ASSESSMENT OF PERSONALITY AND INTERVENTIONS IN CLINICAL

PSYCHOLOGY

JACOBSON’S PROGRESSIVE MUSCLE RELAXATION

REFLECTIVE JOURNAL

Demonstration: 01

Date:

INTRODUCTION:

Jacobson’s Muscle Relaxation technique was introduced by Dr. Edmund Jacobson to help his
patients deal with anxiety in the 1920s and felt that relaxing the muscles could relax the mind as
well. The JPMR technique involves tightening and relaxing various muscle groups in a specific
sequence to help release tension and be aware of our physical sensations. These JPMR sessions
can usually last from 20-30 minutes.

JPMR has shown to help with many mental and physiological concerns and conditions including
but not limited to: anxiety, stress, blood pressure, insomnia, pain relief, schizophrenia [used as an
alternative method to deal with states of anxiety and stress in schizophrenia patients] and also for
sport athletes to optimize their sport performance and relieve their daily tension. JPMR seems to
have multiple long-term beneficial effects like a decrease in generalized anxiety and anticipatory
anxiety, reducing duration of panic attacks, improving concentration, self-esteem and even
creativity.

Though this technique is simple, it may take several sessions of practice before it is completely
mastered. Once this practice is learned, an abbreviated version can be practiced by creating
tension in certain muscle groups. For example, a shorthand method might include tensing only
hands and arms or just the forehead, eyes and jaw. It is possible to become so proficient at PMR
that it is only necessary to focus on one muscle group to produce these results. Tightening and
relaxing the first muscle group for each area of the body, while saying the world RELAX, is one
way to shorten the practice with experience.
Various studies have been performed to demonstrate the beneficial effects of Jacobson’s
Progressive Muscle Relaxation technique for a variety of populations and conditions. A study by
Ravindra and Patel conducted in 2021 studied the effect of JPMR on stress in cancer patients
over 18 years of age. The results showed that there was a significant decrease in stress reported
by 74% of the sample. (Ravindra, Patel; 2021). JPMR also seemed to have a positive effect in
hospitalized older adults in India where it seemed to help the 30 inpatients in the experimental
group out of the total 60, experienced reduced anxiety and psychological distress and improved
quality of sleep. JPMR here was also combined with deep breathing exercises.(Kalra N., Khakha
D.C., Satapathy S., Dey A.B., 2015). The effect of JPMR training was also studied in HIV/
AIDS patients to see if it helped relieve their anxiety and depression and the results showed that
it did with anxiety being independent of the demographic of 30 patients from Udupi and
depression being dependent on their previous psychiatric illness. (Bommareddi, Valsaraj,
Shalini; 2014).

JPMR was also found to be useful in reducing the social anxiety of school going adolescents
from Udupi, where the social anxiety seemed to be related to parental strictness, conflict,
teacher’s strictness, peer rejection, trouble with appearance etc. (Joy F.E., Jose T., Nayak A;
2014) and it was also shown to reduce prevalent educational stress along with hypertension [per
NHBPEP guidelines] in students in a study done in Kerala with 145 adolescents
(Manjushambika R. et. al; 2017). Another study done on patients with chronic malignant pain as
a result of disorders like Fibromyalgia, chronic headache and somatic symptom disorder. This
study aimed to find the effect of JPMR on the psychopathologies of these patients and the
difference between the pre and post-test seemed to show reduced anxiety and depression in these
chronic pain patients and this shows continued proof of using JPMR in a pain management
program.(Suri K., Pandey M.; 2018).

A research by Maheshwari and colleagues done in 2018 on the elderly in old age homes of
Kolkata showed a decreased levels of stress in this population too (Maheswari T., Debarchana.,
Shipra M.; 2019). Another study done during the pandemic with young adult women whose
anxiety was measured using the STAI measure were given the JPMR relaxation training for one
month, showed there was a significant decrease in state anxiety but not trait anxiety for these
women. (Sudheer V., Nachimuthu K.P, 2022)
CONTENT:

Jacobson’s Progressive Muscle Relaxation involved the sequence of relaxing various muscle
groups. This technique incorporates breathing along with systematic tensing and relaxation of
muscle groups. Relaxation is a simple, effective method for cancer patients to manage theeir
symptoms for the disease and the treatment.

Relaxation therapy works well for most age groups from 18-80 years old and has been used to
decrease the symptoms of stress, anxiety, depression, blood pressure and pre/post menstrual
syndrome. The impact of progressive muscle relaxation has also been studied on cancer patients
and it was found that symptoms of cancer and the treatment like nausea, vomiting, pain, stress
and anxiety seemed to decrease (Hiltebrand, 1998, Shealy, 1996, Woodham, 1997)

There are 16 muscle groups in total that are focused upon and they are: Right hand and lower
arm, Left hand and lower arm, Right upper arm, Left upper arm, Right lower leg and foot, Left
lower leg and foot, Both thighs, Abdomen, Chest, Shoulders and back, Neck and throat, Lips,
Eyes, Lower forehead, Upper forehead. These 16 muscle groups’ sequences are the most
recommended but there are also alternative muscle sequences. Shorter sequences of 4 muscle
group sequence includes: Left and right hands, arms and biceps, Muscles of the face and neck,
Chest, shoulders, back and abdomen, Left and right thighs, calves and feet. These alternative
muscle sequences were given by Bernstein and Borkovec (1973). The 16 muscle groups, why
those muscle groups are relaxed and how it can be applicable in daily life for general relaxation
or calming.

