“Although difficult and going against my natural reaction to curl up in the response to my cramps, I stretched out on my back and breathed slowly so that my stomach got bigger with each inhalation. My menstrual pain slowly decreased and disappeared.
“For as long as I remember, I had stomach problems and when I went to doctors, they said, I had acid reflux. I was prescribed medication and nothing worked. The problem of acid reflux got really bad when I went to college and often interfered with my social activities. After learning diaphragmatic breathing so that my stomach expanded instead of my chest, I am free of my symptoms and can even eat the foods that previously triggered the acid reflux.”
In the late 19th earlier part of the 20th century many women were diagnosed with Neurasthenia. The symptoms included fatigue, anxiety, headache, fainting, light headedness, heart palpitation, high blood pressure, neuralgia and depression. It was perceived as a weakness of the nerves. Even though the diagnosis is no longer used, similar symptoms still occur and are aggravated when the abdomen is constricted with a corset or by stylish clothing (see Fig 1).
Figure 1. Wearing a corset squeezes the abdomen.
The constricted waist compromises the functions of digestion and breathing. When the person inhales, the abdomen cannot expand as the diaphragm is flattening and pushing down. Thus, the person is forced to breathe more shallowly by lifting their ribs which increases neck and shoulder tension and the risk of anxiety, heart palpitation, and fatigue. It also can contribute to abdominal discomfort since abdomen is being squeezed by the corset and forcing the abdominal organs upward. It was the reason why the room on top of stairs in the old Victorian houses was call the fainting room (Melissa, 2015).
During inhalation the diaphragm flattens and attempts to descend which increases the pressure of the abdominal content. In some cases this causes the stomach content to be pushed upward into the esophagus which could result in heart burn and acid reflux. To avoid this, health care providers often advice patients with acid reflux to sleep on a slanted bed with the head higher than their feet so that the stomach content flows downward. However, they may not teach the person to wear looser clothing that does not constrict the waist and prevent designer jean syndrome. If the clothing around the waist is loosened, then the abdomen may expand in all directions in response to the downward movement of the diaphragm during inhalation and not squeeze the stomach and thereby pushing its content upward into the esophagus.
Most people have experienced the benefits of loosening the waist when eating a large meal. The moment the stomach is given the room to spread out, you feel more comfortable. If you experienced this, ask yourself, “Could there be a long term cost of keeping my waist constricted?” A constricted waist may be as harmful to our health as having the emergency brake on while driving for a car.
We are usually unaware that shallow rapid breathing in our chest can contribute to symptoms such as anxiety, neck and shoulder tension, heart palpitations, headaches, abdominal discomfort such as heart burn, acid reflux, irritable bowel syndrome, dysmenorrhea and even reduced fertility (Peper, Mason, & Huey, 2017; Domar, Seibel, & Benson, 1990).
Assess whether you are at risk for faulty breathing
Stand up and observe what happens when you take in a big breath and then exhale. Did you feel taller when you inhaled and shorter/smaller when you exhaled?
If the answer is YES, your breathing pattern may compromise your health. Most likely when you inhaled you lifted your chest, slightly arched your back, tightened and raised your shoulders, and lifted your head up while slightly pulling the stomach in. When you exhaled, your body relaxed and collapsed downward and even the stomach may have relaxed and expanded. This is a dysfunctional breathing pattern and the opposite of a breathing pattern that supports health and regeneration as shown in figure 2.
Figure 2. Incorrect and correct breathing. Source unknown.
Observe babies, young children, dogs, and cats when they are peaceful. The abdomen is what moves during breathing. While breathing in, the abdomen expands in all 360 degrees directions and when breathing out, the abdomen constricts and comes in. Similarly when dogs or cats are lying on their sides, their stomach goes up during inhalation and goes down during exhalation.
Many people tend to breathe shallowly in their chest and have forgotten—or cannot– allow their abdomen and lower ribs to widen during inhalation (Peper et al, 2016). These factors include:
- Constriction by the modern corset called “Spanx” to slim the figure or by wearing tight fitting pants. In either case the abdominal content is pushed upward and interferes with normal healthy breathing.
- Maintaining a slim figure by pulling the abdomen (I will look fat when my stomach expands; I will suck it in).
- Avoiding post-surgical abdominal pain by inhibiting abdominal movement. Numerous patients have unknowingly learned to shallowly breathe in their chest to avoid pain at the site of the incision of the abdominal surgery such as for hernia repair or a cesarean operation. This dysfunctional breathing became the new normal unless they actively practice diaphragmatic breathing.
