Relaxation techniques are an integral part of treating mental health disorders and other conditions like headaches. They are also effective for reducing stress and play an important role in preventive healthcare.
Widely recognized methods include progressive muscle relaxation (PMR) by Jacobson, autogenic training, biofeedback, and modern hypnosis. Additionally, various forms of meditation and imaginative techniques (based on visualization) have relaxing effects. Many of these methods originate outside Western cultures, such as yoga or Zen practices.
Progressive Muscle Relaxation
Progressive muscle relaxation is not only the easiest to learn but also the most thoroughly researched method, making it generally preferable to other techniques. However, other methods may also be beneficial for individuals.
American physiologist Edmund Jacobson (1885–1976) developed progressive muscle relaxation, discovering in 1929 that muscle tension increases with feelings of restlessness or excitement. Conversely, anxiety can be reduced by decreasing muscle tension. While the original method required over 50 sessions to master, simplified versions are now available and can be learned in just a few hours.
Principle of Progressive Muscle Relaxation
A muscle group can be effectively relaxed by first intentionally tensing it. Progressive muscle relaxation leverages this effect: as relaxation moves from one muscle group to another, it triggers further relaxation throughout the body. This process can lower blood pressure, slow heart rate and digestion, and promote calmer breathing.
Performing Progressive Muscle Relaxation
The exercises are performed either lying down or in a comfortable chair. One muscle group at a time is worked on by tensing it, holding the tension briefly, and then releasing it—starting with the right hand, moving through the arms, face, neck, back, abdomen, and finally the legs and feet. Throughout, attention is focused on the sensations associated with muscle activity during both tension and relaxation.
During training, participants learn to distinguish between normal and excessive tension, developing a conscious awareness of their body. In advanced stages, similar to autogenic training, participants focus on the sensations of “letting go” to enable relaxation in daily life situations.
Applications of Progressive Muscle Relaxation
This method is used as a supportive treatment for many psychological and physical disorders. It is often included in systematic desensitization, where a patient gradually confronts fear-inducing objects or situations while using relaxation techniques.
Progressive muscle relaxation promotes calmness and serenity, helps manage certain types of sleep disorders, and generally improves stress tolerance. It is especially suitable for patients who are nervous or internally restless.
When addressing sleep disorders, it is important to first master the technique before using it in challenging situations. This means the individual should have prior experience successfully achieving a relaxed state during high tension. Only then does it become effective for managing insomnia caused by restlessness or nervousness (though not all sleep disorders involve these factors).
Additionally, progressive muscle relaxation is effective for chronic pain, with proven benefits for chronic tension headaches.
Because it is the easiest relaxation technique to learn, it is also helpful for hyperactive or restless children. However, it is not recommended for individuals with acute psychosis, muscle disorders, or muscle cramps.
Autogenic Training
Autogenic training is another widely practiced relaxation method in Germany, though it is less well-researched compared to progressive muscle relaxation (PMR). It is also harder to learn, making it less universally recommended.
Autogenic training was developed in 1932 by the German physician Johannes H. Schultz (1884–1970), who had extensive experience with hypnosis and understood the power of suggestion. Schultz aimed to create a method of self-induced relaxation through mental influence.
Principle of Autogenic Training
Autogenic training is a form of self-hypnosis designed to shift physical and autonomic functions (such as blood circulation, heart rate, and breathing) into a state of rest. Unlike PMR, where relaxation is achieved indirectly through voluntary muscle tension, autogenic training uses focused mental concentration to induce calm directly.
Practicing Autogenic Training
Exercises are performed in specific postures, such as the “coachman’s posture” while sitting or lying down. Guided by phrases like “I am completely calm” or “My left arm is very warm,” thoughts and visualizations are directed to specific sensations. By repeating these phrases multiple times—ideally after some practice under guidance—a state of relaxation eventually occurs automatically.
Basic Exercises (First Phase: Lower Level)
This phase focuses on influencing physical processes. Key exercises include:
- Heaviness Exercise: Starting with one body part, the sensation of heaviness is practiced, eventually extending to the whole body for general relaxation. Example phrase: “My right arm is very heavy.”
