Autogenic training

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Autogenic training
MeSH D001326

Autogenic training is a desensitization-relaxation technique developed by the German psychiatrist Johannes Heinrich Schultz [1] by which a psychophysiologically determined relaxation response is obtained. [2] The technique was first published in 1932. Studying the self-reports of people immersed in a hypnotic state, J.H. Schultz noted that physiological changes are accompanied by certain feelings. [3] Abbé Faria and Émile Coué are the forerunners of Schultz. The technique involves repetitions of a set of visualisations that induce a state of relaxation and is based on passive concentration of bodily perceptions (e.g., heaviness and warmth of arms, legs), which are facilitated by self-suggestions. [2] [4] The technique is used to alleviate many stress-induced psychosomatic disorders. [4]

Contents

Biofeedback practitioners integrate basic elements of autogenic imagery and have simplified versions of parallel techniques that are used in combination with biofeedback. This was done at the Menninger Foundation by Elmer Green, Steve Fahrio, Patricia Norris, Joe Sargent, Dale Walters and others. They incorporated the hand warming imagery of autogenic training and used it as an aid to develop thermal biofeedback. [1]

History

The roots of this technique lie in the research carried out by Oscar Vogt in the field of sleep and hypnosis. Vogt investigated individuals who had experience in hypnotic sessions. Under his guidance, they were able to go into a state (similar to a hypnotic state) for a self-determined period of time. These short-term mental exercises appeared to reduce stress or effects such as fatigue and tension. In the meantime, other disturbing effects (e.g. headaches) could be avoided. Inspired by this research and Vogt's work, Johannes Heinrich Schultz became interested in the phenomenon of autosuggestion. He wanted to explore an approach, which would avoid undesirable implications of hypnotherapy (e.g., the passivity of the individual and dependency on the therapist). When he was investigating hallucinations in healthy persons, he found that a majority of the subjects reported having two types of experienced sensation: heaviness in the extremities and feeling of warmth. Schultz wanted to understand whether simply imagining a state of heaviness and warmth in one's limbs could induce a state similar to hypnosis. Based on this idea he developed six basic exercises. [5]

Autogenic training was popularized in North America and the English-speaking world by Wolfgang Luthe, who co-authored, with Schultz, a multi-volume tome on autogenic training. In 1963 Luthe discovered the significance of "autogenic discharges", paroxysmic phenomena of motor, sensorial, visual and emotional nature related to the traumatic history of the patient, and developed the method of "autogenic abreaction". His disciple Luis de Rivera, a McGill University-trained psychiatrist, introduced psychodynamic concepts [6] into Luthe's approach, developing "autogenic analysis" [7] as a new method for uncovering the unconscious.

Practice and effects

The main purpose of autogenic training is the achievement of autonomic self-regulation by removing environmental distraction, training imagery that accompanies autonomic self-regulation, and by providing a facilitative set of exercises that are easy to learn and remember. [8]

Autogenic training is based on 3 main principles: [5]

In the context of autogenic training passive concentration means that the trainee is instructed to concentrate on inner sensations rather than environmental stimuli. Passiveness refers to allowing sensations to happen and being an observer rather than a manipulator. [4]

The training can be performed in different postures: [5]

The technique consists of six standard exercises according to Schultz: [5] [9]

  1. Muscular relaxation by repetition of a verbal formula, "My right arm is heavy", emphasizing heaviness. During the initial stages of the training, the feeling of heaviness in the trained arm is more expressed and occurs more rapidly. The same feeling can be experienced in the other extremities at the same time in the other arm. Within a week, a short concentration can trigger the sensation of heaviness in a trainee's arms and legs. [4]
  2. Passive concentration focuses on feeling warm, initiated by the instruction "My right arm is warm".
  3. Initiation of cardiac activity using the formula "My heartbeat is calm and regular".
  4. Passive concentration on the respiratory mechanism with the formula "It breathes me".
  5. Concentration on the warmth in the abdominal region with "My solar plexus is warm" formula.
  6. Passive concentration on coolness in the cranial region with the formula "My forehead is cool".

