Tension is a state of physical stiffness in the body that can cause pain and even emotional reactions such as anxiety. Physical relaxation aims to undo this tension and progressively relax muscles and muscle groups. Psychological relaxation occurs when the mind is relatively free of stress and distraction. People may still have stress in their lives or tasks to complete when they are psychologically relaxed, but stress and tension are not foremost in the minds of relaxed people. Psychological relaxation can affect physical relaxation, and people under stress frequently experience physical aches and pains as well as muscle tension.
Some people have more trouble with relaxation than others. People who tend toward anxiety may experience fewer states of relaxation than others. Depression, anxiety, external stress such as unemployment, diet, and drug use can all affect a person’s state of relaxation.
Stress has damaging effects on health and the immune system. Relaxation techniques are helpful tools for coping with stress and promoting long-term health by slowing down the body and quieting the mind. Such techniques generally entail: refocusing attention (for example, noticing areas of tension), increasing body awareness, and exercises (such as meditation) to connect the body and mind together. Used daily, these practices can lead to a healthier perspective on stressful circumstances.
Autogenic training
It is a desensitization-relaxation technique developed by the German psychiatrist Johannes Heinrich Schultz. by which a psycho-physiologically determined relaxation response is obtained. This technique uses both visual imagery and body awareness to move a person into a deep state of relaxation. The person imagines a peaceful place and then focuses on different physical sensations, moving from the feet to the head. For example, one might focus on warmth and heaviness in the limbs, easy, natural breathing, or a calm heartbeat. The main purpose of autogenic training is the achievement of autonomic self-regulation by removing environmental distraction, training imagery that accompanies autonomic self-regulation, and by providing a facilitative set of exercises that are easy to learn and remember.
In the context of autogenic training passive concentration means that the trainee is instructed to concentrate on inner sensations rather than environmental stimuli. Passiveness refers to allowing sensations to happen and being an observer rather than a manipulator.
The training can be performed in different postures-
· Simple sitting
· Reclined armchair
· Horizontal posture
The technique consists of 6 standard exercises according to Schultz-
Muscular relaxation by a repetition of a verbal formula, "My right arm is heavy", emphasizing heaviness. During the initial stages of the training, the feeling of heaviness in the trained arm is more expressed and occurs more rapidly. The same feeling can be experienced in the other extremities at the same time in the other arm. Within a week, a short concentration can trigger the sensation of heaviness in a trainee's arms and legs.
1. Passive concentration focuses on feeling warm, initiated by the instruction "My right arm is warm".
2. Initiation of cardiac activity using the formula "My heartbeat is calm and regular".
3. Passive concentration on the respiratory mechanism with the formula "It breathes me".
4. Concentration on the warmth in the abdominal region with "My solar plexus is warm" formula.
5. Passive concentration on coolness in the cranial region with the formula "My forehead is cool".
*Autogenic training is contraindicated for children below the age of 5 and the individuals whose symptoms cannot be controlled.
Breathing
In breathing techniques, you place one hand on your chest and the other on your belly. Take a slow, deep breath, sucking in as much air as you can. As you are doing this, your belly should push against your hand. Hold your breath and then slowly exhale. Deep breathing also goes by the names of diaphragmatic breathing, abdominal breathing, belly breathing, and paced respiration. When you breathe deeply, the air coming in through your nose fully fills your lungs, and the lower belly rises. For many of us, deep breathing seems unnatural. There are several reasons for this. For one, body image has a negative impact on respiration in our culture. A flat stomach is considered attractive, so women (and men) tend to hold in their stomach muscles. This interferes with deep breathing and gradually makes shallow "chest breathing" seem normal, which increases tension and anxiety. Shallow breathing limits the diaphragm's range of motion. The lowest part of the lungs doesn't get a full share of oxygenated air. That can make you feel short of breath and anxious. Deep abdominal breathing encourages full oxygen exchange — that is, the beneficial trade of incoming oxygen for outgoing carbon dioxide. Not surprisingly, it can slow the heartbeat and lower or stabilize blood pressure. Deep breathing is one of the best ways to lower stress in the body. This is because when you breathe deeply, it sends a message to your brain to calm down and relax. The brain then sends this message to your body. Those things that happen when you are stressed, such as increased heart rate, fast breathing, and high blood pressure, all decrease as you breathe deeply to relax.
· The way you breathe affects your whole body. Breathing exercises are a good way to relax, reduce tension, and relieve stress.
