The Mothers and Babies Project

Logo: Hugo Molina

THE MOTHERS AND BABIES COURSE

RELAXATION METHODS FOR

MANAGING STRESS

Michelle A. Ramos, M.A.

Manuela A. Diaz, Ph.D.
Ricardo F. Muñoz, Ph.D.
Guido G. Urízar, Ph.D.

San Francisco General Hospital

University of California, San Francisco
© Copyright 2002, 2007 by Ramos, Diaz, Muñoz, & Urizar.
Do not cite or reproduce without authors’ permission.
All Rights Reserved.
 Stress

Before beginning to learn about relaxation and its benefits, it would be useful to identify the
situations and circumstances that prevent us from relaxing. One of the most common obstacles
to reaching a relaxed state is stress. We often hear people talking about it, but what is meant
by “stress”?

I. What is stress?

The term stress is generally used to refer to the pressures and tensions that we experience in
our daily lives. Stress is the physical and psychological reaction of our body when it is faced
with overwhelming situations.

II. What are the sources of stress?

A variety of situations can cause us to experience stress. These overwhelming situations can be
related to what is occurring in our external reality (in the world around us), what is happening in
our internal reality (in our mind), and also to what is happening in our body.

 Events in our external reality (in the world around us):

Such as financial problems, disagreements or conflicts with other people, too many tasks or
errands to do and not enough time, too much work, a crying baby that is difficult to console,
etc.

 Events in our internal reality (in our mind):

Such as negative/harmful thoughts, painful memories, worries, negative emotions (i.e. guilt,
sadness, frustration, anxiety), etc.

 Changes in our body or in our physical condition:

Sometimes changes in our body can cause us to feel stress. For example, an illness,
headaches, a cold or flu, aches and pains associated with pregnancy, labor pains, fatigue,
etc.

III. In what ways does stress affect us?

Since every person is different, stress affects us all in different ways. It can affect us:

- Physically (causing changes in our body)

- Emotionally (altering our mood and our confidence in our ability to effectively carry out
our role as a mother)
- In our behavior (affecting the kind and number of activities we do during the day and
allowing less time for pleasant activities)
- In our thoughts (affecting the kinds of thoughts we have)
- In our relationships with others (influencing our relationships with our family, friends,
and children).

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IV. What are the signs that indicate we are stressed?

Changes in our body: Our body can detect stress before we become aware of it. Frequently,
when we feel stress, various changes, some more obvious than others, occur in the way our body
functions.

Here are some common symptoms related to stress:

; Muscle tension
; Head and body aches
; Pain in the neck and shoulder area
; Problems falling asleep, staying asleep, or waking up too early
; Rapid breathing and heart palpitations
; Loss of breath
; Fatigue or tiredness
; Nervousness such as sweating and shaky hands
; Increase or decrease in appetite
; Digestive Problems
; Chest pains
; Nausea or dizziness
; Illness such as a cold or flu (due to a weakened immune system)

Changes in our mood and in our emotions: Stress not only affects our body, but also influences
our mood, our thoughts, and the activities we do.

ƒ If our mood is regular (if we have a 5 on our mood thermometer) and we are confronted
by a stressful situation, it is likely that our mood will get worse, that we will do fewer
pleasant activities, and that we will have more negative/harmful thoughts.

ƒ It is normal for this change in mood to happen, but if we continue to feel this way for too
long or if we frequently experience these changes in our mood, it could lead to us to
develop more serious difficulties such as depression, chronic anxiety, and other
psychological problems.

Changes in our relationships with others: Our relationships with other people can be affected
by the level of stress that we experience in our lives.

ƒ When we are stressed, we become irritated and upset more easily with people around us.

ƒ If we feel sad or if we are often in a bad mood, it is more likely that we will distance or
isolate ourselves from other people and that we will have negative contacts with them,
which can cause disagreements and friction in our relationships.

ƒ Stress can also affect the way we interact with our children, and the relationship we
develop with them. If our children observe that we are constantly in a bad mood or
worried, and that we always scold them for anything they do, they will learn that life is
full of worries. Consequently, the memories that they will have of their mother will not
be as pleasant as they could be.

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 STRESS
V. What can we do to reduce the stress in our lives?

Stress is an inevitable part of our lives. It cannot be avoided completely due to all the
obligations, responsibilities, and unexpected events that happen in our lives. While we may not
be able to totally eliminate the stress in our lives, we can learn to reduce the amount of stress
we experience.

