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Relaxation Teclmiques forworking with Clients

Michele B. Engoran, MA, CSW609-750-7432

Wednesday December 10,2008

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The Bodv Scan COlnesfrom traditional Mindfulness Practices. It is a way ofexperiencing the present mOlnent by being Inore fully "in the body." Thechallenge here is to "experience" the body withoutjudgInent (without runningcOlninentary, judgment and self-dialogue). This powerful technique is used notonly to establish contact with the body, but also to develop concentration andflexibility of attention. These are building blocks for Ineditation as well as stress-free living in general.

Body scan: How it's done

1. Bring your attention to each area of your body. Do not have a dialogueabout your body; siinply hold the awareness of your body and its sensationsin your awareness. As you systematically work your way through each partby holding each it in your attention for about 30 seconds to 1 Ininute.

2. Each tiine you notice your Inind wandering gende steer it back to the bodypart. Do not judge your thoughts or get caught up in theIn, just return tosiinple body awareness.

3. Each tiine you do a body scan see if you can hold your awareness in eachbody part a litde more each time that you practice.

Instructions for leading the Body Scan

1 Ask the person to find a cOlnfortable seated position or lie down.2 Ask thein to close their eyes3 Ask theIn to bring their attention into the space around them, even to thesounds in the room without judgInent, just notice what they sense4 Then ask them to bring their attention into their body, feel the body as an object5 Start with the head and end at the toes

6 Lead thein through each body part saying something like: "And now bring yourawareness into your left arm. Hold your attention there. Allow your attention tofill your ann. No judgInent. Just reinain gendy noticing the feel of the arm.Allow your awareness to rest there for a few moments, a few breathes. Be silentask they practice this.7 Depending upon how much tiine you have and on the sensed attention span ofthe individual you can skip body parts and keep it Inore general or get as specificas you wish8 When you complete the whole body ask thein to "Now bring your attentionback to the body as a whole and then back into the space around thein.9 Ask them to open eyes slowlywith soft gaze looking down before returning tononnal awareness

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Progressive Relaxation

Progressive muscle relaxation (or PMR) was developed by American physician EdmundJacobson in the early 1920s.He argued that since muscular tension accompanies anxiety, onecan reduce anxiety by learning how to relax the muscular tension.

In general Progressive Relaxation is moving slowly and systematically through the bodytensing/contracting each muscle/body part and then releasing and relaxing the same part.

Instructions:

1. Same as Body Scan - sit in a comfortable chair or lie down on a bed or couch

2. Say something like "I am going to lead you through the body. Follow my guidance. Youwill be tensing and then relaxing each muscle group or body part. Do not strain or struggle.Through this you can teach yourself to control muscle tension and relaxation. Remember tobreathe throughout this process."

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1. Hands. The fists are tensed; relaxed. The fingers are extended; relaxed.2. Biceps and triceps. The biceps are tensed (make a muscle - but shake your hands to

make sure not tensing them into a fist); relaxed (drop your arm to the chair). Thetriceps are tensed (try to bend your arms the wrong way); relaxed (drop them).

3. Shoulders. Pull them back gently; relax them. Push the shoulders forward (hunch);relax.

4. Neck (lateral). With the shoulders straight and relaxed, the head is turned slowly tothe right, as far as you can; relax. Turn to the left; relax.

5. Neck (forward). Dig your chin into your chest; relax. (Bringing the head back is notrecommended - you could break your neck)

6. Mouth. The mouth is opened as far as possible; relaxed. The lips are brought togetheror pursed as tightly as possible; relaxed.

7. Eyes. Open them as wide as possible (furrow your brow); relax. Close your eyestightly (squint); relax. Make sure you completely relax the eyes, forehead, and noseafter each of the tensing.

8. Back. With shoulders resting on the back of the chair, push your body forward so thatyour back is arched; relax. Be very careful with this one, or don't do it at all.

9. Butt. Tense the butt tightly and raise pelvis slightly off chair; relax. Dig buttocks intochair; relax.

10. Thighs. Extend legs and raise them about 6in. off the floor or the foot rest but don'ttense the stomach' relax. Dig your feet (heels) into the floor or foot rest; relax.

11. Stomach. Pull in the stomach as far as possible; relax completely. Push out thestomach or tense it as if you were preparing for a punch in the gut; relax.

12. Calves and feet. Point the toes (without raising the legs); relax. Point the feet up as faras possible (beware of cramps - if you get them or feel them coming on, shake themloose); relax.

