Incorporating the Hawaiian ho'oponopono prayer (I'm sorry, please forgive me, thank you, I love you) into a daily yoga therapy plan to reduce anger.

Goal is to reduce a client's anger within 7 days. Client will engage in the yoga therapy protocol twice a day before repeating the prayer for ten minutes. Client will end each day with an entry in an anger journal; we aim to reduce the client's anger level by 15% as measured by the clinical anger scale.

Male, 31, depression, mild intermittent explosive disorder, low back pain. Client has three kids and a wife and lives with his parents; he reports that his anger is a large contributor to his depression and has caused issues in relationships with his family. Client was once a promising soccer player that also deals with lower back pain, which contributes to his anger.

I envisioned the two of us starting his yoga therapy journey by reviewing and briefly discussing his intake form. We would then go over studies from Pubmed showing how yoga can help to reduce anger. Next, we would reframe yoga therapy into plain language (client is Christian) before discussing the Clinical Anger Scale, journaling process, and treatment goals. After laying the basic framework and answering questions, we would move into the yoga therapy protocol: the various movements and how they will help his lower back pain, the resonance breathing exercise and the ho'oponopono prayer. I wanted to make sure he would be ok with the prayer by allowing for modifications to make it more Christian-friendly. After the yoga therapy session, I planned for us to discuss how everything felt and see if any adaptations were called for. Finally, we would review the journaling process.

The branch of yoga most utilized here is Bhakti Yoga, as the protocol has strong overtones of love, devotion, compassion, and related emotions. Before this module, I didn't realize how harmful anger could be for mental health. Bhakti Yoga relates to the key teaching of using prayer to overcome negative emotions.
I used Raja Yoga in the use of asana and pranayama. Anger is a visceral emotion; one way to combat it is on the level of the gross body through movement and breathing. Hatha Yoga was also utilized this way.
I used Jnana Yoga in our discussion of the medical literature. Education/wisdom can also improve mental health outcomes, and the prayer can bring about feelings of unity consciousness.
I used Japa Yoga with our repetition of the phrase associated with the ho'oponopono prayer. I chose a prayer that I felt would be especially helpful for anger.

Working with this client did not follow the process I had imagined. The client was not very interested in discussing himself or how yoga is shown to improve anger in the medical literature. He did not find any issue with yoga and his Christian faith. He very quickly grasped the journaling and the clinical anger scale after acknowledging that his anger was a big problem. The session became very movement heavy very quickly, as soon as I mentioned the first movement we would be doing and tried to discuss the benefits, he started moving and asking questions. He continued to move, and then moved more as I gave him permission to explore his physicality. I had to encourage him to slow down, I didn't want him to aggravate his back pain. He got very into the prayer portion of the protocol, and spontaneously added "Christ loves and forgives all" to the end of the prayer after the first repetition.

I would advise the client to continue with the protocol and SLOWLY expand his movement practice. He was surprised to find out how much better he felt after moving and stretching, and was thrilled to be able to do it all with no equipment. I would counsel that he focus on being conscious of the movements in the body and the level of tension in his various muscles so he doesn't overdo it. The prayer turned out to be very effective for him, I would advise he continue to use it and add to it. He reported that he found himself repeating it several times randomly throughout the day, and he was happy to have it "stuck in his head". I would also suggest that he not give up on the breathing exercises; he admitted that he found himself cutting resonance breathing short or skipping it altogether. I would like for him to incorporate basic alternate nostril breathing and box breathing.

I feel that I did apply my intended plan, though the timeframe that I had in mind for each part of the protocol did not align with my plan. I do feel that the goal was achieved, although the client admitted to me that he did not answer all 21 questions of the clinical anger scale each day, because he felt that it was too time consuming. Instead, he answered 7 of the questions, then totaled that score and multiplied that by 3. Based on his scoring, his anger went from a 33 out of 63 (52%) before our first session to a 20 out of 33 (32%) after our last, a 20% improvement. He felt that the yoga was very helpful to decrease his anger in the short term, and he was having fewer outbursts, but throughout the day his anger would slowly come back. He felt that the prayer had a cleansing effect on him, and he especially loved his addition of "Christ loves and forgives all".

I did have to adapt my plan, yet again. This is not the first time a client has gotten very engaged in a particular piece of the protocol - in this case, the movements. I learned that I should have backup movements in mind in order to be able to adapt in the moment, while at the same time finding a way to encourage clients to transmute their physical energy into energy that goes towards more subtle practices. Movement is fun and "shiny," while subtle practices might seem dull by comparison to some, so I think it would be useful to devise some more dynamic, fun guided meditations for those that have trouble sitting still.
I also learned that the scale that I used this time was too lengthy and led to a compliance issue. I do think it's useful and important to implement metrics to measure progress, but I need to be mindful of how much time I'm asking clients to commit.

I do think that I would mostly approach this the same way in the future, with a few additions. I think it would be best to overprepare for each aspect of the protocol, as this particular client was very fixated on the movement aspect of the practice, but I've had clients in the past who were more interested in talking about science, yogic philosophy, or breathing. If I have some related information and/or plans in mind for each aspect of the protocol, it becomes less likely I'll feel suddenly unprepared by a client's desire to dive deep into one aspect in lieu of others.
I think the prayer went very well, and I plan to add a prayer/mantra/affirmation as a standard in my protocols moving forward, in case clients take to it like this particular client did. We found that having a basic foundation along with freedom to personalize made a big difference in the experience.
The biggest takeaway for me was the need for me to be more mindful of compliance when setting up progress tracking. This client is a longtime friend of mine, so he felt comfortable admitting to me that he didn't do the whole CAS scale every time, but other clients might just skip it and say nothing instead.