Relaxation methods: which techniques can help combat stress?

Frequent and persistent stress can make people ill. As relaxation techniques help people deal with stress, they play an important role in maintaining good health and preventing several medical conditions.

People who are frequently stressed often also feel exhausted and worn-out. Stress can cause digestive system, nervous system and cardiovascular system disorders and diseases. It can also weaken the immune system, making people more susceptible to infectious diseases, for example. Stress can furthermore impede wound healing or make vaccinations less effective.

If the body feels overburdened by too much stress, it usually indicates this through one or more warning signals, which can differ from person to person. Examples include:

• headaches
• neck and back ache
• diarrhea, constipation or nausea
• shortness of breath
• skin problems
• problems sleeping
• weight gain or loss
• irritability

Some people try to cope with stress by consuming harmful substances such as alcohol, cigarettes or other drugs. This is not good for the health in the long term though.

Anyone who frequently feels stressed and has noticed their body giving off one or more physical warning signs should seek some relaxation. For some people, it suffices to take breaks from stressful everyday life and do the things they enjoy more often. The details can vary from one person to the next: a games evening with friends, quietly reading an exciting book or a romantic trip to the countryside. Many people relieve stress through exercise. This can mean anything from running to dancing to playing football – what matters is that it is enjoyable.

For some people, however, this is not enough to successfully cope with stress and sufficiently relax at particularly stressful times. In this case, various relaxation methods and techniques can help. These have even proven to be effective treatment methods for several mental and physical conditions such as anxiety disorders, mild to moderate depression, high blood pressure or headaches.

A huge range of relaxation techniques are available. This article only covers a select number of techniques, the effectiveness of which has been proven in multiple studies and which can be used over the long term without the support of therapists or doctors. Professional guidance is initially useful for many techniques though, for example within the scope of a course.

For other methods such as biofeedback and hypnosis, on the other hand, professional support is always required. Such methods are not covered by this article but all recognized relaxation techniques have a similar effect on the body.

The best way to determine which technique helps you relax most successfully is simply to try the different options. Some people can relax sufficiently with purely mental techniques where they turn their attention completely inwards rather than involving any form of exercise. Examples include autogenic training and most forms of meditation. For others, a light physical component with active muscle stimulation and relaxation is helpful, as with progressive muscle relaxation for example. Yet others find relaxation through physically active techniques such as yoga, tai chi or qigong.

Due to their many positive effects, relaxation techniques are not only used to manage stress and prevent diseases, but also to support the treatment of a variety of mental and physical health conditions. Examples include anxiety disorders, mild to moderate depression, high blood pressure, headaches, bronchial asthma and fibromyalgia. Autogenic training and progressive muscle relaxation in particular are often used for therapeutic purposes.

Although relaxation techniques are used to treat many health conditions, they are usually merely part of a broader treatment concept. The relaxation technique can be a central treatment method, for example within the scope of psychotherapy, or solely support the actual therapy, as in the case of cancer treatment.

Although the various relaxation techniques are performed differently, they usually have similar effects on the person practicing them:

• self-control: the sense of being able to control the body and its emotions
• training the concentration and attention
• calming
• heightened sense of wellbeing

The relaxation techniques can trigger several changes in the body (“relaxation reactions”), including:

• relaxed skeletal muscles
• expanded blood vessels and reduced blood pressure
• calm breathing
• decreased oxygen consumption

When first starting to practice, these effects usually only occur to a limited extent. Only with more frequent practice can the relaxation reaction be triggered more quickly and completely. In more experienced people, the reaction can also be triggered by certain key stimuli that are linked to the act of relaxing during the practice, for example music or odors.

Many relaxation techniques are initially practiced in a guided course. The long-term effectiveness of a technique also depends on whether people continue practicing it after the course is finished. Only about a third of participants of relaxation courses succeed in doing this. With progressive muscle relaxation, the probability of the practices being continued is higher than with autogenic training.

Progressive muscle relaxation, also known as Jacobson’s relaxation technique, is one of the most commonly used relaxation techniques.