13. Toes. With legs relaxed, dig your toes into the floor; relax. Bend the toes up as far aspossible; relax.

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Deep Breathing or "Conscious Breathwork"

The body's natural response to fear or stress is to restrict breathing. The breath becomesshort, shallow and primarily in the chest. Unaware of this restrictive "fight or flight"breathing pattern, we have become a nation of "chest breathers." The natural healthy way tobreathe, and the way we breathe when we are relaxed is "belly breathing." We can relearn todrop the breath into the belly for slow, long and full inhalations and exhalations. This type ofbreathing immediately induces the "Relaxation Response." When practiced over time, itbuilds energy and endurance, contributes to emotional mastery, helps the healing process,manages pain and increases mental alertness and concentration.

Leadin2 Diauhra2matic Breathin2

x Do you know what and where your diaphragm is? The diaphragm, located below thelungs, is the major muscle of respiration.

X Gently place your hands just above the naval. Focus your attention there and takedeep breath. You may want to close your eyes.

X Feel the rise and fall of the belly, the expansion and contraction.

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Feel the ribs to slightly flare out to the sides. Shoulders, upper chest and abdomenremain motionless.Breathe smoothly and effortlessly as possible. Release any jerkiness, resistance orhesitation, breathe with a steady flow.Breathe slowly, but within your comfortable capacity, not straining or gettinginsufficient air.Breathe at a comfortable depth; deeply, not shallow, but without force or exaggerationAllow breath to flow continuously, with no pause allowed between the breathsBreathe evenly, so that exhalation and inhalation are of the same duration. Once that iscomfortable, allow the exhalation to be twice as long as the inhalation during thepractice time.

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Additional comments:

"Just breathe"

"Pay attention to thefeel of your breathe"

"Feel the breath, don't think about it, justfeel it"

"Nice and easy"

"If your mind wanders, simply return to the breath"

"Feel the sensation of breathing this way"

"Don't worry about getting it right. Just find a rhythm"

"You're doing great. Great job."

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AL TERNA TE NOSTRIL BREATHING

. Place thumb on one side of your nose and middle finger on the other side

. Begin on the out-breathe

. Breathe out and in on one side

. Close the nostril and switch to the other side, breathe out and back in on that side

. Continue slowly breathing in and gently out, continually switching sides

. Always start with the out-breathe first

BREATHE OF FIRE (RAPID BREATHING) TO INCREASE ENERGY & VITALITY

. Place hands in prayer position (optional)

. Breathe rapidly in and out through the nose without pausing

. You should be able to hear the breathe audibly (sounds like a train)

. Push diaphragm/stomach in and out as you breathe

. Continue for 30 seconds to 3 minutes

. Take a break, return to normal breathing, and begin again

. If you become lightheaded or uncomfortable simply return to normal breathing

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ADDITIONAL BREATHING EXERCISES

. Countingthebreathe

. Squeezingout all the air

. Startingwiththe exhale

. Inhaleandexhalewitha hum

. Breathingwithan extendedcount

. Breathingwithopen-eyegaze

. TheHA!breathe

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The Relaxing Breath

1. Place tongue at the roof of the mouth behind your upper teeth.

2. Inhale through your nose quietly.

3. Exhale through your mouth noisily, exhaling around yourtongue, it will make a whooshing sound.

4. When you inhale do so to the count of four

5. Then gently hold your breath for a count of seven

6. Then exhale through your mouth completely (around yourtongue) for the count of eight

7. Repeat for several cycles, allow a rhythm to form. Give yourselfa chance to get used to this type of deliberate and measuredbreathing. The result is a deeply relaxed state of being.

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TiDSfor Better Breathinq

1. Stop throughout the day and observe your breathing. Is your breath shallow or deep?Is it rapid or slow? Take a moment and follow your breath without trying to influenceand alter it. Just tune it to your breath.

2. Remember Abdominal Breathing. Expand your belly with the breath. Don't restrictyour breathing. Take the full volume of air with each breathe and your lungs willincrease their capacity for air.

3. Remember deeper, slower, quieter, more regular breathing. You are retrainingyourself on how to breathe in a healthy way. With regular practice all of your body'ssystems will function more smoothly and optimally.

4. Begin a regular "breathwork" practice. Just 5-10 minutes per day of consciousbreathing will do the trick. You will notice subtle difference at first and profounddifferencesin the longrun.