When a new exercise step is added in autogenic training, the trainee should always concentrate initially on the already learned exercises and then add a new exercise. In the beginning, a new exercise is added for only brief periods. [4]

According to the specific clinical needs, different modifications of formulas are used. These modifications can be classified into 3 main types: [4]

A study by Spencer [1] suggests that autogenic training restores the balance between the activity of the sympathetic (flight or fight) and the parasympathetic (rest and digest) branches of the autonomic nervous system. The author hypothesizes that this can have important health benefits, as the parasympathetic activity promotes digestion and bowel movements, lowers the blood pressure, slows the heart rate, and promotes the functions of the immune system.

Neurophysiological aspects

There is a lack of neurophysiological investigations addressing this topic; however, one EEG study from 1963 suggests that the decrease in afferent stimulation induces: [10]

The same study suggests that EEG patterns obtained from subjects with different level of practice are not similar.

Another study from 1958 hypothesizes that autogenic state is between the normal waking state and sleep. It suggests that EEG patterns occurring during autogenic training are similar to electrophysiological changes occurring during initial stages of sleep. [11]

Contraindications

Autogenic training is contra-indicated for children below the age of 5 and the individuals whose symptoms cannot be controlled. [5]

Clinical application and evidence

Autogenic training has different applications and is used in a variety of pathophysiological conditions, such as bronchial asthma or hypertension, as well as psychological disorders e.g. anxiety and depression. [5] [9] Autogenic training has been subject to clinical evaluation from its early days in Germany, and from the early 1980s worldwide. In 2002, a meta-analysis of 60 studies was published in Applied Psychophysiology and Biofeedback, [12] finding significant positive effects of treatment when compared to normals over a number of diagnoses; finding these effects to be similar to best recommended rival therapies; and finding positive additional effects by patients, such as their perceived quality of life. Autogenic training is recommended in the 2016 European Society of Cardiology Guideline for prevention of cardiovascular disease in persons who experience psychosocial problems. [13] The International Journal of Dermatology conducted a study and found that Autogenic Training was potentially helpful for improving aged skin in women experiencing menopause. [14]

In Japan, researchers from the Tokyo Psychology and Counseling Service Center have formulated a measure for reporting clinical effectiveness of autogenic training. [15]

Versus other relaxation techniques

The principle of passive concentration in autogenic training makes this technique different from other relaxation techniques such as progressive muscle relaxation and biofeedback, in which trainees try to control physiological functions. As in biofeedback, bidirectional change in physiological activity is possible. Autogenic training is classified as a self-hypnotic technique. It is different from hetero-hypnosis, where trance is induced by another individual. Autogenic training emphasizes a trainee's independence and gives control from therapist to the trainee. By this, the need for physiological feedback devices or a hypnotherapist is eliminated. [4]

See also

Related Research Articles

Milton H. Erickson

Milton Hyland Erickson was an American psychiatrist and psychologist specializing in medical hypnosis and family therapy. He was founding president of the American Society for Clinical Hypnosis and a fellow of the American Psychiatric Association, the American Psychological Association, and the American Psychopathological Association. He is noted for his approach to the unconscious mind as creative and solution-generating. He is also noted for influencing brief therapy, strategic family therapy, family systems therapy, solution focused brief therapy, and neuro-linguistic programming.

Biofeedback Process of gaining greater awareness of many physiological functions primarily using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will

Biofeedback is the process of gaining greater awareness of many physiological functions of one's own body, commercially by using electronic or other instruments, and with a goal of being able to manipulate the body's systems at will. Humans conduct biofeedback naturally all the time, at varied levels of consciousness and intentionality. Biofeedback and the biofeedback loop can also be thought of as self-regulation. Some of the processes that can be controlled include brainwaves, muscle tone, skin conductance, heart rate and pain perception.

Autosuggestion is a psychological technique related to the placebo effect, developed by apothecary Émile Coué at the beginning of the 20th century. It is a form of self-induced suggestion in which individuals guide their own thoughts, feelings, or behavior. The technique is often used in self-hypnosis.

Self-hypnosis or auto-hypnosis is a form, a process, or the result of a self-induced hypnotic state.

Neurofeedback

Neurofeedback (NFB), also called neurotherapy or neurobiofeedback, is a type of biofeedback that uses real-time displays of brain activity—most commonly electroencephalography (EEG)—in an attempt to teach self-regulation of brain function. Typically, sensors are placed on the scalp to measure electrical activity, with measurements displayed using video displays or sound. There is significant evidence supporting neurotherapy for generalized treatment of mental disorders and has been practiced over four decades, although never gaining prominence in the medical mainstream. NFB is relatively non-invasive and is administered as a long term treatment option, typically taking a month to complete. It is estimated over 15,000 clinicians, world-wide are using this technology.

