Panic Disorder Coping Progressive Muscle Relaxation (PMR) for Anxiety By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on September 16, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print paolomartinezphotography/Getty Images Progressive muscle relaxation (PMR) is an exercise that anyone can use to alleviate disturbing and disruptive emotional symptoms such as anxiety or insomnia. Like breathing exercises, visualization, and yoga, PMR is considered a relaxation technique. It's especially helpful in moments of high stress or nervousness, and even can help someone get through a panic attack. History of PMR PMR was first described by an American physician, Edmund Jacobson, in the 1920s. Jacobson noted that regardless of their illness, the majority of his patients suffered from muscle pain and tension. When he suggested that they relax, he noticed that most people didn't seem connected to and aware enough of their physical tension to release it. This inspired Jacobson to develop a sequence of steps for tightening and then relaxing groups of muscles. He found this allowed his patients to become more aware of their tension, to learn how to let go of it, and to recognize what it feels like to be in a relaxed state. Since then, the technique has been modified many times but all modern variations of PMR are based on Jacobson’s original idea of systematically squeezing and then releasing isolated muscle groups. How PMR Works PMR works in part by helping to counteract a normal reaction to stress known as the flight-or-fight response. In evolutionary terms, this reaction developed as a way to help animals survive a threat—either by running away or by meeting the opposition head-on. Unfortunately, when it's not needed for actual survival, repeated activation of the flight-or-fight reaction tends to take its toll on the body in a variety of ways. Also, muscle pain, tension, and stiffness are common symptoms brought on by stress and anxiety. Relaxation techniques, including PMR, have the reverse effect on the body, eliciting the relaxation response, lowering heart rate, calming the mind, and reducing bodily tension. PMR also can help a person become more aware of how their physical stress may be contributing to their emotional state. By relaxing the body, a person may be able to let go of anxious thoughts and feelings. PMR Step-by-Step For a quick taste of how PMR works, squeeze one of your fists as hard as you can. Notice how tight your fingers and forearm feel. Count to ten and then release the clinch. Allow your hand to relax completely and let go of any tension. Let your hand go limp and notice how relaxed it feels now compared to before your clinched your fist. This methodical approach to increasing and releasing tension throughout your body is the linchpin of PMR. By systematically constricting and releasing various muscle groups it is possible to relieve physical stress and quiet and calm the mind. Here are the steps for one version of PMR that anyone can do. Try it next time you're feeling nervous, anxious, or find yourself tossing, turning, and unable to sleep. Step 1 Get comfortable. You don't have to lie down to do PMR; it will work if you're sitting up in a chair. Do make sure you're in a place that's free of distraction. Close your eyes if that feels best for you. Step 2 Breathe. Inhale deeply through your nose, feeling your abdomen rise as you fill your diaphragm with air. Then slowly exhale from your mouth, drawing your navel toward your spine. Repeat three to five times. Step 3 Tighten and release your muscles, starting with your feet. Clench your toes and pressing your heels toward the ground. Squeeze tightly for a few breaths and then release. Now flex your feet in, pointing your toes up towards your head. Hold for a few seconds and then release. Step 4 Continue to work your way up to your body, tightening and releasing each muscle group. Work your way up in this order: legs, glutes, abdomen, back, hands, arms, shoulders, neck, and face. Try to tighten each muscle group for a few breaths and then slowly release. Repeat any areas that feel especially stiff. Step 5 Take a few more deep breaths, noting how much more calm and relaxed you feel. A Word From Verywell PMR is a skill, one that takes practice to master. In order to be able to draw on PMR when you need it—in other words when you're truly in a stressful or anxiety-provoking situation—you'll want to learn how to do it while you aren't under pressure. Practice PMR several times a week to become aware of what it's like to feel relaxed. Understanding this feeling can help you to more readily let go of tension when anxiety rises. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Hayes-skelton SA, Roemer L, Orsillo SM, Borkovec TD. A contemporary view of applied relaxation for generalized anxiety disorder. Cogn Behav Ther. 2013;42(4):292-302. doi:10.1080/16506073.2013.777106 The man who invented relaxation. BBC News. Published November 4, 2015. Jacobson E. The origins and development of progressive relaxation. J Behav Ther Exp Psychiatry. 1977;8(2):119-123. doi:10.1016/0005-7916(77)90031-3 Luberto CM, Hall DL, Park ER, Haramati A, Cotton S. A Perspective on the Similarities and Differences Between Mindfulness and Relaxation. Glob Adv Health Med. 2020;9:2164956120905597. doi:10.1177/2164956120905597 American Psychological Association. Stress effects on the body. American College of Cardiology. Stress Management: Doing Progressive Muscle Relaxation. Additional Reading Davis M, Eshelman E, McKay M. The Relaxation & Stress Reduction Workbook, Sixth Edition. Oakland, California: New Harbinger Publications; 2008. Seaward BL. Managing Stress: Principles and Strategies for Health and Wellbeing, 8th Edition. Burlington, Massachusetts: Jones & Bartlett Learning; 2013. By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.