Basic principles

According to Jacobson, any anxiety, any psychic tension or, to be more precise, any thought, always leads to an increase in muscular tension, in particular that of the phonator or oculomotor muscles (thinking in words or images).

To prove this, he uses an electromyograph (which Jacobson calls a neurovoltometer), which objectively demonstrates the presence of a slight muscular tension when a subject contracts a muscle only in thought, even if he does not do so voluntarily.

Furthermore, according to Jacobson, the reverse is automatically true in the sense that if a person can relax his muscles completely, there will be a reduction or even a complete disappearance of anxiety or mental tension.

So to be able to relax, you just need to relax your muscles well.

To do this, Jacobson recommends the following steps:

• Get used to locating your different muscle groups correctly;
• Becoming aware of tension;
• And practising letting it go.

The learning stages of Jacobson's progressive and differential relaxation

Jacobson's progressive and differential relaxation is taught in four phases or stages:

1) The active phase

Objectives:

• Learn to locate the different muscle groups.
• To feel better the effect of muscle tension by emphasising it through contraction.
• Distinguish clearly between feelings of tension and relaxation.

How to proceed:

• During this phase, you will be asked to contract the main muscle groups of the body one by one, starting with the limbs, then the trunk and finally the face.
• On average, the contraction phase lasts 3 to 5 seconds and the relaxation phase 15 to 20 seconds.

2) The differential phase

Objectives:

• To acquire the ability, through daily activities, not to contract unnecessarily muscle groups that are not involved in the current activity.
• For example, don't contract the muscles in your face and shoulders unnecessarily when driving a car.

How to proceed:

• During the contraction phase, instead of concentrating on the contracted muscle groups as in the active phase, focus on the other muscle groups to relax them.
• The contractions last much longer than in the active phase, 30 seconds or more, to allow the non-contracted muscle groups to relax in turn.
• After a few days of training, you will be asked to integrate this form of relaxation into your daily life, remembering to relax the muscle groups not involved in common activities such as reading, walking or talking as often as possible.

3) The shortened or reduced phase of the exercises

Objectives:

• This phase serves as a transition between the active and passive phases.

How to proceed:

• During the first part, most of the exercises from the active phase are grouped into seven major movements covering the main areas of the body: arms, legs, abdomen, chest, shoulders and face (two movements are used for the face). This first part lasts just over ten minutes.
• During the second part, you remain still and mentally go through your main muscle groups with the aim of relaxing them as completely as possible. This second part also takes about ten minutes.

4) The passive phase

At this stage, most people are able to locate their different muscle groups well and quickly identify areas of tension.

During the passive phase, therefore, you will remain still and effortlessly check your different muscle groups one by one to identify their areas of tension and then make them disappear.

If you manage to deeply relax all your muscles, your anxiety will be under control, because the absence of muscle tension necessarily implies the absence, or at least the reduction, of anxiety, as demonstrated by Jacobson.

You will therefore be completely relaxed, both physically and mentally, and the technique will have achieved its goal.

It should be noted that many people who learn Jacobson's Progressive Relaxation restrict themselves to the active phase only.

The result is a practice that has more to do with physical exercise than relaxation.

The active phase is only one stage of learning and it is necessary to continue through the passive phase to get the most out of this technique.

Indications for relaxation techniques

Anxiety disorders

Relaxation techniques in general, and Jacobson's Progressive Relaxation in particular, are particularly effective in the treatment of anxiety disorders.

They do not cure phobias, panic attacks, obsessions, etc., but they can be a useful adjunct to their treatment, particularly in reducing the high levels of anxiety that usually accompany them.

Mood disorders

Learning relaxation techniques may be indicated for mild mood disorders, such as adjustment disorder with anxious mood or other forms of mild depression.

It may also be helpful in comorbid bipolar disorder with anxiety.

However, it is usually not very effective and is sometimes contraindicated in more severe mood disorders, such as major depression.

Psychosomatic illnesses

Relaxation techniques are generally effective for psychosomatic conditions that are mainly functional in origin, and in which anxiety often plays a significant role. Let's look at some examples:

• Tension headache;
• Respiratory disorders of mainly functional origin: dyspnoea, hyperventilation, feeling of suffocation or pressure, etc;
• Digestive disorders of partly functional origin: nausea, lump in the throat, slow or difficult digestion, etc;
• Certain chronic pains, various sleep disorders, various sexual dysfunctions, etc.

Relaxation techniques are less effective but still useful in the treatment of certain chronic organic pathologies where anxiety may be a less important but real factor, such as asthma, eczema, ulcerative colitis or others.

Quality of life

Relaxation techniques are also indicated to improve the quality of life. There are three main reasons for this:

• They help prevent stress and anxiety-related illnesses.
• They improve performance in various areas of life. They make you more productive at work, more creative, better at sports, etc.
• They increase physical and mental stamina, making individuals better able to cope with the normal stressors and difficulties of life.

Some contraindications to relaxation techniques

1) Certain severe psychiatric pathologies, e.g:

• Severe psychosis.
• Severe depression.
• Certain organic psychoses in which the subject is unable to complete a stage.
• Certain acute states of anxiety where the anxiety is so great that any learning is impossible.

2) In certain organic pathologies:

• Certain muscular or bone pathologies, certain spinal pathologies, certain forms of arthritis, etc. can make it difficult or impossible to learn Jacobson's progressive relaxation.

3) In some mentally handicapped people or people whose intellectual resources are very limited.

4) When motivation is insufficient.

Instructions before learning Jacobson Progressive Relaxation

1. Relaxation exercises should be practised for about 20 minutes at a time, once or twice a day, either in the morning before lunch, after getting dressed and/or at the end of the day.
2. Avoid exercising after meals or after consuming stimulants (caffeine) or alcohol.
3. Sit down alone in a quiet, well-ventilated, cool, semi-dark room, as far away as possible from household noises: telephone, children, spouse, visitors, etc.
4. Lie comfortably on your back on a bed or sofa, with your head supported by a pillow of your choice, your arms stretched along your body and folded, palms facing the floor, your legs straight, heels a few centimetres apart and your feet turned slightly outwards. You can also use a good, comfortable chair.
5. Loosen any clothing that is too tight around the waist, chest and neck.
6. Distractions during practice are normal and common, especially at the beginning. When they occur, gently bring your attention back to the exercise, without impatience or effort.
7. For each exercise, it is important to contract the muscles vigorously and then release them gradually. Do not go beyond the point where you feel faint. If there is trembling or pain, the contraction is unnecessarily excessive.
8. Notice the vague discomfort caused by the contraction, then the comfort caused by the relaxation.
9. During periods of relaxation, carefully identify any areas of tension that persist and make them disappear as best you can.
10. At the end of each session, take a deep breath, open your eyes, stretch all your limbs and then exhale. Before standing up, sit on the edge of the bed or couch for a few seconds to avoid dizziness.
11. If you feel uncomfortable or very anxious, stop the current technique, take a deep breath, open your eyes and tense your limbs. If these symptoms recur too often, stop the practice and continue only after discussing it with your therapist.