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PROGRESSIVE RELAXATION PROTOCOL

Protocol: One month, 2 x daily

Time 1 Time 2
Week One 16 Muscles 16 Muscles
Week Two 8 Muscles 16 Muscles
Week Three 4 Muscles 16 Muscles
Week Four Recall-Relaxation 16 Muscles

Progressive Muscle Relaxation - 16 Muscles

1. Choose a quiet location with a comfortable chair or bed.
2. Loosen tight clothing and remove glasses or contact lenses.
Tense for 10 seconds and relax for 20 seconds, repeating the word “relax” silently to
3.
yourself on each exhalation, for the following major muscle groups:
1, 2 Lower arms
3, 4 Upper arms
5, 6 Lower legs
7, 8 Upper legs
9 Abdomen
10 Chest
11 Shoulders
12 Neck
13 Mouth, throat, and jaw
14 Eyes
15 Lower forehead
16 Upper forehead
4. Focus your attention on the sensations of tension and relaxation.
After tensing and releasing the 16 muscle groups, count from 1 to 5 to deepen relaxation,
5.
and breathe slowly for 2 minutes, repeating the word “relax” with every exhalation.
6. Count from 5 to 1 to return to a state of alertness.

All credit for the protocol below should be given to: Craske, M. G. and Barlow, D. H. (2006).
Mastery of your anxiety and worry: Workbook (2nd ed.). Oxford University Press.
 2

Example of Progressive Muscle Relaxation - 16 Muscles

Get into a comfortable position, close your eyes, and sit quietly for a few seconds, taking some
slow, deep breaths.

1. Build up the tension in your lower arms by making fists with your hands and pulling up
on your wrists. If your nails are long, press your fingers against your palms to make fists.
Feel the tension through your lower arms, wrists, fingers, knuckles, and hands. Focus on
the tension. Notice the sensations of pulling, of discomfort, of tightness. Hold the tension
(10 seconds). Now, release the tension and let your hands and lower arms relax onto the
chair or bed, with your palms facing down. Focus your attention on the sensations of
relaxation in your hands and arms. Feel the release from tension. Relax the muscles (20
seconds), and as you relax, breathe smoothly and slowly from your abdomen. Each time
you exhale, think the word "relax."

2. Now, build tip the tension in your upper arms by pulling your arms back and in, toward
your sides. Feel the tension in the back of your arms and radiating up into your shoulders
and back. Focus on the sensations of tension. Hold the tension (10 seconds). Now, release
your arms and let them relax. Focus on your upper arms, and feel the difference
compared with the tension. Your arms might feel heavy, warm, and relaxed. As you relax
(20 seconds), breathe smoothly and slowly from your abdomen. Each time you exhale,
think the word "relax."

3. Now, build up the tension in your lower legs by flexing your feet and pulling your toes
toward your upper body. Feel the tension as it spreads through your feet, ankles, shins,
and calves. Focus on the tension spreading down the back of your leg, into your foot,
under your foot, and around your toes. Concentrate on that part of your body (10
seconds). Now, release the tension. Let your legs relax heavily onto the chair or bed. Feel
the difference in the muscles as they relax. Feel the release from tension, the sense of
comfort, and the warmth and heaviness of relaxation (20 seconds). As you breathe
smoothly and slowly, think the word "relax" each time you exhale.

4. Build up the tension in your upper legs by pulling your knees together and lifting your
legs off the bed or chair. Focus on the tightness in your upper legs. Feel the pulling
sensations from the hip down and notice the tension in your legs. Focus on that part of
your body (10 seconds). Now, release the tension, and let your legs drop down heavily
onto the chair or bed. Let the tension go away. Concentrate on the feeling of relaxation.
Feel the difference in your legs. Focus on the feeling of comfort (20 seconds), and as you
breathe smoothly and slowly, think the word "relax" each time you exhale.

5. Now, build up the tension in your stomach by pulling your stomach in toward your spine
very tightly. Feel the tension. Feel the tightness and focus on that part of your body (10
seconds). Now, let your stomach relax outwards. Let it go further and further. Feel the
sense of warmth circulating across your stomach. Feel the comfort of relaxation (20
seconds). As you breathe smoothly and slowly, think the word "relax" each time you
exhale.

