Author Archives: Jackie Aim

Everyday relaxation

Older man gardening
Everyday activities and hobbies can be useful for relaxation. These allow you to take time out of your day and focus on enjoyable activities. Some examples are:

Listening to music or a favourite radio station.
Sitting with a magazine or book.
Gentle exercise or walking.
Spending time with family or friends e.g. going out for a coffee.
Gardening, crafts, baking or working with your hands.

Think about what activities you enjoy which help you to feel more relaxed and calm. Try and do one of these activities every day.

You can also practice specific relaxation techniques, which can be very helpful.

Relaxation techniques do not come naturally to many people and they are skills which need to be practised. Think of it like learning to play a musical instrument, the more practice the more skilled you will become.

With time and practice you can become very good at relaxation techniques and better at managing anxiety and stress. There are two types of relaxation techniques on audio clips to try on the following pages.

Useful tips for relaxation

A woman sitting on the floor, with her legs crossed, meditating

Where should you practice your relaxation?
Choose somewhere quiet, warm and private, where you will not be disturbed by other people. Ask your family/carers not to interrupt you for a period of time. Put your phone on silent for a few moments while you are doing your relaxation. Turn off the television for some quiet time. Choose the place where you will be most comfortable.

Eventually you will be able to use your relaxation skills in a number of different places e.g. in your home, in shops, when travelling on a bus and when anxious or stressed.

When is it best for you to practice?
It is a good idea to practice every day, at times when you are not in a hurry to do something else. It is difficult to relax if you are thinking about what you need to do next. Choose times when you know you are unlikely to be disturbed. Many people say it is helpful to build relaxation time into your regular routine. Avoid trying to relax after a big meal.

Your Position.
Get into a comfortable position. You may want to sit down or lie down. Make sure your body is comfortable and well supported – use extra cushions for support if needed.

Your chest.
It can be useful before you start your relaxation to clear your chest and think about doing your active cycle of breathing if you have been taught this technique. You may want to do your relaxation time after you have taken your regular inhaler. Once your chest feels more comfortable, you can start to focus on other areas of your body where you carry tension in your muscles.

Practice.
At the beginning, the effects of relaxation can be quite small or it can feel a little strange to do. Don’t give up after one or two sessions. Relaxation is a skill and requires practice. Try to practice this skill every day at a planned time (e.g. not just when feeling stressed or anxious). Relaxation does not need to take a lot of time; it can be a short relaxation for 10 minutes or build up to a longer one as you improve your relaxation technique.

Benefits of relaxation

If you can make time to practice relaxation regularly you will become skilled at doing which ever method suits you best. You should start to notice some of the following benefits;

Lower blood pressure.
Slower more controlled breathing.
Improved mood.
Increased blood flow to muscles.
Less muscle tension and for some people, reduced muscle pain.
Lower levels of stress hormones resulting in you feeling calmer and making you feel better.
Reduced fatigue and tiredness.
Improved sleep.

Other benefits can include better posture, feeling more in control and having more energy.

What is Relaxation

One definition of relaxation is: a state of being free from tension and anxiety.

Relaxation is about resting your mind and body. It is an important part of taking care of yourself. It is a useful method for managing anxiety, stress and the fight/flight response.

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Heart: Adrenalin triggers increased heart rate and faster pulse feeding more blood to the muscles, preparing the body to cope with the stressful situation (fight or run away).
Stomach: Digestion slows down or ceases as blood is directed away from the stomach and this can cause nausea, indigestion, or the feeling of butterflies in your stomach.
Lungs: Breathing can become faster and shallower as oxygen is supplied to the muscles. This can cause breathlessness, chest pains, tingling, palpitations as the body prepares itself to fight or run away.
Neck and shoulders: Neck and shoulder muscles can tense as your body prepares itself to fight or run away. This can trigger aching and tightness in neck / shoulders and back.
Body and skin: Adrenalin causes blood vessels in your skins surface to open up making you to feel hot. Sweating is the body’s natural way of cooling itself down.
Legs: Muscles tense as the body prepares itself to fight or run away. This can trigger shaking or trembling in the body.
Bladder and bowels: muscles in the bladder or bowels relax and can cause you to rush to the toilet.
Brain: you can only think about the stressful situation and problem solving becomes more difficult. As an automatic response to this you may also get a dry mouth.

