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Santa Fe 2009 298Many of the people I work with in both taijiquan and counseling have chronic pain. According to the National Health Interview Survey done by the CDC , about 25 million Americans suffer daily pain and about 54 million Americans have chronic pain. In working with pain, I use a combination of movement and mindfulness. Taijiquan and qigong can work wonders for pain relief. Each is a gentle way to get moving again and a way to attain balance in all parts of life.

There are several books I suggest to folks. First are the works of Toni Bernhard. You can read more about her at http://tonibernhard.com/. She addresses pain management from a Buddhist perspective. She has written several books on the topic and about her own coping with chronic pain. Another book is “The Pain Antidote: The Proven Program to Help You Stop Suffering from Chronic Pain, Avoid Addiction to Painkillers and Reclaim Your Life”, by Mel Pohl, MD and Katherine Ketcham. You can find out more about it at http://www.thepainantidotebook.com/index.html. Pohl helps people get off opiates and develop alternate and more effective ways of coping with pain.

Taiji and qigong work with pain by changing your relationship with gravity, changing the way you breathe, and calming your mind and body. A principle of taiji is that you only expend the energy and engage the muscles for whatever it is you are doing at that moment. Everything else is relaxed but ready. Your joints are never locked. Your spine is upright and your head rests in balance on your shoulders. If you had a plumb bob attached to the center of the top of your head and it ran down the center of your body, that plumb bob would always touch the floor somewhere between your feet as you move. Standing at rest, it would be equidistant between your ankles. Your shoulders are relaxed – neither tucked forward nor pulled back. When you change your relationship with gravity and are balanced, there is less pain because you are not tilted forward or back putting a lot of work on your neck, shoulders, and back. You also carry your body differently according to mood. Being in balance and harmony with gravity can also balance your mood.

Breathing to your diaphragm also reduces stress which can reduce pain. There is an emotional component to pain. Calming the emotions can help reduce the pain. Abdominal breathing slows the heartbeat, reduces blood pressure and blood sugar, lowers stress hormones in the blood, changes the blood flow in the body, improves digestion, and even changes your vision. You are going from fight-flee-freeze-faint mode to rest and digest mode. This is a guide to finding balance in a standing meditation.

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You can read more about the principles of taijiquan and qigong here.

You can also change your relationship with pain by changing the emotional relationship with it. Rather than fighting it, have a conversation with it. What is it trying to tell you? How does it feel? Is it hot, cold, throbbing, a dull ache? Notice it, be with it. Change your self talk with pain to change that relationship, too. Pain is not a bad thing, it is there to tell us something is wrong. Sometimes the harder we try to make it go away, the harder it works to be heard. Changing self talk can help with that as well. You change your relationship with pain.

 

Another option is humor. In 1979, Norman Cousins wrote a book called, “Anatomy of an Illness As Perceived by the Patient – Reflections on Healing and Regeneration.” I came across it back when it was published in 1979. My dad was in an intensive care unit for most of two years during that time. Cousins found that a component of his healing was humor and included things like watching Candid Camera and Marx Brothers movies. Laughter changes the hormones in your body and can bring on pain relief. Even just a smile can begin to bring calm and start to lessen pain. When people have found that support groups sometimes unhelpfully come down to contests of who hurts the most, humor can erupt to help with coping, especially in the form of Monty Python. Just the thought of the Yorkshire men can bring on a smile.

 

 

 

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2015 May 16 to 23 Bar Harbor 052

Root to the earth and rise to the sky like a tall straight tree.

It is difficult to feel centered sometimes. We are scattered by all sorts of distractions – perseverating thoughts, loud noises, flickering lights, and most often these days from electronic devices like phones and tablets. There seem to be multiple things at any given moment getting us scattered mentally and emotionally, and also physically. Pay attention to your body when you are feeling scattered. Are you grounded and relaxed and in harmony with gravity? Or are you tense, stiff, tilted forward or to one side with gravity pulling you down.

