Progressive Relaxation Techniques – Intervention for anxiety

wpid-anxiety.jpg

              Your heart starts pounding faster as your breath quickens. Your senses become sharper and you are aware an uneasiness creeping up onto you. Your thoughts run wild and in a moment, you feel breathless as if someone is choking your neck and a big rock weighing in your heart. Your body starts to feel cold or you may experience sweaty hands and /or feet. The more you think, the more you feel insecure. Your mouth starts to become dry and tingling of numbness sensation in your hand and feet coming to you. Perhaps you may start feeling dizzy or even nausea. And the last you may realize is your muscle tightness in your whole body.

              Anxiety is a normal human emotion that most experiences at time especially for those who lives in this stimulating and complex city. It can cause numerous stress symptoms which vary from person to person. The most common symptoms are often stiffness and soreness on the body. When you sense danger (whether is real or imagined) the body defenses in a way which is known as an automatic process called the “fight or flight” reaction or rather the generic stress response. This response is the body’s way of protecting you. Often when we feel anxious, we avoid doing things of what we intend to do and worry about the outcome. Anxiety can habitually follow us and subconsciously you may not be even aware although it may be part and parcel of daily life stressors.

              The therapist will need to understand and find out from the client where and how is this anxiety being formed, where is it located at and what words will be best to describe it. These notions are important during the progressive relaxation therapy as it helps the therapist to choose their words and imagery accordingly during hypnosis. As therapist slowly guides client into relaxation mode with their eyes close, control breathing technique will be apply and client will learn to identify and recognize the intense sensation when they scan through their body from head to toe. Direct suggestions will be apply for generalized relaxation in client when they achieve a light to medium trance. Some clients’ response well in a structural method for progressive relaxation by bringing awareness to each individual part of their body and bringing attention to each individual muscle groups focusing from the head to leg or vice versa until all muscle groups are relaxed.

Space

              Your eyes are closed and you begin by getting into a comfortable position. Now breathe in slowly and exhale gently to empty your lung as much as possible. Keep breathing and as slowly as you can. It may be very difficult at first but that is okay. As you breathe in and out gently, notice and feel where the tensions are located at. Inhale slowly, letting the rhythm of your breathing to slow down. Feel the relaxation beginning at the bottom of your feet. It may have a tingling sensation as if you are stepping on the warm floor or simply loose and limp. Let the tension seep through your feet to the toes and allow the relaxation to spread all over your feet and up to your ankles. Allow this relaxation to spread to your tight calf and feel the tension slowly disappearing. Let your calf relax… limp and slack. Let this flow of relaxation continue to spread to your knees and up to the thighs. Feel the sensation of tightness disappearing and let your thigh muscles relax. Let it be loose… limp and slack. Allow this relaxation to continue to spread throughout your body. And now this relaxation is rising up to your hips and slowly to your upper body, to your stomach and lower back. Now to your chest and upper back. Gently breathe in and breathe out slowly. Feel the muscles on your lower body are totally relaxed, limp and slack. And this relaxation continues to spread to your arms, elbows and wrists. Now when you see your hands, hold it tight and clench your hands into fists. Feel the stiffness and tension on both your hands and squeeze it tight when you breathe in. Now open your hands slowly when you exhale and relax. Notice how your hands and arms are feeling now. Feel the relaxation in your hands and arms… loose and relaxed. Feel your body relaxing further and allow your shoulders to ease back slightly. Feel yourself sinking deeper and deeper into the chair. While you breathe in gently, you see the tension emitting out from your shoulder when you breathe out slowly. Allow your upper back to relax even further, let your shoulder fully relax, and your neck, let it sink deeper and deeper into the chair. Feel this sensation of relaxation continue to spread to your chin, to your mouth, your cheeks, and nose and to your eyes. Your eyelids are heavy and relaxed. Your forehead is light and cool, let this relaxation spread further to the back of your head and slowly moves to the top of your head. Your entire body is fully relaxed and calm. You can even relax further as you let your spine to relax completely. Feel the relaxation flowing throughout your body now. Breathe in slowly and hold your breath now, gently exhale out from your nose and relax your muscles totally. Let all the tension in your body leaving with each breath out. Continue to breathe slowly and smoothly as you scan your body looking for any possible remaining tension.

