Ishvara Pranidhana, the last precept of Niyamas (Observance), is a practice of self-surrender, having faith in divine force at work in our lives. This precept invites us to surrender our egos, open our hearts, and accept the higher purpose of our being, and ultimately free us from unnecessary suffering created by the modifications of the mind.

Goal is to allow the client the opportunity for self-reflection through prompted journaling to cultivate a sense of acceptance and surrender. She will practice Ishvara Pranidhana by exploring what the divine force means to her in the vocabulary she feels comfortable with. The progress will be monitored by sharing the experience at the next session.

72 old Asian female. Retired, divorced, and lives alone. Has elevated BP, pre-diabetic, elevated HDL. Limited mobility and ROM present in the right shoulder due to a tear, which details are unknown. Since she retired, her primary passion has been performing and teaching hula dance. The client expressed her challenges and frustration for not being able to dance freely due to her shoulder injury. She attributes the sources of stress to the pandemic and her unspecified anxiety about living alone.

30 min. sessions x 3
- Brief centering, warm-up, and asanas modified for her ailments
- Introduce meditation practice w/an intent of staying in the present and connecting with something greater than she is. Explore together what would help her envision that image
- Nadi Suddhi to be applied to her anxiety. Incorporate Pratipaksa Bhavana (“Exhale resistance/fighting life, inhale acceptance")
- Prompted journaling as an assignment for self-reflection of her life (Prompts in the supplemental doc)

Raja: Ishwara Pranidhana was introduced as a key concept of the session as the ct. explored how self-surrender or having faith can reduce unnecessary suffering. Self-reflection and meditation were utilized. Pratipaksa Bhavana for cultivating acceptance
Japa: Customized mantra repetition leads to an awareness of and attunement to cosmic vibration
Bhakti: Used a Hawaiian deity as a personal deity for mantra repetition, which was relatable to the client
Jnana: Self-inquiry and reflection through daily journaling facilitates seeing self as part of a larger plan
Hatha (pranayama)/Raja: Nadi Suddhi with Pratipaksa Bhavana facilitates identifying emotional blockage or negative quality in her life to be an opposite positive quality. It would also benefit her at the time of feeling anxiety, worry, and stress through PNS activation and by bringing sattvic quality into a rajasic state.

Session 1: Reserved, but with full attention. Expressed judgment and worry re her ability to meditate and to complete other home assignments. Starting with centering and asana (modified sun salute with chair support) appeared to make her feel more relaxed.
Was able to follow instructions for Nadi Suddhi with ease, while presenting with concern about if she is “doing it right”.
For mantra meditation, ct. suggested Pele, a destroyer/creator, similar to the Hindi deity Kali. Seemed apprehensive about journaling when discussing Prompt #1.
Session 2: Reported challenges for pranayama and meditation. Presented with judgment re ability to “quiet the mind”. Responded positively to the reflection/journaling assignment but she held back the details.
Session 3: Reported replacing mantra with humming helped focus and calm the mind. Willingly shared the details of self-reflection

For long-term I suggested the ct. consider regular pranayama and meditation practice to regulate anxiety and agitation, and to keep blood pressure in control. Also suggested she designate a corner of a room for the practice with some inspiring imagery such as nature to evoke a sense of peace. Offered a phone check-in after she returned from a trip in January to answer any questions.

Ct. reported that self-reflection through prompted journaling was the highlight for her. I encouraged her to continue journaling and offered some other ideas for the theme for further exploration of positive aspects in life, such as gratitude or listing positive qualities for a person.

Each plan was applied, with some adjustments along the course. The most successful part was prompted journaling where the client enjoyed the exercise of self-reflection, in which she expressed "gained a renewed perspective on how adverse events in life resulted in producing positive outcomes". In particular, she discussed her difficult divorce and a cultural stigma associated with being a single mother in the 90s in Japan. She reflected that accepting the hardship while keeping her heart open to others ultimately supported her path forward. Ct. summarized as “do the best and leave the rest to the laws of the universe”.

Ct. expressed discomfort of mantra meditation being “a little strange”, so it did not support her exploration of a higher power. However, “humming” meditation along with nadi suddhi appeared to affect her PNS resulted in a decrease in systolic BP by 10-15 mmHg.

Mantra was replaced with humming as a focal point for meditation practice. For those who are not accustomed to practicing spiritual aspects of yoga, repeating mantra can be uncomfortable even they initially agreed to try. Instilling the teaching of Raja Yoga requires creativity and deep thoughts and not merely reframing the language. Meditation with imagery could have been more effective for my ct.

For the pranayama and meditation, we needed to review the setting once we discovered she was doing pranamaya while reading a book for the first few days. Never assume--was the lesson learned. General guidelines (“in a quiet, designated place”) was discussed at the initial session but we could have explored what the setting could look like in her actual living space. Being immersed in yoga lifestyle, it is easy for us to assume people have some basic knowledge about yoga practice.

For those who are completely new to pranayama or meditation, I would provide a handout detailing where, when, how to practice. General guidelines will still be given in the session where my client can ask questions. A list of practical tips would help the understanding without taking much time away from in-person session. As an introduction, meditation practice appeared to have been effective for my ct in making it more accessible, affirming her that one sitting can be as short as a few minutes.

The practice tracking sheet along with the prompt worked well for showing quantifiable results. Contrary to her initial concern about her inability to complete the assignment, she appeared to have been motivated to do it daily. My ct. reported that she went quite deep into self-reflection and the exercise inspired her to do more journaling on her own.

• Raja-TCA-Reference.pdf
• Home-Practice-Progress-Sheet.pdf