T’ai Chi for Stress Management David X. Swenson PhD LP MSSA, March 21, 2014

1. T’ai Chi for Stress Management David X. Swenson PhD LP MSSA, March 21, 2014

2. Objectives • describe t’ai chi practices • identify physiological and psychological benefits of t’ai chi practice • identify health conditions for which t’ai chi has been used • explain cautions in using t’ai chi as a treatment modality • demonstrate basic a basic t’ai chi sequence

3. Chang San Feng watches the snake and bird (circa 1400)

4. Dynamic interaction of opposites Yin – Yang Qualities Dark – Light Inside – Outside Receptive – Assertive Yielding – Forcing Relaxation – Tension Rest – Movement Soft – Hard Sinking – Rising Contraction – Expansion Front – Back Introvert – Extravert Roots – Branches T’ai Chi Tu: Yin Yang Symbol

5. What is considered “conventional treatment” changes over time • I have an earache: • 2000 B.C.B Here, eat this root. • 1000 A.D.B That root is heathen. Here, say this prayer • 1850 A.D.B That prayer is superstition. Here, drink this potion. • 1940 A.D.B That potion is snake oil. Here, swallow this pill. • 1985 A.D.B That pill is ineffective. Here, take this antibiotic. • 2000 A.D.B That antibiotic is artificial. Here, eat this root • --anon

6. It’s time for t’ai chi: The Western Way of Life can be hazardous to your health • 70% of physician visits are due to stress; 50% of Americans report moderate-high levels of stress (Univ. of Waterloo) • 45 million Americans have recurrent headaches (National Headache Foundation) • 350,000 people die each year from inactivity-related diseases • 66% of adults are overweight or obese (Natl Center for Health Statistics) • 16-25% of the US population will experience depression at some time in their lives (Journal of the American Medical Association) • 42% of American workers report incidents of yelling or verbal abuse in the workplace (American Association of Anger Management Providers) • 50 million Americans have high blood pressure (American Heart Association) • 40 million people have joint problems (Arthritis Foundation) • 30-40 million grind their teeth (Colgate Co.) • 50-80% have back pain at some time in their lives (Arthritis Foundation)

7. Yerkes-Dodson Stress Curve: Too little or too much Performance Stress Level

8. Stress and the Nervous System: Getting stuck in the “on” position • Sympathetic Branch: • acute hearing • visual scanning • pupil dilation • hyperalert • inhibit salivation • faster heart rate • rapid breathing • cold hands • muscle tension • adrenaline rush • liver releases glucose • loss of appetite • slowed digestion • contract sphincters • constipation • Parasympathetic Branch • slower, deeper breathing • slow heart rate • constricts pupil • warm extremities • hunger, digestion • tired, fatigued • relaxed muscles • contract bladder • release sphincters Rebound Reaction

9. Ch’i, ch’i gong, and “energy”

11. More and better research on t’ai chi Very little rigorous research support for benefits of t’ai chi until 2000 Klein, P. J., & Adams, W. D. (September, 2004). Comprehensive therapeutic benefits of taiji: A critical review. American Journal of Physical Medicine and Rehabilitation,83(9), 735-745.

12. T’ai Chi Healing Mechanisms Action Benefit Centering & Rooting, Posture alignment, Low impact, slow movement, circularity Balance, postural stability, reduced fear of falling Decreased muscle tension and anxiety, decreased stress reaction for immune response, improved sleep & mood, lessen pain Relaxation, deep breathing Focused, relaxed & alert attention Improved concentration, alertness, mental orientation Improved lymphatic flow, immune functioning, range of motion Continuous expanding & contracting movements Moderately deep stances, moderate duration, sparring Cardiovascular fitness, endurance, strength, improved mood Confidence, reduced aggression, relax under stress, spontaneity Partner practice (e.g, push-hands)

13. Psychological benefits • Emotional calmness and stability • Confidence & esteem • Reduced fear of falling • Decreased self consciousness • Mental quieting (meditation) • Greater patience • Improved body awareness • Improved attention, focus • Euthymia (endorphin high) • More stable mood (anger, anxiety, depression) • Cultural awareness & appreciation

14. Muscular relaxation • Improved lower body strength • Upper body strength • Grip strength • Faster reaction time • Efficient actions • Improved sport performance • Enhanced balance • Postural alignment • Improved gait • Increased gait velocity • Improved joint stability • Increased range of motion/flexibility • Greater coordination • Bone density • Moderate aerobic activity • Increased tidal volume (respiration) • Increased endurance/stamina. Physiological benefits • Circulation improvement • Enhanced peripheral vascular control • Slower heart rate • Increased heart rate variability • Decreased blood pressure • Improved skin vasculature • Reduced cholesterol & lipids • Improved sleep quality • Recovery from injury • Enhanced immune response

