The human body is beautifully designed and balanced. Just as we have the ability to trigger a stress reaction when we feel threatened, we also have, hard-wired into our nervous system, an opposite physiological state of total relaxation. Harvard's Dr. Herbert Benson calls this "The Relaxation Response." It's not only a pleasant state to be in, but is an important natural antidote to the stress reaction, allowing our bodies to recover from and reverse the effects of sustained stress.

The "relaxation response" is the mirror image opposite of the "fight-or-flight reaction." When we feel threatened our heart rates speed up, blood pressure rises, breathing gets faster, muscles tense, etc. In a relaxation state, the heart rate slows down, blood pressure decreases, breathing gets slower and deeper, muscles relax and so on. However, unlike the stress reaction, which is involuntary and triggers automatically, the relaxation response has to be brought forth voluntarily and by intention. This means that we have to choose to become relaxed in order for it to happen. Fortunately, there are many ways to do this that are easy to learn: meditation, yoga, hypnosis, visualization and others.

In the "relaxation response," unlike sleep, the body is fully relaxed but the mind is awake and under conscious control. The goal is to "empty the mind" of thoughts and concerns and to let it simply exist in a relaxed state. To prevent distracting thoughts, concentrate on a mantra, or your breathing or other calming, repetitive images.

Relaxation exercises should be done in a quiet, comfortable environment. You can sit or lie down. Loosen tight clothing, remove shoes and glasses, and get fully comfortable. For maximum benefit, you should practice regularly (15-20 minutes/day) but you can also use the skills on an "as needed" basis (e.g. before a job interview or giving a presentation).

Relaxation (abdominal) breathing

Relaxation breathing can be used on its own, but is often combined with other techniques. It gets its name from the fact that we breathe differently when we're stressed than when we're relaxed. Under stress, the chest expands, shoulders rise, and we breathe rapidly in order to take in air quickly. During relaxation, the movement is in the abdomen, which expands with each breath in. This is the way we all breathed when we were infants and how we still breathe when we're asleep. As Eli Bay of "The Relaxation Response" in Toronto puts it, "When you breathe as if you are relaxed, you become relaxed."

Five principles of relaxation breathing:

1. Breathe in through your nose and out through your nose or mouth (opened slightly).
2. Breathe into your abdomen and feel your tummy rise as you inhale and fall as you exhale.
3. Breathe slowly, otherwise you'll hyperventilate.
4. Start by breathing out, to empty your lungs in preparation for the first deep breath.
5. Focus on and observe your breathing (like a form of self-hypnosis).
If you're having trouble coordinating this, put one hand on your tummy and the other hand on your chest. As you breathe, focus on the abdominal hand moving, but the chest hand staying still. Practice this for five minutes to start, then slowly increase to 15 or 20 minutes.

Progressive muscle relaxation

Edmund Jacobson was a Chicago physician who published a 1929 book called, Progressive Relaxation. In it he described a technique of deep muscle relaxation which reverses the muscle tension of a stress reaction. This is another way of accessing the relaxation response. It involves focusing on different muscle groups and consciously letting them relax. Start from your toes and work up, going slowly and with conscious awareness. Focus your attention on the muscles of your toes and allow them to relax. Then move your attention to the muscles of your feet and then let them relax. Then your ankles, shins, calves, knees, etc. As you let go of tension in each muscle group, continue to relax the muscles that you've already relaxed so that you can feel the wave of relaxation rising in your body.

The best books for learning a variety of relaxation techniques are: The Relaxation and Stress Reduction Workbook, by Davis, Eshelman, and McKay (New Harbinger Publications) and The Wellness Book by Dr. Herbert Benson and Eileen Stuart (Birch Lane Press, 1992).

While these techniques can be learned from books or even tapes, I think the best way of acquiring these skills is to take a course. It gives you hands-on teaching and practice, along with structure and support if you have problems with self-discipline. I recommend that couples take the course together, to increase the commitment and to be able to give support to each other.

Relaxation techniques are safe, portable, natural, and have no negative side effects. They are easy to learn, pleasant to do, and there are multitudes of different techniques to choose from. And they work!

All material copyrighted, David B. Posen M.D.