Progressive Muscle Relaxation
Progressive relaxation training originated in the 1930’s as a treatment for tension and anxiety. Edmund Jacobsen developed a systematic and lengthy program of relaxation training which involved training clients to systematically tense and release muscle groups and to attend to the resulting feelings of relaxation (Jacobsen, 1934, 1938, 1964). Joseph Wolpe built upon Jacobsen’s work and integrated relaxation techniques into his program of systemic desensitization. Wolpe’s insight was that fear responses could be counterconditioned: evoking an incompatible response while simultaneously presenting a feared stimulus could eliminate a fear reaction (Wolpe, 1958). Wolpe significantly shortened the Jacobsonian relaxation training program, as well as integrating it within a theory of conditioning for the treatment of anxiety. Bernstein & Borkovec (1973) described standardized progressive muscle relaxation procedures which have subsequently been used in many research trials.
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Introduction & Theoretical Background
Progressive relaxation training has been demonstrated to be a clinically important intervention. Selected results include:
- Applied relaxation (incorporating progressive muscle relaxation) in the treatment of generalized anxiety disorder (GAD) resulted in treatment effects that were comparable to CBT (Dugas et al, 2010).
- A meta-analysis comparing ‘less complex’ interventions (including progressive muscle relaxation) with ‘more complex’ interventions (such as CBT, EMDR, and behavioral therapies) for a wide range of conditions found that ‘less complex’ treatments yielded medium effect sizes. ‘More complex’ interventions added only modest additional benefits (Stevens et al, 2007).
- Progressive muscle relaxation is effective in reducing acute feelings of stress and anxiety in patients with schizophrenia (Vancampfort et al, 2011)
- Progressive muscle relaxation is of debatable utility in the treatment of panic attacks and panic disorder. Some research has indicated that relaxation can be beneficial in the treatment of panic (e.g. Ost, 1988) although dismantling studies indicate that
Therapist Guidance
Clients should be given a rationale for the utility of learning progressive muscle relaxation. Bernstein & Borkovec (1973) used the following:
“Progressive relaxation training consists of learning to sequentially tense and then relax various groups of muscles, all through the body, while at the same time paying very close and careful attention to the feelings associated with both tension and relaxation.”
Clients should be instructed to:
- Focus their attention on each muscle group in turn
- Tense the muscle group
- Maintain the tension for 5-7 seconds
- Release the tension
- Maintain the focus of attention on the muscle group for about 20-30 seconds and notice feelings of relaxation before moving on to the next muscle group
A recommended full sequence of muscle groups is given below:
- Right hand and lower arm (clench your fist and tense the lower arm)
- Left hand and lower arm
- Right upper arm
References And Further Reading
- Bernstein, D. A., Borkovec, T. D. (1973). Progressive relaxation training: a manual for the helping professions. Champaign, Illinois: Research Press.
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23.
- Day, M. A., Eyer, J. C., Thorn, B. E. (2014). Therapeutic relaxation, in The Wiley Handbook of Cognitive Behavioral Therapy. John Wiley & Sons, Ltd.
- Dugas, M. J., Brillon, P., Savard, P., Turcotte, J., Gaudet, A., Ladouceur, R., Leblanc, R., & Gervais, N. J. (2010). A randomized clinical trial of cognitive-behavioral therapy and applied relaxation for adults with generalized anxiety disorder. Behavior Therapy, 41(1), 46-58.
- Jacobson, E. (1934). You must relax. New York: McGraw-Hill.
- Jacobson, E. (1938). Progressive relaxation. Chicago: Chicago University Press.
- Jacobson, E. (1964). Anxiety and tension control. Philadelphia: Lippincott.
- Öst, L.-G.