By implementing the breath practice of extended exhalation, my client can shift from a sympathetic response to a parasympathetic response and better respond to stressful situations.

The client will do 10 minutes of pranayama practice every day for a week consistently.

Male, 48, no chronic health concerns other than high blood pressure (not disclosed if controlled by medication). At one time used tobacco products, has been alcohol free for almost 18 months. Does vape cannabis for stress relief. Feels work to be main source of stress. Also battles anxiety and depression.

The client loves to learn all that he can about physiology, and to understand the "why" behind any practice. Knowing his enjoyment of discussion, I intended to share an overview of the stress response, highlighting the sympathetic and parasympathetic nervous systems, and how pranayama practice allows us to influence a shift towards parasympathetic activation.

Again, knowing his enjoyment of discussion, I wanted to include some asana practice. While his work could be described as physically demanding in his role as a maintenance technician for a local fitness company, his duties placed him in what he described as "awkward body positions" that left him physically, mentally, emotionally and spiritually drained at the end of each day. Despite holding certifications in personal training and holistic nutrition, he lacked motivation to pursue any mindful movement.

The client has a deep appreciation for holistic nutrition and wellness. He also has developed a recent passion for plants, having started fruits and herbs from seed. I introduced the eight limbs of yoga using the metaphor of a tree, and encouraged him to begin his practice by cultivating deep roots of yama and niyama. I referred to the first yama of ahimsa as the "taproot" that will nourish the rest of his practice and development of the remaining "branches" that will become his tree of practice. We began exploring three asana poses: tadasana, sukhasana, and savasana. I encouraged him to explore each pose, allowing as much movement as he felt he needed, then exploring stillness in each pose - allowing all of it to be guided by the breath. I encouraged him to notice as much as he could about the breath in each pose - where he felt the movement, and what was unique in each pose.

After initial practice of the three mentioned asana, the client commented that he "felt more energized than he had felt all day," and more so that he usually did following his daily afternoon nap. After about a minute of simple breath awareness in each pose, I encouraged him to try 3-5 breaths of the extended exhalation practice in each as well. It proved to be a very accessible and enjoyable practice for him.

I encouraged him to continue his practice, and to develop his sadhana. His after work afternoon routine consists of a 20-30 minute nap, followed by gaming on his PlayStation, which he purchased in 2020 during quarantine. Prior to our sessions his only yoga experiences had been in gym classes where we work, so one piece of homework I gave him was to choose one asana he enjoyed from each of the following categories: forward bend, backbend, lateral bend, inversion, and rotation. His initial responses were: tadasana with a lateral bends, ustrasana, uttanasana, setubandha sarvangasana, and supta matsyendrasana. I encouraged him to explore these as a sequence, spending as much time as he wanted in each pose, exploring whatever movement felt needed in each one, and most importantly, focusing on allowing the breath to guide each exploration.

Yes, and yes. The initial exploration of three asana rekindled his interest in practice. Prior to COVID he had started practicing, and had lost motivation with the return to work and the stress of a job he no longer enjoyed. Not only did he utilize the extended exhalation practice, but also began practicing nadi suddhi and ujjayi breathing. He started taking classes twice a week, and getting back in the pool once a week.

The client loves to think, to the extent of overthinking with little or no action in different areas of his life, all of this by his own admission. My initial suggestion of ten minutes of daily pranayama practice was too much to begin. Knowing the ultimate goal is for him to develop a daily sadhana that he can practically maintain, and even more, anticipate and enjoy, we needed a smaller first step. Together we decided the goal would be two minutes of pranayama, two minutes of meditation, and two minutes of journaling. The first week he completed the practices four times. He also found opportunities during the workday to practice extended exhalation when he felt stressed or anxious.

Yes, and no. Much like my client I too tend to overthink and overprepare. My initial plan was too aggressive and demanding for where he was at the time. While his completing an intake form prior to the initial meeting was very helpful, I did not have a separate conversation with him about how he saw the purpose of yoga therapy and what he specifically hoped to gain from it. We could have talked about this prior to the meeting, or I could have scheduled some extra time at the start of the session to discuss and plan.

Knowing that every client and every session will be unique, I believe that I will always need to adjust my plan as each session unfolds. The practice of yoga therapy requires me to be fully present in the moment so that I can be sensitive to the needs of the client, and just as with my personal sadhana, I hope I am always adjusting to the needs of each experience.

For the purpose of the TCA, having a close friend participate offered countless opportunities to have more in-depth discussions on yama and niyama, and regular attendance of some of my weekly classes. But when it comes to the relationships with future clients, I believe I will need set boundaries.