Relaxation means far more than simply seeking the absence of stress and elevating one's feet on their favorite recliner. Neither can relaxation be pursued with the same vengeance with which we drive ourselves to distraction to succeed and to reach our self-imposed standards for productivity and workaholism. Many of us endure by preoccupation with production standards and defining ourselves by what we achieve and strive to become, rather than by who we are and how we live. Simply learning to BE remains out of mind and out of reach. In today's rapid-paced society, the day to day grind of technostress leaves little time and few opportunities to decompress from stress and unwind into something that involves absolutely no score, no schedule and no outcome measures.

The best way to define genuine relaxation is as an experience that involves nothing more than finding complete peace of mind, a feeling of unburdening, and giving oneself the chance to let go and put aside all unpleasantries. This demands a personal commitment for setting aside time for pure and unadulterated thoughtful reflection and sensitivity to one's own needs for physical, mental and spiritual calm, serenity and diversion . Unfortunately, it is usually easy to ignore and dismiss these very basic needs, yet they remain essential to our survival.

One of the basic secrets of true relaxation is to discover those activities that provide you genuine gratification and then to invest energy and regularity in your commitment to them. Allocate at least twenty minutes each day to maintain balance in your life. Take a pledge of enthusiasm for this alteration in your goals for healthier living and promotion of your personal wellbeing. Whether this means playing your oboe, reading a novel by your favorite author, water skiing, knitting, painting a still life or your walls, taking a woodworking class, or walking along the shoreline of your largest local body of water, your chosen activities must offer you the occasion to feel fully restored and consumed with feelings of wellbeing. Allow yourself the freedom to engage in new activities that may fulfill your requirements for total enjoyment and personal satisfaction.

The inextricable link between chronic pain and stress make relaxation/relaxation breathing techniques necessary survival skills for chronic pain sufferers. In fact, the very act of slow, deep and rhythmic breathing can serve as an antidote to stress and tension. It is also an indisputable fact that muscle tension may be both a causal and an incremental factor in the experience of pain and the perception of it ( Lazarus and Mayne, 1990). Face it; breathing is so basic to life, we frequently overlook the fact that it is both an involuntary and a voluntary function. We can be taught to alter breathing as a voluntary process by virtue of the fact that it occurs so regularly. It is easy to focus upon it by attending and concentrating "as a focal point for our thoughts" (Benson, 1975). Breathing techniques can reverse the effects of the fight or flight reaction

bringing about a calming response that reduces blood pressure, heart rate and respiration rate. The primary goal of relaxation breathing techniques is to breathe increasingly slowly, deeply and rhythmically in order to increase oxygen consumption and, consequently, to intensify overall attention-concentration capabilities, problem-solving skills, and the link between body and mind (Melillo, 1986). These techniques form the basis for Lamaze and natural childbirth preparation techniques. Appropriate breathing is unquestionably necessary for the health of both mind and body, as well as the prolongation of life. As a pain reducer, it is an essential component of effective pain management and an antidote to the stress of living with chronic pain when practiced regularly.

Relaxation/Diaphragmatic Breathing Exercise

Practice of proper breathing techniques can readily permit reduction of anxiety, tension, stress, pain, muscle tension, fatigue and feelings of irritability. The impact of routine practice of these techniques may be a surprisingly powerful one in terms of symptom management (Davis, McKay, and Eshelman, 1980).

Find a comfortable place to sit or recline. Bend your knees and move your feet approximately eight inches apart making sure your spine remains straight.

Scan your body to assess your level of tension.

Place one hand on your abdomen and the other on your chest.

Inhale slowly and deeply through your nose and down into your abdomen, observing the movement of your hand as you push it upward with your breath. Your chest should move only slightly and in tandem with your abdomen.

When you feel comfortable with step 4, smile ever so slightly, inhale through your nose, exhale gently through your mouth and allow yourself to release a long sigh or "whoshing" sound. Breathe out like the summer wind.

Take long, slow, deep and rhythmic breaths that raise and lower your abdomen.

Pay close attention to the soothing sounds of your rhythmic breathing and the feelings of relaxation that begin to surround and fill you.

Continue deep breathing for five to ten minutes, once or twice daily.

Scan your body for tension once again and note the difference between the tension you experienced before and after this exercise.

Concentrate upon abdominal or diaphragmatic breathing as many times a day as you remember or desire and pay attention to the feelings of relaxation that you are able to generate with this breathing method.

Keep this stress and tension antidote readily available.

One cannot be in two places at the same time. Neither can we experience feelings of relaxation and well-being simultaneously with physical and psychological stress. Progressive muscle relaxation techniques can decrease heart rate, blood pressure, respiration rate and even perspiration rate. Deep muscle relaxation may serve as a suitable adjunct to anti-anxiety and antihypertensive medications (Davis, McKay, and Eshelman, 1980). It is a known scientific fact that thoughts, stressors and events that are anxiety-provoking in nature, cause the body to respond in kind with muscle tension. This can rapidly become a vicious cycle as bodily tension tends to elicit feelings of anxiety and psychological distress. The very good news is that progressive muscle relaxation diminishes bodily tension, as it is absolutely inconsistent with anxiety, tension and stress reactivity. The fact of the matter is that progressive muscle relaxation has demonstrated its widespread effectiveness in the treatment of anxiety disorders, any number of disorders involving chronic pain, muscle tension and spasms, hypertension, fatigue, phobias and stuttering (Davis, McKay, and Eshelman, 1980).

