RELAXATION (CONTINUED)

 Tense-release

2 sessions are devoted to learning this version of progressive relaxation. The procedures are first demonstrated by the trainer and carried out by the trainee to ensure that they have been understood. A debriefing session follows. Participants are instructed to practice twice daily. They are asked to record the level of relaxation achieved using a 0-100 scale where, 0=total relaxation; 100=maximum tension; 50=normal. They are also asked to keep a note of the length of practice time taken to reach the level achieved.

Release only

In this phase of instruction, the tension part of the sequence is eliminated, leaving just the “release” part. As a result, the relaxed state can be achieved in less time than when working with the full sequence; 5-7 mins are suggested instead of the 15 of the tense-release sessions. The session is terminated like the previous one. Homework assignment is twice daily. The trainee is asked to record afterwards the level of relaxation achieved and how long it took to reach it.

Cue-controlled or conditioned relaxation

It is focused on breathing. It begins by asking the trainee to relax himself by employing the release only method of progressive relaxation. Once relaxed, he/she is asked to begin silently to recite the word “relax”, he/she recite it once each time he/she breathes only. Following many repetitions, an association is built up between capable of inducing a measure of relaxation. The word has thus become a cue; the stronger the association, the greater the power of the cue word. Expressed in other terms, a conditioning process has been set up, as a result of which the trainee feels himself relaxed whenever he thinks the word “relax”. Leading with the instructions of “inhale” and relax for 5 breaths, the trainer then asks the participants to continue on his own for a further 5 breathes after a few minutes rest, the full sequence is repeated. As the proficiency increases, the command “inhale” can be dropped and the word “relax” is used on its own. Participants must be warned against over-breathing, i.e. allowing the breathing to become deeper or more rapid.

Differential relaxation

In this stage we apply the skills previously learned. This technique focuses on controlling the levels of muscle tension while the individual is engaged in some activity. Although some tension is needed in order to carry out the task, the level is often greater than is necessary and may need to be reduced. There may be unnecessary tension in the muscles not directly engaged in the task. Since an ability to recognize muscle tension at its varying levels is essential for developing this skill, differential relaxation is presented after the individual has been trained in progressive relaxation. 2 sessions of tuition are indicated, one dealing with sitting and the other with standing activities (both sessions begin with a revision of cue-controlled relaxation).

Rapid relaxation

This component is designed to reduce still further the time it takes to become relaxed; it also gives the trainee opportunity to practice in everyday situations. The trainee’s environment is arranged so that a regularly used appliance acts as a cue to relax. For example, the wristwatch or phone is marked with colored dot which reminds the individual to relax whenever he/she sees it. Every time he/she looks at his/her watch or makes a telephone call he is reminded to release tension. Each time the dot is seen, the following is done: “take a slow breath, think relax, then exhale. Repeat this twice, scan the body for unnecessary tensions and release them.”

Application training

Applying relaxation skills to situations of potential stress is the subject of this phase. The trainee is provided with a range of opportunities in which to use the technique he has learned. Anxiety provoking situations should however be presented at a level of challenge which the trainee can cope with. As a preliminary, the individual could visualize himself successfully coping in the stress-provoking situation before exposing himself to the same event in real life.

Note- the above descriptions are only suggestions, the therapist can adopt according to the need of the patient.

RELAXATION

Relaxation is “a state of consciousness characterised by feelings of peace, and release from tension, anxiety and fear”.

The 3 aims of relaxation:

·        A preventive measure, to protect body organs from necessary wear and tear and in particular the organs involved in stress-related disease

·        A treatment, to help relieve stress in conditions such as essential hypertension, tension headache, insomnia, asthma, immune deficiency, panic and many others. Relaxation strategies may help to make the body’s innate healing mechanism more available.

·        A coping skill, to calm the mind and allow thinking to become clearer and more effective. Stress can impair people mentally, relaxation can help to restore clarity of thought. It has been found that positive information in memory becomes more accessible when a person is relaxed.

Deep relaxation:

1.   Procedures which induce an effect of large magnitude

2.   Carried out in a calm environment

3.   With the trainee lying down

4.   Examples- progressive relaxation and autogenic training.

Brief relaxation:

1.   Produces immediate effects

2.   Can be used when individual is face with stressful events

3.   The object here is the rapid release of excess tension

PROGRESSIVE RELAXATION

Edmund Jacobson, a pioneer in this field; his works lays the foundation of both the tense-release and passive approaches. Arising out of electromyography (EMG), he was able to demonstrate that thinking was related to muscle state and that mental images, particularly those associated with movement were accompanied by small but detectable levels of activity in the muscles concerned. Just as a calm mind would be reflected in a tension-free body, so Jacobson proposed a relaxation musculature would be accompanied by the quieting of thoughts and the reduction of sympathetic activity, notions that would have relevance in the treatment of anxiety and associated conditions. Muscle activity is accompanied by sensations so faint that we do not normally notice them. To promote awareness of tension, Jacobson emphasized the need to concentrate on those sensations, cultivating what he called “learned awareness”. Once tension had been recognized, it would be easier to release it.

Introducing the method- points to be included in psycho-education/ rationale for relaxation

·        resting enables body energy to be used more efficiently

·        it helps protect us from illness

·        by creating and releasing tension you will learn: to tune into subtle feelings in the muscles and to recognize different levels of tension and to release that tension

·        muscles that are unnecessarily tense reflect their tension in the mind. If that muscle tension can be released, you will feel mentally calmer.

·        Your internal organs will also benefit (pulse rate and Blood pressure will be lowered while you are relaxing)

·        It is not possible to learn it in 1 lesson; the more you practise, the more proficient you become.

APPLIED RELAXATION

The methods described previously are concerned with the induction of deep relaxation. Their purpose is to equip the individual with routines to be performed in the privacy. These methods are useful for unwinding after a stressful day, but may not however, provide strategies for coping with stress as it occurs. Goldfried (1971) recognized the extent of the gulf between relaxation in the therapeutic environment and relaxation in the stressful situation, focused expressly on the issues of the application of the skills. He emphasized the need for a portable and shortened form of progressive relaxation, a form that could use as a general coping skill in everyday life. In doing so, he gave the individual a new role, defining him as an active agent in his treatment rather than a passive client. The approach was called “training in self-control” because it implied active mastery of anxiety by the individual himself. The method consists of 6 components, in each of which a particular aspect of relaxation is taught:

1.   Tense-release technique

2.   Release only technique

3.   Cue-controlled (conditioned) relaxation

4.   Differential relaxation

5.   Rapid relaxation

6.   Application training