Ch.19 Relaxation and guided imagery

Progressive muscle relaxation

Muscle relaxation is when each muscle is forcibly contracted, then released in sequence. Another term for progressive neuromuscular relaxation is progressive neuromuscular relaxation

Muscle Physiology

Skeletal muscles engage in several physiological functions, including generating force (strength and speed), generating heat, supporting posture, and aiding in breathing.

Each skeletal muscle is composed of many muscle fibers (cells), each of which can contract or relax. Muscle fiber contracts when it receives a nerve impulse from the central nervous system (brain and spinal cord). After contracting, a muscle fiber relaxes until it gets another nerve impulse.

motor unit

consists of a single motor nerve and all the muscle fibers to which it sends impulses (as shown in Figure 19.1). When a motor unit receives a message from the nervous system, each muscle fiber responds with a burst of energy. When this happens, tiny filaments, which are the smallest parts of the muscle, pull on each other and cause a muscle contraction, or shortening of the muscle fibers.

all-or-none principle

Physiological characteristic of a contracting muscle that says a muscle fiber contracts completely or not at all.

flight or fight

This is an automatic response in the presence of a threat. As we have mentioned, most modern threats are those we create in our mind. But because we still perceive threats, the autonomic nervous system responds the same way it did in ages past—by gearing up to run or fight. As a result, our muscles tense. The dilemma is that because our modern threats—financial concerns, school requirements, relationship battles—do not end immediately, the fight-or-flight response remains activated and, therefore, muscle contraction is continuous.

Progressive muscle relaxation

it activates the parasympathetic nervous system in a consciously directed way as you first tense a group of muscles and then consciously release the tension in that muscle group. The technique is called progressive muscle relaxation because you move progressively through the major areas of the body.

Of the many variations of the original PMR technique in use today, all have in common the objective of teaching a person to relax the muscles at will by first developing conscious awareness of what it feels like to be tense and then what it feels like to be relaxed. Once you learn to distinguish between tension and relaxation, you can control tension. The primary feature of this method is the ability to relax muscles selectively on command.

it helps decrease insomnia and posttraumatic stress disorder. One study showed that those who practiced progressive relaxation experienced a lower heart rate, less anxiety, lower perceived stress, and a significant decrease in salivary cortisol (indicating a physiological reduction in sympathetic nervous system activity) compared to control subjects. The subjects in this study also self-reported increased relaxation.

Active Progressive Muscle Relaxation

in active progressive muscle relaxation, you inhale while you tense a group of muscles fairly tightly—to about 70 to 80% of a maximum contraction. Once they are contracted sufficiently, you hold them in this state of tension for up to 8 seconds while holding the breath. Then you immediately release those tightened muscles for 15 to 30 seconds. During this relaxation phase, you slowly exhale while you consciously relax the muscles even more completely.

Incremental Muscle Relaxation

It is a method that sensitizes the individual to actual muscle tension levels. Working through each group of muscles, first tense the muscles maximally to what feels like 100% contraction. After 5 to 10 seconds of contracting maximally, relax that muscle group entirely for 15 to 30 seconds. Contract the same muscles a second time, this time contracting to what feels like about 50% of maximal contraction. After 5 to 10 seconds of holding this contraction, relax the muscles completely for 15 to 30 seconds. On a third contraction of the same muscles, flex the muscles at no more than 10% of maximal contraction. At this point, you are barely creating any tension. Hold this contraction for 5 to 10 seconds, and then relax the muscles completely for 15 to 30 seconds. Progress to the next set of muscles and follow the same procedure.

Active Progressive Relaxation Script

Make yourself as comfortable as possible. Gently close your eyes. Take a nice, natural, deep breath in through your nose … and exhale out your nose. Again, a deep breath in … and exhale. Continue to breathe deeply in and out, keeping your eyes closed. (long pause) Allow all thoughts of your past and future to drift away.

When you tighten an area, do it only to a point at which you feel real tension but not pain. If a specific area or muscle is sore or uncomfortable, skip that area. As you tighten the various muscles during this session, inhale and briefly hold your breath. As you exhale, you release the tension.

