Some individuals with generalized anxiety disorder prefer worrying over relaxing to avoid experiencing a sharp spike in negative emotion, according to new research published in the Journal of Affective Disorders. The study sheds light on a phenomenon known as relaxation induced anxiety, which up until now has received little empirical investigation.
“I became interested in this topic since I could see in some of my clinical cases that patients feel even more anxious while they are trying to relax themselves,” explained study author Hanjoo Kim, a clinical psychology doctoral student at Pennsylvania State University.
“Relaxation training (also called applied relaxation) is one of the most widely used cognitive behavioral therapy techniques, which is designed to help individuals with anxiety disorders. The paradoxical increase during relaxation training is called relaxation induced anxiety (RIA) and this phenomenon was suggested by anxiety researchers in 1980s but remained untested for almost 30 years.”
“As a clinician and researcher, I wanted to find a way to help benefit patients who experience RIA. While looking for the reasons for this phenomenon, I and my advisor, Dr. Michelle Newman thought that it might be because of their motives to avoid a large shift in anxiety. At the time, my advisor suggested a new theory called Contrast Avoidance Model (CAM) and we found this theory very relevant to the RIA phenomenon,” Kim told PsyPost.
“CAM explains that some people have an aversion against a sudden jump in anxiety (quickly moving from a relaxed state to one of fear, for example) and they use worry as a way of preventing this large jump in anxiety if something bad happens. In a similar vein, the theory also explains that engaging with relaxation increases the likelihood of experiencing a greater jump in anxiety.”
“We thought that the second line of the theory fits perfectly with the RIA phenomenon. We hypothesized that the reason some anxious people avoid RIA is due to their tendency of avoiding negative emotional contrast,” Kim said.
In the study, 32 people with generalized anxiety disorder, 34 people with major depressive disorder, and 30 controls with neither disorder completed relaxation exercises before watching videos that elicit fear or sadness.
The participants then reported the degree to which the relaxation task hindered them from coping with the changes in their emotional state induced by the video.
Afterward, the researchers led the participants through a second relaxation session and had them complete a survey that assessed their relaxation induced anxiety.
The researchers found that relaxation induced anxiety in anxious people was linked to their tendency to avoid negative emotional contrast. People with generalized anxiety disorder tended to be more sensitive to shifts in emotion and this sensitivity was linked to feeling anxious during sessions intended to induce relaxation.
“People may think worry helps them to cope with anxiety but relaxation does not. However, it is actually healthier to let yourself relaxed and allow yourself to experience negative emotional shifts. Most of your worrisome thoughts would not happen in the future and when some of the situations actually happen, they would be better than your anticipated scenarios,” Kim told PsyPost.
“Therefore, engaging with worry is not the best use of your time. Although it can be difficult to engage with relaxation at the beginning, the more you practice, the more you will realize that it is easier to do.”
“Practicing relaxation and exposing yourself to sudden negative emotional spikes will help you decrease your sensitivity to a large jump in anxiety and this will eventually help you overcome relaxation induced anxiety,” Kim explained.
The researchers hope the results will help clinicians provide better care for people with anxiety.
“Although we found evidence supporting the link between contrast avoidance and RIA in this study, it would be important to develop and validate a manualized treatment method so that clinician can easily integrate it into their practice. Also, it would be important to examine RIA in other disorders, such as panic disorder and persistent mild depression,” Kim said.
The study, “The paradox of relaxation training: Relaxation induced anxiety and mediation effects of negative contrast sensitivity in generalized anxiety disorder and major depressive disorder“, was authored by Hanjoo Kim and Michelle G. Newman.
