Relaxation Training
By learning to recognize fight-or-flight arousal and to reduce the level of arousal, it is possible for you to obtain some relief from the physical symptoms associated with your anxiety.
Before embarking on relaxation training, it helps to have a clear understanding of the fight-or-flight response and the relaxation response. Most relaxation training focuses on two activities: breathing and muscle relaxation.
Breathing
There are specific changes in breathing that are part of the fight-or-flight response. By learning to distinguish between the type of breathing associated with anxiety and the type of breathing that leads to relaxation, it is possible to change the way you breathe and to reduce your overall level of arousal.
Generally speaking, there are two ways that you can breathe: high in your chest, or low in your abdomen. Along with how fast you breathe, where you are breathing (chest or abdomen) at any given time will have a significant impact on how you are feeling. Breathing slowly, low down in the abdomen, is associated with feelings of calm and relaxation.
Abdominal or "belly breathing" results in an increased supply of oxygen to your muscles, promoting relaxation. It also stimulates the relaxation response of the parasympathetic nervous system. For most of us, when we are relaxed and resting, our breathing occurs primarily in the belly. When we are engaged in belly breathing, we are using a muscle called the diaphragm, which is just beneath the rib cage. If you ever watch a baby sleeping, you will notice that babies breathe almost exclusively with their bellies.
When we encounter a threatening or stressful situation, and the flight-or-flight response kicks in, even slightly, most people begin to breathe higher in the chest. Some people have developed the habit of breathing high in their chest most of the time, even when they are not particularly stressed or anxious. Chest breathing produces a series of changes in the normal operation of your body. First, breathing high in your chest reduces the level of carbon dioxide in your body, lowering the acid content of your blood. The body reacts to this low acid or alkaline blood by narrowing the blood vessels in certain parts of the body. The result is a restriction in blood flow to the brain and certain other tissues. This change is not dangerous, however, it is part of the fight-or-flight response and triggers all of the other physical changes associated with fight-or-flight arousal. The effects of chest breathing can be subtle at times. Even slight chest breathing, continuing over a long period of time, can set you up for an acute fight-or-flight reaction in response to even mild stressors.
If you have been primarily a chest breather for a long time, beginning to breathe from your belly may be a bit difficult or uncomfortable at first. A therapist skilled in CBT can coach you through the process of changing how you breathe. There are exercises that you can learn to stretch your diaphragm and help you to identify what proper belly breathing feels like.
To determine whether you are more of a belly or chest breather, take a few minutes to perform this simple test:
The Breathing Test
Sit up straight in a comfortable chair with your feet flat on the floor. Put one hand flat on your chest, and put your other hand flat on your stomach, right over your belly button. Take several slow, deep breaths. Notice the movement of your hands. Which hand moves the most as you breathe in? Do you breathe primarily in your chest, or mostly in your belly? If you breathe both in your chest and in your belly, where is the breathing initiated? What percentage of the movement is in your chest vs. in your belly? Is it 50/50? 80/20?
Muscle Tension
Perhaps the most remarkable physical change that occurs during the fight-or-flight response is the increased muscle tension experienced in the large muscles of the arms, legs, back, shoulders, neck and jaw. These are the muscles we use for fighting and "flighting". While this increased tension in the muscles of the shoulders, back and arms prepares us to take on our enemies in hand-to-hand combat, it can also leave us with a sore back and result in shaking and trembling of the arms and hands. The clenching and grinding of the jaw muscles is a similarly aggressive response that can leave the muscles of the face and head tight, resulting in face pain, headaches, and ringing of the ears.
On a mechanical level, muscles become tense because they are filled with blood. When blood is trapped in the muscle for a long period of time, toxins begin to build up in the muscle tissue. By learning to systematically tighten and release groups of muscles, you can mechanically "pump" blood and toxins out of them. This allows a flesh supply of blood to enter the muscle, which you will experience as a warming or relaxing sensation. Deep abdominal breathing facilitates this relaxation of the muscles by increasing the level of oxygen in the tissues.
When muscles are tense, the body as well as the brain are in "crisis mode." In this state, you are more likely to anticipate problems and negative outcomes. By learning to relax your muscles at will, you send your brain the message that there is no crisis. A therapist trained in CBT can teach you a variety of techniques for recognizing muscle tension and relaxing muscles that are critical to the fight-or-flight response.
Relaxation to "Let Go" of Control
While learning to breathe primarily in your belly and to relax your muscles can reduce your baseline level of anxiety and arousal throughout the day, these effects are very general and will only get you so far. Relaxation training alone does not address the control paradox which often triggers and maintains anxiety. While reducing your baseline anxiety and muscle tension is great, in those moments when you are faced with intense anxiety and worry, trying to "breathe away" your feelings is not likely to work. When used as part of the LLAMP approach, which integrates elements of CBT and ACT, relaxation exercises serve as a reminder to "let go" of control.
Fight-or-flight arousal is part of a more general "control response" designed to help us take control of emergency situations. Instead of using relaxation techniques to increase your control over anxiety (which paradoxically can lead to more anxiety), breathing properly and relaxing your muscles can be used to let go of the control response.