Applied Tension

Applied tension is a technique we can use as soon as we are exposed to phobia-triggering content. The more pro-actively we use it, the better we can prevent feeling faint, and certainly the better we can prevent fainting. While this tool is awesome for keeping us from ending up flat on the floor, there may be added benefits to using it as often as we can.

‍The benefits

Many people find that the “woozy” feelings that come about due to medical stuff is pretty distressing. I still haven’t met a person who enjoyed the sensation of light-headedness, nausea, and general malaise that comes with feeling faint. So, every time we experience something medical related, we also feel a bit sick. No wonder we want to avoid our medical triggers – we would probably also avoid cats, crosswalks, and soda cans if they made us feel instantly unwell and woozy.

So, every time we do applied tension and prevent those unpleasant feelings from happening, we might also be uncoupling a powerfully negative association.  Our brains learn from experience what is “bad, sickening, and unsafe”. We can also provide our brains with new information by giving it new experiences - for example, that medical-type stuff is “neutral and survivable”.

To do it right, do it rhythmic

Typically, the way applied tension is taught is wrong. Well, not wrong per se, but sub-optimal.

Commonly, people are instructed to:

flex their large muscle groups (abdomen, legs, arms)

hold the tension for 15-30 seconds

then release the tension for another 15 seconds

repeat until you feel better.

This is meant to help keep our blood pressure steady and keep the oxygen supply to our brain consistent.  You can tell its working if your face feels a bit warmer.

But is this the best way?

Bodycoat et al (2000) found that 5 seconds of tension followed by 5 seconds of releasing tension was better. Why? Perhaps because the constant movement keeps circulation moving more effectively. Perhaps also, there is too much relaxation happening if you tire your muscles out by tensing for up to 30 seconds and then releasing for 15. During the releasing, people can begin to feel lightheaded and dizzy again.

So, the “rhythmic” approach to Applied Tension might be better. You might want to try them both out and see for yourself.

Other ways you can apply Applied Tension

Tiptoeing, or raising up on your toes using your calf muscles to lift you

Crossing your legs tightly if you are sitting

Isometric exercises – pushing your hands together, pushing your legs against each other, pushing against a wall

Slow the breath – you don’t want to take too deep of breaths or hyperventilate. Taking slow, shallow breaths may actually help you reduce dizziness and distress. You can learn more about why “take a deep breath” isn’t always the best advice here.

One last thought

The biggest muscle is your butt muscle. I’ve noticed that many sources ignore this – perhaps because they don’t want to be impolite and tell you to squeeze your butt when you start to feel squeamish. So let me be the first – it really does help to squeeze your butt.  

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References:

Bodycoat, N., Grauaug, L., Olson, A., & Page, A. C. (2000). Constant versus rhythmic muscle tension in applied tension. Behaviour Change, 17(2), 97–102. https://doi.org/10.1375/bech.17.2.97

Ritz, T., Wilhelm, F. H., Meuret, A. E., Gerlach, A. L., & Roth, W. T. (2009). Do blood phobia patients hyperventilate during exposure by breathing faster, deeper, or both? Depression and Anxiety, 26(2), E60–E67. https://doi.org/10.1002/da.20466

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