Holding space with active listening to assist a client through a difficult time.

The client needs to have a painful medical procedure done. The goal is to meet and provide a safe space for the client to explore her thoughts and feelings about the procedure, as well as provide some tools she can use while she is experiencing it. We will measure her stress level before and after the medical appointment.

The client is a female in her late 40s with a history of heavy bleeding. She was told it could be perimenopause. To try to determine the cause and to rule out more severe diagnoses, she has had to go through multiple invasive and painful medical procedures. With this next visit, not only is she concerned about the procedure itself, but also what the results might mean for her health. Luckily, she has found a new doctor, whom she trusts, and will work with her moving forward.

We planned on meeting before the medical appointment to strategize on how she could maintain her peace during such a painful and stressful event. I hoped to be a sounding board for her to examine her emotions and feelings so she could be calm during the actual procedure. We could start with the Awareness Practice as a way to check in with her current state without judgement. Together, we also wanted to come up with some yogic tools (e.g. pranayama) that she could use before and during the appointment.

Afterwards, we could have a short meeting to analyze how it went. If she received the results before her follow-up medical appointment, we could review it together so she wouldn’t have to learn the results by herself. This session would be more about processing and planning, and less about “doing.”

There was fear about the unknown – the first doctor didn’t communicate and my client had to find out about escalating procedures through the scheduler and by reading her case notes. There was anger about her medical treatment – one technician refused to perform the doctor-prescribed tests, resulting in my client needing to make another visit for the rest of the tests at a medical facility far from her home.

I used Raja Yoga to help my client process the feelings and emotions brought up from this protracted experience. We worked on nonattachment to prepare for the next visit; there was no use worrying about a diagnosis beforehand. Surrender allowed her to release control and trust in her journey through the medical system. We used pranayama to work on her stress levels, allowing her to focus her mind.

My client is a yogi, so is quite self-aware. She was open to discussions of Raja Yoga for working through her feelings about the upcoming medical procedure. We talked about diaphragmatic breathing to reduce her stress and help her body relax during the procedure. She made the suggestion of using a beaded bracelet a friend gave her to help her focus. Another friend had given her a stuffie to hold, but she wisely suspected that it would cause her to tense/squeeze her muscles during the procedure. Her stress level was 8 before the appointment.

During the procedure, she said she used the bracelet as a mala to count her breaths and keep her present despite the pain. Her doctor remarked on how well she did. Her stress lowered to a 4 afterwards.
Update: She let me know that the test results came back negative so she was very relieved and not so nervous about her follow-up.

I advised my client that she should contact me if there is any additional news regarding her test results or diagnosis. In the meantime, if she finds her stress level rising, she can check in with herself using the Awareness Practice as a way to ground herself and take a step back from her emotions. We will check in after her next medical follow-up.

I wasn’t sure what to expect from our meeting, but made myself available to hold space for whatever emotions might arise during our conversation. Luckily it went quite smoothly. She was able to vent her frustrations about the medical system and talk through how she was feeling about the procedure before we moved onto the topics of how she could work through these thoughts. My client was familiar with and amenable to talking about the specific philosophies and themes from Raja Yoga. I do feel that my client felt safe and “heard” regarding her experiences.

Letting go of needing to be prepared for every contingency is a good goal for myself when interacting with clients. Thankfully I have a good relationship with this client and was quite comfortable dealing with whatever might come up. However, with someone I am just getting to know, there might be more nervousness involved. I think allowing myself the freedom to act spontaneously and without judgment will be something to remind myself of for the future.

I wouldn’t change my approach with this client; since I had an existing relationship with her before this series of events, the intensity of feeling and emotions that came up was something I could anticipate. Also, being open to whatever arose was important to creating a space that was safe and optimum for healing to begin.

If I were to interact with a new client, however, I would take extra efforts to make sure I was well grounded and mentally prepared before our meeting. I would want to ensure I had the capacity to hold space securely for both of us. I have not been consistent with creating a grounding ritual for myself before client meetings. I know I will need to do so moving forward not only for the client’s sake in creating a safe, open and nonjudgmental environment, but for my own security as well. This also points to the importance of maintaining my own personal sadhana so that I can come from a strong base of support when interacting with future clients. It is something I continue to work with and refine on a day-to-day basis.

• jwh.2015.5556.pdf
• Effectiveness_of_diaphragmatic_breathing_for.6.pdf