Training Toolkit: Relaxation

Our ability to relax can be enhanced by improving sleep and understanding its function. In and learning specific relaxation techniques which can all contribute to mitigating emotional distress.

By accessing the materials in this topic, it will enable you to:

• Demonstrate awareness of their own sleep pattern/rhythms
• Understand the link between sleep/relaxation and the impact on mental and emotional health and wellbeing
• Be aware of practical techniques and to encourage a healthy sleep pattern
• Understand that any medical concerns should be discussed with their doctor
• Understand the potential of relaxation techniques on health and well being
• Demonstrate a brief understanding of a range of relaxation techniques by engaging in activities
• Be aware of research evidence underpinning the brief text provided in the toolkit by having access to references

Sleep is related to our physical, cognitive, and psychological well-being. When we sleep our cells restore and repair, restoring energy and releasing important hormones. Our nerves cells reorganise while we are asleep which promotes healthy brain function. When we sleep, important cytokines are also produced, which help us fight infection and inflammation. When we are unwell or stressed it is therefore particularly important that we have enough sleep.

So how much sleep do we need? Most adults and teenagers over 14 years old need between 6 and 9 hours sleep a night. Children require more sleep than adults because they are rapidly growing and learning; for example, a 1-year-old requires 2 hours 30 minutes daytime hours and 11 hours a night.

Severe lack of sleep is linked to reduced daytime performance, fatigue, depression and anxiety, decreased immunity and poor cognitive performance. Regular poor sleep can put us at risk of serious medical conditions, such as obesity, diabetes and heart disease and it has the potential to shorten life expectancy. Experts agree that sleep plays a vital role in recalibrating the emotional functioning of our brains and that insufficient sleep can lead to a reduction in emotional regulation.

Although stress and anxiety can hinder sleep, some medical conditions can also be the cause of poor sleep patterns. If you are concerned you should speak to a doctor, however, for most people who have trouble sleeping (insomnia) the main cause is often bad sleep habits. If you experience regular periods of insomnia there may be some simple steps or changes that you can take to help you sleep. So, the good news is that you can do something about it!

Things that you can do to help yourself to develop good habits to promote sleep might include: 

• avoiding having a big meal late at night
• avoiding caffeine in the afternoon or evening- try decaffeinated substitutes
• creating a routine with a regular time to go to bed and get up
• avoiding alcohol as it can disturb sleep; alcohol is a stimulant; having a nightcap to sleep is a myth!
• thinking about your bedroom, use think curtains thick or even consider an eye mask to create darkness
• avoiding using a computer, watching TV or using mobile phones in the bedroom
• taking a warm bath an hour before you plan to go to bed
• trying earplugs if noises disturbing you in your bedroom#
• reading a book
• listening to calming music
• being more active during the day but avoid exercising too much late at night before you go to bed
• writing down the things that worry you or things that you want to remember before try to sleep

There is considerable evidence that music may be effective in improving the quality of sleep-in adults who experience insomnia. Consider what type of music you find relaxing and might help you sleep. There are many free resources available online to download, soothing sleep music, sleep meditation recordings. If you have a smart phone there are sleep and calm apps that might work for you.  Remember you don’t want to be searching just before bedtime as this won’t help you settle, take time during the day to download any online resources so that you can just play them at bedtime.

Many of us experience periods of insomnia and some employers are considering the benefits of providing relaxation techniques for ‘power naps’ in the workplace. However, this does not replace a good night’s sleep.

Some people turn to other self-help or complementary approaches to help them sleep; these are always a matter of personal choice and of trial and error. It is always advisable to discuss with your doctor about any supplements that you consider using. Melatonin is a hormone made by your body which helps regulate sleep. Your body needs Vitamin B6 to make melatonin. Foods high in vitamin B6 might therefore be helpful to your body e.g., fish, chicken, tofu, pork, beef, sweet potatoes, bananas, potatoes, avocados, and pistachios. Brazil nuts and Walnuts can also help you produce melatonin. Please refer to the How to Do It section below for further practical examples.

