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Relaxation Training

(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
  • 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
  • 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
    • 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
  • 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
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