Paired Muscle relaxation technique (DBT)

This is Diane Melendez. I'm a therapist in Boulder, Colorado. Today, I am recording this video especially for my clients. We have been practicing this technique and they asked me if I could record a video so they can also practice at home. So I hope that anybody that watches this video can use it and find it useful. What we're going to do today is a technique called the paired muscle relaxation technique. It's very well-known and a lot of therapists use it, and it has been proven to help with anxiety and intense emotions. So I'm going to be guiding you into this process, and I hope you like it and find it relaxing.

So let's start with, first of all, find a quiet place and reduce distractions. At the beginning, you want to do this, but later on you want to try to do this practice in any kind of environment so you can relax effectively when you most need to. Remember that effectiveness improve with practice. So you want to practice. This is a skill, so the more that you practice, the easier it's going to be for you to relax with the practice that you're doing.

Remember that muscles have memory and when we create a habit, our body remembers that this is paired with relaxation. So you want to practice, practice, practice. At the beginning today, we're going to do the 16 muscle groups. So you'll learn every single muscle group. We're going to tense them and then we're going to relax them. But later on as you do this, you can almost just tense all your body in a couple of seconds and relax, and you probably will find it beneficial.

But if you have never done this practice and you have a lot of anxiety, perhaps you want to do a longer... Well do this, the whole 16 muscles. So you can start seeing how your body slowly start relaxing and understanding that when we do this, we can relax and release stress.

So let's see. First of all, you want to get your body into a comfortable position. You can lay down. I'm going to do it sitting down so I can guide you in this process. You want have loose clothing so you feel comfortable of course. I'm going to be guiding you with a couple of muscles and we're going to start with the hands. What you want to do is to hold tension in each of the muscles that I'm going to be pointing out for five to six seconds. I'm going to let you know, I'm going to count so to give you an idea.

As you hold the tension, you're going to inhale. So let's say I'm tensing my hands and my wrists so I'm going to inhale for around five seconds and then I'm going to exhale, relaxing this area. In both situations, so when you're tensing that muscle, you want to stay aware of how does it feel in and around that area. So as I'm inhaling and tensing that muscle for those five seconds, I want to notice how does it feel? How does it feel to tense my wrist? How does it feel around the area of my hands and my arm? So to stay present and to really notice the difference when you relax, how does it feel now.

As we relax, I want you to say in your mind, relax as you are exhaling. You can say it out loud if you want, but just imagine like you're putting that intention of I'm relaxing, I'm relaxing my muscles, I'm relaxing my mind. We're going to stay there for 10 to 15 seconds to allow yourself to be aware of how does it feel to tense and relax these wrists, for example, in this example that I'm giving. So how it felt when it was tense, how it feel now that you intentionally relax your wrist, okay?

So let's start. I'm going to start with hands and face. Later on, I'm going to give you more detailed explanation of legs. So I will put the video a little bit farther away so I can show you what muscles you have to tense. So let's start with hands and wrists. So make fists with your both hands and pull fists up on the wrists. So let's inhale for five seconds and noticing the tension of your hands or wrists. So one, two, three, four, five. Relaxing and just notice how your hands and wrists feel for 10 seconds.

Let's go to the lower and upper arms. Make fists and bend both arms up to touch your shoulders. So let's tense them for five seconds, inhaling. Relaxing, just noticing the relaxation now after you tensed up those muscles. Let's go to the shoulders. Pull both shoulders up to your ears. So like this, five seconds, inhaling. Relaxing for 10 seconds, noticing how your shoulders feel. Let's go to the forehead. So pull eyebrows close together like you're worried, wrinkling the forehead for five seconds, inhaling. Exhaling, relaxing that area of your forehead and eyebrows, noticing what are you feeling.

