The Tao of Progressive Muscle Relaxation (PMR)
The Science of PMR
Anxiety and stress-induced tension consists of subjective, behavioral, and physiological components that interact to create a complex physical and emotional experience. When a stressor is perceived, it can cause fear, anxiety or nervousness. The thoughts preceding or accompanying these sensations may add additional tension that further amplifies the stress reaction. This increases discomfort and physiological activation in a continuing spiral that may cause panic, negative thoughts, and a variety of other behavioral and physiological symptoms.
PMR is a way of reducing the arousal provoked by the stress reaction. When muscle activity is reduced with PMR, there is a corresponding reduction in nervous system activity. This is due to the negative feedback from the muscles to the brain (more specifically, the ascending reticular activation system and the hypothalamus). Resting muscles send little or no feedback information to the brain structures; the lack of feedback results in a decrease in autonomic activation. As muscle tension drops, heart rate and blood pressure are also lowered.
PMR is just one way of achieving a state of deep relaxation. There are many other ways to relax, some good (biofeedback, controlled breathing, autogenic training, stretch-based relaxation, and quiet meditation), and some not so good (alcohol, nicotine, drugs), all of which capitalize on the same psychophysiological mechanisms.
The advantages that PMR has over all other methods is that it is easy to learn, requires no equipment, and can be practiced any time and virtually anywhere.
The PMR Tensing-Relaxing Sequence
PMR is learning to tense and relax groups of muscles in your body, while at the same time learning the sensations that go with tension and relaxation. So, in addition to learning how to relax, you will also learn to recognize the sensations that go with tension and relaxation in everyday situations.
Learning relaxation skills is like learning any other skill, such as swimming or golfing or riding a bicycle. So, in order to get better at relaxing, you will need to practice doing it just as you would practice other skills. PMR simply involves learning the skill; there is nothing magical or mysterious about it. Let’s see how it works.
The skill simply consists in tensing and then relaxing various groups of muscles in your body. You may be wondering why, in learning how to relax, you would start off by producing tension.
There are three reasons for that. The first reason is that PMR helps you learn to reduce muscle tension in your body well below your normal tension any time you wish. To learn how to do this, it is not enough to just focus your attention, for example, on the muscles in your right hand and lower arm and then just tell yourself to relax them. To a certain extent, you probably can do just that. However, PMR teaches you to produce larger and more noticeable drops in muscle tension. The best way to do this is by first raising the tension in the muscle group and then, all at once, release it. This helps to create a trigger which allows the muscles to drop well below their normal tension level.
The effect is similar to a pendulum. If we want it to swing far to the right, we can push it hard in that direction. It is much easier, however, to start by pulling the pendulum in the opposite direction and then letting it go. In the same way, tensing muscle groups and then letting them relax is a “running start” toward deeper relaxation created by the tension release.
The second reason for the tensing-relaxing sequence is to give you a chance to focus your attention on and become more aware of what tension really feels like in each of the muscle groups.
Third, the tensing-relaxing procedure creates a more vivid and memorable contrast between tension and relaxation and gives you the opportunity to compare the two directly and to appreciate the difference in feeling associated with each.
Learning to feel the difference, in the body as well as emotionally, between tension and relaxation will teach you how to relax your muscles at will, anywhere, at any time.
How to Tense & Relax the PMR Muscle Groups
- Right hand and forearm: Make a tight fist while allowing the upper arm to remain relaxed.
- Right upper arm: Press the elbow down against the armrest of the chair or against the floor.
- Left hand and forearm: Make a tight fist while allowing the upper arm to remain relaxed.
- Left upper arm: Press the elbow down against the armrest of the chair or against the floor.
- Forehead: Raise your eyebrows as high as possible.
- Upper cheeks and nose: Squint your eyes and wrinkle your nose.
- Lower face: Clench your teeth and pull back the corners of your mouth.
- Neck: Raise and lower your chin simultaneously.
- Chest, shoulders, upper back: Take a deep breath; hold it and pull your shoulder blades together.
- Abdomen: Push the stomach out and try to pull it back in at the same time.
- Right upper leg: Tense the large thigh muscle in the front while trying to feel the tension in the two smaller muscles in the back of the thigh.
- Right calf: Point your toes toward your head.
