Yoga Therapy Class for Kyphosis

1. EDUCATIONAL SECTION

ANNAMAYAKOSHA:
In the panchakosha system the the annamayakosha is the physical body,  Kyphosis on a physical level is a forward rounding of the back. Although, some rounding is normal, "kyphosis" usually refers to an exaggerated rounding of the back. While kyphosis can occur at any age, it's most common in older women. Other names for kyphosis are  Hyperkyphosis, Roundback; Dowager’s Hump. Hunchback and Postural kyphosis

Age-related kyphosis often occurs after osteoporosis weakens spinal bones to the point that they crack and compress. Other types of kyphosis are seen in infants or teens due to malformation of the spine or wedging of the spinal bones over time.

Mild kyphosis causes few problems, but severe cases can cause pain and be disfiguring. Treatment for kyphosis depends on your age, the cause of the curvature and its effects.

The individual bones (vertebrae) that make up a healthy spine look like cylinders stacked in a column. Kyphosis occurs when the vertebrae in the upper back become more wedge-shaped. This deformity can be caused by a variety of problems, including:

Osteoporosis. This bone-thinning disorder can result in crushed vertebrae (compression fractures). Osteoporosis is most common in older adults, particularly women, and in people who have taken high doses of corticosteroids for long periods of time.

Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks dry out and shrink, which often worsens kyphosis.

Scheuermann's disease. Also called Scheuermann's kyphosis, this disease typically begins during the growth spurt that occurs before puberty. Boys are affected more often than are girls. The rounding of the back may worsen as the child finishes growing.

Birth defects. If a baby's spinal column doesn't develop properly in the womb, the spinal bones may not form properly, causing kyphosis.

Syndromes. Kyphosis in children can also be associated with certain syndromes, such as Marfan syndrome or Prader-Willi disease.

Cancer and cancer treatments. Cancer in the spine can weaken vertebrae and make them more prone to compression fractures, as can chemotherapy and radiation cancer treatments.

An increased curve in the upper spine also can be caused by slouching. Called postural kyphosis, this condition doesn't involve any deformities in the spine. It's most common in teenagers

In some cases, the misalignment of the spine can lead to pain, which can become severe and disabling.

Decreased appetite. In severe cases, the curve may cause the abdomen to be compressed and lead to decreased appetite.”

PRANAMAYAKOSHA

Pranamayakosha is the breath and energy body. Kyphosis of thoracic spine can make it difficult to breath and affect the function of the heart.  Decreased lung capacity is a possible complication of kyphosis. Fatigue is also a symptom.

MANOMAYAKOSHA

Manomayakosha is the psycho-emotional body. Kyphosis can lead to body image problems. Adolescents especially may develop a poor body image from having a rounded back or from wearing a brace to correct the condition.  These psychological effects may persist for years after patients have had treatment, or surgery.

http://www.oandp.org/olc/lessons/html/200407-20/section_16.asp?frmCourseSectionId=3572B3C1-48C6-4F38-9991-F41DA4528D53

I also ask myself can I poor self esteem lead to rounding of the back.  The desire to collapse in and protect ourselves?

As humans we walk upright. This uprightness exposes the vulnerability of the human organism
In the animal world, the soft and vulnerable parts of the organism are close to the ground, protected by the hard back and the limbs. Most animals meet the world protected. As humans we meet the world exposed and upright. The upright stance exposes the soft front to the environment, increasing the surface area of the nervous system and adding to the information provided by the senses of the head – the eyes, ears, nose.  Kyphosis, a condition where we collapse in helps us protect our exposed self.


VIJNANAMAYAKOSHA

This is where the mind is the ‘witness’, observing behaviors, understanding where we are not our personality.  Herein lies an opportunity to reframe one’s core beliefs.

Through yoga therapy we can work on understanding the strengths and weakness of  the physical chest and well as the emotional and astral chest. Using asana, pranayama, yoga nidra and meditation to witness and perhaps heal the samskaras that is preventing the heart to stay open and the chest and shoulders to collapse in and forward,


ANANDAMAYAKOSHA
Anandamayakosha is a state of being or state of meditation where we recognize bliss and ease of well-being. Our natural state of wholeness where separation and confusions are not present.

Meditation on physical, pranic, emotional and spirtual expansion may bring the client back to wholeness and experience joy.


