I’ve been teaching a stress less/relaxation class for years and below is one the handouts that participants report is most helpful.:
Change the situation: Avoid – Alter. Change your reaction: Adapt – Accept
1. Avoid unnecessary stress
Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed.
Learn how to say “no” – Know your limits and stick to them.
Avoid people who stress you out –Limit the amount of time you spend with people that cause you stress.
Take control of your environment – If the evening news makes you anxious, turn the TV off.
Avoid hot-button topics –If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.
Pare down your to-do list –If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.”
2. Alter the situation
If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem doesn’t present itself in the future.
Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way.
Be willing to compromise. When you ask someone to change their behavior, be willing to do the same.
Be more assertive. Deal with problems head on, doing your best to anticipate and prevent them.
Manage your time better. Plan ahead and make sure you don’t overextend yourself.
3. Adapt to the stressor
If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.
Reframe problems. Try to view stressful situations from a more positive perspective.
Look at the big picture. Will it matter in a month, or a year?
Adjust your standards. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”
Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts.
4. Accept what you can’t change
Some sources of stress are unavoidable, in such cases; the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.
Don’t try to control the uncontrollable. Focus on the things you can control such as the way you choose to react to problems.
Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth.
Share your feelings. Talk to a trusted friend or make an appointment with a therapist.
Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes.
Stress can be indicated when a person becomes stuck/frozen or stopped in a bodily movement that can be described as either gestural, ( movements isolated to parts or part of the body) or postural ( movements carried constantly through the whole body). When there is a continuous flow of movement from gesture to posture and vice versa than the person is considered moving in balance and not not indicated to be in stress. one example of this is something that has come up in the last 20 years of leading stress reduction exercises with groups. I ask the participants how they know they are stressed out and the top answers are:
I notice I am gripping the steering wheel- I notice I am making a fist- I am clenching my teeth-I am clenching my butt.
Each one of these actions is a frozen gesture and they generally use the most “force”, muscle, blood flow of any other component of the body while they are active. Think about it, if you clench your fist the blood flow increases due to the sudden contraction of the muscles, a part of your attention is brought to the area because its being engaged, the rest of the body begins to respond to the clenched fist starting with the arm, shoulders, spine, abdominal muscles and so on ad so on. Suddenly your attention increases to the area dramatically and you realize; “oh I’m clenching my fist….”
The first step to releasing this body stress is the breath. When stressed we tend to hold our breath and/or it becomes shallow breathing. Taking a big breath in and a big breath out begins to increase the oxygen to the brain (and the rest if the body). That big breath also automatically signals to the body on a primal level that the stressor is less and the body begins to relax its muscular contractions. Also when we consciously are taking in a big breath we are exerting voluntary control over our bodies which is the opposite of the stress response which is a involuntary response. This voluntary and controlled breath also signals to the brain on a primal level that the stressor is lessen, resulting in the muscles lessening their contradiction.
Of course simply breathing does not seem like much of an answer for someone who experiences chronic stress/anxiety. But it is one more tool that one can use. Like mindfulness, visualizations, and other techniques, breathing is something that needs to be practiced and the more you practice the more effective it becomes.
Here is another handout that I often give to clients/patients. I should add that I do all of the ideas in my handouts. No point talking about something if you can walk it too.
The body’s natural relaxation response is a powerful antidote to stress. Relaxation techniques such as deep breathing, visualization, progressive muscle relaxation, meditation, and yoga can help you activate this relaxation response. When practiced regularly, these activities lead to a reduction in your everyday stress levels and a boost in your feelings of joy and serenity. What’s more, they also serve a protective quality by teaching you how to stay calm and collected in the face of life’s curveballs.
|The relaxation response is not:||The relaxation response is:|
|laying on the couch
|a mentally active process that leaves the body relaxed
best done in an awake state
trainable and becomes more profound with practice
Starting a relaxation practice
A variety of relaxation techniques help you achieve the relaxation response. Those whose stress-busting benefits have been widely studied include deep breathing, progressive muscle relaxation, meditation, visualization, yoga, and tai chi.
Learning the basics of these relaxation techniques isn’t difficult. But it takes practice to truly harness their stress-relieving power: daily practice, in fact. Most stress experts recommend setting aside at least 10 to 20 minutes a day for your relaxation practice. If you’d like to get even more stress relief, aim for 30 minutes to an hour.
Getting the most out of your relaxation practice
Set aside time in your daily schedule. The best way to start and maintain a relaxation practice is by incorporating it into your daily routine. Schedule a set time either once or twice a day for your practice. You may find that it’s easier to stick with your practice if you do it first thing in the morning, before other tasks and responsibilities get in the way.
Don’t practice when you’re sleepy. These techniques can relax you so much that they can make you very sleepy, especially if it’s close to bedtime. You will get the most out of these techniques if you practice when you’re fully awake and alert.
Choose a technique that appeals to you. There is no single relaxation technique that is best. When choosing a relaxation technique, consider your specific needs, preferences, and fitness level. The right relaxation technique is the one that resonates with you and fits your lifestyle.
Do you need alone time or social stimulation?
