Complimentary Therapies

Guided imagery

What is it?

• Guided imagery is an important tool in treating a variety of health problems. It provides benefits and it poses virtually no risk. Guided imagery is used in many medical settings to help manage an array of conditions and diseases from stress to pain to the side effects of cancer.
• Imagery is the thought process that invokes and uses the senses. You use it to see in your “mind’s eye” a beautiful vista, or to conjure up aromas of your favorite foods. Guided imagery has been used by cultures throughout the ages as a healing tool. It relies on memories, dreams, fantasies and visions to serve as a bridge between the mind and body.
• Ancient Egyptians and Greeks, including Aristotle and Hippocrates, believed that images released spirits in the brain that aroused the heart and body. They also believed that a strong image of disease was enough to cause symptoms. Navajo Indians practice an elaborate form of imagery that encourages the individual to envision himself or herself as healthy.
• Evidence of peoples’ ability to use their imaginations to assist in curing their ailments was documented by both Sigmund Freud and Carl Jung.
• Modern research has shown that mental images produce physiological, biochemical and immunological changes in the body that affect health. Researchers have found that imagery can change specific immune system responses that affect such things as white blood cell count. Imagery also has shown a potential to improve quality of life in some people with cancer.

How does it work?

• Guided imagery is a program of directed thoughts and suggestions that guide your imagination toward a relaxed, focused state. Guided imagery is based on the concept that your body and mind are connected. Using all of your senses, your body seems to respond as though what you are imagining is real. An example often used is to imagine an orange or a lemon in great detail-the smell, the color, the texture of the peel. Continue to imagine the smell of the lemon, and then see yourself taking a bite of the lemon and feel the juice squirting into your mouth. Many people salivate when they do this. This exercise demonstrates how your body can respond to what you are imagining.
• You can achieve a relaxed state when you imagine all the details of a safe, comfortable place, such as a beach or a garden. This relaxed state may aid healing, learning, creativity, and performance. It may help you feel more in control of your emotions and thought processes, which may improve your attitude, health, and sense of well-being.

Science behind Guided Imagery

Research using positron emission tomography (PET) scanning have found that the same parts of the brain are activated when people are imagining something as when they’re actually experiencing it. For example, when someone imagines a serene image, the optic cortex is activated in the same way as when the person is actually seeing the beautiful vista. Vivid imagery sends messages from the cerebral cortex to the lower brain, including the limbic system, the emotional control center of the brain. From there the message is relayed to the endocrine and the autonomic nervous systems, which affect a wide range of bodily functions, including heart and respiration rates, and blood pressure.

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Guided imagery can offer relief from symptoms such as anxiety and stress simply by closing your eyes to the outside world. Imagery can empower the mind to create healing.

When first learning imagery techniques, many people find listening to a CD to be helpful.

Four steps are important in making imagery work for you.

Step 1: Relaxation

• To create a desirable image, the mind must be cleared of all chatter and ego-based distractions. Loosen tight fitting clothing and find a comfortable, quiet place. Once you are quiet and comfortable, began taking slow, deep breaths and releasing all random thoughts as you exhale.

Step 2: Concentration

• Focus attention on your breathing as a means to clear your mind. If your mind wanders, acknowledge the thoughts, release them easily and effortlessly as you exhale. Then re focus your attention on your breathing.

Step 3: Visualization

• Now combine a desired image with an intention and for the next several minutes, focus on this image. You may find that your mind wanders-this may happen frequently, especially during the early stages of visualization. When it does, bring your focus back by using a slow, deep breath.

Step 4: Affirmation

• A positive affirmation coupled with the image will help to create a positive message that will be stored and easily recalled at a later time. Combining an image with a word or phrase may help to engage both sides of your brain.

Light Therapy

Bright Light and Blue Light Therapy improve Sleep in People with certain chronic conditions.

