wholeness, health, and well-being. My hope is that this practice will remind the client that this basic wholeness is always with him and that he can access it at a moment’s notice whenever he needs to. My hope is to encourage the client to learn how to better control his reactions to external and internal stressors as they arise throughout the day and experience lasting peace and healing.

I will be using practices from the Integral Yoga (IY) Branch of Hatha Yoga, such as asana, pranayama, and Yoga Nidra, to encourage the client to release tension and stress and discover his inherent peaceful nature. I will also be offering tools from IY’s branch of Raja Yoga, such as dharana, concentration, and dhyana, meditation, to allow the client to better control his mind. I will also be using Pratyahara or withdrawal and control of senses, to allow the client to mentally let go of his involvement with external sensations and attain inner calmness.

When the client arrived for his short session, he said that he had a stressful day at work and that he felt “tired.” He said he was “worried” that he would fall asleep in the relaxation pose but that he was looking forward to the practice and would like to go ahead. The client appeared focused, alert, and very patient as the props were arranged and adjusted for comfort and proper angle. He easily relaxed into the supported breathing pose and began to naturally breathe into the abdomen. He shared that diaphragmatic breathing was his preferred way of breathing and that he uses it when he tries to relax. The client continued to explore his breathing before being prompted by placing his palms on and around the parts of his body where he could sense and feel his breathing (abdomen, sides of ribcage, upper chest). The client continued the practice on his own with several rounds of deep breathing with the arms alongside the body. After the breathing practice we continued with 10 minutes of deep relaxation with guided meditation.

At the end of the practice the client shared that he felt “calm” and “relaxed.” At the end of the breathing practice, the client said that he had noticed that his breathing was automatic. “It’s very easy.” He shared that he was able to move his breath all the way up to his upper chest during the three-part-breath and that he normally does not feel it up that high up. He said the breath felt “like a friend who is always with me.”

The next day, he shared the beginning of a poem that he said he wrote in his mind as he began focusing on his breath:

My Friend Breath.

My friend Breath
Has always been with me.
He/She/It was there when I was born.
He/She/It is always next to me.

I suggested that he take time to notice the breath during the day as he encounters different situations and to take deep breathing breaks to break the cycle of tension.

Yes, I applied the intended plan and achieved my goal. The client was able to release anxiety and stress and achieve a state of balance and peace.

Yes. I had planned to slowly introduce the client to the three-part-breath and then guide him through 3 rounds of deep breathing. I underestimated how little time it would take the client to settle into the relaxation pose and begin to relax. I learned that I need to begin my instructions more promptly or else I will lose the client’s attention and have them fall asleep.

The client was familiar and comfortable with diaphragmatic breathing. I think I handled the situation well by letting the client explore his breath at his own pace. The initial breath assessment had indicated that the client’s breath was shallow. It appeared shallow when the client arrived at the session. I did not realize that the client was familiar with diaphragmic breathing! If I had known I might have had the client explore alternate nostril breathing to further deepen his relaxation. I will ensure that I ask future clients about their familiarity with breathing practices. In addition, even though the client appeared calm and relaxed at the end of the practice, I did not know if the practice had any impact on his blood pressure. I think it might be helpful to ask with future clients if they would like to have their blood pressure checked before and after a practice. Some clients may want or need to know.