This work includes a case study and theoretical basis which led to the accomplishment of a therapy plan and of a therapeutical deal and to client’s positive evolution. We also may highlight good consequences of Schultz-Jacobson relaxation methods and breathing exercises. The case study is a part of our daily reality and shows the importance of cognitive-behavioral approach for treating anxiety and long-term stress, and the progress which can be made this way, especially because the client had encountering a high level of anxiety, which generated difficulty in relaxation exercises. The client, female, age 23, was also encoutering difficulties in the relationship with her parents, especially with her mother, state of facts which started with financial problems, and in time, those difficulties had increased leading to her mother’s violent behavior. Eventually we have accomplished an improvement of her general status and of her ability to establish relationships with her close pearsons.
THE AUTOGENUOUS TRAINING (SCHULTZ)
The controlled modification of biological stress reactions involves using techniques which reduce psycho-physiological parameters of stress. One of the most important techniques is the autogenuous training.
The fundamentation of this method by J.H. Schultz at the beginning of XXth century, in Germany, is closely linked with medical hypnosis’ development.
The autogenuous training is a scientifically well foundamented method, experimentally and clinically verified which is characterised by simplicity and economicity, meaning it is easy to learn and it takes little time. The effects of this kind of training may be observed even from the very first days of practicing (a better relaxation, reduced anxiety, better sleep, concentration capacity and better memory capacity).
This method consists in a secquence of commands expressed in an internal language, adressed to to psycho-somatic fonctions, in order to achieve the autogenuous status, meaning a self induced psycho-somatic status, with special recovery effects. The autogenuous status has homeostatic effects, by itself, and by activating recovery fonctions of human body, which are mobilised this way.
The experimental research show that stress modifies neurovegetative balance, meaning it activates excesivelly the sympathetic nervous system (SNS), which becomes dominant vs. the parasympathetic nervous system (PNS). The dominance of produces most of adaptaition diseases. The autogenuous training, and also the progressive relaxation or hypnosis, determines diminution of SNS activity and the dominance of PNS in the nervous system.
The autogenuous training leads to preponderance of alpha waves and increasing of their syncronisation with theta waves (alpha waves are linked to relaxation). The arterial blood pressure decreases and skin temperature – an index of peripheral blood flowing- increases. It’s been known that the main temperature regulation mechanism is situated in hypothalamus, which works like a physiological thermostat. A control of skin temperature means, in fact, a control of hypothalamus activity.
In conclusion, by normalising the bio-psychic answer of the organism, the autogenuous training has significant anti-stress effects. This leads to an improvement of persons’ tonus and develops the organism’s adaptation capacity for all kinds of stress.
The author of this method highlights the fact that, especially during the learning phase, it is necessary to respect some conditions ment to easy relaxation, by reducing exterior disruptive stimula. This way, it is indicated that relaxation is realised in silence, normal temperature and dusk.
It’s recommended to use three postures which are more suitable for relaxation:
- The sitting on an armchair posture – head pillowed, arms laying comfortably on armchairs’ edges, feet in a sable position;
- Whip’s posture (this term apeared following the observations made during that period about this professional cathegory, which used to adopt frequently a relaxing posture at the working place). Sitting on a chair, the client bends from his waist. Feet are secluded, elbows sitting on thigs.
- „Dorsal decubitus” posture – (supine).
Laying on a bed, hand and feet laying in parallel with body.
During the learning period of this technique, it is indicated practicing this posture undes a psychologists’ guidance, twice or thrice a week, the client beeing trained to continue exercising at home, during short sessions of 5-7 minutes. After a good appropriation of this technique, the individual relaxation period might be extended untill 15 minutes.
The inferior cycle of the training may be used successfully in psychotherapy, and also preventively, in psychological training of personnel, especially for those who develop activities with a high degree of risk, due to it’s contribution to general quieteness of the organism, the amortisation of negative affective states’ resonance, peripheral blood pressure adjustment, increasing concentration capacity and self control.
The autogenuous training (the inferior cycle) is an important way of recovery after effort.
The method’s principle consists in inducing, by psycho-psysiological practicing, of a general organism’s decontractura, which like hypnosis techniques, allows communicating some suggestions. The autogenuous training contains two cycles of exercises:
The inferior cycle
Includes exercises in which concentration decontractare is focused on following directions:
The exercises which must be covered are:
- weight exercise;
- heating exercise;
- heart exercise;
- respiration control exercise;
- solar plexus exercise;
- head exercise.
Theese exercises are learned in a period between 6 untill 10 weeks, their practice leading to an interior calm mood.
We present a model of autogenuous training, the inferior cycle (a model adopted after Schultz technique):
a) Inducing weight sensation at an arm’s level:
„I am entirely quiet, and absolutely calm”
„everything passes around me like around a tree: neutral, absent, unconcerned”
„ all my muscles are relaxed”
„ a pleasant silence surrounds me”
„nothing disturbs my silence”
„I feel profound interior peace and silence”
„my right arm is getting heavier and heavier”
„a lead weight invades my shoulder, my hand and it goes to my fingers”
„my right arm is very heavy”
„my right arm is heavy like lead”
„ I feel only silence and weight”
Similar formulas are used for progressive induction of weight sensation at left arm’s level, at right foot, and the left foot level.
b) Generalization of weight sensation:
„ a pleasant silence surrounds me”
„ calm mood is flooding me”
„ I feel interior silence and peace”
„I am completely calm”
„my whole body is relaxed”
„my shoulders, my arms, my hands, my feet are heavy, very heavy”
„my whole body is very heavy”
„my whole body is fool of a huge weight”
„my body is heavy, like lead”
„I am very calm, and tranquil”
c) Inducing heat sensation at arm’s level:
„ a pleasant heat floods my right arm”
„a pleasant heat floods my right arm, reaching untill every finger tip”
„blood vessels are expanding and I feel heat in the right arm”
„my right arm becomes warm, like being sinked in a warm bath”
„my right arm is surrounded by a resting heat”
„silence, weight, warmth”
Similar commands are used for inducing heat sensation for the left arm and feet.
