|
"Finish each day
and be done with it.
You have done what you can.
Some blunders and absurdities
no doubt crept in.
Forget them as soon as you can.
Tomorrow is a new day.
You shall begin it
well and serenely".
Ralph Waldo Emerson
Helping patients learn relaxation techniques to aid stress reduction and
management is based on the concept of the mind-body connection: Whatever
relaxes the musculature produces mental relaxation and vice versa. Since the
relaxation response counteracts the stress response, it is impossible to be
both relaxed and tense at the same time. Further, the relaxation response
can reduce existing distress and eventually ameliorate its effect.
Progressive muscle relaxation is a simple and effective way to help patients
learn how to relax.
Relaxation: A state of relative freedom from both
anxiety and
skeletal
muscle
tension. Source:
University of Newcastle upon Tyne
1.
Relaxation Effect Models
The Specific Effects Model
The frequently observed desynchronies across behavioral,
cognitive, and somatic measures of anxiety has led
researchers (e.g., Davidson & Schwartz, 1976) to develop the
specific-effects model. They suggest that relaxation
oriented to one modality will benefit symptoms of that
modality. Based on this model, for example, Jacobson's
progressive relaxation, a somatic treatment, will help
somatic symptoms such as tension headaches.
The Relaxation Response Model
H. Benson (1975, 1983), based in his observation of the
relaxation effects, argued that all the relaxation
techniques produce a single "relaxation response,"
characterized by diminished sympathetic arousal.
Integrative Model
Schwartz, Davidson, and Goleman (1978), suggests that the
majority of the relaxation procedures have highly specific
effects, as well as more generally stress-reducing effects,
therefore, the specific effects of various relaxation
techniques may be superimposed upon a general relaxation
effect. For example, AT have specific effects on the
autonomic functions included in the autogenic exercises, but
it also produces a general decrease in physiological
arousal.
A somatic-cognitive-behavioral distinction has been
proposed by different researchers to help in the selection
of appropriate relaxation techniques. Their rationale is
that techniques directed to one of these modalities appear
to have their greatest and most consistent effects on that
particular modality.
Jacobson's Method versus
Modified Jacobsonian Procedures
The many differences between the Jacobson's PMR technique
and modified PMR methods warrant separate consideration.
Applied relaxation, Differential relaxation, and Rapid
relaxation are included among the modified methods.
Source and Documentations:
http://www.coedu.usf.edu/zalaquett/relax/About_Relaxation.htm
|
2. Relaxation
through Pacing
Pacing is about learning what your body can
cope with without causing a relapse or a
set back. Pacing is what many people with M.E. learn
to do. Pacing is about learning what you really can
do. Pacing is about not expecting or doing
too much. Pacing is about staying
positive about getting better and working
sensibly towards that aim. Pacing is about
not harming yourself by trying too hard.
Some ideas on how to pace yourself
1. Keep a simple diary
of everything you do for at least two
weeks. Write down how you felt at mid-day, at
tea-time and at bed-time. You can get someone to
help you do this if you find it hard to remember or
if you feel too tired.
2. After two weeks, read over it
to find out what things you did easily without
getting tired. You may find you ought to
start doing less!
3. Carry on keeping your diary.
4. When you read your diary you
may spot that certain things you did made
you very tired, like having to do a lot of
talking. Could it be that phone calls are a real
problem for you? Check.
5. Mental tasks, like
talking and listening, can be very tiring. So,
when thinking about things to do, it's important to
include thinking tasks, such as
reading and writing, as well as those that are
physical, such as brushing your
teeth or getting dressed. Most of the things we do
need to use both brain and muscle power.
6. Quite often the full effect
of something you did won't be felt for up to
3 days afterwards. A diary can be really
helpful in spotting these sorts of patterns.
7. Don't just do things
the way you have always done them. For
example, if you get up in the morning and eat your
breakfast, maybe have a rest before you get dressed.
8. If you get tired in the
middle of doing something - STOP! Go
back to it later in the day or week.
9. As the days and weeks go by,
try to build up slowly. Little by
little you do more and more. You may have set-backs
and off-days, but that is normal. Don't push
too hard.
10. Your muscles may ache at
times. This is normal if you haven't used those
muscles for a while. But watch out! Really bad aches
or pain mean you are pushing too hard. Don't do it. Pace
yourself! You have to become an
expert at reading your body.
11. Do more of the sort
of things you enjoy and are good at, so
that you are less likely to get fed up or bored and
give up.
12. It can really help to
switch between brain activities,
like reading and listening, and moving about,
physical activities.
13. Make sure you make time to
rest and relax. Resting means just
that - doing nothing! Reading and watching TV may be
relaxing, but your brain will still be active. Sit
in a comfy chair or lie down. Why not listen to a
tape or CD that is especially made to help people
relax?
14. Don't be tempted to
compare what you can do now with what you used to do
before you got ill. It will make you really
fed up and gets you nowhere!
15. Many people find that they
begin to feel better as soon as they stop
fighting the illness. Do what you can.
Build up gently. In the end the illness will have
run its course and you will have helped yourself to
get strong again.
