relaxation stress control



An astute physician is lamenting the times:


“But the present world is a different one. Grief, calamity, and evil cause inner bitterness . . . there is disobedience and rebellion . . . Evil influences strike from early morning until late at night . . . they injure the mind and reduce its intelligence and they also injure the muscles and the flesh.”


This chronicler lived 4,600 years ago in China, even though his observat-ions appear contemporary. Human beings have always felt subjected to stress and often seem to look longingly backward to more peaceful times. Yet with each new generation, complexity and additional stress are added to our lives. The truth is that most of the persistent problems of this planet are even further from solution than when the Chinese doctor decried them. The technology of the past forty-six centuries, and especially that of the last century which was supposed to make life easier for people, often seems to intensify the stress in our day-to-day existence.


VICTIMS OF STRESS


What psychological price do we pay in attempting to adjust to the knowledge that war or its imminence is with us every day? Are we proud that our scientific know- how has increased the sophistication of weapons since that time when a shepherd named David could defeat an entire army with a rock thrown from a sling? Or do we knowingly or subconsciously despair of the current nuclear weaponry that could exterminate every human being, indeed almost all life?


Most of us find that we are helpless in solving the big problems. We have some vague hope that the leaders we elect (and the experts they in turn rely on) can find the solutions. But our concern usually involves everyday difficulties. Our frustrations come about because we generally can’t even solve the less earthshaking problems, such as being on time to work in a large, congested city. Indeed, the everyday demands of living make it more and more difficult to escape the ever increasingly adverse psychological effects that seem built into our existence. Whatever it may be—the daily commute, or the rising cost of living, or the noise and fumes of the city, or unemployment, or random violence—we find it very difficult to reach a satisfactory equilibrium, and as a result we become the victims of stress.


Our rapidly changing world has necessitated many other adjustments. For example, before the women’s-liberation movement had filtered so far and deep, people were married under a set of unspoken agreements that society now questions and sometimes shatters. Today, women must reexamine their own roles and life-styles against conflicting expectations and suppositions. For the older woman, the problems of reeducation and readjustment can be over-whelming. Men must also adjust to a new role that may mean more responsibility for family and household. They are being forced to view women in a new way, one that may be threatening to their old accustomed role. Concurrent with and related to the movement is the change of the family structure. Mobility separates families into small nuclear units. Women raise children outside of marriage. Divorced fathers assume custody of children. All share in the impact of societal changes.


How are these anxieties and stresses affecting us? The presence of mental stress as a part of modern living has been the subject of a number of books, most of which concentrate on the psychology of stress. We will consider stress from a somewhat different perspective, for our concern is not only the psychology but also the physiology of stress.


We will explore what happens to you internally under stressful situations and how stress physically undermines your health. This will be done by examining the relation between your emotional reactions and what they may cost you in hypertension, heart attacks, strokes, and other diseases. We will then point out what you can do about the effects of stress. We will show how, by your personal adoption of a simple psychological technique, you can improve your physical and mental well-being.


THE HIDDEN EPIDEMIC


We are in the midst of an epidemic, one that is all too prevalent in the United States and other industrial nations. The name of this epidemic is hypertension, the medical term for high blood pressure. Hypertension predisposes one to the diseases of artherosc1erosis (hardening of the arteries), heart attacks, and strokes. These diseases of the heart and brain account for more than 50 percent of the deaths each year in the United States. Therefore, it is not surprising that various degrees of hypertension are present in 15 to 33 percent of the adult population. Although this epidemic is not infectious in nature, it may be even more insidious, simply because its manifestations do not affect large numbers at the same time and because we are not generally aware that the disease is slowly developing within us. Throughout its course there are few, if any, symptoms. Yet each day we see it strike without any warning, cutting short by decades the lives of our friends and loved ones. According to carefully compiled Government vital statistics, the diseases resulting from this epidemic account for an average of two deaths every minute in the United States alone . Put another way, that is nearly one million out of two million deaths a year. Translate this statistic into your own personal experience—the loss of a friend who leaves young children, the premature death of a father about to enjoy his retirement years. You are a most fortunate individual if you have not personally experienced the ravages of this epidemic.


High blood pressure, heart attacks, and strokes have markedly increased, not only afflicting a growing percentage of the population but steadily finding their way into younger age groups . The late Dr. Samuel A. Levine, an eminent American cardiologist, pointed out in 1963 that in families he had treated for many years, sons suffered heart attacks at an average of thirteen years younger than the age at which the fathers experienced theirs. Today many cardiologists observe this same significant shift. Five to ten years ago it would have been a relatively rare event to witness a stroke or heart attack in a person in his thirties and it would have been astonishing if the patient were in his twenties. Now, today, interns and house staff just starting in medicine consider heart attacks in men in their thirties common-place.


There is no shortage of theories to explain the rapidly increasing prevalence of hypertension and the associated increase in the number of heart attacks and strokes, suffered mainly in the Western world. The traditional explanations have been (i) inappropriate diet, (2) lack of exercise, and (3) family disposition. Yet there is another factor, which has often been ignored: environmental stress. Although environmental stress is gaining recognition as an important factor in the development of these diseases, it is still poorly understood. All four factors play a role. What has yet to be adequately determined is the relative significance of each.


Doctors a have recognized for years that stress is taking a toll. It is not difficult to understand the correlation between the highly competitive, time-pressured society in which we live and mental stress - with its influence on heart disease. For example, a commonly heard warning is “Don’t get upset, you’ll get high blood pressure.” The problem has been how to quantify stress. In other words, how do we objectively measure the effects of stress upon the body? Medicine has recently made inroads, moving from psychological speculation to hard, measurable, physiologic data.


