Jacobson's progressive muscle relaxation: method, steps and benefits

Jacobson relaxation is a relaxation technique that consists of contracting a muscle group, then releasing it, moving from one area of the body to another. It is also found under the names progressive muscle relaxation, Jacobson progressive relaxation or PMR, for progressive muscle relaxation.

It starts from a simple observation: anxiety and muscle tension can reinforce each other[1]. By feeling the difference between a tense muscle and a relaxed muscle, you learn to spot your tensions and reduce them.

How does it work?

According to Jacobson, every psychological tension is accompanied by muscle tension, sometimes so slight that it goes unnoticed. He measured it with an electromyograph[12]. His thesis went far: completely relaxing one's muscles would reduce anxiety by the same amount[12]. That is his thesis, not a result established by the studies cited below.

The most cited description is that of the "relaxation response" by the cardiologist Herbert Benson. The activity of the sympathetic nervous system, linked to stress, gives way to that of the parasympathetic system, with a drop in muscle tension, heart rate, breathing and blood pressure[12]. This description applies to relaxation techniques in general, not only to Jacobson's.

From Edmund Jacobson to behavioral therapy

Edmund Jacobson, an American physician, presented the technique at Harvard in 1908[3], then published it in 1929 in Progressive Relaxation[1]. The original version requires one instruction session each week and daily practice[3].

Joseph Wolpe later shortened it to an exercise of about 20 minutes, used to counter the fear response[3]. Today there is no single protocol: the number of muscle groups and the duration vary according to the versions[1][3].

The method has been studied for stress, anxiety, sleep and headaches. Here is what the studies say, with their limits.

Stress and anxiety

A 2024 systematic review brought together 46 publications from 16 countries, covering more than 3,400 adults. It concludes that stress, anxiety and depression decrease, more markedly when the method is combined with other interventions[5].

A meta-analysis of 27 studies, published in 2008, measures a medium to large effect of relaxation training on anxiety. It groups several methods, including Jacobson's, and the effect is more marked for meditation and long interventions[4].

Not all results point in the same direction. In a trial of 83 patients followed in respiratory rehabilitation, anxiety decreased in both groups, with no significant difference between those who practiced relaxation and the others[10].

Phobias, panic and generalized anxiety

According to a Quebec clinical guide, relaxation techniques do not as such cure phobias, panic attacks or obsessions. They can help lower the level of anxiety that accompanies them[12].

In panic disorder, an analysis of 72 trials and 4,064 participants does not make it a priority component of CBT and highlights exposure to bodily sensations[15]. Relaxation keeps a supporting role there, which the practitioner doses according to the patient.

In generalized anxiety, a meta-analysis of 23 studies finds negligible differences between applied relaxation, which teaches how to use relaxation in anxiety-provoking situations, and CBT without relaxation[16].

Sleep

A meta-analysis published in 2026 brought together 14 randomized trials and 957 participants. Sleep quality, as reported by the people themselves, improves, but results vary greatly from one study to another. The effect remains uncertain after age 55, and it does not clearly depend on the number of sessions[6].

Migraine and headaches

The method has been used to prevent migraine since the early 1970s. A 2018 review reports meta-analyses in which it proves as effective as drug options, provided it is practiced every day for 5 to 25 minutes. Its authors also note the lack of recent research[7].

A 2025 American trial offered the method on smartphone to patients leaving the emergency department for a migraine. Among 69 patients followed, 82% saw their migraine-related disability decrease by at least 5 points on the scale used, compared with 46% in the control group. The number of headache days did not differ between the groups[17]. Do not change a treatment without talking to your doctor.

During chemotherapy

A 2018 review covered seven trials combining this relaxation with guided imagery, almost all on breast cancer. All report a benefit on mood, anxiety or depression[11]. The observed effect is that of the combination, not of Jacobson's method alone.

Other uses

The same Quebec guide also cites tension headaches, certain chronic pains and several sleep disorders, and expects less from it in organic diseases[12]. These are clinical indications, not quantified results. For pain, the data are less clear: a study in orthopedic surgery found no change in its intensity[3].