All credit for the protocol below should be given to: Craske, M. G. and Barlow, D. H. (2006).
Mastery of your anxiety and worry: Workbook (2nd ed.). Oxford University Press.
 3

6. Now, build up the tension around your chest by taking a deep breath and holding it. Your
chest is expanded, and the muscles are stretched around it. Feel the tension in your chest
and back. Hold your breath (10 seconds). Now, slowly, let the air escape and breathe
normally, letting the air flow in and out smoothly and easily. Feel the comfort of
relaxation (20 seconds). Notice the difference as the muscles relax compared with the
tension and think the word "relax" each time you exhale.

7. Imagine that your shoulders are on strings and are pulled up toward your ears. Feel the
tension around your shoulders, radiating down into your back and up into your neck and
the back of your head. Focus on this part of your body. Concentrate on the sensations
around your neck and shoulders (10 seconds), and then let your shoulders droop. Relax
and let them droop further and further. Feel the sense of relaxation around your neck and
shoulders. Concentrate on the sensation of relaxation (20 seconds) in this part of your
body. As you breathe smoothly and slowly, think the word "relax" each time you exhale.

8. Build up the tension around your neck by pressing the back of your neck toward the chair
or bed and pulling your chin down toward your chest. Feel the tightness around the back
of your neck spreading up into the back of your head. Focus on the tension (10 seconds).
Now, release the tension, letting your head rest comfortably against the bed or chair.
Concentrate on the relaxation (20 seconds) and feel the difference from the tension. As
you breathe smoothly and slowly, think the word "relax" each time you exhale.

9. Build up the tension around your mouth, jaw, and throat by clenching your teeth and
forcing the corners of your mouth hack into a forced smile (10 seconds). Feel the
tightness and concentrate on the sensations. Then, release the tension, letting your mouth
drop open and the muscles around your throat and jaw relax. Concentrate on the
difference in the sensations in that part of your body (20 seconds). As you breathe
smoothly and slowly, think the word "relax" each time you exhale.

10. Build up the tension around your eyes by squeezing your eyes tightly shut for a few
seconds, and then releasing. Then, let the tension around your eyes slide away. Feel the
difference as the muscles relax (20 seconds). As you breathe smoothly and slowly, think
the word "relax" each time you exhale.

11. Build up the tension across your lower forehead by frowning, pulling your eyebrows
down and toward the center. Feel the tension across your forehead and the top of your
head. Concentrate on the tension (10 seconds), and then release, smoothing out the
wrinkles and letting your forehead relax. Feel the difference as you relax (20 seconds).
As you breathe smoothly and slowly, think the word "relax" each time you exhale.

12. Build up the tension across your upper forehead by raising your eyebrows brows as high
as you can. Feel the wrinkling and pulling sensations across your forehead and the top of
your head. Hold the tension (10 seconds), and then relax, letting your eyebrows rest and
the tension leave. Concentrate on the sensations of relaxation and feel the difference in
comparison to tension (20 seconds). As you breathe smoothly and slowly, think the word
"relax" each time you exhale.

All credit for the protocol below should be given to: Craske, M. G. and Barlow, D. H. (2006).
Mastery of your anxiety and worry: Workbook (2nd ed.). Oxford University Press.
 4

13. Now your whole body is feeling relaxed and comfortable. As you feel yourself becoming
even more relaxed, count from one to five. One, letting all of the tension leave your body.
Two, sinking further and further into relaxation. Three, feeling more and more relaxed.
Four, feeling very relaxed. Five, feeling deeply relaxed. As you spend a few minutes in
this relaxed state, think about your breathing. Feel the cool air as you breathe in and the
warm air as you breathe out. Your breathing is slow and regular. Every time you breathe
out, think the word "relax" (2 minutes). Now, count backward from five, gradually
feeling yourself become more alert and awake. Five, feeling more awake. Four, coming
out of the relaxation. Three, feeling more alert. Two, opening your eyes. One, sitting up.

