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Relaxation technique

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For other forms of relaxation, see Relaxation.
Relaxation technique
ICD-9-CM94.33

A relaxation technique (also known as relaxation training) is any method, process, procedure, or activity that helps a person to relax; attain a state of increased calmness; or otherwise reduce levels of pain, anxiety, stress or anger. Relaxation techniques are often employed as one element of a wider stress management program and can decrease muscle tension, lower blood pressure, and slow heart and breath rates, among other health benefits.[1]

Relaxation therapy, the application of relaxation techniques, can be applied in various settings to complement treatment for stress, anxiety, depression, and pain. It addresses both psychological and physiological effects of stress such as increased heart rate, sweating, and muscle tension.[2] There are many variations of relaxation techniques, including progressive muscle relaxation, autogenic training, guided imagery, biofeedback-assisted relaxation, and other techniques.[3][4][5][6]

Thus, relaxation techniques are useful for either emotional pain caused by stress, anger, anxiety, and mood of depression, or chronic pain caused by strains, single-side muscle use, awkward position, restriction of movement in certain areas of the spine, improper form during physical activity, and stressful posture.[7] Multiple relaxation techniques share a fundamental principle to decrease muscle tension and lower physical or mental pain.[7]

Relaxation techniques are generally safe for healthy individuals.[8] Occasional instances exist where individuals have reported negative experiences after receiving relaxation techniques.[9]

Background

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Current and past researchers have explored the relationship between physical and mental disorders through various methods and investigated the effects of relaxation techniques. The subsequent literature review presents a brief and succinct overview of the latest research discoveries, providing a background for the understanding of relaxation techniques.

Claude Bernard, a scientist in 1865, observed that maintaining a constant internal environment, our internal milieu, when facing changes in external environment and conditions is critical for life and well-being.[10]

Additionally, chronic stressors can have negative consequences, and they are especially prevalent in humans, potentially due to their high cognitive ability, which may cause ongoing stress responses to various adverse life and work circumstances.[11] The connection between psychosocial stressors and chronic illness is intricate and influenced by various factors, such as the type, quantity, and duration of stressors, along with an individual's biological susceptibility (like genetics and inherent characteristics) and their learned ways of coping.[11]

Previous studies have indicated that relaxation techniques, including but not limited to deep breathing, guided imagery, meditation, and progressive muscle relaxation, are effective ways to reduce stress, indicating that relaxation techniques are effective in promoting relaxation both physically and psychologically.[12]

Research released in the 1980s indicated stronger ties between stress and health and showed benefits from a wider range of relaxation techniques than had been previously known. This research received national media attention, including a New York Times article in 1986.[13]

A more recent study found that participants who practiced progressive muscle relaxation, deep breathing, and guided imagery experienced a statistically significant increase in relaxation compared to the control group.[14] While there was no significant difference in relaxation levels before training, all intervention groups demonstrated significantly higher levels of relaxation after training compared to the control group.[14] Additionally, there was a linear association between progressive muscle relaxation & guided imagery and physiological relaxation, while the deep breathing group initially showed increased physiological arousal before quickly returning to baseline levels.[14] These findings support existing research findings on the effectiveness of relaxation techniques, which can effectively enhance relaxation states both psychologically and physiologically.

Uses

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People use relaxation techniques for the following reasons, among others:[medical citation needed]

Thus, relaxation techniques are used and designed to help individuals reduce tension and anxiety, both physically and psychologically, by inducing the body's "relaxation response," characterized by a slower respiratory rate, reduced blood pressure, and a slower heart rate.[15] The main techniques are progressive muscle relaxation, autogenic training, guided imagery, and biofeedback-assisted relaxation.

