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.     

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.     

Initial relaxation response: contrasts between clinical patients and normal volunteers

The effectiveness of EMG biofeedback, progressive muscle relaxation, autogenic training, and self-relaxation were compared using a within-subjects design. Thirteen clinical subjects and 48 normal volunteers participated in 4 counterbalanced relaxation sessions using one of the techniques. Frontalis EMG and surface skin temperature were monitored throughout the sessions. For reducing EMG, biofeedback was more effective than the other three techniques. A significant interaction of treatment X subjects was found for changes in skin temperature. Clinical subjects had the greatest increase in skin temperature with EMG biofeedback and analog subjects responded best to self-relaxation. There were no significant differences in initial measures of EMG or skin temperature for the two samples.     

Promotion of creativity (divergent productions) and convergent productions by systematic-relaxation exercises: empirical evidence from five experimental studies with children,young adults,and elderly

Presented are the results of five experimental studies on the effects of systematic-relaxation exercises on divergent as well as convergent performance. Subjects were 40 elementary school children, 120 college students, and 52 elderly. In Experiments 1, 2, 4, and 5, subjects were assigned at random to either an experimental group (participating in a short systematic-relaxation exercise without pre-experience or exercising autogenic training which subjects had learned at least 6 months before) or to a control group (with unspecific relaxation instructions). In Experiment 3, subjects with against without experience of autogenic training were matched for age, gender, years of study, and creativity pretest scores. Before and after systematic against unsystematic relaxation, subjects were tested for divergent performances (word fluency, associational fluency, expressional fluency, and ideational fluency) and convergent performances (short-term memory, concentration, and general intelligence). Results of all experiments consistently show significant improvements of divergent and—to a lesser extent—convergent performances in the experimental groups after systematic-relaxation exercises. These short-term effects of systematic-relaxation exercises are discussed with respect to characteristics and problems of divergent problem solving processes in individuals and groups. © 1997 by John Wiley & Sons, Ltd.     

Autogenic training within the therapeutic scope of schizophrenic patients]

The author calls the reader's attention to the rather strange fact that autogenic training, in spite of worldwide recognition and extensive uses of the method in various disciplines of medicine and spheres of live, has not so far been finding wide application in the medical specialty dealing with mental disorders. After discussing some possible causes of this situation and commenting on first signs of a necessary change in attitude toward autogenic training, he reports his own experience in the treatment of schizophrenic patients with this psychotherapeutic method, emphasizing the need for including psychotherapy in a complex concept of the treatment of psychoses.     

Objectifying the effect of autogenic training on disordered ventilation in bronchial asthma]

Forty-one persons suffering from asthma (aged 20 to 55; duration of disease: greater than or equal 2 years) were divided into 2 groups and participated in courses of instruction in autogenic training. The control group was comprised of 14 patients. The effects of autogenic training on the maximum rate of expiration as well as the limiting respiratory value were recorded. The control group showed a seasonal decrease in the maximum rate of expiration and the limiting respiratory value by 10 to 20% in the period extending from April through November. The autogenic-training patients showed a temporally similar increase in the maximum rate of expiration of 27 and 22%, respectively (the difference to the control group being 47 and 42%, respectively). In 35 patients the increase in the limiting respiratory value was equal to or greater than the effect produced by novodrine. Catamnesis after one year (n = 40): Absence from work in a twelve-month period was 663 days prior to autogenic training and 77 days (11.6%) subsequent to autogenic training. Accordingly, autogenic training may be considered to be an objectively effective component of a combination of therapeutical methods used in the treatment of bronchial asthma.     

BIOFEEDBACK,AUTOGENIC TRAINING,AND PROGRESSIVE RELAXATION IN THE TREATMENT OF RAYNAUD'S DISEASE: A COMPARATIVE STUDY

Twenty-one female patients suffering from diagnosed idiopathic Raynaud's Disease were trained to raise digital skin temperature using either autogenic training, progressive muscle relaxation, or a combination of autogenic training and skin temperature feedback. Patients were instructed in the treatment procedures in three one-hour group sessions spaced one week apart. All patients were instructed to practice what they had learned twice a day at home. Patients kept records of the frequency of vasospastic attacks occurring over a four-week baseline period, and during the first four weeks and the ninth week of training. In addition, patients underwent four laboratory cold stress tests during which they were instructed to maintain digital temperature as the ambient temperature was slowly dropped from 26° to 17°C. Cold stress tests were given during week 1 of baseline and during weeks 1, 3, and 5 of training. Results indicated that all patients improved during the first four weeks of training. No significant differences between the three behavioral treatment procedures were obtained. In addition, the ability of patients to maintain digital temperature during the cold stress challenge showed significant improvement from the first to the last tests. Symptomatic improvement was maintained by all patients nine weeks after the start of the training. The implications of these findings for the behavioral treatment of Raynaud's Disease are discussed.     

