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Physician Health and Well-Being: The Relaxation Response

Physician Health and Well-Being: The Relaxation Response
By John Patterson
, MD, MSPH, FAAFP, ABIHM
Founding co-chair LMS Physician Wellness Program

          Just relax! It sounds so simple. Relaxation is indeed simple but it isn’t necessarily easy. More to the point- there are many unskillful, unhealthy lifestyle ways to relax. But you, your staff and your patients can achieve significant cardiovascular and other health benefits from the regular practice of skillful relaxation for stress management.

          One of the best ways to skillfully relax is by practicing the ‘relaxation response.’ Harvard cardiologist Herbert Benson coined the phrase ‘relaxation response’ in the 1970s after studying meditation’s effects on cardiovascular disease and other medical conditions. He basically gave a popular name to the parasympathetic activity of the autonomic nervous system- the ‘rest and digest’ antidote to the sympathetic ‘fight or flight’ response. His research showed that the simple practice of skillful relaxation helped lower blood pressure, pulse rate, respiratory rate, muscle tension and overall metabolic rate- even helping some patients reduce their medication needs.

          Over 40 years at the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine, the relaxation response has been shown to help a wide variety of stress-related medical conditions including chronic pain, sleep disorders, anxiety, depression, arthritis, intestinal disorders, skin conditions and much more. It has also been shown to improve the quality of life for those with life-threatening disease such as cancer and HIV/AIDS.

       Here are the steps to practicing Benson’s Relaxation Response. Note- the practice of relaxation techniques can lower one’s maintenance medication needs for conditions such as hypertension and diabetes. Careful monitoring is advised to assess for possible dosage adjustments.
1.  First, choose a focus word (or short phrase, prayer or sound). You can choose a word that has a religious or special meaning to you or a neutral word such as: one, now, being, ocean, love, peace, calm, relax, present or present moment. The meaning of the focus word is not the point. Rather you are cultivating the gentle resting of your attention on the word. Eventually, the word may fade away as you repeat it- leaving you in a state of ‘restful alertness,’ which Benson described as a ‘hypometabolic physiologic state.’
2. Turn off phones and arrange it so the dog, cat or 2-year-old won’t startle you by jumping into your lap. You may want to inform others that you are taking a health break and close the door. You can make a sign for the door saying ‘Quiet Please’ or ‘Meditating’.
3. Sit quietly in a comfortable seated or reclining position and close your eyes.
You can also lie down but that will increase the likelihood of falling asleep. Sleep is great but that isn’t the usual goal of the relaxation response practice.
4. Relax your muscles, especially paying attention to the jaw, neck, shoulders, back and other places you know you hold tension. As you become more sensitive to your own body, you may detect tension and relaxation in places you never imagined needing your attention.
5. Breathe slowly and naturally, and as you do, repeat your focus word, phrase, prayer or sound silently to yourself. At least in the beginning, this repetition may be easier to coordinate with the out breath. Over time, however, try to repeat your word without timing the repetition to the breath.
6. Be non-judgmental about distractions. When external sounds, body sensations and thoughts come to mind, simply notice them without judgment and gently return attention to the repetition.
7. Ideally, practice for 10-20 minutes, although even 1 minute (especially during stressful times) can help manage stress and cultivate a sense of self-mastery and self-care.
8. After your practice period ends, rather than quickly returning to activity, continue sitting quietly for a minute or so, allowing other thoughts to return. Then, open your eyes and sit for another minute before returning to regular activity. Notice this important transition time. Your eyes are open as in daily activity, yet the mind is quieter than usual after your practice. Later in the day, by simply remembering this calmness with eyes open, a hint of relaxation and self care can be cultivated at any moment throughout your day.
9. Practice! Practice! Practice! This technique is most effective if practiced once or twice daily. Although anytime is fine, ideal practice times are before breakfast and before the evening meal. Practicing before meals helps digestion- another important ingredient in self-care, cardiovascular health and managing stress-related conditions.

Resources

Benson-Henry Institute for Mind Body Medicine https://bensonhenryinstitute.org/

Audio recordings by Dr. Patterson for relaxation and mindfulness are available at the Mind Body Studio web site
http://www.mindbodystudio.org/?page_id=1594

About the author- Dr Patterson is past president of the Kentucky Academy of Family Physicians and is certified in family medicine, integrative holistic medicine, mind-body medicine, mindfulness-based stress reduction, yoga therapy and physician coaching. He teaches stress management for UK Health and Wellness, Saybrook University’s College of Integrative Medicine and Health Sciences (Pasadena) and the Center for Mind Body Medicine (Washington, DC). He operates the Mind Body Studio in Lexington, where he offers consultations and group classes promoting health professional well-being and managing stress-related chronic disease. He can be reached through his website at www.mindbodystudio.org