The relaxation response

Behavioral treatment parameters with primary dysmenorrhea

Fourteen women with primary dysmenorrhea were administered four sessions of systematic desensitization (SD) by either a male or a female therapist. The following measures were taken during the flow periods before and after treatment and at a 6-month follow-up: menstrual symptom checklist, medication usage, invalid hours, and menstrual attitudes. At pretreatment, menstrually distressed women had significantly higher scores on all measures compared to a normative group and an explicitly nondistressed group. At posttreatment, treated women's scores on the dependent variables were significantly reduced. All indices were reduced to a "nondistressed level" at posttreatment and at 6-month follow-up. Type of dysmenorrhea (congestive vs. spasmodic), trait anxiety level, and therepist sex did not predict differential responsiveness to SD. SD did not affect frontailis EMG, peripheral blood flow, or pain threshold. A Retrospective Symptom Scale of menstrual distress was found to be highly reliable, valid, and sensitive.

The relative effectiveness of three techniques to induce the trophotropic response

The purpose of this study was to examine the relative effectiveness of electromyographic biofeedback training (EMG BFT), meditation, and progressive muscle relaxation (PMR) in eliciting a relaxation or trophotropic response as measured by frontalis muscle tension, heart rate, electrodermal response, respiration rate, and skin temperature. Fifty-four college students were randomly assigned to one of five groups: (1) control, (2) placebo control, (3) EMG BFT, (4) meditation, (5) PMR. After baseline measures were obtained subjects were trained in 10 30-minute training sessions and posttested. Comparisons by ANOVAs indicated there was a significant decrease in muscle tension in the EMG BFT and meditation groups and significant decreases in respiration rate in the meditation and PMR groups. No other changes were attributed to treatment.

Decreased VO2 consumption during exercise with elicitation of the relaxation response

Oxygen consumption is usually considered to be predictable and unalterable at a fixed work intensity. The relaxation response is hypothesized to be an integrated hypothalamic response which results in generalized decreased sympathetic nervous system activity. One physiologic manifestation of the relaxation response is decreased oxygen consumption. The possibility that the elicitation of the relaxation response could decrease oxygen consumption at a fixed work intensity was investigated. Oxygen consumption was decreased 4 percent (p less than 0.05) in eight subjects working at a fixed intensity when the relaxation response was simultaneously elicited.

Daily relaxation response breaks in a working population: I. Effects on self-reported measures of health, performance, and well-being

An experiment conducted at the corporate offices of a manufacturing firm investigated the effects of daily relaxation breaks on five self-reported measures of health, performance, and well-being. For 12 weeks, 126 volunteers filled out daily records and reported bi-weekly for additional measurements. After four weeks of baseline monitoring, they were divided randomly into three groups: Group A was taught a technique for producing the relaxation response; Group B was instructed to sit quiety; Group C received no instructions. Groups A and B were asked to take two 15-minute relaxation breaks daily. After an eight-week experimental period, the greatest mean improvements on every index occurred in Group A; the least improvements occurred in Group C; Group B was intermediate. Differences between the mean changes in Groups A vs C reached statistical significance (p < 0.05) on four of the five indices: Symptoms, Illness Days, Performance, and Sociability-Satisfaction. Improvements on the Happiness-Unhappiness Index were not significantly different among the three groups. The relationship between amount of change and rate of practicing the relaxation response was different for the different indices. While less than three practice periods per week produced little change on any index, two daily sessions appeared to be more practice than was necessary for many individuals to achieve positive changes. Somatic symptoms and performance responded with less practice of the relaxation response than did behavioral symptoms and measures of well-being. (Am. J. Public Health 67:946-953,1977)

Daily relaxation response breaks in a working population: II. Effects on blood pressure

