Relaxation
Jeanne Anselmo
Nurse Healer OBJECTIVES
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Theoretical
Learn the definitions of relaxation and selfregulation.
Compare and contrast different relaxation exercises.
List the body-mind-spirit changes that accompany profound relaxation.
Clinical
Describe three different types of relaxation exercises and their appropriate clinical application.
Describe the indications and contraindications for two forms of relaxation practice.
Identify commonly used technology or equipment from your nursing practice, and describe how it can be used as a biofeedback device.
Use breathing strategies with a client, and record the subjective and clinical changes that occur with relaxed breathing.
Personal
Pick one or a combination of relaxation and/or meditation practices and apply them to a stressful moment. Explore the ways they support your well-being and how they affect your ability to transform stress.
Identify through focused awareness areas in your body where you most often accumulate tension.
Identify three personally meaningful therapeutic suggestions, and use them as reminders to support your self-care relaxation practice and well-being.
DEFINITIONS
Autogenic training: Developed by Drs. Johannes Schultz and Wolfgang Luthe, this practice teaches relaxation through the repetition of phrases that influence muscle relaxation by bringing an awareness of sensations and feelings of warmth, heaviness, and relaxation to one’s body.
Biofeedback: The use of technology or monitors that augment and feed back usually imperceptible signals from the person’s psychophysiologic processes for the purpose of cultivating the ability to influence or change stress-related patterns or symptoms. This self-regulation process, which is usually paired with a relaxation practice, offers the person an opportunity to be an active participant in his or her own healing and health maintenance.
Hypnosis: A process for focused awareness and expanded consciousness with diminishing perception of peripheral sensations, thoughts, and feelings.
Mantra: A word, short phrase, or prayer that is repeated either silently or aloud as a focus of concentration during the practice of meditation.
Meditation: Originally based in spiritual traditions, the practice of awareness, focus, and concentration while maintaining a passive yet awake attitude; evolves with discipline and practice and is known to provide health benefits as well as being a road to personal and spiritual transformation.
Pain (medical definition): Localized sensation of hurt, or an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
Pain (nursing definition): A subjective experience including both verbal and nonverbal behavior.
Power: Barrett’s theory of power as knowing participation in change is being aware of what one is choosing to do, feeling free to do it, and doing it intentionally.
Progressive muscle relaxation: The process of alternately tensing and relaxing muscle groups to become aware of subtle degrees of tension and relaxation; originally developed by Edmund Jacobson.
Relaxation (psychophysiologic definition): A psychophysiologic experience characterized by parasympathetic dominance involving multiple visceral and somatic systems; the absence of physical, mental, and emotional tension; the opposite of Canon’s fight-or-flight response and Selye’s general adaptation syndrome.
Relaxation response: An alert, hypokinetic process of decreased sympathetic nervous system arousal that may be achieved in a number of ways, including through breathing exercises, relaxation and imagery exercises, biofeedback, and prayer. A degree of discipline is required to evoke this response, which increases mental and physical well-being.
Self-hypnosis: An approach for voluntarily fostering a consciousness process for the purpose of influencing one’s thoughts, perceptions, behaviors, or sensations.
Stress (psychophysiologic definition): The felt experience of overactivity of the sympathetic nervous system.
▪ THEORY AND RESEARCH
People are frequently told to “just relax” or “take it easy” as part of their recovery from illness, as if everyone knew how to practice this skill. Yet the ancients knew that relaxation is a paradox; it is and is not simple. Throughout the ages, in cultures around the world, practitioners of the sacred healing arts and sciences developed and practiced stopping, quieting, and calming on a disciplined and regular basis, offering themselves deep rest to still the bodymindspirit and emotions. They did this not only to access their natural ability to heal, restore, and renew their bodymindspirit, but also to open themselves to the divine, the oneness of being, the numinous. As the waves of the mind stilled and the activity of the body quieted into the deep rest and relaxation found within their meditative refuge and relaxation practice, this oneness of being offered itself to these ancient spiritual voyagers.
Today we continue this voyage to touch shores beyond our unhealthy habit patterns and belief systems through the practice of the ancient arts of relaxation, meditation, yoga, qi gong, and breathing, and their modern counterparts: autogenic training, progressive muscle relaxation, hypnosis, biofeedback, self-regulation, relaxation response, and body scanning.
