Lisa Hoffman & Charles Atkins

Published July 21, 2005

Charlie Writes:

I get the call from Lisa early Wednesday morning.

"I didn’t sleep all night," she starts. "I was up, I was down and nothing seemed to work; even following your advice to not lie in bed and watch television, but to sit in a chair. I had too many things on my mind, including having to deal again with Medicare taking away my very necessary aides; it’s a nightmare. I tried to watch television in the chair but found that the nighttime shows were worse than the ones in the daytime; they were certainly not relaxing. It made me feel worse, so I turned it off, and just obsessed about how I couldn’t fall asleep. Do you have a relaxation tape?"

I, at that very moment, was in the midst of a clinical emergency and was not at my empathic best, so I told her I’d see what I could do, but that I couldn’t talk.

"You can’t even talk for a minute?" she said.

I really couldn’t, and so I told her that I’d see what I could come up with, and felt wonderfully guilty about having cut her off.

"Good," she says, when I read the above at her condo a couple hours later. "You should feel guilty. You’re like Dr. Atkins and Mr. Hyde. One minute so kind, and the next, ‘I can’t talk right now’ . . . and you cut me off. Whereas I always have time and am always sweet and lovely."

Knowing that she’s not feeling well I say nothing. If left to her own devices Lisa would never get off the telephone, an instrument I loathe. Although, with the advent of wireless and hands-free technology I can more easily chat while doing something else.

"I can’t stand that," she comments, "You’re always clanging the dishes around why can’t you stop and talk like a normal person and not always be running around like a maniac? Why do you have to be doing so many things at once?"

Which brings us to today’s subject. With Lisa’s struggles with high blood pressure, stress and headaches, it’s been recommended that she try some relaxation exercises. I’d brought her one tape, which turned out to be confusing and required headphones. So, as I searched my house for something more suitable and reviewed various Yoga, Mindfulness, meditation etc. tapes and DVDs I realized that they were either too physical, too esoteric, or that she’d hate the New Age background music. Instead, I grabbed a CD of Pachelbel’s Canon—a dreamy favorite for folks walking down the aisle—a recently purchased aluminum bundt pan (I’ll explain later), and ran through my repertoire of ways to help folks relax, get calm, fall asleep . . . and yes, even lower blood pressure.

There’s good evidence that there are many ways to improve overall health and well being without medication. The curious thing is that for various reasons we’re a society that prefers pills. So while it’s clear that regular exercise is a good treatment for depression—as are various talking therapies—most folks still ask for medications if given the choice. Likewise, there are many good studies that show the benefits of Yoga, meditation, bio feedback and other techniques to assist with complaints ranging from anxiety and depression to high blood pressure and insomnia. The good news is that increasingly I hear doctors, nurses and other healthcare providers try to steer their patients to these low-risk, high-benefit strategies, often in combination with medication. But with the average doctor visit lasting seven minutes; you can’t give great in-depth instructions. So translating what’s known in the literature, to what might work for any given person—as demonstrated in the mismatch of the relaxation tape I’d given Lisa—becomes an issue.

To prevent that from happening again, I show up at Lisa’s with the intent of making a customized relaxation tape that will take into account her goals, strengths, limitations and preferences.

Her eyes light up when she sees the bundt pan, "Are we making a cake?"

"No, we’re making a relaxation tape. You game?"

"Yes."

Her willingness to try new things is important. Whenever attempting a new exercise regimen or relaxation technique allowing yourself to be open to the experience increases your chances of benefiting from it. When people come in to a foreign activity with an attitude of ‘this is stupid’ or ‘this isn’t going to work’ they’re less likely to engage and won’t receive the full benefit.

"This is what we’re going to do," I say, while hitting the record button. "I’m going to take you through a series of relaxation exercises. We’re not trying to make anything happen, and when listening to this tape, if there are exercises you don’t like, it’s fine to skip over them, and get to one that you prefer. All you have to do is get into a comfortable position and follow along. You ready?"

She readjusts her riser chair, gets comfy, and we’re good to go.