These are steps that we can follow to reduce stress:

1. Recognize the signs that indicate we are stressed:
ƒ At first, this step may seem difficult for some, but it is important to notice the
changes that stressful situations cause in our body or in our physical condition and in
our mood.
For Example: Learning to be conscious of the tension in our muscles. When we feel
tension in our muscles it is important to take notice because it will help us to recognize
the situation that is causing us to be tense, and thus, negatively affecting us.

2. Have a plan to manage stress:

ƒ Plan ahead of time what you will do to reduce stress and the effect it has on our
lives.
For example: Using relaxation methods, having a support system when you are
experiencing a stressful situation, resting when you are tired or without energy, following
a well-balanced diet, exercising, planning enjoyable activities, giving advice to yourself
when you are having negative thoughts, etc.

3. Apply the plan:

ƒ Knowing what to do is not enough to manage our stress, but we must also put our
plan into practice. To learn to relax, one has to make a conscious effort. Remember
that we can only benefit from relaxation methods if we practice them, even if it is
only for a few minutes each time.
For example: Practice using relaxation methods when a stressful event occurs. People
can benefit greatly from using relaxation techniques when they practice them 2 times a
day for at least 2 continuous weeks, and then continue to use them regularly.

4. Evaluate the relaxation method used:

ƒ After putting your relaxation plan into practice, it is important that you evaluate how
you feel after having used a particular relaxation technique and that you also
congratulate yourself for having done it. If you do not feel more relaxed after
completing a certain relaxation exercise, you can choose another method of
relaxation and evaluate it as well.
For example: Note your level of stress before you use a relaxation exercise and also
afterwards, so you can see if your stress level was reduced. It is also important to note
what helped and what did not help you to relax during a particular relaxation exercise.

5. Recognize beforehand the situations that cause us stress in our daily lives, to be
prepared to deal with these situations:
ƒ By recognizing the situations and events that cause us stress, whether it is in our
relationships or in our workplace, we can: (1) prevent similar situations from
occurring, or (2) be prepared to deal with these events, which may sometimes be
unavoidable.
For example: Pay attention to what is happening in your relationship with your
spouse/partner, with your baby, with the rest of your family, etc.

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 Relaxation
I. What is relaxation?

Relaxation is a method we can use to manage stress and to reach a healthy balance in our lives.
Relaxation exercises can help you to deal with stressful situations when they occur. Relaxation
is an enjoyable and pleasant activity that you can share with your baby, so that he/she will not
only learn to benefit from these exercises, but will also have wonderful memories of you.
Children can be taught how to do relaxation exercises from a very young age, similar to how
they are taught to brush their teeth, how to pray, how to be polite, how to eat regularly, etc.

II. What are some of the benefits of using relaxation methods?

 Reduces muscular tension. Many scientific studies have demonstrated that using relaxation
methods is especially beneficial for pregnant women. These methods help to reduce the
pain and the tension in the muscles involved during the labor process, such as the muscles in
the cervix, the abdomen, and the back.

 Helps to sleep. Many pregnant women have difficulty sleeping due to the baby’s movement
in the womb or to the discomfort caused by the size of their abdomen, especially during the
last few months of pregnancy.

 Helps to improve our mood. When our body is relaxed, we feel calmer, which can increase
the likelihood of having a regular mood or better (a 5 or higher on our mood thermometer).

 Helps to organize our thoughts. Relaxation exercises are useful for clearing our mind,
especially when we are having difficulty concentrating because we are too tired or busy.
Once we are relaxed, it is easier to plan how to effectively manage stress and negative
thoughts.

 Reduces the need to use alcohol, cigarettes, and other recreational drugs to deal with
stress. Research studies suggest that many bad habits and addictions develop because
people do not know how to deal effectively with the stress they encounter. Abuse of these
harmful substances increases the risk of suffering from health problems, which over time can
put our lives in danger. Instead, your child can learn to deal with stress in a positive way
from the example that you set for him/her.

 Helps during labor to conserve energy, to reduce fatigue, tension, and pain, and to calm
us. Each woman has a different experience with labor. This depends on the presence of any
complications, our expectations, beliefs, and the manner in which we confront stressful
situations in our lives. When the body is relaxed, the mind is also relaxed. In other words,
you are less anxious and more relaxed, which can greatly help in managing the pain that is
part of the labor process. Relaxation is especially helpful in alleviating the aches associated
with pregnancy and in diminishing the pains during labor. Although using relaxation methods
does not guarantee that you will have a labor without any pain or complications, it can
reduce the pain to a level that is more tolerable so you can have a more positive labor
experience.

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III. What is the relationship between stress, mood, and relaxation?

