Ch. 12 Breathing, Relaxation, and Guided Imagery

progressive muscle relaxation (PMR)

-PMR=Alternate tensing and relaxing of various muscle groups in the body. Progressive or deep muscle relaxation (PMR) involves a physical component—usually the tensing and relaxing of various muscle groups in the body in a sequential pattern—and a mental component—focusing on the distinction between the feelings of tension and relaxation (see Figure 12.4). A physician named Edmund Jacobson developed PMR in the early 1920s to help patients relax their muscles before surgery so they would respond better and recover more quickly. Since muscle tension accompanies anxiety, he theorized that learning how to relax the muscles could reduce anxiety. Jacobson spent more than seven decades documenting the effectiveness of PMR as a preventive measure to reduce stress and as part of the treatment for problems such as hypertension and insomnia. (See "Technique: Tense and Relax Exercise" in Chapter 2.) PMR teaches you to recognize what your body feels like when its muscles are very tense and when they are very relaxed. In active or overt PMR, you focus your attention on a specific muscle group such as the arm muscles and tense them tightly. After the tension builds for 20 to 30 seconds, you let go, and the tension flows away. In passive PMR, you quietly pay attention to a certain muscle or body part and let go of any tension you may feel. You do not have to do anything except allow the tension to flow away. Here are guidelines for a basic active PMR exercise. Record and listen to the instructions below, or pair up with a classmate and take turns leading each other through this exercise: 1) Sit comfortably in a quiet place. Turn off your cell phone and all notifications and alerts. 2) Begin with your major muscle groups starting by clenching your fists as tightly as possible and then letting the tension go. Then move elsewhere as the instructions indicate. 3) When you tense your muscles, do so vigorously, but not so much that you develop a cramp. Hold the muscle in its tensed position for five to seven seconds, count "one thousand one, one thousand two, one thousand three," and so on, to time the contraction. Relax for 15 to 20 seconds. 4) Concentrate on what is happening. Feel the buildup of tension; notice the tightening of the muscles; feel the strain and then the release; relax and enjoy the sudden feeling of limpness. 5) You will be tensing and relaxing each muscle group twice. If any specific part of your body still feels tense after completing the exercises, go back and tense and relax those muscles again. 6) Keep all other muscles relaxed as you work on specific muscle groups. This is challenging at first, but you will soon become adept. 7) To begin, take three deep breaths, holding each one for five to seven seconds. 8) Clench your dominant fist (right, if you're right-handed; left, if left-handed). Hold and count for five to seven seconds; relax. Repeat. 9) Flex your dominant bicep. Tense, relax, tense, relax. 10) Clench the fist of your non-dominant hand; relax. Repeat. Proceed to the non-dominant bicep. Take a couple of deep breaths, and notice how relaxed and warm your arms feel. Enjoy the feeling. 11) Tense the muscles of your forehead by raising your eyebrows as far as you can. Hold for five seconds. Relax. Repeat. Let the wave of relaxation cover your face. 12) Close your eyes very tightly. Release and notice the relaxation. Repeat. 13) Clench your jaws very tightly. Make an exaggerated smile. Release and repeat. 14) Take a couple of deep breaths, and notice how relaxed the muscles of your arms and head feel. 15) Take a deep breath, and hold it for a few seconds. Release slowly. Repeat. 16) Try to touch your chin to your chest but use your neck muscles to keep it from touching. Release and repeat. 17) Try to touch your back with your head, but use your neck muscles to push the opposite way. Notice the tension building up. Release quickly. Repeat and let your neck become completely relaxed. 18) Push your shoulder blades back and try to make them touch. Notice the tension across your shoulders and chest. Relax and repeat. 19) Try to touch your shoulders by pushing them forward as far as you can. Hold, relax, and repeat. 20) Shrug your shoulders, trying to touch them to your ears. Hold, relax and repeat. 21) Take a very deep breath. Hold for several seconds, and release slowly. Do this again, noticing the wave of relaxation overtaking your body. 22) Tighten your stomach muscles and hold for several seconds. Release. Notice the relaxation in your abdomen. Repeat. 23) Tighten your buttocks. Hold, release, and repeat. 24) Tense your thighs, release quickly. Repeat. 25) Point your toes away from your body. Notice the tension. Return to a normal position. Repeat. 26) Point your toes toward your head; return to normal position. Repeat. 27) Point your feet outward, release quickly. Repeat. 28) Point your feet inward; hold. Relax and repeat. 29) Just let your body relax for a few minutes. Notice and enjoy the good feeling. PMR exercises become more effective the more you use them, so you are able to relax more deeply in less time. Focusing your attention on this process becomes relaxing in itself. And there is an additional important benefit: You learn to recognize subtle tension that builds up during the day, and you can release it because you now know what complete relaxation feels like with simple exercises such as the following: Stress Reliever-Quick Muscle Relaxers: Curl both of your hands into fists, tightening your biceps and forearms. Hold this pose for five to seven seconds and then relax for 15 to 30 seconds, noticing the contrast between the sensations of tension and relaxation. Roll your head on your neck in a complete circle, first clockwise then counterclockwise. Scrunch the muscles of your face—wrinkle your forehead, squeeze your eyes, clench your jaws. Relax. Straighten your legs and point your toes back toward your face, tightening your calves and thighs. Hold for five to second seconds and then relax. Straighten your legs and curl your toes as you tighten and release your calves, thighs, and buttocks.

