TCA StageReport
StudentJoe Duquette
Entry ID5618
Date CreatedFebruary 23, 2023
Date UpdatedFebruary 27, 2023
AdvisorSarala Evans
Core Module NameHuman Body: Ease and Dis-ease

Plan Information

Selected key teaching (specific core concept):

A lack of balance, one of the proprioception disorders, can lead to problems walking up or down stairs, or cause you to fall. I ask myself, “Does working on proprioception affect balance?”, and/or “Does working on balance affect proprioception?”

Goal for implementation with client (Specific, measurable, attainable, relevant, time-bound relating to the client):

N will check for the location of the small of his back by feeling it, or by doing cat-cow to seek alignment, then stand in Mountain Pose, breathing mindfully to become centered, then do a walking meditation across the room, stepping mindfully, to assess his balance. N will do these exercises at home for 10 minutes/day until we meet again.

Relevant Client(s) Details

N is a 76-year-old male from an upper-middle class neighborhood in New York, married with three children, one set of twins. He has made his living as a performing artist, an educator/administrator, and music teacher. He became a grandfather last month, and would like to live long enough to enjoy his new granddaughter for many years. N is morbidly obese, gets very tired, is absent-minded, has medical conditions, hearing and balance issues, and has fallen several times, especially on stairs.

Session Outline
Practice/Activity (5 words or less) Amount of time (in minutes)
Seek back alignment 1 minute
Mountain Pose while breathing Mindfully 5 minutes
Walking Meditation stepping Mindfully 5 minutes

Report Information

How did you envision working with the client(s) to incorporate the selected teaching? (Define the plan)

1. Seated, seek back alignment - Check for the location of the small of the back by doing the cat-cow exercise, and come back slightly from cow to seek alignment and a lengthened back.

2. Seated Breath awareness for 3 minutes – Become aware with the inner eye of inhaling and individually filling the abdomen, middle chest, and upper chest, then exhaling and deflating in the opposite direction.

3. Stand in Mountain Pose, breathing mindfully, as he did seated, to become centered for 5 minutes.

4. Do a Walking Meditation across the room, stepping mindfully, to assess balance.

5. After finding his balance, Add a word-affirmation with each step.

6. N will do these exercises at home for 5 minutes/day until we meet again.

What branch(es) of IY did you use? How does each support your goal/relate to the key teaching?

Hatha Yoga – Back alignment gives us good posture, seated and standing breathwork calms, centers and balances us. I could have added a short Yoga Nidra – I will do that in the next session.

Raja Yoga - Walking meditation allows us to step mindfully and strengthens concentration.

Jnana Yoga – I touched on Ayurveda when I mentioned the “Crimes of Wisdom” and being an educator, this really excited N and he wants to know more.

N states that he is not religious or spiritual, and that he does not believe in God, but I’ve known him for a long time and I’m not really sure about that, so I keep to Hatha, Jnana, and the basics of meditation and mindfulness of Raja.

Short notes on time with client:

N is very receptive to new ideas and is anxious to try any ideas for increasing his physical balance, though balance in other areas would be ripe for future sessions.

Follow up suggestions for your client (whether with you or on their own):

First session:

Sitting, align your back 1 minute
Sitting, become aware of your breath 3 minutes
Stand in Mountain Pose while breathing mindfully 3 minutes
(Build to 5, then 10)
Do a Walking Meditation while stepping Mindfully 3 minutes
(Build to 5, then 10)
Word-affirmation with each step after walking is steady 3 minutes
Sitting back in chair, close eyes, review how you feel 2 minutes

Second session:
!. Keep the same exercises
2. Visualize your axial skeleton gliding through space, not swaying; only your arms and legs move
3. Rather than having your arms stiff by your side, begin to alternately swing them forward and back
4. Think “LIFT” You may lift somewhat, but you are not consciously initiating it

The Axial skeleton - The head, neck, back, and chest
The Appendicular skeleton - The upper and lower limbs, the bones that attach them to the axial skeleton

Reflection
Did you apply your intended plan once you met with the client(s)? Was the goal achieved? Explain.

Yes. In addition to homework, I have included links to some research articles to loss of hearing and falling.

N said: “Clearly, the Walking Meditation relating to balance has helped his balance.” In my homework, I gave the instruction to alternately swing his arms which might curtail or stop the swaying

At our next session, I will ask N to show me how he walks up and down the stairs, and maybe it will give me an opportunity to give him some other ideas for achieving balance in this activity. We will also continue to evaluate progress made.

(See more in summation section.)

Did you have to adapt anything in your plan? What lessons did you learn?

N did not understand the extremely reflective questions in my Selected Key Teaching and, actually, I was not crystal clear myself, so I will know better next time before phrasing my question(s). I rephrased the questions by adding one word: “Does knowledge of proprioception affect balance or does balance affect proprioception?” and asked him again at our next session. Though I better understood what I was asking, N still did not grasp what I was going for, was becoming frustrated, in addition to his not being able to walk without swaying. I decided to eliminate that line of questioning.

N said that I gave him perspective, a different way of experiencing life, the Walking Meditation and Standing also made him more aware of where he was, and it has helped his balance. N says he is profiting from my exercises, insightful ideas, and is thankful for my concern about his personal life.

If you are faced with the same situation again in the future, would you approach it in the same way? Why or why not? What went well? What you might change and why? Summarize.

N’s wife and gym trainer have both commented that he does not walk properly, so I’m not telling him anything new. He felt frustrated that he could not do the walking meditation without shifting, says he thinks that maybe he just has a certain gate, or one leg is shorter than the other, which tells me that he is listening mindfully.

I will not ask N another question referring to my core concept, though I have now re-worded my question into two parts: “Does knowledge of how proprioception works help your balance?” and “Does balance help you visualize and be aware of your proprioception?” My initial answer to both of these questions is yes. In the first instance, knowledge of proprioception gives one a concept, a framework of how one has the ability to realize that one is usually moving through space unconsciously (unless one has a health obstacle and is maneuvering very consciously), which I would assume leads one to better balance, and on the other hand, to consciously strive for the best balance possible, and to internalize that consciousness in order to make it unconscious, is a worthwhile practice, which in the doing of the practice, is answering the second question as well.

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