              Edmund Jacobson (1934a, 1934b, 1938, 1964, 1967, 1970) who originated and developed the method of progressive muscle relaxation (PMR) stated that muscle relaxation has been an important therapeutic technique in the modern treatment of anxiety disorders. When the client has already achieved significant tension reduction, appropriate deepening procedures are used such as fractionalization technique. Client is asked to open their eyes for a moment, and then close their eyes. These steps will be repeated consecutively up to five times when therapist gently swift their hands down from the client’s face or with a snap of their fingers to bring client right back to an even more satisfying level of deeper relaxation and concentration.
images1

              Anxious people also hold on to many negative cognitive thoughts on why they are behaving that way and don’t necessarily always link to negativity. You can face anxiety even when you are experiencing positivity with high demand when you just received a promotion, buying a house or getting married, relocation or going to college. This stress response helps you to meet and face your challenges and also leads you to tension on your body muscle. A study researcher, Jens C. Pruessner, PhD (2011), director of the Douglas Mental Health Institute at McGill University in Montreal stated that living in big cities with many, many people surrounding you sensitizes you to respond more strongly to stress. It’s a stronger response of those areas that typically regulate fear and emotion. Pruessner (2011) reported that city dwellers’ mental health is negatively affected: mood and anxiety disorders are more prevalent in city dwellers and the incidence of schizophrenia is strongly increased in people born and raised in cities. In their finding, they use functional magnetic resonance imaging in three independent experiments, that urban upbringing and city living have dissociable impacts on social evaluative stress processing in humans. Current city living was associated with increased amygdala activity, whereas urban upbringing affected the perigenual anterior cingulate cortex, a key region for regulation of amygdala activity, negative affect and stress.

              Long term stress can rewire the brain and leads you to anxiety and depression vulnerability. The challenge since young when we are culturally mold to be more cautious and fear of losing out; often we, in Singapore context are being labeled as “kiasu” which literally means “fears of losing”. Since young, these memes have been passed down through the generations which resonate very well with my family and own values. Our humane brain functions very reactively and stored many hidden treasures in it that causes anxiety which distort the breathing patterns and subconscious fear. The conceptual style of creating a safe place with reality of perception and going through the progressive muscle relaxation with the anxious client do prove a certain success rate in controlling anxiety for a long period of time. Jacobson (1938) cited that progressive muscle relaxation originated from the theory that a psychobiological state called neuromuscular hypertension is the basis for a variety of negative emotional states and psychosomatic diseases. Jacobson asserted that relaxation of muscles would lead to relaxation of the mind, “because an emotional state fails to exist in the presence of complete relaxation of the peripheral parts involved”. Client will learn how to recognize and identify the contraction and relaxation of muscle in various parts of their body in a certain order. Grawe, Donati, and Bernauer (2001) found 66 studies in which progressive muscle relaxation or one of its successors was applied as a therapeutic intervention.

              Epictetus, a Greek Stoic philosopher quoted: “Man is not worried by real problems so much as by his imagined anxieties about real problems”.
epictetus

References

Grawe, K., Donati, R., & Bernauer, F. (2001). Psychotherapie im Wandel: Von der Konfession zur Profession (5th ed.). Go¨ttingen: Hogrefe.

Jacobson, E. (1938). Progressive relaxation (2nd ed.). Chicago: University of Chicago Press.

Jacobson, E. (1934a). Electrical measurements concerning muscular contraction (tonus) and the cultivation of relaxation in man: relaxation times of individuals. American Journal of Physiology, 108, 573–580.

Jacobson, E. (1934b). Electrical measurements concerning muscular contraction (tonus) and the cultivation of relaxation in man: studies on arm flexors. American Journal of Physiology, 107, 230–248.

Jacobson, E. (1938). Progressive relaxation (2nd ed.). Chicago: University of Chicago Press.