Progressive Muscle Relaxation - 8 Muscles

1. Choose a quiet location with a comfortable chair or bed.

2. Loosen tight clothing, and remove glasses or contact lenses.
Tense for 10 seconds and relax for 20 seconds, repeating the word “relax” silently to
3.
yourself on each exhalation, for the following major muscle groups:
1 Upper and lower arms
2 Upper and lower legs
3 Abdomen
4 Chest
5 Shoulders
6 Neck
7 Eyes
8 Forehead
4. Focus your attention on the sensations of tension and relaxation.
After tensing and releasing the 8 muscle groups, count from 1 to 5 to deepen relaxation,
5.
and breathe slowly for 2 minutes, repeating the word “relax” with every exhalation.
6. Count from 5 to 1 to return to a state of alertness

Progressive Muscle Relaxation - 4 Muscles

1. Choose a quiet location with a comfortable chair or bed.
2. Loosen tight clothing and remove glasses or contact lenses.
Tense for 10 seconds and relax for 20 seconds, repeating the word “relax” silently to
3.
yourself on each exhalation, for the following major muscle groups:
1 Abdomen
2 Chest
3 Shoulders
4 Forehead
4. Focus your attention on the sensations of tension and relaxation.
After tensing and releasing the 8 muscle groups, count from 1 to 5 to deepen relaxation,
5.
and breathe slowly for 2 minutes, repeating the word “relax” with every exhalation.
6. Count from 5 to 1 to return to a state of alertness

All credit for the protocol below should be given to: Craske, M. G. and Barlow, D. H. (2006).
Mastery of your anxiety and worry: Workbook (2nd ed.). Oxford University Press.
 5

Recall-Relaxation Procedure

1. Choose a quiet location with a comfortable chair or bed.

2. Loosen tight clothing, and remove glasses or contact lenses.
Concentrate on each of the four muscle groups in turn: abdomen, chest, shoulders, and
3.
forehead.
4. Let go of the tension, as you recall the feelings of relaxation in each muscle group.
Relax for five minutes, maintaining a pattern of slow, regular breathing and repeating the
5.
word “relax” with every exhalation.

Supplemental

Once you learn to do this set of exercises, it is very possible that you will lower your heart rate
and blood pressure. For that reason, do not stand up quickly afterward.

After going through the full set of tensing and releasing exercises, evaluate your experience.
Were there any parts of your body that were difficult to relax? For very tense parts of your body,
it may help to tense and release several times. Were you able to focus your attention? Remember
that equally important as physical relaxation is mental relaxation or learning to shift your
attention away from worrisome thoughts and onto the physical sensations associated with the
tension and relaxation exercises.

If other thoughts enter your mind, let them pass, and redirect your attention to the physical
sensations of relaxation. It doesn't matter if the worrisome thoughts remain main in the back of
your mind-you are teaching yourself that those worrisome thoughts do not deserve your full
attention.

Did you feel anxiety during the procedure? You may experience an initial increase in anxiety as
you follow the relaxation exercises, for several reasons. Unusual sensations, such as a floating
sensation or a sinking feeling, sometimes occur because of deep relaxation, and these sensations
may produce anxiety, although they are normal and harmless.

Sometimes the sense of "letting go" is disturbing initially. Again, this may take some getting
used to, especially if you usually tend to be on edge, vigilant, and ready for any possibility.
"Letting go" will feel unfamiliar at first, and perhaps a little threatening. However, with practice,
you will learn that negative events are not more likely to occur, just because you allow yourself
to relax.

Another reason that relaxation will sometimes increase anxiety is that you may be worrying
about things that you should be doing while you're attempting to relax. In this case, practice
dismissing these thoughts and shifting your attention back to the sensations of tensing and
relaxing your muscles.

If you did become anxious because of the relaxation technique, you should continue practicing
the exercise regardless. With repetition, your anxiety will decrease, and you will feel the true
effects of relaxation.
All credit for the protocol below should be given to: Craske, M. G. and Barlow, D. H. (2006).
Mastery of your anxiety and worry: Workbook (2nd ed.). Oxford University Press.
 6

Keep a record of your relaxation practice on a relaxation record so that you can evaluate
your progress.

On the record:
• Note the level of relaxation that you achieve by the end of the exercise (on a 0 - to 100
point scale, where 0 = no relaxation and 100 = excellent relaxation).
• Rate your average degree of concentration during the procedure (using a 0 - to 100 point
scale, where 0 = no concentration and 100 = excellent concentration). Remember,
concentration refers to focusing on the sensations of tension and relaxation.

All credit for the protocol below should be given to: Craske, M. G. and Barlow, D. H. (2006).
Mastery of your anxiety and worry: Workbook (2nd ed.). Oxford University Press.