relaxation technique
A relaxation technique (also known as relaxation training) is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of pain, anxiety, stress or anger. Rela ...
developed by the
German
German(s) may refer to:
* Germany (of or related to)
** Germania (historical use)
* Germans, citizens of Germany, people of German ancestry, or native speakers of the German language
** For citizens of Germany, see also German nationality law
**Ge ...
psychiatrist Johannes Heinrich Schultz by which a psychophysiologically determined relaxation response is obtained. The technique was first published in 1932. Studying the self-reports of people immersed in a hypnotic state, J.H. Schultz noted that physiological changes are accompanied by certain feelings.
Abbé Faria
Abbé Faria (), or Abbé (Abbot) (born José Custódio de Faria; 31 May 1756 – 20 September 1819), was a Luso- Goan Catholic monk who was one of the pioneers of the scientific study of hypnotism, following on from the work of Franz Mesmer ...
and
Émile Coué
Émile Coué de la Châtaigneraie (; 26 February 1857 – 2 July 1926) was a French psychologist and pharmacist who introduced a popular method of psychotherapy and self-improvement based on optimistic autosuggestion.
Considered by Charles B ...
are the forerunners of Schultz. The technique involves repetitions of a set of visualisations that induce a state of relaxation and is based on passive concentration of bodily perceptions (e.g., heaviness and warmth of arms, legs), which are facilitated by self-suggestions. The technique is used to alleviate many
stress
Stress may refer to:
Science and medicine
* Stress (biology), an organism's response to a stressor such as an environmental condition
* Stress (linguistics), relative emphasis or prominence given to a syllable in a word, or to a word in a phrase ...
-induced
psychosomatic
A somatic symptom disorder, formerly known as a somatoform disorder,(2013) Biofeedback practitioners integrate basic elements of autogenic imagery and have simplified versions of parallel techniques that are used in combination with biofeedback. This was done at the
Menninger Foundation
The Menninger Foundation was founded in 1919 by the Menninger family in Topeka, Kansas. The Menninger Foundation, known locally as Menninger's, consists of a clinic, a sanatorium, and a school of psychiatry, all of which bear the Menninger name. ...
by Elmer Green, Steve Fahrion, Patricia Norris, Joe Sargent, Dale Walters and others. They incorporated the hand warming imagery of autogenic training and used it as an aid to develop thermal biofeedback.
History
The roots of this technique lie in the research carried out by Oscar Vogt in the field of
sleep
Sleep is a sedentary state of mind and body. It is characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity and reduced interactions with surroundings. It is distinguished from wakefulness by a de ...
and
hypnosis
Hypnosis is a human condition involving focused attention (the selective attention/selective inattention hypothesis, SASI), reduced peripheral awareness, and an enhanced capacity to respond to suggestion.In 2015, the American Psychologica ...
. Vogt investigated individuals who had experience in hypnotic sessions. Under his guidance, they were able to go into a state (similar to a hypnotic state) for a self-determined period of time. These short-term mental exercises appeared to reduce stress or effects such as fatigue and tension. In the meantime, other disturbing effects (e.g. headaches) could be avoided. Inspired by this research and Vogt's work, Johannes Heinrich Schultz became interested in the phenomenon of
autosuggestion
Autosuggestion is a psychological technique related to the placebo effect, developed by apothecary Émile Coué at the beginning of the 20th century. It is a form of self-induced suggestion in which individuals guide their own thoughts, feelings ...
. He wanted to explore an approach, which would avoid undesirable implications of hypnotherapy (e.g., the passivity of the individual and dependency on the therapist). When he was investigating hallucinations in healthy persons, he found that a majority of the subjects reported having two types of experienced sensation: heaviness in the extremities and feeling of warmth. Schultz wanted to understand whether simply imagining a state of heaviness and warmth in one's limbs could induce a state similar to hypnosis. Based on this idea he developed six basic exercises.
Autogenic training was popularized in North America and the English-speaking world by
Wolfgang Luthe
Wolfgang Luthe (1922-1985) was a German physician and psychotherapist, who brought autogenic training to the attention of the English-speaking world.
His contributions to autogenic training, and collaboration over several decades with JH Schultz ...