- Warmth Exercise: The sensation of warmth begins with one body part and spreads throughout the body, promoting vasodilation and calming effects. Example phrase: “My right arm is very warm.”
- Heart Exercise: Concentrating on the heartbeat helps calm it. Example phrase: “My heart beats calmly and regularly.”
- Breathing Exercise: This stabilizes breathing frequency. Example phrase: “My breathing is calm.”
- Solar Plexus Exercise: Focuses on relaxing and harmonizing the digestive organs. Example phrase: “My solar plexus feels radiantly warm.”
- Head Exercise: Visualization creates a sensation of a cool, clear head. Example phrase: “My forehead is pleasantly cool.”
Advanced Exercises (Second Phase: Upper Level)
This phase involves a waking-dream technique, where imagined images are brought into awareness and reflected upon. This technique promotes deeper self-awareness and, under a psychotherapist’s guidance, can aid in conflict resolution and identifying new solutions.
Application of Autogenic Training
Autogenic training is used for many psychological and psychosomatic disorders. The method aims to promote calmness, relaxation, and improved concentration. It enhances stress tolerance and is effective for managing chronic pain. However, it should be used cautiously in cases of excessive physiological dysregulation (e.g., heart palpitations, fainting spells). Imaginative techniques associated with autogenic training are unsuitable for patients with psychoses.
Biofeedback
Similar to autogenic training, biofeedback involves learning to consciously influence involuntary bodily functions. This is achieved by using electronic devices to make these functions perceptible. For example, muscle activity can be measured with surface electrodes, amplified, and converted into visible or audible signals. This feedback allows individuals to understand their muscle tension and consciously adjust it through focused thought.
The method is most commonly used to measure skin resistance for reducing muscle tension and to control breathing for relaxation. Using technological tools, biofeedback can also enhance blood flow, regulate heart rate, or influence the activity of the cerebral cortex.
Modern Hypnosis
Hypnosis is one of the oldest methods incorporated into psychotherapy. It was practiced as a technique of suggestion in ancient Egypt, demonstrating an early understanding of influencing a person’s thoughts, emotions, will, and actions. Modern hypnosis is a short-term therapy that works quickly and effectively to achieve targeted results.
Principle of Modern Hypnosis
Hypnosis induces a state of altered consciousness (trance) in patients, while autonomic body functions (e.g., breathing) shift toward relaxation. This state of focused awareness allows the therapist to make targeted suggestions based on the patient’s illness or symptoms. Despite feelings of heaviness and drowsiness, hypnosis is not a sleep-like state, as confirmed by electroencephalogram (EEG) readings.
Conducting Modern Hypnosis
As with any therapy, hypnosis should be preceded by a thorough physical and psychological examination. An initial informative conversation is crucial for building trust between the therapist and the patient.
There are several techniques for inducing a trance state:
- One approach involves soothing verbal suggestions delivered in a monotone voice to convey calmness, warmth, and increasing drowsiness.
- Another common technique is the fixation method, where the patient focuses intently on a small nearby object, gradually tiring their eyes and leading to a trance state.
The therapist’s repetitive voice and monotonous, vivid imagery narrow the patient’s awareness, relax their muscles, and cause blood vessels to dilate.
At the end of a hypnosis session, the trance state is reversed to prevent any unwanted aftereffects, such as lingering drowsiness.
Applications of Modern Hypnosis
Hypnosis can be helpful for certain psychological and physical conditions or for addressing specific symptoms such as headaches, anxiety, or trembling. It is often used in pain management and for preparing patients for surgery. Additionally, hypnosis can sometimes uncover unconscious memories. However, it is not recommended for patients with psychoses.
Occupational Therapy in Psychiatric Treatment
Occupational therapy supports and guides individuals of all ages who are limited in their ability to function or are at risk of such limitations. The goal is to help them engage in meaningful activities related to self-care, productivity, and leisure within their personal environment.
Occupational therapy is offered in various settings:
- Inpatient: Within psychiatric and psychotherapeutic clinics.
- Partial Inpatient: In day clinics.
- Outpatient: In private practices or social psychiatric outpatient services.
Treatment can take the form of individual therapy, small group sessions, or larger group therapy, depending on the patient’s needs.