- Slouching as we sit or watch digital screens or look down at our cell phone.
Observe how slouching affects the space in your abdomen.
When you shift from an upright erect position to a slouched or protective position the distance between your pubic bone and the bottom of the sternum (xiphoid process) is significantly reduced.
- Tighten our abdomen to protect ourselves from pain and danger as shown in Figure 3.
Figure 3. Erect versus collapsed posture. There is less space for the abdomen to expand in the protective collapsed position. Reproduced by permission from Clinical Somatics (http://www.clinicalsomatics.ie/).
Regardless why people breathe shallowly in their chest or avoid abdominal and lower rib movement during breathing, by re-establishing normal diaphragmatic breathing many symptoms may be reduced. Numerous students have reported that when they shift to diaphragmatic breathing which means the abdomen and lower ribs expand during inhalation and come in during exhalation as shown in Figure 4, their symptoms such as acid reflux and menstrual cramp significantly decrease.
Figure 4. Diaphragmatic breathing. Reproduced from: www.devang.house/blogs/thejob/belly-breathing-follow-your-gut.
Reduce acid reflux
A 21-year old student, who has had acid reflux (GERD-gastroesophageal reflux diseases) since age 6, observed that she only breathed in her chest and that there were no abdominal movements. When she learned and practiced slower diaphragmatic breathing which allowed her abdomen to expand naturally during inhalation and reduce in size during exhalation her symptoms decreased. The image she used was that her lungs were like a balloon located in her abdomen. To create space for the diaphragm going down, she bought larger size pants so that her abdominal could spread out instead of squeezing her stomach (see Figure 5).
Figure 5. Hydraulic model who inhaling without the abdomen expanding increases pressure on the stomach and possibly cause stomach fluids to be pushed into the esophagus.
She practiced diaphragmatic breathing many times during the day. In addition, the moment she felt stressed and tightened her abdomen, she interrupted this tightening and re-established abdominal breathing. Practicing this was very challenging since she had to accept that she would still be attractive even if her stomach expanded during inhalation. She reported that within two weeks her symptom disappeared and upon a year follow-up she has had no more symptoms. For a detailed description how this successfully cured irritable bowel syndrome see: https://peperperspective.com/2017/06/23/healing-irritable-bowel-syndrome-with-diaphragmatic-breathing/
Take control of menstrual cramps
Numerous college students have reported that when they experience menstrual cramps, their natural impulse is to curl up in a protective cocoon. If instead they interrupted this natural protective pattern and lie relaxed on their back with their legs straight out and breathe diaphragmatically with their abdomen expanding and going upward during inhalation, they report a 50 percent decrease in discomfort (Gibney & Peper, 2003). For some the discomfort totally disappears when they place a warm pad on their lower abdomen and focused on breathing slowly about six breaths per minute so that the abdomen goes up when inhaling and goes down when exhaling. At the same time, they also imagine that the air would flow like a stream from their abdomen through their legs and out their feet while exhaling. They observed that as long as they held their abdomen tight the discomfort including the congestive PMS symptoms remained. Yet, the moment they practice abdominal breathing, the congestion and discomfort is decreased. Most likely the expanding and constricting of the abdomen during the diaphragmatic breathing acts as a pump in the abdomen to increase the lymph and venous blood return and improve circulation.
Breathing is the body-mind bridge and offers hope for numerous disorders. Slower diaphragmatic breathing with the corresponding abdomen movement at about six breaths per minute may reduce autonomic dysregulation. It has profound self-healing effects and may increase calmness and relaxation. At the same time, it may reduce heart palpitations, hypertension, asthma, anxiety, and many other symptoms.
DeVault, K.R. & Castell, D.O. (2005). Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. The American Journal of Gastroenterology, 100, 190-200.
Domar, A.D., Seibel, M.M., & Benson, H. (1990). The Mind/Body Program for Infertility: a new behavioral treatment approach for women with infertility. Fertility and sterility, 53(2), 246-249.
Gibney, H.K. & Peper, E. (2003). Taking control: Strategies to reduce hot flashes and premenstrual mood swings. Biofeedback, 31(3), 20-24.
