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SELF-HEALTH SYSTEMS
2850 Sixth Avenue, Suite 222
San Diego, Calif 92103
(619) 298-3464
Delivered To: Date: ____________
____________________________
____________________________
____________________________
____________________________
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INVOICE
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Qty Description Unit Price Total
___ Self-Health Stress Manager 49.95 _____
___ 7.25% Sales Tax (Calif only) 3.62 _____
Comments:
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TOTAL ______
The software shown above has been delivered and accepted
by the customer. Upon receipt of this paid invoice, a
printed manual, current disk, 3 cassette training tapes
and user ID number will be sent to the customer.
========================================================
Disk type: ___ 5.25" ___ 3.5"
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SELF-HEALTH SYSTEMS |
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6 STEP |
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STRESS MANAGEMENT PROGRAM (tm) |
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For use with |
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IBM PC's & Compatibles |
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Copyright (c) 1990
SELF-HEALTH SYSTEMS
All Rights Reserved
________________________________________________________________
User's Manual Copyright (c) 1990 Self-Health Systems
All Rights Reserved
Respiration Training, Progressive Muscle Relaxation, and
Autogenic Training cassette tapes and written text
Copyright (c) 1990 Self-Health Systems. All Rights Reserved.
Programs and Files Copyright (c) 1990 Self-Health Systems
All Rights Reserved
Portions of the programs Copyright (c) 1989 Microsoft
Corporation
6 Step Stress Management Program is a trademark of Self-
Health Systems
All other marks in this manual are the trademarks of their
respective companies
DISCLAIMER & WARRANTY
Self-Health Systems hereby disclaims all warranties relating
to this software, either express or implied, including but
not limited to implied warranties of merchantability and
fitness for a particular purpose. In no event shall Self-
Health Systems be liable of any indirect, consequential,
special or exemplary damages such as, but not limited to,
loss of revenue, data, anticipated profits, lost business or
any other economic, psychological or medical loss arising
out of or in connection with your use of, or inability to
use, this Software. Your sole and exclusive remedy for any
and all claims against Self- Health Systems arising out of or
in connection with this product, whether based on contract or
tort, is the refund of the purchase price or replacement of
the Software.
________________________________________________________________
i
SINGLE-USER SOFTWARE LICENSE
You are free to copy and distribute this Software as long as
you do not charge ANY fee for the Software, and as long as
you include all files, documentation and copyright notices.
A nominal fee may be charged for media, expenses and
handling, but must not exceed $15.00.
THIS SOFTWARE IS NOT FREE, NOR IS IT PUBLIC DOMAIN
If you find this Software to be satisfactory after a 30 DAY
EVALUATION PERIOD, and intend to continue using it for your
purposes, you are obliged to send a registration fee of
$49.95 to Self-Health Systems. With your paid registration,
you will receive the following:
1. A disk with the latest version of the Software.
2. A printed manual.
3. A set of three cassette training tapes to be used with
the system.
4. A counting notebook.
5. A registered user ID number for unlimited phone
support.
6. You will be placed on the list for notification of all
future upgrades.
Your timely registration will be greatly appreciated.
MULTIPLE-COPY SITE LICENSE
Professionals or Companies desiring to utilize the 6 Step
Stress Manager can obtain the following pricing.
Quantity Price Each
────────────────────────────────────────────────
1-9 systems ......................... $49.95
10-50 systems ......................... $39.95
50+ systems ......................... $29.95
These prices apply on one-time quantity purchase, not on
accumulated totals. Site licenses are available for
Professionals or Companies desiring to do in-house
duplication of the software, manual and cassette tapes.
Site License fees quoted on a case-by-case basis.
Member
Association of Shareware Professionals
ii
_________________________________________________________________
SELF-HEALTH SYSTEMS
2850 Sixth Avenue, Suite 222
San Diego, California 92103 U.S.A.
(619) 298-3464
SHAREWARE - HONEST PRICES FOR HONEST CUSTOMERS
Develop a piece of software and you quickly will be overwhelmed
with the cost of marketing, packaging, and distribution. In
order to be at all profitable, the mark-up on commercial software
is astronomical. Wholesalers and Distributors want a MINIMUM of
50%; packaging costs another 10%; business overhead & advertising
is another 30+% - leaving a very small amount for income!
Although we did investigate the release of this software in the
commercial market, we felt that the price that we would have to
charge was just too much, and would defeat our original intent -
to provide a high quality, useful tool to the public at a
reasonable price. The alternative was to deliver the program
through Shareware.
Shareware is based on a rather unique concept these days -
honesty! The truth is, most people are honest. Shareware
operates on the principle that if you like, and intend to use, an
authors software, then you are obligated to send that author a
registration fee. There is no coercion, no force...just honesty.
You will not find any of our software to be "crippled" (e.g.
works only for a while, or allows a minimum of entries). We ship
full-featured software and rely on your honesty and satisfaction
for reimbursement.
If you have not investigated the shareware market, please do
yourself a favor. You will find an astonishing amount of
professional software at unbelievable prices. You can test them
BEFORE you buy, and can therefore choose your library carefully.
This remarkable approach needs your cooperation, so please,
register your software at your earliest convenience.
Self-Health Systems
iii
COMMENTS FROM THE AUTHORS
The following Stress Management program and techniques have been
developed by us and many other professionals over many years. We
have used these techniques with our own patients and have found
them to be effective and long-lasting. In designing a self-
administered program, we obviously had many professional and
ethical questions to work out. The end result has been well worth
the effort. We feel that this system will be of great assistance
to people in a wide variety of stressful circumstances.
Obviously no single approach works for all people, so we must
point out a simple, but important, caveat. If this system does
not seem to be working for you, you should seek the counsel of a
professional. The effects of stress are oftentimes quite
serious, and warrant the attention of first-hand professional
intervention. A good rule of thumb...If you have any doubt, see
a professional...you're worth it!
Also, we'd really like to know how you are doing so we can
improve the quality of help our system provides. Please take a
little time to tell us your thoughts and experiences with the
system. Write to:
Self-Health Systems
2850 Sixth Avenue Suite 222
San Diego, CA 92103
Again, we'd like to hear from you.
David W. Jacobs, Ph.D. B. Scott Diener, Ph.D.
iv
TABLE OF CONTENTS
_________________________________________________________________
I N T R O D U C T I O N
What is Stress? .............................................. 1
Symptoms of Stress ........................................... 2
Sources of Stress ............................................ 2
Useful and Harmful Coping Strategies ......................... 3
The Best Coping Strategy ..................................... 4
The Self-Health Systems Program .............................. 5
I N S T A L L A T I O N
System Requirements .......................................... 7
Running the Software ......................................... 7
M E A S U R I N G Y O U R
S T R E S S L E V E L - S T E P 1
Introduction ................................................. 8
Interpreting the Stress Test ................................. 8
Understanding the Graph ...................................... 9
I D E N T I F Y I N G AND A S S E S S I N G
Y O U R S T R E S S O R S - S T E P 2
Subjective Units of Discomfort (SUDS) ........................ 12
The Counting Notebook ........................................ 13
E N T E R I N G S T R E S S O R S AND
E S T A B L I S H I N G B A S E L I N E S - S T E P 3
Purpose of Baselines ......................................... 14
Stressor Information Card .................................... 15
Options Menu ................................................. 16
L E A R N I N G R E L A X A T I O N
S K I L L S - S T E P 4
Introduction ................................................. 17
Abdominal Breathing .......................................... 18
Progressive Muscle Relaxation ................................ 19
Autogenic Training ........................................... 20
M O N I T O R I N G C H A N G E S IN
S T R E S S O R L E V E L S - S T E P 5
Using the Relaxation Response ................................ 21
Fact vs Subjective Opinion ................................... 22
Graphing the Results ......................................... 23
G E N E R A L I Z I N G
Y O U R S K I L L S - S T E P 6
Stimulus Generalization ...................................... 24
Response Generalization ..................................... 24
A P P E N D I C E S
Counting Notebook Sheets ..................................... 27
Making Your Own Relaxation Tapes ............................. 28
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I N T R O D U C T I O N
What is stress?
Since you are reading this manual, the odds are pretty good that
you are feeling stressed. The manual describes some useful ways
to manage stress that use your computer. (Of course, we all know
that the computer itself can be a source of stress, but it can
also be quite useful in doing something about it).
Perhaps we ought to start by making clear what stress is all
about. Stress is what happens when the arousal level in your body
goes up - and stays there. People's arousal level goes up all
the time. It needs to, since it's our way of getting ready to do
whatever it is that needs to be done. But when we're done, we
need to reduce the arousal level again. Hunting is a good
example. If you were living in prehistoric times, you would
periodically go out to hunt for food. If we were measuring your
arousal level during the hunt, we would see it gradually go up
until just before the prey was taken. At that point it would
rise very rapidly, only to fall off again as soon as the hunt was
over. The arousal level would look like this:
┌──────────────────────────────────────────┐
│ │
A │ ** │
R │ *** * │
O │ *** * │
U │ *** * │
S │ ****** * │
A │ *** * │
L │ * * │
│******* ********│
│ │
└──────────────────────────────────────────┘
TIME
Sleeping Hungry Hunting Eating Sleeping
Unfortunately, that's not what happens to us in a modern society.
