Progressive Muscle Relaxation

Progressive Muscle Relaxation has been used for decades as a structured relaxation and stress-management technique.

The practice teaches you to deliberately create mild muscle tension, release it, and notice the difference.

PMR itself is broader than DBT and predates DBT.

It is therefore not accurate to describe Progressive Muscle Relaxation as a standalone DBT skill.

DBT's TIPP skills include:

Paired Muscle Relaxation.

That skill is based on progressive relaxation practice.

In DBT, relaxation is eventually paired with breathing out so that the exhale becomes a cue for releasing muscle tension.

Progressive Muscle Relaxation is useful for first learning the physical difference between:

tension and release.

The purpose is not:

“Tense as hard as physically possible.”

Use only enough tension to clearly notice the muscles becoming tighter.

You should not be causing:

• Pain
• Cramping
• Strain
• Significant discomfort

If that happens, stop tightening the area.

You can use:

less tension.

For example, instead of squeezing your fist tightly, close your hand just enough to feel the muscles engage.

PMR does not become more effective simply because you tense harder.

You do not have to tense every muscle group.

Skip an area if it is:

• Injured
• Painful
• Recently operated on
• Prone to spasms or cramping
• Otherwise medically restricted

You can simply notice and soften that area instead.

If you have:

• Chronic pain
• Serious injuries
• Frequent muscle spasms
• Recent surgery
• A condition affected by muscle contraction

consider getting guidance from your health-care team before using the tense-and-release version.

A release-only version may be more appropriate.

A related practice, sometimes called:

Progressive Relaxation,

moves attention through muscle groups without deliberately tightening them first.

Instead:

1. Bring attention to an area.
2. Notice how it feels.
3. Invite the muscles to soften.
4. Move to the next area.

This may be preferable when muscle contraction causes pain or discomfort.

You might notice:

“My jaw is already tight.”

Instead of clenching it harder, simply notice the tension and experiment with:

letting the jaw become a little less tight.

You can do this throughout the entire body.

People sometimes automatically hold their breath when tightening muscles.

Try to keep breathing.

One simple pattern is:

gently tense while breathing in, then release while breathing out.

The breathing should remain comfortable rather than forced.

If coordinating muscle tension with breathing feels confusing, simply breathe normally.

The essential PMR skill is:

tension → release → notice.

You do not need a complicated breathing pattern.

Make gentle fists.

Notice:

• Fingers curling
• Pressure in your palms
• Tension through the hands

Then release.

Let the fingers rest naturally.

Notice the difference.

Gently tighten your upper arms.

You might bend your elbows slightly as though making a small biceps muscle.

Hold briefly.

Then release completely.

Notice whether the arms feel:

• Heavier
• Warmer
• Looser
• About the same

Gently lift your shoulders toward your ears.

Notice the tension around your:

• Shoulders
• Upper back
• Neck

Then let your shoulders drop.

Notice the contrast.

Raise your eyebrows or wrinkle your forehead gently.

Notice the tension.

Then let your forehead become smooth and neutral.

If comfortable, gently squeeze the muscles around your eyes.

Do not strain.

Then release and allow the eyelids and surrounding muscles to soften.

Skip this area if eye tension is uncomfortable or medically inappropriate.

You may gently bring the jaw muscles into tension.

Do not grind or strongly clamp your teeth together.

Then release and allow a little space between your teeth.

If you have:

• Jaw pain
• TMJ problems
• Dental pain

skip deliberate jaw tightening and practice release only.

Gently tighten the muscles around your mouth.

One option is a broad smile.

Hold briefly, then let your mouth return to a neutral position.

The neck can be sensitive to strain.

If you include it, use very gentle tension rather than forceful movement.

If you have:

• Neck pain
• Injury
• Dizziness with neck movement
• Medical restrictions

skip deliberate neck tensing.

You can simply notice whether the neck can soften.

If comfortable, gently activate the muscles through your back.

Avoid forceful arching, especially if you have back pain or injury.

Then release and let your body be supported by the chair, bed, or floor.

Gently tighten your abdominal muscles as though bracing.

Notice the firmness.

Then release and allow your abdomen to soften.

Continue breathing.

Gently tighten the muscles around your hips and buttocks.

Hold briefly.

Then release and notice the difference.

Tighten the muscles in your thighs gently.

Notice the tension through the upper legs.

Then release.

You can gently:

• Point your toes away
• Or draw them slightly toward you

to notice tension in different lower-leg muscles.

Do not force the position or continue if cramping begins.

Then release your feet and legs completely.

After moving through the muscle groups, stop actively tightening anything.

Notice your whole body.

Ask:

• Where do I feel less tension?
• Where am I still holding?
• Do any areas feel heavy, warm, or loose?
• Does anything feel unchanged?

There is no required final sensation.

If one muscle group still feels especially tense, you can repeat a gentle tense-and-release cycle there.

Or simply spend a few breaths allowing the area to soften.

The purpose of tightening first is partly to make the contrast clearer.

Notice:

“This is tension.”

Then:

“This is what less tension feels like.”