Paying attention to your mood and your stress level can prevent unpleasant and distressing
moments. Difficult situations happen to us all, but by being prepared to deal with these types of
situations we can avoid much unnecessary suffering.

Best 9 9 9 9 9 9 9
 You begin the day with a 5 on
8 8 8 8 8 8 8
your mood thermometer, a
7 7 7 7 7 7 7
regular mood, but at 11a.m. you
6 6 6 6 6 6 6
have a disagreement/argument
with your spouse/partner, which Regular g g 5 5 5 5 5

causes your mood to change for 4 4 4 f 4 4 4

the worse. 3 3 e 3 e 3 e
2 2 2 2 2 d 2
Worst 1 1 1 1 1 1 1
9 am 10 am 11 am 12 pm 1 pm 2 pm 3 pm

You have an
argument with
your partner.

Best 9 9 9 9 9 9 9
 You begin your day with a 4 on 8 8 8 8 8 8 8
your mood thermometer. If your 7 7 7 7 7 7 7
day has begun with a lower than
6 6 6 6 6 6 6
regular mood, and something
Regular 5 5 5 5 5 5 5
upsetting occurs, it is more likely
f f 4 4 4 4 4
that your mood will go even lower,
3 3 3 e 3 3 3
possibly even to the bottom.
2 2 d 2 d 2 d
Worst 1 1 1 1 1 c 1
9 am 10 am 11 am 12 pm 1 pm 2 pm 3 pm

You have an
argument with
your partner.

 You begin the day with a 4 on your Best 9 9 9 9 9 9 9

mood thermometer. On the one 8 8 8 8 8 8 8
hand, your day has begun exactly like 7 i 7 7 7 7 7
the previous example, but you do 6 6 6 h 6 6 6
something that lifts your mood, such 5 5 5 5
as a relaxation exercise. Even if a
Regular g g g
f 4 4 4 4 f 4
stressful event occurs, your mood
3 3 3 3 3 3 3
might drop some, but it will not bring
2 2 2 2 2 2 2
you down as far as if you had not
done the relaxation exercise. Worst 1 1 1 1 1 1 1
9 am 10 am 11 am 12 pm 1 pm 2 pm 3 pm

You do a You have an

relaxation argument with
exercise. your partner.
Page 6 of 25
IV. There are many ways to achieve deep relaxation:

Relaxation exercises are pleasant activities that reduce anxiety and tension. Now that you are
learning to recognize your stress level and the negative effects that high levels of stress have on
your life, you can begin to reduce your own stress level using the relaxation methods we
describe in the following pages. Remember that every person is unique. Each of us will find
that some methods will work better for us than others. Find the ones that will work best for
you, and which methods (or combination of methods) will be most helpful in certain situations.

Try each of them, and pick the ones that are most to your liking:
1) Using your breath to relax
2) Using muscle tension to relax
3) Using mental images to relax

A FEW THINGS TO KEEP IN MIND ABOUT LEARNING TO RELAX

1. Practice, Practice, Practice:

Learning to relax is similar to learning any new skill— like knitting, cooking, or
painting. It takes regular practice, patience and time. With consistent practice, you
will soon be able to control your bodily tension and experience a greater degree of
relaxation.

2. The goal: to relax without doing the exercise:

Once you have mastered the ability to achieve a relaxed state, try to reach this state
without doing the exercise, just by simply telling yourself to relax. In this manner, you
can begin to apply this new skill in your daily living. We recommend that you start with
a relatively simple activity. For example, try relaxing while you are reading the
newspaper. Then try it in more challenging situations, such as when you are in a hurry,
or when you feel you are about to get angry with someone. Even after you get to this
point, it is still useful to occasionally run through the actual exercises to keep in
practice and remind yourself how powerful relaxation can be.

3. The relaxation exercises can be done while moving:

This will help you prepare for labor and delivery, when you will probably have to move
around, change positions, and be in the midst of activity around you. Your goal is to
reach the same level of relaxation while fully alert and moving around as when you
were sitting still with your eyes closed. We suggest that you begin practicing these
relaxation exercises while sitting still, and gradually increase your activity level while
relaxing, until you can relax even while moving relatively fast.

4. As you prepare to relax:

- Choose a quiet, comfortable environment where there are few distractions.
- Choose a time of day when you are least likely to be disturbed, and not too soon
after a meal. For example, try relaxing upon awakening or when you are ready to
go to sleep. Also, try relaxing during the middle of the day, particularly just before
you have to do something difficult or just after you have had to face a stressful
situation.
- Select a comfortable position.
- Try not to worry about how well you are doing. If you begin to experience
distracting thoughts, slowly return your mind to the task of relaxing.

