Anxiety and Relaxation
Clinical Sciences Building
Department of Clinical
Neuropsychology
0161 206 4694
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Department of Clinical Neuropsychology,
Salford Royal NHS Foundation Trust
Stott Lane, Salford, M6 8HD
Michelle Fairnie, Emily Daniel, Natalie Arran,
Melanie Booth and Dr Antonia Kirkby
About the authors
Michelle Fairnie, Emily Daniel, Natalie Arran
and Melanie Booth are assistant psychologists,
based at the Greater Manchester
Neurosciences Centre, Salford Royal. They
are involved in the neuropsychological
assessment of clients with acquired brain
injury and neurological conditions, and assist
with therapeutic interventions of clients with
psychological conditions.
Dr Antonia Kirkby is a consultant clinical
neuropsychologist also working at the
Greater Manchester Neurosciences Centre,
Salford Royal. Her role involves co-ordinating
psychological services for patients following
the diagnosis of NEAD. She is an experienced
therapist and the information in this booklet
is derived from her clinical experience with
clients as well as a review of the published
literature.
Acknowledgements
The authors would like to thank many people
for contributing to the production of this
booklet or for commenting on its content:
Service users attending the neuroscience
centre for psychological intervention;
And our neuroscience colleagues at
the centre, particularly members of the
Neuropsychology service.
1
Contents
Page
What is anxiety?……………………………………………………….………………
3
What leads us to developing anxiety and stress? …..
4
What happens when I am anxious?
5
Physical symptoms
6
Psychological symptoms
7
Behavioural reactions
8
The vicious circle
………………………………………………………...
Managing your anxiety
………………………………………………...
10
11
Introduction to relaxation
12
Relaxation exercises
13
Relaxed breathing
14
Visual imagery
15
Muscle relaxation
17
Progressive muscle relaxation
19
Useful resources
21
Appendix 1: Relaxation monitoring form
22
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What is anxiety?
Anxiety is a normal feeling that we
can all experience at certain times. It
happens to everyone at times of danger
or in worrying situations. For example,
if we are in a near-miss accident, if
someone close to us is ill, if we are
going for an interview, or if we are
waiting for someone who is much later
than they should be.
However, some people may feel anxious
in everyday situations where there is
no real danger or source of concern,
such as waiting in queues, travelling in
buses, being with friends, and leaving
the house. This is when anxiety may
become problematic and interfere
with everyday life. People’s bodies and
minds begin to over-react to everyday
situations as if they were threatening.
So a small event, such as losing your
keys or having to do extra things when
you are already busy, can make you feel
anxious and wound-up more easily and
last for longer.
There are many different terms people
may use to describe feelings of anxiety
such as:
“Bad with your nerves”
“I’m a worrier”
“Stressed out”
“Unable to relax”
“Tense and nervous“
3
What leads us to developing anxiety and stress?
People can be stressed by any situation
that makes them feel frustrated, angry,
or nervous. If someone has too much
stress for too long, anxiety is very often
the result.
What causes anxiety for one person
may not necessarily cause anxiety for
another. Feelings of anxiety may occur
for a number of reasons:
Individual - perhaps you have
always tended to be the worrying
type or you may have been
through difficult times earlier in
life which you have previously
overcome. Recent experiences or
events may bring back previous
worries or emotions.
Events / Environment - events that
have happened recently or are
happening now may be putting
you under a lot of stress – having
had a bereavement, difficulties
at work or loss of job, physical
health problems, having moved
house, finding it hard to make
friends, behaviour problems with
children, strains in the relationship
with your partner or family, caring
for an elderly relative or money
problems
High anxiety
Any of the things described above can
be a source of stress and strain.
If several of them happen close together
and you are having difficulty coping
with them, this may make you feel more
anxious.
Stressor
How we feel
The individual
The environment
Unhelpful
Coping
Strategies
Manageable anxiety
Although it can sometimes be
difficult to change the stressors we
are experiencing, learning to cope
differently with the stress can lead to
a reduction in the anxiety. The scales
become balanced when Helpful Coping
Strategies such as relaxation are learnt.
Stressor
How we feel
The individual
The environment
Relaxation
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What happens when I am anxious?
The next section looks at three main
ways that anxiety affects people:
Physically (how the body reacts
during anxiety)
Psychologically (the thoughts and
emotions of anxiety)
Behaviourally (what people do
when they are anxious)
Physical symptoms of anxiety changes in your body
The reasons why we experience
physical symptoms during anxiety can
be understood from looking at our
evolution. Thousands of years ago
cavemen and women experienced
severe danger from predators such as
sabre-toothed tigers!
