262 ASSESSMENT AND INTERVENTION STRATEGIES
“The best way to learn deep muscle relaxation is through demonstration,
coaching, and practice. I am going to ask you to produce tension in particular
muscle groups, hold the tension for 5–7 seconds, and then release this tension. I will
instruct you on how to tense and release various muscles. Throughout the proce-
dure I will be prompting you to focus on the feelings of tension and relaxation. This
is a very important part of the technique because you need to learn how it feels to be
relaxed. We will begin by tensing and relaxing 10 different muscle groups and the
whole procedure will take about 20 minutes. I will be asking you to tense and then
relax particular muscles. For example, let’s quickly run through the procedure with
each of the muscles so you will know what to expect. Take your right arm, extend
it in front of you, make a tight fist, and hold it. Do you notice any tension or tight-
ness in your arm? [Ask client to indicate whether tension was felt in hands, forearm,
elbow, and bicep of the arm.] Now tense the arm again and this time release the
tension by letting your arm fall back into your lap, with the arm slightly bent at the
elbow. How does it feel now? [Client is asked to describe the feeling of relaxation in
the arm.] Now I am going to demonstrate for you how to tense and relax the other
9 muscle groups. Each time I would like you to watch how I do it and then try for
yourself. I do need to warn you we’ll be making some funny faces in order to tense
the facial muscles. Are you okay with that? [Therapist then demonstrates how to
tense and relax muscles based on Table 7.5.]
“[After demonstrating the 10-muscle tense– release procedure, the therapist
continues with the introduction.] It is important that you realize that deep muscle
relaxation is a skill that takes repeated practice to learn. Just like learning to ride
a bicycle or drive a car, the technique may at first feel unnatural to you. You may
not feel very relaxed. However, the more you practice it, the easier it will become
and you will get better and better at inducing a deeper level of relaxation. Also once
you’ve mastered the 10 muscle technique, I will teach you how to do the abbrevi-
ated version of muscle relaxation so that you can literally induce relaxation in a
few minutes anywhere, anytime. But to get to that point, you will need to practice
relaxation twice a day, every day for 15 minutes. I will be giving you a CD with
relaxation instructions that should help you do the homework practice. Also I will
ask that you complete a Weekly Progressive Muscle Relaxation Record [see Appen-
dix 7.4] so we can monitor your progress. Do you have any questions? Okay, let’s
begin with our first relaxation training session.”It is important to emphasize that the effectiveness of relaxation training depends on
a conducive setting. Bourne (2000) offers a number of practical suggestions for enhanc-
ing the relaxation experience. Choose a quiet location, a dimly lit room, and a comfort-
able chair or sofa. Practice on an empty stomach and loosen any tight- fitting garments.
Remove shoes, watches, and glasses, and keep eyes closed. Tell the client to assume
a passive, detached attitude in which “you let everything, all thoughts, feelings, and
behavior, just happen. Don’t try to control what you are thinking or evaluate how you
are performing. Just ‘let yourself go’ and don’t worry about whether you are doing the
procedure correctly.” If the person has difficulty relaxing a particular muscle group,
he or she should just skip to the next group of muscles. Not all muscle groups have to
achieve the same level of deep relaxation. Emphasize that it is important to practice
twice a day for 15 minutes preferably at a regular time.