Freeing the neck and shoulders*

Stress, incorrect posture, poor vision and not knowing how to relax may all contribute to neck and shoulder tension.   More than 30% of all adults experience neck pain and 45% of girls and 19% of boys 18 year old, report back, neck and shoulder pain (Cohen, 2015; Côté, Cassidy, & Carroll, 2003; Hakala, Rimpelä, Salminen, Virtanen, & Rimpelä, 2002).  Shoulder pain affects almost a quarter of adults in the Australian community (Hill et al, 2010). Most employees working at the computer experience neck and shoulder tenderness and pain (Brandt et al, 2014), more than 33% of European workers complained of back-ache (The European Agency for Safety and Health at Work, 2004), more than 25% of Europeans experience work-related neck-shoulder pain, and 15% experience work-related arm pain (Blatter & De Kraker, 2005; Eijckelhof et al, 2013), and more than 90% of college students report some muscular discomfort at the end of the semester especially if they work on the computer (Peper & Harvey, 2008).

The stiffness in the neck and shoulders or the escalating headache at the end of the day may be the result of craning the head more and more forward or concentrating too long on the computer screen. Or, we are unaware that we unknowingly tighten muscles not necessary for the task performance—for example, hunching our shoulders or holding our breath. This misdirected effort is usually unconscious, and unfortunately, can lead to fatigue, soreness, and a buildup of additional muscle tension.

The stiffness in the neck and shoulders or the escalating headache at the end of the day may be the result of craning the head more and more forward or concentrating too long on the computer screen. Poor posture or compromised vision can contribute to discomfort; however, in many cases stress is major factor.  Tightening the neck and shoulders is a protective biological response to danger.  Danger that for thousands of years ago evoke a biological defense reaction so that we could run from or fight from the predator.  The predator is now symbolic, a deadline to meet, having hurry up sickness with too many things to do, anticipating a conflict with your partner or co-worker, worrying how your child is doing in school, or struggling to have enough money to pay for the rent.

Mind-set also plays a role. When we’re anxious, angry, or frustrated most of us tighten the muscles at the back of the neck. We can also experience this when insecure, afraid or worrying about what will happen next. Although this is a normal pattern, anticipating the worst can make us stressed. Thus, implement self-care strategies to prevent the occurrence of discomfort.

What can you do to free up the neck and shoulder? 

Become aware what factors precede the neck and shoulder tension. For a week monitor yourself, keep a log during the day and observe what situations occur that precede the neck and should discomfort. If the situation is mainly caused by:

  • Immobility while sitting and being captured by the screen. Interrupt sitting every 15 to 20 minutes and move such as walking around while swinging your arms.
  • Ergonomic factors such as looking down at the computer or laptop screen while working. Change your work environment to optimize the ergonomics such as using a detached keyboard and raising the laptop screen so that the top of the screen is at eyebrow level.
  • Emotional factors. Learn strategies to let go of the negative emotions and do problem solving. Take a slow deep breath and as you exhale imagine the stressor to flow out and away from you. Be willing to explore and change ask yourself: “What do I have to have to lose to change?”, “Who or what is that pain in my neck?”, or “What am I protecting by being so rigid?”

Regardless of the cause, explore the following five relaxation and stretching exercises to free up the neck and shoulders. Be gentle, do not force and stop if your discomfort increases. When moving, continue to breathe.

1. WIGGLE. Wiggle and shake your body many times during the day.  The movements can be done surreptitiously such as, moving your feet back and forth in circles or tapping feet to the beat of your favorite music, slightly arching or curling your spine, sifting the weight on your buttock from one to the other, dropping your hands along your side while moving and rotating your fingers and wrists, rotating your head and neck in small unpredictable circles, or gently bouncing your shoulders up and down as if you are giggling. Every ten minutes, wiggle to facilitate blood flow and muscle relaxation.

2. SHAKE AND BOUNCE. Stand up, bend your knees slightly, and let your arms hang along your trunk.  Gently bounce your body up and down by bending and straightening your knees. Allow the whole body to shake and move for about one minute like a raggedy Ann doll. Then stop bouncing and alternately reach up with your hand and arm to the ceiling and then let the arm drop. Be sure to continue to breathe.

3. ROTATION MOVEMENT (Adapted from the work by Sue Wilson and reproduced by permission from: Gorter, R. & Peper, E. (2011). Fighting Cancer- A Nontoxic Approach to Treatment).

Pre-assessment:  Stand up and give yourself enough space, so that when you lift your arms to shoulder level and rotate, you don’t touch anything. Continue to stand in the same spot during the exercise as shown in figures 1a and 1b.

Lift your arms and hold them out, so that they are at shoulder level, positioned like airplane wings. Gently rotate your arms to the left as far as you can without discomfort. Look along your left arm to your fingertips and beyond to a spot on the wall and remember that spot. Rotate back to center and drop your arms to your sides and relax.