understanding breathing

-The anatomy of a breath. Each breath carries oxygen through the nose and trachea into the lungs. -A breath begins in the nose, which draws in air, warms it to body temperature, humidifies, and partially cleanses it. Air then travels down the trachea to the lungs. Like a tree, each lung has many branches, called bronchial tubes, that carry air to the alveoli, elastic air sacs in the lungs that expand when air is inhaled and contract when it is exhaled. -The small blood vessels called capillaries that surround the alveoli receive oxygen and carry it to the heart, which pumps oxygenated blood to all parts of the body. Blood cells receive oxygen and release carbon dioxide, which travels back to the heart and lungs. The diaphragm, the muscle that separates the lungs and the abdomen, contracts as you breathe in and relaxes as you breathe out. -The two major types of breathing patterns are chest or thoracic breathing and diaphragmatic or abdominal breathing (sometimes called "belly breathing"). Although you don't actually breathe in your abdomen, its movements are a key to releasing your diaphragm. -chest or thoracic breathing= a shallow breathing pattern, in which the chest expands and the shoulders rise with every inhalation, that delivers less oxygen to the heart and lungs. -diaphragmatic or abdominal breathing= Inhaling in a way that causes the diaphragm to contract and move down, drawing air deep into the lungs. -In thoracic breathing, the chest expands and the shoulders rise with every inhalation. Because chest breathing is shallow, the body receives less oxygen, and carbon dioxide builds up, causing feelings of fatigue. During the stress response (see Chapter 2), rapid, irregular chest breathing can produce symptoms such as light-headedness, shortness of breath, heart palpitations, weakness, numbness, tingling, and hyperventilation (extremely rapid and shallow breathing). -Diaphragmatic breathing draws air deep into the lungs as the abdominal cavity expands and the diaphragm contracts downward (diaphragm flattens when it contracts). When exhaling, the diaphragm relaxes, pushing up into the lungs and expelling air. This breathing pattern, deeper and slower than chest breathing, enhances the respiratory system's ability to do its job of producing energy from oxygen and removing carbon dioxide. -As breathing becomes more rhythmic, the number of inhalations and exhalations per minute decreases. Diaphragmatic breathing also reduces the activity of the sympathetic nervous system, the branch of the autonomic nervous system responsible for initiating the fight-or-flight response. -We automatically engage in abdominal breathing when we sleep. Athletes, singers, and dancers consciously practice abdominal breathing to maintain stamina and perform at their best. -Athletes practice deep diaphragmatic breathing to increase stamina and enhance performance. Stress Reliever-How to "Belly Breathe": Close your eyes, lean back in your seat or lie down, and place one hand on your stomach area. Take a deep breath in through your nose and slowly exhale through your mouth. As you inhale, visualize that you are filling a balloon in your belly. With each exhale, notice how your diaphragm contracts. Visualize yourself exhaling stress and/or tension along with your breath. Pay attention to how your diaphragm contracts to expel these things.

