Holladay Physical Medicine

Stress management strategy is to evoke the relaxation physical response on a regular, daily basis.


Facilities Related Services Products Doctors Contact us DTS Spinal Decompression Newsletters All about Chiropractic 7 Keys to Absolute Health Conditions We Manage Accidents and Injuries Ask the Doctor Account Status Review fee Schedule View Driving	STRESS REDUCTION What is the definition of stress? Stress is defined as a person's response to his environment. Stress is measured in terms of arousal or stimulation. As such, stress must be present for a person to function. Each person has his own normal (homeostatic) level of arousal at which he functions best. If something unusual in the environment occurs, this level of arousal is affected. We offer stress reduction using the Chi Machine. You should use it 3 minutes each day to eliminate the storage of stress. It works! UNDERSTANDING STRESS: There are three phases of arousal: Phase 1. Alarm phase: When an unusual (or stressful) event occurs, the output of energy drops for a short period as the event is registered in the person's mind. Phase 2. Adaptation phase: Next, the output of energy increases above the normal level; arousal is heightened as the person seeks to deal with the situation. Adaptation responses available to humans include physically running away, fighting, freezing (self immobilization), suppression emotion, or learning. Phase 3. Exhaustion phase: Finally the person's available energy is expended and his capacity to function effectively is reduced. The physical response to stress is as follows: Increased: heart rate, blood pressure, respiration, perspiration, pupil dilation, muscle tension. In the state of chronic stress, heart rate, blood pressure, and respiration are chronically elevated The physical response to relaxation is as follows: Decreased heart rate, blood pressure, respiration, pupil dilation, muscle tension Stress management strategy is to evoke the relaxation physical response on a regular, daily basis. Personal Life Events analysis To learn the level of stress (distress) in your life, circle the value at the right of each of the following events if it has occurred within the past 12 months: Death of spouse.........................................100 Divorce...................................................73 Marital separation.......................................65 Jail term..................................................63 Death of close family member.........................63 Personal injury or illness................................53 Marriage...................................................50 Fired from job............................................47 Marital reconciliation....................................45 Retirement................................................45 Change in family member's health.....................44 Pregnancy.................................................40 Sexual difficulties........................................39 Addition to family........................................39 Business readjustment...................................39 Change in financial status...............................38 Death of close friend....................................37 Career change............................................36 Change in number of marital arguments...............35 Mortgage or loan over $10,000..........................31 Foreclosure of mortgage or loan........................30 Change in work responsibilities.........................29 Son or daughter leaving home...........................29 Trouble with in-laws......................................29 Outstanding personal achievement......................28 Spouse begins or ceases working........................26 Starting or finishing school...............................26 Change in living conditions...............................25 Revision of personal habits...............................24 Trouble with boss..........................................23 Change in work hours, conditions.......................20 Change in residence.......................................20 Change in schools..........................................20 Change in recreational habits............................19 Change in church activities..............................19 Change in social activities...............................18 Mortgage or loan under $10,000.........................17 Change in sleeping habits................................16 Change in number of family gatherings................15 Change in eating habits..................................15 Vacation....................................................13 Christmas season..........................................12 Minor violation of the law................................11 How to analyze your score: Add the circled values. If your total score is more than 150, find ways to reduce stress in your daily life so that your stress level doesn't increase. The higher the score, the harder one needs to work at staying physically well. Suggested uses for personal Life Events analysis: 1. Become familiar with the different events and the amounts of stress they promote. 2. Put the list of events where your family can easily refer to it several times a day. 3. Practice recognizing the stress level when one of these events happens. 4. Think about the meaning of the event for you and identify your feelings. 5. Think about the different ways you can adjust to the event. 6. Take your time in arriving at decisions. 7. Anticipate life changes and plan for them well in advance whenever possible. 8. Pace yourself. It can be done even if you are in a hurry. 9. Look at the accomplishment of a task as a part of ongoing daily living; avoid looking at such an achievement as a stopping point. Congratulate yourself and push ahead. 