Source:
http://www.a4me.org.uk/youandmeundertwelvetreatments.asp?id=8
3.1 Quick Relaxation Techniques
Curling up with a good book, a two-mile jog, or a midday
nap can produce relaxing effects, but it is not always
possible to do these activities in the middle of a busy
day. The following list of relaxation techniques can be
interspersed throughout your daily activities. These
`quick' relaxations take only 10-15 seconds and can be
practiced while your waiting at a stoplight, listening
to lectures, talking on the telephone, walking to an
appointment or any time. Some of the brief relaxations
can also be extended for 15-20 minutes to achieve a
deeper physically relaxed, mentally calm and centered
feeling. Daily practicing and in-depth relaxation will
also help the 15 second `quickies' during the day to be
more effective.
Experiment with each of these `quick' techniques
until you find which ones work best for you. A reference
source for the in-depth procedure is listed for each
technique.
- Tense-Release. This simple technique helps relax
muscle tension. Tense yourself all over a part at a
time. Start with your face muscles and progess down
to your feet. Hold yourself tense all over for 4 to
5 seconds . . . . then let go all at once. Focus on
the feelings of relaxation when releasing the
tension.
Jacobson, Edmund. (1962). You Must Relax. New
York: McGraw-Hill.
- Deep Breath. Deep breathe a minimum of twenty
slow continuous breaths twice a day. As you breath
in, say `I am' and as you breath out say `relaxed.'
Any time you feel distressed, practice this deep
breath and feel the tension leaving your body.
Geba, B. (1973). Breath Away Your Tensions. New
York: Random House/William Bookworks.
- Warm hands indicate relaxation. Cool hands
indicate tension. Visualize your hands as warm.
Imagine them in warm gloves, near a fire or in warm
water. Say to yourself, `My hands are warm, relaxed
and warm.'
Rosa, K.R. (1976). You and AT. New York: Saturday
Review Press/E.P. Datton.
- Instant vacation. Close your eyes, breathe
deeply, relax every part of your body. Imagine
yourself in a calm, nurturing environment. Recreate
in your mind whatever gives you the greatest most
relaxing pleasure -- swinging in a hammock,
sunbathing on the beach, strolling in the woods. Be
there completely. Feel the sun on your face. Smell
the scent of flowers or pine. Hear the rustling of
leaves or water splashing. Experience all the
pleasant sensations of this relaxing environment.
Samuels, M. & N. (1975). Seeing with the Mind's
Eye. New York: Random House.
- Four S. First, smile slightly and tell your eyes
to `sparkle'. Take a deep breath. As you exhale
slowly let your jaw hang slack, shoulders sag, and
forehead smooth out. Feel the tension pass all the
way through your body until it seeps out through the
soles of your feet. Remember the Four S's =
Smile, Slack, Sag, Smooth.
Stroebel, C. Quieting Reflex Training, an audio
tape series produced by BMA Audion Cassettes, 200
Park Avenue South, New York, NY 10003
- When you are first learning a relaxation
technique, the use of audio cassette tapes can be
very beneficial. Listed below are a few of the
companies producing relaxation tapes.
Bio Monitoring Applications, 2770 Madison Avenue,
New York, NY 10016
Conscious Living Foundation, Box 513, Manhatten,
KS 66502 New Harbinger Publications, 220 Adeline,
#305, Oakland, CA 94607
3.2 Quick Relaxers
The East Lambs Primary Care Group
have
produced the following ‘mini-quick’ relaxers:
Tense-release
Tense yourself all over, one
part at a time. Pull your toes up as if to touch your shins and hold
it. Tense your thigh muscles…your buttocks…tense your fists and your
arms, take a deep breath and hold it. Clench your jaws and close
your eyelids tight. Hold yourself tense all over for four or five
seconds then let go all at once. Don’t ease off, let go. And
feel the tension leave your body.
Cool air in, warm air out
With your eyes closed, shift
your attention to the tip of your nose. As you breathe in, become
aware of the air coming in your nostrils. As you breathe out, be
aware of the sensations of the air passing back out. Perhaps
you notice that the air coming in tends to be cooler and the air you
breathe out tends to be warmer. Just be aware of cool air in; warm
air out.
Heavy feet
Just imagine that your feet
and legs are getting heavier and heavier with each breath out. It’s
almost as if you are wearing lead boots, my feet are heavy. Just
imagine this for a few seconds. Or perhaps, some other part of your
body works for you.
Hands warm
Visualise you hands as warm,
relaxed and warm. You might imagine them in a bucket of warm water,
near a fire or in warm, woolly gloves. Perhaps you can even begin to
feel blood flowing down your arms into your hands. Hands are
warm…relaxed and warm.
Breathing tensions away
Gently focus your attention on
your feet. As you take in a slow, deep breath, imagine
collecting all the tension in your feet and legs, breathing them
into your lungs and expelling them as you exhale. Then with a
second deep breath, all the tensions in your trunk, hands and arms,
expel that. With a third one, collect and expel all those in
your shoulders, neck and head. With practice, some people are
able to collect tension in the entire body in one deep inhalation.
Ideal relaxation
With your eyes closed, take a
moment to create, in your mind’s eye, an ideal spot for relaxation.
You can make it any place, real or imagined. Perhaps it is a
favourite room, a beautiful meadow, an ocean beach, or a floating
cloud. See yourself in comfortable clothes. Now, once you have
created it, go back there for 15 seconds or go whenever you feel the
need to relax.