They were immediately faced with two
choices - to take FLIGHT and run away
from the tiger or to stay and FIGHT
the tiger. Those who responded to the
dangers quickly were the most likely
to survive and passed this tendency
onto their children, therefore these
protective ways of reacting to danger
evolved.
So why do these physical
symptoms happen?
When a person perceives danger,
adrenaline is released into the body.
This is a chemical messenger that
prepares the body for the FLIGHT or
FIGHT response. When adrenaline is
released, it causes physical changes in
the body, which can feel particularly
unpleasant.
The main effects of adrenaline:
Increased heart rate; to pump blood
to the arms and legs and enable us to
escape quickly.
Faster breathing: to oxygenate the
blood being pumped around the
body.
Light headedness: as blood is
temporarily being directed elsewhere,
it is common to get feelings of
dizziness.
Perspiration: as more blood is
pumped to the muscles, body
temperature rises and increased
sweating occurs to cool the body
down.
Butterflies: because blood is directed
away from the stomach to the
muscles and digestion is halted.
The diagram on the next page shows
some other effects of adrenaline.
5
Physical symptoms of anxiety caused by an increase in adrenaline:
Ringing in the ears
Tightness in the throat
Dry mouth
Feeling of choking
Butterflies
Churning stomach
Feeling sick
Needing the toilet
Weakness in legs
Legs like jelly
Headache
Dizziness / light-headed
Blurred vision
Tiredness
Tense and stiff shoulders
Racing heart
Tight chest
Unable to breathe
Fast and shallow breathing
Palpitations
Hot and sweating
Tense muscles, sore joints
Pins and needles
Obviously, we do not encounter sabre-toothed tigers now, but there are times when we
think we are in danger and that harm might come to us, therefore adrenaline is released
into the body. What differs between people is the type of event they may think is a threat.
If someone tends to worry a lot, this can lead to adrenaline being released into the body
even though there is nothing really threatening or dangerous there. For other people, an
everyday event, such as going to the shops, travelling by bus, or being with a large group
of people, can feel frightening and threatening so the body reacts by releasing adrenaline.
What physical symptoms do you experience when you feel anxious?
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Psychological symptoms of
anxiety - thoughts and emotions
When we feel frightened or threatened,
psychological as well as physical
symptoms can occur. Psychological
symptoms include particular thoughts
and feelings/emotions that occur during
the episode of anxiety.
Distress
“There’s that feeling again I must be
really ill!”
“People must be able to see how I
feel”
Loss of control
“Oh no, now my legs feel like jelly!”
“I feel as if my heart’s going to burst”
Common thoughts and emotions:
Scared
“I feel like I’m going to have a heart
attack”
“I’ll end up in an ambulance being
taken to hospital”
When a person becomes anxious they
can have anxious thoughts about the
physical symptoms of anxiety and think
something terrible is going to happen.
My breathing will stop
I will run out of air
Uncertainty
I will have a heart attack
Embarrassed
I will go blind
“Everyone’s looking at me”
I will have a stroke
“What’s wrong with me?”
I will go crazy
“I can’t bear this any more”
I will lose control
“I should never have gone out.”
I am having a seizure
Irritability
Fear
Excitement
Anger
“Why is everyone else all right and
not me?”
“I feel terrible”
Panic
“I have to get out of here.”
“I’ll never manage again”
“I must get straight home”
I am going to collapse
These are common concerns that
individuals have when they are
experiencing the physical symptoms
of anxiety. However, the physical
symptoms are due to normal reactions
in the body that occur due to the effects
of adrenaline.
A person can also have anxious thoughts
about the type of situation they are in
and what is happening in the situation.
Different types of thoughts can lead to a
range of different emotions, depending
on the individual.
7
What psychological symptoms
(thoughts and emotions) do you
experience when you are anxious?
Behavioural reactions to anxiety what you do
The thoughts and emotions that a
person experiences during an anxiety
episode may stop them doing things
they used to do. An individual may
dread experiencing the physical
symptoms, thoughts and emotions
of anxiety so they may start to avoid
the situations where these symptoms
happen. For example, a person may
avoid seeing people, going shopping,
queuing, or travelling on buses.
Avoiding situations may cause a person
to experience other behavioural
reactions. This may include becoming
short-tempered, being unable to
concentrate on TV and reading, or
work, being unable to sleep, and
generally having difficulty coping.