We now understand relaxation to be an ancient art with many modern interpretations, which have been anchored throughout nursing practice from childbirth education to pre- and postoperative teaching. Relaxation has been defined in medical and scientific terms as a psychophysiologic state characterized by parasympathetic dominance involving multiple visceral and somatic systems. It is also defined as the absence of physical, mental, and emotional tension, and the opposite of Canon’s fight-or-flight response.
Relaxation can also be described as an experience or process of calm, comfort, deep rest, natural nurturing, inner connectedness, renewal, and openness that every living creature instinctively and intuitively knows how to access.
Unfortunately, the conditioning in place makes this activity more the exceptional experience than the norm, thereby leading to the development of stress-related illnesses (which account for 75-80% of illness in modern life).
Unfortunately, the conditioning in place makes this activity more the exceptional experience than the norm, thereby leading to the development of stress-related illnesses (which account for 75-80% of illness in modern life).
Therefore, the benefits of relaxation practice are great, especially for our hectic, modern, overscheduled, multitasking, technology-driven lives. Relaxation interventions are useful for people in all stages of health and illness: the critically ill, expectant parents attending childbirth preparation classes, taxi drivers learning to regulate blood pressure while weaving through city traffic, and nursing students dealing with test anxiety.1 Even in the acute phase of recovery from a myocardial infarction, or during an examination in an emergency room after an accident, clients can derive the clinical benefits of relaxation by learning basic breathing and muscle relaxation exercises (see Exhibit 16-1).
Over the past four decades, nurses in all areas of practice can be found who offer relaxation and breathing techniques and some form of meditation to their clients. Yet this is not new to nursing. Florence Nightingale counseled her nurses to support patients’ rest and well-being by reducing unnecessary noise, not awakening patients out of their first sleep, and protecting patients from unnecessary disturbances such as conversations of doctors or friends within earshot and the disturbing rustling of crinolines. She advised that “all hurry or bustle is peculiarly painful to the sick.”2 One wonders what Nightingale would say if she were to visit hospitals and healthcare settings today and witness our efforts to follow her legacy in the chaos of our times.
EXHIBIT 16-1 Clinical Benefits of Relaxation
Relaxation training has the following clinical benefits:
Decreases the anxiety accompanying painful situations, such as debridement or dressing changes
Eases the muscle tension pain of skeletal muscle contractions
Decreases fatigue by interrupting the fight-or-flight response
Provides a period of rest as beneficial as a nap
Helps the client fall asleep quickly
Increases the effect of pain medications
Increases ability to tolerate pain
These days, nurses offer relaxation practices in self-care circles for themselves and their colleagues, as well as for clients in hospitals, community and adult education programs, outpatient clinics, and homeless shelters, to promote a variety of personal benefits (see Exhibit 16-2). Nurses also offer these practices to individuals, families, groups, children in classrooms, clients and families in home care and hospice, and workers and executives in workplaces and corporations.
Cross-Cultural Context
Relaxation practices are found throughout time in all cultures around the world. Whether these practices are mediated through the use of herbs, acupuncture, movement, or prayer, evidence of the power, impact, and importance of relaxation and the use of breath can be seen in shamanic healing, yoga, meditation, Chinese medicine, and other traditions around the globe. Modern research exploring the area of psychoneuroimmunology demonstrates the vital importance of relaxation in improving immune system function. Thus, psychoneuroimmunologic research suggests the importance of this ancient practice for our modern scientific world. (See Chapter 31 for further information.) Modern psychology uses relaxation as a dimension of systematic desensitization, in which clients learn to relax in the face of mild, then moderate, and then intense stressors. Neuroplasticity research investigates how neuroscience is influenced by practices of mindfulness showing how the structure and function of the brain are much more changeable than originally believed. This new field demonstrates that cultivating the mind also changes
or grows the brain.3 Practitioners of biofeedback include relaxation practice with their therapy to help clients learn to self-regulate their peripheral temperature, heart rate velocity, muscle activity, and brain wave frequencies.
or grows the brain.3 Practitioners of biofeedback include relaxation practice with their therapy to help clients learn to self-regulate their peripheral temperature, heart rate velocity, muscle activity, and brain wave frequencies.
