Relaxation Instructions Research Articles

Effects of metronome-conditioned relaxation, metronome-induced relaxation, and progressive muscle relaxation on insomnia

Although several controlled studies have indicated that relaxation can be effectively employed in the treatment of insomnia (Borkovec and Fowles, 1973; Steinmark and Borkovec. 1974; Haynes et al., 1974), the relaxation training procedures thus far utilized have typically necessitated several hours of therapist-client contact. The possibility of a more efficient relaxation procedure for treating insomniacs suggests an attractive alternative to the tense-relax instructions of progressive muscle relaxation (Jacobson, 1938). Brady (1973) has reported that the sound of a metronome set at 60 beats per min is inherently relaxing, and although he has only reported on the effects of the metronome when paired with verbally-induced relaxation (both general suggestions of relaxation and instructions to tense and relax successive muscle groups), he has successfully employed this technique in the treatment of borborygmi (rumbling noises in the abdomen) and essential hypertension (Brady, 1973; Brady, Luborsky and Kron, 1974). If the sound of the metronome alone, which would require minimal therapist-client contact, is sufficient to induce relaxation, the efficiency with which relaxation can be achieved in the treatment of insomnia, as well as other tension-related disorders. may be greatly enhanced. The present study was designed to assess the relaxation-inducing properties of (a) Brady's metronome-conditioned relaxation (metronome plus verbal relaxation instructions), (b) progressive muscle relaxation and (c) metronome-induced relaxation (the sound of a metronome alone) in the treatment of insomnia. In order to provide an evaluation of the effectiveness of relaxation techniques with a broader population than was sampled in previous investigations of this nature, this study included employed adults as well as college students in the subject pool. In addition to its implications for treating insomnia, this study was designed to yield an independent test of the hypothesis that a 60 beat per min metronome sound has the capacity by itself to induce relaxation.

Electromyographic biofeedback and relaxation instructions in the treatment of muscle contraction headaches

To assess the comparative effectiveness of relaxation instructions and frontalis electromyographic (EMG) biofeedback in the treatment of muscle-contraction (tension) headaches, 21 volunteers were assigned to either a relaxation training group, a biofeedback group or a no-treatment control group. Each group met for six 1/2-hr sessions. The EMG biofeedback and the relaxation instructions resulted in significant decreases in reported headache activity. Both procedures were significantly more effective than the control procedure, but did not differ significantly from each other in effectiveness. The effectiveness of the two experimental procedures was maintained at follow-up. Frontalis EMG levels were higher during sessions in which a headache was reported than in sessions when no headache was reported. The importance of individual differences is emphasized.

The effect of relaxation instructions on erotic arousal in homosexual and heterosexual males

Sexual arousal in homosexual and heterosexual males was examined under control and relaxation conditions. Subjects were shown slides of males, females, and sexually neutral materials while penile circumference was monitored. Verbal ratings of physical sexual arousal and pleasantness were also recorded. Results showed there was no significant difference for penile responses to the nonpreferred sex and neutral slides. However, both homosexual and heterosexual subjects responded significantly more to their preferred sex under the relaxation condition than the control condition. Verbal ratings of sexual arousal and pleasantness did not discriminate between relaxation and control conditions but homosexual subjects' ratings of sexual arousal were significantly larger for slides of males than females and, in turn, larger for slides of females than neutral slides. All their pleasantness ratings were positive. Heterosexual subjects found only slides of females sexually arousing and rated slides of males as unpleasant.

Anxiety reduction through self-administered relaxation.

Possible usefulness of self-administered instructions for relaxation is illustrated by the case of a bright, 40-yr.-old male who reported chronic anxiety.

Differential effectiveness of electromyograph feedback, verbal relaxation instructions, and medication placebo with tension headaches.

Differential effectiveness of electromyograph feedback, verbal relaxation instructions, and medication placebo with tension headaches.

An audiovisual program for group desensitization

The responses of 102 subjects to 160 scenes, 80 fearful and 80 pleasant, were used in developing audiovisual hierarchies of 27 fearful and 27 pleasant scenes related to flying. A film was made presenting these scenes in pairs for automated treatment, each pair being preceded and followed by relaxation instructions.

