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Relaxation Therapies
What is it? Overview Usage Side Effects and Warnings

Relaxation Therapies Overview

Written by FoundHealth, ritasharma.


Constant stress is one of the defining features of modern life, and the source of many common health problems. Stress plays an obvious role in nervousness, anxiety, and insomnia, but it is also thought to contribute to a vast number of other illnesses.

In the past, most people engaged in many hours of physical exercise daily, an activity that reduces the effects of psychological stress. Life was also slower then and more in harmony with the natural cycles of day and season. Today, however, our bodies are relatively sedentary, while our minds are forced to respond to the rapid pace of a society that never stops. The result is high levels of stress and reduced ability to cope with it.

There are several ways to mitigate the damage caused by stress. Increased physical exercise can help, as can simple, common sense steps like taking relaxation breaks and vacations. If these approaches don’t have adequate results, there are more formal methods that may be helpful.

This article discusses a group of stress-reduction techniques often called relaxation therapies. In addition to these methods, yoga , Tai Chi , hypnosis , massage , and biofeedback can also help induce a relaxed state.

What Are Relaxation Therapies?

There are many types of relaxation therapies, and they use a variety of techniques. However, most of them share certain related features.

In a great many relaxation techniques, one begins by either lying down or assuming a relaxed, seated posture in a quiet place and closing the eyes. The next step differs depending on the method. In autogenic training, relaxation response, and certain forms of meditation, one focuses one’s mind on internal sensations, such as the breath. Guided-imagery techniques employ deliberate visualization of scenes or actions, such as walking on a quiet beach. Progressive relaxation techniques involve gradual relaxation of the muscles. Finally, some schools of meditation incorporate the repetition of a phrase or sound silently or aloud.

All of these techniques are best learned with the aid of a trained practitioner. The usual format is a group class supplemented by regular home practice. If you are diligent enough, experience suggests that you can develop the ability to call on a relaxed state at will, even in the middle of a very stressful situation.

What Is the Scientific Evidence for Relaxation Therapies?

Although many studies have been performed on relaxation therapies, most of them suffer from inadequate design. To be fair, there are considerable difficulties in the path of any researcher who wishes to scientifically assess the effectiveness of a relaxation therapy such as hypnosis. There are several factors involved, but the most important is fairly fundamental: it isn’t easy to design a proper double-blind, placebo-controlled study of relaxation therapy. Researchers studying the herb St. John’s wort, for example, can use placebo pills that are indistinguishable from the real thing. However, it’s difficult to design a form of placebo relaxation therapy that can’t be detected as such by both practitioners and patients.

One very clever method used by some researchers involves the use of intentionally neutral visualizations. Instead of imagining lying in bed and sleeping peacefully, patients in the placebo group might be told to visualize something like a green box. The problem here is that researchers teaching the visualization method to participants may inadvertently convey a sense of disbelief in the placebo treatment. This can be solved by using relatively untrained people who are themselves deceived by experimenters to teach the method, but the practical obstacles are significant.

For this reason, many studies of relaxation therapy have made major compromises to the double-blind, placebo-controlled model. Some randomly assigned participants to receive either relaxation therapy or no treatment. In the best of these studies, results were rated by examiners who didn’t know which participants were in which group (in other words, “blinded observers”). However, it isn’t clear whether benefits reported in such studies are due to the relaxation therapy or less specific factors, such as mere attention.

Other studies have compared relaxation therapies to different techniques, such as hypnosis or cognitive psychotherapy. However, the same difficulties arise when trying to study these latter therapies, and the results of a study that compares an unproven treatment to one that is also imperfectly documented are not very meaningful

Even less meaningful studies of relaxation therapies simply involved giving people the therapy and monitoring them to see whether they improved. For at least a dozen reasons, such open-label trials prove nothing at all, and we do not report them here. (The reasons are discussed in the article Why Does This Database Rely on Double-blind Studies? )

Given these caveats, the following is a summary of what science knows about the medical benefits of relaxation therapy.

The Possible Benefits of Relaxation Therapy


Numerous controlled studies have evaluated relaxation therapies for the treatment of insomnia . 1 These studies are difficult to summarize because many involved therapy combined with other methods such as biofeedback, sleep restriction, and paradoxical intent (trying notto sleep). The type of relaxation therapy used in the majority of these trials was progressive muscle relaxation (PMR). Many of these trials used the clever form of placebo treatment described above; others simply compared relaxation therapy to no treatment.

Overall, the evidence indicates that relaxation therapies may be somewhat helpful for insomnia, although not dramatically so. For example, in a controlled study of 70 people with insomnia, participants using progressive relaxation showed no meaningful improvement in the time to fall asleep or the duration of sleep, but they reported feeling more rested in the morning. 2 In another study, 20 minutes of relaxation practice was required to increase sleeping time by 30 minutes. 3


A review article published in 2002 found 15 published controlled trials that evaluated relaxation therapies for the treatment of asthma . 4 Most of the studies were rated as very poor or poor quality. Overall the results failed to demonstrate improvement, although a muscular relaxation technique called Jacobsen’s relaxation did show a hint of benefit.


