Stress is the body’s natural reaction to events or situations that confuse, frighten, excite, anger, please, or surprise us. We may find stress pleasant or distressing, depending on how the event or situation is interpreted. Negative stress typically triggers the “fight or flight” syndrome. We have all experienced the stress reaction. Under stress, we tense our muscles and our rate of breathing, our heart rate, and blood pressure all increases as adrenaline and cortisol (a glucocorticoid released by the adrenal glands) surge through our bodies, to help us prepare for coping with the situation at hand.
This response is helpful when the threat is real and temporary. If we are attacked by a wild animal, the stress response improves our chances of survival by giving us extra strength to flee if we can or fight if we must. The rapid pace of modern life, however, has resulted in a wide variety of stressful situations—stressors—from which we have too few opportunities to escape. The problem is that the stress response uses inner resources (physical, emotional, mental, and spiritual) at an accelerated rated, which reduces the resources available for growth and healing.
For the past 50 years or so, the correlation between certain kinds of stress and illness have been well-documented. We require a certain amount of stress in our lives, of course, to remain active. Too much stress—especially when we think that the factors causing the stress are beyond our control—can cause a wide-variety of physical, emotional, and mental problems. The relationship between stress and illness is, in fact one of the foundational concepts of psychosomatic medicine. [See “Stress and Psychosomatic Phenomena” in Rossi (1993), The Psychobiology of Mind-body Healing.]
In recent years, the accumulation of stress has been tied to a wide variety of individual and social problems. For the individual, stress has been tied to cancer, heart disease, and psychological problems as well as to a variety of less serious illnesses, such as colds and flu. Prolonged periods of stress suppress the immune system, so it is easy to see why this is true. On a social scale, accumulated stress has also been tied to both domestic and workplace violence, road rage, and similar sorts of antisocial behavior.
Stress Reduction
Health practitioners and many organizations now recognize the importance of stress reduction to avoid the kinds of problems associated with accumulated stress. Stress sets off an alarm in the brain, arousing the nervous system in what is called the fight or flight response. Muscles tense, and stress hormones are produced. Research indicates that stress plays an important role in several types of chronic health problems—especially cardiovascular disease, musculoskeletal disease, such as back and upper-extremity problems, and psychological disorders, including depression and burnout.
In the workplace, stress-related problems account for a tremendous loss in productivity as well as higher rates of absenteeism and employee turnover. The Journal of Occupational and Environmental Medicine reports that health care expenditures are nearly 50% greater for workers who report high levels of stress.
According to National Institute for Occupational Safety and Health (NIOSH), developing such self-protection strategies as relaxation methods and improved heath behaviors is critical. A regular program of exercise, getting extra rest (taking naps or sleeping longer at night), an improved diet (drinking clean water, reducing alcohol, eliminating caffeine and tobacco; and increasing the amount of fruits, vegetables and whole grains) meditation, self-hypnosis, and soaking in a hot tub are all well-know ways of reducing stress or counteracting its effects. Almost anything that allows you to relax and gives you pleasure will help reduce your level of stress.
Two of the most effective yet often overlooked methods of reducing stress to promote health and well-being are bodywork (massage) and work on the energy system. Bodywork and energy-based approaches are not, of course, mutually exclusive. Some bodyworkers have a good sense of the energy system and deliberately include energy work along with the work on the body, and some therapist who specialize in work on the energy system also include massage, especially work on the meridians.
Bodywork: Massage Therapy
Massage is an ancient form of hands-on therapy. Currently, about 100 different methods have been classified as massage therapy, and even a simple back rub can be therapeutic. The primary goal of all forms of body work is to encourage relaxation, health, and a sense of well-being through touch. Bodywork usually (but not always) feels good and has been shown to reduce stress and improve the functioning of the immune system. Bodywork is designed to release tension that accumulates in muscle tissue allowing the muscles and associated organs to return to normal functioning.