• Light therapy can provide another addition to an overall therapy plan for people with chronic conditions. Sleep disturbances and sleep disorders are typical symptoms of many forms of ilnesses. There are probably many contributors to these disturbances, but the main cause is undoubtedly the disruption of Circadian Rhythms.
• Circadian rhythm is the psychological, biological and physiological period that closely approximates a day. It is the pattern, controlled by the brain, that puts us to sleep about the same time every night and wakes us up in the morning; the reason that our systems are confused by jet travel. It is the pulse of our being that synchronizes us with natures day-night cycle.
• Some illnesses affects the part of the brain responsible for circadian rhythms, the suprachiasmatic nucleus, which is located in the hypothalamus. It is the deterioration of the cells in this part of the brain that disturbs the circadian rhythms and causes sleep disorders. Periodic exposure to bright light and blue light of the proper color and intensity can reset these rhythms restore more natural sleep patterns.
• Natural sunlight is the best source for light to set and maintain these natural biorhythms (Sunlight also provides vitamin D, also important for cognitive performance and possibly for the prevention and treatment of neurological disease.)
• It is sometimes difficult to provide an adequate amount of natural sunlight, especially if one loses mobility due to a chronic illness. There are artificial light sources that provide the color (full spectrum white) and intensity (5000 LUX to 10,000 Lux) necessary to have the desired effect.
• Certain blue light can also be used to reset these circadian rhythms. The benefit of both bright light and blue light therapy is more natural sleep patterns without drugs, or with fewer drugs. This means a better quality of life for the person with a chronic illness.

Meditation

What is it?

• Meditation may be the perfect complement to the rush of a busy, complicated life. As the evidence supporting the use of meditation grows, adding it to your daily schedule may be just the antidote you need to deal with a hectic routine. In addition, if meditation helps to lower your blood pressure and reduce stress in your life, so much the better. The long term benefits of meditation continue to undergo study.
• The term meditation refers to a group of techniques, many of which have their roots in Eastern religious or spiritual traditions. Today, many people use meditation for health and wellness purposes.
• In meditation, a person focuses attention on his or her breathing, or on repeating a word, phrase or sound in order to suspend the stream of thoughts that normally occupies the conscious mind. Meditation is believed to lead to a state of physical relaxation, mental calmness, alertness and psychological balance. Practicing meditation can change how a person relates to the flow of emotions and thoughts and may help you control how you respond to a challenging situation.
• Meditation may be practiced on its own or as a part of another mind-body therapy, such as yoga or tai chi. Like other mind-body therapies, once you learn how to meditate, you can do it on your own.

How does it work?

• Practicing meditation has been shown to induce some changes in the body, such as in the body’s fight-or-flight response. The system responsible for this response is the autonomic nervous system.It regulates many body activities, including heartbeat, perspiration, breathing and digestion. The autonomic nervous system is divided into two parts:
• The sympathetic nervous system helps mobilise the body into action. When you’re under stress, it produces the fight-or-flight response. Heart rate and breathing increase, blood vessels narrow and muscles become tense.
• The parasympathetic nervous system response is opposite to that of the sympathetic system. It creates what is called the “rest and digest” response. The parasympathetic system prompts the heart to beat more slowly, the blood vessels to dilate, improving blood flow, and the digestive tract to increase activity.
• Researchers studying the effects of meditation are focusing on the brain and how meditation may reduce the activity of the sympathetic nervous system and increase that of the parasympathetic system.

Science behind meditation: A growing body of scientific research is supporting the health benefits of meditation, some research suggests that meditation may help such conditions as:

• Allergies
• Anxiety disorders/stress
• Asthma
• Binge eating
• Fibromyalgia
• Cancer
• Depression
• Fatigue
• Heart disease
• High blood pressure
• Pain
• Sleep problems
• Substance abuse

Several studies have shown that a program of meditation effectively reduces blood pressure in people with hypertension, similarly some improvement in symptoms has been reported by people with fibromyalgia who practiced meditation and preliminary research of the use of transcendental meditation in treating people with asthma has shown some positive results, and finally preliminary results for treating anxiety and stress have shown promise in the short term, but conclusive evidence that meditation reduces anxiety over the long term isn’t currently available.

