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Many people find that learning to relax helps them reduce worry and anxiety. It can also help improve sleep and relieve physical symptoms caused by stress, such as headaches or stomach pains. Learning to relax is a skill, and takes practice before it can be done properly.

The relaxation training protocol described here is known as Progressive Muscular Relaxation (PMR). Developed by Dr. Edmund Jacobson in 1939, PMR is widely followed to this day. It causes deep muscular relaxation in muscle groups which usually tense under stressful situations. Muscular tension produces aches and pains, particularly in the neck and back. For many individuals, the shoulder muscles provide a kind of internal thermometer for their level of tension. If you tell yourself regularly to "drop your shoulders," you’ll be surprised to find how often there is something to drop!

The PMR procedure teaches you to relax your muscles through a two-step process. First you deliberately apply tension to certain muscle groups, and then you stop the tension and turn your attention to noticing how the muscles relax as the tension flows away.

Through repetitive practice you quickly learn to recognize — and distinguish — the associated feelings of a tensed muscle and a completely relaxed muscle. With this simple knowledge, you can then induce physical muscular relaxation at the first signs of the tension that accompanies anxiety. And with physical relaxation comes mental calmness — in any situation.

The aim is to work systematically through the body, and it is usual to start with the hands, work up to the shoulders, then back to the feet and up to the shoulders again, leaving the face and neck for last. There is no reason to suppose that you have to rigidly stick to a particular order, but it might be difficult to start with areas in which physical and emotional tension seems to concentrate, such as the shoulders, neck and face.

Before practicing PMR, you should consult with your family physician in case you have a history of serious injuries, muscle spasms or back problems, because the deliberate muscle tensing of the PMR procedure could exacerbate any of these pre-existing conditions.

Procedure Proper

There are two steps in the Progressive Muscle Relaxation procedure:

  • deliberately tensing muscle groups
  • releasing the induced tension

Tension-Relaxation Procedure

Step One: Tension. The process of applying tension to a muscle is essentially the same regardless of which muscle group you are using. First, focus your mind on the muscle group; for example, your right hand. Then inhale and simply squeeze the muscles as hard as you can and hold to the count of 5; in the example, this would involve making a tight fist with your hand. Beginners usually make the mistake of allowing muscles other than the intended group to tense as well; in the example, this would mean that there will be a tendency to tense muscles in your right arm and shoulder along with those of the right hand. With practice you will learn to make fine discriminations among muscles; for the moment just do the best you can.

It’s important to really feel the tension. Done properly, the tension procedure will cause the muscles to start to shake, and you might feel some pain but don't over do it. Be careful not to hurt yourself, as compared to feeling mild pain. Contracting the muscles in your feet and your back, especially, can cause serious problems if not done carefully, i.e., gently but deliberately.

Step Two: Releasing the Tension. This is the best part because it is actually pleasurable. After the count to 5, just suddenly but gently let go. Let all the tightness and pain flow out of the muscles as you simultaneously exhale. In the example, this would be imagining tightness and pain flowing out of your hand through your fingertips as you exhale. Feel the muscles relax and become loose and limp, tension flowing away like water out of a faucet. Focus on and notice the difference between tension and relaxation.

The point here is to really focus on the change that occurs as the tension is let go. Do this deliberately, because you are trying to learn to make some very subtle distinctions between muscular tension and muscular relaxation.

Stay relaxed for about 15 seconds, and then repeat the tension-relaxation cycle. You’ll probably notice more sensations the second time.

It is of utmost important to coordinate your breathing with the tension relaxation cycle. Every time you let go, exhale and feel the tension go out from the concerned muscle group along with the outgoing breath. The breathing must be relaxed and preferably abdominal.

Muscle Groups

Here is an order that patients find easy to remember, so that they do not miss out on any muscle group.

  • Hands: Clench the fists; relax. Extend the fingers; relax.
  • Arms and forearms: Tense your biceps; relax. Tense your triceps (try to bend your elbow the wrong way); relax. Shake your hands as you are doing this, so that you do not tense your hands.
  • Shoulders: Breath in, hold your breath and raise your shoulders as if to touch your ears; exhale as you relax.
  • Feet: Screw up your toes; relax. Bend the toes up as far as possible; relax.
  • Front of legs: Point your foot away from you so that it is almost parallel with your leg; relax.
  • Back of Legs: Flex your feet upwards, stretching your heels down; relax.
  • Thighs: Extend legs and raise them about 15 cm. off the floor (don't tense the stomach); relax. Dig your heels into the floor; relax.
  • Bottom: Tense the buttocks tightly and raise pelvis slightly off floor; relax. Dig buttocks into the floor; relax.
  • Stomach: Pull in the stomach as far as possible; relax. Push out and tense the stomach as if you were preparing for a punch in the gut; relax.
  • Lower Back: Press the small of your back into the floor; relax.
  • Chest: Breath in, hold your breath and tighten all your chest muscles; exhale as you relax.
  • Shoulders: Breath in, hold your breath and raise your shoulders as if to touch your ears; exhale as you relax.
  • Neck (lateral): With the shoulders straight and relaxed, the head is turned slowly to the right, as far as you can; relax. Turn to the left; relax.
  • Neck (forward): Bend your head forward until your chin reaches the chest; relax.
  • Mouth: The mouth is opened as far as possible; relaxed. The lips are brought together or pursed as tightly as possible; relaxed.
  • Tongue (extended and retracted): With mouth open, extend the tongue as far as possible; relax (let it sit in the bottom of your mouth). Bring it back in your throat as far as possible; relax.
  • Tongue (roof and floor): Dig your tongue into the roof of your mouth; relax. Dig it into the floor of your mouth; relax.
  • Eyes: Open them as wide as possible (furrow your brow); relax. Close your eyes tightly; relax. Make sure you completely relax the eyes, forehead and nose after each the tensing.

During the first few days, you will spend about 15 to 20 minutes a day for PMR. With time and practice (usually 4 to 6 weeks), however, you’ll be able to shorten the exercise gradually. For example, you could try collapsing some of the muscle groups until you only work on your arms, legs, abdomen, chest and face. Ultimately, you will acquire something that will probably become an indispensable part of your daily life, and the initial drudgery of practice will be long-forgotten.

Here are some suggestions for practice:

  1. Always practice PMR in a quiet place, alone, with no electronic distractions, not even background music. Make sure you have switched off your handset.
  2. Remove your shoes and wear loose clothing.
  3. It’s best to practice before meals rather than after, for the sake of your digestive processes. Never practice after using intoxicants like alcohol.
  4. Lie down flat on your back, preferably on a firm mattress.
  5. When you finish a session, relax with your eyes closed for a few seconds, and then get up slowly.
  6. Some people like to count backwards from 5 to 1, timed to slow, deep breathing, and then say, “Eyes open. Supremely calm. Fully alert.”

Practice is a must

All relaxation techniques are essentially skills, and skills get better with practice. By practicing PMR regularly, you should be able to achieve a greater depth of relaxation in a shortened amount of time. Once mastered, you should be able to relax tense muscles on cue in many stressful situations.

Give PMR a shot! It only takes a few minutes out of your day - and the reward, the ability to more effectively manage stress, is well worth the investment.

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