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Breathing for Better Mental Health with Dr. Adrian Lopresti and Dr. Judy Lovas

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Breathing for Better Mental Health: Dr. Adrian Lopresti and Dr. Judy Lovas

Dr. Adrian Lopresti talks with Dr. Judy Lovas, the Director of Art and Science of Relaxation and an expert on relaxation therapy in this week’s podcast. Together, they discuss techniques practitioners can adopt to support both themselves and their clients to reduce stress by adopting several relaxation techniques. Judy imparts her knowledge on the techniques of diaphragmatic breathing and immerses us in a guided imagery session while explaining the difference between stress and distress and the evidence-based research supporting relaxation therapy. 

Covered in this episode

[00:39] Welcoming Dr. Judy Lovas
[01:21] The impact of relaxation on the mind and body
[03:17] Relaxation vs. relaxation therapy
[04:18] Examples of evidence-based relaxation
[08:17] Is all stress bad?
[14:19] Diaphragmatic breathing and its effects on the body
[20:26] Teaching diaphragmatic breathing 
[24:17] Precautions
[25:47] Guided imagery/visualisation
[29:58] choosing a scene for guided imagery
[34:07] Judy takes us through a brief guided imagery exercise
[41:25] Practitioner training on the Art and Science of Relaxation
[43:03] Thanking Judy and closing remarks

Key takeaways 

  • Relaxation techniques can be adopted as a treatment for chronic distress reduction and to treat chronic disease 
  • Eustress is beneficial to meet the requirements of our lives, stress levels beyond that which we can cope with is referred to as distress and has been associated with chronic inflammation. 
  • Diaphragmatic breathing can stimulate the vagus nerve to promote digestion and parasympathetic nervous system activity. 
  • Guided imagery can support a reduction in distress levels and can be adopted by both practitioners and clients daily with minimal disruption to the day. 
  • It is important for practitioners to trial relaxation techniques before recommending them to a client to ensure that they are best able to support the client with the technique. 
  • Guided imagery should ideally be based on an image/location that the client selects to ensure that it supports relaxation. 

Practice pearls 

  • It is beneficial for practitioners to engage in relaxation techniques before recommending them and supporting their clients. 
  • Stress is beneficial for normal functioning, when stress exceeds our ability to cope it is referred to as distress and can lead to chronic inflammation. 
  • Diaphragmatic breathing supports vagus nerve stimulation. 
  • Guided imagery is best done in consultation with the client to ensure that the scene chosen is relaxing to the client. 

Resources discussed

Judy's website: Art and Science of Relaxation
Video: Introduction to Psychoneuroimmunology with Candace Pert
Study: Breathing Practices for Treatment of Psychiatric and Stress-Related Medical Condition (Brown, et al., 2013)
Study: The Therapeutic Role of Guided Mental Imagery in Treating Stress and Insomnia: A Neuropsychological Perspective Open Journal of Medical Psychology (Jerath, et al., 2020)
Study: Mental Imagery: Functional Mechanisms and Clinical Applications Trends in Cognitive Sciences (Pearson, et al., 2015)


Adrian: Hi, and welcome to FX Medicine, where we bring you the latest in evidence-based integrative, functional, and complementary medicine. I'm Dr. Adrian Lopresti and with us on the line today is Dr. Judy Lovas. Judy is an expert on relaxation therapy and director of Art and Science of Relaxation.

Today, we'll be discussing relaxation, particularly breathing and guided imagery from an evidence-based perspective. We'll cover how these techniques can help improve certain conditions and improve overall health. 

So welcome to FX Medicine, Judy, how are you today?

Judy: I'm very well, thank you. It's good to be with FX Medicine this morning, this afternoon.

Adrian: Yes, probably afternoon for you and morning for me. 

So certainly today we obviously will talk about relaxation and I know that you train a lot of practitioners in how to do relaxation. So can you tell us a little bit about how you became interested in this as a specialty?

Judy: Yes, I became interested… initially, I studied psychology and then decided that being a psychologist was not necessarily for me, and did a massage course. And I worked as a massage therapist and then taught massage therapy at TAFE for many, many years. And it was obvious that people come to massage therapy essentially for two things, because they're stressed or because they're in pain.

Adrian: Yes.