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 USING YOUR BREATH TO LEARN TO RELAX

Breathe in through your

nose and breathe out
through your mouth…

Steps to follow:
 Sit quietly in a comfortable position.

 Close your eyes.

 Relax all your muscles as fully and deeply as possible. Start with either end of the body
(your feet or your head) and move systematically all the way up or down, focusing on
each muscle, and relaxing each one.

 Breathe easily and naturally through your nose. Become aware of your breathing. As
you breathe out, say a brief word you have chosen to repeat (for example, the word
"one" or the word "relax".)

 Continue for about ten minutes at first, until you get used to producing the feeling of
relaxation. Your goal is to be able to produce this feeling in one minute or even less at
any time you choose. This way, you can provide yourself with a moment of relaxation
as often as you wish throughout your day.

 Before you open your eyes, remind yourself to retain this feeling of deep relaxation
and simultaneous alertness when you return to your normal activities.

This method is nicely described in a book called The Relaxation Response by Herbert
Benson (New York: Avon Books, 1975).

Page 8 of 25
 USING MUSCLE TENSION TO LEARN TO RELAX
This method involves first tightening and then releasing the muscles throughout your
body. You will do the following twice for each part of your body: (a) tense the muscle
group, (b) hold and study the tension for 5 seconds, then (c) relax the muscles for 20
seconds, noticing the difference in feeling. It’s very important to pay attention to the
difference between the feeling of tension and the feeling of relaxation. After tensing
and relaxing twice, move on to the next muscle group.

D Hands. Tighten your right hand by making a fist and squeezing. Do this twice. Repeat
with the left hand.

D Forearms and back of hands. With your right arm resting on a chair, and the back of
your hand facing up, bend your hand at the wrist, pointing your fingers straight up.
Study the tension this creates in the back of your hand and forearm. Repeat. Now do
it with the left hand and arm.

D Biceps. Flex the large muscles in your upper arm by trying to touch your right
shoulder with your right fist, tightening the biceps. Repeat. Right arm first, then left.

D Shoulders. Bring your shoulders up, as if to touch your ears with them. Repeat.

D Forehead. Wrinkle your forehead by bringing your eyebrows as far as they will go.
Repeat.

D Face. Wrinkle your nose and close your eyes tightly. Repeat.

D Lips. Press your lips tightly together. Repeat

D Tongue. Push your tongue into the roof of your mouth. Repeat

D Neck. Press your head against the back of the chair. Repeat.

D Chest. Take a breath that is so deep you can feel it stretch your chest muscles. Hold
it. Release it slowly. Feel yourself relax as the air leaves your lungs. Relax and
repeat.

D Stomach. Suck in and tighten your abdomen, as though preparing to receive a punch
in the stomach. Repeat. (We recommend that you skip this step until after you
have delivered your baby.)

D Back. Arch your back away from the chair. Repeat.

D Legs and thighs. Lift your legs up from the chair, holding them straight out in the
air. Repeat.

D Calves. Point your toes back toward your chest, creating tension in your lower legs.
Repeat.

D Feet. Curl your toes downward, as if digging them into sand. Feel the tension in your
arches. Repeat.

When you have finished this, notice how you feel all over your body. Allow your whole
body to remain relaxed a while longer.

Page 9 of 25
 USING MENTAL IMAGES TO RELAX
(Using your imagination)

Another way to relax is to bring your thoughts into harmony with your physical state. You
can relax your muscles to relax your mind. You ca also relax your mind to further relax
your muscles. Certain visual images may bring your thoughts into balance with your
relaxed physical state. These images can be used in conjunction with your relaxation
practice. They are meant to deepen your relaxation.

1. Putting down a load. Imagine yourself carrying all your responsibilities in a big sack
on your shoulders. Once you are ready to begin relaxing your muscles, as you sit
quietly with your eyes closed, imagine yourself putting down your load. For the time
you have allotted to do relaxation, you do not have to worry about it. You are
responsible for nothing. You don't have to do anything but relax.

2. The puppet. This image is particularly good to use during the time when you are
tensing and relaxing your muscles. Think of a puppet standing up straight, being held
up by taut strings that make it move. If the puppeteer's hands let go of the strings,
they will go loose and the puppet will crumple into a totally relaxed heap. Now, your
brain is the puppeteer, and it can let go of you whenever it wants to. As you relax
each muscle, imagine letting go of the puppet strings, as it goes limp, you go limp.

3. The balloon. Imagine yourself as a balloon that has been inflated to capacity. It is
tight, tense. As you use the breathing to help you relax, imagine that you are letting
air escape from the balloon. As more and more air escapes, the tightness decreases,
the tension disappears. You become wonderfully relaxed.