Johnson, L.F. & DeMeester, T.R. (1981). Evaluation of elevation of the head of the bed, bethanechol, and antacid foam tablets on gastroesophageal reflux. Digestive Diseases Sciences, 26, 673-680. https://www.ncbi.nlm.nih.gov/pubmed/7261830
Melissa. (2015). Why women fainted so much in the 19th century. May 20, 2015. Donloaded October 2, 1018. http://www.todayifoundout.com/index.php/2015/05/women-fainted-much-19th-century/
Peper, E., Booiman, A., Lin, I-M, Harvey, R., & Mitose, J. (2016). Abdominal SEMG Feedback for Diaphragmatic Breathing: A Methodological Note. Biofeedback. 44(1), 42-49.
Peper, E., Mason, L., Huey, C. (2017). Healing irritable bowel syndrome with diaphragmatic breathing. Biofeedback. (45-4)
Most of us are aware that thoughts affect our body; however, we often overlook the impact of this effect. To demonstrate the power of visualization, participants are guided through a lemon imagery. In a study with 131 college students, 94% report an increase in salivation which is a parasympathetic nervous system response. The participants now know–not believe–that visualization affects physiology. Once salivation has been experienced, participants may apply other visualization techniques to change their physiology and behavior. Through visualization we communicate with our autonomic nervous system which can provide a matrix for self-healing and enhanced performance. In addition, the guided practice shows that almost everyone holds their breath when asked to tighten their muscles and some people have difficulty relaxing after tightening. Once aware, the person can and continue to breathe and relax the muscles. Enjoy the guided exercise, Mindbody connection: Lemon Imagery.
*I thank Paul Godina, Jung Lee and Lena Stampfli for participating in the videos.
Adapted from Peper, E., Gibney, K.H. & Holt. C. (2002). Make Health Happen: Training Yourself to Create Wellness. Dubuque, IA: Kendall-Hunt
“I couldn’t belief it. I thought that I was strong and yet, I could not resist the downward pressure when I recalled a hopeless and helpless memory. Yet a minute later, I could easily resist the downward pressure on my arm when I thought of a positive and empower memory. I now understand how thoughts affect me.”
Thoughts/emotions affect body and body affects thoughts and emotions is the basis of the psychophysiological principle formulated by the biofeedback pioneers Elmer and Alice Green. The language we use, the thoughts we contemplate, the worries and ruminations that preoccupy us may impact our health.
Changing thoughts is the basis of cognitive behavior therapy and practitioners often teach clients to become aware of their negative thoughts and transform the internal language from hopeless, helpless, or powerless to empowered and positive. Think and visualize what you want and not what you do not want. For example, state, “I have studied and I will perform as best as I can” or “I choose to be a non-smoker instead of stating, “I hope I do not fail the exam” or “I want to stop smoking.” The more you imagine what you what in graphic detail, the more likely will it occur.
Most people rationally accept that thoughts may affect their body; however, it is abstract and not a felt experience. Also, some people have less awareness of the mind-body connection unless it causes discomfort. Our attention tends to be captured by visual and auditory stimuli that constantly bombard us so that we are d less aware of the subtle somatic changes.
This guided practice explores what happens when you recall helpless, hopeless, powerless or defeated memories as compared to recalling empowering positive memories. It allows a person to experience–instead of believing—how thoughts impact the body. 98% of participants felt significantly weaker after recalling the helpless, hopeless, powerless or defeated memories. Once the participants have experienced the effect, they realize how thoughts effect their body.
The loss of strength is metaphor of what may happen to our immune system and health. Do you want to be stronger or weaker? The challenge in transforming thoughts is that they occur automatically and we often doubt that we can change them. The key is to become aware of the onset of the thought and transform the thought. Thoughts are habit patterns and the more you practice a habit, the more it becomes automatic. Enjoy the experiential exercise, Mind-body/Bodymind-connection: Muscle testing.
*I thank Paul Godina, Jung Lee and Lena Stampfli for participating in the videos.
The practice was adapted from, Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley: North Atlantic.
“When I saw the exam questions, I blanked out and slouched in defeat. Then I shifted to an erect/tall position and took a diaphragmatic breath. All of a sudden I remembered the answer.” College student
Anticipating that math is difficult, experiencing test anxiety, blanking out on exams, or being scared when asked to give class presentation are common experiences of many students. Their thoughts include, “I am not good enough,” “What will the other students think,” “I am embarrassed and can’t remember what to say,” or “I only thought of the correct answer after it was all over.” Many students report some test anxiety: 32% report severe test anxiety, fear of math and blanking out on exams while less than 10 percent report minimal test anxiety, fear of math and blanking out on exams.