Jacobson, E. (1964). Anxiety and tension control: a physiologic approach. Philadelphia: Lippincott.

Jacobson, E. (1967). Tension in medicine. Springfield, IL: Thomas.

Jens C. Pruessner (2011). City living and urban upbringing affect neural social stress. Nature. Print on June 23, 2011, from http://www.nature.com/nature/journal/v474/n7352/abs/nature10190- f1.2.html#supplementary-information.





Mabel Ang from The School of Positive Psychology

Famous Historian of Mesmerism: Animal Magnetism

Anton Mesmer

              Have you ever been immersed on a beautiful scene or pretty things or sink into deep thoughts as if you felt like in a trance mode dreamlike state? You have probably been mesmerized many times in your life. The verb “mesmerize” was rooted from Mesmer’s name and the creator for mesmerism was Franz Anton Mesmer (May 23, 1734 – March 5, 1815) whom was a German physician with an interest in Astronomy, was also referred to as Friedrich Anton Mesmer. In 1771, Mesmer influenced by Maximilian Hell’s (May 15, 1720 – April 14, 1792), a court astronomer and Jesuit priest, was intrigued by Hell when he used magnets to heal patients by applying steel plates to the naked body when he was a medical student at the University of Vienna. In 1774, Mesmer gave one of his female patient, Franzl Oesterline’s prescriptions containing iron after experiencing frustrating failures with ordinary medical techniques. Oesterline had to live in Mesmer’s house to receive round-the clock care due to her vulnerable illnesses. After having her swallowed the solution, it was reported that she felt streams of mysterious fluid running through her body. It was then Mesmer perceived the flow was affected by his own will and he named it as “Animal Magnetism”. He believed that certain individuals had more or less innate animal magnetism, and he has the ability to manipulate the flow of this fluid in their body. Mesmer affirmed that the sun, moon, and fixed stars mutually affect each other in their orbits; that they cause and direct in our earth a flux and reflux not only in the sea, but in the atmosphere, and affect in a similar manner all organized bodies through the medium of a subtle and mobile fluid, which pervades the universe and associates all things together in mutual intercourse and harmony (MacKay, 1841). Goodwin (1999) stated that what Mesmer hadn’t realized is that he was showcasing the power of suggestion, not magnetism. Mesmer used his talent, the art of mesmerism providing powerful words of suggestion which send people into frenzied convulsions or sleeplike trances.

            Mesmer would channel this magnetic force on patients by touching, tapping and “laying on of hands” on their body or inflicted parts and explained to his patients it was due to the obstruction of the abnormal flow of fluid in their body that blocked the flow and caused the pain and illnesses to evolve. Mesmer would sit in front of his patient with his knees touching their knees, pressing the patient’s thumbs in his hands and looking fixedly to the patient’s eyes. All these treatments were done in his apartment that was dimly lit hung with thick drapes and mirrors on the walls accompanied with the music of a glass harmonica (invented by Benjamin Franklin). The patients were seated placed in relation by means of chord around a sort of vat which Mesmer called it a baquet, that contained with iron filings and broken glass. Mesmer wore a lilac silk robe with flamboyant gold slippers slowly passing his hands on patient’s bodies or with a simple flick of his magnetized wand provoking contagious hysterical scream and laughter, vomiting and dramatic convulsions catharsis.

            Mesmer was able to treat patients with various conditions at a remarkable success. In 1777, his attempt to cure an 18-year-old blind female pianist, singer, and composer, Maria Theresia von Paradis, was not successful due to the malicious rumor scandal that Mesmer was on a relationship with Paradis which led him to leave Vienna to Paris in 1778. Mesmer rented an apartment and set up a clinic in the city where the wealthy and powerful in authority stayed. He tried and failed to get into the Royal Academy of Sciences or Royal Society of Medicine to prove official approval for his doctrines. Finally he managed to gain one influential physician, Charles d’Eslon, whom became Mesmer’s disciple in 1778. In 1784, King Louis XVI appointed a royal of commissioners to investigate animal magnetism by d”Eslon which included the great French scientist and chemist Antoine Lavoisier, the physician Joseph-Ignace Guillotin, the astronomer Jean Sylvain Bailly, and the American ambassador to France, Benjamin Franklin. The verdict of their finding found no scientific evidence to Mesmer’s theories of animal magnetism which purely as mere illusions that benefitted to the patients spiritually.