4. The cloud. Imagine yourself as a calm and fluffy cloud. You are floating pleasantly in
the middle of a clear blue sky. Feel the wind touching your face. Feel how light you
are. Enjoy the peaceful sensation.

Now stop reading for a while, and conjure up one of the above images. Let the image
have its effect on you. Try to think of other images that would relax you. Tailor them to
fit you. These images should bring out feelings like those of being relaxed: unwinding,
letting go, floating, melting, flowing, smoothness, pleasing warmth or coolness,
peacefulness, lightness, having nothing to worry about. Remember that you can enter
this state at any moment you wish.

Page 10 of 25
 A COUNTRY DAY

Steps to follow:
 Sit in a comfortable chair with your arms at your side or lie down on your bed in a
comfortable position with your arms and legs uncrossed. You can also choose any
other position in which you feel totally comfortable. We recommend that you ask
somebody to read this exercise to you slowly or tape it and play it.
 Close your eyes. This will allow you to concentrate and to keep your mind from
wandering.
 Put one hand on your abdomen. Now take a deep breath and feel your abdomen rise
slowly as you inhale and go down as you exhale. You can mentally say to yourself “in”
with each inhalation through your nose and “out” with each exhalation through your
mouth (Pause).
 Begin to focus on your breathing. Inhale deeply through your nose and exhale slowly
through your mouth. Each breath you take leaves you more and more relaxed... it
purifies your whole body and mind.
 Now imagine a landscape, any landscape you like. Let your imagination run free and
take you to this place. Walk slowly down this path until you can enter into this quiet
place in your mind…
 You have arrived at this beautiful landscape. Look all around you… you see every
detail like a picture. Notice the aroma… take a deep breath and let the peace and
tranquility of this place spread throughout your entire body. Smell the fresh air mixed
with the scent of wild flowers. Now you can begin to hear the sounds, listen to the
singing of the birds flying high above you. Look as far as you can see… what do you
see? Pause…
 It is a beautiful day! You feel the soft wind blow through your hair. A gentle breeze
caresses your face and body. It is cool and refreshing.
 As you walk along a path, you see all the beauty surrounding you…
 You shift your attention to the sun, expanding its rays throughout nature. The sun is
radiant… there are no clouds in the sky. Now you feel the sun’s rays wrap your body
with warmth… you feel energized…
 Enjoy this moment… the beauty of this landscape… you feel bathed in peace. You feel
relaxed, safe and comfortable. This is a place where there are no worries…
 Continue breathing and begin to move your body slowly. When you are ready, open
your eyes.

Page 11 of 25
 MY SECRET PARADISE

Steps to follow:
 Get into a comfortable position, and let the weight of your body rest comfortably on
the surface you are sitting or laying on. Rest your arms at your sides or on your lap and
avoid crossing your legs. Loosen the tension in your shoulders…in your back…in your
chest…
 Close your eyes... Take a deep breath through your nose…feel your abdomen
expand…and hold for 3 seconds…exhale and let the air escape through your
mouth…feel how your abdomen relaxes…now return to your normal breathing. Repeat
to yourself "Breathe in"… "Exhale"… and breathe regularly again. One more
time…"Breathe in"…"Exhale" …and resume your normal breathing. Continue relaxing
your body, allowing your muscles to feel loose.
 Concentrate on your breathing, letting the entrance and exit of air follow a steady,
natural rhythm. Staying very calm… (Pause for 5 seconds)
 Imagine yourself strolling through a meadow…It is a clear, beautiful day...Feel the
warmth of the sun touch your face and the soft breeze on your skin…

 You come to a path and begin walking slowly…you feel very relaxed and calm…In the
distance you smell a wonderful aroma…You follow the scent until you reach a wooden
door…The aroma is coming from inside…Open the door and walk into this new
place…Suddenly, you are surrounded by hundreds of flowers of all different colors and
scents…There are also huge trees full of fruit …The aroma from the flowers and the
fruits were what attracted you to this special place.
 Explore the interior of this place…continue walking inside…Look up at a tree and pick
your favorite fruit…Bite into it and taste its sweetness…Feel the refreshing air under
the shade of these trees…You hear the sound of rushing water…Follow it …With every
step you take you hear it getting louder…It is a river…Sit at the edge of the fresh,
warm water and place your feet in it…Concentrate on this sensation…You feel
completely relaxed in this paradise…peaceful and content (Pause for 10 seconds)

 The time has arrived to return to the path that has brought you to this
paradise…Before leaving this place smell the aroma of the flowers and trees once
more…Continue walking until you reach the door through which you entered…Open it
and exit…

Remember that your paradise awaits you at whatever moment you wish to return. Now
take a deep breath one more time…Exhale slowly…When you are ready, open your eyes.