2. BODY AWARENESS (ADAPTED SCRIPT FOR THE BACK AND SPINE FROM CHAPTER 2 THE IYT STUDY GUIDE)

Come to a comfortable position – seated in a chair, lying on your back in savasana or constructive rest, or sitting on the floor with the back against the wall.


Allow the eyes to close and focus your awareness on the feelings and sensations in the body.

I will lead you on a guided journey through the body. As I guide you through the different parts of the body, become aware of each as fully as you can. Notice which parts of the body feel open and relaxed, and which feel tight or contracted. Bring your awareness to your left fingers and feel them fully, noticing all the sensations there.

Bring awareness to the left hand and feel them fully, noticing all the sensations there.
Bring awareness to the left lower arm and feel it fully, noticing all the sensations there.
Bring awareness to the left upper arm and feel  it fully, noticing all the sensations there.
Bring awareness to the left shoulder and feel it fully, noticing all the sensations there.

Bring awareness to the right hand and feel them fully, noticing all the sensations there.
Bring awareness to the right lower arm and feel it fully, noticing all the sensations there.
Bring awareness to the right upper arm and feel  it fully, noticing all the sensations there.
Bring awareness to the right shoulder and feel it fully, noticing all the sensations there.

Bring awareness to the left toes and feel them fully, noticing all the sensations there.
Bring awareness to the left lower leg and feel it fully, noticing all the sensations there.
Bring awareness to the left upper leg and feel  it fully, noticing all the sensations there.

Bring awareness to the right toes and feel them fully, noticing all the sensations there.
Bring awareness to the right lower leg and feel it fully, noticing all the sensations there.
Bring awareness to the right upper leg and feel  it fully, noticing all the sensations there.

Bring awareness to the hips and feel them fully, noticing all the sensations there. Notice the right hip . . . the left hip . . . is there any difference between the sides?  Notice the front of the hips . . . and then the back of the hips. , , notice the entirety of the hips and all the sensations.

Bring awareness to the pelvis leg and feel it fully, noticing all the sensations there.

Bring awareness to the left buttocks and feel  it fully, noticing all the sensations there.
Bring awareness to the right buttocks and feel  it fully, noticing all the sensations there.
Notice any difference between the left and right buttock.
Now bring awareness to the entire buttock, noticing all the sensations there.

Bring awareness to the left side of the back and feel  it fully, noticing all the sensations there.
Bring awareness to the Right side of the back.and feel  it fully, noticing all the sensations there.

Bring awareness to the Lumbar vertebrae, the five vertebrae between the rib cage and the pelvis and feel them fully, noticing all the sensations there.
Bring awareness to the Thoracic vertebrae, the upper- and middle-back. It joins the cervical spine and extends down about five inches past the bottom of the shoulder blades, where it connects with the lumbar spine and feel them fully, noticing all the sensations there..
Bring awareness to the Cervical vertebrae, vertebrae in the neck spine and feel them fully, noticing all the sensations there.
Bring awareness the whole of the spin and feel it fully, noticing all the sensations there...

Bring awareness to  the whole of the back and feel it fully, noticing all the sensations there.
Bring awareness to the Abdomen  and feel it fully, noticing all the sensations there.

Bring awareness to the low back and feel it fully, noticing all the sensations there..
Now bring awareness to both the abdomen and low back and feel it fully, noticing all the sensations there.

Bring awareness to the Solar plexus and notice what sensations are there
Bring awareness to the mid back and notice the sensations there, and feel it fully.
Now bring awareness to both the solar plexus and mid back and notice what sensations are.

Bring awareness to the Chest, feel it fully, and notice the sensations
Bring awareness to the upper back, and feel it fully and notice the sensations.
Now bring awareness to both the chest and upper back, and notice the sensations
Bring awareness to the Throat and feel it fully and notice these sensations
Bring awareness to the cylinder of the neck – the front of the neck, the sides of the neck and the back
of the neck.

Bring awareness to the Head, examine the head mentally, feel any sensations there
Notice the jaw , feel it fully, noticing any sensations.
Notice the mouth, feel it fully, noticing any sensations
Notice the eyes, feel it fully, noticing any sensations
Notice the forehead, feel it fully, noticing any sensations
Become aware of the scalp, feel it fully, noticing any sensations

Bring the awareness to the Left side of the body, feel it fully, noticing any sensations
Bring the awareness to the right sides of the body, feel it fully, noticing any sensations.