Passive progressive relaxation

Lie on your back in a comfortable place, such as on a foam pad on the floor or your bed. This method is most effective for muscle relaxation, rather than to induce sleep. Muscles can stay in a contracted, tensed position, even during sleep, so the goal here is first to relax the muscles. A more peaceful sleep may follow. Make sure that you will be warm enough. You might want to cover yourself with a blanket.

Allow your eyes to close gently.

Feel the rising and falling of your belly with each inbreath and outbreath through the nose.

Take a few moments to feel your body as a “whole,” from head to toe, the “envelope” of your skin, the sensations associated with touch in the places you are in contact with on the floor or the bed.

Bring your attention to the toes of the left foot. As you focus your attention on them, see if you can “direct,” or channel, your breathing to them as well, so it feels as if you are breathing into and out from your toes. It may take a while for you to get the hang of this. It may help to imagine your breath traveling down the body from your nose into the lungs, then continuing through the abdomen, down the left leg all the way to the toes, then back again, and out through your nose.

Allow yourself to feel any sensations from your toes, distinguishing between them and watching the flux of sensations in this region. If you don’t feel anything now, that’s fine, too. Just allow yourself to feel “not feeling anything.”

When you are ready to continue, take in a deeper, more intentional breath down to the toes, and on the outbreath allow them to “dissolve” in your “mind’s eye.” Stay with your breathing for a few breaths at least, and then move on to the sole of the foot, the heel, the top of the foot, and the ankle, continuing to breathe into and out from each region as you observe the sensation you are experiencing, and then letting go of it and moving on.

Each time you notice that your attention has wandered off, bring your mind back to your breathing and to the region you are focusing on.

Continue to move slowly up your left leg, your right leg, and through the rest of your body as you maintain the focus on your breath and on the feeling of the particular regions as you come to them, breathe with them, and let go of them.

After you have completed scanning your body, focusing on each part with as little effort as possible, return to ordinary waking consciousness by slowly arousing various parts of your body. Gently begin to move your arms and hands, your legs and feet, and your neck and shoulders, until you have revived yourself sufficiently to resume your day.Lie on your back in a comfortable place, such as on a foam pad on the floor or your bed. This method is most effective for muscle relaxation, rather than to induce sleep. Muscles can stay in a contracted, tensed position, even during sleep, so the goal here is first to relax the muscles. A more peaceful sleep may follow. Make sure that you will be warm enough. You might want to cover yourself with a blanket.

Allow your eyes to close gently.

Feel the rising and falling of your belly with each inbreath and outbreath through the nose.

Take a few moments to feel your body as a “whole,” from head to toe, the “envelope” of your skin, the sensations associated with touch in the places you are in contact with on the floor or the bed.

Bring your attention to the toes of the left foot. As you focus your attention on them, see if you can “direct,” or channel, your breathing to them as well, so it feels as if you are breathing into and out from your toes. It may take a while for you to get the hang of this. It may help to imagine your breath traveling down the body from your nose into the lungs, then continuing through the abdomen, down the left leg all the way to the toes, then back again, and out through your nose.

Allow yourself to feel any sensations from your toes, distinguishing between them and watching the flux of sensations in this region. If you don’t feel anything now, that’s fine, too. Just allow yourself to feel “not feeling anything.”

When you are ready to continue, take in a deeper, more intentional breath down to the toes, and on the outbreath allow them to “dissolve” in your “mind’s eye.” Stay with your breathing for a few breaths at least, and then move on to the sole of the foot, the heel, the top of the foot, and the ankle, continuing to breathe into and out from each region as you observe the sensation you are experiencing, and then letting go of it and moving on.

Each time you notice that your attention has wandered off, bring your mind back to your breathing and to the region you are focusing on.

Continue to move slowly up your left leg, your right leg, and through the rest of your body as you maintain the focus on your breath and on the feeling of the particular regions as you come to them, breathe with them, and let go of them.

After you have completed scanning your body, focusing on each part with as little effort as possible, return to ordinary waking consciousness by slowly arousing various parts of your body. Gently begin to move your arms and hands, your legs and feet, and your neck and shoulders, until you have revived yourself sufficiently to resume your day.

