Semester I

SEC
Unit 3
EFFECT OF BRIEF RELAXATION ON STATE ANXIETY AND PULSE RATE (PRE
AND POST DESIGN)

Dr. Dinaz R. Jeejeebhoy, Loreto College, Dr. Suvosree Bhattacharya, Gokhale Memorial
Girls’ College and Mr. Kaustav Manna, Maharani Kasiswari Devi College.

General Problem – On Relaxation Training

Specific Problem – To demonstrate the effect of induced relaxation training (Jacobson’s

Progressive Muscular Relaxation) on the state anxiety level, pulse rate, and subjective
experience of the participant.

Basic Concept – Relaxation is the emotional state of low tension, in which there is a
reduction of arousal, particularly from negative sources such as anger, anxiety, or fear
(Oxford Dictionaries, 2014). Relaxation techniques refer to any strategies aimed at reducing
arousal. Some procedures involve active components, in which an activity (eg. muscle
tensing) is used to aid in the eventual reduction of arousal, whereas others are passive in
nature and involve components that focus solely on relaxation and tranquility. Relaxation
procedures can be used either as a component of a more elaborate behavioural intervention,
such as systematic desensitisation, or as a major therapeutic tool in its own right (Rimm and
Masters, 1974). Relaxation can be achieved through meditation, autogenics, breathing
exercises, progressive muscle relaxation amongst other methods. The parasympathetic
nervous system (PNS) controls the body’s ability to relax and the sympathetic nervous system
controls the fight or flight response. One of the key ways the PNS decreases anxiety is by
slowing down the heart rate which is associated with relaxation and reduced anxiety. It also
helps reduce blood pressure. The PNS, by promoting relaxation and reducing stress, can
indirectly support a stronger immune response. Activation of the PNS leads to an overall
sense of relaxation and calmness, this includes reducing muscle tension, slowing down the
respiratory rate, and promoting a feeling of general well-being. Anxiety can impair cognitive
functions like decision-making and problem-solving. By reducing anxiety, the PNS can
improve cognitive clarity and functioning. It also plays a role in emotional regulation and can
help reduce the intensity of emotional responses, making it easier to manage and cope with
anxiety-provoking situations (Hurley, 2018).

Anxiety is a negative mood state characterized by bodily symptoms of physical tension and
by apprehension about the future (American Psychiatric Association, 2000; Barlow, 2002). It
can be a subjective sense of unease, a set of behaviors (looking worried and anxious or
fidgeting), or a physiological response originating in the brain and reflected in elevated heart
rate and muscle tension. Anxiety is not pleasant, but we seem programmed to experience it
almost every time we engage ourselves with something important. Anxiety is good for us, at
least in moderate amounts and psychologists have known for over a century that we perform
better when we are a little anxious (Yerkes & Dodson, 1908). For example, we would be
better prepared for an examination or a job interview that were coming up if we had an
optimal level of anxiety. Social, physical and intellectual performances are driven and
enhanced by anxiety. According to Howard Liddell (1949), the human ability to plan in some
detail for the future was connected to that plaguing feeling that things could go wrong and we
had better be prepared for them. This is why anxiety is a future oriented mood state. But what

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happens when one experiences too much anxiety? One might actually fail the exam because
they are unable to concentrate on the questions and all they can think about is that they are
too anxious and that how terrible it will be to fail. As much as it can hinder life, and certainly
feel very unpleasant, not experiencing (or having a very low level) of anxiety can create a
variety of problems in life. Very low levels of anxiety may sound positive, but can make it
difficult for one to recognise difficult or potentially dangerous situations.