JPMR is a two-step relaxation practice to reduce stress and build awareness of sensations of
tension and deep relaxation in various muscle groups. The first step in this practice is to create
tension in specific muscle groups and begin to notice what tension feels like in this body part.
The second step is to then release this muscle tension and begin to notice what a relaxed muscle
feels like as the tension drains away. By moving through the body by alternately tensing and
relaxing different muscle groups in a certain order, one builds awareness of how to recognize and
differentiate between the associated feelings of a tensed muscle and a completely relaxed one.
Often, it is recommended to create tension and relaxation several times in the same muscle
groups, with diminishing degrees of tension, to deepen awareness and train the body to more
deeply relax. Through repetitive practice, a person can then induce physical muscular relaxation
at the first signs of the tension that accompanies stress. After the practice, there may be one or
two areas that are still tense, requiring one to repeat tensing and relaxing that muscle group.

PROCESS:

JPMR can be practiced in a comfortable position sitting or lying down in a place that you will be
undisturbed for 10-15 minutes. Focus your attention on each of the groups of muscles in the list
below and work through them one muscle group at a time. Tense each muscle group and notice
how that muscle feels when it is tensed. Hold this tension for five seconds while breathing in.
Then, release and relax that muscle all at once. Pay close attention to the feeling of relaxation
when releasing the contracted muscle. If any of the exercises cause discomfort or cramping, ease
up, stop or skip this body part entirely so as not to exacerbate any pre-existing injury or cause
pain. This rhythmic pattern of breathing and movement can enhance the feeling of relaxation
throughout the body and help calm the mind.

When you have a good sense of what it feels like to be relaxed in that area of the body, transition
on to the next muscle group. Make sure to not hold your breath during this practice. If it begins
to hurt, cramp or feel uncomfortable while tensing a certain part of the body, reduce the
contraction or stop and move on to the next muscle group. When going through the PMR
exercise, it is recommended to start at one part of your body and move systematically. For
example, some people start with the feet, others at the face. You may do one side of the body
(hand, arm, leg, foot) at a time, or do both sides at the same time.

OUTCOME

The Jacobson's Progressive Muscle Relaxation technique has various beneficial outcomes. It
results in the body feeling relaxed and loose. It helps calm the mind and reduce symptoms of
anxiety and stress. It's also known to improve our blood pressure, heart rate and oxygen
consumption. JPMR also helps in improving concentration, performance and relieves muscle
tension too.
INTROSPECTION-

The Jacobson's Progressive Muscle Relaxation technique was demonstrated on us in a classroom

setting. Overall, with the added calming music and instructions, there was an improvement in
physical sensations for sure and mentally, my mind felt clear. When the demonstration started, I
was unaware of how physically tense or mentally occupied I was. Starting with the hands and
upper arms, I didn't notice too much of a difference in my state. Moving to the shoulders and
neck region, I was able to tense and relax well and my mind felt more clear. I noticed my
muscles felt very sore but it felt relieving. I slowly made an effort to keep my mind calm, blank
and drift to a happy place. Moving forward with each muscle group, I could feel the relief and
the constant thoughts and worries slowly came to a halt. It was relieving to solely focus on the
one body part and relaxing and nothing else. It felt like mentally heaving a big sigh. I could
notice that the sounds around that would usually be distracting now seemed barely noticeable.

When moving to the leg and calf muscles, I felt discomfort as the sitting position in a classroom
setting made it uncomfortable to stretch, tense and relax the leg muscles efficiently. It was
distracting at that point and my calmness was lost. The demonstration slowly ended with trying
to get back in the calm headspace. Reflecting back, there was certainly a large improvement in
how I felt physically and mentally. As a person who tends to overthink and spiral in their
thoughts, it was extremely relieving to switch that off in a healthy way instead of mindlessly
scrolling on a phone or engaging in media. It felt like an added bonus to how physically relaxed I
felt too. It was a realization of how tense and stuff I was in certain areas. After the
demonstration, I felt more clear headed and focused and was able to retain information from
what was taught well.

CRITICISM:

Some reported criticisms of JPMR is that in rare cases for people with anxiety, the increased
body awareness that comes with relaxation training leads to more anxiety instead of a reduction
in anxiety in some people. In some more very rare cases, there have been instances of pain, heart
palpitations and muscle twitching (progressive muscle relaxation, 2022)
Another criticism of the technique is that its not ideal or effective for people with medical
conditions like chronic pain, arthritis etc. since it involves tensing muscles. Some people might
also just find the technique uncomfortable to practice and find something like mindfulness, deep-
breathing exercises much more suitable. (Touissant et.al, 2021)

In the demo of the above JPMR exercise, the classroom environment was not the most ideal and
the sitting position in desks made it difficult to effectively tense and relax the torso and legs, not
really feeling the full effectiveness of the JPMR exercise personally.

CONCLUSION:

Jacobson’s Progressive Muscle Relaxation is proven to be a viable and effective technique for
reducing physical and mental stress and anxiety providing immediate relief to a certain extent
and has multiple long-term beneficial effects for various physiological chronic conditions and
mental concerns and disorders too. Even for certain medical and health conditions, Jacobson's
progressive muscle relaxation approach can reduce mild to moderate anxiety and symptoms of
the illness. It can also aid in reducing the signs and symptoms of medical conditions. When
combined with well-established therapies like cognitive-behavioral therapy or medication, it can
be extremely helpful. However, if you are exhibiting severe signs of anxiety or ongoing stress,
you should consult a physician or other mental health professional. JPMR is also very efficient at
enhancing the quality of sleep by helping the body and mind to become well at ease for sufficient
sleep.

When used carefully and correctly, relaxation techniques can be highly beneficial in regaining
and maintaining focus, calming the mind. A variety of populations and settings, including those
with generalized anxiety disorder, chronic pain, cardiovascular disease, and hypertension, may
benefit from Jacobson's Progressive Muscle Relaxation technique's ability to reduce anxiety,
stress, and muscle tension.
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