 

Figure 1Figures 1a and 1b. Rotating the arms as far as is comfortable (photos by Jana Asenbrennerova)

Movement practice. Again, lift your arms to the side so that they are like airplane wings pointing to the left and right. Gently rotate your trunk, keeping your arms fixed at a right angle to your body. Rotate your arms to the right and turn your head to the left. Then reverse the direction and rotate your arms in a fixed position to the left and turn your head to the right. Do not try to stretch or push yourself. Repeat the sequence three times in each direction and then drop your arms to your sides and relax.

With your arms at your sides, lift your shoulders toward your ears while you keep your neck relaxed. Feel the tension in your shoulders, and hold your shoulder up for five seconds. Let your shoulders drop and relax. Then relax even more. Stay relaxed for ten seconds.

Repeat this sequence, lifting, dropping, and relaxing your shoulders two more times. Remember to keep breathing; and each time you drop your shoulders, relax even more after they have dropped.

Repeat the same sequence, but this time, very slowly lift your shoulders so that it takes five seconds to raise them to your ears while you continue to breathe. Keep relaxing your neck and feel the tension just in your shoulders. Then hold the tension for a count of three. Now relax your shoulders very slowly so that it takes five seconds to lower them. Once they are lowered, relax them even more and stay relaxed for five seconds. Repeat this sequence two more times.

Now raise your shoulders quickly toward your ears, feel the tension in your upper shoulders, and hold it for the count of five. Let the tension go and relax. Just let your shoulders drop. Relax, and then relax even more.

Post-assessment.  Lift your arms up to the side so that they are at shoulder level and are positioned like airplane wings. Gently rotate without discomfort to the left as far as you can while you look along your left arm to your fingers and beyond to a spot on the wall.

 Almost everyone reports that when they rotate the last time, they rotated significantly further than the first time. The increased flexibility is the result of loosening your shoulder muscles.

 

4. TAPPING FEET (adapted from the work of Servaas Mes)

Diagonal movements underlie human coordination and if your coordination is in sync, this will happen as a reflex without thought. There are many examples of these basic reflexes, all based on diagonal coordination such as arm and leg movement while walking. To restore this coordination, we use exercises that emphasize diagonal movements. This will help you reverse unnecessary tension and use your body more efficiently and thereby reducing “sensory motor amnesia” and dysponesis (Hanna, 2004). Remember to do the practices without straining, with a sense of freedom, while you continue relaxed breathing. If you feel pain, you have gone too far, and you’ll want to ease up a bit. This practice offers brief, simple practices to avoid and reverse dysfunctional patterns of bracing and tension and reduce discomfort. Practicing healthy patterns of movement can reestablish normal tone and reduce tension and pain. This is a light series of movements that involve tapping your feet and turning your head. You’ll be able to do the entire exercise in less than twenty seconds.

Pre-assessment. Sit erect at the edge of the chair with your hands on your lap and your feet shoulders’ width apart, with your heels beneath your knees.

First, notice your flexibility by gently rotating your head to the right as far as you can. Now look at a spot on the wall as a measure of how far you can comfortably turn your head and remember that spot. Then rotate back to the center.

Practicing rotating feet and head. Become familiar with the feet movement, lift the balls of your feet so your feet are resting on your heels. Lightly pivot the balls of your feet to the right, tap the floor, and then stop and relax your feet for just a second. Now lift the balls of your feet, pivot your feet to the left, tap, relax, and pivot back to the right.

Just let your knees follow the movement naturally. This is a series of ten light, quick, relaxed pivoting movements—each pivot and tap takes only about one or two seconds.

Add head rotation. Turn your head in the opposite direction of your feet. This series of movements provides effortless stretches that you can do in less than half a minute as shown in figures 2a and 2b.

Figure 2Figures 2a and 2b. Rotating the feet and head in opposite directions (photos by Gary Palmer)

When you’re facing right, move your feet to the left and lightly tap. Then face left and move your feet to the right and tap.

  • Continue the tapping movement, but each time pivot your head in the opposite direction. Don’t try to stretch or force the movement.
  • Do this sequence ten times. Now stop, face straight head, relax your legs, and just keep breathing.

Post assessment. Rotate your head to the right as far as you can see and look at a spot on the wall. Notice how much more flexibility/rotation you have achieved.

Almost everyone reports being able to rotate significantly farther after the exercise than before. They also report that they have less stiffness in their neck and shoulders.