Any activity which helps you destress or feel calm can be considered a relaxation technique. We are all individuals, and you might find that some relaxation techniques or strategies help you more than others and at certain points of your life. If one technique doesn’t work for you, don’t give up, try something else until you become aware of a range of relaxation activities that work for you to some degree. Consider that you are building up your own ‘tool kit’ of activities as a resource- you can try and use a range of different tools whenever you feel stressed or anxious; or even better develop a strategy to relax regularly anyway! It’s good for your health!

Consider these simple steps that you can engage with today:

• Schedule time to read a book or magazine that is not work or study related
• Take time for a relaxing bath
• Go for a walk, engage with nature- look and listen, noticing birds, plants, insects
• Get creative, have you ever tried playing an instrument, drawing, knitting, it doesn’t matter how good you are.

Many relaxation techniques include focusing on or controlling your breathing. Using an approach that focuses on your breathing to relax can impact on the effects of stress, including hypertension, anxiety, and insomnia. Controlled breathing triggers a relaxation response, activating the parasympathetic nervous system, which can slow down your heart rate.

Relaxation techniques include practices such as progressive relaxation, guided imagery, biofeedback, self-hypnosis, and deep breathing exercises. The goal is to produce the body’s natural relaxation response, by slowing breathing, lowering blood pressure, and create a feeling of improved well-being. Meditation and meditation with movement, such as yoga and tai chi, can also help you relax. There is still a need for further evidence to confirm the effectiveness of many relaxation techniques, but many people rely on them to improve their health and wellbeing. Relaxation techniques are considered harmless for healthy people but if you have any doubt you should seek advice from a healthcare professional. There is some overlap in definition between relaxation techniques and meditation and mindfulness. Please refer to the How to Do It section below for further practical examples.

Things that you can do to help yourself to develop good habits to promote sleep might include: 

• avoiding having a big meal late at night
• avoiding caffeine in the afternoon or evening- try decaffeinated substitutes
• creating a routine with a regular time to go to bed and get up
• avoiding alcohol as it can disturb sleep; alcohol is a stimulant; having a nightcap to sleep is a myth!
• thinking about your bedroom, use think curtains thick or even consider an eye mask to create darkness
• avoiding using a computer, watching TV or using mobile phones in the bedroom
• taking a warm bath an hour before you plan to go to bed
• trying earplugs if noises disturbing you in your bedroom#
• reading a book
• listening to calming music
• being more active during the day but avoid exercising too much late at night before you go to bed
• writing down the things that worry you or things that you want to remember before try to sleep

There is considerable evidence that music may be effective in improving the quality of sleep-in adults who experience insomnia. Consider what type of music you find relaxing and might help you sleep. There are many free resources available online to download, soothing sleep music, sleep meditation recordings. If you have a smart phone there are sleep and calm apps that might work for you.  Remember you don’t want to be searching just before bedtime as this won’t help you settle, take time during the day to download any online resources so that you can just play them at bedtime.

Many of us experience periods of insomnia and some employers are considering the benefits of providing relaxation techniques for ‘power naps’ in the workplace. However, this does not replace a good night’s sleep.

Some people turn to other self-help or complementary approaches to help them sleep; these are always a matter of personal choice and of trial and error. It is always advisable to discuss with your doctor about any supplements that you consider using. Melatonin is a hormone made by your body which helps regulate sleep. Your body needs Vitamin B6 to make melatonin. Foods high in vitamin B6 might therefore be helpful to your body e.g., fish, chicken, tofu, pork, beef, sweet potatoes, bananas, potatoes, avocados, and pistachios. Brazil nuts and Walnuts can also help you produce melatonin.

Aids to sleep:

• Valerian is found in some over the counter sleep remedies. It should not be taken with alcohol. This is a root which historically has been used as a sedative.
• Melatonin supplements which in short term use some people find helpful.
• Camomile tea contains glycine which relaxes nerves and muscles
• Lavender pillow sprays
• Warm skimmed milk can release chemicals to relax the body due to the calcium

Are you ready to work on developing skills to improve sleep? If so, you may start by referring to the Case studies/videos and then consider the identified activities in the Ready to take the leap section.