Progressive Muscle Relaxation

Sit as comfortably as you can in a chair or recliner. Lying down is equally

acceptable.

Gently close you eyes.

Take a long, slow, deep breath. As you slowly exhale, feel yourself sinking

into the surface that supports you.

Relax all the muscles in your scalp, in your forehead and around your eyes.

Feel each tiny muscle fiber becoming loose, limp and very relaxed.

Let all of the muscle groups in your cheeks, jaw and around your mouth

become very loose, limp and relaxed. Allow your tongue to relax so that it sinks to the floor of your mouth.

Allow all of the tension in your neck and shoulders to flow out of your body so

that your shoulders sag and your head sinks back into the chair or whatever

surface you are resting upon. (Avoid this portion of the exercise if it is even

remotely likely to cause you discomfort.)

7. Let all of the muscle groups between your shoulder blades,

down through your back, and all around your spine relax and loosen, releasing any and all tension and discomfort and discharging it from your body.

8. Let your arms relax from your shoulders, down to your elbows, down to

wrists, down through your hands and into all ten fingers. Let tension drain

from the tips of your fingers and into the surface or floor below you.

Relax all of the muscles in your chest and abdomen and down through your

waist, allowing your breathing to become even more slow, deep and rhythmic. Each time you exhale let yourself become even more deeply

relaxed. Relax every single muscle group back to front and side to side.

Relax all of the muscles in your hips and thighs, down to your knees.

Let each tiny muscle fiber become very loose and limp and relaxed.

11. Allow all of the muscles in your calves, down through your ankles, into your

heels, down through your feet, and into the very tips of your toes to become

completely and totally relaxed, loose and limp. Let any remaining tension

drain out the bottoms of your feet and into the floor below you.

Sink down even further into the surface upon which you are reclining or

laying as you begin to experience a total meltdown of comfort and deep

relaxation throughout every portion of your body. Allow yourself to feel like a rag doll; completely loose and limp and comfortable throughout.

Complete this exercise with two deep relaxation breaths.

Repeat as often as necessary or desirable.

The Relaxation Response

The Relaxation Response allows the individual to create physiological changes within the body that are polar opposites to those bodily reactions produced by tension and stress. This, too, allows heart and respiration rates to decrease, overall metabolic rates to diminish and blood flow to the muscles to abate. The relaxation response can be considered a preventative measure to the negative impact of overstress, this being a major factor in aggravation of chronic pain. The four step process to eliciting this response is amazingly simple.

Find a quiet place where distractions can best be avoided. A QUIET ENVIRONMENT is key to producing the relaxation response. Once you

have mastered this technique, however, you can reproduce it anywhere and at anytime.

SELECT A COMFORTABLE POSITION. Lying down is not recommended for this exercise, as it may be easily associated with the onset of sleep versus conscious relaxation. Sitting up in a straight-backed chair is preferable as this supports the spine more effectively and permits unimpeded and complete breathing.

CHOOSE A MENTAL TOOL. This may be a sound (hummmmm or ommmmmm), a word (peace, serenity, one, relax or the like), or a pleasant mental image (your favorite tropical beach or fishing hole, soft and puffy clouds, a special room where you feel most safe and secure or a garden brimming with flowers). Focus intently on your breathing and the gentle movement of air in and out of your lungs as your chest rises and falls. Think of patterning your breathing after the rolling in and rolling out of ocean waves. Close your eyes. Create a mental picture of your selected image or repeat your word or sound silently to yourself over and over again.

Maintain a PASSIVE ATTITUDE. The primary purpose behind this exercise

is to bring about deep rest as well as physical and mental relaxation. This calls for an absolutely passive attitude. If you find your mind wandering, gently and effortlessly bring your thoughts back to your word, sound or visual image.

PRACTICE the relaxation response on a regular basis (twice a day for twenty minutes is recommended) and until you are able to recreate this process routinely. When you have completed this five step process, sit quietly for a few moments before opening your eyes. With time, the entire process will come about automatically and with relative ease.

Autogenic Training

The process of altering blood flow distribution in the body results in the creation of feelings of warmth and heaviness in the extremities (arms and legs). The autogenic training technique allows the individual to train body and mind to respond rapidly and thoroughly to verbal commands to relax; to strive effortlessly to achieve a state of inner harmony and to discharge chronic stress and tension. The primary goal of autogenic training is to normalize the physical, mental and emotional imbalances created by chronic stress (in addition to chronic pain), resulting in unhealthy alterations in body chemistry (Davis, McKay, and Eshelman, 1980). On a longer term basis, the likely outcome may be the onset of any number of stress-related diseases (among them, hypertension, heart disease, ulcers, colitis, migraine headaches, autoimmune disorders, atherosclerosis, cancer and the like), as well as the likelihood that existing disorders (like chronic pain) will worsen and progress. The induction of sensations of warmth and heaviness is deceptively simple but offers a multitude of benefits.

