Anxiety in Childhood and Adolescence

Encouraging Self-Help Through Relaxation Training

Frank Carter, Peter Cheesman

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317393351
• Edition: 1
• Topic: Psychology
• Subtopic: Abnormal Psychology
• Index: Psychology

Many counter-productive behaviours in children may be anxiety-related and in this book, originally published in 1988, the authors proposed that a disabling level of tension and stress experienced by many children frequently goes unrecognised. This often leads to failure to analyse psychological and educational problems and inappropriate ways of dealing with them.

This book was aimed at all professional staff working with children, particularly educational and clinical psychologists and teachers. The book is however written in a jargon-free manner and should have wide appeal. The authors show how tension reduction therapy can help children overcome many problems which may manifest themselves as disturbed behaviour, poor sleep patterns, anorexia, school phobia, or poor relationship-making skills. As an extreme example it is shown how significant gains can be made by cerebral palsied children using these approaches. The book, however, is not just a manual of relaxation training; it advocates a less stress-inducing approach generally to working with children, and gives many case studies.

1
Learning How to Relax

The contents of this chapter are useful in their own right. Moreover, anyone who has become familiar with 'how to relax' will have a keener appreciation of the chapters to follow.

Let us start with learning a relaxation technique.

You, the reader, are addressed in this chapter and encouraged to be guided by the ideas which follow — if you wish to become proficient in relaxing yourself, and/or help develop useful relaxation skills in others. In due course you will learn to adopt a more relaxed strategy in coping with your own concerns — including the concern you have about your own child or children for whom you are responsible. You will help children to relax if you yourself are more relaxed to begin with.

Your first priority in developing skills is to create optimum conditions whereby effective learning can take place.

Although attention will be given to transferring the learned skills to those situations where they are most needed, initially relaxation training can best take place in the quiet seclusion of your own home. Make a point of setting aside a fixed time every day over a period of say, 1½–2 weeks, when you can be alone and undisturbed. Choose a room free from distractions. Make sure none of your clothing is restrictive, but allows you full freedom of movement. Give yourself enough arm room and floor space, so that you are not impeded from stretching out fully in all directions, and have handy a comfortable, but firm, hard-backed chair.

Also to hand it is advisable to have a standard cassette-recorder. If the notes which follow are pre-recorded, you will find it easier to engage in the exercises, freed from having to read as you go along. The recorded voice should be soothing as well as clear in pitch and tone, and needs to inspire confidence in the listener.

So much is obvious. Remember that, as well as what you do at home, you should get into the way of practising your relaxation exercises at odd moments throughout the day. Accordingly, the exercises are arranged in sets: those which you can undertake while sitting down, some for when you are standing, and others when you are able to lie and stretch out. Some you can do in any position.

Each exercise takes the form of a stretching or a tensing of certain muscles, followed by relaxing the same muscles. If, by tensing any area of the body, you feel pain, or the muscles remain tensed or tend to spasm, you should forgo the tensing stage and concentrate only on relaxing the area concerned. No exercise is intended to do more than produce a degree of tension compatible with your own individual limits of what is comfortable, but clearly you must profit from the exercise. Repeatedly, you are asked to take each exercise to whatever point is necessary to enable you to distinguish between feeling tense and feeling relaxed.

You are also advised to work to your own plan. Some may complete all three sets of exercises in sequence; others may prefer a break between them. Depending on the time you allow between the exercises or sets, you may complete the programme in anything from ½ hour to 1½ hours. Eventually you should select according to need; do not skimp but spend plenty of time in the early stages to master what may at first seem a misleadingly simple repertoire.

Throughout the three sets the language is similar, so as to consolidate previous learning while exercising the same or adjacent muscle groups. This allows you options when wishing to exercise during the day.

The suggested images are often similar too. The idea of the image is to provide yourself with some picture, the more remote from reality the better, which will help you associate any tension you experience at any time, with a relaxed response. Peter Russell, in The brain book (1979), describes how invoking images can aid recollection — the memory then serves to consolidate the learning as it takes place.

