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       # 2022-01-22 - The Relaxation Response by Herbert Benson
       
       # Foreword
       
       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
       
       "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:
 (DIR) 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
       
       ## How to Bring Forth the Relaxation Response
       
       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-
 (TXT) detail: gopher://gopherpedia.com/0/The_Relaxation_Response
       LOC:    RA785 .B48
       tags:   book,health,meditation,non-fiction,science
       title:  The Relaxation Response
       
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 (DIR) health
 (DIR) meditation
 (DIR) non-fiction
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