yogic breathing

-You can practice breathing exercises in any quiet, relaxing place. -Many people associate yoga with postures that stretch, strengthen, and relax the muscles (see Chapter 14 for a full description). However, another important component is yogic breathing (called pranayama in Sanskrit), which help energize the body, quiet the mind, and clarify perception. -yogic breathing=Breathing practices such as slowing down breathing, making inhalations and exhalations even, then holding the breath briefly during each cycle; used along with yoga postures. Also called pranayama. -pranayama=The Sanskrit term for yogic breathing practices. Yogic breathing practices include slowing your breaths, making inhalations and exhalations even, and holding your breath briefly during each cycle as a way of stopping mental turmoil. The best way to learn yogic breathing and postures is from a teacher. However, you can experiment with yogic breathing on your own. Keep these basic principles in mind: -Don't strain or make an all-out effort. Breathe with ease—and precision. -Stop if you feel dizzy or uncomfortable. Try again later or the next day. -Keep some of your attention on relaxing, especially the muscles that aren't involved in breathing, such as your lower jaw, arms, shoulders, and legs. -Don't hold your breath for more than a brief pause. The following breath awareness exercise is a good introduction to yogic breathing: 1) Lie on a firm yet comfortable surface, such as a thick blanket folded in half. You can bend your knees or straighten your legs. If bent, your knees and feet should be slightly apart, about the same as the width of your hips. If your legs are straight, they should be comfortable close together. 2) Rest your arms on the floor at your sides or bend your elbows a bit and rest your hands on your hips or upper thighs. 3) Close your eyes. Bring your attention to the sensations of heaviest where your body presses into the floor. Let the floor support your head, back, buttocks, legs, and arm. 4) After a few minutes, sift your attention to your breathing. Feel your belly, chest, and back moving in rhythm with your breath. 5) Continue this focus for a while and then explore the sensations made by your moving breath. Feel the rush of air past your nostrils, into your throat, down into your chest. Notice that the air is cool when entering your body and warm when leaving it. Feel the swelling of your belly as you inhale. 6) Notice the sensations in the muscles at the base of your ribs, in your mid-chest, in your back, in your shoulders and neck. Feel your muscles as you both inhale and exhale. 7) Even as you notice the feelings in other parts of your body, keep your attention on some sensation of breathing. If your mind wanders, gently guide your focus back to your breathing. This may happen over and over. That's fine; just keep doing back to your breath. 8) After five to ten minutes, take some purposeful deep breathes, stretch your arms and legs, and then roll onto your side. After a few seconds, slowly sit up. Do not feel frustrated if you repeatedly lose focus. Return again and again to your breath, and notice that when you are really engrossed in a breath, your mind stops its usual chatter. Even though it may happen only for a second, this quieting slows your breathing and calms your mind.

diaphragmic breathing with pelvic tilt

1) Lie on your back on a firm but comfortable surface, such as a folded thick blanket on the floor. Bend your knees at a 90-degree angle. They should be slightly apart, about the same width as your hips. 2) Place your hands over your lower rib cage so your little fingers are just below your lowest rib. Rest your elbows on the floor. 3) Close your eyes. 4) Inhale, sending your breath under your hands. Feel your belly puff up toward the ceiling as you inhale and drop toward the floor as you exhale. 5) Take several deep controlled breaths. Your belly will puff out with each inhalation and drop toward the floor with each exhalation. 6) As you exhale, rock your pelvis so that the waistline part of your back drops toward the floor. Your lower back may even touch the floor as you complete your exhalation. 7) As you inhale, let your pelvis rock back to where it came from, and your lower back will arch slightly upwards, to its prior position. 8) Don't press into the floor with your feet in order to rock your pelvis. Let your legs rest, your feet relaxing into the floor. The muscle action that creates this movement is only in your abdomen. Your back, buttocks, and legs stay relaxed. 9) Continue this breath/movement, tipping your pelvis as you exhale so your lower back descends toward the floor, and releasing this effort as you inhale so your pelvis untilts; that is, it returns to its "neutral" position, as does your back. 10) Continue for five to ten minutes. When your mind wanders to a thought, just bring it back to what you are doing. 11) To finish, end your control of your breath and return to autonomic, effortless breathing, noticing how this transition feels.

controlled breathing

1) Sit quietly in a room and focus on your breathing. 2) Take five slow, deep breaths, pulling air down into your lower abdomen. Concentrate on your breathing. If thoughts come into your mind, such as "I better check my messages," brush them aside and refocus on the rhythm of your breathing. 3) As you breathe in, let your belly rise, and picture yourself inhaling warm, soothing air. 4) As you breathe out, let your belly fall, and visualize yourself exhaling. 5) Imagine that you are gently rocking a baby as your belly extends and recedes. 6) Feel your diaphragm descend then lift as you count up to thirty. *Whenever stress builds, this technique can also serve as a quick antidote.

