Relaxation Techniques

Intervention Techniques: Meditation Autogenic Training Guided Imagery Biofeedback Progressive Relaxation Hypnosis

Meditation Simply put, it’s a mental relaxation exercise that has profound physical benefits when applied consistently Purpose > to gain control over your attention (of body & mind) so that you can chose what to focus upon rather than being lead by egoic thoughts Grounded primarily from eastern cultures (India & Tibet)

Types of Meditation: Transcendental- uses a Sanskrit word (i.e. “Ohm”) Soto Zen- uses external objects (candle, figure) Rinzai Zen- uses koans (illogical riddles) Tibetan- use a mandala (geometric figure that has spiritual/psychological importance) Hindu- uses pranayama breathing techniques Zen- uses anapanasati breathing (counting) Others > yoga, sufism, jewish etc.

Two General Approaches: 1) Opening of Attention Requires a nonjudgmental attitude Allows stimuli (internal & external) to enter your awareness without grasping at them > absorbed 2) Focusing of Attention- Object of focus is either something repetitive (mantra, nadam) or something unchanging (candle)

Benefits of Meditation: Physiological effects- originally discovered on Indian yogis & Zen masters (Brosse 1946) Psychological effects- profound health benefits discovered (Shapiro & Gerber) Trophotropic Response- the physiological state achieved when one is relaxed (also known as the “relaxation response”)

Physiological Effects: Drop in respiration to 4-6 breaths/min. Drop in HR by 20+ beats Drop in GSR by 70% Emission of the preferred alpha brain waves Decrease in muscle tension Drop in BP & cortisol levels Headache relief Less alcohol/drug use & health services

Psychological Effects: Reduction in anxiety Improved internal locus of control Greater self-actualization More positive attitude in general & to stressors Improved sleep Lower dependency on vices/addictions Reduction of fears/phobias Reduction of eating disorders

Proper Technique: Seated, either cross-legged or upright in chair If in a chair, back straight & feet flat on floor Let your muscles relax…don’t force relaxation Close you eyes & focus on your breath (inhalation & exhalation separately but don’t try to control your breathing) for ~ 20 min. Afterwards, come out of it slowly by taking 3 deep breaths and gradually opening eyes Rise slowly to avoid dizziness

Suggestions: First thing in am &/or last thing before bed Be sure to do it on an empty stomach Avoid caffeine, sugar, alcohol beforehand Avoid clocks/alarms When distracted with thoughts, always return to your breath Don’t worry about problems but instead be focused on being present in your body…your problems will be there when you’re done but will be less of an issue 

Biofeedback: Instrumentation used to measure psycho-physiological processes of which the individual is not normally aware & which may be brought under involuntary control Findings are then reported back to the person being monitored Simply, its receiving info about what is occurring at a given time and then helping you control that occurrence

Three phases of Biofeedback: Measuring- energetic/physiological parameter Converting- into tangible form (temp/freq) Feeding Back- info to the person involved

Parameters Manipulated: Temperature Heart rate GSR level Vasodilation Brain waves omitted Muscle tension Blood pressure HCL secretion

Types: Electromyographic (EMG)- measures muscle contraction Thermal- measures temperature Quantum- measures ionic reactions (energy) in your body and brain With any of these, the feedback loop zeros in on your baseline (tension, temp, energy) & sends back an alternate pulse to which your body responds by altering its own frequency

Physiological Benefits: asthma HTN Spams Ulcers Paralysis Tinnitus Headaches IBS/IBD Incontinence TMJ insomnia

Psychological Benefits: Depression Drug abuse Alcohol abuse ADD Phobias Anxiety Sexual dysfunctions

Autogenic Training: Imagining of one’s own limbs (arms & legs) & torso to be heavy, warm and tingling thought to bring an “auto-hypnotic” (relaxed) state Vasodilation & muscle relaxation Used specifically with neurotic patients & psychosomatic illnesses Now also used with people who want to try to regulate their own psychological & physiological processes

Benefits: Psychological: increased pain tolerance reduction in anxiety, depression, symptoms of fatigue Increased in alpha brain waves & resistance to stress Physiological: decrease in HR, BP, cholesterol, muscle tension, & respiration increase in peripheral blood flow migraines, raynaud’s, insomnia, HTN, asthma, digestion, cramps, TB, diabetes, back pain

How to do Autogenic Training: If pre-existing psychological condition, do so in a clinical environment Modified version (to be described) should be done 15-40 min/day to see results Focus on physical relaxation while visualizing a relaxing environment Prerequisites- motivation, cooperation, self-control, maintenance of body posture, mental focus & concentration on bodily sensations

Positions 1) Reclined/supine- on back, legs straight, feet slightly apart & arms at sides w/ palms up; use pillows as necessary 2) Seated w/ support- back straight, butt against back of chair, head aligned with torso, arms relaxed & feet flat 3) Seated w/out support- using a stool, sit forward with elbows resting on thighs, hands & head hang loosely, feet shoulder width

6 Sequential Stages to AT: 1) focus on sensations of heaviness in limbs “my left arm is heavy” (repeat 3-5 times in head) 2) focus on sensations of warmth in limbs “my right leg is warm” (repeat) 3) focus on warmth & heaviness in heart “my heart is calm & warm” (repeat) 4) focus on breathing “my breathing is relaxed” (repeat) 5) focus on warmth in the abdomen “my abdomen is relaxed & warm” (repeat) 6) focus on coolness in forehead “my forehead is cool” (repeat)