You might like to think of your own images, to encourage you to day-dream your way through the exercises! So you will learn to use your day-dreams as an aid to relaxation. While, for some, an image cannot easily be conjured up, and for others it is not needed, if imagery helps you, use it. The images should not in any way restrict or inhibit, but should serve as cues to the relaxation process. Encourage the child you are teaching to develop his own images, and through them establish reliable cues.

A. Sitting Exercises

1. Sitting posture

Suggested image: you are king of the castle; you are in control, perfectly calm, governed by reason and governing reasonably; only when you are ready will you move, and do what you consider needs doing.

Sit with your back against the upright of the chair, so that you are not slouching at all. Put your hands down by your sides and under your buttocks, so that you are seated on the palms of your hands. In this position your fingers should feel two bones as your body weight presses down on to your hands. These are known as your 'sitting bones'. Remove your hands. Whenever you sit you should consciously try to ensure that both these bones are in contact with the seat of your chair.

With your back against the upright of the chair and your bottom set firmly on the seat, now plant your two feet about a shoulder's width apart, on the floor immediately in front of the chair. The soles and heels of your feet should both be in contact with the floor.

Rest both wrists on top of your thighs, so that your slightly bent fingers almost reach your knees.

In this position your body is well set to begin to relax thoroughly; and if this is an unfamilar position for you to hold for any length of time, nevertheless persevere with it. Remind yourself periodically throughout the day to adopt this sitting posture rather than the sideways slouch, the cross-legged perch, etc.

2. Deep breathing

Suggested image: now you are sitting on a cloud; when you inhale, the fresh breezes fill the cloud to bursting point, providing you with a platform of buoyancy and self-confidence; exhale, and take a well-earned rest as the pillow deflates.

Place one hand on your stomach. Inhale fully and, as you do so, feel your stomach rise (not flatten); your hand registers the movement outwards. Hold one full breath for some five seconds and then exhale slowly. As you breathe out, so your tummy flattens; now your hand registers the movement downwards and inwards.

An additional guide to you that you are breathing in a relaxed fashion is that, as you inhale and your stomach rises, so the small of your back leaves the upright of the chair. As you exhale you again feel contact between the small of your back and the back of the chair.

Practise breathing in and out in this manner for five or six full breaths. For all the exercises which follow, try to maintain a steady, even breathing rhythm.

3. Hands and arms

Suggested image: you have to repeatedly stop yourself from falling over a cliff edge; finally you are safe and can breathe easy.

Lift your hands off your thighs a few inches, clench your fists as tightly as possible for five seconds. Feel the tension in your fists and lower arms, unclench them and allow them to fall back on to your thighs and relax thoroughly. Experience the relief of all that tension leaving your hands and lower arms.

Check sitting position and breathing rhythm.

When you are ready, bend both arms to try to place the back of each hand on its respective shoulder (back of right hand on right shoulder, etc.). The top side of your lower arm should almost touch the bicep of that same arm. Hold for five seconds and feel the tension in biceps and cocked wrists. Relax, let both hands come to rest again on your thighs. Enjoy the sensation of relief as the tension ebbs out of arms and hands.

Check your sitting and breathing.

When ready, stretch both arms straight ahead at shoulder height, keeping them a shoulder's width apart. Stretch as far as you can. Note the strain in lower and upper arm. Hold this position for five or six seconds. Relax; once more allow your arms to drop by your side, elbows tucked in and wrists resting on your thighs.

Sit quietly, breathing comfortably, eyes closed if you prefer it that way, and reflect on the feelings you have just experienced. Note the difference between feeling tense and feeling relaxed.

4. Neck and shoulders

Suggested image: you are a child climbing up the inside of a chimney; you are hemmed in on all sides; at last you pop your head out of the top; you look all around, surveying the whole world.

Hunch your shoulders as high as you can, so that they almost touch your ears. Feel the strain in your sides, shoulders and neck. Hold for five or six seconds, then relax, letting your shoulders droop. But maintain contact between your back and the upright of the chair. Rest your lower arms, wrists and hands on your thighs.

