ABSTRACT
This chapter focuses explicitly on stress and anxiety, how these relate to non-cardiac chest pain (NCCP) and strategies for reduction and management. By now many patients will have already derived benefit from abdominal breathing, which may have built up their confidence in the biopsychosocial approach. If they begin to see the relevance of the different factors in the chest pain cycle, they may be better prepared to begin working directly on psychosocial factors affecting their chest pain. Stress and anxiety are normal reactions to threat. They cause changes in peoples' body and mind that are designed to prepare them to cope with this threat. When faced with potential danger, the body automatically releases noradrenaline. Applied relaxation targets both physiological and psychological causes of chest pain. Like breathing, it is relevant to most patients, regardless of current stress levels. Chest pain is often linked to muscle tension, particularly around the ribs, shoulders and back.
