Relaxation Techniques

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Author: Ron Cridland, MD

The Purpose of Relaxation

If you are tired and your mind is relaxed, you fall asleep naturally.  A relaxation technique does not "put you to sleep".  It distracts your mind and relaxes your body.  Essentially, it keeps your thoughts out of the way while you are waiting for sleep to happen by itself.  Relaxation is a simple skill that anyone can learn, and everyone should be able to do it.  It enables you to control your mind and thoughts when you want to.  Relaxation is not only helpful for sleep, but it can also be used before and during exams, performances, speeches, athletic competitions, and any other situation you can think of that requires a calm, focused mind.

Not everyone is a "natural" at relaxation.  It is like learning to play the piano.  Not everyone is a musician but almost anyone can learn to play if they practice enough.  Relaxation is similar in that most people can learn enough relaxation to be able to turn their mind off when they want to sleep.

When trying to fall asleep, it is often difficult to turn your mind off.  When you try to blank out your mind, it acts like a vacuum and sucks thoughts back in.  These thoughts are not necessarily conducive to sleep.  A relaxation technique gives your mind something to do that is conducive to sleep.  It makes it easier to turn your mind off so you can fall asleep.  

Even if you do not have trouble falling asleep, if you go to sleep with "stuff" on your mind, "stuff" may fuel your dream content and disturb your sleep quality.  If you do a relaxation technique and fall asleep with pleasant, relaxing thoughts, you are more likely to have pleasant, relaxing dreams.

If you practice relaxation every night, you are more likely to become good at it.  In addition, if every night you do a relaxation technique and then fall asleep, you will also become conditioned to associate relaxation with falling asleep.  When you wake up at night, remember that you are still tired and want to sleep.  It is typically your mind keeping your awake.  Repeating the relaxation technique and turning your mind off will help you will fall back to sleep. 

Some people make the mistake of doing relaxation only when they are having trouble falling asleep.  They run the risk of learning to associate relaxation with trouble falling asleep.  It is like practicing “self defense” only when you are being mugged.  You will never get very good at it.  However, if you practice self defense in self defense class where you are not worried about getting injured and you have the opportunity to develop the skills and the reflexes, when you need it, it is automatic, and you don't have to think about it.  Similarly, if you practice relaxation every night when you go to bed, especially when you fall asleep anyway, you will learn to associate relaxation with falling asleep.  Then when you need it, you are good at it.

Some people will tell me, “I don’t need to relax when I go to bed because I don’t have any trouble falling asleep".  However, they are seeing me because they DO have trouble falling asleep when they wake up in the night.  If you want to sleep well, you need to do relaxation every night, even when you do not have trouble falling asleep initially.  Relaxation then becomes a habit that requires no effort.  It is a critical skill that will help you return to sleep during the night.

Use of Relaxation CD’s, Audio Files and Apps

Do the relaxation technique in bed, with the lights out and eyes closed. Give yourself permission to fall asleep during the technique.  If you are worried about disturbing your bed partner, get their permission to use it in bed.  If you play it quietly on your side of the bed, it is probably not going to bother your bed partner.  If they are a good sleeper and listen to it, they are going to fall asleep.  If they are not a good sleeper, then they should be listening to it anyway.  If they object, then you could start off by sleeping in another room until you have learned to do it on your own without the audio file.  Another option is to listen to it before bed enough times until you can do it on your own in your head.

A common relaxation technique is Breathing Relaxation.  Lie down on your back or sit with your feet flat on the floor if you are practicing this outside of bed.  You can start by taking three, slow, controlled, deep breaths.  Breathe in for a count of 4 heart beats, hold for a count of 4, breathe out for a count of four and hold out for a count of 2.  Repeat two times to focus your attention away from everything else and onto your breathing.  Deep breathing is relaxing but because it is an "active process" it can also keep you awake.  After you have done three controlled, deep breaths, stop controlling your breathing and just monitor your natural breathing.  Put a hand on your abdomen.  Notice as you breathe in your abdomen goes up.  As you breathe out notice your abdomen goes down.  In-out, up-down.  As you breathe in through your nose, notice the air in your nostrils is cool.  As you breathe out, notice the air in your nostrils is warm.  In-out, up-down, cool-warm.  This is a lot to think about and should keep all your thoughts occupied with your breathing.

Another relaxation technique is Progressive Relaxation.  Start off by tightening one particular muscular group like your hands and forearms by clenching a fist or tighten your feet and calves by pointing your toes.  Tighten the muscles as tight as you can in order to "experience" what tension feels like.  A word of caution if you have fibromyalgia, tendonitis, or a tendency to muscle cramps.  If you tighten too hard, you may increase your pain or cause a cramp.  Instead, just tighten enough to feel the tension.  When you stop tightening and “let go”, you have an opportunity to experience the contrast between tension and relaxation and get a feeling for what it is like to relax.  Then you “progressively” work through the muscle groups of your body tightening and relaxing each one from head to toe or toe to head. 