There are many different types of relaxation and we will only discuss some types on the following pages including:

Everyday Relaxation.
Simple Relaxation.
Visualisation.

It does not matter which type of relaxation you use. Everyone will have their own favourites. The important thing is to find a way to relax and rest your body and mind.

Relaxation and asthma

Relaxation can help if you also use breathing techniques and chest clearance methods. Like any new skill, you will need to practice relaxation. The more you practice the easier it becomes.

One of the main methods is used to recognise the tension in your muscles and learn how to release it by using small movements and adjustments in your posture. This is called simple relaxation. This also uses slow breathing so you can concentrate on relaxation.

If you would like to try this form of relaxation listen to the following audio clip. You can also download this clip.

Duration: 27 minutes 25 seconds
Voiceover: Louise Mason, Occupational Therapist, NHS Lothian

View audio transcript - simple relaxation

I am going to talk you through a relaxation called simple relaxation.
Don’t try to do this relaxation if you have just eaten a meal.
When you choose to do it, think about the environment that you are relaxing in. Switch off any phones. Let other people know that you are about to relax so they don’t disturb you.
Think about your body. Think about if you are sitting or lying down. Are you comfortable? Are you well supported? Use extra cushions for support if needed.

Notice the points of contact that exist between your body and the chair / bed you are resting on.
Take time to settle your body, and your mind, for this period of relaxation.
You may still hear noises of life going on elsewhere, but put this to one side for just now and give yourself permission to take time out to practice relaxation.
You are going to work around your body, undertaking certain movements, slightly adjusting your positioning each time.

As you move through this relaxation exercise I will repeat each instruction for changing your positioning twice. Getting you to let go of the tension you may be feeling between each change in position.

Take time to notice and register your new position as accurately as you can, trying to concentrate on the new positions and how they feel. A more relaxed posture can be used to support more relaxed positioning at other times
Initially this will require concentration and practice, but it does become easier the more regularly you practice
Just remember The position of your body will vary each time you do the relaxation because each time you do it you will be starting from a slightly different position
What is important is the instruction to yourself. These instructions never change:
1. Move and Feel the release of tension
2. Stop
3. Feel the release of tension
4. Repeat once more
As you progress and feel comfortable practicing this relaxation you may wish to change the order in which you move around your body. This is ok, the important thing is to take your time to notice the relaxed position and to concentrate on what it feels like for you

I am going to start off at your feet and ankles and then slowly progress through your body.
So starting at your feet and your ankles,
MOVE and slowly push your feet away from your face. If sitting you may come onto the balls of your feet.
FEEL the stretch down the front of your legs and across your ankles. You may feel increased tension in the muscle at the back of your legs. Notice what that feels like.
STOP, and let your feet return to a comfortable position.
FEEL the slow release of tension in your muscles as they settle back into a comfortable position.

I am going to ask you to repeat that movement again.
MOVE and slowly push your feet away from your face. If sitting you may come onto the balls of your feet.
FEEL the stretch down the front of your legs and across your ankles. You may feel increased tension in the muscle at the back of your legs.
STOP, and let go, let your feet return to a comfortable position.
FEEL the slow release of tension in your muscles in your feet, around your ankles and in your lower legs as they settle back into a comfortable position. Take your time. Enjoy the sensation of your feet resting at the end of your legs.

I am now going to ask you to move your attention from your feet and your ankles to your knees and your thighs.
MOVE your knees, gently squeezing them together, and hold in this position.
FEEL the increased tension in the muscles of your thighs. Notice where you feel that increased tension.
STOP, and let go. Let your knees return to a comfortable position. Your knees may gently fall apart.
FEEL the slow release of tension in your thigh muscles as your legs settle back into a comfortable position.

