Somatic Control Strategies

Progressive Muscle Relaxation

Progressive muscle relaxation can be conducted in many ways, although one of the most common involves a tension-release model. In this procedure, a client is instructed to sit in a comfortable chair in a therapist's office and try to relax as much as possible. The lights may be dimmed with the goal of providing as relaxed an environment as possible. The therapist then asks the client to concentrate on his or her voice to the exclusion of other distractions. During the procedure, described completely by the therapist, the voice should be kept even and smooth to promote a sense of calm.

The initial target of progressive muscle relaxation can vary but often involves the hands. The client is instructed to ball one of his or her hands into a fist. The client is then told to squeeze the fist as tightly as possible, with care taken with long fingernails or any physical condition (e.g., arthritis) the client may have. The fist is held tightly for 5 to 10 seconds, after which the client is instructed to quickly release the fist and allow the hand to fall limp. After a period of several seconds, the client is again instructed to ball his or her hand into a fist and hold it tightly for 5 to 10 seconds. The therapist should carefully examine the client's hand to see if it is indeed tightly held and instruct the client to squeeze harder if necessary. Following the second period of tension, the client is again asked to let go quickly of the fist and allow the hand to feel limp. The process is repeated with the other hand. At this point, the therapist may wish to help the client understand the difference between a tense fist and a loose hand and the accompanying sensations. As the hand falls limp after tension, for example, most people report sensations of relaxed muscles, warmth, and tingliness. This should be shown to the client as different from sensations of tension, tightness, and pain.

Following this initial procedure, the therapist may instruct the client to tense and release additional muscle groups. A common second target is the arms, which may be twisted and tensed and released individually or together. Again, the procedure is to have the client tense for 5 to 10 seconds and release quickly to feel the relaxation. Intermittently throughout the progressive muscle relaxation procedure, the therapist praises the client for his or her effort and expresses the belief that the client will become a good relaxer. In addition, the client is reminded periodically during the process to focus on the difference between tensed and relaxed muscles, a difference not always recognized in people with anxiety disorders or chronic tension.

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