Hypnosis and Slow Eye Movements

Abstract Electro-oculograms (EOG) were recorded from 12 male and 4 female college students following relaxation instructions and hypnotic induction instructions. The conditions were counterbalanced, Ss serving as their own controls. No significant differences were found between conditions or between high and low susceptible Ss in either slow eye movements (SEM) or SEM cones production.

Massed group desensitization in reduction of test-anxiety.

30 test-anxious nursing students were randomly assigned to either a massed desensitization, placebo, or control group. All treatment was applied in 3 2-hr. and 20-min. sessions over an 8-day period. The massed group desensitization sessions began with 20 min. of recorded relaxation instructions. The remainder of the sessions consisted of Ss visualizing items from a test-anxiety hierarchy while concentrating on remaining relaxed. The placebo group sessions began with 20 min. of a recorded presentation on the merits of good study techniques, concentration, learning, and personal efficiency. Lectures on these topics comprised the remainder of the sessions. The control Ss merely received the pre- and post-treatment measures. A significant difference ( p.01) was obtained on the posttest measure between the massed desensitization group and the placebo group and between the massed desensitization and control groups. The results of this study agree with earlier studies which indicate that massed group desensitization is an efficient and efficacious procedure for the reduction of anxiety based disorders.

The current status of systematic densitization.

Systematic desensitization is indicated for phobias, obsessions, compulsions, and anxiety reactions that are maintained by anxiety-reducing defense mechanisms. The technique involves instruction in deep muscle relaxation, construction of an anxiety hierarchy, and stepwise pairing of relaxation with imagined anxiety-provoking scenes. The basic principle is that relaxation is incompatible with anxiety. Relaxation can be induced by direct instruction, drugs, carbon dioxide, hypnosis, positive imagery, and a metronome-conditioned method. More than 100 outcome studies indicate that systematic desensitization produces significantly better results than a variety of comparison therapies.

Effect of instructions upon an autonomic response: an analogue of systematic desensitization.

Summary.-The purpose of this study was to explore the effect of different types of instructions on autonomic arousal. The instructions were presented to 42 Ss after a series of muluplicarion trials. The multiplication trials were defined as autonomic stressors, acd the recovery of autonomic responses was measured. Mental relaxation instructions resulted in superior recovery of skin resistance levels over other types of instructions (p < .01). The findings were interpreted as supporting Rachrnan's (1968) hypothesis concerning the lack of the necessity of physical relaxation instructions for systematic desensitization. According to Wolpe (1958), desensitization consists of two major elements: muscular relaxation and other incompatible responses to anxiety, and a graded and gradual presentation of anxiety evoking stimuli. According to this literature, muscular relaxation facilitates the reduction of anxiety to phobic or other anxiety producing stimuli. A number of investigators have questioned whether muscular relaxation is necessary for successful desensitization. Desensitization has been accomplished in situations where there has been brief training in relaxation (Cooke, 1966; Paul, 1966; Ramsey, et al., 1966) and without training in relaxation techniques (Ricter, 1968; Cooper, et al., 1969). A futther indication that muscular relaxation may not be necessary for desensitization is found in studies by Lader and Mathews, cited in Rachman's ( 1968) micle. Lader found that Ss who stated that they felt calm showed no decline in electtomyogram amplitude. Mathews reported that Ss showed reductions in muscle tension by means of instructions to feel calm and peaceful. A number of other investigators have found little difference in the effect of various types of instructions which lowered autonomic responses, including instructions which emphasized and did not emphasize muscular relaxation (Grossberg, 1965; O'ConneU & Ome, 1968; Mathews & Gelder, 1969; Lader & Mathews, 1968; Paid & Trimble, 1970; Edelrnan, 1970a, 1970b). The assumption may be made therefore that mental relaxation and mental calmness may be a sufficient condition for successful desensitization and a general reduction of stress. If this assumption is correct, what has been reported in the desensitization literature as a state of relaxation may have been a feeling of mental calmness and have very little to do with the state of muscular tension. Perhaps experiments were able to induce in Ss a feeling of mental tranquility through the monotonous repetition of instructions related to mental calmness. Since Wolpe's method of systematic desensitizacion rests upon the assumption

Treatment of insomnia in an eleven-year-old child through self-relaxation

This case report demonstrates the in vivo use of relaxation in the treatment of insomnia in an 11-yr-old child. The client was provided with taped relaxation instructions, which were used each evening at bedtime. These external directions were gradually faded over a period of several weeks, until the client became capable of rapidly placing herself in a deep state of relaxation completely of her own accord. Self-relaxation was found to be successful in eliminating the insomnia, as well as other related difficulties.