There is a fair amount of evidence in support of relaxation therapies as means to treat the symptoms of anxiety , at least in the short-term. 5 In a 2008 review of 27 studies, researchers concluded that relaxation therapies (including Jacobson's progressive relaxation, autogenic training, applied relaxation, and meditation) were effective against anxiety. 6 However, these favorable findings should be tempered by the fact that not all of the studies were randomized, controlled trials.


It seems intuitive that relaxation should lower blood pressure. Indeed, many studies have evaluated the benefits of relaxation therapies for hypertension and related cardiovascular risks. 7 The results, however, have been mixed at best. In a review of 25 studies of various relaxation therapies for high blood pressure (totaling 1,198 participants), researchers found that those studies employing a control group had no significant effect on lowering blood pressure compared to sham (placebo) therapies. 8 On the other hand, a separate review of nine randomized trials concluded that the regular use of transcendental meditation may significantly reduce both systolic and diastolic blood pressure compared to a control. 9 Similarly, an analysis of 17 randomized controlled trials of various relaxation therapies, found that only transcendental meditation resulted in significant reductions in blood pressure; biofeedback, progressive muscle relaxation, and stress management training produced no such benefit. 10 In addition, a trial of 86 patients with hypertension suggested that daily, music-guided slow breathing reduced systolic blood pressure measured over a 24-hour period. 11

Other Conditions

Other conditions that have at least minimal supporting evidence for response to relaxation therapies include the following:

  • Angina 12
  • Back pain 13
  • Bulimia nervosa 14
  • Cancer treatment support , 15 16 17 18 19 20 including cancer pain 21
  • Chronic pain in general 22 23 24 25
  • Congestive heart failure 26
  • Depression 27
  • Fibromyalgia 28
  • Interstitial cystitis 29
  • Irritable bowel syndrome 30
  • Menopause 31
  • Obsessive-compulsive disorder (OCD) 32
  • Osteoarthritis 33
  • Premenstrual syndrome (PMS) 34
  • Pregnancy support (reducing perceived stress) 35
  • Psoriasis 36
  • Rheumatoid arthritis 37
  • Stress in general 38 39
  • Stroke rehabilitation 40
  • Surgery support (primarily reducing pain and stress before or after surgery) 41
  • Tension headaches 42
  • Ulcerative colitis 43

In many cases the results are marginal at best, and contradictory outcomes between trials are common.

One study suggests that the use of visualizations prior to surgery cannot only reduce the need for pain medications, it can also help prevent hematomas (collections of blood under the skin). 44 However, more study would be needed to verify this somewhat difficult-to-believe result. A more easily accepted study found that either relaxation therapy or aerobic exercise can improve symptoms of fatigue after cancer surgery, and that each approach is about as effective as the other. 45 Another study found that cancer patients exposed to empathetic care along with self-hypnotic relaxation experienced significantly less pain and anxiety during an uncomfortable, invasive procedure than similar patients receiving only empathetic or usual care. These interesting results suggest that pain under these circumstances is more effectively relieved when the patient relies on his or her own self-coping abilities rather than someone else’s kindness. 46 Researchers in Taiwain have also studied the role of relaxing music in reducing cancer pain. One hundred and twenty-six hospitalized patients were randomly selected to listen to music for 30 minutes and take pain medication or just take the medication. Patients were given the choice of folk songs, Buddhist hymns (Taiwanese music), plus harp, or piano (American). The group who listened to music experienced significantly more pain relief coompared to the group that did not. 47 Numerous studies have also investigated the benefits of relaxation therapies on patients with HIV . A careful review of 35 randomized trials found that relaxation therapies may be generally helpful at improving the quality of life of HIV-positive patients and in reducing their anxiety , depression , stress , and fatigue . 48 These interventions, though, had no significant effect on the growth of the virus, nor did they influence immunologic or hormonal activity. Subsequently, however, a small study involving 48 HIV patients found that mindfulness meditation—a popular method for inducing the relaxation response—slowed the loss of the specific immune cells destroyed by the virus, though more research needs to be done to confirm this result. 49 Some studies have evaluated highly specific guided visualizations, rather than general relaxation. For example, it has been suggested that a systematic program of imagining microscopic soldiers shooting down one’s cancer cells can improve the chances of surviving cancer . Unfortunately, despite much enthusiasm shown by some patients and practitioners, there is still no meaningful evidence to support this appealing idea at present. 50 Nonetheless, there is some evidence from a set of small trials that specific immune-oriented visualizations can provide enhanced protection against herpes flare-ups and winter colds . 51 Contrary to common claims, published evidence does notdemonstrate that transcendental meditation (TM) improves mental functioning. 52 There is a bit of evidence, however, that TM might be helpful for improving exercise capacity and general quality of life in people with congestive heart failure . 53 A careful review of 20 trials found psychological interventions such as cognitive behavioral therapy, biofeedback, relaxation and coping were associated with reduced chronic headache or migraine pain in 589 children as compared to sham (placebo), standard therapies, waiting list control or other active treatments. 54

How to Choose a Relaxation Therapist

There is no widely accepted license for practicing relaxation therapy. However, it is often practiced by therapists and psychologists.