Judy: And I saw clearly from a clinical perspective how massage therapy enabled people to relax, I guess both physically and psychologically. And with the psych background being largely to do with the mind, and then massage therapy focused on the body, it got me very interested in the connections between the two and the impact of relaxation on both the mind and the body.

And really also seeing how stress is an everyday part of life and how distress is a part of every health and medical condition. And I started joining the dots and realising that relaxation is actually therapeutic in many forms.

Adrian: No, it's great. Certainly myself, I love massage as a form of relaxation and obviously to manage pain. So it's really nice how you started off as a massage therapist and then gone into the relaxation side of things.

Judy: That's right. And it was all linked by, okay, what do all the massage therapy and other interventions do for the extent of stress that we experience?

Adrian: Wow, okay. All right. So before we then get into discussing relaxation, and particularly evidence-based relaxation techniques, can you first just tell us a little bit about what the difference is between relaxation and relaxation therapy?

Judy: Sure, well, you essentially covered it there. Relaxation is our individual preferred ways to unwind, to let go of the worries or the hectic life that we lead. Whereas relaxation therapy is using evidence-based techniques for specific conditions.

So the techniques have been well researched with randomised controlled trials, and written up in peer-reviewed journals. And they are used for the express purpose of decreasing the impact of chronic conditions. And most of what we see as practitioners are chronic conditions.

Adrian: Okay, so when you talk about evidence-based relaxation, what examples are you referring to there?

Judy: There are numerous interventions and techniques and forms of relaxation that have been well studied. And the research that's coming out now is increasingly sophisticated. It's very exciting to read the research now.
For me, the first and foremost form of relaxation that's evidence-based, and to me is the framework or the foundation of anything else is diaphragmatic breathing. It's the first technique that I teach because for me, and from my clinical experience, it then underpins, it enables people to then perform other techniques better. So there's diaphragmatic breathing, and the extent of research, again, is extraordinary. We can talk about that later.

Guided imagery is another one that is well researched. Yoga is increasingly examined, and particularly...so all these techniques, the research now looks at, what does yoga do for asthma? What can diaphragmatic breathing do for anxiety? Mindfulness. Meditation. There's very sophisticated evidence to support the efficacy of these techniques for the conditions that we see clinically every day.

Adrian: Okay, so you've got your relaxation-based therapies, like obviously, when you mentioned the core being your diaphragmatic breathing and all the other techniques that you've talked about. And then the other side, you've got just kind of for what, engaging in relaxing activities, which are not necessarily the same but they might be soothing to the body, they might be... Would you call things like massage, would that be a relaxation therapy, or just a relaxation, a form of relaxation?

Judy: That's an interesting one. Certainly, as you mentioned at the beginning, people go to have a massage to relax. And that relaxation can be muscular. So we break down the muscular tension with massage therapy. Or it enables someone to have that, if it's an hour-long massage, to have that hour's break from the day-to-day activities. And massage therapy is also supported with a lot of research.

I guess the difference is that massage therapies...I mean, there is self-massage, and that's a valuable thing as well. What I try and do when I teach medical and health practitioners is to concentrate on techniques that are easy to integrate into clinical practice, be it a psychologist or a doctor, or a social worker, counsellor. These professionals, most often are not massage therapists, so you won't be saying to a patient or a client, “Well, I'm going to give you a massage as well.” But you can teach them how to take a few slow, deep breaths.

So the techniques that I focus on are those which health and medical practitioners can be taught well to do, and then taught well to apply clinically. And that again, is why I concentrate on diaphragmatic breathing and guided imagery, rather than yoga or massage because most practitioners won't include that in their practice.

Adrian: Okay, so these are more around ones that people can kind of take home and do it from home, and be able to implement it at different times of the day or wherever necessary, and possibly even do it in different settings.

Judy: Oh, yes.

Adrian: Yes.

Judy: Yes. And that's an important thing to discuss with your clients or patients when trying to encourage them to use these techniques regularly.

Adrian: So if we talk about relaxation and the benefit of relaxation, and obviously, many people know that it's important to relax. Does that then mean that all stress is bad, or how do you define when stress becomes bad?

Judy: That's an excellent question. And it's a myth that I like to bust because stress is not bad for us, stress is a fundamental part of life. And the true definition of stress from a health and medical point of view is the demands that are placed upon us that force us to adapt or to change. And so you know, in this day and age, Coronavirus, is a stress. It forces us to adapt, to change, to get used to wearing masks, to keep distance, socially distant. But everything about our lives involves stress.