 

Our bodies and minds are one and when you are scattered in one, the other is out of balance as well. In taijiquan and qigong, your center is your lower dantien. That is the energy center about three finger widths below your belly button and three finger widths inside your body. Essentially, it is your center of gravity, and we move around and breathe from that center. I sometimes say in taijiquan class that life is a struggle in finding balance with gravity. It is always there. Astronaut Scott Kelly was two inches taller after spending about a year in space. Gravity compressed his body back that two inches after his return to earth. When you are out of balance with gravity, your body pays a price. Your neck, your lower back, and your spine all struggle to keep you upright. The outcome is increased pain and an increased risk of falling.

When you are out of balance, you also do not breathe as efficiently. Beginning about age 6 or 7, our breathing tends to start moving from our belly towards our upper chest. This style of breathing is less efficient. We get less oxygen, we have to work harder to breathe and tend to breathe more quickly. This “upper chest” breathing engages your sympathetic nervous system, or your fight/flee/freeze/faint system. Your heart rate, blood pressure, blood sugar and breathing rate all rise. You get tunnel vision. Your blood moves from your internal organs and brain out to your arms and legs to get you ready for action. Your ability to think and improvise goes away and you automatically “go with what you know.” Your adrenalin and cortisol levels rise and form a feedback loop between your adrenal glands and your brain that causes the levels to continue to rise. Take a moment and put one hand on your upper chest and the other hand on your abdomen just below your belly button. Now breathe like you normally breathe. Which hand moves? Are you breathing from your abdomen or your upper chest?

You can practice getting your center – finding your balance and breathing efficiently. You will move better. You will feel better. You will function more from the parasympathetic nervous system’s rest and digest way of being. You might even be more likely to use the other response to a threat – tend and befriend – when you are balanced.

This is an exercise we do at the beginning of classes to find balance with the earth and harmony with gravity.

When you hurt another, you may ask forgiveness from them. The Pope has asked forgiveness of those molested by priests and for the treatment of indigenous people in the New World. People convicted in court may ask forgiveness just before sentencing. Preachers and politicians ask forgiveness when caught in sin and then enter rehab to prove just how sincere they are. All of us do wrong at some time. Forgiveness is an issue that comes up often in life and in counseling. What does that word mean?

It does not mean saying that the wrong is now okay. “Sure you hurt me, but I forgive you, now it is okay.” That definition makes forgiveness extremely difficult if not impossible. It is giving a gift of dispensation to the one who harmed you. There is another view. Forgiveness can mean, “I don’t like what you did, and it is not okay but I will let it go. It doesn’t mean I want to have anything to do with you again, but I am not going to let anger and resentment devour me.” A quote attributed to the Buddha is that holding onto anger is like grasping a hot coal. The one who gets burned is you.

Many years ago I was having a conversation with a person who was working on recovery in AA and was doing step work. The eighth step is making a list of people you have harmed and you become willing to make amends to them. The ninth step is to make direct amends to those you have harmed except when to do so would injure them or others. It became quickly obvious that the person’s goal was to seek forgiveness even though in that case it would cause pain to the person wounded and to others. There was no talk about making amends. One universal principle throughout cultures and spiritual traditions (including secular ones) is to give without thought of return. When the Bodhidharma met with the Emperor Wu, one of the questions Wu asked was how much merit he had earned for all the monasteries he had built and all the other good deeds he had done in the name of the Buddha. “None,” said Bodhidharma. According to the story, the conversation was a short one. There are times when asking forgiveness is a manipulative act. We are asking forgiveness of the one we have already harmed with the sole purpose of making ourselves feel better. What is the merit of that? None. You are just doing more harm.

This is a place where the steps give good guidance. Look into your heart. It may be better to seek how you can make amends to those you hurt rather than ask forgiveness. Forgiveness belongs to the one harmed, and it is for them and within them that forgiveness occurs. If you are going to ask anything, ask how you can make amends and even then, only ask when doing so causes no further harm. Making amends with no expectations (including the expectation of forgiveness) may be a better way and work better at allowing yourself forgiveness with time.

For further thoughts on working on reconciliation and the process of forgiveness I strongly recommend “Negotiating the Nonnegotiable: How to Resolve Your Most Emotionally Charged Conflicts,” by Daniel Shapiro. Shapiro is the founder and director of the Harvard International Negotiation Program. As a psychologist and negotiation specialist, he has worked with families as well as corporate and governmental groups including conflicting parties in the Middle East. He provides a very thoughtful and guided method for the process of forgiveness and reconciliation.