The arousal pattern is much more chronic than acute. It looks
like this:
┌─────────────────────────────────────────┐
A │ │
R │ │
O │ *******│
U │ ***** │
S │ ********** │
A │ * │
L │ ******** │
│ * │
│ * │
│ ***** │
│ * │
│** │
└─────────────────────────────────────────┘
TIME
Alarm Traffic Fight with Etc.
Clock Jam Boss
1
The reason that stress is such a problem is that from an
evolutionary point of view, we are much better at handling acute
stress than we are at handling chronic stress. Our minds and our
bodies can get up for a problem, just so long as the problem has
an end. It's when the problem goes on forever that we have our
greatest difficulties.
SYMPTOMS OF STRESS
Stress can affect us in many ways. Stress affects the way our
bodies function. When the stress level is high it can affect
heart rate, blood pressure, breathing patterns, muscle tension,
digestive functioning and almost any other aspect of
physiological activity. In some people, the changes in bodily
functioning can affect such significant medical problems as
chronic head pain, hypertension, gastrointestinal distress and
other disorders. We can't be sure if stress causes such
disorders, but it sure can make them worse.
Stress also affects us psychologically. Have you ever noticed
that when you have way too much to do, the fun seems to go out of
doing it? Even things you normally enjoy doing. That's because
when you are stressed, the positive emotions tend to disappear
and be replaced by negative ones. Stressed people are unhappy
people. They are irritable, depressed and aggressive.
When we're stressed we also have more difficulty processing
information. We forget things like appointments and birthdays,
we can't remember what we just read and have difficulty figuring
out problems. Most of that is due to an inability to
concentrate. When we are stressed, we have lots of intruding
thoughts that make it very difficult for us to use our minds
effectively.
Since stress affects our minds and bodies, it isn't surprising
that it can also affect how we behave. Sometimes that's obvious.
Remember the legendary baseball player, mighty Casey? When he
came to bat, he was a bad clutch hitter. He was probably too
stressed. When we are stressed we tense up and don't behave in
smooth, integrated ways.
SOURCES OF STRESS
It's time to start asking where all this stress comes from.
Stressors (the causes of stress) can come from many kinds of
situations and places. A good way to think about stressors is to
distinguish between work-related, family-related and peer group-
related stressors.
Work-related stress arises because the vast majority of
workplaces are organized around the needs of the marketplace, not
the needs of the people who produce the goods and services. Most
work is simultaneously demanding and repetitious, which means you
have to pay close attention to uninteresting material. In
addition, many work environments are organized around conserving
power in as few hands as possible, which makes it impossible to
have authority that fits with your responsibilities. that
combination makes for a very stressful place to work in.
2
Family-related stressors tend to stem from what is called the
nuclear family. Nuclear families consist of parents and children
living in the same household, but excluding grandparents, uncles,
aunts, cousins, etc. Families that include all those folks are
called extended families, and, believe it or not, they are less
stressful to live in. Extended families provide alternative
parents and alternative children, baby sitters, financial help,
etc. Nuclear families go it alone and the resultant lack of a
support system makes for intense, difficult interactions among
the members of the family.
Peers also can be a source of stress. Poor communication
patterns, competitive traditions and personality clashes can all
make it difficult to use peer groups for support in times of
stress.
Well, if you are going to be stressed by all these forces, get
rid of them. No work, no family, no friends. It's called
solitary confinement and it's the second worse punishment we can
devise.
So it's clear that stress is inevitable and we need to learn how
to cope with it. Actually, we have some coping techniques that
work pretty well, at least in the short run. Like alcohol and
other related drugs. Wrap yourself around a few martinis after
work and it's amazing how rapidly the stress is replaced by a
very pleasant glow. But you don't have to wait until you get
home. A few of the right pills during the day and you won't
hardly notice the stress at all. There are some problems with
those solutions, like possible liver damage, increased tolerance
levels and bad detoxification experiences, but there are those
who think they are worth it.
Those who don't like drugs sometimes turn to food. Usually
fattening foods like hamburgers, french fries, soft drinks and
candy. Many people report that this diet reduces stress, at
least temporarily. Unfortunately, the effects on health and
appearance are less than optimal.
USEFUL AND HARMFUL COPING STRATEGIES
O.K., let's think about some ways of handling these problems that
are less toxic than alcohol, drugs and fattening foods. There are
two ways of thinking about dealing with stress that are
productive. One is to alter the stressors so that they reduce
the stress. Psychologists have developed some neat ways of doing
that, including cognitive restructuring, assertiveness training
and active listening. No, that's not psychobabble. These are
effective, learnable procedures. There are self-help books that
describe these techniques, or you can visit your local therapist
if you'd like some help learning them. (Your state or county
psychological association will be happy to refer you to people
who specialize in stress management work). We have put some of
our folks to work to see if we can computerize some of these
techniques and will let those of you who register the program
know when they are available.
3
A second way to think about dealing with stress is to
deliberately reduce the arousal level in situations in which
there are many stressors. There are several ways of doing that.
One of the better ones is exercise. For reasons we don't
entirely understand, (which stresses us no end), there are
systematic changes in mind and body that accompany exercise that
are very helpful in reducing stress. Some points to keep in mind
if you are going to start an exercise program:
1. Consult a physician who knows something about the
effects of exercise on the body before beginning a
program.
2. Develop the program gradually. If you have been
sedentary for a long time, it may take as much as six
months to get back into decent shape. Patience.
3. Do exercises you like. If you hate running, don't run.
Swimming, biking, hiking, tennis (singles) and skiing
(cross-country) are all good for you. If you hate all
forms of exercise, walk. (Make believe that walking
isn't exercise). Start with ten minutes a day and
build it up to thirty minutes or so of brisk walking
three or four times a week. The point is to get your
heart rate up and keep it there for a while on a
frequent basis. The effects on stress are dramatic.
THE BEST COPING STRATEGY
But the single best stress manager is to deliberately cultivate a
low arousal level when you are around your stressors. The stress
reduction program we offer here is unique in that it is computer
controlled, but the general idea has been around for twenty
years. If you can learn to stay in a state of relaxation (low
arousal) in potentially high stress situations, you can manage
most of the bad effects of stress.
However, remember that relaxation is like playing the piano. You
can't simply decide to play the piano, you can only decide to
learn how to play the piano. So it is with relaxation. You can't
simply decide to relax, you can only decide to learn how to do
it. Being relaxed in the face of a lot of stress is something
you need to train yourself to do. The program we have developed
is designed to help you learn the necessary skills to induce a
state of relaxation whenever you want to, no matter how stressed
you are feeling at the time. Then, whenever you are feeling
stressed, deliberately induce the low arousal state to block the
effects.
4
THE SELF-HEALTH SYSTEMS PROGRAM
At this point, you may be somewhat curious about the role your
computer plays in this program. The answer lies in the fact that
this system is designed to be self-contained, and teaches you how
to regulate stress levels. The computer adds to the power and
effectiveness of the program by doing some of the important
things another person might do, such as providing you with
information and feedback .
The Self-Health Systems Stress Management Program involves
working your way through six phases or steps of learning. The
steps are briefly described in this section and in more detail in
the sections which follow.
Step 1 - ASSESS YOUR STRESS LEVEL. People differ in the
amount of stress they have and the ways in which
the stress manifests itself. An effective stress
management program takes these differences into
account. So the first step is to take a test which
evaluates your stress level and stress pattern.
Step 2 - IDENTIFY YOUR STRESSORS. Stressors are events that
induce a stressful state. People differ in what
constitutes stressors and in how stressful they
are. As in Step 1, an effective stress management
program takes these differences into account. The
second step in this program is an identification of
your stressors.
Step 3 - ESTABLISH STRESSOR BASELINES. In order for you to
determine the effectiveness of your stress
management program, you need to know the level of
stressfulness of each stressor at the start of the
program. Step 3 asks you to evaluate the stressor
level for one week, to establish a baseline before
beginning the program.
Step 4 - LEARN THE RELAXATION SKILLS. Managing the stress
implies that you can reduce the arousal level, even
when in the presence of the stressors. The three
cassette tapes in the relaxation module are
designed to teach you three specific relaxation
skills which form the basis of the stress
management program. Step 4 is to spend at least
one week working with each of these tapes until you
have overlearned the skill it teaches and can
readily use it.
Step 5 - RECORD AND MONITOR THE CHANGES IN YOUR STRESS
LEVEL. During the time you are learning the
relaxation skills and as you apply these relaxation
skills to stressor situations, it is important to
keep track of your progress and difficulties. Step
5 is to monitor your stress levels on a daily basis
and record your observations in the stress
management program.
Step 6 - GENERALIZING YOUR SKILLS. Apply the relaxation
skills to your thoughts and images about the
stressors, to reduce their impact. As you master
old stressors, you will find new ones to be
managed. Step 6 is to apply the skills you have
learned to new stressor situations.
5
To help achieve these steps, the program includes two components:
* THE COMPUTERIZED INFORMATION AND CONTROL SYSTEM
The computerized information and control system sub-
components provide a system for managing the development
of your stress coping skills. These sub-components are:
(A) A stress test designed to measure and analyze your
overall stress level.
(B) A method for identifying your stressors and assessing
their intensity levels.
(C) A display system for showing trends over time in stress
levels for different stressors.
* THE RELAXATION CASSETTE TAPES.
The sub-components of the tape system are three cassette
tapes. These tapes help you to develop and integrate the
skills to maintain a state of relaxation necessary to
counter the effects of stress. The three tapes are:
(A) Respiration training.
(B) Muscle relaxation.
