A guide to relaxation

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					A guide to
relaxation
 Information for patients
Relaxation
Why is relaxation helpful?

v When we are stressed, our muscles tense up. This tension causes
  uncomfortable bodily feelings such as headaches and backache.
v The aches and pains of tension can cause worry, making us
  even more anxious and tense.
v When we are tense/anxious our body system speeds up -
  relaxation slows us down again.
v If we can learn to turn on the bodily feelings of relaxation we
  can turn off the symptoms of tension. You can’t experience
  relaxation and tension at the same time.

Everyday relaxation

It is a good idea to try and change your day-to-day activities in such
a way as to include something relaxing every day. It is helpful to try
and set aside some time every day for relaxing and unwinding. If
possible this should be for a minimum of 30 minutes a day. If you
live with other people you might need to train them gradually to
accept that you would like to be left alone at certain times each day.
For some people just managing to have 30 minutes on their own
every day can make a great deal of difference. There are a number
of things you can do that you might find relaxing. You might have
to experiment to see which has the most relaxing effect on you.
Why not try some of these suggestions and see what effect they
have on you. There may well be some other ideas that suit you
better. Try them and see what is best for you.




2 A guide to relaxation
Relaxing activities, some suggestions:

v Have a long hot bath - maybe try some aromatherapy oils in it
v Read an easy book
v Listen to some soft music
v Lie on your bed and imagine spending a million pounds
v Yoga
v Go for a walk
v Swim
v Cycle

Exercise

Physical effort helps to reduce anxiety by using up some of the build
up of adrenalin stress hormones. Exercise can therefore make you
feel better.



   SummaRy
   A final word

   Relaxing is about slowing things down. Everyone is different
   - experiment until you find your best way to relax.

   Ten minutes ‘out’ of a busy day is a good investment for
   your health and well-being.




                                                A guide to relaxation   3
Relaxation
Relaxation is a very powerful tool. When people are stressed over a
long period of time, they can often wake up feeling tense and go to
bed feeling tense. Therefore they don’t always recognise that they
are feeling tense.

We do not expect you to be relaxed all the time (everyone needs
some tension in their body to walk, sit, even hold themselves
upright!). However, by helping you to learn to relax, you can help
to reduce you overall stress levels. Also, by giving you an experience
of feeling relaxed, you will begin to be able to differentiate between
feeling relaxed and feeling tense. What we want you to do is to
learn to look out for when you feel tense. Therefore when you are
in a stressful situation, you can recognise that you are tense and
take charge of the situation by applying relaxation techniques. A
final point to note about relaxation is that practise makes perfect!
Relaxation can be very powerful, but, like any skill, you need to
practise it to perfect it.

Research has demonstrated that the ability to relax improves
the quality of life for everybody who experiences psychological
difficulties, regardless of whether they feel depressed and/or
anxious. Therefore we want everyone to learn to relax as it will
benefit you all.

Over the rest of this booklet, you will be introduced to three
relaxation techniques:
v Muscular relaxation
v Visual imagery
v Diaphragmatic breathing

Some people prefer different strategies to others, and we hope that
you can identify the method which works best for you.



4 A guide to relaxation
muSculaR Relaxation
Whilst there are many relaxation techniques available, some of
which you may already be using, e.g. yoga, exercise etc... the
method of relaxation that we are going to suggest you use is known
as Muscular Relaxation.

This is a technique that helps you become aware of tension in your
body. By practising the exercises you will tune in and recognise
signs of tension more readily. As a result, by recognising the
bodily symptoms of tension earlier, you will be able to prevent
further tension from building up by putting your relaxation skills in
to practice.

Muscular relaxation uses the pendulum method, if you want a
pendulum to swing in the opposite direction you first have to pull it
back. Practice therefore involves tightening up the muscle groups
first and then letting them go - tensing then relaxing. You will work
systematically through your body tensing and relaxing muscles.