d) Generalization of heat sensation:
„my whole body is relaxed, perfectly tranquil”
„a pleasant heat surrounds my shoulders, arms, hands, feet”
„a pleasant heat surrounds my whole body”
„a pleasant heat surrounds my whole body, like in a hot bath”
„I am tranquil and relaxed”
„quietness and equilibrium surround me”
„I am completely tranquil”
„I am defenetely calm”
„my whole body is relaxed, lethargic”
„my whole body is heavy”
„I feel in my whole body an overwhelming weight”
„my body is heavy and relaxed”
„my whole body is surrounded in a tranquil and pleasant heat”
„I feel a pleasant heat which surrounds my whole body”
e) The heart exercise:
„my heart beats quietly, very quietly”
„my heart beats quietly and equally, spreading all blood into my body”
„my heart beats quietly and equally”
„ my heart seems to be working by itself”
„my heart beats calmly, quietly and equally”
„ I am perfectly calm and relaxed”
f) Breathing control exercises:
„my breath becomes quiet and rare”
„I breathe freely and naturally the air around me”
„I breathe calmly, quietly, without effort”
„ I breathe very calmly and quietly”
g) Exercise for heat sensation at solar plexus level:
„I am perfectly calm and relaxed”
„I am perfectly tranquil”
„my abdomen is very relaxed”
„my abdomen muscles are relaxed, every tension is disapearing”
„my solar plexus is flooded with a pleasant heat”
„my solar plexus in warm and relaxed”
h) exercise for inducing vasoconstriction in forehead area:
„I feel my head free and easy”
„my face’s muscles are relaxed”
„my chin is relaxed”
„my forehead becomes colder and colder and more relaxed”
„I feel cold air surrounding my temples”
„I feel coolness around my forehead”
„My mind is clear, like a mountain water spring”
„I feel my head very clear”
„I am perfectly tranquil and relaxed”.
During practicing autogenuous training, we must avoid using positions associated with anxious situations (for example „dead man’s position) or suggestions which may bring unpleasant sensations.
The superior cycle
Involves practicing the inferior cycle for 6 months until 2 years. The exercises corresponding for this stage, might be practiced only after perfectly learning of those from the inferior cycle, the author sustaining that complete learning of exercises from the second stage may last until 6 years.
The exercises for superior cycle, are, generally:
- Concentrating on a favourite colour;
- Concentrating on colours imposed by the therapist;
- Concentrating on concrete objects;
- Concentrating on abstract ideas;
- Living the „own feeling” (the client is asked to reproduce in his interior the emotions that he wants the most);
- Interogating his own unconscious.
Doing this kind of exercises, involves a good knowlwdge about relaxation techniques and a proper guidance from psychotherapist.
The research activity and clinical experience have proved that only the exercises from the inferior cycle are totally harmless, the others could generate severe disturbances on human personality, if used incorrectly.
M.C., young female, age 23, single, comes at therapy because of troubles given by high level of stress and fatigue and difficulties encountered in her relationship with her parents, especially with her mother. During the last period, for about 5 months, he used o have a very loaded program, and several repeated conflicts with her parents with whom she used to live together. This twill was due also to financial problems, because the domain in which the client and her mother used to work (Real Estate), had suffered an economical decrease, which had lead also to income decrease. Her parents reproached usually that until her age she must have been already married and to have a good material situation, and move out, not live together with them and her other three siblings. The client comes at therapy with a high degree of anxiety generated by the conflicts with her parents and by the fact that those might determine her to move out without enough livelihoods. She also has got sepparated from her boyfriend accusing him of infidelity.
The client accuses insomnia, anxiety, negative recurrent thoughts (she won’t be able to find a partner for a long time relationship), lack of appetite, high degree of fatigue, thoughts linked to suicide, even though on a more attentive investigation she replied that she never tried something like that.
Stage I: sessions 1st and 2nd:
- clinical interview, data about the client. She is askes to analise her expactances about therapy and future;
Stage II: Sessions 3th and 4th:
- an inventory and client’s problem hierarchy;
- establishing psychotherapy objectives, the psychotherapeutical contract, a short relaxation session. To note that at the first relaxation session she hardly succeeded to relax, which shows a high degree of anxiety;
Stage III: Sessions 5th, 6 th, and 7th:
- concentrating over her way of building relationships, especially with men;
- talking about possible ways of solving client’s problems – the therapist guide her to fiind proper solving for a better communication with the others and especially with her mother;
- Schultz-Jacobson relaxation exercises combined with suggestions for decreasing aniety level;
- As homework, the client had to write down a list of ten qualities of her;
Stage IV: Sessions 8th, 9th, 10th:
- talking about modalities of imagining her future, after one year and after a number of years;
- relaxation sessions combined with Self strenghtening suggestions and guided imaging, in which the client is suggested to see a positive imagine of her future, the image of a person who looks like her and who is successfull;
- as a homework, the client must write down a list of ten defects of her;
Stage V: Sessions 11th, 12th, 13th, 14th:
- establishing objectives to realise into the future (a better relationship with her mother and with males), a better ability of facing detrimental and stressing events;
- relaxation sessions focused on guided imaging, better self-esteem and trusting her future and her own success.
During therapy sessions the client received homeworks, as finding another job, and why not, moving out separately, at least for a period, and also to attend a dancing course.
Depending client’s evolution, the psychotherapy might last for more 5-10 sessions, in which psychotherapy objectives may be resumed and reevaluated.