5. SHOULDER AWARENESS PRACTICE.  Sit comfortably with your hands on your lap.  Allow your jaw to hang loose and breathe diaphragmatically.  Continue to breathe slowly as you do the following:

  • Shrug, raising your shoulders towards your ears to 70% of maximum   effort and hold them up for about 10 seconds (note the sensations of tension).
  • Let your shoulders drop and relax for 10 to 20 seconds
  • Shrug, raising your shoulders towards your ears to 50% of maximum effort and hold them up for about 10 seconds (note the sensations of tension).
  • Let your shoulders drop and relax for 10 to 20 seconds
  • Shrug, raising your shoulders towards your ears to 25% of maximum effort and hold them up for about 10 seconds (note the sensations of tension).
  • Let your shoulders drop and relax for 10 to 20 seconds
  • Shrug, raising your shoulders towards ears to 5% of maximum effort and hold them up for about 10 seconds (note the sensations of tension).
  • Let your shoulders drop and relax for 10 to 20 seconds
  • Pull your shoulders down to 25% of maximum effort and hold them up for about 10 seconds (note the sensations of tension).
  • Allow your shoulders to come back up and relax for 10 to 20 seconds

Remember to relax your shoulders completely after each incremental tightening. If you tend to hold your breath while raising your shoulders, gently exhale and continue to breathe.  When you return to work, check in occasionally with your shoulders and ask yourself if you can feel any of the sensations of tension.  If so, drop your shoulders and relax for a few seconds before resuming your tasks.

In summary, when employees and students change their environment and integrate many movements during the day, they report a significant decrease in neck and shoulder discomfort and an increase in energy and health.  As one employee reported, after taking many short movement breaks while working at the computer, that he no longer felt tired at the end of the day, “Now, there is life after five”.

To explore how prevent and reverse the automatic somatic stress reactions, read Thomas Hanna‘s book, Somatics: Reawakening The Mind’s Control of Movement, Flexibility, and Health For easy to do neck and shoulder  guided instructions stretches, see the following ebsite:  http://greatist.com/move/stretches-for-tight-shoulders

References:

Blatter, B. M., & Kraker, H. D. (2005). Prevalentiecijfers van RSI-klachten en het vóórkomen van risicofactoren in 15 Europese landen. Tijdschrift voor gezondheidswetenschappen, 1, 83, 8-15.  

Brandt, M., Sundstrup, E., Jakobsen, M. D., Jay, K., Colado, J. C., Wang, Y., … & Andersen, L. L. (2014). Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain research and treatment, 2014.

Cohen, S. P. (2015, February). Epidemiology, diagnosis, and treatment of neck pain. In Mayo Clinic Proceedings (Vol. 90, No. 2, pp. 284-299). Elsevier. 

Côté, P., Cassidy, J. D., & Carroll, L. (2003). The epidemiology of neck pain: what we have learned from our population-based studies. The Journal of the Canadian Chiropractic Association47(4), 284. http://www.pain-initiative-un.org/doc-

Eijckelhof, B. H. W., Huysmans, M. A., Garza, J. B., Blatter, B. M., Van Dieën, J. H., Dennerlein, J. T., & Van Der Beek, A. J. (2013). The effects of workplace stressors on muscle activity in the neck-shoulder and forearm muscles during computer work: A systematic review and meta-analysis. European Journal of Applied Physiology, 113(12), 2897-2912.

European Agency for Safety and Health at Work (2004). http://europa.eu.int/comm/employment_social/news/2004/nov/musculoskeletaldisorders_en.html

Gorter, R. & Peper, E. (2011). Fighting Cancer- A Nontoxic Approach to Treatment. Berkeley: North Atlantic.

Hakala, P., Rimpelä, A., Salminen, J. J., Virtanen, S. M., & Rimpelä, M. (2002). Back, neck, and shoulder pain in Finnish adolescents: national cross sectional surveys. Bmj325(7367), 743.

Hanna, T. (2004). Somatics-Reawakening The Mind’s Control Of Movement, Flexibility, And Health Boston: Da Capo Press.

Hill, C. L., Gill, T. K., Shanahan, E. M., & Taylor, A. W. (2010). Prevalence and correlates of shoulder pain and stiffness in a population‐based study: the North West Adelaide Health Study. International journal of rheumatic diseases13(3), 215-222.

Paoli, P., Merllié, D., & Fundação Europeia para a Melhoria das Condições de Vida e de Trabalho. (2001). Troisième enquête européenne sur les conditions de travail, 2000.

Peper, E. & Harvey, R. (2008). From technostress to technohealth.  Japanese Journal of Biofeedback Research, 35(2), 107-114.

*I thank Sue Wilson and Servaas Mes for teaching me these somatic practices.


Be a tree and share gratitude

 

It was late in the afternoon and I was tired. A knock on my office door.  One of my students came in and started to read to me from a card.  “I want to thank you for all your help in my self-healing project…I didn’t know the improvements were possible for me in a span of 5 weeks…. I thank you so much for encouraging and supporting me…. I have taken back control of myself and continue to make new discoveries about my identity and find my own happiness and fulfillment… Thank you so much.”

I was deeply touched and my eyes started to fill with tears. At that moment, I felt so appreciated. We hugged. My tiredness disappeared and I felt at peace.

