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.     

The efficacy of progressive relaxation in systematic desensitization and a proposal for an alternative competitive response--the relaxation response.

The theoretical basis of systematic desensitization is reciprocal inhibition in which an alternative, competitive response to anxiety is conditioned to arousal-producing, phobic stimuli. Abbreviated training in progressive relaxation is believed to serve as a competitive response to anxiety by decreasing autonomic nervous system activity. However, physiologic studies of progressive relaxation have not substantiated that its practice is associated with such decreased autonomic activity. Consequently, the use of progressive relaxation has been a confounding factor in the determination of the function of reciprocal inhibition in systematic desensitization. To confirm and refine the theoretical constructs of reciprocal inhibition, it is necessary to test the effects of a response which is competitive to the anxiety response. Such a response may be the relaxation response which is characterized by physiologic changes consistent with decreased autonomic nervous system activity. Derived from meditational practices, techniques which ehcit the relaxation response incorporate the element of focused attention which has been implicated as a critical factor in systematic desensitization. Thus, the use of the relaxation response should be a more appropriate method than progressive relaxation if the therapeutic usefulness of systematic desensitization is indeed due to reciprocal inhibition.     

An examination of methods for producing relaxation during short-term laboratory sessions

Reductions in psychological and physiological correlates of tension produced by various muscle relaxation training techniques were examined during a short-term laboratory session. Two studies are described involving a combined total of one hundred subjects receiving either abbreviated progressive relaxation, visual, auditory, or tactile electromyographic (EMG) biofeedback procedures. The Anxiety Differential was administered before and after the laboratory session. Heart rate, respiratory rate, skin conductance, systolic blood pressure, and frontalis and dominant forearm extensor EMG measures were obtained before, during, and after administration of relaxation training. Results indicated feedback in the tactile modality to produce overall reductions in tension comparable to those produced by progressive relaxation. Overall reductions in tension displayed by both progressive relaxation and tactile feedback were generally greater than reductions shown by visual or auditory feedback procedures. Interpretations suggest that certain forms of EMG feedback may offer an alternative to progressive relaxation techniques for producing short-term reductions in tension. Feedback modality is further indicated as a potentially important variable during relaxation training using the EMG feedback technique.     

Treatment of urinary urgency and excessive frequency: a case study

A 39-year-old male presenting with a 5 year history of excessive urinary frequency and urgency was treated first with scheduling of urination, use of external urinary catheter and progressive muscular relaxation and then with a urinary retention training procedure. After the first set of procedures, urinary frequency decreased, whereas urgency increased slightly. After completion of retention training, both symptoms were alleviated. Overall, urinary frequency decreased from a baseline average of 14 urinations daily to a post-treatment average of 6.5 urinations per day. Urinary urgency decreased from a baseline average of 35 urges per day to a post-treatment average of 9.3 urges per day. Gains were maintained at 3 and 5 month follow-up.     

Anxiety management and applied relaxation in reducing general anxiety

Sixty-three generally anxious subjects were assigned to anxiety management training, applied relaxation training, relaxation-only, placebo and untreated control conditions. After 6 weeks of treatment, anxiety management training led to reductions on a variety of self-report measures of state and trait anxiety and decreases in maladaptive cognitions during a laboratory stress procedure. On several measures, subjects in anxiety management training differed from relaxation-only and placebo subjects as well as untreated controls. However, treatment effects did not extend to performance and physiological measures of anxiety. Applied relaxation training, which in contrast to anxiety management training lacks structured rehearsal involving the recognition and reduction of tension cues during the treatment sessions, resulted in less consistent decreases in measures of general anxiety.     

Evaluation of Progressive Muscle Relaxation with Conduct-Problem,Learning-Disabled Children

Four learning-disabled, conduct-problem children were trained in the use of progressive muscle relaxation to determine the effect of subsequent relaxation practice on behavior in the classroom. After three initial sessions of relaxation training, the children performed in 21 daily classroom periods. Each period was 12 minutes in length. Prior to each classroom period, the children engaged in one of two activities with the relaxation trainer for 15 minutes, i.e., either practice at relaxation with the trainer or card-playing. Measures of disruption, on-task, academic rate, and academic accuracy were gathered in the classroom. In addition, a relaxation checklist was employed to determine the extent to which the child was relaxed in the relaxation practice sessions. The results gave no evidence of differential effects as a consequence of the relaxation procedures or any of the classroom measures. These results suggest that the overzealous use of progressive relaxation training as a setting event or as a non-specific treatment procedure with school children may be unwarranted at this time.     

