Sunday, December 21, 2014

The Benefits of Cranial Facial Release


I would like to recommend a safe chiropractic treatment that has the capacity to improve quality of life. While reading about orofacial pain disorders I encountered a description of a technique called Cranial Facial Release (CFR). After reading about it for a few months, I eventually decided to undergo the procedure myself. I knew that I held a lot of tension in my nose and behind my eyes and I was hoping that CFR could help to alleviate the pressure there. I figured that such a strong form of stimulation could increase the circulation to my nasal tissues, alleviate the trauma that they held, and help reduce the tone in my facial musculature. My nose was broken 15 years prior (at age 17) and was numb and painful at times. I really felt like my nasopharynx was a tense rock in the middle of my head, and I hoped the technique would help me better incorporate it into a calm, healthy facial posture.




I found that Dr. Adam Del Torto, the chiropractor that originated this form of the technique lived near me. Cranial facial release involves inserting a balloon into the nasal cavity, up through each nostril. The balloon travels through the nasal cavity, past one of the three nasal turbinates. The balloon is then inflated and as it fills with air it passes through the nasopharynx and out into the throat. This opens up the breathing passageways and mobilizes the bones of the face and cranium. I felt an expansion under my face and a tremendous amount of relief afterwards. Many patients choose to have the procedure done on a regular basis for years. Dr. Del Torto usually charges a fixed amount for 4 sessions – the minimum recommended treatment. He views it as a chiropractic adjustment for the cranium. Similar to any chiropractic adjustment, the cranial bones crack allowing the osseous release of cranial fixations at the sutures. During my visit Dr. Del Torto explained to me in depth how the treatment stimulates specific neurological structures to provide a form of relief that can't be found any other way. His technical explanations made a lot of sense to me, but I imagine that there are other benefits as well. 





I cranial facial release as a form of myofacial release for the nasal passages. I am convinced that the soft tissues in this area can become traumatized due to stress, cold, physical injury or undue tension and then remain excessively tense so that: 1) circulation decreases and inflammation increases, 2) the muscles atrophy and undergo “adaptive muscle shortening,” 3) the neurons in the area relay pain messages to the brain, and 4) this causes the facial muscles to become excessively tense further exacerbating the psychological stress. I am also convinced that reduced circulation diminishes the immunological response rendering these tissues more susceptible to upper respiratory tract infection. I think that CFR helps to correct each of these four problems. The balloon puts strong pressure on many muscles and soft tissues throughout the nasopharynx, and nasal cavity. It seems to me that this pressure (applied to soft tissues that are rarely, if ever, stimulated) that reverses these four degenerative processes.

The stimulation and physical compression of the tissues helps to reduce past trauma, and in my opinion is much like massaging a sprained ankle. Massage and isometric stretching is really the only way to return an ankle to its premorbid state. Of course it is painful to massage, but compressing the muscles is the best way to reduce their tone. The fact that the muscles and soft tissues deep in our nasal cavity are never stimulated forces them to “remember” past trauma. They become a “somatic anchor” deep within the face for pain. For me, as with most patients, each CFR treatment was less uncomfortable. My fifth treatment was not uncomfortable at all. This means that when stimulated the nociceptive neurons in these tissues are sending reduced pain signals. I believe that even when not stimulated these areas were sending pain signals to my brain and now are no longer doing so.




CFR has the potential to help anyone, but may produce the best results for people that focus concertedly on remaining calm afterwards. Influencing how your brain interprets intense forms of stimulation is incredibly important to how your body copes with them. The way that you breathe surrounding an injury before, during and after helps the body to appraise the injury and determine how best to deal with it. I recommend making calm a priority after the procedure and attempting to breathe diaphragmatically, employing deep breathing exercises, and perhaps the “ujjayi breath” technique. I would recommend going home, resting quietly, even napping. After each visit I went home, laid around, stretched, and spent the rest of the night breathing diaphragmatically. I think that it is also important to remain very calm before, and after the procedure. For this reason, I thought it was great that Dr. Del Torto was peaceful, reassuring and congenial during the visits.