In a world where we are constantly bombarded by negative, fearful stories and images, we forget that our response to these stories impacts our health.  When people watch fear eliciting videos, their heart rate increases and their whole body responds with a defense reaction as if they are personally being threatened (Kreibig, Wilhelm, Roth, & Gross, 2007). Afterwards, we may continue to interpret and react to new stimuli as if they are the same as what happened in the video.  For example, while watching a horror movie, we may hold our breath, perspire and feel our heart racing; however, when we leave the theatre and walk down the street by ourselves, we continue to be afraid and react to stimuli as if what happened in video will now happen to us.

When we feel threatened, our body responds to defend itself. It reduces the blood flow to the gastrointestinal tract where digestion is taking place and sends it to large muscles so that we can run and fight.  When threatened, most of our resources shifted to the processes that promote survival while withdrawing it from processes that do not lead to immediate survival such as digestion or regeneration (Sapolsky, 2004).  From an evolutionary perspective, why spent resources to heal yourself, enhance your immune system or digest your food when you will become someone else’s lunch!

The more we feel threatened, the more we will interpret the events around us negatively. We become more stressed, defensive, and pessimistic.  If this response occurs frequently, it contributes to increased morbidity and mortality. We may not be in control of external or personal event; however, we may be able to learn how to change our reactions to these events.  It is our reactions and interpretations of the event that contributes to our ongoing stress responses. The stressor can be labeled as crisis or opportunity.

Mobilize your own healing when you take charge. When 92 students as part of a class at San Francisco State University practiced self-healing skill, most reported significant improvements in their health as shown in Figure 1.

 

figure1

Figure 1.  Average self-reported improvement after practicing self-healing skills for at least four weeks. (Reproduced with permission from Tseng, Abili, Peper, & Harvey, 2016).

A strategy that many students used was to interrupt their cascading automatic negative reactions. The moment they became aware of their negative thought and body slumping, they interrupted the process and practiced a very short relaxation or meditation technique.

Implement what the students have done by taking charge of your stress responses and depressive thoughts by 1) beginning the day with a relaxation technique, Relax Body-Mind, 2) interrupting the automatic response to stressors with a rapid stress reduction technique, Breathe and be a Tree, and 3) increasing vitality by the practice, Share Gratitude (Gorter & Peper, 2011).

Relax Body-Mind to start the day*

  • Lie down or sit and close your eyes. During the practice if your attention wanders, just bring it back to that part of the body you are asked to tighten or let go.
  • Wrinkle your face for ten seconds while continuing to breathe. Let go and relax for ten seconds.
  • Bring your hands to your face with the fingers touching the forehead while continuing to breathe. While exhaling, pull your fingers down your face so that you feel your jaw being pulled down and relaxing. Drop your hands to your lap. Feel the sensations in your face and your fingers for ten seconds.
  • Make a fist with your hands and lift them slightly up from your lap while continuing to breathe. Feel the sensations of tension in your hands, arms and shoulders for ten seconds. Let go and relax by allowing the arms to drop to your lap and relax. Feel the sensations change in your hands, arms and shoulders for ten seconds.
  • Tighten your buttocks and flex your ankles so that the toes are reaching upwards to your knees. Hold for ten seconds while continuing to breathe. Let go and relax for ten seconds.
  • Take a big breath while slightly arching your back away from the bed ore chair and expand your stomach while keeping your arms, neck, buttocks and legs relaxed. Hold the breath for twenty seconds. Exhale and let your back relax while allowing the breathing to continue evenly while sensing your body’s contact with the bed or chair for twenty seconds.  Repeat three times.
  • Gently shake your arms and legs for ten seconds while continuing to breathe. Let go and relax. Feel the tingling sensations in your arms and legs for 20 seconds.
  • Evoke a past positive memory where you felt at peace and nurtured.
  • Stretch and get up. Know you have done the first self-healing step of the day.

*Be gentle to yourself and stop the tightening or breath holding if it feels uncomfortable.

Breathe and be a Tree to dissipate stress and focus on growth

  • Look at a tall tree and realize that you are like a tree that is rooted in the ground and reaching upward to the light. It continues to grow even though it has been buffeted by storms.
  • When you become aware of being stressed, exhale slowly and inhale so that your stomach expands, the while slowly exhaling, look upward to the top of a real or imagined tree, admire the upper branches and leaves that are reaching towards the light and smile.
  • Remember that even though you started to respond to a stressor, the stressor will pass just like storms battering the tree. By breathing and looking upward, accept what happened and know you are growing just like the tree.

Share Gratitude to increase vitality and health (adapted from Professor Martin Seligman’s 2004 TED presentation, The new era of positive psychology).