- Right foot: Point your toes downward, turn your foot in, and curl your toes gently.
- Left upper leg: Tense the large thigh muscle in the front while trying to feel the tension in the two smaller muscles in the back of the thigh.
- Left calf: Point your toes toward your head.
- Left foot: Point your toes downward, turn your foot in, and curl your toes gently.
The PMR Setting
Pick a location where there will be minimum distraction. Prevent loud noises or the sound of conversation from reaching you. You could place a sign on the door to prevent interruptions. Windows and drapes should be closed, and dim lighting is best.
If you feel discomfort in this type of environment, try and resolve these concerns before proceeding; you can also pick a brightly lit, noisy room, if you wish. Just remember that results may vary.
A good reclining chair is ideal if it provides full support for the entire body. Otherwise a mat on the floor or a sleeping bag will also be a good choice. Pick whatever makes your body comfortable and more likely to relax. Wear comfortable clothing.
Step-by-Step PMR Instructions
- Remove or loosen any items (glasses, cell phone or tight belts) that may cause discomfort during PMR.
- Get in a comfortable position in your chair—start!
- Focus your attention on one muscle group at a time. Pay attention to the sensations you experience in that muscle group, letting the rest of your body remain relaxed. Tense and relax each of the muscle groups in the same order each time.
- Tense the muscles in each group by saying the word, “Now.” This will be your cue to tense the muscles. Do not tense the muscles until after you say, “now.”
- Relax the muscles in each group by saying the word, “OK.” This will be your cue to relax the muscles. Do not relax the muscles until after you say, “OK.”
- Tense and relax each muscle group twice. After the second time, check if the muscle group is completely relaxed. If not, repeat the relaxation for the muscle group.
- Try not to move any more than is necessary to remain comfortable. Do not move any muscles that have already been relaxed.
- Do not talk to anyone during the session unless it is absolutely necessary.
- A complete PMR should take about 45 minutes.
Some problems may appear during PMR. In some cases, you may have to find your own unique solutions to them. However, here are some of the more common problems and their suggested solutions.
Cramping may occur in some muscle groups. If this happens, move the affected muscles to alleviate the cramping, while keeping the rest of the body as relaxed as possible. For areas of the body in which there may be frequent cramping, use shorter tension periods of no more than 3–5 seconds. Once the cramp passes, return to the previous level of relaxation.
Frequent movement may indicate that you are not relaxing. Do not move any more than is necessary to be comfortable and do not move any parts of the body that have already been relaxed. Movement may also indicate a problem in understanding the purpose and method of PMR. If so, re-read the rationale and instructions.
You may laugh during relaxation, especially when you first try it. This is not a reason for stopping the session. Laughter may indicate something about motivation, feelings, or responses that are stimulated by the process. It may be useful to explore the meaning of the laughter after the relaxation session is completed.
Talking should be avoided unless necessary.
You may sometimes experience involuntary muscle twitches during relaxation. Be assured that twitches are common; they indicate deepening relaxation, and you should not try to control them.
If you experience anxiety-producing thoughts during PMR, try reviewing the instructions and focus only on the sensations experienced in the muscles. Or you may decide to focus your mind on some pleasant image or thought. This the technique of “thought switching,” in which you deliberately change the focus of your thoughts by concentrating on a pleasant image during the release phase. Another approach may be to alter the rate and/or depth of your breathing.
You may fall asleep during PMR. This is perfectly okay and should be seen as a good outcome of PMR. You can resume your relaxation session after you wake up or at some other time.
Coughing and Sneezing
Coughing or sneezing may occasionally interrupt relaxation. Infrequent coughing or sneezing does not interfere with PMR, but if you have a cold and coughing or sneezing is frequent, PMR should probably be postponed. If you are a smoker, be aware that deep breathing can trigger coughing. In this case, take only shallow breaths during tension or, alternatively, maintain normal breathing during tension and relaxation. Sometimes a change in body position can help reduce coughing.
If you believe you may have a condition that could prevent you from benefitting from PMR or may cause adverse effects, please consult your physician.
Have you tried PMR? Share your thoughts and experiences in the comments. Check out Stresshacker’s StressWise program: more stress relaxation techniques, stress coaching, online webinars, downloads for making sense of stress, and for better stress and stressor management.