A 12-week randomized experiment investigated the effects of daily relaxation breaks on office workers with "normal" blood pressure. Blood pressures of 126 volunteers from the corporate offices of a manufacturing firm were measured biweekly. After four weeks of baseline monitoring,volunteers were divided randomly into three groups: Group A was taught a technique for producing the relaxation response; Group B was "taught" to sit quietly; and Group C was taught nothing. Groups A and B were asked to take two 15-minute relaxation breaks daily. During the baseline period, mean systolic blood pressures (SBP) were 119.7, 118.4, and 114.2 for Groups A, B and C respectively; mean diastolic pressures (DBP) were 78.7 and 75.7 Between the first and last measurements, mean changes in SBP were -11.6, -6.5, and +0.4 mm Hg in Groups A, B, and C; mean DBP decreased by 7.9, 3.1, and 0.3. Between the fourweek baseline period and last four weeks of the experimental period, mean SBP and DBP, mean changes in Group A were significantly greater than those in Group B (p < 0.05) and in Group C (p < 0.001). The same pattern of changes among the three groups was exhibited by both sexes, all ages, and at all initial levels of blood pressure. However, in general, within Group A, the higher the initial blood pressure, the greater the decrease. (Am. J. Public Health 67;954-959, 1977)

Relaxation

The relaxed state, to me, is simply the state of being mentally and physically at ease. This does not necessarily mean a passive state, in a quiet place, day-dreaming. It could mean an active state where the individual is working or playing in the day-to-day environment. To achieve this relaxed state the aim is to regulate the amount of stress so it does not exceed a determined level. Above this level, stress becomes counterproductive. We aim for the level of stress that is optimal for each individual at a particular time, performing a particular task. At this level the individual may be active or passive and still be relaxed.

Note upon steady visual fixation and repeated auditory stimulation in meditation and the laboratory

The techniques of steady visual fixation and repetitious auditory input are used in the laboratory for investigating perceptual phenomena and in yoga and meditation for facilitating altered states of awareness. Phenomena related to mild sensory deprivation are reported in both circumstances.

Biofeedback-aided relaxation and meditation in the management of hypertension

Based on clinical, epidemiological, and experimental work, a possible pathogenesis of essential hypertension is outlined. In the light of this possible pathogenesis, a behavioral treatment program is suggested which centers on the regular use of systematic training. Several controlled studies are described in which experimental patients given such training show clinically significant and lasting reductions in systolic and diastolic pressure. Following training, experimental patients also show quicker recovery of blood pressures to baseline levels after exposure to standardized laboratory stressors. Probable long-term benefits of relaxation training are suggested. Such benefits, however, can only be maintained if the patient regularly practices relaxation and integrates this into his everyday activities. How to motivated symptomless hypertensives to accept this requirement is discussed in the light of the writer's personal experience.

Biofeedback and progressive relaxation treatment of sleep-onset insomnia: a controlled, all-night investigation

Previous research suggests that self-defined insomniacs are distinguished from normals by high levels of anxiety and physiological arousal, which might be mitigated by muscle relaxation. This study assessed the relative effects of frontal EMG biofeedback, progressive relaxation, and a placebo set of "relaxation" exercises on the sleep of 18 onset insomniacs. Each subject was trained in one of these three methods for six half-hour sessions and slept in the laboratory for two consecutive nights before and after training. The experimental groups demonstrated significant decreases in physiological activity during training while changes in the control group were minimal. Reductions in sleep-onset time were: biofeedback group, 29.66 minutes; progressive relaxation group, 22.92 minutes; control group, 2.79 minutes. The experimental groups improved significantly (p less than 905) more than the control group, but did not differ from each other. No significant relationships between physiological levels and sleep-onset time were found, which suggests that muscle relaxation alone was not responsible for subjects' improvements. Since 20 minutes of daily practice were required to achieve an approximate 30-minute decrease in sleep-onset time, the practical utility of the methods is questioned.

Basis for recurring ventricular fibrillation in the absence of coronary heart disease and its management

A 39-year-old man twice experienced ventricular fibrillation and exhibited numerous ventricular premature beats. Coronary arteries were normal, and no impaired cardiac function was found upon catheterization. Evidence was adduced that the ventricular premature beats were related to higher nervous activity. The patient had serious psychiatric problems; the ventricular premature beats were provoked by psychophysiologic stress, increased during REM sleep, were reduced by meditation, and were controlled by beta-adrenergic blockade, phenytoin and digitalization. We conclude that psychologic and neurophysiologic factors may predispose to life-threatening cardiac arrhythmia in the absence of organic heart disease. Effective management of the recurrent ventricular arrhythmia involved; acute drug testing for assessing antiarrhythmic efficacy; use of programmed trendscription to provide on-line information on drug action; a treatment program involving more than one agent; and use of measures to reduce sympathetic nervous activity.