10. Recognize that your internal mechanism of coping with stress is directly tied to how your health and well being will be influenced by it. Note: This scale is derived from the Holmes-Rahe Social Readjustment Scale. Holmes, T. & Rahe, R. (1967) "Holmes-Rahe Social Readjustment Rating Scale", Journal of Psychosomatic Research, vol. II. Learning to relax:* You may have grown to accept a certain high level of stress and anxiety as ``normal.'' You may be unfamiliar with what it feels like to be relaxed, calm, and unstressed. With progressive relaxation you learn what it feels like to be relaxed, you learn to increase relaxation to a new level. By doing this you not only improve your physical well being by reducing hypertension, headaches, and other physical complaints, but you improve your mental state by reducing stress, anxiety, irritability, and depression. The physical setting: Progressive relaxation should take place in a quiet, attractive room. You should be completely supported. There should be no need for exertion to maintain body support. You should wear comfortable, loose fitting clothing during the sessions. The process: Lie on the floor or a bed and follow the directions of the relaxation technique in the following Relaxation Training Technique as you tense and relax various muscle groups. After the initial tensing of the muscles, release the tension instantly and completely. This is very important in order to get the ``pendulum effect.'' The muscles relax beyond the point of their normal relaxed state. You should then feel the important difference between tension and relaxation. You should concentrate on the feeling of relaxation, learn what it is to relax and how to increase it. Continually repeat to yourself, ``Know what it feels like to be relaxed, deepen the relaxation, know what it is to be relaxed. '' Do's and don'ts'' of relaxation: Do: Make sure you have comfortable, loose clothing and proper back support Don't: Put your self in an awkward position or in a position that will make it easy to fall asleep Do: Allow your mind to quiet down. If tense thoughts enter while you are relaxing, let them pass out of your head. Don't: Think your way into tension. If you can't clear your mind, take a long, deep breath and let it out slowly. Do: Stay alert and conscious while you are relaxing. Pay close attention and note any changes in your body (feelings that stand out for you). Don't: Allow yourself to become groggy and sleepy. If you start falling asleep, open your eyes and sit up. When you are ready, return to relaxation posture. Do: Go at your own pace and let go of your muscles as your body decides to give up tension. Don't: Expect yourself to relax all at one. Like any other physical exercise, you must practice letting go step by step. Do: Give your body messages of appreciation for relaxing as you notice these feelings going through your body. Don't: Get down on your self for not relaxing. Your body should be trusted to go at its own pace. Do: Stay aware of your breathing. Observe how much air you're taking in full breaths at regular rhythms. Don't: Smoke before, during or after relaxation as it tightens lung tissue and blood vessels. Let your body breathe. A full breathing exercise Step 1: Lie prone on the floor. Loosen your belt and restrictive clothing. Step 2: Relax and exhale as completely as possible. Begin to inhale slowly making your belly rise. Now move your rib cage. Now your chest. Hold it for a second. Now, exhale completely, all the air out of your lungs. Try it again. This is complete breathing. Breathe normally for a while, and in the next minute take at least one more complete breath. Pause one minute. Step 3: You are still lying prone. As you lie there you will begin stretching muscles to achieve unblocked circulation. Bring your arms above your head and stretch them away from you fully. Now stretch your legs and feet downward, away from you, take a deep breath, let go and relax. Pause ten seconds. Feel the effects of the stretch on your body and on your breathing. Pause 15 seconds. Now sit up very slowly. Step 4: Stand up for this part of the exercise. There are three very basic stretching postures to increase flexibility. backward bend forward bend side-to-side bend As you do your backward bend pay attention to stretching your abdomen and back muscles. Important: Go only as far as you can. Don't push yourself. Bend slowly. As you do your forward bend, pay attention to the stretch of your back muscles and backs of legs; blood in head and arms. As you do your side stretch, pay attention to stretching in your chest, sides and neck. Step 5: Assume a comfortable sitting posture, one you can hold for 15 to 20 minutes. This could be in a chair. Get comfortable and close your eyes when you are ready. Please note everything you are aware of: outside sounds, your bodily awareness, thoughts; note this awareness and do not change it. Then, notice shifting from outside sounds to thoughts of bodily awareness. After approximately five minutes of this, notice that breathing is occurring; again, not to change it but only to notice it. One can enhance this noticing by attaching the words ``breathing out'' to the breath as it leaves the nostrils and ``breathing in'' as the breath reenters. As awareness shifts from breathing to thoughts of external sounds, allow that to happen and the return to ``breathing out-breathing in'' (following the breath). Continue this for five to seven minutes. At this point, try to incorporate some visual imagery in the form of a golden light with the in-breath. See yourself breathing in this golden light and watching it fill the inside of your body. This could be in a particle, vapor, smoke, or mist like form, whatever is comfortable for you. Visualize this light in your head, shoulders, chest and breath out any tensions in the form of a black color. Continue until you visually experience your whole body as being filled with this golden light. Experience that feeling. Stay with this experience for another minute or two. Then, become aware of your breath again, with your body sitting on the floor or chair (feeling grounded). When ready, open your eyes. Step 6: Try this breathing exercise for 15 to 20 minutes daily until you are able to achieve full breathing and stress reduction in a progressively shorter period of time. Exercise to Dissipate Stress. After you have practiced this several times, establish a daily routine for exercise. Start with walking and then rpogress to weight lifting and then high level aerobic routines to dissapate stress. This will insure that the stress you take in every day will not accumulate and be stored as myofascial pain syndrome, arthritis, colitis, gastric ulcer, hypertension and other chronic disorders.

