Relaxation (Leaflet 6)

The information given below is designed to help you manage your stable long-term breathlessness. If your breathing is getting worse, or you are experiencing breathlessness as a new feeling, it is important to seek medical advice from your GP.

Learning to relax

Breathlessness can often cause anxiety and feelings of panic and Leaflet 5: Managing thoughts about breathlessness, explains the reasons for this in more detail. Anxiety tends to make the feeling of breathlessness stronger, which in turn leads to more anxiety. It is important to remember that breathlessness in itself is not harmful and you will recover your breathing on resting. It is also possible to try to control the level of anxiety you are feeling and relaxation is one way of helping with this. Relaxation is a useful skill that you can learn. This leaflet will go through some ways to help you to learn how to relax.

Preparing for relaxation

Relaxation is not always easy, but the more you practice the easier and more effective you will find it. Try to allow yourself to have some time each day to practice your relaxation exercise. Tell the people with whom you share your home that you will need at least 20 minutes every day to practice relaxation undisturbed. Try to ensure the light and temperature of the room is at a comfortable level.

Positioning

• Check your posture.
• Ensure that your neck, shoulders and arms are as relaxed as possible.
• Sit or lie with your legs uncrossed.
• Try to have your elbows supported at your side on cushions, or on the arm of the chair.
• Let your shoulders and arms sink down into the cushions.
• Try to close your eyes. If this is too difficult, choose a spot in front of you, on the wall or floor, and keep your eyes fixed on this point. When you are more relaxed it will be easier to keep your eyes closed.

When you finish your relaxation exercise

• Become aware of the real surroundings by listening to the sounds around you.
• Be aware of how relaxed you feel.
• Start to move very gently by stretching your arms and legs before moving from your position.

Relaxation exercises

These might be something that you can try with a friend or relative together. It might be helpful to have someone read these out to you for the first few times until they become familiar.

A. Visualisation

Visualising a relaxing scene can often help us to feel more relaxed. It could be your favourite place, a walk that you know, a garden, or the beach. It could also be somewhere from your imagination. Somewhere that makes your feel happy and secure, but not places that evoke bad or sad memories. Sometimes visualising colours, and images associated with these colours can also be relaxing. Here are some examples that you might like to try.

Relaxation using colour

Make yourself comfortable
Think about the colour green
Concentrate on green all around you
The green of spring turf on cliff tops
The damp green of misty hillsides
Cricket on a lazy village green
Close your eyes and feel the freshness of green (try changing the colours and images of that colour to one that you find most relaxing)

Cottage by the sea

First make yourself completely comfortable. Take yourself in your imagination to the garden of a cottage by the sea. You are sitting in a comfortable garden chair with plump cushions. All around you are the flowers of the cottage garden and you have a wonderful view out to the sea. In the distance you hear the rhythmic beating of the waves on the beach below.

After a while, you get up from your chair and walk across the brilliant, sun-warmed grass of the lawn. You make your way down a flight of steps which lead directly onto the wide, smooth, sandy beach. You take off your shoes, and walk over the pale, warm, dry sand down towards the water's edge. Feel the warmth coming from the sand beneath your feet, feel the sand between your toes.

As you get nearer to the sea, the sand becomes smooth, hard and damp. Now you can come to the water's edge. You watch the sparkling foam running up the beach towards you, and you let the warm, shallow water flow around your ankles. You walk along the water's edge, enjoying the rhythmic swish of the waves swirling around your ankles, the sunlight dancing on the water.

Now you turn back towards the cottage. You walk back over the smooth, hard sand, over the pale, powdery sand. You go up the steps which lead back onto the lawn. The grass feels cool and refreshing to your warm, bare, sandy feet. You sit down in your chair again, allow your eyes to close and bask in the warmth of the late afternoon sun.

Enjoy this scene for a few minutes. Then begin to bring your attention back to the room in which you are in. Become aware of the feeling of relaxation that you are bringing back with you. An in your own time open your eyes.

Tranquillity exercise

Think about the word tranquillity
Say tranquillity three times in your mind
Think about a colour associated with tranquillity
Imagine all the things that this colour reminds you of
Now imagine yourself in a place that brings a feeling of tranquillity
What does it smell like in this place? What can you hear?
Enjoy this feeling of tranquillity

Ref: Thew, M, (2008) ‘Portable’ Relaxation for Every Day Living’ In: Thew, M & McKenna, J. (Eds) (2008) Lifestyle Management in Health and Social Care. Oxford: Wiley Publishing

B. Letting go of thoughts

• Spend a few moments taking control of the pace and regularity of your breathing.
• Close your eyes and imagine that you are sitting on the bank of a river.
• You are warm and relaxed, and able to breathe freely.
• You see many leaves slowly drifting downstream.
• When a thought or feeling comes into your mind, try to see this as a leaf and let it drift away from you, and disappear.
• When it's gone, return to gazing at the river waiting for the next leaf to float by with a new thought.
• Try not to think about the contents of each leaf. Just observe it and then let it go.
• Sometimes the same leaf may come up many times or several leaves will seem related to each other, or the leaves may be empty. That's okay.
• Don't allow yourself to be concerned with these thoughts. Just watch them pass in front of your mind's eye.

C. Body scan

• Begin by focusing your attention on your feet, trying to release the tension in your muscles.
• First think of your toes, working up through your ankles to your calves and shins, over your knees and along your thighs.
• Notice how loose your legs feel now.
• Become aware of your tummy and then your chest. Feel the tension flowing out of your body.
• Now think of your shoulders travelling down to your elbows, through your forearms, and into your wrists, hands and fingers.
• Become aware even of your fingertips.
• Notice how loose your arms feel now.
• Next, focus your attention on your lower back and pelvis. Try to release any tension you are feeling here.
• Allow this feeling of looseness rise up your back, to the back of your chest and shoulder blades
• Continuing up into your neck and scalp, to the crown of your head.
• Slowly begin to focus on your forehead and move down to your jaw.
• Imagine that you have a giant paint brush, sweeping over your body, following the same route and creating a feeling of calm and relaxation.
• Feel that every part of your body is relaxed.

Further information

For further help or advice contact the Breathlessness Intervention Service on 01223 274404 - 09:00 to 17:00 Monday to Friday.