In a time when stress and anxiety seem everywhere, therapists need a varied set of interventions to help clients find relief. While talk therapy holds undeniable power, sometimes words alone don't soothe a dysregulated nervous system. That's where somatic interventions play a role.

Therapists can help clients feel more calm, grounded, and resilient by focusing on the body's natural ability for self-regulation. Progressive muscle relaxation, a technique that stands the test of time, offers a simple yet effective way to promote relaxation and reduce stress. Let’s take a closer look at the origins and applications of progressive relaxation scripts, providing practical tips for using this tool in your clinical practice.

What Is Progressive Muscle Relaxation?
Edmund Jacobson developed progressive muscle relaxation in the 1920s, which involves systematically tensing and releasing different muscle groups. As clients focus on each body area in sequence, they learn to distinguish between tension and relaxation. The ultimate goal is to increase body awareness, reduce overall muscular tension, and activate the parasympathetic nervous system—our body's natural "rest and digest" response.

Clinical Indications and Applications
Progressive muscle relaxation helps a wide range of clients, especially those dealing with:

• Anxiety disorders: Including generalized anxiety, panic attacks, and phobias
• Sleep difficulties: Insomnia, restless sleep, and trouble falling asleep
• Somatic symptoms: Muscle tension, headaches, and gastrointestinal distress caused by stress
• Post-traumatic stress disorder (PTSD): Hyperarousal, intrusive thoughts, and avoidance behaviors

This adaptable technique finds use in various settings, such as:

• Individual therapy sessions
• Group therapy or workshops
• Telehealth platforms for remote sessions

Progressive muscle relaxation scripts serve several roles within a therapy context:

• Psychoeducation: Educating clients about the mind-body connection and how physiological arousal impacts emotional distress
• Active practice: Leading clients through the tension-release sequence to build relaxation skills
• Session openers: Assisting clients in transitioning into the therapy space and establishing a calm, focused mindset
• Grounding tools: Offering a practical strategy for managing acute distress or anxiety during sessions
• Between-session homework: Encouraging clients to independently practice relaxation skills to reinforce learning and broaden benefits

Therapists can incorporate progressive muscle relaxation into treatment plans based on each client's specific needs and goals. For some, it may serve as a foundational skill to practice regularly, while for others, it can be a targeted intervention for particular situations or symptoms.

Progressive Muscle Relaxation Example Script
When crafting a progressive relaxation script, several important decisions need to be made. One of the first is the sequence of muscle groups you'll guide your clients through. Below is an example of what that script could look like: 

Read the following script out loud to your client. The numbers within parentheses indicate the number of seconds of silence. These are a cue for you as the clinician and should not be spoken aloud.

Begin by settling into a comfortable position and allow your eyes to close or keep them open with a softened gaze (2)

Relax your jaw (2)

Relax the muscles in your face (2)

Don’t try to force anything special to happen (4)

Let yourself be at ease (2)

Feel the natural state of the body (2)

Notice the natural state of the breath (4)

Not judging, just allowing it to be (4)

Feel the breath rising and falling (2)

The simple natural structure of the breath (2)
Easy and as it is (2)

Notice any discomfort

Shift to make yourself more comfortable (2 seconds of silence)

We’ll continue breathing normally, not changing the breath, just letting it come as it is and flow naturally

Our attention is normally like a bright floodlight encompassing the entire body

Shift the attention to a very small spotlight that moves deliberately down the body (2)

Begin by resting the awareness on the toes of the left foot (2)

Curl the toes and tense the arch of the foot

Noticing the sensations

Release the tension, notice the new sensation of relaxation (2)

Bring the spotlight of awareness to the calf of the left leg (2)

Tense the muscles in the calf, holding them tightly

Notice the sensations (2)

Then release the tension, and notice the relaxation (2)

Bring the awareness to the upper left leg (2)

Tensing the muscles in the left thigh and pelvis

Notice the sensations (2)

Then release the tension, feel the relaxation throughout the left leg (2)

Bring the spotlight of awareness back to the breath (2)

Continue to breathe (2)

Now rest the awareness on the toes of the right foot (2)

Curl the toes and tense the arch of the foot

Noticing the sensations (2)

Release the tension, notice the new sensation of relaxation (2)

Bring the spotlight of awareness to the calf of the right leg (2)

Tense the muscles in the calf, holding them tightly

Notice the sensations (2)

Then release the tension, and notice the relaxation (2)

Bring your awareness now to the upper right leg (2)

Tensing the muscles in your right thigh and pelvis

Notice the sensations (2)

Then release the tension, feel the relaxation throughout the right leg (2)

Bring the attention to the front part of the torso, the abdomen (2)

Be aware of the breath, as the belly rises and falls (4)

Begin to tense the stomach and chest.