what you need to know about guided imagery

All you really need to try this technique is imagination. Find a quiet place, make yourself comfortable in a sitting position, shut off any source of distraction, and block off as much time as your schedule allows. If you're dubious about this technique, just relax and give it a chance. Free your imagination to conjure anything and everything, possible or impossible. There are no barriers or limits. Enjoy the experience; play with ideas and images; dare to imagine big, bold scenes; let symbols or pictures bubble up from your unconscious. Don't critique them or worry what others might think about them. Images are most effective if they reflect your convictions and values. Add as many details and sensations as possible to make them come alive. Be sure to put yourself in the picture rather than observing as if you were watching a film or play. Tap into your feelings; if you become upset or sad, accept this emotional response as a sign that the images are working at a deep level of your unconscious mind. Use the same posture—such as sitting with your head back and your hands in your lap—every time you practice guided imagery. This physical cue provides an anchor that signals your body to respond the way it has in previous sessions. If your mind wanders, don't worry. Simply make your way back to your imaginary place. You can combine guided imagery with other relaxation techniques, such as breathing or massage. At the end of a session, give yourself time to travel back to the real world. Remain seated, and breathe deeply for several minutes.

breathing

Breathing, the process of transporting and exchanging oxygen and carbon dioxide, is essential to sustain life. You don't need to think about breathing. Just as your heart beats even when you're asleep or unconscious, your body breathes for you. But unlike your heartbeat, you can control your breathing, making it voluntary rather than automatic. This section describes various approaches to controlling your breathing in ways that enhance the flow of gases to and from your body and relieve many stress-related symptoms.

ABC relaxation

Check-In: Have you ever experienced any of the following after a relaxation exercise? Sleepy Quiet At ease/at peace Energized Aware Joyous Thankful Prayerful In awe Filled with a sense of wonder, mystery, love, and boundless infinity Other According to the ABC theory, relaxation or "centering" consists of three stages: -Attention (sustained focus on a single thing) -Behavior (minimal purposeful activity) -Cognition (passive observation rather than analysis, planning, and other thoughts) The ABC concept applies to any relaxation technique that involves sustained focus and minimal physical and mental activity. In studies, volunteers who regularly practiced ABC forms of relaxation reported a range of feelings, including those listed above. As you experiment with relaxation techniques, continue to monitor yourself and take notes on your experiences. What matters more than how you feel immediately after a relaxation session is how you feel and function throughout the day. Do you feel more alert? Calmer? Better able to handle the unexpected? Whenever you feel tension build, remind yourself to do something vitally important: Breathe!

relaxation

Chill; lighten up; take five; calm down. Whatever the words and phrases, you've probably been told to relax. It's good advice, since your body and mind crave balance and calm. However, you can't achieve this degree of relaxation simply by streaming videos or playing computer games. Relaxation, in the clinical sense, is a process of letting go of the residual stress that builds up, often without notice, in our muscles/body and our minds. With regular practice, relaxation techniques can prevent stress overload and help restore health and wholeness. Relaxation is an important component of many other stress-relieving practices, including meditation, massage, hypnosis, yoga, and t'ai chi.

what you need to know

Deliberate, systematic relaxation is a skill that anyone can master with regular practice. As you learn relaxation techniques, you'll become more aware of muscle tension and other physical sensations of stress. Once you recognize these feelings, you can make a conscious effort to employ a relaxation technique the moment your muscles start to tense. This can prevent stress from intensifying. There are countless routes to relaxation, but most share certain common characteristics: -A quiet environment -A mental device to focus your attention -A passive, accepting attitude -A comfortable position Caution: Some people, especially those with mental disorders or a history of being abused, may experience feelings of emotional discomfort during relaxation exercises. Although this is rare, if relaxation exercises produce distressing feelings, stop what you're doing. You may want to consider talking to a mental health professional about your reaction.

Benefits of diaphragmatic breathing

Diaphragmatic breathing is a relaxation technique in itself as well as a key component of practices such as progressive muscle relaxation (PMR), discussed later in this chapter, and autogenics, discussed in Chapter 14 (see Figure 12.2). Deep rhythmic breathing, used along with other techniques, has proven effective in relieving a variety of psychological and physical problems. Its benefits include: -Cooling off anger -Lifting feelings of depression -Lowering anxiety in people with generalized anxiety or panic attacks -Improving sleep -Relieving muscle tension and pain Diaphragmatic or belly breathing. Begin by exhaling forcefully. As you inhale through your nose, feel your abdominal cavity expand with air. Exhale slowly through your mouth. Repeat.

