11 minute read
CHAPTER 4: Strategies for Body Regulation
“Life is ten percent what you experience and ninety percent how you respond to it.”
— Dorothy M. Neddermeyer Being aware of how your body responds to stress and anxiety, sometimes referred to as your ‘bottom up’ response, is very important. It is also important to recognize that different types of strategies work for different levels of physiological activation. For example, if you are very activated, perhaps even approaching panic, breathing exercises do not always work and may even heighten your activation level unless you have had a lot of practice with breathing exercises. Therefore, a first step is to notice your overall level of activation. In general, if you are at a medium to high level of activation, try a strategy that involves more movement. Imagine that when you have a high level of physiological or body activation, it is like your body is full of tiger fighting energy. You can’t go from fighting tigers, which is the state your body is in when you are anxious, to calm instantly, it takes time to return to a regulated or calm state and to a feeling of being safe.
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Level of Activation
While the scale you use is not that important, what does matter is the concept that we have different levels of activation which correspond with different physiological events and are managed by different strategies. For example, if you choose a 10 point scale where 0 represents being asleep and 10 represents a panic attack, the 0 to 5 range corresponds with low to medium levels of activation and 5 to 10 corresponds with high activation such as panic. Whatever scale you use, the important part is to differentiate between low to medium levels of activation and high levels of activation because different bottom-up strategies will be effective depending on the level of activation.
The purpose of the bottom up or body regulation strategies are to manage your physiological response. The goal is to get to a state of calm, but this can be a lofty goal for many people who struggle with anxiety. Many people rarely feel calm. Thus, while calm is the goal to work towards over time, the immediate focus is on down regulating the activation level in your body. You can think of this as if you’re ‘turning down the volume’ on your body’s response. With practice, you will get better and better at this and over time be able to achieve a feeling of calm.
As a general guideline, breathing and muscle relaxation will be effective in the low to medium range (0 to 5 on the sample scale), while movement will be effective in the high range. I have had many people tell me that breathing doesn’t work for them and makes their anxiety worse. When we investigate more fully, we realize that they are using breathing during a period of high activation which often increases their level of activation. There are many different breathing and body regulation activities. I will outline only a few of them here. I encourage you to add your own favourites to the list.
Below, I will share some ideas of strategies that will help you to down regulate your body’s response to stress and anxiety. I will provide some for low to middle levels of activation and others for middle to high levels of activation. Most important however, is to find body regulation strategies
that work for you. Also recognize that you must practice these, starting off by practicing them when you are already calm, so that you can effectively use them when you are experiencing stress and anxiety. Typically, you will need to practice for several weeks before you are able to use the strategies effectively to settle down your body’s response to stress and anxiety. Also, keep in mind that everyone is different and you need to find the strategy that works for you. The list provided here is by no means exhaustive, and you will likely want to consider adding your own. Keep practicing until you find what works best in your 3A Toolkit!
Before we get to the strategies, consider what kind of stressors or triggers correspond with different levels of activation, where 10 is very high (e.g., panic) and 0 is very low (e.g., asleep). Write down a few of the situations and events that tend to lead to lots of worry for you and some of the situations and events that lead to a little bit of worry for you. Imagine that the number 0 to 10 represents how full of worry your body is with between 0 and 5 being a low to middle level of worry and 5 to 10 being a high level of worry.
Level of Activation
10
Stressors and triggers
5
0
It is important to notice how activated or full of worry your body is so you can match the right strategy to the level of activation. Below are some examples of strategies that match to the level of activation you are experiencing. They are explained in more detail next.
10
5
0
Body Regulation Strategies
Medium to High Level of Activation
Walking, Running, Sport Activity of Your Choice
Bilaterial movements that are slow, rhythmic and intentional (e.g. butterfly hug, finger pushups)
Shaking
Low to Medium Level of Activation
Orienting
Breathing practice with a focus on a long exhale (e.g. figure 8 breathing)
Yoga or other movement that is slow and gentle
Progressive muscle relaxation
Mindfulness
Body Calming Strategies for Low to Medium Level of Activation
Breathing
There are many different breathing exercises. For managing high activation such as anxiety, the general principle is to focus on a longer exhale and on breathing from the diaphragm rather than the chest. It can be helpful to go through even breathing (when the exhale and inhale are of similar lengths), breathing with a longer exhale, and breathing with a longer inhale to increase your awareness of your breathing patterns. A longer inhale is usually more activating and the opposite of what you want if you are working on managing stress and anxiety. The longer inhale can be useful when you are trying to be more energetic but this is not what we are working on in this workbook.
