Relaxation & Mindfulness

When humans face a threat, our bodies respond through the fight or flight response. The body gets ready for action – literally, either ready to fight or ready to run to safety – by bringing extra blood flow to the muscles, raising heart rate and blood pressure, and increasing muscle tension for speed and strength. Like the body’s response to pain, the fight or flight response was intended for rare moments of extreme need to help you survive danger. The body was not meant to be this way all the time. Most importantly, while these changes are helpful for our survival from a life or death threat, they have consequences to our physical and emotional well-being if they persist for a long period of time. This includes making our pain, fatigue, and stress worse.

One of the most effective tools for managing pain, fatigue, and other symptoms is to learn how to stop or calm the fight or flight response. Ongoing symptoms of pain conditions do not need to be met by this alarm-type response. If we can calm ourselves, we can also calm our nervous system, reduce our stress, and give ourselves a chance to find other ways to cope with our pain, fatigue, and other symptoms.

We calm our system through relaxation strategies. A state of relaxation is the opposite of the “fight or flight response” and changes how you deal, emotionally and physically, with stress. Relaxation is a very effective tool for managing pain and several symptoms that are also experienced by people with chronic pain, including fatigue, problems with sleep, stress, and depressed mood.

Relaxation is helpful for pain because:

• Tense muscles make pain worse. Your body naturally protects itself by tensing muscles around an area that hurts or that it needs to protect. When your muscles are tense for too long, your pain may increase. Relaxation helps decrease this muscle tension that occurs when feeling pain.
• Relaxation is also a way to counter the well-known negative effects stress has on pain and other physical problems (counteracts the “fight-or-flight” response).
• Relaxation also has a beneficial effect on the areas of the brain that are involved in sensing and reducing pain.

Relaxation can also be helpful for other symptoms because:

• It is common to feel tense when you feel depressed or anxious. Relaxation helps decrease physical and mental tension that can make depression and anxiety worse.
• Relaxation can help you sleep better.
• Relaxation is a good way to take a break or “time-out” from stressful situations or emotions. It is a helpful activity you can do to take care of yourself.
• People are usually better at planning and problem solving when they feel relaxed compared to when they fell stressed.

Autogenic

Click here for a guided exercise on autogenic relaxation that will help you decrease bodily tension through deep breathing and awareness.

• Duration: 10 minutes
• Diminishes physiological arousal
• Trains the body to calm physiological processes

Deep breathing

The following audio is designed to teach you how to breathe deeper and more effectively, which may decrease your anxiety and improve your mood.

• Duration: 5 minutes
• Improves the quality of your breathing to help you relax.
• One of the easiest and most effective relaxation skills

Guided imagery

The following audio will guide you through a visualization exercise where you remember a place that you feel fondly about and focus all your attention on that setting.

• Duration: 6 minutes
• Uses mental imagery of calm places to induce relaxation
• Uses all your senses to produce a vivid mental image that distracts you from stress

Progressive muscle relaxation

The following audio will guide you through a relaxation exercise in which you learn to tense and release different muscles in your body.

• Duration: 4 minutes
• A quick technique for achieving the relaxation response
• Recommended after you have mastered other techniques that take longer
• Can be more easily applied in real-world settings outside the home

Body scan 1

The following clip will guide you through a floor relaxation exercise aimed at decreasing bodily tension.

• Duration: 6 minutes
• Mentally scan your body for stress
• Decreases tension

Body scan 2

Listen to the audio below for a chair relaxation exercise that will release stress in your body.

• Duration: 7 minutes
• Mentally scan your body for stress
• Decreases tension

Mindfulness meditation

The audio below is a guided meditation that will help you focus on the present moment.

• Duration: 2 minutes
• Focuses one’s attention on the present moment
• Allows negative thoughts to flow through one’s mind without evoking stress
• When we do not attach our minds to negative thoughts, they have less energy, and it is easier to let them go.

Practicing relaxation regularly, even when you are feeling well, can have beneficial effects, including reducing the number and severity of painful episodes and building energy. The more you use relaxation, the more benefit from it you’ll discover.