Bring awareness to the Front of the body, feel it fully, noticing any sensations
Bring awareness to the back of the body, feel it fully, noticing any sensations.

Bring Awareness to The whole body, feel it fully, noticing any sensations.

FOLLOW UP ACTIVITY: BODY MAP AND DISCUSSION

First the client will fill out the body map
After the client is done the client and yoga therapist will discuss the map

3. INITIAL BREATHING EXERCISE – SPINAL BREATHING

Breathing in the Spine
One excellent way to become more aware of, and more centered in, the spine is through learning to breathe in the astral spine

Sit upright with a straight spine.

Visualize the spine: Touch the tip of the tailbone (coccyx) with one forefinger, and the medulla oblongata area with the other.
upward movement of energy, while the downward wave of relaxation on the exhalation coincides with the down-ward movement of energy in the spine. The physical expansion and relax
Visualize a hollow tube, about as big around as your thumb, connecting those two points, and energy flowing up through that tube with each inhalation, and down with each exhalation.

Next move the first finger to the spiritual eye and visualize breathing through the entire astral spine: from tailbone to medulla, then bending forward to the spiritual eye. Relax the hands to the lap and continue the breathing and visualization.

Use the Full Yogic Breath pattern: the upward wave of expansion in the torso on the inhalation
coincides with ation will help students tune into the energy movements.

Ujjayi breathing is an option: the constriction at the back of the throat slows the breath and helps draw one’s attention to the spine (since the back of the throat is very near the cervical spine).
“Spinal breathing” can help students focus on — and center in — the astral spine.

4. MUDRA

In a comfortable seated position for, Urdhvam Merundanda Mudra, the Gesture of the Upper Spine.
This mudra cultivates opennes, optimism and enthusiasm. Its core quality is expansiveness. It releases tension from the upper back, especially between the shoulder blades

The affirmation of this mudra is: “Breathing freely in the back of my body, I open to my infinite possibilities.”

Work with repeating the affirmation 3 x: Once aloud, once as a whisper, and once silently.

5. ASANA PROGRAM

According to yoga therapist Terry Smith, Ph.D., co-founder of the Healthy Back, Healthy Body program, a yoga therapy program for hyperkyphosis should contain several components. It must strengthen weak core muscles, open and realign the heart and chest area to improve and reverse the hunched back and rounded shoulders, and at the same time restore alignment by building greater awareness of how the person holds their body. Particularly useful to reverse dowager’s hump are yoga poses that target the muscles and joints most affected by hyperkyphosis, including shoulders, spinal erectors, abdominals, and neck.

WARM UPS
- Joint Freeing Series with emphasis on the spine (Joint Freeing Series 6,7,8,12,13,14, 15-21)
- Myofascial release on the thoracic spine with Yoga Tune Up Balls and foam roller

CORE STABLIZATION (child’s pose between each posture)
- Pelvic Tilt Lying
- Pelvic Tilt on All Fours
- Bird Dog
- Plank or Modified Plank
- Forearm Plank or Modified Forearm Plank
- Side Plank or Gate Pose
- Dolphin
- Boat Pose or Yoga Sit Up
- Single leg raises

ASANA
- Tadasana with alignment cues and spinal breathing
- ½ Moon Pose
- Sun Salutations – Sivananda Lineage (using knees chest and chin/8 limb pose)
- Triangle
- Standing Bow Pulling Poses aka Dancer
- Stork with Possibility to move to Toe Finger Posture
- Tree
- Janu Sirshasana
- Cobra
- ½ Bow
- Full Bow

COOL DOWN – RESTORATIVE POSES

- Flamenco Pose with a strap or toe to finger depending on flexibility
- Sphinx Pose or Aligator if Sphinx is too agressive
- Supta Baddha Konasana with props
- Moving Bridge to Supported Bridge to Supported Shoulder Stand with a Block
- Constructive Rest on a Foam Roller
- Apanasa to Spinal Twist – Reclined
- Stick Pose Supine aka The Great Stretch