After CFR you become aware of muscles and tissues behind your face that you never noticed before. I laid down for several hours with my eyes closed in order to focus on the accompanying sensations. You feel these muscles tighten and release for hours after the procedure. While this happened I tried my best to memorize what it felt like for these areas to release and I tried to keep them relaxed. Simply turning your attention to these sensations builds somatotopic and musculotopic maps in the cerebral cortex which help you sense and control these areas. I believe that after the procedure patients want to build these cortical maps so that they can notice and become conscious of tension in these areas later. As I did this I used other facial muscles, flaring and constricting my nostrils, in an attempt to link these new cortical maps to existing ones. I noticed that the less attention I paid to my nose, the tighter it would become. Conversely the more attention, the more it relaxed. It would be interesting to follow the efferent nerve pathways from these areas up into the brain. Pain signals originating in the nasal cavity are sent to subcortical threat/stress areas such as the amygdala, and end up in cortical ones such as the anterior cingulate cortex, and the insula.

After the procedure I went on a long walk and I noticed that my face felt surprisingly calm. As I passed people on the street I was worried that perhaps I would appear “too” calm. I realized that I should embrace the calmness and try to take full advantage of my current state and really focus on allowing my face to remain placid. I focused on breathing deeply and evenly, with eyes wide while looking upwards. I figured that if I practiced this over the course of a few days it would look natural. It really did. I no longer have a perpetual pained and fearful expression on my face and I no longer look like someone who had their nose broken violently. There are claims that CFR changes the look of people’s faces. It does have a cosmetic or aesthetic component and definitely helped me to develop a more relaxed countenance. I have realized that before the procedure I was perpetually wincing. I notice myself wincing from time to time but it is much easier now to stop it.

I had five CFR sessions over the course of a month. Before the month, during and after I probed my nose with q-tips. Again, at first this was very uncomfortable but became much less painful with time. I didn’t press very far but would make circles with the q-tips just past my nostrils while breathing deeply. Using the qtips beforehand probably complemented the CFR and also made the actual balloon inflation less uncomfortable for me.

I can breathe through my nose much better now. In fact Dr. Del Torto intentionally opened up two of my six turbinates that were completely closed down. I think that the most important thing about CFR is to appraise it positively. It is “invasive” in some ways and you want your body to embrace the sensations that you feel afterward rather than reject them. I want to encourage you to appraise the treatment as a deep tissue massage that is providing relief. The key is to self-soothe and to trigger the relaxation response. Afterwards you want to think about how to build this relaxed nasopharyngeal posture into your normal day-to-day facial posture.

See my blog entry about self massage for the nasopharynx here:

http://www.observedimpulse.com/2015/05/intraoral-myofacial-release-for.html

Monday, September 29, 2014

Removing Tension from the Eyes: Ocular Muscles and Eyelashes


Here I describe three techniques, a method for releasing tension in the ocular muscles that control eye movements, and a method for releasing tension in the eyelids. We hold a lot of tension around our eyes as well, and I have previously written about how to remove tension from the orbicularis oculi muscles here.
I am convinced that we all hold pent up tension in the ocular muscles that sit behind our eyes, within the orbits, and turn our eyes up and down, left and right. I would venture to say that in anxiety and in disorders like schizophrenia, the eyeballs might be tighter than in the average population. This puts a frantic pressure on smooth eye pursuit and normal saccades, disturbing movements that should be calm and effortless. This tension in the ocular muscles may in turn exacerbate anxiety, headaches, and chronic pain. Here is how I stretched my ocular muscles and definitely found a release. In fact, this exercise hurts at first, but after doing it for a minute every day over the course of two weeks, the pain went away completely. You basically want to place your forefingers on the four corners of your eyes and press in while looking around. For example, while placing your fingers on the bottom left of your eyeballs and pressing up and to the right, you will find that you feel the biggest stretching sensation while you are looking up and to the right. If you place your fingers directly above each eye and press down, you will feel the biggest stretch when you look upwards. The basic idea is to put gentle pressure on the eyeball, displacing it a few millimeters from its normal location, stretching the ocular muscles and enhancing the stretch by looking around. Please be very careful while doing this. I imagine that it would be easy to strain these tiny ocular muscles. Moreover, it is probably important to do this stretch while breathing deeply or diaphragmatically to obtain the best results. A final thing that you can do is to use your thumbs to put pressure on the place where your superior ocular muscle anchors in the orbit. You will find a tiny patch of sore connective tissue just above and medial to each eye. Mine were incredibly sore at first, but with a little bit of compression and massage, this will go away.
Next, we will focus on releasing some tension in the eyelids. The tips of my eyelids used to hurt, and if I did not sleep well for one night, they would turn bright red or purple. This is because I was overusing them. The muscle tone in these tiny muscles was too high. The idea is to massage/compress them with a simple squeeze, forcing the muscles to stop, contracting and allowing them to adjust and diminish their muscle tone. In the shower, use your thumb and forefinger to pinch the outside of your eyelids, providing a gentle squeeze. You can do this to the top and bottom eyelids. Hold and squeeze the eyelids all over, especially close to the eyelashes. Be very careful, make sure you are calm, breathing deeply, and make sure your hands are clean. After doing this for 30 seconds a day for two weeks, I found that my eyelids were no longer reddish and that they did not feel tense anymore.
The bottom eyelid is actually difficult to pinch in this way. In order to compress and relax the muscles here, it helps to actually get one finger inside the eyelid. I wear a rubber glove and pull the bottom eyelid out by the eyelashes. With the forefinger of the other hand, I reach inside the eyelid and grab it. Again, the forefinger is inside the eyelid and the thumb is outside it, pinching together. You can shift your pinch from one side of the bottom lid to the other. The first time I did this, I could feel the tension here. The next morning, my eyes felt relaxed, and my lower lid was dramatically smaller. This is because the inflammation from overused muscles had subsided. Try it!
 