Figure 8 breathing
Draw a figure 8 on the back of your hand. If you do not want pen on your hand, you can trace the shape with your finger. Trace the figure 8 with your finger, exhale as you trace the curve of the 8 and pause and inhale as you reach the center where the lines intersect. I find this breathing exercise helpful as it makes it easy to focus on the exhale, it brings your attention to the present moment, and the touch of your finger on your skin is soothing. I usually practice this for at least one minute a day. It is important to practice these new skills when you are not anxious so that you can use them effectively when you are.
Figure 8 breathing
Progressive Muscle Relaxation
Progressive muscle relaxation is an established practice and many different scripts and protocols exist for this practice. I will leave it to you to find your favourite -- there are many options available with a quick search online. The key principle of this practice is to move through different regions of the body and tense one region at a time and bring your full awareness to the experience, then relax the same body region for about twice as long as you were tense for. In this way, you develop awareness of where you hold tension in your body and become capable of relaxing when you set your intention and attention to do so. An example of body regions you may choose to focus on when tensing and then releasing your muscles are: right arm, left arm, face and head, neck and shoulders, mid-section, right leg, left leg. Once tensing and releasing your muscles in those regions, finish the practice with a body scan to see if any tension remains.
Orienting
Orienting is another widely used practice. Orienting is a way of bringing attention to the present moment and providing the brain with information that you are safe in this moment. There are different orienting practices and I suggest finding one that is a good fit for you. A very simple practice is to simply name objects that you see in the space around you. This gives the amygdala, the security guard, information that there is in fact no physical threat present so it will settle down a bit. A longer orienting practice that I find more effective is 5, 4, 3, 2, 1. In this practice, the client names 5 things they see, hear, and feel. This is followed by 4 then 3 then 2 then 1 thing they see, hear, and feel. This practice engages multiple senses to provide the amygdala with accurate information about safety, thus providing down regulation of the amygdala and nervous system.
Mindfulness
Along with being important for your foundation of strong mental health and wellbeing, mindfulness (present moment awareness without judgment) can also be helpful for reducing body activation when you are worried. Just be aware that mindfulness can be challenging for many people with anxiety or a history of traumatic experiences. If you have trouble with mindfulness practice, know that it really is worth learning how to do, but perhaps seek assistance from a trained helping professional and know that it can be a difficult for some people.
As previously mentioned, breathing is not always effective for high levels of activation. For high levels of activation, regulation strategies involving movement are often more effective. There are many different ways you can incorporate movement strategies and I suggest using activities that you are interested in such as a sport you enjoy, yoga, and dance. Just going for a walk can also be helpful. What is important is to come up with movement that you like and will actually use. Other movement approaches for when you are not able to leave the room include the following (not an exhaustive list):
Finger Pushups
Press the fingers tips of both hands together, then slowly and intentionally lift each pair of fingers away from each other and then press them back together. Continue this way with each pair of fingers for as long as needed.
Bilateral Foot Movements
This exercise works well when you are seated and not able to get up and walk. Slowly and intentionally lift the toes and ball of one foot keeping the heel on the ground, and then follow the same movement with the other foot and continue as needed. Keep the movement slow and measured as quick movements may increase the level of activation.
Butterfly or Bear hug
Place each hand on the opposite arm in a gentle self-embrace using the amount of pressure that feels soothing. Then alternate squeezing one side and then then other. Some people like a gentle embrace (butterfly hug) and others prefer much firmer contact (bear hug).
Shaking
Engage in vigorous” shaking of your whole body for about a minute. You will notice partway through this practice that you really want to stop. This lets you know your ‘brakes’ are starting to work. Once the time is up, allow yourself to rest, feeling your relaxed muscles. This practice works really well for people who go to a high activation very quickly. I suggest finding somewhere private to do this as you do look a bit silly. Many people report very quick results with shaking though, they are able to regulate quite quickly so it really is worth trying.
Practice, Practice, Practice….
As I mentioned before, whichever strategy you think will work for you, you will need to practice it. Perhaps choose a strategy from the low to middle level of activation section and another one for the higher levels of activation and practice those for a week at least and see how they work for you. You usually need about three weeks to start to be really good at something new. If you find a strategy doesn’t work for you or you don’t like it, try another one. There will be something that works for you, but you may need to try a few things before you find the right match. And
remember, match the strategy with how activated your body is. Otherwise, even the right strategy won’t work if you use it for the wrong level of activation. Breathing is a good example of this. Breathing is wonderful for calming down the body. But it does not always work well for higher levels of activation. In fact, some people find it even makes them feel worse. This doesn’t mean that breathing doesn’t work, it just means you need to use it at the right time. Enjoy your practice and know that you are getting better at shrinking your worry every time you practice!