• This skill, like all the skills described in MyPelvicPlan, is most helpful when practiced.
• It is best to practice relaxation exercises often. We recommend that you practice a relaxation exercise once a day for 10-30 minutes.
• Even practicing for a couple of minutes a day helps you learn this skill, and using it becomes more and more automatic.
• It’s also best, when you’re learning a new skill, to practice it when your symptoms are not at their worst.
• Try to find a quiet place to relax. Being in a calm and quiet place makes it easier to relax.
• You can practice relaxation with or without the assistance of guided recordings.
• The more you practice, the more this tool will benefit you and help you when your symptoms are bothersome.
• Track the time you spend practicing on your self-management log. You may also rate your stress level before and after practicing, using a 0-10 rating (0 = not at all stressed to 10 = worst stress/discomfort imaginable)

It might seem counterproductive to spend time practicing relaxation when life is so busy. However, relaxation may improve your pain, stress, and ability to focus on what you are doing. Below are some common barriers people face when learning to control their body’s relaxation response.

• “I don’t have time to practice.”: Your ability to relax can improve with regular practice. Start by practicing for just 5 minutes each morning or evening and simply be mindful of your breathing, something that is always with you and available for practice. If you work at a desk job, consider setting a reminder on your phone or computer to practice deep breathing a few times a day. With time, it will become easier for you to relax as you learn how to do it. You may start looking forward to your “relaxation time.”
• “I want to relax, but other people need me.”: Sometimes, other people need you, leaving you little or no time for yourself. Your time is precious and something that you have control over.  Explain to them that having time for yourself to relax may help reduce your pain, raise your energy level, and ease your stress. To protect this time, you may want to talk with them about how much they can ask of you and when. It may feel selfish at first, but it is important that you make time to take care of yourself. You must learn to help yourself, before you can aid others.  The Communication Module may help you with this.
• “I’m not sure I’m relaxing the right way.”: If the approaches discussed here aren’t working for you, there are other books, tapes, and classes that can help you learn more ways to relax. In addition to practicing some form of relaxation most days, a good way to tell if you are being effective is to write down what you are doing.
• “I don’t feel comfortable when I relax.”: If you are not used to sitting in silence, it’s possible you may become anxious or more aware of any bodily discomfort at first instead of feeling calm and rested. This new awareness of your body and mind is normal, especially if you’re used to feeling tense. A small number of people may get very emotional and upset when they try certain relaxation techniques. If this happens to you, feel free to take a pause in your practice. If possible, talk with your healthcare provider about what you are feeling.
• “I have a hard time sitting still.”: For some people, it is hard to sit or lie still when they are first practicing relaxation. If this is true for you, you might try a movement relaxation exercise. This might include doing some gentle stretches and focusing on your breathing, or practicing deep breathing while on a slow, relaxing walk. As you get more and more comfortable with your relaxation practice, you can incorporate new elements, such as stillness.
• “It’s hard making relaxation a priority.”: For the relaxation response to work, you need to practice regularly. If you are having problems practicing, think about the benefits of relaxation for you. But go easy on yourself. It may take practice to make relaxation a regular part of your life.

When someone you care about is struggling with pain, helping them practice relaxation and mindfulness, even for just a few minutes, may have important health benefits. You may find these techniques helpful for you too! You can help by:

• Helping with daily chores and tasks so he or she has more time to take care of herself or himself.

• Doing a relaxation exercise together such as deep breathing, stretching, muscle relaxation, and meditation

• Encourage the person you care about to take time to enjoy other calming activities such as:

  • Going for a walk
  • Watching a movie
  • Playing with a pet
  • Calling a friend or family member
  • Listening to music or audio story

• Check in with you family member or friend to see if they are making progress towards their relaxation goals.

• Recommend scheduling relaxation time on the calendar so that it won’t be forgotten.

There are many additional resources available to help you find a relaxation and mindfulness practice that works well for you.

• Meditation or relaxation apps are available for free or for purchase to download to your smartphone or other device. Some examples include: Headspace, Calm, MyLife, Sanvello, and Insight Timer
• Several mindfulness-focused websites have tips on incorporating mindfulness into your daily life and practicing meditation techniques.
• There are many books that provide more information on relaxation strategies and tips for success. Some examples:
• Get Some Headspace: 10 Minutes Can Make All the Difference
• Meditation for Fidgety Skeptics: A 10% Happier How-To Book
• How to Meditate: A Practical Guide to Making Friends with Your Mind

Many people find it helpful to practice relaxation and mindfulness while they are doing physical activities like Tai Chi and Yoga.