There are many forms of meditation, many with an ancient history. These include spiritual meditation, mindfulness meditation, movement meditation, focused meditation, visualisation/imagery meditation and chanting meditation. There are many ways of meditating and no one right way. Meditation is an exercise for the mind which trains your attention and awareness. It can stop you reacting to your thoughts and feelings, particularly those that you may find disturbing or upsetting. Meditating often involves focusing on a single point such as the breath, body sensations, a phrase or a chant (often referred to as a mantra)

Mindfulness meditation has become increasingly popular in recent years.  Jon Kabat-Zinn an American Professor of medicine created a Stress Reduction Clinic and the Centre for Mindfulness in Medicine based on his experience as a student of Zen Buddhism. The stress reduction program created by Kabat-Zinn, known as the mindfulness-based stress reduction (MBSR), is offered by many medical centres, hospitals, and health care organisations and influences many self-care strategies practiced by individuals across the globe.

Mindfulness focuses on our ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us. We often live our lives on auto pilot and becoming mindful by awakening our senses and focusing ‘on the moment’ can bring about a sense of calm in or busy lives. Have you ever driven somewhere and cannot recall the drive? Have you ever finished a meal while thinking of something else and not really focused on what you were eating? This is all too common in our busy schedules but by training our minds to focus on what we are doing in the moment we can bring about a sense of clam control. Mindfulness is described as the practice of paying attention in the present moment, doing it intentionally and without judgment. It’s that simple, paying more attention to the present moment – to your own thoughts and feelings, and to the world around you – can improve your mental wellbeing! Mindfulness is even recommended by the National Institute for Health and Care Excellence (NICE) in the UK to prevent depression in people who have had 3 or more bouts of depression in the past.

As well as practising mindfulness in daily life, many people set aside time for formal mindfulness practice which involves sitting silently and paying attention to thoughts, sounds, the sensations of breathing or parts of the body, bringing attention back whenever the mind starts to wander. It’s ok if your mind wanders when you’re attempting this, just notice it non-judgementally and bring your mind back to the moment. There are many organisations that offer mindfulness training and free websites and apps that can guide you to explore adopting mindful practices.

Mindfulness is associated with improved psychological healing, well-being and transformation. It helps emotional regulation, decreases reactivity, and response flexibility which helps stress and anxiety reduction.

When the focus of a meditation is an image with a defined outcome, the meditation is often referred to as visualisation. Visualisation is sometimes called mental or guided imagery and can be guided by a therapist or practised alone. It is something that you can practice for yourself- you can imagine yourself in a favourite setting and experience the impact of that setting on your body and mind. This is something you may have done without realising; part way through a stressful day you pictured that special day on the beach when you were completely relaxed. Further developing such natural imagery skills can provide you with a useful relaxation technique.

There are many benefits to visualisation are plentiful including:

• Improved performance.
• Increased focus.
• Decreased levels of stress and anxiety.
• Insomnia relief.
• Boosted immunity.
• Alleviated migraines and chronic pain.
• Decreased depression
• Boosted confidence.

Why not give it a try? Make yourself comfortable close your eyes and take yourself in your mind to a place that you know you always feel relaxed. Don’t just place yourself immediately there but walk yourself thorough the journey to get there, imagine yourself with someone that you feel safe and comforted by, think of the warmth on your skin, the breeze gently touching your brow, the smell of the sea, the sound of the waves…….it has to be your relaxing image, but this gives you an idea. Sometimes people find it helpful to visualise a good outcome of something that has troubled them to help them heal emotionally and this can be guided by an experienced practitioner.

Guided imagery is a useful technique for managing stress and coping with difficult situations:

Step 1: Find a quiet place.

