Posts Tagged ‘parasympathetic nervous system’

By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Wellness Coach, ACSM Personal Trainer

For the past few years, I’ve been reading and learning more about evidence-based practices, research methods, and, sadly, the paucity of solid research backing up the medical benefits of massage therapy. While some members of the massage community are diligently working to improve the quality and quantity of massage research, there are many misconceptions about massage that have been taught to massage therapists in massage school and then passed on to massage clients. Some of these misconceptions have to do with the idea that “massage releases toxins” (technically, it does not and what people mean by “toxins”is unclear as well), that you must drink water after a massage (often as way to “flush” these said” toxins”). Some massage therapists and massage clients believe massage is a healing modality and that massage can release muscle “knots,”  While massage can reduce muscle tension, the conceptualization of knots in our muscles is misleading.  Many of these claims have either been seriously called into question, or explained to be misconceptions caused by massage school instructors trying to simplify physiological explanations.

More will be revealed about how massage therpy works

More will be revealed about how massage therapy works

That all said, I do believe that massage has some physical, mental and possibly, medical benefits. I do believe that most massage therapists genuinely want to help people feel better, want to use massage as  a healing tool and are doing their best to teach clients what they know about the benefits of massage. And I think that while it is important to understand the mechanism of how massage therapist works on our bodies and minds, for now until the research we need pours forth, I would like to propose a few simple explanations as to how massage can benefit us:

1. Most massage therapy, whether performed on a massage chair or massage table, puts the person being massaged into a really relaxing comfortable position. And in our culture, people rarely have a chance to relax or just sit. If we sit down to relax, we often think we are being lazy or unproductive. So giving ourselves permission to get a massage “for our health” or to “reduce stress” allows us to give ourselves permission to sit down and do relatively nothing for a period of time. It’s not magical. It’s not mystical. But relaxing is good for our health. By sitting down or laying down for a period of time, from 10 minutes to an hour or more, allows our nervous systems to move from sympathetic (fight or flight adrenaline pumping mode) to parasympathetic resting and digesting mode).

Just laying down on a massage table is relaxing

Just laying down on a massage table is relaxing

This may seem obvious to you, and you may think, “well what’s the big deal about that?” The big deal is this, in my experience few people in this culture will take the time to just sit down and do nothing or to lay down and relax, especially during a work day or when the kids needs help with homework or they want to spend time with friends. Relaxing is only socially acceptable if we do it in a structured environment like during a massage or while doing meditation. (Even though yoga was originally designed to calm the nervous system and relax the body, in the U.S., we even add words like “power” to yoga and add weight training to a yoga session! Which in my view, really defeats the purpose of doing yoga in the first place.)

2. Another aspect of our culture is that we are super “busy”…and often touch deprived. Our to do lists have to do lists. If we are not accomplishing, if we are not helping kids, parents or friends or making money (or being good consumers by spending money) we are not being “responsible, we are not being “productive” and we are not being “good” parents, children, neighbors, workers, bosses, employees, friends, community members. We are, in an unspoken way, not supposed to take time for ourselves (unless it is to work out, “power” style) because that is considered to be “selfish.” But getting a massage lets a person take care of him or herself without guilt. Instead of this being a selfish act, getting a massage is now seen an act of self caring. If we do not take care of ourselves, we cannot give to others because we will be too sick or too stressed out to be of much use! When you get a massage we allow ourselves to say, “hey this is my hour, or my ten minutes and I want the attention to be on me. I want to feel good, I want to be touched in a positive,  kind way, without the touch feeling sexual or violent or ticklish. And it is for my health so it’s okay in this instance for me to do something for my self.

Getting a massage gives you a little window of time for self care

Getting a massage gives you a little window of time for self care

Likely down the road, we will be able to use science to explain the psychology of massage through random clinical trails. Someday soon we will be able to point to research that shows more specifically how one person touching another via massage actually causes the recipient’s nervous system to shift into parasympathetic mode. But for now, I am content in my own explanations. I know my clients, and clients of other Working Well Massage therapists, benefit from our massages. I know people relax and enjoy getting massages. The science will come. Until then, we will keep providing relaxation, comfort and care to massage clients. And we will acknowledge and encourage their willingness to take care of themselves.

