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Guide VI-104

Autogenic training and autogenic therapy

J. H. Schultz, Wolfgang Luthe1920Jena
A 12 · L 54 · M 3423 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: J. H. Schultz's Autogenes Training (AT) as taught in German-speaking medical and psychotherapeutic courses: Grundstufe (basic stage), formelhafte Vorsatzbildung (formulaic intentions), Oberstufe (advanced, meditative stage). The six standard exercises are given in Schultz's classical order (heaviness, warmth, heart, breathing, solar plexus, forehead), with the common German course variant (breathing before heart, plus a calm formula) noted. Wolfgang Luthe's extensions ("autogenic therapy": autogenic modification, autogenic meditation, autogenic neutralisation) are added at the level of structure that the sources describe. [source: Abuín 2016; Husmann 2020; Klinik Prof. Schedel handout; German Wikipedia mirror (bionity)]

AT is a self-administered relaxation method. Schultz developed it in Jena and Berlin from 1920 onward, out of Oskar Vogt's fractionated hypnosis. He noticed that hypnotised subjects almost always reported heaviness and warmth. He then taught patients to produce that state themselves by passively concentrating on brief verbal formulas. He published it in 1932 as Das autogene Training. Konzentrative Selbstentspannung. [source: Husmann 2020] Luthe, Schultz's collaborator, spread the method internationally after 1958 and built it into a wider system, Autogenic Therapy (Schultz & Luthe 1969 and later volumes). [source: Husmann 2020; Abuín 2016; EN Wikipedia]

Core idea of change: daily practice of passive concentration on standard bodily formulas produces a trained shift towards a calm, low-arousal "autogenic state". The patient learns to enter this state, with growing generalisation, without a therapist. In Luthe's view, the brain also uses the state to discharge accumulated disturbing material as spontaneous "autogenic discharges", which the patient observes without interfering. Additional formulas, meditation and neutralisation methods are used when standard practice is not enough. [source: Abuín 2016; Guiote et al. 2024; Husmann 2020] Germany has a medical society for the method, the Deutsche Gesellschaft für ärztliche Hypnose und Autogenes Training (DGÄHAT), founded 1968. [source: Husmann 2020] DGÄHAT's own curricula are not drawn on here. [uncertain]

Scope and positioning. AT is a clinical self-regulation method that grew out of hypnosis. It is not stage hypnosis, and it involves no covert induction: the patient practises with full knowledge and controls every session. Schultz placed AT mainly for milder, "peripheral" disorders and held that complex disorders need longer psychotherapy. [source: Husmann 2020] For medical conditions (headache, hypertension, gastrointestinal complaints, pain), use AT only as an adjunct within medical care, after medical assessment. It never replaces medical treatment, and it is not a treatment for cancer or any other physical disease. [source: HealthLink BC; bionity; synthesis]

2. Framework

Phase 0: Assessment, medical clarification and indication (1–2 individual sessions) [source: Husmann 2020; Krampen; HealthLink BC; UCLH]

  • Goals: screen out contraindications (Section 4, intervention 1), get medical clarification of somatic complaints, agree on the aim and the practice commitment, and decide between group and individual format.
  • In the hypnosis tradition AT came from, Schultz required a thorough somatic-psychiatric work-up before any suggestive method, and later required the same for AT. Practitioners should be licensed and trained well enough to manage crises. [source: Husmann 2020]
  • UCLH (Royal London Hospital for Integrated Medicine) begins with an assessment by a therapist trained by the British Autogenic Society (BAS), who recommends a course only if it fits. [source: UCLH]
  • Move on when the patient has no absolute contraindication, relative contraindications have been weighed, any needed medical check is done, and the patient agrees to daily practice.

Phase 1: Grundstufe, the six standard exercises [source: Klinik Prof. Schedel; Abuín 2016; UCLH; HealthLink BC]

  • Goal: reliable self-induction of the autogenic state through the standard exercises, ending every session with a correct Zurücknehmen (taking back).
  • Pacing: one new exercise added at a time, each practised for at least about a week. Move on only when the current sensation comes noticeably faster. [source: Klinik Prof. Schedel; EN Wikipedia]
  • Home practice: 2–3 times daily for about 3 minutes in the first two months, later 5–10 minutes, then a maintenance phase of about 3 times a week. [source: Klinik Prof. Schedel] Abuín describes Luthe-tradition practice as at least three times a day. [source: Abuín 2016] HealthLink BC puts mastery of all six at 4–6 months of slow, steady practice. [source: HealthLink BC]
  • Formats reported:
    • UCLH/BAS: 8 weekly 2-hour group sessions with 6–8 patients. [source: UCLH]
    • Six 1-hour teaching sessions, then a discussion session and boosters at 2, 4 and 6 months. [source: Abuín 2016, citing ter Kuile et al. 1995]
    • 9 weekly group sessions of 1.5–2 hours. [source: Abuín 2016, citing Ehlers et al. 1995]
    • 8 sessions plus home practice from a recording. [source: Abuín 2016, citing Shinozaki et al. 2010]
    • Instructor-led training appears to work better than recording-only training. [source: Abuín 2016]
  • Criteria for completion: the patient can run the full sequence (or a short form) alone, shows the expected sensations, generalises them beyond the training limb, and always takes back correctly. Practice logs show regular practice.