Some common behavioural
reactions
You lose your temper
You stop doing the things that you
used to
You avoid going out or into particular
situations
You can’t sleep
You can’t concentrate
You try to get out of a situation if
things get too much
You drink, smoke or eat more
You fidget
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What behavioural reactions do you experience?
9
The vicious circle
The more a person avoids situations, the
more likely it is that they will experience
the physical symptoms, thoughts and
emotions of anxiety which may lead to
a behavioural response when they enter
that situation again.
Anxiety is therefore a vicious circle of
physical feelings, thoughts, emotions,
and behaviours. The reactions all
ADRENALINE
feed into each other, releasing more
adrenaline and keeping the whole
circle going. Anxious thoughts lead
to emotional changes, which causes
physical changes in the body, thus
affecting behaviour. An anxious person
tends to avoid the situation that makes
them feel anxious, which causes an
increase in their negative thinking, thus
keeping the circle going.
Negative Thoughts
“I need to escape”
“I’m going to die”
“I’m going to faint”
Emotions
Fear
Panic
Nervousness
Sense of threat
Behaviour
Avoiding leaving
the house
Avoiding being on
your own
ADRENALINE
ADRENALINE
Physical
Heart racing
Dizziness
Palpitations
Muscle tension
ADRENALINE
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Managing your anxiety
There are many things that you can
do to help manage your symptoms
of anxiety. This booklet will explain
one of the methods commonly used
- Relaxation, which can be used
alongside the CD provided.
Additional techniques that can be
used to manage your anxiety are
briefly described below.
Cognitive Behavioural Therapy
(CBT) :
Is based on the idea that
our thoughts, behaviours,
and emotions all interact.
Specifically, anxious thoughts
lead to anxious emotions
and behaviour. This approach
teaches how to challenge
negative thinking, which can
lead to less anxiety.
Assertiveness Training This teaches people how to
become more confident, stand
up for themselves and cope
with stressful situations.
Complimentary Therapies These can include; yoga,
meditation, aromatherapy,
massage, homeopathy,
hypnotherapy and reflexology.
These can help with relaxation
and also help improve sleep
patterns.
Exercise / Healthy Living Taking regular exercise can help
to reduce feelings of anxiety and
tension. It uses up adrenaline and
other stress hormones, therefore
allowing muscles to relax. Healthy
eating increases energy, improves
the way the body functions, and
strengthens the immune system.
Reducing your alcohol intake may
be beneficial. Even moderate
drinking carries some risks. Alcohol
can disrupt sleep and distort your
judgement of situations, thus
contributing to anxiety.
For more information about the above
techniques, please contact your GP or
local Clinical Psychology Service.
11
Introduction to relaxation
The purpose of relaxation is to learn
to reduce the physical symptoms of
anxiety by learning specific relaxation
techniques. By practising these
techniques you can learn to achieve a
state of deep relaxation. Learning to
relax is a skill and like any other skill,
such as riding a bicycle, it requires a
lot of effort to get it right. Therefore
when you start to do relaxation you
may find it difficult to get the hang of
the exercises but eventually you will be
able to ‘switch on’ into a relaxed state
much more quickly.
Relaxation can be used in two different
situations. First, it can help you feel
more relaxed before facing a difficult
situation that you are worried may
make you feel anxious. Second, it can
help you ‘let go’ when you already feel
anxious so making the anxiety pass
much more quickly. Many people tense
up in trying to suppress the anxiety,
which only makes the anxiety worse. It
is sometimes better to try to ride out
the feelings of anxiety, which can make
you feel a bit shaky at first but helps
you feel better quicker.
By practicing relaxation
techniques some of the following
bodily changes may occur:
Hormone production decreases
Sweating decreases markedly
Breathing rate decreases, as less
oxygen is needed
Mind becomes more tranquil
Heart rate decreases and blood
pressure drops
Muscles relax
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Relaxation exercises
The following sections contain some
relaxation exercises for you to try.
These can be found in orange boxes .
The techniques outlined here are:
RELAXED BREATHING
VISUAL IMAGERY
MUSCLE RELAXATION
Learning to relax is a skill and it
takes practice before it can be
done properly
Relaxation exercises should be done
at least once a day to begin with,
preferably before any activity that
might prove difficult. For maximum
benefit practice daily for a period of
eight weeks in order to achieve really
long lasting effects. Some people
continue daily relaxation for many
years. If you can do this, we strongly
advise it. However, not all people
continue relaxation in this way. It is our
experience that people who benefit
most from relaxation either practice
regularly, or practice immediately when
they notice any increase in tension or
anxiety.