The effects of muscle relaxation and stress on the blood pressure levels of normotensives

Shoemaker and Tasto (1975) found that progressive muscle relaxation lowers the blood pressure levels of essential hypertensives to within a normal range under laboratory conditions. As a sequel to this study the effects of muscle relaxation and stress on the blood pressure levels of normotensives were studied. One group was taught relaxation, one group was stressed, one group read, and one group did nothing. Blood pressure measurements taken immediately after the completion of these tasks indicated that muscle relaxation does not lower the blood pressure levels of normotensives but that stress significantly raises both the systolic and diastolic levels.Level of arousal can, at least in one sense, be viewed as occurring on a dimension defined by extreme anxiety at one end and extreme relaxation at the other. Research on the physiological correlates and/or defining properties of arousal has produced inconsistent and equivocal results. Little work has been done relating blood pressure levels to arousal, however. Shoemaker and Tasto (1975) found a consistent and predictable drop in the blood pressure levels of essential hypertensives as a result of progressive muscle relaxation. In their study those subjects with the highest blood pressure levels showed the greatest drop while those with moderately high levels showed moderate drops and those with the lowest levels (yet still above normal) showed the least amount of change. The amount by which blood pressure dropped as a result of progressive relaxation was positively correlated with the pretreatment level of blood pressure. The result of progressive relaxation was to lower blood pressure levels to within a normal range, with all subjects appearing to approach a lower asymptotic level. Because of the consistent picture which began to emerge, the question arose as to whether blood pressure might be a reliable physiological correlate of the relaxation-anxiety dimension.The more specific questions emanating from this issue were: what effect does progressive relaxation have on the blood pressure levels of normotensives; what effect does stress have on the blood pressure levels of normotensives; and, what effect does stress have on the blood pressure levels of essential hypertensives? Since we could not immediately foresee the benefits that would outweigh the potential harm that might arise by placing hypertensives under stress, this study was limited to addressing the first two questions.Since the blood pressure levels of normotensives are probably at an optimal level for the physiological functioning of the organism, lower levels would be physiologically nonadaptive. and thus progressive relaxation should not lower the blood pressure levels of normotensives as it does those of essential hypertensives. On the other hand, if the elevated blood pressure levels of essential hypertensives are at least in part the result of a stress reaction, it would be expected that the blood pressure levels of normotensives might rise under stress conditions.     

The Potential of Relaxation Training for the Hyperkinetic Training for the Hyperkinetic Trainable Mentally Retarded Child

The literature addressing relaxation training for retarded individuals is limited. Adding to the controversy over the benefits of relaxation training is the failure of many researchers to document levels of relaxation through physiological measures. The following single-subject study was designed to determine if relaxation techniques could be learned by a hyperkinetic, moderately retarded child based on a predetermined criteria, and the extent to which these techniques resulted in quantifiable muscle relaxation. The child was able to learn the relaxation techniques to criteria within five sessions. Reduced levels of muscle tension as indicated by an electromyogram were evident during relaxation training sessions when compared with baseline sessions. Implications of these techniques for classroom use are discussed.     

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.     

The role of physiological attention-focusing in the relaxation treatment of sleep disturbance,general tension,and specific stress reaction

Three experiments comparing the effects of muscle tension-release relaxation with vs without physiological attention-focusing and no-treatment on (a) sleep disturbance, (b) general tension, and (c) a variety of time estimation, heart rate perception, and stress reaction measures, are reported. The two relaxation conditions produced equivalent reductions in latency to sleep onset reports, suggesting the importance of tension-release in the relaxation treatment of sleep disturbance. Relaxation without physiological attention-focusing was unexpectedly superior to the other relaxation condition in reducing reported daily tension, supporting Denny's (1976) hypothesis that pervasive anxiety may be a function of anxiety conditioned to relaxation-produced cues. Sleep disturbed subjects over-estimated elapsed time, and relaxation training improved accuracy of time estimation. Several additional differences between sleep and tension subjects and among the three treatment conditions on physiological activity during stress are reported and discussed.     

How to relax and how not to relax: A re-evaluation of the work of Edmund Jacobson—I

Jacobson's method of progressive relaxation is contrasted with modified techniques that emphasize suggestion, brevity and the feeling of large contrasts between tension and relaxation. The experimental literature is reviewed, and suggests that the modifications may have been premature. The psychophysiological effects of suggestion are weaker than those of progressive relaxation. Tape-recorded instruction appears to be completely ineffective as a method for teaching relaxation as a skill that can be used across situations. Live training contributes more than simple feedback to Ss. Its effectiveness may lie in individualized adaptation of training technique. EMG biofeedback makes taped training more-effective, but contributes nothing to intensive live training. Despite its greater length, Jacobson's original technique is preferred to the modified techniques, particularly for cases where psychophysiological effects are important. Length of training does not, by itself, appear to be a critical factor.     

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.     

Self-control progressive relaxation training as an alternative nonpharmacological treatment for essential hypertension: therapeutic effects in the natural environment.

Two clients with 3 and 5$\text{1}\text{2}$ yr history of essential hypertension were successfully treated using self-control progressive relaxation training (PRT). Blood pressure was self-recorded twice daily in the natural environment by each client. The natural environment blood pressures of both clients declined during treatment and stabilized within the normotensive range. Blood pressure reductions were maintained at six months follow-up for one client and two months for the other.     

