you experience.”
Anne and I spent the next weeks working on her breathing, improving her ability to relax, and talking about her strained relationship with Justin as he continued to shun her attempts to connect. I suggested that she back off for now, as her hovering was probably exacerbating his anger and resentment.
Anne glared at me, her face flushing. “How do I stop caring for my son? How do I stop worrying about his safety and well-being? You are asking me to let go of the most important part of my life. Nothing matters to me as much as my family, and I’m worried about Justin.”
I gently reminded her that Justin was in good hands with his therapist and that he needed to get help from someone other than her right now. “It is not that he doesn’t love you,” I reassured her. “He just has to figure out for himself what is going on, how to build friendships, and what his next steps are after high school. Some of this will involve you and Stephen, but much of it he needs to do on his own and within the framework of his peer group. He will come back to you in time. In the meantime, it would be useful for you to focus on your own needs and how to make this time in your life more gratifying.”
Anne admitted that paying attention to her own needs had never been a priority. “My mother taught me that thinking too much about myself was selfish and unbecoming.”
“Tell me more,” I encouraged her.
In an instant, Anne shut down again, as if I’d crossed an invisible line. Her resistance to speaking about her inner world concerned me, but I decided that if we kept working on the relaxation techniques, she would begin to trust me enough to open up and share more of her story. Either way, the skills she was learning would serve her well.
The next time I met with Anne, something about her seemed different. I asked how her week had gone.
“I practiced breathing in the constructive-rest position at least once a day, sometimes twice,” she said. “At first, it took effort just to get myself into position. After a few days, I began looking forward to my time to lie down, relax, and just focus on breathing. I’ve definitely begun to enjoy the constructive rest.” She smiled warmly and told me that long ago she used to enjoy practicing yoga.
I asked Anne if she wanted to talk about anything in particular. “Yes,” she said. “Justin began his support group and likes the other kids so far. Stephen and I bought him a cell phone, and he seems to be connecting with more of his peers. For the first time in almost two years, he’s been talking to me. I’m so relieved.”
“That’s great,” I replied. “Anything else?”
“Well, as you know, I’ve been smoking most of my life to relax and unwind. Now that I’ve been practicing the breathing, even when I go outside to smoke, the stench seems to permeate the house. The breathing is giving me something positive to focus on when I need to relax, rather than instantly reaching for a cigarette. I’ve been cutting back. A number of times, I chose not to smoke and instead got myself into the constructive-rest position. It definitely helps. Other times, when I’m on autopilot, I go for the smoke. Sometimes I want to go numb, and smoking does that for me. I need to rethink the way I care for myself. Clearly, I haven’t been very good at it. This is such difficult work for me, but I’m committed to doing whatever it takes to feel healthier and better about myself.”
Anne adjusted her posture as she sat on the couch; she still looked fragile and tired, but more approachable. Her breathing seemed more fluid and regular. I complimented Anne on her achievements of cutting back on smoking and making some important self-observations. Then, uncharacteristically, I decided to reveal something from my own experience with cigarette addiction, hoping my self-disclosure would pave the way for Anne to do more of the same: “I struggled with my own cigarette habit, and the abdominal breathing helped me conquer the addiction. Whenever I craved a cigarette, I would go outside, regardless of the weather, and practice deep-breathing exercises. The more the breathing became ingrained in me, the less I wanted to smoke, until I finally quit. You will know when it’s time for you to give up the smoking. In the meantime, just keep practicing the breathing in any or all of the ways that we discussed.”
The Relaxation Response
At our next session, I asked Anne if she was interested in learning another technique known as the “relaxation response.” She readily agreed.
Relaxation response is a term that was coined by Herbert Benson in the mid-1970s. Benson popularized the ancient technique of meditation through research and scientific validation. He found that the relaxation response was the counterpoint to the “fight-or-flight” response. Relaxation occurs when the body no longer perceives danger and the functioning of the autonomic nervous system returns to normal. The body releases chemicals and the brain sends signals that make the muscles and organs slow down. Metabolism decreases, as do heart rate, blood pressure, and muscular tension. Breathing becomes slower and deeper, leading to diminished anxiety, irritability, and pain levels. There is also an increase in blood flow to the brain, creating a calming effect, and an increase in energy, motivation, and concentration. Initiation of the relaxation response also helps with sleep disorders.
I told her we would take about ten minutes to practice this method, which was a slight variation of Benson’s original technique. We began by focusing on the breath, the lowest common denominator for any relaxation training. I suggested, “Straighten yourself up in a comfortable sitting position. You will automatically breathe more deeply and efficiently when you are in good postural alignment. Uncross your arms and legs. Relax your shoulders so they fall naturally over your torso. Gently press your lower back against the couch or use one of the pillows for support. Lift up your chest bone and let your lower back continue to sink down into the back of the couch. Don’t worry about your posture after you begin this exercise, just allow yourself to relax into it.”
I encouraged Anne to remove her glasses and to loosen the top button of her pants so she could breathe more fully. “Relax your closed eyes.” I noticed her eyes fluttering, as though she was having difficulty with this instruction. “You don’t have to do anything that makes you feel uncomfortable,” I told her. “These are only suggestions.”
“I’m ready to do this. My body is just being rebellious. I’m still not used to relaxing. It all feels strange, but I want to learn.”
“You will. Relax your eyes closed, allowing your eyes to roll slightly upward without straining them. Relax all of your facial muscles, especially the little muscles around your eyes and jaw. Part your lips and relax your tongue. Let your face become serene and expressionless. Allow your whole body to relax into the couch, feeling fully supported. Feel the contact that your feet are making with the floor and feel your feet being fully supported. Remain still and notice the rise and fall of each breath without manipulating the breath in any way. Just observe the sensation of the breath in your body. Now repeat the word in to yourself as you breathe in, and out as you breathe out. Notice the rise and fall of each breath. When your mind wanders, gently bring your attention back to your breath. Thoughts are like the clouds passing by in the sky. Let them keep moving through. Allow any sound or distractions to serve as cues to bring you back to the breath. Most importantly, just allow yourself to be in the present moment without judgment.”
Anne and I practiced this exercise silently together. I reminded her a few times to breathe in and breathe out and to gently and lovingly bring her attention back to the breath whenever her mind wandered. After about ten minutes of practice, I told her, “Release the repetition of the words in and out and slowly bring yourself back into the room, back into the present moment, and, when you are ready, gradually begin opening your eyes.” Once she opened her eyes and had a moment to adjust, I asked her what she had noticed. Anne said, “I don’t think I was doing it right. I couldn’t concentrate or remain still, and the barrage of thoughts never stopped, although I do feel quite relaxed.”
I assured Anne, “Taking the time to sit still and focus on the breath at any given time is a form of relaxation. It is also considered to be a form of meditation.” Additionally, this technique and the breath work are vehicles for developing mindfulness. It takes time and practice for people to feel like they are mastering this skill. The most