The following are the most common forms of bodywork:
• Swedish Massage. Swedish massage is often called “deep tissue” massage because it includes kneading, a form of penetrating pressure, the muscles. Developed by a Swedish doctor, Per Henrick Ling, it is the best known and most widely available form of massage therapy. It has been shown to be effective for almost any condition and is especially useful to improve circulation; to relieve muscle tension, back, and neck pain; and to promote general relaxation while reducing stress.
• Acupressure. Acupressure, a noninvasive precursor of acupuncture, stimulates the flow of energy (chi) circulating along the body’s meridians by applying pressure with the thumbs and fingertips. It has been shown to be highly effective for managing stress and treating sciatica, arthritis, headaches, fatigue, and general irritability.
• Reflexology. Reflexology affects the internal organs and glands by stimulating reflex points in the hands and feet that are believed to correspond to every part of the body. Reflexology evolved out of an earlier European system known as Zone Therapy, and was first introduced to America by Wm. Fitzgerald, M.D. Research on the study of reflexology indicate that it is helpful for premenstral syndrome (PMS), hypertension, anxiety, or and other painful conditions.
• Myofascial Release. Myofascial release is designed to help muscles in spasm to relax by applying gentle pressure to connective tissues or fascia. As normal alignment and function are restored, the pain of the spasm is eliminated. Myofascial release is typically used to treat neck and back pain, headaches, and recurring sports injuries.
• Polarity. Polarity is a form of massage that uses both hands (one is considered positive and the other is thought to be negative) to release energy blocks in the body by holding specific pressure points. Because of its use of energy, Polarity therapy (developed by Randolph Stone, D.C., D.O., N.D.) promotes changes on the physical, mental, and emotional levels and helps clients achieve a heightened sense of well-being.
• CranioSacral Therapy. The craniosacral system includes the brain, spinal cord, meninges, cranial bones and sacrum (the lower end of the spinal column, the “tail bone”). By using a light touch, practitioners evaluate and treat malfunctions in the craniosacral system. The term CranioSacral Therapy was coined by Dr. John Upledger, an osteopathic physician and researcher. It is effective in treating chronic pain, eye difficulties, scoliosis, motor-coordination impairments, learning disabilities, and other health challenges.
• Shiatsu. Shiatsu is an ancient and widely practiced Japanese form of acupressure in which the practitioner applies rhythmic pressure on specific points along the body’s meridians using his or her fingers, hands, elbows, knees and even feet. Shiatsu is designed to treat the whole body, but can also be effective for specific aliments, by relieving stiffness and improving muscle tone and circulation.
• Rolfing. Rolfing is the popular name for Structural Integration because it was developed by biochemist Ida P. Rolf. Rolfers use pressure applied with the fingers, knuckles, and elbows to release fascial adhesion. Rolfing is perhaps the deepest of “deep tissue” forms of massage, and it can be painful. It is useful in correcting long-term imbalances in the musculoskeletal system.
Energy-based Stress Reduction
The most common of the energy-based therapies are acupuncture, Therapeutic Touch™, Reiki, Jin Shin Jyutsu, and Healing Touch™. Although practitioners of the energy based systems may include some form of physical touch or massage in their work, the main focus of energy work is on the human energy system. When it is healthy, energy flows in, through, and out the body.
A growing body of research, such as that being conducted at the University of Arizona’s Integrative Medicine Clinic, has shown that these methods help to induce relaxation, relieve pain, speed the healing of wounds, and boost immune function. These therapies are also effective in treating stress related conditions, such as gastrointestinal problems and skin disorders and are increasingly being offered in hospitals and other health-care settings as adjuncts to conventional care.
• Acupuncture. Acupuncture is the art of using extremely fine needles at certain points (called acupoints) on the meridians to produce healing. Although Western medical practitioners had initially been reluctant to accept acupuncture as a legitimate therapy, it has demonstrated such a high success rate that even the most skeptical health practitioners are beginning to acknowledge its success in reducing stress and promoting health and well-being. The turning point for acceptance came in the 1970s when acupuncture was demonstrated to provide relief from chronic pain and to serve as anesthesia during general surgery. It is currently the best-accepted form of energy-based medicine.