Implementation

This technique involves working in sequence through individual muscle groups, tightening them for a few seconds and then relaxing them for about 30 seconds. The exercises are performed to instructions – from a trainer, CD or mobile phone. Several typical examples include:

•  “Bend your left/right elbow.”
• “Press your entire left/right foot into the floor.”
• “Close your eyes tightly.”

The muscle tension should be kept as low as possible during the exercises. One aim is to heighten people’s self-awareness so they can notice and relieve even the slightest of tension.

Where possible, the technique will involve all of the body’s muscle groups, but not necessarily all at once in a single training session. In the original version of progressive muscle relaxation (according to the inventor Jacobson), three muscle groups are trained per session. In such cases, each session lasts about an hour. Nowadays, shorter and other versions of progressive muscle relaxation are available too though. As the exercises are relatively easy to learn, progressive muscle relaxation is even suitable for children.

Effect

The precise effects of progressive muscle relaxation on the processes in the body have not yet been fully understood. The positive effect on various symptoms and clinical pictures has been sufficiently proven though. Progressive muscle relaxation is the relaxation technique with the most reliable proof of effectiveness.

Areas of use

Progressive muscle relaxation is particularly effective at treating tension headaches. When treating migraines and high blood pressure, the technique can be successfully used to complement other therapies. Muscle relaxation has also been seen to have positive effects during the treatment of many other health conditions, such as coronary heart disease, diabetes, asthma and cancer.

Autogenic training is one of the best known relaxation techniques in Europe. It is frequently used in internal medicine, psychiatry and psychotherapy as well as for self-help.

Implementation

Autogenic training is a kind of “self-hypnosis” where the person practicing the technique says certain phrases to themselves in their head, e.g. “My right arm is warm”.

There are six standard phrases or exercises that are particularly common during autogenic training:

• Heaviness exercise: “My right arm is heavy.”
• Warmth exercise: “My right arm is warm.”
• Heart exercise: “My heartbeat is calm and regular.”
• Breathing exercise: “My breathing breathes me.”
• Solar plexus exercise: “Warmth is flowing through my solar plexus.”
• Forehead cooling exercise: “My forehead is pleasantly cool.”

Supportive phrases like “I am completely calm” or organ-specific phrases that focus on designated areas of the body can also be used.

Effect

Autogenic training is similarly as effective at helping people relax as other relaxation techniques and has the aforementioned relaxation reaction effects on the body. Regular practice can also have other positive effects on the body and metabolism.

As indicated by the name, “training” is required to achieve the desired effects. However, initial successes can be observed after quite a short time – about two to three weeks.

The greatest effects with autogenic training can be achieved when people are already reasonably relaxed before starting. If people are extremely tense on starting the training, it can be hard to achieve the desired effect.

Areas of use

Autogenic training can be used in a wide variety of ways, for example to support the treatment of:

• fatigue
• nervousness or inner tension
• performance and behavioral difficulties
• pain-induced strain

It is also used in several non-clinical areas, including:

• for improving general health
• for helping process everyday stressful moments
• for improving performance within the scope of sports psychology

There are only a few situations in which autogenic training should not be used, for example in the case of certain mental disorders such as obsessive-compulsive disorders and acute psychoses. Skills such as concentration, cooperation and self-control are needed to learn to use autogenic training and practice it independently. As the statements used often contradict what people are experiencing, especially at the beginning of the training, some people doubt the effectiveness of the practice and lose motivation. As such, autogenic training is regarded as harder to learn than other relaxation techniques.

“Meditation” is generally used as an umbrella term for several techniques that are practiced while sitting down.

Implementation

By concentrating on physical factors such as the breath, sentences that are repeated in the mind or out loud (mantras) or mental images, the mind should become calm and a sense of relaxation should occur. Meditation techniques include mindfulness meditation and autogenic meditation, an advanced level of autogenic training. The practice of mindfulness meditation involves either systematically moving through the entire body or spending a while in a specific region. 
There are also a number of meditation techniques that involve movement, where the attention is drawn to the way movements are made, for example tai chi and qigong.

