Stress Reduction & Coping Skills

Relaxed Breathing

How to do relaxed breathing
• To practice make sure you are sitting or lying comfortably
• Close your eyes if you are comfortable doing so
• Try to breathe through your nose rather than your mouth
• Deliberately slow your breathing down. Breathe in to a count of 4, pause for a
moment, then breathe out to a count of four
• Make sure that your breaths are smooth, steady, and continuous – not jerky
• Pay particular attention to your out-breath – make sure it is smooth and steady
Am I doing it right? What should I be paying attention to?
• Relaxed breathing should be low down in the abdomen (belly), and not high in the
chest. You can check this by putting one hand on your stomach and one on your chest
Try to keep the top hand still, your breathing should only move the bottom hand
• Focus your attention on your breath – some people find it helpful to count in their head
to begin with (”In … two … three … four … pause … Out … two … three … four … pause …”)
How long and how often?
• Try breathing in a relaxed way for at least a few minutes at a time – it might take a few
minutes for you to notice an effect. If you are comfortable, aim for 5-10 minutes
• Try to practice regularly – perhaps three times a day
Variations and troubleshooting
• Find a slow breathing rhythm that is comfortable for you. Counting to 4 isn’t an
absolute rule. Try 3 or 5. The important thing is that the breathing is slow and steady
• Some people find the sensation of relaxing to be unusual or uncomfortable at first but
this normally passes with practice. Do persist and keep practising
When we are anxious or threatened our breathing speeds up in order to get our body
ready for danger. Relaxed breathing (sometimes called abdominal or diaphragmatic
breathing) signals the body that it is safe to relax. Relaxed breathing is slower and
deeper than normal breathing, and it happens lower in the body (the belly rather than
the chest).


Managing Stress

Stress hormones can alter the level of certain chemicals in the brain, which may
contribute to headaches as well. If you tense your muscles, grind your teeth or stiffen
your shoulders in response to stress, you may only make your headaches worse.

Stop the cycle
You can’t avoid daily stress. But you can keep stress under control — which can help
prevent headaches. Consider these tips:
• Simplify your life. Rather than looking for ways to squeeze more activities or chores
into the day, leave some things out. Ask yourself what really needs to be done,
what can wait and what can be dropped entirely. It’s OK to say no occasionally.
• Manage your time wisely. Update your to-do list every day — both at work and at
home. Delegate what you can, and break large projects into manageable chunks.
Tackle the rest one task at a time.
• Be prepared. Organize your day ahead of time. Anticipate challenges. Try to keep
your plan flexible, in case a headache strikes and you need to change course.
• Let go. Don’t worry about things you can’t control.
• Adjust your attitude. If you find yourself thinking, “This can’t be done,” snap back to
attention. Think instead, “This will be tough. But I can make it work.” Putting a
positive spin on negative thoughts can help you work through stressful situations.
• Relax. Set aside time for yourself every day, even if it’s only a few minutes. When
you feel your muscles begin to tense, breathe deeply. Inhale to the count of six,
pause for a second and then slowly exhale.
• Take a break. If you feel overwhelmed, take some time to clear your mind. A few
slow stretches or a brisk walk may renew your energy for the task at hand. Or
take a mental vacation. Imagine yourself in a calm, relaxing place.
• Exercise regularly. Exercise is a proven way to prevent — and sometimes treat —
headaches. Exercise also provides a break from the stress of daily life. Be
careful to warm up slowly. Sudden, intense exercise can cause headaches.
• Eat smart. A diet rich in fruits, vegetables and whole grains can give you more
energy — plus the fuel you need to keep stress under control.
• Laugh. Humor is a great way to relieve stress. Laughter releases endorphins,
natural substances that help you feel better and maintain a positive attitude.
• Change the pace. Occasionally break away from your routine and try something
new. A vacation or weekend getaway may help you develop a new outlook.


Identify your stressors – what’s making you stressed?

