Relaxation techniques are a great way to help “fitness focused” clients respond to stressful situations. These techniques involve having the client change and de-escalate physical sensations and body signals when the client notices that they are rising. These techniques are based on the principles that you cannot be both relaxed and anxious at the same time. Inducing an incompatible physiological state when the client is anxious will lead to a reduction in distress.
Relaxation techniques can be useful to simply calm a client down so that they can begin engaging in problem solving and rational thinking. They can also counter the tunnel vision and emotional distortions that many who are distressed experience, which can lead to broadening the mind to a wider array of possible responses.
Relaxation techniques can be introduced at any point in CBT-Fitness coaching and are especially helpful for clients with generalized anxiety or insomnia. These techniques stimulate the activation of the Parasympathetic Nervous System, which helps induce sleep. We recommend first rehearsing these techniques in a 1-to-1 coaching session and then assigning practicing these techniques at least 3-4x throughout the following week. If client’s don’t practice these techniques frequently, they likely will not maximise their utility.
A word of caution is also appropriate at this time as relaxation techniques are actually contraindicated for presenting issues such as panic disorder or health anxiety. While you will learn about these disorders in more detail (if taking the CBT-Fitness Certification Course), you simply need to know right now that relaxation techniques can become safety behaviors and can fuel avoidance of physical sensations that escalate these presenting problems. These clients need to learn that their sensations are NOT dangerous and teaching them to avoid them even more with relaxation techniques can do more harm than good. Make sure you implement these techniques in a deliberate fashion and do NOT just mindlessly do these with clients at all times. There are many clients that will resist these techniques as well so be prepared to explain the rationale behind them or draw from other tools in your CBT-Fitness toolbox.
Deep Breathing Techniques:
Deep breathing techniques are designed to help clients engage in a physiologically incompatible response to anxiety. When clients become anxious, their breathing becomes quicker so that more oxygen can be utilized to respond to threats. Purposefully engaging in relaxed breathing (or breathing from the diaphragm) can counter anxiety signals and let your clients body know that it’s safe to relax.
Deep breathing can be a conscious override of what are usually unconscious anxiety signals distressed clients send to their body. Relaxed breathing differs from anxious breathing in that it is slower and deeper and occurs from the belly rather than the chest. For those clients who aren’t sure what this is like, have them place one hand on their stomach and one on their chest and then tell them to breathe so that the top hand remains still.
Relaxed breathing is smooth, steady and continuous while distressed breathing is inconsistent and rough. Deep breathing usually involves breathing through the nose, rather than the mouth as well. Deep breathing should be done for a minimum of 3-4 minutes at a time, otherwise it will not have much of an effect.
One thing to teach clients about breathing is in the relation to oxygen and carbon dioxide production. When you breathe you take in oxygen and convert it to carbon dioxide. Normal breathing leads to balanced levels of both and so does exercising because you are taking in more oxygen but also using it. However, anxious breathing leads to more oxygen intake without using it. Your body takes in more oxygen, expecting to use it for vigorous exercise but this doesn’t happen. The result is an imbalance and loss of carbon dioxide in the blood (respiratory alkalosis) that can cause feelings of light-headedness, clamminess and tingling. These are unpleasant sensations that can contribute to feeling distressed and may themselves be triggers for further escalation of anxiety. Deep breathing techniques counter these negative effects and can help calm a client down enough to problem solve.
The most popular meditation techniques are based on either transcendental or mindfulness meditation. It is beyond the scope of CBT Meets Fitness, to engage in a full review of these practices. However a brief overview for your knowledge:
Transcendental meditation: Involves having the client repeat a mantra (a single word of phrase) while clearing their mind and entering a relaxed state.
Mindfulness meditation: Involves having clients focus their awareness on the sensations and thoughts of the present moment, simply observing them non-judgmentally and allowing them to pass.
If you wish to learn more about this, there are many resources around Mindfulness Based Cognitive Therapy that will give you much greater detail.
Progressive Muscle Relaxation (PMR)
This technique involves tensing and releasing tension in each muscle group of the body in a systematic fashion, combined with deep breathing and sometimes imagery. This technique is designed to help the client become aware of what muscle tension feels like and to be reminded of what relaxation feels like as well. This exercise can also help clients realize how tense they usually are and can prompt them to engage in deliberate muscle relaxation. Clients should be encouraged to tense muscles for 7-10 seconds and then relax afterwards for 10-15 seconds. After tension and relaxation in one muscle group, encourage the client to do the same with the next muscle group until the exercise is completed.
PMF Follows certain universal principles that include:
- Focusing on physical sensations: which clients typically describe as, “heavy, floating, flowing, sinking, slow, warm, etc.”
- Passivity: PMR encourages the client to enter a passive state that allows them to let go of their tension and be more open and accepting of their experience.
- Body Sensation Awareness: PMR encourages the client to become more aware of the physiological state and reminds them of what relaxation feels like.
- Informed Consent: Before doing PMR, explain the rationale behind it and what the client can expect in order to get informed consent to participate in the exercise.
- Eyes: Eyes can be either open or closed, whatever the client finds more comfortable.
- Body Scan: Before starting, do a body scan with the client so that the client can determine if any part of the body is more sensitive so that so they can be more sensitive and gentle with it.
There are many other benefits to PMR, including the meta-messages that the exercise sends to the client. PMR facilitates a sense of self-efficacy and leads to believing one has more control over one’s physiological experience. It gives clients permission to prioritize and focus on their own comfort and feelings. Many women who you might work with may have a core belief of “I don’t matter.” PMR counters these ideas with validating the importance of self-care.