Anxiety involves a general feeling of apprehension about possible future danger, and fear is
an alarm reaction that occurs. The anxiety response pattern is a complex blend of unpleasant
emotions and cognitions that is both more oriented to the future and much more diffused than
fear (Barlow, 1988, 2002). But like fear, it has not only cognitive/subjective components but
also physiological and behavioral components. At the cognitive/subjective level, anxiety
involves a negative mood, worry about possible future threats or danger, self-preoccupation,
and a sense of being unable to predict the future threat or to control it if it occurs. At a
physiological level, anxiety often creates a state of tension and chronic over arousal, which
may reflect risk assessment and readiness for dealing with danger should it occur. At a
behavioral level, anxiety may create a strong tendency to avoid situations where danger might
be encountered, but there is not the immediate behavioral urge to flee with anxiety as there is
with fear (Barlow, 1988, 2002). Thus, Anxiety is an alerting signal; it warns of impending
danger and enables a person to take measures to deal with a threat. It involves increased
somatic and autonomic activity controlled by the interaction of the sympathetic and
parasympathetic nervous systems.

In the study of anxiety, there are two complementary concepts: a psychophysiological state
(state anxiety) and a personality trait (trait anxiety). State anxiety reflects the psychological
and physiological transient reactions directly related to adverse situations in a specific
moment. In contrast, the term trait anxiety refers to an internal characteristic of personality,
describing individual differences related to a tendency to present state anxiety. Trait anxiety,
"...refers to relatively stable individual differences in anxiety proneness..." (1970), i.e., the
disposition to respond with State anxiety in situations which are appraised by the individual
as threatening. Furthermore, in Spielberger's framework of anxiety, stressor stimuli that evoke
psychological threats to self-esteem and produce differential levels of State anxiety in persons
are given special consideration. State anxiety is conceptualized by Spielberger (1970) as "....a
transitory emotional state or condition of the human organism that varies in intensity and
fluctuates over time. This condition is characterized by subjective, consciously perceived
feelings of tension and apprehension, and activation of the autonomic nervous system.
“Furthermore, State anxiety will be low in non-stressful and non - threatening circumstances
in which a situation is not perceived as threatening. It will be high in circumstances that are
perceived by an individual to be threatening. Trait anxiety is, therefore, relatively stable over
time (Vagg, Speilberger and O’Hearn, 1980) and considered an important characteristic of
patients with anxiety disorders, as they present higher trait anxiety in comparison to healthy
individuals (Kennedy, Schwab, Morris and Beldia, 2001). Hans Eysenck’s (1975) theory of
personality incorporates the description of an individual with high ‘neuroticism’, a specific
dimension of personality and a trait that exists on a spectrum in the population, as
“....anxious, worrying individual...his main characteristic is a constant preoccupation with
things that might go wrong, and a strong emotional reaction of anxiety to these thoughts...”
which resembles a person with high trait anxiety. On the other end of the spectrum, we have
emotional stability that is characterised by our ability to cope with stress, resist our impulses,
and adapt to change.

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In our modern world, stress has become an unwelcome companion, affecting our well-being.
To combat this, numerous relaxation techniques have emerged, and one such method is
Jacobson’s Progressive Muscle Relaxation (JPMR) (Jacobson, 1938). JPMR works by
systematically tensing and relaxing muscle groups, reducing muscle tension and promoting
deep physical and mental relaxation, which can help alleviate anxiety and stress. This
relaxation technique enhances self-awareness and helps individuals recognize and release
unnecessary muscle tension. By engaging in the deliberate sequence of muscle contraction
and release, JPMR taps into the mind-body connection, promoting a state of calmness and
providing individuals with a sense of control over their physiological responses. Regular
practice of JPMR can lead to improved stress management, reduced anxiety levels, and an
overall sense of well-being. JPMR offers an array of benefits for both physical and mental
health. By sequentially tensing and relaxing specific muscle groups, JPMR helps individuals
develop an enhanced awareness of their body’s response to stress and tension (Harvard
Health Publishing, 2020). This heightened awareness serves as a valuable tool for managing
anxiety, reducing muscle tension, and promoting overall relaxation. This technique utilizes
the principles of neuronal “top-down” and “bottom-up” processing to achieve results
(Keptner, Fitzgibbon and O’Sullivan, 2020). In “top-down” processing, participants use areas
higher in the nervous system like the cerebral cortex and the cerebellum to contract muscles
and gradually release the tension. In “bottom-up” processing, the holding and releasing of
bodily tension produce proprioceptive stimulation from peripheral muscles that ascends to the
brain via the spinal cord and the brainstem. With both stimulatory passages activated, PMR
provides participants with quick and immediate relief.