, who co-authored, with Schultz, a multi-volume tome on autogenic training. In 1963 Luthe discovered the significance of "autogenic discharges", paroxysmic phenomena of motor, sensorial, visual and emotional nature related to the traumatic history of the patient, and developed the method of "autogenic abreaction". His disciple Luis de Rivera, a
McGill University
McGill University (french: link=no, Université McGill) is an English-language public research university located in Montreal, Quebec, Canada. Founded in 1821 by royal charter granted by King George IV,Frost, Stanley Brice. ''McGill Universit ...
-trained psychiatrist, introduced
psychodynamic
Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
concepts into Luthe's approach, developing "autogenic analysis" as a new method for uncovering the unconscious.
Practice and effects
The main purpose of autogenic training is the achievement of autonomic self-regulation by removing environmental distraction, training imagery that accompanies autonomic self-regulation, and by providing a facilitative set of exercises that are easy to learn and remember.
Autogenic training is based on three main principles:
* Reduction of afferent stimulation (both exteroceptive and proprioceptive)
* Mental repetition of verbal formulae
* Passive concentration
In the context of autogenic training passive concentration means that the trainee is instructed to concentrate on inner sensations rather than environmental stimuli. Passiveness refers to allowing sensations to happen and being an observer rather than a manipulator.
The training can be performed in different postures:
* Simple sitting
* Reclined armchair
* Horizontal posture
The technique consists of six standard exercises according to Schultz:
# Muscular relaxation by repetition of a verbal formula, "My right arm is heavy", emphasizing heaviness. During the initial stages of the training, the feeling of heaviness in the trained arm is more expressed and occurs more rapidly. The same feeling can be experienced in the other extremities at the same time in the other arm. Within a week, a short concentration can trigger the sensation of heaviness in a trainee's arms and legs.
# Passive concentration focuses on feeling warm, initiated by the instruction "My right arm is warm".
# Initiation of cardiac activity using the formula "My heartbeat is calm and regular".
# Passive concentration on the respiratory mechanism with the formula "It breathes me".
# Concentration on the warmth in the abdominal region with "My solar plexus is warm" formula.
# Passive concentration on coolness in the cranial region with the formula "My forehead is cool".
When a new exercise step is added in autogenic training, the trainee should always concentrate initially on the already learned exercises and then add a new exercise. In the beginning, a new exercise is added for only brief periods.
According to the specific clinical needs, different modifications of formulas are used. These modifications can be classified into 3 main types:
* Only a few formulas are used (e.g., the formulas of heaviness and warmth)
* The standard set of formulas is taught, but one specific formula is modified
* The standard set is used and a complementary, problem-specific formula is added.
A study by Spencer suggests that autogenic training restores the balance between the activity of the sympathetic (flight or fight) and the parasympathetic (rest and digest) branches of the
autonomic nervous system
The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the peripheral nervous system that supplies viscera, internal organs, smooth muscle and glands. The autonomic nervous system is a control ...
. The author hypothesizes that this can have important health benefits, as the parasympathetic activity promotes
digestion
Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intest ...
and bowel movements, lowers the blood pressure, slows the
heart rate
Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions (beats) of the heart per minute (bpm). The heart rate can vary according to the body's physical needs, including the need to absorb oxygen and excr ...
, and promotes the functions of the
immune system
The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...
.
Neurophysiological aspects
There is a lack of neurophysiological investigations addressing this topic; however, one
EEG
Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The biosignals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neocortex ...
study from 1963 suggests that the decrease in afferent stimulation induces:
* A reduction in reticulo-cortical activity
* A decrease in thalamo-cortical activity
* Functional changes in the structures connected to reticular system (
hypothalamus
The hypothalamus () is a part of the brain that contains a number of small nuclei with a variety of functions. One of the most important functions is to link the nervous system to the endocrine system via the pituitary gland. The hypothalamu ...
,
limbic system
The limbic system, also known as the paleomammalian cortex, is a set of brain structures located on both sides of the thalamus, immediately beneath the medial temporal lobe of the cerebrum primarily in the forebrain.Schacter, Daniel L. 2012. ''Ps ...
