By Matthew J. Taylor, PT, PhD
Support Through the Cancer Journey with Rest and Relaxation
Quiz time. Finish this Lao Tzu quote, "The journey of 1000 miles begins with..."
You probably correctly answered, "one step." What I was surprised to learn from our Taoist master was that Lao Tzu may have been wrong. The reality is that the journey of 1000 miles can only begin with a step if there is something to step off from! Imagine trying to walk out of quicksand. No base of support to push off from and down you go. The same is true in optimizing your health in a cancer care environment. Developing the ability to rest and relax well creates the foundation in order to step off down the journey of care. Unfortunately as a society, we have very few skills when it comes to rest and relaxation.
What is Rest?
In our 24/7, hypermedia rich culture, many people confuse rest with distraction and entertainment. We come back from vacations exhausted, we solve murder cases on TV to "rest" in the evening and listen to contentious talk radio on the way home to unwind. To enhance our rest we install surround sound with megawatt woofers and sip caffeinated beverages. True rest is when we create the appropriate environment that allows our entire being to recover, rebuild and replenish. The physical body is not just reclined, but the breath moves fully and softly, the mind slows, the emotions ease and a sense of ease and wellbeing envelopes the person in actual rest and relaxation.
What rest is not is having your attention distracted outside of yourself, holding postural patterns of pain and tension, ruminating on fears or conflicts and ingesting stimulating foodstuffs. It has been said that the diagnosis of cancer invites change. One powerful change is to adopt a practice of quality rest that breaks the old patterns and begins to build a better foundation for healing. The good news is that it's cheap and relatively simple.
What Difference Does Rest Make?
 Before addressing the how, a few more insights into the why rest well. (Sounds silly when I write it now, doesn't it?) Eliciting the rest and relaxation response well is a skill. Skills require practice. In Herbert Benson's book The Relaxation Revolution released in 2010, you can read about all of the powerful effects such a practice has on health. Most exciting for those challenged with cancer are the more recent findings regarding both turning off of tumor creating genes and the turning on of immune enhancing genes by the practice! This field of epigenetics (on top of genes) is revolutionary as it demonstrates the radical effects of a practice of rest and relaxation on the way your body can optimize its healing responses to complement the effects of an appropriate work portion of exercise. The literature also shows that mood can be stabilized, anxiety eased, sleep enhanced, nausea and joint pains tapered with quality rest and relaxation.
Personally I find the phenomenon of entrainment as it relates to breathing and relating with others from a place of rest an amazing benefit to the practice. En-train, or coupled together is when two systems begin to self regulate toward the rhythm of each other. Consider the difference between how you feel when the nurse at your appointment is harried, distracted and short with you vs. the nurse who is at ease, thoughtful and treats you like you are the only patient that day. Well that entraining feeds off of many factors, of which one of the most powerful is each person's state of relaxation and ease. So whether you are someone with cancer or supporting someone that has cancer, when we practice being at rest, that quite literally rubs off on those we are near. We can literally gift the good health benefits by becoming skilled ourselves... and it's free!
How to Rest as an Exercise
You can practice rest two ways: formally by "doing" relaxation exercises and secretly by Stealth Resting. First, the formal doing practice. The doing practice involves setting aside time in a quiet, relaxing space. There are many roads to the outcome, but all involve bringing attention inward to your own experience, being supported comfortably and paying attention to your breathing. The act of turning inward and sustaining attention there is critical. Probably the simplest example is to lie down on the floor with your legs bent and supported on a chair or ottoman. Put your arms out slightly away from your side with palms facing upward, let your knees drop apart and place a book on your lower abdomen. Then pay attention to the movement of the book up and down, sensing the movement and the sound of the breath or the temperature of the breath at the base of the nose. The "work" is to notice when you aren't paying attention and return without judgment or criticism for 15 minutes. There are many more possibilities available and they are listed in the resources section at the conclusion of the article.