EXHIBIT 16-2 Whole Self Benefits of Relaxation
Relaxation has the following benefits to self:
Decreases pain
Decreases anxiety
Improves immune system function
Quiets the fight-or-flight sympathetic response
Facilitates sleep
Provides rest
Increases efficacy of pain medications
Reduces muscle tension and increases blood flow
Improves sense of well-being
Offers insight and creativity
Jon Kabat-Zinn in his original research at the University of Massachusetts found relaxation breathing and body scanning to be a vital dimension of a mindfulness-based stress reduction practice used for dealing with pain and depression.4 Dean Ornish includes relaxation, meditation, breathing, and yoga in his pioneering cardiac rehab program to reverse heart disease.5 Dolores Krieger and Dora Kunz guided nurses to perform sustained centering and presencing, a practice of meditative inner connection and relaxed awareness, before entering into therapeutic touch practice with their clients.6,7 These modern pioneers all continue to validate the importance of the ancient practice of relaxation through the use of its modern counterparts.
Caring for Ourselves, Caring for Others: A Spiritual Journey
These days the practice of relaxation in its many forms is more important for nurses than it ever was. These challenging times of constant change and global uncertainty require nurses to walk a wellness path of self-care, self-healing, and spiritual awareness. Finding and then cultivating a personal relaxation practice can help nurses restore, renew, deepen professional self-development avoid burnout, as well as model a personal wellness path for their clients. Living this path and sharing by example gives nurses an inner understanding and appreciation of the benefits and challenges their clients face as they start to integrate complementary practice into their everyday lives.
Relaxation practice offers nurses an important refuge, a self-awareness foundation for deepening their spiritual journey as holistic caregivers. Whether individuals are being with themselves and with “all that is” in meditation; exploring their own past issues, traumas, or painful life experiences in counseling and psychotherapy; or expanding their awareness in intuitive practices and energy healing, a foundation of deep relaxation of the bodymindspirit is a fundamental step on the path. Long-time practitioners of healing arts continue to loop back, reconnect, and deepen their abilities to relax and renew with each step of their path (see Exhibit 16-3).
The American psyche, poised to do everything with intensity and competitiveness, also enters with us into self-healing and spiritual practices. This intensity and competitiveness can be our undoing, especially if we forget the importance to our bodymindspirit of nondoing, which is different from “doing nothing.” Holistic practice, whether offered within the biomedical healthcare system or explored in a retreat setting, offers health and healing benefits with clinical implications but remains in its essence an avenue for spiritual renewal. Achaan Chah offers us guidance in his wise insight on letting go, peace, and nondoing.
EXHIBIT 16-3 Benefits of Relaxation for the Nurse and Holistic Nursing Practice
Relaxation:
Is an essential element of self-care
Cultivates a centered, calm presence
As a self-care practice offers insights into challenges and benefits clients will experience
Offers a vehicle to modulate and self-regulate the nurse’s own stress response in stress-filled work settings
Supports a therapeutic energetic bond and connectedness when practicing along with clients or colleagues
Creates opportunity for intuitive exploration, insight, and understanding of self and others, issues, and problems
Is an excellent vehicle for beginning professional gatherings and staff meetings; offers opportunity to be present, creative, open, and connected
Can be done anywhere, without any cost or equipment, is easily teachable, and easily practiced
Can be a spiritual practice for opening ourselves to deeper ways of being
Do everything with a mind that lets go,
Do not expect any praise or reward.
If you let go a little, you will have a little peace.
If you let go a lot, you will have a lot of peace.
If you let go completely, you will know complete peace and freedom.
Your struggles with the world will have come to an end.8
Nurses must reclaim their legacy of caring by cultivating their compassion, wisdom, spirit of service, and heart-centered health care in their culture. Relaxation is a first step along this path. It is easy to learn and practice; its benefits are demonstrated quite readily; and it offers nurses an easy entree to a self-care plan for themselves, their colleagues, and their clients.
