SMOKING RECOVERY PROGRAM
RELAXATION AND STRESS MANAGEMENT
SESSION 4

• Rationale
  One of the most frequently encountered rationales for smoking is, "It helps me manage stress." It is not uncommon for smokers to reinforce their addiction by "chaining" their habit with recurring "stressful" times such as deadlines, reports, meetings and so forth. As so far as "stress" is a reality in the daily lives of everyone, alternatives for dealing with stress are central to smoking cessation.



• Objectives
  
  1. To educate participants about the physiological aspects of stress including the "fight" or "flight" response.
  2. To pin point sources of stress and encourage acceptance.
  3. Learn to gauge their stress levels by looking at oneself symptomatically.
  4. Participants will be taught deep muscle relaxation.

• Activities
  
  1. Participants will practice deep muscle relaxation and guided imagery
  2. Participants will complete the "stress symptoms checklist".

• Homework Assignment
  
1. Listen to relaxation tape and practice relexation exercise.
2. Begin reading "The Relaxation" article.

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RELAXATION PROCEDURES

1. Dominant hand and forearm (make a tight fits).
2. Dominant biceps (force elbow into chair).
3. Non-dominant hand and forearm.
4. Non-dominant biceps.
5. Forehead (raise eyebrows).
6. Upper cheeks and nose (wrinkle nose and squint).
7. Lower cheeks and jaws (bite down and tighten corners of mouth).
8. Neck and throat (place neck on chest).
9. Chest, shoulders, and upper back (breathe deeply, pull shoulders together).
10. Abdominal or stomach region (tighten stomach, push in or out).
11. Dominant thigh (force upper leg into chair).
12. dominant calf (pull toes toward head).
13. Dominant foot (point and curl toes).
14. Non-dominant thigh.
15. Non-dominant calf.
16. Non dominant foot.

INSTRUCTIONS: Your attention should be focused on each muscle group, tension is maintained for a period of 5-7 seconds, after which tension is released at once (not gradually). Maintain focus on muscle group during the relaxation period.

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RELAXATION RESPONSE
"Quiet Time"
A Very Simple Technique

The basic technique for the elicitation of the relaxation response is extremely simple. Its elements have been known and used for centuries in many cultures throughout the world.
Four basic elements comprise the relaxation response: a quiet environment, a mental device, a passive attitude and a comfortable position.

1. A quiet enviroment
   One should choose a quiet, calm environment with as few distractions as possible. Sound, even background noise, may prevent the response. Choose a convenient, suitable place -- for example, at an office desk in a quiet room.
2. A mental device
   The mediator employs the constant stimulus of a single-syllable sound or word. the syllable is repeated silently or in a low, gentle tone. the purpose of the repetition is to free oneself from logical, externally oriented thought by focusing solely on the stimulus. Many different words and sounds have been used in traditional practices. Because of it simplicity and neutrality, the use of the syllable "one" is suggested.
3. A passive attitude
   The purpose of the response is to help one rest and relax, and requires a completely passive attitude. One should not try to scrutinize his performance or try to force the response, because this may well prevent the response from occuring. When distracting thougfhts enter the mind, they should be promptly disregarded.
4. A comfortable position
   The meditator should sit in a comfortable chair in as restful a position as possible. The purpose is to reduce muscular effort to a minimum. The head may be supported; the arms should be balanced or supported as well. The shoes may be removed and the feet propped up several inches, if desired. Loosen all tightfitting clothing.

Begin by closing your eyes and breathing through your nose. Concentrate on relaxing the muscles in your body beginning at your feet and progressing up to your neck and face. continue breathing and saying your word mentally to yourself as you breathe out for 10-20 minutes a day.

Taken from: The Relaxation Response by Dr. Herbert Benson
William-Morrow & Co., Inc., Ny, 1975.

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SHORT EXERCISE IDEAS

Pause: (about ten seconds):
• Identify any stimulus that is presently annoying you.
• Tell yourself, "I don't have to become too tense over this."
• Take two easy deep breaths (counting from 1 to 4 as you inhale and exhale).
• Ease any tense spot quickly, to the best of your ability.
• Stretch and resume your activity.

Body Stress Scanning: (about two minutes):
• Take two deep easy breaths and exhale each slowly.
• Scan Your body to find a tense spot and relax it as much as possible (i.e. forehead, jaw, shoulders, back, hand).
• Do two brief yoga exercises do them slowly, through).
1. Head Rotation: Rotate your head slowly around in a circular motion, or twice in both directions.
2. Shoulder roll: Slowly roll your shoulders forward and backwards a couple times in each direction.
• Recall a pleasant thought, image, memory or feelings for a few seconds (as long as you want).
• Take one more deep, slow breath, exhale slowly and return to your activity.

Focusing On An Image: (about ten seconds minimum):
• Simply focus on a favorite fantasy or image, either one which you have chosen previously (see imagery section ) or something that occurs to you spontaneously.
• As you think about, or feel this image, take deep, slow breaths and return to your activity when you're ready.

Find One Thing To Appreciate: (about ten seconds minimum):
• Simply pick out one enjoyable or beautiful aspect of your environment, whereever you happen to be. In some settings it is easier, but you can almost always find something to appreciate. Examples include a patch of a favorite color, a nice piece of furniture, art, another person, a sound or a personal object (i.e. a pen, your ring, an attractive purse etc.).
• Focus only on this object to admire it for a moment and breathe deeply and easily as you do it. Return to your activity when you want.

Meditation: (about five to ten minutes):
• First, scan your body, see how your muscles feel, attempt to relax and loosen your muscles, allow yourself to feel body sensations and stay with this "body scanning" for a little while. Allow the muscles to feel as heavy and warm as possible, and enjoy these sensations. Especially notice how you're breathing and let your breathing become easy and deep as you relax.
• Next, focus on your thoughts. What are you thinking? What kinds of thinking have you been doing today, and what types of thoughts "come to mind" now? Are these thoughts upsetting, comforting, exciting, neutral? Do they seem to have an objective or subjective quality? Allow yor thinking to occupy your awareness for a little while. See where this leads you.
• At this point, focus on emotions or feelings. What do you feel? How intense is this emotion? Are you content? Angry? Annoyed? Excited? Sad? Guilty? Peaceful? Proud? Apprehensive? or Afraid? Do you have "mixed emotions"? Are you comfortable with your feeling(s), whatever this may be? Allow yourself to stay with feelings for a little while.
• Take three deep easy and slow breaths and return to your activity

These exercises are merely examples of what can be done. Many people expand on these examples to create their own individual exercises. People who are learning to use temperature biofeedback often add handwarming to the short exercises. Handwarming in itself can be a good pause, especially if the occurrence of a painful symptom calls for a need to initiate some handwarming.

After relaxing, you can expect to feel somewhat refreshed, perhaps able to coincentrate a little more clearly, and many people experience a "lift" or renewal of their energy. Be patient with yourself - at first, you may not be able to relax in a short period of time. Difficulty at the beginning is very natural, but you will be able to relax if you keep practicing relaxation and continue to give yourself opportunities to use it.

Using the three forms of relaxation (deep relaxation, relaxing before sleep and short exercises) together makes sense and it takes roughly one hour of total time each day if you add it up. A typical type of daily relaxation might amount to several short pauses during the day, a deep relaxation or meditative time in the evening, and a little unwinding before sleep. The main points are:

1. Make relaxation natural for you. This paper has hopefully provided ideas but use it in ways and at times that please you. Let relaxation times be something you can enjoy.


2. Relax everyday. Many people lead successful, but fast-paced and highly stressful lifestyles. Relaxing everyday for a few imutes can diminish the buildup of stress

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