,
red nucleus
The red nucleus or nucleus ruber is a structure in the rostral midbrain involved in motor coordination. The red nucleus is pale pink, which is believed to be due to the presence of iron in at least two different forms: hemoglobin and ferritin. ...
,
globus pallidus
The globus pallidus (GP), also known as paleostriatum or dorsal pallidum, is a subcortical structure of the brain. It consists of two adjacent segments, one external, known in rodents simply as the globus pallidus, and one internal, known in rod ...
)
The same study suggests that EEG patterns obtained from subjects with different level of practice are not similar.
Another study from 1958 hypothesizes that autogenic state is between the normal waking state and sleep. It suggests that EEG patterns occurring during autogenic training are similar to electrophysiological changes occurring during initial stages of
sleep
Sleep is a sedentary state of mind and body. It is characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity and reduced interactions with surroundings. It is distinguished from wakefulness by a de ...
.
Contraindications
Autogenic training is contra-indicated for children below the age of 5 and the individuals whose symptoms cannot be controlled.
Clinical application and evidence
Autogenic training has different applications and is used in a variety of pathophysiological conditions, such as bronchial asthma or
hypertension
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
, as well as psychological disorders e.g.
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
and depression.
Autogenic training has been subject to clinical evaluation from its early days in Germany, and from the early 1980s worldwide. In 2002, a
meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
of 60 studies was published in ''Applied Psychophysiology and Biofeedback'', finding significant positive effects of treatment when compared to normals over a number of diagnoses; finding these effects to be similar to best recommended rival therapies; and finding positive additional effects by patients, such as their perceived quality of life. Autogenic training is recommended in the 2016 European Society of Cardiology Guideline for prevention of cardiovascular disease in persons who experience psychosocial problems. The International Journal of Dermatology conducted a study and found that Autogenic Training was potentially helpful for improving aged skin in women experiencing menopause.
In Japan, researchers from the Tokyo Psychology and Counseling Service Center have formulated a measure for reporting clinical effectiveness of autogenic training.
Versus other relaxation techniques
The principle of passive concentration in autogenic training makes this technique different from other relaxation techniques such as
progressive muscle relaxation
Progressive muscle relaxation (PMR) is a non-pharmacological method of deep muscle relaxation, based on the premise that muscle tension is the body's psychological response to anxiety-provoking thoughts and that muscle relaxation blocks anxiety. ...
and biofeedback, in which trainees try to control physiological functions. As in biofeedback, bidirectional change in physiological activity is possible. Autogenic training is classified as a self-hypnotic technique. It is different from hetero-hypnosis, where trance is induced by another individual. Autogenic training emphasizes a trainee's independence and gives control from therapist to the trainee. By this, the need for physiological feedback devices or a hypnotherapist is eliminated.
Progressive muscle relaxation
Progressive muscle relaxation (PMR) is a non-pharmacological method of deep muscle relaxation, based on the premise that muscle tension is the body's psychological response to anxiety-provoking thoughts and that muscle relaxation blocks anxiety. ...
*
Qigong
''Qigong'' (), ''qi gong'', ''chi kung'', ''chi 'ung'', or ''chi gung'' () is a system of coordinated body-posture and movement, breathing, and meditation
used for the purposes of health, spirituality, and martial-arts training. With roots in ...
The Relaxation Response
''The Relaxation Response'' is a book written in 1975 by Herbert Benson, a Harvard physician, and Miriam Z. Klipper. The response described in the book is an autonomic reaction elicited by a mental device and a passive attitude that has been use ...
''
*
Yoga nidra
Yoga nidra ( sa, योग निद्रा, ) or yogic sleep in modern usage is a state of consciousness between waking and sleeping, typically induced by a guided meditation.
A state called yoga nidra is mentioned in the Upanishads and the ...
References
Further reading
*
*
* Republished in 2001 by The British Autogenic Society. In six volumes.
:Vol. 1 Autogenic Methods
:Vol. 2 Medical Applications
:Vol. 3 Applications in Psychotherapy
:Vol. 4 Research and Theory
:Vol. 5 Dynamics of Autogenic Neutralisation
:Vol. 6 Treatment with Autogenic Neutralisation