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Most types of meditation require four elements

A quiet place:

• Many people who meditate prefer a place with as few distractions as possible. This can be particularly helpful for those just starting to practice meditation.

A specific posture:

• Depending on the type of meditation being practiced, it can be done while sitting, standing, lying down, walking or in other positions.

Focused attention:

• Focusing your attention is an important part of meditating. For example, you may focus on a mantra, a specific word or set of words. You may also choose to focus on your breathing, or on an object such as a candle or an image.

An open attitude:

• Keeping an open attitude during meditation means letting distractions come and go without engaging them, without stopping to think about them. When distracting or wandering thoughts occur during meditation, they aren’t suppressed. Rather, you gently bring your attention back to the focus. In some types of meditation, the meditator learns to observe the rising and the falling of thoughts and emotions as they occur.

Zen Meditation Instructions

• Zazen is a particular kind of meditation, unique to Zen, that functions centrally as the very heart of the practice.It's a very simple practice. It's very easy to describe and very easy to follow. But like all other practices, it takes doing in order for it to happen.
• The first thing to pay attention to is the position of the body in zazen. How you position your body has a lot to do with what happens with your mind and your breath. Throughout the years of the evolution of Buddhism, the most effective positioning of the body for the practice of zazen has been the pyramid structure of the seated Buddha. Sitting on the floor is recommended because it is very stable. We use a zafu - a small pillow - to raise the behind just a little, so that the knees can touch the ground. With your bottom on the pillow and two knees touching the ground, you form a tripod base that gives three hundred and sixty-degree stability.
• There are several different leg positions that are possible while seated this way. The first and simplest is the Burmese position, in which the legs are crossed and both feet rest flat on the floor. The knees should also rest on the floor, though sometimes it takes a bit of exercise to be able to get the legs to drop that far. After awhile the muscles will loosen up and the knees will begin to drop. To help that happen, sit on the front third of the zafu, shifting your body forward a little bit. By imagining the top of your head pushing upward to the ceiling and by stretching your body that way, get your spine straight - then just let the muscles go soft and relax. With the buttocks up on the zafu and your stomach pushing out a little, there will be a slight curve in the lower region of the back. In this position, it takes very little effort to keep the body upright.
• Another position is the half lotus, where the left foot is placed up onto the right thigh and the right leg is tucked under. This position is slightly asymmetrical and sometimes the upper body needs to compensate in order to keep itself absolutely straight.
• By far the most stable of all the positions is the full lotus, where each foot is placed up on the opposite thigh. This is perfectly symmetrical and very solid. Stability and efficiency are the important reasons sitting cross-legged on the floor works so well. There is absolutely no esoteric significance to the different positions. What is most important in zazen is what you do with your mind, not what you do with your feet or legs.
• There is also the seiza position. You can sit seiza without a pillow, kneeling, with the buttocks resting on the upturned feet which form an anatomical cushion. Or you can use a pillow to keep the weight off your ankles. A third way of sitting seiza is to use the seiza bench. It keeps all the weight off your feet and helps to keep your spine straight.
• Finally, it's fine to sit in a chair with your feet flat on the floor. You can use the cushion, or zafu, the same way you would use it on the floor - sitting on the forward third of it. Alternatively, you can place the zafu at the small of the back. It's very important to keep the spine straight with the lower part of the back curved. All of the aspects of the posture that are important when seated on the floor are just as important when sitting in a chair.