            Whether any individual in the eighteenth century believe in the power of psychic ability to heal one illness is quantified by the self-transcendence scale, which is composed of three sub-sets: “self-forgetfulness” (as in the tendency to become totally absorbed in some activity, such as reading); “transpersonal identification” (a feeling of connectedness to a larger universe); and “mysticism” (an openness to believe things not literally provable, such as ESP). Self-transcendence is an essential component in the processes of integration and maturation of personality which is cited by Robert Cloninger (2004). In the nineteenth century, the theory of animal magnetism attracted many followers in Europe and United States and became very popular by Charles Poyen, who made him known as the “Professor of Animal Magentism”, a pupil of Marquis de Puysegur in 1836. Benjamin & Baker (2004) cited; “In certain ways, mesmerism was the first secular psychotherapy in America, a way of ministering psychologically to the great America unchurched. It was an ambitious attempt to combine religion with psychotherapy, and it spawned ideologies such as mind cure philosophy, the New Thought movement, Christian Science and American spiritualism.”.

 

References

Benjamin, L.T., & Baker, D.B. (2004). The beginnings of psychological practice:
Psychology’s other occult doubles. From Séance to Science: A History
of the Profession of Psychology in America
(pp.21-24). California:
Wadsworth/Thomson Learning.

Cloninger CR. Feeling good: The science of well-being. New York: Oxford University Press, 2004.

Goodwin, C.J. (1999). Psychoanalysis and clinical psychology: Mesmerism and hypnosis. A History of Modern Psychology (pp. 363-365). New York: John Wiley & Sons, Inc.

Mackay, Charles. (1995). Extraordinary Popular Delusions & the Madness of Crowds. Crown Publishing. Originally published in 1841.

Mesmer, F.A. (1980); Mesmerism: A Translation of the Original Medical and Scientific Writings; Bloch, G.J. (tr.); Kaufmann Inc.; Los Altos, CA

 

Mabel Ang from The School of Positive Psychology

Techniques and Benefits of Hypnotherapy: Hypnosis Process

Image

               Hypnosis is a powerful tool that allows one to experiences the hypnotic state and heal the psychological damage that has went through traumatic experience. Hypnosis unlocks one’s inner potential to empower one to achieve their goal in a safe and natural manner. Warmly lit decorated environment is best suited for hypnotherapy session with a comfortable reclining chair to allow client to enter into trance easily feeling comfortable and relax. Hypnotherapy is effective for mental and physical healing that helps to remove the toxic symptom and fill in the space with positive suggestions. This technique effectively help client to better understand and identify their problems that has suppressed in them in their long forgotten memories as well as kicking off bad habits, removing or reducing fears and anxiety. In clinical hypnosis, it also aids in improving immune systems, pain management and used as an anesthesia method in dentistry and childbirth surgery.  In 1845 a book was published by James Esdaile MD called ‘Hypnosis in medicine and surgery’ in which he describes a method of production of anesthesia by the use of hypnosis. Holroyd, Jean (1996) reviews recent controlled clinical studies in which hypnosis compares favorably with other interventions; links advances in understanding endogenous pain modulation to a neurophysiologic view of hypnosis and hypnoanalgesia; relates the neurophysiology of hypnoanalgesia to management of chronic pain; challenges the view that hypnotic pain control is only for the highly hypnotizable patient; and raises issues about how people learn to control pain with hypnosis. Training in hypnotic analgesia may usefully enhance nervous system inhibitory processes that attenuate pain.

