Progressive Muscle Relaxation (PGMR

PGMR is an effective technique that breaks into the vicious cycle of worry and anxiety in GAD. Practiced daily, it targets the physical symptom of tension, can help reduce the frequency of worries, the physical symptoms of tension as well as improve your sleep.

You can begin to use the PGMR technique straight away. Aim to do it once, or ideally twice a day, at a set neutral time. You only need to set aside around 10-15 minutes for each PGMR practice. You should do it at a planned time, like after brushing your teeth in the morning, to get into a routine with it. PGMR isn’t a technique to do when you feel anxious, it is a skill that builds up over time, that teaches your body to notice early warning signs of tension in the muscles and let them go. This helps your body to learn early warning signs of tension and to let it go earlier through a process called kinaesthetic awareness. PGMR is an evidence based tool that is recommended in clinical guidelines to reduce tension symptoms, worry and improve sleep. It can also help you to feel less irritable and more able to deal with the stressful situations we all have to deal with in our daily life. We carry a tension load in our bodies, this can build up like a coiled spring when we are under stress and worrying. When we worry, we feel tense. In turn, tension can then lead to aches and pains, headaches, gastro-intestinal upset, disrupt our sleep, and lead to even more worrying, in a vicious cycle of symptoms. PGMR can really help with this. It can take a while to reach its full effects, so keep going with it. Many people use it everyday in their lives to help them to manage tension and stress, even when they feel better.

John: “I made sure I set time aside each morning and evening for PGMR. I was extremely tense from all my worrying, causing my muscles to ache, headaches and had poor sleep too. At the start, I found it quite hard isolating just one muscle. I found this became easier with practice. Your body will slowly learn how to relax your muscles and keep you more relaxed.”

PGMR has a 5/15 time limit. Tense a single muscle group for 5 seconds, noticing how it feels tensed and then rapidly drop the tension, paying attention to how it feels relaxed for a further 15 seconds

How to do PGMR:

You work through your body to really tense a single isolated muscle group for 5 seconds, then you rapidly drop the tension and release it for 15 seconds. You really focus your attention on the muscle and how it feels both when tensed and relaxed. You tense the muscle as much as you can for 5 seconds to help your body to notice the signs of tension and then rapidly drop it, so your body is registering it held tense and then the contrast with the muscle in a relaxed state afterwards. Then you move to the next muscle group, following the PGMR worksheet on the next page. Sit down comfortably in a chair and remember to take off your shoes. Use a quiet place, free of any distractions where you can really focus your attention on your muscles. Starting at your head or feet, whichever you prefer, you tense and then release one muscle group at a time. Many people find starting PGMR from the head down You don’t want to hold a muscle tense for more than 5 seconds as it could lead to stiffness or cramping. 5 seconds is enough time for the body to register the tension in the muscle in comparison with it relaxed. PGMR takes regular practice, keep it going for at least three months to get the maximum benefit from it. For the first two weeks aim to do it up to twice a day if you can, then move to once per day.

My forehead: lift my eyebrows as high as I can and tense. My face: tighten up the muscles in my face, around my cheeks and nose and hold it tense.

My jaw: hold my jaw slightly open and tense it.

My neck: gently lean my head right back, stretching my neck and hold it tense My shoulders: lift up my shoulders to my neck and tense.

My upper back: push my arms backwards at chest level, with elbows towards each other

My right arm at the top: tighten my bicep muscle and tense it as if showing someone my muscles.

My left arm at the top: repeat as above with my left bicep muscle.

My right hand and forearm: make a fist and tense my lower arm and stretch it out, keeping it tense.

My left hand and forearm: repeat the above with my left hand and forearm.

My upper back and shoulder blades: stretch up my back and shoulder blades and hold them tense. My abdomen and lower back: pull in my tummy muscles and hold them tight and tense. My buttocks: tighten my buttocks and tense them up.

My entire right leg: put my leg out and tense it all the way down.

My entire left leg: repeat the above on my left side.

My lower right leg and calf: tense my calf muscle in my lower leg.

My lower left leg and calf: repeat the above with my left side.

My right foot: curl up my toes and tense my foot.

My left foot: repeat the above with my left foot.

John: “I found I often felt overwhelmed and put things off that I needed to deal with. That just backfired as I then spent ages worrying about them anyway and felt worse and worse. Learning to separate if I am having a practical or a hypothetical worry and taking action on the practical ones straight away really helped me to break that cycle. Even when taking the action is hard, it is better than feeling terrible all day. I have learned to break things down and stop procrastinating.”