There is a Zen story of a master who stands with his eyes closed and yet catches a falling object while those wide eyed around him have not yet perceived the object’s fall. He is in the moment and completely attentive.

Ruth M. Buczynski, PhD, president of the National Institute for the Clinical
Application of Behavioral Medicine
, recently talked about how to rewire your brain to improve willpower. A March 23, 2015 article in Medscape discussed a study in Sydney, Australia that looked at nine modifiable triggers for low back pain. The leading trigger is distraction while performing a task or activity.

What do willpower and distraction have in common? Both are associated with losing focus. How can we practice focus and get better at it? Buczynski suggests a simple breathing exercise for five minutes a day. Simple does not mean easy, however. Many people give up mindfulness or meditation because of a racing mind. Buczynski recommends just focusing on your breath, and when thoughts come into your mind (as they inevitably will) just acknowledge them and return to breathing. You can focus on the sound of the air as it flows in and out or the temperature of the air or whatever works for you. The important thing is, return to focusing on the breath. It gives you practice for staying on task, and returning to the task when you wander.

Any time I work with someone who has issues with anxiety and stress, we start with the breath. Slowing your breathing and breathing abdominally does many good things for you – lowers blood pressure and heart rate, lowers stress hormones and in doing so lowers blood sugar and redirects blood flow to the organs. You are balancing your sympathetic and parasympathetic nervous systems.

So if you want to feel better and more balanced mentally, emotionally, and physically, start just focusing on breathing to your abdomen slowly and mindfully. You will improve your willpower and your focus. Paying attention to where you are now can also save your back.

Setting goals is important, and how you frame them is critical to succeding. A goal can be as broad as “I want to live a life of integrity” to as specific as “I want to run a four minute mile.” With the former you need to define just what integrity is – how will you know when you are living that life and when are you veering off course. How do you get back on course? For the latter, you need training, a workout schedule and a sense of just how realistic that goal is. Whether your motivation is internal or external also has an effect on succeeding. You are less likely to burn out if you are focused on getting better for you.

One thing both those goals have in common is that they are positive goals. Positive goals are “I am going to do something.” They are action oriented in that something will happen and you will know it. It gives you a place to move towards. All too often we define our goals in a negative fashion – “I am not going to do something.” There are many problems with that. First off, you are activating your brain to think about what you don’t want to do. Do not picture a blue jay in your mind at this moment. What picture just appeared in your mind? I spoke with someone recently whose goal was, “I don’t want to be lonely.” “Well, what do you want to be?” I asked. How will you know you are not lonely? Focusing on loneliness tends to leave one lonely. So we began to look at how she wants to connect with people, what kinds of relationships does she want, and first off, what kind of relationship does she want with herself. It is much easier to be in the company of someone who is comfortable and secure with themselves. Negative goals too often become self fulfilling prophecies. I can’t tell you how many times I have heard someone say, “I didn’t want to be like my parent.” And then they realized that in focusing on what they didn’t want to become, they took on those qualities and became what they vowed they would not be.

A negative goal is inactive. Tough to prove a negative. So when you are setting goals, make them positive, something you will know is present. Put in as much detail as you can. It is like writing a good story of what you want to do or become. You can even use a 10 scale to track your progress. A ten is you have achieved the goal.  A zero is you haven’t even begun. Where are you now? Track your progress up the scale. That gives you some flexibility, too. Stuck at five? Reevaluate and redefine and see what you need to do to move up even to a 5.1. Edit your story.  One of my favorite exercises is “start-stop-continue” from Jerry Lynch and Chungliang Al Huang. What do I need to start doing, stop doing and continue doing to function at a higher level? And remember the concept of wu wei or effortless effort. Sometimes when you push too hard, you push yourself into the ground and get stuck. Have a plan but relax into it and have fun. It is hard to stick with a goal when the process is something you hate or find punishing. That is why so many resolutions for diets and exercise programs fail. Flow and adapt, and make your goals positive.