Tightening your muscles is like using "training wheels" on a bicycle.  Training wheels help you develop a feeling for riding a bike.  Once you get a feeling for balancing on two wheels, you take the training wheels off because they prevent you from progressing.  After a week or so of practicing the progressive relaxation technique, you know what it feels like to relax and you no longer need to tighten the muscles any more.  Now you can modify the technique. Instead of tightening the muscle group, just become aware of the tension or other sensations that are already there.  Then when it is time to relax, let it go and remember what it feels like to relax.  Without controlling your breathing, it is helpful to time the "letting go" thought with the natural exhalation phase of your breathing.  There is a physiological "relaxation" that occurs naturally every time you exhale which will augment the effect of the relaxation thought and deepen the relaxation effect. 

You can probably remember a time in your past when you had an aggravating or frustrating experience.  Just by thinking about it again you will probably start to feel uptight or tense.  This means that you have the ability to recall an experience from the past and re-experience it in the present.  Now, if you can recall a pleasant, relaxing experience like walking on the beach, having a massage, or what it felt like when you tensed your muscles and then let them go, you can remember what it felt like to relax and recreate that feeling.  Herbert Benson, a medical doctor from the Harvard Medical School in the 1970's, coined the term the "Relaxation Response” to describe this experience.  The "Relaxation Response" is the physiological change that occurs in your body when you remember what it feels like to relax.

Once you become familiar with Progressive Relaxation and Relaxing Breathing you can combine the two techniques.  To use a martial arts analogy, this is like the "black belt" of relaxation.  You combine everything you have learned about relaxation and take it to another level.  As you breathe in become aware of the sensations in the muscle group you are focusing on such as your foot, calve, hand or forearm.  As you breathe out let it go.  As you breathe in again become aware of the residual sensations in those muscles.  As you breathe out again, let that go too.  With each exhalation, you relax the muscles further and further until that limb or part of the body is as relaxed as it is going to get.  The limb may feel numb or warm.  It may feel light and floating or heavy and sinking.  Notice what it feels like.  Then you go on to the next part of the body and repeat the process.

There are nerve endings in the muscles, tendons and joints called proprioreceptors that sense motion and tell your brain where your limb is in space.  When you relax and stop moving your body for a while, the proprioreceptors stop providing information to the brain.  This is why the limb may feel numb or light or heavy.  It doesn't matter which.  It just means the limb is relaxed. 

While you are juggling awareness of your muscles and the phases of your breathing, it is really hard to think of anything else.  That is why it works so well.

No one relaxation CD or APP is perfectly worded for every individual.  There will always be some words or phrases that may “rub you the wrong way” and may not feel relaxing.  Do not get worked up by thinking about the parts you don’t like.  Just ignore these parts by focusing on the last part you did like or on your breathing, relaxing deeper with each exhalation until the voice on the audio file gets to a part that you do like.

A third technique is called Autogenic Relaxation which is visualization and imagery.  For example, you could imagine walking on a beach on a warm, summer day.  You could imagine that you feel the warmth of the sun on your skin, the sand between your toes, or the breeze in your hair.  You could try to picture the ocean, beach, sky, and vegetation.  You could imagine that you can hear the waves or seagulls.  You might be able to taste an ice-cream cone or smell the salty air.  You should try and get as many of your five senses involved in the image.  If you like beaches, you will find it relaxing.  However, the same principles could be applied to the image of a mountain stream, a cabin in the woods, sitting in a flower garden, having a massage, or anything in your experience that you have found relaxing and enjoyable.  Even if you are not good at visualization, with a little practice, you should be able to get at least one or two of your senses involved in the “image”.  In fact, the most important part of the image is not what it looks like.  It is what it feels like.  What it looks like is just to set the scene for what it feels like.  If you can imagine the warmth of the sun on your skin, the feeling of warmth is a very powerful relaxing cue.  If you can imagine that you are so relaxed that you feel heavy, like you are creating an indentation in the sand with the weight of your body as you lie on the beach, the feeling of heaviness is a very powerful relaxing cue.  If you an imagine that your arm is so relaxed that it feels light, like it is floating.  Even though it is the opposite of heavy, the feeling of lightness is also a very powerful relaxing cue.  

Relaxation is a simple skill.  After a week or two you should be able to learn the principles of these techniques and do it your own way in your mind without having to listen to the audio files anymore.  This is when it works the best because you can emphasize the parts you like, leave out the parts you do not, mix and match different techniques, and do your own thing. In the beginning you will have to guide yourself through the technique.  Eventually, you just "relax".  It becomes a habit that requires little effort. It is kind of like learning to swing a golf club.  Initially, you have to think about all the parts of the swing.  Eventually you develop muscle memory and just swing it.

There are many relaxation, breathing and meditation techniques that you can learn from CD’s, DVD’s, the internet, smart phone apps, books, meditation, stress management classes and yoga.  I encourage you to try some and add them to your repertoire.  


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