Phase 2: Formelhafte Vorsatzbildung / autogenic modification (built on a working Grundstufe) [source: Abuín 2016; bionity; Tirol PKA handout; Kraft 2015 listing]

  • Goal: add brief, individually tailored formulas once the autogenic state is reliable. These are either intentional formulas (psychological aims) or organ-specific formulas (physiological functions). [source: Abuín 2016]
  • Some German course material calls this the "Mittelstufe". [source: Tirol PKA handout] Kraft's 5th edition (2015) gives it its own chapter. [source: Kraft 2015, publisher listing only] [uncertain]
  • Move on when the formula is in daily use and the patient reports transfer to the target situation.

Phase 3: Oberstufe / autogenic meditation (optional; for selected patients) [source: bionity; Abuín 2016; Husmann 2020]

  • Goal: imagery-based self-exploration and personality development from within the autogenic state.
  • Prerequisites: mastery of the Grundstufe (bionity), and the ability to hold the state for long periods. Luthe's meditative series uses sessions of about 30–60 minutes. [source: Abuín 2016]
  • The German sequence runs from colours to concrete objects, abstract values, questions to oneself, and set journeys, ending with personal goal images. [source: bionity] It usually takes place inside psychotherapy, with the content discussed afterwards. [source: bionity]

Phase 4: Autogenic neutralisation (Luthe; specialist; a minority of patients) [source: Abuín 2016; Guiote et al. 2024]

  • Goal: work through disturbing material that keeps disrupting standard practice, using autogenic abreaction or autogenic verbalisation.
  • Indication: standard AT is not enough. Luthe and Blumberger estimated this at 10–20% of patients. [source: Abuín 2016] Guiote et al. describe these as advanced methods to use when discharges do not resolve with standard practice. [source: Guiote et al. 2024]
  • Trauma rules apply (Section 4, interventions 19–21): readiness criteria, dosing and closure. The full procedure is in Luthe's volumes, which are not drawn on here. [uncertain]

Maintenance: booster sessions (for example at 2, 4 and 6 months) and continued practice about 3 times a week. [source: Abuín 2016; Klinik Prof. Schedel]

3. Guiding principles

  • Passive concentration: attend to the formula and the sensation, not to a result; never "try to make" the arm warm. Practically, if the patient strains, effort is the problem. [source: Abuín 2016]
  • Passive acceptance / non-interference: whatever arises (sensations, images, twitches, emotions) is observed, not fought or chased. Practically, normalise discharges and teach the patient to let them pass. [source: Abuín 2016]
  • Self-help, not heterosuggestion: Schultz's maxim was "Der Patient übt, der Arzt schweigt!" (the patient practises, the doctor is silent). [source: Husmann 2020] Practically, the experience must come from the patient. Teach, then let them practise in silence; do not narrate sensations to them. Krampen allows extra heterosuggestion only as a case-by-case adaptation (intervention 17). [source: Krampen]
  • Exact taking back every time: Schultz insisted on precise activation at the end of every exercise. [source: Husmann 2020] Practically, check in session that the patient does it and does not skip it (except when using AT to fall asleep). [source: Klinik Prof. Schedel]
  • Regular, ritualised practice is the active ingredient: short sessions several times a day, at fixed times, in low-stimulus settings, then moved into daily life. Practically, negotiate concrete practice slots, not good intentions. [source: Klinik Prof. Schedel; UCLH; HealthLink BC]
  • Graded progression: one new exercise at a time, and only when the previous one comes easily. Practically, do not rush the sequence to fit a course calendar. [source: Klinik Prof. Schedel; EN Wikipedia]
  • Clarify first, then train: medical and psychiatric clarification comes before AT, and the trainer must be able to handle crises. Practically, do not start AT for an undiagnosed physical symptom. [source: Husmann 2020; bionity; HealthLink BC]
  • Know the indication range: AT suits milder disorders. Use it as a preparation for, or alongside, psychotherapy for more complex problems, not instead of it. [source: Husmann 2020; Krampen]
  • Tailor formulas when clinically needed: formulas can be shortened, worded differently, or left out for individual patients. Practically, adapt rather than force a formula that provokes symptoms. [source: EN Wikipedia; Krampen; Abuín 2016]
  • The group supports, but is not group therapy: in group courses members support each other, but the group does not process personal material. [source: UCLH] Practically, keep group check-ins about practice experience, and take personal material to individual sessions.
  • Adjunct within medical care: do not use AT to replace medicines or other conventional treatment. [source: HealthLink BC]

4. Intervention inventory

Formula wording below is limited to the short standard formula names, plus brief paraphrase. Schultz's and Luthe's full formula texts and instructions are not reproduced. Example language is my own illustrative wording.

