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Relaxation Techniques

  1. Introducing Relaxation Techniques
    1. The Acute Stress Response / Fight-Or-Flight
    2. The Relaxation Response
    3. When Should Relaxation Skills Be Used?
    4. Practicing Relaxation Skills
  2. Deep Breathing
  3. Progressive Muscle Relaxation
  4. Visualization
  5. Mindfulness Meditation
  6. References
Relaxation Techniques

Relaxation skills are excellent tools for the treatment of stress, anxiety, and anger. In addition to being easy to use, relaxation techniques are some of the few tools that offer an immediate sense of relief from the symptoms of mental illness.

Over time, therapists develop their own scripts, tips, and tricks for teaching relaxation skills more effectively. In this guide, we share some of the knowledge that we’ve built from a combination of on-the-job experience and a review of scientific research. We’ve also put together some helpful relaxation audio clips, worksheets, scripts, and other tools, which you’ll find below.

Introducing Relaxation Techniques

Without basic knowledge of the stress response, relaxation skills lack context. They seem like tricks that feel good, but don’t serve a broader purpose. For this reason, psychoeducation about the acute stress response (“the fight-or-flight response”), and your client’s unique needs, is an excellent place to begin.

The Stress Response / Fight-Or-Flight

The fight-or-flight response is a reaction to perceived danger, whether that danger is real or not. It’s important to note that “danger” does not only apply to physical threats, but also threats to emotional well-being. For example, the fear of embarrassment could trigger the fight-or-flight response prior to giving a speech.

The fight-or-flight response prepares your body to confront (“fight”) or flee (“flight”) a threat by triggering several physiological changes, or symptoms.

    Symptoms of Fight-or-Flight
  • Increased heart rate
  • Sweating
  • Rapid, shallow breathing
  • Difficulty concentrating or thinking straight
  • Shaking
  • Tensed muscles

Although the symptoms of the fight-or-flight response are an important part of protecting us from danger, they can cause problems when they’re too extreme, or when they occur in the wrong situation. Many stressors—such as exams, presentations, or an argument with a partner—are easily made worse by a strong fight-or-flight response.

Tip: There are a lot of ways to describe the fight-or-flight response, but our favorite is the metaphor of the “reptile brain”. Try describing the fight-or-flight response as the primitive part of a person’s brain kicking into full gear, where the only goal is survival. The higher “thinking brain” is turned off, and the body just reacts… sort of like a reptile.

The Relaxation Response

In opposition to the fight-or-flight response is the relaxation response. As you might imagine, the relaxation response puts your body at rest, and counteracts many symptoms of the fight-or-flight response. Relaxation techniques are used to trigger this response.

Technically, the fight-or-flight and relaxation responses are not exact opposites. Some of their symptoms are unrelated, or even complementary with one another. However, in the case of relaxation versus anxiety, we can safely focus on the symptoms that are in opposition.

Tip: When explaining the fight-or-flight and relaxation responses, try using the example of driving a car. At the height of the fight-or-flight response, you are speeding ahead, much too fast. Putting your foot on the brake is analogous to using a technique to trigger the relaxation response.

When Should Relaxation Skills Be Used?

After discussing the stress and relaxation responses, your client should learn how these concepts apply to their specific situation. Are they experiencing anger, anxiety, stress, or fear? What symptoms do they experience when these emotions arise?

The more insight your client has developed about their symptoms, the better. Without the ability to recognize triggers and warning signs, you may find that they have difficulty remembering to use their relaxation skills until it’s too late.

Triggers and warning signs naturally lead into a discussion of when, specifically, relaxation skills should be used. Does your client feel nervous in the mornings before school, or maybe right before giving a presentation at work? Do they feel a steady level of stress all day? Not only will this conversation help your client learn when to use their skills, it will help you determine what skills are a good fit.

Tip: Deep breathing probably won’t be enough to end an episode of rage at its peak, but it can stop that same rage from ever occurring. A discussion about triggers and warning signs will go a long way in preventing these episodes from ever occurring. A CBT thought log is one excellent tool for building this form of awareness.