The Stress Response
The last decade has brought new awareness to what constitutes an emergency response, both for individuals and for society. Whether we are dealing with a national or international tragedy or disaster or the everyday intense internal reactions we experience when faced with a truck cutting in front of us on the highway, a “code blue” coming over the loudspeaker, or a child darting into the street, we experience what some researchers refer to as an “adrenaline rush,” the familiar fight-or-flight response. This response is actually a complex series of psychophysiologic processes that prepare us to deal with the real or perceived emergency. It is important to note that people respond to an imagined threat in the same way that they respond to an actual threat to their well-being. That is why in times of personal threat, such as facing a possible health crisis or the fear of potential terrorism, these practices help us keep balanced or self-regulated.
The following are the generalized stress responses of the body, mind, and energy field:
Constriction of blood flow to the hands and feet (cool extremities)
Tightening of the muscles
Constriction of one’s energy field (closing down or blocking flow)
Increased heart rate
Increased oxygen consumption
Increased brain wave activity
Increased sweat gland activity
Increased blood pressure
Increased anxiety
This stress response readies the bodymindspirit through this instinctive response pattern to prepare for a stress, shock, or trauma. In modern life, the body physically alerts or readies itself far beyond what is needed to deal with a fastpaced stressful life. Most people know how to turn on this stress response but have little familiarity with how to relax or turn it off. Not only
do people not know how to relax, but our society typically has a negative view of relaxed people.
do people not know how to relax, but our society typically has a negative view of relaxed people.
The paradox is that masters of ancient practices have learned that, although instinctive responses such as the fight-or-flight response can put one on alert to help protect one in an emergency or a crisis, a more conscious relaxation discipline, practice, and philosophy offer deeper possibilities.
An example for understanding this philosophy is the ancient Chinese hexagram for crisis. The two Chinese characters that make up the word crisis are danger and opportunity. Hidden within each crisis is an opportunity, not just a danger. People must learn to face the danger and seize the opportunity. In practice, relaxation offers people that possibility of turning a difficult situation around for the better.
EXERCISE
Imagine a relaxed person. Write as many words as you can to describe that image. After making your list, note how many of those words you consider to represent a positive quality in a person, how many of those words society considers as representing a positive quality, and how many of those words are considered as representing a positive quality of a person in the workplace. Log any awareness or insights you gain from this exercise in a journal. See if these insights help you when you are discussing relaxation practice with clients, colleagues, family members, and others. Look into the real and perceived costs and benefits of multitasking. This exercise may help you to become aware of conscious or unconscious positive and negative attitudes that can affect clients’ interest and motivation to learn to relax.
▪ MEDITATION
Relaxation Response Meditation
Though many people call the body-mind-spirit effects of relaxation the “relaxation response,” this phrase is attributed to Herbert Benson and his colleagues at Harvard University, who used a nonreligious form of meditation that is similar to transcendental meditation to produce the opposite of the fight-or-flight response. Their relaxation response meditation has been introduced into many healthcare settings and has been applied in a variety of studies that demonstrate its efficacy in treating hypertension and anxiety.9 Both transcendental meditation and relaxation response meditation offer a practice consisting of 20 minutes of daily passive concentration focused on a neutral word, such as the Sanskrit word Om in transcendental meditation or one in relaxation response meditation. In relaxation response meditation, slow repetition of the word with each exhalation has been shown to bring about the same psychophysiologic responses as other deep relaxation processes (described later). Further studies have documented a deep relaxation response when the client focuses on a short, personally meaningful religious statement or quotation, as was found in what Benson termed the “faith factor.”
The changes that occur when an individual reaches a deep level of relaxation are exactly the opposite of those that occur in the fight-or-flight response. Alterations take place in the automatic, endocrine, immune, and neuropeptide systems as follows:
Deep relaxation increases
Peripheral blood flow (warm extremities)
Electrical resistance of skin (dry palms)
Production of slow alpha waves
Activity of natural killer cells (improved immune function)
Deep relaxation decreases the following functions in the body:
Oxygen consumption
Carbon dioxide elimination
Blood lactate levels
Respiratory rate and volume
Heart rate
Skeletal muscle tension
Epinephrine level
Gastric acidity and motility
Sweat gland activity
Blood pressure, especially in hypertensive individuals10
Benson calls relaxation response meditation “a very simple technique.” For centuries, many
elements of the relaxation response have been elicited within a religious context in cultures around the world.
elements of the relaxation response have been elicited within a religious context in cultures around the world.