Background

Stephen Covey said, “All things are created twice.” He explained that, first, we have a mental creation—a picture in mind of what we want to create. The second creation occurs when we do the necessary things to bring into the physical dimension the image that was first established in mind.

When we fear or worry about something, we produce fearful images about future events. We see potentially painful outcomes happening in our imagination. These painful images activate the stress response. The imagined event is as real to the mind as the event that happens in our physical experience. So, whether you are eating a lemon, improving your golf game, or learning to relax, what you first experience in your mind affects your physical experience.

Hypnosis

Hypnosis is not a relaxation technique you will be practicing; however, understanding what goes on during hypnosis can help you get a clear picture of why and how guided imagery works.

Visualization. It has been called “going to the movies” and it may be the most important part of your mental package.

— Ray Floyd , winner of the PGA, Master’s, and U.S. Open golf tournaments

Visualization

It uses the imagination to picture or see a place or thing. The focus when visualizing is on the sense of sight

Imagery

It is an imagined flow of thoughts that includes tactile qualities from one or more of the senses. Imagery can include smell, touch, hearing, taste, position, and motion, as well as visual images. Imagery is a broader term. The more clearly you can imagine a scene, event, or situation, and the more senses you involve, the more real it becomes to your mind.

Imagery is not characterized by a lessening of the person’s own will, nor does it emphasize responding to a hypnotist’s suggestions. Imagery does not try to access unconscious materials; instead, imagery is based on memory

Improvement of performance skills.

Mental imagery is repetitive mental practice or mental training that includes mental representation of the performance. Mental imagery is a technique that athletes can use to supplement physical practice and improve their performance in their given sport. Mental imagery seems to be better than no practice at all, but mental imagery alone is not as good as physical practice alone. Mental imagery cannot completely substitute for physical practice, and it appears as though a combination of mental imagery and physical practice leads to the most effective performance.

Improvement of confidence and positive thinking.

You can do this by replaying in your mind earlier times when you performed at a high and satisfying level. For example, if you were preparing to give a speech in front of a large group of people, you could review earlier times when you gave talks successfully and let the images of those successful presentations help you build confidence for the upcoming speech.

Tactical rehearsal and problem-solving

You can use this method to visualize outcomes that may arise in a given situation and decide on alternatives for handling the results. For example, imagine different scenarios for how your boss will respond to your request for a raise. Picture yourself in the situation and imagine how you would respond to questions from your boss

Performance review and analysis

Soon after completing or taking part in an event, you can use your imagination to review your performance and assess yourself for strengths to build on and weaknesses to improve.

Control arousal and anxiety.

Many studies show that mental imagery helps reduce stress and anxiety and increase relaxation. Most frequently, performers use imagery before a competitive event or performance rather than during or after.

Relax.

. This first tool represents the essence of this book. The performer must learn how to relax. Relaxing doesn’t mean chillin’ in front of the television or hangin’ out with some friends. It involves the regular practice of relaxation techniques specifically designed to turn off the stress response.

Consider the golfer who is lining up a putt. The worry that there may be some lousy outcome if he or she misses is interpreted by the body as a threat, and the stress response activates automatically. When this happens, the running and fighting muscles tense, rather than the golfing muscles. The shot is more likely to go awry, and performance will suffer.

Learning how to relax the mind and body through repeated practice helps prevent the onset of the stress response. The more often the performer practices relaxation techniques, the more that relaxed state becomes one’s normal state. So, learning to relax is the first, and possibly most important, tool to help the athlete perform optimally. Chapters 16, 17, 18, 19, 20, 21, and 22 of this book give you the best techniques for relaxation.

Be mindful.

Stay in the moment. A successful track coach shared the advice he gives his runners to help them stay focused: “Keep your brain in your lane.” Keeping your mind focused steadily on what you are doing, while keeping the mental chatter to a minimum, allows you to concentrate more fully. The chapter in this book on mindfulness offers a thorough exploration of how to do this.

Monitor your self-talk.