the benefits of guided imagery

Guided imagery has proven helpful in the treatment of many medical problems, including headaches, asthma, and hypertension, and in promoting healing after surgery. In research studies, cancer patients who imagined their immune system devouring vulnerable cancer cells reported relief from the side-effects of chemotherapy, lower anxiety and pain, and a greater sense of control. Imagery reduces blood loss during surgery, lowers blood pressure and cholesterol levels, and heightens short-term immune activity. The simple act of imagining a peaceful place decreases arousal of the stimulating branch of the nervous system that triggers the stress response. By freeing your mind to think outside the box, imagery can lead to creative solutions to problems. Adding music to imaging sessions can enhance their positive impact on well-being, mood, and physical stress. (See Chapter 15 for more on music therapy.) Mental rehearsal, another imaging technique, lowers stress by improving confidence and positive thinking. A quarterback may pause for a second to visualize his pass soaring toward a receiver in the end zone. A ballerina may see every intricate gesture of a pas de deux as the curtain rises. Students who imagine themselves preparing for a test, sitting down, completing the exam with confidence, and getting a good grade report feeling calmer during a test and better able to remember the information they studied. Stress Reliever-Take a Screenshot: The next time you're about to engage in a situation that is stressful to you: Conjure a snapshot image of it going the way you'd like it to turn out. Take mental note of the parts of the situation that you have control over. Encourage yourself through self-talk, such as "I'm going to ace this." Imagine the result, such as going on line to check your grade and seeing an A. Take a few minutes and write or share how you felt during this exercise and afterward.

introductory guided imagery exercise

Guided imagery is a skill that anyone can develop with practice. You can record the following basic steps and play back the instructions or team up with a partner and take turns reading them: 1) Close your eyes. Roll your eyeballs inward and upward as if you were trying to look at your own forehead (this practice in itself may alter brain wave activity). 2) Let an imaginary scene appear in your mind. Some people create a sandy beach on a perfect summer day; others walk through leafy forests, climb mountain peaks, or sail across a deep blue sea. Choose where you want to go in your mind. 3) If your imaginary scene is fuzzy or incomplete, concentrate more intently and ask, "What is this?" Keep focusing, and watch whatever appears in your imagination. The more details that you can include in your imagined scene, the easier it will be to relax. 4) You can fill in more details by asking questions such as: What is the temperature at the scene? What colors does it contain? What sounds are present? What movements are occurring? 5) Outline the images as if you were tracing them with a pencil. Concentrate on the colors. Are they vivid or muted? Is there a source of light? Where does it fall? Are there shadows? Is the wind blowing? What does the air smell like? If you are sitting or lying down, how does your body feel against the ground? 6) Think of yourself running your fingers over various objects and making note of how they feel to your touch. 7) From what perspective are you viewing the scene? Are you an outsider looking in? If so, shift your perspective so that you are looking at whatever you would view if you were in the scene. Rather than seeing yourself floating on a tranquil pond, shift your perspective so that you are looking up at the sky and feeling the water buoying up your body. 8) If you're on a beach, feel the white sand beneath your toes; smell the salty air; lift your face to the warmth of the sun; listen to the water lapping the shore. Each time the breeze picks up, feel your muscles become more and more relaxed. Watch each wave as it rises and falls onto the shore. 9) As you inhabit this imaginary scene, let feelings of ease and happiness spread from head to toe. Feel your heart rate and breathing slow. 10) Relax for as long as your schedule allows. Gradually open your eyes. Take a deep breath. As you stretch and slowly stand, bask in the feeling of being at ease and in control. As with other mind-based practices, your ability to create images get stronger with practice. Set aside time every day to imagine yourself in another place. If your shuttle bus gets caught in traffic, close your eyes and take yourself on a mini-vacation. Check-In-Pause and Reflect: As you finish your guided imagery exercise, take a moment to tune in to your feelings: Is your mind less cluttered? Do you feel more focused? How does your body feel? How would you rate the tension in your muscles? Do you feel differently than you did after the breathing exercises? If so, what is different?

breathing for pain relief

If you suffer from headaches, backaches, or other forms of chronic pain, use this exercise along with your doctor's prescribed treatments. 1) Close your eyes, and get comfortable. 2) Breathe deeply with your diaphragm to fill your abdominal area with air. 3) Visualize yourself gaining nourishment or strength with each inhalation. 4) Expel all the air from your body. As you do, imagine that you are exhaling your pain and stress. 5) To reinforce this image, add a mantra, such as "I am letting go" or "I am releasing my pain."