(C) Autogenic training
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I N S T A L L A T I O N |
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I N S T A L L A T I O N
SYSTEM REQUIREMENTS
IBM Compatible PC, XT or AT
512 Kilobytes memory (RAM)
One 5.25" (or 3.5") Floppy Drive or One Floppy Drive and 1
Hard Drive
Color (CGA,EGA,VGA), Mono, or LCD Display
Dot Matrix printer
RUNNING THE SOFTWARE
Once the program has been unpacked, you may run the Self-
Health Systems software by doing the following:
Floppy Disk Systems
Insert the PROGRAM disk in drive A and a formatted DATA disk
in drive B.
Type SH Enter
Hard Disk Systems
It is recommended that you place the Self-Health Systems
software in its own directory. There is no limitation on how
you configure the system.
From the C: prompt:
Type CD\Health Enter
Type SH Enter
In either case you will be presented with the Opening Menu as
follows:
┌───────── OPENING MENU ─────────┐
├────────────────────────────────┤
│ Stressor Counting Module │
│ Stress Test Module │
├────────────────────────────────┤
│ Shareware Information │
│ Print Users' Manual │
│ Print Registration Invoice │
├────────────────────────────────┤
│ Change Set-up │
│ Quit Program │
└────────────────────────────────┘
Move the highlight to the CHANGE SET-UP item and press [Enter].
You will then be asked to enter the necessary information to
configure the software to your system. You may change this setup
at any time, so if you make a mistake, just come back to this
menu item. That's all there is to it!
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M E A S U R I N G Y O U R |
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S T R E S S L E V E L |
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Step 1 - MEASURING YOUR STRESS LEVEL
The first step in this stress management program is to determine
how stressed you are. We have developed a computer based stress
test for this purpose. The test measures your overall stress
level, as well as the levels of the physiological, emotional and
behavioral manifestations of your stress.
From the Opening Menu, select the "STRESS TEST" item and then
select the (B)egin item from the pop-up submenu that will be
displayed. This will bring the stress test up on the screen,
with instructions for taking the test.
You should take this test at three points in the program so it
can be used to track your progress in learning to manage stress.
Test 1 - Should be taken when you first begin the program.
This will give you an accurate baseline of stress
reactivity, and will give you something to compare
your progress against.
Test 2 - Should be taken after you have done Step 4 of the
program. You may find that one area that was high
in the beginning has dropped, only to be replaced by
a high reading in another of the areas. This second
test, then, allows you to monitor any subtle changes
in your own coping mechanisms.
Test 3 - Should be taken at the end of the program. This
administration should show you that you have made
considerable progress over the course of the
program. Used in concert with the daily and weekly
stressor graphs (described later in the manual), you
can accurately see that you have made progress in
learning new coping skills.
The program will keep track of your scores each time you take it
and cumulatively display them. Facility has been provided so
that you can erase all previous test data and begin anew.
INTERPRETING THE STRESS TEST
Introduction
Now that you have completed the stress test, the computer will
automatically score it and provide you with a graph of the
results. Study the graph carefully. It will tell you some things
you will want to know about your overall stress level and the
ways in which your stress manifests itself. But before looking
at the graph, a few words of caution might be in order. Scores
on tests like these are expressed in the precise language of
arithmetic. In that language, 1 + 1 = 2 and 4 is twice as much
as 2. Always, and exactly. But when that language is applied to
the real world, there is always a little slippage. When measured
precisely, a steel rod 4 inches long turns out to be only
approximately twice as long as one 2 inches long. The more
precise the measurement, the less certain is the application of
numbers to the real world.
8
So it is with this stress test. The scores reflect your
judgement of your stress level on the day you took it. On
another day, when you are feeling a little differently, some of
the item entries might be a little different, and the scores
would be changed accordingly. Since that is the case, approach
what you read here with what a famous psychologist once called
"cool benevolence". Read it, think about and take it seriously
enough to act on it. But don't become obsessed about the
numbers. An overall stress test score of 95 is not a lot better
than 100 and not a lot worse than 90. These numbers are
pointers, not meters.
II. Test Results
Now let's look at the test results. The test consists of thirty
items, each of which is scored on a 1 to 5 scale. Therefore, if
you scored each one of the items at "1", the lowest possible
score for an individual item, you would get a total score of
thirty. If you scored each item at "5", the highest possible
score for an individual item, you would get a total score of one
hundred and fifty. So your overall score on this test must lie
somewhere in the range of thirty to one hundred and fifty.
In addition, the test items can be grouped so that they show your
scores on three sub-tests: one for physical stress, one for
emotional stress and one for social stress. That means we can
analyze your stress levels by four scores, one for the overall
test and one for each of the three sub-tests.
To understand the significance of these scores, we need to
understand two things. First, the structure of the stress test
itself. Each test item reflects a specific kind of stress. You
were asked to estimate the frequency with which that stress
symptom occurs in your life. High scores mean that you are
experiencing that particular symptom very frequently, while low
scores mean that you aren't experiencing that stress very often.
Second, the role of individual differences in the expression of
their stress. No two people express their stress in exactly the
same way. Everyone has their own pattern of stress expression.
Therefore, to understand your stress, you need to know something
about the pattern with which you express the stress. The stress
test is designed to tell you something about both the frequency
of expression of stress symptoms and the pattern of their
occurrence.
The graph will show you how you rate in four areas - Physical,
Emotional, and Social stress and an Overall stress score. The
higher the score on each of these, the greater the height of the
bar. The screen is divided into three areas - (H)igh, (M)oderate
and (L)ow amount of stress. These are labelled on the right hand
side of the screen.
Now, let's consider these results. Each of your four stress test
scores can be compared to the score ranges on the right hand side
of the graph. The score ranges reflect low, medium and high
levels of stress. By seeing where your scores fit in those
ranges, you can estimate your stress level for each of the four
areas.
9
Let's look at the physical stress scores, which are in the first
sub-test. The items in that group are concerned with the bodily
symptoms of stress, like tightness in the chest, tension
headaches or sweaty palms. A low score on this test indicates
that you are expressing your stress in some other way. A high
score on this sub-test indicates that you are the kind of person
who expresses your stress somewhere in your body. Stress can be
expressed in any organ system, from the skin to the activity of
the heart. [Sometimes it is hard to tell if you are having a
stress-related reaction or not when you are experiencing physical
symptoms. When in doubt, be sure to check with your physician].
Your physical symptoms are probably stress-related if their
severity varies with the intrusiveness of the stressors in your
life, e.g., if the only time you get headaches is when the boss
asks you to work overtime.
Now we can consider the emotional sub-test, the second one in the
table. This sub-test describes the emotional and cognitive
aspects of stress, like being angry for no good reason or
forgetting an important appointment. A low score on this test
implies that stress has little effect on how you feel or think.
A high score indicates that you express stress through your
emotions and how you think. The most likely form of emotional
expression in the early stages of stress is irritability. You
know, the "short fuse". Somebody says "Good morning" and you say
"What's so good about it"? Later stages of emotionally expressed
stress can include irrational outbursts of anger and feelings of
depression. [Stress is not the only reason for sustained
feelings of negative emotionality. If you are not sure if your
feelings are stress-related, you might want to confer with a
psychologist or some other mental health professional]. These
symptoms are probably stress-related if their severity varies
with the intrusiveness of stressors in your life, e.g., if you
get depressed only when your spouse (or other significant other)
is giving you a hard time.
The last sub-test is concerned with the social aspects of stress.
If you find yourself feeling alienated from your family or angry
when someone praises you, there is a possibility that you are
feeling some socially related stress. A low score on this sub-
test implies that you express your stress in personal, rather
than social ways. A high score indicates that you tend to
express your stress through your interactions with other people.
For example, this can include being upset when meeting strangers,
feeling confused and angry at being praised or finding it
difficult to give negative feedback to someone. Such symptoms
are probably stress-related if they occur in the absence of a
long history of such problems, coupled with an increase in the
severity of your stressors, e.g., they begin to occur while you
are coping with a chronic illness in your family.
The final score to consider is the overall stress test score.
This is simply an integration of the scores on the three tests.
If this score is low, it probably means that your stress level is
not a cause for immediate alarm. You might want to use this time
to learn some relaxation skills to get ready for the time when
the stress levels will increase. If the score is in the moderate
or high range, it probably means that your pattern of stress
expression involves all three areas covered in the stress sub-
tests. You can best understand it by considering the pattern of
the three sub-tests in relation to each other.
10
If the pattern discloses that one area is significantly higher
than the others, e.g, that you tend to express much of your high
stress level emotionally, then that's what you need to deal with.
If they are all high, then the stress has affected much of your
life. Treat the pattern as a set of pointers to tell you what to
pay attention to. Your good judgement will tell you what to do
next.
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STEP 2 |
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I D E N T I F Y I N G AND A S S E S S I N G |
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Y O U R S T R E S S O R S |
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Step 2 - IDENTIFYING AND ASSESSING YOUR STRESSORS
Now we can go on to the second step, which is to identify the
stressors, the events that cause all that stress. Your first
impulse may be to grab a piece of paper (or a blank monitor
screen) and start listing all the things that are ticking you off
right now. Not a bad idea, actually. It goes in the right
direction. A "stressor" is any event that causes you to become
stressed, and results in you becoming angry, agitated, tearful,
anxious, forgetful, cranky, or depressed. Examples of stressors
might include moving to a new job, arguing with a member of your
family or getting calls from a collection agency.
Some ways of describing stressors are more useful than others.