So for your listeners to concentrate on what we're saying is a demand placed upon them to not think about what they're going to be doing after the podcast, and to adapt to the information that's coming through this discussion. So the information that we impart is a stressor that people need to adapt to and listen carefully and think about.

The food that we eat is a stress. It's a stressor on our digestive system. We need to adapt to digesting the food, to stimulating the digestive juices. And the digestive system responds and adapts to the food. The food is a stressor. It's a demand placed upon our digestive system to adapt, to change.

Getting up from a chair is a stressor on our proprioception and on our erector spinae muscles. And it's effortless for us usually. We adapt, we change. We accommodate that demand. What happens is, it's all about the ability to cope. So when you say what makes stress bad, it's when we can no longer...not no longer, it's when we are compromised, when our coping skills are compromised.

So if I have, for whatever reason, if I'm particularly... If somebody has asthma or a respiratory condition, wearing a mask might be particularly difficult. And so their coping is reduced in wearing a mask, and that reduces their ability to go out. In our everyday lives, we cope with things all the time but it's when the demands become too much or too many that our coping skills are reduced and that's when stress becomes distress.

So when our patients or clients come to us and say, "I am so stressed, I've had it up to here,” they actually mean, “Well, I'm not coping and I'm distressed.” Very, very important distinct difference between stress and distress. And the English language in our everyday language we talk about stress, but we actually mean distress.

Adrian: Yes, okay. All right. So you've got then stress that can be...you may be experiencing a stressor, that stressor may actually help facilitate change, or might help you achieve your goals, and so forth. But when it becomes debilitating for you or impacts on your ability to do things, then becomes bad and then we potentially need to look at alternative ways of managing it.

Judy: That's exactly right. And when you say it challenges us and makes us achieve things, there is some stress which is demands placed upon us to adapt and change. Distress is when we can't cope adequately with those demands. And eustress, E-U-S-T-R-E-S-S, is positive stress. And that's what gets us out of bed in the morning and motivates us, and enables us to achieve the things that we want to. So it's positive stress, it invigorates us, it's a positive challenge and we cope well with it.

Adrian: Got you. Okay, all right, great. So I think that's important for practitioners to be aware and for us to explain to our clients that certainly, stress is not always bad, and sometimes it's actually really helpful.
Obviously, if you got a lion running after you, you want to experience a...

Judy: Yes.

Adrian: ...significant level of stress to help you run faster, so there's a purpose there. I suppose when you're exercising, you're putting stress on the joints. And that is not necessarily a bad thing, that might actually help facilitate and help muscles grow and things like that.

Judy: It depends to what extent. When you talk about a lion or a sabre-toothed tiger running after us and it elicits the fight or flight response, that is a coping mechanism. And if we can run away fast enough, we've achieved...then that threat is gone and we've adapted to the demand of being face to face with a lion or dangerous animal.

Adrian: Yes. I suppose when you get to a point when a lion is running after you, it's probably too late anyway. The odds are not too great.

Judy: But we don't want to, and I think our modern...that was a major demand and challenge of times gone by when we're faced with a wild animal. But it is the typical example that we use for initiating the fight or flight response, or freeze.

Adrian: Yes, exactly.

Judy: But we have far more modern-day distressors now, unfortunately.

Adrian: Yes, absolutely. All right. So I just wanted to go back to your discussion about diaphragmatic breathing. So can you tell us a bit about diaphragmatic breathing, why it's beneficial for mental and physical health?

Judy: It's a big question. On so many levels, taking slow breaths is beneficial. So in the first and perhaps most obvious way, it encourages us to oxygenate our cells. Surprisingly, we have, the literature does vary, but up to 70 trillion cells in our body, and almost all of them need oxygen. And we need oxygen...when you look at the three primary necessities for life - oxygen, water, and food - the primary one is oxygen. We need oxygen before we need water and food.

So the mere oxygenation of all our cells enables them to function. And cell life, cellular activities is, again, just remarkable and incredibly complex, and it needs adequate supplies of oxygen.

Adrian: Yes.

Judy: So that's probably the most direct way. To speak generally, it also does stimulate the vagus nerve. And the vagus nerve is involved in the parasympathetic nervous system. So the autonomic nervous system, of course, is split into two. And one deals with stress, prepares us for distress and challenges, and the other enables us to relax. And that is important as a moderator between sleep and meeting life's challenges. So, on a physiological level, there's countless ways...

