Insomnia

Insomnia Part 5: Relaxation Therapy

By September 15, 2012 October 30th, 2014 No Comments

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 the 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.

How to perform 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’tĀ 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 15 seconds. Count “1,000 2,000…” 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.

1. Hands. The fists are tensed; relaxed. The fingers are extended; relaxed.

2. 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).

3. Shoulders. Pull them back (careful with this one); relax them. Push the shoulders forward (hunch); relax.

4. 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.

5. Neck (forward). Dig your chin into your chest; relax.

6. Mouth. The mouth is opened as far as possible; relaxed. The lips are brought together or pursed as tightly as possible; relaxed.

7. 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.

8. Tongue (roof and floor). Dig your tongue into the roof of your mouth; relax. Dig it into the bottom of your mouth; relax.

9. 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.

10. 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.

11. 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.

12. Butt. Tense the butt tightly and raise pelvis slightly off bed; relax. Dig buttocks into bed; relax.

13. Thighs. Contract thighs; relax. Dig your feet (heels) into the bed; relax.

14. 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;

15. 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.

16. 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, 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 highly recommended.

Insomnia Part 6: Guided Imagery Relaxation