Seven Habits for Personal Balance: COVID-19 Stress Reduction 1

Seven Habits for Personal Balance: COVID-19 Stress Reduction Humbly Offered by Dave Walker, Ph.D. Licensed Psychologist Anisahon Consulting, PLLC, Seattle, Washington [email protected] 1. Breathe. 2. Meditate. 3. Exercise. 4. Relax. 5. Express. 6. Eat Right. 7. Abstain. NOTE: This document is a public offering and is not to be considered a substitute for professional advice in any way. No psychologist-client relationship is implied or intended between Dr. Walker and any person or persons reading or relying upon the educational information provided. This document is intended for health care providers, isolated people, and others NOT currently experiencing symptoms of COVID-19. This work began as a brief manual of stress reduction techniques for my private practice clients. I’ve updated and rewritten it for anyone from front-line COVID-19 health care providers to isolated individuals sheltering in place. I give credit where I know or recall the source, and this work is not intended to be a peer-reviewed, scholarly document. I do hope these “Seven Habits” - culled, copied, pasted, personally recollected and tried, and taught to and learned from clients, colleagues, and healers over my thirty years as a practicing psychologist - will somehow prove useful to you and yours as we face off with these difficult times together. 1 1. Breathe.(adapted from Reg Conally) The Basic Message - remember to breathe using your diaphragm (belly muscles) rather than your upper chest. You typically default to upper chest breathing, and when your nervous or scared, this form of breathing can escalate the physical experience of anxiety or panic. • A word on “anxiety”: From an evolutionary standpoint, when we can’t see into a darkened forest at night, we keep our backs to the campfire and our eyes scanning the shadows for trouble. “Anxiety” is an adaptive stance we need to survive. It includes hypervigilance, heightened reactivity, increased muscle tension, elevated heart rate, etc. • Chronic tension, poor posture, anxious thinking, elevated heart rate, etc. create breathing patterns that are not particularly great for us. We have to help ourselves relax and breathe in a healthier manner. • When we’re often anxious, we automatically use rapid, upper chest breathing… leading to over- breathing… which can contribute to an unbalanced depletion of carbon dioxide. By “automatically,” I mean this tendency is generally routinized, that is, out of conscious awareness. • One means by which breathing helps us deal with stress is by creating an optimum balance of oxygen and carbon dioxide in our bodies to deal with our circumstances. • It’s not so important how much oxygen or carbon dioxide you have in your system but rather the ongoing exchange between the two gases. o Too much oxygen (relative to the level of carbon dioxide) and we tend to feel agitated and jumpy. o Too much carbon dioxide (again, relative to the level of oxygen) and we tend to feel sluggish and sleepy and tired. o Carbon dioxide has received undeserved ‘bad press’ for no solid scientific reason in recent years. Yet one of its key roles is that of being a ‘natural tranquilizer.’ o Repetitive, shallow, rapid upper chest breathing tends to expel too much carbon dioxide, which can cause us to feel more agitated, breathless, and tense. o In extreme cases this kind of breathing can result in tetany – the symptoms of which include a tingling feeling in the lips, metallic taste in the mouth, and sometimes cramping of the feet or hands. o Check this link if you need more science: https://www.scientificamerican.com/article/proper- breathing-brings-better-health/ o This document is intended for health care providers, isolated people, and others NOT experiencing symptoms of COVID-19, and the above article mentions that some practitioners feel teaching breathing techniques to very ill people may increase panic and agitation. I suspect reduced blood oxygenation in COVID-19 might decrease the efficiency of breathing techniques in inducing calm. On the other hand, modeling these techniques and “trying them out” with a patient less affected by respiratory issues might be potentially worthwhile in giving them a greater sense of control over their own agitation and fear. o Learn more about the relationship of 5-second diaphragmatic inhalation and exhalation to “heart rate coherence” and self-calming here: https://www.frontiersin.org/articles/10.3389/fpubh.2017.00267/full 2 Diaphragmatic breathing can truly reduce anxiety or panic. • Being more like sponges than muscles your lungs cannot produce the exchange of gases required in breathing. They must rely on the contraction of the muscle surrounding them – the diaphragm. • This is why using your abdominal or stomach muscles in breathing, which indirectly activate your diaphragm, produces better breathing. First