Adrian: Yes.

Judy: ...many ways that that increased oxygen, that use of the diaphragm assists us to go from the sympathetic response to a parasympathetic nervous response. Also using the diaphragm stimulates the viscera, our organs, our abdominal organs. So in turn that can help us digest better. It can calm…

Adrian: Okay.

Judy: I mentioned the autonomic nervous system, it releases calming neurotransmitters. It releases anti-inflammatory immune cells.

Adrian: Yes.

Judy: So on so many levels, the simple, simple act of taking slow breaths, initiates a cascade of events, both psychologically and across the range of systems, immune, neurological, endocrinological, and then, of course, psychological as well.

Adrian: Wow, it's amazing as you're speaking, I'm kind of hearing about all the potential effects that diaphragmatic breathing can have in our body, and it's really important for us to really assess that in all our clients really then. So if we think about all the different mental health conditions that people present with, diaphragmatic breathing can obviously help anxiety, but it probably would have an effect on depression and things like that, too. Would that be right?

Judy: It does. It does or it can. And there is evidence to demonstrate that, as I mentioned earlier, really well-done research. And I guess because taking slow, deep breaths, does, directly and indirectly, affect most of our bodily systems, it then, in turn, has an impact on each and every chronic condition that we see.

A lot of the work I do, the research that I look at falls under the area of psychoneuroimmunology. And I know that you've had a podcast on PNI before. And to me, PNI is the vehicle. It is the research that demonstrates how relaxation techniques such as diaphragmatic breathing actually make a difference. So they follow the physiological pathways through the nervous system, or through the endocrine system, through the immune system, and demonstrate the impact that relaxation such as diaphragmatic breathing can do.

Probably the most researched condition is anxiety for diaphragmatic breathing. And the evidence is strong. I can't emphasise enough how much really good evidence there is to demonstrate that anxiety can be reduced.
And to me, the more I work in this area, the more, as you said, each and every healthcare practitioner ideally — I don't like to say should — but ideally, hopefully, will incorporate an understanding of relaxation and how to take slow, deep breaths using the diaphragm properly. Because the benefit of including these as a tool in your practitioner toolkit, is that these relaxation techniques are evidence-based, they're non-pharmacological, they're non-invasive, they are certainly cost-effective.

And there's a whole realm of research that shows that we can reduce the burden of healthcare dollars, cost of healthcare, by implementing relaxation techniques on certain chronic conditions. And there's a lot of research that has shown that. So the argument for incorporating these techniques becomes stronger and stronger.

Adrian: So, I know that...we often will talk to people about taking slow, deep breaths. And I don't know if we can't get into it in detail in this podcast. But how do you go about teaching diaphragmatic breathing?

Judy: Well, teaching all medical and health practitioners is a win-win situation. Because the way to teach it is to first get the practitioner to experience it and to learn to do it themselves.

Adrian: Yes.

Judy: And to understand the importance of regular practice, to understand the importance of doing it correctly. And again, I can't emphasise enough that relaxation has an accumulative effect, and it is most effective when it is performed regularly. Now that might put people off thinking, “I can't afford to do something every day.” Whereas in the reality is that it's not necessarily the duration, even a few minutes, every day makes a difference. There are important things to stress to the practitioners, that if you spend a few minutes taking slow, deep breaths, almost every day, the impact can be quite stark on your health and well-being.

So the first step is to train the practitioner to...it is, what's the term? Healer, heal thyself, or physician, heal thyself. You can't recommend a technique until you have gained proficiency for yourself. And then you also can honestly and genuinely say, “Look, initially, I found it difficult. I got a little bit breathless, or I found it hard to commit to doing it every day. But I found that this helped me or this was beneficial, and this became easier.” And you can explain to your patients what your own experience is, and that makes it real for them.

So the first step in enabling practitioners to teach clients is to really teach the practitioner and get the practitioner to become proficient and to experience the benefits for themselves.

Adrian: Okay, so it's really important for them to really try it themselves, practice it. Set some time about practicing the techniques. You make a really good point there because I remember myself years ago, or 20 years ago, learning progressive muscle relaxation. And I really had to practice that every day. And it took a while for me to experience any benefit from it. I think it was really a couple of weeks before I really experienced any benefit from it. And then I was like, "Ah, I've got it, now this makes sense. Now I can feel it.”

