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(p. 19) Relax Your Body 

(p. 19) Relax Your Body
Chapter:
(p. 19) Relax Your Body
Author(s):

David H. Barlow

, Ronald M. Rapee

, and Sarah Perini

DOI:
10.1093/med:psych/9780199917532.003.0002
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date: 03 August 2020

Anyone who has experienced stress (and that’s everyone) knows that it can take a physical toll. When you are highly stressed, you spend much of your day feeling and acting tense. Eventually this “hyped-up” state becomes so familiar that you do not realize when you start tensing up. Instead, you feel only the end products of that tension: tiredness, headaches, or possibly back pain. Managing your stress means breaking this cycle of tension. To do this, our first mission is to help you identify the areas of tension in your body and then provide you with techniques to help you reduce that tension.

Identification

Tension, like stress, can be desirable at low levels. For example, you would not be able to write if you could not tense the hand that holds the pen. However, you do not need to tense your whole body, your neck, or your back just to write; your hand is enough. People who have a high level of general stress often tense their entire bodies when they need to tense only one or two muscles. For this reason, it is important to learn to isolate the various muscle groups in your body, so that you will know how each one feels when it is tense.

Reduction

Once you have learned how your various muscles feel when they are tense, you will be able to tell when they are tensing up needlessly. This is when you will want to reduce the unnecessary tension. Reducing unwanted tension (relaxation) is a skill that requires a great deal of practice. It is not some sort of “psychological Valium” or a handy crutch you can pull out when you are feeling (p. 20) uptight and then hide away until you need it again. Instead, relaxation must be practiced often—at least once a day at first, for 20 minutes each time. The results will be worth it.

You have probably heard of various relaxation techniques, all with catchy names designed to snare the consumer. Most of them work in much the same way. In fact, you may have already tried some of them. Research has not shown that any particular technique is best for any particular type of person or problem. The deep muscle relaxation technique we recommend here has been studied, researched, and clinically tested and has worked well for many people. Give it a chance to work for you. Remember that this is helping you build a valuable new skill. However, if you have a favorite relaxation technique that works for you, it is quite okay to stick with that. The key is not the particular technique itself—rather it is the regular, consistent practice that is important, together with incorporating relaxation into your life.

The rest of this lesson will show you how to practice deep muscle relaxation. Although no technique is a magic cure for all your troubles, relaxation is an important part of your stress management program.

Getting Ready to Practice

Think of a sport you enjoy—let’s use tennis as our example. Remember how clumsy you felt the first time you tried to hit that ball over the net? If you had quit then, as you might have wanted to, just think of all the pleasure you would have missed. It’s much the same with relaxation. You may not “get it” at first; you may feel as awkward trying to relax as you did trying to keep a tennis ball in play. But gradually, if you keep practicing, you will master the skill and become proficient in its use. Before you begin, there are some preparations you can make to create the right environment.

First, choose a time and a place to practice relaxation. If you use a calendar or planner, write it down. Remember to be specific. It is not advisable for you to try and sneak it into spare moments when you are likely to be interrupted. Instead, choose a time when no one else is around or when you can ask others not to bother you for about 20 minutes. Now select a place. Eventually you will be able to do your relaxation anywhere and at any time. But when you are just starting out, make it easy on yourself. Find a quiet room, pull the shades down, turn down the lights, and sit in a comfortable chair. A bed is okay as long as you don’t fall asleep. It is difficult to learn when you are sleeping! We recommend you practice the relaxation skill either before your day begins or toward the end of your day. You may need to get up a little earlier or go to bed a little later, but the few minutes of lost sleep will be well worth the effort.

Deep Muscle Relaxation

Deep muscle relaxation is a process of tensing, then relaxing, individual muscle groups. In this way, you will learn how each group of muscles feels when it is tense and when it is relaxed. You will then learn how to reduce unwanted tension in each one. We will begin with a large number (p. 21) of muscle groups and then, over the weeks, reduce the number, making your relaxation technique shorter and more portable. The chart below lists some of the major muscle groups and suggests ways of tensing them.

12 Muscle Groups: Suggestions for Tensing Muscles

Lower arm: Make fist, palm down, and bend at wrist toward upper arm.

Upper arm: Tense biceps, with arms by side, pull upper arm toward side. (Try not to tense the lower arm; let the lower arm hang loosely.)

Lower leg and foot: Point toes upward to knees.

Thighs: Push feet hard against floor.

Abdomen: Pull in stomach toward back.

Chest and breathing: Take a deep breath and hold it about 10 seconds, then release.

Shoulders and lower neck: Shrug shoulders and then bring them up toward ears.

Back of neck: Press head back against back of chair.

Lips: Press lips together but don’t clench teeth or jaw.

Eyes: Close eyes tightly but don’t close too hard (be careful if you have contacts).

Lower forehead: Pull eyebrows down (try to get them to meet).

Upper forehead: Raise eyebrows and wrinkle your forehead.