This relaxation method has existed for a long time and has therefore already been scientifically validated many times. You can use it with your patients with any anxiety disorder, with all phobias, in particular agoraphobia, and generalized anxiety disorder (chronically stressed people who need relaxation). But nothing prevents you from using it in all mental pathologies. For example, it can be useful for patients who are addicted, who are smokers or alcoholics, because it gives them the possibility of doing something rather than smoking. You can therefore even teach it for addictions.

There are three relaxation methods: vagal relaxation, Schultz's autogenic training and Jacobson's progressive muscle relaxation. So which one to choose? Sometimes your patients will ask you which one to favor. In that case, the best thing is to ask them how they feel. If for one the main problem is that they feel tense, that their shoulders hurt, that their neck is stiff, that their legs hurt, then the Jacobson method is the most suitable. If, on the other hand, another tells you that they feel sensations of warmth when anxious, strange sensations of unease, then Schultz's autogenic training is the most appropriate method. As for vagal relaxation, it is very quick to teach and to apply and should therefore be an automatic reflex.

A Quebec clinical guide proposes a nearby benchmark, as a working hypothesis: a passive method suits a person with little anxiety better, an active method a person with a lot of anxiety. Jacobson relaxation sits rather on the side of marked anxiety, autogenic training on the side of more moderate anxiety[12].

Research still compares these techniques with one another very little. In a trial of 60 healthy students, 20 minutes of muscle relaxation, deep breathing or guided imagery all increased the state of relaxation compared with the control group. Muscle relaxation and imagery lowered physiological activation right from the start, whereas deep breathing first increased it briefly[8]. This trial covers a single session: it does not say which method suits an anxious patient best.

As part of a relaxation session, ask your patient to sit or lie down, take off their handbag, their jacket: to make themselves comfortable. Nothing prevents you from putting on background music if you wish. Doctor Malbos advises in particular to use music called “Space Music”, a type of electronic music which allows for a very calm musical background and therefore conducive to relaxation or meditation. The temperature of the room is also important. It should be pleasant, so don't hesitate to turn on a fan or the heater. In addition, when you speak, you should remember to speak slowly and with a deep, calm and warm voice, this encourages the relaxation process.

Let's begin the Jacobson method. Start by telling your patient to clench their right fist at 80%, so quite hard. Ask them to focus on the sensation of pressure, the sensation of burning, the sensation of tension in the fist. This is very important: only the fist should be contracted. The forearm, the biceps, the shoulder, and the rest of the body must be completely relaxed. At first, your patient will find it hard to contract only the requested muscle components in isolation, but that is normal. Practice will make this exercise easier to carry out.

The second phase of this method is the relaxation phase.

Tell your patient to relax their right hand very gently, very slowly. They should concentrate on this fading of the pain and on the pressure that is easing off. They need to realize that this tension is disappearing. Their palm then opens, still very gently. Their fingers will spread apart until they reach a state of total relaxation.

These two phases sum up the whole idea behind the Jacobson relaxation method. The method boils down to a contraction phase at 80%, strong and slightly painful, followed by a relaxation phase. This is why it is called "Jacobson progressive muscle relaxation": it gives patients a better awareness of how contracted their muscles are. Learning this method will allow them to detect when their muscles are too tense and, above all, to be able to relax them, to release them.

Everything else consists of repeating exactly the same thing for each muscle group. However, there is a muscle order to follow, recommended by Dr. Malbos:

• 1. fist
• 2. biceps
• 3. forehead (orbicularis, frowning)
• 4. jaws (masseter muscles, clenching the teeth)
• 5. lips (pouting)
• 6. neck (sternocleidomastoid muscles, ask your patient to put their hand on their forehead while the forehead pushes against that hand)
• 7. trapezius muscles (shrugging the shoulders)
• 8. diaphragm and the accessory muscles of breathing (taking a deep breath and holding it)
• 9. abdominal muscles
• 10. gluteal muscles
• 11. quadriceps muscles (moving the leg or not)
• 12. calves (muscles that lift the feet, raising the front of the foot)
• 13. toes (lifting muscles, raising the toes)

You can suggest the following approach to your patient: one side one day, the other side the next day. Non-athletic patients, who often have little awareness of their body, may sometimes suffer from slight muscle soreness, as if they had just done a sports session. At the start of the relaxation exercise, you must make it clear to them that they should only contract the muscle at 80%, and after the session, reassure them and tell them that muscle soreness is possible in the following days and perfectly normal. Training will reduce it.