Evaluate Your Breathing Habits 1. Rest one hand on your upper chest and the other over your navel area. 2. Breathe normally for a minute or so 3. Notice which hand rises first when you inhale. • If the upper hand rises first you are using upper chest breathing. • If the lower hand rises first you are breathing with your diaphragm. • If both move at the same time you are using a mix of both. Upper-Chest Breathing • If you mainly use upper-chest breathing, you have to breathe more rapidly in order to achieve the proper exchange of gases which breathing aims to produce. • Upper-chest rapid breathers are more prone to over-breathing or hyperventilation • Diaphragmatic breathing, particularly if accompanied by a slower and more shallow rate of breathing, optimizes carbon dioxide-oxygen balance Using Your Diaphragm to Breathe • Spend five minutes practicing using your diaphragm to breathe: 1. Sit in an upright position looking straight ahead. Close your eyes if it helps you concentrate. 2. Put one palm on your upper chest and the other over your navel. 3. Make the lower hand rise first when you breathe in. 4. Breathe out gently and effortlessly for a count of five seconds. 5. Now wait for a second or so until the body spontaneously begins to inhale – let it occur naturally. 6. Allow the air to naturally flow in for five seconds. 7. Make no effort to deepen your inhalation. You are allowing your body to find its own natural rate of breathing and, through relaxing into the process, allowing your breathing to slow down and become more and more shallow. 8. Remember your aim is to relax and conserve your ‘natural tranquilizer’ – to counter the effects of losing carbon dioxide caused by anxious, rapid, upper chest breathing. 9. Continue doing this for about 5 minutes. 3 • Many people find that they can only do this form of breathing for a minute or two at first. Be patient and gradually extend your time to five minutes. • Many people experience a fluttering effect in the diaphragm. This is caused by anxiety and tension and will pass with practice. • This breathing exercise is also a great way of getting to sleep at night. o While lying on your back, rest your dominant palm over your heart. o each time you breathe in, visualize energy surging into your chest. o As you exhale calmly and slowly, concentrate on your palm getting warmer. o Shift your attention periodically to parts of you that “feel sleepy” versus the parts that feel agitated. o Many people have reported to me their palm and heart region do feel warmer doing this exercise and the warmth soothed them to sleep. 4 2. Meditate. Mindfulness Meditation (Hybridized Vipassana Method & Jon Kabot-Zinn): Level One: Observe your breath. That is, attempt to maintain attention and concentration on your breath. § Breathe naturally. No need to radically change your breathing, but it helps to seek calm, diaphragmatic breathing. § Maintain attention and concentration on your breath. Say “in” and “out” inside your mind with each inhalation and exhalation. § If this approach to meditation runs contrary to your spiritual beliefs, consider using a phrase from a favorite prayer or teaching in place of saying "in" and "out." Remember, contemplative traditions are a part of many world spiritual paths. A person may be very religious or not at all and still benefit from meditation. § Concentrate on watching your breath while making your “in” and “out” or chosen phrase quieter and quieter. § Seek to create an “inner space of quietness” that involves simply observing your breath. § Your mind will eventually wander (this is common even among experienced meditators). When this occurs, simply move your attention and concentration back to your breath. Stay nonjudgmental. § If you feel like you need to shift your sitting posture or to sneeze or cough or whatever, do so. § If you’d like to avoid feeling like you need to swallow, try placing your tongue at the roof of your mouth and gently parting your lips. Breathe restfully through your nose. § Meditate for 10 minutes or so each day for the first week or so before moving on to Exercise Two. Level Two: With Breath as Your Anchor, Shift Toward Bodily Sensations • Move to this exercise only when you feel like you can maintain your attention on your breath for fairly periods over 10 minutes. • Meditate by focusing on your breath for 10 minutes. • gently move your attention to an awareness of your body. • Focus first on just noticing your body as a whole. • Next, work with the following exercise: o Slowly scan from your head throughout your toes and from your toes to your top of your head. o Notice sensations and vibrations of your body while you scan. o Notice areas in your body where there is tension, pressure, aches and pains. o In a relaxed way, direct your mindful attention into these areas of tension.

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