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Relaxation and Trauma
This article discusses the concept of relaxation and trauma, and some of the challenges associated with using relaxation techniques to cope with panic.
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A relatively common experience for survivors of traumatic events is increased anxiety when they try to relax. Even those who do not
have such a history may find that relaxation exercises are not soothing,
and in fact may be anxiety provoking.
Why might this be, that something intended to be relaxing is actually the opposite?
Relaxation is directive - in a relaxation
script, directions are given for the listener to follow - which may make
some listeners feel as if they are being told what to do or are not in
control. The very act of relaxing means giving up a degree of control -
"letting go" - which means that someone who often feels anxious and
unsafe may be reluctant to participate, or even more anxious because
they feel fearful of giving up control (and therefore, safety). People
who have experienced trauma are often hyper vigilant or hyperaware, and
tend not to let their guard down. The mere suggestion that they do so
can incite panic.
Relaxation can increase awareness of sensations and the body,
and this can provoke anxiety if it is associated with trauma or
increases the awareness of physical symptoms of anxiety. The power of
suggestion can create anxiety because the simple mention of symptoms can
create the symptoms - what I mean is that just talking about a panic
attack can induce one.
Some component of the relaxation may remind the listener of a traumatic experience
or may otherwise provoke fear (for example, visualizing a place that
reminds the listener of something frightening - someone who had a
frightening experience falling into a river, for instance, may become
frightened when water is mentioned in a relaxation script). Even certain
words or music may bring back traumatic memories or trigger anxiety.
Relaxation can cause decreased awareness of or connection with the environment.
This can contribute to anxiety, and can also be related to the trauma
survivor's tendency to withdraw from the outside world for
How to use relaxation to cope with panic symptoms
The article "Coping with PTSD" (From www.hiddenhurt.co.uk) has some excellent tips for coping with trauma. One of the tips for coping with trauma and PTSD is to practice relaxation methods.
Quote: "While relaxation techniques can be helpful, they can sometimes increase distress by focusing attention on disturbing physical sensations or reducing contact with the external environment. Be aware that while physical sensations may become more apparent when a person is relaxed, continuing with relaxation in a way that is tolerable (i.e., interspersed with music, walking, or other activities) is, in the long run, helpful in reducing negative reactions to internal thoughts, feelings, or perceptions." (From www.hiddenhurt.co.uk).
One of the goals of healing from trauma is to regain a sense of control. Relaxation can be a way of training oneself to have some influence over physical and emotional symptoms of panic. Being able to exert some control over the panic experience can be liberating and empowering.
A listener, Lexie, from California has some excellent ideas about panic and relaxation. Here is a quote from her:
I'm wondering if there are other people out there with anxiety, panic, PTSD or whatever, who (a) don't try relaxation until they are in a bad state, when maybe they'd be better served trying it when their system is NOT aroused, to train themselves, and (b) blame themselves for the fact that they got into an anxious state and think that if they tried hard enough (thus fighting it!) they can make it stop. I can't imagine that I'm the only one for whom self-directed gentleness feels really hard when I'm anxious.
That is so true. Using relaxation when you are already in panic mode can be difficult and frustrating. It is much easier to master the skill of relaxation if you practice when you are not in overload.
It is incredibly common for those with anxiety to fight it, hoping that they can make it stop. Fighting panic usually serves to make the anxiety even stronger. Though this seems like a contradiction, there is surprising power in acceptance.
When using relaxation to cope with panic symptoms, or if relaxation tends to increase your anxiety, it is important to know your triggers. Then you can decide when you need to do relaxation exercises that do not have these triggers, and decide when you would like to face the triggers to work on making them less powerful.
When using relaxation just for the purpose of becoming calm and relaxed, you can select relaxation scripts that are effective for you that will not trigger any anxiety. Which scripts these are will depend on the individual. Progressive muscle relaxation is usually recommended for trauma survivors (because it teaches you to relax your muscles), but there are a variety of other methods to choose from as well, such as meditation, visualization, and more. If you review written scripts before using them, you can determine which scripts will be the most relaxing (and the least "triggering") for you.
When using relaxation for the purpose of training yourself to handle panic symptoms, choose a time when you are feeling reasonably calm, strong, and ready to face the anxiety. Then select a relaxation script that contains some anxiety triggers (a relaxation script that provokes some anxiety for you). When listening to the script and choosing to endure the anxiety and just ride it out, you are doing a technique called "exposure." Exposure is when you expose yourself to something that provokes fear, stress, or anxiety, in order to desensitize yourself to that stimulus. Exposure is probably the most effective method of dealing with (and eradicating) anxiety. After exposing yourself to the trigger, your anxiety the next time will probably be less than it was the first. Eventually it is possible to either not have any anxiety when faced with the trigger, OR to be able to manage the anxiety that does occur. Part of what you are doing when you use exposure is ACCEPTANCE. If fighting anxiety makes it stronger, accepting it makes it LESS powerful.
Remember, if you do decide to try exposure techniques, that first and foremost it is essential to take care of yourself. If you attempt exposure before you are ready or that is to intense, you may re-traumatize yourself and add to the problem rather than getting better. If you want to try exposure techniques, I recommend you obtain some more information on healthy exposure therapy and consult a therapist for support.
It can be challenging to find a healthy balance between protecting yourself and facing your fears. Too much protecting yourself can lead to avoidance and keeps you from living your life. On the other hand, panic can be worsened by a lack of a safe, supportive environment.
If you have a therapist to practice exposure with, you may even want to consider having the therapist help you to deliberately induce a panic attack during a session. When you try to get your anxiety up as high as possible, paradoxically, it goes down.
You can read more about this phenomenon in David Burns' book When Panic Attacks .
Distraction can be very helpful. Exercise, artwork, music, reading...anything to get your mind on something else can help.
When experiencing a panic attack, if relaxation techniques do not
seem to lessen the symptoms, physically moving can be a highly
effective way to not only mentally distract oneself, but also a way to
get rid of the stress hormones the body has built up. Going for a short,
brisk walk, doing some jumping jacks, doing push ups, trying some
kickboxing moves...there are many ways to get the body moving and
The reason physical activity can be so effective is that when a
person experiences anxiety, the body is in fight-or-flight mode. A
number of physical responses occur to prepare the body for running away
from or fighting off danger. When no fighting or fleeing occur, the
responses that would have so effectively allowed the body to escape from
danger are not so helpful anymore. Problematic symptoms occur. By
engaging in physical activity, the body is able to do what it is meant
to, and use the extra oxygen, muscle tension, and blood flow for
exercise. When the exercise occurs, the problematic symptoms of stress
are prevented, or at least decreased.
Relaxation is helpful for calming the mind, relaxing the body,
and training a person to relax. If long relaxation sessions are
difficult, it is possible to intersperse relaxation with physical
activity, do relaxation during an activity (for example, do deep
breathing while going for a walk, relaxation during artwork as in
creative expression relaxation, etc), or select relaxation scripts that
are short and simple to start with.
As you develop skills in relaxation, it will get easier to relax because the relaxation response,
which is the opposite of the stress response, will actually start to
come under voluntary control. This means that you can CHOOSE to cause
the relaxation response (a lowered heart rate, decreased oxygen
Check out these relaxation for panic exercises to help calm the mind and body during a panic attack:
For more information on techniques to manage anxiety, check out the excellent books and resources below:
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