There’s a reason for each of these
parts. As we get tense, our facial muscles tend to get tense
and ‘hard-looking.’ Smiling breaks that up – it’s difficult to
remain as stressed after smiling. A deep breath counteracts the
tension-filled shallow breathing. We tend to tense our jaws
when stressed, so letting it hang slack lets go of some of that
stress. The same with our shoulders – up and tense with stress, so
letting them go and relaxing lets of the stress. And, letting
our forehead smooth out releases the tensions we tend to gather there when we
frown or wrinkle our forehead.
Massage
The individual can also relax through massage. Deep, firm touch,
moving from the head down the spine will help individuals with sleep
difficulties. individuals who become overstimulated easily may
benefit from massage throughout the day to help them calm down and
relax.
3.3 Basic Releasing Techniques
IDEA
Health & Fitness Source,
April 2004 v22 i4 p80(1)
Relaxation 101.
(handout)
Full Text: COPYRIGHT
2004 IDEA Health & Fitness
Ready to rip your hair out?
So stressed you can't sleep?
Tired of tense muscles? It's
time to relax. Stress isn't good
for you. Mentally, stress causes
anxiety, tension and
hyper-alertness. Prolonged,
unmanaged stress leads to
irritability, loss of
concentration and a weakened
immune system. Learning how to
relax can counteract these
stress responses.
By releasing both physical
and mental tension, relaxation
restores your mind and body to a
balanced state. Breathing
exercises and progressive
relaxation soothe the body.
Guided imagery and visualization
install peace of mind,
especially when combined with
physical relaxation. Striking a
balance is the key.
To learn how to relax, try
these techniques from Shirley
Archer, JD, MA, a Pain Alto,
California, wellness educator
and fitness specialist who is
the author of The Pilates Deck,
The Strength & Toning Deck and
Pilates Fusion: Wellbeing for
Body, Mind and Spirit.
1. Conscious Breathing
Effective physical relaxation
methods include simple breathing
exercises, progressive
relaxation and gentle, static
stretching. If you don't have
much time, simply take a few
moments to focus on your
breathing. Mentally "observe"
your inhalation and exhalation,
without making any effort to
control the breath. Pay
attention to how the breath
moves the body. Notice
subtleties, such as whether the
chest or belly rises with
inhalation, and how the body
responds to exhalation. This
singular focus brings you into
the present moment and into the
immediate experience of your
body. It often results in
slower, deeper diaphragmatic
breaths that further relax the
body.
2. Progressive Relaxation
After you are comfortable
with conscious breathing, try
progressive relaxation. It
consists of sequentially tensing
and relaxing individual muscles.
This method helps you develop
body awareness and educates you
on how to release tension. When
you do progressive relaxation,
start from the top of the body
and progress to the bottom, or
vice versa. Proceeding
sequentially gives you an
easy-to-follow sense of order.
3. Visualization
Mental techniques can also be
helpful. Visualization uses
images that appeal to the
senses--sight, sound, smell,
touch and taste--to create
mental and physical responses.
Visualization involves mentally
rehearsing a perfect performance
or specific goal and includes
all aspects of the experience,
triggering sense and memory.
Athletes use visualization to
enhance sports performance. The
technique is effective because
images are almost as real to the
mind as actual experience.
Regularly using visualization
can create confidence, direct
positive behavioral change,
strengthen motivation and
engender feelings of control.
You may experience anxiety
when trying a new relaxation
technique. Know, too, that some
methods can periodically bring
strong emotions to the surface.
You may cry or feel sad. Don't
worry. This type of release is
normal and can represent an
important "letting go." If you
have an extremely strong
emotional reaction, you may want
to consult with a counselor or
other health care provider.
GUIDED IMAGERY
Guided imagery is a mental
relaxation technique. In
contrast to visualization,
guided imagery is not used to
rehearse any specific behavior.
Rather, it is used to create a
mind-body relaxation experience.
Guided imagery incorporates all
the senses and focuses attention
inward. In this technique you
listen to someone (live or on
audiotape or CD) who helps guide
you into imagining a comfortable
place or private sanctuary. This
exercise helps if you have
difficulty bringing up specific
images to lead you into a
comfortable and relaxed
experience.
To find tapes or CDs on
guided imagery and meditation
(or on breathing, progressive
relaxation and visualization),
search an online bookseller,
such as amazon.com, or visit a
local bookshop or music store.
When doing guided imagery at
home, set up a soothing setting.
Dim the lights, and close the
door to eliminate extraneous
noise. Since body temperature
usually falls when people relax,
have a blanket or sweater
nearby. If you enjoy fragrance,
scent the air with aromatic
burners or soothing essential
oils like lavender to create a
special feeling of relaxation.
|
|
|
|
| 3.4 Relaxation
Exercises Relaxation exercises
are effective
techniques for reducing stress. These
exercises help you to feel less tense and
more relaxed. The result is a greater sense
of physical and emotional well-being. A
brief relaxation activity requires 60 to 90
seconds, so it can be done easily and
quickly on the job, in the car, or in a few
minutes of free time at home.
- Step 1. Assume a passive and
comfortable position. Although sitting
may be most conducive to relaxation, you
can do these exercises while standing,
riding in a car, lying down, or as you
prepare for an anticipated stressful
event.
- Step 2. Practice one or more of the
following activities several times each
day. This will help keep you calm, and
will reduce tension when it occurs.