  • Think of someone who did something for you that impacted your life in a positive direction and whom you never properly thanked. This could be a neighbor, teacher, friend, parent, or other family members.
  • Write a 300-word testimonial describing specifically what the person did and how it positively impacted you and changed the course of your life.
  • Arrange an actual face-to-face meeting with the person. Tell them you would like to see him/her. If they are far away, arrange a Skype call where you can actually see and hear him/her. Do not do it by email or texting.
  • Meet with the person and read the testimonial to her/him.
  • It may seem awkward to read the testimonial, after you have done it, you will feel closer and more deeply connected to the person. Moreover, the person to whom you read the testimonial, will usually feel deeply touched. Both your hearts will open.

point-reyes-trees

References:

Gorter, R. & Peper, E. (2011). Fighting cancer: A nontoxic approach to treatment. Berkeley, CA: North Atlantic Books, 205-207.

Kreibig, S. D., Wilhelm, F. H., Roth, W. T., & Gross, J. J. (2007). Cardiovascular, electrodermal, and respiratory response patterns to fear‐and sadness‐inducing films. Psychophysiology44(5), 787-806.Kreibig, Sylvia D., Frank H. Wilhelm, Walton T. Roth, and James J. Gross. “Cardiovascular, electrodermal, and respiratory response patterns to fear‐and sadness‐inducing films.” Psychophysiology 44, no. 5 (2007): 787-806.

Sapolsky, R. (2004). Why Zebras Don’t Get Ulcers. New York: Owl Books

Seligman, M. (2014). The new era of positive psychology. Ted Talk. Retrieved, December 10, 2016. https://www.ted.com/talks/martin_seligman_on_the_state_of_psychology

Tseng, C., Abili, R., Peper, E., & Harvey, R. (2016). Reducing Acne-Stress and an integrated self-healing approach. Appl Psychophysiol Biofeedback, 4(4), 445.)

 

 


Education versus treatment for self-healing: Eliminating a headache[1]

“I have had headaches for six years, at first occurring almost every day. When I got put on an antidepressant, they slowed to about 3 times a week (sometimes more) and continued this way until I learned relaxation techniques. I am 20 years old and now headache free. Everyone should have this educational opportunity to heal themselves.”  -Melinda, a 20 year old student

Health and wellness is a basic right for all people. When students learn stress management skills which include awareness of stress, progressive muscle relaxation, Autogenic phrases, slower breathing, posture change, transforming internal language, self-healing imagery, the role of diet, exercise embedded within an evolutionary perspective  as part of a college class their health often improves. When students systematically applied these self-awareness techniques to address a self-selected illness or health behavior (e.g., eczema, diet, exercise, insomnia, or migraine headaches), 80% reported significant improvement in their health during that semester (Peper et al., 2014b; Tseng, et al., 2016).  The semester long program is based upon the practices described in the book, Make Health Happen, (Peper, Gibney, & Holt, 2002).  

The benefits often last beyond the semester. Numerous students reported remarkable outcomes at follow-up many months after the class had ended because they had mastered the self-regulation skills and continued to implement these skills into their daily lives.  The educational model utilized in holistic health courses is often different from the clinical/treatment model.

Educational approach:   I am a student and I have an illness (most of me is healthy and only part of me is sick).

Clinical treatment approach:  I am a patient and I am sick (all of me is sick)

Some of the concepts underlying the differences between the educational and the clinical approach are shown in Table 1.

Educational approach Clinic/treatment approach
Focuses on growth and  learning Focuses on remediation
Focuses on what is right Focuses on what is wrong
Focuses on what people can do for themselves Focuses on how the therapist can help patients
Assumes students as being competent Implies patients are damaged and incompetent
Students defined as being competent to master the skills Patients defined as requiring others to help them
Encourages active participation in the healing process Assumes passive participation in the healing process
Students keep logs and write integrative and reflective papers, which encourage insight and awareness Patients usually do not keep logs nor are asked to reflect at the end of treatment to see which factors contributed to success
Students meet in small groups, develop social support and perspective Patients meet only with practitioners and stay isolated
Students experience an increased sense of mastery and empowerment Patients experience no change or possibly a decrease in sense of mastery
Students develop skills and become equal or better than the instructor Patients are healed, but therapist is always seen as more competent than patient
Students can become  colleagues and friends with their teachers Patients cannot become  friends of the therapist and thus are always distanced

Table 1. Comparison of an educational versus clinical/treatment approach

The educational approach focuses on mastering skills and empowerment. As part of the course work, students become more mindful of their health behavior patterns and gradually better able to transform  their previously covert harm promoting patterns. This educational approach is illustrated in a case report which describes how a student reduced her chronic migraines.

Case Example: Elimination of Chronic Migraines

Melinda, a 20-year-old female student, experienced four to five chronic migraines per week since age 14.  A neurologist had prescribed several medications including Imitrex (used to treat migraines) and Topamax (used to prevent seizures as well as migraine headaches), although they were ineffective in treating her migraines. Nortriptyline (a tricyclic antidepressant) and Excedrin Migraine (which contains caffeine, aspirin, and acetaminophen) reduced the frequency of symptoms to three times per week.