Now stretch the neck muscles in harmony with your breathing rhythm. As you breathe in, concentrate your gaze straight ahead; then as you exhale, turn your head at right angles so that your chin is over your right shoulder. Hold that position for a few seconds then face front again, inhaling as you do so. Exhale when turning this time to the left. Repeat several times to right and left, breathing fully and evenly as you go.

Again, from the eyes-front position, inhale deeply. As you exhale look down, tucking the chin tight into your chest. Repeat several times.

Eyes-front, inhale. And as you breathe out, push your head as far back as it will go so that the back of your head touches between the shoulder blades. Repeat.

Now relax all the muscles you have just been stretching, flopping your head this way and that. Note the difference between tension and relaxation in those muscles.

5. The face

Suggested image: your entire face is a pool of water; as you wrinkle your eyes, tense your jaw, etc., you cause ripples on the water's surface; but you can disperse all ripples leaving the pool perfectly calm and undisturbed.

Concentrate on your eyes; close them very tightly for six or seven seconds. Relax; feel the tension begin to evaporate from around the eyes.

Now assume the surprised stare. Open your eyes as wide as you can, stretching the forehead upwards. Hold for a count of seven. Then relax all those muscles you have just stretched around the eyes and forehead; let your eyes gently close.

Imagine the most peaceful scene. Bask in the comfort of relaxation; compare it with the ache of the tension you have been experiencing.

Give your attention to your mouth. Begin by pressing your lips tightly together, forcing them shut, allowing nothing to enter or leave. Hold for several seconds. Relax, parting your lips slightly. Feel them tingle, let your eyelids fall, and have a rest.

Check your sitting and breathing.

Think of your tongue. Concentrate on pressing the tip of your tongue into the roof of your mouth. Note the strain on tongue and in lower jaw. Hold. Relax, allowing your tongue to find repose at the bottom of your mouth.

Finally, clench teeth, setting your jaw as determinedly as possible. Hold for as long as you are able, up to ten seconds. Relax, close your eyes, let your jaw hang loose and enjoy release from all that tension. Take your time before continuing.

6. Feet and legs

Suggested image: your legs form a bridge which people must cross to safety; as the numbers on the bridge increase so does the strain; first one bridge support then the other takes the strain; but at length all get across to the peace and safety of the other side.

Check your breathing and your sitting posture.

Stretch your legs straight out parallel to the floor. Point toes and keep both legs steady, about a shoulder's width apart. Hold for up to ten seconds. Note where you feel tensions. Relax, letting your feet fall to the floor. Draw your feet back towards the chair as you resettle into your sitting posture.

Now, taking one leg at a time, grasp the left leg on the shin just below the knee and gently pull it up, towards and across your chest until you feel the strain. Hold for ten to 15 seconds. Repeat with the right leg. Relax, and settle back into your sitting posture.

7. Rest and review

As before, take stock of what you have been doing. Note the tension you have induced and the relaxation response you have been able to bring into effect. Give some thought to how and when, throughout the day, you might practise some or all of these exercises. In your mind's eye try to build associations between familiar daily occurrences and these images or something similarly far-fetched — e.g. associate sitting down to lunch with sitting on your cloud — and learn to relax when eating. Continually check posture and breathing, especially when pressure looms. At most moments of stress, at least you will be able to clench and release your fists or stretch your legs. Simply — learn to relax when sitting.

B. Standing Exercises

1. Standing posture

Suggested image: like the Statue of Liberty you stand tall and assertive; you are dependable and aware, taking in all you see around you.

Legs apart, stand with your weight equally balanced between both feet. Allow arms and hands to hang by your sides. Straighten your back and lift your chin. Sway gently from side to...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Original Title
• Original Copyright
• Contents
• Introduction
• 1. Learning How to Relax
• 2. How Tension Develops
• 3. Relaxation – the Other Side of Tension
• 4. Tension Management
• 5. De-fusing Anxiety
• 6. The Cerebral Palsied Child
• 7. A Learning Framework
• 8. Matters Arising
• 9. Teaching How to Relax
• Bibliography
• Index