1) Find a quiet and relaxing place
Initially, do the exercises in a quiet
room, free from interruptions. Select
a comfortable chair with good
support for your head and shoulders,
so that you can give your entire
concentration to relaxation. It is a
good idea, if possible, to explain to
those you live with why you are doing
the exercises and the importance of
minimising interruptions.
2) Clear your mind
Before you start the relaxation
exercises, try to clear your mind of
all worries or disturbing thoughts. It
can be helpful to write down these
worries or disturbing thoughts. If
these worries or thoughts drift back
into your mind while you are relaxing,
do not try to stop them; just let them
float gently across and out of your
mind without reacting to them. Let
your mind be clear and calm.
Enjoy the feeling of
relaxation!!
13
Relaxed breathing
When we become anxious we breathe
more quickly and less deeply, which
leads to a build up of carbon dioxide
(CO2) in the body. If you breathe
deeply but more slowly, this in turn will
decrease the heart rate, expel the CO2
and help to reduce the physical feelings
of anxiety.
How deeply are you breathing?
The aim of breathing correctly is to
fill your lungs with air as effectively
as possible. The diaphragm is a large
muscle situated underneath your lungs,
at the bottom of your ribcage. As you
breathe in, this muscle should push
your tummy out, allowing your lungs to
expand down and out into the space it
creates.
How regularly are you breathing?
Once you are breathing properly, you
need to learn to breathe regularly, in
and out. There should be no gasping
or gulping so try to make sure that you
breathe in and out for roughly the same
number of seconds. Concentrate on
letting the air flow in and out evenly.
How fast are you breathing?
Next, you need to measure the speed at
which you are breathing. Try breathing
in while counting slowly to 3, and
then breathing out, again counting to
3. Remember not to hold your breath
- simply breathe in, pushing out your
tummy, and then when your lungs
are full, breathe slowly out again,
controlling the flow of air. Try that for a
minute, in …2, …3… and out ..2,…3…
Exercise 1
Breathing exercises can be found on
Track 1 of the Relaxation CD
Put one hand on your chest and one on
your tummy. Try to keep the hand on
the top part of your chest still, while
pushing the hand on your tummy out
as you breath in. Make your tummy as
big as you can. If you are using your
diaphragm to breathe, you shouldn’t
need to use your shoulders or your
chest, and this can help relieve tension
around your neck and shoulders.
As you breathe in, try to fill the whole
of your lungs letting them expand
down and out. Exhale for twice as long
as you inhale, slowing your breathing
down and allowing the carbon dioxide
to leave your body.
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Visual imagery
The use of visual imagery in relaxation
can take our mind away from everyday
worries and concerns.
Exercise 2
In visualisation you use your
imagination. This is an extremely
powerful tool, one that we develop
as children and then often fail to use
as adults. In terms of relaxation it has
three main uses:
Imagine a scene, place or event that you
remember as peaceful, restful, beautiful
and happy
1. The imagination is creative; it
gives the mind ideas to play with
which prevents it from getting
bored.
You may wish to play a relaxing CD whilst
doing this exercise.
What can you see?
Are you alone? Who is there with you?
What smells are there around?
What can you hear?
How do you feel?
2. By focusing on relaxing images
it reminds us of the fact that we
are in a safe environment, which
allows us to deepen our physical
relaxation.
Or picture your worries as a colour,
shape or object and focus on
transforming them until they being to
dissolve away.
3. Over time the mind will absorb
the relaxing images, enabling
you to become calmer and more
relaxed in your everyday life.
What shape are they?
The important point when using mental
imagery is making sure that the image
is one that suits you that you find easy
to bring to mind, and can hold there.
This takes practice, but will ultimately
help your relaxation to become more
effective, as you detach yourself from
your environment.
What do your worries look like?
What colour are they?
What texture are they?
Imagine the … getting smaller/ lighter/
softer
Imagine it floating away, drifting, like a
cloud …
It is no longer attached to you, or part
of you. Watch it float away…
On the next two pages are details of
two visual imagery exercises.
15
Exercise 3
This exercise can be found on Track 2 of the Relaxation CD.
Breathe slowly and deeply, in through your nose and out through your
mouth. Allow your ribcage to expand fully on inhale and gradually empty
on exhale. Continue slow deep breathing noticing yourself becoming
more and more relaxed…… more and more calm……. relaxed and calm.