Personal Life Events analysis

To learn the level of stress (distress) in your life, circle the value at the right of each of the following events if it has occurred within the past 12 months:

Death of spouse.........................................100
Divorce...................................................73
Marital separation.......................................65
Jail term..................................................63
Death of close family member.........................63
Personal injury or illness................................53
Marriage...................................................50
Fired from job............................................47
Marital reconciliation....................................45
Retirement................................................45
Change in family member's health.....................44
Pregnancy.................................................40
Sexual difficulties........................................39
Addition to family........................................39
Business readjustment...................................39
Change in financial status...............................38
Death of close friend....................................37
Career change............................................36
Change in number of marital arguments...............35
Mortgage or loan over $10,000..........................31
Foreclosure of mortgage or loan........................30
Change in work responsibilities.........................29
Son or daughter leaving home...........................29
Trouble with in-laws......................................29
Outstanding personal achievement......................28
Spouse begins or ceases working........................26
Starting or finishing school...............................26
Change in living conditions...............................25
Revision of personal habits...............................24
Trouble with boss..........................................23
Change in work hours, conditions.......................20
Change in residence.......................................20
Change in schools..........................................20
Change in recreational habits............................19
Change in church activities..............................19
Change in social activities...............................18
Mortgage or loan under $10,000.........................17
Change in sleeping habits................................16
Change in number of family gatherings................15
Change in eating habits..................................15
Vacation....................................................13
Christmas season..........................................12
Minor violation of the law................................11

How to analyze your score:
Add the circled values. If your total score is more than 150, find ways to reduce stress in your daily life so that your stress level doesn't increase. The higher the score, the harder one needs to work at staying physically well.

Suggested uses for personal Life Events analysis:
1. Become familiar with the different events and the amounts of stress they promote.
2. Put the list of events where your family can easily refer to it several times a day.
3. Practice recognizing the stress level when one of these events happens.
4. Think about the meaning of the event for you and identify your feelings.
5. Think about the different ways you can adjust to the event.
6. Take your time in arriving at decisions.
7. Anticipate life changes and plan for them well in advance whenever possible.
8. Pace yourself. It can be done even if you are in a hurry.
9. Look at the accomplishment of a task as a part of ongoing daily living; avoid looking at such an achievement as a stopping point. Congratulate yourself and push ahead.
10. Recognize that your internal mechanism of coping with stress is directly tied to how your health and well being will be influenced by it.

*Note: This scale is derived from the Holmes-Rahe Social Readjustment Scale. Holmes, T. & Rahe, R. (1967) "Holmes-Rahe Social Readjustment Rating Scale", Journal of Psychosomatic Research, vol. II.

Learning to relax:

You may have grown to accept a certain high level of stress and anxiety as ``normal.'' You may be unfamiliar with what it feels like to be relaxed, calm, and unstressed. With progressive relaxation you learn what it feels like to be relaxed, you learn to increase relaxation to a new level. By doing this you not only improve your physical well being by reducing hypertension, headaches, and other physical complaints, but you improve your mental state by reducing stress, anxiety, irritability, and depression.

The physical setting: Progressive relaxation should take place in a quiet, attractive room. You should be completely supported. There should be no need for exertion to maintain body support. You should wear comfortable, loose fitting clothing during the sessions.

The process: Lie on the floor or a bed and follow the directions of the relaxation technique in the following Relaxation Training Technique as you tense and relax various muscle groups. After the initial tensing of the muscles, release the tension instantly and completely. This is very important in order to get the ``pendulum effect.'' The muscles relax beyond the point of their normal relaxed state. You should then feel the important difference between tension and relaxation. You should concentrate on the feeling of relaxation, learn what it is to relax and how to increase it. Continually repeat to yourself, ``Know what it feels like to be relaxed, deepen the relaxation, know what it is to be relaxed.