  1. Morin CM, Hauri PJ, Espie CA, Spielman AJ, Buysse DJ, Bootzin RR. Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review. Sleep. 22(8):1134-56.
  2. Espie CA, Lindsay WR, Brooks DN, Hood EM, Turvey T. A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia. Behav Res Ther. 27(1):79-88.
  3. Freedman R, Papsdorf JD. Biofeedback and progressive relaxation treatment of sleep-onset insomnia: a controlled, all-night investigation. Biofeedback Self Regul. 1(3):253-71.
  4. Huntley A, White AR, Ernst E. Relaxation therapies for asthma: a systematic review. Thorax. 57(2):127-31.
  5. Wachelka D, Katz RC. Reducing test anxiety and improving academic self-esteem in high school and college students with learning disabilities. J Behav Ther Exp Psychiatry. 30(3):191-8.
  6. Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry. 8():41.
  7. Castillo-Richmond A, Schneider RH, Alexander CN, Cook R, Myers H, Nidich S, Haney C, Rainforth M, Salerno J. Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke. 31(3):568-73.
  8. Heather OD, Fiona C, Fiona RB, et al. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2008;CD004935.
  9. Anderson JW, Liu C, Kryscio RJ. Blood pressure response to transcendental meditation: a meta-analysis. Am J Hypertens. 21(3):310-6.
  10. Rainforth MV, Schneider RH, Nidich SI, Gaylord-King C, Salerno JW, Anderson JW. Stress reduction programs in patients with elevated blood pressure: a systematic review and meta-analysis. Curr Hypertens Rep. 9(6):520-8.
  11. Modesti PA, Ferrari A, Bazzini C, et al. Psychological predictors of the antihypertensive effects of music-guided slow breathing. J Hypertens. 2010 May;28(5):1097.
  12. Blumenthal JA, Sherwood A, Babyak MA, Watkins LL, Waugh R, Georgiades A, Bacon SL, Hayano J, Coleman RE, Hinderliter A. Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: a randomized controlled trial. JAMA. 293(13):1626-34.
  13. Morone NE, Greco CM, Weiner DK. Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain. 134(3):310-9.
  14. Esplen MJ, Garfinkel PE, Olmsted M, Gallop RM, Kennedy S. A randomized controlled trial of guided imagery in bulimia nervosa. Psychol Med. 28(6):1347-57.
  15. Lyles JN, Burish TG, Krozely MG, Oldham RK. Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy. J Consult Clin Psychol. 50(4):509-24.
  16. Troesch LM, Rodehaver CB, Delaney EA, Yanes B. The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncol Nurs Forum. 20(8):1179-85.
  17. Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain. 63(2):189-98.
  18. Speca M, Carlson LE, Goodey E, Angen M. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med. 62(5):613-22.
  19. Zeltzer L, LeBaron S. Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. J Pediatr. 101(6):1032-5.
  20. Walker LG, Walker MB, Ogston K, Heys SD, Ah-See AK, Miller ID, Hutcheon AW, Sarkar TK, Eremin O. Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy. Br J Cancer. 80(1-2):262-8.
  21. Huang ST, Good M, Zauszniewski JA. The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud. 47(11):1354-62.
  22. Carrol D, Seers K. Relaxation for the relief of chronic pain: A systematic review. J Adv Nursing. 1996:27:476-487.
  23. Fernandez E, Turk DC. The utility of cognitive coping strategies for altering pain perception: a meta-analysis. Pain. 38(2):123-35.
  24. Rusy LM, Weisman SJ. Complementary therapies for acute pediatric pain management. Pediatr Clin North Am. 47(3):589-99.
  25. Kanji N. Management of pain through autogenic training. Complement Ther Nurs Midwifery. 6(3):143-8.
  26. Jayadevappa R, Johnson JC, Bloom BS, et al. Effectiveness of transcendental meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study. Eth Dis. 2007;17:72-77.
  27. Jorm AF, Morgan AJ, Hetrick SE. Relaxation for depression. Cochrane Database Syst Rev. (4):CD007142.
  28. Fors EA, Sexton H, Götestam KG. The effect of guided imagery and amitriptyline on daily fibromyalgia pain: a prospective, randomized, controlled trial. J Psychiatr Res. 36(3):179-87.
  29. Carrico DJ, Peters KM, Diokno AC. Guided imagery for women with interstitial cystitis: results of a prospective, randomized controlled pilot study. J Altern Complement Med. 14(1):53-60.
