RELAXATION

Click here to read "The Impact of Stress on Pregnancy Rates."

The "Relaxation Response" is different physiologically from sleep or simply resting. The relaxation response is a state of deep relaxation in which the heart rate, blood pressure and breathing rate decrease. Muscle tension relaxes, stress hormone levels fall, and the mind becomes tranquil. The relaxation response was first defined by Dr. Herbert Benson of the Harvard Mind/Body Medical Institute. Dr. Alice Domar's Mind/Body Program for Infertility incorporates the use of the relaxation response on a daily basis to help reduce the stress and anxiety related to infertility.

There are many techniques that may be used to elicit this response. Those taught in Domar's Program include: Breath Focus, Body Scan, Progressive Muscle Relaxation, Meditation, Prayer, Mindfulness, Guided Imagery, Autogenic Training and Yoga. The following abbreviated techniques are taken from her books Healing Mind, Healthy Woman and Conquering Infertility.

For more complete instructions on using these techniques, please refer to either of these books (both are available on Amazon.com) or attend a Mind/Body Program for more personalized attention. Try each method and choose the ones that work best for you.

Before beginning to elicit the relaxation response, Dr. Domar offers these basic guidelines:

· Find a quiet place in your home where you can be comfortable.
· Arrange the time so you won't be disturbed by family members, pets or the telephone.
· Choose a regular time of day that works into your schedule and stick with it.
· Sitting is usually the preferred position, but lying down is fine as long as you don't drift off to sleep.
· Time spent in the relaxation response is generally 15-25 minutes — more or less as meets the need. Practice the relaxation response daily — twice daily if stress is especially high.

BREATH FOCUS
This technique is the foundation for all the other methods because slow deep abdominal breathing is essential to relaxation. Abdominal breathing expands the belly as it expands the lungs. Chest breathing is shallower and does not provide the full oxygenation that comes with abdominal breathing, therefore making the heart work harder.

To focus on your breath:
· Close your eyes
· Take slow deep breaths, inhaling through your nose to a count of 1-2-3-4. As you inhale, feel your belly rise. Pause
· Exhale slowly through your nose (or mouth if you prefer) to a count of 4-3-2-1.
· Repeat this breathing technique
· After a few minutes of breath focus, you may want to visualize breathing in "peace and calm" and breathing out "tension and anxiety"

BODY SCAN
Spend a few minutes doing deep abdominal breathing, then begin to focus on tension in different parts of your body, consciously releasing this tension as you exhale.

Concentrate on your forehead, noticing any tension that may be present. Release this tension with several slow deep breaths.

Move down to your eyes and repeat the process, expanding your belly as you inhale and allowing it to fall as you exhale.

Move gradually down your body, repeating the process at each area — mouth/jaw, neck, shoulders, back, arms, chest, stomach, pelvis, legs and feet.

PROGRESSIVE MUSCLE RELAXATION
Begin as before with several deep abdominal breaths.

Concentrate on your forehead and consciously tighten the muscles of your forehead to a count of 1-2-3-4-5. Then release these muscles with a slow deep breath. Do this tighten/release process twice before moving to the next part of your body.

Repeat this procedure for the rest of your body, using the sequence given for the body scan, gradually going all the way down to your feet — tensing, then relaxing each part of your body.

MEDITATION
Dr. Benson describes the key elements of meditation to elicit the relaxation response: focus your thoughts inward, focus on repetitive deep breathing, and repeat in your mind a simple word, phrase or prayer. Any thoughts that come into your mind during meditation are allowed to float on through your mind as you dismiss them and return to your focus.

Sit comfortably, close your eyes (or keep them open if you prefer). Starting with ten, count down to zero taking a full deep breath with each count.

Choose a single phrase or word, i.e. "Let Go," "Relax Now," or the old Sanskrit mantra
"Ham Sah."

As you breathe in, concentrate on the word Ham, letting the "hmmm" sound reverberate through your mind. As you exhale, concentrate on the word Sah, like a sigh.

