Therapeutic Interventions

When we are anxious, in distress, in pain, worried, or feeling burned out, we often don’t realize the changes and impact it is having on our mind and body.
The following methods and approaches may be helpful in reducing distressing experiences and bringing about the relaxation response, awareness, and self-regulation in stressful situations. They can be easily taught to patients, and family/caregivers. For some, bringing awareness and connection to the body may not be/feel safe or comfortable. It is important to ask permission of the person prior to engaging with any of these approaches.
People may already have techniques that are part of their spiritual or cultural practice and it is important to identify and encourage these as early as possible.

GROUNDING

  • Take a moment to bring awareness of how your body is making connection to the ground/chair/bed etc. Notice your feet and how they feel as they connect with the ground. Notice your sitting bones and how they feel as they make connection with the chair/bed/floor.
  • If you are standing, notice other parts of your body - legs, arms, head etc. - and how in this moment they are all interconnected and making connection with the ground/earth/chair/bed etc.
  • As you bring awareness to these connections notice the sensations that may be present for you - heat, coolness, tingling, tightness, numbness etc. - and make any adjustments you need to in order to make yourself comfortable as you ground yourself in the present moment.

BREATHING

Example 1

  • Place one hand on abdomen and one hand on chest
  • Inhale slowly and deeply through nose, breathing all the way down to your belly (this allows more airflow into the lungs)
  • Notice how your abdomen rises and the chest follows
  • Exhale slowly out your nose or mouth, whichever is most comfortable
  • Take a moment to pause between each inhalation and exhalation
  • Count to three as you breathe in, pause, and count to three as you breathe out
  • Notice the nice, slow rhythm of your breath
  • Notice any changes that may be happening in your body
  • This exercise may last for only a few minutes or longer. Each person will be different

Quick tools

These exercises may be helpful in distressing situations where there is little time to prepare

1) Breathe in deeply and clench your fists
Breathe out slowly and let yourself go as limp and loose as possible
Start yawning
Repeat these 3 steps as often as necessary

2) Breathe in slowly through your nose to the count of 4
Breathe slowly out of your mouth for a count of 6
As you are exhaling, imagine that you are blowing bubbles and your mouth is in a circular shape

RELAXATION

Focus word

  • Pick a focus word, short phrase, or prayer that is firmly rooted in your belief system
  • Sit or lie quietly in a comfortable position and close your eyes
  • Relax your muscles, starting at your head and neck, your shoulders, moving to your chest, abdomen, and down your legs to your thighs, down to your calves, to your feet and all the way through to your toes. (If this feels uncomfortable, start from your feet and work up to the head). This may take several minutes, or as long as the individual needs
  • Breathe slowly and naturally, and as you do, say your focus word, sound, phrase, or prayer silently to yourself as you exhale
  • If other thoughts come to your mind, don’t worry. Gently return to your focus word
  • Slowly open your eyes. Continue where you are for a minute or two before moving around

Example
Breathing in – “I breathe in calmness and peacefulness”
Breathing out – “I breathe out distress and worry”

BODY SCAN

Take a moment to sit or lie down. Scan through your body from the top of your head to the tips of your toes.
Notice any areas of tension or relaxation, your heartbeat, your breath, the temperature of your hands and feet.
Imagine any tension or discomfort gently flowing downward through your body, through the legs, and out through the soles of the feet into the ground.

Quick tools

These exercises may be helpful in distressing situations where there is little time to prepare

1) Sitting down, gently place one hand on the forehead and the other hand on the back of the neck.
This quick, yet effective tool naturally calms the mind and helps induce the relaxation response.

2) While you are (sitting, lying down, standing etc.) take a moment to notice your breathing and where you feel the breath going in your body.
As you breathe in, imagine that your breath is filling you wherever your attention to your body goes.
As you breathe out, notice any changes that may be happening in your body

IMAGERY AND VISUALISATION

Imagery and visualization are ways of daydreaming or creating an inner picture that you find peaceful at that moment. It often uses all your senses. These approaches for reducing stress combine deep breathing and meditation.
Your mind imagines a peaceful scene, setting, or experience often from a memory, as you practice deep breathing.
In this place of calm relaxation, you may imagine pain, tension, or discomfort washing away, your body becoming relaxed, or making spiritual connections. Some may find the use of soft gentle music helpful during this process.

SOURCES/REFERENCES

  1. Benson H. The relaxation response. New York: Harper Collins; 2000.
  2. Cane P. Trauma, healing and transformation: awakening a new heart. Capacitar Inc; 2005.
  3. Kabat-Zinn J. Full catastrophe living. Using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte; 1990.

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