Relaxation Research Hub for Health Practitioners
Health educators, teachers, psychologists, therapists, coaches and other practitioners may wish to learn more about relaxation techniques and methods they could use within their client groups. Under the Research Hub section, we intend listing research and information on relaxation techniques that could inform the practice of relaxation.
Relaxation vs Cognitive and Behaviour Therapies for Anxiety Disorders
There are many academic research papers and studies published in peer reviewed journals looking at relaxation techniques and approaches. There is one recent study that has interesting results. In the meta-analysis published by Montero et al., (2018) titled ‘Is cognitive–behavioural therapy more effective than relaxation therapy in the treatment of anxiety disorders? A meta-analysis‘, the results provided a useful insight into the relative effectiveness of relaxation vs CBT. The meta-analysis included 50 studies (2801 patients) comparing relaxation training with behavioural and cognitive treatments of anxiety. Importantly, no significant difference was found between relaxation and cognitive and behavioural therapies for panic disorder, generalized anxiety disorder, social anxiety disorder and specific phobias (considering social anxiety and specific phobias separately). This suggests that relatively simple interventions such as relaxation techniques, if professionally taught, could help many sufferers of these conditions without receiving CBT. Relaxation is fairly easy to teach people of all ages and unlike CBT, could be a service that can be provided at a lower cost by health providers thereby reaching more clients and patients both nationally and possibly internationally too. Around the world many health systems are under-resourced and simple relaxation techniques could be applied more generally to help clients and patients to tackle a range of psychological conditions.
Overview to the effectiveness of relaxation techniques
To provide a comprehensive overview to relaxation techniques and their effectiveness for a range of disorders, we do suggest reading a key paper: What you need to know about relaxation techniques (NCCIH, 2019). The chapter, Your life in your hands: teaching ‘relaxed living’ in post-war Britain, provides an overview to the development of the relaxation movement in Britain.
Contraindications of relaxation and mindfulness techniques
There has been research into the indications and contra-indications and side-effects of both relaxation and mindfulness techniques. The NCCIH (2019) article states that there are few side-effects of relaxation techniques although there are still some worth considering eg care may need to be taken with clients with high blood pressure using Progressive Muscle Relaxation. However, the research into mindfulness techniques has found a number of contra-indications and negative side-effects (see Britton, 2019). Reynolds et al., (2017) compared the efficacy of a brief mindfulness-based intervention (bMBT) with relaxation therapy on reducing distress amongst chemotherapy patients. The relaxation training intervention was derived from a standard physically focused relaxation techniques (e.g. Progressive Muscle Relaxation). Both groups reported reductions in overall and cancer-related stress over time. However, immediately post-intervention, brief mindfulness-based intervention (but not the relaxation training) participants reported decreased quality of life, increased symptom distress, and marginally increased social avoidance. The researchers concluded that ‘care is needed in employing mindfulness-based interventions in acute health treatment contexts‘.
It is important for health professionals to be aware of the issues that could arise when using these techniques.
A non-profit organisation, Cheetah House, provides support to those experiencing meditation-related difficulties and aims to provide a balanced, realistic and informed perspective about the risks associated with meditation through the dissemination of research-based information. Their website provides a table of 59 categories of meditation-related experiences that can be distressing or associated with impairment in functioning. This list is based on the Varieties of Contemplative Experience research study, by Drs. Lindahl and Britton. Symptoms are listed into seven domains: affective, cognitive, somatic, perceptual, sense of self, conative, and social. There are many other useful resources on their website. In the video below, Dr Britton of Cheetah House shares how she started studying the adverse effects of meditation.
In the following video below, Dr Britton describes signs of meditation-induced dissociation and how to tell the difference between dissociation and meditative calm.
Britton W. B. (2019). Can mindfulness be too much of a good thing? The value of a middle way. Current opinion in psychology, 28, 159–165. https://doi.org/10.1016/j.copsyc.2018.12.011
Montero-Marin, J., Garcia-Campayo, J., López-Montoyo, A., Zabaleta-del-Olmo, E., & Cuijpers, P. (2018). Is cognitive–behavioural therapy more effective than relaxation therapy in the treatment of anxiety disorders? A meta-analysis. Psychological Medicine, 48(9), 1427-1436. doi:10.1017/S0033291717003099
Reynolds, L.M., Bissett, I.P., Porter, D. et al. (2017). A Brief Mindfulness Intervention Is Associated with Negative Outcomes in a Randomised Controlled Trial Among Chemotherapy Patients. Mindfulness 8, 1291–1303. https://doi.org/10.1007/s12671-017-0705-2