- Deep breathing: Exhale
slowly, and tell all your muscles to
relax. Say as you exhale, "I feel
tension and energy flowing out of my
body". Repeat the above exercise five or
six times and you'll become more
relaxed.
- Whole body tension: Tense
every muscle in your body, stay with
that tension, and hold it as long as you
can without feeling any pain. Slowly
release the tension and very gradually
feel it leave your body. Repeat three
times. Notice how your feelings change.
- Shoulder shrugs and head rolls:
Try to raise your shoulders up to your
ears. Hold for the count of four, then
drop your shoulders back to normal
position. Rotate your head and neck.
Vary this by rotating your shoulders up
and down, and head and neck
around--first one way, then the other,
then both at the same time.
- Imagine air as a cloud: Open
your imagination and focus on your
breathing. As your breathing becomes
calm and regular, imagine that the air
comes to you as a cloud--it fills you
and goes out. Notice that your breathing
becomes regular as you relax.
Some relaxation exercises work better for
some people than others. Practice whatever
exercises seem to fit you best. (These
exercises were adapted from Stress and
How to Live With It. Cheryl Tevis, Ed
Meredith Corp. 1982.) |
|
|
Take 5 minutes a day to practice a relaxation technique such
as: breathing techniques, music therapy, massage therapy,
taking a bath, and reading a book. And, never underestimate
the relaxation power of a long stroll, walk or run!
Treatment for arthritis includes
relaxation therapy, or learning ways to release muscle
tension by yourself, such as progressive relaxation
where you tighten muscle groups one by one, relaxing
tension throughout your body.
| 3.5 More Relaxation
Exercises Before trying the full exercise below, first
practice steps 1 through 5, so you can get used
to deep breathing and muscle relaxation.
Exercise 1
- Find a quiet place where you can rest
undisturbed for 20 minutes. Let others know
you need this time for yourself.
- Make sure the setting is relaxing. For
example, dim the lights if you like, and
find a comfortable chair or couch.
- Get into a comfortable position where
you can relax your muscles. Close your eyes
and clear your mind of distractions.
- Breathe deeply, at a slow and relaxing
pace. People usually breathe shallowly, high
in their chests. Concentrate on breathing
deeply and slowly, raising your belly,
rather than just your chest, with each
breath.
- Next, go through each of your major
muscle groups, tensing (squeezing) them for
10 seconds and then relaxing. If tensing any
particular muscle group is painful, skip the
tensing step and concentrate just on
relaxing. Focus completely on releasing all
the tension from your muscles and notice the
differences you feel when they are relaxed.
Focus on the pleasant feeling of relaxation.
In turn, tense, hold, and relax your:
- Right and left arms. Make a
fist and bring it up to your shoulder,
tightening your arm.
- Lips, eyes, and forehead.
Scowl, raise your eyebrows, pucker your
lips, and then grin.
- Jaws and neck. Clench your
teeth and relax, then tilt your chin
down toward your chest.
- Shoulders. Shrug your
shoulders upward toward your ears.
- Chest. Push out your chest.
- Stomach. Suck in your
stomach.
- Lower back. Stretch your
lower back so that it forms a gentle
arch, with your stomach pushed outward.
Make sure to do this gently, as these
muscles are often tight.
- Buttocks. Squeeze buttocks
together.
- Thighs. Press thighs
together.
- Calves. Point your toes up,
toward your knees.
- Feet. Point your toes down,
like a ballet dancer's.
You may find that your mind wanders. When
you notice yourself thinking of something
else, gently direct your attention back to
your deepening relaxation. Be sure to
maintain your deep breathing.
- Review these parts of your body again,
and release any tension that remains. Be
sure to maintain your deep breathing.
- Now that you are relaxed, imagine a
calming scene. Choose a spot that is
particularly pleasant to you. It may be a
favorite comfortable room, a sandy beach, a
chair in front of a fireplace, or any other
relaxing place. Concentrate on the details:
- What can you see around you?
- What do you smell?
- What are the sounds that you hear?
For example, if you are on the beach,
how does the sand feel on your feet, how
do the waves sound, and how does the air
smell?
- Can you taste anything?
Continue to breathe deeply, as you
imagine yourself relaxing in your safe,
comfortable place.
- Some people find it helpful at this
point to focus on thoughts that enhance
their relaxation. For example: "My arms and
legs are very comfortable. I can just sink
into this chair and focus only on the
relaxation."
- Spend a few more minutes enjoying the
feeling of comfort and relaxation.
- When you are ready, start gently moving
your hands and feet and bringing yourself
back to reality. Open your eyes, and spend a
few minutes becoming more alert. Notice how
you feel now that you have completed the
relaxation exercise, and try to carry these
feelings with you into the rest of your day.
Exercise 2
- Sit comfortably. Loosen any tight
clothes. Close your eyes. Clear your mind
and relax your muscles using steps 4 and 5
above.
- Focus your mind on your right arm.
Repeat to yourself, "My right arm feels
heavy and warm." Stick with it until your
arm does feel heavy and warm.