Take the time to listen to what you consistently say to yourself during a performance. Negative messages, self-doubt, and criticism will hinder performance and turn on the stress response. Replace negative self-talk with positive affirmations such as “I have prepared well and will perform at my best. I can do this! I am calm and confident.” How to control self-talk and manage your thoughts are outlined in Chapter 6.

Imagine your success.

The fourth tool, guided imagery, is the focus of this chapter. Imagining clearly your perfect performance is a useful skill that prepares you to perform more closely to perfection in the actual event. Each time you imagine the ideal performance, you gain more confidence in your abilities. The subconscious part of your mind doesn’t easily distinguish between an imagined event and a real one. Therefore, when you visualize your performance, it is as if you are really doing it. This instills greater confidence and reduces stress.

Use imagery to involve as many of your senses as possible. See yourself performing correctly, but also imagine how it would feel kinesthetically. Sense how it feels to shoot the foul shot that goes through the hoop. Imagine what you might hear, smell, or taste, such as sweat mixing with your saliva or the aromas of the event. Put yourself, mentally, into the scene, and then see yourself performing flawlessly. Imagine you are watching yourself on television, or view the scene as if looking out from your own eyes. Run the mental movie over and over, and feel your confidence grow each time you succeed.

Let go and get out of your own way

The ability to perform physically is already an attribute of the advanced athlete. Most successful athletes will tell you that once their physical training has been optimized, their top performances come by letting go and allowing the process of playing to happen through them, rather than deliberating about how it should happen. This higher level of functioning is described as “being in the zone,” or being “in the flow” of the game. At this stage, the athlete doesn’t need to think about the “how” of doing the sport. The physical tools are already in place. Letting go involves letting those skills go to work on their own, without letting thoughts about how it’s done get in the way. This cannot be forced or coerced. We shouldn’t “try” to make it happen; in fact, it seems to happen when we are least “trying” to make it happen. By applying these 5 mental skills to your pre-performance time, as well as during the action, you dramatically increase the likelihood of experiencing these peak moments when playing and performing are the most enjoyable.

Relaxation guided imagery (RGI)

Technique designed to connect with the subconscious mind in a way that will activate the relaxation response by using the imagination in a directed way toward a specific image, scene, or sensation.Guided imagery focuses the imagination on a relaxing image, scene, or sensation. This relaxing imagery decreases sympathetic nervous system activity and activates parasympathetic nervous system activity resulting in a reduction in the fight-or-flight response.

Guided imagery is like hypnosis in that what we imagine can be translated into changes in our physiology, biochemistry, and, as a result, our health outcomes. Because the subconscious mind doesn’t know the difference between something experienced and something clearly imagined, it can be used to help a person deeply relax. When our mind thinks of something or somewhere relaxing, the subconscious mind automatically responds as if we were really in that place. Inherent in relaxing guided imagery is a lack of any threat. Because there is no threat, the body relaxes and returns to a state of homeostasis.

Benefits of Guided Imagery

Athletes, performers, businesspeople, inventors, and even people who try to overcome various illnesses have used their imagination to help them produce desired outcomes. Guided imagery also has helped treat many stress-related symptoms, including headaches, muscle spasms, chronic pain, and general or situation-specific anxiety.

Carl Simonton and Stephanie Simonton pioneered the application of imagery in cancer patients. Their patients were encouraged to imagine their immune system cells engulfing and devouring vulnerable cancer cells. Although a definitive study that demonstrates whether this works has not happened, many patients found it helpful, even if they were not cured, and reported relief from anxiety and pain, better toleration of chemotherapy and radiation, and an increased sense of control.

Guided imagery is especially useful in producing deep relaxation in those who practice it regularly. RGI is another powerful way to provide quick and noticeable relaxation. Don’t take it lightly because of its simplicity

Asthma

Asthma is a common disease of the respiratory system, especially among younger people in our culture. Asthmatics have difficulty breathing because the bronchial airways are temporarily blocked due to constriction of the muscles surrounding the airways. A person with asthma doesn’t struggle with inhaling but, instead, has a tough time exhaling. Asthma often is triggered by emotional distress.

