Relaxation Techniques Stress Management for Your Mindy & Body Do you have 5 to 10 minutes of time at home, at work, or the middle of a store to lower your body s reaction to pain, stress, anxiety, or anger? If so, read through the following pages to learn how you can easily reduce the tension in your muscles, heart, lungs and thoughts through simple steps. Think back through the past seven days when you became aware of an increase in pain, stress, anxiety, anger or a mix of these feelings. Identify one situation that is easy for you to recall. How did your body feel when you experienced one or more of these powerful feelings? Do you have the experience in your mind? Did you notice that your: heart was beating faster than normal perhaps pounding at a fast rate breathing changed to short, shallow breaths and that your lungs worked harder than they normally due when you are calm body increased sweating in your hands, head or other areas of your body mouth became dry jaw clinched or you may have grinded your teeth body was absorbing tension in certain areas, such as your neck, shoulders or temple body began to shake or feel jittery Make a note of all the sensations that you could identify when your body reacted to your strong feelings of pain, anxiety, stress or anger. Your experience is known as the fight-or-flight response that was triggered by a flareup of pain, stress, anxiety or anger. Your body is designed to trigger the fight-or-flight response to handle emergencies, by increasing your heart rate and blood flow to multiple areas of the body, including the brain breathing (to take in more oxygen for increased energy), arousal of certain senses, including sight, vision and smell, flow of blood sugar, fats, and cholesterol for added energy, and tension in muscles that will be required to move fast The problem is that you rarely use the system to fight or flight; so your body is filling up with unused fuel; i.e., sugar, while draining your body of its energy. You may not run when you are stressed or worried about pain, 1 Updated on December 3, 2013
but you become exhausted, anyway. Further, the fight-or-flight system was designed for a short burst of energy while you run away or fight; the system was not designed to stay on for hours. If you struggle with chronic pain, stress, anxiety, or ongoing anger, the fight-or-flight system may stay on for hours, causing even more exhaustion and tension. The good news is that you can learn how to shut off or slow down the fight-or-flight system through a variety of stress management and relaxation techniques. You can slow down your heart rate, breathing, and flow of sugar in your body. You can also learn to stretch your muscles around the area of your body where you feel pain. Are you ready to find the shut-of switch? If yes, keep reading: You can build a tool-box of stress management techniques to manage your fight-or-flight system. The fight-orflight system can impact all areas of your body, including your thoughts; so you can use a variety of tools to slow down different areas of your body. Before reading the list in the table, consider these guidelines for expanding your tool box of stress management techniques: Prepare for slow changes, not major reductions stress management techniques will help you manage your pain or emotions while you approach your valued-driven objectives each day these techniques are not designed to eliminate pain, stress, anxiety, or anger, but rather help you navigate through these feelings as you move forward Use the simple techniques first select the techniques that seem to be the easiest for you to use first and expand your techniques over time we recommend using deep breathing first followed by other tools Use preloading techniques to plan how, when and where you will start using one or more of the stress management techniques develop a detailed plan in your head for the next day for how you will use a brief stress management technique in your busy schedule (see module 4 for more details) Reduce pain, stress, anger or anxiety before it grows into a monster use stress management techniques to prevent these emotions from getting out of hand, by using them in the morning before you start feeling pain, anxiety or anger a nice combination is: 2 Updated on December 3, 2013
1. to eat something for breakfast within 60 minutes of waking, 2. preload your brain for today s or tomorrow s important objectives while you are eating breakfast, 3. practice deep breathing for 5 to 10 minutes before or after breakfast, 4. complete 5 minutes of gratitude journaling just before you preload your brain (it helps expand your thinking), and 5. add in exercise, such as walking or stretching, during your lunch break at work or after work. Effective and brief stress management techniques are listed in the following table. Each technique is described in the following sections. Stress Management Body area Benefit Technique Pre-loading your brain with 24-hour plans Improves your thinking while you are stressed, anxious or angry has a preventive function in Pre-loading plans can help you complete tasks while that you can plan in advance Gratitude journaling Improves your thinking and brings your thoughts mental rules, into the present time frame Exercise walking or any other low, moderate or high impact exercise Deep breathing Mindfulness exercises Progressive muscle relaxation (PMR) Helps to burn off unused sugar in your blood stream, fat & cholesterol that was released when you became stressed or anxious Helps to slow down your breathing and heart rate to normal levels Helps calm down your mind and keep you focused in the present and for slowing down the heart rate Used to release tension in muscles around the body your stressed or angry Can increase mental energy and has a calming effect Helps all areas of the body, can help with sleep & increases energy Effective for stress management Effective