Resources on Breathinq

Conscious Breathing by Gay Hendricks, Ph.D (Book)

Breathing: The Master Key to Self Healing by Dr. Andrew Weil (CD)

Meditation for Optimum Health: Using Mindfulness and Breathing to Heal by Jon KabatZinn and Dr. Andrew Weil (CD)

Free Your Breath, Free Your Life by Dennis Lewis (Book)

Meditation. .. Relaxation.. .Stress Reduction...

Michele B. Engoran, MA, CSW is a teacher, healer and coach who provides individualsessions from her office in Plainsboro, NJ. If you want to learn practical tools for reducing

stress, relaxing and getting the most out of life,call her for an appointment at 609-750-7432.

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Simple Meditation: Using a Silent Word or Phrase

Start with several deep, slow, rhythmic breathesState your mantra out loud softly

Subvocalize your mantraRepeat the mantra slowly and methodically to yourself

Match the word, sound or phrase with the rhythm of your deep breathingAllow breathe and mantra to naturally unite

As thoughts persist just gently but firmly return to your mantra

Examples

. BlueSky

. Peace, Calm

. ClearDay

. Sunshine

. Blissful

. In,Out

. One,two

. Takein, release

. Quiet,Still

. Peace Within

. lam

. Soft breathe

. Here,Now

. AtPeace

. Mab-yam. Shi-rim

. Ha-sam

. Tab-sam

. Sat-nam

. Shan-ti

. Shi-va

. Ma-nam

. Ra-ma

. Ti-ra

. Oh-nam

. Ra-yim. Sha-Iom

. Or choose your own

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What is Guided Ima2erv?

According to Belleruth Naparstek, LISW, Guided Imagery pioneer, and authorof "Staying Well with Guided Imagery,"

Guided imagery is a form of deliberate, directed daydreaming - a purposeful useof the imagination, that deploys words and phrases designed to evoke rich,multi-sensory fantasy and memory. The voice tone, pacing and choice oflanguage, usually accompanied by relaxing music, create a deeply immersivemind-state which is ideal for catalyzing desired changes in mind, body, psycheand spirit. For most people, imagery is an easy user-friendly form of meditationthat yields immediate results. Its gentle nature belies its potency and itsresearch-proven, cumulative efficacy.

*Imagery has been found to reduce anxiety and depression, lower bloodpressure, reduce cholesterol and lipid peroxides, speed up healing f rom cuts,factures and bums, reduce blood loss and length of hospital stay in surgerypatients, beef up short term immune function, reduce pain from arthritis andfibromyalgia.(*All of the above are:-documented through clinical studies. The informationcan be found on Belleruth Naparstek's web site: www.healthjoumeys.com)

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Why it works so well: 3 Principles of Guided Imagery

1st Principle: the Mind-Body ConnectionThe body and mind are interconnected. And to the body, images created in the mind arealmost as real as actual, external events. The mind doesn't quite distinguish the difference.That's why when read a recipe, we start to salivate. When images invoke strong emotionalcontent through memory and fantasy, they are especially powerful. Sensory images are thetrue language of the body.

2nd Principle: the Altered StateGuided imagery leads one into an "altered state." In this natural state, we're capable of morerapid and intense healing, growth, learning and performance. Weare even more intuitive andcreative. In this ordinary but profound state, our brainwaves and biochemistry shift, our moodand cognition changes and we access more of our innate potential. In addition, from thisstate, our minds are less guarded and defended, and are more open and receptive to change.

3rd Principle: Locus of ControlGuided imagery gives us a sense that we are in control of our well-being. When we have asense of being in control, that in and of itself helps us to feel better and act better. Feeling incontrol fosters optimism, self-esteem, self-mastery, and more. Because Guided Imagery isinternally self-driven, the use decides when, where, and how it is applied, helping us feel inempowered and in control.

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Basic Elements of Effective Guided Imagery1 Set up Intro2 Connecting to Body & Heart

3 Create Safety & Control4 Release old5 Travel Deeper for Healing6 Create new imagery/future/personal/specific images & goals7 Integration8 Anchoring changes in the body9 Returning gradually and safely

Qualities & tips for effective/powerful guidance with clients

x Gain trust & rapport (starts soon as you walk in the room)x Believe in what you are doingx Lead by going into altered/relaxed state yourself.x Quality of voice. (relaxed cadence, gentle flow, natural rhythm and timbre)x Fairly even emphasis. (create an non-distracting platform)x Pace yourself...speak clearly and slowly* Give them permission to stop at any time.