Practicing Relaxation Skills

Therapy sessions provide the perfect opportunity to teach new relaxation skills, but a few minutes of practice each week is not enough to see real benefits. We suggest that clients practice not just once in session, but regularly over the course of many sessions. Additionally, collaborate with your client to create a plan for them to practice every day at home.

Be sure to provide your client with the tools they need to practice effectively at home. This could be a script for progressive muscle relaxation, a deep breathing video, or a copy of audio exercises that they can listen to at any time.

Deep Breathing

Deep breathing (also known as diaphragmatic breathing, belly breathing, or abdominal breathing) is one of the most versatile and easy-to-use relaxation skills. Additionally, the discreet nature of deep breathing makes it a good choice for many situations.

Why Deep Breathing Works

The fight-or-flight response triggers symptoms throughout the body, including rapid and shallow breathing. Deep breathing works by deliberately taking slow and deep breaths, which reverses this symptom, and triggers a relaxation response.

When taking deep breaths, our bodies are better able to exchange carbon dioxide for oxygen, which results in a slower heart rate, lower blood pressure, and, consequently, a feeling of relaxation.

In addition to altering the body’s flow of oxygen, deep breathing acts as a form of distraction from the source of negative emotions. It’s similar to the old idea of “counting to 10”, with other helpful benefits thrown in.

    How to Use Deep Breathing
  1. Sit back in a comfortable position. You can close your eyes, but it isn’t necessary. TIP: When learning to use deep breathing, try placing one hand on your abdomen so you can feel it rise and fall with each breath. This will get you in the habit of taking large breaths, filling your lungs.
  2. Breathe in slowly through your nose. Time the inhalation to last 4 seconds. It's fine to go even slower, if you prefer.
  3. Hold the air within your lungs, but not to the point of strain. 4 seconds is a good target to aim for.
  4. Pucker your lips, and slowly exhale through your mouth. Time the exhalation to last 6 seconds. TIP: For practice, try exhaling through a straw. This will get you in the habit of exhaling slowly.
  5. Repeat the breathing cycle for at least 2 minutes. Practice for 5 to 10 minutes for greater benefits.

Deep Breathing Tips

Naturally, many people take fast and shallow breaths. It’s easy to fall back into that habit, even in the middle of deep breathing practice. Stress the importance of timing every inhalation and exhalation. Try watching the second hand of a clock or listening to an audio relaxation tool if you have difficulty timing yourself.

Although deep breathing is often used to counter the fight-or-flight response in the moment, it should also be practiced during periods of relaxation. The positive effects of deep breathing can generalize, and reduce anxiety even hours later. Additionally, frequent practice will help you become better at the skill for when you really need it.

Progressive Muscle Relaxation

Progressive muscle relaxation (PMR) requires a greater time investment than deep breathing, and it’s a bit less discreet, but its effects can be very powerful. During PMR, you will tense and then relax small groups of muscles in your body, one-by-one. This process will teach you to recognize what tension feels like, and practice releasing that tension from your muscles.

Why Progressive Muscle Relaxation Works

During the fight-or-flight response your muscles will unconsciously become tense. If you make a point to pay attention, you feel this change all throughout your body. With enough time, this tension can cause muscle pain and soreness.

PMR works by increasing awareness of the tension that occurs during stress, and then consciously releasing that tension. This process creates a feeling of relaxation—both physically and emotionally.

    How to Use Progressive Muscle Relaxation
  1. Sit back or lie down in a comfortable position. Close your eyes if you’re comfortable doing so.
  2. Beginning at your feet, notice how your muscles feel. Are they tense, or relaxed?
  3. Tightly tense the muscles in your feet by curling your toes. Hold the tension for 5-10 seconds.
  4. Release the tension from your feet, and allow them to relax. Notice how different the states of tension and relaxation feel.
  5. Move up your body, repeating the cycle of tensing and relaxing each group of muscles. Be sure to practice on the following groups of muscles: legs, pelvis, stomach, chest, back, arms, hands, neck, and face.
  6. Practice daily. PMR does not have to be used “in the moment” because its positive effects are long lasting, but it should be used regularly.