Over time, this can make unnecessary muscle tension easier to recognize during daily life.

Your muscles maintain normal activity to support posture and movement.

The goal is not to eliminate all muscle activity.

You are practicing letting go of:

unnecessary holding.

You may notice anxiety in:

• Your shoulders
• Your jaw
• Your hands
• Your stomach
• Your legs

PMR gives you a structured way to respond to that physical activation.

You may still feel anxious after relaxing your muscles.

The goal can simply be:

“I am anxious, and I do not also have to keep every muscle clenched.”

Other skills may address the remaining thoughts, emotions, or situation.

A full sequence may feel like too much when you are highly distressed.

Choose only:

• Hands
• Shoulders
• Jaw

and practice:

tense → release

once with each.

A short version still counts.

Strong urges can come with:

• Restlessness
• Muscle tension
• A feeling that you need to act immediately

PMR can give your body another task:

notice tension and practice releasing it.

It does not require the urge itself to disappear.

Once physical activation is more manageable, you may also use:

• Delay the Urge
• Urge Surfing
• Mindfulness of Urges
• Pros and Cons

depending on what you need next.

Once you understand the technique, you can practice only the areas where you commonly hold tension.

For example:

Hands → Shoulders → Jaw

may be enough for a brief reset during the day.

Gently tense:

your shoulders.

Notice.

Release.

Then gently tense:

your hands.

Notice.

Release.

Finish by noticing your whole body for one breath.

Learning PMR for the first time during extreme distress can be difficult.

Practicing when your stress level is lower lets you learn:

• Which muscles to use
• How much tension feels appropriate
• Which areas tend to stay tense
• What release feels like

Then the skill is more familiar when you actually need it.

Early practice may take:

10 to 15 minutes.

After you become familiar with the contrast between tension and release, you may be able to relax larger muscle groups more quickly.

PMR helps you learn:

“This is tension.”

and:

“This is letting go.”

Once that difference is familiar, relaxation can become faster and less deliberate.

One DBT-based extension is to:

1. Gently tense the muscles.
2. Notice the tension.
3. Breathe out.
4. Release the muscles while exhaling.
5. Use a simple internal cue such as “relax.”

With practice, the exhale itself can become associated with releasing tension.

This is the basis of DBT's:

Paired Muscle Relaxation.

If you are specifically trying to use the DBT distress-tolerance skill, see:

TIPP.

PMR is useful as a more detailed way of learning the muscle-relaxation component.

After several practices, you may discover:

“My jaw is almost always tight.”

Or:

“I raise my shoulders whenever I'm working.”

Or:

“I clench my hands when I'm angry.”

That awareness can help you catch physical activation earlier.

Ask:

• Are my shoulders raised?
• Is my jaw clenched?
• Are my hands gripping something?
• Am I bracing my abdomen?

If so, you may be able to release the tension without doing a full PMR sequence.

PMR includes awareness, but it is not only an observation exercise.

You deliberately:

create tension and then release it.

This makes the contrast easier to feel.

If muscle tension is part of feeling wound up at night, PMR may be one relaxation option before sleep.

You might practice:

• In a chair before bed
• Lying down when ready to sleep
• With a guided recording

Avoid turning PMR into:

“I did the exercise, so I should be asleep now.”

It can support relaxation.

Persistent insomnia may require more targeted sleep treatment.

See:

Sleep Hygiene

for more information.

Do not deliberately intensify pain in order to:

“complete the exercise.”

If a muscle group is painful, consider:

• Using much less tension
• Skipping that area
• Using release-only Progressive Relaxation

Muscle relaxation may sometimes help with discomfort or tension.

It cannot tell you what is causing a physical symptom.

Seek appropriate care for pain that is:

• New
• Severe
• Worsening
• Associated with injury
• Otherwise concerning

After PMR, you might feel:

• Much more relaxed
• A little less tense
• Sleepy
• More aware of your body
• Almost the same

None of these proves that you practiced correctly or incorrectly.

Watch for thoughts like:

“Why am I not relaxed yet?”

Or:

“I need to get all the tension out.”

Instead, return to the smaller task:

notice tension, release what you can, move on.

Some people become:

• More anxious
• More aware of uncomfortable sensations
• Restless
• Uneasy about letting go of tension

during relaxation practice.

You do not need to force PMR if it is making distress significantly worse.

PMR does not require closing your eyes.

You may practice while looking at:

• A neutral object
• The room around you
• A fixed point

if staying visually oriented feels better.

If body-focused attention is increasing distress, orient outward.

Notice:

• Objects around you
• Sounds
• Colors
• Your location

Grounding may be a better choice in that moment.

During a guided practice, you do not need to remember:

• Which muscle comes next
• How long to hold
• When to release

You can simply follow the instructions.

If a recording says:

“Tense your lower back,”

but that is not comfortable for you, skip it.

A guided recording does not override what your body is telling you.

PMR can reduce alertness and involves deliberately shifting attention inward.

Do not practice an immersive full-body relaxation exercise while:

• Driving
• Operating machinery
• Doing something that requires full attention

Choose a safe place to practice instead.