 

Thursday, August 21, 2014

Overcoming the Inferiority Instinct

As primates we have innate instincts that were designed to help us communicate nonverbally about our social ranking. They are hardwired into our brains, faces, breathing, and posture. These instincts force us to regulate our body in a way that is less-than-efficient in order to send the signal: “I am not operating on all cylinders.” It is a form of self-handicapping. These subordination displays are used by mammals to show submission to more dominant animals, and thereby keep from being attacked. We are all constantly but unconsciously sending out signals about our own inferiority. These would have kept us safe during hunting and gathering times, may have kept us safe on the playground as children, but probably only hurt us in adulthood. Unfortunately, these signals activate the body’s stress systems and can be taken to be the physical embodiment of our psychological pain, angst, and misery. If we can become aware of how we are signaling subordination and dominance, we can interrupt the displays that do not serve us. The table below lists three types of displays (inferiority, neutral and dominance) and highlights the recommended display in bold.

Inferiority Display
Neutral Display
Dominance Display



Eyes looking down
Eyes straight
Eyes looking up
Minimized eye contact
Appropriate Eye Contact
Excessive Eye Contact
Eyes squinting
Eyes neutral
Eyes wide open
Raised eyebrows
Neutral eyebrows
Furrowed eyebrows
Head down
Head horizontal
Nose in the air
Neck and back hunched
Neck and back neutral
Neck and back flexed
Shoulders raised
Shoulders neutral
Shoulders down
Voice high
Voice neutral to low
Voice deep to raspy
Face tense and wincing
Face relaxed
Face tense and grimacing
Chin jutting out
Chin neutral
Chin to chest
Gluteus limp, lumbar lordosis, genitals hidden
Hips and pelvis neutral
Gluteus flexed, lumbar kyphosis, genitals on display
Jaw and neck tense
Jaw and neck neutral
Jaw and neck tense
Breathing short, quick, shallow
Neutral breathing
Breathing long, slow and deep
 
 
 

Here is a list of recommendations that have helped me:

  1. Be very calm in social situations. Retain complete composure.
  2. Make calm a priority, even over appearing rude or unsophisticated.
  3. Be very calm when you model social interactions in your head.
  4. Expect that the calmest version of you has what it takes to resolve any scenario.
  5. You want to reprogram yourself so that you are calm socially all the time, automatically, even in your dreams.
  6. Always breathe at least 5 seconds in and 7 seconds out. Your breath should be a tiny but continuous sip of air that never pauses and always proceeds at the same rate.
  7. Monitor your breathing carefully during conversations, it will be too shallow at first.
  8. Take deep breaths when the other person talks.
  9. Take deep inhalations before you start your sentence, and don’t breathe in again until you are almost out of air.
  10. Don’t jump back into the conversation quickly with no regard for finishing your breath. Your breath comes first.
  11. Minimize squinting socially, especially when you smile.
  12. Minimize raising your eyebrows socially.
  13. Achieve more with a small, slow smile that grows gradually.
  14. Do not use nervous laughter.
  15. Do not make your voice high pitched as an indication of affection or compromise. If you do speak in an unnaturally high voice, just to be nice, too often, you will develop a permanent lump in your throat.
  16. Look above the horizon and above the eyeline as much as possible.
  17. After making eye contact look above the eyeline rather than below it.
  18. When you watch television, look all of the characters straight in the eye as much as possible. Lying down on the floor, watching television upside down will help you learn to look up without effort.
  19. Stand tall, sit tall.
  20. The best posture for the neck is to look upwards while brining your chin to your chest.
  21. Notice the way that you hold tension in your voice and in your face after you finish speaking.
  22. Never replay or imagine negative social scenarios, especially confrontational or violent ones.
  23. Do not respond with your face or words to provocation.
  24. Notice before you meet someone, or even make a call, or send a text, that your face and neck will tighten up and you will start breathing shallowly.
  25. Try being “dead calm,” first by yourself, then with others.
  26. Think of yourself as pure of heart, slow to anger, and not easily offended.
  27. Make your posture and countenance ruthless, uncompromising, and unapologetic but temper this by making your personality humble, thoughtful and affectionate.



Wednesday, May 28, 2014

Can You Look Yourself in the Eye? I Couldn’t


I have spent a lot of time over the last two years looking myself in the face in an attempt to ensure that my face remains calm. I would search for pressure in the brow, and tension around the eyes, lips and cheeks. I would do this without making eye contact with myself. When I started trying to make eye contact with myself it was uncomfortable and difficult. After a while I realized that eye contact with others may be uncomfortable for me because eye contact with myself is uncomfortable.

I realized that instead of looking myself directly in the pupil I would usually just look at my nose, or around rather than at the eyes. I even realized that often when I thought I was making eye contact with others, I was not looking them straight in the eye. I asked myself: “What does it mean that you cannot look yourself in the eye?” “Don’t you trust yourself?

The most interesting thing about this to me is what would happen if I tried to sustain eye contact with myself. I would look into my own pupil in the mirror for only a second or two and my eye would start to flinch. My eye would unconsciously begin to saccade away from making eye contact. This is because the brain areas devoted to controlling eye movements (such as the frontal eye fields, and the superior colliculus) were not habituated to continual eye contact. They were acting out of fear. The motor systems that control the eyes have been programmed unconsciously by some of our worst social experiences – the kinds of experiences where threat forces us to avert our gaze. We should all try to break this neurological reflex because it stunts our social growth. Also from junior high on two of my best friends had strabismus which prevents a person from directing both eyes toward the same fixation point (also known as cross-eye or lazy-eye). Because of this they avoided eye contact and I learned to do the same.

At this point I knew that it was very important for me to spend a few minutes each day staring into my own pupils while monitoring my breathing and heart rate. If you can breathe deeply and peacefully while doing any activity you can habituate to it much faster. Try looking into your own eyes without making a face, without raising your eyebrows, and without squinting. Also, focus on noticing and resisting the impulse to glance away. After practicing this for a few weeks I can now make unwavering eye contact and feel calm while doing it. I have a slightly different relationship to myself now. I feel more trustworthy, and making eye contact with others looks more natural and feels less effortful.

I believe that lower eye-control centers, such as the superior colliculi are a hub for holding stress and anxiety. I think that I can sometimes feel the pressure to keep glancing around neurotically, and this comes from eye-motor centers that act below the level of conscious awareness. I think that the best way to retrain these centers is to incorporate “fixed gaze” practices into your meditation routine. When you are relaxing, spend a few minutes staring at a single point, and notice, and override the impulses you have to look around nervously.

Monday, April 7, 2014

Looking Upwards to Increase Happiness, and Calmness


We have all learned to cast our gaze downwards habitually for unfortunate reasons. I used to look at the floor every time I spoke to people. I would do it after I finished a sentence, or after the other person did. In fact, I would actually look at the ground around my feet for most of the conversation. Looking down is a submissive social signal that communicates politeness at best and inferiority at worst. Sadly, we all do this all the time, even when we are not in social situations. When we are by ourselves we often simulate social situations in our head and we end up looking down even when no one else is around. Looking down is probably associated neurologically with depression and anxiety through numerous neurological pathways. Our nervous systems are used to looking down, this means that even when we are sleeping we are looking down. In our waking life and even in our dreams we have programmed ourselves not to look up, stifling our happiness and well-being.  In order to overcome it there are two main things that we can do: 1) we can become accustomed to looking straight or looking up more often, 2) we can build the ocular muscles responsible for lifting the eyes.

