What is relaxation therapy and how does one perform this technique? Relaxation therapy describes all techniques used to counter stress, anxiety, or sympathetic arousal. Two such techniques widely used include progressive muscle relaxation(PMR) and guided imagery relaxation. PMR is a technique for reducing anxiety or improving insomnia, by alternately tensing and relaxing the muscles. It was developed by American physician Edmund Jacobson in the early 1920s. Jacobson argued that since muscle tension accompanies anxiety, one can reduce anxiety by learning how to relax the muscular tension. PMR entails a physical and mental component. The physical component involves the tensing and relaxing of muscle groups over the legs, abdomen, chest, arms and face. With the eyes closed and in a sequential pattern, tension in a given muscle group is purposefully done for approximately 10 seconds and then released for 20 seconds before continuing with the next muscle group. The mental component focuses on the difference between the feelings of tension and relaxation. Because the eyes are closed, one is forced to concentrate on the sensation of tension and relaxation. Because the feelings of warmth and heaviness are felt in the relaxed muscle after it is tensed, a mental relaxation is felt as a result. With practice, a patient learns how to effectively relax and deter anxiety and improve sleep onset and sleep maintenance.
PROGRESSIVE MUSCLE RELAXATION
For sleep improvement, perform PMR in bed. Get as comfortable as possible–no tight clothes, no shoes, don’t cross your legs. Take a deep breath; let it out slowly. Again. What you’ll be doing is alternately tensing and relaxing specific groups of muscles. After tension, a muscle will be more relaxed than prior to the tensing. Concentrate on the feel of the muscles, specifically the contrast between tension and relaxation. In time, you will recognize tension in any specific muscle and be able to reduce that tension. Don’t tense muscles other than the specific group at each step. Don’t hold your breath, grit your teeth, or squint! Breath slowly and evenly and think only about the tension-relaxation contrast. Each “tensing” is for 10 seconds; each “relaxing” is for 20 seconds. Count “one one thousand, two one thousand…” until you have a feel for the time span. Note that each step is really two steps–one cycle of tension-relaxation for each set of opposing muscles. Do the entire sequence once a day if you can, until you feel you are able to control your muscle tensions. Be careful: If you have problems with pulled muscles, broken bones, or any medical contraindication for physical activities, consult your doctor first.
- Hands. The fists are tensed; relaxed. The fingers are extended; relaxed.
- Biceps and triceps. The biceps are tensed (make a muscle–but shake your hands to make sure not tensing them into a fist); relaxed (drop your arm to the bed–really drop them). The triceps are tensed (try to bend your arms the wrong way); relaxed (drop them).
- Shoulders. Pull them back (careful with this one); relax them. Push the shoulders forward (hunch); relax.
- Neck (lateral). With the shoulders straight and relaxed, the head is turned slowly to the right, as far as you can; relax. Turn to the left; relax.
- Neck (forward). Dig your chin into your chest; relax.
- Mouth. The mouth is opened as far as possible; relaxed. The lips are brought together or pursed as tightly as possible; relaxed.
- Tongue (extended and retracted). With mouth open, extend the tongue as far as possible; relax (let it sit in the bottom of your mouth). Bring it back in your throat as far as possible; relax.
- Tongue (roof and floor). Dig your tongue into the roof of your mouth; relax. Dig it into the bottom of your mouth; relax.
- Eyes. Open them as wide as possible (furrow your brow); relax. Close your eyes tightly (squint); relax. Make sure you completely relax the eyes, forehead, and nose after each of the tensings–this is actually a toughy.
- Breathing. Take as deep a breath as possible–and then take a little more; let it out and breathe normally for 15 seconds. Let all the breath in your lungs out–and then a little more; inhale and breathe normally for 15 seconds.
- Back. With shoulders resting against the bed, push your body forward so that your back is arched; relax. Be very careful with this one, or don’t do it at all.