Techniques

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Progressive muscle relaxation (PMR)

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Progressive muscle relaxation (PMR) is one of the most important and easy-to-learn relaxation techniques developed by Dr. Edmund Jacobson in the 1920s, setting the foundation for the development of relaxation techniques.[16] It involves the effective and repetitive relaxation of 14 different muscle groups and has been used to treat anxiety, tension headaches, migraines, TMJ, neck pain, insomnia, bipolar disorder, anxiety, backaches, high blood pressure, etc.[17] PMR is a two-step practice that involves creating tension in specific muscle groups and then releasing it to build awareness of the sensations of tension and deep relaxation.[18] It is recommended to repeat the process several times and to practice regularly to induce physical muscular relaxation at the first signs of stress.

After the initial practice of PMR, several muscle groups may still require additional tensing and relaxation to achieve maximum effects. Decreasing the degree of muscle tension is typically recommended by Dr. Edmund to “train” the body for immediate and continuous response.[17]

The following steps are recommended to perform effective PMR.[16]

  1. First, to practice PMR, find a comfortable place where you will not be disturbed for 10-15 minutes.
  2. Begin by focusing on each muscle group and tensing them for five seconds while breathing in, then releasing and relaxing the muscle while noticing the feeling of relaxation.
  3. Repeat this process for each muscle group while gradually reducing the amount of tension used to deepen the sense of relaxation.
  4. Transition to the next muscle group once you feel relaxed in the current one.
  5. It is recommended to start at one part of the body and move systematically, and to not hold your breath or tense muscles that cause discomfort.

Guided imagery

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Guided imagery (GI) is a well-established technique for reducing stress and anxiety. It involves replacing distressing memories with positive mental imagery through a process of sensory engagement and behavioral and physiological responses.[4] The technique is guided by an instructor or audio recording that directs participants to imagine a peaceful or pleasant setting, often involving rich sensory experiences such as sounds, smells, and visual details.[19]

By actively engaging the senses and focusing on specific contextual details, guided imagery enables individuals to generate vivid and realistic mental images that create a strong sense of presence and immersion in the imagined scenario, which helps to divert attention away from negative thoughts and feelings, and fosters a sense of relaxation and tranquility.[20] When used in combination with progressive muscle relaxation (PMR), the PMR-GI approach is a highly effective method for managing the symptoms of nausea and vomiting, as well as improving patients' overall mental well-being.[21]

Nature-based vs traditional GI

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Studies have identified several connections between exposure to natural environments and health outcomes.[22][23] Specifically, there is compelling evidence linking nature exposure to enhancements in cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep.[24] However, it may not always be feasible to alleviate anxiety symptoms by spending time in natural settings, depending on the situation and context.[25] Studies have demonstrated that incorporating nature-based GI interventions can overcome the barriers of limited access to natural environments and enhance the effectiveness of GI interventions.[25] Nature-based GI techniques have been shown to be highly effective in managing anxiety, while also offering the advantages of being affordable and highly accessible, providing a great alternative to traditional GI.[25]

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Biofeedback is a technique that enables individuals to make subtle changes in their body, such as the relaxation of muscles, which can help alleviate pain and decrease tension.[26] With the aid of an electronic device that provides feedback and real-time information on changes in heart rate, blood pressure, or muscle tension, individuals can learn to monitor their level of relaxation and recognize and regulate their body's response to stress.[26] Biofeedback-related relaxation techniques are found by researchers to decrease test anxiety in nursing students, significantly reduce average blood glucose, A1C, muscle tension, and lower hypertension.[27][28][29]

Other techniques

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Various techniques are used by individuals to improve their state of relaxation. Some of the methods are performed alone; some require the help of another person (often a trained professional); some involve movement, some focus on stillness; while other methods involve different elements.