Benson cites four basic elements that are common to all relaxation response practices: a quiet environment, a mental device, a passive attitude, and a comfortable position. To incorporate these four factors, Benson recommends that the practitioner first create a quiet environment devoid of all noises and distractions. Next, the meditator is asked to choose a mental device, that is, the “constant stimulus of a single-syllable sound or word.” This word is repeated silently or in a low, gentle tone. To allow rest and relaxation, the person is invited to adopt a passive attitude, not forcing the relaxation response. The meditator also is counseled to simply disregard any distracting thoughts that enter the mind.11 To reduce any stress or muscular effort, the meditator should assume a comfortable position on the floor or use a chair. Incorporating these elements and focusing on the mental device of the word one for 20 minutes each day facilitates the relaxation response.
The holistic nurse may wish to explore and experience each of the relaxation practices presented in this chapter and write her or his insights and experiences in a journal.
Breathing In and Breathing Out
One of the simplest and deepest relaxation practices is right under our noses every moment of every day: breathing. We have special breathing practices to assist childbirth, and we recognize special breathing patterns when we are dying. In between, we breathe each moment, and our breathing patterns reflect our lives’ peaks and valleys, our stresses, and our relaxing moments.
Beyond the unconscious breathing pattern that most people are involuntarily practicing is a conscious breathing practice described long ago in the ancient sacred texts of yoga, the Buddha’s Four Foundations of Mindfulness, Taoist qi gong practice, native shamanic practices, and spiritual teachings and practices from around the world.
Conscious awareness of breathing—whether the slow, deep, diaphragmatic breaths of hatha yoga or the mindful awareness of breathing in and out in mindfulness meditation—can be practiced in formal sessions of 20 to 45 minutes once or twice a day. Conscious awareness of breathing also can be practiced informally by breathing with mindfulness during everyday activities.
Jon Kabat-Zinn developed a mindfulnessbased stress-reduction program that demonstrates how conscious awareness of breathing can help to relieve chronic pain, depression, and anxiety. Participants in the 8-week program practice mindfulness meditation every day; they also practice body scanning (systematically bringing attention to each part of the body, letting the attention rest there, letting go of any judgment about how it is “supposed to feel,” being with this part of the body, and then moving on to the next place in the body), and yoga (performance of meditative asanas or postures combined with breathing to create a union of body, mind, and spirit). Several studies in clinics, communities, and prisons have demonstrated that Kabat-Zinn’s program, as well as other modern forms of meditation, can improve quality of life and reduce symptoms (see Table 16-1).
Breathing and Energy Healing Practice
Breathing practice is also an integral dimension of yoga and qi gong. The breath or life force, called prana in yoga and qi (or chi or ki) in Chinese energy practice, is the vital force or energy that animates life. Nurses practicing therapeutic touch center themselves through conscious meditation on their intention to help or to heal, by letting go of outside distractions, and by opening themselves to allow the universal life force to flow through them to their clients. They can use their breathing practice to help enhance this sustained centeredness and their openness to this healing life force.
The ancient yogis knew that by learning to consciously control their breathing and their bodies through practicing a series of yoga postures (asanas), they could open and ready themselves for transcendent awareness. As mentioned previously, yoga practices also have been demonstrated in the work of Kabat-Zinn and Ornish to have great health benefits.
Qi gong practices date back to about 5000 bce. Taoist and Buddhist qi gong masters channeled the flow of qi from nature and the universe through their bodies by practicing simple movements, combined with an awareness of breathing and meditation.
TABLE 16-1 Research-Based Outcomes of Meditation | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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These ancient Chinese practices, which are one of the dimensions of traditional Chinese medicine, have long been renowned for producing health benefits and slowing the aging process. These effects are now being researched and documented in scientific literature (see Table 16-1).
Yoga and qi gong practitioners consider these disciplines essential self-care practices for the unitary body-mind-spirit. These practitioners demonstrate a living legacy of self-care that not only offers healing to their patients, but is the fundamental requirement for development of a healer or teacher. In contrast, the Western scientific course of study does not emphasize the cultivation of one’s own personal wellness and spiritual development as a prerequisite for becoming a licensed healthcare professional.