Our focus will be on the relation between stressful. psychological events and their associated physiologic changes, as they affect your health. Traditionally psychology and medicine have long been separated by their different methodologies of research. This dichotomy has kept most physicians from seeing the relation between the psychologically laden term “stress~~ (hinging as it does on personal behavior and environmental events) and the functioning of the body and related diseases. Although most doctors would agree that stress does affect health, they are not attuned to the psychological, non-medical literature about stress. Concerned mainly with bodily signs and symptoms, the physician treats stress by prescribing medication and, when no specific diseases are present, by reassurance and some counseling. More often than not he will dispense so-called tranquilizing drugs rather than delve into the psychological roots of the problem. On the other hand, most psychiatrists and psychologists do not directly treat organic disease states. Their major concerns are emotions, thoughts, and personality. Psychiatrists may prescribe pills, but treatment is directed essentially to the psyche . If bodily symptoms are apparent, the patient will most likely be referred to a medical doctor, thus completing a circle with little interplay between the professions.


However, these traditional barriers are slowly crumbling. There is still a long way to go, and most physicians, because of the very paucity of concrete data, remain distrustful of psychosomatic or psyhophysical diagnosis and treatment. Nevertheless, the specialty called psychosomatic medicine, which is the study and treatment of diseases caused or influenced by psychological events, is now a rapidly spreading field of medical research.


THE FIGHT -OR- FLIGHT RESPONSE


The stressful consequences of living in our modern, Western society—constant insecurity in a job, inability to make deadlines because of the sheer weight of obligations, or the shift in social rules once binding and now inappropriate—will be described here in a manner that clearly explains how they lead to the ravaging diseases such as hyper-tension which are prevalent today and which are likely to become more widespread in the years ahead. We are all too familiar with the stresses we encounter. However, we are less knowledgeable about the many consequences of these stresses, not only psychological but physiologic. Humans, like other animals, react in a predictable way to acute and chronic stressful situations, which trigger an inborn response that has been part of our physiologic makeup for perhaps millions of years . This has been popularly labeled the “fight-or-flight” response.


When we are faced with situations that require adjustment of our behavior, an involuntary response increases our blood pressure, heart rate, rate of breathing, blood flow to the muscles, and metabolism, preparing us for conflict or escape.


This innate fight-or-flight reaction is well recognized in animals. A frightened cat standing with arched back and hair on end, ready to run or fight; an enraged dog with dilated pupils, snarling at its adversary; an African gazelle running from a predator; all are responding by activation of the fight-or-flight response. Because we tend to think of man in Cartesian terms, as essentially a rational being, we have lost sight of his origins and of his Darwinian struggle for survival where the successful use of the fight-or-flight response was a matter of life or death.


Man’s ancestors with the most highly developed fight-or-flight reactions had an increased chance of surviving long enough to reproduce. Natural selection favored the continuation of the response. As progeny of ancestors who developed the response over millions of years, modern man almost certainly still possesses it.


In fact, the fight-or-flight response, with its bodily changes of increased blood pressure, rate of breathing, muscle blood flow, metabolism, and heart rate, has been measured in man. Situations that demand that we adjust our behavior elicit this response. It is observed, for example, among athletes prior to a competitive event. But the response is not used as it was intended—that is, in preparation for running or fighting with an enemy. Today, it is often brought on by situations that require behavioral adjustments, and when not used appropriately, which is most of the time, the fight-or-flight response repeatedly elicited may ultimately lead to the dire diseases of heart attack and stroke.


If the continual need to adjust to new situations can bring on a detrimental fight- or-flight response, and if we live continuously with stressful events which trigger that response, it is natural to question whether we know how to check the dangerous results that inevitably follow. Take this line of reasoning one step further . If the fight-or-flight response resides within animals and humans, is there an innate physiologic response that is diametrically different? The answer is Yes. Each of us possesses a natural and innate protective mechanism against “overstress,” which allows us to turn off harmful bodily effects, to counter the effects of the fight-or-flight response. This response against “overstress” brings on bodily changes that decrease heart rate, lower metabolism, decrease the rate of breathing, and bring the body back into what is probably a healthier balance. This is the Relaxation Response.


This book will first explain the ways in which heart attacks and strokes develop within the body, often undetected, through the insidious mechanism of high blood pressure. We will show how high blood pressure is related to stress through the inappropriate elicitation of the fight-or-flight response.


OUR MAIN PURPOSE, HOWEVER, IS TO DISCUSS THE RELAX- ATION RESPONSE, for it may have a profound influence on your ability to deal with difficult situations and on the prevention and treatment of high blood pressure and its related, widespread diseases including heart attacks and strokes. The Relax -ation Response has always existed in the context of religious teachings. Its use has been most widespread in the Eastern cultures, where it has been an essential part of daily existence. But its physiology has only recently been defined. Religious prayers and related mental techniques have measurable, definable physiologic effects on the body which will be explained. From the collected writings of the East and West, we have devised a simplified method of eliciting the Relaxation Response and we will explain its use in your daily life. You will learn that evoking the Relaxation Response is extremely simple if you follow a very short set of instructions which incorporate four essential elements: (1) a quiet environment; (2) a mental device such as a word or a phrase which should be repeated in a specific fashion over and over again; (3) the adoption of a passive attitude, which is perhaps the most important of the elements; and (4) a comfortable position. Your appropriate practice of these four elements for ten to twenty minutes once or twice daily should markedly enhance your well-being.


Stress has long been the subject of psychological and physiologic speculation. In fact, more often than not, the word itself is ill-defined and overused, meaning different things to different people. Emotional stress, for example, can come about as the result of a family argument or the death of a loved one. Environmental stress, such as exposure to excessive heat or cold, is an entirely different phenomenon. Physiologic stress has been described as the outpouring of the steroid hormones from the adrenal glands, a theory elaborated upon by Dr. Hans Selye of Montreal, who believes these hormones are vitally important for the survival of an organism and are exquisitely sensitive indices of stress. Whatever its guise, a lack of a firm definition has seriously impeded past research.


Drs. Thomas H. Holmes and Richard H. Rahe, psychiatrists at the University of Washington Medical School, have devised a scale of stressful events. Hundreds of persons of varying ages, backgrounds, and classes were asked to rank the relative amount of adjustment required to meet a series of life events. Holmes and Rahe have called this list “the social readjustment scale.” The scale is based on interviews with 394 individuals. The actual numerical rating was the average number of units these individuals assigned to the various life events after being told marriage was equivalent to fifty units. Heading the list is death of a spouse. The doctors subsequently found that ten times more widows and widowers die during the first year after the death of their husbands or wives than all others in their age group; that divorced persons have an illness rate twelve times higher than married persons in the year following the divorce. According to the doctors, change whether for “good” or “bad” causes stress to a human being, leaving him more susceptible to disease.