Relaxation training, relaxation instruction, and repeated exposure to a stressor film.

Relaxation training, relaxation instruction, and repeated exposure to a stressor film.

Subject posture and hypnotic susceptibility: a comparison of standing, sitting, and lying-down subjects.

Abstract Because of the prominence of relaxation instructions and suggestions of sleep within common hypnotic induction procedures, it seemed a reasonable conjecture that, in comparison to the customary sitting posture, a lying-down posture would facilitate hypnosis and a standing posture inhibit it. A preliminary experiment, using a slightly modified, tape-recorded Stanford Hypnotic Susceptibility Scale, Form C, failed to support either hypothesis. A subsequent experiment under improved conditions with 20 Ss in each group (standing, sitting, and lying down) also showed no significant difference of mean hypnotic susceptibility scores between any 2 of the conditions. Although Ss expressed dislike for the standing posture, the only objective disadvantage seemed to be some dizziness or nausea generated for some Ss (5 out of 39 tested in the standing condition). No clear evidence exists that this effect is to be attributed to hypnosis rather than to standing with eyes closed for an appreciable time. The resul...

Dimensions of affective expression in four expressive modes

This study compares dimensions of affect expression in four expressive modes. The subjects were asked, under light hypnosis or with relaxation instructions, to express several affects verbally, graphically, and facially and posturally. Verbal excepts, drawings, movies of facial and postural expression, and affect labels and definitions (“theoretical” mode) were each exposed to groups of raters who evaluated the material using a “semantic differential” type instrument. Separate factor analyses of scale intercorrelations, followed by orthogonal rotation of factors, were performed on data from each expressive mode. Interpretable factors were generally similar across the modes. Accounting for the largest proportion of total variance were factors interpreted as activity and evaluation. Less salient but consistently appearing factors were interpreted as temporality and object-relatedness. Potency and spatial orientation factors were also identified in each mode. A factor tentatively called containment emerged only in the analyses of data from non-verbal modes. Rank difference correlations of affect scores showed, in general, a high correspondence of affect ranks among modes, indicating high cross-modal similarity of affective meaning perceived in the complex rating material. The factors are discussed in terms of differences among modes and comparison with previous literature is made.

Recorded vs. “Live” relaxation training and hypnotic suggestion: Comparative effectiveness for reducing physiological arousal and inhibiting stress response

Relaxation training and hypnotically suggested relaxation by means of prerecorded tapes were evaluated against the same procedures conducted in the usual “live” manner regarding effectiveness for reducing subjective tension (Anxiety Differential) and physiological arousal (heart rate, respiratory rate, tonic muscle tension, skin conductance) and for inhibiting the physiological response to stressful imagery. Three groups (N=10 each) of undergraduate female Ss participated individually for two sessions, 1 week apart, receiving (a) abbreviated progressive relaxation instructions via recorded tape without E's presence, (b) a hypnotic induction emphasizing direct suggestions of relaxation, heaviness, etc., via recorded tape without Es presence, or (c) a self-relaxation control procedure, without E's presence. The physiological response to individually determined stressful images was assessed before trainin and after an analog desensitization procedure following two training sessions. Data from the recorded, E-absent treatments were compared with those previously obtained by the same procedures (N=20 per group) conducted “live,” with E present. In general, neither hypnotic nor control conditions were affected by mode of presentation. Recorded relaxation, however, was significantly inferior to the “live” procedure on all counts except self-report. The lack of effectiveness of recorded relaxation instructions appears to result from the loss of response-contingent progression.

Sex differences and generalization of anxiety reduction with automated de-sensitization and minimal therapist interaction

