"50 CBT tools for panic and anxiety are divided into several categories: general skills, initial relaxation training, initial cognitive restructuring, advanced mindfulness training, advanced cognitive restructuring, and exposure treatment."
Prior to starting relaxation training, it is necessary to understand several aspects of relaxation. For further information, read Why Are Meditative Relaxation and Mindfulness Important?
1) Relaxation is not just for anxiety or stress. Engaging in some sort of basic relaxation methods are beneficial for all of us. Relaxation and mindfulness meditative techniques have been shown to improve health and quality of life for people with chronic pain such as headaches, fibromyalgia, low back pain, or rheumatoid arthritis. In addition, it has been shown to improve health for those with cardiovascular disease and hypertension, reduce blood sugar in diabetics, improved immune functioning in HIV patients, reduce irritable bowel symptoms, and aid a wide variety of other health conditions (Carlson, 2012). Also, substantial research shows the benefit of relaxation methods for managing work stress (Richardson and RothStein, 2008). Therefore, all of us could benefit from regular relaxation practice just as routine exercise helps prevent health problems and improve overall health.
2) Relaxation requires routine practice. Not only do we need to engage in relaxation methods routinely, but we need to recognize that to reap the reward of relaxation it requires practice over time. Again with the exercise example: it wouldn't be reasonable to start an exercise program and expect to run a marathon right away.
Commonly, my clients with anxiety believe that they SHOULD just be able to relax without extensive training (they use the relaxation when having a panic attack and then tell me it didn't work). Or, once they are in control of the anxiety, they believe they no longer need to do relaxation.
Such clients who believe they no longer need to use relaxation methods because their anxiety is under control often return to therapy with a new bout of anxiety. I explain to them that they have the tools they need to maintain psychological health but that these tools are like exercise for physical health. If you quit using them, your health will likely decline. I tell my clients that if relaxation is a health practice that can benefit most of us, it is even more important for people with anxiety disorders to engage in routine relaxation exercises throughout their lifetime.
3) Relaxation-induced anxiety doesn't need to be an obstacle. A subset of people with anxiety disorders (17-53% depending upon the method used) may experience relaxation-induced anxiety (Astin et al., 2003). This means that when they try to do relaxation, they experience increased anxiety. Often this is due to either trying too hard at relaxing, or discomfort with noticing the body sensations, or fear of losing control.
If you experience relaxation-induced anxiety while trying any of these methods don't give up on relaxation. I believe that learning relaxation methods is even more important for those who have relaxation-induced anxiety. First try to identify why you are feeling anxious. Sometimes when people TRY to relax they become more tense. In this is the case, it is best to tell yourself just to practice the relaxation but not to try and make yourself relax. Over time you will experience more of the relaxation.
Some people with anxiety disorders, especially those with Panic Disorder, try to avoid noticing the physical sensations of their body. Since relaxation is paying attention to the body it can be disconcerting for them. Others feel that if they let go of their tension they might lose emotional control. If this occurs I usually tell my clients to try the short anxiety methods first or to do active relaxation such as qigong or yoga. For some clients, I will have them just play the relaxation audio in the background while doing something else until they gradually get used to it. You may need to obtain professional help to address this issue if you continue to have problems with relaxation-induced anxiety.
The short stress management techniques on this site are a good starting point for practicing relaxation for several reasons:
1) Easier to learn. Most of the time people can obtain immediate benefit from the short techniques and they are simple methods easy to remember. Not much practice is required although they may not be effective when anxiety has reached a high level unless other methods have been practiced routinely.
2) Time. The short stress management methods take a minute or two to obtain some benefit. However, even greater benefit may be obtained in this short time if you practice the deeper relaxation methods regularly because you will become more skilled at quickly relaxing.
3) Availability. These techniques are beneficial for the long-term management of anxiety. Specifically, the more you practice the other methods of relaxation, the more effective these shorter techniques can become to aid you when having panic or high anxiety. Once you know these techniques, they are available to you just about any time and any place. You do not need to have a quiet place to close your eyes for twenty minutes and listen to an audio. Most of these short techniques, once learned, can be used when doing something else. For instance, you can do mindful breathing while talking to someone or sitting in a meeting. READ MORE: page 4