When students anticipate that they will perform poorly on an exam or class presentation, they tend to sit in a slouched or collapsed position, coincident with feelings of powerlessness, hopelessness and defeat. This posture not only communicates to others that they are powerless and defeated, it also decreases their self-esteem, mood and cognitive performance. In previous research, Tsai et al (2016) and Peper et al (2017) observed that when participants sat in a slouched posture, they could access hopeless, helpless, powerless and defeated memories much more easily than when they sat in the upright/erect position. In the upright position it was much easier to access positive and empowering memories. For numerous participants they also experienced being captured and flooded by emotions associated with defeat and hopelessness when they slouched. These feelings and memories associated with a slouched posture may affect how we feel and perform. Nair et al (2015) found that adopting an upright seated posture in the face of stress can maintain self-esteem, reduce negative mood, and increase positive mood as compared to a slumped posture. Furthermore, sitting upright increases rate of speech and reduces self-focus.” Posture may also affect our hormone levels. Harvard Social Psychologist Amy Cuddy has reported that sitting in a slouched posture (powerless position) decreased testosterone (the hormone associated dominance and assertiveness) and increased cortisol (the hormone associated with stress) and performance on a stressor test (Cuddy, 2012; Carney et al, 2010).
This blog points out how posture significantly impacts math performance especially for students who have test anxiety, are fearful of math, and blank out on exams and is adapted from our published research article, Peper, E., Harvey, R., Mason, L., & Lin, I-M. (2018). Do better in math: How your body posture may change stereotype threat response. NeuroRegulation, 5(2), 67-74
In our study 125 university students participated. Half the students sat in an erect position while the other half sat in a slouched position and were asked to mentally subtract 7 serially from 964 for 30 seconds. They then reversed the positions before repeating the math subtraction task beginning at 834. They rated the math task difficulty on a scale from 0 (none) to 10 (extreme).
Figure 1. Sitting in a collapsed position and upright position (photo from: http://news.sfsu.edu/news-story/good-posture-important-physical-and-mental-health)
The students rated the mental math significantly more difficult while sitting slouched than while sitting erect as shown in Figure 2.
Figure 2. The subjective rating of difficulty in performing the serial 7 math subtraction when sitting in a collapsed or upright position.
For the students with the lowest 30% test anxiety, math difficulty and blanking out scores, there was no significant difference between slouched and erect positions in mental math performance. More importantly, students with the highest 30% test anxiety, math difficulty and blanking out scores rated the math task significantly more difficult and some could not do it at all and blanked out in the slouched position as compared to the erect position as shown in Figure 3.
Figure 3. Effect of posture on math performance for students with test anxiety, math difficulty and blanking out.
The students with the highest test anxiety, math difficulty and blanking out scores also reported significantly more somatic symptoms as compared with those with the lowest scores as shown in Figure 4.
Figure 4. Self-reported symptoms associated with the highest and lowest 30% of summed test anxiety, math difficulty and blanking out.
Posture affects mental math and inhibit abstract thinking. By incorporating posture changes clinicians and teachers may help students improve performance. The slouched position was associated with increased difficulty in performing a math subtraction task for 15 seconds, especially for students reporting higher test anxiety, math difficulty and blanking out on exams. In contrast, slouched position had no significant effect on students who reported that they were not stressed about performance. For participants who report higher test anxiety, math difficulty and blanking out they also reported significant increase in breathing difficulty, neck and shoulder tension, headaches, depression and anxiety. Most likely, the students attribute physiological reactions such as increased heart rate and breathing changes negatively, which amplifies their negative self-perception and exacerbates their anxiety symptoms which then may inhibit their cognitive ability to perform on math tasks.
The slouched position combined with the somatic symptoms activate are part of the a “defense reaction.” The slouch posture evokes a classically conditioned response to protect oneself under conditions of perceived physical threat. The activation of this defense pattern is associated with reduced levels of abstract thinking and frontal cortical deactivation as observed in this study. This biological defense response is triggered when the person expects the situation to be ‘dangerous’ and include conditions of social-evaluative threat. By changing posture to an erect/upright posture appears to inhibit the defense reaction; thus, the person may perform better on cognitive tasks.