This study dealt with: (A) the effectiveness of automated desensitization with minimal therapist-patient interaction, (B) the effects of therapist-patient sex differences on treatment outcome, and (C) the generalization of anxiety reduction to objects and/or situations not directly treated by the automated desensitization procedure. Sixteen male and female snake-anxious college students were selected for treatment on the basis of a modified Fear Survey Schedule and behavioral avoidance tests to a snake and spider. Four treatment groups were used in order to balance for therapist-client sex differences. Four additional groups, balanced for sex differences, who received the same number of self-rating and behavioral avoidance tests but no desensitization served as controls. Desensitization was conducted using a modified Stenorette dictating machine, timers, and a series of standardized tapes which dealt with various aspects of the desensitization procedure. Each treatment S received two sessions of relaxation training, two sessions of visualization training, and five sessions of automated desensitization in order to complete and partially review a standardized, 16 item snake hierarchy. After each hierarchy item was presented for visualization, the S pressed one of four buttons corresponding to different levels of anxiety. The equipment was programmed to move forward to the next item or return to relaxation instructions depending on the S's button response. There was no personal interaction between the E and S once therapy began. Dependent measures were obtained prior to treatment, after treatment, and four weeks following treatment. Results indicated that automated desensitization was effective in significantly reducing anxiety toward the target behavior, snakes. Sex differences between therapist and client were not a critical factor in treatment outcome. Evidence for generalized anxiety reduction following automated desensitization was less conclusive due to changes that occurred in both experimental and control groups. It was concluded that automated desensitization can be a useful and time-saving psychotherapeutic approach; however, there are certain considerations (e.g. initial instructions, Ss control of visualization and relaxation, amount of relaxation practice, etc.) which should be taken into account.

Evaluation of Tension Control Courses for College Women

Abstract Skill in tension control was significantly improved in college women by a short course of muscular training, completed in ten hours. Changes noted by the studentsselves included a reduction of general fatigue and nervousness, better sleeping habits, and improvement in physical efficiency. Tests of specific muscle groups were done with a portable neurovoltmeter before and after the course. Slight variations in the time of day that students were retested had little significance. Both teaching and testing were done by the methods of Edmund Jacobson, M.D., as described in books and articles. A control group of untrained college women was tested twice at about the same intervals. While microvoltage was lowered in trained groups, values rose in controls receiving no instruction in relaxation.

The effects of suggestions of altertness in hypnosis on pupillary response: Report on a single subject

Abstract The pupil size of a single S was recorded under 2 types of hypnotic suggestion: alertness instructions and traditional relaxation instructions. It was found that the size of the pupil increased significantly under alertness instructions. This result was taken as further corroboration of the hypothesis that changes in various parameters of arousal apparently associated with hypnosis may be attributed to specifiable characteristics of the instructions used rather than to stable characteristics of the “state” of hypnosis.

Relaxation methods in U.S. Navy Air Schools.

1. In 1943 at United States primary naval training stations many cadets (perhaps about half) showed symptoms and signs of restlessness, insomnia, fatigue, and apprehension. Questionnaires filled out by 3,181 cadets at 5 preflight schools in their ninth week of training indicated nervous complaints on the part of most of the cadets. 2. Group methods of instruction were employed with the purpose of reducing nervous irritability and excitement in cadets. In preparation, 5 officers were given a course of instruction in progressive relaxation by Dr. Edmund Jacobson. These officers subsequently instructed other officers, until a total of 100 relaxation officers became available for instruction of cadets. The cadets were taught progressive relaxation in classes numbering up to 300. 3. The course in relaxation for cadets was of 10 weeks duration, consisting of 3 periods per week of ½ hour each. This was an abbreviated course, according to Jacobson's classification, since the total was about 10% of the 150 hours of instruction required in a more thorough course. In addition, the cadets generally did not practice with daily regularity as Jacobson prescribes. Accordingly the following procedures can be regarded as tests of results secured by relaxation methods employed on groups under severe limitations, rather than tests of what could have been accomplished under more satisfactory conditions. 4. Tests at the preflight school at Iowa City on 983 cadets who had received such relaxation training indicated approximately 19% reduction of strains, sprains, fractures, and other minor injuries in the test group as compared with a control group. 5. Tests on these same groups revealed a 38% reduction of days lost from injuries. Since the control group was considerably smaller than the test group, no quantitative accuracy can be attached to these figures but they would seem to indicate that on the whole a noteworthy reduction of injuries and of days lost from injuries was probably accomplished by the relaxation training. 6. In 3 preflight schools data were secured concerning the rest in bed of 140 cadets who had received relaxation training as compared with 190 cadets without training. Marked increase of quietude, recorded in percentages as from 27 to 56, occurred in the number of full body turns, parts of body movements, and of talking or mumbling. The reports suggested a marked diminution in dreaming. Figures for the total group indicated that the cadets who had received such relaxation training went to sleep more quickly on the whole and suffered less from insomnia during the night.