1. Screening, contraindications and medical clarification

  • Purpose / when: before any training, and again before Phase 3 or 4.
  • Steps:
    1. Take a psychiatric and medical history. Ask about current medical care for any somatic complaint the patient hopes AT will help (headache, blood pressure, digestive complaints, pain), and arrange medical clarification if it is missing. [source: bionity; HealthLink BC; Husmann 2020]
    2. Check the absolute contraindications Krampen lists: acute psychotic phases; Debilität (the source's dated term for marked intellectual impairment); psychic twilight (Dämmer-) states; acute intoxication; withdrawal syndromes; bleeding peptic ulcer. [source: Krampen]
    3. Weigh the relative contraindications: phase and severity of illness, personality, attitudes and motivation. Ignoring them makes learning and transfer unlikely, raises dropout, and risks harm from repeated failure. Symptom provocation through heightened attention to disorder-specific symptoms is the central risk. [source: Krampen]
    4. Note the specific cautions from the sources:
      • Solar-plexus/abdominal warmth formulas are advised against in peptic ulcer or gastritis. [source: Abuín 2016]
      • Some people show paradoxical blood-pressure rises. HealthLink BC reports sharp rises or drops, so with high or low blood pressure, have readings checked. [source: Abuín 2016; HealthLink BC]
      • Some epilepsy patients with infrequent seizures had more seizures during AT. [source: Abuín 2016]
      • Patients with diabetes, a heart condition or another serious disease should learn and use AT only under their doctor's supervision. [source: HealthLink BC]
      • Not recommended for children under 5, or for people with severe mental or emotional disorders, or whose symptoms cannot be controlled. [source: HealthLink BC; EN Wikipedia]
      • Learning ability falls as neurotic or psychotic tendencies increase. [source: bionity]
      • Depressive tendencies, hypochondriasis and "hysteria" go with poorer learning. Self-focused attention and low self-confidence work against it, and heightened self-perception can amplify negative thoughts. [source: Krampen, citing Badura 1977]
    5. Added cautions [synthesis]:
      • Insulin-treated diabetes: ask the patient to monitor glucose more closely when starting, and agree this with the treating physician.
      • Cardiac anxiety, panic disorder or arrhythmia: decide in advance whether to omit or reword the heart exercise (intervention 7).
      • Asthma or breathing-focused panic: plan the breathing exercise carefully.
      • Severe dissociative symptoms or untreated PTSD: teach the Grundstufe only with stabilisation in place, short exercises and eyes-open options. Do not do neutralisation without trauma competence.
      • Ongoing medication for blood pressure or glucose: tell the prescriber that AT has started.
  • Example language (illustrative): "Before we start, I need to know about your health and any treatment you're having, because this method can shift blood pressure and some body sensations. If you have a physical complaint that hasn't been checked, let's get it checked first."
  • Watch for: patients hoping AT will replace medication. HealthLink BC advises against this. [source: HealthLink BC]

2. Introduction and practice contract

  • Purpose / when: first teaching session. Builds the rationale and the commitment to home practice that the method depends on.
  • Steps:
    1. Explain AT as concentrative self-relaxation: you learn it by practising, the effects build over weeks, and you stay in control throughout. [source: Husmann 2020; DocCheck]
    2. Explain passive concentration and passive acceptance (Section 3). [source: Abuín 2016]
    3. Agree concrete practice times (2–3 short sessions a day), a quiet place, and when not to practise (directly after coffee, sport or work stress). [source: Klinik Prof. Schedel]
    4. Explain attendance expectations. UCLH stresses attending all sessions and practising three times a day. [source: UCLH]
    5. Explain that unusual sensations (discharges) can occur and are reported, not suppressed (intervention 22). [source: Abuín 2016]
  • Example language (illustrative): "This is like learning an instrument: a few minutes, several times a day, is what makes it work. You can't force the sensations. You repeat the phrase, notice, and let whatever happens happen."
  • Watch for: expectations of instant results, or a wish to use recordings only. Abuín notes that recorded instruction differs from instructor-led training. [source: Abuín 2016]

3. Training postures

  • Purpose / when: taught in session 1. Lets the patient practise anywhere.
  • Steps:
    1. Lying: on the back, head slightly supported, arms loosely beside the body with elbows a little bent, legs relaxed. Beginners often find this easiest. [source: bionity; hypnomanchester; DocCheck]
    2. Reclining armchair (Lehnstuhl): head supported against the back, arms on the armrests or thighs. [source: hypnomanchester]
    3. Sitting "Droschkenkutscherhaltung" (cab-driver posture): on a stool or chair edge, trunk slumped forward and head bowed, forearms and hands resting on the thighs, feet slightly apart. Usable anywhere. [source: bionity; hypnomanchester; DocCheck]
    4. Eyes closed, or gaze fixed on one point. [source: Klinik Prof. Schedel]
  • Example language (illustrative): "Find a position where no muscle has to hold you up. Let the head hang a little forward, rest your forearms on your thighs, and let your eyes close."
  • Watch for: neck or back strain in the sitting posture; falling asleep when lying down (fine at bedtime, a problem for daytime practice).
  • Variant: one practitioner page adds a 2–3-minute warm-up before the exercises: letting the face go slack, lowering the jaw, slow abdominal breathing with a longer out-breath. [source: hypnomanchester] This is a teacher's addition, not documented as Schultz's. [uncertain]

4. Ruhetönung and calm formula ("Ich bin ganz ruhig")

  • Purpose / when: opens every session, and in German courses runs between the exercises.
  • Steps:
    1. Settle into the posture, sigh out, let the face relax, and turn attention inward. [source: Klinik Prof. Schedel]
    2. Silently repeat the calm formula (standard name: "I am completely calm"). [source: DocCheck; Klinik Prof. Schedel; bionity] Some courses insert it once after the arm formula. [source: Klinik Prof. Schedel]
    3. Treat thoughts and noises as unimportant and gently return to the formula. [source: Klinik Prof. Schedel; bionity]
  • Example language (illustrative): "Before the first phrase, give yourself a moment to arrive. Thoughts may come and go; they don't need answering."
  • Watch for: patients who fight intrusive thoughts. Remind them of passive acceptance.