6. PRANAYAMA
- Diaphragmatic Breathing in Constructive rest with hands on the belly
- Breathing in an out of the nostrils (ujjayi)
- On the inhale the belly rises like a balloon on the exhale the belly falls
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7.PRATYAHARA/ YOGA  NIDRA or GUIDED IMAGERY

8 STAGE YOGA NIDRA FOR THE KYPHOSIS
(STAGE 1 - INTERNALIZATION)

 (Setting Up):  If you have a cell phone make sure it is off.
Prepare for the practice of Yoga Nidra by lying on your back in Savasana – if this is not comfortable you can try putting a pillow under your head or if back hurts bend the knees or try putting pillow or blanket under knees. If you are pregnant please lie on the side in a fetal position.  You can also sit in a chair, on the floor with the back against wall.

You might want to have a blanket because the body temperature tends to drop during Yoga Nidra.

Also put a blanket under any area that is sensitive.

Try to be as aligned and symmetrical from feet to head. Feel your spine aligned. In shavansasana, arms are away from sides palm up or down.  If anything is on you tight like glasses or a wrist watch you can take it off.  Eyes should be closed to avoid visual distraction. .  Say to yourself mentally “I am practicing Yoga Nidra for the chakras. . . I will stay awake for Yoga Nidra for the chakras” …..

(Relaxation): Take a full breath in with the exhalation think the word “expansion”. Do this at least 2 more times…. Become aware of the body relaxing. Feel supported across the whole body. Feel the feet supported, Feel arms and hands supported, feel the legs supported, feel the shoulders and head supported. Feel every place where the body is supported and allow yourself to release more deeply.

 Let go of all effort of holding the body.  For a short time notice the rhythm of the breath.

Be aware of distant sounds.  . . sounds outside the room . . . sounds inside the room . .. sounds of the body… Become aware of the sound of your breath.

In Yoga Nidra, it is best if the body remains still.  If you become uncomfortable you may move but come back to stillness as soon as you can.  Say to yourself mentally “I will remain still for Yoga Nidra.” (pause)

(STAGE 2 - SANKALPA)

It is time for the Sankalpa.  A sankalpa is  a short positive statement in the present or future tense. It is a resolve, intention affirmation.  If you do not have yet have a sankalpa use the resolve “I will find the right sankalpa for me” Repeat your resolve 3 x each time with exact same wording and the confidence that it will come true..

(STAGE 3 - Rotation of Consciousness):

Moving on to the rotation of consciousness through the body.  The body remains motionless. When a part of the body is named either repeat the name of the body part in mentally, bring awareness to the part of the body, or visualize the body part. We will begin on the right hand side body.

Right hand thumb, index finger, middle finger, ring finger, pinky finger,  palm of the hand, back of the hand, wrist, lower arm, elbow, upper arm, shoulder, arm pit, right side of the ribcage, waist, hip, upper leg,  kneecap, lower leg, ankle,  heel, instep, sole of the foot, top of the foot, the right big toe, 2nd toe, third toe, fourth toe, fifth toe

Bring awareness to the left side of the body starting with the left thumb. Left hand thumb, index finger, middle finger, ring finger, pinky finger,  palm of the hand, back of the hand, wrist, lower arm, elbow, upper arm, shoulder, arm pit, left side of the ribcage, waist, hip, upper leg,  kneecap, lower leg, ankle, heel,  instep, sole of the foot, top of the foot, the left big toe, 2nd toe, third toe, fourth toe, left 5th toe. Stay awake.

Bring awareness to the top of the head, the forehead,  right temple, left temple, the right eyebrow, the left eyebrow, eyebrow center, the right eyelid, the left eyelid, the right eye, the left eye, the right ear, the left ear, the top of the nose, the right nostril, the left nostril,  the right cheek, the left cheek, the upper lip, the lower lip, teeth, tongue, jaw, front of the neck, right collar bone, left collar bone, the hallow between the collar bones, right chest, left chest, center of chest, upper  abdomen, navel, lower abdomen, pelvis, buttocks, lower back, middle back, upper back, the entire spinal column, right shoulder blade, left shoulder blade, back of the head, top of the head. STAY AWAKE
 (pause)

Bring the awareness to the spine

Become aware of the medulla oblongata and to the spinal cord
Starting from the cervical vertebrae at the base of the skull
Move inside each vertebra and the disc below it.

