CEU Update. Relaxation Techniques for Health

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1 CEU Update A semi-annual publication of the National Association for Health Professionals January 2016 Issue # CEU credits Relaxation Techniques for Health How much do we know about relaxation techniques? A substantial amount of research has been done on relaxation techniques. However, for many health conditions, the number or size of the studies has been small, and some studies have been of poor quality. What do we know about the effectiveness of relaxation techniques? Relaxation techniques may be helpful in managing a variety of health conditions, including anxiety associated with illnesses or medical procedures, insomnia, labor pain, chemotherapyinduced nausea, and temporomandibular joint dysfunction. Psychological therapies, which may include relaxation techniques, can help manage chronic headaches and other types of chronic pain in children and adolescents. Relaxation techniques have also been studied for other conditions, but either they haven't been shown to be useful, research results have been inconsistent, or the evidence is limited. What do we know about the safety of relaxation techniques? Relaxation techniques are generally considered safe for healthy people, although there have been a few reports of unpleasant experiences such as increased anxiety. People with serious physical or mental health problems should discuss relaxation techniques with their health care providers. What Are Relaxation Techniques? Relaxation techniques include a number of practices such as progressive relaxation, guided imagery,biofeedback, self-hypnosis, and deep breathing exercises. The goal is similar in all: to produce the body's natural relaxation response, characterized by slower breathing, lower blood pressure, and a feeling of increased well-being. Meditation and practices that include meditation with movement, such as yoga and tai chi, can also promote relaxation. You can find information about these practices elsewhere on the NCCIH Web site. Stress management programs commonly include relaxation techniques. The Importance of Practice Relaxation techniques are skills, and like other skills, they need practice. People who use relaxation techniques frequently are more likely to benefit from them. Regular, frequent practice is particularly important if you're using relaxation techniques to help manage a chronic health problem. Continuing use of relaxation techniques is more effective than short-term use. Relaxation techniques include the following: Autogenic Training In autogenic training, you learn to concentrate on the physical sensations of warmth, heaviness, and relaxation in different parts of your body. Biofeedback-Assisted Relaxation Biofeedback techniques measure body functions and give you information about them so that 1

2 so that you can learn to control them. Biofeedback-assisted relaxation uses electric devices to teach you to produce changes in your body that are associated with relaxation, such as reduced muscle tension. Deep Breathing or Breathing Exercises This technique involves focusing on taking slow, deep, even breaths. Breathe in through your nose, hold the breath for a few seconds and then exhale through your mouth. The time it takes to exhale should be about twice what it is to inhale. Guided Imagery For this technique, people are taught to focus on pleasant images to replace negative or stressful feelings. Guided imagery may be self-directed or led by a practitioner or a recording. Progressive Relaxation This technique, also called Jacobson relaxation or progressive muscle relaxation, involves tightening and relaxing various muscle groups. Progressive relaxation is often combined with guided imagery and breathing exercises. Self-Hypnosis In self-hypnosis programs, people are taught to produce the relaxation response when prompted by a phrase or nonverbal cue (called a suggestion ). What the Science Says About the Effectiveness of Relaxation Techniques Researchers have evaluated relaxation techniques to see whether they could play a role in managing a variety of health conditions, including the following: Anxiety Studies have shown relaxation techniques may reduce anxiety in people with ongoing health problems such as heart disease or inflammatory bowel disease, and in those who are having medical procedures such as breast biopsies or dental treatment. Relaxation techniques have also been shown to be useful for older adults with anxiety. On the other hand, relaxation techniques may not be the best way to help people with generalized anxiety disorder. Generalized anxiety disorder is a mental health condition, lasting for months or longer, in which a person is often worried or anxious about many things and finds it hard to control the anxiety. Studies indicate that long-term results are better in people with generalized anxiety disorder who receive a type of psychotherapy called cognitive-behavioral therapy than in those who are taught relaxation techniques. Depression An evaluation of 15 studies concluded that relaxation techniques are better than no treatment in reducing symptoms of depression but are not as beneficial as psychological therapies such as cognitive-behavioral therapy. Insomnia There is evidence that relaxation techniques can be helpful in managing chronic insomnia. Relaxation techniques can be combined with other strategies for getting a good night's sleep, such as maintaining a consistent sleep schedule; avoiding caffeine, alcohol, heavy meals, and strenuous exercise too close to bedtime; and sleeping in a quiet, cool, dark room. Pain Evaluations of the research evidence have found promising but not conclusive evidence that guided imagery may relieve musculoskeletal pain (pain involving the bones or muscles) and other types of pain. An analysis of data on hospitalized cancer patients showed that those who received integrative medicine therapies, such as guided imagery and relaxation response training, during their hospitalization had reductions in both pain and anxiety. 2