You can do this by sucking in the stomach, engaging the core (2)

Continue to hold (2)

Then release the tension, breathing deeply (2)

Let yourself notice the relaxation (4)

Become aware of the shoulders and upper back(2)

Tense the muscles in your back by squeezing your shoulders together behind you (2)

Continue to hold (2)

Release the tension in your shoulder and back

Feel the relaxation in your body (2)

Bring your awareness to your right arm and hand (2)

Make a fist with your right hand, and squeeze all the way up your right arm (2)

Continue to hold (2)

Release the tension from your right arm and hand

Allow your right arm to be limp (2)

Bring your awareness to your left arm and hand (2)

Make a fist with your left hand, and squeeze all the way up your left arm (2)

Continue to hold (2)

Release the tension from your left arm and hand

Allow your left arm to be limp (2)

Now, become aware of the neck with all the muscles, bones, and the breath passing through it (2)

Continue moving the attention up into the head (2)

Tense your face and neck by scrunching the muscles in your face, squeeze the eyes shut (2)

Release the tension from your face and neck (2)

Now tense the entire body at once. Feet, legs, stomach, back, arms, neck and face (2)

And release

Feel relaxation flood the body (2)

Relax the jaw (2)

The chin (2),

The teeth (2),

The tongue (2)

The lips (2)

The cheeks (2)

The eyes (2)

Become aware of this amazing vehicle in which we live (5)
This whole body that is breathing and functioning in this moment. Thinking, feeling, imagining, yet still present. Still here. (10)

If you feel any tension, tightness, or discomfort in any part of your body, you may take your attention to that part of your body (2)
Allow that feeling to be there.
Breathe through that sensation (10)

Now, you may wiggle your fingers and toes (2)
Wake your body back up (4)
Now with a greater sense of relaxation throughout the body (4)

Shift and move your body  (4 )
As you feel ready you may slowly open your eyes (60)

Practical Guidance When Using in a Client Session
Before starting a progressive muscle relaxation practice with your clients, it's important to set the stage for a safe and effective experience. Begin by setting clear expectations about the process and obtaining informed consent. Explain the purpose of the exercise, what it will involve, and how it may feel physically. Make sure the client knows they are in control and can stop or modify the practice at any time.

When working with clients who have experienced trauma, it's vital to adapt your approach to prioritize safety and choice. Some key modifications include:

• Emphasizing control: Regularly remind the client that they are in charge of their experience and can take breaks or stop the practice whenever needed.
• Avoiding vulnerable positions: Be mindful of body positions that may feel exposing or triggering, such as lying on one's back with eyes closed. Offer alternative positions like seated or standing relaxation and the option to keep one’s eyes closed or open and letting their gaze fall softly to the floor.
• Using invitational language: Frame instructions as gentle suggestions rather than commands. For example, say "If it feels comfortable, you might try..." instead of "Now do this..."
• Providing grounding resources: Have grounding tools available, such as a weighted blanket, textured objects, or a list of anchoring phrases, in case the client feels unsettled.

Progressive relaxation scripts may need to be adjusted for clients with physical limitations, neurodivergence, or tendencies toward dissociation. Some potential adjustments include:

• Modified tensing: For clients with mobility issues or chronic pain, guide them to tense muscle groups more gently or visualize the sensation of tension without actual movement.
• Sensory preferences: Be aware of any sensory sensitivities or aversions, and adjust your language and pacing accordingly. Some clients may prefer more or less detail in the body scan portion.

After the relaxation practice, allow time for the client to process their experience and any emotions that may have arisen. Ask open-ended questions about what they noticed in their body and mind, what felt challenging or helpful, and how they might use this practice in their daily life. This discussion helps integrate the experience and reinforce the client's learning.

Benefits and Limitations of Progressive Muscle Relaxation
Many studies show that progressive relaxation effectively reduces stress, anxiety, and even symptoms of depression. The outcomes are impressive:

• Reduced anxiety: PMR consistently lowers feelings of anxiety and promotes calmness.
• Improved sleep: Regular practice of PMR can lead to better sleep quality and decreased insomnia symptoms.
• Lower blood pressure: The deep relaxation from PMR helps reduce blood pressure, both immediately and over time with regular practice.
• Enhanced mood: PMR boosts overall mood and well-being, likely due to its stress-reducing effects.