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The holidays can be stressful. Shopping, parties, family obligations, and of course, extra traffic, can all lead you to feel a little anxious. But what happens when that stress produces a full blown anxiety attack? Read on to find the latest treatments for panic disorders and some simple fixes you can do for stress and anxiety…even if you don’t have full blown panic attacks! (Hint: Cutting down caffeine really helps curb anxiety.)

Excerpted from High Anxiety by Joseph Hart in Experience Life

40 million Americans who have been derailed by what psychiatrists call “anxiety disorders.” It’s a broad medical diagnosis that includes several distinct categories:

Obsessive-compulsive disorder, which consists of intrusive thoughts (obsessions) combined with repetitive behaviors (compulsions), such as excessive hand washing, that the sufferer performs to avoid the obsessive thoughts.

Panic disorder refers to recurring episodes of intense physical fear, without an obvious or immediate source of fear. These episodes, also called anxiety attacks, are commonly characterized by heart palpitations and may be accompanied by chest pains. It might also be difficult to breathe, and you may feel like you are choking (symptoms that can make the situation even more frightening and further ratchet up anxiety).

Posttraumatic stress disorder (PTSD) follows a severe traumatic event that threatens actual harm.

Social anxiety disorder describes the condition of people who suffer overwhelming anxiety when faced with everyday social interactions.

Generalized anxiety disorder is a catchall category that describes any chronic anxiety or exaggerated worry that lacks an obvious cause.

While these diagnoses, symptoms and distinctions sound clear-cut on paper, in practice they are anything but. In part, this is because separating the typical from the pathological isn’t always easy. The human brain, it seems, is hardwired to worry even under the best of conditions.

“Because we humans have prefrontal lobes, we can anticipate the future and make up a scenario that is harmful
to us,” says Melissa Blacker, MA, a psychotherapist and associate director of the Stress Reduction Clinic at the University of Massachusetts Medical School’s Center for Mindfulness.

Some degree of anxiety and fear are normal responses to life. “Healthy anxiety is part of our fight-or-flight response system,” says Jonathan Abramowitz, PhD, director of the Anxiety and Stress Disorder Clinic at the University of North Carolina, Chapel Hill. “As a basic emotion, it is helpful. In fact, we would all be dead without it, because it protects us from harm.”

So where does a healthy emotional response to stress leave off and an anxiety disorder begin? “Anxiety is a response to the perception of threat,” Abramowitz explains. “When we’re talking about a real danger, that’s healthy stress and anxiety, but when the perception of threat is based on either a misinterpretation of the severity of the threat or the likelihood of harm, then we’re talking about a disorder.”

Mind-Body Connections

The biological processes triggered by anxiety — sweaty hands, shallow breathing, increased heart rate, dizziness — are hardwired human responses to stressful situations. Most of these responses serve some biological purpose, such as preparing our bodies to react (fight or flee), or they are the byproduct of the chemicals, such as cortisol and adrenaline, that such a reaction might require. It’s when we perceive a major threat in situations where, objectively speaking, there is little or none — for example, in a crowded elevator (claustrophobia), crossing a bridge (fear of heights), leaving the house (agoraphobia) or at an office mixer (social anxiety) — that anxiety is classified as a disorder.

The more frequently or dramatically an unwarranted response occurs, and the more it interferes with a person’s daily life, the more severe that classification is likely to be.

Although pharmaceutical drugs can help moderate our bodies’ physical response to stressful thoughts or stimuli, nonpharmaceutical treatments — like cognitive behavioral therapy (CBT) — are beginning to replace drugs as the preferred treatment for anxiety disorders.

Unlike medications that attempt to suppress our physiological responses to perceived threats, CBT is aimed at correcting our perception of those threats, and thus encouraging a self-moderating response.

The first goal of CBT is simply education, says Abramowitz. “We teach people about their symptoms,” he explains. “We explain that when you feel nauseated, it’s not because you’re going to throw up; when your heart races, it’s not because you’re having a heart attack.” For many, just recognizing the symptoms of anxiety for what they are — and realizing that they do not represent an immediate danger — can prevent an attack from worsening.