5. Heaviness exercise (Schwereübung)

  • Purpose / when: first exercise, about week 1. Trains muscular relaxation and the basic skill of passive concentration. [source: Abuín 2016; EN Wikipedia]
  • Steps:
    1. In posture, after the calm formula, repeat silently "right arm heavy" (left arm for left-handers, i.e. the dominant arm), about six times, while noticing the arm. [source: Klinik Prof. Schedel; EN Wikipedia]
    2. Take back (intervention 11). Keep early sessions very short, about 3 minutes in total. [source: Klinik Prof. Schedel]
    3. Over the following days, extend to both arms, both legs, then the whole body (generalisation). [source: EN Wikipedia; Klinik Prof. Schedel; DocCheck]
  • Example language (illustrative): "Say the phrase to yourself like a quiet reminder, not an order, and just notice the arm. Whether it feels heavy or not, you've done the exercise."
  • Watch for: the arm feeling heavy, limp or sinking. Within about a week, brief concentration should bring heaviness in arms and legs. [source: EN Wikipedia] Also watch for twitches or tingling (discharges, intervention 22) and for strain.

6. Warmth exercise (Wärmeübung)

  • Purpose / when: second exercise, added once heaviness comes easily. Trains peripheral vasodilation. [source: Abuín 2016; bionity]
  • Steps:
    1. Calm formula, then the heaviness formula (short).
    2. Add the warmth formula (standard name: "right arm warm", in German often "strömend warm", i.e. flowing warm), repeated several times. [source: Klinik Prof. Schedel; DocCheck; EN Wikipedia]
    3. Generalise to arms and legs. [source: DocCheck]
    4. Take back.
  • Example language (illustrative): "Add the warmth phrase after the heaviness. Some people feel it in the hands first. Simply notice where it shows up."
  • Watch for: warm, tingling hands. Paradoxical coldness or anxiety means checking for striving, and keeping the exercise brief.

7. Heart exercise (Herzübung)

  • Purpose / when: third exercise in Schultz's order. In many German courses it comes after breathing. [source: Abuín 2016; EN Wikipedia; bionity; Tirol PKA handout] Passive attention to a calm, even heartbeat.
  • Steps:
    1. After calm, heaviness and warmth, attend to the heart region and repeat the heart formula (standard name: "heartbeat calm and regular"). [source: EN Wikipedia; DocCheck; Klinik Prof. Schedel]
    2. Take back.
  • Example language (illustrative): "You don't have to feel your heartbeat. If you notice it in your chest or your pulse somewhere, simply let it be as it is."
  • Watch for and cautions:
    • Heart conditions call for medical supervision. [source: HealthLink BC]
    • Formulas can be omitted or reworded for clinical needs. [source: EN Wikipedia; Krampen]
    • [synthesis] With cardiac anxiety or panic, attention to the heart can trigger the very symptom the patient fears. Options: omit the exercise, reword it in a neutral way (for example warmth in the chest), or postpone it. Stop if anxiety rises sharply. [source for stopping: HealthLink BC]

8. Breathing exercise (Atemübung)

  • Purpose / when: fourth in Schultz's order; often placed earlier in German courses. Passive concentration on breathing without controlling it. [source: Abuín 2016; EN Wikipedia; bionity]
  • Steps:
    1. After the previous formulas, attend to the breath and repeat the breathing formula. Standard names: "breathing calm and even", or "it breathes me" (German "es atmet mich"). [source: EN Wikipedia; DocCheck; Klinik Prof. Schedel; bionity]
    2. Take back.
  • Example language (illustrative): "This isn't a breathing technique. Don't change the breath. Let it happen by itself and just ride along with it."
  • Watch for: patients who start controlling or deepening the breath (correct towards passivity), and air hunger or dizziness. [synthesis] In asthma or breathing-focused panic, keep this exercise very short, or skip it after discussion.

9. Solar plexus exercise (Sonnengeflecht / Leibwärme)

  • Purpose / when: fifth exercise. Passive concentration on warmth in the upper abdomen. [source: Abuín 2016; bionity; Husmann 2020]
  • Steps:
    1. After the previous formulas, attend to the upper abdomen (between navel and lower end of the breastbone) and repeat the solar plexus formula (standard name: "solar plexus flowing warm"). [source: DocCheck; EN Wikipedia; Klinik Prof. Schedel]
    2. Take back.
  • Example language (illustrative): "Rest your attention on your upper belly, behind the stomach, and let the warmth phrase simply sit there."
  • Watch for and cautions:
    • Advised against in peptic ulcer or gastritis. [source: Abuín 2016]
    • Bleeding peptic ulcer is an absolute contraindication to AT. [source: Krampen]
    • Watch for gurgling or abdominal sensations; these are normal discharges.