Step 2: Choose your setting. Imagine yourself there, use all of your senses to immerse yourself in the experience, and include as many details as possible.

Step 3: Relax, for as long as your schedule allows you to.

Remember imagery is most effective when you use all your senses. The more details that you can include in your imagined scene, the easier it will be for you to relax.

Meditation is usually associated with stillness, however moving meditation is a meditative state, a shift of consciousness, while doing simple movements. It can calm the mind and creating awareness. Yoga and Tai Chi are both able to utilise meditation with movement.

Yoga originated from ancient Indian practices and combines physical, mental, and spiritual practices to unite the mind and body in a meditative practice. Today it has been developed into a posture-based physical fitness, stress-relief and relaxation technique. Different styles of yoga include, Iyengar, Sivananda and Ashtanga. Some are more physical than others and some focus more on breathing.  No style is better or more authentic than another.

There is some evidence that yoga when practiced regularly can be beneficial for people with depression and stress.

Yoga Associations include:

The main UK yoga associations are:

• British Wheel of Yoga (BWY), the Sport England-recognised governing body for yoga
• Independent Yoga Network
• Iyengar Yoga (UK)
• Yoga Alliance Professionals

Tai Chi was first developed as a martial art in 13th-century China. It is now practised around the world as exercise to improve health and well- being. Combining deep breathing and relaxation with flowing movements, Tai Chi involves slow, graceful, flowing movements and can reduce stress levels in healthy individuals. You can practice the soothing mind-body concepts of Tai Chi without performing the movements when you are in a stressful situation but typically it is helpful as a form of exercise with a series of slow movements performed in a focused manner and accompanied by deep breathing.

Benefits may include:

• Decreased stress, anxiety and depression
• Improved mood
• Improved aerobic capacity
• Increased energy and stamina
• Improved flexibility, balance and agility
• Improved muscle strength and definition

The principle behind biofeedback is that your mind becomes aware of what’s going on within your body. Sensors attached to your body send signals to a monitor, which can display a picture, sound, or image that represents your heart and breathing rate, blood pressure, skin temperature, sweating, or even muscle activity. This allows you to see your response to stress and/or relaxation. You can practice relaxation techniques such as meditation, guided imagery or controlled breathing and see your response on the monitor. Such control over your body utilising the power of the mind promotes relaxation. There is some evidence that controlling physiological effects of stress or anxiety in this way can support good health and even improve performance.

Heart Rate Variability (HRV) is an easy-to-learn method to reduce stress. The aim of HRV-biofeedback is to increase HRV by controlling your breaths to approximately 6 breaths per minute. A device measures heart rate and provides feedback information on the ideal breathing rate to improve HRV. HRV is not your heart rate but the variation in the time interval between heartbeats; the variation of the beat-to-beat interval. HRV-biofeedback has shown to be effective in reducing stress and anxiety in general adult populations with an anxiety and in lowering depression, stress, and anxiety symptoms in students and young adults. HRV assisted relaxation is sometimes referred to as cardiac coherence training or Heart Math training by those delivering training or producing bio-feedback software. As HRV assisted relaxation has become more popular there are now numerous apps supporting you to engage in the technique.

Many of the relaxation techniques highlighted within this toolkit involve attending training, classes or using tools available online. Remember a simple, calm breathing technique can be used for stress, anxiety or even panic that can be practiced by anyone anywhere and can become part of your daily routine. Just follow these simple steps:

1. Find a comfortable position
2. Loosen any tight clothing
3. Place your arms and legs in a comfortable position with your feet hip-width apart
4. Breath in as deep as you comfortably can
5. Breath gently and rhythmically in through your nose and out through your mouth- make a sighing noise if you wish
6. If you find it helpful count slowly and steadily to four…. four in…. four out
7. Practice this for 5 minutes at a time whenever you find it helpful
8. Try to begin and end your day with this exercise

Are you ready to work on developing your relaxation skills? If so, you may start by referring to the Case studies/videos and then consider the identified activities in the Ready to take the leap section.