Decreased premature ventricular contractions through use of the relaxation response in patients with stable ischaemic heart-disease

To determine whether decreased sympathetic-nervous-system activity achieved by the relaxation response could decrease premature ventricular contractions (P.V.C.s), eleven ambulatory patients with proven, stable ischaemic heart-disease and P.V.C.s were investigated. The patients, who were taking no medication for the P.V.C.s, were trained to elicit regularly the relaxation response through a non-cultic psychological technique. The frequency of the P.V.C.s was measured by computer analysis of Holter monitor tapes for 2 complete days before learning the technique, which was learned in approximately 5 minutes after the second day. Patients were instructed to evoke the response for 20 minutes twice daily thereafter. After 4 weeks, a reduced frequency of P.V.C.s was documented in eight of the eleven patients. This effect was especially striking during the sleeping hours and less so during the entire monitoring session. The relaxation response is a simple, no cost, non-pharmacological mechanism without side-effects which seemed to decrease the frequency of P.C.V.s in most patients with ischaemic heart-disease.

Continuous measurement of O2 consumption and CO2 elimination during a wakeful hypometabolic state

A previous investigation has demonstrated that the practice of a meditational technique elicits a wakeful, hypometabolic state. Measurement of O2 consumption and CO2 elimination was made by sampling techniques; mean values of these parameters were calculated from 6-10 minute samples. The present study extends this investigation, using a recently developed method of continuous measurement of O2 consumption and CO2 elimination. Continuous measurement of these parameters permitted the determination of mean values for the entire experimental periods as well as for selected intervals and permitted the examination of the sequence of respiratory changes. The present study reports statistically significant decreases in O2 consumption of 5 per cent and CO2 elimination of 6 percent for the entire 20 minutes of the mediation period. These are lower than the sample values of 16 percent and 15 percent reported in the previous study. However, when selected intervals of the mediation period are examined, decreases in O2 consumption and CO2 elimination are comparable to those previously reported. The results are consistent with the difference between the discontinuous sampling measurement method originally employed and the continuous measurement method of the present investigation.

Biofeedback and self-control of physiological functions: clinical applications

The parameters amenable to biofeedback learning are mentioned, including brainwaves, muscle tension, temperature, the cardiovascular system, and others. A discussion follows of the clinical application of biofeedback in the treatment of such disorders as tension headaches, neuromuscular re-education, epilepsy, "dysponesis," cardiac arrhythmias, blood pressure and migraines. The usefulness of biofeedback has been demonstrated also in the field of psychotherapy for purposes of desensitization, treating anxious patients, encouraging specific personality changes, and indicating stress to patients.

Hypnosis as a treatment method in psychosomatic medicine

Recent research findings are used to illustrate the areas of uncertainty and controversy in the understanding of hypnosis. Despite similarities, hypnosis is presented as more than and different from relaxation, suggestibility, and the placebo response. An overview of the clinical use of hypnosis includes the three main methods of application, namely: relaxation or mild hypnosis, symptom removal, and hypnotherapy. A few brief case reports are included. As a means of narrowing the gap between laboratory research and clinical experience, the author recommends the assessment of hypnotizability in all patients treated with hypnosis.

The relaxation response: psychophysiologic aspects and clinical applications

It is hypothesized that situations requiring continous behavioral adjustment activate an integrated, hypothalamic response, the emergency reaction. The frequent elicitation of the physiologic changes associated with the emergency reaction has been implicated in the development of diseases such as hypertension. Prevention and treatment of these diseases may be through the use of the relaxation response, an integrated hypothalamic response whose physiologic changes appear to be the counterpart of the emergency reaction. This article describes the basic elements of techniques which elicit the relaxation response and discusses the results of clinical investigations which employ the relaxation response as a therapeutic intervention.

Operant conditioning: a new theoretical approach in psychosomatic medicine

Recent advances in behavioral psychology have disproved the notion that autonomic responses are involuntary. New techniques based on operant conditioning have shown that when given the proper feedback and motivation, animal and human subjects can learn to control a wide variety of physiological responses. These new data suggest a behavioral alternative to present theories of psychosomatic medicine which rely heavily on psychodynamic formulations for their therapeutic technique. Such a behavioral approach would, like other forms of behavior modification, treat the symptom directly through the use of learning techniques based on operant conditioning. Experimental and clinical examples of these techniques as applied to problems of muscle tension and blood pressure are presented.