Head-upright/erect postures may make it easier to access ‘positive and empowering’ thoughts and memories, thereby helping students, especially those who are anxious or fearful of math and blank-out during exams, Anxious students who also slouch may benefit from training with a posture feedback devices such as the UpRight Go™. We recommend that students use posture feedback to become aware of the situations that are associated with slouching, such as ergonomic factors (looking down at the screen), being tired, or having depressive thoughts or feeling of powerless and defeat.
The moment students experience the feedback that they are slouching, they become aware and have the option to shift to an upright posture and perform interventions to counter the factors that caused the slouching. These interventions included ergonomic changes of their computer or laptop, transforming self-critical thoughts to empowering thoughts, or taking a break or performing movements. When students practice these interventions for four weeks, they report an increase of confidence, decrease in stress levels and an improvement in health and performance (Colombo et al, 2017; Harvey et al, in press). Equally important is to teach the participants self-regulation strategies such as slower breathing, heart rate variability training, and muscle relaxation to reduce symptoms. The training needs to be generalized and practiced at home, school or work.
We recommend that students guide themselves through the posture positions as described in this research while performing mental math to experience how posture impacts performance. This experiential practice may increase motivation to be tall since the participant can now have a choice based upon self-experience.
Take home message echoes what your mother said, “Don’t slouch. Sit up tall!”
- If you feel secure and safe, posture has little to no effect on performance–you can be collapsed or slouched.
- If you are anxious and fearful, sitting tall/erect may improve your performance.
- If you want to become aware when you slouch, posture feedback from a wearable posture feedback device such as an UpRight Go can provide vibration feedback each time you slouch. The feedback can be the reminder to sit tall and change your thoughts.
- If you automatically slouch while working at the computer or sitting in chair, change your furniture so that you sit in an upright position while studying or watching digital devices.
- If you experience significant somatic symptoms (e.g., headaches, breathing difficulty, neck and shoulder tension, or depression and anxiety) learn self-regulation skills such as slower diaphragmatic breathing and heartrate variability training in conjunction with transforming negative self-talk to positive self-talk to improve performance.
Changing posture may also impact other areas of one’s life besides improving math performance as illustrated by the report from a mother of ten-year old boy.
”At the moment I am trying to be aware of the situation in front of me rather that reacting to it. For example, yesterday my son who is 10 had a bad mood and I did not know what had happened, and he at first refused to tell me. Because I was aware of the posture information I could help him open up by making him change his posture without knowing. He became more open and told me what had happened earlier and I could help him move forward.”
Colombo, S., Joy, M., Mason, L., Peper, E., Harvey, R., & Booiman, A.C. (2017). Posture Change Feedback Training and its Effect on Health. Poster presented at the 48th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Chicago, IL March, 2017. Abstract published in Applied Psychophysiology and Biofeedback.42(2), 147.
Harvey, R., Mason, L., Joy, M., & Peper, E. (in press). Effect of Posture Feedback Training on Health, Applied Psychophysiology and Biofeedback.
In a superb meta-analysis, Professor Ping-Tao Tseng and colleagues (2018), found that breast feeding reduces the risk of ADHD. The longer the breast feeding was the sole food source, the lower the risk of ADHD. Read the complete article, Material breastfeeding and attention-deficit/hyperactivity disorders in children: a meta-analysis.
One should not be surprised by this finding– breastmilk has been the primary food source for babies since the dawn of human evolution. To accept that formula is as good as breast milk is foolish. Breast milk provides the essential nutrients for infants’ growth, contains the appropriate fatty acids for brain development, and the bioactive factors to protect the baby against disease (Oddy, 2001). It modulates the sleep wake cycle since the evening breast milk contains nucleotides that promote baby’s sleep which are different from morning breast milk that promotes wakefulness (Sanchez et al, 2009). In addition, it reduces the risk of asthma, eczema, and allergic rhinitis (Lodge et al, 2015). Despite the commercial advertisements that formal is as good as breast milk, it contributes to neural malnutrition. That babies do develop with formula is a remarkable demonstration of human adaptability.
Food is our building blocks. When we consume low quality foods, we may increase the risk of developing illness. This is analogous to using superb building materials when constructing a house as the building is more resilient and may better survive the assault from the environment such as termites, storms, or earthquakes than if built from inferior materials.
People, businesses and government have a choice. We can pay the upfront costs to support women to breastfeed their babies for a year by providing paid leave from their jobs or pay much higher long term costs to remediate and treat the deficiencies induced by not supporting breast feeding.