stress management technique Effective for stress management, chronic pain, & increasing energy Visual imagery (VI) Helps to calm down the mind Effective for stress management Preloading your brain Review the technique of pre-loading your brain in Module 4. Use preloading to plan for the next day or the week. Gratitude journaling You can expand your brain s capacity to think by writing down a short sentence about someone in your life who has been helpful or kind to you in the past few days. The exercise is simple, but effective because you can get your brain to start thinking positive thoughts based on real experiences, which can increase your sense of hope and support. Your thinking becomes narrow and one-dimensional when you experience pain, stress, anxiety or anger for hours each day. You probably noticed that you struggle to come up with ideas when you ve been thinking about stress, anxiety or frustration, instead of thinking about how to approach your value-driven objectives. Gratitude journaling is an easy way of expanding your thoughts the same way jogging can expand your lung capacity. Set aside about 5 to 10 minutes every 3 to 7 days to complete the exercise and follow these guidelines: 3 Updated on December 3, 2013
think about a person who was kind or helpful to you in the past few days, such as your partner, friends, or a stranger think about how the person helped you or went out their way to be a better person because of you, such as o your partner cooking a fantastic meal, o a coworker helping you at work when you were tired, o a stranger giving you directions when you were lost, or o your daughter or son worked hard on their homework last night after following your advice write down the person s name and why you have gratitude or appreciation for what the person did to help you or show you extra kindness select simple acts of kindness or help because these events tend to occur frequently, like a coworker who was sincerely concerned about you when they asked if they could help or a family member who always remembers to call you to check in don t force yourself to come up with positive experiences and, instead, spend a few minutes looking for those moments in your day that made a difference to you, even if it was small avoid writing down situations where someone stopped irritating you, as this will only serve to remind you of how frustrated you were with the person it will feed your anger or stress Exercise Walking or any other exercise can help burn off the fuel that is building up in your blood stream from pain, stress and anxiety. Exercise can also help you increase your energy, which can be drained by chronic pain, stress, anxiety, anger, or depression. Any additional body movements can help you, including adding 10 minutes of additional walking each day; so pick any type of activity that gets your body moving. Start small and add a few more minutes to an existing activity, such as adding additional walking time when you walk around the block Exercise in the morning to help kick start your body and mind (helpful for people who struggle with sleep) Avoid exercising late at night as this can disrupt your sleep; however, you can use a variety of relaxation techniques noted below. Deep Breathing Deep breathing is the easiest stress management technique for you to start or increase. Deep breathing works by resetting your lungs to breath more slowly and stops the short, shallow breathes that you may be taking when you feel pain or become stressed or anxious. Stress or anxiety triggers a breathing a pattern of short, shallow breaths that is helpful for a few minutes if you need to move fast (e.g., running away from danger), but can be exhausting if you experience stress for several hours. You may not be aware that your breathing pattern is leading to exhaustion when you are overwhelmed with pain (or the fear of pain), stress or anxiety. A deep breathing exercise for 5 to 10 minutes in the morning can help to return your body and lungs to a more normal breathing pattern while also providing a calming effect. Take a deep breath through your nose that expands your stomach for 3 to 4 seconds and exhale for another 3 to 4 seconds through your mouth (inhale and exhale at the same rate). Repeat this pattern for 10 minutes in the morning and whenever you notice your breathing becoming constricted or rapid. If your stomach expands when you are breathing, you are doing it right. You can also sneak in deep breathing exercises in crowded 4 Updated on December 3, 2013
places, on a bus, or in your office. People won t notice if you take deep slow breaths through your nose and slowly exhale through your mouth, so use deep breathing in any situation. Mindfulness and Staying in the Moment You can slow down your heart rate as well as your racing thoughts through mindfulness exercises that can be done within 5 to 10 minutes. You may worry about the distant future or you may concentrate on your past mistakes and pain. Either way, your mind dwells in the past or future, but not in the present. Mindfulness exercises can be used to direct your thoughts to the present as well as slow your body down in the process. The MW&R website has several mindfulness exercises that you can use to refocus yourself in the present. Each exercise can be completed in 5 to 10 minutes you can add more time as needed. Before reading on, stop what you are doing and listen to your heart beat for two minutes breath normally, but stop moving your body (and sit down while you are listening to your heart). Block out any sounds in your environment and focus on the feel and sound of your heart beating. Focus on the feeling of each beat, which you can feel in your upper chest. As you focus and listen, you can probably pick up the quiet sound of each heart beat in your body. Now anticipate the rhythm of your heart rate focus on the speed of beats in the minute. Can you feel and hear your heart beat? If so, you just completed your first episode of mindfulness. Another easy mindfulness exercise is to observe your breathing in the morning when you are doing your deep breathing exercise. You can add two comments that you can say in your head or out loud, such as: I m breathing in air to my lungs and I m breathing air out from my body While you are breathing, focus on the sensations of your body as you take in deep, long breaths. Notice that your chest is expanding along with muscles around your chest area. Notice the smells in the air as you breathe in and notice the feel of your throat as you breathe out again. Sound simple? The technique is easy to do if you can stay focused on the sensations of your body. The biggest challenge is keeping your mind focused on the sensations of your body or any other mindfulness target (e.g., 5 Updated on December 3, 2013