Certain relaxation techniques known as "formal and passive relaxation exercises" are generally performed while sitting or lying quietly, with minimal movement, and involve "a degree of withdrawal".[6] These include:

Movement-based relaxation methods incorporate exercises such as walking, gardening, yoga, tai chi, qigong, and more. Some forms of bodywork are helpful in promoting a state of increased relaxation. Examples include massage, acupuncture, the Feldenkrais Method, myotherapy, reflexology and self-regulation.[medical citation needed]

Some relaxation methods can also be used during other activities, for example, autosuggestion and prayer. At least one study has suggested that listening to certain types of music, particularly new-age music and classical music, can increase feelings associated with relaxation, such as peacefulness and a sense of ease.[30]

A technique growing in popularity is flotation therapy, which is the use of a float tank in which a solution of Epsom salt is kept at skin temperature to provide effortless floating. Research in USA and Sweden has demonstrated a powerful and profound relaxation after twenty minutes. In some cases, floating may reduce pain and stress and has been shown to release endorphins.

Even actions as simple as a walk in the park have been shown to aid feelings of relaxation, regardless of the initial reason for the visit.[31]

A new relaxation technique course, developed specifically for medical students in universities, was found to be effective in reducing anxiety, burnout, and depression, leading to significant improvements in academic performance and evaluated parameters.[32] Introducing this particular course is important because the prevalence of stress-related mental disorders in medical students is significantly higher than in the general public.[32]

Side effects

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Relaxation techniques are generally deemed safe for healthy individuals, with most research studies reporting no adverse side effects.[33] However, there have been occasional instances where individuals have reported negative experiences such as heightened anxiety, intrusive thoughts, or fear of losing control.[34]

In particular, some relaxation techniques may not be suitable for individuals with certain medical or psychiatric conditions.[35] In rare cases, these techniques may even exacerbate existing symptoms. For instance, there have been reports that certain relaxation methods can trigger or worsen symptoms in individuals with epilepsy, psychiatric disorders, or a history of abuse or trauma.[36]

