Wednesday, January 4, 2017

Case Study 1 - Elena

Read the three case studies and answer the following questions for each one.

Case Study One: Elena

Elena is 51 and married for the second time. Her 10-year-old daughter is from her current
marriage and her 22-year-old son is from her first. Both Elena and her husband work long
hours at stressful jobs in the field of education. Elena tends to overcommit herself with
work, family, and social responsibilities. This results in a great deal of rushing around and a
short fuse on her temper. She is also in perimenopause. She suffers from migraines, menstrual irregularity, hot flashes, night sweats, mood swings, and a variety of other menopausal symptoms. Her doctor has put her on hormone replacement therapy for her menopausal symptoms and Paxil to help her with the migraine headaches. She is hoping that Yoga therapy will help her control her
menopausal challenges, reduce her reliance on Paxil, and decrease her level of stress.

1. What is your best guess for this individual’s Ayurvedic constitution and present condition? Consider both their prakruti AND vikruti.

My guess is that she is a Pitta

2. How do you see the dosha implicated in the individual’s health concern?
Cues towards the dosha

married twice - Vata or Pitta maybe
stressful job - Common Pitta Condition
overcommits with work, family and social responsibilities - Common Pitta Condition
rushes around - Common Pitta Condition
short fuse on temper - Common Pitta Condition
migraines - Common Pitta Condition
menstrual irregularity - Common Vata Condition
hot flashes - Common Pitta Condition
night sweats - Common Pitta Condition
mood swings - depressed Pitta

3. What specific Yoga tools (asana, pranayama, mudra, relaxation, meditation, etc.) would you recommend to address their health concerns? Why?

a) Practice yoga in a non-competitve, cooling, nurturing, expansive and relaxing way
b) Emphasize the exhalation
c) Practice from a place of creativity and intuition
d) Practice with eyes closed when possible
e) Avoid creating to much heat and sweating
f) Root inhalation at navel center
g) Slow the breath
h) Practice Uddiyana Bandha
i) Incorporate moon salutations, twists, peacock and straight leg variations of standing poses, such as wide legged forward fold, forward bends that stretch the inner and outer legs, tree, triangle and balacing half moon.
j) In the morning, she can incorporate counterbalancing poses for poses that create heat such as sun salutations, arm balances, strong backbemds and inversions
k) Also incorporate calming poses that activate the parasympathetic nervous system such as supported backbends (supine cobbler), cooling inversions (half shoulder stand and legs of the wall and yogassage)
l) Cooling breathing pattern during asana - exhalation longer than inhalation
m) Smooth rhythmic breath during postures'
n) Suspension of breath after exhalation is also good
o) Shitali or Sitkari Pranayama
p) Chandra bhedanan
q) Pratiloma Ujjayi Pranayama
r) Focus on heart chakra to develop compassion and on 6th and 7th chakra to develop intuition, insight and spiritual awareness
s) Use cooling mudras
t) Cooling Imagery: Air, Ether Water or Goddess Guided Imagery or Natural Landscapes, Images of Peace, Harmony or Interconnectedness
u) Toning sounds like "ahhh" and "shh"
v) Meditation is recommended
w) Metta Meditation
x) Abdominal Breathing
y) Nadi Shodhana
z) Vipassana anf Yoga Nidra
aa) Jalashaya Mudra

4. Based on their dosha and their presenting imbalances, how would you recommend they approach the practice of Yoga? Include time of day, season, age of the client, and where appropriate, the koshas, the five elements, and/or the three gunas.

a)l Pitta-type can exaggerate their practice and aggravate imbalances by going towards aggressive types of yoga
b) Avoid heating styles of yoga, pranayama and meditation
c) Guide her away from externalizing and objectifying the Yoga practice

Time of Day for Practice

"Exercising in the morning when it is still cool is best for pitta as it will prevent them from overheating later in the day."


In the morning, Pitta's can incorporate so poses that create heat such as sun salutations, arm balances, strong backbemds and inversions as long as they counter balance them

"(In the evening) It is time to wind down from the days activities. Even though kapha is becoming dominant at this point, the effects of pitta and vata can carry over in the form of an overactive mind. Use this kapha energy to calm over activity and promote relaxation. The evening is a time for nurturing the self."


In the evening, Pitta's should incorporate calming poses that activate the parasympathetic nervous system such as supported backbends (supine cobbler), cooling inversions (half shoulder stand and legs of the wall and yogassage)


"The summer season is ruled by the pitta dosha. Composed of the elements fire and water, pitta is oily, hot, light, spreading, and liquid: Think humidity. This time of year can express in the body as agitation, low digestive fire, sour stomach, and skin irritations. Here are some simple tips to remedy the effects of the pitta season.....Try a restorative or yin yoga practice, both great for cooling the system." (


Elena is transitioning out of the Pitta stage of life (ends at 50) in to the Pitta/Vata stage of life (50-75).

"The late adult phase is called hermitage because in ancient times people left their homes and took up a small hermitage just outside the village, so that they could  live in retirement but still were able to provide help and advice as needed. This stage marks the transition between Pitta and Vata. We are seeking Dharma, honor and truth, and the need for wealth gradually subsides. At this time we show characteristics of both Pitta and Vata qualities and imbalances."

According to Srivitsa Ramawami

"During the early part of life, learning yoga as a physical art form is most beneficial for the self-confidence and discipline it instills. In middle age, yoga should focus on physical therapy and maintaining optimum health as far into life as possible. In the last stages of life, the practitioner will be ready to focus on the ultimate goal--true understanding of the philosophy behind yoga and the realization of truth."


Elena is in a rajasic state right now with her mood swings and short temper


Elena seems most closely connected to the Fire Element


Should not approach too aggressively
Perform asana in a non-competitive way, cooling, nurturing expansive and relaxing
Emphasize relaxing during exhale
Practice in ways that are creative and emerge from intuitive reflection rather than outer drive or competition including working with the eyes closed
Avoid creating too much heat
Root inhale at the navel center, and slowing the breath
Uddiyana bandha is one of the primary practices for balancing pitta
Moon salutations, all kinds of twists, mayurasana, straight legged variations of standing pose (wide legged forward fold, tree, triangle, balancing half moon) Include forward bends that stretch the inner and outer legs
Create counter balancing poses for those that create heat
Include supported backbends - supine cobbler, cooling inverted poses, half-shoulder stand, legs up the wall

long exhale
Suspension of breath after exhalation
Chandra bhedana
Pratiloma ujjayi
Focus on heart chakra to develop compassion and on the 6th and 7th chakras to develop intuition, insight and spiritual awareness

Cooling mudras
Water or goddess imagery
Tones like ah or shhh

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