She was enrolled in a university biofeedback class that focused on learning self-regulation and biofeedback skills. All these students were taught the fundamentals of biofeedback and practiced Autogenic Training (AT) every day during the semester (Luthe, 1979; Luthe & Schultz, 1969; Peper & Williams, 1980).

In the class, students practiced with surface electromyography (SEMG) feedback to identify the presence of shoulder muscle overexertion (dysponesis), as well as awareness of minimum muscle tension.  Additional practices included hand warming, awareness of thoracic and diaphragmatic breathing, and other biofeedback or somatic awareness approaches. In parallel with awareness of physical sensations, students practiced behavioral awareness such as alternating between a slouching body posture (associated with feeling self-critical and powerless) and an upright body posture (associated with feeling powerful and in control). Psychological awareness was focused on transforming negative thoughts and self-judgments to positive empowering thoughts (Harvey and Peper, 2011; Peper et al., 2014a; Peper et al, 2015).  Taken together, students systematically increased awareness of physical, behavioral, and psychological aspects of their reactions to stress.

The major determinant for success is to generalize training at school, home and at work.  Each time Melinda felt her shoulders tightening, she learned to relax and release the tension in her shoulders, practiced Autogenic Training with the phrase “my neck and shoulders are heavy.”  In addition, whenever she felt her body beginning to slouch or noticed a negative self-critical thought arising in her mind, she shifted her body to an upright empowered posture, and substituted positive thoughts to reduce her cortisol level and increase access to positive thoughts (Carney & Cuddy, 2010; Cuddy, 2012; Tsai, et al., 2016). Postural feedback was also informally given by Melinda’s instructor. Every time the instructor noticed her slouching in class or the hallway, he visually changed his own posture to remind her to be erect.

Results

Melinda’s headaches reduced from between three and five per week before enrolling in the class to zero following the course, as shown in Figure 2. She has learned to shift her posture from slouching to upright and relaxed. In addition, she reported feeling empowered, mentally clear, and her acne cleared up. All medications were eliminated.   At a two year follow-up, she reported that since she took the class, she had only few headaches which were triggered by excessive stress. figure3

Figure 2. Frequency of migraine and the implementation of self-practices.

The major factors that contributed to success were:

  • Becoming aware of muscle tension through the SEMG feedback. Melinda realized that she had tension when she thought she was relaxed.
  • Keeping detailed logs and developing a third person perspective by analyzing her own data and writing a report. A process that encouraged acceptance of self, thereby becoming less judgmental.
  • Acquiring a new belief that she could learn to overcome her headaches, facilitated by class lecture and verbal feedback from the instructor.
  • Taking active control by becoming aware of the initial negative thoughts or sensations and interrupting the escalating chain of negative thoughts and sensations by shifting the attention to positive empowering thoughts and sensations–a process that integrated mindfulness, acceptance and action. Thus, transforming judgmental thoughts into accepting and positive thoughts.
  • Becoming more aware throughout the day, at school and at home, of initial triggers related to body collapse and muscle tension, then changing her body posture and relaxing her shoulders. This awareness was initially developed because the instructor continuously gave feedback whenever she started to slouch in class or when he saw her slouching in the hallways.
  • Practicing many, many times during the day. Namely, increasing her ongoing mindfulness of posture, neck, and shoulder tension, and of negative internal dialogue without judgment.

The benefits of this educational approach is captured by Melinda’s summary, “The combined Autogenic biofeedback awareness and skill with the changes in posture helped me remarkably. It improved my self-esteem, empowerment, reduced my stress, and even improved the quality of my skin. It proves the concept that health is a whole system between mind, body, and spirit. When I listen carefully and act on it, my overall well-being is exceptionally improved.”

References:

Carney, D. R., Cuddy, A. J., & Yap, A. J. (2010). Power posing brief nonverbal displays affect neuroendocrine levels and risk tolerance. Psychological Science, 21(10), 1363-1368.

Cuddy, A. (2012).  Your body language shapes who you are.  Technology, Entertainment, and Design (TED) Talk, available at:  http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are

Harvey, E. & Peper, E. (2011). I thought I was relaxed: The use of SEMG biofeedback for training awareness and control (pp. 144-159). In W. A. Edmonds, & G. Tenenbaum (Eds.), Case studies in applied psychophysiology: Neurofeedback and biofeedback treatments for advances in human performance. West Sussex, UK: Wiley-Blackwell.

Luthe, W. (1979). About the methods of autogenic therapy (pp. 167-186). In E. Peper, S. Ancoli, & M. Quinn, Mind/body integration. New York: Springer.

Luthe, W., & Schultz, J.H. (1969). Autogenic therapy (Vols. 1-6).  New York, NY: Grune and Stratton.

