Objective
The relaxation response (RR) is a physiological state that is the counterpart to the stress response. We investigate the psychological and biological effects, as well as the correlation between these two effects that are associated with short-term vs. long-term practice of techniques that elicit the RR (“RR practice”).
Methods
The study comprised both a cross sectional and an 8-week prospective design. The study sample included individuals with a long-term RR practice (“long-term practitioners” n = 28) and those with no prior RR practice experience (“novices” n = 28). The novices received 8 weeks of RR-elicitation training (“RR training”) for the prospective analysis (short-term practice).
Results
Long-term practitioners reported lower levels of psychological distress than the novices before they received RR training. As a result of the 8-week RR training, novices significantly reduced their psychological distress to levels comparable to that of long-term practitioners. Long-term practitioners had greater immediate (after listening to a RR-eliciting CD) decreases in psychological distress level than the 8-week trained novices. Furthermore, the reduction in psychological distress levels for long-term practitioners correlated with a reduction in biological measures of stress, after controlling for baseline values. There was no reduction in biological measures and no correlation with psychological measures in the 8-week trained novices.
Conclusions
While our data indicate that even a short-term 8-week RR-eliciting practice can decrease psychological distress levels, only after years of RR practice does psychological distress reduction coincide with biological change.
The relaxation response (RR) was originally named more than 30 years ago as the counterpart to the stress response due to their opposite effects on physiological state. RR-elicitation reduces (and stress increases) heart and respiratory rates and oxygen consumption.1 Various mind-body techniques including deep breathing exercises, guided imagery, meditation, progressive muscle relaxation, yoga, tai-chi, and qigong can be used to elicit the RR.1 These techniques are commonly used by those with medical conditions, but also by healthy individuals in the US adult population.2 and 3
The psychological effects of practicing techniques which elicit the RR (“RR practice”) are well documented. For example, a recent meta-analysis of studies from the past 10 years found that relaxation training (including Jacobson's progressive muscle relaxation, autogenic training, and meditation) showed a medium effect size in the treatment of anxiety.4 Current evidence in the literature also supports the use of a variety of RR-eliciting techniques (such as meditation, autogenic training, and yoga) for control of pain and anxiety during cancer treatment,5 to decrease self-rated depression symptoms,6 and among healthy individuals to reduce stress, anxiety, and enhance spirituality.7 and 8
Biological effects of the RR are also reported in the literature; however, study results are inconsistent and, thus, biomarkers emblematic of the RR have not been clearly identified. Some studies have found that the practice of various forms of meditation are associated with decreasing cortisol levels,9, 10, 11 and 12 and also with lowering an elevated cortisol response to stressors.13 Other studies reported no changes in cortisol levels after a short term compassion meditation intervention (6 weeks)14 or after relaxation and visualization therapy (24 days).15 It has been suggested that a longer intervention period might be necessary to evoke biological changes.
The connection between psychological and biological functioning in the human body is well-recognized in the literature. A higher proportion of depressed patients have elevated cortisol levels.16 Clinically depressed patients had higher cortisol levels after exposure to psychological stress than did non-depressed individuals.17 In clinical practice, psychobiological models have been adapted for treating various health conditions.18 and 19 Improved understanding of the interaction between psychological and biological effects that are associated with the RR practice could, therefore, contribute to a low-cost approach for improving health.
To date, very few studies have examined the association between the psychological and biological effects of RR-elicitation. A randomized trial found that a 2-week breathing-focused yoga practice significantly reduced cortisol and adrenocorticotropic hormone (ACTH) among alcohol-dependent patients;20 in addition, the reduction in cortisol level was correlated with a decrease in depression scores for the yoga practice group, but not for the control group. Another study reported that lower levels of anxiety were associated with lower cortisol levels after 24 consecutive days of relaxation and visualization therapy among cancer patients undergoing radiotherapy.15 These two studies evaluated changes from short term interventions (2 weeks and 24 days) and the biological outcomes were limited to cortisol and ACTH.
We designed the current study to investigate the psychological and biological effects as well as to examine the correlation between these two effects that are associated with short-term vs. long-term RR practice. We hypothesize that long-term practices will result in greater psychological and biological beneficial effects than short-term practices and that these two effects are correlated