THE RELAXATION RESPONSE


TABLE ONE


* * * * * * * * * * * *


THE STRESS OF ADJUSTING TO CHANGE

 

Event Occurring                        Scale of Impact.


 

Death of spouse                                              100

Divorce                                                            73

Marital separation                                           65

Jail term                                                           63                                             

Death of close family member                        63

Personal injury or illness                                 53

Marriage                                                          50

Fired at work                                                   47

Marital reconciliation                                      45

Retirement                                                       45

Change in health of family member    44

Pregnancy                                                        40

Sex difficulties                                                39

Gain of new family member                           39

Business readjustment                                     39

Change in financial state                                 38

Death of close friend                                       37

Change to different line of work   36

Change in number of arguments with spouse 35

Mortgage over $10,000                                   31

Foreclosure of mortgage or loan           30 

Change in responsibilities at work        29

Son or daughter leaving home    29

Trouble with in-laws        29

Outstanding personal achievement       28

Wife begins or stops work          26

Begin or end school          26

Change in living conditions                            25

Revision of personal habits                             24

Trouble with boss                                            23

Change in work hours or conditions     20

Change in residence                                        20

Change in schools                                           20

Change in recreation                                       19

Change in church activities                             19

Change in social activities                    18

Mortgage or loan less than $10,000      17

Change in sleeping habits                                16

Change in number of family get-togethers 15

Change in eating habits                         15

Vacation                                                          13

Christmas                                                        12

Minor violations of the law                             11




Our approach is similar in that we define stress as environmental conditions that require behavioral adjustment. For example, stressful circumstances are those associated with rapid cultural change, urbanization and migration, socioeconomic mobility, or uncertainty in the immediate environment. I formulated this working definition in the course of early studies in collaboration with Dr. Mary C. Gutmann at the Harvard Medical School’s Thorndike Memorial and Channing Laboratories at the Boston City Hospital. The research provided a starting point for measuring how stress interacts with blood pressure.


WHO DEVELOPS HYPERTENSiON?


Life-threatening events are the most obvious environmental circumstances requiring behavioral adjustment. On April 16, 1947, a ship containing explosive material blew up in Texas City with a blast estimated to equal the force of the Bikini atomic bombs. Practicing physicians in the area, according to a study, found a marked increase in the blood pressures of their patients for days after the explosion. During World War II, physicians observed elevated blood pressures among the besieged Russian population of Leningrad, as they did among soldiers going to battle.


Less dramatic but more immediately relevant is what happens to people who have to adjust to city living. Several studies have examined how inividuals are affected when social roles break down and they are forced to establish new ones. Tests have shown that high blood pressure goes hand in hand with adjustment to city life. For example, one of our studies demonstrated that citizens living in Puerto Rican rural areas had practically no hypertension. In contrast, 18 percent of their counterparts living within a Puerto Rican metropolitan area had blood pressures in the hypertensive range . Higher blood pressure paralleled the degree of “Westernization” of Fiji Islanders. Members of an African Zulu tribe also showed a rise in blood pressure after migration from primitive to urban areas . Stress associated with the adjustment of becoming a city dweller is felt to be an important contributory factor in hypertension.




SLEEP VS. MEDITATION


The experiments showed that during meditation there was a marked decrease in the body’s oxygen consumption. As mentioned in Chapter 2, each cell makes use of the energy in foods by slowly “burning” the nutrients. In order to “burn” the many nutrients the cell usually utilizes oxygen brought to it through the blood stream. The sum of the individual metabolism of each of the cells utilizing oxygen constitutes the total oxygen consumption, or metabolism, of the body. The major physiologic change associated with meditation is a decrease in the rate of metabolism


Such a state of decreased metabolism, called hypo-metabolism, is a restful state. Like sleep, another hypo-metabolic state, meditation causes bodily energy resources to be taxed less. Humans rarely achieve a hypo-metabolic state, associated with an oxygen consumption that is lower than occurs when you sit quietly in a chair or lie down. In fact, there are very few conditions that lead to hypometabolism. Sleep is one; hibernation is another. Since oxygen consumption is significantly lowered during the practice of meditation, it was first thought this decreased consumption of oxygen might be due to an unknown hibernation-like response in people . One way to know whether hibernation is occurring is to measure the body’s rectal temperature. During hibernation this temperature decreases. Meditators, it appears, do not hibernate. Their rectal temperatures do not decrease during the practice of meditation.


Are the physiologic changes associated with meditation the same as those found in sleep, another hypometabolic state? There is little resemblance. During both sleep and meditation there is a decrease in oxygen consumption. However, there are marked differences in the rate of oxygen-consumption decrease during sleep and meditation. During sleep, oxygen consumption decreases slowly and progressively, until, after four or five hours, it is .about 8 percent lower than during wakefulness. During meditation, however, the decrease averages between 10 and 20 percent and occurs during the first three minutes of meditation.


It is not possible for a person to bring about such decreases by other means. For example, if you hold your breath, your tissues will continue to utilize the available oxygen at the same rate and there will be no change in the amount of oxygen you consume. Another physiologic difference between meditation and sleep has been documented with the electroencephalogram. Alpha waves, slow brain waves, increase in intensity and frequency during the practice of meditation but are not commonly found in sleep. We still do not know the significance of alpha waves, but, as previously noted, we do know that they are present when people feel very relaxed.


Other brain-wave patterns during meditation are also distinctly different from those during sleep. For example, none or few of the brain-wave electric signals characteristic of rapid eye movement, often seen in sleep and associated with dreaming, are recorded during meditation.


Meditation is therefore not a form of sleep; nor can it be used as a substitute for sleep. Meditation evokes some of the physiologic changes that are found it sleep, but the two are not in any way interchangeable, nor is one a substitute for the other. In fact, a look into the sleeping habits of meditators left us with reports that some slept more after regularly practicing meditation and others less . Some noted no change at all.