· Breathing exercises are easy to learn. You can do them whenever you want, and you don't need any special tools or equipment to do them.
· You can do different exercises to see which work best for you.
Progressive muscle relaxation (PMR)
It is a non-pharmacological method of deep muscle relaxation, based on the premise that muscle tension is the body's psychological response to anxiety-provoking thoughts and that muscle relaxation blocks anxiety.[1] The technique involves learning to monitor the tension in specific muscle groups by first tensing each muscle group. This tension is then released, as attention is directed towards the differences felt during tension and relaxation.
This technique involves slowly tensing and then releasing each muscle group individually, starting with the muscles in the toes and finishing with those in the head.
These learning sessions are not exercises or self-hypnosis. Training sessions are conducted in a darkened room with the learner in a reclined position and eyes closed. The instructions begin by telling the person to relax and just let go, detaching from thoughts or physical distractions or trying to solve problems. In each session the teacher reviews tensing one particular muscle group. A modification of the technique is "biofeedback" in which one uses external measuring devices to indicate how successful one is in relaxing and then to use those techniques to relax without the help of external measuring devices. Progressive muscle relaxation is suggested to be applied daily. The technique has its own top-down sequence, beginning with the upper body and proceeding to the lower parts. Typically, the duration of a course is eight weeks, with each weekly session each lasting an hour or so. Progressive muscle relaxation technique requires a high degree of personal motivation, as the effects are often seen only after prolonged sessions. Before starting a course it might be recommended to consult with a doctor in order to ensure special care and attention is paid to selected muscle groups, as well as to obtain a recommendation on the ideal course. Jacobson's progressive relaxation has remained popular with modern physical therapists. Although many institutions and individuals offer progressive muscle relaxation training, what they teach is not standardized, and no credentialing process is available for progressive muscle relaxation technique instructors.
Meditation
The two most popular forms of meditation in the U.S. include Transcendental Meditation (students repeat a mantra, a single word or phrase) and mindfulness meditation (students focus their attention on their thoughts and sensations). Meditation has a long history, most frequently being associated with the Buddhist religion (particularly the Zen cult) and with Yoga. More recently Transcendental meditation has attracted large groups of people, particularly the young. Experimental studies have shown that meditation can produce striking psychophysiological effects, including alleviation of tension, lowering of oxygen consumption and metabolic rate, and decrease of cardiac output. Many techniques exist for the production of meditation, ranging from practiced suspension of thinking to concentration on monotonous environmental stimuli, to a repetition of certain sounds or words (mantras), to special forms of physical exercise. The association of meditation with mysticism is understandable. As in hypnosis, a change of body image and the evocation of weird fantasies may strike some as evidence of preternatural worlds, But meditation may be practiced apart from a mystical union with the absolute and without achievement of “enlightenment” and universal wisdom. Faith practice from 20 to 30 minutes daily is usually required for proper practice toward mastery of tension
Self-Hypnosis
Self-hypnosis (which can easily be learned), shying away from ego-building or exploratory suggestions so as to limit the extraneous suggestions and to focus the objective on relaxation. The technique is simple. The patient is enjoined to practice for 20 minutes, twice daily, sitting in a comfortable chair in a quiet room, shutting the eyes, and breathing gently, but deeply concentrating on ones breathing. The patient is then asked to relax muscles progressively starting with the forehead and working down to the fingertips and then shoulders to toes. The reverse can also be done, that is, starting with the toes and slowly relaxing muscle groups to the forehead. Finally, the patient counts very slowly from I to 20 listening to his or her breathing. After the count the patient is enjoined to let the mind become passively languid, avoiding concentrating on thoughts and ideas. Should these obtrude themselves, the patient is to revert back to listening to the breathing. In a short period these exercises may be learned to achieve what the more complex meditation practices accomplish without unnecessary adornments. In some instances this author has made a cassette recording for the patient utilizing the format outlined in the section on hypnosis later in this chapter but eliminating the ego-building suggestions and summation of suggestions. Such relaxation practices have been extremely helpful to patients under excessive tension, without interfering with the psychotherapeutic process.