And I found that really useful to be able to explain to my clients that sometimes you got to persist, sometimes you actually may feel more uncomfortable initially, but it's obviously a task that needs to be practiced.

Judy: Definitely. And I think people will respond to hearing a practitioner's experience. And yes, there's a lot.

Adrian: Yes.

Judy: Part of the clinical application of something like diaphragmatic breathing is negotiating with the client or patient, “Well, okay, let's talk about when you are going to include this in your daily life.” So I teach practitioners practical ways to recommend to themselves, and for their clients, how to incorporate taking a few slow, deep breaths every day. And there are some practical hints that can encourage compliance and regular practice.

Adrian: Terrific. All right, so just a question then with regards to diaphragmatic breathing. Is there anybody that we should be careful with regard to using diaphragmatic breathing, any precautions around it?

Judy: Look, there's certainly no absolute contraindications. Well, really, I think the only contraindication I ever came across was if somebody is having a psychotic episode, then relaxation is not what they need at that time. So, you need to look into what are the person's, the individual's current conditions. If somebody is diabetic, then you start the relaxation, making sure that their blood sugar levels are okay. If somebody is asthmatic, ideally, they'd have a puffer available should they need it.

I guess the first and foremost caution is if somebody has low blood pressure because relaxation decreases blood pressure. So if they've already got low blood pressure, you may want to consider relaxing them in a seated position rather than lying down, and certainly help them up. I mean, one of the rules of taking people through relaxation is to bring them back slowly, to stand by them as they stand up. Have a drink of water, make sure you come back to the real world very carefully and slowly.

Adrian: The other one you mentioned which I wanted to talk about briefly in this podcast was the guided imagery. So can you tell us a bit about guided imagery, and what it involves?

Judy: Guided imagery has many names. To me, it's actually similar to daydreaming. And I find it quite sad when we sort of...if ever a child is told, “Stop staring out the window and get on with something.” To see things in our mind's eye, I love the expression, mind's eye. When we see things in our head, we are strengthening not the reality of them, but the impact of them, the effect of it.

And very often we use guided imagery to plan for something. What kind of holiday do I want? And you see yourself exploring a certain place, or whether it's a sporting kind of holiday or a lazy holiday. We actually use our mind's eye more often than we're aware.

So guided imagery is also called mental imagery or visualisation, guided visualisation. The difference between them, I guess, is are you doing it for yourself, or is someone or technology guiding you? So guided imagery is when a practitioner takes you through a scenario for therapeutic purposes.

And my sense of it, or from my years of experience, I think that guided imagery for therapeutic purposes can be split into two. One is general relaxation, and the other is specifically to decrease the effects of chronic conditions. And I want to put in here that when I talk about chronic conditions, I think that they fall under...all chronic conditions can be classified under five or six areas.

So there's mood disorders. So that is your anxiety and depression, and the other mood disorders. You have pain. And obviously, there's a vast array of different types of pain. Sleep disorders, of which insomnia is one.

Adrian: Yes.

Judy: Then there's the trauma of which PTSD is one kind of trauma. And what we know now to be absolutely true, is inflammation is a chronic condition. And inflammation is part of...chronic inflammation and disease go hand in hand.

About five years ago, eight years ago, we were tentatively saying, “It looks like most diseases involve chronic inflammation.” We can categorically say now that chronic disease, chronic inflammation go hand in hand. So when we look at whether it's guided imagery or diaphragmatic breathing for chronic conditions, I think we cover everything when we look at...

Adrian: Yes.

Judy: ...mood disorders, sleep disorders, pain, trauma, and inflammation. So I wanted to clarify that.

Adrian: Absolutely.

Judy: So there's the difference, you can use guided imagery for, “I'm fed up, I'm exhausted, I want to relax.” So a good clinician can take you through a relaxation scene. And there's very specific things...there are a few guidelines that a clinician needs to be aware of to do that well.

And then a more specific way of using guided imagery is to look at the condition in particular, how does the individual patient or client experience that condition? And then how can you use guided imagery to reduce it? I never say, cure or eliminate, but certainly, decrease and reduce.

Adrian: Yes. So how do you choose a scene when it comes to guided imagery?