- Repeat with the rest of your muscles
until you are fully relaxed.
| These exercises don't work right
away for everyone. It can take some time
to feel these exercises are working, so
practicing may help. If any of these
steps makes you feel uncomfortable, feel
free to leave it out. Ask your doctor or
nurse about other ways to relax if these
exercises don't work for you. |
|
|
Source:
http://www.cancer.gov/cancertopics/life-after-treatment/page11#4
4. Relaxation
through Enjoyment
4.1 Enjoying Life
Consider some of these activities that will help you enjoy
life, reduce stress and relax:
- Reading a good book
- Visiting with friends
- Walking in the woods
- Taking a relaxing bath or shower
- Perusing a hobby
- Seeking spiritual peace
- Watching a funny video
- Laughing with family members
- Healthy food and good digestion
- Giving things away.
| 4.2 Manage Your Psychological Well-being
One way to manage your psychological and
physical well-being is to have people you
can turn to for emotional support. This
support might come from family, church
members, friends, or others who have
experienced the kind of stress you are
experiencing. Emotional support involves
give-and-take. You must be willing to
support other people in addition to
receiving support from them.
Diet also appears to influence a person's
ability to cope with stress. Elevated blood
cholesterol levels combined with
hypertension or high blood pressure increase
your chances of stroke and heart attack. Be
moderate in your consumption of coffee, tea,
soft drinks, and drugs containing caffeine.
Caffeine stimulates the sympathetic nervous
system and may promote even more nervousness
and tension. Although alcohol and drugs are
common ways of dealing with stress, they can
be addictive and tend to deal only with the
symptoms of the problems. They mask the
cause of stress without eliminating it. Eat
an adequate and nutritious breakfast each
day. Most authorities suggest you consume at
least one-fourth of your daily calories and
nutrients at breakfast. Hunger can leave you
less able to cope with stress. All in all,
it just makes good sense to eat moderately
and regularly, especially when you're under
stress.
A basic exercise program also is likely
to improve your ability to manage stress.
Stretching and flexing the muscles of the
neck, arms, shoulders, back, thighs, and
midsection reduce the chance that these
muscles will tighten up and produce common
indicators of stress-headache, neckache,
and backache. A more advanced exercise
program that is likely to help manage stress
involves cardiovascular fitness. Over a
period of time, cardiovascular exercise will
benefit the heart, lungs, and arteries and
result in biochemical changes that elevate
your mood and encourage a healthy
self-concept. You can do more work or do
your regular work with less fatigue.
Although many people may be "on the go"
during the day, their activity is most often
sporadic and does not necessarily improve
the strength and endurance of the
cardiovascular system.
The best cardiovascular fitness program
involves daily aerobic or rhythmic,
repetitive exercise three times a week.
Aerobic exercise moves oxygen through the
body. The activities most commonly used for
cardiovascular conditioning are running,
brisk walking, cycling, swimming, rowing,
aerobic dancing, and cross-country skiing.
These activities are noncompetitive and less
psychologically stressful than other sports
such as golf or tennis.
If you're older than 35, have a thorough
medical checkup before beginning such a
program. In addition to support groups,
diet, and exercise, managing stress also
means balancing your personal, social, and
work-related activities.
- Develop a variety of interests,
activities, and relationships.
- Balance work with recreation.
- Don't keep anxiety and anger bottled
up (talk about problems to someone who
cares).
- Set reasonable personal expectations
and goals.
- Learn to accept what cannot be
changed.
- Learn to say no to requests you
cannot reasonably handle.
- Give in once in a while, even if you
think you are right.
Monitor Your Present Level of Stress
Recognizing early warning signals of
stress-related problems is the second step
in reducing damage caused by stress. Not all
symptoms of excessive stress can be observed
easily.
Early Warning Signs:
- Exaggerated, out-of-proportion
anxiety;
- Excessive moodiness;
- Withdrawal from responsibility;
- Constant insomnia;
- Poor emotional control;
- Severe feelings of helplessness and
dependency;
- Marked change in appetite or sex
drive;
- Chronic fatigue; and
- Susceptibility to illness.
Other indicators of stress are such comments
as:
- "I can't keep my mind on my work;"
- "I feel all tied up in knots;"
- "I can't relax;" and
- "I feel miserable and I don't know
why."
Or have you noticed:
- A door slammed a little too hard;
- An overpowering sense of fatigue;
- Lots of faultfinding and bickering;
and
- A constant state of turmoil.
All of these signs indicate stress has
reached a serious level.In addition
to recognizing symptoms of stress, you need
to be prepared for potentially stressful
events. For instance, certain times of the
year may be par-ticularly stressful for some
people because of work or other pressures.
Or you may be anticipating, or undergoing,
major changes such as moving, retire-ment,
pregnancy, or a new job, which could be very
stressful. If you are undergoing many
changes, look for ways of coping with stress
and avoid, if possible, taking on anything
new at this time.
A helpful way of monitoring your stress
level is to keep a Daily Stress Log like the
following sample. Record how often, causes
of, and reactions to stress-ful events,
people, places, and situations. As you take
steps to manage stress, the Daily Stress Log
provides a before and after check on your
progress. A Daily Stress Log worksheet is
provided at the end of this lesson to help
you monitor your own levels of stress.
Maneuver to Avoid Extremely Stressful
Situations
You can handle stress through two
maneuvers- arrange stress and change your
reaction to stress-ful events.
Arrange Stress
This suggestion is always questioned. How
can anyone arrange stressful situations?
Most of the time you cannot, because many
stressful events occur unexpectedly.