  30. Keefer L, Blanchard EB. The effects of relaxation response meditation on the symptoms of irritable bowel syndrome: results of a controlled treatment study. Behav Res Ther. 39(7):801-11.
  31. Freedman RR, Woodward S. Behavioral treatment of menopausal hot flushes: evaluation by ambulatory monitoring. Am J Obstet Gynecol. 167(2):436-9.
  32. Hanstede M, Gidron Y, Nyklícek I. The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population. J Nerv Ment Dis. 196(10):776-9.
  33. Baird CL, Sands LP. Effect of guided imagery with relaxation on health-related quality of life in older women with osteoarthritis. Res Nurs Health. 29(5):442-51.
  34. Goodale IL, Domar AD, Benson H. Alleviation of premenstrual syndrome symptoms with the relaxation response. Obstet Gynecol. 75(4):649-55.
  35. Bastani F, Hidarnia A, Kazemnejad A, et al. A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery. 2005;50:36-40.
  36. Kabat-Zinn J, Wheeler E, Light T, Skillings A, Scharf MJ, Cropley TG, Hosmer D, Bernhard JD. Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosom Med. 60(5):625-32.
  37. Lundgren S, Stenström CH. Muscle relaxation training and quality of life in rheumatoid arthritis. A randomized controlled clinical trial. Scand J Rheumatol. 28(1):47-53.
  38. McKinney CH, Antoni MH, Kumar M, Tims FC, McCabe PM. Effects of guided imagery and music (GIM) therapy on mood and cortisol in healthy adults. Health Psychol. 16(4):390-400.
  39. Ernst E, Kanji N. Autogenic training for stress and anxiety: a systematic review. Complement Ther Med. 8(2):106-10.
  40. Page SJ, Levine P, Sisto S, Johnston MV. A randomized efficacy and feasibility study of imagery in acute stroke. Clin Rehabil. 15(3):233-40.
  41. Gaston-Johansson F, Fall-Dickson JM, Nanda J, Ohly KV, Stillman S, Krumm S, Kennedy MJ. The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nurs. 23(4):277-85.
  42. ter Kuile MM, Spinhoven P, Linssen AC, Zitman FG, Van Dyck R, Rooijmans HG. Autogenic training and cognitive self-hypnosis for the treatment of recurrent headaches in three different subject groups. Pain. 58(3):331-40.
  43. Shaw L, Ehrlich A. Relaxation training as a treatment for chronic pain caused by ulcerative colitis. Pain. 29(3):287-93.
  44. Omlor G, Kiewitz S, Pietschmann S, Roesler S. [Effect of preoperative preoperative visualization therapy on postoperative outcome after inguinal hernia surgery and thyroid resection] Zentralbl Chir. 125(4):380-5; discussion 385-6.
  45. Dimeo FC, Thomas F, Raabe-Menssen C, Pröpper F, Mathias M. Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial. Support Care Cancer. 12(11):774-9.
  46. Lang EV, Berbaum KS, Pauker SG, et al. Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: When being nice does not suffice. J Vasc Interv Radiol. 2008;19:897-905.
  47. Huang ST, Good M, Zauszniewski JA. The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud. 47(11):1354-62.
  48. Scott-Sheldon LA, Kalichman SC, Carey MP, Fielder RL. Stress management interventions for HIV+ adults: a meta-analysis of randomized controlled trials, 1989 to 2006. Health Psychol. 27(2):129-39.
  49. Creswell JD, Myers HF, Cole SW, Irwin MR. Mindfulness meditation training effects on CD4+ T lymphocytes in HIV-1 infected adults: a small randomized controlled trial. Brain Behav Immun. 23(2):184-8.
  50. Spiegel D, Moore R. Imagery and hypnosis in the treatment of cancer patients. Oncology (Huntingt). 1997;11:1179-1189.
  51. Gruzelier JH. A review of the impact of hypnosis, relaxation, guided imagery and individual differences on aspects of immunity and health. Stress. 5(2):147-63.
  52. Canter PH, Ernst E. The cumulative effects of Transcendental Meditation on cognitive function--a systematic review of randomised controlled trials. Wien Klin Wochenschr. 115(21-22):758-66.
  53. Jayadevappa R, Johnson JC, Bloom BS, et al. Effectiveness of transcendental meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study. Eth Dis. 2007;17:72-77.
  54. Eccleston C, Palermo T, Williams A, Lewandowski A, Morley S. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database of Systematic Reviews. 2009;CD003968.


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