Find a comfortable place to sit or recline, assuring that distractions may be minimal. Keep your eyes closed whenever possible. You may chose to record these phrases in your own voice and then to use your recording to achieve maximum benefits from this exercise. Repeat the following phrases slowly and silently to yourself three times:

I am calm and relaxed (repeat silently to yourself three times).

My right arm is warm and heavy (repeat silently to yourself

three times).

My left arm is warm and heavy.

Both of my arms are warm and heavy and very relaxed.

My right leg is warm and heavy.

My left leg is warm and heavy.

My right leg is warm and heavy.

Both of my legs are warm and heavy and very relaxed.

My heartbeat is calm and regular.

I feel quite quiet.

My mind is quiet and peaceful.

12. My solar plexus is warm. It breathes me.

I feel an inward quietness.

14. My entire body feels warm and heavy and quiet.

15. My thoughts are turned inward and I am at peace.

16. My face feels warm and comfortable and serene.

I withdraw my thoughts from my surroundings and feel

completely serene and still.

Deep within my mind I see and experience myself as relaxed

and warm and comfortable.

Every part of me feels calm and quiet and warm.

I am at peace with myself and the world around me.

Practice this autogenic training exercise for twenty to thirty minutes, daily if possible. Results will undoubtedly occur more rapidly with regular practice.

Guided Visualization

Your imagination is an extremely powerful entity. If you abide by the premise that you are what you think you are and that you can make your thoughts a reality, then you can also learn to refocus your attention on images that are positive and healing in nature (Davis, McKay, and Eshelman, 1980). Such measures can be highly effective in reducing the symptoms of stress-related illnesses, tension and chronic pain. If you believe in the fact that you can feel better by utilizing the powers of your own mind, then you can expect symptom reduction with regular practice. With visual imagery you may allow yourself to focus your awareness on pleasant "pictures" or memories in your "mind's eye" while reducing your focus on negative thoughts, feelings and sensations.

Record these exercises on a tape recorder in your voice or the voice of someone that you find pleasant to hear. Listen to your taped exercise with your eyes closed and while sitting or reclining comfortably, minimizing any distractions. Enjoyable background music may further enhance your experience.

Close your eyes. Assign a color and a shape to your tension or pain.

Change the shape and color of your discomfort.

Pause.

Let color and shape diminish and fade until they disappear completely from your awareness.

.................................

Imagine your breathing becoming as rhythmic as the gentle waves of the ocean rolling in and rolling back out.

2. Picture yourself strolling along the shoreline of a tropical beach in late

summer.

3. Hear the squawking of the seagulls diving and swooping and playing

in the surf.

4. Feel the soft and velvety sand sifting through your toes.

5. Feel the gentle trickling of the surf over your toes washing all tension

and discomfort far out to sea.

6. Experience the warm rays of the sun emanating through every cell in

your body, warming you and relaxing you through every portion of

your being.
7. It is late afternoon and the sun is beginning its journey into the sea.

8. The sea welcomes the sun, allowing it to fall gently below the horizon

and to sleep peacefully until dawn.

9. The sky is now ablaze with every color of the rainbow splashed across

twilight sky. You are overwhelmed by their brilliance.

10. You feel yourself in utter harmony and at total peace with yourself and

the universe, surrounded by dazzling starlight. This offers you the

knowledge that all is well with you and the galaxy of which you are an

integral part.

Set aside quiet time daily to listen to your guided visualization. Allow your

imagery to come to life for you. Make it as lifelike as if you might truly see it, listen to it, smell it, touch it and feel it. Successful outcomes, once again, depend upon routine practice.

The most important factor in achieving maximum benefits from any type of relaxation exercise is making regular practice of them an essential part of your daily routine. Success and mastery of these exercises depends upon it.

Kathy Platoni, Psy.D.

Clinical Psychologist

63 B South Main Street

Centerville, Ohio 45434-7056

937-291-2716

References

1. Benson, Herbert. The Relaxation Response . Avon Books, New York. 1975.

2. Davis, Martha; Eshelman, Elizabeth R.; and McKay, Matthew; The Relaxation

and Stress Reduction Workbook. New Harbinger Publications; Richmond,

CA. 1980.

3. Lazarus, Arnold A. and Mayne, Tracy J.; "Relaxation: Some Limitations, Side

Effects, and Proposed Solutions". Psychotherapy. Volume 27 (2). 1990.

Pages 261-266.

4. Melillo, Wendy. "Breathing Intricacies". The Washington Post Health

Section. March 26, 1986. Pages 8-9.