I am going to ask you to do that once more.
MOVE your knees, gently squeezing them together, and hold in this position.
FEEL the increased tension in the muscles of your thighs. Notice where you feel that increased tension.
STOP, and let go. Let your knees return to a comfortable position. Your knees may gently fall apart.
FEEL the slow release of tension in your thigh muscles as your legs settle back into a comfortable position. Take your time. Enjoy the sensation of your legs relaxing.

I am now going to ask you to move your attention to your body. To your abdomen and your chest.
Gently MOVE, slowly pushing your body back into the support of the chair or the bed that you are on. Do that now. Just gently and slowly push your body back in to the support and feel the contact of your body against the support of the chair or the bed. Notice how the chair or the bed, how it feels supporting your body. Notice any increase in tension across your abdomen and chest, register how this feels.
STOP, and let go.
FEEL your body let go, and notice your body may slump forward slightly as you return to a comfortable position letting go of any tension you created. Gently move your body. Once your body is settled I am going to ask you to repeat this movement again.

Slowly pushing your body back into the support of the chair or the bed that you are on. Do that now. Just gently and slowly push your body back in to the support and feel the contact of your body against the support of the chair or the bed. Notice how the chair or the bed, how it feels supporting your body. Notice any increase in tension across your abdomen and chest, register how this feels.
STOP, and let go.
FEEL your body let go, and notice your body may slump forward slightly as you return to a comfortable position letting go of any tension you created. Let your body settle at rest.

I am going to ask you to take your attention to your shoulders. On your next outward breath gently
MOVE your shoulders. Let them drop towards your feet…. noticing any downward movement of your shoulders.
FEEL this movement, noticing it is a very small movement but your shoulders are further away from your ears. Notice how you feel in this position.
STOP, and let go.
On your next inward breath FEEL your shoulders bounce back slightly, trying to return to their starting position. This is perfectly natural.

I am going to ask you to repeat this movement so that on your next outward breath gently
MOVE your shoulders. Let them drop towards your feet…. noticing any downward movement of your shoulders.
FEEL this movement, noticing it is a very small movement but your shoulders are further away from your ears. Notice how you feel in this position.
STOP, and let go.
On your next inward breath FEEL your shoulders bounce back slightly, trying to return to their starting position. Just notice what this feels like around your shoulders, around your chest. As you breathe in and as you breathe out let your shoulders move slowly towards your feet, letting them relax.

I am now going to take your attention down from your shoulders down your arms to your elbows. Focus your attention to your elbows.

Gently MOVE your elbows out and open. Move your upper arms away from your body, not lifting them but FEEL the angle opening up at your elbows by moving your forearms away from your sides. Not a large movement, a small movement.
STOP.
FEEL your upper arms away from your body, and feel the wider angle at your elbows…. notice this new position, and then let go. Let your arms drop back to your sides.

I am going to ask you to do this once more.
Gently MOVE your elbows out and open. Move your upper arms away from your body, not lifting them but FEEL the angle opening up at your elbows by moving your forearms away from your sides. Not a large movement, a small movement.
STOP.
Let go and feel the difference in the position of your elbows now. Your elbows are no longer glued to your sides. There is a more open angle at your elbows.

DO NOT HURRY your way through this relaxation. Just take your time and notice the changes in your positioning and what this feels like.

I am now going to ask you to move your attention down from your elbows to your hands.
MOVE your hands, trying to keep your hand supported, gently stretch out your fingers long and wide. FEEL the space between each finger. Feel the stretch
STOP and let go. Let your hands rest, fingers long, resting against the support.
FEEL your fingers and thumbs stretched out and separated, touching the support of the surface they are resting on.

I am going to ask you to repeat this movement once more.
Stretch out your fingers long and wide. Feel that stretch across your palms and down your fingers. Then STOP and let go. Let your hands rest, fingers long. Take a moment to register the position of your hand. Register the space that is between your fingers. Take a moment to register what messages are travelling up through your fingertips to your brain. Pay attention to the texture of the surface that they are resting on. Is it rough or is it smooth? Is it warm or cool to the touch. Take a moment to notice what your fingertips are telling you that at other times of the day you are too busy to notice.