Do you have a quiet room and a comfortable chair? Okay, now you are ready to begin. First, spend a minute or two just settling deeper and deeper into the chair. Breathe slowly and evenly, in and out. Each time you breathe out, picture some of the tension leaving your body, like a bird gliding away. Close your eyes and keep breathing, slowly and smoothly. If closing your eyes makes you uncomfortable, you can start by keeping them open, focusing on one spot on the floor or wall.

When you feel calm and can concentrate, you are ready to start working with your muscles. Keep breathing evenly as you tense and relax each muscle group. Do not hold your breath!

Tense

Begin with your hands and lower arms. As you breathe in, make fists and tense your hands and lower arms. Tense them to about three-quarters of their maximum tension—enough so that the muscles feel tight, but not so much that they are painful.

Isolate

It is important to try to isolate the tension to the one area as much as possible. Therefore, when you tense, make a quick mental check of the rest of your body to make sure that other muscles (p. 22) are not tensing too. For example, when you tense your hands and lower arms, the tension should be restricted simply to these areas. At first, it is likely that you will also tense other parts of your body—your shoulders, stomach, legs—even your breathing may stop. If you notice this happening, try to intentionally relax all parts of your body except for the one or two muscles that you are trying to tighten, and keep your breathing smooth and even.

Concentrate

Keep breathing smoothly and normally. As you breathe, concentrate on the feeling in your hands and arms. Hold the tension for 10 to 15 seconds, about 2 or 3 breaths.

Flop

The next time you exhale, let the tension go. Relax the muscles quickly. You might want to think of your muscles as flopping, the way a rubber band does when you release it. Concentrate on the relaxed feeling. Notice how different relaxed muscles feel from tense muscles? Keep breathing normally. After three breaths or so, your muscles should be completely relaxed. You are now ready to start the process again, with the same muscles.

Break

After you have practiced tensing and relaxing your hands and lower arms two times, take a break for a minute or so. During this time, keep breathing slowly and evenly. Each time you breathe in, count to yourself (1, 2, and so on). Each time you breathe out, say the word “relax” to yourself. Try to picture the numbers and words in your mind as you say them to yourself. If your mind wanders away from the word, let your thoughts go and gently turn it back.

Continue

After a minute or so (around 10 to 12 breaths if you are relaxed), move on to another muscle group. For each group listed in the 12 Muscle Groups chart, repeat the process you used with your hands and lower arms: tensing the muscles for 10 or 15 seconds, then relaxing them for 30 seconds. Keep breathing evenly. Try to tense the muscles as you breathe in, and release them a few breaths later as you exhale. Tense and release each muscle group twice. Each time, focus on isolating the tension, concentrating on the feeling, and letting the muscles flop when you let go. It is important that you take a break after each muscle group, and relax for at least a minute before you start on the next one. These “between muscle” segments are really important and help you to build your concentration and focus away from your worries—a type of meditation. This will help you with a later exercise we will teach you—“staying present”.

(p. 23) Your entire practice session should take 20 to 25 minutes. When you finish the last muscle group, give yourself some time to slowly reconnect with the world. Relax all your muscles, then gently open your eyes. See how long you can keep the relaxed feeling as you go about the day’s activities.

Problems with Practice

Everyone knows the saying, “Practice makes perfect.” When you are first getting started, “perfect” may not describe your practice sessions. Here we will discuss five common difficulties our clients have faced as they began to practice relaxation and suggest ways of dealing with each of them.

Concentrating

Spending 20 quiet minutes alone is a luxury for most people. They have trouble keeping their minds on the task at hand—namely, learning to relax. If you find your mind wandering, do not despair. You are in good company; this is probably the most common problem people encounter and is a particular problem for people who are stressed. It is important to overcome it, however, so that when you are truly stressed, you will be able to clear your mind, concentrate, and relax.

Think of your attention as a muscle. Like any muscle in your body, it becomes weak when it is not used much, and it strengthens gradually as you exercise it. When you start relaxing, you will probably find that you don’t get very far in counting your breaths before you start to think of other things—your chores, the kids, what you are doing on the weekend, or your worries. When your attention wanders like this during practice sessions, try not to get angry with yourself. Simply let the extra thoughts that crossed your mind go—release them. You can think about them later; right now, you have more important things to do.

Deliberately turn your attention, as you would turn a car, back to the road of relaxation. Don’t worry about what number you were up to—just go back to the number “1” and start counting your breathing all over. The more you do this, the stronger your attention “muscle” will become. Once you start enjoying relaxation and as you become better at concentrating, your attention will wander less often. This exercise will help you get the most out of “staying present,” a technique we will introduce you to later.

Isolating Muscles

Some people find it difficult to tense one muscle group while keeping the rest of the body relaxed. The only solution to this problem is the obvious one: Keep trying! Like all skills, this one improves with practice. Try not to be too hard on yourself. You cannot perfectly isolate (p. 24) each muscle group because the muscles in your body are connected. If you have difficulty, lower your standards. If most of the muscles in your body are more relaxed than they usually are, and the muscle group you are working on is more tense than usual, that is fine. But if you find that when you tense your legs, for example, your arms, stomach, face, and breathing all tense up, then you need lots more practice.