                                                 A guide to relaxation   4
PoSSible PRoblemS With muSculaR Relaxation
Given that the initial stages of this method require that you tense
your muscles, people who have serious physical/medical conditions,
e.g. back problems, may be unsure whether they should carry out
these exercises. If you are worried, consult your GP first.

People who suffer from pains in their joints, e.g. those caused by
arthritis, may not be able to use the pendulum method as it may
hurt to tense up before letting go. If this is a problem for you, you
can learn to relax just by focusing on each muscle group in turn and
relaxing the muscles.

Some people may find that the sensations they experience when
they first begin using relaxation alarming. They may feel like
they are about to lose control rather than sinking into the state of
calmness and restfulness they expected. This sometimes happens
because our bodies have got used to being tense and being relaxed
can come as a bit of a shock to the system! However, if you proceed
at your own pace it does not take long to realise that nothing
alarming happens when you do relax.

Relaxation CDs are widely available. You may also download freely
available relaxation guides on the internet. The following are
particularly helpful:

v http://www.glasgowsteps.com/self-help.jsp
  This website contains a range of self help materials and free
  audio tracks.

v http://www.livinglifetothefull.com
  This website has four relaxation audio track to download along
  with a wide range of self help materials.




6 A guide to relaxation
If you prefer to read a relaxation script and practice yourself without
a CD then you can use the relaxation script below.

1. Start by getting into a comfortable position. Close your eyes.
   Place the feet flat on the floor, legs uncrossed and your hands
   resting comfortably at your side or on your lap.

2. Reading the instructions below (the ‘script’), allowing plenty of
   time for pauses, (if you wish) into a recorder and play it back for
   your use:

3. Begin by noticing your breathing, noticing your abdomen rise
   and fall with each breath. (Allow a pause) As your breathing
   becomes more relaxed and restful, take your awareness down
   to your feet. We will start this process with the muscles in the
   feet and toes. When I say ‘tense’ you will tense the muscles in
   the feet by curling the toes down and holding for a count of
   four full seconds and then will release the muscles in the feet
   when I say ‘release’, and will repeat this process two times in
   various muscle groups throughout the body. Ready...So,
   with your awareness in the feet and toes now tense the feet
   and hold for one... two... three...four..., and ‘release’. Notice
   the difference between a tense muscle and a relaxed muscle as
   you go through the process. Remembering to inhale through
   the nose and exhale through the mouth, releasing any residual
   tension in the feet. With each tense and release cycle, you will
   notice it becomes easier and easier to release and relax each
   muscle group...Now again, bring your awareness to the feet and
   toes and ‘tense’ and hold for one... two... three...four..., and
   release... inhaling through the nose and exhaling through the
   mouth, relaxing even more with each breath.




                                                  A guide to relaxation   7
4. Now, we will move our awareness to the lower legs... to the calf
   area. When I say ‘tense’, we will tense these muscles by pointing
   the toes towards the knees, and again holding for a count of
   three, and then releasing the calf muscles. Ready...So, with your
   awareness in the calf muscles now tense the calves and hold for
   one... two... three...four..., and ‘release’. Notice the difference
   between a tense muscle and a relaxed muscle as you go
   through the process. Remembering to inhale through the nose
   and exhale through the mouth, releasing any residual tension
   in the calves. With each tense and release cycle, you will notice
   it becomes easier and easier to release and relax each muscle
   group...Now again, bring your awareness to the calves and
   ‘tense’ and hold for one... two... three...four..., and release...
   inhaling through the nose and exhaling through the mouth,
   relaxing even more with each breath.

5. Notice the muscles in the thighs. When I say ‘tense’, we will
   tense the muscles in the thighs by pressing the back of the
   legs in the bottom of the chair and holding for a count of four
   seconds and then release. Ready...So, with your awareness in
   the thighs now tense and hold for one... two... three...four....,
   and ‘release’. Notice the difference between a tense muscle and
   a relaxed muscle as you go through the process. Remembering
   to inhale through the nose and exhale through the mouth,
   releasing any residual tension in the thighs. With each cycle,
   you notice it becomes easier and easier to release and relax each
   muscle group...Now again, bring your awareness to the
   thighs and ‘tense’ and hold for one... two... three...four..., and
   release... inhaling through the nose and exhaling through the
   mouth, relaxing even more with each breath.