A study reported in the journal Psychology in Schools examined the effectiveness of guided imagery as a way of reducing stress and the severity of an asthma attack in young people with asthma. Junior high students who had been diagnosed with asthma were selected for the study. Each subject experienced mild to severe levels of asthma when upset.

In the study, which lasted 8 weeks, the students were taught relaxation guided imagery (RGI), which involved a specific script incorporating

general relaxation exercises (i.e., letting the tension go in each part of the body and imagining being in a pleasant, peaceful place);

guided imagery in which the participant imagines specific biological healing mechanisms in the bronchial tubes and lungs;

instructions to imagine doing a favorite activity during which the participant has no problems with his or her asthma; and

guided imagery in which the participant visualizes breathing in uniquely colored air that completely clears the airways and lungs.

Students engaged in the RGI exercises for 20 minutes for an average of 4 times per week. At the end of the study, each subject reported a noticeable decrease in feelings of anxiety, which tend to trigger asthma attacks. The overall results suggest that RGI is a promising intervention in treating children with asthma as an adjunct to medical intervention.

Guided Imagery

When guided imagery is used as a method for relaxing, it usually is best done lying on a couch or bed or sitting up in a chair. Environmental conditions that enhance the effects of guided imagery are similar to the other relaxation techniques: It should be done in a place where you won’t be disturbed and where the lights can be turned down. Sometimes using relaxing music is helpful. It is important to feel comfortably warm. Have a blanket ready to cover you in case of a chill.

Because the imagination is unlimited, there is no end to the things you can imagine to achieve a relaxed state. A typical RGI session begins with a brief relaxation exercise such as meditation, relaxing breathing, a body scan, or progressive relaxation. After two or three minutes relaxing the mind and body, you start using your imagination.

Some common and simple images that can help you turn off the stress response include walking along the beach with gentle ocean waves caressing your legs and feet, walking peacefully through a forest, being in the mountains or by a tranquil lake, or sitting by a running river. You can picture yourself drifting slowly down a lazy stream, seated atop a silent peak overlooking a majestic view, or resting in the stillness of a quiet field. There is something profoundly relaxing about seeing ourselves in peaceful places in nature. You can experiment until you find the most tranquil, relaxing place you can imagine.

Although some people see a relaxing setting when using RGI, for others it will be more elusive and more like a general impression of relaxation. Shakti Gawain, the author of the book Creative Visualization, suggests:

Solution

To enhance your relaxation experience even more, increase the amount of sensory information you put into your imagination. For example, as you walk along the beach, add the colors of the blue sky with puffy white clouds overhead. You might add the sounds of gulls, the feel and sound of a gentle breeze, and the feel of soft, grainy sand under your feet as you walk. The more senses you involve in the imagery, the more powerful the effect—the more you will feel like you are there. By thoroughly using your senses in your imagination and imagining scenes that are pleasant and relaxing, you quickly bring feelings of deep relaxation into your mind and body.

Guided imagery typically is done by having someone read a script or by using a recording that directs your imagination through a relaxing situation or scene. You will find some examples of guided imagery in MindTap or the instructor-provided audio files. You may want to freely use your imagination on your own to create the imagined scene.

Suggestions for Improving Guided Imagery Practice

One’s ability to access all the senses for imagery practice will vary, depending on his or her preferred and most easily used sensory expression and motivation. It will also depend on each person’s natural and innate ability to imagine. If you are one of those individuals who lack a vivid imagination, don’t be discouraged. Research has found one key factor in imagery success in people with less vivid imaginations. Strong motivation to engage in imagery can produce some benefits even in individuals with limited abilities to imagine.

Think in terms of the unlimited—no limits, no barriers in your imagination. If you want to fly in your imagination, you are free to fly. If you can imagine it, anything is possible.

Release all thoughts of what others might think. There are no “others” in your imagination, so don’t be shy. Act boldly and freely.

Include relaxing music in the background, such as classical or New Age music without lyrics.

Be playful. Don’t be too serious when you play in your imagination. The harder you try, the harder it will be to “view” your imageries well.