Judy: Great question, and this is really important. And maybe I can best describe the importance of choosing it by telling you how when I started many, many years ago, I made the mistake of… I chose the scene, and I took about a dozen people through a day at the beach. And then when we finished, I asked them, “How was that?” And three people said, "That was dreadful." One said, "I hate the beach, I've got fair skin, I never spend a day at the beach." Somebody else said, "I don't swim, I never go to the beach."

So the whole point of guided imagery is that you take a scene from...you take the cues and clues from each client. What do you find relaxing? What is your place? And that place can be real. So it can be a beach, it can be a bed, it can be lying on a hammock, it can be having dinner with extended family. People relax differently, and a relaxing scene is very individual.

So I ask the client, “What's relaxing for you? Where are you?" Actually, there are a variety of ways of doing it. One way is to ask them what their scene is. And the other is if they say I love being wherever it is, in a hammock on the deck, by the beach, whatever it is. So then I say, “Okay, do you like gentle swinging of the hammock?” And I get cues from them, and then I talk them through that scene.

Adrian: Good, great.

Judy: The other way that I use more often because it's simpler is to get the...and this is also much better if you're taking a group through guided imagery, is to ask everybody, think of your favourite relaxed, safe, happy place. You don't need to tell me what it is. But I want you to start in your mind's eye thinking of where you would most rather be to relax.

And then I simply go through, what do you see here? Look at the colours, be aware of the sights that are so special in this place. What do you hear here? What are the sounds that relax you? And take them through...I don't even know where they are.

Adrian: Yes.

Judy: But I'm in a generic way taking them through the senses, one or two of the five senses of being in that favourite place. And that's a generic way to do it which works well.

It's a little bit more technical and specific when dealing with chronic conditions, but the trick is to ask the patient or client for their experience. If they're feeling pain, to get some words of how they experience that pain or descriptions. And this takes practice, and this is what I train practitioners to do. It does take time and practice.

Adrian: So that's great advice. I mean, it sounds like certainly individualising it and we’ve got to be careful, because I know that for some people, that's not necessarily relaxing, and we need to really find out more about the person or get them to kind of be involved in that process. So identify that image, and I think it's really valuable advice. Thanks for that.

Judy: Yes. No, my pleasure. So in the clinical setting, it does take a bit of time to prepare. And then particularly when you're seeing a client repeatedly, it becomes easier and more streamlined to take them through that scene, or that imagery.

Adrian: Yes. Yes. Now, it'd be interesting, I think it'd be great for people to go through an example of a guided imagery. Is that something that you would be able to take us through a brief guided imagery exercise now?

Judy: Happily. And it would be a good way to demonstrate this generic way where if I can...

Adrian: Absolutely.

Judy: ...ask the listeners to take a moment now to think of...as I said, it can be real or it can be imaginary. So my favourite place is lying on a cumulus cloud that's soft and contoured to me, and with the gentle sun. So any place where you are happy, and safe, and comfortable, and relaxed, if you bring that place to mind, I am happy. How long would you like to go for?

Adrian: A couple of minutes, just a few minutes, if you can just take through a brief one, that'd be great for people to be able to hear out the process and actually participate in it themselves.

Judy: Terrific. All right, well, it'll take more than a couple of minutes.

Adrian: Yes.

Judy: But I'll just spend a few minutes doing it and people can get a sense of it.

Adrian: That would be fun.

Judy: So as you prepare to now go through a guided imagery relaxation session, bring to mind in your mind's eye the place where you really love to go. And if you are seated, then bring your buttocks back in the chair, straighten your spine. Bring your shoulders down. Turn your phone...well, eliminate as many possible disruptions.

And if you're lying down, put a pillow under your knees. And I encourage you to close your eyes. And I usually start people with taking a few slow breaths, which we haven't formally done but it's always nice to do. And as you prepare with your eyes closed, taking a couple of slow, deep breaths, and all your attention on those two or three slow breaths before we start the imagery and allowing yourself to be completely in the moment. And bringing your attention to your breath first.

Taking a couple of slow breaths, expanding your torso as you inhale, and slowly sinking down as you exhale. One more slow breath, expanding your torso, inhale, and smoothly letting go as you exhale. Allow your breath now to flow comfortably, breathing as effortlessly as possible.

And in your own time, it's always at your own pace, bring to your mind's eye what you see in this wonderful relaxing place. As other thoughts come to mind, let them drift away and come back to the colours, the shapes. What do you see? Be aware of the sites around you. Notice what you see. Look closely. Look all around, sights.

