2022-01-22 - The Relaxation Response by Herbert Benson
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Foreword
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Three decades ago [1975] it was considered scientific heresy for a
Harvard physician and researcher to hypothesize that stress
contributes to health problems and to publish studies showing that
mental focusing techniques were good for the body. I broke ranks
with the medical establishment when I decided to pursue this theory
and to prove or disprove it in my medical research.
Seeing that we continue to neglect our potential for self-healing is
a source of both frustration and motivation for me. My goal has
always been to promote a healthy balance between self-care approaches
and more traditional approaches.
Amazingly, the very room and building in which my colleagues and I
studied the Transcendental Meditation devotees was where Walter B.
Cannon, the famous Harvard physiologist, had discovered "the
fight-or-flight response" 60 years before. Cannon theorized that
mammals have a physical ability to react to stress that evolved as a
survival mechanism. When faced with stressful situations, our bodies
release hormones--adrenaline and noradrenaline, or epinephrine and
norepinephrine--to increase heart rate, breathing rate, blood
pressure, metabolic rate, and blood flow to the muscles, gearing our
bodies to either do battle with an opponent or to flee.
Our studies revealed that the opposite was also true. The body is
also imbued with what I termed the Relaxation Response--an inducible,
physiologic state of quietude. Indeed, our progenitors handed down
to us a second, equally essential survival mechanism--the ability to
heal and rejuvenate our bodies.
... we extracted four essential components that would elicit the
Relaxation Response:
* A quiet environment.
* A mental device--a sound, word, phrase, or prayer repeated
silently or aloud, or a fixed gaze at an object.
* A passive attitude--not worrying about how well one is performing
the technique and simply putting aside distracting thoughts to
return to one's focus.
* A comfortable position.
Later we discovered that only the middle two components--the mental
device and the passive attitude--were required.
This is the generic technique that I have taught patients and that I
have used myself for many years:
* Pick a focus word, short phrase, or prayer that is firmly rooted
in your belief system.
* Sit quietly in a comfortable position.
* Close your eyes.
* Relax your muscles, progressively from your feet to your calves,
thighs, abdomen, shoulders, back, and head.
* Breathe slowly and naturally, and as you do, say your focus word,
sound, phrase, or prayer silently to yourself as you exhale.
* Assume a very passive attitude. Don't worry about how well
you're doing. When other thoughts come to mind, simply say to
yourself, "Oh well," and gently return to your repetitions.
* Continue for 10 to 20 minutes.
* Do not stand immediately. Continue sitting quietly for a minute
or so, allowing other thoughts to return. Then open your eyes and
sit for another minute before rising.
* Practice the technique once or twice daily. Good times to do so
are before breakfast and before dinner.
The argument most frequently used to disregard our findings was the
suggestion that the Relaxation Response was nothing more than the
re-observation of the prevalent--and I might add, consistently
misunderstood--placebo effect. In other words, critics said that the
physiologic changes my colleagues and I observed in our clinical
patients were self-suggested or "all in the patients' heads."
Together with other researchers, I established that the success of
the Relaxation Response was not attributable to the placebo effect.
The Relaxation Response worked regardless of a patients' belief.
When teaching patients to evoke the Relaxation Response, we asked
[patients], "Would you prefer a secular or religious approach?" We
put patients at ease, allowing them to choose a self-tailored
approach. And patients were far more apt to adhere to a regular
practice of mental focusing if the approach they selected was
meaningful and compelling to them personally.
Academic medicine, on the other hand, largely dismissed our findings
for the next 15 years.
Throughout my career, I resisted being associated with alternative
medicine. I did this for several reasons.
First, our findings were evidence-based and subjected to the strict
standards of Western scientific medicine. I contended that a
treatment or technique ceases to be "alternative" once it has
survived the battery of scientific proofs and has been published in
peer-reviewed medical journals.
Second, a major asset of the Relaxation Response... is that they are
self-administered. In this way, self-care is revolutionary and quite
different from the medicine commonly practiced in both traditional
and non-traditional settings.
Third, alternative medicine adds costs to traditional medicine while
the Relaxation Response and other self-care approaches reduce costs.
Research has shown that when mind/body medicine is employed, patients
make fewer visits to their doctors at health maintenance
organizations.