Other Forms of Meditation
As illustrated by transcendental meditation and the works of Benson and Kabat-Zinn, there are many forms of meditation. Some say that hundreds of practices can be listed under the heading of meditation. Each practice cultivates a qualitative state of mind that can induce a deep experience of relaxation and calm. In some meditative practices, such as transcendental meditation and relaxation response meditation, the individual focuses on an object of meditation to move away from and minimize thoughts. Other traditions, such as mindfulness meditation, insight meditation, and vispassana meditation, invite practitioners to cultivate greater focus by returning to the breath as sensations, thoughts, and feelings are present.
Centering prayer, a Christian meditation practice developed by Father Thomas Keating, focuses on words or sounds in somewhat the same way that transcendental meditation uses mantras (sacred Sanskrit syllables and words such as Om). Other meditation practices invite meditators to gaze at the flame of a candle, a sacred image, or a mandala; to chant aloud; or to concentrate on a nondualist or unanswerable question (or koan), as in Zen practice.
Janet Macrae calls therapeutic touch a moving meditation.23 Sufi dancing is another form of moving meditation, as are Native American and shamanic ritual dances, which may continue for many hours or many days. The purpose of spiritually focused meditation is to awaken to a higher consciousness, to be at one with the sacredness of “All,” and to become one with the Divine. Individuals practice such meditation to open the bodymindspirit to the qualities of compassion, wisdom, forgiveness, skillfulness, no fear, stillness, openness, and interconnectedness.
The healing arts are the underpinning of many cultures’ healing traditions. For example, Tibetan healers begin their education at an early age, studying sacred texts on healing and herbs as well as meditating and praying each day to cultivate a heart of compassion and loving kindness and to become one with the compassionate healing energy and wisdom of the limitless realms. After years of study and apprenticeship (some healers apprentice from childhood), they practice their healing art, the science of the bodymindspirit.
What would health care be like if nurses, physicians, and other healthcare practitioners began by cultivating a heart of compassion and service? What would the healthcare system be like? Would burnout exist? (See the section titled “Loving Kindness Meditation” later in this chapter.)
Meditation Practices
This era will give birth to many distillations of ancient meditative practices, including intricate Tibetan meditative practices, because of their health benefits. Finding a meditation practice and learning to explore it deeply offer healing and insight, a gift only gained from committed practice.
Mindful Breathing During Nursing Practice
Nurses who wish to be more present with their clients, to practice self-care, and to awaken to the simple sacredness of everyday nursing practice (e.g., hanging an intravenous bag, writing nursing notes, eating, walking down a hall, feeding a patient) may want to practice mindful breathing each moment, as in the following exercises.
EXERCISE: BREATHING I
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EXERCISE: BREATHING II
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Begin with the breath, reminding oneself to offer self-care in each moment by consciously breathing with each activity, is a gift of selfrenewal, freshness, and aliveness that deepens with practice. It is a gift nurses can give to themselves every moment.
Mindful Breathing Meditations
Exploring and practicing relaxation and meditation help the nurse gain insight into specific methods and issues that clients may face as they work to integrate these techniques into their daily lives. It also offers the nurse an opportunity for personal wellness, self-care, and spiritual development. When choosing a meditation practice to explore, the nurse should commit to that practice for at least 4-6 weeks before trying another, while keeping a journal of his or her reflections along the way.
EXERCISE
Mindfulness of the Breath Exercise I (Lying Down)
Mindfulness of breathing is made up of two forms of energy: the energy cultivated by bringing attention to the breath called awareness and the energy of bringing attention back lovingly over and over to the breath called concentration. Our minds naturally wander, so the practice of bringing the attention back to the breath is itself an integral practice of mindfulness meditation. To begin, lie on the floor with your hands on your abdomen. Close your eyes and feel the movement of your body with every rise and fall of the breath. Follow both the inhalation and exhalation fully.
