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Healthcare Training Institute - Quality Education since 1979

Section 7
Track #7: Instant Calm - Six Second Skill

Table of Contents | NCCAP/NCTRC CE Booklet

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Note-Taking Exercise

What are the four steps in Belly Breathing?
Step 1.  
Step 2. 
Step 3.  
Step 4. 

In what two ways do breathing techniques help turn on the calming system?
1.
2.

If distracting thoughts enter your mind during breathing exercises, what two things might you concentrate on to reshift your focus?
1.
2.

Transcript of Track 7

As mentioned on the previous track, one of the reasons you may spend time wheel-spinning in a problem focused rather than a solution-focused mode is your use of one or more of the 6 D's.  If you recall, the 6 D's are defensiveness, depression, disorganization, defiance, dependence, and decision-making difficulties.

On this track you will be provided with the Instant Calm technique to deescalate the stress that maybe contributing to your 6 D issues.  The 6 D’s tend to create a lot of mental chatter or overwhelm preventing you from becoming proactive and applying the four steps in the solution-focused approach to reducing your stress.  Agree? As a review the four parts in the solution- focused approach to a stressor in your facility are:   defining your  problem or stressor in terms of what do you want, how can you get it, what resources do you have, and what new opportunities can be created?  These are intentionally repeated during this course so they will be second nature to you and a thought pattern you start to adapt when approaching any challenge both in and out of the facility.

The Instant Calm technique involves something as simple as your breath.  I hope you will play this track often to ingrain this breathing exercise as part of your normal de-stress routine to enable you to more effectively shift away from a problem focus and into a solution focus at the facility in such areas a transporting residents, negotiating to get shower, medication and therapy schedules changed to maximize resident participation in activities.  Let’s review why your breath is so important to stress reduction. 

To feel calm, you need to, of course, switch off your arousal system, which generates stress.  You turn on your calming system! You accomplish that by focusing your attention internally.  And using the appropriate actions to shift yourself down into a calm state.  You will receive two techniques.

First, one of the best and easiest ways to shift into calm is a “Sigh” type of Breath.

The Deep “Sigh” type of Breath is the first tool in mastering the feeling of calm.  Thus you intentionally reverse the process of holding your breath associated with stress which has been perhaps cause by one or a combination of the 6 D’s discussed on the last track.  As you know, holding your breath often automatically accompanies a reaction to a stressful situation like feeling disorganized or defensive. However, to produce an almost instant state of emotional peace simply take a deep breath and release it. Now in the case of a “Sigh” breath, depending on your level of privacy, you can either vocalize a sigh, for example in your car, or simply breath as if you were sighing but do it without a vocalization. 

The “Sigh” breath, whether used with an AHHH sound, or without a sound, automatically sends a message to your body to relax.  When you hear the musical tone, turn the CD player off, and try three “Sigh” breaths.  As you do each breath, increase your awareness as to how the relaxation spreads through your arms, chest, and other areas of your body.  Before you start you might make a mental scan of your body to assess where you are currently holding tension, so you will notice the change.  MUSIC

Actually, you can stop this track right now, and not listen to the rest, because if you just remember to breathe more deeply than normal when you are in a stressful situation; at the facility, you can actually master instant calm without others noticing.  Thus, you can achieve instant calm in six seconds. 

However, if you find yourself becoming stressed as you are hearing additional details regarding breathing, just keep it simple and tell yourself to breathe when confronted with a stressful situation at the facility. 

Here is a more detailed procedure to practice.  Once you have turned on your calming system, you can use a stomach or belly breathing exercise to continue or increase the depth of your calm state! The reason why belly breathing can be a great tool for you is that your lungs fill more fully from the bottom to the top, rather than vice versa.  Here are the four steps in belly breathing.

Step 1. Inhale and expand your stomach: Inhale easily and smoothly, either through your nose or through your mouth.  If you can, try to envision your stomach fill up with air and expand out.   So if you have spent a lifetime holding in your stomach, be prepared, you may find step one of expanding your stomach a challenge.  To facilitate this process placing one hand on your stomach may help to increase your awareness of expanding your stomach and not raising your chest when you inhale.  When you hear the musical tone, try two or three deep inhalations and exhalations, concentrating on not raising your chest, but pushing your stomach out.  This may take some practice.  MUSIC

Step 2 is a slow, complete exhalation. In Step Two of belly breathing, it’s pretty easy.  You simply release your breath like a sigh, as you did on the first part of this track, letting the air come out slowly at its own natural rate through your mouth.  When you hear the musical tone, practice inhaling and pushing your stomach out, then exhale slowly and completely, as if you were sighing.  If you are in the car by yourself, you might choose to make a nice ahhhh vocalization.  MUSIC

In addition inhaling and expanding your stomach and a slow, complete exhalation, Step 3 is Rest. After exhaling, rest as long as you comfortably can—until your body tells you it’s time to inhale again, expanding your stomach and not raising your chest.  When you hear the musical tone, this time after your inhalation, expanding your stomach; and your slow complete exhalation, focus your attention internally.  By that I mean when your body gives you your signal to breathe in, listen to your body..  However, this is not a breath-holding contest, but a way of increasing your awareness of subtle, physical messages that your body sends to you.  Now try the inhale, exhale, rest for body awareness; then repeat inhale, exhale, and rest body awareness two or three times.  MUSIC

Step 4:  You may be thinking, after I inhale, expand my stomach, exhale slowly and completely, and pause focusing on internal body awareness, what else is there?  Step four is increasing your awareness of target areas where your body retains muscle tension.  This time when you hear the musical tone, think about keeping your jaw, shoulders, arms and legs relaxed. Think about continuing to rest your body parts as long as you comfortably can. Feel how much you can let go. Make a game of it.  As you inhale and exhale, even though you may be driving a car, how relaxed can you get, of course without falling asleep.  The focus is you can enjoy the comfort that your body brings you by let­ting go of tightness and tension in specific areas.  Practice Step  4 by inhaling and expanding your stomach, exhaling slowly and completely, increasing your awareness of body sensations, and finally step 4, intentionally relaxing specific areas of your body.  MUSIC

You might consider repeating this for 10 breaths. Allow your body to establish its own slow, steady breathing rhythm, by letting go and waiting for your signal to inhale again.

This breathing will soon become effortless.
Instead of doing the breathing yourself, it’s as if you are being breathed...
If distracting thoughts come into your mind, simply refocus your attention on...
• feeling your stomach moving...
• feeling the air enter and leave your lungs,
and... feeling for your body’s signal to inhale again.
Stay in the internal feeling sense as best you can.
This quiet, stomach breathing imitates the breathing patterns of babies, and of people in sleep. When you choose to breathe like this, you send strong messages to our brain that say:

“Everything is fine... You can relax... Calm down... Feel peaceful ...”

Of course at work you can’t always stop and perform 10 breaths. However, one or two inaudible belly breaths are socially acceptable, because with practice, you can do them in such a way that no one notices.   Think about attending you Care Plan Conference and how belly breathing might be practiced.   Or when you notice something has not bee done related to, for example,  transporting residents; schedule changes to accommodate activity attendance; or staff providing residents with the activity left in their room.

With what you have learned on this track you will  be quietly taking control of yourself and making your body generate calm. However, this ability depends on one thing knowing what to do so well that you just do it!  As with the other tracks in this series, if a silent sigh, or belly breathing seems to resonate with you and feels like a beneficial technique, play this track as often as you need to review the technique in a structured manner to enable you to know it so well that you just do it!