Acupuncture is thought to work by stimulating the flow of chi along the meridians, helping produce greater balance in the energy system. Research into exactly how acupuncture works continues. Nevertheless, for most people, the critical factor is that it does work and is an effective treatment for relieving stress and chronic pain and for improving health in a wide variety of ways.
• Therapeutic Touch™. Therapeutic Touch (TT) was developed in the early 1970's by Dolores Krieger, Ph.D., R.N., a Professor of Nursing at New York University, and her mentor, Dora Kunz, a well-respected "natural" healer. It was first conceived as an extension of professional nursing care.
Practitioners of TT use their hands to clean (or unruffle) the Human Energy Field (HTF), to drain pain from injured tissues, and to help the body reestablish a healthy energy flow. In recent years, TT has come under attack because it is difficult to measure the HTF with current instruments and practitioners are not always able to detect the presence of an HTF in laboratory settings.
Because the detection of the HTF depends on the intent of the practitioner, however, and intent—like the HTF itself—is difficult to measure, detecting the HTF in a laboratory setting is different from detecting it in a therapeutic setting. Ample evidence exists to show that TT has measurable effect on those receiving it, even when the placebo effect is taken into account. The exchange of energy between therapist and client has, for example, been shown to significantly increase the client’s blood-hemoglobin levels, indicating that the blood is carrying more oxygen (see Gerber, p. 304).
• Reiki. Reiki (pronounced ray-key) was developed in Japan in the mid-1800’s by Mikao Usui and came to the United States in the late 1930’s. It is one of the more widely known forms of healing through direct application of chi. The goal is to balance and enhance the individual’s energy to promote optimum health. In a typical Reiki session, the therapist places one or both of his or her hands on the client’s body, usually in the general area of the problem.
Because the energy is thought to have its own wisdom, the specific placement is not considered critical. Practitioners believe that the energy will locate areas where more energy is needed and provide it and, at the same time, find areas were too much energy is present and drain the excess off.
Reiki is often used as an adjunct treatment for acute or chronic pain. Reiki practitioners do not, however, usually think of themselves as curing disease or injuries. Rather, they think of themselves as assisting the client achieve his or her ideal form. University of Michigan researchers are currently investigating the effectiveness of Reiki in managing pain caused by diabetic neuropathy.
• Jin Shin Jyutsu. Jin Shin Jyutsu (pronounced gin shin jit-su) is a natural art of healing that is able to restore an individual's physical, mental, emotional and spiritual balance. Literally translated, it means “Art of the Creator through compassionate and knowing man.” This powerful healing art was rediscovered in Japan in the beginning of this century by Jiro Murai.
As is true in many forms of Oriental medicine, the practitioner listens carefully to the client’s pulse for information about energy flow. The belief is that disease begins with blockages of energy, and the pulse indicates the specific energy points that need to be held to restore the harmonious flow of energy. The treatment consists of gently holding points in various combinations until the harmony of energy is re-established. The practitioner uses his or her hands as conduits for the energy, enabling universal energy to flow through the client's body and reawaken its natural healing ability.
• Healing Touch™. Like the other forms of energy-based healing, Healing Touch (HT) is based on a connection between the energy fields of two or more persons, using a centered or intentional state of consciousness that has as its focus the natural dynamics of the client’s HTF.
Janet Mentgen, RN, BSN, incorporated the work of many hands-on healers in developing HT, which accounts for its versatility. HT uses hands-on and energy-based techniques to balance and align the HTF, addressing the needs of the body, emotions, mind, and spirit. HT practitioners believe that all healing is self-healing and that individuals should be empowered to participate fully in their own healing.
HT not only promotes relaxation and reduces stress, but also is helpful in treating a wide variety of physical and psychological disorders.