- Butt. Tense the butt tightly and raise pelvis slightly off bed; relax. Dig buttocks into bed; relax.
- Thighs. Contract thighs; relax. Dig your feet (heels) into the bed; relax.
- Stomach. Pull in the stomach as far as possible; relax completely. Push out the stomach or tense it as if you were preparing for a punch in the gut;
- Calves and feet. Point the toes (without raising the legs); relax. Point the feet up as far as possible (beware of cramps-if you get them or feel them coming on, shake them loose); relax.
- Toes. With legs relaxed, dig your toes into the bed; relax. Bend the toes up as far as possible; relax. Now just relax for a while.
As your days of practice progress, you may wish to skip the steps that do not appear to be a problem for you. After you’ve become an expert on your tension areas (after a few weeks), you can concern yourself only with those. These exercises will not eliminate tension permanently, but when it arises, you will know it immediately, and you will be able to “tense-relax” it away or even simply wish it away. Please note that an exercise program of any sort that stresses and stretches a full range of muscles can be used in this fashion if only you pay attention to the differences between tensions and relaxations of the muscles. Yoga is particularly good, but is very demanding at first. Tai chi is also highly recommended.
GUIDED IMAGERY RELAXATION
Another technique, under the umbrella of relaxation therapy, is Guided Imagery Relaxation. This technique focuses on cognitive arousal and uses techniques of visualizing a relaxing setting or activity. Imagery can be generated from within your own thoughts or it can be guided. Guided imagery is a type of visualization relaxation where the stream of your imagery is guided by someone else – a therapist, a coach, or an downloaded app. The following are three examples of guided imagery exercises. Set aside some time when you won’t be interrupted. You can pre-record these exercises first and then listen with your eyes closed.
Imagery Exercise #1:
Pick a favorite place. It could be a garden, a waterfall, a room, or anything else. A place where you feel good and safe. Now, close your eyes and go to that favorite place. Walk around slowly and notice the colors and textures around you. What do you see? … What do you feel? … What do you hear? … What do you smell? Take your time while you walk around. Spend some time exploring each of your senses. And notice how good and relaxed you feel. Remember these sensations, they are the sensations of your very special place. A place where you can relax. Say to yourself: “I am relaxed, my body feels warm and heavy, I am safe here”. Enjoy the feeling of deep relaxation. When you are ready, gently open your eyes and come back to the present moment.
Imagery Exercise #2:
Day at the beach. Imagine – It is a beautiful sunny day…you are walking on a beach…the sky is blue…the water is crystal clear…you hear the sound of gentle waves lapping, as the light breeze caresses your skin…the white sand feels warm on your bare feet and between your toes…you are wearing flowing light clothes and breathing deeply, inhaling the smell of fresh ocean air…a sense of freedom washes over your body…you lie down and let your body sink into the warm soft sand…your are completely relaxed…you sink deeper and deeper into relaxation… When you are ready, gently open your eyes and come back to the present moment.
Imagery Exercise #3:
Imagery for tension release. Imagine an object or a color that represents stress to you. For example, you can imagine the color red, or a rope with knots, or a loud startling noise. When you have your image, say to yourself: “I release tension”. Imagine your image slowly transforming into something calming. The color red can slowly fade into a nice soft and gentle color pink. The rope with knots can slowly transform into a smooth and soft silk or velvet fabric. And the loud noise can gradually transform into a soothing sound of ocean waves. When you are done with the transformation, say to yourself: “I am relaxed”. When you are ready, gently open your eyes and come back to the present moment.
I find these techniques for relaxing to be so effective that if I am not careful I may be taking a great nap before I even notice. Remember, there are many downloadable apps that provide a recited dialogue for Progressive Muscular Relaxation and for Guided Imagery Relaxation if that will help to get started or continue in therapy. As a reminder relaxation therapy and cognitive therapy have been shown in research to be more effective in the long run than prescription medications. So give it a try and relax.