These benefits appear across diverse groups, from students to pregnant women to postoperative patients, showing PMR's versatility and wide application. Additionally, combining PMR with other stress reduction techniques, like deep breathing or meditation, often leads to even greater relaxation and stress relief.

However, it's important to recognize that PMR may not suit every client. Some common challenges include:

• Restlessness: Some clients may struggle to sit still or focus on the progressive tensing and releasing of muscles, especially if they feel highly anxious or restless.
• Emotional surfacing: The deep relaxation state achieved through PMR can sometimes bring up unexpected emotions or memories that may be uncomfortable or triggering.
• Frustration with pacing: The slow, deliberate pace of PMR scripts can feel tedious for clients who prefer a faster or more engaging relaxation experience.

If a client consistently struggles with PMR or finds it counterproductive, it may be necessary to pause the practice and explore other relaxation techniques that better fit their needs and preferences. Open communication and collaboration between therapist and client help determine when PMR is no longer beneficial.

Integrating Scripts into Broader Treatment Plans
Progressive muscle relaxation scripts play an important role within a comprehensive treatment approach. When combined with cognitive behavioral therapy (CBT), mindfulness practices, or psychoeducation, these scripts enhance the therapeutic process.

CBT, which targets unhelpful thoughts and behaviors, works well with relaxation techniques that address the physical aspects of anxiety. Introducing progressive relaxation early in CBT can help build distress tolerance, making cognitive restructuring more accessible and effective. As clients learn to reduce bodily tension through relaxation, they create a calmer mental state that facilitates challenging negative thoughts.

Mindfulness practices, such as deep breathing and body scans, naturally work alongside progressive relaxation scripts. Incorporating mindfulness into the relaxation process helps clients develop present-moment awareness and acceptance, enhancing the calming effects of the practice.

Psychoeducation helps clients understand the reasoning behind progressive relaxation and its benefits. Therapists can teach clients about the nervous system's role in stress and relaxation, emphasizing the importance of regular practice for long-term symptom reduction and emotional regulation.

To support clients' independent use of progressive relaxation, therapists can provide:

• Recordings: Audio or video guides for at-home practice
• Handouts: Written instructions or visual aids outlining the steps
• Apps: Recommendations for relaxation apps with progressive muscle relaxation exercises

Encouraging clients to include relaxation in their daily routines can lead to sustained benefits. Therapists might suggest linking the practice to existing habits, such as practicing progressive relaxation before bedtime. For clients with anxiety or panic disorders, adding relaxation scripts into personalized crisis plans can provide a grounding tool during challenging moments.

Empowering Clients Through Mind-Body Techniques
Progressive relaxation serves as a straightforward yet effective tool in mind-body therapy. This technique allows clients to play an active role in their mental health journey, offering them a practical skill to independently manage stress, anxiety, and physical tension. As therapists, we introduce this valuable resource and guide clients in making it their own.

Encouraging personalization helps clients fully engage with progressive relaxation. This may involve:

• Adapting scripts: Changing language, accommodating physical differences or abilities, pacing, or sequence to fit individual preferences and needs
• Exploring variations: Trying different relaxation scripts or including elements like visualization and breath work to enrich the experience
• Finding the right fit: Assisting clients in discovering the best time, place, and format for their practice, whether that's using an app, listening to a recording, or following a written guide

Regular practice is important for gaining the full benefits of progressive relaxation. Therapists can support clients in establishing a consistent routine by:

• Setting realistic goals and expectations
• Identifying potential barriers and finding solutions
• Celebrating progress and achievements along the way

Providing clients with a variety of resources can further empower them in their practice. Consider offering:

• Scripts: Written guides or transcripts of progressive relaxation exercises
• Recordings: Audio or video files for guided practice
• Apps: Suggestions for reputable relaxation apps that include progressive muscle relaxation
• Further training: Information on local workshops, online courses, or books for those who want to explore further

Progressive relaxation is just one of many mind-body techniques that can support mental health and well-being. As research continues to show the effectiveness of these approaches, therapists have a chance to expand their toolkits and provide clients with holistic strategies for healing and growth. Embracing the mind-body connection opens up new paths for promoting resilience, self-regulation, and overall wellness.

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