Along with the drop in oxygen consumption and alpha-wave production during meditation, there is a marked decrease in blood lactate, a substance produced by the metabolism of skeletal muscles and of particular interest because of its newly purported association with anxiety. . In 1967, Drs. F. N. Pitts, Jr., and J. N. McLure, Jr., of the Washington University School of Medicine, in St. Louis, investigated a group of patients who suffered from neurosis and frequent attacks of anxiety. They injected into their subjects either a non-active salt solution or a solution of lactate. (The bottles were mixed so that neither the subjects nor the physicians knew which was being infused.) They found that when lactate was being infused, practically every patient with anxiety neurosis experienced an anxiety attack . If the other salt solutions were injected, the percentage of anxiety attacks fell significantly . When they took normal people and infused lactate into them, they found that 20 percent of these “normal” people would experience an anxiety attack while practically none ~ou1d experience an anxiety attack when the non-active salt solution was injected.



If increased lactate is instrumental in producing regular attacks of anxiety, the finding of low levels of lactate in meditators is consistent with their reports of significantly more relaxed, less anxious feelings. Blood-lactate levels fall rapidly within the first ten minutes of meditation . Though the reason for decreased lactate is uncertain, it is consistent with decreased activity of the sympathetic nervous system. This is the system that is activated during elicitation of the fight-or-flight response.


Putting aside changes in oxygen consumption, brain waves, and lactate levels, other measurements supported the concept of meditation as a highly relaxed condition associated with lowered activity in the sympathetic nervous system . In the tests of the volunteer meditators the heart rate decreased on the average about three beats per minute, and respiration rate, or rate of breathing, also slowed.


All these physiologic changes in people who were practicing the simply learned technique of Transcendental Meditation were very similar to feats observed in highly trained experts in Yoga and Zcn with fifteen to twenty years of highly concentrated experience in meditation.


What did not change in these early experiments involving young, healthy subjects was blood pressure. The blood pressure of the meditators was low before, during, and after the experiment. Although blood pressures remained unchanged during the practice of meditation, the low blood pressures of the meditators pointed the way to future experiments. Perhaps they had low blood pressure because of their continued practice of meditation. If this was true, the possibility existed that people wih hyper-tension could lower their blood pressures through such a practice.


As the experiments progressed over several years, the concept developed that the various physiologic changes that accompanied Transcendental Meditation were part of an integrated response opposite to the fight-or-flight response and that they were in no way unique to Transcendental Meditation. Indeed, lowered oxygen consumption, heart rate, respiration, and blood lactate are indicative of decreased activity of the sympathetic nervous system and represent a hypometabolic, or restful, state. On the other hand, the physiologic changes of the fight-or-flight response are associated with increased sympathetic nervous system activity and represent a hypermetabolic state.




DR. HESS’S CRUCIAL EXPERIMENTS


          Dr. Walter R. Hess, the Swiss Nobel Prize-winning physiologist, produced the changes associated with the fight-or-flight response by stimulating a part of the cat’s brain within the hypothalamus. Moreover, by stimulating another area within the hypothalamus, Dr. Hess demonstrated a response whose physiologic changes were similar to those measured during the practice of meditation, that is, a response opposite to the fight-or-flight response. He termed this reaction the trophotropic response and described it as “a protective mechanism against overstress...A way to achieve this altered state of consciousness associated with the Relaxation Response is through the practice of what has been called meditation. The term “meditation” is difficult for some people to grasp because it may connote exotic Eastern cults or Christian monks who spend most of their waking hours in their monastery cells contemplating God . As Dr. Robert E. Ornstein points out in his book The Psychology of Consciousness, the Western “impersonal, objective scientific approach, with its exclusive emphasis on logic and analysis makes it difficult for most of us even to conceive of a psychology which could be based on the existence of another, intuitive gestalt mode of thought.” The notion of attaining “altered consciousness” may seem to you like some mystic experience involving a deep philosophical or religious ritual, and therefore too much like a cult.


AGE-OLD WISDOM


The altered state of consciousness associated with a the Relaxation Response has been routinely experienced in Eastern and Western cultures throughout all ages. Subjectively, the feelings associated with this altered state of consciousness have been described as ecstatic, clairvoyant, beautiful, and totally relaxing. Others have felt ease with the world, peace of mind, and a sense of well-being akin to that feeling experienced after a period of exercise but without the fatigue. Most describe their feelings as pleasurable. Despite the diversity of description, there appears to be a universal element of rising above the mundane senses, a feeling beyond that of common-day existence. Many authors have pointed out the similarities between Eastern and Western mysticism, and have emphasized a universality of certain impulses in the human mind. Indeed, the subjective accounts of practitioners of different meditative backgrounds are similar to many experiences depicted in religious, historical, and philosophical writings. We will attempt to show that the Relaxation Response has been experienced throughout history. We will do so by extracting methods described in various literatures, primarily religious. Some of these methods are thousands of years old. Our chief purpose is to illustrate the age-old universality of this altered state of consciousness by citing certain elements that appear to be necessary to evoke this experience, or “response.” No technique can claim uniqueness.


This approach is not to be interpreted as viewing religion or philosophy in a mechanistic fashion . The ultimate purpose of any exercise to attain transcendent experience corresponds to the philosophy or religion in which it is used. For example, John of Ruysbroeck , a Flemish mystic in the thirteenth century, states that through inward exercises man feels a ghostly union with God. Whosoever then has, in his inward exercise, an imageless and free ascent unto his God, and means nought else but the glory of God, must taste of the goodness of God; and he must feel from within a true union with God. And in this union, the inward and spiritual life is made perfect; for in this union, the desirous power is perpetually enticed anew and stirred to new inward activity. And by each >act, the spirit rises upwards to a new union.


Or. according to the teachings of Buddha, meditational exercises will help one realize and experience perfected selflessness leading to a cessation of unhappiness and a state of peace. However, the experience of this altered state of consciousness is not dependent upon one philosophical or religious belief. William James, one of the fathers of modern psychology, expresses this view in The Variety of Religious Experience:


                    The fact is that the mystical feeling of enlargement,

                    union and emancipation has no specific intellectual

                     content whatever of its own. It is capable of forming

                     matrimonial alliances with material furnished by the

                     most diverse philosophies and theology, provided only

                     they can find a place in their framework for its peculiar

                    emotional mood.


