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"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.
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"
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.
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
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 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 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
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
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.
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" 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.