• The importance of keeping the back straight is to allow the diaphragm to move freely. The breathing you will be doing in zazen becomes very, very deep. Your abdomen will rise and fall much the same way an infant's belly rises and falls. In general, as we mature, our breathing becomes restricted, and less and less complete. We tend to take shallow breaths in the upper part of the chest. Usually, we've got our belts on very tight or we wear tight clothing around the waist. As a result, deep, complete breathing rarely occurs. In zazen it is important to loosen up anything that is tight around the waist and to wear clothing that is non-binding. For instance, material should not gather behind the knees when you cross the legs, inhibiting circulation. Allow the diaphragm to move freely so that the breathing can be deep, easy, and natural. You don't have to control it. You don't have to make it happen. It will happen by itself if you assume the right posture and position your body properly.
• Once you've positioned yourself, there are a few other things you can check on. The mouth is kept closed. Unless you have some kind of a nasal blockage, breathe through your nose. The tongue is pressed lightly against the upper palate. This reduces the need to salivate and swallow. The eyes are kept lowered, with your gaze resting on the ground about two or three feet in front of you. Your eyes will be mostly covered by your eyelids, which eliminates the necessity to blink repeatedly. The chin is slightly tucked in. Although zazen looks very disciplined, the muscles should be soft. There should be no tension in the body. It doesn't take strength to keep the body straight. The nose is centered in line with the navel, the upper torso leaning neither forward nor back.
• The hands are folded in the cosmic mudra. The dominant hand is held palm up holding the other hand, also palm up, so that the knuckles of both hands overlap. If you're right-handed, your right hand is holding the left hand; if you're left-handed, your left hand is holding the right hand. The thumbs are lightly touching, thus the hands form an oval, which can rest on the upturned soles of your feet if you're sitting full lotus. If you're sitting Burmese, the mudra can rest on your thighs. The cosmic mudra tends to turn your attention inward. There are many different ways of focusing the mind. There are visual images called mandalas that are used in some traditions as a point of concentration. There are mantras, or vocal images. There are different kinds of mudras used in various Eastern religions. In zazen, we focus on the breath. The breath is life. The word "spirit" means breath. The words "ki" in Japanese and "chi" in Chinese, meaning power or energy, both derive from breath. Breath is the vital force; it's the central activity of our bodies. Mind and breath are one reality: when your mind is agitated your breath is agitated; when you're nervous you breathe quickly and shallowly; when your mind is at rest the breath is deep, easy, and effortless.
• It is important to center your attention in the hara. The hara is a place within the body, located two inches below the navel. It's the physical and spiritual center of the body. Put your attention there; put your mind there. As you develop your zazen, you'll become more aware of the hara as the center of your attentiveness.
• Begin rocking the body back and forth, slowly, in decreasing arcs, until you settle at your center of gravity. The mind is in the hara, hands are folded in the cosmic mudra, mouth is closed, tongue pressed on the upper palate. You're breathing through the nose and you're tasting the breath. Keep your attention on the hara and the breath. Imagine the breath coming down into the hara, the viscera, and returning from there. Make it part of the whole cycle of breathing.
• We begin working on ourselves by counting the breath, counting each inhalation and each exhalation, beginning with one and counting up to ten. When you get to ten, come back to one and start all over. The only agreement that you make with yourself in this process is that if your mind begins to wander - if you become aware that what you're doing is chasing thoughts - you will look at the thought, acknowledge it, and then deliberately and consciously let it go and begin the count again at one.
• The counting is a feedback to help you know when your mind has drifted off. Each time you return to the breath you are empowering yourself with the ability to put your mind where you want it, when you want it there, for as long as you want it there. That simple fact is extremely important. We call this power of concentration joriki. Joriki manifests itself in many ways. It's the center of the martial and visual arts in Zen. In fact, it's the source of all the activity of our lives.