'' Do's and don'ts'' of relaxation:

Do: Make sure you have comfortable, loose clothing and proper back support
Don't: Put your self in an awkward position or in a position that will make it easy to fall asleep

Do: Allow your mind to quiet down. If tense thoughts enter while you are relaxing, let them pass out of your head.
Don't: Think your way into tension. If you can't clear your mind, take a long, deep breath and let it out slowly.

Do: Stay alert and conscious while you are relaxing. Pay close attention and note any changes in your body (feelings that stand out for you).
Don't: Allow yourself to become groggy and sleepy. If you start falling asleep, open your eyes and sit up. When you are ready, return to relaxation posture.

Do: Go at your own pace and let go of your muscles as your body decides to give up tension.
Don't: Expect yourself to relax all at one. Like any other physical exercise, you must practice letting go step by step.

Do: Give your body messages of appreciation for relaxing as you notice these feelings going through your body.
Don't: Get down on your self for not relaxing. Your body should be trusted to go at its own pace.

Do: Stay aware of your breathing. Observe how much air you're taking in full breaths at regular rhythms.
Don't: Smoke before, during or after relaxation as it tightens lung tissue and blood vessels. Let your body breathe.

A full breathing exercise

Step 1: Lie prone on the floor. Loosen your belt and restrictive clothing.

Step 2: Relax and exhale as completely as possible. Begin to inhale slowly making your belly rise. Now move your rib cage. Now your chest. Hold it for a second. Now, exhale completely, all the air out of your lungs. Try it again. This is complete breathing. Breathe normally for a while, and in the next minute take at least one more complete breath. Pause one minute.

Step 3: You are still lying prone. As you lie there you will begin stretching muscles to achieve unblocked circulation. Bring your arms above your head and stretch them away from you fully. Now stretch your legs and feet downward, away from you, take a deep breath, let go and relax. Pause ten seconds. Feel the effects of the stretch on your body and on your breathing. Pause 15 seconds. Now sit up very slowly.

Step 4: Stand up for this part of the exercise. There are three very basic stretching postures to increase flexibility. backward bend forward bend side-to-side bend As you do your backward bend pay attention to stretching your abdomen and back muscles. Important: Go only as far as you can. Don't push yourself. Bend slowly. As you do your forward bend, pay attention to the stretch of your back muscles and backs of legs; blood in head and arms. As you do your side stretch, pay attention to stretching in your chest, sides and neck.

Step 5: Assume a comfortable sitting posture, one you can hold for 15 to 20 minutes. This could be in a chair. Get comfortable and close your eyes when you are ready. Please note everything you are aware of: outside sounds, your bodily awareness, thoughts; note this awareness and do not change it. Then, notice shifting from outside sounds to thoughts of bodily awareness.

After approximately five minutes of this, notice that breathing is occurring; again, not to change it but only to notice it. One can enhance this noticing by attaching the words ``breathing out'' to the breath as it leaves the nostrils and ``breathing in'' as the breath reenters. As awareness shifts from breathing to thoughts of external sounds, allow that to happen and the return to ``breathing out-breathing in'' (following the breath).

Continue this for five to seven minutes. At this point, try to incorporate some visual imagery in the form of a golden light with the in-breath. See yourself breathing in this golden light and watching it fill the inside of your body. This could be in a particle, vapor, smoke, or mist like form, whatever is comfortable for you. Visualize this light in your head, shoulders, chest and breath out any tensions in the form of a black color. Continue until you visually experience your whole body as being filled with this golden light. Experience that feeling.

Stay with this experience for another minute or two. Then, become aware of your breath again, with your body sitting on the floor or chair (feeling grounded). When ready, open your eyes.

Step 6: Try this breathing exercise for 15 to 20 minutes daily until you are able to achieve full breathing and stress reduction in a progressively shorter period of time.

Exercise to Dissipate Stress. After you have practiced this several times, establish a daily routine for exercise. Start with walking and then rpogress to weight lifting and then high level aerobic routines to dissapate stress. This will insure that the stress you take in every day will not accumulate and be stored as myofascial pain syndrome, arthritis, colitis, gastric ulcer, hypertension and other chronic disorders.