Also, many of the contemplative techniques set forth in the writings of Christian mystics used their own experiences and techniques only as example. An anonymous monk writing in the fourteenth century states in The Cloud of Unknowing:


                    And if you think that the labor is great, then

                    you may seek to develop special ways, tricks,

                    private techniques, and spiritual devices by

                    means of which you can put other thoughts

                    away. And it is best to learn these methods

                    from God by your own experience rather than

                    from any man in this life. Although this is so,

                    I will tell you what seems to me to be the best

                    of these special ways. Test them and improve

                    upon them if you can.


Hence, by selecting elements from various techniques which appear to be necessary for eliciting experiences of transcendence, we are not espousing a certain tradition or taking away the special meaning of any practice for the individual. Because of the variety of experiences and methods, a person may find that any one of many practices best suits his or her purpose. As William James aptly states: “To find religion is only one out of many ways of reaching unity; and the process of remedying inner incompleteness and reducing inner discord is a general psychological process.”


MEDITATION: THE FOUR BASIC ELEMENTS


Most accounts of what we now call the Relaxation Response are subjective descriptions of deeply personal, unique experiences. However, there appear to be four basic elements underlying the elicitation of the Relaxation Response, regardless of the cultural source.


The first element is a quiet environment. One must “turn off” not only internal stimuli but also external distractions. A quiet room or a place of worship may be suitable. The nature mystics meditated outdoors.


The second element is an object to dwell upon. This object may be a word or sound repetition; gazing at a symbol; concentrating on a particular feeling. For example, directing one’s attention to the repetition of a syllable will help clear the mind. When distracting thoughts do occur, one can return to this repetition of the syllable to help eliminate other thoughts.


The third element is a passive altitude. It is an emptying of all thoughts and distractions from one’s mind. A passive attitude appears to be the most essential factor in eliciting the Relaxation Response. Thoughts, imagery, and feelings may drift into one’s, awareness. One should not concentrate on these perceptions but allow them to pass on. A person should not be concerned with how well he or she is doing.


The fourth element is a comfortable position. One should be in a comfortable posture that will allow an individual to remain in the same position for at least twenty minutes. Usually a sitting position is recommended. We believe the sitting, kneeling, squatting, swaying postures assumed in various forms of prayer have evolved to keep the practitioner from falling asleep. The desired altered state of consciousness is not sleep, but the same four elements will lead to sleep if the practitioner is lying down.


The first selections illustrating these four elements will be from Christian writers, most of whom have been labeled mystics. However, the term mysticism was not a common term until medieval times. Rather, the subject of these writings was contemplation, whose end point was direct union with God. Let us begin with St. Augustine (A.D. 354-430) , who wrote during the first great period of theological controversy, a time marking the begining of Western civilization.


Contemplation for St. Augustine was upon the unchangeable—that is, on God, “the Light Unchangeable.” Dom Cuthbert Butler, in his book Western Mysticism, states that St. Augustine does not designate his experience as union with God, as do the later Christian mystics, although he expresses the idea of some kind of spiritual contact. Preparation for contemplation according to St. Augustine is recollection, a term later used by many Christian mystics, which corresponds with the idea of a passive attitude. Recollection is an exercise of abstraction, of recollecting and gathering together thoughts (“memory”) and concentrating the mind. The object is to shut off the mind from external thoughts and to produce a mental solitude. St. Augustine speaks of recollection or the preparation for contemplation in the following passage from Confessions:


So great is the force of memory, so great the

                              force of life, even in the mortal life of man.

                              What shall I do then, 0 thou my true life,

                              my God? I will pass even beyond this power

                              of mine which is called memory; yea I will

                              pass beyond it, that I may approach unto 

                               Thee, sweet Light.


St. Augustine’s work is a moving chronicle that describes his own intensely personal experiences. In addition to portraying their own subjective experiences, later Christian mystics set forth various components of contemplation which they thought would lead their readers to this particular state of consciousness.


The Cloud of Unknowing, a book written probably during the fourteenth century, provided practical advice for all individuals desiring “to be knit to God in spirit, in unity of love, and accordance of will.” The author, a monk, most likely remained anonymous because he feared he would be accused of heresy. He believed religion allowed for independent inquiry and individual experience, which at that time were condemned by the church. In his book he wrote that man gained direct knowledge of God by losing all awareness of himself. Referring to his title, the author depicts a passive attitude as the way “to cover,” or forget, all distractions:


“Try to cover these thoughts with a thick cloud of forgetting as though they never existed neither for you nor for any other man. And if they continue to arise, continue to put them down.”


He goes on to discuss the element of “dwelling upon” and advises that his readers can develop “special ways, tricks, private techniques, and spiritual devices” in order to achieve contemplation. One means is the use of a single syllable such as “God”

or “love”:


                    Choose whichever one you prefer, or if you like,

                    choose another that suits your tastes, provided

                    that it is of one syllable. And clasp this word

tightly in your heart so that it never leaves it

                    no matter what may happen. This word shall

                    be your shield and your spear whether you ride

in peace or in war. With this word you shall

                    beat upon the cloud and the darkness, which

                    are above you. With this word you shall strike

                    down thoughts of every kind and drive them

                    beneath the cloud of forgetting.


Germany in the fourteenth century produced a great number of mystics. As in The Cloud of Unknowing, the essence of their mysticism was the belief that the individual could directly commune with God when he was in a state of perfect solitude. Martin Luther drew upon this doctrine of individual transcendence to God. Rudolph Otto, a prominent German theologian and philosopher, describes methods of prayer from Luther’s book How Man Should Pray , Meister Peter, the Barber, written in 1534. io prepare for prayers of inward recollections, the true language of the heart, in which one concentrates solely upon God, one must achieve a passive attitude by dwelling upon an object . It is necessary to have “the heart free itself and become joyous” in order to prevent thoughts from intruding. For the object upon which one concentrates, Luther suggests the words of the Lord’s Prayer, the Ten Commandments, the Psalms, or a number of the sayings of Christ or Paul.


