The Jacobson Method: everything you need to know
With which patient should it be applied?
This relaxation method has been around for a long time and has been scientifically validated many times. You can use it with your patients with all anxiety disorders, with all phobias, especially agoraphobia, generalized anxiety disorder (chronically stressed people who need relaxation). But nothing prevents you from using them in all mental disorders. For example, it can be useful for patients who are addicted, who are smokers or alcoholics, because it gives them a possibility to do an action instead of smoking. So you can even teach it for addictions.
Which relaxation method for which patient?
There are three methods of relaxation: vagal, Schultz’s autogenic training and Jacobson’s progressive muscle relaxation. But which one should you choose? Sometimes your patients will ask you which one to pick. In this case, it is best to ask them how they feel. If the main problem for one patient is that he feels tense, that his shoulders hurt, that his neck is stiff, that his legs hurt, then the Jacobson method is the most appropriate. If, on the other hand, another person tells you that he or she feels hot sensations when he or she is anxious, strange sensations of uneasiness, then Schultz’ autogenic training is the most appropriate method. Regarding vagal relaxation, it is very quick to teach and to apply and should therefore be automatic.
Starting a Jacobson relaxation session
During a relaxation session, ask your patient to sit or lie down, to take off his or her purse and jacket: to make himself or herself comfortable. Nothing prevents you from putting on background music if you want. Dr. Malbos advises in particular to use music called “Space Music”, a kind of electronic music which allows to have a very calm musical background and thus favourable for relaxation or meditation. The temperature of the room is also important. It must be pleasant, so do not hesitate to turn on a fan or the heating. In addition, when you speak, you should keep in mind to speak slowly and with a low, calm and warm voice, which encourages the relaxation process.
Let’s begin the Jacobson method. Start by telling your patient to clench his or her right fist 80%, i.e., quite hard. Ask him to concentrate on the sensation of pressure, the sensation of burning, the sensation of tension in the fist. It is very important, only the fist should be contracted. The forearm, the biceps, the shoulder, and the rest of the body must be completely relaxed. At first, your patient will have difficulty contracting only the requested muscle components in isolation, but this is normal. Practice will make this exercise easier to perform.
The second phase of this method is the relaxation phase. Tell your patient to very gently, very slowly, relax his right hand. He should concentrate on the pain disappearing and the pressure decreasing. He must realize that this tension is disappearing. Then his palm opens, still very gently. His fingers will spread until a state of total relaxation is reached.
These two phases are a summary of the whole idea behind the Jacobson relaxation method. This method consists in doing a phase of contraction at 80%, strong and slightly painful, followed by a phase of relaxation. That’s why it is called “progressive Jacobson’s muscle relaxation”, because it allows patients to have a better knowledge of the state of their muscle contraction. Learning this method will allow them to detect when their muscles are too tense and above all to be able to also relax them.
All the rest will consist in doing exactly the same thing for each muscle group. A muscular order however is to be followed and is advised by Doctor Malbos :
3. forehead (orbicularis, frowning)
3. jaw (masseter muscles, clenching the teeth)
4. lips (pouting)
5. neck (stermo cleido mastoid muscles, ask your patient to put his hand on his forehead and at the same time the forehead pushes against this hand)
6. trapezius muscles (shrugs shoulders)
7. diaphragm and accessory muscles of respiration (make a deep breath and stay in apnea)
8. abdominal muscles
9. gluteal muscles
10. quadriceps muscles (moving the leg or not)
11. calves (foot lifting muscles, lifting the front of the foot)
12. toes (lifting muscles, raising the toes)
You may want to advise your patient to do this one day, one side and one day, another. Non-athletic patients, who often have a low awareness of their body, can sometimes suffer from slight aches and pains as if they had just done a sports session. At the beginning of the relaxation exercise, it should be made clear to them that they should only contract 80% of their muscles and after the session, they should be reassured that soreness is possible in the days to follow and is completely normal. Training will reduce them.
Speaking of training, how often should the Jacobson method of progressive muscle relaxation be done? 2 times a week according to Dr. Malbos.
The Jacobson relaxation method should be done with your patients so that they become aware of the difference between the state of contraction and relaxation and thus be able to relax their body at any time.
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