Peper, E., Booiman, A., Lin, I-M., & Shaffer, F. (2014a). Making the unaware aware-Surface electromyography to unmask tension and teach awareness. Biofeedback. 42(1), 16-23.

Peper, E., Gibney, K.H. & Holt. C. (2002).  Make health happen: Training yourself to create wellness.  Dubuque, IA: Kendall-Hunt. ISBN-13: 978-0787293314

Peper, E., Lin, I-M, Harvey, R., Gilbert, M., Gubbala, P., Ratkovich, A., & Fletcher, F. (2014b). Transforming chained behaviors: Case studies of overcoming smoking, eczema and hair pulling (trichotillomania). Biofeedback, 42(4), 154-160.

Peper, E., Nemoto, S., Lin, I-M., & Harvey, R. (2015). Seeing is believing: Biofeedback a tool to enhance motivation for cognitive therapy. Biofeedback, 43(4), 168-172.   doi: 10.5298/1081-5937-43.4.03

Peper, E. & Williams, E.A. (1980). Autogenic therapy (pp. 131-137). In: A. C. Hastings, J. Fadiman,  & J. S. Gordon (Eds.). Health for the whole person. Boulder: Westview Press.

Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23-27.

Tseng, C., Abili, R., Peper, E., & Harvey, R. (2016). Reducing acne-stress and an integrated self-healing approach. Poster presented at the 47th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Seattle WA, March 9-12, 2016.

[1] Adapted from: Peper, E., Miceli, B., & Harvey, R. (2016). Educational Model for Self-healing: Eliminating a Chronic Migraine with Electromyography, Autogenic Training, Posture, and Mindfulness. Biofeedback, 44(3), 130–137. https://biofeedbackhealth.files.wordpress.com/2011/01/a-educational-model-for-self-healing-biofeedback.pdf

 


Your body “tells” of your emotional state

Sweating, finger temperature, muscle tension, breathing, heart rate, posture and other body signals covertly and overtly display your emotional state. The feedback from these signals can facilitate awareness and control to promote your health. Watch my presentation, The skin you’re in and other signals “Tells” of emotional state,   presented at the  TransTech-Transformative Technology Conference, Sofia University, Palo Alto, CA, Oct 14, 2016.

 


Increase energy*

Are you full of pep and energy, ready to do more? Or do you feel drained and exhausted? After giving at the office, is there nothing left to give at home? Do you feel as if you are on a treadmill that will never stop, that more things feel draining than energizing?

Feeling chronically drained is often a precursor for illness; conversely, feeling energized enhances productivity and encourages health. An important aspect of staying healthy is that one’s daily activities are filled more with activities that contribute to our energy than with tasks and activities that drain our energy. Similarly, Dr. John Gottman and colleagues have discovered that marriages prosper when there are many more positive appreciations communicated by each partner than negative critiques.

Energy is the subjective sense of feeling alive and vibrant.  An energy gain is an activity, task, or thought that makes you feel better and slightly more alive—those things we want to or choose to do. An energy drain is the opposite feeling—less alive and almost depressed—those things we have to or must do; often something that we do not want to do.  In almost all cases, it is not that we have to, should, or must do, it is a choice.  Remember, even though you may say, “I have to study.”  It is a choice.  You can choose not to study and choose to drop out of school. Similarly, when you say, “I have to do the dishes,” it is still a choice.  You can choose to do the dishes or let the dirty dishes pile up and just use paper plates.

Energy drains and gains are always unique to the individual; namely, what is a drain for one can be a gain for another.  Energy drains can be doing the dishes and feeling resentful that your partner or children are not doing them, or anticipating seeing a person whom you do not really want to see. An energy gain can be meeting a friend and talking or going for a walk in the woods, or finishing a work project.

When patients with cancer start exploring what they truly would like to do and start acting on their unfulfilled dreams, a few experience that their health improves as documented by Dr. Lawrence LeShan in his remarkable book, Cancer as a Turning Point. So often our lives are filled with things that we should do versus want to do.  In some cases, the lives we created are not the ones we wanted but the result of self-doubt and worry, “If I did do this, my family and friends won’t like me”, or “I am not sure I will be successful so I will do something that is safe.”  Just ask yourself the question when you woke up this morning and most mornings this week, “How did you feel?” Did you felt happy and looking forward to the day?

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Explore strategies to decrease the drains and increase the energy gains. Use the following exercise to increase your energy:

  1. For one week monitor your energy drains and energy gains. Monitor events, activities, thoughts, or emotions that increase or decrease energy at home and at work. For example some drains can include cleaning bathroom, cooking another meal, or talking to a family member on the phone, while gains can be taking a walk, talking to a friend, completing a work task. Be very honest, just note the events that change your energy level.
  2. After the week look over your notes and identify at least one activity that drains your energy and one activity that increases your energy
    • Develop a strategy to decrease one of the energy drains.  Be very specific how, where, when, with whom, and which situations decreasing the tasks that drain your energy.  As you think about it, anticipate obstacles that may interfere with reducing your drains and develop new ways to overcome these obstacles such as trading tasks with others (I will cook if you clean the bathroom), setting time limits, giving yourself positive reward after finishing the task (a cup of tea, a text or phone message to a close friend, watching a video in the evening).
    • Develop new ways how you can increase energy gains such as doing exercise, completing a task.
  3. Each day implement the behavior to reduce one less energy drain and increase one energy gain and observe what happens.