• When you've been practicing this process for a while, your awareness will sharpen. You'll begin to notice things that were always there but escaped your attention. Because of the preoccupation with the internal dialogue, you were too full to be able to see what was happening around you. The process of zazen begins to open that up.
• When you're able to stay with the counting and repeatedly get to ten without any effort and without thoughts interfering, it's time to begin counting every cycle of the breath. Inhalation and exhalation will count as one, the next inhalation and exhalation as two. This provides less feedback, but with time you will need less feedback.
• Eventually, you'll want to just follow the breath and abandon the counting altogether. Just be with the breath. Just be the breath. Let the breath breathe itself. That's the beginning of the falling away of body and mind. It takes some time and you shouldn't rush it; you shouldn't move too fast from counting every breath to counting every other breath and on to following the breath. If you move ahead prematurely, you'll end up not developing strong joriki. And it's that power of concentration that ultimately leads to what we call samadhi, or single-pointedness of mind. In the process of working with the breath, the thoughts that come up, for the most part, will be just noise, just random thoughts. Sometimes, however, when you're in a crisis or involved in something important in your life, you'll find that the thought, when you let it go, will recur. You let it go again but it comes back, you let it go and it still comes back. Sometimes that needs to happen. Don't treat that as a failure; treat it as another way of practicing. This is the time to let the thought happen, engage it, let it run its full course. But watch it, be aware of it. Allow it to do what it's got to do, let it exhaust itself. Then release it, let it go. Come back again to the breath. Start at one and continue the process. Don't use zazen to suppress thoughts or issues that need to come up.
• Scattered mental activity and energy keeps us separated from each other, from our environment, and from ourselves. In the process of sitting, the surface activity of our minds begins to slow down. The mind is like the surface of a pond - when the wind is blowing, the surface is disturbed and there are ripples. Nothing can be seen clearly because of the ripples; the reflected image of the sun or the moon is broken up into many fragments.
• Out of that stillness, our whole life arises. If we don't get in touch with it at some time in our life, we will never get the opportunity to come to a point of rest. In deep zazen, deep samadhi, a person breathes at a rate of only two or three breaths a minute. Normally, at rest, a person will breathe about fifteen breaths a minute - even when we're relaxing, we don't quite relax. The more completely your mind is at rest, the more deeply your body is at rest. Respiration, heart rate, circulation, and metabolism slow down in deep zazen. The whole body comes to a point of stillness that it doesn't reach even in deep sleep. This is a very important and very natural aspect of being human. It is not something particularly unusual. All creatures of the earth have learned this and practice this. It's a very important part of being alive and staying alive: the ability to be completely awake.
• Once the counting of the breath has been really learned, and concentration, true one-pointedness of mind, has developed, we usually go on to other practices such as koan study or shikantaza ("just sitting"). This progression should not be thought of in terms of "gain" or "promotion"; that would imply that counting the breath was just a preparation for the "real" thing. Each step is the real thing. Whatever our practice is, the important thing is to put ourselves into it completely. When counting the breath, we just count the breath.
• It is also important to be patient and persistent, to not be constantly thinking of a goal, of how the sitting practice may help us. We just put ourselves into it and let go of our thoughts, opinions, positions - everything our minds hold onto. The human mind is basically free, not clinging. In zazen we learn to uncover that mind, to see who we really are.