... I from that point on began to teach our patients the "two-step
procedure" the monks had practiced. First, you evoke the Relaxation
Response and reap its healthful rewards. Then, when your mind is
quiet, when focusing has opened a door in your mind, visualize an
outcome that is meaningful to you. Whatever your goal, these two
steps can be powerful...
... other self-care approaches such as exercise, stress management,
and nutrition. We learned that with self-care, we can effectively
treat any disorder to the extent that it is caused by stress or
mind/body interactions.
Medicine continues to be a reductionist practice, determined to find
specific factors that cause an illness as well as specific pills and
procedures that alleviate it. While this approach has great merit,
changes do not occur in the body in isolated steps. Rather, many
steps take place simultaneously.
Chapter 1
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"But the present world is a different one. Grief, calamity, and evil
cause inner bitterness... Evil influences strike from early morning
until late at night... they injure the mind and reduce its
intelligence and they also injure the muscles and the flesh."
This chronicler lived 4,600 years ago in China, even though his
observations appear contemporary. Human beings have always felt
subjected to stress and often seem to look longingly backwards to
more peaceful times. Yet with each generation, complexity and
additional stress are added to our lives.
Humans, like other animals, react in a predictable way to acute and
chronic stressful situations, which trigger an inborn response that
has been part of our physiologic makeup for perhaps millions of
years. When we are faced with situations that require adjustment of
our behavior, an involuntary response increases our blood pressure,
heart rate, rate of breathing, blood flow to the muscles, and
metabolism, preparing us for conflict or escape.
But the response is not used as it was intended--that is, to prepare
for running or fighting with an enemy. ... When not used
appropriately, which is, most of the time, the fight-or-flight
response repeatedly elicited may ultimately lead to dire disease of
heart attack and stroke.
Each of us possesses a natural and innate protective mechanism
against "overstress," which allows us to turn off harmful bodily
effects... This response against "overstress" brings on bodily
changes that decrease heart rate, lower metabolism, decrease the rate
of breathing, and bring the body back into what is probably a
healthier balance. This is the Relaxation Response.
Chapter 3
=========
Stress has long been the subject of psychological and physiological
speculation. Physiological stress has been described as the
outpouring of the steroid hormones from the adrenal glands, a theory
elaborated upon by Dr. Hans Selye of Montreal, who believes these
hormones are vitally important for the survival of an organism and
are exquisitely sensitive indices of stress.
According to the doctors, change, whether for "good" or "bad," causes
stress to a human being, leaving him [or her] more susceptible to
disease.
Our approach is similar in that we define stress as environmental
conditions that require behavioral adjustment. [This must include
the internal environment.]
Higher blood pressure paralleled the degree of "Westernization" of
Fiji Islanders. [The same held true for Puerto Ricans, Zulus, and
others.]
Reaching a long-sought-after, desirable position, for which you do
not feel adequately prepared, can raise blood pressure.
The degree of high blood pressure among blacks is not simply genetic
but probably is related to the living standards and stress under
which black people exist.
The concept of a hypertensive personality evolved from retrospective
studies [AKA longitudinal cohort studies]. Retrospective studies
have repeatedly shown that hypertensive individuals are persons who
do not deal with their emotions well or who cannot let out their
emotions.
The fallacy of this type of reasoning is obvious, because the disease
of hypertension itself may influence personality traits. What is
needed are "prospective" studies [AKA case-control studies]... No
such studies exist.
We believe the more often the fight-or-flight response is activated,
the more likely it is that you will develop high blood pressure,
especially if circumstances do not actually allow you to give battle
or flee. We may differ in what is stressful to us individually,
depending on our own value systems, but our society poses enough
stressful circumstances to affect all of us.
The involuntary, or autonomic, nervous system deals with the everyday
bodily functions that normally do not come into consciousness, such
as the maintenance of heart beat and blood pressure, regular
breathing, [and] the digestion of food. When the fight-or-flight
response is evoked, it brings into play the sympathetic nervous
system, which is part of the autonomic nervous system. The
sympathetic nervous system acts by secreting specific hormones:
adrenaline or epinephrine and noradrenaline and noradrenaline and
norepinephrine. [The fight-or-flight response] is controlled by a
part of an area in the brain called the hypothalamus and most, if not
all, of the response occurs in a coordinated, simultaneous manner.
[The] Relaxation Response [is] an opposite, involuntary response that
causes a reduction in the activity of the sympathetic nervous system.