Use your five senses to enrich the following experience; allow your mind
to generate a personal oasis……
Imagine yourself on a beautiful sandy beach….. Notice the soft white
sand….. Notice the shades of blue in the water….. Notice the blue sky
with soft white clouds rolling slowly past….. Notice the lush tropical
plants and flowers……
Listen to the sound of the breeze blowing gently in the trees….. Notice
the sound of the waves rolling slowly to the shore….. Notice the sound of
the birds softly calling…..
Feel the sunshine warm on your skin….. Notice the warm sand
underfoot….. and the cool breeze on your hair and face…..
Smell the fresh ocean scent…… Notice the sweet fragrance of tropical
plants
Notice a pleasant taste in your mouth…… perhaps from a tall cool
drink……
Notice yourself relaxed and calm…… relaxed and calm…… relaxed and
calm……
Enjoy the feeling of relaxation…… Notice as it moves from the top of
your head slowly down your face…… neck…… shoulders…… chest……
arms…… abdomen…… legs…… knees…… shins…… feet…… toes……
Notice yourself relaxed and calm…… relaxed and calm…… relaxed and
calm……
When you are ready slowly open your eyes refreshed and awake.
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Muscle relaxation
Effective relaxation involves releasing tension in the body because of the physical effects
of stress and anxiety.
One way of approaching this is to focus on individual groups of muscles, to be aware of
how they feel in their tensed and relaxed state, and to relax them one by one.
You should take into
consideration where you feel the
tension:
Do you notice tension in your face
and jaw?
Do you clench your fists?
What other parts of your body feel
tense?
Are there parts of your body where
tension goes unnoticed until you
feel pain?
Where do you feel tension?
You should take into account the
characteristics of the tension:
Do the muscles feel stretched and
sore?
Do the muscles feel hard and
contracted?
Do the muscles feel fatigued?
Does there appear to be effort
involved in maintaining a normal
posture?
What does it feel like?
17
You should also consider what
events within yourself lead to an
increase in tension?
And which external events lead to
an increase in tension?
The way people speak to you?
Anger?
Loud noises?
Thinking about your difficulties?
Changes in breathing or heart rate?
Having to wait in queues or at traffic
lights?
Loneliness?
Being watched while working?
Boredom?
Your relationships?
Impatience?
What internal events lead to your
tension?
What external events lead to your
tension?
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Progressive muscle relaxation
Track 3 on the Relaxation CD
Neck - press head back on surface on
which it rests
Chin and chest - bring head forward
and try to bury chin right inside chest
Select a comfortable chair in a quiet
place free from interruptions, settle
back, close your eyes and focus on the
image of your relaxing and peaceful
place. Concentrate on your breathing,
in and out, evenly and slowly,
controlling the flow of air and using
your diaphragm. In turn, focus your
mind on each of the muscle groups
listed below, tensing and relaxing each
of the muscles in turn, and being aware
of how they feel in their tensed and
relaxed states.
Muscle groups and action
required to tense muscles
Hands - clench fists
Forearms - bend both hands back at
wrists
Biceps (upper arms) - clench fists and
bring them up towards shoulders
Shoulders - shrug shoulders up
towards ears
Forehead - wrinkle forehead and
eyebrows
Eyes - close eyes tightly
Upper back - arch back
Thighs - stretch both legs out
Calves and Feet 1) Point toes down
2) Bend feet back at ankles
An example of progressive muscle
relaxation using one muscle group
1) Focus your mind on a muscle group,
for example your right hand. Be
aware of any tension in your hand.
2) Inhale and squeeze the muscles fairly
tightly for between 3-6 seconds (this
involves making a tight fist with your
hand).
3) Release the tension in your hand. Let
all the tightness and pain flow out of
the muscles. Imagine any tightness or
pain flowing out of your hand as you
exhale.
4) Relax your hand for between 10-15
seconds and notice the difference
between the pleasant feelings of
relaxation and the feelings of tension
you felt beforehand.
Jaws - tense jaws and clench teeth
Lips - purse lips
19
Hints for practicing progressive
muscle relaxation
Try to practice daily, at least to begin
with, preferably before any activity
that may prove difficult.
It is a good idea to try monitoring
the tension in your body using the
comments section on the form in
Appendix 1 (at the back of the
booklet) to indicate the location
of your tension and the degree of
tension.
If you have specific tensions in one
part of your body, the Relaxation
CD has four tracks related to four
summary muscle groups.