15. Disorders Treated: A to Zzz’s • Anger management • Anxiety • Arthritis • Asthma • Attention Deficit Hyperactivity Disorder • Back injury • Chronic fatigue syndrome • Depression • Diabetes • Fibromyalgia • Heart attack recovery • Knee/joint injury • Migraine • Multiple sclerosis • Muscle tension headache • Osteoporosis • Pain disorders • Parkinsonism • Restless leg syndrome • Sleep disorder • Smoking cessation • Tense, painful shoulders • Type-A behavior

16. T’ai chi Solo Forms

17. Alignment & Balance

18. Principles of alignment… • Feet flat & relaxed • Knees slightly bent • Pelvis slightly tucked (flat lower back) • Deep & regular breathing in lower abdomen • Back straight & aligned • Shoulders relaxed • Head floating • Tongue on roof of mouth …and movement • Don’t double-weight (more on one or the other leg) • Step forward with heel, then shift weight • Step backward with toe, touch, shift weight • Pivot on heel • Don’t turn until weight is less than ½ in leg • Turn with whole torso • Move body with unity • Let momentum of body move arms • Move arms in circles • Move slow motion & continuously

19. Yang Style T’ai Chi: Abbreviated Form Opening Ward-off left Grasp bird’s tail Push Press Roll-back

20. Apparently Closing Single Whip Closing Apparently Closing (cont’d)

21. TuiShou (sensing hands): Partner Practice • Single hand horizontal & vertical circles • Two-hands mirroring (fixed step) • Two hands mirroring (moving step) • Demo: single push hands • Demo: double push hands • Demo: san shou (free style) • Light, soft touch • Use front/back of hand • Stay attached • Continuous movement • Smooth circles • Focus on sensing • Help each other

22. Taming the Ox & Monkey— Quieting the busy mind Taming the blundering oblivious ox Taming the ever curious, restless monkey

23. Types of meditation • Protected time (20-30”) • Quiet • Loose clothing • Balanced & poised posture • Attentional focus • Sitting • Standing • Moving • Concentrative • Mindfulness • Emptiness

24. Benefits of Meditation In a study of 184 General Motors employees who regularly meditated for a period of six months, the following results were found: • 60% reported better emotional stability • 55% eliminated or reduced smoking • 53% felt more confident • 53% noted improved ability to organize • 50% fell asleep faster • 37% needed less sleep • 37% used less liquor • 23% used less beer & wine • 20% used less coffee • 20% used less aspirin • Other benefits: • Increased flexibility in thinking • Better concentration & self discipline • Slower heart rate • Lower respiration rate • Normalized blood pressure • Weight normalization • Fewer autonomic stress fluctuations • Decreased muscle tension • Reduced pain perception

25. Benefits of meditation • Benefits of meditation in as little as 10 minutes • Increased alpha brain waves (relaxed alertness) • Positive feelings, & decreased anxiety & tension • Increased vascularization and slows pulse • Lowers level of blood lactate and cortisol (stress response) • Reduces blood pressure • Decreases cholesterol levels • Decreased metabolic rate • Increases serotonin levels (decreases headaches, depression, obesity, insomnia) • Reduces pre-menstrual syndrome symptoms • Aids post-operative healing

26. Benefits cont’d • Enhances immune system by increasing “natural killer cells” & increasing antibodies • Self control of compulsive behaviors (smoking, alcohol), panic attacks, irritability, moodiness • Better self observation, understanding & insight • Improved concentration & memory • Increased deep breathing & air flow (reduced asthma symptoms) • Lower pain perception • Improved heart rate variability • Improved blood glucose and insulin levels • Feelings of happiness and well being • Decreased seizure frequency, irritable bowel syndrome, headaches

27. Cautions & Contraindications • Avoid standing meditations or stressful static postures if you have joint, muscle, and blood pressure problems • Incorrect weight shifting, stretching, and practice can injure knees, back, and other joints • Check with health care provider before practice if you have significant illness, chronic, painful, or degenerative conditions (e.g., osteoporosis, hernia) • Relaxation and lower stress can sometimes reduce medication levels needed, resulting in possible overdose (e.g., diabetes– monitor closely) • Herbal remedies can cause problems due to allergies, overdose, contamination, and interaction with other drugs

28. Cautions cont’d • Deep relaxation following a high stress period may elicit rebound or migraine headaches • Unqualified instructors can teach bad practices or behave unethically • Paranormal and magical explanations should be avoided with delusional clients (focus on reality contact instead) • Prolonged meditation should be avoided for inexperienced persons or those with serious mental conditions (psychosis, major depression, dissociative, obsessive-compulsive) • Fast forms, partner practice, or sparring should be avoided by persons with back or joint problems • Meditation can raise anxiety if repressed issues emerge

29. Final Thoughts…… • T’ai chi is a single activity with many psychological & physiological benefits • There is a growing body of sound research on t’ai chi, but more needs to be understood • There is a lot of mythology on t’ai chi– be a courteous skeptic • You can’t learn it just from books and movies • Make sure of the credentials and expertise of the instructor • If you have a medical condition check with your healthcare professional • Build it into your daily lifestyle, a little bit each day • Relax, quiet your mind, have fun– you deserve it!

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