Since we cannot easily change the nature of modern life, perhaps
better prevention and therapy of hypertension [and other
stress-related diseases] might be achieved by actively bringing forth
the Relaxation Response.
Chapter 4
=========
Visceral learning, or biofeedback, as it is popularly called,
established that man[kind] could control his [or her] involuntary or
autonomic nervous system.
But centuries before such research, dramatic claims for control of
physiologic functions had already come to us from the East.
Fortunately, from a scientific standpoint, Transcendental Meditation,
developed by Maharishi Mahesh Yogi, is a simple Yogic technique
carried out under relatively uniform conditions.
A great debt is owed Maharishi Mahesh Yogi, a guru, who early in his
life had studied physics. Following the teachings of his mentor,
Shri Guru Deva, he eliminated from Yoga certain elements that he
considered to be nonessential.
Before beginning the tests, I met with the Maharishi to establish
whether he would be willing to cooperate with the new research even
if the findings proved to be detrimental to his movement. Convinced
that only beneficial results would follow, the Maharishi readily
agreed to accept my research findings.
The experiments showed that during meditation there was a remarkable
decrease in the body's oxygen consumption. The major physiologic
change associated with meditation is a decrease in the rate of
metabolism. Such a state of decreased metabolism, called
hypometabolism, is a restful state. [Body temperature does not drop
during meditation, differentiating it from hibernation.]
During sleep, oxygen consumption decreases slowly and progressively,
until, after 4 or 5 hours, it is about 8 percent lower than during
wakefulness. During meditation, however, the decrease averages
between 10 and 20 percent and occurs during the first 3 minutes of
meditation. It is not possible for a person to bring about such
decreases by other means.
Another physiologic difference between meditation and sleep has been
documented with the electroencephalogram. Alpha waves, slow brain
waves, increase in intensity and frequency during the practice of
meditation but are not commonly found in sleep.
Along with the [beneficial effects of meditation already mentioned],
there is a marked decrease in blood lactate, a substance produced by
the metabolism of skeletal muscles and of particular interest because
of its purported association with anxiety.
If increased lactate is instrumental in producing regular attacks of
anxiety, the finding of low levels of lactate in meditators is
consistent with their reports of significantly more relaxed, less
anxious feelings. Blood-lactate levels fall rapidly within the first
10 minutes of meditation.
Putting aside changes [already mentioned], other measurements
supported the concept of meditation as a highly relaxed condition
associated with lowered activity in the sympathetic nervous system.
In the tests of the volunteer meditators the heart rate decreased at
the average of about 3 beats per minute, and respiration rate, or
rate of breathing, also slowed. All these physiologic changes in
people who were practicing the simply learned technique of
Transcendental Meditation were very similar to the feats observed in
highly trained experts in Yoga and Zen with 15 to 20 years of
concentrated experience in meditation.
As the experiments progressed over several years, the concept
developed that the various physiologic changes that accompanied
Transcendental Meditation were part of an integrated response
opposite to the fight-or-flight response and that they were in no way
unique to Transcendental Meditation.
The trophotropic response described by [Dr. Walter R. Hess] in cats
is, we believe, the Relaxation Response in man[kind].
Autogenic Training is a technique of medical therapy based on six
mental exercises devised by Dr. H.H. Schultz, a German neurologist.
Progressive Relaxation emphasized the relaxation of voluntary
skeletal muscles... [Sounds somewhat similar to TRE. See also:
TRE
]
Hypnosis may be defined as an altered state of consciousness which is
artificially induced and characterized by increased receptiveness to
suggestions. When deep relaxation is the suggested state to be
achieved by hypnosis, the physiologic changes of the Relaxation
Response may be evoked.
Sentic Cycles, devices by Dr. Manfred Clynes, a psychophysiological
researcher, demonstrates the close relation between emotional states
and predictable physiologic changes. A Sentic "Cycle" is composed of
eight "sentic states," or self-induced emotional experiences.
Changes consistent with the elicitation of the Relaxation Response
have been noted during the imagined emotional experiences of
reverence, love, and grief.
