Emotion can be regulated by practicing mindfulness, breathing and reframing thoughts.

The client would like to be able to manage her feeling of guilt and accept ‘what is’. The goal for implementation is to conduct a 60 min session that includes mindfulness practice, breathing and replacing negative thoughts with positive ones.

The client is a female in her 40s. She has been dealing with long Covid-19 that results in chronic fatigue and most recently join pain (after got Covid-19 for the second time). Her physical ability varies from day to day. When the symptom flares up, she is not able to perform normal household chores (cleaning, laundry etc.) and spends most of her time sleeping. Although she has great support from her husband, as a house wife, the client feels that she fails to do her part.

I planed to introduce the client to tools that she can use when she feels guilty/depressed or frustrated. I would begin with check-in to determine the client mental and physical states, then lead her through various practices. Awareness practice is physical and psychological check-in that helps the client to bring her attention to the present moment. The practice also brings calmness and cultivates acceptance to what is (Healing and Relationship Study Guide). I then would introduce the client to 5-4-3-2-1 which is a practice that cultivates mindfulness. This would be followed by extended exhalation with guide imagery to stimulate relaxation response and replace negative emotion with a positive one (Stress Management TT). I then discussed with the client about 'homework'. We would decide on practices that the client could do on her own. I would follow up with her a week later.

I used Raja yoga to support the key teaching. Specifically, I used Pratipaksha bhavana (Book 2, sutra 33) that replace negative thoughts with positive ones. I also relied on Book 2, sutra 42 'By contentment, supreme joy is gained' to cultivate acceptance. Finally, I used pranayama (Book 2, sutra 49) to bring calmness and regulate mental state (shifting from negative to positive emotion).

The client mental state was good (7 out of 10 score). She had researched potential causes of her joint pain. She felt that there were something that at least she could do. Not knowing what causes the pain has given her anxiety. Her physical state was fair (6 out of 10); she had a rough few days before the session. After the awareness practice, the client reported that she was grateful for supports from her family and others. We skipped five sense grounding because the client is familiar with it and has used this tool to support her daughter when she has a panic attack. However, she has never thought of using it herself. The client responded positively to breathing practice and guided imagery; she had a smile on her face while doing it. Her mental state at the end of the session was 8 out of 10 score.

I suggested the client to repeat positive affirmation when she wakes up, even before she gets out of bed. She reported that this helps her starting her day with a good frame of mind. I also suggested the client to try five sense grounding when she is in a negative thought loop. However, she is still struggling with remembering to do the practice. The client reported that she had an appointment with a rheumatoid arthritis specialist who uses holistic approach to address the issue. I suggested the client to check with the doctor about gluten-free diet whether this would help reducing the joint pain.

I applied the intended plan with one exception. Because the client is familiar with the five senses grounding, we did not practice that during the session. However, I suggested that she tried this tool when she need to bring her mind the the present moment. Overall, I think that the goal was achieved because the client felt better mentally after the session. In addition, the client reported that positive affirmation has been very helpful.

I skipped the five sense grounding practice. After I learned that the client is familiar with the practice, I checked with her whether she wanted to do it during the session. The client felt that we could skip it. Because it was a client-center therapy, I decided to forego the practice. This also gave me more time for other practices (breathing and guided imagery) and discussing homework.

Overall, I think the session went well, but I feel that it would be better if I recorded my voice guiding her through the awareness practice as well as breathing practice with guided imagery and then shared that with the client. The client responded positively to the two practices based on her body language (calm facial expression with gentle smile) and feedback. However, it is is unlikely that the client would be able to do them on her own. If the client has the record, she can listen to it whenever she needs.