Research has shown that regular practice of the JPMR can yield numerous positive outcomes.
It has been found effective in reducing symptoms of anxiety disorders, insomnia, and chronic
pain. Furthermore, JPMR has been observed to improve overall psychological well-being,
leading to increased self-control, improved concentration, and better coping mechanisms
during stressful situations.

Study design plays an important role in the quality, execution, and interpretation of
biomedical and public health research (Woodward, 1999). Interventional study designs, also
called experimental study designs, are those where the researcher intervenes at some point
throughout the study. The most common and strongest interventional study design is a
randomized controlled trial, however, there are other interventional study designs, including
pre-post study design, non-randomized controlled trials, and quasi-experiments (Rothman,
Greenland and Lash, 2008; Ahrens and Pigeot, 2005; Haynes, 2012). A pre-post study design
is a research methodology used to evaluate the effectiveness of treatments by comparing
results measured before and after an intervention. It is commonly used in clinical trials, but
can also be applied more broadly in other scientific contexts. Pre-post studies could also be
referred to as “before-and-after” studies. A pre post study is a type of interventional study
rather than an observational study. Pre-post studies are valuable tools for evaluating how
interventions affect outcomes over time, and can be applied across many different clinical
research settings. They are generally less costly and simpler to implement than RCTs, and can
also be feasible with relatively smaller sample sizes. The primary advantages of pre-post
studies are that they can be comparatively quick to set up and inexpensive to conduct, but the
trade-off is that they provide relatively low levels of evidence due to the limited control over
confounding variables (Thiese, 2014). The level of evidence provided by a given study
design describes the potential degree of validity and reliability of its findings. In general,
pre-post studies provide a lower level of evidence than randomized controlled trials (RCTs).
RCTs involve randomizing participants into different groups and controlling for external

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factors that could influence results, which can produce more scientifically robust evidence
than pre-post studies. Pre-post analysis can be useful for gaining insight into programs or
interventions, but experimenters should use caution when interpreting results due to the
potential for bias arising from uncontrolled variables. A major limitation of the pre-post
design is that it cannot prove causality; there may be changes in the outcome variable that are
due to factors unrelated to the intervention or study period.

The present study aims to see the effect of Relaxation Training (Using JPMR) on the level of
state anxiety of the participant using the STAI. Further, it was also aimed to see if relaxation
training brought about a difference in the physiological measure of pulse rate of the
participant using the Oximeter.

Steps/Design–
STEP 1 – Establish rapport with the participant.
STEP 2 – 2 Form X 1 of STAI will be taken, 1 will be handed over to the participant and the
other will remain with the test administrator.
STEP 3 – The instructions will be read out to the participant while the participant is asked to
read it silently alongside.
STEP 4 – The participant will be asked to begin and is told that if they have any difficulty
they can ask the administrator.
STEP 5 – The administrator makes sure that all the items in the test are responded to when
the testee/participant hands over the test form.
STEP 6 – Steps 2-5 will be repeated, this time using Form X 2 of STAI.
STEP 7 – Pulse Rate reading will be taken using the Fingertip Pulse Oximeter
STEP 8 – General instructions for JPMR will be given.
STEP 9 – JPMR will be administered.
STEP 10 – Pulse Rate reading will be taken using the Fingertip Pulse Oximeter
STEP 11 – Steps 2-5 will be repeated.
STEP 12 – Verbal report will be taken.
STEP 13 – Scoring will be done by referring to the scoring manual.
STEP 14 – Interpretations will be drawn and conclusions reached.

