I know there is (somewhat) widespread agreement that relaxation techniques can be used as a form of avoidance of exposure in panic disorder, and hence breathing techniques and progressive muscle relaxation are discouraged so that the client feels the full physiological activation and becomes aware that the symptoms that he/she experiences are not actually dangerous or life-threatening in any way.
However, I was wondering whether this would apply as well to exposures in other forms of anxiety, say, specific phobia or social phobia. In those instances, it seems to me that the exposure to the phobic stimulus is not prevented by the relaxation/breathing techniques, and so these techniques would be merely an aid to facilitate the exposure. The client would not habituate to the physiological activation (which would be dampened by the relaxation techniques), but he/she could still dispel his/her irrational beliefs about coming into contact with the feared object.
Any science to back this up?
Cheers!
Hi there,
You might want to consult the meta-analyses on the efficacy of ps. interventions for SAS, such as
Powers et al., 2008:
https://guilfordjournals.com/doi/abs/10.1521/ijct.2008.1.2.94
Acarturk et al. 2009:
https://www.cambridge.org/core/journals/psychological-medicine/article/psychological-treatment-of-social-anxiety-disorder-a-metaanalysis/B2978698DCBABC0A6CF9B74D1F894FF4/core-reader
(This one concluded that inclusion of applied relaxation did not result in higher effect sizes)
Cuijpers et al. 2016:
https://www.sciencedirect.com/science/article/pii/S0887618516301980
(this one did not include studies on applied relaxation (AR) alone, but included those where AR was part of behavior therapy).
I hope this helps.
Flooding or exposure forms of CBT EFFICACY and risks, should be considered in the context of patients baseline individual differences in PREDISPOSING(Wickramasekera 1979,1996) personality variables like Hypnotizability,Negative affectivity,catastrophizing, self deception,etc.This is important particularly for "exposure' forms of therapy and the risk of central sensitization(Wickramasekera 1970). .Also with respect to the probability of the efficacy of situational procedures( delayed or immediate)biofeedback(Zlllmer and Wickramasekera 1987) or relaxation or meditation procedures for the a)extinction &b) acquisition of learned maladaptive responses.
Ian wickramasekera PhD.
P.S one paper I sent you does not directly present the personality risk factors for THREAT perception of the HRMTP (Wickramasekera 1979 1986 1988,1995) that can amplify or attenuate anxiety,phobias,PTSD etc.
Here is the direct exposition of the HRMTP .
Ian Wickramasekera PhD.
Traditional CBT would say that using breathing techniques was a “safety” behaviour so shouldn’t be used.
Jenna Bollinger, that's my understanding, too, but wouldn't one be able to conceptualize it as a "coping strategy", rather than a "safety behavior"? Although, I guess, reducing the stress associated with the exposure would beat the point of exposing yourself in the first place, since you won't be able to habituate to the anxiety, which will be prevented by the relaxation techniques... hmmmm! Maybe a possible treatment would be full exposure first, followed by coping strategies in an attempt to eliminate any residual symptoms?
Marc Josep Garcia Hervás that sounds like an interesting idea! And I suppose it would depend on the ultimate aim- to eliminate distress or manage more effectively?
Jenna Bollinger, that might be so, though I can't think of a reason why you'd want to manage rather than eliminate... like I said, breathing retraining or relaxation techniques make sense to me only as a way to manage perhaps residual symptomatology or increase the sense of agency and control, since locus is often displaced to the outside in anxiety disorders.
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