Deep Relaxation Techniques for Fibromyalgia Patients
July 21, 2004
By Connie A. O'Reilly, Ph.D.
Clinical Psychologist, Oregon Fibromyalgia Team
The Relaxation Response (RR) is a quieting of the sympathetic nervous system, the opposite response of the "fight-or-flight" response. It results in a decrease in blood pressure, heart rate and oxygen consumption. There are many techniques which have been used over centuries which can induce the relaxation response.
• Focused breathing
• Progressive Muscle Relaxation
• Guided Imagery
• Autogenic Training
All these techniques have two simple steps in common:
1. Focusing one's mind on a repetitive phrase, word, breath or action;
2. Adopting a passive attitude toward the thoughts that go through one's head.
Extensive research has shown that regular practice of techniques that bring about the RR decrease the responsiveness of the sympathetic nervous system. In addition to the immediate results of decreasing heart rate, blood pressure, breath rate, and oxygen consumption, regular practice over a month or more seems to lead to a change in how the body responds to adrenaline. Research suggests that there are decreases in anxiety and depression, and an enhanced ability to cope with life stressors, after regular practice of RR techniques.
The Relaxation Response is not to be confused with feelings of relaxation one may experience after reading a good book, watching TV, or listening to music. While those activities may be enjoyable, they do not result in either the immediate or long term physiological changes associated with the RR. While the RR is a natural response of the body, it is only truly effective after a person is specifically trained and regularly practices the techniques.
1. DIAPHRAGMATIC BREATHING
Deep abdominal breathing is the basic skill necessary for most deep relaxation techniques. Most people have "unlearned" the healthy abdominal breathing we all did as infants and children, after many years of stress, tension and anxiety. We take short shallow breaths that result in our chest and shoulders expanding on inhalation. Our abdominal muscles (and diaphragms) are often very rigid and tight.
The goal is to learn to relax the diaphragm, allowing expansion of the lung cavity, so that the lungs may fill more completely upon inhalation. You can learn to do this by finding a comfortable place to recline or lie on your back, wear comfortable clothes and practice the following: Place one hand on your chest and the other over your belly button. Close your eyes and become aware of which hand is rising and falling as you breathe slowly and deeply. Try to make the hand over your chest remain fairly still, while you allow the hand over your belly button to rise (as if a balloon were filling inside your stomach) each time you inhale, and to fall again as you exhale.
2. MINI-RELAXATION PROCEDURE
For relaxation to be of the most benefit, you need to learn how to relax and calm yourself instantly upon your awareness of tension or irritability. While a 20-30 minute relaxation period is great, and very pleasant, you cannot escape and listen to your tape or do your long practice when you are tense in traffic or irritated with your family or coworkers. You must have developed good deep relaxation skills, and have practiced them daily for many weeks, before you will be able to perform mini-relaxations effectively.
A mini-relaxation is done as follows:
1. Take a deep breath and raise your shoulders slightly (until you can feel increased muscle tension).
2. Starting at the top of your head, focus on letting go of muscle tension (beginning with the muscles across your forehead). Allow sensations of relaxation, release, and heaviness to flow downward from your forehead, downward through your face, shoulders, arms, torso, and legs and imagine all the muscle tightness and tension draining right out your feet. Exhale as you allow the tension to drain away, and use your "key word" as you do so (this may be Relax, Peace, Calm, Serene, Ocean or any other word or phrase that denotes deep relaxation to you). Be certain that your deep breath was a deep diaphragmatic breath.
3. This whole procedure should take no more than about 30 seconds (and can be done in as little as 10 seconds if that's all the time you have). At the end of this period, go about your business regardless of how relaxed you feel.
4. Repeat this process many times during the day, at least 20. Use the colored dot procedure to remind yourself to do a minirelaxation, preferably several times an hour. Place colored dots in places you will see them often: your telephone, kitchen faucet, refrigerator, bathroom mirror, the door frame of doors you walk through frequently, your notebook or appointment book that you consult frequently, in the center of the steering wheel of your car, and even cut a small part of the colored dot to place on your watchband. Whenever you see the colored dot, that is your reminder to do a minirelaxation: deep breath, raise shoulders, let go of muscle tension as you breathe out and drop your shoulders, while repeating your "key word."
You will notice that you become better and better at producing sensations of relaxation in a very short period of time, as you practice this over days and weeks. Do not extend your minirelaxation more than one minute. If you are still tense, continue with what you are doing, and do another minirelaxation the next time you see a dot, or the next time you are aware of feeling annoyed.
NOTES: A note of caution regarding relaxation if you are driving your car: Never practice long periods of deep relaxation while driving. Never listen to a deep relaxation tape while driving. However, you may use the "colored dot technique" while you are stopped at stop signs or otherwise stuck in traffic.
Frequency is the key! The more you practice relaxation, or minirelaxation, the better you will become at releasing stress and tension quickly and effectively. It is a skill, just like playing tennis or the piano. You cannot expect to be immediately skilled at these techniques. But you will definitely get better the longer and more often you practice. It is a skill that will serve you well over the rest of your life.
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