Regular practice of PMR will create a lasting feeling of relaxation that extends beyond the 5-10 minutes it takes to complete the exercise. PMR is a bit more complicated than some other relaxation techniques, and it’s suggested that you use an audio or video aid if you are practicing alone.

Visualization / Guided Imagery

Visualization uses the power of the mind to evoke positive emotions. It works, quite simply, by imagining a relaxing scene in great detail. Maybe it sounds silly, or too simple, but trust us: it works.

Why Visualization Works

Here’s something you can try now: Think of your favorite food. Really think about it. Close your eyes, and imagine it’s sitting on the table in front of you. Imagine how its smell, texture, and taste. Don’t just think about it for a few seconds and move on. Imagine the food as if it’s real.

If you were at least a little bit hungry, you probably just became hungrier. Maybe your mouth is even watering. This example shows us the direct connection between our thoughts and our bodies. Visualization takes advantage of this same phenomenon to influence our emotional state.

Tip: Another example to help clients understand visualization is the effect that books and movies can have on our mood. Have you ever felt sad after watching a depressing movie? Of course, we don’t actually experience the sad events of movies, but the mere thought of them has an emotional impact.
    How to Use Visualization
  1. Sit back or lie down in a comfortable position. You’ll get the best results if you close your eyes for this technique, but you don’t have to.
  2. Think of a place that’s calming to you. Some ideas are a warm beach, a secluded mountaintop, or a cozy coffee shop.
  3. Begin to imagine your chosen scene. Don’t just think about it in passing—really imagine the scene. Imagine what you would see, hear, smell, feel, and taste. For example, if you choose a beach, imagine the way the sand feels between your toes, the sound of waves crashing on the shore, and the smell of salty air.
  4. Set a timer for 5-10 minutes and allow yourself to get lost in the scene. Remember that this time is about your relaxation and nothing else.

Mindfulness Meditation

Jon Kabat-Zinn—a leader in the field of mindfulness and health—has defined mindfulness as "paying attention in a particular way: on purpose, in the present moment, and non-judgmentally." This means consciously paying attention to our senses and our feelings, without further judgement.

Mindfulness meditation is one exercise of many based upon the idea of mindfulness. In mindfulness meditation, you will focus on the present moment by turning your attention toward the cycle of breathing, and all the sensations that come with it.

    How to Use Mindfulness Meditation
  1. Find a comfortable place to sit, with few distractions. If you are sitting on the floor, cross your legs. If you’re in a chair, place your feet on the ground. Sit in an upright, but comfortable position.
  2. Turn your attention toward your breathing. Try to notice everything about it, from the feeling as it travels through your nose or mouth, to the sensation of it filling your lungs. Notice how it feels when you exhale and the air slowly returns to the atmosphere.
  3. When your thoughts start to wander—which they eventually will—simply acknowledge that this has happened, and turn your focus back to your breathing. It’s natural that your thoughts will wander, and it might take a moment before you catch yourself.
  4. Set a timer, and practice! 5 minutes is a good starting point, but aim for longer practice sessions as you progress.

This wraps up our overview of relaxation techniques. Below, we’ve linked several resources below that didn’t fit into any of the previous sections. Good luck!

References

Bigham, E., McDannel, L., Luciano, I., & Salgado-Lopez, G. (2014). Effect of a brief guided imagery on stress. Biofeedback, 42(1), 28-35.

Harvard Health Publications: Harvard Medical School (2016, March 18). Relaxation techniques: Breath control helps quell errant stress response.

McCallie, M. S., Blum, C. M., & Hood, C. J. (2006). Progressive muscle relaxation. Journal of Human Behavior in the Social Environment, 13(3), 51-66.

Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General hospital psychiatry, 17(3), 192-200.
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