Progressive muscle relaxation

What is it?

• Progressive muscle relaxation is designed to reduce the tension in your muscles. Your goal may be to reduce anxiety and stress, which may be related to conditions such as panic disorder, high blood pressure, depression and stress. Progressive muscle relaxation may also be used simply to improve concentration.
• How does it work?
• The process of progressive muscle relaxation is simply that of isolating one muscle group, creating tension for 8 -10 seconds, and then letting the muscle relax and the tension go. For example: take your right hand, tighten it into a fist, and notice what happens. You can feel the muscle tension increase in your hand and up your forearm. The longer you hold it, the more tense it becomes. You become aware that it does not feel good. In fact, it begins to hurt. This is an example of exaggerated muscle tension. If such tension exists around the neck you get a neck ache, and if it is in the forehead you get a headache. Continue to hold the tension and now, all at once, relax and let go. Allow your hand to flop down into your lap and notice the difference. The muscles now begin to relax, and the muscle tension just flows away, melts, dissolves, and disappears.

Science behind muscle relaxation:

• This process of relaxation is guaranteed to happen because it is based on a principle of muscle physiology. Whenever you create tension in a muscle and then release the tension the muscle has to relax. The muscle does not have a choice. It must happen. The interesting aspect of this process is that the muscle will not only quickly relax back to its pre-tensed state, but if it is allowed to rest, will become even more relaxed that it was. As this procedure of creating tension and then releasing it is applied to every major muscle group of the body, all of these muscles will become more relaxed than when you started.
• The key to triggering the relaxation response in this manner is to take charge of the voluntary muscles by tensing them and forcing them into a state of relaxation. Once the muscles relax then the other components of the relaxation response will naturally follow. Relaxed muscles require less oxygen so the breathing pattern slows and deepens. The heart does not need to be beating so fast to carry oxygen out to tense muscles. Heart rate and blood pressure decline. The normal blood flow returns to the belly and digestion resumes. The belly is calmed. Hands and feet warm up. Such a series of bodily adaptations all start and fall naturally into place because the voluntary muscles are being directed into a state of relaxation. Soon changes in mood follow, and you become more calm and refreshed.

Music Therapy

What is it?

Music has been used in medicine for thousands of years. Ancient greek philosophers believed that music could heal both the body and soul. New studies indicate that listening to music affects the release of powerful brain chemicals that can regulate mood, reduce aggression and depression, and improve sleep.

Why music?

Music can serve a means of communication for those where the function of language has become very challenging or lost. Language appears to be a relatively new function of the brain in human history, whereas music is pre-verbal and is pancultural. Music is a pre-verbal and sometimes non-verbal brain function, predating the ability for language. Furthermore, music is processed by many different parts of the brain rather than just one center, as in language. The elements of music such as rhythm, pitch, and melody and are all processed differently. The emotions are also tied in with music, thus activating the limbic system. Oliver Sacks (Professor of neurology at Columbia University Medical Centre), an advocate of music therapy, says that we listen to music with our muscles. The arousal is in the brain stem and the dynamic registers in the basal ganglia. With music being received and processed at the brain stem level, it shows how basic and primeval sound is to humans. This is why, as Sacks says, deeply demented people respond to music.

What is music therapy used for?

• encourage emotional expression
• promote social interaction
• help reduce pain
• deal with anxiety
• relieve chemotherapy-induced nausea and vomiting
• reduce stress
• lower heart rate
• lower blood pressure
• lower breathing rate
• aid healing
• improve physical movement
• enrich a patients quality of life Specifically for Alzheimer’s disease

What does music therapy involve?

• making music
• listening to music
• writing songs
• talking about lyrics

Music therapy may also involve imagery and learning through music.

Science behind music therapy

• For centuries, music has been known to calm people down and provide relief from stress and tension. One possible explanation for its effects is found in a study by researchers at the University of Miami’s School of Medicine in Florida, led by Dr. Ardash Kumar.
• The study assessed how music therapy affected secretion levels of five brain chemicals (melatonin, serotonin, norepinephrine, epinephrine, and prolactin).
• "For centuries, music has been known to calm people down and provide relief from stress and tension. Music therapy can be a useful therapeutic tool to promote interactive communication."
• After a month-long program (30 minutes a day, five days a week), the team found that music therapy led to increased secretion levels of melatonin, a hormone associated with mood regulation, lower aggression, reduced depression and enhanced sleep. The higher melatonin levels persisted even six weeks after music therapy sessions had stopped. Secretions of epinephrine and norepinephrine rose immediately after music therapy sessions but did not remain for long after the sessions had ceased. Music therapy did not influence secretions of serotonin and prolactin.