guided imagery

Imagine that you are holding an apple. How does it feel in your hand? What color is its skin? Is it shiny? Lift it to your mouth and take a bite. Can you hear the crunch? How does it taste? How do the sensations in your mouth change as you chew and swallow? Although you may not be aware of it, you probably salivated a bit as you added vivid details to your imaginary snack. The reason is that our bodies respond to mental images and sensations almost as if they were real. This concept is fundamental to visualization and guided imagery. Although the terms are often used interchangeably, visualization, as its name implies, uses the imagination to "see" a place, person, or object in your mind. Guided imagery is a program of directed suggestions that involve all the senses—sounds, tastes, smells, textures, sights. Considered a relaxation technique, a meditation exercise, and a form of self-hypnosis, guided imagery is especially effective in reducing stress because it involves body, mind, senses, and emotions. -visualization=Use of the imagination to "see" a place, person, or object in your mind. -guided imagery=A program of directed suggestions that involve all the senses—sounds, tastes, smells, textures, sights—to relax the body, promote healing, or improve performance.

the relaxation response

In the 1970s cardiologist Herbert Benson and his colleagues at Harvard Medical School documented physiological changes in regular practitioners of transcendental meditation (discussed in Chapter 13), including reduced heart and respiration rate, lower blood pressure, and altered brain activity. They dubbed this state of reduced arousal the "relaxation response," a period of rest and recovery that undoes the harmful effects of the stress response. As extensive research has documented, the relaxation response brings about long-term health benefits and counteracts the adverse effects of stress on hypertension, anxiety, diabetes and aging. Here are the basic instructions for inducing the Relaxation Response. Record and listen to the instructions below, or pair up with a classmate and take turns leading each other through this exercise. 1) Sit quietly and close your eyes. 2) Breathe through your nose. Become aware of your breathing. As you breathe out, say the word, "ONE", silently to yourself. For example, breathe IN & OUT, "ONE", IN... OUT, "ONE", etc. Breathe easily and naturally. 3) Beginning at your toes, relax various muscle groups in your body: the feet, the shin, the thigh, the pelvic area, the lower back, the upper back, the shoulders, each arm and hand (including the fingers), the neck, the jaw, the forehead. 4) Continue for 10 to 20 minutes. You may open your eyes to check the time, but do not use an alarm. 5) When you finish, sit quietly for several minutes, at first with your eyes closed and then with your eyes open. Do not stand up for a few moments. 6) Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace. 7) Do not practice this technique within two hours after any meal, because the digestive processes seem to interfere with the elicitation of the Relaxation Response. 8) Do not rush. Complete each step, skipping none. Stress Reliever-The Faith Factor: In his research, Benson found that repetitive prayer—"Hail, Mary" for Catholics, "Our Father" for other Christians, "Shalom" for Jews—can help evoke the relaxation response. If prayer or religion is an important part of your life, repeat a prayer or phrase from your faith as you breathe in and out.

nasal switching or alternative-nostril breathing

In this exercise you use your breathing to access your whole brain—the right, or "feeling" hemisphere and the left, or "thinking" hemisphere. It also is an excellent preparatory step for meditation and mindfulness exercises. 1) Sit in a comfortable position, with your spine erect and shoulders relaxed. 2) You can simply close your right nostril by pressing your thumb against it, and inhale through your left nostril. Try a few shallow breaths that bring air into your chest. Then inhale as deeply as you can, slowly and soundlessly, through your left nostril. Exhale as thoroughly as possible. Then switch, and block your left nostril as you inhale and exhale through your right nostril. 3) Yoga practitioners include alternate-nostril breathing in their breathing practices, discussed, but with a different hand position: Place the tip of your index finger and the middle finger of your right hand in between the eyebrows, the ring finger and little finger on the left nostril, and the thumb on the right nostril (see the following figure). Use the ring finger and little finger to close the left nostril and the thumb for the right nostril. 4) Press your thumb on the right nostril and breathe out gently through the left nostril. 5) After a few breaths, breathe in from the left nostril and then press the left nostril gently with the ring finger and little finger. 6) Remove your right thumb from your right nostril, and breathe out from the right. 7) Breathe in from the right nostril and exhale from the left. Continue inhaling and exhaling from alternate nostrils. 8) After every exhalation, remember to breathe in from the same nostril from which you exhaled. 9) Keep your eyes closed and continue taking long, deep, smooth breaths without any force or effort. In nasal switching, you alternately block one nostril and breathe from the other.