Paul Assaiante is the winningest coach you probably never heard of.  His squash teams at Trinity College won 224 straight and 282 out of 292 matches during a sixteen year stretch.  Squash doesn’t play well on television and is most popular in former British colonies post 1776. Consequently, he is not well known in America despite his success.  He recently wrote a book on coaching to overcome fear called Run To the Roar. His story begins with a tale of a lion pride on the African savanna.   The oldest lioness is no longer able to run fast and hunt like the younger members. What she can still do is roar.  When the pride hunts, the young lions spot a heard of prey and stealthily move in the bush to the far side of the hunted.  The old lion stays on the near side and when all is ready, lets out a ferocious roar.  The prey, reacting to the perceived threat, run from the roar and right into the teeth of the waiting pride.  Coach Assaiante helps his athletes face their fears and move towards them. Running away never gives them a chance to cope with their fears and anxieties.

Pema Chodron addresses this in The Places That Scare You: A Guide to Fearlessness in Difficult Times.  She teaches mind training in Buddhist tradition to help one cope and learn from that which we fear.  We pay attention, we do not avoid life as it is, but embrace it with loving kindness.  We listen to the stories we tell our selves, and we re-write those stories.  She calls it training in the warrior’s journey.

We are all embarking on, as Joesph Campbell wrote, a hero’s journey in this life.  Our fears and anxieties and our failures are also our teachers. Our brain’s have remarkable plasticity and ability to change over our lifetimes.  Our minds can grow and we can re-write our stories.  Listen to the phrases you say to yourself. How are those beliefs and stories affecting your life? What we tell ourselves, we become.

Sometimes it is hard to know when to quit. Einstein is credited with saying that “doing the same thing over and over again and expecting different results is the definition of insanity.”  But like most sayings there is always its opposite partner. Just keep trying, you will get there – winners never quit and quitters never win. So which is it?

We remember stories like how many record companies rejected the Beatles before they finally got a contract. We hear about how The Police had something like 9 attendees at a gig during their first UStour. We think about John Kennedy Toole who tried so hard to get his novel published and finally gave up and killed himself. His mother then started trying to get his book published and finally accomplished it when Walker Percy stepped in to help. A Confederacy of Dunces went on to win the Pulitzer Prize for fiction.

I have worked with students who were miserable in college. There were a variety of reasons. Some were only in college because they felt pressured to be there. Some wanted to be in college, but had chosen one that was not a good fit for them. They were miserable but having spent a year or two or more at school, wanted to tough it out to get the degree and so they would not feel like they had wasted the years they had already spent.

Listen to your self talk. Is that time truly a waste? What did you learn, not only in class, but about yourself? How can you use that in your life? What are the costs and benefits of sticking with it versus moving to something where you might be happier and feel like you were spending your time wisely?

There are a couple of metaphors that can be helpful in making a decision. Are you in a hole and just getting deeper and feeling worse and worse? It may be time to stop digging and get out. Remember Lyndon Johnson. The recorded phone conversations between him and Sen. Long revealed how he agonized over the war. It was not winnable in a traditional sense, but he also did not want to be the first US president to “lose” a war. Pride got in the way, and people lost their lives. If you are in your own privateVietnam, is pride getting in the way of your decision? Remember that is the conflict that gave us the expression, “we destroyed the village in order to save it.”  How are you treating yourself?

If you are having trouble with decision making and coping with the situation you are in, it can be helpful to talk to someone who can listen and help you think through things – a trusted friend, a nonjudgmental family member, your spiritual advisor, a trusted teacher, or a professional. You only have this life. How do you want to spend it? A popular phrase these days is, “it is what it is.” I recently heard a good variation – “it is what it is, in this moment.” Whatever situation you are in, it will pass. The question is, how do you want it to pass and into what.

Do you ever get tired of being told to “look on the bright side”, to “make lemonade from the lemons life gives you” and how supposedly the Chinese character for “crisis” is the same as for “opportunity”? Barbara Ehrenreich has written a book called Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America. She looks at the developmental history of the American style of optimism and its relationship to Calvinism. She examines proponents from pioneers Phineas Parkhurst Quimby and Mary Baker Eddy to modern proponents as different at Joel Osteen and Joyce Meyer on the religious side to Martin Seligman and positive psychology in the secular realm. She also looks at the effects of positive thinking  in areas such as cancer, particularly breast cancer (and looks at research as to whether a positive attitude affects onset and outcome of the disease), and at the economy and economic experts’ faith in positive outcomes of what were actually bubbles. Ehrenreich posits that we have been blinded by the light of unrealistic optimism with sometimes dire consequences. And yet, we keep following the same path.