I am going to ask you now to draw your attention back from your hands, up past your elbows, back up to your shoulders. Don’t hurry, just take your time and notice what your body is telling you. Check the position of your shoulders. Are they still relaxed? Keep on moving up wards taking your attention to your mouth. You can carry a lot of tension around your jaw area without realising it.
Slowly MOVE your bottom jaw downwards, separating your lower teeth from your top teeth. As this happens you may feel the stretching of your skin over your cheeks.
STOP, and let go.
FEEL your separated teeth. Your lips may gently be touching or as you stop stretching your jaws may slowly return to their earlier position. Notice how this feels and let your tongue rest against your bottom teeth, noticing how this feels. Try to stop your teeth from clenching together.

I am going to ask you to repeat this movement again.

Slowly MOVE your bottom jaw downwards, separating your lower teeth from your top teeth. As this happens you may feel the stretching of your skin over your cheeks. Notice any changes you feel around your mouth and jaw.
STOP, and let go.
FEEL your separated teeth. Notice the position of your lips. They may gently be touching or as you stop stretching your jaws may slowly return to their earlier position. Notice how this feels and let your tongue rest against your bottom teeth, noticing how this feels.

I am going to ask you now to move your attention to your eyes.
MOVE – If you haven’t already done so, and you now feel safe enough to do so, gently close your eyes. FEEL your upper lids resting gently over your eyes.
STOP.
FEEL your eyelashes gently resting together; let your eyes and the associated muscles rest.

I am going to ask you to repeat this movement again.
Gently let your eye lids rest closed. Feeing your upper lids resting over your eyes. STOP. Notice what this feels like. Notice what it feels like with your eyelashes gently resting together. Enjoy the peace you have created.

Now think about moving your attention to the area above your eyebrows to your forehead. Think about gently smoothing away any frowns or worry lines. Trying to move away any stress or tension from this area with each outward breath. Breathing in and breathing out. Slowly moving the tension over the top of your head and feeling a smoothing sensation at the back for your neck. STOP, Take a moment. Feel the smoothing action across your forehead. Over the top of your head and down your neck.

Try this again. Think about gently smoothing away any frowns or worry lines. Move any of the stress or tension away from your forehead. Breathing in and breathing out. Slowly moving the tension away from your forehead. Take your time and enjoy this sensation.

Coming to the end of this relaxation. Take a moment to think about your breathing. Do not try to change the rate or the depth of your breathing but just notice the gentle rise and fall of your chest and your ribcage on each breath. Feel your lower ribs move gently outwards and upwards as you breathe in. As you slowly breathe out your ribs return to the starting position. Repeat this as many times as is helpful for you. Take your time. Use your outward breath to breathe out any hot spots of tightness or tension that you have found in your body. Take time to check over your body, repeating any or all of these movements as you see fit. Take your attention to the parts of the body where you feel the most tension. Use the change in position to help you relax. Make time to practice this relaxation on a regular basis. Remember, never rush from relaxing to standing and moving around. You have slowed your body down. Gently stretch to get your body moving. Stretch your fingers, rock your feet back and forward. Get your body slowly moving again. This is important after you have slowed your body down to prevent and dizziness.

An alternative method of relaxation is visualisation.
You can hear an audio clip here. You can also download this clip.