Like the anonymous fourteenth-century monk and Martin Luther, Fray Francisco de Osuna, a monk writing in the sixteenth century, sets forth spiritual exercises for those wishing to obtain union with God. In his preface to The Third Spiritual


Alphabet, Fray Francisco de Osuna defends recollection as a natural means by which man can rise to the knowledge of God, citing references from the very teachings of the Bible . For Fray Francisco de Osuna the act of contemplation is the act of love for God. In his Sixth Treatise of The Third Spiritual Alphabet , he advocates a quiet environment by relating the custom of Christ, who would retreat to the desert:


                    Although these practices and others of the same

                    kind are excellent, our Letter advises those who

                    wish to make further progress and follow better

things to accustom themselves to recollection,

                    for they will thus imitate and follow our Lord,

                    whose custom it was to go into the desert,

                    where, alone and recollected, he could pray

                    more secretly and spiritually to his and our

                    heavenly Father.


Later, he describes the element of a quiet environment as “the quiet that nature ordains before sleep is ordained by the devout soul for prayer.”


This sixteenth-century monk elaborates on the passive attitude by describing the soul as mute and deaf to purposeful and spontaneous thoughts:


You must also know that the world is by nature deaf, which must be understood to mean in this case that the soul which is mute, not meditating on any subject, should also be deaf regarding thoughts which drag it down, and repress the senses with their many distractions. Therefore it is well that under this Letter should be included the two words dumb and deaf, for the one forbids the wandering thoughts we purposely encourage, and the other prevents those that would arise from our many occupations and levity.


Two methods of dwelling upon an object are suggested for recollection. One method is gazing, which can be accomplished even in a crowd: I do not tell you simply to lower your eyes, but to keep them fixed steadily on the ground, like men who are forgetful and as it were out of themselves, who stand immovable, wrapt in thought. Some people find it more easy to be recollected if they keep their eyes shut, but in order to avoid remark, it is better when in company to keep our gaze fixed on the ground, on some place where there is little to look at so that there may be less to stir our fancy and imagination. Thus, even in a crowd you may be deeply recollected by keeping your gaze bent, fixed on one place. The smaller and darker the place, the more limited your view will be and the less will your heart be thus distracted.


The second exercise is to repeat “no” when distracting thoughts occur: If you do wish to acquire recollection by practicing this holy exercise, remember to make use of a very brief means of ridding yourself of various distracting thoughts. This is that you say “No” to them when they come to you during prayer.


Fray Francisco de Osuna continues and expands this idea of using the word “no” as a means of maintaining a passive attitude. When thoughts do occur during recollection one should not ponder whether they are signals from God:


I warn you against discussing the matter further in your mind; it would greatly disturb your recollection; to examine into the matter would be a hindrance; therefore, shut the door with no. You will know that the Lord will come and enter your soul if the doors, which are your senses, are closed . . . But you will answer that it would be wrong to say no to God and he alone is expected. But God comes in some other way of which you know nothing.


To St. Teresa was very much influenced by Fray Francisco’s writings on recollection. In 1562 she wrote The Way to Perfection to teach her fellow

Sisters the habit of recollection:


                              May the Lord teach this manner of prayer

                              to those who do not know it for I confess,

                              myself, that I never knew what it was to pray

                              with satisfaction until he instructed me in this

                              method.


To St. Teresa, a passive attitude is the soul’s transcendence of earthly things:


                              so the soul raises herself to a loftier region;

                              she withdraws her senses from exterior objects

                              ... those who adopt this method almost always

                              pray with their eyes shut.., because it is making

                              an effort not to think about earthly things.


Although some call pure contemplation the prayer of the quiet, St. Teresa contends that many persons are raised to high contemplation by vocal prayers An old dear acquaintance was much distressed because she could not pray mentally:


                              [She] could never make any but vocal prayer,

                              and, faithful to this, she had everything. Yet

                               if she did not recite the words, her thoughts

                              wandered so much that she could not bear it.

                              But would that all had such mental prayer .

                              I saw, that faithful to the Paternoster, she had

                              reached pure contemplation.


On Mt. Athos, a peninsula of Greece, a traveler may still find monasteries that have remained essentially unchanged since the thirteenth century. The very primitive Christianity of Mt. Athos represents the Eastern Orthodox Church at the time of the split between the Western and Eastern churches. In the late nineteen-fifties three men documented the lives of the monks living on Mt. Athos. In the following passage Father Nicolas discusses the hermit’s life and explains how after isolating oneself from the world one must also abstract himself from his body and mind:

          After years in a monastery or in a skete, detaching oneself from the

          world, the difficulty lies just in finding oneself alone, face to face

          with oneself, alone in control of your body and your mind. Because

          the mind is a wanderer, you know. Thoughts never stop follow- 

          ing each other through your head, buzzing, preventing concentration,

          while in order to pray you need a great emptiness in your mind. After

          you’ve hunted out and punished all your vices, passions, faults—how-

          ever trivial—you have to hunt out all your thoughts. You have to create

          an immense silence round you before you can reach the deepest silence

          in the depths of yourself. Continual prayer, repeating the same words

           of praise to the Lord; that’s what allows one to pray . It’s not a question

           of seeing God, but of being in God, and it’s not easy to contain

          in the narrow limits of your body the limitless spirit which is always

           trying to escape . That’s a hermit’s life, more or less.


The repetition of words of praise to God is a form of prayer called Prayer of

the Heart or Prayer of Jesus . It is a method of Hesychasm, which was first adopted by Russian mysticism and developed at Mt. Athos. The Prayer of the Heart was often used as a method of contemplation in Russian monasticism. It was also used by devout lay people especially among the poor peasantry. The philosophical basis for the Prayer of the Heart dates back to the Greeks and St. Gregory Palamas, who believed that after the body and intellect are purified a man can then regain intuitive wisdom, as before the fall of mankind depicted by Adam. The method of repetitive prayer purifies the intellect by means of a passive attitude, emptying it of all thought, image, and passion . A compendium of the writings of Greek fathers and the masters of Byzantine spirituality, the Philokalia, contains extensive writings concerning the Prayer of the Heart. All four elements of a quiet environment, a proper posture, a dwelling upon an object, and a passive attitude are found in the Philokalia:


                              Sit down alone and in silence. Lower your head,

                              shut your eyes, breathe out gently, and imagine

                              yourself looking into your own heart. As you

                              breathe out, say “Lord Jesus Christ, have mercy

                              on me.” Say it, moving your lips gently, or

                              simply say it in your mind. Try to put all other

                              thoughts aside. Be calm, be patient and repeat

                              the process very frequently.