The second phase of CBT focuses on exposure and response protection. Some CBT therapists actually place the sufferer in the situation that causes him or her fear — whether that situation is external, like playing with a large dog, or internal, like experiencing an accelerated heart rate. “When a person repeatedly confronts their fears, they learn that the outcomes they worry about aren’t nearly as likely as they think,” Abramowitz explains.

Moreover, they learn that the initial fight-or-flight response is transitory; anxiety eases when you’re able to stay in a situation and your fears aren’t realized.

It can take 10 to 15 sessions of CBT to produce lasting results, says Abramowitz, and the success rate is fairly high — as many as 70 percent of patients conquer their anxieties. (To find a cognitive-behavioral therapist near you, visit the National Association of Cognitive-Behavioral Therapists at http://nacbt.org/searchfortherapists.asp.)

Anxiety as a Physical Condition

The physical aspects of anxiety — our fight-or-flight response — are governed by the sympathetic nervous system. CBT works by essentially reprogramming our involuntary activation of this system. But other treatment approaches focus on the body’s parasympathetic nervous system, which regulates the healing, recharging part of the nervous system and helps shut off the fight-or-flight response.

Patricia Gerbarg, PhD, MD, a clinical psychiatrist at the New York Medical College and coauthor of How to Use Herbs, Nutrients, and Yoga in Mental Health Care (Norton, 2009), is studying how to activate the parasympathetic nervous system to quiet anxiety. She and her colleagues have discovered that some ancient practices are highly effective.

In particular, yoga breathing induces a very calm, clear-minded state — the opposite of the anxious fight-or-flight state of the sympathetic nervous system. “When you change the pattern of breathing,” explains Gerbarg, “it changes what happens in your emotion centers and thinking centers,” slowing the fight-or-flight actions of the amygdala and quieting the areas of the cortex that process worry.

Gerbarg and her colleagues have been able to quantify the effects of breathing techniques on the parasympathetic nervous system, and they are using what they’ve learned to train patients to interrupt anxiety with breathing. “We have seen some very rapid effects,” she says. “In five minutes, people may go from severe anxiety to complete relaxation.”

Psychotherapist Kathryn Templeton, who spent 20 years working with soldiers suffering from PTSD at the National Center for Posttraumatic Stress Disorder at the U.S. Department of Veterans Affairs and now works with abused children, uses breathing and yoga extensively in her treatments. She has her patients begin by inhaling slowly for three counts and exhaling for six counts, a practice that cultivates awareness of their breathing patterns. “Breathing creates resiliency and releases tension,” she explains. It is physically impossible to breathe deeply and feel anxious at the same time.

The power of breath to reduce symptoms of anxiety helps illustrate how anxiety lives in both brain and body. Because anxiety is as much a physical condition as a mental one, a variety of physical activities can offer relief.  Exercise in particular, writes Edward Hallowell in Worry: Hope and Help for a Common Condition (Random House, 1998), “is a terrific antidote for worry.”

Exercise quiets the anxiety response, not by changing the situation that is causing anxiety, he explains, but by changing “the vessel of your worry, the physical state of your body and brain.” He notes that exercise produces a variety of chemicals, such as endorphins, corticosteroids and neurotrophins, as well as various neurotransmitters like serotonin that can help soothe the worried mind.

If you start to feel anxiety welling up and you have even just a few free minutes, a couple treks up and down the stairs or a brisk walk around the block can work wonders, says Hallowell. You won’t always have the opportunity to break into a sprint when you feel your anxiety spiking, but, he continues, “A regular exercise program — exercise three or four times a week — will almost always cut down on worry. Exercise should be incorporated into any plan to reduce anxiety and control worry.”

Finally, no approach to anxiety management can be optimally successful unless it is supported by proper nutrition. Our brains require certain fats, proteins and nutrients to function normally and regulate mood — and no amount of yogic breathing or CBT can compensate for a mineral or omega-3-fat deficiency. (To learn more about what to eat to reduce anxiety and stabilize mood, see “Comfort Food for Your Brain.”) It is also important to limit your intake of stimulants such as caffeine, which prime the body and brain for heightened anxiety.

Mix Your Own Cure

Ultimately, regardless of whether or not you choose to treat your anxiety with medication, it makes sense to avail yourself of the full spectrum of other interventions, too — from good nutrition and regular exercise, to yoga, deep breathing and psychological approaches like CBT.

