Stress Management

Hypnotic techniques promote a state of relaxation to achieve a desired clinical outcome. The hypnotic state may be self-induced or induced by another.

Hypnosis practices include three phases: presuggestion to promote relaxation, suggestion to promote desired therapeutic goal and postsuggestion to integrate the suggestion. The presuggestion component may include imagery, progressive muscle relaxation, or any other technique to promote muscle relaxation. During the hypnotic, a suggestion is offered such as decreased craving for nicotine or experience less pain postoperatively postsuggestion phase involves incorporating the suggestion into one’s life.

Imagery is frequently thought of as closing one’s eyes and seeing a desired image. Effective imagery actually uses a combination of senses. The image is more powerful and easy to create, if it is moving and involves other senses (e.g., the smell of pine trees, the feel of warm sun and a cool breeze on the skin, or the sound of a bubbling brook). Preferred imagery is a personal choice.

Meditation has three basic forms. One form is to focus the mind. The object of focus can be your breath, a candle flame, a word or a sound. The second type of meditative practice is to widen the view to observe the activity of the mind. Termed “mindfulness,” the object of this practice is to observe as the mind leaps from past to future, stirring emotions as it travels back and forth.
The third type of meditative practice is done to cultivate within oneself a desired quality. The quality can be compassion, harmlessness, or the ability to express unconditional love.

This type of meditation may be used within religious tradition and beings who express this quality may be called upon for assistance (e.g. Quan Yin, Jesus or Krishna).

While many different meditative practices are used, three specific practices have been significantly researched in the United States. These practices include: transcendental meditation (TM), the relaxation response, and mindfulness-based stress reduction (MBSR). TM and the relaxation response are examples of focused meditation.

TM was introduced in the United States in the 1970s. Derived from the Ayruvedic medical tradition, people are given a one-syllable sound, based on their year of birth. This sound, repeated silently, is particularly matched to the constitution of the practitioner. More information about this type of meditation is available from www.tm.org.

In a practice similar to TM, people are encouraged to sit quietly each day and focus their thoughts on a word. For this form of meditation people are encouraged to choose a word that has particular meaning for them (for example, love, peace, joy, soft belly).

MBSR is a form of mediation that combines components from different meditative traditions and relaxation techniques. Established by Jon Kabat-Zinn at the University of Massachusetts, the Center for Mindfulness Internet site provides a wealth of information about courses and research (see www.umassmed.edu/cfm). Emphasizing a focus on the breath, MBSR also includes a tolerant observation that the mind has a tendency to “chatter” and jump from past to future. Emotions are frequently attached to thoughts.

Thinking about the future may trigger feelings of anxiety or desire, while thinking about the past may trigger feelings of guilt or anger. MBSR practice emphasizes gentle acceptance of that experience and return to focus on the breath.

In addition, MBSR emphasizes bringing this state of mindfulness into one’s everyday affairs.

This practice uses machines or other devices to provide audible, visual, or tactile information about body processes that frequently are under subconscious influence.

This feedback can be as simple as holding a piece of tape that changes color when someone successfully practices a relaxation technique and warms their hands.

In contrast, some very sophisticated computer programs allow a person to proceed in a computer game when their brain waves shift in a certain manner. Somewhere between these levels of technology are machines that provide light or sound feedback when a person successfully relaxes a muscle, lowers blood pressure, or lessens nervous system stress measured through changes in electrical conductance of the skin.

These forms of movement therapy are integral parts of the Ayruvedic (medicine from India) and Oriental medical systems. They involve slow movement combined with deep slow breathing.

This combination of slow movement and breathing has been used for thousands of years to both prevent and treat disease.

In many traditional societies, art, music, and dance are integrated into everyday life. In this culture, many people only participate in these activities when they interact with children.

Creative activities provide an outlet for expression of subconscious beliefs or feelings. Once these beliefs are mobilized or brought to a conscious level, they can be modified or used to promote a healing response.

Art, music, and dance are considered essential activities for all humans by some cultures, regardless of medical condition. These therapies can be done individually or in group settings.

Cited to be a significant force in promoting well-being, the practice of forgiving self and others has special importance to anyone diagnosed with chronic health condition(s).

To practice forgiveness is frequently very difficult, because it seems an irrational act. Of course, there is a reason to be angry. Deciding to release the reason and choose to forgive requires effort.

Many people draw upon their religious faith to make this effort less of a struggle. Sometimes it is only after repeatedly practicing forgiveness that people are truly able to appreciate that forgiving really does improve the quality of their own life. Forgiveness of selfand others is recommended as a daily practice to help reduce stress and improve overall health.

Frequently taught as part of yoga practice, belly breathing changes the tone of the nervous system allowing someone to respond to stress in a more balanced way. While an infant naturally breaths this way, many adults have forgotten how. To remember you can practice the following:

• Start by thinking of the trunk of your body as a bottle, filling with your favorite drink – grape juice, sparkling mineral water, chocolate milk. (Calories are nonexistent in this image.) You fill the bottle from the bottom up and empty from the top down. Attach the same enthusiasm for filling your body with air as you would for drinking your favorite beverage if you were very thirsty. Many people’s bodies are starved for adequate oxygen. Know that each breath of light filled air is sustaining and improving your health. By increasing the amount of air in the lungs through deep belly breathing, you are better nourishing each of body with oxygen.
• Lie face up in bed.
• Place your hands or a small bag of rice on your belly.
• Inhale through your nose and push your belly out, away from your back.
• Exhale through your mouth, pulling towards back.

After you have mastered belly out with inhale and belly in with exhale (possibly overcoming years of encouragement to “suck in the gut”), you are ready to proceed to the next phase.

• Move one hand off the belly to the middle of your chest.
• Imagine that as the belly moves out, it is making room for the lungs to hold more life-sustaining air. You start filling the body with air from the belly up. First belly, then the middle of the chest, then the top of chest.
• As you exhale, empty your body of air in the reverse fashion. Air out from top, then the middle of chest, followed by the belly coming in to the back.

Once you have mastered belly breathing lying down, you can try it standing and sitting. While belly breathing is great to do early in the morning before arising and late at night before bed, it becomes even more effective in promoting well-being when practiced throughout the day. Link doing a belly breath with something you do at least 20 times throughout your waking hours – walk through a door, look at a watch, hit CTRL-ALT-DEL on the computer, answer the phone. Those of us reading this chapter are all breathing on a regular basis. The goal is to maximize the quality of the breathing we do.