RELAXATION

Stress releases adrenaline causing sympathetic stimulation (“fight or flight”) with tachycardia, increased respiration and mental arousal. Relaxation opposes the effects of anxiety. It increases parasympathetic activity with slowing of both pulse and respiration associated with mental calmness (and increased regularity and amplitude of alpha wave activity in the brain).

Relaxation therapy is of considerable benefit to many patients facing terminal illness.  It can raise the pain threshold, reduce dyspnea, reduce fear and anxiety, and increase patients’ abilities to cope by fostering a sense of mastery over their situations. Relaxation therapy can also be useful for family members and carers.

There are four essential elements:

• Quiet environment

• Constant stimulus (sound or touch)

• Passive attitude

• Decreased muscle tone

There are many approaches to relaxation therapy, including:

• Massage

• Progressive muscular relaxation

• Breathing exercises

• Biofeedback

• Meditation

• Hypnosis

• Spiritual healing

• Visualization

The best form of physical and mental relaxation is provided by regular deep meditation. However meditation demands a degree of concentration and can be difficult for some patients who are very tense and who need to focus on physical relaxation, initially with massage, progressive muscular relaxation (contracting then relaxing different muscle groups) and breathing exercises (encouraging full expiration, lowering of the shoulders and diaphragmatic breathing so a hand on the chest remains still). These are best taught on an individual basis, then practiced daily with the help of tape recordings.

Simple techniques that the patient can grasp easily are usually best. It is important in a panic situation that the patient feels some relief right away. It is useful to involve family carers, as they can confirm any instructions, and they will usually be the ones present to help the patient through a panic situation.

Biofeedback can be useful for people who find it difficult to relax, particularly as they start a program of relaxation. Measurements of pulse, galvanic skin resistance (sweat) and electromyography (muscle tension) can demonstrate control of autonomic responses and boost confidence in self-control.

Meditation is a method of focusing attention which reduces the body’s state of arousal. The focus of attention may be a visual image, a repeated sound (mantra) or a physical repetition (breath pattern). Meditation is a simple technique, but it needs to be taught and practiced. Correct posture is important (sitting, not lying).

Hypnosis is a form of guided meditation during which suggestibility is increased. “Glove and stocking anesthesia” can be easily induced, which demonstrates the power of the mind over the body. The patient can then be taught a method of self-hypnosis (which is similar to meditation).

Spiritual healing, which includes emotional counseling, positive thinking and physical touch (often in a religious context), can result in deep relaxation.

Visualization (a technique developed from motivational psychology) means the regular practice of visualizing a desired outcome, such as shrinkage of cancer cells. Even if cancer is spreading, visualization can still be used to create positive mental attitudes, and to help the patient have a sense of control over a worsening situation. Visualization is best when combined with a program of relaxation, exercise and healthy diet. Drawings of imagined symbols can be useful to explore attitudes to disease, to overcome resentments and to identify new goals. (see Visualization)

Art therapy and music therapy can be important tools in achieving relaxation, and in exploring the patient’s attitudes and fears. Relaxation is also an important component of some of the complementary therapies such as reflexology and aromatherapy.

«  These techniques are properly used as adjuncts to competent pharmacological symptom control, not as attempted substitutes.

The author and publisher have taken precautions to ensure that the information in this book is error-free. However, readers must be guided by their own personal and professional standards of good practice in evaluating and applying recommendations made herein. The contents of this book represent the views and experience of the author, and not necessarily those of the publisher.