Page 12 of 25
 WALKING RELAXATION

Most of us walk a lot throughout the course of the day. Therefore, walking can be an
activity that can be used to practice relaxation. The following exercise can be done at
any time. For example, when you are running an errand or when you are walking in the
park with your baby in the stroller. This exercise incorporates walking, breathing, and
counting.

Steps to follow:
 Focus on your breathing before or while you are walking. Take deep full breaths:
inhale through your nose and exhale through your mouth.

 It is recommended you walk at a slower pace as you begin to do this exercise.

 Continue concentrating on your breathing. Breathe deeply through your nose and
exhale slowly through your mouth. Repeat five times.

 Now that you are aware of your breathing, count your steps while you breathe deeply.

 Inhale while you walk and say to yourself "1…2…3…" and now exhale and take five
more steps "1…2…3…4…5…" Repeat this and continue breathing deeply and slowly.

 Continue counting your steps while breathing through your nose and exhaling through
your mouth. Your body feels relaxed.

Try to carry this feeling of relaxation into your everyday life.

Page 13 of 25
 RELAXING WITH DISTRACTION

You can use this relaxation strategy in almost any situation, especially when you are
experiencing a particularly stressful life event. For example, you can use this exercise
when you are waiting in a long line at the store or when you are ready to give birth. For
this exercise you can use any fruit or food that you enjoy such as an apple, or imagine a
food or dish of your choice (it could be your favorite pastry, a dish from home, or a cup of
tea).

Steps to follow:
 Pay attention to signs that you are stressed. (For example, your muscles feel tight or
your breathing is shallow and rapid).
 Concentrate on your breathing (you can do this either with your eyes closed or open).
Breathe in deeply through your nose and exhale slowly through your mouth. One more
time, breathe in through your nose and gently let the air flow out through your mouth.
 Now that you are focusing on your breathing, in the next five minutes, concentrate on
the apple or image of a food to help you focus on the present.
 Observe the color of the food or fruit. Now focus on its shape. Touch it and notice its
texture, how it feels. For example, if you are imagining your favorite pastry, observe
its different colors, what it feels like as you hold it, and its smell.
 Think about where this particular food came from. Did it grow from the soil? What part
of the world did it come from? What steps are necessary to prepare this food?
 Focus on what you are looking at or imagining at the present moment. Enjoy the aroma
of that food before you put it in your mouth. Notice its taste and texture while it is in
your mouth.
 It is natural to be distracted by other thoughts. However, when this happens, return to
the present and continue focusing on your enjoyment of this food.
 Continue using the food or image that you created to continue focusing on the present,
on what you are doing, and your breathing. Try not to think of what you have to do
afterwards or what you did last week.
 Breathe in deeply through your nose and exhale slowly through your mouth. One more
time, breathe in through your nose and gently let the warm air escape through your
mouth.

Notice how you feel at this moment (your stress level, your breathing). It is important to
focus on the present and “practice being in the present.

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 THE ORANGE EXERCISE

Steps to follow:
 You need an orange for this exercise.

 For the next two minutes you are going to try to think only about the orange that is in
front of you.

 Sometimes your thoughts may wander, and you may find yourself thinking about other
things, like things that are worrying you. When that happens, you should try to return
to the orange.

 You may look at the orange and think about what it looks like, how it feels, how it
smells. You can choose to do what you want with the orange. You can peel it, eat it,
or just look at it.

 When you are done doing this, reflect on what it was like to just think about the orange
and nothing else and think about some of the thoughts that came up as you were
observing their oranges. Also determine whether focusing on the orange changed any
thoughts you were having and how you were feeling. If you like, you can also rate your
mood and compare your rating to the rating you gave before beginning the exercise.

You may have difficulty keeping their thoughts focused on the orange. Remember that it
is hard for you to forget about all the things you have to do and focus on the orange.
However, being in the moment is a very important skill that can reduce stress. In the
future, you will want to be in the present with your child and be able to have moments
where you are just able to focus on being and playing with her/him without thinking
about other things you have to do. Also, If you do not have an orange, you can do this
exercise with anything. The idea is to practice mindfulness, meaning practicing being in
the moment and having your thoughts be in one place, where you are in the present. We
use the orange to serve as an anchor to the present. You could also use a flower, a tree,
a cup of tea, anything really although we have found that objects that have connections
to multiple senses are the most useful.