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Maximizing With Music Therapy

• There is not a single music that is good for everyone. People have different tastes. It is important that you like the music being played.The following are general guidelines to maximize the effectiveness of the music.
• To wash away stress, try taking a 20-minute "sound bath." Put some relaxing music on your stereo, then lie in a comfortable position on a couch or on the floor near the speakers. For a deeper experience, you can wear headphones to focus your attention and to avoid distraction.
• Choose music with a slow rhythm - slower than the natural heart beat which is about 72 beats per minute. Music that has repeating or cyclical pattern is found to be effective in most people.
• As the music plays, allow it to wash over you, rinsing off the stress from the day. Focus on your breathing, letting it deepen, slow and become regular. Concentrate on the silence between the notes in the music; this keeps you from analyzing the music and makes relaxation more complete.
• If you need a stimulation after a day of work, go for a faster music rather than slow calming music.
• When going gets tough, go for a music you are familiar with - such as a childhood favorite or favorite oldies. Familiarity often breeds calmness.
• Take walks with your favorite music playing on the walkman. Inhale and exhale in tune with the music. Let the music takes you. This is a great stress reliever by combining exercise (brisk walk), imagery and music.
• Listening to the sounds of nature, such as ocean waves or the calm of a deep forest, can reduce stress. Try taking a 15- to 20-minute walk if you're near the seashore or a quiet patch of woods. If not, you can buy tapes of these sounds in many music stores.

Pilates

The history of many ancient fitness activities is sometimes sketchy. Tai chi, swimming, Yoga and even running all started thousands of years ago, and although there is some documentation, the precise beginnings are unknown. Things are different with Pilates. The beginning is clear. It was created in the 1920s by the physical trainer Joseph Pilates (1880-1967) for the purpose of rehabilitation. Some of the first people treated by Pilates were soldiers returning from war and dancers such as Martha Graham and George Balanchine (to strengthen their bodies and heal their aches and pains). Since the 1920s, the basic tenets that Joseph Pilates set down have been preserved, and to this day, even with some modifications, the Pilates remains true to its origins.

What is Pilates?

• The Pilates "method," as it is now known, is an exercise system focused on improving flexibility, strength, and body awareness, without necessarily building bulk. The method is a series of controlled movements performed on specially designed spring-resistant exercise apparatus (the Reformer, the Cadillac, the Spine Corrector, the Ladder Barrel, and the Wunda Chair) or on the floor (mat work), and the sessions are supervised by specially trained instructors. Pilates is resistance exercise, not aerobic (cardio), although the heart rate will certainly rise for a deconditioned individual. However, it's closer to weight lifting than it is to jogging, biking, or other aerobic activities, and so you should consider it resistance exercise.
• Two of the key elements of Pilates are core muscle strength* and spinal alignment. The core musculature is loosely defined as the spine, abdomen, pelvis, hips, and the muscles that support these structures. Some of the main core muscles are the erector spinae (located in your back along your spine), the internal and external obliques (the sides of your abdomen), the transverse abdominis (located deep in your gut, this muscle pulls your belly button in toward your spine), the rectus abdominis (the "six-pack"), and hip flexors (in your pelvis and upper leg).
• During a Pilates session, whether it's on the machines or the floor, your instructor will continuously prompt you to concentrate deeply on your core muscles, as well as on your breath, the contraction of your muscles, and the quality (not quantity) of your movements. These are also key elements of Pilates, and your instructor will emphasize them at every session. The objective is a coordination of mind, body, and spirit, something Joseph Pilates called "contrology." In his first book published in 1945, Pilates' Return to Life Through Contrology, the 34 original exercises that Pilates taught to his students are described along with the guiding principles of contrology.

Does Pilates work?

• Pilates practitioners swear by the method, and in some circles, it almost reaches cultlike status. It is true that there are many benefits to Pilates, but some of the benefits, even if they do occur, are unproven in research. What I've done here is present the claims made by Pilates proponents and then objectively present whether there is research to support the claims. Before I go further, I want to state that I believe that Pilates can be a great workout. It can help strengthen and tone muscles, improve flexibility, and the movements on the machines can be challenging and fun. It also has the potential to be an intense workout since the movements are slow, controlled, and deliberate. The people who show interest in Pilates 
• are looking for an alternative or complement to weight lifting,
• (2) might need supervised resistance-exercise sessions, (3) want a change of pace and would like to try something new.

