(5-6-15)
Handouts
“Trophotropic state”: generalized state of reduced physiological activity; awakened state of hypometabolic functioning
- Anxiety/arousal management techniques
- a number of techniques/procedures have been demonstrated to affect state arousal (and possibly, with repeated use, trait anxiety), to produce a “trophotropic state: generalized state of decreased psychophysiological activity: awakened state of hypometabolic functioning
- diaphramatic breathing and some other breathing techniques
- meditation, both mindfulness and focused meditation techniques
- relaxing mental imagery
- autogenic suggestions
- relaxation training
- hypnosis **
- exercise **
- biofeedback **
- anxiolytic, antidepressant, neuroleptic medications **
- Jacobson: Progressive Relaxation Training
- a number of techniques/procedures have been demonstrated to affect state arousal (and possibly, with repeated use, trait anxiety), to produce a “trophotropic state: generalized state of decreased psychophysiological activity: awakened state of hypometabolic functioning
- Anxiety control methods–Similarities (from Paul, 1969)
- 1. limited sensory intake
- 2. limited body activity
- 3. restricted (focused) attention
- 4. deliberately monotonous stimuli
- 5. altered body awareness
- 6. eyes closed
- 7. motivational instructions
- Uses of relaxation training
- 1. reduce chronic tension level in emotional disorders
- anxiety disorders
- somatoform disorders
- mood disorders
- 2. stress management/self-control–increased feeling of mastery
- 3. preparatory for additional therapy
- systematic desensitization, covert techniques, guided imagery, other behavior and imagery therapies
- 4. general health education
- 1. reduce chronic tension level in emotional disorders
- Screening:
- 1. Purpose of training clarified
- 2. Sensory handicaps
- 3. Motor handicaps
- 4. Psychosis
- 5. Paranoid ideation
- 6. Fear of loss of control/relaxation sensations aversive
- 7. Previous training/experience
- 8. Athletic experience
- 9. Caution: headache
- 10. Caution: back pain
- 11. Caution: contact lenses
- Rationale (from Bernstein & Borkovec, 1973):
- 1. procedure called progressive relaxation training
- 2. consists of learning to tense and release various muscle groups
- 3. essential part of learning to relax involves learning to pay close attention to the feeling of tension and relaxation in your body
- 4. learning relaxation is like learning other motor skills:
- a. it is not done to you, you are taught a technique you can use
- b. skill increases with practice
- 5. tension is used to produce relaxation
- a. strong tension is more noticeable and will help you learn to attend to these feelings
- b. initial production of tension produces some “momentum” that will carry muscles to deeper relaxation when released
- 6. questions?
- 7. demonstrate how to tense
- 8. release tension all at once when given the cue: “relax”, “calm”, “whatever”, rather than gradually
- 9. Once a muscle group is relaxed do not move it unnecessarily (except to make yourself more comfortable)
- 10. Do not talk to me during the session. If I ask for a signal, lift little finger of hand nearest me
- 11. inform of length of session and invite to visit rest room
- 12. remove constraining items
- 13. explain dimming of lights
- Physical Setting
- 1. lighting
- 2. body support
- 3. temperature
- 4. quiet
- Procedural
- 1. sequence
- 2. number of groups
- 3. trials (two usually)
- 4. timing (5-7″ tense, 30-40″ relax, 45-60″: relax)
- 5. patter
- 6. cues and instruction (signal system)
- 7. termination ritual
- Evaluation
- Inquiry: open ended to specific questions
- Observations: behavior during training, initial response to termination, recovery time
- clinician rating:
- -3 refuses to participate, terminates session
- -2 talks, moves, opens eyes, noncompliance, increased tension
- -1 some movement, eyes open intermittently, tense
- 0 no change in tension
- +1 some relaxation, breathing slows, compliant
- +2 good response, breathing slowed, jaw opens, hips rotate
- +3 deep relaxation, recovery phenomenon, time distortion
- clinician rating:
- SUD’s rating (Subjective Units of Disturbance) 0-100 or 0-10 (completely relaxed to panic attack), pre- post-ratings
- Problems
- 1. difficulty producing tension
2. movement
3. falling asleep
4. finding feelings of relaxation distressing
5. intrusive thoughts- benign: mind wanders
- disturbing: anxiety producing, sexual/aggressive content
- 6. emotional abreaction
- 1. difficulty producing tension
- Variations
- Jacobson tension-release cycles
- Relax Only (“passive relaxation”)
- Differential relaxation
- Cue conditioned relaxation
- Personal relaxing image
- Thought stopping and Cautela’s Self-Control Triad
- Group training
- Use of tapes and scripts