Initially it may seem impossible, many students and clients report that the practice made them aware, increased their energy, and they had more control over their lives than they thought.  It also encouraged them to explore the question, “What is it that you really want to do?”  So often we do energy drains because of convention, habit and fear which makes us feel powerless and suppresses our immune system thereby increasing the risk of illness.  In observing the energy drains and energy gains, it may give the person a choice.  Sometimes, the choice is not changing the tasks but how we think about it.  Many of the things we do are not MUSTs; they are choices.  I do the work at my job because I choose to benefits of earning money.

How your internal language impacts your energy**

Sit and think of something that you feel you have to do, should do, or must do. Something you slightly dread such as cleaning the dishes, doing a math assignment. While sitting say to yourself, “I have to do, should do, or must do_______________.”  Keep repeating the phrase for a minute.

Then change your internal phrase and instead say one of the following phrases, “I choose to do,”  “I look forward to doing,” or “I choose not to do _________.”  Keep repeating the phrase for a minute.

Now compare how you felt.  Almost all people feel slight less energy and more depressed when they are thinking, “I have to do,” “should do”, or must do”.  While when they shifted the phrase to, “I choose to,” “I look forward to doing,” or “I choose not to do it,” they feel lighter, more expanded and more optimistic.  When university students practice this change of language during the week, they find it was easier to start and complete their homework tasks.

Watch your thoughts; they become words. 

Watch your words; they become actions. 

Watch your actions; they become habits. 

Watch your habits; they become character.

Watch your character; it becomes your destiny.

– Frank Outlaw

 References

Gottman, J.M. & Silver, N. (2015). The Seven Principles for Making Marriage Work. New York: Harmony.

LeShan, L. (1999). Cancer as a Turning Point. New York: Plume

*Adapted from: Peper, E. (2016). Increase energy. Western Edition. April, pp4.  http://thewesternedition.com/admin/files/magazines/WE-April-2016.pdf

**Adapted from: Gorter, R. & Peper, E. (2011). Fighting Cancer-A Nontoxic Approach to Treatment.  Berkeley: North Atlantic Books, 107-200.

 


Free resources: Your Healing Journey and Information on Complementary and Alternative Medicine

The old song, The hipbone is connected to the thigh bone, expresses that we are part of a system in which every part is affected and affects every other part.  This system includes the physical, mental, emotional, social, environment and spiritual factors (see figure 1).

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Figure 1. The healing environment–we are all interconnected. From: Optimal Healing Environment, Samueli Institute, 2013 (http://www.samueliinstitute.org/health-policy/your-healing-journey).

Not only are we an integrated system, we also need to feel SAFE in order to heal and grow.  Without feeling safe, we are on guard–a state that inhibits our self-healing potential. It is no wonder that sometimes people are dissatisfied with traditional medical care and visit holistic health/complementary and alternative health care providers.  These professionals often take more time to listen, touch you, and make you feel SAFE.

It can be challenging to make sense out of the overwhelming barrage of information available on the web.  How do you know what is appropriate,  what is healing strategy , or even what is a holistic perspective?

To put healing in context and to offer a frame work for what is useful, the recent free book and videos by the Samueli Institute and the information on National Center for Complementary and Alternative Medicine (NCCAM)’s  website are very useful (http://nccam.nih.gov).

Samueli Institute publications

The free book Optimal Healing Environments: Your Healing Journey and video resources were developed by the Samueli Institute  in collaboration with the Clinton Foundation’s Health Matters Initiative. It is a personal resource for understanding the role of Optimal Healing Environments in your personal and professional quest for health and well-being..  Go to their website and down load the free book and videos (http://www.samueliinstitute.org/health-policy/your-healing-journey).

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National Center for Complementary and Alternative Medicine (NCCAM)

The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government’s lead agency for scientific research on complementary and alternative medicine (CAM).  The mission of NCCAM is to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care. One of the best sources for evidence based medicine on CAM that can be used to help decision making.

The NCCAM website offers free resources and comprehensive video lectures about research in complementary health approaches that provide an in-depth perspective on the current state of science, as related to complementary medicine. Topics range from mind-body pain therapies to acupuncture.  Watch these online video lectures from the National Institutes of Health (NIH) Complementary and Alternative Medicine Online Continuing Education Series (http://nccam.nih.gov/training/videolectures).

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