With each inhale, repeat, in your mind, “Breathing in, I am aware of breathing in,” and on each exhale, “Breathing out, I am aware of breathing out.” As you continue, you may shorten the phrase by repeating gently in your mind “In” on the in breath and “Out” on the out breath. As you are breathing and lying comfortably with your hands on your abdomen, allow a gentle smile to bloom on your lips and at the corners of your eyes. (After all, this is supposed to be an enjoyable practice.) Try this practice for 15 to 20 minutes. Observe and note any awareness, reflections, and insights in your personal journal. To extend this practice during the next week, you may wish to continue lying down in a comfortable position, or you may choose a sitting meditation practice, as described next.
EXERCISE
Mindfulness of the Breath Exercise II (Sitting)
In a quiet place, find a comfortable seated position. Either sit on a chair with your feet on the floor and your back supported and straight, or sit on the floor using a
meditation cushion (zafu) or a regular pillow folded in half to create a supportive lift under your buttocks. If you are sitting on the floor, find a comfortable way to place your legs, either (1) crossed in lotus or half-lotus position with or without pillows under your knees, (2) Indian style, or (3) straight out in front of you, with a pillow under your knees and your back supported against a reclining support or against the wall. Focus on a point on the floor in front of you and gently lower your lids until they are almost closed. Gently bring your attention to your breath.
meditation cushion (zafu) or a regular pillow folded in half to create a supportive lift under your buttocks. If you are sitting on the floor, find a comfortable way to place your legs, either (1) crossed in lotus or half-lotus position with or without pillows under your knees, (2) Indian style, or (3) straight out in front of you, with a pillow under your knees and your back supported against a reclining support or against the wall. Focus on a point on the floor in front of you and gently lower your lids until they are almost closed. Gently bring your attention to your breath.
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Continue to bring your attention to your breath, allowing any thoughts, feelings, or sensations to be gently held by your mindful awareness, as you gently bring your attention back to the breath and the repeated phrase. Practice for approximately 15 to 20 minutes. After your practice, note your experience in your journal.
This practice is an example of using meditation to become aware of our minds and to practice just being, being present in this moment, and nondoing rather than “doing nothing.” We get so caught up in believing that we always have to be doing or multitasking that we lose the essence of what is of true value. Mindfulness helps us to get back in touch with what is truly healing within and around us.
As you continue, you may want to note Kabat-Zinn’s attitudinal foundations of mindfulness practice, which include nonjudging, patience, trust, nonstriving, the cultivated freshness of seeing everything as new (called beginner’s mind), acceptance, and letting go.25
Walking Meditation
Walking as if one were planting peace with each step—this is the essence of walking meditation.4pp33-39 This practice can be especially helpful during times of trauma and crisis and can be done to center oneself in the most challenging and traumatic of circumstances.
To practice, start with the left foot and begin walking slowly by synchronizing the in and out of the breathing meditation practice with each step. Sometimes you may take three steps to the inhale and three steps to the exhale. Play with your practice, exploring how carefully you can become aware of the subtle sensations of slowly lifting, moving, and placing each step as you continue your awareness of breathing.
This practice can be interspersed between sitting practice sessions: 20 minutes of sitting, 10 minutes of walking, 20 minutes of sitting, 10 minutes of walking. This also is a wonderful meditation to practice at a more normal pace of walking at work, as well as going to and from work. “Walking down the hall, I am aware of my footsteps and my breathing. Being in this present moment, I know this is the only moment.” Practicing walking meditation often allows the practice to be in our bones so that it is there for us when we need it most.
Cultivating the Heart of Compassion Meditation
Loving Kindness Meditation
This meditation for helping professionals is adapted from Thich Nhat Hanh’s loving kindness meditation in Teachings on Love.26
Sitting peacefully, begin as in sitting meditation practice, and then plant each phrase like a healing seed within your heart, following your breath and focusing on your intention to cultivate compassion. Say each line to yourself in your mind, or ask a friend to read this meditation aloud to you, pausing after each line so that you can slowly repeat it silently to yourself.
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In Part II of this meditation, repeat the same meditation while imagining that someone you care about or are having difficulty with is sitting in front of you, and center your attention on cultivating and offering compassion while repeating silently in your mind:
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Then, in Part III, imagine offering compassion to all beings on Earth, to the Earth, to all the planets, and to all beings throughout the universe and beyond time and space:
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