Effect

Due to the many different meditation techniques, it is impossible to make a general statement about how meditation affects the body. However, many studies have shown that meditation generally triggers a pronounced relaxation reaction – comparable to the effect of progressive muscle relaxation, biofeedback and hypnosis. This means that meditation can have positive effects on stress, high blood pressure and anxiety, for example. However, achieving these effects requires a fair bit of practice. Once people are more experienced though, they only need to meditate briefly and at a low intensity to enjoy the effects and feel relaxed.

Areas of use

One technique for treating health conditions that combines mindfulness meditation with physical exercises from Hatha yoga is mindfulness-based stress reduction (MBSR). Several studies have proven this to effectively reduce stress. It can even help to combat depression and anxiety disorders. MBSR courses involving weekly group sessions are now offered in many places.

Yoga originated in ancient India and is now extremely popular worldwide.

Implementation

There are many different types of yoga, the most common of which in the Western world is Hatha yoga. This incorporates physical exercises, meditation and controlled breathing. The end positions of the yoga exercises are designed to only be possible when certain muscle groups are relaxed. The exercises act as a kind of aid that helps the muscles relax. Yoga aims to harmonize the body and mind.

Effect

Studies have shown that, in addition to relaxation, yoga also has a variety of other positive effects on the body. Compared to people who do not practice yoga, those who do so regularly have:

• lower levels of the stress hormone cortisol in their blood
• a lower blood pressure
• a lower heart rate
• lower blood sugar and cholesterol levels

Thanks to these effects, regular yoga practice can reduce the risk of cardiovascular diseases.

Areas of use

Yoga can be used during cancer treatment, for example, to strengthen patients’ mental health and therefore support their recovery. Yoga has also been used to successfully help treat depression, osteoarthritis and high blood pressure. It can furthermore be used as a complementary therapy for treating panic disorders.

In general, statutory health insurance providers cover part of the cost of relaxation courses used for prevention and their entire cost within the scope of treatment.

Prevention

In addition to preventive activities in relation to exercise, diet and addictive substance use, health insurance providers also fund preventive courses on several relaxation techniques. The aim is to motivate insured persons to actively do something to stay healthy and support them as they do so. After all, persistent stress that is not managed through relaxation techniques or other measures can negatively affect the health just as much as a lack of exercise or an unhealthy diet.

The health insurance provider will individually assess whether course costs are fully or partially covered on a case-by-case basis. Various criteria are considered in this regard, such as the provider’s qualifications and the effectiveness of the technique. The level of reimbursement depends on the specific health insurance provider. You can find out whether and to what extent your health insurance provider covers the cost of a certain course by contacting them by telephone or checking out their website.

Treatment

Progressive muscle relaxation, meditation and autogenic training in the form of individual or group therapy can also be part of psychotherapy. In this case, health insurance providers will cover the cost in full.

The digitization of the healthcare system offers multiple opportunities – including for people who are looking for services to help them relax and deal with stress.

Internet services

The internet offers various online programs for treating mental and physical conditions, some of which involve relaxation techniques. There are also many online prevention courses on relaxation and stress as well as freely available video and audio files with instructions on the various relaxation techniques.

Services for mobile phones and tablets

There are multiple paid and free self-help apps for mobile phones or tablets, including relaxation and stress management apps.

There are two types of apps:

• Health apps, which aim to promote healthy behavior and a healthy lifestyle for preventive reasons.
• Medical apps – known as digital health applications (DiGA) or “apps on prescription” – used to accompany the treatment of health conditions such as depression or anxiety disorders. Similarly to psychotherapy, these sometimes also incorporate relaxation techniques into the treatment.

Such apps can provide background information and instructions in relation to relaxation techniques and support them with audio and video materials. They also offer people a way to independently monitor their relaxation techniques with the aid of logs and reminders. Apps can motivate their users to perform the relaxation techniques on a daily basis. As interactive apps are particularly attractive to children and adolescents, they are even increasingly being used to complement other treatments within these age groups.

If you find courses, apps or other services for learning relaxation techniques on the internet, you should always check if they come from a trustworthy provider and if there is any evidence of the respective technique’s effectiveness before using them. They can be regarded as trustworthy, for example, if they come from a health insurance provider.