Count out each vertebra and disc:
seven cervical  vertebrae at the neck
c1
c2
c3
C4
C5
C6
C7

twelve thoracic at the chest
t1
t2
t3
t4
t5
t6
t7
t8
t9
t10
t11
t12

five lumbar at the lower back
l1
l2
l3
l4
l5

the triangular bone called the sacrum
the coccyx or tail bone.
Feel the spinal cord and the back becoming loose and comfortable.
Feel the discs softening.
Feel your spine expanding and elongating, making you taller

(pause)

Now bring the awareness to
The whole Right Arm
The whole Left Arm
The whole Right Leg,
The whole Left Leg
The Whole Front of the Body
 The Whole back of the body
The Whole Spine
The whole body together
The whole body together
The whole body together
Not let go of the body scan and come back to natural breathing

(STAGE 4 - Breath Awareness)
Once again visualize breathing in the Spine

Become aware of the tip of the tailbone, the bottom of the spine called the coccyx and then the top of
the spine the medulla oblongata at the back of the sprain and top of the neck.

Visualize a hollow tube, about as big around as your thumb, connecting those two points, and energy flowing up through that tube with each inhalation, and down with each exhalation.

Begin to breath from the tailbone to the medulla oblongata

With each inhale the breath moves from the tailbone to the medulla oblongata and with each exhale the breath moves from the medulla oblongata to the tailbone

 Continuing counting backwards from 18 to 0 with awareness of the breath moving from tailbone to medulla oblongata and the medulla oblongata to the tailbone
If the count is lost begin again at 18 (pause)

If the count reaches zero start again at 18 (pause)

Stay with the counting (pause)

Stay with awareness of the breath moving from tailbone to medulla oblongata and medulla oblongata to tailbone (pause)

Stay awake and aware (pause)

Now let go of the counting and let go of awareness of the breath at moving from the tailbone to medulla oblongata and medulla oblongata to tailbone and come back to natural breathing

Bring awareness to upper back behind the chest.  This area is associated with the heart chakra.  The sacred sound of healing from the heart chakra is YAM (pronounced Yum)

Begin to inhale and exhale the mantra YAM – inhaling YAM and exhaling YAM mentally

If this doesn’t seem appropriate you can also continually chant the mantra YAM
(stay with the practice of chanting YAM)
(1 minute)

The neck is associated with the throat chakra.  The sacred sound of the throat chakra is HAM (pronounced hum)

Begin to inhale and exhale the mantra HAM or chant continuous hum, hum, hum, hum
(stay with the practice of chanting HAM)

(1 minute)

Now let go of the mantra practice and come back to natural breathing

(STAGE 5 - OPPOSITES)
(HEAVY)
Bring awareness to the spinal column.
Feel only the spinal column and no other part of the body
Imagine the spinal column very heavy
the coccyx center is heavy, the sacrum is heavy, the solar plexuses are heavy, the heart is heavy, throat is heavy, the  third eye is heavy the crown of the head heavy is heavy. The whole spine is heavy the whole spinal column is heavy as if were made of lead
Let go of heaviness and go to the opposite sensation of lightness

(LIGHT)
imagine the spinal column light the crown of the head is light, the third eye is light, the throat is light, the heart is light, the solar plexuses are light, the sacrum is light, the coccyx is light.  The spinal column is light as if it could rise above the floor light a feather.  The whole spine is light
Light go of lightness and

(STAGE 6 - VISUALIZATIONS)
Bring the awareness to the chidakasha the mind space in front of the closed eyes.

Notice if there are in colors or patterns there.

Let the awareness be at the chiddakasha, the mind screen, the mind move and in that space

Visualize the backbone. Let the backbone be straight and aligned. Visualize it, see it, and just in the middle of it visualize a nerve, delicate as the lotus thread, running in the center of your spinal column...

In the spine, just in the center, there is a silver cord – a very delicate nerve. It is not really a nerve in the physiological sense.

If one performs and operation to find it; it will not be there. But in deep meditation it is seen.

Through that thread we are related to the body, and through that thread also we are related to our soul.

First, visualize the spine, seeing the spinal column...

See the body structure from within.

See your bones, blood, veins,

Come inside the body

Relax.

Concentrate on the spinal column

Allow the body to relax and feel the breath moving like a gentle wave through the body.

Allow the breath to move into any remaining areas of discomfort

Notice which area is calling for your attention in this moment and begin to explore it.