Track 4 - Hands, arms and shoulders
Explain the exercises to those
that you live with to reduce any
embarrassment you may feel about
doing them and help minimise any
interruptions during them.
Wear comfortable or no shoes and
wear loose clothing.
Avoid eating, smoking or drinking
just beforehand.
Sit in a comfortable chair with good
support for your head and shoulders,
you can practice lying down but not
if you are likely to fall asleep.
When you finish a session, relax with
your eyes closed for a few seconds
and then get up slowly.
Track 5 - Face
Track 6 - Neck, chest and upper back
Track 7 - Thighs, calves and feet
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Useful resources
Anxiety Care
Cardinal Heenan Centre, 326 High Road,
Ilford, Essex IG1 1QP
Helpline: 020 8478 3400, Tel. 020 8262 8891
Web: www.anxietycare.org.uk
Helps people to recover from anxiety
disorders
National Phobics Society
Zion CRC, 339 Stretford Road, Hulme,
Manchester M15 4ZY
Tel. 0870 770 0456
Web: www.phobics-society.org.uk
Support, help and information for those
with anxiety disorders.
BASIC (Brain and Spinal Injury Centre)
The Neurocare Centre
554 Eccles New Road
Salford
M5 5AP
NICE (National Institute for Clinical
Excellence)
MidCity Place,71 High Holborn, London
WC1V 6NA
Web: www.nice.org.uk
Contact for copies of guidelines for doctors
and medical staff on caring for people with
generalised anxiety disorder.
British Association for Behavioural and
Cognitive Psychotherapies (BABCP)
The Globe Centre, PO Box 9, Accrington
BB5 0XB
Tel. 01254 875 277
Web: www.babcp.com
Can provide details of accredited therapists
British Association for Counselling and
Psychotherapy (BACP)
BACP House, 35 37 Albert Street, Rugby
CV21 2SG
Tel. 0870 443 5252
Web: www.bacp.org.uk
Contact for details of local practitioners
The British Psychological Society
St Andrews House, 48 Princess Road East,
Leicester LE1 7DR
Tel. 0116 254 9568
Web: www.bps.org.uk
Produces a directory of chartered
psychologists
First Steps to Freedom
1 Taylor Close, Kenilworth CV8 2LW
Helpline: 0845 120 2916, Tel. 01926 864 473
Web: www.first-steps.org
Offers practical help to those who suffer
from anxiety problems
No Panic
93 Brands Farm Way, Telford, Shropshire
TF3 2JQ
Helpline: 0808 808 0545, Tel. 01952 590 005
Web: www.nopanic.org.uk
Provides a helpline, step-by-step
programmes, and support for those with
anxiety disorders
Triumph Over Phobia (TOP UK)
PO Box 3760, Bath BA2 3WY
Tel. 0845 600 9601,
Web: www.triumphoverphobia.com
Helpline and network of structured
self-help groups for people experiencing
phobia or obsessive-compulsive disorder
UK Council for Psychotherapy (UKCP)
167 169 Great Portland Street, London
W1W 5PF
Tel. 020 7436 3002
Web: www.psychotherapy.org.uk
A membership body of almost 80
psychotherapy organisations in the UK.
Maintains a voluntary register of qualified
psychotherapists.
21
am
pm
1
2
3
4
5
6
7
8
9 10 1
2
3
4
Very Tense Very Relaxed
5
6
Very Tense Time in
7 8 9 10 Minutes
After Relaxation Session
PART 2
Comments
© G17021303W. Design Services, Salford Royal NHS Foundation Trust,
All Rights Reserved 2017. Document for issue as handout.
Unique Identifier: NOE05(17). Review date: April 2019
Now carry out the relaxation procedure. At the end of the session, complete part 2, recording the time taken and the number that
now best describes your general level of tension or relaxation.
Before starting relaxation complete part 1 of the index. This records when you are practising the procedure and how tense or
relaxed you are feeling right now (1 means ‘totally relaxed’ and 10 means ‘extremely tense’). Also in the far right-hand column,
briefly list the reasons why you feel tense or relaxed before your practice session.
Date
Time of Day Very Relaxed
Before Relaxation Session
PART 1
Appendix 1: Relaxation monitoring form
22
© G17021303W. Design Services
Salford Royal NHS Foundation Trust
All Rights Reserved 2017
This document MUST NOT be photocopied
Information Leaflet Control Policy:
Unique Identifier: NOE05(17)
Review Date: April 2019
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