If your mind wanders or other thoughts intrude, gently dismiss them and return to your "Ham Sah."

Continue this meditation for as long as you like.

PRAYER
Prayer can be practiced exactly as meditation, except the focus word or phrase has a religious or spiritual meaning for you. For example: Our Father, Hail Mary, Come Lord Jesus, Shalom, Hashem.

MINDFULNESS
Mindfulness is a practice that allows us to focus fully and completely on a given simple activity. Dr. Domar suggests something as simple as eating a Hershey's Chocolate Kiss and giving full attention to every detail of that Kiss — the wrapping, the color, the texture, the taste — savoring it completely. This practice — whether it is eating a piece of chocolate, taking a mindful walk and noticing the beauty of the trees and warmth of the air, or any other activity you choose — enables you to focus completely on the present and fully appreciate every aspect of what you are doing.

GUIDED IMAGERY
This is a method of eliciting the relaxation response by creating mental images of places or experiences that bring a feeling of inner peace. For some this may be a warm, sandy beach with the sounds of the birds and the ocean tide. For others it may be a cool deep forest. The place can be completely what you want it to be — a place where you feel calm and serene.

To practice this technique, first get very comfortable and take several slow, deep breaths.
Now go in your mind to that special place. Spend time in this place —- notice the colors and shapes — the blue of the sky, the deep green of the trees, the shape of the clouds, the colors in the fire of the fireplace. Focus on the smells — the salt air, pine needles or cookies in the oven. Focus on the sounds — listen to the ocean, the music or the babbling of a mountain stream. Focus on sensations —the feel of the sand beneath your feet, the coolness of the water on your skin. Let yourself be completely immersed in this special place. If other thoughts intrude, release them and return your focus to your place of relaxation.

There are tapes available that can help you with this process by talking you through an ocean or forest or mountainside, describing all the images and sensations one might experience. For more information on relaxation tapes, see the Resources page on this website.

AUTOGENIC TRAINING
Since the mind often interferes with the body's ability to relax, this method uses the mind to instruct the body to relax.

Focus on the sensations of breathing. Tell yourself your breathing is calm and effortless. Repeat this phrase as you imagine waves of relaxation flowing through your body — you may want to use the same sequence found in the body scan or progressive muscle relaxation. Then begin to focus on your arms — tell yourself that your arms are getting heavy and warm. Then move this sensation of warmth to the rest of your body- your legs and feet. Then notice and think to yourself how each part of your body is becoming more and more relaxed. As you take slow deep breaths think to yourself "I am calm . . . I am calm." Continue this process for as long as you wish.

Remember to always end your relaxation techniques with a deep cleansing breath, then open your eyes, rise slowly and stretch.

MINI RELAXATIONS:
"Mini relaxations" or "minis" are short exercises designed to shift the breathing from shallow chest breathing to deep abdominal breathing (Healing Mind, Healthy Woman, p. 77). They are useful when you need to relax and lower your stress level but don't have time for a full relaxation exercise — when you are getting a blood draw, about to talk to the nurse about lab results, or are in the waiting room before a procedure. There are numerous times when "minis" can be helpful. The following techniques are from Dr. Domar's books, Conquering Infertility and Healing Mind/Healthy Woman. For more detailed information, please refer to either of these books.

Version #1: Sit or lie down in a comfortable position. Become aware of your breathing.
Is it shallow chest breathing or deep abdominal breathing? Shift to slow, deep abdominal breaths, feeling your belly rise as you inhale and fall as you exhale. Focus on this breathing for as long as you like.

Version #2: Shift from chest to abdominal breathing. Count down from ten to zero, taking one complete breath (inhale/exhale) with each number. If you begin to feel light-headed, slow your counting. Repeat if desired.

Version #3: Shift from chest to abdominal breathing. As you inhale, count 1-2-3-4. As you exhale count 4-3-2-1. Do this for several breaths.

Version #4: Use one of the three versions described above, but this time pause for a few seconds after each in-breath. Then pause again after each out-breath. Continue as long as you like.