Let's go to the eyes. Shut eyes tightly. So for five seconds, inhaling. Exhaling, relaxing your eyes and noticing the sensation of the eyes, how they feel more relaxed as you release the tension. If at any point you feel kind of anxious because of the exercise, you can do paced breathing, which means you can start inhaling for five seconds, belly breathing and releasing for seven seconds. So try to make the exhalation a little bit longer than the inhalation, or whatever works for you. People are different, but this is what is recommended in some of the distress tolerance techniques in the therapy, the dialectical behavioral therapy.

So let's go to the nose and upper cheeks. So scrunch up your nose like this and bring the upper lips and cheeks up toward your eyes, so like this, five seconds. Releasing, letting this relax and noticing that area of your body and waiting for 10 seconds. Now we're going to do the tongue and the mouth. So your tongue pushes up in the upper mouth like that and your teeth together and your teeth and your tongue pushing on the upper mouth, okay? Five seconds and relaxing.

We can do the lips and the lower face. So press lip together and bring the edges of the lips back toward ears. So like that. So you're pushing your lips back toward the ears, okay? So five seconds again. Releasing for 10 seconds, noticing your lips, how they feel. So remember inhaling every time that you tense the muscle, exhaling, saying the word relax as you exhale.

So the next muscle group is the neck. So you can push head back into the chair, so like that, or push chin down to chest just like this, okay? So let's do that one five seconds, one, two, three, four, five, and releasing, six, seven, eight, nine, 10. Let's do the chest. So take a deep breath and hold it for five seconds. Release, just noticing how your chest feels relaxed.

Let's do the back. So you arch your back, bringing shoulder blades together for five seconds. Relax for 10 seconds, noticing that area of your body. Let's do the same thing with the stomach, holding stomach in tightly for five seconds. Relaxing, exhaling for 10 seconds, just staying there, noticing how your stomach feels. Of course you can change the time and I'm probably variating like my time here a little bit just to give you an idea. Once you learn all the areas, you probably can do it on your own. So let's do the buttocks. So squeeze buttocks together for five seconds, one, two, three, four, five. Exhale, relaxing for 10 seconds.

Now we're going to do the legs. So I'm going to pause for a second so I can show you what we're doing with the legs. So for the legs, it's pretty simple, but I just want to show you. We're going to tense the thighs. So you're going to do legs out and you're just going to press the thighs. So for five seconds and releasing, just allowing yourself to feel your thighs when they're tense and when you're relaxing them.

Then we're going to do the calves. So you want to put your legs out, but this time you're going to put your toes... Let me see if I can show you here. So you going to put toes down. Toes down, so then your tensing this area of your body for five seconds, four, five. You release for 10 seconds, just noticing that part of your body.

Our last one, we're going to do the ankles. So you're going to put your legs out, both legs, and you're going to put your toes close together like that. I don't know if you can see it but you're going to put... These are your feet, toes together and your ankles outside and your toes curl on there. So we just press for five seconds and release, notice if you felt that in the ankles. I'm going to pause for a second so we can talk a little bit about middle muscles and large muscles.

So this is it. This was the paired muscle relaxation techniques step-by-step including 16 muscle groups. But you can variate this technique. So we're going to revise a little bit what are these muscles that we're talking about. So in this particular handout from the DBT book of Marsha Linehan, she divided the 16 muscle groups with the ones that we did just now. If you want to do medium muscles, you can do just hands and wrist and lower and upper arms like that. So that will be the medium muscle. So you're doing more muscles in one time.

So you want to start more specific so you learn a little bit of the intricacies of every single part of your body. But as you repeat this, you probably can just do your whole body, tense it for five seconds and relax. You might notice instantaneous relaxation. So you can do also forehead, eyes, and nose all together. So kind of like tensing all your face. The lips and the tongue and mouth all together and neck as well. You can do the chest and the back together, the stomach and the buttocks at the same time. You can also do your legs, calves, and ankles all together so you can do it faster.

Let's see what else. Of course, can just do, like I said, the whole body, just tense it for a little bit and then say in your mind, relax, so you can feel the benefits of just tensing your body and relaxing and noticing how it feels afterwards. So let me know what you think. I hope this video is helpful and hope to see you next time. Bye-bye.