Relaxation techniques as a therapeutic approach for anxiety
Anxiety disorders, along with depression, represent the most frequent mental illness in our society, affecting more than 15% of people throughout their lives.
The European Study of the Epidemiology of Mental Disorders (ESEMeD) on the prevalence of mental disorders in Europe, carried out in 6 European countries, concluded that around 25% of the world's population will suffer some mental disorder during their lifetime and that 10% have suffered it in the last year; the most frequent being mood disorders with a prevalence of 14% and anxiety disorders with 13.6% (Alonso et al., 2002).
Several studies agree that, currently, practically 30% of consultations at the first level of health care are related to anxiety symptoms (García et al., 2013).
Anxiety is a state of the organism in which it is placed on alert regarding a threat to its integrity (physical or psychological) in order to enable an additional expenditure of energy.
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Anxiety can prepare us for situations that present difficulties or challenges. This anxiety, which we might call normal, will facilitate a better response to any potentially threatening stimulus.
When the anxiety present is not adaptive, or the danger or stimulus present is not real, or when its level of activation and duration is disproportionate to the objective situation, it becomes pathological.
Anxiety can lead to a reduction in a person's autonomy and functionality, sometimes reaching high levels of incapacity to maintain and manage their activities of daily living (ADLs), which generates increased vulnerability.
Psychotherapeutic interventions as a complement to drug prescription
Currently, the most commonly used therapeutic approach for the control or management of anxiety is the prescription of anxiolytic, hypnotic and antidepressant drugs, with psychotherapeutic or psychoeducational treatment taking a back seat.
Multidisciplinary work has allowed in many services the implementation of a greater diversity of approaches, both psychotherapeutic and psychoeducational, in most cases complementary to pharmacological treatment.
The vast majority of these non-pharmacological interventions are being carried out by both clinical psychology professionals and mental health nurse specialists.
One of the most widely used psychotherapeutic or psychoeducational interventions, especially at the community level, both individually and in groups, are relaxation techniques.
How to do a relaxation exercise?
Relaxation techniques are understood as the various procedures whose objective is to provide a person with their own mechanisms to control their level of arousal. It is the most widely used strategy to reduce levels of psychophysiological arousal and thus alleviate the physical symptoms caused by anxiety (Nalgo, 2016).
Relaxation is a consciously and controlled state characterized by a decrease in physiological and psychological arousal. This state of relaxation provides the individual with increased well-being, greater tranquility, and improved adaptation to their environment.
Relaxation can be used as a sole intervention or in conjunction with others (Cerdá et al., 2017) to enhance its effectiveness, being effective in different states or pathologies of mental health such as insomnia (Irwin, 2006), anxiety disorders (Manzoni, 2008), headache in adolescents (Larsson, 2006), depressive disorders (Jorm, 2008), stressful situations (Esch, 2003).
In the "Catàleg d'actuacions no farmacològiques en Salut Mental a l'Atenció Primària" of the Institut Català de la Salut, for example, breathing techniques, relaxation/meditation, physical activity and music therapy stand out as techniques with a high level of scientific evidence in the approach to anxiety.
Regarding specific relaxation techniques, there is scientific evidence that the use of relaxation techniques such as autogenic training and Jacobson's progressive relaxation significantly reduces anxiety in users (Lopera, MJ, 2013)
What do relaxation therapies have in common?
In general terms, we would say that the different relaxation methods or exercises contain common features defined by Lichstein (1988), in which there is always one of the following elements:
- Cognitive restructuring : modification of conscious thought patterns in order to promote behaviors that yield better results.
- Relaxation to reduce physiological stimulation.
- Social skills and self-affirmation training to enhance interpersonal activity.
- Self-control . This involves recognizing the elements that produce stress, noting their occurrence, and observing the level of stress they generate. Self-control encourages the individual to adopt a more objective view of themselves, as well as to develop a plan for their progress.
From my experience in the mental health network of Parc Sanitari Sant Joan de Déu , most of the approaches carried out in the community setting, in which relaxation techniques are used by nurses specializing in mental health, both individually and in groups, result in an objective clinical improvement in the person being treated.
In a high number of cases, an average decrease of about 8-10 points can be observed on the Hamilton scale for anxiety once the therapeutic approach is completed, along with a reduction in the intake of both anxiolytic and hypnotic medication.
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