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Peaceful Place Imagery(read slowly with plenty of silent pauses)

Take a moment to adjust your body so that you are completelycomfortable. ..very good. Gently close your eyes and allow yourself to feelsupported. ... .Now just bring your attention. . .to the way that you are feeling.And tuning in ... to the sounds in the room so that in a moment you can justallow all sounds and thoughts of the outside world to fade away. .. .And nowredirecting your attention to the feel of your own breath. .. .Notice the way thatyour body rises and falls as you breathe in and breathe out. ... With each passingmoment allow yourself. ..to become more and more attuned to the feel of yourbreath.. .moving in and out of your body.. .easily and effortlessly. (pause)

Now continue to breathe gently and fully, deep yet soft breathes Enjoy thepleasurable feel of your breath And imagining that the warm energy of thebreath is spreading to every part of your body. ... .feel the soothing nature ofthe breath moving into all of those areas that are sore, tense or tight. .. ..breath isreaching into all those dark pockets of tension and begins to loosen them,..begins to soften and .gently release all stuck energy and old built up stuff.... . ...so that you can feel even at the deepest level. . . .that there is a cleansinginside of you. . .a deep inner relaxing. ..with the breath. . . ..and all tension fromthe week is being scooped up now. . ..and gently sent out with the nextexhalation. . ..right. . ..very good.

And your mind too... .can begin to clear. . ..as each thought arises. . .those too canbe noted and sent out with the breath.. .so that for just a moment.. .your mind isempty, even for a split second.. ..it is free and clear space. ...you feel a deepinner stillness. . .a sensation of floating. . .peaceful and free. . .(pause)

And now. . .as your mind and body are prepared. . ..turn your attentioninside. . .and begin to imagine your favorite peaceful place. ... .bringing yourselfthere now.. .creating it in living breathing color. ...you are there.. ..lookingaround you. . ..look above you at the blue sky. ..and white puffy clouds floatingby. . ..look beneath you at the green grass underneath your feet. . . .walking aroundin this place...it is your place... touch the trees... .breathe in the fresh air...feelthe gentle breeze caressing your skin. . ..perhaps hearing the sound of birds. . .andsmelling the fragrance of flowers as you take in nature all aroundyou. . . .spending all the time you need now in the next moment of silence tocreate this place in your mind. . .and to fully experience it at every level. . ..(longpause)

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You begin to feel that there is a certain magic about this place....asif somethingwonderful is about to happen. ... you feel a soothing vibrating hum of electricityall around you and inside of you. ...you hearbeautiful sounds....like your veryown songbeing sungjust for you.. .andyou know that you are safe.. .so that youeven know that you are not alone.. .here in this place.. .deep inside ofyou.. .somehow you are supported.. .surrounded. . ..by a circle of friends, alliesand supporters. ..and you can feel their warm support.. ..encircling you in afamiliar feeling of comfort. . .and you know that you are truly home. ...deepinside yourself....

So that you begin to feel more and more comfortable and safe. .. .safe now to letgo. .. .let go of the past. . ..let go of fears. . ..and worries and doubts.. .letting gonow of illness. . ..and stress. your mind reaches in and gently pulls out what isno longer needed.. .and you begin to relax even deeper.. ..surrendering to thepeace of this feeling ...and this place so that you can now take in whateveryou need the most. . .receiving it from this place of peace. . ...drinkingin.. ..allowing in.. ..to your body and mind. ..exactly what you need. andgiving yourself permission now to fully.. ..and completely.. .receive

So that in a moment or two.. ..even as you continue to enjoy the peacefulness ofthis place... that you have created.. ..deep inside.. .your own innersanctuary.. .safe haven.. .you will know its time to return.. .but taking all theserenity that you have created. ..back with you. .. and knowing full well that youcan return here whenever you desire.. ..(pause)

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One more time. .. .taking in the beauty and the tranquility of yoursurroundings. ...before you turn your attention.. ...slowly. ..and gently. ..back toyour breathing.. .feeling again... the warm energy of the breath.. ..allow thebreath now. .. to return to it normal pace. . ..taking deep energizing breathes. . . .asthe breath leads you back to the feel. . ..of your body. ..so that you can graduallyand safely.. ..become aware of your body.. ..relaxed yet energized.. .and thesounds in the room returning. . ..now . . .taking your time. . .so that whenever youare ready... your eyes will slowly open. . .and you will find yourself fullyawake.. .

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