focusing on the sounds of birds at the park). Because you tend to drift into thoughts about the future or the past, you will also practice bringing your focus back to the target of the mindfulness exercise. Don t worry if you can t stay focused at first. Everyone struggles at first to stay focused, but it gets easier over time. Keep practicing for about 5 minutes each day and you will be able to extend your concentration. Select a mindfulness technique that works for you. For instance, if you need to wash dishes and find time for mindfulness, use the time to engage your senses involved in the process, such as focusing on the touch of water (how hot or cold it feels on your hands and wrists) as it pours over your hands, the smell of the soapy water Progressive Muscle Relaxation (PMR) PMR is a technique for reducing muscle tension, increasing flexibility, and reducing pain, stress or anxiety. A common and normal response to pain, stress or anxiety is for you to tighten your muscles. Tightening your muscles can be useful if you plan on using them immediately to exert a lot of energy, such as running fast. However, extended periods of pain, stress or anxiety can lead to a buildup in muscle tension in multiple areas of your body. This build up in tension can lead to soreness and increased pain. You may not be aware that your muscles have become tense, but you can often detect the problem through symptoms of soreness, fatigue, irritability and impatience. PMR can be completed in 10 minutes, although you can spend more time if you would like to release tension throughout your body. Instructions for PMR are located on the MW&R website. You can start the technique now by practicing with your hands. Clinch your right fist for 5 seconds by counting in your head one thousand & one, one thousand & two and then slowly release your fist for another five seconds while noticing the tension leaving as you slowly unfold your fingers. Repeat the exercise with your left hand. You have completed your first exercise in PMR. You can repeat this technique with other muscles in your head (e.g., your eyelids & face), back, shoulders, arms, legs and feet. Any amount of time will help; so pick a few muscles that absorb most of your tension and expand the exercise to other muscles if you have time. Visual Imagery Visual imagery is a relaxation technique for your brain, just like PMR is a relaxation technique for your muscles. Visual imagery is used to reintroduce positive mental states in your mind. Extended pain, anxiety or stress can alter your thoughts to create an underlying sense of hopelessness and negativity. Your sense of confidence can be undermined by overwhelming pain or anxiety that prevents you 6 Updated on December 3, 2013
from participating in valued activities and social events. Consider your thoughts to be like your muscles; when you focus your thoughts on achieving valued activities, your thoughts tend to appear positive, flexible and energizing. Visual imagery can be used as an energizing workout for your thoughts. Like PMR, visual imagery can be completed within five to ten minutes. With practice, you can create powerful positive images that include sensations, smells, and sounds. You and your wellness coach can work on developing scripts for you to practice visual imagery. Instructions for completing VI can be found on the MW&R website. The key to VI is to use several of your senses, including smell, touch, taste, and vision to expand your brain s thinking process. You can write down a script of a place you would like to go and practice the script in your mind while involving your senses. For example, in the picture above, you can think about how hot the sand would feel on your feet as your start walking barefoot, you could notice the smell of salt in the air near the ocean, and the sound of seagulls flying above you. Pick a place where you can identify a range of sensations. Assignment You have reviewed an extensive range of stress management techniques; so now it s time to begin adding some of these techniques into your daily routines. Remember the preloading technique to add in stress management techniques, such as: Over the next seven days, select at least one stress management technique that you will practice for 5 minutes each morning before 10:00am (you can pick any time frame that works for you, but the mornings are the best time for stress management), e.g., o Monday deep breathing after I get out of bed and before I have breakfast in the kitchen o Tuesday preloading my plans for Wednesday I will sit down after dinner, around 7:00pm, and plan out my value-driven activities that need to get done on Wednesday o Wednesday I will practice gratitude journaling at the kitchen table while I m eating breakfast and before I leave the house for work o Thursday I will practice deep breathing and PMR for 10 minutes in my office at 9:30am before I have to go into a series of very stressful meetings o Friday I will walk with my office mate at lunch for 15 minutes 7 Updated on December 3, 2013