8 A guide to relaxation
6. Now, notice the muscles in the abdomen and low back. When
   I say ‘tense’, we will tense the muscles in the abdomen by
   imagining that we are trying to touch the belly button to the
   spine, pressing the low back to the chair and holding for a count
   of four seconds and then release. Ready...So, with your awareness
   in the abdomen, now tense and hold for one... two... three...
   four..., and ‘release’. Notice the difference between a tense
   muscle and a relaxed muscle again. Remembering to inhale
   through the nose and exhale through the mouth, releasing any
   residual tension in the low back and abdomen. With each cycle,
   you notice it becomes easier and easier to release and relax
   each muscle group...Now again, bring your awareness to the
   abdomen, ‘tense’ and hold for one... two... three...four..., and
   release... inhaling through the nose and exhaling through the
   mouth, relaxing even more with each breath.

7. Bring your awareness to the muscles in the right arm. When I
   say ‘tense’, we will tense the muscles in the right arm by curling
   the arm up towards your bicep and holding it as if you are lifting
   a weight and holding it to your chest, holding for a count of
   four seconds and then release. Ready...So, with your awareness
   in the arm now tense and hold for one... two... three...four...,
   and ‘release’. Notice the difference between a tense muscle
   and a relaxed muscle as you go through the process again.
   Remembering to inhale through the nose and exhale through
   the mouth, releasing any residual tension in the arm. With each
   cycle, you notice it becomes easier and easier to release and relax
   each muscle group...Now again, bring your awareness to the arm
   and ‘tense’ and hold for one... two... three...four..., and release...
   inhaling through the nose and exhaling through the mouth,
   relaxing even more with each breath.




                                                    A guide to relaxation   9
8. Now, bring your awareness to the muscles in the right hand.
   When I say ‘tense’, we will tense the muscles in the right hand
   by clenching it into a tight fist, holding for a count of four
   seconds and then release. Ready...So, with your awareness in
   the hand, now tense and hold for one... two... three...four...,
   and ‘release’. Notice the difference between a tense muscle
   and a relaxed muscle as you go through the process again.
   Remembering to inhale through the nose and exhale through
   the mouth, releasing any residual tension in the arm. With
   each cycle, you notice it becomes easier and easier to release
   and relax each muscle group...Now again, bring your awareness
   to the hand and ‘tense’ and hold for one... two... three...four...,
   and release... inhaling through the nose and exhaling through
   the mouth, relaxing even more with each breath.

9. Bring your awareness to the muscles in the left arm. When I say
   ‘tense’, we will tense the muscles in the left arm by curling the
   arm up towards your bicep and holding it as if you are lifting
   a weight and holding it to your chest, holding for a count of
   four seconds and then release. Ready...So, with your awareness
   in the arm now tense and hold for one... two... three...four...,
   and ‘release’. Notice the difference between a tense muscle
   and a relaxed muscle as you go through the process again.
   Remembering to inhale through the nose and exhale through
   the mouth, releasing any residual tension in the arm. With each
   cycle, you notice it becomes easier and easier to release and
   relax each muscle group...Now, bring your awareness to the
   arm and ‘tense’ and hold for one... two... three...four..., and
   release... inhaling through the nose and exhaling through the
   mouth, relaxing even more with each breath.




10 A guide to relaxation
10. Now, bring your awareness to the muscles in the left hand.
    When I say ‘tense’, we will tense the muscles in the left hand by
    clenching it into a tight fist, holding for a count of four seconds
    and then release. Ready... So, with your awareness in the left
    hand, now tense and hold for one... two... three...four..., and
    ‘release’. Notice the difference between a tense muscle and a
    relaxed one. Remembering to inhale through the nose and exhale
    through the mouth, releasing any residual tension in the arm.
    With each cycle, you notice it becomes easier and easier to release
    and relax each muscle group... again, bring your awareness to
    the hand and ‘tense’ and hold for one... two... three...four..., and
    release... inhaling through the nose and exhaling through the
    mouth, relaxing even more with each breath.