Page 15 of 25
 LISTENING TO MUSIC

Steps to follow:
 In this exercise, you will be relaxing by listening to some music. Research suggests that
babies benefit from listening to classical music even before they are born, especially
classical music. Music can be relaxing for both mothers and children. Mothers can
pass on the relaxation skills to their children.

 Please get comfortable. Play a piece of classical music or other relaxing music for 3
minutes. If you feel like it, close your eyes and let the music help you relax. You can
also place your hands on your bellies and see if you can feel your baby moving.

 After you are done listening to a piece of classical/relaxing music, try to answer these
questions: what were some of the thoughts that came up as you were listening to the
music? Did you have any thoughts about your baby and how your baby was listening to
the music?

You can choose any music that you like to relax with. We are all different and we might
like different types of music. In general, music is something that may help your baby
relax. If your baby listens to a piece of music in the womb, that same music may help
her/him relax once they are born. Once your baby is born, playing a specific bedtime
lullaby, can help get her/him into a pattern where they associate sleep with that song.
This will help your baby get into a nighttime ritual where she/he learns to relax with the
song and then goes to sleep.

Page 16 of 25
 A PLEASANT PLACE

Steps to follow:
 In this exercise, you will use your imagination to help you relax. To begin with think of
a place where you like to be, your favorite place. It can be anywhere.

 Now close your eyes and let’s begin by taking a couple of deep breaths. Breathe in and
out… With each breath you are getting closer to your favorite place… Breathe in and
out. You are now there. Let your body relax in your favorite place. What do you see
there?... Look up… to your right… to your left… look down… What do you smell?...
What do you hear?... Breathe deeply and just feel the way it feels to be in your
favorite place. This is a good place for you where there is peace and where you feel at
home… safe…

 Stay in this place… (for 5 minutes).

 Now it’s time to come back, but you will keep this special place with you, and you
know you can return to this place when you want to.

 Let’s breathe in and out… Take a step back and look around at your special place. It is
a part of you… Breathe in and out and step back… Breathe in and out and slowly open
your eyes.

 Continue to breathe in and out, so you can keep the feeling of relaxation that you get
when you are in your special place.

 After you are done listening to a piece of classical/relaxing music, try to answer these
questions: Where were you? Were you able to let go and really be in that place? What
kinds of thoughts did you have during the exercise? How did that make you feel? What
did you think when you had to leave the special place? How did that make you feel?

This exercise demonstrates how powerful our thoughts are. Just by imagining being in a
special place, you can change the way you feel. Your negative thoughts are just as
powerful. When you focus on the negative things in your life or think in negative ways,
you are likely to feel bad. This exercise shows how important it is to be aware of the
types of thoughts you are having because they influence how you feel. It also shows that
it is possible to change the way you think.

Page 17 of 25
 TEACHING YOUR CHILD TO RELAX WITH YOU

I’m going to teach

you how to relax…

 Your child will learn to calm down and relax, when he/she is frustrated, from the
example that you set.

 We recommend that you begin to teach your child these relaxation strategies early on.
That way, it becomes easier to continue practicing these exercises with your child as
he/she grows older.

 Ways to relax with your child (1 to 4 years of age): Sing to your infant (or put on
relaxing music) when he/she cries or when he/she is ready to eat or go to bed.
Enjoying a relaxation exercise with your child will result in a strong and healthy bond
between the two of you.

 Ways to relax with your child (5 years or older): Continue practicing these relaxation
exercises together to share in these pleasant activities. These exercises will also help
your child when he/she is angry. For example, your child will begin to notice when
she/he is stressed and learn to breathe to calm down, with the guidance of his/her
mother.

 The most important part of learning these exercises is to praise your child when she/he
chooses to use them as a way to handle stress (for example, giving them a hug or star),
instead of using a more destructive form (for example, hitting other children). In this
way, your child will behave in a healthy manner and she/he will have more positive
experiences with other children.

 It is important that you practice these relaxation exercises first so that you can then
teach these strategies to your child. It is also important to keep in mind that it will
take time for you and your child to realize the benefits of these exercises.

Remember: We can reach a healthy balance in our lives by becoming aware of how we react to
stress, which is related to our external reality (the events that occur in our lives and in our
environment) and our internal reality (our thoughts and emotions), and by knowing how to
counter the negative effects of stress. Remember that relaxation only takes a few minutes of
your day. Practicing these exercises will bring you many benefits so that you can enjoy life to
its fullest and enjoy your role as a mother.