ch intro

Life begins with a breath. The simple act of inhaling and exhaling air accompanies every minute of our time on Earth. As we breathe in, oxygen fills our lungs and travels through the blood vessels to energize our bodies. As we breathe out, we cleanse ourselves of the waste product carbon dioxide. Breathing can do more than keep you alive. By monitoring, controlling, and directing the flow of air into and out of your lungs, you can progress from a state of stress to its physiological opposite—deep relaxation. Since it is impossible to be both relaxed and stressed at the same time, relaxation is a powerful tool for countering the wear and tear of daily life. Rather than gearing up for fight or flight, the relaxed body grows calmer and works more smoothly. Adding vivid guided imagery takes relaxation to another dimension by enabling the mind to shift its focus from ceaseless fretting. Breathing, relaxation, and imagery have proven effective in easing stress, depression, and anxiety and in enhancing overall well-being. If you are tense or tired, worried or weary, the exercises in this chapter will release residual tension you may carry without even realizing and renew your spirit. We urge you to try several techniques. You may find one that helps you most, or you may prefer to incorporate a variety into your daily routine. Check-In: Just Breathe. Without changing anything about your breathing, notice which parts of your body move with each inhale and exhale. Focus on each inhale and exhale for several breaths. When your mind wanders, return to monitoring your breath and your body.

introductory breathing exercise

Listen to the audio instructions on MindTap, record yourself reading them, or pair up with a classmate and take turns leading each other through this exercise. 1) Choose a time and place where you will not be disturbed. Turn off cell phones, laptops, or any other device that may interrupt this calming exercise. 2) Sit comfortably, with your eyes closed and your spine reasonably straight. Place one hand gently on your abdomen. 3) Bring your attention to your breathing. Press your hand down on your abdomen as you exhale forcefully. Let your abdomen push up against your hand as your inhale. 4) As you slowly inhale and exhale, pay close attention as each inhalation brings air first into your abdomen, then your middle chest, and finally your upper chest. Imagine filling a glass with water from bottom to top as you inhale. 5) Once you establish a pattern of smooth deep breaths, you can slow your breath even more. Inhale through your nostrils and exhale through your mouth as if you were breathing out through a straw. With each breath, feel your abdomen lower and rise. 6) Focus on the sound of your breaths as you become increasingly relaxed. 7) If thoughts or feelings enter your consciousness, take note of their arrival and then return to focusing on your breathing. 8) Repeat this basic breathing exercise for about five or ten minutes once or twice a day. Gradually extend your time to fifteen and then twenty minutes. Check-In-Take a Breath.: As you practice these breathing exercises, ask yourself: What am I feeling? Does the experience differ from what I expected? If so, how? How would you describe what you feel to someone else? Do different breathing exercises produce different sensations?

the benefits of relaxation

Relaxation counters the harmful effects of stress throughout the body. See Figure 12.3. Stress speeds up your heart rate; relaxation slows it. Stress raises blood pressure; relaxation lowers it. Stress makes you breathe more rapidly; relaxation slows your breathing. Stress tightens muscles; relaxation releases them. The long-term practice of regular relaxation activities can also change the expression of genes that control the body's response to stress and trauma. Relaxation provides immediate and long term benefits for your mental and physical health. Among the other health dividends of relaxation techniques: Fewer physical symptoms, such as headaches and back pain Relief of post-menopausal symptoms Relief of anxiety in pregnancy and labor Less anger and frustration More energy Improved concentration Enhanced immunity Better sleep Lower blood pressure Relief of symptoms of anxiety and depression Greater resilience Reduced utilization of healthcare services Among college students, even a shortened PMR exercise has proved beneficial in increasing physical and mental relaxation and lowering anxiety and levels of the stress hormone cortisol.

understanding relaxation

The word "relax" comes from the Latin relaxare, meaning "to loosen." This is exactly what happens during relaxation. When you have a stressful thought, muscles in your body tense. This tension, in turn, increases anxiety. Relaxation exercises break this cycle of tension and stress. Many people cannot consciously relax their muscles completely. However, when deliberately tensed in a step-by-step, systematic process, muscles become exhausted and automatically relax, which helps other internal organs relax and lowers your overall stress level. "Active" forms of relaxation involve muscle tensing followed by release; "passive" forms consist of focusing on a muscle or muscle group and simply letting go of any tension. As described in Chapter 1, the stress response activates the sympathetic nervous system and increases epinephrine and norepinephrine, which speed oxygenated, nutrient-rich blood to the skeletal muscles. Relaxation targets the parasympathetic nervous system, which releases acetylcholine, a neurotransmitter (chemical messenger) that decreases metabolic activity and returns the body to homeostasis. While the sympathetic nervous system acts like a gas pedal pressed to the floor, revving your body for action during, the parasympathetic nervous system, responding to relaxation techniques, serves as a brake.