Pre (Relaxation) Measures Relaxation Post (Relaxation) Measures

STAI - Form X 1 (State) Administration of JPMR Pulse Rate (Using Fingertip

Pulse Oximeter)

STAI - Form X 2 (Trait) STAI - Form X 1 (State)

Pulse Rate (Using Fingertip Verbal Report

Pulse Oximeter)

Preliminaries –
Name (optional):
Age:
Sex:
Educational qualification:

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Date of the study:
Time of the study:
Biological Functioning: Have you faced any significant change in recent times in your sleep,
appetite, level of energy for activities or any other areas of physical functioning:

Current Health Condition (Include history of any chronic condition with ongoing medicine
use and Are you suffering from any kind of pain due to any injury?):

Do you have any form of chronic medical problems for example, spondylosis, high blood
pressure or other cardiovascular problems? If yes, please briefly state your problem:

Are you currently having any psychological issues in the past one month for which you are
undergoing treatment or you feel you have a problem that needs attention. If yes, please
briefly state your problem:

Communication and socialization (Include details of peer relation and relation with
significant others):

Materials Required –
STAI –
State-Trait Anxiety Inventory (Form X-1 – 3 and X-2 – 2)
Manual (for scoring)
Appropriate Norm
Stationary

JPMR –
Comfortable Chair (armrest essential, wide seat)
Fingertip Pulse Oximeter (to be brought by the student for the current academic year
2023-24; to be procured by college for subsequent years)

Description of the Test – The State-Trait Anxiety Inventory (STAI) was devised by
Spielberger Gorsuch and Lushene (1970) to provide a reliable means of distinguishing
between two distinct aspects of anxiety, state anxiety and trait anxiety. Here state anxiety is
conceptualized as a transitory level of anxiety, which is often situationally determined, and
fluctuates with time and circumstances, whereas the trait anxiety is regarded as a relatively
stable individual characteristic. There are 20 items for State Anxiety and 20 items for Trait
Anxiety. Either scale can be used by itself. However, when using both together, it is
recommended that the state anxiety form be administered first (Spielberger et al., 1970). The
inventory is self-administering (either individually or in group). Though there is no time
limit, completion of both forms seldom requires 20 minutes. It was adapted in Bengali by
Nikhil B. Mallik and Prabal K. Chattopadhyay in 1986. Manual of this test includes gender,
language and culture based norms.

Standard Method of Administration:

STAI – Rapport needed to be established with the participant. The mentioned number of self
report forms of STAI are to be taken. The printed instruction will be read aloud to the
participant while at the same time she will be instructed to read them silently. For state
anxiety the participant will be instructed to indicate how she feels ‘right now’ and to respond

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in terms of severity (not at all, somewhat, moderately so and very much so). In case of trait
anxiety, she will be instructed to indicate how she ‘generally feels’ and to respond in terms of
frequency categories (almost never, sometimes, often and almost always). The participant
will further be instructed to answer all the items without much pondering over a single item.
She should respond in terms of what first comes to her mind, on reading the item.

Fingertip Pulse Oximeter – Insert the index finger into the rubber hole (the finger should be
fully extended) with the nail facing up, and then release the clamp. Press the control button to
start the oximeter for detection of pulse rate. During the process it is better not to shake the
fingers and avoid movement of the body. Measurement can be read directly from the display.
The instrument has a sleep function and will enter sleep mode if not used for a certain amount
of time. When battery power is low, the low battery power indication will appear on display,
prompting replacement of batteries. The participant should be made to sit in silence for 1
minute before taking the reading. No instruction to be given before taking the Baseline
measurement of Pulse oximeter (as Pre measure before administration of JPMR).

JPMR –
Requirements of JPMR
Conductive Environment: The setting for relaxation is quiet and free of distraction noises.
The client will be kept physically comfortable in a position.

Relaxation is a very safe Stress Management technique, but there are a few cautions which
must be borne in mind in order to gain maximum effectiveness:

● The tone of voice while administrating the JPMR has to be very calming and very
soothing. There should not be any prolonged gaps during the instructions while
tensing and relaxing the muscles. the duration of 5 seconds of tensing 10 seconds of
relaxation should be filled with the instructions of tensing and relaxing respectively.
● The duration of relaxation should be double or more of that of tensing of the muscles.
● Relaxation should not be practiced whilst driving or doing any other activity that
requires your concentration.
● Relaxation should not be practiced on a full stomach or when there is a bowel or
bladder pressure.
● Relaxation should not be practiced with arms and legs crossed.
● It should not be practiced without professional advice after any injury, trauma or any
other physical state where there is cause for pain or distress
● If the participant has any form of chronic medical or psychological health problem,
they would need to check with their doctor that relaxation is suitable for their
particular condition.
● Progressive Muscle Relaxation (tense/release) should not be practiced if the
participant has high blood pressure or other cardiovascular problems.
● Never practice relaxation to treat undiagnosed symptoms; always consult the doctor
for an accurate diagnosis.
● If the participant has any uncomfortable symptoms while practicing relaxation this
needs to be discussed with the Doctor.
● A few people may experience new sensations such as a feeling of floating, if this
worries the participant, just ask them to stop the relaxation and bring consciousness
back and the symptom will resolve.
● In some individuals’ relaxation techniques may enhance the action of certain drugs.
The doctor should be informed that the participant is regularly practising relaxation

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 techniques, in case he/she wants to monitor their dosage of anti-anxiety,
anti-hypertensive or other medications they may be taking.
● Participants should not stand up straight away after practicing relaxation, they may
remain seated or lying down for a few minutes with their eyes open then get up.
● In people with extreme negative thoughts of self harm and suicide JPMR is not
advisable
● It is advisable that people who are suffering schizophrenia do not practice relaxation
techniques unless advised that they can by their qualified medical practitioner.
● Participants should not wear tight clothes, must take off their shoes, glasses (if any),
and wrist watch before starting JPMR.
● If the participant feels any pain, cramp within the muscles he/she just needs to release
the tension, disregard the tensing instruction, and relax. The participant does not need
to wait for the instruction to be relaxed.
● The participant should be instructed to raise his or her index finger if any kind of
unmanageable discomfort he/she feels during the relaxation training.

Sl.No PROCEDURE OF JACOBSON'S PROGRESSIVE Tensing Relaxation

MUSCLE RELAXATION TECHNIQUE Time Time
1. Hands
a) Clench both fists together, feel the tension in the fists and 5 sec 10 sec
forearm, hold the tension, feel the tension in the muscle
group and now release the tension slowly from your fists
and forearm. Feel the relaxation taking the place of
tension, continue to relax and feel the relaxation.
2. Arms
a) Bend both arms together up at the elbow and tense the 5 sec 10 sec
biceps, keeping the hand relaxed, feel the tension, hold the
tension and now slowly release the tension from the arms
by gently lowering them. feel how relaxing it is to release
the tightness, feel completely relaxed.
b) Straighten both the arms and tense the triceps leaving the 5 sec 10 sec
lower arms relaxed and supported on your lap, feel the
tension, hold the tension for a while and now slowly relax
your triceps. Relax and feel relaxation for a while.
3. Facial Muscles
a) Wrinkle your forehead; try to make your eyebrows touch 5 sec 10 sec
your hairline which produces tension, feel the tension for a
while, hold the tension and now slowly release your
eyebrows, relax and feel relaxation for a while. Relax relax
relax.
b) Close your eyes and screw the muscles around the eyes for 5 sec 10 sec
a while, feel the tension, hold the tension and now slowly
release the tension, feel the relaxation taking the place of
tension, relax and continue to feel the relaxation.
c) Tense the jaw by biting the teeth together, feel the tension 5 sec 10 sec
in the jaw muscles, hold it for a while, hold it and now
slowly release the tension, relax and feel relaxation for a
while.