Yoga and Tai Chi are forms of energy-based exercise that have been shown to be effective in reducing stress and promoting health. Both yoga and Tai Chi combine exercise, breathing, and specific postures and movements to improve the flow of energy throughout the body. All of these, and other meditation and relaxation techniques have one thing in common – they produce altered states and include some form of hypnosis and trance.
Altered States: Hypnosis and Trance 
The word hypnosis refers to both the process by which one is hypnotized and the state one enters after having been hypnotized. When most people think about hypnosis and hypnotic trance, the image that comes to mind is often that of the stage hypnotist and his or her subject, who barks like a dog on command.
Hypnosis is, however, a normal state of mind, one that everyone experiences every day. We experience states similar to hypnosis while falling asleep (the hypnagogic state) and waking up (the hypnopompic state), and throughout the day we experience a number of trance-like states of varying duration.
Such everyday trances are often easier to observe in others than they are in ourselves. You may, for example, have been behind someone at a stoplight when the person was absorbed in thought and failed to notice that the light had changed. Or you may have observed someone staring at the number of options on a grocery store shelf, seemingly in suspended animation. Or you may have even found yourself several miles past your turnoff on the freeway, not knowing for sure how you happened to miss it.
Such phenomena are also aspects of what is called hypnosis. The term hypnosis itself is difficult to define. Milton Erickson, a hypnotherapist of remarkable skill, on at least one occasion defined it as “a reduction in the multiplicity of the foci of attention.” Elsewhere he defined it as “A state of intensified attention and receptiveness, and an increased responsiveness to an idea or set of ideas.”
Ernest Rossi, who worked with Erickson for many years, says “No definition or empirical test has ever been devised to accurately assess whether or not a hypnotic state even exists” (see The Psychobiology of Mind-Body Healing, p. xvii).
Hypnosis is often called an altered state because it is clearly different from what most people consider their normal waking (conscious) state. Those who are in a hypnotic trance are, in fact, entranced, with their attention focused on a limited number of objects. In the normal state of consciousness, the rational left brain usually plays the dominant role. In hypnosis, the right brain typically dominates.
The well-known placebo effect is a form of hypnosis in which the belief in the efficacy of a medication or other health procedure influences the outcome. Recent studies have shown that in trials of new medications, people respond better to medications with strong, unpleasant side effects because they know that placebos do not have side effects. The assumption is that if they are not having unpleasant side effects, they must be taking the placebo instead of the “real” medication.
In fact, all strong beliefs are a form of trance in which an individual focuses his or her attention on what a particular belief makes possible. The limiting beliefs that Monday is the worst day of the week or that you can’t remember names, for example, are actually hypnotic trances. If you have such a belief, you may have hypnotized yourself into having that belief, or someone else—probably unintentionally—hypnotized you into having it.
Hypnosis can, of course, help you undo the effects of such trances and develop new trances that will better serve your purposes (Bowman and Basham, Healing with Language).
Guided imagery is a form of story telling that allows the listener to enter a profound state of relaxation—an altered state of consciousness—in which her or his body’s own natural healing mechanisms can be activated and enhanced. Although the resulting state is a form of hypnosis—as is true for all hypnotic states—the individual remains sufficiently aware to be able to respond to questions and to make choices about her or his process of healing.
Like all forms of hypnosis, the trance or altered state that occurs during guided imagery has a number of well-known characteristics:
• Trance is self-generated. Hypnosis is not something done to you by a hypnotist but is rather a state you choose to enter.
• The person in trance retains control. The popular conception is that when people are hypnotized, they surrender their will to that of the hypnotist, but that is actually not the case. When in trance, you retain full ability to judge which suggestions to accept and which to reject.
• The person relaxes. Although not all trances are characterized by increased relaxation, those used in therapy typically promote relaxation. Your breathing deepens, your heart rate slows, the levels of stress hormones in your body decrease, and your sense of well-being increases. This state, even without specific suggestions, promotes health and well-being.
• Brain waves change. The rhythm of the brain drops from about 14 cycles per second (cps) and above (known as Beta, the “normal” waking state) to about 7 to 14 cps (known as Alpha, a trance-like state). Mental activity also tends to shift from the left hemisphere of the brain to the right hemisphere.