Chapter 5
=========
The physiologic changes of the Relaxation Response we associated with
what has been called an altered state of consciousness. When we
speak of consciousness we should think of a continuum extending from
relatively deep unconsciousness at one end to an extraordinary
sensitivity at the other. The continuum passes from coma to sleep to
drowsiness, to alertness, to hyperalertness. In this continuum, one
of the levels of consciousness, we believe, is associated with the
Relaxation Response. It is an ALTERED state simply because we do not
commonly experience it, and because it usually does not occur
spontaneously; it must be consciously and purposefully evoked.
A way to achieve this altered state of consciousness with the
Relaxation Response is through the practice of what has been called
meditation...
As William Hayce aptly states: "To find religion is only one out of
many ways of reaching unity; and the process of remedying inner
incompleteness and reducing inner discord is a general psychological
process."
However, the term mysticism was not a common term until medieval
times. Rather the subject of these writings was contemplation...
Chapter 6
=========
[Regarding the study of people who began with high blood pressure and
were taught Transcendental Meditation:] We observed, moreover, that
the decreases in blood pressure occurred during periods of the day
unrelated to the meditation. As long as the subjects continued to
meditate regularly for two brief periods a day, their blood pressures
stayed measurably lower. But the meditation had not cured them. The
subjects' lower blood pressure readings lasted only as long as they
practiced the Relaxation Response regularly. When... test
subjects... chose to stop the regular practice of Transcendental
Meditation, their blood pressures returned to their initial
hypertensive levels within four weeks.
By far the most appealing use of the Relaxation Response in relation
to hypertension lies in its preventative aspects.
These figures indicate that over 40 percent discontinued their use of
drugs after the intervention of Transcendental Meditation. After
twenty-one months of regular practice, only 12 percent continued to
use marijuana, a decrease of 66 percent.
Chapter 7
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How to Bring Forth the Relaxation Response
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1) A Quiet Environment
Ideally, you should choose a quiet, calm environment with as few
distractions as possible. A quiet room is suitable, as is a place of
worship. The quiet environment contributes to the effectiveness of
the repeated word or phrase by making it easier to eliminate
distracting thoughts.
2) A Mental Device
To shift the mind form logical, externally oriented thought, there
should be a consistent stimulus: a sound, word, or phrase repeated
silently or aloud; or fixed gazing at an object. Since one of the
major difficulties in elicitation of the Relaxation Response is "mind
wandering," the repetition of the word or phrase is a way to help
break the train of distracting thoughts. Your eyes are usually
closed if you are using a repeated sound or word; of course, your
eyes are open if you are gazing. Attention to the normal rhythm of
breathing is also useful and enhances the repetition of the sound or
the word.
3) A Passive Attitude
When distracting thoughts occur, they are to be disregarded and
attention redirected to the repetition or gazing; you should not
worry about how well you are performing the technique, because this
may well prevent the Relaxation Response form occurring. Adopt a
"let it happen" attitude. The passive attitude is perhaps the most
important element in eliciting the Relaxation Response. Distracting
thoughts will occur. Do not worry about them. When these thoughts
do present themselves and you become aware of them, simply return to
the repetition of the mental device. These other thoughts do not
mean you are performing the technique incorrectly. They are to be
expected.
4) A Comfortable Position
A comfortable position is important so that there is no undue
muscular tension. Some methods call for a sitting position. A few
practitioners use the cross-legged "lotus" position of the Yogi. If
you are lying down, there is a tendency to fall asleep. As we have
noted previously, the various postures of kneeling, swaying, or
sitting in a cross-legged position are believed to have evolved to
prevent falling asleep. You should be comfortable and relaxed.
The subjective feelings that accompany the elicitation of the
Relaxation Response vary among individuals. The majority of people
feel a sense of calm and feel very relaxed. ... Still others have
noted relatively little change on a subjective level. Regardless of
the subjective feelings described by our subjects, we have found that
the physiologic changes, such as decreased oxygen consumption, are
taking place.
From our personal observations, many people who meditate for several
hours every day for weeks at a time tend to hallucinate. [Which
apparently does not contribute to the Relaxation Response.]
Chapter 8
=========
We need the Relaxation Response even more today because our world is
changing at an ever-increasing pace. Is it unreasonable to
incorporate this inborn capacity into our daily lives by having a
"Relaxation Response break" instead of a coffee break?
author: Benson, Herbert, 1935-
detail:
LOC: RA785 .B48
tags: book,health,meditation,non-fiction,science
title: The Relaxation Response
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book
health
meditation
non-fiction
science