Duration: 13 minutes 19 seconds.
Voiceover: Grainne O’Brien, Specialist Psychology Practitioner, NHS Lothian

View audio transcript - visual relaxation

In this relaxation exercise we are going to be creating an image in our mind, taking a journey to a beach. It doesn’t matter if your mind wanders, just try and bring it back to my voice and the image we are creating…… To begin, I would like you to spend a little time getting into a comfortable position……..Loosen any tight clothing you may be wearing………..uncross your arms and legs…..Allow your body to sink into the chair, the bed or whatever is supporting you……
Once you are in a comfortable position, I would like you to close your eyes or gently lower your eyelids so your eyes are facing the floor towards the floor, whichever you are more comfortable with…………
Now bring your attention to your body……Relax your body by releasing any areas of tension…… take some time to scan your body and notice where your tension lays……..Feel your arms and legs becoming loose and relaxed……..Enjoy the feeling of resting, of being completely supported……… ..Make sure that your jaw is loose, that your teeth are not clamped together……….let your lips be slightly parted…..bring your attention to your shoulders and allow them to drop down away from your ears. It might be easier to shrug your shoulders up towards your ears and then let them fall down….. releasing any tension from your shoulders,… your upper body…….. and your lower body….. (longer pause)
Now we are going to focus on the breath. Bring your focus to your breathing, follow the breath as it comes in and out of your body……..(breathe out on tape….) …….observe the rhythm of your breathing…. You may want to try to breathe out for longer than you breathe in…… As you breathe out imagine your body growing limp and heavy. Each time you breath out imagine that you are letting tension flow out of your body and mind……… As you breathe in you can think “I AM…..” and as you breathe out, “RELAXED”, Try to get an even rhythm, with nice slow gentle breaths. “I AM ….RELAXED”……………………. (longer pause)

Remember- It doesn’t matter if your mind wanders as you are doing this exercise -….., just remember that this relaxation is for you, and bring your mind calmly back to the picture….
Feel your body giving up all tension…..becoming more relaxed…….and calm….. peaceful…………Now that your body is feeling a little more relaxed, I want you to imagine you are sitting on a bench looking out toward the ocean….. the weather is pleasant….you are feeling comfortable and warm…
You can hear the waves up ahead…. and smell the ocean spray…. the air is moist and warm…. you feel a pleasant, cool breeze blowing……
You look a little closer at the ocean…., you see the brilliant aqua colour of the ocean ahead….and feel the warmth of the sun upon your face……
There is a long stretch of smooth white sand…. The beach is wide and long and deserted….the sand is a very soft powder…. if you like you can imagine what the sand would feel like under your feet……, feeling the warm dry sand between your toes………
You hear the waves crashing to the shore….
And smell the clean salt water and beach….
You gaze again towards the water…. it is a bright blue-green….
See the waves washing up onto the sand….. and receding back toward the ocean…. washing up…. and flowing back down….. enjoy the ever-repeating rhythm of the waves…
The sand is warm……perhaps you notice the sensations upon your feet……………… as you get nearer to the sea, the sand becomes smooth, hard and damp….feel this new texture, the sand is completely smooth with only here and there a tiny glint of a pink shell………
You can feel the mist from the ocean on your skin…….and smell the salt in the air…….A wave washes over the sand towards you…. before receding….. more waves washing onto the sand and receding back………. …….
You notice the white sand under the water….completely smooth…. the water is a pleasant, warm temperature….
You decide to enjoy the ocean for a few moments….. notice how the sunlight dances on the water….. the warmth of the sun upon your face………..becoming more and more relaxed… allowing yourself to enjoy the ocean….
The sky is blue and clear of any clouds…….. you decide to enjoy this time out for a little longer…….. relaxing….. basking in the warmth of the sun on your body…….. listening to the rhythmic sound of the waves…….
You feel peaceful and relaxed…. allow all your stresses to melt away…. (longer pause)
Spend as long as you would like at this beach…. enjoying the sense of relaxation……..
when you are ready I am going to ask you to count from 5 to 1 in your own time and when you get to ‘1’ I want you to open your eyes….to stretch…..to yawn……. To slowly bring yourself back to the room….take your time……try to hold onto the sense of relaxation that you have created for yourself………………..

Yoga

There are pranayama yoga techniques which include breathing control.

So far there has not been enough research to show if yoga breathing techniques are effective or not for people with asthma. This is why NHS respiratory clinics do not routinely offer this as a treatment for asthma.