Here are some guidelines to use when making up your list of
stressors:
1. Keep the title brief. Short descriptions work best.
2. Make it concrete. Describe specific events in specific
places.
3. Frequently recurring stressors tend to be of greatest
interest.
4. Use events which the stress test tells you are
important. If the test says you rate high on physical
stress, select a stressor that gives rise to that
response.
5. Make a complete list, but don't work on more than two
or three stressors at a time. When you have managed
two or three of them, then select others on your list.
Identifying your stressors is a good start in learning to manage
them, but we recommend doing something more systematic than that.
We're going to ask you to keep a daily log of your stressors
while you are being stressed, and while you are learning to apply
new coping strategies to them. In addition, you should rate the
severity of your stress reaction by assigning a SUDS level to
each encounter. SUDS level?
No, it's not a measurement for producing a whiter wash. SUD is
an acronym for "Subjective Units of Discomfort" and since there
are lots of them, they have come to be called SUDS. Stressors
vary in the degree to which they induce stress. (Most of us are
more stressed by losing a job than by losing our eyeglasses). We
would like to be able to measure the difference in stressor
effect in some way. That's where the SUDS level comes in. It
gives us a method of measuring how strongly we have been affected
by any given stressor.
To measure the severity of a stressor, start by erecting a 1 to
10 scale in your head, where 1 is no stress and 10 is the most
extreme stress you have ever felt. For any given stressor at any
given time and place, you can then generate a number between 1
and 10 that describes the stress severity in SUDS levels.
Practice assigning SUDS levels to stressors a few times just to
get used to the idea. It will soon make sense to you.
12
THE COUNTING NOTEBOOK
We want you to keep a daily counting notebook because human
memory tends to be faulty, especially for unpleasant events. We
tend to forget and distort unpleasant events and are not reliable
reporters about their occurrence once they are over and done
with. This makes it quite difficult for us to accurately judge
whether or not we are making progress, or getting worse. So, in
the interest of accurate information, we are asking you to keep a
little notebook in a convenient place, like a shirt pocket. The
pages of the notebook look like this:
┌──────────────────────┬────────────┐
│ NAME: │Date: │
├──────────────────────┼────────────┤
│ Stressor │ SUDS Level │
├──────────────────────┼────────────┤
├──────────────────────┼────────────┤
├──────────────────────┼────────────┤
├──────────────────────┼────────────┤
├──────────────────────┼────────────┤
├──────────────────────┼────────────┤
├──────────────────────┼────────────┤
└──────────────────────┴────────────┘
There are two ways to get the counting notebook. First, when you
register with SELF-HEALTH SYSTEMS we will send you a packet of
these in the kit you receive. Second, you will find a page of
these already printed out in Appendix A of the manual. Photocopy
more if you need them.
Use a different page for each day, taking care to enter the date
for each one. For each stressor you have identified, fill in the
relevant information on the sheet. Fill in a separate sheet for
each day, listing all the stressors and associated SUDS levels
for that day. Now, what are we going to do with all that data?
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STEP 3 |
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E N T E R I N G S T R E S S O R S |
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A N D |
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E S T A B L I S H I N G B A S E L I N E S |
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Step 3 - ENTERING STRESSORS AND ESTABLISHING BASELINES
What are we going to do with all that data? Put it in the
computer, of course. Once the data is in the computer, there are
a number of things we will do with it. But the first thing to do
is to establish some baselines. These baselines are measurements
of the frequency and intensity (SUDS) of the stressors prior to
the time you begin to use the Stress Management program.
Baselines are important because they tell us about the ways in
which your identified stressors impact your life now. We will
use the baselines to tell how well the stress management program
is working to alter that impact. Furthermore, you can use these
baselines to show yourself that progress is being made. (Many
times with our own patients we find that people get discouraged
in the middle of a stress management program, when their stress
reaction suddenly returns "full blown", and they feel that they
have gotten nowhere. By keeping an accurate baseline, you can
show yourself that although you may on occasion "flare up" to
your old level, you are nonetheless making good progress). You
should keep baseline data on each stressor for seven days before
beginning the program.
In order to track your baselines (and your subsequent progress),
you will need to transfer your list of stressors to the computer.
Data about your stressors is stored in the computer on Stressor
Information Cards. The software provided with your Self-Health
program allows you to establish an unlimited number of Stressor
Information Cards and to access any one of them easily. The
Registered version of the software will allow you to establish
stressor lists for several people, while the unregistered version
allows one person only.
From the Opening Menu, select the "Stressor Counting Module".
You will be presented with the following screen:
┌───────────────────────────────────────────────────────────────┐
│ File Print Quit Help File: STRESSOR │
├───────────────────────────────────────────────────────────────┤
│ │
│ │
│ │
│ │
│ │
│ │
│ │
│ │
│ │
│ │
│ │
│ │
├────────────────────────────────────────────────┬───────┬──────┤
│ F1 = Menu Move Highlight Enter=Select Item │ TIME │ DATE │
└────────────────────────────────────────────────┴───────┴──────┘
This screen is a "window" that will be used to display and manage
the list of your stressors. At the top of the screen you will
see the Menu of options (File Print Quit Help). To access
this menu, press the F1 key. The first letter of each menu item
will be highlighted, and the first menu item, File, will be
completely highlighted.
14
You may use the arrow keys to move the highlight to the Menu item
you want, or you may simply press the first letter of the item.
In this case, press the "F" key or press the Enter key. Either
one will work.
Once a Menu item has been selected, you will be presented with a
"pull-down" submenu for that item. In this case, you will see
the sub-menu for the File option. Move the highlight to "Add
Record to File" and press Enter. You will see a Stressor
Information Card appear on the screen.
┌───────────────────────────────────────────┐
│ STRESSOR INFORMATION CARD │
│ Stressor: │
│ Classification: │
│ Priority: │
│ Begin Date: │
│ End Date: │
├───────────────────────────────────────────┤
│ DESCRIPTION │
├───────────────────────────────────────────┤
│ │
│ │
│ │
└───────────────────────────────────────────┘
Although entering information onto the card is easy, a few
guidelines are in order.
Stressor - Enter the name you have given to that stressor.
Be as brief and descriptive as possible.
Classification - Classify the stressor as to its' source (e.g.,
work, family, peer group, etc.).
Priority - Prioritize the importance of the stressor to you
on a scale of 1 to 5, with 5 being the most
important.
Begin date - Type in the date you start to keep baseline
data.
Description - Type in a brief, but thorough description of the
stressor, the circumstances under which you
normally encounter it, and the coping strategies
you have used in the past.
When you have completed the entries, press the Enter key.
Automatically, the data from the stressor information card will
be stored in its own file, and the name of the stressor will be
shown on the index screen. Whenever you want to enter data about
that stressor into the computer, you will need to recall that
card. To recall a Stressor Information Card, simply move the
highlight to the stressor name on the index screen, and press the
Enter key.
15
With the stressor cards in place, you can start making entries
about the daily SUDS levels. To add SUDS levels data to the
stressor card, take the following steps:
1. Call up the stressor information card (see above).
2. Press (C)ount.
A new screen will come up that will permit you to make data
entries for the date of the occurrence of the stressor, the
frequency with which it occurred on that date and the SUDS level.
To enter information about the SUDS level, take the following
steps:
1. Type in the date (using the Enter key to separate month,
day and year). The cursor will then move to the SUDS
level.
2. Enter the SUDS level for the first occurrence of the
stressor, and press the Enter key.
3. Enter the SUDS level for any subsequent occurrences of the
stressor on that date. The program will calculate and
display the number of times the stressor occurred on that
date from the number of SUDS level entries.
4. Use this same sequence each time you wish to enter new SUDS
level data for subsequent days.
Starting with your Baseline data, then, you should track and
enter the data on a daily basis. The Self-Health program will
only work as well as you allow it. Inadequate or incomplete data
will obviously yield inadequate results. Be as systematic as
possible in noting and entering the data into the computer.
Remember that the F1 key gives you access to the Options menu.
By using the Options menu, you may add, modify or delete stressor
information cards at any time. Similarly, you may print out the
list of stressors or even the stressor cards themselves. To
print out copies of your stressor information cards, select the
(P)rint option from the pull-down menu. You will be presented
with the following submenu:
┌────────────────────────────────┐
│ List of Stressors │
│ All Stressor Information Cards │
│ Individual Information Cards │
├────────────────────────────────┤
│ Daily Graph │
│ Cumulative Graph │
└────────────────────────────────┘
When the sub-menu comes up, use the directional arrows to select
the printing option you want to use, e.g., all the stressor
information cards.
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STEP 4 |
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L E A R N I N G |
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R E L A X A T I O N S K I L L S |
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Step 4 - LEARNING RELAXATION SKILLS.
This portion of the manual covers the use of the three relaxation
tapes. The tapes are designed to help you learn the skills
necessary to induce a state of relaxation whenever you want to.
Before getting to the tapes themselves, we would like to describe
what the state of relaxation is all about and to point out how
best to use the tapes.
First, relaxation is not diversion. Sitting in a chair with a
headset on listening to acid rock may divert you from
concentrating on your stressors, but it is not relaxation.
Relaxation is a state of LOW AROUSAL. Physiologically, that means
slow breathing, lowered levels of muscle tension, slow heart rate
and decreased blood pressure. Psychologically, it means fewer
thoughts, lessened urgency with regard to time and lowered levels
of irritability. If you want to become relaxed, you have to
learn some things about breathing control, muscular control and
control of thought processes. That is what the instructions on
the tapes are designed to help you do.