The invocation should be timed to the rhythm of breathing:


                              You know, brother, how we breathe, we breathe

                              the air in and out. On this is based the life of

                              the body and on this depends its warmth. So,

                              sitting down in your cell, collect your mind,

                              lead it into the path of the breath along which

                              the air enters in, constrain it to enter the heart

altogether with inhaled air, and keep it there.

                              Keep it there, but do not leave it silent and

                              idle, instead give it the following prayer: “Lord,

                              Jesus Christ, Son of God, have mercy upon me.

                              Let this be its constant occupation, never to be

                              abandoned. For this work, by keeping the mind

                              free from dreaming, renders it unassailable to

                              suggestions of the enemy and leads it do Divine

                              desire and love,


In the Judaic literature, one also finds portrayals of contemplative or meditative exercises. As in other religious literatures, the end purpose here is union with God. The earliest form of mysticism in Judaism is Merkabolism, which dates back approximately to the first century A.D., the time of the Second Temple. Practices of this sect included various forms of asceticism, including fasting. Merkabolism’s meditative exercises focused on body posture and the dwelling upon hymns and a magic emblem. The meditator would place his head between his knees and whisper hymns and repeat the name of a magic emblem. Repetition of the magic emblem was used as the object to dwell upon and would chase away distractions and cause the “demons and hostile angels to flight.” A state of ecstasy was reached, which Gershom G. Scholem, a scholar of Jewish mysticism, has described as “an attitude of deep self-oblivion.”


Writings on the techniques of mysticism in Judaism were prevalent in the thirteenth century. Many of the exercises involved dwelling upon the names of God or contemplating the letters constituting the name of God. Rabbi Abulafia developed such a mystical system of meditating upon letters of the Hebrew alphabet as constituents of God’s name. The aim of his mystical theory was to “unseal the soul, to untie the knots which bind it.” Kept with in the limits defined by one’s sensory perceptions and emotions, the soul’s life is finite, for these limits are finite. Hence, man needs a higher form of perception which, rather than blocking the soul’s most deeper regions, will open them up. This perception must be capable of the highest importance without having any importance of its own . In order to accomplish this, one needs an absolute object upon which to meditate. Thus, Rabbi Abulafia used the letters of God’s name because the name is absolute. It reflects the meaning and totality of existence, yet to the human mind has no concrete meaning of its own.


Gershom G. Scholem characterizes Abulafia’s teaching as similar to Yoga, whose meditative techniques will be discussed in a moment. He writes that Abulafia’s teaching represent but a Judaized version of that ancient spiritual technique which has found its classical expression in the practices of the Indian mystics who follow the system known as Yoga. To cite only one instance out of many, an important part in Abulafia’s system is played by the technique of breathing; now this technique has found its highest development in the Indian Yoga, where it is commonly regarded as the most important instrument of mental discipline. Again, Abulafia lays down certain rules of body posture, certain corresponding combinations of consonants and vowels, and certain forms of recitation, and in particular some passages of his book “The Light of the Intellect” give the impression of a Judaized treatise on Yoga. The similarity even extends to some aspects of the doctrine of ecstatic vision, as preceded and brought about by these practices.



In the East, meditative practices have perhaps had a more pervasive role not only in its religions but also in its cultural traditions. Carolyn Spurgeon, a professor of English literature, in an essay on mysticism in English literature points out an interesting difference between Eastern and Western mysticism. Western mysticism, she writes, stemmed from the Greek delight in natural beauty and reached its fullest development with the teachings of Christian faith. Enlightenment in Christianity centered upon the doctrine of Incarnation, in which the mystery of God would reveal itself in human form. Hence, Spurgeon concludes, Western mystical thought has embodied all that is human and natural, of human love and intellect and of the natural world. To Eastern thinking, however, this “humanness” obstructs spiritua~ ascent. The emphasis of Eastern mysticism has been on pure soul-consciousness, to annihilate the flesh and deny its reality in order to reach absolute freedom.


Yoga has been a tradition in India throughout its history . Not merely a philosophy, Yoga has influenced many different practices and beliefs through out the Indian culture. Mircea Eliade has traced the doctrines and methods of Yoga which have permeated numerous Eastern religions and philosophies—Brahmanism, the Upanishads of Vedic literature, Hinduism, Buddhism, Tantrism, just to name a few. Eliade’s definition of Yoga is any ascetic technique and method of meditation. The “classic” system of Yoga can be found in the writings of Patañjali, who has brought together and classfied a series of traditional practices and contemplative formulas. The essence of Yoga meditation is concentration on a single point —for example, a physical object or a thought. By dwelling upon an object one may cancel out all distractions that are associated with one’s everyday life and thus achieve a passive atitude. Eliade describes this concentration, ekãgratã, as damming the mental stream of the mind. Ekàgratc~, or concentration, may be reached through numerous techniques such as decreased muscle tone and rhythmic breathing. By means of these techniques one may attain ckdgrat and ultimately the highest concentration, samadhi, in which one passes beyond the human condition to total freedom.


H. Saddhatissa, in his presentation of Buddhism for Western readers, outlines methods for the practice of meditation which parallel Eliade’s description of Yoga techniques. Buddhism, whose philosophy is attributed to Siddhartha Gautama (?563-?483 B.C.),—not a misprint! (?563-?483), began in the northern province of India. At one time Buddhism prevailed throughout Asia, and for twenty-five centuries it has been part of traditional beliefs in many lands. Saddhatissa now estimates there are five hundred million Buddhists in India, Nepal, China, Japan, Korea, Tibet, Cambodia, Laos, Vietnam, Malaysia, Burma, Thailand, and Ceylon. The preliminary instructions that Saddhatissa presents for meditation include a quiet environment and a comfortable position. One should choose a suitable place, which will have few distractions and therefore help one concentrate. He suggests a sitting posture, not necessarily a lotus, crosslegged, position, but a position that one finds most comfortable.


