Programmed relaxation and reciprocal inhibition with psychotic children

This exploratory project illustrates, in contrast to earlier opinions, that psychotic children can be taught muscular relaxation through carefully structured training in physical relaxation. The learned relaxation behavior was apparently antagonistic to and effected a significant decrement in the generalized response of high anxiety which had previously led to aggressive outbursts. As a result of the exploratory project it was hypothesized that although systematic desensitization may be necessary for modifying specific patterns such as phobias, the generalized excitement response of psychotic and other severely disturbed children may be effectively and parsimoniously modified simply through general training in muscular relaxation.     

Group preprogrammed systematic desensitization without the simultaneous presentation of aversive scenes with relaxation training

This study investigated the assumption that it is necessary to simultaneously present muscle relaxation and aversive scenes in order for decrements in anxiety to occur. Utilizing 70 high test anxious students, the following treatment groups were delineated: (a) preprogrammed systematic desensitization, (b) non-simultaneous (scenes presented prior to muscle relaxation), (c) relaxation, and (d) no-treatment control. Self-report measures of test and general anxiety as well as college grades constituted the dependent measures. The results indicated that there tended to be no significant differences between the preprogrammed systematic desensitization and non-simultaneous groups on the dependent measures and that the latter group tended to show significant decrements in anxiety and obtain better grades than the relaxation and no-treatment control groups. These findings question the necessity of simultaneously pairing muscle relaxation and aversive scenes in treating anxiety by this method.     

Hierarchical simulation: Two case studies of stuttering modification using systematic desensitization

The use of behavior therapy techniques to alleviate stuttering is being extensively applied. Two cases illustrating hierarchical simulation are presented. In the first, a technique incorporating systematic desensitization and reciprocal inhibition was used to reduce the stuttering behavior of a 13-year-old boy while speaking in a classroom situation. The procedure involved the use of color slides to simulate speaking before an actual classroom as an adjunct to systematic desensitization and reciprocal inhibition. Results indicated a reduction in classroom stuttering as reported by the client and his teacher. In the second case, a 5-year-old boy used forceful muscular activity as being reciprocal to anxiety. This procedure involved the use of videotapes to hierarchically simulate anxiety producing classroom situations. Measures of stuttering indicated a mean reduction of 18%. One year after therapy indicated stuttering had been eliminated.     

The importance of home practice for progressive relaxation training

The efficacy of home practice assignments was evaluated as a component of standardized progressive relaxation training. Subjects reporting general anxiety and tension problems were assigned to either a home practice relaxation, no home practice relaxation or wait-list control condition. Treatment was conducted for 10 sessions over a 5-week period. In addition, subjects in both conditions engaged in in-vivo application of their relaxation skills during a final 2-week application period. Group comparisons showed that both progressive relaxation conditions significantly improved on daily self-monitored general anxiety and tension levels relative to the wait-list control condition. Group analyses of percent subject improvements supported the effectiveness of home practice assignments, especially during the application period. No systematic differences between groups, on physiological and self-report variables, were found during several laboratory relaxation evaluation sessions. This study supports the contribution of home practice assignments to progressive relaxation training.     

Sensitivity to phobic imagery: a sensory decision theory analysis

The effects of deep muscle relaxation on anxiety were studied in a systematic desensitization context. A Sensory Decision Theory analysis of anxiety ratings to controlled imagery showed that relaxed Ss were significantly more sensitive to phobic properties of the controlled imagery than nonrelaxed Ss. The results are discussed in terms of Wolpe's theoretical basis for systematic desensitization. Sensory Decision Theory is presented as a useful technique for measuring the effects of therapy on emotional states.     

Drive level, incentive conditions and systematic densensitization

The role of drive level was investigated as it bears upon the process mechanism(s) involved in systematic desensitization. Drive was defined by subjects' performance on a pre-BAT. High and Low Drive subjects were randomly assigned to a systematic desensitization, a reward. an extinction, and a control condition. The results indicated that systematic desensitization was the most effective condition for both high and low drive subjects. However, there were indications that both the extinction and reward conditions may be effective with further trials. The suggestion was that systematic desensitization might be the more efficient, but not the sole effective treatment. If so, the process mechanism involved is likely to be extinction rather than reciprocal inhibition. The role of relaxation, then, would be one of an incentive that permits the subject to maintain exposure to the feared stimuli, thus facilitating extinction.     