Second, using the tapes requires that you be able to set aside
time on a regular basis. You should schedule your day so that
you have a SPECIFIC time to listen and practice. This time
should NOT be at the very end of the day (eg. before bedtime)
when you are overly tired. Early morning or evening times will
generally give you the best results. If you are feeling stressed
when you begin, let your mind float free of intruding thoughts
and concentrate on the tape. Tell yourself that you are going to
take a vacation from your worldly worries for twenty minutes or
so. If at all possible, use the tapes in a quiet place so that
you can concentrate better. No radio or television, turn off the
phones and get some privacy.
At the beginning, stick to the prescribed order of the tape use.
The order has been set up to provide the most effective way to
learn these skills, starting with the easiest material and
proceeding to the more difficult. After you have acquired some
skill, you can start using these skills without the tapes and can
develop your own unique mix of the methods for inducing the
relaxed state.
Take your time about going from one tape to the next, so that you
can learn the skill on one tape thoroughly before going on to the
next one. You should probably spend a minimum of several weeks
on each tape, using it on a daily basis, before going on to the
next tape. If you need more time with one tape, take it. The
point is to overlearn these relaxation skills so that you can
call on them when you are feeling stressed. It really won't take
too long to master these skills. Most people get all the
relaxation skills they will ever need in a few months of
consistent practice.
17
The Self-Health Tapes
1. Abdominal Breathing
The first one is entitled "Abdominal Breathing". Abdominal
breathing means you are going to learn to breathe with your
stomach, or at least with the muscles of the abdomen as
well as the muscles of the chest. It isn't hard to learn,
since it's a perfectly natural form of breathing.
Maybe a few words of explanation will help in understanding
why it is so important to use this way of breathing while
relaxing. You already know that breathing is important
because it brings oxygen into your body while taking out
carbon dioxide. However, it isn't as automatic as you
might think. There is a rate of exchange between these two
gases that is determined by the way in which you breathe.
If you breathe irregularly, e.g., if you hold your breath
between inhaling and exhaling, you disturb the gas exchange
rate. This leads to a build-up in the carbon dioxide
levels in your body. When the carbon dioxide levels build
up we feel it as a tightness in the chest and a feeling of
pressure in the body. Both psychologically and physically,
this in turn makes it much more difficult to let go of the
very muscles we are trying to relax.
If you want to test this, try holding your breath for a few
seconds and see how rapidly the feelings of tension start
to develop in your chest and the muscles of your body. An
optimal breathing pattern, on the other hand, has exactly
the reverse effect. It promotes a proper gas exchange
rate, thereby reducing the feelings of tightness in the
chest and making it much easier for the muscles to let go.
In summary, then, breathing in this fashion facilitates the
gas exchange between oxygen and carbon dioxide, which in
turn facilitates bodily relaxation. It is helpful because
it helps slow heart rate and reduces blood pressure. On
this tape you will find instructions having to do with the
development of abdominal breathing patterns, the kind that
will promote the relaxed state that is the opposite of
stress.
2. Progressive Muscle Relaxation
The second tape is called "Progressive Muscle Relaxation".
It is designed to enhance your awareness of muscular
tension in the major muscle groups by having you
systematically practice the contraction and relaxation of
the muscles. The resulting increase in sensitivity to
changes in muscle tension helps you to signal when you are
getting stressed and in ensuring that the muscles are kept
in a relaxed state. Of course, when you are active you
don't want to be totally relaxed or you would ooze all over
everything. But you don't need to carry much body tension
to do most of the things you do. You are better off with
the minimum body tension you need to complete your tasks.
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Progressive muscle relaxation is a form of relaxation
training that does two things at once: First, it exercises
a given muscle group to encourage relaxation. Second, it
increases your awareness of how the muscles feel when they
are relaxed. The combination of the two is helpful in
simultaneously relaxing specific muscle groups while
inducing a state of generalized relaxation .
Progressive muscle relaxation calls for some concentration,
especially in the early stages of training. It is
important that you stay focussed on how the muscles feel as
you do the exercises and that you do them slowly enough to
get the full effect. At the beginning, set aside twenty
minutes to do this routine. As you develop more
skills, you will be able to achieve excellent relaxation
results in far less time.
Do the exercises in a warm, quiet place that is free of
distractions. You can do them either seated or lying down,
but in either case make sure that your neck and shoulders
are well supported. A recliner chair set at about 45
degrees is optimal, although any chair, sofa or bed will do
just fine.
The procedure calls for you to select a muscle , e.g., the
forearm muscle in your right arm. You will be asked to
tighten that muscle until you feel tension in the area.
When you can clearly feel the tension, you will then be
asked to slowly relax the muscle, paying attention to how
the area feels as the tension is reduced. This sequence is
repeated, so that each muscle is worked twice during each
exercise. You systematically work your way through all the
muscle groups in the body (hence the name "Progressive
Muscle Relaxation").
3. Autogenic Training
The final tape is labelled "Autogenic Training". This tape
is designed to help control the occurrence of intruding
thoughts by substituting relaxation-inducing material for
stress inducing material. Autogenic training is a
relaxation method which involves the use of repeated
phrases to achieve its effects. These phrases are
descriptions of a part of the body that is getting relaxed.
For example, "My eyelids are heavy" is a phrase that might
be used in Autogenic Training to achieve - you guessed it -
heavy eyelids.
The phrases we will be using are similar to one another.
That is done deliberately, so that the repetitive quality
of the phrases can produce a maximal effect. As each
phrase is introduced, the tape will prompt you three times
to silently repeat that phrase, with questions and pauses
between repetitions. Be sure you say each phrase to
yourself slowly each time you do it. Take your time with
this technique. Remember, the effects accumulate with
repetitions.
19
One of the great strengths of Autogenic Training is that it
blocks interfering thoughts. You may be aware of a
frustrating fact that occurs when doing relaxation
training, i.e., when you begin to relax, there is a
tendency for interfering thoughts to come creeping in.
Slowly at first, then with increasing frequency, the
worries of yesterday, today and tomorrow enter your
thoughts. All of the "I have to...", "I ought to...", "I
need to..." worries get in the way of becoming relaxed.
Autogenic training is an excellent tool for managing that
problem, since the autogenic phrases replace the intruding
thoughts.
The texts for the tapes will be found in Appendix B at the end of
this manual. Pre-produced tapes are supplied with the kit that
comes with registration of the program. The registration form
will be found at the beginning of this manual.
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STEP 5 |
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M O N I T O R I N G C H A N G E S |
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S T R E S S L E V E L |
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Step 5 - USING THE RELAXATION RESPONSE
It has probably occurred to you that learning to relax while
sitting alone in a chair at home is of rather restricted value.
Pleasant perhaps, but not very useful in stressful situations.
You need to be able to relax when you are in stressful situations
like a noisy room in a factory, or taking an important test or in
an argument.
In these kinds of situations, the stress response is almost
automatic unless you induce a relaxation response to counteract
it. To do this easily and effectively, you need a means to apply
the relaxation skills you learn with the tapes so that they are
usable in new situations. This section of the program helps you
learn how to generalize your at-home relaxation skills to actual
stressful situations.
You've probably noticed that the stress level increases when you
think about a stressful situation. Research shows that the
stress we experience is considerably reduced when we can think
about a stressor and still remain relaxed. The Self-Health
Systems program, then, next trains you to apply your relaxation
skills while thinking about your particular stressors. Follow the
steps below carefully.
1. Induce a state of relaxation as you have been learning to
do with the Self-Health tapes.
2. Choose one of the stressors you have selected to work on.
3. Imagine being in that stressful situation, but maintain the
relaxed state as you do so. (Make the image as vivid as
you can. Include how things would feel and smell and taste
as well as how they would look).
4. Hold the image for about thirty seconds.
5. Re-relax yourself for another thirty seconds.
6. Repeat the image a second time.
7. Do this for two or three selected stressors in your list.
Repeat the exercise every day until you feel relaxed and
comfortable thinking about those stressors. Once you have
learned to be relaxed with thinking about a stressor, you are
ready to use the relaxation response in the real world on the
real stressor. A word of advice as you initiate this step.
THINK SMALL. Don't try to do too much at any one time. Start
with one of the least stressful stressors, preferably one which
has a brief duration. (A good example would be asking a store
owner for change of a dollar bill for a parking meter).
When you have determined which stressor you will try, rehearse
what you are going to do out loud a few times. If you have a
trusted relation or friend, rehearse it with them. Get some
feedback from them about how you're doing and try some
alternative ways of behaving in the stressful situation. Then
try it out in the real world.
21
Don't be surprised if your performance doesn't meet all your
expectations. If this were easy to do, you would have done it
already. A positive problem-solving attitude will help. Here
are a few questions you can ask yourself that might help in the
problem-solving:
1. Did you maintain the relaxation or did you get so caught up
in the stressor that you forgot?
2. Can you remember just What caused you to lose your state of
relaxation. Was there something specific you remember?
3. What kind of self-limiting thoughts do you remember having
at the time (e.g. "I'm never going to get over this")?
4. What can you do the next time to make it go better?
Before leaving this section of the manual, a few more hints may
be in order. The most important thing is not to attempt too much
at any one time. Because we have a tendency to do things from
habit, behavior change is not easy. By taking on only one or two
stressors at a time instead of six or seven, we increase the ease
with which we can make appropriate changes.
