Applied Relaxation and Tension

Description of the Strategy

Currently popularized in an array of specific versions, relaxation training has demonstrated its ease of adaptation and flexibility for teaching individuals an [Page 24]effective means to cope with and overcome anxiety, tension, and other stress-related conditions. Since its initial application toward patients by Edmund Jacobson in the 1920s, relaxation training has become one of the most widely prescribed therapeutic exercises employed by mental health professionals. In fact, this technique has been described as the “aspirin of therapy.” In its original incarnation, progressive muscle relaxation training (PMRT) sought to teach clients to identify subtle tension sites stored within their skeletal musculature, and by learning to elongate (relax) the specific muscles involved in storing emotional and physical tension, unwanted emotional and mental processes could be corrected. Thus, relaxation was viewed as the means and the end result of treatment.

In the 1950s, Joseph Wolpe adapted PMRT to a briefer form, used in combination with gradual exposure in systematic desensitization, a highly successful behavioral strategy for reducing anxiety and phobias. In its most popular form today, which was highly influenced by the works of Bernstein, Borkovec, and Benson in the 1970s, PMRT is viewed as one component of an effective treatment regimen in therapy. Cognitive-behavioral strategies, such as cognitive restructuring or positive self-talk, are commonly used in conjunction with relaxation training, as there appear to be reciprocal benefits in enhancing the effects of each respective strategy.

Although various alternate versions of PMRT and relaxation training in general are practiced and taught, several common elements exist. All forms are rooted in the basic theory that by bringing about and experiencing sensations that are incompatible with the experience of anxiety (e.g., relaxation, slowing heart rate or breathing, and focusing attention on something other than anxious stimuli), the individual is better able to remain calm and demonstrate control over undesirable, anxiety-provoking situations. It is believed that excessive levels of autonomic arousal are to some extent associated with the client's presenting problems, and, as such, relaxation training is specifically aimed at reducing the arousal level, thereby leading to reduction of the effects (i.e., stress and tension) of the presenting problem. PMRT exercises teach the individual to notice and discriminate degrees of tension, and eventually learn voluntary control of muscular tension. After sufficient practice, the client will be able to easily and quickly achieve a deeply relaxed state.

For the most part, modern PMRT strategies are highly structured yet adaptable and can be taught within 10 sessions. Common to most relaxation techniques, a continuous instructional “patter” is presented throughout the exercises in order to minimize distractions and maintain focus on physical sensations. Most patter consists of a few repetitive cues offered in a loosely structured fashion to remind the client to focus on sensations and appreciate subtle differences between relaxation and tension sensations. (For example, “Notice the difference between tensing and relaxing… as if the tension lifted away from you”). The patter is variable, beginning with a normal tone and gradually becoming slower, quieter, and more monotonous. Jacobson's original method dedicated a full session to examining each muscle group in detail, which meant treatment required at least 13 sessions and could last several months. Wolpe abbreviated this method to incorporate 16 muscle groups to be tensed and relaxed within one session, rather than one muscle group per session. This generally remains the standard at present when using PMRT.

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