“Not every person will use every [approach],” writes Hallowell. “But every [approach] should at least be considered in order to achieve the best results.” That’s because, he notes, in almost all cases, no single approach alone will provide optimal results. Every individual has to find his or her own right mix.

In any life, anxiety is bound to come and go. But when it comes on strong enough to impede our health and happiness, it’s comforting to know that the remedies of modern science, ancient wisdom and simple self-care can all offer relief — and smart ways to keep future anxieties at bay.

The Big Chill-Out

Common signs of an anxiety attack include rapid heart rate, sweating, shaking, shortness of breath, nausea, dizziness, chest pain, numbness in limbs or face, difficulty thinking clearly, and fear of losing control.

Whether or not you are currently experiencing any of these symptoms, here are some top techniques for quickly and effectively reducing anxiety when it rears its ugly head:

Take a deep breath: Perhaps the single most effective way you can get your anxiety under control quickly is to breathe deeply and slowly into your diaphragm. Start simply by closing your eyes, breathing in deeply for a count of three and then exhaling for a count of four. Do it for a minute or two at a time, repeating until you feel calmer.

Pay Attention: Worries and anxieties tend to grow more powerful when we allow them to accumulate in our subconscious. You can interrupt the accumulation of anxieties by bringing them into the forefront of your mind and acknowledging their presence. Don’t worry about trying to talk yourself out of your worries. Just take a minute to step back and observe yourself being anxious. Note any physical symptoms (clenched muscles, shallow breathing, racing heartbeat) and ask yourself: Are my fears appropriate to my current actual level of danger? Simply taking stock of your anxiety and consciously seeing uncomfortable sensations for what they are (vs. indications that you are in physical danger) can make them feel less intense.

Get a Move On: If you feel anxiety rising, quit what you’re doing and take a quick walk, do some pushups, or climb a few flights of stairs. It may be enough to clear your body of accumulating stress chemicals and give your mind a chance to reframe troubling thoughts. Going forward, build some exercise time into your schedule. Regular exercise (most experts recommend vigorous activity three to four times a week to help keep anxiety symptoms at bay) helps your body balance its supply of neurochemicals and hormones and also helps increase your overall resilience. Many people find that yoga provides special anxiety- quelling benefits.

Connect With Nature: If you can step outside, or even focus on a tree, cloud or horizon line you can see from your window, do it. Numerous studies have shown that exposure to natural scenes and environments, even painted views of landscapes, measurably lowers anxiety and reduces perceptions of pain. Spending time in nature also improves mood and reduces reactivity in many people. So make a point of regularly getting outdoors, allowing images, scents and sensations of nature to help you calm your jangled nerves before they get out of control.

For more suggestions on managing anxiety, and a more complete list of symptoms and their causes, check out the Anxiety Disorders Association of America, online at www.adaa.org/GettingHelp/AnxietyDisorders/PanicAttack.asp.

Anxiety Disorders Association of America
(www.adaa.org) provides information about anxiety disorders, treatments, how to choose a therapist, self-tests and more.

The National Association of Cognitive-Behavioral Therapists (www.nacbt.org) provides information about CBT and how it works.

The Midwest Center (www.stresscenter.com/mwc) is a leading provider of self-care and coaching programs for people who suffer from stress, anxiety and depression.

Natural Relief for Anxiety: Complementary Strategies for Easing Fear, Panic & Worry by Edmund J. Bourne, Arlen Brownstein and Lorna Garano (New Harbinger, 2004)

When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life by David D. Burns, MD (Broadway, 2007)

Living Well With Anxiety: What Your Doctor Doesn’t Tell You That You Need to Know by Carolyn Chambers Clark (HarperCollins, 2006)

Worry: Hope and Help for a Common Condition by Edward Hallowell, MD (Random House, 1998)

The Relaxation & Stress Reduction Workbook by Martha Davis, Matthew McKay and Elizabeth Robbins Eshelman (New Harbinger, 2008)

Panic Attacks Workbook: A Guided Program for Beating the Panic Trick by David Carbonell, PhD (Ulysses Press, 2004)

Excerpted from High Anxiety by Joseph Hart in Experience Life

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