However, there are many situations that you
know are stressful. You can plan around
these and lessen the effects of stress. For
many people, stress results when they feel
overwhelmed by many things that need to be
done at the same time. If you plan in
advance how to handle potential problems,
you can often prevent them from getting out
of hand. And, often you can postpone some
situations so that two very stressful events
don't happen at the same time.
Change Your Reactions
Since everyone lives in a stressful
environment at some time, here are a few
rules for handling stress.
- Have a positive attitude-If you can
convince yourself that the source of
stress is necessary, you will have fewer
after-effects.
- Accept and discuss-Accept that your
lifestyle produces stress and that you
can control the unwanted side effects.
Look for trouble spots and do what you
can to try to change them. Discuss
situations that you and your family find
particularly distressing. Work together
to reduce the causes of stress.
- Clarify responsibility-Much stress
in a family can be reduced by clarifying
family members' roles and
responsibilities. Make sure everyone
understands clearly what is expected of
him or her. Set clear priorities for
yourself and your family. Communicate
positively and discuss issues openly.
- Improve your time management-Time,
man-aged well, can help reduce stress
resulting from too much to do in too
little time. Set up realistic time
limits for yourself and others.
- Learn to relax-Often, in the midst
of stressful situations, it might be
difficult to relax. Yet just a few
minutes of sitting in a comfortable
chair listening to soothing music,
taking a warm bath, doing deep muscle
relaxation (alternately tense and relax
muscles of your body), or meditating
will help you relax and reduce stress.
At times you need to loaf a little.
True, too much inactivity often breeds
boredom and may increase stress, but
everyone needs some "do nothing" time.
Daydreaming and reflecting may allow
time for creative solutions to problems.
Source:
http://www.cdc.gov/nasd/docs/d001201-d001300/d001246/d001246.html
|
|
|
Now Enjoy these Actual Bumper Stickers
"Out of my mind. Back in five minutes."
"Laugh alone and the world thinks you're an idiot."
"Sometimes I wake up grumpy; other times I let him sleep"
"It's as BAD as you think, and they ARE out to get you."
"I took an IQ test and the results were negative."
"Warning: Dates in calendar are closer than they appear."
"Give me ambiguity or give me something else."
"He who laughs last, thinks slowest"
"Always remember you're unique, just like everyone else."
"Consciousness: that annoying time between naps."
"Be nice to your kids. They'll choose your nursing home."
"3 kinds of people: those who can count & those who can't."
"Ever stop to think, and forget to start again?"
5. More Relaxation Strategies
Review these links and become
acquainted with all techniques.
Source
http://www-nehc.med.navy.mil/hp/stress/relaxation_strategies.htm
6. Relaxation Effectiveness
Studies
Anxiety
Relaxation techniques are highly efficient and produce
long-term benefits in the treatment of clinical anxiety (Borkovec
& Sides, 1979; Bernstein & Borkovec, 1973; Clum, Clum, &
Surls, 1993; Rasid, & Parish, 1998).
Panic Disorder
Several studies report the elimination of panic attacks
via cognitive or breathing techniques in at least 80-90% of
their clients (Barlow, 1988; Beck, 1988; Clark, 1986; Clark,
Salkovskis, & Chalkley, 1985). A recent study investigated
the efficacy of applied relaxation and cognitive behavior
therapy for treating panic disorder. Thirty-eight
outpatients with no or mild avoidance were assessed. Both
treatments yielded significant improvements that were
maintained or furthered at follow-up. Sixty-five percent of
those who received AR were panic-free after treatment, and
82% were panic-free at follow-up, and 74% of those who
received CBT were panic-free after treatment, and 82% were
panic-free after follow-up. These treatments made lasting
changes in generalized anxiety and depression, which has
shown that AR and CBT are effective treatments for panic
disorder without avoidance (Oest & Westling, 1995).
Generalized Anxiety Symptoms
Different multi-component (cognitive, relaxation, and
exposure techniques) treatments for the treatment of
generalized anxiety have shown significant improvements of
anxiety (Borkovec & Costello, 1993). Deffenbacher and Suinn
(1987) recommend teaching relaxation as a self-control
procedure as part of these treatments. Expressive Relaxation
Training has proven to be quite effective in the treatment
of anxiety. This method was used to treat male and female
psychiatric outpatients with general anxiety disorders.
Ratings of anxiety, depression, avoidance behavior, social
impairment disability, and quality of interpersonal
relationships were markedly improved at ERT termination (Andreoli,
Casolari, & Rigatelli, 1995).
Test Anxiety
Relaxation seems to be effective in the treatment of test
anxiety and significantly better than no-treatment
controls. However, cognitive methods seem to be more
effective than relaxation (Lehrer & Woolfolk, 1993).
Social Phobia
Relaxation appears to be effective in the treatment of
social phobias. Treatment comparisons showed that either
exposure, relaxation, or CT are effective in the treatment
of social phobias (Heimberg, 1989).
Anger, Hostility and Aggressive
Behavior
Relaxation techniques, such as PMR, meditation, and AT
seem to be equally effective as CT in reducing symptoms of
hostility (Deffenbacher, McNamara, Stark, & Sabadell,
1990). However, the combination of CT and relaxation
therapies are particularly effective in treating excessive
anger in children and adults (Kendall & Braswell, 1986;
Meichenbaum & Novaco, 1985; Novaco, 1975). A combination of
cognitive-relaxation compared with relaxation coping skills
was measured to show which proved more useful in treating
general anger. It was shown that some measures slightly
favored the cognitive-relaxation method. The two methods
also showed reductions in clinically meaningful general
anger and maintenance of anger and anxiety after a one year
follow-up period at a somewhat equivalent rate (Deffenbacher
& Stark, 1992).