A second hint worth repeating is to work with stressors that mean
a lot to you, even if they seem harder to manage (they are). The
motivation to make the changes is greater when the issues are
more central.
Third, don't get caught in the psychological trap of "feelings"
about the stressor situation (e.g. "But that's the way I feel").
Recognize that research shows us we can change how we emotionally
react to stressors, thereby reducing the amount of stress they
cause us.
Finally, be sure to make the effort to incorporate what you have
learned into your daily life. Take the relaxation skills you are
learning and put them to work in stressful situations. You will
be impressed with how much easier it is to handle your stressors
when you are relaxed rather than tense.
Facts vs Subjective Opinion: Keeping Track
Now that the data for each stressor is being entered into the
computer on some regular basis, we can do an analysis that
indicates how these stressors function over time. This will tell
us how your stress management program is affecting the stress.
It is often the case that people will not recognize that
significant change is occuring, simply because they aren't able
to get FACTS about the change. Let's face it, this stuff is
pretty subjective at best, and our tendency is to "go with our
feelings" when it comes to judging change.
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The Self-Health Systems program requires you to keep careful note
of the occurrence of the stressors, and gives YOU the feedback
and objective analysis necessary to accurately judge the nature
of the changes you are making. This is done by using a graphic
display for the frequency of occurrence and SUDS level data for
each stressor. Here is what one of the graphic displays looks
like:
┌───────────────────────────────────────────────────────────────┐
│ Period: 11/18/89 - 02/17/90 STRESSOR: Finances │
├───────────────────────────────────────────────────────────────┤
│ ░░............................................................│
│ ░░░░░.........................░░..............................│
│ B░░░░░.░░.░░░.................░░.............................B│
│ ░░░░░░░░░░░░░.................░░..............................│
│ ░░░░░░░░░░░░░░░░░░............░░..............................│
│ ░░░░░░░░░░░░░░░░░░░░░░░.......░░..............................│
│ ░░░░░░░░░░░░░░░░░░░░░░░░......░░..............................│
│ ░░░░░░░░░░░░░░░░░░░░░░░░░.....░░..............................│
│ ░░░░░░░░░░░░░░░░░░░░░░░░░░....░░..............................│
│ ░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░.............................│
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│ ░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░..............│
│ ░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░.........│
│ ░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░...│
│ ░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░│
│ ░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░│
│ FREQUENCY WEEKS B....B = BASELINE │
├────────────────────────────────────────────────┬───────┬──────┤
│ Self-Health Systems Stress Management Software │ TIME │ DATE │
└────────────────────────────────────────────────┴───────┴──────┘
This display shows what has happened during a complete program to
one stressor. Along the abscissa, (that's the horizontal line at
the bottom of the chart) are the weeks that the program was
applied. The ordinate (the vertical axis) shows the frequency
with which the stress was encountered. The greater the frequency
of occurrence of the stress, and the higher the stress level, the
higher the bars on the graph.
The graph used as an example shows that there was a falling off
of the frequency with which this stressor occurred, (except for
the period right in the middle of the training, which must have
been a heller). One could objectively infer that the overall
effects of the stressor were significantly reduced over the
period of the training but, as has been mentioned, many people
experience "rebounds" - periods where the effect of the stressor
returns to a very high level - and subsequently abandon their
attempts at control (e.g. "Here I am, right back at the same old
level...nothing has really changed"). As you can see from the
graph, however, there is very little doubt that this person DID
achieve significant stress control. If this person simply had
access to the data, they would NOT HAVE GIVEN UP!
23
Therefore, YOU SHOULD REVIEW YOUR PERFORMANCE FREQUENTLY so that
you can see how well you are doing. (Don't trust your memory
about your progress, and don't trust your immediate "feeling"
about it either. One way or another, you'll probably lie to
yourself if you do). When things are not going well, try to
analyze the problem and solve it. Use the graphic information to
see your solutions are working.
When you want to call up any of these graphs, select the (P)rint
option from the pull-down menu, and then select one of the Graph
options:
┌────────────────────────────────┐
│ List of Stressors │
│ All Stressor Information Cards │
│ Individual Information Cards │
├────────────────────────────────┤
-----> │ Daily Graph │
-----> │ Cumulative Graph │
└────────────────────────────────┘
Press "D" for daily records, or "C" for records that cover the
whole twelve weeks of the program. Then use the space bar to
bring up new graphical information.
The graphs will display the pattern of your stress activity over
time. Study these carefully. They will show you possible
patterns of stress that you are not aware of. For instance, you
may notice that you are more stressed on particular days, or at
particular times of the day. Use the information in the graph to
help you predict when and where you stress is likely to arise so
that you can be better prepared to manage it.
24
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STEP 6 |
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G E N E R A L I Z I N G |
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Y O U R |
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S K I L L S |
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Step 6. GENERALIZING YOUR SKILLS
This last step in the system is intended to generalize what you
have been learning about stress management to other aspects of
your life. It will help if you understand how generalization
happens in the first place.
Generalization occurs in two ways. The first, situational
similarity, states that if two situations are similar, a response
learned in Situation 1 is likely to occur in Situation 2. (If
you clench your jaws when you are late for a meeting, you'll
probably also clench your jaws when you are late submitting a
report). The second, response similarity, says that if you have
learned a response in a given situation, you are likely to make
similar responses in that same situation. (If being caught in a
traffic jam produces muscle tension in your forehead, it will
also be likely to produce muscle tension in your neck and
shoulders). In either case, generalization occurs primarily on
the basis of similarity between situations or responses.
Therefore, in order to generalize most effectively, you need to
identify the elements that make for the similarities.
Let's start with being able to generalize via situational
similarity. Suppose you have learned the relaxation response in
one situation and want to generalize it to another. That's not
as hard as it sounds since many similarities can exist from one
stressor situation to another. All you need to do is find some
of the similarities and use them as the avenue to generalization.
Some representative examples might be helpful. Ms. A, a 26 year
old administrative assistant at an advertising firm, was
experiencing chronic head pain and stomach cramps which her
physician told her were stress-related. An analysis of the place
of these symptoms showed that at first they occurred only at
work, but had then begun to show up at home as well. (The
symptoms had begun to generalize from one place to another). Ms.
A practised the relaxation response at home until she was able to
control the physical symptoms in a reliable manner. She then
began to practice the relaxation response at work until she could
control the symptoms there as well. In that way, the
generalization that initially spread the symptoms from one place
to another was used to spread the relaxation response from one
place to another.
In another instance, Mr. B, a 41 year old accountant, complained
of a worsening inability to concentrate and failing memory. An
analysis of when this occurred showed that it was at its worst
when he was working on tasks assigned by either his immediate
supervisor or by his rather tyrannical elderly father. The
problem was resolved when Mr. B learned to become relaxed when
working on tasks assigned by his supervisor and then generalizing
the relaxation to those involving his father.
Response similarity can be understood in a comparable way. When
you have learned to make a specific response in a given
situation, other similar responses are likely to occur.
Irritability is likely to generalize into anger when you have
been stressed for a long time and the anger can turn into a
sullen rage if it is not resolved. For another example, and as
noted above, muscle tension in one area is likely to spread to
other areas as well when stressed.
25
Ms. C, a 56 year old housewife, had a history of pain and
soreness in the area around her jaws. In recent years she had
also begun to experience tension headaches and stiffness in her
shoulders and neck. Careful tracking of the symptoms showed that
they occurred only when stressed by her husband or children and
would begin in her jaw area, then radiate to the head, neck and
shoulders. By training for relaxation of one of these groups of
muscles and then generalizing that training to the others, the
problem was resolved.
Generalization in these examples occurred by place and person
respectively. These may also be involved for you, but there are
other ways in which it can occur, e.g., time or some special
sensory characteristic. The key to understanding what is going
on is to remember that generalization occurs via similarity of
some kind. When you recognize what the basis is, it is much
easier to figure out what to do. Use the generalization to work
for you, not against you.
26
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A P P E N D I C E S |
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Appendix A: Counting Notebook Sheets
┌─────────────────────────────┐┌───────────────────────────────┐
│ Date: ││ Date: │
├───────────────────┬─────────┤├─────────────────────┬─────────┤
│ Stressor │ SUDS ││ Stressor │ SUDS │
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
└───────────────────┴─────────┘└─────────────────────┴─────────┘
┌─────────────────────────────┐┌───────────────────────────────┐
│ Date: ││ Date: │
├───────────────────┬─────────┤├─────────────────────┬─────────┤
│ Stressor │ SUDS ││ Stressor │ SUDS │
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
└───────────────────┴─────────┘└─────────────────────┴─────────┘
┌─────────────────────────────┐┌───────────────────────────────┐
│ Date: ││ Date: │
├───────────────────┬─────────┤├─────────────────────┬─────────┤
│ Stressor │ SUDS ││ Stressor │ SUDS │
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
└───────────────────┴─────────┘└─────────────────────┴─────────┘
┌─────────────────────────────┐┌───────────────────────────────┐
│ Date: ││ Date: │
├───────────────────┬─────────┤├─────────────────────┬─────────┤
│ Stressor │ SUDS ││ Stressor │ SUDS │
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
├───────────────────┼─────────┤├─────────────────────┼─────────┤
└───────────────────┴─────────┘└─────────────────────┴─────────┘
27
Appendix B: PREPARING THE RELAXATION TAPES
This section of the manual is designed to help you produce the
three audio tapes that are used by the Self-Health Systems Stress
Management program. If you would prefer tapes prepared in a
professionally recorded format, we will send them to you free of
charge when you register this program with SELF-HEALTH SYSTEMS.