Hemoencephalography (HEG) is a relatively new neurofeedback technique within the field of neurotherapy. Neurofeedback, a specific form of biofeedback, is based on the idea that human beings can consciously alter their brain function through training sessions in which they attempt to change the signal generated by their brain and measured via some neurological feedback mechanism. By so doing, participants increase cerebral blood flow to a specified region of the brain, consequently increasing brain activity and performance on tasks involving that region of the brain.

A relaxation technique is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of pain, anxiety, stress or anger. Relaxation techniques are often employed as one element of a wider stress management program and can decrease muscle tension, lower the blood pressure and slow heart and breath rates, among other health benefits.

Andrew Salter was the founder of conditioned reflex therapy, an early form of behaviour therapy which emphasized assertive and expressive behaviour as the way to combat the inhibitory personality traits which Salter believed were the underlying cause of most neuroses. In the 1940s, Salter introduced to American psychotherapy a Pavlovian model of hypnotherapy and self-hypnosis training.

Progressive muscle relaxation (PMR) is a non-pharmacological method of deep muscle relaxation, based on the premise that muscle tension is the body's psychological response to anxiety-provoking thoughts and that muscle relaxation blocks anxiety. The technique involves learning to monitor the tension in specific muscle groups by first tensing each muscle group. This tension is then released, as attention is directed towards the differences felt during tension and relaxation.

Child psychotherapy, or mental health interventions for children have developed varied approaches over the last century. Two distinct historic pathways can be identified for present-day provision in Western Europe and in the United States: one through the Child Guidance Movement, the other stemming from Adult psychiatry or Psychological Medicine, which evolved a separate Child psychiatry specialism.

Neurofeedback (NFB), also called neurotherapy, neurobiofeedback or EEG biofeedback (EEGBF) is a therapy technique that presents the user with real-time information about activity within their brain, as measured by electrical or blood-flow sensors on the scalp. Brain activity is monitored and processed to provide feedback to the user in one of several ways, for example a video game rocket ship might accelerate when desired brainwaves are produced, or a film or music might pause when undesired brainwaves are produced.

Association for Applied Psychophysiology and Biofeedback

The Association for Applied Psychophysiology and Biofeedback (AAPB) was founded in 1969 as the Biofeedback Research Society (BRS). The association aims to promote understanding of biofeedback and advance the methods used in this practice. AAPB is a non-profit organization as defined in Section 501(c)(6) of the Internal Revenue Service Code.

Chronic headache, or chronic daily headache (CDH), is classified as experiencing fifteen or more days with a headache per month. It is estimated that chronic headaches affect "4% to 5% of the general population". Chronic headaches consist of different sub-groups, primarily categorized as chronic tension-type headaches and chronic migraine headaches. The treatments for chronic headache are vast and varied. Medicinal and non-medicinal methods exist to help patients cope with chronic headache, because chronic headaches cannot be cured. Whether pharmacological or not, treatment plans are often created on an individual basis. Multiple sources recommend multimodal treatment, which is a combination of medicinal and non-medicinal remedies. Some treatments are controversial and are still being tested for effectiveness. Suggested treatments for chronic headaches include medication, physical therapy, acupuncture, relaxation training, and biofeedback. In addition, dietary alteration and behavioral therapy or psychological therapy are other possible treatments for chronic headaches.

Thomas Hice Budzynski was an American psychologist and a pioneer in the field of biofeedback, inventing one of the first electromyographic biofeedback training systems in the mid-1960s. In the early 1970s, he developed the Twilight Learner in collaboration with John Picchiottino. The Twilight Learner was one of the first neurotherapy systems.

Johannes Heinrich Schultz was a German psychiatrist and an independent psychotherapist. Schultz became world-famous for the development of a system of self-hypnosis called autogenic training.

The Biofeedback Certification International Alliance was created in 1981 as a non-profit organization. BCIA is a member of the Institute for Credentialing Excellence (ICE). BCIA certifies individuals who meet education and training standards in biofeedback and neurofeedback and progressively recertifies those who satisfy continuing education requirements. BCIA certification has been endorsed by the Mayo Clinic, the Association for Applied Psychophysiology and Biofeedback (AAPB), the International Society for Neurofeedback and Research (ISNR), and the Washington State Legislature.