Headaches
Relaxation techniques are useful in treating adults
(Primavera & Kaiser, 1992) and children's (Mehta, 1992;
Sartory, Mueller, Metsch, & Pothmann, 1998) headaches.
Relaxation or biofeedback training helps between 40% and 80%
of tension headache sufferers (Blanchard, Ahles, & Shaw,
1979). Greater improvements are reported at follow-up than
immediately after treatment. Autonomically focused
techniques (e.g., TBFK, AT) are used for migraine headaches
(Lisspers & Ost, 1990). Somatic techniques (e.g., PMR) are
used for the treatment of migraine headache (Blanchard,
Appelbaum, Radnitz, Morrill, Kirsch, Hillhouse, Evans,
Guarnieri, Attanasio, Andrasik, Jaccard, & Dentineer,
1990). CT appears to be a particularly potent method for
treating tension headaches (Murphy, Lehrer, & Jurish,
1990). A combination of CT and relaxation therapy has been
shown to be more effective than relaxation alone (Tobin,
Holroyd, Baker, Reynolds, & Holm, 1988). No systematic
differences have been found between CT and relaxation for
migraine headache (Sorbi, Tellegen, & du Long, 1989). Use
of PMR and restricted environmental stimulation therapy
showed a significant decrease in headache reports (Wallbaum,
Rzewnicki, Steele, & Suedfeld, 1991). The active treatment
group improved significantly more than the control group, as
well as showed continuing improvement during follow-up
periods, while the control group had deteriorated by 34%
since the end of the treatment.
Insomnia
PMR is an effective treatment for idiopathic insomnia
(objective insomnia, Borkovec, 1979). Knapp, Downs, and
Alperson (1976) suggests that the majority of the relaxation
training significantly reduces the latency to sleep onset
and the number of awakenings. There is some evidence that
PMR also improves pseudoinsomnia (self-reported insomnia) (Greeff
& Conradie, 1998). Because cognitive rather than
physiological arousal is critical to the cause and/or
maintenance of insomnia, several researchers recommend a
combination of CT and PMR methods (Lacks, 1987). A recent
study has also found that self-administered treatment of
progressive relaxation training is highly effective in
treating insomnia. After a one year follow-up period,
patients had learned to relax to an average of 83%, and also
learned to achieve a state of calmness which improved their
overall sleeping patterns by 86%. (Gustafson, 1992).
Substance Abuse
Between 10-40% of alcoholics suffer panic-related anxiety
disorder, and 10-20% of anxiety disorder clients abuse
alcohol or other drugs (Cox, Norton, Swinson, & Endler,
1990). Relaxation and self-management techniques
significantly reduce anxiety and tension in alcoholics
(Parker & Gilbert, 1978; Parker, Gilbert, & Thoreson, 1978).
Relaxation seems to be highly recommended for anxious
alcoholics (Kushner, Sher, & Beitman, 1990) who drink to
avoid experiencing stress or in response to stress.
Relaxation training effects could substitute for alcohol
effects.
Smoking
Recent studies have found that the use of relaxation
imagery in smoking cessation programs to be effective. The
study targeted smokers aged 18-60, and showed quit rates to
be 69%, and abstinence rates of 55%. These findings suggest
that relaxation imagery can be a useful tool to deter
smoking (Wynd, 1992).
Relaxation Therapies with
Children
Children are as good or better able than adults to learn
relaxation techniques (Zaichkowsky & Zaichkowsky, 1984;
Hiebert, Kirby, & Jaknovorian, 1989). Most of the studies
show that relaxation can be beneficial in treating
anxiety-related academic difficulties and pain (Heitkemper,
Layne, Sullivan, & David, 1993). Relaxation therapy can
also be a positive addition to improving psychosomatic
disorders (Richter, 1984), and hyperactive children's
impulsivity, disruptive behavior, academic performance, and
self-concept (Omizo & Williams, 1982).
Hypertension and Heart Disease
Relaxation training is more effective in controlling mild
essential hypertension than no-treatment, delayed-treatment,
and control procedures (Agras, Southam, & Taylor, 1983).
This training alone, however, is not as effective as
antihypertensive medications in reducing blood pressure
(Jacob, Shapiro, Reeves, Johnson, McDonald, & Coburn,1986).
Some studies of relaxation therapy for hypertension have
reported highly significant effects for relaxation therapies
(Jacob, Chesney, Williams, Ding, & Shapiro, 1991). In 1988,
the joint National Committee on Detection, Evaluation, and
Treatment of High Blood Pressure recommended that relaxation
be used for treatment of mild hypertension, and as an
adjunct to medication for treatment of more severe
hypertension. There is evidence that stress management
techniques can decrease the doses of anti-hypertensive
medications needed (Glasgow, Engel, & D'Lugoff, 1989).