If you are concerned about your child’s future health and want to reduce the risk of ADHD, asthma, eczema, or allergic rhinitis there is only one recommendation: Breast feed your baby for a long time period.
Lodge, C., Tan, D.J., Lau, M.X.., Dai, X., Tham, R., Lowe, A.J., Bowatte, G., Allen, K.J. & Dharmage, S.C. (2015). Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatrica, 104(467), 38-53.
Sanchez, C.L., Cubero, J., Sanchez, J., Chanclon, B., Rivero, M., Rodriguez, A.B., & Barriga, C. (2009). The possible role of human milk nucleotides as sleep inducers. Nutritional Neuroscience, 12(1), 2-9.
Tseng, P-T., Yen, C-F., Chen, Y-W., Chen, Y-W, Stubbs, B., Carvalho, A.F., Whiteley, P., Chu, C-S…. (2018). Maternal breastfeeding and attention-deficit/hyperactivity disorder in children: a meta-analysis. European Child & Adolescent Psychiatry,
Richard Harvey, PhD and Erik Peper, PhD
In a technologically modern world, many people have the option of spending 24 hours a day/ 7 days a week continuously interacting via telephone, text, work and personal emails or internet websites and various social media platforms such as Facebook, What’s App, Instagram, Twitter, LinkedIn and Snapchat. How many people do we know who work too many hours, watch too many episodes on digital screens, commute too many hours, or fill loneliness with online versions of retail therapy? In the rush of work-a-day survival as well as being nudged and bombarded with social media notifications, or advertisements for material goods, we forget to nurture meaningful friendships and family relationships (Peper and Harvey, 2018). The following ‘values clarification’ practice may help us identify what is most important to us and help keep sight of those things that are most relevant in our lives (Hofmann, 2008; Knott, Ribar, & Duson, 1989; Twohig & Crosby, 2009;. Peper, 2014).
Give yourself about 12 minutes of uninterrupted time to do this practice. Do this practice by yourself, in a group, or with family and friends. Have a piece of paper ready. Be guided by the two video clips at the end of the blog. Begin with the Touch Relaxation and Regeneration Practice to relax and let go of thoughts and worries, then follow it with the Value Clarification Practice.
Touch Relaxation and Regeneration Practice
Turn off your cell phone and let other know not to interrupt for the next 12 minutes, then engage in the following six-minute relaxation exercise. If your attention wanders during the practice, then bring your attention back to the various sensations in your body.
- Sit comfortably, then lift your arms from your lap, holding them parallel to the floor and tighten your arms while making a fist in each hand. While holding your fists tightly closed, keep breathing for a total of 10 seconds before dropping the arms to your lap while you relax all of your muscles. Attend for 20 seconds to the changing sensations in arms and hands as they relax. If your attention wanders bring it back to the sensations in your arm and hands.
- Tighten your buttock muscles and bend your ankles so that the toes move upwards in a direction towards your knees. Keep breathing and hold your toes upwards for 10 seconds and then let the toes move down to the floor, letting go and relaxing all the muscles of the lower trunk and legs. Feel your knees widening and feel your buttock muscles relaxing. Continue attending to the body and muscle sensations for the next 20 seconds. If your attention wanders bring it back to the sensations in your body.
- Tighten your whole body by pressing your knees together, lifting your arms up from your lap, making a fist and wrinkling your face. Hold the tension while continuing to breath for 10 seconds. Let go and relax and feel the whole body sinking and relaxing and being supported by the chair for the next 20 seconds.
- Bring your right hand to your left shoulder. Over the next 10 seconds, inhale for three or four seconds and as you exhale for five or six seconds, with your right hand stroke down your left arm from your shoulder to past your hand. Imagine that the exhaled air is flowing through your arm and out your hand. Repeat at least once more.
- Bring your left hand to your right shoulder. Inhale for three or four seconds and as you exhale for five or six seconds with your left hand stroke down your right arm from your shoulder to past your hand. Imagine that the exhaled air is flowing through your arm and out your hand. Repeat at least once more.
- Bring both hands to the sides of your hips. Inhale for three or four seconds and as you exhale for five or six seconds stroke your legs with your hands from the hips to the ankles. Imagine that the exhaled air is flowing through your legs and out your feet. Repeat a least once more.