Relaxation (psychology)

Relaxation in psychology is the emotional state of a living being, of low tension, in which there is an absence of arousal that could come from sources such as anger, anxiety, or fear. According to Oxford Dictionaries relaxation is when the body and mind are free from tension and anxiety. Relaxation is a form of mild ecstasy coming from the frontal lobe of the brain in which the backward cortex sends signals to the frontal cortex via a mild sedative. Relaxation can be achieved through meditation, autogenics, and progressive muscle relaxation. Relaxation helps improve coping with stress. Stress is the leading cause of mental problems and physical problems, therefore feeling relaxed is beneficial for a person's health. When we are stressed, the sympathetic nervous system is activated because we are in a fight-or-flight response mode; over time, this could have negative effects on a human body.

Sophrology, a popular self-help method in continental Europe, uniquely combines Western science and Eastern wisdom to help manage stress, sleep better and discover mindful living. Sophrology is a self-development method and practice using body and mind allowing each individual to create more balance and harmony in themselves and the world around them.

Wolfgang Luthe (1922-1985) was a German physician and psychotherapist, who brought autogenic training to the attention of the English-speaking world.

References

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  3. Moral aspect of Autogenic Training.
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  6. Rivera, José Luis González de (1997). "Autogenic psychotherapy and psychoanalysis" (PDF). In Guimón, J (ed.). The body in psychotherapy: international congress, Geneva, February 1–3, 1996. Basel; New York: Karger. pp. 176–181. ISBN   9783805562850. OCLC   36511904.
  7. Rivera, José Luis González de (2001). "Autogenic analysis: the tool Freud was looking for" (PDF). International Journal of Psychotherapy. 6 (1): 67–76. doi:10.1080/13569080120042216.
  8. Linden, Wolfgang (1994-09-01). "Autogenic Training: A narrative and quantitative review of clinical outcome". Biofeedback and Self-regulation. 19 (3): 227–264. doi:10.1007/bf01721069. ISSN   0363-3586.
  9. 1 2 Autogenic therapy. Luthe, Wolfgang,, Schultz, J. H. (Johannes Heinrich), 1884-1970. New York: Grune & Stratton. ISBN   9780808906643. OCLC   47990.CS1 maint: others (link)
  10. Luthe, W.; Jus, A.; Geissmann, P. (1963). "Autogenic State and Autogenic Shift: Psychophysiologic and Neurophysiologic Aspects". Psychotherapy and Psychosomatics. 11 (1): 1–13. doi:10.1159/000285660. ISSN   0033-3190.
  11. Israel, L., & Rohmer, F. (1958). Variations électroencéphalographiques au cours de la relaxationautogène et hypnotique.In P. Aboulker, L. Chertok,& M. Sapir(Eds.), pp 88-98, La relaxation: Aspects théoriques et pratiques Paris: Expansion Scientifique Française.
  12. Stetter, Friedhelm; Kupper, Sirko (March 2002). "Autogenic training: a meta-analysis of clinical outcome studies". Applied Psychophysiology and Biofeedback. 27 (1): 45–98. doi:10.1023/A:1014576505223. PMID   12001885.
  13. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-Prevention-in-clinical-practice-European-Guidelines-on
  14. "The influence of autogenic training on the physical properties of skin and cardiac autonomic activity in postmenopausal women: an exploratory study". Retrieved 25 September 2019.
  15. Ikezuki, M; Miyauchi, Y; Yamaguchi, H; Koshikawa, F (February 2002). "自律訓練法の臨床効果測定用尺度 (ATCES) の開発 [Development of Autogenic Training Clinical Effectiveness Scale (ATCES)]". 心理学研究 (Shinrigaku Kenkyu) (in Japanese). 72 (6): 475–481. doi: 10.4992/jjpsy.72.475 . PMID   11977841.

Further reading

Vol. 1 Autogenic Methods
Vol. 2 Medical Applications
Vol. 3 Applications in Psychotherapy
Vol. 4 Research and Theory
Vol. 5 Dynamics of Autogenic Neutralisation
Vol. 6 Treatment with Autogenic Neutralisation