Thursday, November 24, 2011

Manage Stress and Avoid Anxiety - Part II Physical methods of stress management

In previous post the physical and psychological symptoms of the unmanaged stress have been pointed out.
Now let us discuss how we can manage stress effectively. There are some physical as well as psychological steps of stress management.
Physical Methods
         DEEP BREATHING - To start with take deep breath in sitting or lying position for 5 minutes. Gradually increase to 15 minutes.
         POSITIVE IMAGERY – Sitting in a relaxed position visualise silent landscapes.
         AEROBIC EXERCISE – Brisk walking, jogging, cycling. Avoid gymnastics which are anaerobic exercises.
         RELAXATION AND LEISURE – For a brief period each day at a particular time sit or lay idle without doing or thinking anything.
         REDUCE /AVOID STIMULANTS - Coffee, tea, smoking


Developed by Jacobson in 1939, Progressive Muscular Relaxation (PMR) is a widely used procedure today. It causes deep muscular relaxation in muscle groups, tensed under stressful conditions. Muscular tension produces aches and pains, particularly in the neck and back. For many individuals, the shoulder muscles provide a kind of internal thermometer for the tension level. If you tell yourself regularly to "drop your shoulders," you will be surprised to find how often there is something to drop!
PMR uses the pendulum method - if you want the pendulum to swing in a particular direction, then you first have to pull it back in the opposite direction and then let go. Similarly in Progressive Muscular Relaxation, first you deliberately apply tension to certain muscle groups, and then you let go, and turn your attention to noticing how the muscles relax as the tension flows away. The aim is to work systematically through the body, and it is usual to start with the hands, work up to the shoulders, then back to the feet and up to the shoulders again, leaving the face and neck to last. There is no reason to suppose that you have to rigidly stick to a particular order, but it might be difficult to start with areas in which physical and emotional tension seem to concentrate, such as the shoulders, neck and face.
Note: Before practicing PMR, you should consult with your physician if you have a history of serious injuries, muscle spasms, or back problems. 
Procedure Proper
There are two steps in the self-administered Progressive Muscle Relaxation procedure: 
·         Deliberately tensing muscle groups.
·         Releasing the induced tension.
Tension–Relaxation Procedure
Step One: Tension - The process of applying tension to a muscle is essentially the same regardless of which muscle group you are using. First, focus your mind on the muscle group; for example, your right hand. Then inhale and simply squeeze the muscles as hard as you can and hold to the count of 5; in the example, this would involve making a tight fist with your hand.
Note. Beginners usually make the mistake of allowing muscles other than the intended group to tense as well; in the example, this would mean that there will be a tendency to tense muscles in your right arm and shoulder along with those of the right hand. With practice you will learn to make very fine discriminations among muscles; for the moment just do the best you can.
It’s important to really feel the tension. Done properly, the tension procedure will cause the muscles to start to shake, and you might feel some pain but don't over do it.
Note. Be careful not to hurt yourself, as compared to feeling mild pain. Contracting the muscles in your feet and your back, especially, can cause serious problems if not done carefully; i.e., gently but deliberately.
Step Two: Releasing the Tension- This is the best part because it is actually pleasurable. After the count to 5, just suddenly but gently let go. Let all the tightness and pain flow out of the muscles as you simultaneously exhale. In the example, this would be imagining tightness and pain flowing out of your hand through your fingertips as you exhale. Feel the muscles relax and become loose and limp, tension flowing away like water out of a faucet. Focus on and notice the difference between tension and relaxation.
Note. The point here is to really focus on the change that occurs as the tension is let go. Do this very deliberately, because you are trying to learn to make some very subtle distinctions between muscular tension and muscular relaxation.
Stay relaxed for about 15 seconds, and then repeat the tension-relaxation cycle. You’ll probably notice more sensations the second time.
Note: It is of utmost important to coordinate your breathing with the tension relaxation cycle. Every time you let go, exhale and feel the tension go out from the concerned muscle group along with the outgoing breath. The breathing must be relaxed and preferably abdominal.
Muscle Groups
Here is an order that we find easy to remember which will help you not to forget any muscle group. 
·         Hands: Clench the fists.
·         Arms: Tighten biceps and lower arms together, without the hands.
·         Shoulders: Raise your shoulders as if they could touch your ears.
·         Feet: Screw up your toes.
·         Front of legs: Point your foot away from you so that it is almost parallel with your leg.
·         Back of Legs: Flex your feet upwards, stretching your heels down.
·         Thighs: Tighten them while pressing your knees down into the floor.
·         Bottom: Clench your buttocks together.
·         Stomach: Hold your stomach muscles in tight.
·         Lower Back: Press the small of your back into the floor.
·         Chest: Breath in, hold your breath, and tighten all your chest muscles.
·         Shoulders: Breath in, hold your breath and raise your shoulders as if to touch your ears.
·         Neck: 
o        Stretch your head up, as if your chin could touch the ceiling.
o        Bend your head forward until your chin reaches your chest.
Mouth and Jaw: Press your lips together and clench your teeth. There are two steps in the self-administered Progressive Muscle Relaxation procedure: 
·         Deliberately tensing muscle groups.
·         Releasing the induced tension.
·         Eyes: Close them up tight.
·         Forehead and scalp: Raise your eyebrows as if they could disappear.
·         Face: Screw all the muscles up together.
After learning the full PMR procedure, you will spend about 10 minutes a day maintaining your proficiency by practicing a shortened form of the procedure. But in the beginning it might take longer and it would be a good idea to tense and relax one limb at a time instead of both together. With time and practice, approximately 3 to 6 weeks, you may shorten the exercise gradually. For example, you could try collapsing some of the muscle groups until you only work on your arms, legs, abdomen, chest and face. Ultimately, you will acquire something that will probably become an indispensable part of your daily life, and the initial drudgery of practice will be long-forgotten.
Dos and don'ts:
It is recommended that you practice full PMR twice a day for about a week before moving on to the shortened form. Of course, the time needed to master the full PMR procedure varies from person to person.
Here are some suggestions for practice:
·         Always practice full PMR in a quiet place, alone, with no electronic distractions, not even background music.
·         Remove your shoes and wear loose clothing.
·         Avoid eating, smoking, or drinking. It’s best to practice before meals rather than after, for the sake of your digestive processes. Never practice after using any intoxicants.
·         Sit in a comfortable chair if possible. You may practice lying down, but this increases the likelihood of falling asleep.
·         If you fall asleep, give yourself credit for the work you did up to the point of sleep.
·         If you practice in bed at night, plan on falling asleep before you complete your cycle. Therefore, consider a practice session at night, in bed, to be in addition to your basic practice.
·         When you finish a session, relax with your eyes closed for a few seconds, and then get up slowly. (Orthostatic hypotension—a sudden drop in blood pressure due to standing up quickly—can cause you to faint.) Some people like to count backwards from 5 to 1, timed to slow, deep breathing, and then say, “Eyes open. Supremely calm. Fully alert.”
See next post: Psychological methods of stress management


  1. Very very informative and expecting next part .. Sir please write the Malayalam version of this Stress Mgt in KGOA News ..