To register the program, complete the registration form located
at the beginning of the manual.
This section is arranged in two parts. Part I has some
suggestions for making good quality audio tapes. Part II has the
actual text for the relaxation tapes themselves.
Part I - TAPE RECORDING INSTRUCTIONS
These suggestions are designed to help you produce good quality
audio tapes for your stress management program. Please follow
the steps and suggestions carefully.
1. Prepare the tapes in a quiet environment. There is
something distracting about a telephone ring, a child's
voice or the drone of a television commercial when you are
doing a relaxation sequence, so you don't want these kinds
of noises on your tapes. If you can't find a quiet place
during the day, record the tapes at night when everyone
else is asleep.
2. Record each script on a separate tape. You will be using
them at different times in your training and will not want
to have to hunt through one cassette for the segment you
want to use.
3. Use tapes that will permit you to get about twenty minutes
worth of time on each tape. High quality tapes that run
sixty minutes will work just fine, and will give you plenty
of lattitude (you won't run out of tape at the end!).
4. Record only one script at a sitting. Your voice and your
attention span will tend to wander if you do more than
that.
5. Use lots of time and patience when you record. Speak in a
slow, unhurried manner, keeping the microphone at a
constant distance from you.
6. Use the "Pause" button on the tape recorder to stop the
movement of the tape when you want to take a short break
(it makes less noise than the "Stop" button) and keep a
glass of water handy when you are taping for when you get
dry.
7. If the sound of your own voice is not comforting to you,
get someone else whose voice you do like to do the
recording.
Finally, be ready to try the taping several times before it works
out to your satisfaction. Try things out before making any final
commitments to any specific taping arrangement.
Good luck and enjoy your experience.
28
Part II - TAPE TEXTS
Tape I - Abdominal Breathing and Meditation
[BEGIN TAPING HERE].
"Get yourself settled as comfortably as you can on the chair or
bed, with your head and neck well supported. Now relax, letting
the chair or bed do the work of supporting you. Just sink into
the surface, taking the arch out of your neck and back muscles.
Feel yourself sinking down into the chair or bed.
Good. Now, let's begin by having you pay attention to your
breathing pattern, without making any attempt to change it.
Notice whether it is fast or slow, deep or shallow. Does it feel
as if you are not getting enough air? Or perhaps too much? Are
there times when you don't seem to be breathing at all?
Let's begin to change that pattern around a little bit. We want
to develop a breathing pattern which is regular and slow, but
which lets in enough air so that your lungs feel comfortably
filled and lets out enough air so that they feel comfortably
emptied.
To develop that pattern, we need to monitor the flow of air in
and out of your lungs. One good way to do this is to monitor air
flow at the nostrils. Focus your attention on your nostrils and
monitor the flow of air at that point. When you inhale you can
feel the cool air going down into your lungs and when you exhale
you can feel the same breath, warmed by your lungs, coming back
out again. Try it. Feel the cool air going down into your
lungs, and the warm air coming back out again.
[Insert ten second pause].
Good. Air flow is an excellent way to monitor your breathing
pattern. A second way is to let yourself become aware changes in
the muscles of the chest wall as you inhale and exhale. They
stretch as you inhale and relax as you exhale. Try it. Feel the
muscles stretch and relax as you breath in and out.
[Insert ten second pause].
So there are two ways of monitoring what your breathing pattern
is like: the first is the flow of air at the nostrils and the
second is the feeling of the muscles in the chest wall. Let's
pause for a moment now while you practice monitoring your
breathing using these two cues..
[Insert sixty second pause].
29
OK, that was good. How did it feel? Were you able to stay
focussed on monitoring your breathing for that one minute period?
If you were not, the odds are pretty good that you were
experiencing some intruding thoughts that got in the way of
staying focussed. Don't worry about that if it happened. It's a
common reaction among people who are feeling stressed. When
stressed, our minds become filled with "Ought to's" and
"Should's" and "Have to's" and "How could I have's". Some people
also report feelings of impatience as they monitor the breathing
pattern, telling themselves that they should be doing more
pressing things. Such interference makes it difficult to
concentrate on something as quiet as monitoring breathing
patterns.
If you are become aware of these interfering thoughts, just
silently say the word "STOP" to yourself and return to what you
are doing. You may have to do this a number of times before you
can stay focussed for a longer period of time, but it will
happen. In fact, the capacity to stay focussed for a long time
is itself an important part of stress management training.
OK, let's get back to breathing. Now that you can monitor your
breathing pattern, we can turn to altering it in a useful way.
The basic breathing pattern is one in which the air flows in and
out of your lungs in a slow, uninterrupted fashion. Take in
enough air so that your lungs feel comfortably filled, then let
out enough air so that they feel comfortably emptied. Do this
slowly. Feel the air flow past your nostrils as it flows in and
out of your lungs and feel the chest wall stretch and relax as
you do so. Let's try that for a moment.
[Insert sixty second pause].
Good. You may already be feeling some relaxation as you breathe
in this leisurely fashion. Feelings of heaviness in your arms
and legs, sleepiness, warmth in your hands and feet and a sense
of withdrawal from the immediate environment are all part of the
relaxation. Don't worry if you are not feeling relaxed right
now. You will get better at this with practice.
Now we're going to make another change in the breathing pattern.
This one is called abdominal breathing. The object is to enlarge
the area into which the lungs can expand as you inhale. You do
this by permitting both the chest and the upper part of the
abdomen to rise at the same time as you inhale, and let them fall
together as you exhale. To monitor this part of the breathing
exercise, place your right hand on the upper part of the abdomen,
just below the rib cage and your left hand in the middle of your
chest. As you inhale, the two hands should rise together. As
you exhale, they should fall together. Let's try that now,
monitoring the rise and fall of the hands as you do so.
[Insert sixty second pause].
OK. How did that feel? Some people report a little difficulty
getting the breathing co-ordinated at the beginning, but a little
practice usually takes care of that nicely.
30
The last alteration in the breathing pattern is the addition of a
simple meditative exercise into the breathing pattern. As you
practice the abdominal breathing, silently repeat the word "one"
each time you exhale. This will help control the interfering
thought patterns and aid in deepening the relaxation. Let's try
that now.
[Insert sixty second pause].
How did that feel? By now you may be feeling the relaxation
response deepening. We'll end this tape by seeing what happens
when we try this breathing pattern we've been learning for a
longer interval. Remember to breathe slowly and evenly, letting
your abdomen rise and fall with your chest and to silently say
the word "one" each time you exhale. Let's begin now.
[Insert a 5 minute pause].
How do you feel now? Remember this feeling of relaxation. Let
yourself get as close to this feeling as you can as you go
through the day. Stay in this relaxed state as long as you like.
When you are ready to get up, take a few deep breaths and stretch
out all the muscles. Then rise slowly."
31
Tape 2 - Progressive Muscle Relaxation
[BEGIN TAPING HERE]
"With your forearms and hands resting at your sides, lift your
right hand, keeping your forearm flat on the resting surface. As
you lift your hand, notice the muscle tension that develops in
the wrist and forearm area. The higher your hand goes, the
greater the tension. Continue to raise your hand until the
feeling of tension becomes very clear to you. Then, very slowly,
start letting your hand come down to the resting position. As
you do so, feel the relaxation move into the wrist and forearm
muscles. The relaxation will become increasingly apparent as
your hand comes down to the resting position. When your arm is
completely free of tension, focus on the contrast between how it
feels when it is tense and when it is relaxed. Begin the
exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Now let's do the left forearm. With your forearms and hands
resting at your sides, lift your left hand, keeping your forearm
flat on the resting surface. As you lift your hand, notice the
muscle tension that develops in the wrist and forearm area. The
higher your hand goes, the greater the tension. Continue to
raise your hand until the feeling of tension becomes very clear
to you. Then, very slowly, start letting your hand come down to
the resting position. As you do so, feel the relaxation move
into the wrist and forearm muscles. The relaxation will become
increasingly apparent as your hand comes down to the resting
position. When your arm is completely free of tension, focus on
the contrast between how it feels when it is tense and when it is
relaxed. Begin the exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Good. Now that we've done both forearms, you have an idea of how
we will proceed. For each muscle group, we slowly tighten it,
paying attention to the increasing muscle tension. Then we
slowly relax it, again paying attention to the increasing
relaxation.
Let's do the same thing now with the muscles of the upper arms.
Slowly press the palm of your left hand down into the resting
surface. Keep increasing the pressure until you feel the tension
clearly in your upper arm. Then slowly relax it. Pay attention
to the change in sensation as you tense and relax the muscle of
the upper left arm.
Begin the exercise now.
[Insert thirty second pause].
32
Now, slowly repeat the sequence.
[Insert thirty second pause].
O.K. Now let's do the same thing with the right arm. Slowly
press the palm of your right hand down into the resting surface.
Keep increasing the pressure until you feel the tension clearly
in your upper arm. Then slowly relax it. Pay attention to the
change in sensation as you tense and relax the muscle of the
upper right arm.
Begin the exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Good. That should help relax your arms. Before we proceed
to relax some of the other muscles, a few comments might be
helpful. Many stressed people find themselves somewhat impatient
as they do these exercises. It feels to them as if it was a
waste of time. They think they should be doing something else,
something "more productive". Don't worry about those feelings.
