Appendix Ie : Relaxation techniques

Relaxation Techniques Relaxation Technique Summary Further Resources

Breathing exercise

This is the foundation of most relaxation techniques. Have patients place one hand on the chest and the other on the abdomen. Instruct them to take a slow, deep breath, as if they were sucking in all the air in the room. While doing this, the hand on the abdomen should rise higher than the hand on the Conscious Breathing by Gay Hendricks is one of chest. This promotes many good resources on using breathing for diaphragmatic breathing that relaxation and health. increases alveolar expansion in the bases of the lungs. Have them hold the breath for a count of 7 and then exhale. Exhalation should take twice as long as inhalation. Repeat this for a total of five breaths, and encourage patients to do this three times a day.

Meditation To prevent distracting thoughts, the subject repeats a mantra (a word or sound) over and over again while sitting in Transcendental/The a comfortable position. If a relaxation response distracting thought comes to mind, it is accepted and let go, with the mind focusing again on the mantra. This represents the philosophy of living in the present or in the moment. The body scan is one technique where the subject uses breathing to obtain a relaxed state while lying or sitting. The mind progressively focuses on different parts of the body, where it feels any and all sensations intentionally but nonjudgmentally before moving on to another part of the body. A patient with back pain may focus on the quality and characteristics of the pain as if to better understand it and bring it under control.

www.mindbody.harvard.edu or The Relaxation Response by Herbert Benson;www.tm.org for information on transcendental meditation.

Mindful meditation

Full Catastrophe Living by Jon Kabat-Zinn describes this technique in full and the program for stress reduction at the University of Massachusetts Medical Center.

Centering prayer

This is a form similar to transcendental meditation that www.Centeringprayer.com ; look under has a more religious method of centering prayer for a foundation. The subject repeats nondenominational discussion. a sacred word similar to a

Relaxation Technique

Summary mantra. As thoughts come to mind, they are accepted and let go, clearing the mind to become more centered on the spirit within, as if the minds preoccupied thoughts are the layers of an onion that are peeled away, allowing better understanding of the spirit at the core. A form of relaxation in which the subject is attuned to the difference in feeling when the muscles are tensed and then relaxed. In a comfortable position, start by tensing the whole body from head to toe. While doing this, notice the feelings of tightness. Take a deep breath in and as you let it out, let the tension release and the muscles relax. This is then followed by progressive tension and relaxation throughout the body. One may start by clenching the fists and then tensing the arms, shoulders, chest, abdomen, hips, legs, and so on, with each step followed by relaxation. The subject uses visualization to recruit images that create a relaxed state. For example, if a person is anxious, visualizing images of a place and a time that were peaceful and comforting would help induce relaxation. This is best used in conjunction with a breathing exercise. This induces a physiologic response by using simple phrases. For example, My legs are heavy and warm is meant to increase the blood flow to this area, resulting in relaxation. This is done progressively from head to toe with the use of deep breathing and repetition of the phrase. After completing this, focus attention on any body part that may still be tense, and then focus the breath and phrase to that area until the whole body is relaxed.

Further Resources

Progressive muscle relaxation (PMR)

www.uaex.edu/publications/pub/fshei28.htm is a good review of PMR as well as other relaxation exercises. It is sponsored by the University of Arkansas. You Must Relax is a book by the founder of this technique, Edmund Jacobson.

Visualization/Selfhypnosis

There are many audiocassettes that can guide people through a visualization script that can result in relaxation. Emmett Miller is one wellknown author.

The British Autogenic Society atwww.autogenictherapy.org.uk resource for more information. is a good

Autogenic training

Relaxation Technique Exercise/Movement

Summary

Further Resources

Aerobic

While performing an aerobic exercise, focus attention on a phrase, sound, word, or prayer and passively disregard other thoughts that may enter the mind. Some may focus on their breathing, saying to themselves, In with inhalation and Out with exhalation, or repeating onetwo, one-two with each step they take with jogging. Doing this will help the mind focus, preventing other thoughts that may cause tension. This has been practiced for thousands of years in India. In America, it has been divided into three aspects: breathing (pranayama yoga), bodily postures or asanas (hatha yoga), and meditation to maintain balance and health. Regular practice induces relaxation. An ancient Chinese martial art that uses slow, graceful movements combined with inner mindfulness and breathing techniques to help bring balance between the mind and body.

Beyond the Relaxation Response by Herbert Benson includes discussion of his research on inducing the relaxation response while exercising.

Yoga

For the following therapies, it is best to encourage patients to take a class at a local community center or gym and to pick up an introductory book at a library or bookstore.

Tai chi

See above.

Qi gong

A traditional Chinese practice that uses movement, meditation, and controlled See above. breathing to balance the bodys vital energy force, Qi.

From Rakel RE (ed): Principles of family practice, ed 6, Philadelphia, 2002, WB Saunders.