Additional Help

Role of Therapist

If it is at all possible, it is much better to enlist the services of a therapist than to try to cope with the effects of stress by yourself. If you can find one who is knowledgeable about relaxation training, that would be ideal. If not, you can still benefit from seeing a therapist to talk with about the stressors in your life. A therapist could give you the empathy, understanding, and acceptance which everyone needs while dealing with problems. He (she) could also help you figure out how to deal with the stressful people and situations you face.

From the standpoint of relaxation practice, there would be an enormous advantage to working with a therapist who specializes in relaxation therapy. He (she) could supervise your step-by-step progress and serve as teacher, motivator, and cheerleader. Seeing a therapist every week is enormously helpful in motivating you to continue to do your practice every day.

Improvement will take place when you do your practice regularly twice a day over a period of six months or so. Very few people have the persistence and faith that it takes to stick with it long enough on their own to see results. That is where seeing a therapist makes all the difference. From the standpoint of motivation, we have found that being a member of a small group of people who are practicing relaxation under the guidance of a therapist is even more effective than seeing a therapist individually.

If your problems are complicated or severe, it is essential that you work with a therapist. You will need the additional help which only a good therapist can provide. Deep relaxation practice would be of some benefit but would not be sufficient to solve your problems by itself. For example, if you have a simple, uncomplicated fear of flying, you can cure yourself of your mild phobia by practicing deep relaxation and the Minis. (The Minis are described under "Relaxation Therapy".)

However, if you have such a severe fear of flying that you are too terrified to be able to get on the plane, then you need the help of a good therapist who has had experience in dealing with phobias.

Use of Biofeedback

Biofeedback is tremendously helpful in learning how to practice deep relaxation. There are a number of different types of biofeedback machines which instantly feed back information to the patient regarding minute changes in a variety of physiological parameters. Some of these are peripheral temperature, muscle tension, galvanic skin response, brain wave activity, heart rate, and heart rate variability. The feedback can be given to the patient by either visual or auditory means.

I have always used biofeedback along with any kind of relaxation training with my patients. The type of biofeedback I have found most useful for this purpose is hand temperature feedback. The machine produces a low beeping tone when the temperature is rising and a high beeping tone when the temperature is falling. A rising temperature indicates a relaxed or passive mind, and a falling temperature indicates a tense or active mind.

It is extremely impressive to people to see so clearly the connection between changes in their physiology and changes in the type of thoughts they are thinking. It is one thing for them to hear about such a connection, but it is quite another to experience it by seeing how their own thoughts continually cause minute changes in some aspect of their physiology which are then fed back to them by the biofeedback machine.

With the help of biofeedback, people were quickly able to identify the type of thoughts which made the temperature go up and the type which made the temperature go down. That made it possible for them to know what type of thoughts to promote and what type of thoughts to discourage in order to achieve and maintain a state of deep relaxation. They learned what to do with their minds to raise their hand temperature to 95.5 or above and then keep it there for the duration of the practice period. Our criterion for achieving a state of deep relaxation was 95.5.

In many cases people started out with hand temperatures in the 70s and 80s. As time went by, their starting temperatures increased gradually until eventually they were 93 or so. A hand temperature of 93 is considered normal. When this happened we knew that the sympathetic and parasympathetic branches of their autonomic nervous system had become re-balanced. When we had achieved that balance, our task then became one of keeping it in balance.

Some people had starting hand temperatures in the 90s, even as high as 95. They still benefited from learning to raise their temperature a degree or two and then keep it there for the entire practice period. Many people who have a normal hand temperature have stress disorders which show up in other ways besides cold hands. Practicing deep relaxation does the same thing for them as it does for people who start with cold hands. It re-balances the two branches of the autonomic nervous system and eliminates the stress disorder.

Biofeedback for Home Use

I frequently loaned patients portable temperature biofeedback machines to use at home for their daily practice sessions. They were very helpful even though they gave only visual feedback. (The patients received auditory feedback during their sessions at my office.) It is possible to purchase such a machine online fairly inexpensively. However, it is not essential. Your practice can be quite successful without any type of biofeedback machine.

As a staff member of the Plaza Blood Pressure Control Center, I led small groups of people who had high blood pressure. In addition to weekly sessions at which we provided individual biofeedback machines (both temperature and muscle tension), we gave each person a tiny thermometer to take home. With the tiny thermometer taped to their finger, they could note and record the starting and ending hand temperatures for each practice session.

I frequently gave one of these tiny thermometers to my private patients in addition to loaning them a portable temperature biofeedback machine because they were simpler to use. I asked them to keep a record of their starting and ending temperatures at their twice-daily practice sessions. As time went by, we could observe that the starting temperatures steadily increased, especially among those who had low hand temperatures when they began their treatment. We could also observe that their hand temperatures always increased while they did their practice.

If you wish to keep track of your hand temperature, you can purchase a small thermometer at a hardware store. If you can find a tiny one with a cardboard backing, you can cut off the bottom inch. Then you can tape it to your finger in a way that makes it possible for you to read the numbers easily.

There are some thermometers which can be held in the palm of your hand. You should not hold one, however, because that would interfere with the total relaxation of your hand and arm. You would need to get one which can be taped to a finger or to your hand so that you do not have to hold it. It does not matter which finger you attach it to, but you should always use the same one.

The thermometer can be taped to your finger or hand before beginning your practice. You can easily check your hand temperature at the start of your practice and then again at the end. If you wish, you can record it. I recommend doing so because it helps to keep you motivated to do your practice by showing you that you are making progress. However, the use of biofeedback in this way is not an essential part of the program. You can be quite successful without it.