See also

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References

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  1. ^ Goleman, Daniel (May 13, 1986). "Relaxation: Surprising benefits detected". The New York Times. Retrieved May 23, 2006.
  2. ^ Norelli, Samantha K.; Long, Ashley; Krepps, Jeffrey M. (2023), "Relaxation Techniques", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30020610, retrieved 2023-04-15
  3. ^ Toussaint, Loren; Nguyen, Quang Anh; Roettger, Claire; Dixon, Kiara; Offenbächer, Martin; Kohls, Niko; Hirsch, Jameson; Sirois, Fuschia (2021-07-02). Taylor-Piliae, Ruth (ed.). "Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation". Evidence-Based Complementary and Alternative Medicine. 2021: 1–8. doi:10.1155/2021/5924040. ISSN 1741-4288. PMC 8272667. PMID 34306146.
  4. ^ a b Naparstek, Belleruth (2008). Staying Well with Guided Imagery. Grand Central Publishing. ISBN 978-1-59995-636-7. OCLC 1034613276.
  5. ^ "Biofeedback - Mayo Clinic". www.mayoclinic.org. Retrieved 2023-04-15.
  6. ^ a b Smith, Jonathan C. (2007). "Ch. 3: The Psychology of Relaxation". In Lehrer, Paul M.; Woolfolk, Robert L.; Sime, Wesley E. (eds.). Principles and Practice of Stress Management (3rd ed.). Guilford Press. p. 38. ISBN 9781606238288.
  7. ^ a b Irnich, Christine (2013). "Relaxation techniques". Myofascial Trigger Points. pp. 245–252. doi:10.1016/b978-0-7020-4312-3.00024-6. ISBN 9780702043123.
  8. ^ Chou, Roger; Deyo, Richard; Friedly, Janna; Skelly, Andrea; Hashimoto, Robin; Weimer, Melissa; Fu, Rochelle; Dana, Tracy; Kraegel, Paul; Griffin, Jessica; Grusing, Sara; Brodt, Erika D. (2017). "Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline". Annals of Internal Medicine. 166 (7): 493–505. doi:10.7326/M16-2459. PMID 28192793. S2CID 20451068.
  9. ^ "Relaxation Techniques for Health". NCCIH. Retrieved 2023-04-15.
  10. ^ Bernard C. An Introduction to the Study of Experimental Medicine. Transl. HC Greene. New York: Collier; 18651961.
  11. ^ a b Schneiderman, Neil; Ironson, Gail; Siegel, Scott D. (2005). "Stress and Health: Psychological, Behavioral, and Biological Determinants". Annual Review of Clinical Psychology. 1: 607–628. doi:10.1146/annurev.clinpsy.1.102803.144141. PMC 2568977. PMID 17716101.
  12. ^ Lehrer P. M., Woolfolk R. L. Principles and Practice of Stress Management. New York, NY, USA: Guilford Press; 2021.
  13. ^ Goleman, Daniel (May 13, 1986). "Relaxation: Surprising benefits detected". The New York Times. Retrieved May 23, 2006.
  14. ^ a b c Toussaint, Loren; Nguyen, Quang Anh; Roettger, Claire; Dixon, Kiara; Offenbächer, Martin; Kohls, Niko; Hirsch, Jameson; Sirois, Fuschia (2021). "Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation". Evidence-Based Complementary and Alternative Medicine. 2021: 1–8. doi:10.1155/2021/5924040. PMC 8272667. PMID 34306146.
  15. ^ "Relaxation Techniques for Health". NCCIH. Retrieved 2023-04-15.
  16. ^ a b Toussaint, Loren; Nguyen, Quang Anh; Roettger, Claire; Dixon, Kiara; Offenbächer, Martin; Kohls, Niko; Hirsch, Jameson; Sirois, Fuschia (2021-07-02). Taylor-Piliae, Ruth (ed.). "Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation". Evidence-Based Complementary and Alternative Medicine. 2021: 1–8. doi:10.1155/2021/5924040. ISSN 1741-4288. PMC 8272667. PMID 34306146.
  17. ^ a b Jacobson, Edmund (1974). Progressive relaxation; a physiological and clinical investigation of muscular states and their significance in psychology and medical practice. University of Chicago Press. OCLC 1330616184.
  18. ^ "VA.gov | Veterans Affairs". www.va.gov. Retrieved 2023-04-15.
  19. ^ "Guided Imagery/Guided Mental Imagery", Encyclopedia of Pain, Berlin, Heidelberg: Springer Berlin Heidelberg, 2007, p. 835, doi:10.1007/978-3-540-29805-2_1687, ISBN 978-3-540-43957-8, retrieved 2023-04-15
  20. ^ Rees, Barbara L. (1995). "Effect of Relaxation with Guided Imagery on Anxiety, Depression, and Self-Esteem in Primiparas". Journal of Holistic Nursing. 13 (3): 255–267. doi:10.1177/089801019501300307. PMID 7650352. S2CID 29229003.
