Anxiety Disorders and Relaxation Training

Relaxation training is a common treatment for anxiety disorders, both as a stand-alone treatment for anxiety disorders or included in a more complex therapy. The prevalence of anxiety is approximately twice among women compared with men.

Anxiety is common among healthy individuals and has been associated with numerous negative health consequences and absenteeism and decreased work productivity.

Studies have persistently shown that anxiety disorders result in ill health, utilization of health care services, sometimes for long time, functional impairment and personal distress, leading to a burden on both private and public health care costs.

Clinical trials have shown that anxiolytic drugs (anti-anxiety tranquilizers) alone have limited long-term efficacy. Additionally, they often have adverse side effects including dependency, drowsiness, impaired cognition and memory and sexual dysfunction.

Consequently, the clinical community has begun to consider alternative old and new approaches targeting anxiety problems and to examine the merits of combined and tailored somatic and psychological treatments.

As a result, relaxation techniques represent one of the most used approach in anxiety management worldwide, both as a stand-alone treatment or included in a more complex therapy.

Although there are many relaxing methods that have received scientific attention, they could be defined as a cognitive and/or behavioral treatment approach which emphasizes the development of a relaxation response to counteract the stress response of anxiety.

The relaxation response is defined by a set of integrated physiological mechanisms and ‘adjustments’ that are elicited when a subject engages in a repetitive mental or physical activity and passively ignores distracting thoughts.

Many studies have been conducted that have shown a positive clinical outcome of the relaxation techniques in connection with anxiety.

Researchers at Harvard Medical School analyzed peer-reviewed references and concluded: Relaxation response techniques, regularly part of professional stress management or mind/body medical settings, represent an important tool to be added to therapeutic strategies dealing with stress-related diseases. (Med Sci Monit 2003/02/26 edition. 2003, 9(2):RA23-34).

Applied Relaxation has been adopted for uses in treatment of generalized anxiety disorder. In two recent studies, applied relaxation has proven to be equally as effective in treating generalized anxiety disorder as cognitive therapy, which demands much more of the therapist.

…These results confirm that both cognitive therapy and applied relaxation are effective treatments for generalized anxiety disorder, and also that there is still room for improvement. (Behav Res Ther. 2003 Jun;41(6):633-46).

…The conclusion that can be drawn is that both applied relaxation and cognitive therapy have potential as treatments for generalized anxiety disorder but they have to be developed further in order to increase the efficacy to the level usually seen in panic disorder, 80-85% clinically improved. (Behav Res Ther. 2000 Aug;38(8):777-90).

Meditation is sometimes considered to be a form of relaxation therapy, however meditation not only creates a relaxation response but also produces an altered state of consciousness which facilitates the meta-cognitive mode of thinking which make possible the expectation of cognitive-behavioral benefits.

Meditation is effective against anxiety, both if considered as a single treatment or included with cognitive therapy.

For example, researchers at the University of Glasgow applied Mindfulness Based Cognitive Therapy (MBCT) in an 8-week course that integrates mindfulness meditation practices and cognitive theory to patients with recurrent depression or recurrent depression and anxiety, finding a great average reduction of anxiety, as well as depression.

The group described a wide range of benefits that came from the course. These included an:

• increased ability to relax,

• a decreased tendency to jump to negative conclusions,

• learning to take time out,

• learning new ways of dealing with difficult emotions

• greater self acceptance.

(BMC Psychiatry. 2006 Apr 7;6:14).

While all relaxation trainings reduce anxiety, applied relaxation, progressive relaxation and meditation showed greater effect sizes than other techniques.

In particular, this meta-analysis evidences the lower potential of multi-methods relaxation. The use of one of the main relaxation techniques is preferable, at least for anxiety reduction.

The most effective trainings are long-lasting, especially with the practice of the exercises at home.

Gian Mauro Manzoni, Francesco Pagnini, Gianluca Castelnuovo, Enrico Molinari. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry 2008, 8:41 (2 June 2008). © 2008 Manzoni et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (

More Articles of Interest:

1 Comment

  1. In my late 50’s found many things triggered anxiety attacks so bad that I thought I was having a heart attack due to the pain it caused. I treated it by carrying around a bottle of Bach Rescue Remedy and putting a few drops under my tongue as soon as I started feeling anxious. Didn’t stop an attack but minimized it tremendously. Now retired I rarely have them.

Comments are closed.