Varieties of relaxation methods and their unique effects

This paper reviews literature on specific effects of various relaxation methods, and of differences between varieties of two widely-used (and widely modified) methods: progressive relaxation and autogenic training. There is considerable evidence for modality-specific effects. Muscularly-oriented methods have the greatest effects on the musculoskeletal system, autonomically-oriented methods on the autonomic nervous system, etc. Modified methods of Jacobson's progressive relaxation technique have a greater cognitive and less muscular focus than Jacobson's original method, and Norris and Fahrion's autogenic feedback training de-emphasizes hypnotic components of autogenic training compared with Schultz and Luthe's original method. Hypotheses are presented regarding differential effects of these modifications on clinical outcome, on their appeal and usefulness to individuals with various personality profiles, and on possible negative side effects.     

The contribution of relaxation to symbolic modeling in the modification of dental fears.

Studies of symbolic modeling suggest that it is a technique which is at least as effective and more efficient (faster) than imaginal desensitization in the treatment of fears (Bandura el al., 1969; Woody and Schaible, 1969). Bandura et al. (1969) assessed the contributions of relaxation to the procedure and found less subjective anxiety and greater positive attitude change with relaxation but no significant differences in oven behavior nor in generalized anxiety reduction. In this study the ‘symbolic modeling only’ subjects received their treatment after they and the other subjects had received the original post-testing assessment. The present experiment was an attempt to assess the contributions of deep muscle relaxation to symbolic modeling without such confounding and with a more nearly clinical population. Dental fear represents a ‘near clinical’ phobia which satisfies Bernstein and Paul's (1971) criteria for analogue desensitization research. That is. dental phobics exhibit a strong, costly and distressing avoidance response which increases in strength as a function of exposure despite high demand.     

Motor and cognitive relaxation in the desensitization of anger

Three procedures were assessed to determine their effectiveness in reducing anger. The procedures were: desensitization, desensitization with cognitive relaxation, and desensitization with the absence of relaxation training. Anger was aroused by exposing white males, selected for their reports of anger toward blacks, to black racial stimuli. The desensitization group reported reductions in anxiety and disgust relative to a no-treatment control group. Therapist ratings indicated reductions in anger for Ss in both the desensitization and desensitization with cognitive relaxation groups. In addition the latter group reported reductions in anger concurrently with increases in diastolic and systolic blood pressure. Post-hoc analyses indicated that Ss for whom desensitization was most effective reported less anger after the pretreatment anger arousal procedure, greater depth of relaxation during treatment, and were liked more by their therapists. These Ss also reported a greater reduction in ethnocentrism and a trend toward lower overt hostility following treatment.     

The effects of progressive relaxation on stress and diabetic control

Four insulin-requiring diabetic Ss were followed in single-S designs to measure the impact of progressive muscle relaxation training on blood glucose and stress levels. Measures of blood glucose, stress, activity and caloric intake were taken four times a day, along with a daily measure of anxiety. Two of the 4 Ss showed a significant decrease in blood glucose during treatment periods as compared to baseline measures. Similarly, 2 of the 4 Ss showed a significant decrease in stress levels during treatment. A multiple regression analysis revealed some significant relationships between blood glucose, stress, activity level and caloric intake. The results support previous studies that show relaxation techniques to be a viable aid in establishing greater diabetic control.     

The role of mental relaxation in experimental desensitization

Certain evidence indicates that training in peripheral muscle relaxation is not an essential factor in the successful experimental desensitization of phobias. Rachman (1968) has suggested that a sense of calmness or mental relaxation is the necessary component and that all the preliminary training techniques leading to successful desensitization, have, as the basis for their success, the inadvertent induction of this state of mental calmness. The direct induction of mental relaxation then, ought to be at least as effective an adjunct to desensitization as training in muscle relaxation. Using spider phobia as the target behaviour, the present study compared the effectiveness of (a) hierarchy presentation paired with deep muscle relaxation; (b) hierarchy presentation paired with instructions to feel calm and relaxed and alternated with imagining a pleasant scene; (c) a combination of these two procedures paired with hierarchy presentation; and (d) a placebo control procedure. The treatment groups all improved significantly more than controls and there there were no differences between treatments. The results were seen as offering strong support of Rachman's position. Both theoretical and practical implications of the results are discussed with consideration being given to the nature of “mental calmness”.     