If you crave solitude, solo relaxation techniques such as meditation or progressive muscle relaxation will give you the power to quiet your mind and recharge your batteries. If you crave social interaction, a class setting will give you the stimulation and support you’re looking for. Practicing with others may also help you stay motivated.
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Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. Part two of evidence based Yoga:
Carpal tunnel syndrome A randomized, single-blind controlled trial of 42 patients with carpal tunnel syndrome assigned subjects to either a yoga treatment group or a wrist splint group, each 8 weeks in duration. Twice a week, the yoga group practiced postures specifically designed to strengthen and stretch each joint in the upper body. Yoga participants showed improvement in grip strength, pain levels, and Phalen’s sign when compared to the wrist splint group. Nerve conduction studies were not performed.15 A Cochrane review of 21 trials that evaluated the clinical outcome of nonsurgical treatment of carpal tunnel syndrome reported that 8 weeks of yoga practice significantly reduced pain as compared to wrist splinting. The yoga was described as having a “significant short-term benefit,” though the duration of this benefit is unknown.16
Depression A 2004 review of five RCTs that evaluated yoga-based interventions for depression and depressive disorders showed some positive outcomes and no adverse effects on patients’ mild to severe depressive disorders. However, poor study design and incomplete methodologic reporting makes this interpretation preliminary.17 An RCT studying 7 weeks of yoga training in a group of breast cancer survivors showed positive changes in emotional function, depression, and mood disturbance.18 “Yoga and stress management” (in the online version of this article) provides more information on this study and others involving the effects of yoga on stress.
Irritable bowel syndrome In an RCT, treatment with loperamide (Imodium) was compared to treatment with a series of 12 yoga postures practiced twice a day for 2 months in a small sample of patients with clinically diagnosed irritable bowel syndrome. Patients underwent measurement of surface electrogastrography, and trait and state anxiety tests were administered before, during, and up to 2 months after treatment. Both intervention groups demonstrated a decrease in bowel symptoms and state anxiety.19
Menopausal symptoms In a recent pilot study, 14 postmenopausal women reported via interview and questionnaire a decrease in the severity and frequency of hot flushes after 8 weeks of 90-minute “restorative yoga” classes. Although this initial finding sounds encouraging, this trial had no control group or objective parameter measurements.20 An RCT studying postmenopausal sleep quality divided 164 women into groups who participated in either 4 months of low-intensity yoga, a moderate-intensity walking program, or a wait-list control group. This study reported no statistically significant interventional effects of any treatment on total sleep quality or on any individual sleep quality domain.21
Multiple sclerosis An RCT of 57 subjects with clinically defined multiple sclerosis were assigned to weekly Iyengar yoga class plus home practice, a cycling program, or a wait-list control group for 6 months. Results showed that both active interventions produced significant improvement in perceived levels of energy and reduced fatigue; however, the specific effects of the yoga practice were not isolated.22 Osteoarthritis In a pilot study, 11 deconditioned, yoga naive subjects with a clinical diagnosis of knee osteoarthritis showed improvements in pain and knee stiffness after 8 weeks of yoga training. The group performed modified Iyengar yoga sessions once a week.23
Seizure disorders In 2000, a systematic review of the published literature revealed that only one study was able to meet the selection criteria for reliable research design. The reviewers concluded that no available evidence pointed to yoga therapy as an efficacious treatment for epilepsy.24
Strength and flexibility In a recent study on the fitness related effects of hatha yoga, 10 yoga-naïve and previously untrained subjects aged 18 to 27 years participated in 85 minutes of pranayama and hatha yoga practice twice a week for 8 weeks. These subjects showed significant improvement in upper and lower body muscular strength, endurance, and flexibility. No statistically significant change in body composition or pulmonary function was observed.13
In a partial RCT with a longer time frame, 54 subjects aged 20 to 25 years participated in either 5 months of yoga instruction or no activity. After that time period, both groups practiced yoga for an additional 5 months. The group practicing 10 months of yoga showed significant improvements in shoulder, trunk, hip, and neck flexibility, as well as a reported improved performance during submaximal exercise testing.25
A well-executed study compared subjects who underwent 24 hours of hatha yoga classes over 8 weeks with a control group. The yoga training group showed a 13% to 35% improvement in flexibility, balance, and muscular endurance. The authors concluded that hatha yoga practice has significant effects on balance and flexibility.26
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16. O’Connor D, Marshall S, Massy-Westropp N. Nonsurgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003(1):CD003219.
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21. Elavsky S, McAuley E. Lack of perceived sleep improvement after 4-month structured exercise programs. Menopause. 2007;14(3, pt 1):535-540.
22. Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology. 2004;62(11):2058-2064.
23. Kolasinski SL, Garfinkel M, Tsai AG, et al. Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study. J Altern Complement Med. 2005;11(4):689-693.
24. Ramaratnam S, Sridharan K. Yoga for epilepsy. Cochrane Database Syst Rev. 2000(3):CD001524.
25. Ray US, Mukhopadhyaya S, Purkayastha SS, et al. Effect of yogic exercises on physical and mental health of young fellowship course trainees. Indian J Physiol Pharmacol. 2001;45(1):37-53.
26. Boehde D, Porcari JP, Greany J, et al. The physiological effects of 8 weeks of yoga training. J Cardiopulm Rehabil. 2005;25(5):290.