The therapeutic use of various relaxation techniques, especially in patients abusing or dependent on alcohol or drugs is mentioned. Changes in psychic state immediately after yogic relaxation were investigated by means of subjective rating scale SUPOS 7Z. After guided relaxation (GR) in which subjects followed a therapist's instructions, favourable changes in mental state occurred in 12 out of 13 subjects. After independently performed relaxation (IR), where subjects practised by themselves according to instructions repeated mentally, 11 subjects responded favourably. Those patients with a lower score of neuroticism responded better after both GR and IR. These results must be regarded as preliminary, considering the small number of subjects and their different experience with relaxation techniques.
Relaxation techniques are widely used in medicine and psychotherapy. They have proved to be effective, e.g. for hypertension*1,*2, insomnia*3, hyperactive children*4, pain relief*5, and as a component of treatment of neurosis, especially anxiety neurosis. Such techniques are also used as part of the complex therapy of alcoholism and drug dependence. According to Aron and Aron, transcendental meditation is very suitable, and according to Shafii et al., it can be useful in preventing alcohol abuse.*6,*7,*8 These effects are interpreted as being due to the patient's more selective reactions to stimuli, and decreased susceptibility to stresses, which could otherwise increase the chance of relapse, and by an improvement in interpersonal relations, etc.*6
Nevertheless, the majority of data about decreased alcohol and drug abuse in meditators is retrospective. According to Ross 35% of transcendental meditation practitioners quit meditation after 4 months, and from Delmonte's sample, 2/3 of those initiated completely stopped meditating after 1½ years. Regular meditators are a self-selected group. So, people who stopped alcohol or drug abuse after regular meditation may not represent a typical sample of abusers. Transcendental meditation 'drop-outs' had significantly higher scores in neuroticism than regular and non-meditators.*9
Calvert, however, who used biofeedback relaxation training in his work with alcoholics, achieved minimal results. He has suggested that the efficiency of relaxation training should increase on screening prospective recipients for personality factors such as a high level of anxiety and tension.*10 Tamez et al. inquired into the question of drug abuse and investigated the consumption of tranquilizers and sedatives in non-psychotic psychiatric inpatients practising live and taped relaxation. They found that the use of drugs decreased, with live relaxation being the more effective method.*11
Our aim was to find out which immediate changes of mental state occurred after yogic relaxation, and whether there were any differences between responses in patients with the lower and higher scores of neuroticism.
In a previous unpublished study we had observed that those patients who were motivated to have treatment and those whose attitude was not entirely negative showed better reaction to yogic relaxation.
Out of 13 subjects, 12 responded favourably after GR, and 11 after IR. After GR and IR, we noted increases in the scores for PE (peace of mind, the feeling of strength and energy) and A (yearning for action), and decreases of O (impulsive reactivity), N (mental disquiet, bad humour), U (anxious tensions, fears), D (mental depressions, feelings of exhaustion) and S (dejection). There were no significant differences between GR and IR, but statistically significant differences in t-test appeared between the groups with lower and higher neuroticism scores (Table 1). Patients with a lower neuroticism score responded better to GR and even more so to IR, and they also practised more frequently outside the joint sessions (Table 2).
The relatively small number of subjects and their different experience with relaxation techniques does not allow any firm conclusion. Those with lower scores of neuroticism responded better to GR and IR. This finding may relate to Delmonte's data that transcendental meditation 'drop-outs' had higher neuroticism, even though our relaxation techniques were quite different. One could also speculate, with reference to the degree of neuroticism, why relaxation techniques decrease the blood pressure of some hypertensives but not of others. Our patients had practised varying numbers of GR sessions before this trial, but this shortcoming probably did not distort our results, because in the lower neuroticism group 3 patients had experienced less than 3 sessions before our experiment (one of them knew autogenic training), and in the higher neuroticism group 2 subjects had had fewer than 3 sessions.
The total number of subjects was 13 men aged from 21 to 55. Ten were being treated for alcohol dependence, 2 for alcohol and drug dependence, and 1 for alcohol abuse. Five of these patients had secondary diagnoses of psychopathy, and 2 of homosexuality. Before the experiment, the patients had experienced from 0-7 GR sessions, and 3 of them had previously experienced autogenic training.
An adaptation of the yogic relaxation technique, yoga nidra*12 was used, with the duration of a session being about 12 minutes. This technique includes muscle relaxation, concentration on spontaneous respiration, and mental relaxation. During the first and second sessions, all subjects practised guided relaxation, and during the third and fourth sessions, independent relaxation, where the therapist remained silent. Before the first session, Eysenck's EOD test, which judges the level of neuroticism, was given. Six were placed in the group with lower neuroticism, while the group who scored higher levels of neuroticism contained 7 members. After every relaxation, the subjective rating scale SUPOS 7Z*13 was administered, to record the changes in mental state compared to that before relaxation. After the last session, a questionnaire was given to find out the subject's feelings during relaxation; whether he practised outside the joint sessions; also whether he wanted to continue the practice after treatment ended; what differences he felt between GR and IR; and whether he slept during relaxation.