Systematic desensitization, muscle relaxation and visual imagery in the counterconditioning of four-year-old phobic child

A four-year-old boy with a severe phobia for loud sudden noises was successfully treated with behavior modification utilizing muscle relaxation and in vivo conditioning in six sessions. The question of theoretical importance was whether muscle relaxation and systematic desensitization by imagining feared stimuli could successfully be employed to treat a phobia in a child this young. The literature does not, to the author's knowledge, contain any reports of the combined use of muscle relaxation and imagination of fear-producing stimuli for treating phobic children of such a young age.     

Studies in desensitization—I: The separate effects of relaxation and desensitization

The purpose of the study was to investigate the separate effects of desensitization and relaxation in Wolpe's technique of “systematic desensitization”. Four small groups of spider-phobic, normal subjects were allocated to the following treatments: desensitization with relaxation, desensitization without relaxation, relaxation only, no-treatment controls. The effects of treatment were assessed by subjective reports, avoidance tests and fear estimates. Marked reductions in fear were obtained only in the desensitization-with-relaxation group and it was concluded that the combined effects of relaxation and desensitization are greater than their separate effects.     

Psychotherapy by reciprocal inhibition

Reciprocal inhibition is a process of relearning whereby in the presence of a stimulus a non-anxiety-producing response is continually repeated until it extinguishes the old, undesirable response. A variety of the techniques based on reciprocal inhibition, such as systematic desensitization, avoidance conditioning, and the use of assertion, are described in detail. Behavior therapy techniques evaluated on the basis of their clinical efficacy are found to have striking success over traditional psychoanalytic methods. Currently, more comparative studies are required which will validate the merit of behavior therapy in the psychotherapeutic field while experimental research should continue to refine the techniques.     

Progressive relaxation and meditation : A study of psychophysiological and therapeutic differences between two techniques

Physiological and self-report data were collected on anxious subjects who participated in a study comparing progressive relaxation, meditation and a waiting-list control. The data provide some support for the Schwartz, Davidson and Goleman (1978) hypothesis of specific effects for different relaxation procedures, superimposed upon a generalized relaxation response. The similarities between techniques, however, were greater than the differences, both on physiological and self-report measures. Both techniques generated positive expectancies and produced decreases in a variety of self-reported symptoms and on EMG: but no skin conductance or frontal EEG effects were observed. Progressive relaxation produced bigger decreases in forearm EMG responsiveness to stressful stimulation and a generally more powerful therapeutic effect than meditation. Meditation produced greater cardiac orienting responses to stressful stimuli, greater absorption in the task and better motivation to practice than progressive relaxation; but it also produced more reports of increased transient anxiety. We found no significant differences between conditions in the therapeutic expectancies they generated. The clinical implications of these findings are discussed.     

Psychophysiological aspects of systematic desensitization: some outstanding issues

Nine psychophysiological propositions generated by systematic desensitization theory were examined in the light of recent research. Four propositions were substantially confirmed, four partially confirmed and one was not confirmed. Facts reviewed did no agree with the prediction from desensitization theory that less threatening stimuli decondition faster than more threatening stimuli. With the exception noted above, desensitization theory was generally supported. A scheme for distinguishing four types of autonomic response change (habituation, reciprocal inhibition, counterconditioning and extinction) was presented.     