Where blood pressure is significantly elevated, however, it
should not be considered safe to maintain hypertensive
patients on relaxation treatment alone. Relaxation-based
interventions also have a prophylactic effect against heart
disease (Dath, Mishra, Kumaraiah, & Yavagal, 1997, Patel,
Marmot, & Terry, 1981; van-Dixhoorn, 1998). A combination
of thermal biofeedback and PMR training administered to
those suffering from essential hypertension has produced
satisfactory results. A significant decline in systolic and
diastolic blood pressure was observed in the treatment
group, as opposed to an increase in both for the control
group. (Hahn, Ro, Song, & Kim, 1993).
Fibromyalgia
Relaxation techniques have been
used to treat those suffering from fibromyalgia. Studies
have compared the effectiveness of relaxation, exercise,
and a combination of the two. It was found that all three
treatment groups produced improvements in self-efficacy for
physical function, which was best maintained by the
combination group after a two year follow-up period (Buckelew,
Conway, Parker, et al., 1998).
Menopausal Symptoms
Applied Relaxation was tested on
individuals who suffered from postmenopausal hot flushes.
The number of flushes was measured from one month before to
six months after treatment was applied, and was found to
reduce the frequency by an average of 73% (Wijma, Melin,
Nedstrand, & Hammar, 1997).
Irritable Bowel Syndrome
Studies combining relaxation and CT have shown positive
results in the treatment of irritable bowel syndrome (Neff &
Blanchard, 1987; Blanchard & Schwarz, 1988). Progressive
Muscle Relaxation administered to those suffering from
Irritable Bowel Syndrome has been shown to significantly
alleviate symptoms associated with the condition (Blanchard,
Greene, Scharff, & Schwarz-McNorris, 1993). Fifty percent of
the group was clinically improved by the end of the
treatment, and results also indicate that relaxation
training alone can be a useful treatment for Irritable Bowel
Syndrome.
Asthma
Relaxation treatments have been shown to produce
significant improvement in asthma (Vazquez & Buceta, 1993),
Facial muscle EMG BFK appears to successful in decreasing
parasympathetically mediated bronchoconstriction. (Kotses,
Harver, Segreto, Glans, Creer, & Young, 1991). After
reviewing the emotional precipitants of asthma, Kotses
(1998) recommends the use of procedures that promote
relaxation and reduce stress.
Diabetes
A recent study tested the hypotheses that persons with
diabetes mellitus treated with twelve sessions of
biofeedback-assisted relaxation would decrease blood glucose
compared with untreated controls. Treatment consisted of EMH
biofeedback, thermal biofeedback, relaxation therapy, and
diabetes education. The results confirmed the stated
hypotheses, as well as an earlier study, which concludes
that biofeedback-assisted relaxation can be an adjunct to
conventional therapy for insulin-dependent diabetes. (McGrady,
Graham, & Bailey, 1996).
Cancer
Relaxation techniques have been used to treat side
effects of cancer therapy. Relaxation training has been
successful in decreasing the duration and severity of post
treatment nausea (Morrow, 1986); and secondary insomnia (Cannici,
Malcolm, & Peek, 1983). Recent studies have also shown
relaxation to be effective in increasing immune effects
during chemotherapy treatment for ovarian cancer . It is
suggested that relaxation can positively affect immune
parameters in cancer patients. (Lekander, Fuerst, Rostein,
Hursti, & Fredrickson, 1997). Relaxation combined with
imagery and cognitive-behavioral training have been used to
reduce pain during cancer treatment with substantiated
success. (Syrjala, Donaldson, Davis, & Kippes, 1995).
Dysmenorrhea
PMR, EMG BFK, TBFK, cognitive restructuring, time
scheduling, and non-directive therapy has been shown to be
effective in the treatment of dysmenorrhea (Balick, Elfrier,
May, & Moore, 1982; Sigmon & Nelson, 1988).
HIV
Progressive muscle relaxation has shown to be quite
effective in treating symptoms associated with HIV.
Conditions such as anxiety, mood, self-esteem, and t-cell
count were measured after a stress management program
consisting of 20 bi-weekly sessions of progressive muscle
relaxation was implemented. Analysis showed significant
improvements on all measures, and suggests that using stress
management to reduce arousal of the nervous system would be
an appropriate component of treatment for HIV infection
(Taylor 1995). Studies have also compared the effectiveness
of guided imagery and PMR on HIV symptoms. Results have
shown that imagery reduced depression and fatigue, while PMR
increased CD4+T lymphocyte count and also reduced depression
(Eller 1995).
Seizures
Progressive relaxation has been shown to be highly
effective in the reduction of seizures (Whitman, Dell,
Legion, & Eibhllyn, 1990). Frequency of seizures was
monitored over an eight-week interval, and three subsequent
follow-up periods after the therapy was implemented. During
the third eight week follow-up interval, seizures were
shown to reduce by over fifty percent.
Alzheimer’s Disease
Studies focusing on PMR for 34 patients with Alzheimer’s
have successfully shown significant decreases in behavioral
disturbances, as well as improved performances on measures
of memory and verbal fluency, from baseline to two month
follow-up testing (Suhr, Anderson, & Tranel, 1999).
Source and Documentations:
http://www.coedu.usf.edu/zalaquett/relax/About_Relaxation.htm
|
|
8. TEST
Study this web-site
for 3 hours for an approved (RN-CEP 11430, MFT- PCE 39)
3-hours Continuing Education Certificate (0.3 CEUs).
Click here for the self-correcting test
& online payment,
and 2) receive your certificate immediately online. All is
online, nothing by post-mail.
More
LearnWell
Courses.
|
|