11. Notice the muscles in the upper back, around the shoulder
    blades. When I say ‘tense’, we will tense the muscles in the upper
    back by pressing the shoulder blades together and holding for
    a count of four seconds and then release. Ready...So, with your
    awareness in the shoulder blades, now tense and hold for one...
    two... three...four..., and ‘release’. Notice the difference between
    tense and relaxed as you go through the process. Remembering
    to inhale through the nose and exhale through the mouth,
    releasing any residual tension. With each cycle, you notice it
    becomes easier and easier to release and relax each muscle
    group...Now again, bring your awareness to the upper back and
    ‘tense’ and hold for one... two... three...four, and release...
    inhaling through the nose and exhaling through the mouth,
    relaxing even more with each breath.




                                                 A guide to relaxation   11
12. Notice the muscles in the shoulder area and neck. When I say
    ‘tense’ we will tense the muscles in the neck by pressing the
    shoulders towards the ears and holding for a count of four
    seconds and then release. Ready...So, with your awareness in
    the neck and shoulders, now tense and hold for one... two...
    three...four..., and ‘release’. Notice the difference between
    a tense muscle and a relaxed muscle as you go through the
    process. Remembering to inhale through the nose and exhale
    through the mouth, releasing any residual tension in this area...
    it becomes easier and easier to release and relax each muscle
    group...Now again, bring your awareness to the shoulders
    and ‘tense’ and hold for one... two... three...four..., and
    release... inhaling through the nose and exhaling through the
    mouth, relaxing even more with each breath.

13. Bring your awareness to the chin and jaw area. When I say
    ‘tense’ we will tense the muscles in the jaw by pressing the chin
    into the chest, gently and holding for a count of four seconds
    and then release. Ready...So, with your awareness in the chin
    and around the jaw area, now tense and hold for one... two...
    three...four..., and ‘release’. Again, noticing the difference
    between a tense muscle and a relaxed muscle as you go
    through the process. Remembering to inhale through the nose
    and exhale through the mouth, releasing any residual tension
    in this area. With each cycle, you notice it becomes easier and
    easier to release and relax each muscle group...Now again,
    bring your awareness to the jaw and ‘tense’ and hold for one...
    two... three...four..., and release... inhaling through the nose
    and exhaling through the mouth, relaxing even more with
    each breath.




12 A guide to relaxation
14. Now, bring your awareness to the facial muscles. When I say
    ‘tense’, please tense the muscles in the face by furrowing the
    brow and squeezing the muscles together as if you’ve just eaten
    a very tart, sour lemon and holding for a count of four seconds
    and then release. Ready...So, with your awareness in the face
    now tense and hold for one... two... three...four..., and ‘release’
    all the muscles in the face. Notice the difference between a
    tense muscle and a relaxed muscle as you go through the
    process. Remembering to inhale through the nose and exhale
    through the mouth, releasing any residual tension in the face.
    With each cycle, you notice it becomes easier and easier to
    release and relax each muscle group... Now again, bring your
    awareness to the face, ‘tense’ and hold for one... two... three...
    face..., and release... inhaling through the nose and exhaling
    through the mouth, relaxing even more with each breath.




                                                 A guide to relaxation   13
ViSual imageRy
Visualisation as a relaxation exercise is simply imaging a relaxing
scene, and feeling the resulting relaxation. In the following example,
I have used a beach, but you may adapt the script to be anything
that works for you or your child. You may prefer the story to be a
walk in the woods, culminating in laying in a meadow for instance.

Close your eyes and try to imagine yourself at the seaside. You are
walking down the beach to the seashore. The sun is shining, it’s warm,
with a gentle breeze. You walk slowly along the water’s edge, looking
around you. You see the seagulls soaring above, in the clear blue sky.
In the distance, you see the sails of a yacht, sailing gently along.