Guided imagery
Similar to autogenic training, guided imagery involves listening to a trained therapist or a guided imagery CD to move into a state of deep relaxation. Once in a relaxed state, the images that come up in your mind can help you uncover important realizations about your emotional, spiritual, and physical health. Guided imagery is a widely used self-directed treatment of anxiety and is often practiced together with meditation or mindfulness training. Guided imagery can be individualized to fit the specific anxiety symptoms of each patient, and has well-known beneficial effects on the immune system, physiological stress responses, and general mental-emotional functioning. The regular practice of mental imagery is beneficial for many anxiety problems, including generalized anxiety, panic attacks, and traumatic memories. Imagery and relaxation techniques are often used together to induce hypnotic trance states resulting in a dramatic reduction in symptoms of generalized anxiety. Combining relaxation with guided imagery is probably more effective than either approach alone. In an open trial, 60 women reporting anxiety and postpartum depressed mood experienced significant reductions in both anxiety and depressed mood using a combined relaxation-guided imagery protocol during the first four weeks after childbirth. In contrast to the largely beneficial effects of relaxation on generalized anxiety symptoms, panic attacks are sometimes reported by individuals diagnosed with Panic Disorder during applied relaxation exercises.
Body scan meditation
This is a type of meditation that that focuses your attention on various parts of your body. Like progressive muscle relaxation, you start with your feet and work your way up. But instead of tensing and relaxing muscles, you simply focus on the way each part of your body feels, without labeling the sensations as either “good” or “bad”. Lie on your back, legs uncrossed, arms relaxed at your sides, eyes open or closed. Focus on your breathing for about two minutes until you start to feel relaxed. Turn your focus to the toes of your right foot. Notice any sensations you feel while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for three to five seconds (or more). Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. After one or two minutes, move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up the torso, through the lower back and abdomen, the upper back and chest, and the shoulders. Pay close attention to any area of the body that causes you pain or discomfort. After completing the body scan, relax for a while in silence and stillness, noting how your body feels. Then slowly open your eyes and stretch, if necessary.
Biofeedback training
It is a recent entry into the arena of self-regulated tension control. There is considerable evidence that one may gain conscious command over involuntary bodily functions by receiving sensory information from visceral organs. There gradually develops a type of operant conditioning that enables a person to monitor certain physiological functions. The most common instruments employed are those that record changes in skin potential (psychogalvanic meter), brain-wave activity (EEG machine), muscular function (electromyograph machine), and skin temperature (thermal machine). By learning to diminish or increase the auditory signals or amplitudes on a visual scale, one may be able to produce greater quantities of alpha waves (a phenomenon associated with lessened anxiety), to reduce the activity of the sympathetic nervous system, and to achieve profound muscle relaxation. Lowering of blood pressure in hypertension, healing of stomach ulcers, and relief of migraine are among the conditions that have been successfully managed. Relatively easily mastered instruments are available for biofeedback training through which most persons are able to develop an ability to regulate subconscious physiological activities. This kind of visceral learning holds out great promise for the future in treating psychosomatic ailments. Therapists may profitably explore this field to see whether it may enhance their therapeutic repertoire, should their practice involve the treatment of many patients with psychophysiological ailments. In the event the therapist does not possess the instruments, the patient may be referred for adjunctive biofeedback therapy to a behavior therapist skilled in the method. Most patients can be trained in about 10 sessions.
Meditation has also been used as part of the treatment for post-traumatic stress disorder (PTSD) in Vietnam veterans, and to break substance abuse patterns in drug and alcohol abusers. Relaxation techniques can also enhance coping skills in migraine sufferers and reduce stress, as well as improve mood in those with cancer. In general, studies show that with consistent practice, relaxation techniques can potentially reduce symptoms or improve outcomes in the following conditions-
Stress
Premenstrual syndrome
Pain
Irritable bowel syndrome
Anxiety
Infertility
High blood pressure
High cholesterol
Diabetes
Panic disorders
Chronic tension headaches
Fibromyalgia
Insomnia
Psoriasis
Arthritis
Hyperactivity in children, as in attention deficit hyperactivity disorder (ADHD)
Labour and childbirth
*It is extremely important that usual medical care and advice be followed for these conditions as well. Relaxation techniques are meant to complement the usual medical care.
REFERENCES
- Arias, A. J., Steinberg, K., Banga, A., & Trestman, R. L. (2006). A systematic review of the efficacy of meditation techniques as treatments for medical illness. Journal of alternative and complementary medicine (New York, N.Y.), 12(8), 817–832. https://doi.org/10.1089/acm.2006.12.817
- Wolberg, L. R. (1977). The technique of psychotherapy. New York: Grune & Stratton.
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