Be aware of the colours of your favourite place. Notice the shapes, contours, shadows. Look around, pour your attention on what you see. Pour your awareness on what you see. Very gently now, bring your awareness to how you feel. Notice how you feel physically. Be aware of what you feel mentally, emotionally.

With your eyes still closed, bring your awareness to the room you're in. Notice the sounds around you where you are, here. With your eyes closed, gently, gently move, wiggle your fingers and toes. If you want to rub your hands together and place them over your eyes, it's a nice way to open your eyes. Become used to the idea of being back in the real world.

And what I'd like to bring your attention to as you start to wiggle and move around and come back to the real world is that that whole exercise was five minutes, four-and-a-half, five minutes. And if it made a difference, again, you can realise that you don't need to spend a lot of time. It's the frequency and it's the focus that makes a big difference. So hopefully, Adrian, you're not too relaxed to keep talking.

Adrian: I am. That's the problem now. Well done. Thank you very much for that. I've just got to slowly get my stress levels back up so I could start doing what I need to do. But that was brilliant. It's really good to see that just within five minutes, you can engage in such an exercise and you can do that anywhere. You can do that sitting in the car. You can do that at home. You can do that...

Judy: I think that's one of the things that I really do emphasise when I teach practitioners is that it doesn't take a lot of time.

Adrian: Yes.

Judy: It's the practicing so that it's performed correctly, and it's the regularity.

Adrian: Terrific. Thank you very much for this. 

So just finishing off. So I know that you do training on the Art and Science of Relaxation. Can you just tell us a bit about this course, and what is covered, and how practitioners can go about doing it?

Judy: Well, Art and Science of Relaxation is dedicated to teaching relaxation therapy, particularly for chronic conditions, but for general relaxation as well. And I run online courses. I run online relaxation sessions for individuals.

And the courses...I mean, one of my courses coming up in the next couple of months is through the Faculty of Medicine at the University of Sydney. It's an online six-hour course. But I'm very flexible and the courses are run for the audience. So they are tailor-made, whether they're...depending on who they're for.

The best thing to do is to go to the website, artandscienceofrelaxation.com. Contact me and we can talk about what you would like to learn and how. And I certainly tailor courses and lessons and relaxation sessions. But there are other courses that people can do that are already online, I've recorded webinars and seminars. So there's a range of ways to do it. And then hopefully, sooner rather than later, we can do some face-to-face seminars as well.

Adrian: All right, that'd be great. Well, terrific. Thanks for letting us know about that. And we'll certainly include links and information in the show notes for people to, if they want to find out more information about your courses.

But thank you very much today for joining us, Judy, to talk about relaxation therapy and techniques, like obviously relaxation techniques and breathing and guided imagery. And definitely thank you very much for the guided imagery exercise that you put us through.

So it's particularly important to understand how they work to improve overall health and to know the various evidence-based relaxation options practitioners can use to treat different mental and physical conditions. And this is especially important considering the mental health crises that we are currently experiencing. So thank you again very much for being with us today.

Judy: It's an absolute pleasure. And I sincerely hope that more and more people recognise the simplicity of evidence-based relaxation techniques and how truly beneficial they are, and particularly in this time of increasing mental and physical conditions. Thank you very much for the opportunity, Adrian.

Adrian: Thank you. And thank you everyone for listening today. Don't forget, you can find all the show notes, transcripts, and other resources from today's episode on the FX Medicine website. I'm Dr. Adrian Lopresti, and thanks for joining us. We'll see you next time.

About Dr. Judy Lovas

Dr Judy Lovas is Australia’s expert in Relaxation Therapy and director of Art & Science of Relaxation.

With up-to-date knowledge, passion and humour, Judy teaches students, adults and health professionals how relaxation therapy enhances mental health and physical wellbeing. She expertly explains leading evidence, demonstrates how to practice regularly and describes clinical outcomes of relaxation therapy.

Judy’s unique and dynamic presentations focus on relaxation for anxiety, pain, PTSD, depression, sleep disorders and chronic inflammatory conditions. Using research from Psychoneuroimmunology, she explains how simple relaxation skills can reduce the effects of chronic conditions.

Judy teaches inhouse, face to face and online and is determined to increase the use of relaxation therapies in today’s health care system. When not teaching, she relaxes with family and friends.

Please visit artandscienceofrelaxation.com for more information.


The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.

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