10. Forehead coolness exercise (Stirnkühle)

  • Purpose / when: sixth and last standard exercise. A clear, cool head that keeps the patient alert. [source: Abuín 2016; bionity]
  • Steps:
    1. After the previous formulas, attend to the forehead and repeat the forehead formula (standard name: "forehead pleasantly cool"). Keep it short.
    2. Take back.
    3. Headache variant: a combination of neck warmth with a cool, clear forehead is quoted for headache patients. [source: DocCheck] Medical clarification of the headache comes first. [source: bionity]
  • Example language (illustrative): "Imagine a slight coolness, like a gentle breeze across the forehead. Only slightly cool, not cold."
  • Watch for: headache or a cold, tight feeling (reduce emphasis; "pleasantly" or "slightly" cool). [synthesis] The sources describe this exercise as keeping the head clear and alert. [source: bionity] [synthesis] So it may be left out when AT is used to fall asleep.

11. Taking back (Zurücknehmen / Rücknahme)

  • Purpose / when: closes every exercise. Schultz considered precise activation essential. [source: Husmann 2020]
  • Steps:
    1. Firmly flex and stretch hands and arms ("arms firm").
    2. Breathe deeply.
    3. Open the eyes. [source: Klinik Prof. Schedel; DocCheck; bionity]
    4. Stand up, or stretch and move. [source: DocCheck; Klinik Prof. Schedel]
    5. Leave out the taking back only when the aim is to fall asleep. [source: Klinik Prof. Schedel]
  • Example language (illustrative): "Now finish properly. Make fists, bend and stretch your arms strongly, take a deep breath, and open your eyes."
  • Watch for: lingering heaviness, dizziness or grogginess (repeat the taking back more vigorously), and patients who skip it. [synthesis] Have them sit for a moment before driving or using machinery.

12. Generalisation and short form

  • Purpose / when: end of the Grundstufe and maintenance. Fast, everyday use.
  • Steps:
    1. Extend sensations from one limb to the whole body, then to mental calm. [source: Klinik Prof. Schedel]
    2. Once proficient, say each formula only once, or use a compressed short sequence linked to a few breaths: calm, heaviness, warmth, abdomen warm, breath and heart calm, forehead cool. [source: Klinik Prof. Schedel]
    3. Move practice gradually from quiet rooms to everyday settings. [source: Klinik Prof. Schedel]
  • Example language (illustrative): "You can now run through the whole thing in a minute or two, for example on a bus. Use the short version, and still finish with taking back."
  • Watch for: the state coming quickly and reliably. If it gets weaker, return to the full form for a while.

13. Practice log and process evaluation

  • Purpose / when: throughout Phase 1. Supports regular practice and shows early warning signs.
  • Steps:
    1. Ask the patient to note, after each practice: time, duration, posture, which sensations came, any discharges, and how well taking back worked. [source: Krampen, citing Krampen, Main & Waelbroeck 1991 on practice logs; log fields are synthesis]
    2. Review the log at the start of every session. Decide whether to add the next exercise only when the current one comes faster. [source: Klinik Prof. Schedel]
    3. Krampen's group used standardised intake diagnostics (AT-EVA), standardised process evaluation and collegial supervision to prevent symptom worsening. [source: Krampen] AT-EVA is a published instrument; its items are not reproduced here.
  • Example language (illustrative): "Let's look at your notes. Where did the heaviness come quickly, and where did nothing happen?"
  • Watch for: empty logs (see Section 5, non-adherence), or rising symptoms in the logs.

14. Formulaic intentions (formelhafte Vorsatzbildung; Luthe's intentional formulas)

  • Purpose / when: after the Grundstufe is reliable. Anchors a personal intention in the autogenic state so that it carries over into daily life, for example staying calm in a stressful situation. [source: bionity; Abuín 2016]
  • Steps:
    1. With the patient, identify one target behaviour or attitude.
    2. Phrase a very short, personal formula. A published example of this kind, from the "Mittelstufe", is "I stay calm and composed" (German "Ich bleibe ruhig und gelassen"). [source: Tirol PKA handout]
    3. In the autogenic state, after the standard formulas, repeat the formula several times. Then take back. [source: bionity; Abuín 2016]
    4. Practise daily, and review transfer to the target situation.
    5. Luthe's intentional formulas resemble hypnotic suggestions but keep passive acceptance and non-interference. [source: Abuín 2016]
  • Formula-writing rules: German texts give rules for building formulas, but none of the sources state them. [uncertain] Common practice [synthesis]: keep formulas short and rhythmic, word them in the patient's own language, state what to do rather than what not to do, keep them realistic, and use one formula at a time. Kraft (2015) has a dedicated chapter, not drawn on here.
  • Example language (illustrative): "Let's find a phrase of a few words that says how you want to be in that meeting. It should sound like you, and be something you can actually believe."
  • Watch for: formulas that are really self-criticism ("I must not..."), or that demand outcomes outside the patient's control. Look for transfer: the patient reports remembering the formula in the situation.

