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Restricted Environmental Stimulation Therapy, or REST, is a very effective intervention for working with stress related disorders, chronic pain, habit disorders, anxiety disorders, and personal enhancement programs. REST offers the benefits associated with relaxation training, hypnosis, meditation and biofeedback, both in the physiological and the cognitive dimension
There are two basic forms of REST, Flotation REST and Chamber REST. Dr. John Cunningham Lilly devised the floatation tank in 1954, at the National Institute of Mental Health. A floatation tank is a sensory deprivation tank with 10-inch deep box of water (93.5 degrees Fahrenheit), enriched by 800 pounds of Epsom salt. The weightlessness, temperature of the water, and sensory deprivation allows the brain to go into the Theta state, the 4-7Hz frequencies the brain experiences before falling asleep. Theta offers access to unconscious material, reverie, free association, sudden insight, and creative inspiration. Floatation offers a relatively stress-free environment where one can be free of the stressful external stimuli his/her system may be experiences, causing it to be in a state of chronic arousal, fatigue, stress, or tension.
The benefits of this experience range from physical to psychological. Floating resets the body's chemical and metabolic balance, strengthening resistance to the negative impact of stress, illness or injury alleviating the affects of a number of diseases from arthritis, blood pressure problems, to hormonal imbalance. Blood pressure and heart rates drop and oxygen and nutrients are transported to the cells while harmful chemicals are released. Beta-endorphins, the body's natural painkillers, are released. Olympic athletes, patients with chronic pain or addiction problems, as well as patients with cardiovascular or psychological conditions benefit from floatation tanks.

Flotation REST in Applied Psychophysiology
Thomas H. Fine, M.A. and Roderick Borrie, Ph.D.

Flotation Rest and Pain Management

An in depth examination of the role of Flotation REST in the management of pain can provide us with a clear picture of the psychophysiological nature of the treatment. Pain programs are generally used as a last referral resort for patients whose intractable pain has not responded to the traditional medical treatments. Biobehaviorally based pain management utilizes counseling and behavioral medicine techniques such as relaxation training, meditation. biofeedback, guided imagery, and self-hypnosis. The goals of such treatment are the development of pain avoidance skills, the establishment of routines for optimal fitness within the limitations of a disability, the reduction or elimination of pain, when possible, and/or the patients acceptance of some level of pain.

Flotation REST can have an important role at several stages of the pain management process. By reducing both muscle tension and pain in a relatively short time and without effort on the part of the patient, flotation provides a dramatic demonstration of the benefits of relaxation. Relief is immediate and, although temporary, offers promise of further relief from REST and other relaxation-based strategies. Symptom reduction gained from flotation can increase a patient's motivation and interest in the remainder of the therapy plan. Pain patients generally come into treatment feeling suspicious and skeptical, requiring a clear demonstration that they can be helped. Flotation can be the vehicle for that demonstration.

The relaxation following flotation can be used to facilitate relaxation training. In the treatment reported here, training in relaxation and other psychological pain control strategies occurred during the flotation REST sessions as well as in counseling sessions. Specially prepared audio programs introduced patients to breathing techniques, progressive muscle relaxation, autogenic training, guided imagery and hypnotic suggestions for pain reduction while they floated. Training and practice in those same techniques followed in counseling sessions and at home.

The most common etiologies of pain in this group of patients were from motor vehicle accidents, work accidents, or chronic illness. Most had endured their pain for longer than six months and had also suffered various levels of anxiety, anger, and depression. These emotional problems must be considered in the treatment of chronic pain patients. The first data are pre-post pain ratings from 16 patients who floated from one to 16 flotation sessions. Each patient reported on up to four body areas, providing a total of 253 pre-post , measures. The average percentage of relief, as measured in decrease from the pre-session value, was 31.3% for all sessions and all measures. To determine whether flotation REST provides more pain relief to some parts of the body as opposed to others, these measurements were examined by body area. Pain reduction in most body areas was close to the overall mean of 31%, except the upper back, which showed a 63.6% pain reduction, the arms which showed a 48.2% reduction, and the legs, which showed a 15.3% pain reduction. The duration of relief varied from two hours to seven days.

A second set of data came from a survey mailed to patients who had completed the program. The questionnaire asked patients to assess how much pain relief they received from the various components of the pain program (Flotation, relaxation training, and counseling) and from other treatments they had received medication (pills and shots), physical therapy, chiropractic, and surgery. Short-term pain relief, long-term pain relief, relief from anxiety or stress, and relief from depression were indicated separately. Additionally, they were asked whether each treatment improved their outlook and/or helped them cope with their pain.

All 27 respondents had received treatments other than those from this pain program: 81% had used pain medications; 56% had had some form of pain injections; 70% had received physical therapy; 59% had received chiropractic treatment; 22% had undergone surgery. These patients reported more short-term and long-term pain relief from flotation than from the other therapeutic modalities.

For non-pain symptoms, the comparisons were even more striking. Patients reported far more relief from anxiety and stress from flotation than any other modality. For depression, flotation was equal to counseling at near 70%, with relaxation training at 53% and physical therapy and medication at 20%. Patients also claimed to have reaped a variety of other benefits from flotation, reporting improvements in sleep (65%), mental concentration (77%), energy (46%), interpersonal relationships (54%), ability to work (35%), ability to cope with pain (88%), ability to cope with stress (92%), and feelings of well-being (65%) resulting from flotation REST.

In answering the question, "Did this treatment improve your outlook toward your pain?" 96% responded positively for flotation, 100% for counseling, 100% for relaxation training, 50% for physical therapy, 24% for pain pills, 17% for pain shots, 15% for chiropractic. To the question, "Did this treatment help you cope effectively with your pain?" 96% responded positively for flotation, 92% for both relaxation training and counseling, 50% for pain shots, 44% for pain injections, 38% for physical therapy, and 17% for chiropractic. It is clear that flotation was rated on average as more effective than other treatments with respect to pain, anxiety and depression relief.

Flotation REST and Chronic Illness

Summing up thus far, the data are supportive of flotation REST being useful in pain reduction, stress and tension abatement, and mood enhancement. Besides chronic pain, other patients treated at our facility were those with chronic physical illnesses, those with cancer, those with trauma to the nervous system, those with depression or bipolar mood disorder. anxiety disorders, and those suffering overwhelming stress.

Uniquely, Flotation REST provides an effortless introduction to deep mental and physical relaxation. The majority of our chronic illness patients suffered from autoimmune diseases, including rheumatoid arthritis, lupus, scleroderma, and Reiters syndrome. For these patients, discovering relaxation meant a dramatic reduction in symptoms, such as joint pain, headache, fatigue and depression. Several patients with lupus reported that regular flotation permitted them to reduce their dosage of prednisone while experiencing less frequency and severity of symptoms. Two patients with scleroderma reported relief from flotation. One reported relief from pain and stiffness that lasted almost a week after her third flotation session. As this patient continued she also experienced relief from her depression about the illness, a dramatic reduction in her use of steroids and other medications, a reduction in joint pain and swelling, and less frequent heartburn and headaches. After a three month course of treatment with flotation and counseling she was able to return to her job.