Speaking of training, how often should the Jacobson progressive muscle relaxation method be done? Twice a week according to Dr. Malbos.

The Jacobson relaxation method is to be carried out with your patients so that they become aware of this difference between the contracted state and the relaxed state, and can thus release their body at any time.

Contracting and releasing is the entry point of the method. To go further, the psychiatrist Louis Chaloult teaches it in four phases, up to relaxation without contraction[12].

Active phase

This is the step described above. The patient contracts each muscle group for 3 to 5 seconds, then relaxes for 15 to 20 seconds. They learn to locate their muscles and to tell tension from relaxation[12].

Differential phase

The patient contracts one muscle group for longer, 30 seconds or more, while directing their attention to the other muscles in order to release them. After a few days, they apply it in daily life: no longer tensing the face and shoulders while driving, for example[12].

Shortened phase

The exercises are grouped into seven major movements: arms, legs, abdomen, chest, shoulders and two for the face. This part lasts a little over ten minutes. The patient then stays still for about ten minutes and mentally runs through their muscles to relax them[12].

Passive phase

There is no longer any contraction. The patient, motionless, checks each muscle group without effort, notices the tensions and lets them go[12].

Moving from one phase to the next depends on the patient: the guide does not set a precise schedule. With training, relaxation can come more quickly, simply by thinking of the memorized sensation[13].

Protocols vary from one team to another. Here are the guidelines that come up most often, useful both for the practitioner and for the patient who practices at home.

A session in four steps

1. Settle in. In a quiet place, seated or lying down, arms and legs uncrossed, clothing loosened[2].
2. Tense. As you breathe in, tense the muscle group for 5 to 6 seconds[2].
3. Release. Release as you breathe out, telling yourself "relax" or "relaxation"[2].
4. Notice. For 10 to 15 seconds, observe what changes in your sensations, then move on to the next group[2].

To finish, take a deep breath in, open your eyes, stretch, then stay seated for a few seconds before standing up, to avoid dizziness[12].

Durations differ depending on the author: from 3 to 10 seconds for the tension, and from 10 to 30 seconds for the relaxation[2][12][13][14]. The same goes for the release: some handouts call for it all at once, others for a gradual release[12], and Dr. Malbos advises a very slow one. Keep whatever best helps the patient feel the difference.

A sequence of 16 muscle groups

This page presents Dr. Malbos's order. There are others, such as this sequence from a French clinical handout[2]:

• Hands and arms: fists and wrists, then arms and forearms.
• Shoulders: raise them toward the ears.
• Face: forehead, eyes, nose and cheeks, lips, tongue and mouth.
• Neck: chin toward the chest.
• Trunk: chest, back, belly, buttocks.
• Legs: thighs, calves, ankles.

The same handout advises starting with these 16 groups, then moving on to medium-sized groups and finally to the large groups[2].

A short 5-minute version

A session lasts from a few minutes to an hour, depending on the number of muscle groups[1]. A 5-minute version can be done on a chair, in four stages[1]. At each stage, tense as you breathe in, hold for 5 seconds while breathing normally, then release on a long out-breath:

• Face: wrinkle your nose and brows, close your eyes, clench your teeth.
• Arms: raise your arms, fists closed.
• Shoulders and chest: raise your shoulders, tense the upper chest.
• Legs: lift your legs, toes pulled toward you.