Worrying about Time

Some people also find relaxation difficult because the whole time they are trying to relax, they are thinking about all the other things they should be doing. If you have a problem like this, then relaxation is exactly what you need! You purposely need to force yourself to spend time relaxing and, in this way, prove to yourself that the world does not end if you “drop out” for 20 minutes. The work will still be there when you finish, but you need to learn to take time for yourself. The more you do relax, the easier it will be to take time for yourself—worry free.

If you are having trouble stopping your worries or your mind wanders while you are trying to relax, remember to gently turn your thoughts back to your counting and the word “relax” or to concentrating on your muscles. With practice, you will get better at concentrating. If you are worried about spending too much time on your relaxation, you can set an alarm (quietly) for a particular time (say 20 minutes) and then can be assured you won’t go over. Eventually, you will find that you are even better at doing your other work when you feel relaxed.

Feeling Frightened

It sounds like a paradox. Some people feel even more stressed when they try to relax. If this is happening to you, it may be because the sensations you feel as your body starts to relax are unfamiliar. You may feel as though you are losing control, and—feeling uncomfortable—you stop. This is perfectly understandable. But it is important to realize that relaxing is not dangerous; in fact, it is healthy. Fear of losing control is one of the main reasons you may be having trouble with stress, so overcoming the fear is important. You may want to try experiencing the feelings of relaxation in gradual steps. For example, start trying to relax with your eyes open, or while a “safe” person is with you.

Consider the example of our case study, Joe. Joe found his work very stressful and spent much of his day in a tensed state. As a result, he often experienced backaches, shoulder pains, and headaches. Obviously, deep muscle relaxation would be a big help to him. But five minutes into his first relaxation session, Joe suddenly jumped up and started pacing. He told us he had felt as if he were falling, and his heart was thumping in a scary way. He didn’t like the feeling, so he ran away from it.

(p. 25) We worked out a plan with Joe. He began practicing relaxation by sitting straight up in a chair and keeping his eyes open, staring at a spot on the floor. Gradually he learned to relax this way. He then tried closing his eyes for 30 seconds or so, until he became accustomed to the feeling of relaxing with his eyes closed. Then, gradually, over the weeks, he settled deeper into his chair and closed his eyes for longer periods of time. Eventually he could do an entire 20-minute practice with his eyes closed.

Falling Asleep

Some people have the opposite experience from Joe. They are so relaxed that they fall asleep. If this happens to you, consider it a sign that you may be overtired. Try to get more sleep at night, and try to practice your relaxation at times when you are not as tired, such as the morning. You can also try practicing in a slightly less comfortable setting, sitting in a harder chair or on the floor. Sleep is important, but you are not going to learn much about relaxation if you sleep through your practice sessions.

How to Practice

We recommend that you practice your relaxation exercises at least twice a day for the full 20 minutes each time. It is a good idea to keep a record of your practice sessions so that you do not forget or procrastinate and so that you can chart your progress. Try using the Relaxation Practice Record on page 28. On this form you can record the date and time of your practice sessions and rate how tense you feel before and after you practice. Using the 0–8 scale, which should be familiar (p. 26) by now, rate the tension and how well you are able to concentrate during practice. Here we have provided Joe’s Relaxation Practice Record.

Relaxation Practice RecordPDF

Joe’s Relaxation Practice Record

Date

Time

Tension Before (0–8)

Tension After (0–8)

Concentration (0–8)

Comments

9/1

7:30 a.m.

5

6

2

Hard to concentrate—not sure if I’m doing it right.

9/2

1 p.m.

6

4

4

Felt better this time.

9/3

1 p.m.

7

6

3

Too stressed to concentrate.

9/4

8 p.m.

6

3

5

Able to focus more. Lots of tension in shoulders.

9/5

8:30 p.m.

5

3

5

Easier to do it when the kids are in bed.

Gradually, your tension level should drop and your concentration level should rise. If you encounter any problems during a session, or discover any techniques that work especially well, write them down on the chart so you will remember them next time.

In addition to your main practice each day, try to do some “mini practices.” When you have a few spare minutes—for example, on your lunch break, in the bathroom, at a traffic light, or during the commercials on television—try tensing and relaxing one or two muscle groups. In particular, work on the muscles that have been giving you the most trouble. Also, as you go through your day, pay attention to which muscles are tensing up, and try to relax them. Sometimes, just doing the meditation part of the exercise (breathing and counting) for 30 seconds or a minute can really help restore a feeling of calm.

Tasks for Step 2

  • Practice the relaxation technique at least once a day, every day, for at least 3 weeks.

  • Always fill in your Relaxation Practice Record.

  • For the first three or four relaxation sessions, reread this chapter before you commence.

  • Don’t forget to use mini relaxations between formal practices.

  • (p. 27) You may stop filling in your Stressful Events Record, but continue filling in your Daily Stress Record and Progress Chart.

  • Continue on to Step 3 in about a week, but keep practicing deep muscle relaxation.

(p. 28)