"Guided imagery is a low-cost diagnostic and therapeutic tool that can help us to see what the MRI fails to reveal and heal what penicillin cannot touch" (Bruce Roberts, Healing Relationships YTT Manual, p.35).

Healing is possible even when cure is not.

Session #1: Assess current stress levels using a single item measure (Stress VAS) & conduct an adapted Healing Imagery Intake (HR Manual, pg.36).
Session #2: Provide Supported Savasana + Guided Imagery tailored to client's specific needs & collaborate with client RE: how / when to use these practices
Follow - Up: Re-assess stress level

Client is in her early 50's. She is juggling the roles of student, mother, and wife while managing perimenopause. Client identifies conflicting priorities, high expectations, and uncertainty about the future as chief sources of stress. She has challenges with racing thoughts (making it difficult to fall asleep) and hot flushes interrupt her sleep (premature waking). She wakes feeling unrested and unsettled making her many daily tasks more challenging to complete..

Goal: Provide client w/Guided Imagery w/Restorative Savasana as a tool for decreasing stress by accessing deep rest.

Session #1: 1) Assess baseline stress level using a single item measure Lesage et al’s (2012) Visual Analogue Scale: “Indicate how stressed you feel on the small ruler” Range= 0 – 100. 2) Conduct Healing Imagery Intake (HR Manual, p. 36) to determine what client experiences as healing/stressful situations, images, scents, sounds.

Intake revealed client preferences include: Blues, greens, water Salt water = healing scents; Most at ease in nature/Enjoys exploring outdoors. Currently relies on self-made imagery for temperature regulation: water flowing over lava rock (See Slide #9 for more).

Session #2: Provide Client w/Restorative Savasana featuring healing guided imagery via curated Yoga Nidra & honor Perimenopause*. Re-assess Stress Level. *See below for HOW.

1) Hatha: RY practices offer our body a chance to guide our brain toward peace via PNS activation. Supta Baddha Konasana (SBK) helps by bringing the chin into flexion (slightly lower than forehead) stimulating PNS & relaxation response (Lasater, p.6). Maintaining a position in-between laying down & sitting up by “Propping the head in ‘straight ahead’ position will help you relax w/o going to sleep” (Lasater, ’17, p. 7).

For this client, given that stress & perimenopause have compromised sleep quality & quantity, propping to a 45-degree angle is critical for obtaining the benefits of relaxation while remaining comfortably alert.

Lasater claims (’11, p.153-8) “SBK benefits = relaxing abdomen, relieves cramps, quiets the mind…places uterus in semi-vertical position, helps menstrual flow move down/harmonizes the apana.”
2) Bhakti: (see below)
3) Hatha: Yoga Nidra (see below)

At Check-In, client relayed highlights from a week full of ups & downs. Self-reported stress was 50 out of 100. We discussed what practice would entail & collaboratively built Supported Bound Angle. Reminded client the goal of RY is not stretch but supported release & she adjusted leg supports accordingly. Guided breath awareness followed, leading into listening to an adapted introduction to Bagalāmukhī, goddess of Perimenopause (Dinsmore-Tuli, p. 379-82; (Slides #4-6). The reading served to bring balance to the client’s frustration w/perimenopause emphasizing the changes are real, powerful, & worthy of acknowledgement--despite society’s ignorance claiming this is a period of loss (Gunter,2021), Bagalāmukhī offers an alternate take: It’s a time to pause, reflect, & (re)claim power. This offering also aimed to give the client’s mind an anchor while in SBK (racing thoughts). (cont’d below)

Transition from SBK to Yoga Nidra: After gentle joint-freeing movement, built supported Savasana (Slides 7-8). Client added eye pillow & blanket on top. Given data from Guided Imagery Intake, I selected a Yoga Nidra practice (H & H in Lusk, 2015) that included “setting sail from a quiet dock, experiencing the sea w/all its beauty & challenges, reaching an island paradise. She was invited to release unnecessary personal “baggage” & return to the dock w/newfound energy.”

Follow-up: Invited client to consider Restorative Yoga, esp. supported savasana + imagery next time she experiences early morning waking. Also discussed ways she could reframe her thoughts/feelings RE: Perimenopause (Raja) by learning more about the Wisdom Goddesses & Bagalāmukhī in particular (Bhakti). In this case, Adapted Bhakti as client is not necessarily comfortable w/“surrender” but is curious to learn more.

Yes & Yes. Client was most in need of rest but had some challenge in “getting there.”
I say goal was achieved because at the end of the session, self-reported stress was 40 out of 100 (10 point reduction!) & client expressed “feeling a little lighter” and genuine curiosity about Bagalāmukhī.

Of note, client went DEEP in Yoga Nidra and took about 3 additional minutes to “return” at end.

Client left session armed with tools and the beginning of the notion that she has the right to rest for her own good (not just the good of serving all around). Client is a conscientious giver who serves family, friends, neighbors, her own clients FIRST and herself last. Perimenopause has forced her to slow down and for the first time she may have seen this as a gift rather than a curse thanks to Bagalāmukhī.

Always.
I learned that this could easily be a 90 minute session depending on the client. Here, 60 minutes was fine since the client had some prior experience with most of the practices offered.

I had prepared to offer a Joint Freeing warm-up prior to the SBK, but after hearing “ The Proposed Plan” client jumped right to building SBK & and said with a grin and gusto “I’m ready to relax!” I honored her preference (over my plan) moving straight to Restorative Yoga + Story Time. She appeared still and breathing steady throughout Part 1 but when I checked in during our transition to Part 2, she reported that her mind was racing at the start and expressed concern that she didn’t “catch all that was saying.”

Lesson learned: Balance honoring client preference w/trusting my gut. For this client, the Joint Freeing (or some gentle movement) prior to RY could have been VERY beneficial.

Next time I’m in this situation, I will applaud the client’s enthusiasm (jumping in/building her SBK) & offer some gentle movement. It’s possible that movement prior to stillness could have discharged some of the tension/racing thoughts she experienced if they were fueled by activation of the sympathetic NS. Addressing stress in the gross body via asana can help make way for addressing stress in the subtle layers (SMTT, 2021)

I think this client benefitted from the Two Part structure. RY prepared her for YN. The structure also meant we had 3 check-ins: start, middle, & end. Knowing what to expect facilitates safety, critical for relaxation. Part of the frustration of (Peri)menopause is the unpredictability. That + lack of control + fear + pain (+misogyny) = a recipe for 20+ years of stress (Gunter, 2021). Having the chance to check in, witness, & adapt throughout practice was key for helping the client re(discover) her peace.
From here, she will remember her true nature is not pain/stress but a peace that begins w/loving & taking good care of herself for her own sake. The client expressed what she appreciated most from this session was feeling cared for. Peace starts now.