15. Organ-specific formulas (autogenic modification)

  • Purpose / when: when standard practice alone does not produce a needed physiological effect. Formulas target a particular function. [source: Abuín 2016]
  • Steps:
    1. Confirm medical assessment and ongoing medical care for the target complaint. [source: bionity; HealthLink BC]
    2. Add a brief, function-directed formula to the standard sequence. The example quoted for headache combines a warm neck with a cool, clear forehead. [source: DocCheck] Any other examples here would be [synthesis].
    3. Keep passive acceptance; take back as usual. [source: Abuín 2016]
  • Example language (illustrative): "We'll add one phrase aimed at your neck tension. Same attitude: say it, notice, don't push."
  • Watch for: symptom provocation from focusing on the affected organ. [source: Krampen] Patients may stop medical treatment; HealthLink BC advises against this. [source: HealthLink BC]

16. Booster and maintenance sessions

  • Purpose / when: after the course, to keep up the skill.
  • Steps:
    1. Schedule boosters, for example at 2, 4 and 6 months after teaching. [source: Abuín 2016, citing ter Kuile et al. 1995]
    2. Agree maintenance practice of about 3 times a week, plus situational short-form use. [source: Klinik Prof. Schedel]
    3. At boosters, review practice, renew the full form, and fix drift (for example skipped taking back). [synthesis]
  • Example language (illustrative): "Let's do the full sequence together again and check what has crept in since we last met."
  • Watch for: practice that has lapsed, and a need for a refresher.

17. Adaptations for patients who have difficulty learning (Krampen, depressive disorders)

  • Purpose / when: case by case, only for patients who struggle to acquire or transfer AT. Krampen developed these for outpatients with depressive disorders, with AT as a preparation for or alongside psychotherapy. Severe depression was not studied. [source: Krampen]
  • Steps (choose as needed) [source: Krampen]:
    • Use very short exercise times, especially at home.
    • Begin with preliminary exercises to release motor tension and relax the body.
    • Explore the daily routine and place home practice at exact times and situations, linked to a following activity.
    • Strengthen self-suggestion: shorter pauses in inner speech, deliberate inner intonation, "reading" the formula beginnings inwardly, static mental images tied to formulas.
    • Introduce autogenic modification early, and use neutralising formulas often.
    • Leave out some standard formulas, and leave out the standardised process evaluation.
    • Strengthen heterosuggestion: the trainer speaks formulas more often and with more intonation; add instrumental music during exercises; give recordings for home practice.
  • Example language (illustrative): "Let's make this smaller: one minute right after you brush your teeth, then you go and make coffee. That's the whole homework."
  • Watch for: negative thoughts that grow during self-observation, and low drive. Be ready to shorten exercises or move AT to after other treatment.

18. Oberstufe / autogenic meditation

  • Purpose / when: selected patients with a solid Grundstufe. Self-exploration through imagery in the autogenic state, usually inside psychotherapy. [source: bionity; Abuín 2016; Husmann 2020]
  • Steps (German sequence) [source: bionity]:
    1. Enter the autogenic state through the standard sequence.
    2. Work through the steps over successive sessions, each tried until it is stable:
      • colours (a self-chosen colour, which tends to develop into dream-like images);
      • concrete objects (for example a candle or a rose);
      • abstract values (for example hope or courage);
      • questions to oneself and self-accepting formulations;
      • set journeys: to the sea floor, then to a mountain summit;
      • personal images aimed at specific goals.
    3. Hold the meditation for about 15 minutes; this is described as ideal. [source: bionity] Luthe's meditative series uses sessions of about 30–60 minutes. [source: Abuín 2016]
    4. Take back thoroughly, then recall and discuss the content in therapy. [source: bionity]
    5. Luthe's version can use therapist-selected or spontaneous themes: colours, objects, feelings, people, problems. [source: Abuín 2016]
  • Example language (illustrative): "When you're settled, let a colour come by itself. You don't need to choose it. Just tell me afterwards what appeared and how it changed."
  • Watch for: distressing images, or images of past trauma. These are experiences to explore, not historical evidence. Do not use imagery to search for or "recover" memories [synthesis] Have stabilising options ready, and stop the session with a full taking back if distress escalates.
  • Version note: the exact steps and their names vary between German texts; Kraft's "autogene Imagination" and Schultz's original Oberstufe are not drawn on here. [uncertain]