Critical procedural variables related to the physiological effects of progressive relaxation: a review.

Twenty-five investigations of the physiological effects of progressive relaxation training were classified according to whether relaxation was found to be superior or equivalent to control conditions. The two sets of studies differed significantly on number of training sessions and in the use of taped vs live administration of training, and they tended to differ in the use of normal vs patient samples. The likelihood of producing significant physiological reductions via progressive relaxation appears to be greater when multi-session, subject-controlled training is conducted with subjects for whom physiological activity contributes to a presenting. clinical problem.     

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.     

Limits, conditions and possibilities in the use of high level autogenic training in aerospace medicine

Initial results obtained by systematic training using high level autogenic training are presented. The use of this very demanding method for psychotherapy requires that the diagnosis given for the patients ist "neurotic development", that the course of treatment is long, that the basic technique of autogenic training has been mastered, and that the group can be used as a therapeutic factor. Patients who are stable when confronted with conflicts do not react to the demands represented by high level training in the same way as those who exhibit lability in conflict situations. The application of high level autogenic training to improve the psychological performance of subjects with a stable mentality still involves many problems.     

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.     

Effects of progressive relaxation and meditation on cognitive and somatic manifestations of daily stress

Meditation and progressive relaxation were compared with a self-monitoring control as treatments for symptoms of stress. Subjects were recruited from advertisements in local newspapers and received five sessions of training. All subjects self-monitored stress symptoms throughout the study and had their behavior rated weekly by a spouse/roommate. The progressive relaxation and meditation treatments resulted in a significant reduction of stress symptomatology over time. Little evidence was generated for differential effects of treatments.     

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.     

Transpersonal approaches to counseling

The transpersonal movement is concerned with expanding the personal boundaries of individuals to facilitate mind and body self-control through various unusual modes, such as autogenic feedback, hypnosis, yoga, and meditation. This article discusses transpersonal approaches to counseling with emphasis on the possibilities of using suggestion, relaxation, hypnosis, imagery, and dreams. The author offers a concept of transpersonal counseling in which children would be trained to control their own mental, emotional, and physiological processes.     

Progressive relaxation exercises and human gastric acid output—A study using telemetric measurements

The effect of progressive muscle relaxation exercises on human gastric acid output was examined using a modification of the Heidelburg Capsule pH telemetering equipment. Fourteen healthy subjects practiced the exercises eight times before the post-exercise acidity measures were compared with control periods in the same session. No mean difference in acidity was observed. It is suggested that gastric acid secretion is more related to cognitive rather than somatic activity. Eleven of the 14 subjects reported feeling physically relaxed yet 7 of these increased acidity. Gastric acid secretion is vagally mediated through the parasympathetic nervous system. Muscle relaxation is associated with lowered sympathetic arousal. It is possible that the relaxation exercises led to increased parasympathetic arousal concomitant with sympathetic lowering since the two systems frequently act antagonistically. Progressive relaxation training does not appear to be an effective method of decreasing gastric acid output.     

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.     

Progressive and imaginal relaxation training for elderly persons with subjective anxiety.

Elders exposed to either progressive or imaginal relaxation procedures reported significant relaxation effects and showed improvement on measures of personal functioning. The results of the Physical Assessment Scale of the Relaxation Inventory indicated that relaxation responses were acquired within and across sessions. Large, consistent changes in relaxation occurred in all 4 sessions. The Symptom Checklist-90-R, which measures self-reported personal adjustment, showed significant positive changes following relaxation training and at 1-month follow-up. Elders who imagined muscle tension release profited as much as those engaged in actual muscle tension-release activities. This finding is of importance for older adults who may experience physical limitations that contraindicate muscle-tension-release procedures.     

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 lateral effects of Dohsa-method relaxation on visual and auditory responses

The effects of relaxation training, using the Dohsa method, on visual and auditory responses were examined. Twelve college students underwent relaxation training either to the left shoulder, left side of the waist, and the left foot, or to the right side. The measures used in this study were weight-bearing, body perception and external perception, visual field, and visual and hearing acuity. Weight-bearing significantly increased for the foot undergoing relaxation training, compared with the untreated foot, indicating that the subjects stood more firmly on the ground on the relaxed foot. Subjects could also perceive positive changes in their "sense of standing firmly on the ground,""sense of activity in the body,""sense of muscular relaxation," and "sense of fullness in the abdomen" on the side of the body receiving relaxation training. There were positive changes in external perception such as "vividness of the external world,""breadth of the visual field," and "active impression of the external world" for subjects' vision on the side receiving relaxation training. Furthermore, visual and hearing acuity on the side on which relaxation training was administered improved significantly.     

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.