What the research says

• Research shows that when practiced regularly, pilates can increase strength. It can also help to lengthen muscles and increase their flexibility. Preliminary research suggests that when practiced regularly may help with weight loss when included in a weight loss program. Pilates may also help reduce low back pain.
• It's important to note that although many of the Pilates claims are unsubstantiated, it doesn't mean that Pilates doesn't provide benefits. It's just that they haven't been confirmed with studies. When a claim is supported with research, it is called empirical evidence. When a claim is supported by what individuals have to say about it, it is called anecdotal evidence. There isn't a lot of empirical evidence for the benefits of Pilates, but it's fair to say that there is lots of anecdotal evidence, and so I suggest that you give it a try if you are curious.
• Interestingly, calorie expenditure during six different Pilates mat exercises has been carefully studied. The researchers found that on average, a 165-pound person burned 480 calories per hour during an advanced Pilates workout (comparable to walking 4.5 miles per hour), 390 calories per hour during an intermediate workout (comparable to basic stepping), and 276 calories per hour during a basic workout (comparable to moderate stretching). But the calories burned varied for each individual, leading the investigators to conclude that "Pilates mat workouts vary widely in energy cost depending on both the skill level/intensity of the workout and the particular exercise movement being performed. The advanced and intermediate workouts tested in this study appear to be of sufficient intensity to provide apparently healthy adult participants with health-fitness benefits."

Relaxed Breathing

What is it?

• Have you ever noticed how you breathe when you’re stressed? Stress typically causes rapid, shallow breathing. This kind of breathing sustains other aspects of the stress response, such as rapid heart rate and perspiration.
• If you can get control of your breathing, the spiraling effects of acute stress may automatically become less intense. Relaxed breathing, also called diaphragmatic breathing, can help you do that.
• As with other relaxation techniques, relaxed breathing is easy to do, it can be done just about anywhere, and it’s an easy way to reduce stress and anxiety without any expense.

What the research says

• There’s evidence that relaxed breathing can help in the treatment of some diseases and conditions. Preliminary research in people with angina suggests that some relaxation techniques may help reduce the frequency of angina attacks, reducing the need for medication. Relaxation techniques including relaxed breathing have been shown to help reduce anxiety and stress in people with panic disorder, work related stress and some phobias. Also, relaxation techniques, such as relaxed breathing, may be combined with conventional therapy to reduce blood pressure and heart rate in people with high blood pressure. Finally, early research suggests that relaxation techniques may help reduce nausea and vomiting related to cancer chemotherapy.

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How to Perform Relaxed Breathing Exercises

• Lie down on the floor. Put a pillow under your head and one under your knees. Place one hand to your side and the other on your stomach.
• Breath in slowly through your nose, pulling in the air as you count silently to six. You should feel your stomach rise up slightly.
• Hold in your breath while you count to four. As you do this, focus on the sensation of having your lungs filled with air.
• Slowly release your breath through your mouth, counting to six while you breathe out. Feel your stomach slowly ease downward as you exhale.
• Count silently to four. Then repeat the process, starting with step 1. Repeat this exercise four times. Stand up slowly.
• Let your arms rest at your sides. Breathe in slowly through your nose and hold for four seconds. Slowly exhale through your mouth.
• With elbows slightly bent, hold your hands in front of your stomach with your palms facing your body, but not touching it.
• As you breathe in slowly through your nose, raise your hands upward. Your hands should follow the path of your body from your navel to just up over your head. When your lungs are filled, your hands will be over your head. Separate them slightly.
• As you slowly exhale through your mouth, lower your hands back down along the path of your body, finally letting them fall back to your sides.
• Repeat this exercise four times, starting with step 7. Once you’ve completed four cycles, repeat the exercise once more, but leave your arms in a relaxed state at your sides.
• Performing these two sets of relaxed breathing exercises twice a day will relax your muscles.

Information prepared by Garvan Lynch.