19. Autogenic abreaction (Luthe; autogenic neutralisation)

  • Purpose / when: a specialist method for the minority of patients (about 10–20% per Luthe and Blumberger) whose disturbing material keeps disrupting standard practice. [source: Abuín 2016; Guiote et al. 2024]
  • Readiness criteria [synthesis, since Luthe's own criteria are not drawn on]:
    • Stable Grundstufe practice.
    • No absolute contraindication.
    • Adequate affect regulation and a stabilisation plan.
    • No acute crisis, suicidality, ongoing danger or substance misuse.
    • Informed consent covering the possibility of strong emotional and bodily reactions.
    • A therapist trained in this method and in trauma.
  • Steps (structure as described) [source: Abuín 2016]:
    1. The patient enters the autogenic state.
    2. The patient describes aloud everything that happens (sensations, images, feelings, thoughts) with a "carte blanche" attitude, without judging or steering.
    3. The therapist listens and supports this non-interfering stance; content is not interpreted.
    4. The session ends when the discharges subside and the patient reaches emotional and physical neutrality.
    5. Close with a full taking back. [synthesis] Add grounding (eyes open, orient to the room, feet on the floor, name the date and place) and a short debrief before the patient leaves.
  • Dosing: the sources give the end criterion (neutrality) but not Luthe's session length or frequency. [uncertain] [synthesis] Book long sessions with buffer time, and schedule no more than one per week at first.
  • Example language (illustrative): "Just describe whatever comes, as if you were reporting the weather. You don't have to understand it or change it. I'll stay with you."
  • Watch for: dissociation, flooding, or loss of contact with the room. Respond with intervention 21 and Section 5. Material that emerges is the client's experience; do not treat it as uncovered historical fact, and never use the method to "recover" memories [synthesis]

20. Autogenic verbalisation (Luthe)

  • Purpose / when: discharging a previously identified theme, for example aggression, anguish or an obsessive theme. [source: Abuín 2016]
  • Steps:
    1. Identify the theme with the patient beforehand. [source: Abuín 2016]
    2. In the autogenic state, the patient speaks freely and repeatedly about the theme until they feel "emptied", which may take about 10–40 minutes. [source: Abuín 2016]
    3. Take back, ground, and debrief. [synthesis]
  • Readiness criteria: as for intervention 19. [synthesis]
  • Example language (illustrative): "Today the theme is your anger at work. Say whatever comes about it, over and over if it comes over and over, until you notice you've run out."
  • Watch for: escalation rather than emptying. If so, stop, ground, and return to stabilisation.

21. Grounding and closure after intense autogenic sessions

  • Purpose / when: after neutralisation or Oberstufe sessions, or whenever a patient leaves the state distressed. [synthesis]
  • Steps [synthesis]:
    1. Vigorous taking back (intervention 11).
    2. Orient: open the eyes, name five things in the room, feel the feet on the floor and the back against the chair.
    3. Rate distress, and continue grounding until it falls to a manageable level.
    4. Briefly name what happened, without processing further.
    5. Agree what the patient will do over the next hours, and a contact route if distress returns.
  • Example language (illustrative): "Eyes open, look around and tell me three colours you can see. Press your feet into the floor. Good. How strong is the upset now, from 0 to 10?"
  • Watch for: residual dissociation (glazed look, delayed answers). Do not let the patient leave, or drive, until oriented.

22. Handling autogenic discharges

  • Purpose / when: any phase. Discharges are spontaneous, unexpected responses during the autogenic state. [source: Abuín 2016]
  • Range: motor, sensory (somatic and visceral), vestibular, auditory, olfactory, gustatory, visual, affective and ideational phenomena. Examples: muscle twitches, crying, headache, anxiety or restlessness, dizziness. [source: Abuín 2016] Guiote et al. note that discharges often relate to traumatic memories, and that most resolve with standard practice. [source: Guiote et al. 2024]
  • Steps:
    1. Teach in advance that discharges can happen and are to be observed, not suppressed. [source: Abuín 2016]
    2. Ask about them at every review (intervention 13).
    3. Mild discharges: continue practice with passive acceptance. [source: Abuín 2016]
    4. Strong or distressing discharges: shorten exercises, take back early, and consider changing or dropping the formula that triggers them. [synthesis; formula adaptation per EN Wikipedia and Krampen]
    5. If the patient is very anxious or restless during or after practice: stop, or continue only under trained supervision. [source: HealthLink BC]
    6. Persistent discharges that block progress: consider neutralisation, by a specialist (interventions 19–20). [source: Guiote et al. 2024; Abuín 2016]
  • Example language (illustrative): "A jerk in the leg or a sudden image is your system letting something go. Notice it, let it pass, and come back to the phrase."
  • Watch for: seizure-like events in epilepsy [source: Abuín 2016]; blood-pressure changes [source: Abuín 2016; HealthLink BC]; trauma intrusions.

23. Further Luthe elements (named only)

Abuín names further components of Luthe's autogenic therapy without describing them. [source: Abuín 2016] The procedures are not specified in the sources, so none are given here. [uncertain]

  • paradoxical intention;
  • exercises that allow crying or other release (sometimes called intentional off-loading exercises);
  • simple advice on everyday conditions that work against homeostasis ("antihomeostatic");
  • the Creativity Mobilisation Technique (Luthe 1976).