Shortened versions have also been studied. A review of 29 experiments found a moderate effect, clearer when delivered one-on-one, with a recording to practice with, and when the intervention lasted longer and included more sessions[9].

How often and when should you practice?

The pace depends on the patient. Dr. Malbos advises 2 sessions per week. The Québec guide, for its part, suggests about 20 minutes, once or twice a day, in the morning or at the end of the day[12]. A handout from the University of Zurich and ETH asks for at least one session a day[1], and the studies on migraine are based on daily practice[7]. The practitioner agrees with the patient on a sustainable pace, then adjusts it.

If possible, avoid practicing after a meal, or after caffeine or alcohol[12]. To track progress, the patient can rate their level of calm from 0 to 10 after each session[12] and discuss it with their therapist.

Before going to sleep

People who want to try it in the evening can practice in bed, in quiet surroundings, with a short version. If focusing on the body keeps you awake, it is better to practice earlier in the evening. Insomnia that persists warrants medical advice.

These mistakes come up often. The practitioner does well to point them out from the very first session.

• Not progressing. With training, you can aim for relaxation without tensing[12].
• Forcing the tension. If it causes trembling or real pain, reduce the intensity[12][13].
• Tensing the whole body. Only the targeted group works, the rest stays relaxed[13].
• Trying to relax at all costs. Keep a passive attitude: relaxation sets in without being forced[12][13].
• Fighting your thoughts. Distractions are normal. Bring your attention back to the exercise, without getting impatient[1][12].
• Standing up all at once. Stay seated for a few seconds at the end of the session[12].

Jacobson relaxation requires few resources, but it has its limits.

When to seek medical advice before starting

A handout from the University of Zurich and ETH asks people to consult a doctor first in cases of[1]:

• severe asthma;
• cardiovascular disease;
• epilepsy;
• acute psychosis;
• a tendency toward dissociation;
• hypochondriacal disorder;
• muscle disease.

The Québec guide adds severe depression, anxiety states so acute that they prevent any learning, and certain diseases of the bones, spine or joints, which can make the exercises difficult[12]. An injury is also a reason to talk to a doctor[3].

Possible drawbacks

• Pain: the tension is firm, but must remain bearable[1][12]. If it becomes truly painful, reduce the intensity or skip that muscle group.
• Muscle soreness: possible at the beginning, especially in people who do little sport.
• Time: the method has to be learned. Isolating a single muscle takes practice.
• Unusual sensations: slight disorientation, a feeling of heaviness or floating may occur. Pleasant for some, they can worry a very anxious person, and the practitioner must reassure them[12].
• Limits of the effect: it helps manage tension, but does not replace psychotherapy or a prescribed treatment[12].

If anxiety rises during the exercise

Stop, breathe deeply, open your eyes and tense your limbs. If this happens repeatedly, stop the sessions and talk to your therapist[12]. In case of suicidal thoughts, in the US call 988[20], 24 hours a day. In the UK, call Samaritans on 116 123[21], 24 hours a day. If you are in another country, contact your local services.

Relaxation has its place in a therapy pathway, for example when the patient needs time to come back down around exposure work. This is the link Wolpe had already drawn between relaxation and fear[3].

Therapeutic virtual reality and Jacobson's method can complement each other. C2Care's relaxation environments make it possible to add a moment of breathing or relaxation during a session, guided by the practitioner.

Research is also interested in relaxation in virtual reality in general, most often in natural settings such as beaches or forests. A review of 19 studies and 1,278 participants in the general population judges it feasible, well accepted and effective in the short term on relaxation and stress, and calls for longer studies[18]. Another, of 18 studies and 848 people living with a mental health disorder, reaches the same conclusion in the short term[19].

Jacobson relaxation rests on a simple gesture: tense, release, notice the difference. It is learned in phases, until you can relax without tensing. Studies support it for stress, anxiety and sleep, with variable results. It helps manage anxiety, but does not replace therapy for a phobia or a panic disorder. At a sustainable pace, it is a tool the practitioner can pass on to the patient and that the patient can keep in daily life.