Effects of metronome-conditioned relaxation,metronome-induced relaxation,and progressive muscle relaxation on insomnia

Although several controlled studies have indicated that relaxation can be effectively employed in the treatment of insomnia (Borkovec and Fowles, 1973; Steinmark and Borkovec. 1974; Haynes et al., 1974), the relaxation training procedures thus far utilized have typically necessitated several hours of therapist-client contact. The possibility of a more efficient relaxation procedure for treating insomniacs suggests an attractive alternative to the tense-relax instructions of progressive muscle relaxation (Jacobson, 1938). Brady (1973) has reported that the sound of a metronome set at 60 beats per min is inherently relaxing, and although he has only reported on the effects of the metronome when paired with verbally-induced relaxation (both general suggestions of relaxation and instructions to tense and relax successive muscle groups), he has successfully employed this technique in the treatment of borborygmi (rumbling noises in the abdomen) and essential hypertension (Brady, 1973; Brady, Luborsky and Kron, 1974). If the sound of the metronome alone, which would require minimal therapist-client contact, is sufficient to induce relaxation, the efficiency with which relaxation can be achieved in the treatment of insomnia, as well as other tension-related disorders. may be greatly enhanced.The present study was designed to assess the relaxation-inducing properties of (a) Brady's metronome-conditioned relaxation (metronome plus verbal relaxation instructions), (b) progressive muscle relaxation and (c) metronome-induced relaxation (the sound of a metronome alone) in the treatment of insomnia. In order to provide an evaluation of the effectiveness of relaxation techniques with a broader population than was sampled in previous investigations of this nature, this study included employed adults as well as college students in the subject pool. In addition to its implications for treating insomnia, this study was designed to yield an independent test of the hypothesis that a 60 beat per min metronome sound has the capacity by itself to induce relaxation.     

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.     

Treating insomnia with a self-administered muscle relaxation training program: a follow-up.

22 subjects seeking psychological help for problems of insomnia were trained to use a self-administered treatment package which contained a booklet explaining the problem and outlining the training program in detail and a tape with three versions of progressive relaxation training. A follow-up study one year later indicated that 90% of the subjects had trained according to the instructions and that 82% experienced a positive effect on sleep both with respect to falling asleep, staying asleep, and consumption of sleeping pills. It was concluded that self-administered relaxation training seems a cheap, convenient, and effective means of treating insomnia.     

Reciprocal inhibition of a laboratory conditioned fear

Electric shock was used to establish a conditioned fear in 48 college Ss, who then received either deep muscle relaxation training, cognitive relaxation training or anxiety relief conditioning. Relaxation was conditioned to a slide of the word NOW and the aversive stimulus was a pure red slide. The compound stimulus NOW on a red background was presented to generate counterconditioning, followed by a re-presentation of pure red as a measure of transfer. GSR and Blood Volume Pulse were recorded for evaluation of the fear reduction generated by each training procedure. All group differences were non-significant. The two relaxation procedures were equally effective, while the Anxiety Relief group manifested consistently smaller response-reduction. Implications and the usefulness of the paradigm were discussed.     

Sequential comparisons of relaxation training and biofeedback in the treatment of three kinds of chronic headache or,the machines may be necessary some time of the time

Two studies are reported in which patients with chronic headache, who did not improve significantly as a result of a 10-session, 8-week relaxation training program, were subsequently treated with biofeedback. For the tension headache sufferers, 36% of the relaxation non-responders showed significant improvement with frontal EMG biofeedback training. For those with vascular headaches, 44% of the relaxation non-responders showed significant improvement with thermal biofeedback. Vascular headache patients with combined migraine and tension symptoms did better than those with only migraine. Psychological test scores significantly differentiated successful vs non-successful biofeedback responders.     

The Effects of Progressive Muscle Relaxation on the Behavior of Autistic Adolescents:

Five autistic adolescents were trained in the use of progressive muscle relaxation to determine the effects of the relaxation training on task-oriented, disruptive, and stereotypic behavior, in a structured academic session. Each academic session was 12 minutes in length. Prior to each session, the children engaged in one of two activities with the relaxation trainer for 10 minutes, i.e., the practice at relaxation or a Simon-says game. Measures of disruption, on-task, and academic rate were gathered in the 12-minute academic session. In addition, a relaxation checklist was used to determine the extent to which the child was relaxed in the relaxation sessions. The results gave little evidence of differential effects as a consequence of the relaxation procedures on any of the dependent measures. The addition of relaxation cues during academic sessions failed to produce any change in the children's behaviors.     

A single session of meditation reduces of physiological indices of anger in both experienced and novice meditators

The goal of the present study was to explore how anger reduction via a single session of meditation might be measured using psychophysiological methodologies. To achieve this, 15 novice meditators (Experiment 1) and 12 practiced meditators (Experiment 2) completed autobiographical anger inductions prior to, and following, meditation training while respiration rate, heart rate, and blood pressure were measured. Participants also reported subjective anger via a visual analog scale. At both stages, the experienced meditators’ physiological reaction to the anger induction reflected that of relaxation: slowed breathing and heart rate and decreased blood pressure. Naïve meditators exhibited physiological reactions that were consistent with anger during the pre-meditation stage, while after meditation training and a second anger induction they elicited physiological evidence of relaxation. The current results examining meditation training show that the naïve group’s physiological measures mimicked those of the experienced group following a single session of meditation training.