Jacobson Progressive Muscle Relaxation

This relaxation method has been around for a long time and has been scientifically validated many times. You can use it with your patients with all anxiety disorders, with all phobias, especially agoraphobia, generalized anxiety disorder (chronically stressed people who need relaxation). But there's nothing to stop you from using them in all mental pathologies. For example, it can be useful for patients who are addicted, who are smokers or alcoholics, because it gives them a possibility to do an action instead of smoking. So you can even teach it for addictions.

There are three methods of relaxation : vagal, Schultz's autogenic training and Jacobson's progressive muscle relaxation. But which one to choose? Sometimes your patients will ask you which one to choose. In this case, it is best to ask them how they feel. If the main problem for one is that he feels tense, that his shoulders hurt, that his neck is stiff, that his legs hurt, then the Jacobson method is the most appropriate. If, on the other hand, another person tells you that he or she feels hot sensations when anxious, strange sensations of uneasiness, then Schultz' autogenic training is the most appropriate method. As for vagal relaxation, it is very quick to teach and apply and should therefore be automatic.

In a relaxation session, ask your patient to sit or lie down, to take off their purse, their jacket: to put themselves at ease. There is nothing to stop you from using background music if you wish. Dr. Malbos advises in particular to use music called "Space Music", a kind of electronic music which allows to have a very calm musical background and thus favourable for relaxation or meditation. The temperature of the room is also important. It should be pleasant, so don't hesitate to turn on a fan or the heater. In addition, when you speak, you should keep in mind to speak slowly and with a low, calm and warm voice, this encourages the relaxation process.

Let's start the Jacobson method. Start by telling your patient to clench his or her right fist at 80%, so quite hard. Ask him to concentrate on the sensation of pressure, the sensation of burning, the sensation of tension in the fist. It is very important, only the fist should be contracted. The forearm, biceps, shoulder, and all the rest of the body should be completely relaxed. At first, your patient will have difficulty contracting only the requested muscle components in isolation, but this is normal. Practice will make this exercise easier to perform.

The second phase of this method is the relaxation phase. Tell your patient to very gently, very slowly, relax his right hand. He/she should concentrate on the pain disappearing and the pressure decreasing. He has to realize that this tension is disappearing. His palm opens then, always very gently. His fingers will spread until a state of total relaxation.

These two phases are a summary of the whole idea behind the Jacobson relaxation method. This method consists in doing a phase of contraction at 80%, strong and slightly painful, followed by a phase of relaxation. That's why it's called "Jacobson's progressive muscle relaxation", because it allows patients to have a better knowledge of their state of contraction of their muscles. Learning this method will allow them to detect when their muscles are too tense and above all to be able to relax them.

Everything else will consist of doing exactly the same thing for each muscle group. A muscular order however is to be followed and is advised by Doctor Malbos :

1. Fist
2. Biceps
3. Forehead (orbicularis, frown)
4. Jaw muscles (masseter muscles, clench the teeth)
5. Lips (pout)
6. Neck (sternocleidomastoid muscles, ask your patient to place their hand on their forehead while the forehead pushes against this hand)
7. Trapezius muscles (shoulder shrug)
8. Diaphragm and accessory breathing muscles (take a deep breath and hold it)
9. Abdominal muscles
10. Gluteal muscles
11. Quadriceps muscles (moving the leg or not)
12. Calves (dorsiflexor muscles, lift the front of the foot)
13. Toes (dorsiflexor muscles, lift the toes)

You can explain the following method to your patient: one day, one side, and the next day, the other side. Non-athletic patients who often have a low awareness of their bodies may sometimes experience mild soreness as if they had just completed a workout session. At the beginning of the relaxation exercise, it is important to specify that they should only contract the muscles at 80%. After the session, reassure them that soreness is possible in the following days and is completely normal. Training will reduce this soreness over time.

Speaking of training, how often should the Jacobson progressive muscle relaxation method be practiced? According to Dr. Malbos, twice a week.

The Jacobson relaxation method should be practiced with your patients so they become aware of the difference between the states of contraction and relaxation, allowing them to relax their bodies at any time.