- Close your eyes and inhale for three or four seconds, then hold your breath for seven seconds slowly exhale for eight seconds. Imagine as you exhale the air flowing through your arms and out your hands and through your legs and out your feet. Continue breathing easily and slowly such as inhaling for three or four seconds, and out for five to seven seconds. If your attention wanders just bring it back to the sensations going down your arms and legs. Feel the relaxation and peacefulness.
- Take another deep breath and then stretch and continue with the Value Clarification
Value Clarification Practice
Get the paper and pen and do the following Value Clarification Practice.
- Quickly (e.g. 30-60 seconds) list the 10 most important things in your life. For the activity to work, the list must contain 10 important things that may be concrete or abstract, ranging from material things such as a smart phone or a car to immaterial things such as family, love, god, health… If you need to, break up a larger category into smaller pieces. For example, if one item on the list is family, and you only have seven items on the list, assuming you have a family of four, then identify separate family members in order to complete a list of 10 important things.
- To start off, in only 10 seconds, please cross off three items from the list, then explain why you removed those three. If done in a group of people turn to the person explain why you made these choices.
- Next, in only 10 seconds, please cross off three more, then explain why you kept what you kept. If done in a group of people turn to the person explain why you made these choices.
- Finally, in only 10 seconds, please cross off three more, then reveal the one most important thing on your list. Share your choice for the item you kept and how you felt while crossing items from the list or keeping them.
- When engaging with this type of values clarification practice, please remind yourself and others that the items on the list were never gone, they are always in your life to the extent that you can honor the presence of those things in your life.
We have done these exercises with thousands of student and adults. The most common final item on the list is family or an individual family member. Sometimes, categories such as health or god appear, however it is extremely rare that material items make it to the final round. For example, no one would report that their last item is their job, their bank account, their house, or their smart phone. It is common that people have difficulty choosing the last item on their list, often taking more than 10 seconds to choose. For example, they find that they cannot choose between eliminating individual family members. For those who find the activity too difficult, remind them that the exercise is voluntary and meant as a ‘thought experiment’ which they may stop at any time.
Reflect how much of your time is spent nurturing what is most important to you? In many cases we feel compelled to finish some employment priorities instead of making time for nurturing our family relationship. And when we become overwhelmed with work demands, we retreat to sooth our difficulties by checking our email or browsing social media rather than supporting the family connections that are so important to us.
Organize an action plan to honor and support your commitment to the items on your list that you value the most. If possible let other people know what you are doing.
- Describe in detail what you will do in real life and in real time in service to honor and support your relationships with the things that you value.
- Describe in detail what you will do, when you will do it, with whom you will do it, at what time you will do it, and anticipate what will get in the way of doing it. For example, how will you resolve any conflicts between what you plan and what you actually do when there is not enough time to carry out your plans?
- Schedule a time during the following week for feedback about your plans to honor and support the things you value.
Many people experience that it is challenging to make time to honor and support their primary values given the ongoing demands of daily living. To be congruent with our values means making ongoing choices such as listening and sharing experiences with your partner versus binging on videos or, using your smartphone for answering email or texting instead of watching your child play ball.
The values you previously identified are similar to those identified by patients who are in hospice and dying. For them as they look back on their lives, the five most common regret are (Ware, 2009; Ware, 2012):
- I wish I’d the courage to live a life true to myself, not the life others expected of me.
- I wish I hadn’t worked so hard.
- I wish I had the courage to express my feelings.
- I wish I had stayed in touch with my friends.
- I wish I had let myself be happier.
Take the time to plan actions that support your identified values. Feel free to watch the following videos that guide you through the activities described here.
Hofmann, S.G. (2008). Acceptance and commitment therapy: New wave or Morita therapy?. Clinical Psychology: Science and Practice, 15(4), 280-285. https://doi.org/10.1111/j.1468-2850.2008.00138.x
Knott, J.E., Ribar, M.C. & Duson, B.M. (1989). Thanatopics: Activities and Exercises for Confronting Death, Lexington Books: Lexington, MA. https://www.amazon.com/Thanatopics-Activities-Exercise-Confronting-Death/dp/066920871X
Peper, E. (October 19, 2014). Choices-Creating meaningful days. https://peperperspective.com/2014/10/19/choices-creating-meaningful-days/
Peper, E. & Harvey, R. (2018). Digital addiction: increased loneliness, depression, and anxiety. NeuroRegulation. 5(1),3–8. doi:10.15540/nr.5.1.3 http://www.neuroregulation.org/article/view/18189/11842
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