  21. ^ Kapogiannis, August; Tsoli, Sofia; Chrousos, George (2018-03-01). "Investigating the Effects of the Progressive Muscle Relaxation-Guided Imagery Combination on Patients with Cancer Receiving Chemotherapy Treatment: A Systematic Review of Randomized Controlled Trials". Explore. 14 (2): 137–143. doi:10.1016/j.explore.2017.10.008. ISSN 1550-8307. PMID 29506956. S2CID 4923110.
  22. ^ Kaplan, Stephen (September 1995). "The restorative benefits of nature: Toward an integrative framework". Journal of Environmental Psychology. 15 (3): 169–182. doi:10.1016/0272-4944(95)90001-2. S2CID 4993000.
  23. ^ Ulrich, Roger S.; Simons, Robert F.; Losito, Barbara D.; Fiorito, Evelyn; Miles, Mark A.; Zelson, Michael (September 1991). "Stress recovery during exposure to natural and urban environments". Journal of Environmental Psychology. 11 (3): 201–230. doi:10.1016/S0272-4944(05)80184-7.
  24. ^ Jimenez, Marcia P.; DeVille, Nicole V.; Elliott, Elise G.; Schiff, Jessica E.; Wilt, Grete E.; Hart, Jaime E.; James, Peter (2021-04-30). "Associations between Nature Exposure and Health: A Review of the Evidence". International Journal of Environmental Research and Public Health. 18 (9): 4790. doi:10.3390/ijerph18094790. ISSN 1660-4601. PMC 8125471. PMID 33946197.
  25. ^ a b c Nguyen, Jessica; Brymer, Eric (2018-10-02). "Nature-Based Guided Imagery as an Intervention for State Anxiety". Frontiers in Psychology. 9: 1858. doi:10.3389/fpsyg.2018.01858. ISSN 1664-1078. PMC 6176042. PMID 30333777.
  26. ^ a b "Biofeedback - Mayo Clinic". www.mayoclinic.org. Retrieved 2023-04-15.
  27. ^ Prato, Catherine A.; Yucha, Carolyn B. (March 2013). "Biofeedback-Assisted Relaxation Training to Decrease Test Anxiety in Nursing Students". Nursing Education Perspectives. 34 (2): 76–81. doi:10.5480/1536-5026-34.2.76. ISSN 1536-5026. PMID 23763019. S2CID 35253272.
  28. ^ doi:10.2337/diacare.28.9.2145
  29. ^ doi:10.1097/00005082-200505000-00012
  30. ^ Smith, Jonathan C. (2007). "Ch. 3: The Psychology of Relaxation". In Lehrer, Paul M.; Woolfolk, Robert L.; Sime, Wesley E. (eds.). Principles and Practice of Stress Management (3rd ed.). Guilford Press. pp. 46–7. ISBN 9781606238288.
  31. ^ Irvine, KN; Warber, SL; Devine-Wright, P; Gaston, K (2013). "Understanding urban green space as a health resource: A qualitative comparison of visit motivation and derived effects among park users in Sheffield, UK". International Journal of Environmental Research and Public Health. 10 (1): 417–42. doi:10.3390/ijerph10010417. PMC 3564151. PMID 23340602.
  32. ^ a b Wild, Katharina; Scholz, Michael; Ropohl, Axel; Bräuer, Lars; Paulsen, Friedrich; Burger, Pascal H. M. (2014-12-17). "Strategies against Burnout and Anxiety in Medical Education – Implementation and Evaluation of a New Course on Relaxation Techniques (Relacs) for Medical Students". PLOS ONE. 9 (12): e114967. Bibcode:2014PLoSO...9k4967W. doi:10.1371/journal.pone.0114967. ISSN 1932-6203. PMC 4269409. PMID 25517399.
  33. ^ Chou, Roger; Deyo, Richard; Friedly, Janna; Skelly, Andrea; Hashimoto, Robin; Weimer, Melissa; Fu, Rochelle; Dana, Tracy; Kraegel, Paul; Griffin, Jessica; Grusing, Sara; Brodt, Erika D. (2017). "Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline". Annals of Internal Medicine. 166 (7): 493–505. doi:10.7326/M16-2459. PMID 28192793. S2CID 20451068.
  34. ^ Goessl, V. C.; Curtiss, J. E.; Hofmann, S. G. (2017). "The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis". Psychological Medicine. 47 (15): 2578–2586. doi:10.1017/S0033291717001003. hdl:2144/26911. PMID 28478782. S2CID 4710497.
  35. ^ Hopper, Susan I.; Murray, Sherrie L.; Ferrara, Lucille R.; Singleton, Joanne K. (2019). "Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults". JBI Database of Systematic Reviews and Implementation Reports. 17 (9): 1855–1876. doi:10.11124/JBISRIR-2017-003848. PMID 31436595. S2CID 201275251.
  36. ^ "Relaxation Techniques for Health". NCCIH. Retrieved 2023-04-15.
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