Where am I when I’m feeling stressed? What am I doing? Who am I with?
What helpful changes could I make? (
What is within my control?
Even if there is little you can do about some situations, maybe making some small
changes – in routine, in the way you handle things, doing things differently, taking
time out, thinking about it in a different way, in getting help, seeking advice – could
make all the difference
Doing things differently
Do something different (to what you normally do)
Make time for yourself each day – relaxation, fun,
enjoyment. ( Create
a healthy balance – allow time for activities which give
you a sense of achievement, those that give a sense of
closeness to others, and of a sense of enjoyment. When
stressed, it’s often the case that we spend more time
doing things that help us achieve, but less of enjoyment
and closeness to others. Aim for a healthy balance as
shown in the pie chart. Keep an ACE Log to help you
keep track

Stress Busting Skills

 Mindfulness – learn Mindful Breathing (
 Focus your attention fully on another activity – Mindful activity
Page 3 of 4
 Relaxation techniques – try lots and find one that works for you
 Put on some music – sing and dance along, or just listen attentively
(use music that is likely to help you feel your desired emotion – avoid
sad songs if you’re depressed) (
 Meditation or Prayer (
 Help others
 Be with others – contact a friend, visit family
 Talk to someone
 Grounding techniques – look around you, what do you see, hear, smell, sense?
Hold a comforting object.
 Physical exercise – walk, swim, go to the gym, cycle (take the stairs instead of the
lift, get off the bus a stop early)
 Engage in a hobby or other interest – if you don’t have one, find one! What have
you enjoyed in the past? What have you sometimes thought about doing but not
got around to?
 Limit your responsibilities – it’s okay to say no
 Write down your thoughts and feelings – get them out of your head
 Just take one step at a time – don’t plan too far ahead
 Positive self-talk – encourage yourself, tell yourself: I can do this, I am strong and
capable – find an affirmation that works for you (even if you don’t believe it at
first!). Write it down and memorise it for when you need it. See Affirmations
 Do something creative – make a box of items that remind you to use the
techniques that help, or put photos on paper, or write and decorate a list
 Use Imagery (
 Tell yourself: “This will pass, it’s only temporary”. “I’ve got through this before, I
can do it now”. When we’re going through a tunnel and become
fearful of being trapped, there’s no point in stopping – we just have to
carry on in order to reach the end of the tunnel.
 Learn to communicate assertively (rather than passively or
aggressively) (
 Eat a healthy balanced diet, with plenty of fruit and vegetables
 Drink less caffeine and more water
 Pamper yourself – do something you really enjoy, or do something relaxing

Thinking differently
 STOPP! Pause, take a breath, don’t react automatically
 Ask yourself:
 What am I reacting to?
 What is it that I think is going to happen here?
 Is this fact or opinion?
 What’s the worst (and best) that could happen? What’s most likely to happen?
 How helpful is it for me to think this way?
 Am I getting things out of proportion?
 Is it worth it?
 How important is this really? How important will it be in 6 months time?
 What meaning am I giving this situation?
 Am I overestimating the threat?
 Am I underestimating my ability to cope?
 Have I got my ‘stress-head’ on?
 What do I look like to other people? How am I affecting them?
 Am I mind-reading what others might be thinking?
 Am I believing I can predict the future?
 Is there another way of looking at this?
 What advice would I give someone else in this situation?
 Am I putting more pressure on myself?
 Just because I feel bad, doesn’t mean things really are bad.
 Can I do things any differently here?
 How much can I control in this situation? What is outside of my control?
 What changes (however small) can I make to those things that I am able to
 What do I want or need from this person or situation? What do they want or
need from me? Is there a compromise?
 What would be the consequences of responding the way I usually do?
 Is there another way of dealing with this?
 What would be the most helpful and effective action to take? (for me, for the
situation, for the other person)

© Carol Vivyan 2009,permission to use for therapy purposes.

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