You are beginning to feel tired, so you walk up a beach a little way,
and lie down in the soft sand. You are looking up at the sky, with the
occasional wispy white cloud float calmly by. You feel the sand beneath
you - how soft and warm it is. You can hear the sounds around you
- the seagulls calling and waves breaking gently onto the sand. The
sound of the sand and pebbles as the waves go back out again. You
can feel the gentle warm breeze on your face and in your hair.

You feel yourself sinking down into the sand a little as it support your
whole body. Your body is feeling heavy and floppy.

Feel yourself breathing and let your breaths slow down, you are
breathing slowly and deeply, letting your tummy rise up and you
breathe in. You lay there for a while, hearing the waves, feeling the soft
warm sand beneath you.

When you want to, count back from 5 to 1, then open your eyes, wiggle
your toes and fingers, stretch, then gently sit up.




14 A guide to relaxation
DiaPhRagmatic bReathing
The diaphragm is the most efficient muscle of breathing. It is a
large, dome-shaped muscle located at the base of the lungs. Your
abdominal muscles help move the diaphragm and give you more
power to empty your lungs.

Diaphragmatic breathing is intended to help you use the
diaphragm correctly while breathing to:
v Strengthen the diaphragm
v Decrease the work of breathing by slowing your breathing rate
v Decrease oxygen demand
v Use less effort and energy to breathe


Diaphragmatic breathing technique

1. Lie on your back on a flat surface or in bed, with your knees
   bent and your head supported. You can use a pillow under your
   knees to support your legs. Place one hand on your upper
   chest and the other just below your rib cage. This will allow you
   to feel your diaphragm move as you breathe.




                                               A guide to relaxation   15
2. Breathe in slowly through your nose so that your stomach
   moves out against your hand. The hand on your chest should
   remain as still as possible.




3. Tighten your stomach muscles, letting them fall inward as you
   exhale through your mouth. The hand on your upper chest
   must remain as still as possible.




         When you first learn the
         diaphragmatic breathing
         technique, it may be easier for
         you to follow the instructions
         lying down, as shown here.
         As you gain more practice,
         you can try the diaphragmatic
         breathing technique while
         sitting in a chair, as shown.




16 A guide to relaxation
To perform this exercise while sitting in a chair:

1. Sit comfortably, with your knees bent and your shoulders, head
   and neck relaxed.
2. Place one hand on your upper chest and the other just below
   your rib cage. This will allow you to feel your diaphragm move
   as you breathe.
3. Tighten your stomach muscles, letting them fall inward as you
   exhale through your mouth. The hand on your upper chest
   must remain as still as possible.

Note: You may notice an increased effort will be needed to use
the diaphragm correctly. At first, you’ll probably get tired while
doing this exercise. But keep at it, because with continued practice,
diaphragmatic breathing will become easy and automatic.

How often should I practice this exercise?

At first, practice this exercise 5-10 minutes about 3-4 times per
day. Gradually increase the amount of time you spend doing this
exercise, and perhaps even increase the effort of the exercise by
placing a book on your abdomen.




                                                A guide to relaxation   17
Relaxation aS a PRactice
Learning to relax takes time. It is something for which you may
have lost the knack and, therefore, like learning any new or lost skill,
it will take time and effort to develop again. Remember, learning
to control your body reactions and to take charge of them is
important in both preventing and relieving psychological difficulties,
particularly anxiety.

1. Learn to relax at you own pace, you may not pick it up
   straight away.

2. Take the time to relax, do not do other odd jobs instead

3. Find a time to practice when you feel calm.

4. Your mind will wander when trying to relax. This is normal, just
   let the thought pass and continue with relaxing.

5. Set aside at least half an hour a day to practice relaxation.

6. Decide on a regular time of day to practice.

7. Try to find a place where you will not be disturbed.

8. Make yourself warm and comfortable.

9. Never practice in the car whilst you are driving.

10. Keep a record of your progress.




18 A guide to relaxation
FuRtheR helP
v Yoga/Pilates classes run by North Lanarkshire Council Leisure
  Centres. Tel: (01236) 762 871, (01698) 750 130
  (payment required)
v For other possible local classes see your local newspaper or
  your local library
v Lanarkshire Links
  Tel: (01698) 265 232