3 What the Science Says About the Safety and Side Effects of Relaxation Techniques Relaxation techniques are generally considered safe for healthy people. However, occasionally, people report unpleasant experiences such as increased anxiety, intrusive thoughts, or fear of losing control. There have been rare reports that certain relaxation techniques might cause or worsen symptoms in people with epilepsy or certain psychiatric conditions, or with a history of abuse or trauma. People with heart disease should talk to their health care provider before doing progressive muscle relaxation. Tips to Make Relaxation Techniques Part of Your Life The best way to start and maintain a relaxation practice is to incorporate it into your daily routine. While it can be tough to find the time in a busy schedule, many of the techniques can be practiced while you re doing other things. You can meditate while commuting to work on a bus or train, for example, or waiting for an appointment. Try deep breathing while you re doing housework or mowing the lawn. Mindfulness walking can be done while exercising your dog, walking to your car, or climbing the stairs at work. Once you ve learned techniques such as tai chi, you can practice them in your office or in the park at lunchtime. Other tips for making relaxation techniques part of your life If possible, schedule a set time to practice each day. Set aside one or two periods each day. You may find that it s easier to stick with your practice if you do it first thing in the morning, before other tasks and responsibilities get in the way. If you exercise, improve the relaxation benefits by adopting mindfulness. Instead of zoning out or staring at a TV as you exercise, try focusing your attention on your body. If you re resistance training, for example, focus on coordinating your breathing with your movements and pay attention to how your body feels as you raise and lower the weights. Avoid practicing when you re sleepy. These techniques can relax you so much that they can make you very sleepy, especially if it s close to bedtime. You will get the most benefit if you practice when you re fully awake and alert. Do not practice after eating a heavy meal or while using drugs, tobacco, or alcohol. Find the relaxation technique for you There is no single relaxation technique that is best for everyone. When choosing a relaxation technique, consider your specific needs, preferences, fitness, and the way you tend to react to stress. The right relaxation technique is the one that resonates with you, fits your lifestyle, and is able to focus your mind and interrupt your everyday thoughts in order to elicit the relaxation response. In many cases, you may find that alternating or combining different techniques will keep you motivated and provide you with the best results. How you react to stress may influence the relaxation technique that works best for you: The fight response. If you tend to become angry, agitated, or keyed up under stress, you will respond best to stress relief activities that quiet you down, such as meditation, progressive muscle relaxation, deep breathing, or guided imagery. The flight response. If you tend to become depressed, withdrawn, or spaced out under stress, you will respond best to stress relief activities that are stimulating and energize your nervous system, such as rhythmic exercise, massage, mindfulness, or power yoga. The immobilization response. If you ve experienced some type of trauma and tend to freeze or become stuck under stress, your challenge is to first rouse your nervous system to a fight or flight response (above) so you can employ the applicable stress relief techniques. To do this, choose physical activity that engages both your arms and legs, such as running, dancing, or tai chi, and perform it mindfully, focusing on the sensations in your limbs as you move. 3