Some people with asthma find that yoga helps to relax the body. There are many types of yoga but if you have not practiced yoga before it can be difficult to do some of the positions. Find out about basic or beginners classes. If you do decide to try yoga, make sure you go to a recognised yoga centre and tell your instructor that you have asthma. Take your inhalers with you.

Important

Do not stop taking your asthma inhalers or medication

Breathing methods

Picture of lungs

The Papworth Method

Developed in Papworth Hospital, this method has been used for over 50 years. It concentrates on using your diaphragm when you breathe. This means you are using all of your lungs and your breathing will become slower with a longer out breath. Most of the movement while you breathe should come from your stomach area and not your chest. This method is useful for people with mild to moderate asthma.

The pursed lips method

This method can be used with the Papworth technique. It involves breathing in slowly through your nose and breathing out through pursed lips as if blowing out a candle. Your out breath should be about twice as long as your in breath.

The Buteyko method

This method uses slow breathing and periods of controlled breath holding. Like other breathing techniques, it is not a treatment for asthma but it may help to change dysfunctional breathing patterns.

Buteyko is not readily available in NHS Scotland respiratory clinics. Although private courses are available, they are expensive and so far there has been no research evidence to show any advantage for patients who use Buteyko rather than any other breathing techniques.

Breathing techniques to help asthma control

In addition to your inhalers and medication, breathing techniques are recommended for people with asthma. For more information please see: SIGN guideline 158: British guideline on the management of asthma.

These breathing techniques should be taught by a respiratory physiotherapist or in some places a specialist respiratory nurse. You may need a series of appointments to learn these techniques and how to use them.

An assessment of your breathing will be done to check if you are using all of your lungs and your diaphragm, not just the upper airways.

Some people with asthma have what is known as dysfunctional breathing. You might also hear the terms hyperventilation or over breathing to describe this dysfunctional breathing. Your body is trying to breathe through narrowed airways and sometimes it adapts to these unhelpful breathing patterns over a period of time. If you breathe through your mouth, the air which gets to your lungs will be colder and drier which can trigger asthma symptoms. Feeling anxious can make dysfunctional breathing worse.

The aim of this treatment is to correct any breathing which is too fast or too shallow. It will also help you to relax the muscles involved in breathing.

There are many different breathing techniques which your respiratory physiotherapist can teach you. Some of these also include relaxation. For more information on chest clearance techniques, please see our section on COPD: How to clear your chest with breathing techniques.

Important

Do not stop your inhalers or asthma medication.

These breathing techniques do not affect your lung function but used alongside your asthma medication and chest clearance methods they can be effective in helping you to cope better by reducing symptoms and improving your quality of life.

If you have a set back

We all have good and bad days. If you have a bad day or an asthma attack take some time to recover before you restart your goal planning and self management. You will soon get back on track.

Reflect on how well you have done and focus on the positives. Small steps will still get you to your goal. No point in worrying about things you can’t do.

Get help when you need it. Family and friends can be very supportive once you explain to them about self management and how you are trying to change how you do day to day tasks. They can help to build your confidence and help you to overcome obstacles.

Making progress

Goal setting and self management is an ongoing process. You should take time to think about the things and tasks which are important to you. Review and refine your self management plans. Write them down and tick each task as you complete it.

Some people like to have reminders of their plans and goals where they can see them often. Try putting your list on to your mobile phone, beside your computer, beside your bed or on the door of your fridge.
Review your progress and your goals within your timescale. Even if your goal has not been fully achieved, think about the parts you have achieved and how well you have done so far.
When you set your next goal think about how you can change your goal this time to help you achieve what you want. For example you might not fully complete a goal if you have not allowed yourself enough time or your goal might not be specific so you are not sure if your goal has been achieved or not.
Give yourself praise. You are trying to make changes to improve your health and well being which are not always easy at first. You can do it.
Write down all the things you have done and all the people who have made a difference to your life. Share this list with those close to you.
If you feel your progress has slowed or stalled, get help to get you back on track. Talk to someone, your family, friends, your healthcare team, someone who also has asthma and who knows about self management.

Why not download your own goal setting template and give it a go: