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Countering stress and anxiety requires active use of a relaxation program. Regular daily practice of deep relaxation for 20-30 minutes a day can over time produce a generalization of relaxation and a significant reduction in anxiety.

Benefits of Deep Relaxation:

• Reduction in generalized anxiety, frequency and severity of panic attacks
• Prevents negative effects of stress and burnout
• Increased energy and productivity
• Improved concentration, memory
• Prevention and/or reduction of physical disorders (e.g. high blood pressure, migraines, asthma, ulcers)
• Reduction of insomnia, fatigue
• Improved self-confidence, and reduced self-blame
• More connectedness to ones feelings and between mind and body

The following are some specific techniques for deep relaxation:

ABDOMINAL BREATHING EXERCISE

1. Lie on your back with your hand on your stomach, between your navel and the bottom of your breastbone.
2. Inhale through your nose and push your stomach out so that you can feel your hand rise. (Do to a count of 4)
3. Exhale through your mouth so you can feel your hand on your stomach drop as your diaphragm displaces the air in your lungs. (Do to a count of 8)
4. Continue at your own rate for 5-10 minutes to begin with. Gradually over time work up to 15-30 minutes per day.

CALMING BREATH EXERCISE

This exercise can be a powerful technique to halting anxiety or the onset of panic and manage stress.

1. Breath from your abdomen, inhale through your nose slowly to count of five.
2. Pause, hold your breath to a count of five
3. Exhale slowly, through nose or mouth to a count of five. Exhale fully
4. After exhaling fully, take two breathes in your normal rhythm, then repeat steps 1-3.
5. Keep this up for 3-5 minutes.  Keep breath smooth and regular. 
6. Optional: each time your exhale, you may say ?Relax? or ?Let Go? or any other phrase you?d like.   

PROGRESSIVE RELAXATION (PR)

PR requires you to tense and relax, in succession, sixteen different muscle groups.

Guidelines:

• Try to practice for 15-20 minutes per day
• Select a comfortable spot to practice without distractions.  
• Practice at regular times times each day (on awakening, before bed, before meals are best)
• Practice on an empty stomach
• Decide to put worry on hold
• Assume a passive, detached attitude; decide to let it happen; do not try to relax or control your body. Let go without judgment.

Instructions:

1. Tense each muscle group vigorously, without straining, for 10 seconds, then let go quickly and then enjoy the feeling of limpness.  Allow other muscle groups to remain relaxed while working on the next group of muscles.
2. Allow 15-20 seconds to notice the feeling of relaxation in your body.  It may help to say to yourself, "I am relaxing," "Let go" or other relaxing phrases during each relaxation periods between successive groups. 
3. Focus on your muscles.  If your attention wanders, gently bring it back.   
4. At end of exercise, scan your body for any lingering tension and tighten and relax any remaining tense muscle groups. 
5. Finish by imagining a wave of relaxation taking over your body from the top of your head down to your toes.   

Order of muscle groups:  Fists, Biceps, Triceps, Forehead, Tense muscles around eyes (clench eyelids tightly shut), Jaw (open moth widely), Back of neck, Shoulders, Breast, Stomach, Lower  back, Buttocks, Thighs, Calf, Feet

THE PEACEFUL SCENE

Especially after PR, visualizing yourself in a peaceful scene can deepen relaxation.  You can also use this visualization exercise any time as a quick escape from anxiety and stress.   Try to determine what a peaceful scene for you might be.  This can be anything! Some popular images include a quiet beach, calm lake, or wooded area.  Other possibilities: your bedroom or home, sitting by a fire, or floating on a cloud.  Make sure you visualize the scene in detail so that it completely absorbs your attention.  Once you have developed your peaceful scene, you can return to it after PR, during deep breathing, or any other time during your day.  

MEDITATION

Meditation allows you to "just be" and has been found to reduce chronic anxiety, alter personality traits, behaviors, and attitudes in addition to having numerous beneficial physiological effects.   While meditation can be the most demanding form of relaxation technique to learn, it is for many people, the most rewarding.

Guidelines:

• Set aside 20-30 minutes.  Beginners may want to start with 5-10 minutes.  Set a timer if needed.  Practice every day.
• Find a quiet space and reduce noise.
• Reduce muscle tension (use PR if needed)
• Sit properly.  Find a straight backed chair and sit with feet on floor and legs uncrossed; place hands on your thighs.  Alternatively, you may also sit cross-legged on the floor, leaning slightly forward.

Instructions:

Two common forms of meditation:

• Use a Mantra
  1. Focus on a word or phrase (e.g. "One, Peace, I am at peace, Let go...")
  2. Repeat this word or phrase on each exhalation
  3. As any thoughts come to mind, gently bring your attention back to your mantra
• Counting Breaths
  1. Focus on your breathing. 
  2. With each exhalation, count the breath. Count until 10 and start again or continue counting as high as you'd like.
  3. After counting for a while, try to focus on the inflow and outflow of breath only.
  4. If your focus wanders, gently bring it back to your breathing. If you lose count, start again at 1.

Adapted from:  Bourne, E.J. (1995).  The Anxiety and Phobia Workbook.  New York:  MJF Books.