There is a great way to determine if the eye muscles responsible for looking up have atrophied due to disuse. Use your index fingers to press the eyelids and eyelashes down, pinning them against the top of the cheek. You want to refrain from squinting, so purse the eyelids “wide shut.” Next look up with the eyes. Look all the way upward, straight up, up and to the left, and up and to the right. If this hurts, or feels uncomfortable to your eye muscles then you know that they are relatively weakened. The only way to strengthen them is to look up more often and to do this exercise.

Try to stop looking down when you talk to people. Try looking straight, even when not making eye contact. Then try looking upwards, above the eye line when in a conversation. You might be concerned that the other person will get puzzled or even angry. If you are not used to looking up, not used to breathing deeply when doing it, or if your eye muscles are weak, it is likely that the other person will be able to tell that it is unnatural for you. The only way for it to look natural is for you to practice it habitually. Pretend that you are using the ceiling or sky as a canvass to paint pictures of the topic of conversation. Looking up appears natural when you use the upper visual field to imagine things in the mind’s eye.

The more you look up the better you will feel. If you can breathe deeply while doing this your body will learn to relax while looking up more quickly. Spend time every day looking up, or looking toward the right and left corners of your visual field.  Like looking up, looking to the far right and left sides keeps you from squinting which is also healthy and helpful. Another great way to make looking up natural and to strengthen your ocular muscles is to lie down in front of the TV with your head near the TV and your toes far from it. Watch a program or two upside down at the top of your visual field. Completely refrain from squinting while you do this. Go to the mirror afterwards, and you might just notice that your eyes look fuller, happier and calmer.

Breathing Through Both the Nose and Mouth Simultaneously


I have pondered for a long time about the most salutary method of breathing. I have read sensible rationales for breathing in different ways, especially for breathing in through the nose and out through the mouth. For a while, I thought it was best to breathe in through the mouth and out through the nose because breathing out through the nose takes longer, and thus extends the exhalation relative to the inhalation, and must therefore activate the vagus nerve and parasympathetic nervous system (the resting branch). Now I prefer breathing in and out through both the nose and the mouth at once, allow me to explain how and why.
To do this, simply breathe in a way that you can feel air passing through both your nostrils and your teeth and lips. At first the only palpable sensations seem to come from these areas, but after a while you notice the pharyngeal structures in the back of the throat that are responsible for this kind of breathing. Not only do you learn how to control them, but you learn how to relax them. Usually when you breathe through your nose the passage way between your trachea and mouth is cut off by your uvula. Look in the mirror and open your mouth wide. When you look into the back of your throat you can see a fleshy, finger-like structure above the back of your tongue. Keep your eye on it and breathe through your nose. You will probably notice that the tongue rises up and obscures the uvula sealing off your mouth from the breath. Now practice breathing through the mouth and nose while keeping an eye on your uvula. It will feel unnatural at first, but keep at it.
 
When I breathe in through both nose and mouth it feels like I am relaxing muscles throughout my face, pharynx, and throat. While doing this, the tension in my nose and around my eyes dissipates. I think that the main reason why people don’t do this habitually is because we are afraid that we look strange to others while doing it. Your face goes dead and you look “too calm.” I believe though that after using this form of breathing over hours, days, and weeks, that the face changes subtly. Bags under the eyes disappear and the eyes look more open, “clear” and happy. Chronic inflammation from the fatigue of your facial muscles disappears, leaving you feeling and looking better. When I first started doing this it felt unnatural and it looked unnatural to others. Now it feels great and looks normal as well.

After you have practiced this for a few days you might notice that you can breathe through both the mouth and nose even when the mouth is closed. By this I mean you can breathe through the nose while still relaxing the pharynx, as if the mouth were open. I started doing this because I was influenced by Taoist and yoga breathing techniques such as ujjayi breathing where one tries to breathe using the back of the throat. Ujjayi breathing makes a hoarse sound and has been called “ocean breath” because it involves vibrating the glottis as air moves in and out. I think that breathing through the nose and mouth together teaches us how to breathe properly and captures the benefits of the ujjayi breath without the costs (glottis tension).