I begin with a five-minute Zen mindfulness exercise, where the sole instruction is to observe the breath. I ring the bundt pan three times to start (A social worker colleague recently showed me how a vintage cast-aluminum bundt pan—preferably not Teflon coated—purchased for 3-5 dollars at the Woodbury flea market, when struck by hand or wooden mallet sounds just like a five-hundred-dollar Tibetan singing bowl). At the end of the five minutes I ring the pan again, and ask "How was that".

She opens her eyes, smiles. "Relaxing," she says.

We then spend a couple minutes discussing the experience; this is an important step as sometimes people need the instructions clarified or they ran into some difficulty. I click the tape back on and we do a second five-minute mindfulness exercise, where the instruction is just "observe and notice sound." I tell her, "If you find yourself wanting to hold onto a sound, just notice, let it go, and observe."

I ring the pan to start and again at the end. "How was that one?" I ask.

"I’m feeling relaxed, but there were neighbors clanking the lids of garbage cans," she says, "there was loud conversation at the mailbox; I heard an ambulance siren screech by."

"It’s strange," I comment, feeling rather floaty myself, "but in the combined ten minutes of these first two exercises I heard three separate sirens. I’d never realized how noisy things are here."

"A morning dove was cooing on my deck," she adds, "and whenever I got distracted I just kept letting myself listen to the sounds; there were so many."

"You’re actually a natural at doing these," I add. "A lot of people when asked to sit still for five minutes and just observe, have difficulty. Often you need to start them with a shorter period of time, like thirty seconds, and then work up."

"I think it has to do with my modeling." She comments, "I used to pose a lot when I was younger for painters and sculptors and had to sit completely still for hours."

"That could be it. . . You ready for something more involved?" I ask.

"Yes."

"This is a bit different and it’s called Progressive Muscle Relaxation, and we’ll modify it on account of your arthritis." I reach back and click on both the tape, which I’m recording, and the CD of dreamy classical music. I instruct Lisa to close her eyes and get comfortable, and talk her through a slow process that involves sequentially contracting and then relaxing each part of her body. We start in her right big toe and spend enough time on each body part to where she can contract for at least one breath, and then relax for three. I stay aware of which joints have arthritis, and when we get to those she’s instructed not to contract, but to just be aware of the joint or body part for the first breath, and then to relax it for the subsequent three. So from the big toe, we travel to the other toes, the ankle, the shin, the knee, the thigh, repeat on the other leg, move up through the pelvis, torso, arms, hands neck, face and finally the scalp.

Halfway through, I wonder if she’s fallen asleep—not a bad thing at all. But then she comes back, and I complete the exercise by giving her a few moments to scan through her body, and release any places where she might be holding tension. I then have her open her eyes [This exercise took roughly 25 minutes]. And ask, "How was that?"

"I felt almost hypnotized," she says. "I think I might have fallen asleep a bit, listening to the quiet voice, and probably because you talked so low, I had to concentrate even more to hear you, and I couldn’t think about anything else that was bothering me."

We finish the morning by passing the digital camera back and forth and snap what have become our trademark hammish pictures. Before I leave, I instruct her to try listening to the tape we just made at bedtime.

A couple days later she calls me up, "You know the other night I put on the tape as I was getting ready to go to bed. I turned it on, and hours later I woke up and it had come to the end. It worked! It really worked."

"Did you use it again last night?

"No, I didn’t. I had it with me, but I got so tired that I didn’t need it."

"What did you think of it, overall?"

"I don’t want to insult any doctors, but I get so tired of all the medications. I think I’d like to pursue this some more, maybe even have somebody from the Yoga Center come to my house and work with me. I normally hate any kind of exercise, but this is more mental than physical so I can handle it."

"Do you think you could do something like this on a daily basis?"

"I might," she says. "Although I do better if someone is actually here."

Which gets me to my final point; these exercises, like many others, work well. But as somebody who’s done Yoga for decades, the key is practice. These things help if you do them, and that’s probably why so many look for answers in pill form; we’re all very busy and would like a quick fix. But sometimes the answers have nothing to do with going fast. Instead the answers are found in slowing down, doing only one thing in the moment, and learning to relax.

[ Home ] [ Up ]