Some Factors Influencing the Effects of Relaxation Techniques
Dr. K. Nespor, Czechoslovakia
Relaxation techniques are used in somatic medicine as well as in psychiatry.
They have proved useful for the treatment of hypertension,*1, *2 bronchial
asthma,*3, *4 insomnia,*5 for pain treatment,*6, *7 as the prevention
and therapy of ischaemic heart disease,*8, *9, *10 in hyperactive children,*11 in gynaecology and obstetrics,*12, *13 for the treatment of migraine,*14
as a measure of prevention and mental hygiene.*15 After short
periods of relaxation the decrease of blood pressure in patients with
hypertension during twenty four hours was observed.*16 Relaxation,
which may be induced by various techniques, represents the physiological
opposite of stress, which causes and/or aggravates many diseases (Fig.
That is why preventive application of relaxation techniques is desirable
for people with stressful professions and people undergoing rapid social,
economic or cultural changes. Without these measures various psychosomatic
diseases (headache and indigestion) and other diseases can result.
Relaxation techniques are usually without side effects, and relief is
often felt immediately after practice. They can be combined with pharmacotherapy
and/or psychotherapy, and are not very demanding on therapist's time and
training. Some factors influencing the effects of relaxation techniques
are described in this paper.
Factors on therapist's part
- Therapist's own experience with relaxation technique and his ability
- Therapist's relation to a patient.
- Therapist's presence or absence. According to Tamez et al. relaxation
with live therapist was more effective than relaxation according to
tape recorded instructions (*17). But it may be possible that this finding
is not relevant for people practising for a long time by themselves
and knowing their technique very well. The mere physical presence of
a therapist can have supportive effect, and this is useful when some
strange or unpleasant feelings or thoughts appear. It is usually recommended
to a client to remain relaxed and indifferent.
Factors on a client's part
- Expectation. Placebo effect occurs during relaxation, and it is
beneficial to use it clinically. Positive expectations also increase
the motivation to practise regularly.
- Personality. Some authors consider self-regulation relaxation techniques
suitable for clients with 'sufficient ego-strength' but not for people
with hysterical symptoms.*18 Careful supportive approach and collaboration
with a psychiatrist is advisable in people susceptible to psychotic
attack. Neuroticism may also be an important consideration. People who
discontinued the practice of Transcendental Meditation had higher neuroticism
than those who continued to practise and those who did not start to
practise.*19 It is debatable if this finding is also relevant for
other relaxation techniques. The ability to visualise is of importance
in some techniques too. Simple relaxation techniques and longer training
will probably be more convenient for people with low intellect.
- Client's relation to a therapist influences positively or negatively
the motivation to practise and results.
- Belief system. This is the reason why some clients prefer or refuse
certain techniques. It is better to clearly explain the mechanism, effects
and benefits of technique before starting training.
- Momentary state. To relax is easier after adequate body and/or mental
activity. The combination of physical exercises and relaxation is very
good, physical activity may decrease depression and anxiety*20, *21
and makes following relaxation deeper. Practitioners may also be able
to perform their technique during stressful situations, e.g. during
dentistry, before an important interview or examination, and be more
- Pleasant/unpleasant feelings. Compliance to practice may increase
when the practice is pleasant, and decrease when unpleasant feelings
- Other factors. Compliance may be zero when treated disease brings
material or psychological gains to a client, e.g. rent.
Factors related to technique
- Frequency and length of practice. This factor is of course crucially
important. Relaxation techniques are usually practised for 5-30 minutes
once or twice daily, sometimes in addition short periods of relaxation
are recommended during normal daily activities. A paper about testing
if a client practises at home or not has been published.*22
- The choice of relaxation technique. There are many techniques bringing
about relaxation: yogic techniques, autogenic training and modifications,
progressive relaxation, biofeedback aided relaxation, hypnotic relaxation.
A suitable technique can be chosen with regard to client's personality
(further research is needed in this area; e.g. mental relaxation like
autogenic training or meditation is efficient in bronchial asthma, but
muscular relaxation is not)*3, *4, to client's belief system, and perhaps
also to his momentary state. The choice of technique is often limited;
many therapists use only one technique, which they know well.
Factors related to training
- The length of training. Usually after longer training the performance
- Environment. Relatively quiet environment is suitable. Later it is
possible to practise e.g. during transport or waiting.
- Time. Some consider late afternoon very suitable, or use relaxation
techniques to induce sleep at night. According to yogic tradition the
best time for meditation is early morning.
- Group or separate training. Group training is less demanding on therapist's
time, and a group can have supportive effect on a trainee. Later group
or individual discussion about feelings etc. is possible.
- Therapeutic milieu. The views of staff, relatives, friends, etc.,
may influence client's opinion about relaxation technique and his practice.
Detailed analysis of the factors influencing the effects of relaxation
techniques is neither usual or necessary when these techniques are applied
routinely. But such analysis may be very useful when training does not
progress well. Influencing factors explain why different results are achieved
with the same technique, and should be considered when relaxation techniques
are compared mutually.
Relaxation techniques are the important components of the treatment of
various psychosomatic diseases, the idea that relaxation creates the bridge
between somatic medicine and psychotherapy is correct.
Fig. 1. Stress and relaxation.
|Suprarenal and thyroid hormones
|Arterial blood lactate
|EEG waves frequency