Helplines

v Breathing Space - mental health helpline
  (Daily: 6pm-2am)............................................................ Tel: 0800 83 85 87

v Depression Alliance ........................................................ Tel: 0845 123 23 20

v Samaritans - confidential support for anyone in a crisis
  24 hours ................................................................................. Tel: 08457 90 90 90
  Textphone: ........................................................................... Tel: 08457 909192

v SANEline ................................................................................. Tel: 08457 67 8000

Websites

v http://www.lanarkshirementalhealth.org.uk/
  Lanarkshire Mental Health and Wellbeing Information Site.
v http://www.aworldofaromatherapy.com
v http://www.glasgowsteps.com/self-help.jsp
  Self help booklets on psychological problems, including
  depression, anxiety, etc
v http://www.livinglifetothefull.com
  A general self help site offering advice on a wide range of issues.
  It helps you to understand your behaviour and thoughts, and
  offers help on healthy living, better sleep, relaxation, etc.

                                                                               A guide to relaxation              19
v http://www.moodjuice.scot.nhs.uk
  Offers information and advice to those experiencing
  troublesome thoughts, feelings and actions.

Books

The following books are available to buy or can be found in your
local library:

v Aitken, Cara “Surviving post natal depression” ISBN 1853028614

v Brewer, Sarah (2000) Simply Relax: The Beginner’s Guide to
  Relaxation Duncan Baird ISBN: 1900131293

v Butler, G and Hope, T (1995) Manage Your Mind Oxford ISBN:
  0192623834 (Chapter 11: Learning to Relax)

v Greenberger, Dennis “Mind over mood” (1995) ISBN 0898621283

v Hauri, Peter & Linde, Shirley “No more sleepless nights” (1996)
  ISBN 0471149047

v Wilson, Paul (1999) Little Book of Calm Penguin ISBN: 0140285261

v Worwood, Valerie Ann (1997) The Fragrant Mind Bantam ISBN:
  0553407996 (An easy read.)

v Worwood, Valerie Ann (1991) The Fragrant Pharmacy Bantam
  ISBN: 0553403974 (An easy read. Complete guide.)




20 A guide to relaxation
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                                                                                                                  A guide to relaxation                          21
Booklets/leaflets available on the following:

v Anger                             v Self-Harm
v Anxiety                           v Self-Help websites
v Bereavement                       v Sleep
v Depression                        v Stress
v Hyperventilation                  v Trauma
v Panic (short version              v How to solve problems:
  and long version)                   a simple DIY technique
v Relaxation                        v Worry

Copies of any of the above booklets are available free of charge from:




22 A guide to relaxation
To cut out and keep:


Controlling your breathing

THINGS TO REMEMBER

v breathe in slowly to the count of four,
  “one elephant, 2 elephant, 3 elephant, 4 elephant”
v hold your breath for the count of four
v breathe out slowly counting elephants




                                            A guide to relaxation   23
Helplines

v Breathing Space - mental health helpline
  (Daily: 6pm-2am)............................................................ Tel: 0800 83 85 87

v Depression Alliance ........................................................ Tel: 0845 123 23 20

v      National Debt-line...........................................................Tel: 0808 808 4000

v Samaritans - confidential support for anyone in a crisis
  24 hours ................................................................................. Tel: 08457 90 90 90
  Textphone: ........................................................................... Tel: 08457 909192

v SANEline ................................................................................. Tel: 08457 67 8000




                                                                Pub. date:              November 2008
                                                                                                                   Design - Medical Illustration, NHS Lanarkshire




                                                                Review date:            November 2009

                                                                Issue No:                                  01

                                                                Produced by:                      MMMHP

                                                                Contact:

                                                                Telephone:

Published by: Mild/Moderate Mental Health Project                                           PIL.RLAXTN.41091.P

				
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