Practice with:

1. Hands: gently tense, then release.
2. Shoulders: gently lift, then release.
3. Jaw: gently activate if appropriate, then release.

Finish by noticing all three areas together.

Move through:

1. Hands and arms
2. Shoulders
3. Face and jaw
4. Abdomen
5. Legs and feet

For each:

gently tense → notice → release → notice.

Set aside approximately 10 to 15 minutes.

Move gradually through:

1. Hands
2. Arms
3. Shoulders
4. Forehead
5. Eyes
6. Jaw and mouth
7. Neck if appropriate
8. Back if appropriate
9. Abdomen
10. Hips
11. Thighs
12. Lower legs and feet

Skip anything that should not be deliberately tensed.

Move through the same muscle groups without tightening them.

At each area:

1. Notice the muscle.
2. Notice any tension already present.
3. Invite the area to soften.
4. Move on.

This may work better when active tensing is uncomfortable.

Several times during the day, check:

• Hands
• Jaw
• Shoulders
• Abdomen

Ask:

“Am I using these muscles for anything right now?”

If not, experiment with letting some tension go.

Choose one muscle group.

First, create moderate, comfortable tension.

Release.

Next time, use less tension.

Release again.

Notice whether you can still detect the contrast without squeezing strongly.

Gently tense one muscle group.

As you breathe out:

let the muscle go.

You may silently use a cue such as:

“release”

or:

“relax.”

Repeat with other muscle groups.

This begins to overlap with DBT Paired Muscle Relaxation.

Before speaking, check:

• Hands
• Shoulders
• Jaw

Briefly tense and release one or two areas if appropriate.

Then notice whether you are physically less braced before entering the conversation.

Once the immediate situation is over, notice whether your muscles are still acting as though the event is happening.

Use PMR to deliberately move through:

tension → release.

This can help mark the transition out of the stressful event.

Practice a short sequence:

hands → shoulders → face → legs

before resting.

Then stop actively trying to relax and allow yourself to rest.

Before PMR, notice:

• Overall tension
• Restlessness
• Physical activation

Practice.

Then check again.

The goal is not to prove the numbers must improve.

You are learning:

when, where, and how much PMR helps you.

Precision is not the main goal.

You only need to create enough safe, comfortable tension to notice:

tightening

followed by:

releasing.

Cut the effort significantly.

Think:

30% tension, not 100%.

You only need enough contrast to recognize the sensation.

Release immediately.

Do not keep holding the contraction.

Next time:

• Use less tension
• Shorten the contraction
• Skip that area
• Use release-only relaxation

Stop tensing the painful area.

Pain is not a required part of PMR.

Use a gentler or release-only version, and seek appropriate medical guidance if needed.

Reduce how hard you are tensing.

Try saying internally:

“inhale”

while tightening, and:

“exhale”

while releasing.

Or ignore breath coordination and simply keep breathing normally.

That is normal.

When you notice that you are thinking about something else, return to:

the muscle group you are working with.

You do not need to restart the whole sequence.

Try a muscle group where the contrast is easy to notice, such as:

• Hands
• Shoulders

Slow the practice down.

Spend several seconds noticing the muscle after release.

The distinction may become clearer with practice.

PMR does not promise complete physical relaxation.

You may:

• Repeat one area
• Use Breathing
• Stretch gently
• Rest
• Choose another regulation skill

if more support is needed.

You do not need to force the practice.

Try:

• Keeping your eyes open
• Doing only one or two muscle groups
• Practicing while seated upright
• Using Grounding instead

PMR is one tool, not a requirement.

PMR can make some people sleepy.

If you are practicing before bed, that may be fine.

If you want to stay awake, try:

• Sitting upright
• Practicing earlier
• Keeping your eyes open

Use fewer muscle groups.

For example:

hands → shoulders → jaw.

A brief, usable skill is often more practical than a longer exercise you never use.

During a Body Scan, you move attention through your body and notice:

what is already there.

You do not need to change the sensation.

During PMR, you intentionally:

tighten → release

to make the contrast between those states easier to notice.

Use Body Scan when observation is the main goal.

Use PMR when you want a more active muscle-relaxation practice.

You deliberately activate a muscle group and then let it go.

You move through the same general body areas while simply:

noticing and softening.

This can be a useful modification when deliberate muscle contraction is uncomfortable or inappropriate.

It can be practiced:

• When calm
• During everyday stress
• As a regular relaxation exercise

DBT uses muscle relaxation as part of a set of distress-tolerance strategies for high emotional arousal.

Paired Muscle Relaxation emphasizes associating:

breathing out

with:

releasing muscle tension.

PMR can help you learn the relaxation response used within that skill.

Breathing exercises may change:

• Breathing rate
• Breathing depth
• Length of the exhale

or simply use breathing as an attentional anchor.

PMR focuses on:

tightening and releasing skeletal muscles.

The two skills are often combined, but either can be practiced on its own.

Stretching generally involves deliberately moving a body part through a comfortable range.

PMR usually asks you to tighten a muscle group without needing a large stretch or range of motion.

You can use both skills when appropriate, but they serve different purposes.