4 A technique growing in popularity is flotation therapy Flotation therapy is the use of a float tank in which a solution of Epsom salt is kept at skin temperature to provide effortless floating. Research in USA and Sweden has demonstrated a powerful and profound relaxation after twenty minutes. In some cases, floating may reduce pain and stress and has been shown to release endorphins. The isolation tank was developed in 1954 by John C. Lilly, a medical practitioner and neuropsychiatrist. During his training in psychoanalysis at the US National Institute of Mental Health (NIMH), Lilly experimented with sensory deprivation in combination with a psychedelic agent, mostly LSD. In neurophysiology, there had been an open question about what keeps the brain going and the origin of its energy sources. One hypothesis was that the energy sources are biological and internal and do not depend upon the outside environment. It was argued that if all stimuli are cut off to the brain then the brain would go to sleep. Lilly decided to test this hypothesis and, with this in mind, created an environment which isolated an individual from external stimulation. From here, he studied the origin of consciousness and its relation to the brain. Peter Suedfeld and Roderick Borrie of the University of British Columbia began experimenting on the therapeutic benefits of isolation tanks in the late 1970s. They named their technique "Restricted Environmental Stimulation Therapy" (REST). Flotation therapy is therapy that is undertaken by floating in a warm salt water in a float tank. People using early float tanks discovered that they enjoyed the experience and that the relaxed state was also a healing state for many conditions including stress, anxiety, pain, swelling, insomnia and jet lag. As a result, float tanks were produced for commercial uses and commercial float centers offering flotation therapy opened in several countries during the period from 1980 to the present day when there are hundreds of flotation centers in dozens of countries. In almost all cases these float centers offer wellness treatments and in particular the release of stress. The San Francisco Bay Area has seen recent growth in such centers. Research into flotation therapy (as opposed to just the effect of isolation) began in the USA at Ohio State University. Floating has been shown to improve creativity in Jazz musicians, accuracy in rifle shooting, focus before academic examinations and stress relief, among others. Research in the U.S., Canada, and Sweden has demonstrated the therapeutic effect on stress and pain. The technique takes advantage of an innate, natural inclination to relax when floating at a comfortable temperature. The temperature is that which allows natural heat generation to escape without the need for muscle action to raise body temperature in homeostasis. The floating posture, usually the supine position allows all the postural muscles to relax. The water pressure on the immersed skin is lower than the blood pressure and thus blood flow continues in skin capillaries. This is in contrast to normal bed rest where local contact pressure inhibits blood flow requiring regular adjustment of posture. When people cannot adjust their posture in bed, e.g. in some illnesses, bed sores can result. When floating there is no tendency to adjust posture and a person can float immobile for many hours. The natural tendency of the body in the floating posture at the correct temperature is to dilate the blood vessels, reducing the blood pressure and maximizing blood flow. The brain activity normally associated with postural muscles is reduced to a minimum. In this state, which we can call the floating state, natural endorphins are released reducing pain. Lactic acid removal is accelerated. Flow in the lymphatic system is increased. 4

5 Issue #0116 Class A CEU CEU QUESTIONNAIRE Complete the questions below to receive 3 continuing education credits. All questions must be answered completely to receive credit. 1. Name 3 health conditions relaxation techniques may help? 2. Who are relaxation techniques generally considered safe for? 3. What is the goal with relaxation techniques? 4. Name the characteristics of the body s natural relaxation response. 5. List 5 relaxation techniques. 6. Progressive relaxation is usually combined with what 2 other techniques? 7. What is generalized anxiety disorder? 8. List 3 strategies for getting a good nights sleep if you have chronic insomnia. 9. What are 2 good ways to find time to practice relaxation techniques with a busy schedule? 10. When should you avoid relaxation techniques? 11. What are the characteristics of the fight response? 5

6 12. What are the 3 reactions to stress that determines what technique may work best for you? 13. If you have the immobilization response how can you rouse your nervous system? 14. Who invented the isolation tank and what was his/her profession? 15. What is the usual floating posture? Please return answer portion only of CEU to NAHP via mail or . Mail to NAHP PO BOX 459 Gardner, KS or Scan and to awhite@nahpusa.com FAXED CEUs ARE NOT ACCEPTED Any CEUs received via fax will be discarded without credit being awarded. Name Address City State Zip Member ID / SSN CEU Update # CEU credits will be awarded 6