PCHC Positive Coping with Health Conditions

The steps toward Relaxation are:

  1. Learn a relaxation method
  2. Practice the method regularly
  3. Choose a “portable” relaxation method
  4. Practice relaxation in stressful situations

“We can’t let daily stress get to us, we have to go with the flow.”

“I use relaxation tapes and visualization – but mainly I use deep breathing.” *

* Quotes from members of a chronic illness support group.

Why Is this Important?

Many people with health conditions experience difficulty with physical tension and mental anxiety. Health conditions can be linked to tension and anxiety in several ways.

First, pain and physical discomfort can cause the body to become more physically tense, as though it were tightening up to withstand suffering. Physical tension can take the form of tightened muscles, rapid breathing, increased heart rate or elevated blood pressure. Second, your concern about the health condition can lead to excessive worry and anxiety. Third, if you have ongoing physical tension, there can be negative impacts on the health condition – physical tension can intensify the experience of pain, increase symptoms like breathlessness or fatigue and make you feel so uncomfortable or nervous that you avoid activity.

Diagram: Symptoms | Pain | Limitations of activity < ----> Physical Tension | Exessive worry and anxiety

How Can I Learn to Relax More Effectively?

In this section, we’ll teach you some effective relaxation methods. These methods have been shown to help individuals reduce anxiety and physical tension.


Learn a Relaxation Method

There are various books and audio tapes available that teach relaxation, using a number of different methods. Some of these are quite good, others not so good. To get you started on learning relaxation, we’ve made an audio CD that takes you through a systematic relaxation method. You might have received the Relaxation CD with this workbook. If not, go to our Web site (, where you can download the audio file (free) or buy a copy of the CD (at low cost). Practicing with this CD is a good place to begin. The Relaxation CD shows you how to let go of tension and how to calm anxious thoughts.

Relaxation CD: Listen online

Find a quiet spot, maybe seated in a comfortable chair, and make sure that you won’t be disturbed for about half an hour. Sit as comfortably as you can, with your feet on the floor and your arms resting at your side. You can listen to the CD through speakers or headphones, whatever feels most comfortable. The relaxation procedure is about 17 minutes long. Now, just sit back and allow yourself to listen. Don’t worry about remembering every bit of the procedure the first time; you’ll be listening to it again.


Practice the Method Regularly

In order to learn the relaxation method, you’re going to need to practice it a number of times. Each time you listen through the relaxation procedure, you’ll learn more about how to relax yourself. It’s like learning any other skill, whether how to swing a golf club or how to prepare
a recipe.

Set a modest goal for how often you’ll practice the relaxation procedure. Maybe start by setting yourself the goal of listening to the Relaxation CD twice per week for the next several weeks. When you set your goal, make sure to specify when you’re going to do it. Your goal should look something like this:


Listening to Relaxation CD

How Often?

Twice per Week


Monday & Wednesday
Evening at 7pm

Every time you listen to the Relaxation CD, make a note in your calendar or diary that you have completed your goal successfully.


Choose a “Portable” Relaxation Method

If you’ve practiced with the Relaxation CD for three to four weeks and it’s been helpful, then it’s time to find a portable relaxation method. After all, you can’t always sit down and listen to a Relaxation CD, and you’re going to be using your relaxation skill throughout the day. You’ll need a brief version of the relaxation technique that you can do easily in any situation.

One portable relaxation method is to use the part of the CD where you focus on your out-breath and, while breathing out, slowly say to yourself Deeply Relaxing. You then continue with each of your out-breaths, focusing on the words Deeply Relaxing as you breathe out – continuing this focus until you feel calmer. This relaxation method is effective for most people and can be done in any situation without drawing attention. It is truly a portable relaxation method. Because this method usually causes breathing to become slower and deeper, we call it the Slow Breathing Method.

You might also figure out your own portable relaxation method, using the Relaxation CD or other mental strategies that help you relax. Perhaps there’s a particular image that has always been calming for you, something like a sunny beach or a cool pond. Go with whatever works for you, so long as it helps you relax and can be done easily in different situations.


Practice Relaxation in Stressful Situations

Certain kinds of situations are more likely to bring out anxiety or physical tension. For example, waiting for a medical appointment might increase anxiety because it’s linked in your mind to hearing bad news. Or having an increase in pain might cause your muscles to become tense, as though this would somehow help the pain (actually, muscle tension can make pain worse). When you’re in one of these stressful situations, practice your portable relaxation method to lessen the tension and anxiety.

The more you practice relaxation, the more skilled you will be at staying calm in all types of situations.


Christine's Story

Christine was a 52-year-old lawyer. She had always suffered from headaches, as far back as she could remember. These were diagnosed as migraine headaches when she was 28. Every couple of weeks, one of these migraines would flood her with pain – she would have to cancel appointments, go home and lie in a dark room. By the next morning, the pain would be tolerable enough that she could catch up with work. But she would be exhausted for several days. She tried a lot of different medications, but none of them gave her full relief. She accepted that she would have to build her life around the migraines. She also had “ordinary” headaches several times a week, but these were easier to handle and she could usually ignore this kind of pain.

During a visit to her family doctor, Christine talked about how hard it was to deal with the headaches and to feel so powerless. She also described how tense her shoulder muscles were most of the time and how difficult she found it to physically relax. The physician explained that sometimes migraines are triggered by ordinary “tension” headaches, and so better control of muscle tension might prevent ordinary headaches and perhaps help the migraines. The physician encouraged Christine to get a copy of the Positive Coping workbook and to practice the Relaxation skill.

Christine practiced relaxation three times a week – every time she practiced, she got better at relaxing. Sometimes she would practice with the CD and sometimes on her own. She began using a “portable” relaxation method during which she imagined her shoulder muscles gradually letting go of tension while she focused on Slow Breathing, repeating the words Deeply Relaxing with her out-breath. She also increased her physical activity level – she joined a yoga class, where she learned exercises that helped to relax her shoulder and back muscles.

Over the next few months, Christine became more physically relaxed. Her tension-type headaches were happening less often – in fact, she could go a full week without having one. But, most importantly, she was having migraine attacks less often. Over the next year, as she continued to practice relaxation, Christine continued to have fewer ordinary headaches and fewer migraines. This really improved the quality of her life. She felt more control over her own health.