It is necessary to comment in connection with Calvert's study that the choice of relaxation technique may be important, e.g. in bronchial asthma, muscle relaxation has no effect, whereas mental relaxation has.*14 We do not know which technique is the most suitable for alcoholics.
There is some evidence that mastering a relaxation technique increases resistance to chronic stresses which could make a dependent patient take refuge in alcohol or drugs. In conclusion, we consider the use of relaxation technique as a component of a complex management program and the favourable changes in mental state after yogic relaxation may also help to create positive therapeutic relationships.
| All Subjects | Guided Relaxation | Independent Relaxation | ||||
|---|---|---|---|---|---|---|
| GR | IR | n | N | n | N | |
| PE | 3.4 | 3.5 | 4.9* | 2.1* | 5.7* | 1.6* |
| A | 1.2 | 1.7 | 1.7 | 1.1 | 3.3* | 0.4 |
| O | -2.1 | -2.2 | -3.2 | -1.4 | -2.8 | -1.6 |
| N | -3.0 | -3.9 | -4.7* | -1.5* | -4.8* | -1.2* |
| U | -3.5 | -3.0 | -5.3* | -1.9* | -4.6 | -1.7 |
| D | -3.8 | -3.2 | -5.1 | -2.7 | -5.0 | -1.7* |
| S | -3.0 | -2.5 | -2.3 | -2.1 | -4.5* | -0.7* |
Table 1: Average changes in mental states of subjects after guided relaxation and independent relaxation measured by SUPOS 7Z. This is comprised of PE (peace of mind, the feeling of strength and energy), A (a yearning for action), O (impulsive reactivity), N (mental disquiet, bad humour), U (anxious tensions, fears), D (mental depressions, feelings of exhaustion) and S (dejection). GR- guided relaxation. IR- independent relaxation, n- group with lower scores in neuroticism. N- group with higher scores in neuroticism.
| Favorable change according to SUPOS 7Z | Practice outside joint sessions | Intention to practice after ended | preference of GR | Sleep during relaxation | ||
|---|---|---|---|---|---|---|
| After GR | After IR | |||||
| n | 100% | 100% | 67% | 100% | 67% | 29% |
| n | 86% | 71% | 14% | 71% | 71% | 29% |
Table 2: The comparison between patients with the lower (n) and the higher (N) scores in neuroticism.
*1. Datey, K .K., Desmukh, S., Dalvi, L. and Vinekar, S. L., 'Shavasana: a yogic exercise in the management of hypertension', Angiology, 20:325-333, 1969.
*2. Patel, C. and North, W. R. S., 'Randomized controlled trial of yoga and biofeedback in management of hypertension', Lancet, 2/7925:93-95, 1975.
*3. Sheay, R. C., The effectiveness of various treatment techniques on different degrees and durations of sleep-onset insomnia', Behav. Res. & Ther., 17(6): 541-546, 1979.
*4. Dunn, T. H., 'Relaxation technique and its relationship to hyperactivity in boys', Diss. Abstr. Int., 41 (1):348B, 1980.
*5. Varni, J. V., 'Self-regulation techniques in the management of chronic arthritic pain in hemophilia', Behav. Ther., 12(2):185-194, 1981.
*6. Aron, A. and Aron, E. N., 'The transcendental meditation program's effect on addictive behavior', Psychol, 7(4):235-255, 1980.
*7. Giesler, M., Transcendental meditation as a therapeutic tool for drug users', Zeitschrift Klin. Psychol, 7(4):235-255, 1980. In: Psychol Abstr., 63:700, 1980.
*8. Shafii, M., Lavely, R. and Jaffe, R., 'Meditation and the prevention of alcohol abuse', Amer. J. Psychiat., 132:942-945, 1975.
*9. Delmonte, M. M., 'Personality characteristics and regularity of meditation', Psychol Rep., 46: 703-712, 1980.
*10. Calvert, E. F., 'Effectiveness of biofeedback relaxation training as an adjunct to treatment of alcoholism', Diss. Abstr. Int., 41(5):888B, 1980.
*11. Tamez, E. G., Moore, M. J. and Brown, P. L., 'Relaxation technique as a nursing intervention versus p.r.n. medication', Nurs. Res., 28(3):160, 1978.
*12. Swami Satyananda Saraswati, Sure Ways to Self Realization, BSY Monghyr, 1980, pp. 102-109.
*13. Miksik, O., 'K posuzovani stuktury a dynamiky psychickych stavu', Ceckoslov. Psychol, 24(5): 411-423, 1980.
*14. Erskine-Milliss, J. and Schonell, M., 'Relaxation therapy in asthma: a critical review', Psychosom. Med., 43(4):365-372, 1981.