Where is this area located?

What is the feeling or sensation?

What is the shape, size, color, density? Can you take your awareness inside this area?

What is the area around it like? Breathe into that area and allow all tension to be released on the exhaling breath.

  What is the feeling or emotion in that area. Is it anger, fear, sadness?

Take your awareness slowly through the body from the toes all the way up to the crown of the head.
As you do so, notice the place in the body that feels the most whole, the most comfortable in this moment.

When you find this place, tell me where it is. [Allow them to locate this place.]

 Notice this feeling of openness.

There may even be a color, a sound, or a symbol that goes along with it naturally.

What’s your experience of this area?

Notice what are the feeling and images that go along with it.

Now, begin to allow this feeling to spread through the body. Allow it to flow down to the toes, completely filling the feet and toes.

Legs,
Hips
Arms,
Lower, middle and upper Back
Abdomen, chest
shoulders
Neck
head
Now let go of the visualization practice
And  let go of chiddakasha
And come back to the heart beat
In your heart beat hear your heart’s desire, your Sankalpa

(STAGE 7 - Sankalpa): The same Sankalpa you made at the beginning of the practice. Repeat it mentally 3 times with the exact same wording and with the faith that it will come true.

(STAGE 8 - Externalization)
Become aware the breath.

 Listen for sounds in this room….sounds outside this room….. Find the furthest sound that you can hear…… Start to remember this room: remember the walls… remember the ceiling… remember the floor.  Remember your place in the room.,..  Remember who’s in this room with you…  Remember the chakras….Become aware of your body lying on the floor, (or sitting on the chair, or against the wall)… Notice the weight of your body and all the points where your body is supported…. Extend your attention through your entire body…  Become aware of your entire body from you head to your finger tips…. Become aware of your body extending from your head to your toes…  Be aware of your breath… Become aware of the entire physically body and the breath inside your body…. Consciously make your breath deeper and full… Make your breath deeper. … Inhaling and Exhaling deeply… Make your breath very full…. Inhaling and exhaling fully….Keep your eyes closed and Say to yourself mentally “The practice of Yoga Nidra is now complete.”…. Start moving your body and stretching.
Making your movements larger and larger. Inhale your arms over your head.

Remembering to be mindful of what’s near you.  Stretch (3) Yawn. Gently roll to a side in a fetal position and use it is a transition to come up to seated. (long pause) Open your eyes. You are fully alert and ready to go on with the rest of your day/evening.

OR GUIDED IMAGERY

Allow the body to completely relax and feel the breath moving through the body like a gentle, slow motion wave from the soles of the feet to the crown of the head…

As you do so, notice any areas of the body that are still holding tension or tightness. [Allow them to locate this place of tension.]

What is the area and what is your experience of it? [Allow them to describe the feeling and any images that go along with it. If they have no major areas of tension at this point in the process, go directly to the next phase, Relaxation].

Bring your awareness to the area of tension you will be working with and make a mental picture of that area. Now, take your awareness to your left hand. Feel the sensations there and allow an image of the hand to form in your mind’s eye.

Now also, visualize an image of the hand placed over the area of tightness you are working with. Feel as if this image of your hand were gently holding the area of tension. Very slowly, as I count from one to five, I’m going to ask you to begin to close your left hand into a fist and at the same time to close and tighten the image of the hand that you have around the area of tension you are working with. After contracting both the hand and your image, we will be loosening them both so that you can completely relax this tight area.

 Now, slowly begin to close the hand into a fist as I count from 1 to 5 and, at the same time, close the visualized hand around that area of tightness. 1… 2… 3… 4… 5… Hold the fist and the area of tightness as tightly contracted as possible. Take an inhaling breath and now, as you exhale, slowly begin to release both the fist and the area of contraction as I count down from 5 to 1. 5… 4… 3… 2… 1

8, MUDRA MEDITATION
Sitting in Urdhvam Merundanda Mudra, the gesture of the Upper Spine once again work with the
AFFITMATION x 3

“Breathing freely in the back of my body, I open to my infinite possibilities
First aloud, then as a whisper. And last one silently.

Sit for 1 to 5 minutes in this mudra meditation

9. FINAL DISCUSSION

10. CLOSING

3 AUMS
3 Shantis
Namaste