Page 18 of 25
 EVALUATING YOUR RELAXATION EXERCISE
 An important part of these relaxation exercises is to evaluate them and examine how they make you feel afterwards. We recommend
that you practice these exercises 2 times a day (when you first wake up and before you go to bed).

 Use the table below to help you evaluate your exercises every day. Place a circle around the number that best reflects your level of
stress, both before and after completing each relaxation exercise you choose. Write down what helps you and what does not help you
relax during each practice.

How do you feel?: c = Little or No Stress g= Moderately Stressed k = Extremely Stressed

STRESS LEVEL NOTES/COMMENTS

Date Practice # Time Before Exercise After Exercise

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

Page 19 of 25
 EVALUATING YOUR RELAXATION EXERCISE
 An important part of these relaxation exercises is to evaluate them and examine how they make you feel afterwards. We recommend
that you practice these exercises 2 times a day (when you first wake up and before you go to bed).

 Use the table below to help you evaluate your exercises every day. Place a circle around the number that best reflects your level of
stress, both before and after completing each relaxation exercise you choose. Write down what helps you and what does not help you
relax during each practice.

How do you feel?: c = Little or No Stress g= Moderately Stressed k = Extremely Stressed

STRESS LEVEL NOTES/COMMENTS

Date Practice # Time Before Exercise After Exercise

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

Page 20 of 25
 EVALUATING YOUR RELAXATION EXERCISE
 An important part of these relaxation exercises is to evaluate them and examine how they make you feel afterwards. We recommend
that you practice these exercises 2 times a day (when you first wake up and before you go to bed).

 Use the table below to help you evaluate your exercises every day. Place a circle around the number that best reflects your level of
stress, both before and after completing each relaxation exercise you choose. Write down what helps you and what does not help you
relax during each practice.

How do you feel?: c = Little or No Stress g= Moderately Stressed k = Extremely Stressed

STRESS LEVEL NOTES/COMMENTS

Date Practice # Time Before Exercise After Exercise

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

Page 21 of 25
 EVALUATING YOUR RELAXATION EXERCISE
 An important part of these relaxation exercises is to evaluate them and examine how they make you feel afterwards. We recommend
that you practice these exercises 2 times a day (when you first wake up and before you go to bed).

 Use the table below to help you evaluate your exercises every day. Place a circle around the number that best reflects your level of
stress, both before and after completing each relaxation exercise you choose. Write down what helps you and what does not help you
relax during each practice.

How do you feel?: c = Little or No Stress g= Moderately Stressed k = Extremely Stressed

STRESS LEVEL NOTES/COMMENTS

Date Practice # Time Before Exercise After Exercise

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

Page 22 of 25
 EVALUATING YOUR RELAXATION EXERCISE
 An important part of these relaxation exercises is to evaluate them and examine how they make you feel afterwards. We recommend
that you practice these exercises 2 times a day (when you first wake up and before you go to bed).

 Use the table below to help you evaluate your exercises every day. Place a circle around the number that best reflects your level of
stress, both before and after completing each relaxation exercise you choose. Write down what helps you and what does not help you
relax during each practice.

How do you feel?: c = Little or No Stress g= Moderately Stressed k = Extremely Stressed

STRESS LEVEL NOTES/COMMENTS

Date Practice # Time Before Exercise After Exercise

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

Page 23 of 25
 EVALUATING YOUR RELAXATION EXERCISE
 An important part of these relaxation exercises is to evaluate them and examine how they make you feel afterwards. We recommend
that you practice these exercises 2 times a day (when you first wake up and before you go to bed).

 Use the table below to help you evaluate your exercises every day. Place a circle around the number that best reflects your level of
stress, both before and after completing each relaxation exercise you choose. Write down what helps you and what does not help you
relax during each practice.

How do you feel?: c = Little or No Stress g= Moderately Stressed k = Extremely Stressed

STRESS LEVEL NOTES/COMMENTS

Date Practice # Time Before Exercise After Exercise

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

Page 24 of 25
 EVALUATING YOUR RELAXATION EXERCISE
 An important part of these relaxation exercises is to evaluate them and examine how they make you feel afterwards. We recommend
that you practice these exercises 2 times a day (when you first wake up and before you go to bed).

 Use the table below to help you evaluate your exercises every day. Place a circle around the number that best reflects your level of
stress, both before and after completing each relaxation exercise you choose. Write down what helps you and what does not help you
relax during each practice.

How do you feel?: c = Little or No Stress g= Moderately Stressed k = Extremely Stressed

STRESS LEVEL NOTES/COMMENTS

Date Practice # Time Before Exercise After Exercise

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

1st Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

2nd Practice 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9

Page 25 of 25