              Therapist will need to gather information from client and access the history so those objectives can be set in place to allow clients to have some positive expectation. It is essential to explain and demystify the myths with client to allow them to feel at ease before entering the process so that greater result can be achieved efficiently. Most importantly, hypnosis cannot make anyone do anything that is against their morals or values and they are always in control to accept or reject any suggestion that the hypnotist has given. You need a certain amount of letting go and openness during the hypnosis. With the guide of the hypnotist’s soothing, calm and confident voice, it allows you to go into a relaxation trance state with your eyes close to center your thoughts. As you continue to relax even further, gradually the hypnotist’s voice seems to distant away and soon you may experience a strong or light sensation in your body and your mind starts to drift away. The hypnotic voice who is speaking to you will bring you back to the past and unfold the hidden memories that reside in your subconscious mind. The hypnotherapist doesn’t provide the client’s answers; they are guided into their subconscious mind that leads to their Higher Consciousness for problem solving and getting their own answers. Albert Einstein (1940) quoted; great spirits have always encountered violent opposition from mediocre minds. The mediocre mind is incapable of understanding the man who refuses to bow blindly to conventional prejudices and chooses instead to express his opinions courageously and honestly.

              Somehow you enter into the trance state and it feels as if you are in a movie theater and are watching your very own show. You are slowly guided by therapist to see the event that created the strong emotions in you that house your long term memories of emotions and feelings. You feel as if you are right there back in the scene experiencing the total wonderment of emotions of what you think, imagine or recall and sometimes you may be watching your own movie as in another person’s perspective. The scene and things in the movie may be amplified and sometime you may not be able to see any event and while you are recollecting back the memories, you are given time to sink deeper and continue with your movie. You are guided with each step slowly in decision making and building your awareness on every stage of your movie and you get benefitted as long you are willing to go along with the suggestion from the hypnotist. Therapist acts like a coach in helping you to achieve the result and answer of your own which in fact you are doing your own work all this while. Andre M. Weitzenhoffer (1976) cited; Erickson believed that the unconscious mind was always listening, and that, whether or not the patient was in trance, suggestions could be made which would have a hypnotic influence, as long as those suggestions found some resonance at the unconscious level. As the last show is coming to an end, you will be brought to a safe place of yours to be rejuvenated and feel balance before you are awake from your hypnotic state of trance. Some may feel totally relaxed in their own movie that allows them to slip into an ordinary sleep and when that happens, you can have a nap and some may takes a little while to wake up from hypnosis. This is very common in hypnotherapy which shows that the client has entered into the trance state.

              Whether you are hypnotizable, as long you have your 5 senses (smell, taste, hearing, feel and see) functioning well, able to day dream and ever absorbed yourself feeling all the tensions and emotion into a good movie or TV show, you are hypnotizable. Erickson maintained that trance is a common, everyday occurrence while waiting for buses and trains, reading or listening, or even being involved in strenuous physical exercise, it’s quite normal to become immersed in the activity and go into a trance state, removed from any other irrelevant stimuli. These states are so common and familiar that most people do not consciously recognize them as hypnotic phenomena (Erickson & Rossi, 1976).

              Hippocrates (460-377 BC) the Greek physician considered the “Father of Medicine” and whose oath all graduating physicians must take was referring to hypnosis when he said: “The affliction suffered by the body, the soul sees quite well with the eyes shut”.

 

References

Albert Einstein (1940), in a letter to Morris Raphael Cohen, professor emeritus of
              philosophy at the College of the City of New York, defending the
              appointment of Bertrand Russell to a teaching position (19 March 1940)

Andre M. Weitzenhoffer (1976) Introduction/forward in Hypnotic Realities Erickson
              & Rossi

Erickson & Rossi: Two-Level Communication and the Microdynamics of Trance
              and Suggestion
, The American Journal of Clinical Hypnosis, 1976
              Reprinted in Collected Papers Vol.1

Holroyd, Jean (1996). Hypnosis treatment of clinical pain: Understanding why
              hypnosis is useful. International Journal of Clinical and Experimental
              Hypnosis, 44 (1), 33-51.


Mabel Ang from The School of Positive Psychology