This change often entails a shift in mental activity from the analytical left brain to the more holistic right brain. It is similar to the hypnopompic state between sleeping and waking up and the hypnagogic state between being awake and falling asleep.
• The focus of mental activity turns inward. Instead of focusing on the external environment, the individual turns his or her attention inward, often creating images (visualizations) that accompany and illustrate what the therapist is saying. Similar visualization also happens during what is considered the “normal” waking state, but the individual may have less conscious awareness of the imagery.
• Trance facilitates change. Habits are ingrained below the level of conscious awareness, and the conscious mind tends to protect what is already ingrained and to resist change. People typically seek therapy because they have not been able to achieve the desired change through a conscious, rational decision. Trance helps bypass conscious resistance to address needs and desires that lie below the level of conscious awareness.
Remember that the trance resulting from using guided imagery or hypnosis is really no different from the altered state someone enters when watching a movie or an engaging TV show. If you enjoy reading novels, for example, you may enter an altered state in which your imagination allows you to identify with the characters, time, and place of the novel. When the hero or heroine is in trouble, your heart beats faster, and when the hero or heroine is finally able to relax and rest, your heart and respiratory rates also drop, and you allow yourself to relax and rest as well.
This kind of story-telling is actually very old, going back to the days when early humans would sit around campfires in the evening and listen to the tribal elders tell stories. The elders would pass the wisdom of the tribe from generation to generation, covering beliefs about the nature of the universe, how their tribe came to be, and the feats of ancestral hunters and warriors.
Myths, nursery rhymes, and most of what we think of as “literature” are stories that create the same kind of altered state that, when used by a skilled practitioner, can be of significant therapeutic value. The same techniques that help someone tell a good story for entertainment purposes help with the delivery of guided imagery for therapeutic purposes (Bowman and Basham, Imagine Healing: Guided Imagery to Help You Heal).
When you’re hypnotized, you can concentrate intensely on a specific thought, memory, feeling or sensation while blocking out distractions. You’re more open than usual to suggestions, and this can be used to change your behavior and thereby improve your health and well-being. Who is hypnosis for? Hypnotherapy has the potential to help relieve the symptoms of a wide variety of diseases and conditions. It can be used independently or along with other treatments.
Hypnosis is one of several relaxation methods for treating chronic pain that has been approved by an independent panel convened by the National Institutes of Health (www.mayoclinic.com/health/hypnosis/SA00084).
Essential Elements of Self-Care 
Self-care has some essential elements, and those will need to be customized to fit you. In the same way that prolonged stress has a detrimental effect, doing things that are good for you can lead to positive change. If you raise the anchor, the boat can go forward. The same is true for your self-care. When you remove blocks and correct problems, you enable yourself to go forward with a greater sense of health, happiness, and well-being.
Generative change, however, makes removing the anchor unnecessary. It makes the anchor irrelevant. What was a block is no more, not because you spend time removing it, but because you have done something good for you enough that the anchor simply no longer exists. You are more in tune with the state of well-being you want to have. When you think in terms of correcting problems, you are setting your conscious intent on remedial change. When you think in terms of allowing yourselves to be balanced and in harmony, you are setting your conscious intent on generative change. The essential elements of self-care include:
S — Silence
E — Exercise
L — Laughter
F — Fun
C — Creativity
A — Awareness
R — Rest and Relaxation
E — Eating nutritious foods
The effect of both stress and relaxation is cumulative. Your learning to relax is one of the greatest gifts you can give to yourself. Immune function, memory, and cognition can improve. The link between our emotions and our physical health has been proven. One of our responsibilities as living creatures is to build and maintain healthy-minded consciousness that supports the natural healing and renewal process of your life. You can see how your enjoying the process of discovering the specific essential elements of self-care that are right for you helps you live a healthier live now. Health is your natural state. In a real sense, it is always true that you are whole.
Stress and Modern Life, Joel P. Bowman & Debra Basham