Following the practice and before you get up, take an inventory of how you feel, the size and pace of your breathing, the pace and quality of your thinking and your overall emotional state. [Be sure to pause on your side when getting up as there may be some light headedness related to the response.] Then when standing notice your weight distribution and sense of balance and ease. Soak up the entire collection of sensations and awareness because all of these can be summoned as a new and healthier response by you at anytime now that your nervous systems has a target of what "rest" feels like. The real practice then takes place moment to moment in what I call Stealth Rest.
How to Rest No Matter What... Stealth Resting!
Once your systems have experienced rest, you can begin to generate the response throughout your day with no one knowing. The 3 keys to doing Stealth Resting are posture, breath and attention. Exercising these 3 principles will allow you to transform a waiting room, infusion suite or a middle of the night, wide-awake experience into true rest.
1.) Posture: Don't change the position you are in and just notice how you are breathing, where you feel the breath causing movement, and the length of the front of your body from pubic bone to chin. Got it? Now, scoot fully back into your chair and onto your sitting bones rather than tailbone. Put your feet flat on the floor, knees above your ankles and legs apart with soft hands. Now revisit those 3 measures of how you are breathing, where and the length of the front of your body. Chances are you are breathing deeper, slower and feel taller. I call this "Sitting Like Abe" as in Abe Lincoln in the Lincoln Memorial. Bringing your attention to your posture creates a natural relaxation response by the hardwired relationship between your pelvic floor, diaphragm and thoracic outlet. This isn't ramrod military posture, but an easy sitting position in balance. When lying down, use pillows and blankets to again keep the legs apart, the front of the body long and hands relaxed. Good alignment generates ease. Use your physical body to create rest in everyday situations. The yogis call easy sitting "sukhasana" literally translated sweet sitting.
2.) Breath: Clients consistently report that establishing the connection to their breathing is the single most valuable tip they get during their care. We have to breathe, it's always there and it's free! The act of turning our attention to the sound, temperature and feeling of movement associated with our breathing has been demonstrated to slow the parts of our brain that generate stress and fear. Success isn't unbroken concentration, but noticing we have lost focus and returning with a gentle, smiling awareness. An additional bonus is that we humans have the ability to split attention. That is we can sense our breathing at the same time we are conversing, reading, or engaging in work. It takes practice, but with gentleness and persistence the skill develops quickly.
3.) Attention: Feel your right big toe. Now your left thumb. How about the sound of your breathing? Did you get a sense of movement as you did that? In the West we aren't used to thinking of attention as an exercise or movement and yet if we put you in a PET scanner sure enough your brain is mimicking movement. So monitoring and controlling your attention is a form of exercise. While you can easily see how attention in posture and breathing is exercise related, what about what your attention moves toward on the television, in conversation or sitting in a waiting room? That's right, gently noticing and reclaiming your attention to experiences and sensory input that are nourishing rather than distressing and draining is powerful exercise and promotes better rest even in the midst of the chaos of cancer care. You are in charge and with some regular practice you will be amazed at how quickly you develop your attention "muscles" to allow for rest and recovery at any time day or night.
Additional Resting Resources
The following will give you additional information and practices to develop your resting skill. So go get to "work" at resting. The more you practice, the better the foundation you will build to continue the many steps in your journey through cancer and life!
1. Full Catastrophe Living by Jon Kabat-Zinn
2. Relax and Renew: Restful Yoga for Stressful Times by Judith Lasater, PT, PhD
3. Yoga Nidra by Richard Miller, PhD
4. Yoga and Cancer by Stephanie Jean Sohl, PhD, RYT
5. The Relaxation Revolution by Herbert Benson, MD and William Proctor, JD
About the Author
 Matthew J. Taylor, PT, PhD, teaches mindbody science to rehabilitation professionals. He writes, presents at national conferences and conducts research. He is a professional advisor to the Wellness Community of Arizona and past president and research chair for the International Association of Yoga Therapists. His busy clinical practice includes oncological patients with chronic, complex pain challenges. Learn more on his website and you can reach him by email at matthew@matthewjtaylor.com.
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