Progressive muscle relaxation

Domain II · Behavioural & cognitive · Edmund Jacobson · 1908

What it is

Progressive muscle relaxation (PMR) is a learned self-regulation skill, not a therapy for one disorder. The client tenses a muscle group, releases it, and attends to the contrast between the sensations of tension and of letting go. Edmund Jacobson, a physician, developed the method from about 1908…

Format

• Home practice. Two sessions a day of 15–20 min are treated as essential. Practise when not under time pressure. Pressure of time and low motivation are the usual barriers.
• The client reaches deep relaxation in every group in session, without signalling residual tension, or only after one extra cycle.

Who practises it, and how they are trained or regulated

• The Bernstein & Borkovec programme reduces training in steps: 16 separate muscle groups are combined into 7 and then into 4 body areas in a fixed order, over about 10 sessions. Tensing is then dropped (relaxation via recall), a count is added, and finally counting alone is used. Each stage depends on mastering the one before.
• Format. Individual training is the reference format. A reclining chair with full support for head, arms and legs is used, with the eyes closed. Sessions are usually weekly. Group courses are common in Germany; Krampen (2012) ran 7 group sessions of about 15 people, once or twice weekly. Typical totals there were 6–10 sessions of 30–60 min for the 16-group form and 5–7 for an 11-group form.
• Jacobson's original structure (for contrast). Jacobson isolated single muscle actions (for example bending back one hand) and worked through scores of muscle groups. The client lay down, tension was faint, and the client simply stopped the effort. Training ran to dozens of sessions over many months, with daily practice. Wolpe combined groups (for example all five fingers at once), which cut training to a few…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Reports of rising anxiety while relaxing (see 5.5).
• Dizziness on standing, grogginess, or still feeling drowsy before driving.
• Cramp-prone groups (feet, calves). Use less tension or a shorter hold there.
• Unsupported limbs (they create tension of their own); a cold room; interruptions.
• See the systematic desensitisation guide for exposure-specific consent and safety steps.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.