Klesha. The chronic-stress & burnout protocol.
One of eight Focuses · available on Pause, Reset, and View · £1,000 – £1,800 indicative
A structured protocol for the guest recognising the pattern — years of running slightly too hot, cortisol that no longer follows the shape it used to, sleep that stopped restoring, energy that stopped recovering. Led jointly by Dr Marie-Christine Dix (integrative and functional medicine) and the Manas clinical psychologist. Bloodwork covers the endocrine and nutrient markers most commonly deranged in burnout; the clinical work spans four to six one-to-one psychology sessions and a structured CBT-I course; the take-home protocol combines nutrition, sleep, movement, and targeted supplementation the guest continues after departure. Named after Sanskrit klesha — the classical Ayurvedic and yogic term for the afflictions that cloud the mind and disturb the body.
The full endocrine, psychological, and behavioural read.
- Dr Marie-Christine Dix intake consultation — sixty minutes on day one. Functional-medicine questioning: onset, contributing life-course factors, work pattern, sleep pattern, digestive pattern, medication and supplement review, family history. The intake shapes the panel and the psychology approach.
- DUTCH cortisol-rhythm panel — dried urine steroid panel capturing cortisol across the day (waking, noon, evening, bedtime), full sex-hormone profile, and metabolite pathways. Shared with the Kanti Focus if both are chosen; the deduplication rule means the panel is delivered once.
- Extended thyroid work — beyond the standard TSH/free T4, adds free T3, reverse T3, and thyroid antibodies (anti-TPO, anti-TG). Burnout frequently masks or overlaps with functional hypothyroidism; the extended panel surfaces it if present.
- Nutrient panel — magnesium (RBC), B12 and folate, vitamin D, ferritin, zinc, and full haematology. The classical burnout depletion pattern.
- Four to six one-to-one Manas psychologist sessions — cognitive and behavioural work with the Manas clinical psychologist, focused on the patterns that produced the burnout state. Number scales with stay length: four on Pause, five on Reset, six on View. Shared with the Manas Focus if both are chosen (the psychologist time is delivered once; the second Focus is discounted).
- Structured CBT-I course — three to four sessions of cognitive behavioural therapy for insomnia with the Manas psychologist. The evidence-based first-line intervention for sleep disturbance that co-occurs with burnout. Shared with the Nidra Focus if both are chosen.
- Dr Marie-Christine Dix mid-stay review — thirty-minute clinical check-in reviewing initial bloodwork against the intake picture, refining the take-home protocol.
- Written structured take-home protocol — nutrition (specific to the deficiencies surfaced), sleep (the CBT-I continuation plan), movement (matched to current tolerance rather than aspiration), and a targeted supplementation regime with clear duration and re-test timing.
These two Focuses overlap deliberately. Klesha is the stress-and-burnout lane specifically — cortisol biology, endocrine work, and psychology sessions oriented to the burnout pattern. Manas is the general depth-of-mental-health lane — more psychology sessions, MBSR foundation, optional EMDR. A guest with a clear burnout picture picks Klesha. A guest wanting broader psychological depth picks Manas. Guests picking both get the combined session count once (dedup) and a Focus that spans both angles.
Where each part of the £1,600 actually goes.
The Klesha Focus is priced at £1,600 recommended (indicative range £1,000 – £1,800). Inside that fee, £200 flows through to Medilab as the indicative pass-through cost of the DUTCH panel, extended thyroid work, and nutrient panel. The remaining £1,400 stays with the hotel and funds the clinical work — Dr Marie-Christine Dix's intake and mid-stay review, four to six Manas psychologist sessions, and the three-to-four-session CBT-I course. Klesha is deliberately clinician-heavy — that is the Focus's substance, not a design accident — so the hotel-delivery cost is meaningful at £590 (psychologist time at the Programmes-page baseline £55/hr loaded). Net contribution to new investment: £810 per Focus — a 58% margin on the net-to-hotel residual.
Only Medilab is a true third-party pass-through. Dr Marie-Christine Dix and the Manas psychologist are employed hires (see the Sama Clinic workforce table); their time is costed at Programmes-page baseline rates — £65/hr loaded for Dr Marie-Christine Dix (matching Dr Prasanna Kerur's specialist-doctor tier), £55/hr loaded for the Manas psychologist. The absolute contribution is higher than most other Focuses because Klesha commands the joint-top Focus fee.
What price does each margin imply?
Costs are fixed: £200 of pass-through to Medilab, plus £590 of hotel delivery (clinician time at Programmes-page baseline rates). The only thing that changes with a different target margin is the Focus fee. Drag the slider.
Recommended: £1,600 — the substance of a genuine functional-medicine and CBT-I intervention. Private-practice equivalents (Dr Marie-Christine Dix intake £250+, private psychologist sessions £150–£220 each, DUTCH panel £275+ retail) would total well over £2,500 unbundled. The slider lets you test alternatives.
Who Klesha isn't for.
- Active severe depression or suicidal ideation — requires a psychiatric care pathway, not a wellness Focus. Dr Marie-Christine Dix or the Manas psychologist may recommend referral to an independent psychiatrist during intake and defer the Focus.
- Untreated PTSD or unprocessed acute trauma — needs specialist trauma therapy (typically EMDR or trauma-focused CBT), delivered over more sessions than a Focus provides. May be more appropriate to book the Manas Focus (which includes optional EMDR) or to defer to a longer engagement.
- Recent psychiatric medication changes — the endocrine and nutrient bloodwork is less interpretable when a new medication is still normalising. Defer the Focus until three months of medication stability.
- Pregnancy or breastfeeding — the DUTCH panel is not clinically informative during pregnancy, and several elements of the take-home supplementation would need substantive modification. Focus is deferred until the postpartum window.
- Recent bereavement (within 6 months) — grief is a separate clinical picture from burnout, better served by specialist bereavement therapy. The Manas Focus's broader psychology depth may be a better fit if the guest wants to work on it in-stay.