Imagery for AT: Visualization is key! Choose one color and focus on it Then visualize different colors making pictures

Progressive Relaxation: Too much muscular contraction can interfere with using proper form Bracing- unnecessary muscular contraction due to an obscured stimulus/stressor Having a relaxed approach and lax muscles lead to more efficient and effective results

Progressive Relaxation: Intervention technique used to induce nerve and hence muscular relaxation Involves the contraction & subsequent relaxation of muscle groups, gradually progressing from one group to the next Teaches what muscle tension feels like & thus the sensation of relaxation Idea is “learn or sense” when we’re tense & how to more readily induce relaxation

Like autogenic training, it relaxes the mind by relaxing the body first Does not induce a hypnotic state like autogenic training or meditation though

Benefits: Physiological Relaxation of digestive & cardiovascular Relief of headaches, back pain, cramps, insomnia Athletic & musical performance Psychological Improved self-image & confidence Reduction is depression & anxiety Less likely than other techniques to induce anxiety

Technique: First, recognize your tension & learn to use it as a clue to initiate relaxation Preferred position- lying on your back, arms & legs relaxed, neck supported with a pillow (also ok to do sitting/standing) Exercises- isometric contractions (against an immovable object) OR isometric squeezes; try not to skip any body part unless injured Start with feet/legs & move upward Spend twice as long relaxing, as contracting

Sequence: Feet/toes > calves > thighs > hamstrings > Hips > buttocks > Abdomen > low back > chest > upper back > Shoulders > upper arm > forearm > hand > Neck > face/forehead > Whole body NOTE: hold 5-10 sec. each then relax for 15-20

Some quick exercises: Shoulder tension > tense shoulders further by raising them towards your ears then relax Improper breathing > contract your abdominal muscles & breath through your chest; then relax your abdomen and breathe through your belly watching the rise & fall of your breath Can isolate any particular muscle group to focus on it specifically

Breathing: We breathe via a few mechanisms: Upper costals - upper 3rd of chest and scalenes muscles Thoracic/lower costals- from the 6th rib down Diaphragm- from the abdomen Optimal, deep & relaxed breathing Pranayama- 1) alternate nostril breathing, 2) breath of fire

Diaphragmatic Breathing: Lie on your back and place both hands on your abdomen, OR one hand on belly and the other on your chest Inhale for 5 sec, then exhale for 5 sec focusing on the rise and fall of your belly If desired, repeat a mantra as you move through your breath (i.e. “breathing in I calm myself, breathing out I smile”)

Pranayama Breathing: Alternate Nostril Breathing Place your right index & middle finger on the bridge of your nose; left hand is relaxed in lap Cover your right nostril with your thumb as you breathe in through your left nostril for 5 sec Hold for a few sec then cover left nostril with your ring finger as you breathe OUT through your right Then keeping your left nostril closed, breathe IN through your right for 5 sec Finally, cover your right with your thumb again and breathe out through your left; repeat 10 times

Pranayama Breathing: Breath of Fire Sitting in a cross-legged position, have arms gently resting on your knees Idea is to rapidly contract your abdominals & diaphragm to forcefully expel air from your lungs Mouth remains closed so exhalation should be done solely through your nose Rate should be to your level of comfort/pace to maintain for 1 min; relax/break then repeat

Tai Chi Exercise & relaxation technique from China that involves slow, focused movements 5 Basic Principles: Relaxation- using only minimal energy necessary Yin vs. Yang- using opposing forces Turning the waist- to keep flexible Erect back- to maintain balance & relaxation Total body movement- all as one fluid motion

Qi Gong: Similar to Tai Chi Series of slow, focused movements that are aimed at creating clarity & relaxation Also can involved a series of bouncing movement that help move “qi” (vital force) throughout body

Yoga: Eastern derived practice of mindfully moving through a series of postures (asanas) Aimed at cleansing both the body & mind, stretching muscles and relaxing the nervous system Emphasis is placed on proper body alignment and positioning to facilitate optimal effects Many different types: hatha, kundalini, bikram, tantric, etc.

Mindfulness: Practice of maintaining present moment awareness & consciousness Living in the here & now and not fixated on past events or the uncertainty of the future Helpful in treating many conditions besides general stress > chronic pain, arthritis, cancer, autoimmune conditions, anxiety, etc.

Instant Calming Sequence: Series of 5 exercises that elicit an immediate relaxation response to stress: 1) Uninterrupted Breathing- 2) Positive Face- stop to smile at your stress 3) Balanced Posture- chin up, back straight 4) Wave of Relaxation- to specific body parts 5) Mental Control- acknowledge the reality of the situation

Body Scanning: Focused searching for and identifying relaxed body parts That sensation is then directed towards other particular body parts to relax it For example a sensation of warmth going from your abdomen to your shoulders

Sound as Relaxation: Sound has tremendous physiological and psychological effects on the body “White noise”- soothing noise which drowns out other disturbing sounds (i.e. the ocean, birds chirping, etc. in nature CDs) Music- profound relaxation effects depending on the type of music listened to Music has been shown to decrease BP and depression as well as improve self-esteem and spirituality

Pets & Stress Relief: Reduce overall stress & cortisol levels Improve overall mood and survival chances of a life-threatening illness Reduce health care costs by preventing illness & promoting wellness Reduce aggressive behavior in violent people (or bring it out…Michael Vick) Provide companionship & improve social life