Saddhatissa proceeds from these preparations to categorize two types of Buddhist meditation— samatha, the development of calm and concentration, and vispassanã, the development of insight. In samatha the meditator concentrates on a fixed object, either external or internal. Anãpanasati, one of the foremost practices of samatha, was used by the Buddha on the night of his enlightenment. It is the practice of in-breathing and out-breathing. Focusing his attention at the tip of his nostrils, the meditator quietly “watches” the breath flowing in and out past the tip of the nostril. It is recommended that he count breaths, not going past ten, and repeating the count to aid his concentration.


Ashvagosha, an eminent Buddhist of the first century A.D., formulated and then expounded the teachings of the Mahayana school, a more elaborate and developed form of the original doctrines of Buddhism. Ashvagosha’s book The Awakening of Faith instructs the reader how to practice the Mahayana faith. The practice consist of five stages, the fifth being the “stage of preventing vain thoughts, and the practice of divine wisdom or judgments. ” These two concepts are to be most gradually activated at the same time. The practice of checking vain thoughts is accomplished through a quiet environment, a proper posture, and a passive attitude:


As to the practice of checking vain thoughts, it should be done in a quiet place, properly seated and in a proper spirit . . . for all kinds of ideas as soon as thought of must be put away, even the idea of banishing them must also be put away. As all existence originally came to be without any idea of its own, it ceases to be also without any idea of its own; any thoughts arising therefore must be from being absolutely passive. Nor must one follow the mind in its excursions to everything outside itself and then chase that thought away. If the mind wanders far away, it must be brought back into its proper state . One should know that the proper state is that of the soul alone without anything outside.


Eventually the practitioner will perfect this practice and the mind will be at rest, from which one will proceed to reach the “peace of the Eternal.” In the practices of Sufism, a system of Muhammadan mysticism, one discovers all of the four known elements that together may bring about transcendent experiences. Muhammadanism was founded by Muhammad, the Arab prophet, who lived in the sixth century. However, the origins of the practices of Sufism may be traced back to the second century, and it is of interest to note its similarities to Christianity and Buddhism. Al-Ghazali, who has been described as the greatest Muslim since Muhammad, found the true way of life through Sufism although he remained an orthodox Muhammadan. Dhikr, a special method of worship in Sufism, is explained   by Al-Ghazali in a passage that has been summarized by D. B. Macdonald and cited in A Moslem Seeker After God as follows:


                              Let the worshipper reduce his heart to a state

                              in which the existence of anything and its non-

                              existence are the same to him. Then let him sit

                              alone in some corner, limiting his religious

                              duties to what is absolutely necessary, and not

                              occupying himself either with reciting the Ko-

                              ran or considering its meaning or with books

                              of religious traditions or with anything of the

                              sort. And let him see to it that nothing save

                              God most High enters his mind. Then, as he

                              sits in solitude, let him not cease saying con-

tinuously with his tongue, “Allah, Allah,”

keeping his thought on it. At last he will reach

                              a state when the motion of his tongue will cease,

                              and it will seem as though the word flowed

                              from it. Let him persevere in this until all trace

                              of motion is removed from his tongue, and he

                              finds his heart persevering in the thought. Let

                              him still persevere until the form of the word,

Its letters and shape, is removed from his heart,

                              and there remains the idea alone, as though

                              clinging to his heart, inseparable from it. So far,

                              all is dependent on his will and choice; but to

                              bring the mercy of God does not stand in his

                              will or choice . He has now laid himself bare to

                              the breathings of that mercy, and nothing re-

                              mains but to wait what God will open to him,

                              as God has done after this manner to prophets

                              and saints.    If he follows the above course, he

                              may be sure that the light of the Real will

                              shine out in his heart.


Taoism, one of the influential philosophical systems in the history and thought of China, dates back to the sixth century B.C., with the writing of Lao Tzu, which embodies all of Taoist philosophy. Chuang Tzu, who lived two hundred years later, elaborated upon the teachings of Lao Tzu, developing more clearly the concepts of Taoism and placing a stronger emphasis on the individual. To practice Taoism, according to Chuang Tzu, is “To regard the fundamental as the essence, to regard things as coarse, to regard accumulation as deficiency, and to dwell quietly alone with the spiritual and the intellect—herein lie the techniques of Tao of the ancients. . . . They built their doctrines on the principle of the eternal non-being and held the idea of the Great One as fundamental.” Through iranquillity of mind one achieves accord with nature and hence with Tao, the “One.” Chuang Tzu says that dwelling quietly alone with the spirit and the intellect means “forgetting everything,” much as the author of The Cloud of Unknowing instructs the reader to cover thoughts with a “thick cloud of forgetting” Chuang Tzu presents the following passage:

          Yen Hui said, “I have made some progress.


                    “What do you mean ?“ asked Confucius.


          “I have forgotten humanity and righteous ness,” replied Yen Hui.

                    “Very good, but that is not enough,” said Confucius.

 

On another day Yen Hui saw Confucius again and said, “I have made some progress. “What do you mean ?“ asked Confucius.


          “I have forgotten ceremonies and music,” replied Yen Hui.

                    “Very good, but that is not enough,” said Confucius..

 

Another day Yen Hui saw Confucius again and said, “I have made some progress.

          “What do you mean ?“ asked Confucius.


          Yen~ Hui said, “I forget everything while sitting down.”

Confucius’ face turned pale. He said, “What do you mean by sitting down and forgetting everything?”

 

          “I cast aside my limbs,” replied Yen Hui, “discard my intelligence, detach from both body and mind, and become one with the Great Universal [Tao 1. This is called sitting down and forgetting everything.”

 

Confucius said, “When you become one with the Great Universal, you will have no partiality, and when you are part of the process of transformation, you will have no constancy.  You are really a worthy man. I beg to follow

          your steps.”

SOURCE:

The Relaxation Response

Copyright @ 1975 by: William Morrow & Company, Inc.

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