Psychophysiological and cognitive responses to stressful stimuli in subjects practicing progressive relaxation and clinically standardized meditation

Thirty-six volunteer subjects were assigned to one of three conditions: progressive relaxation, clinically standardized meditation, or a waiting list control group asked to relax daily (without specific instruction). Subjects were given paper and pencil tests two times, separated by 5 weeks during which time the two treatment groups received 4 weekly sessions of group training. All subjects were tested in the psychophysiology laboratory at the end of the 5-week period, during which time they were exposed to 5 very loud tones. While relaxing as deeply as possible using the techniques they had learned and anticipating the loud tones, the meditation group exhibited higher heart rates and higher integrated frontalis EMG activity, but they also showed greater cardiac decelerations following each tone, more frontal alpha, and fewer symptoms of cognitive anxiety than the other two groups. The relaxation group reported more sensations of muscular relaxation than the other groups, but also some symptoms of hyperventilation. The results are generally consistent with Davidson and Schwartz's (1976) categorization of meditation as a ‘cognitive’ technique, and suggest that frontal EEG alpha may be a physiological marker for the absence of cognitive anxiety. Physiological findings also support Goleman and Schwartz's (1976) suggestion that meditation prepares people to cope with stress.     

Play desensitization of fear of darkness in preschool children.

Systematic desensitization therapy (SDT) is considered to be a technique of established effectiveness in reducing monosymptomatic fears (Paul, 1969a, 1969b), yet little systematic research has been done to investigate the merit of desensitization procedures in modifying children's behavior. The few available controlled studies (Miller et al., 1972; Obler and Terwilliger, 1970; Oliver, 1971) on desensitization with children have produced equivocal results. Although imagery and relaxation have been reported of benefit when used separately (Graziano and Kean, 1971; Lazarus and Abramovitz, 1962), evidence suggests that the usual combination of imagery and relaxation is not effective in reducing children's fears (Miller et al., 1972). Investigators in this area have often modified traditional SDT to include alternatives to imagery such as pictures, drawings, play (Cassell, 1965; Lazarus, 1960; Obler and Terwilliger, 1970; Patterson, 1965), or in vivo exposure to the feared stimulus (Obler and Terwilliger, 1970). Relaxation has often been replaced with other responses thought to be incompatible with anxiety such as eating (Jones, 1924). Another deviation from traditional SDT has been the delivery of positive reinforcement (food, praise, or toys) contingent upon the child's approaching the feared object (Obler and Terwilliger, 1970; Patterson, 1965). On the basis of such varied techniques, it is impossible to determine which of these procedures constitutes an effective treatment method for children. In the following study, three desensitization procedures involving graded exposure to the feared stimulus (darkness) through symbolic play, were compared to no-treatment and placebo control groups under differing instructional sets. Treatments were designed to determine the therapeutic efficacy of play as a method of stimulus presentation with children, and to determine whether reciprocal inhibition, extinction, operant reinforcement, or instructional set contribute to fear reduction in desensitization with children.     

Use of relaxation skills in differentially skilled athletes

ObjectivesTo examine the use of relaxation skills by differentially skilled athletes in relation to the deliberate practice framework.DesignDifferentially skilled athletes completed a survey about their use of relaxation skills.Method150 athletes representing three skill levels (recreational, college, and professional) completed the deliberate relaxation for sport survey, which assessed relaxation on three deliberate practice dimensions (relevancy, concentration, and enjoyment); time spent in different relaxation skills in a recent typical week; and functions of relaxation.ResultsAthletes perceived relaxation as relevant to performance, requiring concentration, and enjoyable, and the relationships between these dimensions were positive. Professional and college athletes perceived relaxation as more relevant to effective competition than recreational athletes. Professional athletes engaged in more relaxation in a typical week than college and recreational athletes. In a typical week, autogenic, eastern, and muscle relaxation types were used least, deep breathing, meditation, and imagery relaxation types moderately, and stretching most. Athletes reported the primary functions of relaxation were to cope with competitive anxiety and promote recovery but relaxation was also reported to be used to cope with “everyday” anxieties associated with being an athlete. More physical (e.g., muscle relaxation) than mental relaxation types were used in relation to coping with competitive anxiety, whereas more mental (e.g., meditation) than physical relaxation types were used in relation to coping with everyday anxiety.ConclusionsThe study provides support for the sport-specific framework of deliberate practice in relation to use of relaxation skills and informs the current understanding of self-regulation by athletes.