When your brain perceives danger, it responds with a ‘stress response’ and you feel anxious. Engaging in relaxation exercises may help you deal with your anxiety and you may feel calmer. There are various types of relaxation techniques that can be adopted to achieve calm. When systematic desensitization was first conceptualized, relaxation exercises were included in ERP (Wolpe, 1954) and are still used frequently (Whiteside et al., 2016).
One of the ways in which you can teach your body to relax is progressive muscle relaxation. When you are anxious, one of the physical manifestations is tensing of muscles. When your muscles relax, the tension in them eases off and you feel calmer. Using PMR, you can release the tension in your muscles to relieve the feelings of anxiety. In PMR, you are required to tense a group of muscles as you breathe in through movements like clenching or flexing, and relax them as you breathe out. All the muscles are systematically worked upon in a certain order, starting with the toes and progressively moving up, covering other muscles, until all the muscles in the body are relaxed.
Also, PMR may help you sleep better if you have trouble falling asleep. If you practice PMR for at least a week to ten days before you start the process of facing your fears, you can get better at the skill of relaxing yourself when stressed and that will be a helpful skill to have after exposures. PMR should be practiced as a discipline by both you and your family and not just for the duration of the recovery process. It can come handy anytime even in the future, even after recovery. You do not even need to know how to do it yourself. There are various guided meditation apps like Calm, Insight Timer, Headspace, etc. that provide you with audios that you need to listen to and just follow the instructions provided. Once you get better at it, you may not need to listen to the audio and you may be able to do PMR at will from memory. But even if you always need to use a guided meditation audio or video for PMR, it is fine.
To start PMR, choose a place where, and time when there will be no interruptions (such as the TV blaring or the kids screaming or the dog barking and so on) and lie down on your back and make yourself comfortable. Breathe slowly and deeply four or five times and focus on your breath. Breathe in slowly as if smelling a rose and breathe out slowly as if blowing a balloon. Deep and slow breathing helps the brain to calm down. Start PMR by tensing your toes while breathing in for about 5 seconds. As you breathe out, relax the toes. Move to your other muscles after that and follow the same process. Move up to your calves, your thighs, and so on. Doing this for the muscles of the entire body will have a relaxing effect. You may begin to notice that your muscles feel completely relaxed and your stress reducing after following this method.
After you have completed your PMR, breathe in and out slowly and deeply once again for five times and complete the exercise. The whole exercise should not take more than fifteen minutes at the most.
When you do the PMR regularly, every morning and evening and whenever you have an extra fifteen minutes, you will get into the practice and then will be able to use it when you are feeling anxious. It is important to build the practice of PMR on a regular basis. You need to do it enough number of times when you are not anxious for you to be able to use it when you are. Trying to use PMR to calm yourself down when you are anxious without building sufficient practice is like trying to repair a leaking roof when it is raining. If you repair it when it is not raining, it is likely to hold better.
In the PMR sheet provided as Additional Resource 2.9, you will find links to two YouTube videos, one in a male voice and the other in a female voice. Use whichever you are comfortable with. You will also find a list of the muscle groups with suggestions on how to tense and un-tense them, that has been taken from an article from the University of Michigan Health website. If you use PMR regularly, you can train yourself to relax in the most stressful of situations.
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