Wednesday, October 17, 2012

Somatic Relaxation


Somatic relaxation refers to a method that emphasizes muscle relaxation through detailed observation of and introspection of the body’s kinesthetic sensations (i.e., purposeful relaxation of muscles).Cognitive relaxation refers to the use of a mental device (e.g., word, thought, sound, breathing) and the practice of a passive or nonjudgmental attitude to induce relaxation in the mind and body. In this article we discuss two somatic relaxation methods, JPRT and APRT. JPRT is a systematic but lengthy method of becoming aware of  and relaxing all the muscles in the body. APRT is a shortened version of the JPRT and differs from JPRT in its basic principles of application.
Research on the physiologic effects of APRT demonstrated that relaxation practice blunted the excitatory autonomic changes experienced in response to everyday life events. APRT accomplished this effect by modulating both arms of the autonomic cardiovascular control system (i.e.,  sympathetic and vagal). Relaxation also induced the release of endogenous opioids. These opioids are partially responsible for reducing circulatory stress reactivity that occurs in response to relaxation practice. The practice of relaxation was discovered to improve immune competence, especially in older populations who often experience a loss of immune function.
APRT has been effectively used as an intervention for a variety of medical conditions, including chemotherapy induced nausea and vomiting, hypertension, pain control mood state management, and epilepsy.
PHILOSOPHY OF PROGRESSIVE MUSCLE RELAXATION THERAPY
Jacobson would eventually conclude that (1) detailed observation and introspection of the body’s kinesthetic sensations, as well as the mental processes that accompany them, were necessities if a person were to accomplish complete relaxation; and (2) localized body tensions occur as meaningful acts that originate in one’s imagination and thoughts. For example, just the thought of moving a limb produces measurable EMG responses in that limb.
Jacobson concluded that all thought is followed by musculoskeletal activity, even though the response amplitude may be nearly undetectable. Conversely, mental processes diminish or disappear as muscle relaxation reaches its maximal levels. In other words, although we may not think with our muscles, our muscles are involved in the thinking process. Jacobson believed cognitive activities were identical to the energies expended when neuromuscular circuits resonate. Therefore if neuromuscular circuits become completely relaxed( i.e., are silenced), then cognitive activity will also be silenced.
Jacobson argued that experiencing emotion while being totally relaxed was impossible. Thus the key to developing emotional control, Jacobson believed, was to learn progressive relaxation. Jacobson taught that relaxing the muscles that embody an undesired emotion will contain or eliminate the undesired emotion. This embodiment of the mind and emotions in the musculature was an essential part of Jacobson’s teachings. Tension was the process by which the emotions were embodied; the purpose of the tension was the meaning. The two concepts-the tension process and the meaning of the tension-became the foundation of Jacobson’s future relaxation research. For the next 70 years, Jacobson tested his basic concepts and the foundational principle: To relax the mind and body, the individual must relax all skeletal musculature.
Jacobson believed that to remain healthy, a person must develop habits of effective rest. If these habits are learned and practiced, then tension maladies can be prevented, and bodily energy would be used more efficiently. Jacobson noted that a startle response (i.e., a fight-or-flight effect) normally results in people hunching forward, rising to the balls of their feet, and preparing for battle (Cannon, 1929). This startle reaction naturally elicits a cascade of autonomic and endocrine responses that help the person survive. However, if this condition becomes chronic, and if relaxation fails to follow, then a continued state of hyperactivity occurs in the body that can result in pathologic abnormalities. Successful application of progressive muscle relaxation returns the body to a healthier state. Accomplishing progressive relaxation meant literally getting in touch with and learning to control the tension levels in all the striated muscles in the body.
MECHANISMS OF RELAXATION
Jacobson’s Progressive Relaxation Therapy
To practice the method known as JPRT, a person learns to identify highly sensitive sensory observations of what occurs beneath the skin. This learning considered a form of physiologic introspection. Whereas tension is a contraction of muscle fibers that elicits a tension sensation, relaxation is the lengthening of these fibers that then eliminates the tension sensation. The process of observing the tension, relaxing it away, and observing the difference in a muscle before and after relaxation is then systematically applied to all major muscle groups. With practice, the individual can fine-tune the ability to recognize sensory tension signals and then, at will, to relax away any tension not desirable in the body. The final goal of JPRT is to develop what is known as automaticity –a state in which the person automatically and unconsciously monitors and eliminates unwanted bodily tensions ( McGuigan, 1993).
Learning progressive relaxation involves detecting the faintest of tension signals. The individual often starts with obvious signals, such as raising the hand at a 90-degree angle. Then the person experiences the effects of tension in the forearm and carefully observes and notes the sensations. The person then moves on to more subtle tension cues, such as raising the hand to a 45-degree angle, then to a 20-degree angle, and so on. When the student is proficient at this practice, he or she can identify a tension signal of perhaps one-one thousandth(1/1000), the intensity of the signal experienced in the first exercise. This level of signaling is common in muscles of the tongue and eyes. Requesting an individual to generate and experience high-intensity tension is, Jacobson believed, counterproductive given that the purpose of JPRT is to learn control of more and more subtle. Therefore no purposeful tensing of muscles should occur while practicing JPRT.
JPRT is quite different from hypnosis because practitioners avoid using suggestion, that is, telling students their muscles are getting heavy or warm. Jacobson was careful to note that he intended students to learn physiologic control, leading to changes in the body different from those that occur in response to suggestion (Benson, Greenwood, and Klemchuk, 1976; Jacobson, 1938). Jacobson believed that relaxation had occurred when, in fact, it had not. Other researchers have pointed out that the words relaxation exercise and response are inappropriate in the context of Jacobsonian progressive relaxation. JPRT was intended to be delivered in a scientific and clinical context, and because relaxation is opposite of work, the terms  exercise and response are contradictory to the intended outcome. A person cannot make an effort to relax, because effort guarantees failure (McGuigan, 1993).
Initially, the required time investment to learn JPRT seemed extreme to many people. For example, practicing in one position might take as long as 3 hours. Jacobson eventually shortened his methods to allow practice of three positions in 1 hour. However, Jacobson believed no true shortcuts existed to learning to relax a body that had been in a state of tension for decades.