Magazine article Clinical Psychiatry News

The How-To of Relaxation Techniques

Magazine article Clinical Psychiatry News

The How-To of Relaxation Techniques

Article excerpt

In many "Toolbox" columns, I have discussed assisting patients via the learning, philosophizing, and action technique I have developed over the last 25 years.

The LPA technique is my integration of various kinds of cognitive-behavioral therapy into a pragmatic approach to addressing many DSM disorders and many emotional situations that affect people but do not fit the DSM model.

When the learning and philosophizing aspects are either over or not necessary, I have often found that specific relaxation techniques can be adjunctively used to teach behavior modification strategies that can help patients develop skills to tackle specific problems.

Several readers have asked me to explain how to quickly get a patient into a relaxed state in which he or she would be receptive to a strategy that helps change certain thinking patterns and behaviors and develop new, more productive ones. In other words, what is the best way to set the stage for the action phase of the LPA technique?

For openers, note that not everyone is a candidate for a rapid (or any other) relaxation technique. One size does not fit all. Our strategies need to be tailored to people's needs and, of course, their capabilities.

The therapist must identify the problem and determine whether these methods are appropriate.

For example, among the problems I have helped patients with and treated them for are smoking cessation, weight control, insomnia, phobic responses, obsessive disorders, generalized anxiety disorders, stress-related disorders, psychosomatic conditions, chronic pain patterns (both physiological and psychological in origin), as well as many other habits and patterns of unwanted behaviors that patients have wanted to reprocess.

When the problem fits the criteria I use, I then go on to teach a quick relaxation technique, which allows the patient to focus on the strategy being taught. I still like, after all these years, the method developed by Dr. Herbert Spiegel and Dr. David Spiegel in "Trance and Treatment: Clinical Uses of Hypnosis."

Now for the techniques I often use. Each allows patients to use projection and imagery to develop new thinking styles and behaviors:

* Screen or split-screen technique (sometimes modified to the blue-sky method).

* 20-steps technique.

* Balloon technique.

Split-Screen Technique

With the patient in a relaxed state, suggest that the patient imagine a large movie screen. As he sees this screen, get him to visualize a line right down the center of the screen, dividing it into a left side and a right side.

I use the left side of the screen to allow the patient to project and visualize his difficulties, worries, or anxieties. The point is that he sees these difficulties on the screen but does not experience them as he would in real life. Seeing the problem without experiencing it puts the patient on the first leg of the desensitization/relearning process. As the patient becomes comfortable with this approach, I have him switch over to the right side of the screen, where he sees himself drift into a pleasant and rewarding situation of his choosing.

This type of reciprocal inhibition of the unpleasant or troubling thoughts or behavior, coupled with a competing new pleasant set of thoughts, has been shown to be effective and long-lasting. Relaxation with the pleasant, non-anxiety-provoking images or thoughts is usually incompatible with stressful and anxiety-provoking experiences. …

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