Progressive Muscle Relaxation

How Progressive Muscle Relaxation can help people with PTSD

One of the worst responses to someone showing symptoms of post-traumatic stress disorder is to tell them ‘Just relax!”. You can’t switch off your responses like a light.

Instead, a mixture of therapies can alleviate the challenges you face, and decrease the impact of your PTSD. One of those therapies is often telling your muscles to relax though!

This is known as Progressive Muscular Relaxation. It includes steps you can take to create healthier sleep patterns for individuals with PTSD. Hospitals and other healthcare providers often recommend Progressive Muscular Relaxation to help manage chronic pain too.

This article explains the origins and advantages of Progressive Muscle Relaxation.

Why does this work?

One of the instinctive human responses is to tense muscles when you feel threatened or anxious. From clenching your jaw with gritted teeth to curling your toes, your body responds to stress by activating muscles. You must know the expression that someone is a ‘pain in the neck’ meaning they are creating stress. It shows the strong link between our emotions and physical reactions.

It stands to reason then, that if you work on tensing then relaxing your muscles, you can send messages to the brain that all is well, and ease emotional responses. Especially when you combine this with breathing exercises, aromatherapy or soothing music, which are other important ways to calm the symptoms of PTSD.

This is the basis of Progressive Muscular Relaxation.

The development of Progressive Muscle Therapy

Progressive Muscular Relaxation is a long-standing anxiety disorder therapy, first developed by American physician Edmund Jacobsen in the early 1930s.

In the 1950s, influential South African psychiatrist and behavioural therapist Joseph Wolpe developed the concept further. He blended the relaxation technique with other activities which can deescalate and desensitise anxiety disorders.

The major change Wolpe made was to reduce the complexities and timescale of Jacobsen’s original process. This was aimed at ensuring the muscle tensing and relaxing regime didn’t actually stimulate and extend stress responses.

Since then, clinical trials have backed up its potential benefits and therapists have incorporated Progressive Muscular Relaxation into their methods to alleviate PTSD symptoms. Including using it in conjunction with Cognitive Behaviour Therapy.

How to benefit from Progressive Muscular Relaxation

The steps involved are simple and can be done whenever anxiety threatens to overwhelm you. Though the usual recommendation is that you are lying down on a bed or floor, it is possible to mindfully tense and relax muscles while sat on a chair. It’s important to be undisturbed if you can, so you can focus solely on this therapy option. If your hypervigilance dictates, perhaps ask a friend or family member to sit outside your door, or in the room with you, so help put you at ease.

Progressive Muscular Relaxation involves tensing then easing each group of muscles in turn, as you take deep breathes. This is done at 10-20 second intervals, in a recommended cycle, and will cover your entire body.

The University of Michigan provides these steps to try Progressive Muscle Relaxation yourself:

  1. Breathe in, and tense the first muscle group (hard but not to the point of pain or cramping) for 4 to 10 seconds.
  2. Breathe out, and suddenly and completely relax the muscle group (do not relax it gradually).
  3. Relax for 10 to 20 seconds before you work on the next muscle group. Notice the difference between how the muscles feel when they are tense and how they feel when they are relaxed.
  4. When you are finished with all of the muscle groups, count backward from 5 to 1 to bring your focus back to the present.

They suggest the best order and actions to take:

  • Hands: Clench them.
  • Wrists and forearms: Extend them, and bend your hands back at the wrist.
  • Biceps and upper arms: Clench your hands into fists, bend your arms at the elbows, and flex your biceps.
  • Shoulders: Shrug them (raise toward your ears).
  • Forehead: Wrinkle it into a deep frown.
  • Around the eyes and bridge of the nose: Close your eyes as tightly as you can. (Remove contact lenses before you start the exercise.)
  • Cheeks and jaws: Smile as widely as you can.
  • Around the mouth: Press your lips together tightly. (Check your face for tension. You just want to use your lips.)
  • Back of the neck: Press the back of your head against the floor or chair.
  • Front of the neck: Touch your chin to your chest. (Try not to create tension in your neck and head.)
  • Chest: Take a deep breath, and hold it for 4 to 10 seconds.
  • Back: Arch your back up and away from the floor or chair.
  • Stomach: Suck it into a tight knot. (Check your chest and stomach for tension.)
  • Hips and buttocks: Press your buttocks together tightly.
  • Thighs: Clench them hard.
  • Lower legs: Point your toes toward your face. Then point your toes away, and curl them downward at the same time. (Check the area from your waist down for tension.)

PTSD and insomnia

One of the best times to take advantage of this simple stress relief technique is in the evening. It can be an important aid in easing tension before you go to sleep and may help avoid disrupted slumber and nightmares.

Insomnia is a common challenge for people with PTSD. Finding a way to go to sleep quicker, and stay asleep, can be an important step in your recovery.

It’s important to note, that while choosing your PTSD recovery path you need to address both the symptoms and the underlying condition. NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).

Please remember, these aren’t meant to be medical recommendations, but they’re tactics that have worked for others and might work for you, too. Be sure to work with a professional to find the best methods for you.

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