At the end she does have a solution – realism.  She does say that negative thinking can be just as delusional as positive thinking, and is not advocating absolute pessimism either.  Realistic thinking is not easy. We see the world through our own blinders, and groups do the same thing.  Ultimately she espouses the power of critical thinking – something all too often missing in our lives these days in our relationships with ourselves and with others.  We need look no further than our political discourse, or perhaps our disagreements with friends and family.

Jamie Hale recently wrote an article on critical thinking which can be found at http://psychcentral.com/blog/archives/2011/01/12/critical-thinking-what-is-true-and-what-to-do/.  Hale says that critical thinking is based on rationality.  We look at the evidence. We do not just look for what will prove us right, but what will also prove that idea wrong.  Ehrenreich refers to “anxious vigilance” in child raising. Ronald Reagan is often quoted with the phrase, “trust but verify.”  Hale says that, “In order for our beliefs to be rational they must be in agreement with evidence.  In order for our actions to be rational they must be conducive to obtaining our goals.”  Ultimately critical thinking is about trying our best to determine what is true, and then being sure that our actions in achieving our goals are consistent with that evidence.

When Admiral James Stockdale, who was held captive for years as a prisoner of war in North Vietnam, was asked by James Collins about those who did not survive imprisonment, he said, “Oh, that’s easy, the optimists. Oh, they were the ones who said, ‘We’re going to be out by Christmas.’ And Christmas would come, and Christmas would go. Then they’d say, ‘We’re going to be out by Easter.’ And Easter would come, and Easter would go. And then Thanksgiving, and then it would be Christmas again. And they died of a broken heart.”  Stockdale said he survived because, “I never lost faith in the end of the story, I never doubted not only that I would get out, but also that I would prevail in the end and turn the experience into the defining event of my life, which, in retrospect, I would not trade.”  He then said, “This is a very important lesson. You must never confuse faith that you will prevail in the end—which you can never afford to lose—with the discipline to confront the most brutal facts of your current reality, whatever they might be.”

Self confidence and self efficacy have to be backed up with ability and a realistic assessment of what is. Otherwise that confidence is false and will ultimately fail.  Ehrenreich and Hale are both reads I recommend.

Many of the people I see have problems with anxiety and stress.  There is always stress in one’s life.  What matters is how we frame it and how we manage it.  We frame it with our life narrative, our central organizing principal.  Those are the words you say to yourself as you live your life.  It may be something like, “no matter what happens, I will always land on my feet” and you take a problem solving approach anStress managementd see stress as opportunity for growth.  On the other hand, the mantra may be “I am always a failure and everybody can see that.”  The lack of self efficacy and self confidence can really raise one’s anxiety level.

When we perceive something as threatening, the amygdala springs into action sending messages to get stress hormones moving to get us ready to fight or flee.  We may be overwhelmed and freeze or even faint. The emotion hits first milliseconds before we are able to think.  There are a couple of techniques to practice to help cope with that rush, and to help you move towards another possible reaction to stress – flow. Flow is more akin to the reaction that the person who sees a crisis as an opportunity for growth and who actively problem solves will use.  Some of these techniques involve breathing and grounding.  You can practice by getting relaxed in a chair sitting so that your body parts have good blood circulations and don’t “fall asleep.” Close your eyes and breathe in through your nose and out through your mouth.  Breathe to your diaphragm.  Place one hand on your upper chest and one on your stomach.  When you breathe, only the hand on your stomach should move.  Breathe slowly – count to four as you breathe in, hold it for a count of four, breathe out for a count of four.  Practice the breathing technique several times a day. You can pair a word with the exercise, something as simple as “serenity” or “relax” so that eventually you can just say the word to yourself and the relaxation begins.  Grounding is the process of getting yourself into the present moment – “be here now.”  Feel your feet on the floor, the way your clothes feel upon your skin, notice the colors of your environment, the shapes, the sounds, the smells, etc.  Focus on the surroundings to take yourself out of that vision of stress and into the present.

We will look at other techniques in later entries, but breathing is a good place to start and is fundamental.  When you slow your breathing down, it slows your heart rate, lowers your blood pressure, and reduces the stress you feel.  Then you can approach whatever the issue is with a clear mind.

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