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d) Press the tongue hard and flat against the roof of your 5 sec 10 sec
mouth with lips closed, notice tension in your throat and
feel it for a few seconds. Now Release the tension, relax
and feel relaxation in your entire face and facial muscles.
Feel your facial muscles completely relaxed.
4. Neck & shoulder
a) Push the head back as far as it will go (against the 5 sec 10 sec
chair),feel the tension for a while and now bring your head
back to a comfortable position, relax and feel relaxation
for a while:
b) Bring the head down and press the chin down onto the 5 sec 10 sec
chest for a few seconds. Bring the head back to a
comfortable position, relax and feel relaxation . Relax,
relax, relax.
c) Tense your shoulders by tightening and shrinking 5 sec 10 sec
shoulders (Shrug your shoulders up to your ears), feel the
tension, hold the tension, hold it and now slowly r lease the
tension. Release, relax and feel relaxation for a while.
5. Chest
a) Take a deep breath, completely filling the lungs, hold the 5 sec 10 sec
breath for a few seconds and passively exhale. Relax and
feel relaxation taking the place of tension.
6. Stomach
a) Pull in the stomach and tense the stomach muscle, hold it, 5 sec 10 sec
try and push it as far in as possible, hold it and now release
the tension from the stomach, relax and feel the relaxation
for a while.
7. Back
a) Arch your back away from the chair and feel tension for a 5 sec 10 sec
few seconds. Now slowly relax and return to a comfortable
position, feel relaxation for a while. Now your entire upper
body is relaxed, feel the relaxation in the your entire upper
body. Relax, relax, relax.
8. Thighs & Buttocks
a) Tense both thigh muscles and buttocks by squeezing 5 sec 10 sec
muscles together and feel tensing for a few seconds, hold it
and now slowly release the muscles, relax and feel
relaxation for a while.
9. Lower Legs
a) Point toes towards your head, producing tension in calf 5 sec 10 sec
muscles, and feel tensing for a few seconds. Build up that
tension, hold the tension and now slowly release the
tension, continue to release the tension and observe
relaxation taking its place, feel your legs go limp. Relax
and feel relaxation for a while.
b) Point the toes away from the head, feel the tension, feel the 5 sec 10 sec
pull in your calf muscles and feet, hold the tension for a
while and now slowly release the tension, and feel yourself
in a relaxed state, relax, relax, relax.

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10. Toes
a) Now gradually curl your toes and tense the muscles in the 5 sec 10 sec
soles of your feet, hold it for a few seconds, hold it and
now slowly release the tension from the soles of your feet,
feel the tension wash away. Relax and feel relaxation for a
while.
11. After Exercises
a) Now your entire body is in a state of relaxation. feel the
relaxation in your entire body. your hands, your arms, your
facial muscles, neck and shoulder muscles are all relaxed. 2 min relaxation
Your chest muscles, stomach muscles, back, thighs and
buttocks muscles are all feeling very very relaxed. Your
legs, toes and feet are also completely relaxed. Your entire
body is in a state of relaxation which is a wonderful
feeling. Relax, relax, relax. Relax your whole body
completely.
b) Keep your eyes closed and let yourself remain in the
relaxed position for a minute or two and wait for further
instructions from me.
c) Open your eyes slowly, sit up straight (take your time,
there is no rush) and enjoy renewed energy, feel relaxed
and refreshed. (TAKE PULSE READING)
d) Sit up, stretch, and stand up slowly.

Please Note: All of the above steps for JPMR are administered twice each (consecutively) in
a lying down position with hands by the participant’s side. It is carried out in a quiet space in
a dimly lit room and at a comfortable room temperature. In the present demonstration
(because of laboratory limitations) it is being administered with the participant sitting in a
chair with armrests as comfortably as possible, in a quiet space, free from distraction and
noise.

The above procedure may be demonstrated once in a group situation to all the students,
so that they are aware of the complete procedure. For classroom practical and
examination purposes the following procedure will be followed.

Sl.No PROCEDURE OF JACOBSON'S PROGRESSIVE Tensing Relaxation

MUSCLE RELAXATION TECHNIQUE Time Time
1. Hands and Arms
a) Clench both fists together, bend both arms together up at 5 sec 10 sec
the elbow and tense the biceps and triceps, feel the tension
in the fists, forearm, biceps and triceps, hold the tension,
feel the tension in your entire hands and arms and now
release the tension slowly from your fists and forearm,
from your biceps and triceps. Feel the relaxation taking the
place of tension, continue to relax and feel the relaxation.
Relax and feel relaxation for a while. Relax… relax…
relax…
REPEAT THIS STEP TWICE