5. Handling problems

  • "Nothing happens" / stuck at an exercise
    • Check for striving: the patient is trying to produce the sensation. Re-teach passive concentration. [source: Abuín 2016]
    • Accept slow progress. Learners vary, so stay with the current exercise until it comes noticeably faster. [source: Klinik Prof. Schedel]
    • [synthesis] Check posture, timing (not right after coffee, sport or stress [source: Klinik Prof. Schedel]) and session length. Shorter is often better.
    • Learning success is lower with depressive or hypochondriacal tendencies and self-focused attention. [source: Krampen] Use the Krampen adaptations (intervention 17).
  • Wandering thoughts and noise: return gently to the formula, or treat thoughts and noises as irrelevant; do not fight them. [source: Klinik Prof. Schedel; bionity]
  • Non-adherence (no home practice)
    • Regular practice is essential; without it AT is unlikely to work. [source: UCLH; HealthLink BC]
    • Explore the daily routine, set precise practice times linked to existing habits, and shorten exercises. [source: Krampen]
    • Review logs every session. [source: Krampen]
    • [synthesis] Name the gap without blame, and reduce the task until it is doable. If adherence stays absent after several weeks, review the indication rather than keep pushing.
    • UCLH refers non-attenders back to the GP. [source: UCLH]
  • Symptom worsening / symptom provocation (for example more palpitations, headache, abdominal discomfort, anxiety)
    • Krampen names this as the central risk. Safeguards are process evaluation and supervision. [source: Krampen]
    • Steps [synthesis, with formula adaptation per EN Wikipedia and Krampen]: identify which formula triggers it; shorten, reword or omit that formula; consider medical review.
    • If the patient is very anxious or restless: stop, or continue only under trained supervision. [source: HealthLink BC]
  • Overwhelm, flooding or dissociation in session
    • [synthesis] Stop the formulas. Do a vigorous taking back (intervention 11). Ground: eyes open, orientation, sensory anchors (intervention 21). Lower the arousal before ending.
    • Afterwards, return to Grundstufe practice with eyes-open and short-session options, and strengthen stabilisation before any further neutralisation or Oberstufe work.
    • Do not treat emerging images as memories to be explored for "truth"; do not use AT to recover memories.
  • Strong autogenic discharges
    • Normalise them, and keep the observing stance. [source: Abuín 2016]
    • If they persist, adapt the formulas, or refer for specialist neutralisation. [source: Guiote et al. 2024; Abuín 2016]
    • Watch seizures in epilepsy, and blood pressure. [source: Abuín 2016; HealthLink BC]
  • Physical side effects after practice (dizziness, heaviness, sleepiness): repeat a vigorous taking back, and check that it is being done after every practice. [source: Husmann 2020; Klinik Prof. Schedel] [synthesis] Get up slowly, especially with low blood pressure.
  • Medical issues
    • Patients with diabetes or a heart condition practise under medical supervision. [source: HealthLink BC]
    • [synthesis] Advise extra glucose checks in insulin-treated diabetes. Tell prescribers of blood-pressure medication, since paradoxical changes can occur. [source for paradoxical changes: Abuín 2016; HealthLink BC]
    • Do not use the solar plexus formula with ulcer or gastritis. [source: Abuín 2016]
    • Never let AT replace medical treatment. [source: HealthLink BC]
  • Psychotic symptoms, intoxication or withdrawal appearing during the course: stop AT. These are absolute contraindications. [source: Krampen] [synthesis] Arrange psychiatric review.
  • Rupture or a power struggle with the trainer
    • [synthesis] Recall Schultz's principle that the patient practises and the trainer is silent. [source: Husmann 2020] Reduce instruction and pressure, and hand control back to the patient.
    • Explore whether AT feels like an imposed exercise, or a test the patient fails. Repair openly, and adjust goals.
  • Group difficulties (comparison, competition, one member dominating with personal material)
    • Keep the group's focus on practice experience. AT is not group psychotherapy. [source: UCLH]
    • [synthesis] Offer an individual session to a member who needs to process material.
  • Recording-dependence: recordings are one of Krampen's adaptations. [source: Krampen] Recording-only training may be less effective than instructor-led training. [source: Abuín 2016] [synthesis] Fade recordings towards silent self-practice.
  • Using AT to avoid: [synthesis] if a patient uses AT to escape feared situations (relaxing instead of facing them), combine it with the indicated psychotherapy. Schultz placed complex problems outside AT's range. [source: Husmann 2020]
  • Children: not before age 5. [source: HealthLink BC; EN Wikipedia] [synthesis] For older children, adapt the language and keep sessions short.

Sources

Sources:

Further reading (not drawn on; primary texts, their content here comes only via the sources above) [uncertain]:

  • Schultz, J. H. (1932). Das autogene Training. Konzentrative Selbstentspannung. Leipzig: Thieme (many later editions).
  • Schultz, J. H. & Luthe, W. (1969). Autogenic Therapy, Vol. 1: Autogenic Methods. New York: Grune & Stratton (Vols. 2–6 by Luthe and co-authors, including Dynamics of Autogenic Neutralization and Treatment with Autogenic Neutralization).
  • Luthe, W. (1976). Creativity Mobilization Technique. New York: Grune & Stratton.
  • Luthe, W. (1979). The source Guiote et al. 2024 cite for the absolute and relative non-indications and contraindications. Its title was not verified.
  • Kraft, H. (2015). Autogenes Training. Grundlagen, Technik, Anwendung (5th ed.). Berlin: MWV.
  • Krampen, G. (2013). Entspannungsverfahren in Therapie und Prävention. Göttingen: Hogrefe.
  • Krampen, G. (1997). Zeitschrift für Klinische Psychologie, Psychiatrie und Psychotherapie, 45, 214–232.
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