The Role of Relaxation in Anxiety Treatment


In my early clinical training, relaxation training was emphasized as a frontline intervention in the struggle with anxiety. However, my clients with severe anxiety disorders would come in week after week having tried desperately to relax in the face of anxiety only to find that their anxiety kept building anyway.

I am a big fan of relaxation techniques such as progressive muscle relaxation, breathing exercises, imagery, meditation, and so on. For most of us it can work wonders as a component of an overall stress management plan. Anything that decreases stress seems to have the side effect of lowering our base-line level of anxiety. It can improve sleep and overall quality of life, as well.

It is now recognized that relaxation can have a dark side when it comes to anxiety disorders. If your anxiety disorder commands you to relax or else you’ll die, lose control, panic forever, harm someone, or some other catastrophic threat, you’re in a no-win situation if you comply. (1) You’re unlikely to succeed in relaxing in the face of such feared outcomes. Think about how hard it is to sleep if you try to force yourself into slumber. Usually the result is that you are much more wide awake. If anxiety says relax or else, you are likely to feel even more anxious if you try to force the relaxation. (2) Let’s say that you were able to relax in the face of panic—what’s the result? Well anxiety said you would die or go crazy or some other such nonsense and guess what? You survived sanity intact! Now your panic has some credibility in your mind, you believe you MUST relax or else. But you would have survived anyway! Relaxation becomes a safety behavior which does not allow you to process that you would have been ok and the anxiety would have eventually subsided on its own. The anxiety strengthens its hold over you, forcing you to comply with its wishes.

In the moment of phobic anxiety or panic, your job is to learn that you can cope with the situation all on your own; that it is not imminently dangerous. Now, it is OK if you happen to relax while facing your fear, but it is ok if you do not. So for instance, you are in the grocery store and anxiety is telling you that something horrible is happening (assuming that you have had your doctor rule-out a medical problem) and you begin to tense your body as a result. It is ok for you to tell yourself, “Ok, here comes the fear. I can handle this. I can NOT fight it, not tense or tighten to feel more protected. I can hang loose; maybe even take a relaxing breath. I do this to approach and STAY with the discomfort, not to run from the situation. If I feel better, that’s fine, and if not that’s ok too. I’ll let my body deal with the anxiety while I stroll the aisles and get the rest of the groceries on my list.” This is very different from the common inner dialogue, “Breathe, damn it! Relax or you’re going to die! Oh my God, it’s not working! I can’t handle this! I’ve got to get comfortable before I am forever damaged!!!!!!”

So, relaxation is good for overall wellness practice. If you happen to relax while facing your fears, that’s fine too. But if you feel you must relax or else, that’s anxiety talking.

Eric Goodman, Ph.D.