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2. Facial Muscles
a) We will now tense all the facial muscles together. Wrinkle 5 sec 10 sec
your forehead; try to make your eyebrows touch your
hairline which produces tension, screw the muscles around
the eyes for a while, tense the jaw by biting the teeth
together, feel the tension in the jaw muscles, Press the
tongue hard and flat against the roof of your mouth with
lips closed, feel the tension for a while, hold the tension
and now slowly release the tension from your eyebrows,
eyes, jaw, tongue and lips.. relax and feel relaxation for a
while. feel your entire face and facial muscles go limp,
experience relaxation taking the place of tension. continue
to feel the relaxation. Relax relax relax.
REPEAT THIS STEP TWICE
3. Chest, Shoulders, Upper Back, Stomach
a) Push the head back as far as it will go (against the chair), 5 sec 10 sec
tense your shoulders by tightening and shrugging them,
arch your upper back, take a deep breath completely filling
the lungs, pull in the stomach and tense the stomach
muscle, hold it, try and push it as far in as possible, feel the
tension for a while in your entire upper torso. Be sure to
contract only the said specific muscle groups and now
bring your head back to a comfortable position, release the
tension from your shoulders, release the tightness from
your upper back, release the tension in your stomach. relax
and feel relaxation in your entire upper body, feel the
relaxation and let all the muscles go limp, continue to relax
for a while. Relax, relax, relax..
REPEAT THIS STEP TWICE
4. Buttocks and Both Upper Legs
a) Tense both thigh muscles and buttocks by squeezing 5 sec 10 sec
muscles together and feel tensing for a few seconds, hold
it, hold it for a while… and now slowly release the
muscles, release the tension, release the tension and relax,
relax, relax… feel the relaxation for a while. feel the
relaxation… Relax, relax, relax..
REPEAT THIS STEP TWICE
5. Both Lower Legs and Feet
a) Point toes towards your head without lifting it off the 5 sec 10 sec
ground, producing tension in calf muscles, curl your toes
and tense the muscles in the soles of your feet, and feel
tensing for a few seconds. Build up that tension, hold the
tension and now slowly release the tension, continue to
release the tension in your calf muscles, in your feet and in
your toes, and observe relaxation taking its place, feel your
legs go limp. Continue to release the tension completely.
Relax and feel relaxation for a while. Relax, relax, relax..
REPEAT THIS STEP TWICE
6. After Exercises

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a) Now your entire body is in a state of relaxation. feel the
relaxation in your entire body. your hands, your arms, your
facial muscles, neck and shoulder muscles are all relaxed. 2 min relaxation
Your chest muscles, stomach muscles, back, thighs and
buttocks muscles are all feeling very very relaxed. Your
legs, toes and feet are also completely relaxed. Your entire
body is in a state of relaxation which is a wonderful
feeling. Relax, relax, relax. Relax your whole body
completely.
b) Keep your eyes closed and let yourself remain in the
relaxed position for a minute or two and wait for further
instructions from me.
c) Open your eyes slowly, sit up straight (take your time,
there is no rush) and enjoy renewed energy, feel relaxed
and refreshed. (TAKE PULSE READING)
d) Sit up, stretch, and stand up slowly.

Instructions –
STAI – To be read as written on the test form.

JPMR – General Instruction (Before and During Muscle Relaxation Exercise): This
instruction is kept simple and is easily understood by students exposed to Jacobson’s
progressive muscle relaxation technique and gives a clear picture of how to cooperate during
the exercise regimen. The detailed instruction appears in the procedure itself and can be used
from there.

“For this relaxation, you need to be seated in a comfortable chair. Just make sure that you are
warm enough, and that you are comfortable. Let your hands rest loosely in your lap, or by
your side as you feel comfortable. You can change your position to feel as comfortable as
possible during the procedure as well. Keep your body loose... light... and free. Be calm and
comfortable. Keep your eyes closed. Avoid stray thoughts. Avoid extra movements of the
body. During the part of the exercise cycle tense the muscle tightly and hold for a slow count
of 5 seconds. (Repeat silently 1001, 1002, 1003,…). During the relaxation part of the exercise
cycle relax the muscle quickly and completely. Let your mind relax and appreciate how
relaxed the muscle is feeling for 10 seconds. While relaxing, notice and experience relaxation
taking the place of tension. Try to keep all other muscles relaxed as you exercise a specific
muscle group. As you exercise from head to toe… … Observe changes like tightness and the
development of light and soothing sensations. Remember when asked to tense one set of
muscles, make a conscious effort not to tense other groups of muscles. Tense only the muscle
group that has been asked to tense. If you feel any pain or cramping in the muscles when you
are tensing it, just release the tension, disregard the tensing instruction, and relax. If you feel
any kind of unmanageable discomfort during the relaxation training, please raise the index
finger of your right hand and I will attend to you but keep your eyes closed at all times. Now
close your eyes. Let us begin the exercise.”

Verbal Report after the completion of JPMR:

The instructions for verbal report:
“Thank you for participating in the study. Before ending the session I would be happy if you
just pen down your experiences of going through the relaxation training. Please write your
thoughts focussing on:

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 ● How were you feeling before the relaxation training started?
● How did you feel during the time you were undergoing relaxation training?
● How are you feeling now, after completion of the relaxation training? Is there a
difference in your feeling state from the time before the relaxation training took
place?”

Results –
Comparative Chart – Showing the pre and post measures of STAI Form X 1 and pulse rate
of the participant.

Pre Score/ Relaxation Post Score/

(Relaxation) Reading (Relaxation) Reading
Measures Measures

STAI - Form X Administration STAI - Form X 1

1 (State) of JPMR (State)

STAI - Form X – –
2 (Trait)

Pulse Rate Pulse Rate

(Using (Using Fingertip
Fingertip Pulse Pulse Oximeter)
Oximeter)

Interpretation –

The present study aimed to see the effect of Relaxation Training (Using JPMR) on the level
of state anxiety of the participant using the STAI. Further, it was also aimed to see if
relaxation training brought about a difference in the physiological measure of pulse rate of
the participant using the Oximeter.

At the baseline the STAI scores were found to be (X) on Trait anxiety and (Y) on state
anxiety (describe w.r.t. the norms). The pulse rate was found to be Z. The verbal report
indicated the participant was feeling………

After the completion of the Relaxation training another measure of pulse rate and STAI (state
anxiety) was taken. The subject scored Y1 on state anxiety (describe w.r.t. the norms) and Z1
on pulse rate.

The score on State anxiety before and after the administration of the JPMR indicates that…

1. There is an effect of relaxation.

Pre Post

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 SA > SA

PR > PR

Lowering of state anxiety and pulse rate to be explained w.r.t. trait anxiety. Functioning of
sympathetic & parasympathetic NS may be highlighted. Further substantiate with verbal
report.
2. There is no effect of relaxation

Low TA + SA Hypoarousal (Reached

a ceiling limit)

High TA + SA Hyperarousal

In both cases single administration of JPMR might not be enough to bring change
Further substantiate with verbal report. Detrimental effect of high/low anxiety maybe
related with the findings
3. There is no effect of relaxation

Pre Post
Substantiate the findings with trait anxiety &
verbal report. Verbal SA < SA Report: by exploring the
feeling state of the subject at the moment of
undergoing JPMR. PR < PR
4. There is an effect of relaxation

Pre Post
Substantiate the findings with trait anxiety
& verbal SA < SA report. Verbal Report: by
exploring the feeling state of the subject at
the moment of PR x PR undergoing JPMR. PR may
represent the functional level for the
participant. Conditions such as
Tachycardia. (Background information is important.)

Interpretations must be written mentioning the rationale and references. The interpretation
must mention that more than one session is required for true relaxation.

Conclusion:
Mention the scores on all pre and post measures. Highlight the findings in a line or two.

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Reference Books:
1. Behavior Therapy: Techniques and Empirical Findings, David C. Rimm and John C.
Masters, Academic Press, New York, San Francisco, 1974
2. Cognitive Behavior Therapy for Psychiatric Problems: A Practical Guide, Keith
Hawton, Oxford Medical Publication, 1989.
3. Handbook of Stress: Theoretical and Clinical Aspect, Goldberg and Breznitz, The
Free Press Collier, MacMillan Publishers, 1986.

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