counting or bedtime breathing

This form of diaphragmatic breathing uses counting to focus your mind. Although it can be performed at any time, it is especially useful in relaxing your body and clearing your mind before sleep. 1) Get into a comfortable position, and close your eyes. 2) Pay attention to your abdominal area as you take slow, deep, relaxing, diaphragmatic breaths. Continue to inhale and exhale while counting backwards from 100. Once you reach 0, pause, and slowly exhale. 3) Repeat this cycle. If your mind wanders, notice the thought but redirect your focus back to your breathing. 4) With each breath cycle, feel your body become more relaxed. 5) You also can experiment with counting during breaths: Inhale to a count of three, pause, then exhale to the count of three. 6) After a few breathing cycles, picture your body and mind beginning to relax. Inhale to the count of four, pause, and exhale to the count of four, picturing yourself relaxing more and more. 7) Repeat this cycle with increasing counts for each inhalation and exhalation. As you count to a bigger number, your average breaths per minute will decrease, and you will feel more relaxed and calm.

visualization breathing

This is good preparation for the guided imagery exercises described on Introductory Guided Imagery Exercise . 1) Close your eyes, and get comfortable. 2) Breathe deeply in and out. 3) Choose a color you associate with strength or healing to represent the air coming into your body. Imagine this color nourishing and calming your body and mind. 4) Pause before exhaling, and visualize this color changing within your body as it energizes you and absorbs your stress. 5) As you slowly exhale, imagine the transformed color leaving your body and carrying with it your worries. 6) As you are expelling your stress, imagine your muscles loosening, and say to yourself "I am relaxed" or "I am at peace." 7) Repeat this cycle, visualizing the positive, healthful colored air entering your body, transforming into a different color as it heals you, and taking away bits of your stress with each exhalation.

understanding guided imagery

Your mind constantly cues or directs your body to respond in certain ways. Think of a cherished pet, and you may smile. Hear a certain song, and you may get tears in your eyes as you remember listening to it with someone who is no longer in your life. Guided imagery takes full advantage of this mind-body connection to transport you deep into the unconscious. It is most effective when you choose images that you find meaningful. If you listen to an audio of instructions, your imagination will automatically edit and change the script by conjuring images that are unique to your life experience. Guided imagery changes your brain waves and biochemistry in ways that enhance intuition and creativity. Freed from the limits of logic, you can do things in this altered state that would be impossible in real life, such as soaring among the stars or floating on a cloud. As you concentrate fully on an imagined scene, you become less aware of your actual surroundings. You become calm and in control, a feeling that boosts self-esteem and optimism as it lowers anxiety and stress. Even while sitting on a crowded bus, you can take yourself on an imaginary journey to a lush tropical island and relax. Because your unconscious doesn't know the difference between something real and something imagined, it responds physiologically as if you were really in that place. Your fellow passengers will never guess why you're smiling despite the bustle around you. Guided imagery allows your mind to travel to beautiful, peaceful places where you can fully relax. Stress Reliever-Soothing Images: Waves: With each inhalation, imagine a wave cresting just above your belly button, and with each exhalation imagine the wave washing away tension from every muscle in your body. Colors: Imagine that you are breathing in air that is rich with a color that soothes you. With each exhalation, the air you breathe out is a little lighter. The soothing color fills your whole body, getting deeper and richer with each inhalation. Sponge: Imagine that your body is a sponge in a pool of very warm water. As you breathe in, your body soaks up the warm water, and as you breathe out, the warm water saturates your body sponge. As you continue, your body becomes warmer and warmer and softer and softer.

what you need to know

you will need a quiet and private place for your breathing exercises. If you share a room or an apartment, you might work around your roommates' schedules or ask them to respect your need for quiet, uninterrupted time alone. If you live at home, explain your assignment to your family so they won't interrupt. As you practice diaphragmatic breathing, you can incorporate other stress-relieving strategies, such as mental imagery, positive self-talk, or mantras. Here are some exercises for you to try: