Monday, April 2, 2007

Relaxation Part 1

Relaxation is a key part of your recovery. However, many CFS/ME patients are challenged by relaxation. I believe that this is because of the dis-ease in the nervous systems. The peripheral nerves, particularly those in the arms and legs, are constantly firing off, making relaxation very difficult. As part of your recovery I recommend that you take several structured rests per day (the exact amount will depend on your individual needs and stage of recovery). There are several considerations.

Try and take your rests in a place where you do not sleep. I picked up a treatment couch from e-bay for £30. If you aren't able to get a couch, then a piece of thick foam with a quilt over it is an option. If your home allows it, try and make yourself a space in the home that is just for relaxation. Have it all set up with clean covers and 2 pillows. You will also need an eye mask. Again, I got one from e-bay which was silk covered for £3 including delivery (I had to put a new strap on it so it wasn't too tight as this is also a consideration for CFS/ME patients). Alternatively you can just cover your eyes with a suitable piece of cloth (either cotton or silk). Make sure it is reasonably heavy so that it doesn't slip off.

Some music is recommended. In particular, 'spiritual' music designed to relax you (heavy metal is obviously not a choice at this point, even if you love it!). If spiritual music is not to your taste, try and go for something gentle and instrumental, without lyrics. Make sure the music is not too loud and not too quiet.

Make sure the temperate is to your liking (easier said that done if your body thermostat is up and down due to ME/CFS!). If there are distracting sounds outside, close windows and doors for the duration of the relaxation.

You will need 2 pillows and a blanket or quilt. 1 pillow goes under your knees and the other under your head. With the pillow under your knees you can let go of your legs more easily. (I sometimes sleep like this also, although it is best not to do it to often as according to my highly skilled osteopath, Shirley Kay, it may shorten your hamstrings if you sleep like this permanently).

Allow yourself a few minutes to settle. Fidget until your clothes/nightwear are in a comfortable position, your eye mask is comfortable, and your pillows and cover are perfectly comfy. Have patience with yourself and allow yourself comfort before you start.

When you are ready, check that your arms are straight by your side (palm up if it is comfortable) but not rigid, and that your legs are straight and slightly apart. Then take a deep breath and send relaxation down your body as you breath out. Imagine feel a calming wave going through your whole body. Do this several times if it feels good.

Now check your breathing. Place your one hand on your abdomen and one hand on your chest. Try to practice abdominal breathing which means that most of the movement should be coming from your abdomen. If you are challenged by this try placing both your hands on your abdomen with you fingers slightly touching. As you breath out your fingers should move apart, and as you breath in they should move together. Don't force your breath or your abdomen - keep everything nice and soft. This takes lots of practice for many people, so be gentle with yourself if you can't get it right away. It will come over time.

The next part is really important and the key to relaxation – I do this every time I lay down (even in bed) and I find that it improves relaxation greatly. I have turned it into a bit of a sequence for myself, that I have included here, but it is more important to get the relaxation than the sequence in the right order. Focus on the basics rather than the detail. It involves tensing and relaxing all the muscles from toe to head. Please do not under-estimate the importance of this part of the exercise. As a yoga teacher what I believe that it does for the CFS/ME patient is switches off the constant firing of the nervous system.

On an in breath, tense your feet towards your head. Hold the tension in your feet as you breath out, then breath in again (feet still tense), and release the tension in your feet on the next out breath. It is probably best to always tense on an in breath and release on an out breath. I've added the extra breath in between as through experimentation I have found it to be most effective. Following the tension and relaxation of each body part take several more slow, deep breaths before moving on to the next part. This helps to slow the process down so you are not quickly jumping around from one muscle to the next. This sequence is repeated throughout the whole body:

thighs and buttocks,
hands (into fists),
shoulders (shrugged),
back (very slightly and gently arched),
neck – the breathing is not as crucial here - keep your head on the pillow and tilt it slightly forward, then gently and slowly role a little to the left and then right, before centering head back on the pillow.
face – scrunch up tightly
jaw – open your mouth as wide as you can to eliminate jaw tension.

This is not as complicated as it may seem. Basically all we are doing is tensing each body part from toe to head and using the breath to make it more effective. If you do have a friend or partner that can read out the sequence then great, but if you don't, just make up your own – as long as you have tensed every body part from toe to head in some kind of sequence, the order doesn't matter.

This whole sequence if done slowly and gently, takes about three to five minutes. Generally, the longer you take in this initial phase, the more effective the relaxation.

Then, send a couple of breaths down your body – breath out and imagine that your breath is going down your body and relaxing any remaining tense parts.

At this point, hopefully you should be feeling much more relaxed than if you had just layed down. Again, be gentle if you don't get it first time.

Now there are a number of things you can do in this position to keep your mind from wondering. It is important to note that if you lay here and stress about bills, relationships or anything else, then it will be counterproductive. If you do have trouble switching your mind off (which is incredibly common with ME/CFS patients due to the over-active nature of the condition), then try and allow yourself at least this time each day to give yourself a break from over-thinking. It is good, at this point, to have a focus. One example from yoga will illustrate that each person has a different way of remaining focused in this position. If we take the abdomen rising and falling, as yoga teachers we are taught that some people like to imagine their abdomen rising and falling, others like to feel their abdomen rising and falling, whilst others like to say “rise” and “fall” in their mind as their abdomen rises and falls. Personally as a CFS/ME patient with an overactive mind I have found that it is good to have a mantra (word or phrase) repeated in my head to keep me focused.

One suggestion is: each time you breath out send peace, or love, or healing, or relax down your body – simply say one of the words: peace/love/healing/relax in your mind on an out breath and feel it travel down your body. Try and stick with one word.

Other options are to: send a feeling of joy to every cell in your body each time you breath out; imagine your favorite colour and send it down your body every time you breath out; send light down your body etc. Whatever works for you.

If you can take the basics of these techniques on board your relaxation time will change dramatically. This is a huge key to your healing. In part 2 of this series I will be giving some specific breathing exercises to carry out in this position which greatly enhance the exercise. I wish you a joyful and relaxing day!

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