They are just part of the stress syndrome. Remember that the
time you spend doing this is just for you. It is your time to
reduce the stress in your life and for right now, nothing is more
important than that. Let all intruding thoughts float away and
come back to what we're doing here.
Now let's move to the legs. We'll start with the lower part of
your right leg. Slowly press the toes of your right foot into
the bottom of your shoe. Become aware of the tension in your
calf muscle as you do so. When the tension level becomes clear
to you, slowly begin to relax your toes. Be aware of the
reduction in the tension level and the corresponding increase in
the relaxation level. When your toes are completely relaxed,
rest for a moment. Compare how the right lower leg felt when it
was tensed as opposed to how it felt when it was relaxed. Begin
the exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Now let's move to the lower part of your left leg. Slowly press
the toes of your left foot into the bottom of your shoe. Become
aware of the tension in your calf muscle as you do so. When the
tension level becomes clear to you, slowly begin to relax your
toes. Be aware of the reduction in the tension level and the
corresponding increase in the relaxation level. When your toes
are completely relaxed, rest for a moment. Compare how the left
lower leg felt when it was tensed as opposed to how it felt when
it was relaxed.
Begin the exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
33
That's fine. Next we'll do the upper part of your right leg.
Slowly extend your right leg until it is fully stretched out. As
you do so, become aware of the tension levels in your right thigh
muscles. When the tension level is clear to you, hold it for a
moment. Then slowly lower your leg, letting yourself become
aware of the relaxation entering the thigh muscles as you do so.
When your right leg is fully relaxed, rest it for a moment.
Compare how the muscles felt when they were tense and when they
were relaxed. Begin the exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Now we'll do the upper part of your left leg. Slowly extend your
left leg until it is fully stretched out. As you do so, become
aware of the tension levels in your left thigh muscles. When the
tension level is clear to you, hold it for a moment. Then slowly
lower your leg, letting yourself become aware of the relaxation
entering the thigh muscles as you do so. When your left leg is
fully relaxed, rest it for a moment. Compare how the muscles
felt when they were tense and when they were relaxed. Begin the
exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Good. Now that we've worked the limbs, were going to shift to
the facial muscles. When people are stressed, they often carry a
lot of tension in the forehead, around the eyes and in the jaw
muscles. Let's see if we can get those to relax.
A good way to start relaxing the forehead is to slowly bring your
eyebrows together in a frown. As you do so, you will feel the
tension develop between your eyebrows. When it is clear to you,
slowly relax the frown until the area feels relaxed. Compare the
feelings in that area when there is contraction and relaxation.
Now, slowly lift your eyebrows as if you were surprised. Get
them up high enough so that you can clearly feel the tension in
the forehead. Then slowly lower your eyebrows until the tension
has been replaced by relaxation. Compare the way the muscles
feel when they are tense and when they are relaxed. Begin the
exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
We'll move on now to the eyelids. Just close your eyes and
slowly squeeze the eyelids shut until they feel very tense. Then
slowly relax them. When they are fully relaxed, compare the
feelings of tension and relaxation in the eyelids. Begin the
exercise now.
[Insert thirty second pause].
34
Now, slowly repeat the sequence.
[Insert thirty second pause].
OK, let's do the muscles of the jaw. Very gently press your back
teeth together until you clearly feel the tension in the jaw
muscles. Don't press any harder than you need to get the
sensation. Then slowly let your teeth come apart and your lower
jaw hang slack. Feel the difference in the jaw muscles as you
let go of the tension. Begin the exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Good. The last muscle group we'll work on will be the muscles of
the lower back and buttocks. Slowly squeeze all of those muscles
together, feeling the tension in the area as you do so. When the
feeling is clear, slowly relax them until all the tension is
gone. Compare the sensations of tension and relaxation in the
lower back and buttock muscles. Begin the exercise now.
[Insert thirty second pause].
Now, slowly repeat the sequence.
[Insert thirty second pause].
Now, check around your body and see if there are remaining areas
of tension. If there are, repeat what we have done in those
areas, i.e., tensing and relaxing the muscles until the
relaxation is achieved. After you feel relaxed all over, let
yourself stay in that state for as long as you like, enjoying the
sensations of relaxation. When you are ready to get up, take a
few deep breaths, stretch all the muscles and rise slowly."
Tape 3 - Autogenic Training
[BEGIN TAPING HERE].
"Lean back in your chair or bed and make yourself as comfortable
as you can. As you say each phrase, close your eyes and
concentrate on relaxing the part of the body described in the
phrase.
Phrase 1 - "My left arm is heavy and limp. My left arm is
letting go". Close your eyes, and slowly repeat that phrase to
yourself, letting the words and the arm come together in a
relaxed state. Begin now.
[Insert twenty second pause].
How does your left arm feel? Does it feel heavy and limp? Don't
worry if at first there is not much effect. You will need to
practice this a number of times to get the effect you want.
Let's try it again. Slowly now - "My left arm is heavy and limp.
My left are is letting go". Begin now
[Insert twenty second pause].
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How does your left arm feel now? Is it heavy and limp? Did you
let it go? Compare the left and right arms to see if there is
any difference in feeling. If there is, let the one that is more
tense feel like the one that is less tense. Alright - now the
third time. "My left arm is heavy and limp. My left arm is
letting go". Say that over and over to yourself, silently,
making a connection between the words and your arm. Begin now.
[Insert twenty second pause].
Once more, check to see how your left arm feels. Is it relaxed?
O.K. Now we'll shift to the right arm.
Phrase 2 - My right arm is heavy and limp. My right arm is
letting go". Close your eyes, and slowly repeat that phrase to
yourself, letting the words and the arm come together in a
relaxed state. Begin now.
[Insert twenty second pause].
How does your right arm feel? Does it feel heavy and limp?
Don't worry if at first there is not much effect. You will need
to practice this to get the effect you want. Let's try it again.
Slowly now - "My right arm is heavy and limp. My right arm is
letting go". Begin now.
[Insert twenty second pause].
How does your right arm feel now? Is it heavy and limp? Did you
let it go? Compare the right and left arms to see if there is
any difference in feeling. If there is, let the one that is more
tense feel like the one that is less tense. Alright - now the
third time. "My right arm is heavy and limp. My right arm is
letting go". Say that over and over to yourself, silently,
making a connection between the works and your arm. Begin now.
[Insert twenty second pause].
Once more, check to see how your right arm feels. Is it relaxed?
O.K. Now we'll shift to the left leg.
Phrase 3- "My left leg is heavy and limp. My left leg is
letting go". Close your eyes, and slowly repeat that phrase to
yourself, letting the words and the leg come together in a
relaxed state. Begin now.
[Insert twenty second pause].
How does your left leg feel? Does it feel heavy and limp? Let's
try it again. Slowly now - "My left leg is heavy and limp. My
left leg is letting go". Begin now
[Insert twenty second pause].
How does your left leg feel now? Is it heavy and limp? Did you
let it go? Compare the left and right legs to see if there is
any difference in feeling. If there is, let the one that is more
tense feel like the one that is less tense. Alright - now the
third time. "My left leg is heavy and limp. My left leg is
letting go". Say that phrase over and over silently to yourself,
making a connection between the word and your leg. Begin now.
[Insert twenty second pause].
36
Once more, check to see how your left leg feels. Is it relaxed?
O.K. Now we'll shift to the right leg.
Phrase 4- "My right leg is heavy and limp. My right leg is
letting go". Close your eyes, and slowly repeat that phrase to
yourself, letting the words and the arm come together in a
relaxed state. Begin now.
[Insert twenty second pause].
How does your right leg feel? Does it feel heavy and limp?
Let's try it again. Slowly now - "My right leg is heavy and
limp. My right leg is letting go". Begin now
[Insert twenty second pause].
How does your right leg feel now? Is it heavy and limp? Did you
let it go? Compare the right and left legs to see if there is
any difference in feeling. If there is, let the one that is more
tense feel like the one that is less tense. Alright - now the
third time. "My right leg is heavy and limp. My right leg is
letting go". Say that phrase over and over silently to yourself,
making a connection between the words and your leg. Begin now.
[Insert twenty second pause].
Once more, check to see how your right leg feels. Is it relaxed?
O.K. Now we'll shift to all four limbs at once.
Phrase 5- My arms and legs are heavy and limp. My arms and legs
are letting go". Close your eyes, and slowly repeat that phrase
to yourself, letting the words and the limbs come together in a
relaxed state. Begin now.
[Insert twenty second pause].
How do your arms and legs feel? Do they feel heavy and limp?
Let's try it again. Slowly now - "My arms and legs are heavy and
limp. My arms and legs are is letting go". Begin now
[Insert twenty second pause].
How do your arms and legs feel now? Are they heavy and limp?
Did you let them go? Compare the right and left arms and legs to
see if there is any difference in feeling. If there is, let the
limbs that are more tense feel like the limbs that are less
tense. Alright - now the third time. "My arms and legs are
heavy and limp. My arms and legs are letting go". Say that
phrase over and over to yourself, silently, making a connection
between your limbs and the words. Begin now.
[Insert twenty second pause].
Once more, check to see how your arms and legs feel. Are they
relaxed? O.K.
Well done. You have finished the Autogenic Training tape for
this session. If you wish, remain in this relaxed position for a
long as you like, but before arising from the chair or bed, be
sure to stretch your muscles and take several deep breaths. Then
rise slowly while your body returns to its normal arousal
levels."
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