I believe that the most efficient and effective way of breathing is to breathe through both airways simultaneously, anything less than this, and you are handicapping yourself. I also believe that breathing through either one or the other is a form of social submission and expression of desperation used by mammals to communicate rank and fear. It seems clear to me that the more I keep this up, the calmer I look and feel.

Expose Your Eyes to More Sunlight in Order to Feel More Positive


I recently started to expose myself to more sunlight in order to widen my eyes and improve my mood and affect. It really has worked, my eyes are wider, calmer and I feel better. I also squint less, especially when I am outside during the day. Living indoors we get a lot less sunlight than our ancestors and it has been shown that there is a huge relationship between depression and diminished exposure to the sun. Different forms of depression including seasonal affective disorder, common malaise and angst may be ameliorated by exposure to sunlight. Common forms of phototherapy have shown great promise but these usually use artificial light and do not address squinting, which I think plays a big causal role in negative affect. I think that squinting is tied neurologically to anxiety and depression and that if we can stop squinting, and have wider eyes we can live happier lives.

The only problem is when we are out in the sun, we squint heavily. I have tried to expose myself to just the right amount of indirect sunlight so that I can bask in it, wide-eyed, without squinting. I have worked up from here exposing myself to more and more sunlight without having to squint but every time I tried to expose my eyes to direct sunlight (not looking directly at the sun of course) I couldn’t help but to squint. The following is a great exercise that should allow you to tolerate more sunlight without squinting.

Allow yourself to sit or lie in the sun so that the sun’s rays enter into your eyes. You are not looking directly at the sun but your eyes are getting direct sunlight. This means that your skull and brow are not providing any shadow for your eyes. Close your eyes and breathe deeply for a few seconds to five minutes without squinting. Your eyes should be closed, top to bottom, with your lids “wide shut,” meaning that you are not squinting at all. You can even do this through your windshield or window at home to reduce your exposure to harmful rays. This practice will allow you to tolerate more sunlight and will improve the look of your eyes, making them feel and appear more healthy, calm and open.  

Wednesday, March 12, 2014

One Isometric Stretch to Improve Posture and Strength in the Chest, Neck and Shoulders



In my opinion the simple act of pushing the shoulders to the floor can remodel the upper body, making it easier to put on muscle and relieve tension and strain. We all walk around, sit, and sleep in our beds with raised shoulders. This is not the way our body was designed to hold itself and it introduces tension into the shoulder blades, neck and arms. This tension affects us in an adverse way psychologically. In Pilates they recommend pushing the ears away from the shoulders. In yoga it can be part of Tadasana or “mountain pose.” 

My favorite way to perform this isometric stretch is to lay on the floor:

1)      Lie down on the floor on your back and slightly tuck your shoulder blades underneath you.
2)      Put your arms at your sides, raise them to the level of your hips, and push down as if you were reaching for your knees.
3)      Do this for several seconds at a time breathing deeply.

It is really that simple. As long as you are breathing slowly and deeply your nervous system will start to embrace this posture. After a few sessions try walking around like this. With time you will notice that the muscles throughout your back and chest work together dynamically to push your shoulders down. It actually allows the chest and back to push against each other antagonistically. The more they can push against each other, the more they can coax each other to grow. Their synergistic relationship will even cause the base of the neck to become stronger and more healthy. This posture is the “core” of the upper body and it lends strength and poise to all upper body movements. It will help you grow stronger and help to improve your overall physique. 

Other poses that complement this one:

1)      Clasp the hands together behind the back, press the hands back and down and arch the chest upward and forward.
2)      Bend over reaching toward the ground with the hands clasped and arch the chest inward (backward, the other way) and hold.
3)      Simply raise the hands and arms above the head for a few minutes at a time while arching the chest inward, outward and laterally to each side.
4)      Stand straight with the elbows bent, press the elbows toward the ground and make small circles with the elbows as if you were flapping chicken wings.

I do these 4 exercises for prolonged periods while walking and together, over the course of a year they have changed my life.