Summary: People with anxiety and depressive disorders can sometimes resist relaxation; sensitivity to sudden increases in negative emotion helps explain why relaxation can paradoxically trigger anxiety.
Source: Penn State
Relaxation is generally recommended for physical and mental wellbeing, but new Penn State research shows that some people—especially those sensitive to sudden shifts into negative emotion—may experience increased anxiety during relaxation exercises.
Researchers found that individuals who are highly sensitive to rapid changes in negative emotion—for example, moving quickly from a calm state to fear—are more likely to feel anxious while taking part in guided relaxation. This counterintuitive reaction, known as relaxation-induced anxiety (RIA), helps explain why relaxation techniques sometimes backfire for people with certain mood and anxiety disorders.
Michelle Newman, professor of psychology and lead author of the study, said the findings shed light on RIA and offer directions for improving clinical care.
“Some people keep themselves chronically anxious to avoid the intense emotional spike that would occur if something bad happens after they let down their guard,” Newman explained. “Allowing yourself to experience brief emotional shifts is healthier. With practice—through mindfulness and treatments that teach tolerance of shifting emotions—people can learn to relax without fearing the potential rebound in anxiety.”
Hanjoo Kim, a graduate student and co-author, noted that the people most likely to experience RIA are often those who could benefit most from relaxation, such as patients with generalized anxiety disorder (GAD) and major depressive disorder (MDD).
“Relaxation techniques are intended to help, not to increase distress,” Kim said. “Understanding who is vulnerable to relaxation-induced anxiety will help clinicians tailor interventions so relaxation becomes a resource rather than a stressor.”
Newman developed the contrast avoidance theory in 2011, which proposes that some individuals deliberately maintain worry to avoid a sudden drop and subsequent surge in negative emotion. The current study tested whether sensitivity to negative emotional contrast mediates the relationship between diagnostic status (GAD or MDD) and RIA.
Study design and participants
The study involved 96 college students grouped by diagnosis: 32 with generalized anxiety disorder, 34 with major depressive disorder, and 30 healthy controls without either disorder. Participants completed a series of relaxation exercises and viewed emotionally negative video clips to create a negative emotional contrast—moving from a relaxed state into induced fear or sadness. After the first relaxation and the video exposure, participants completed measures assessing how sensitive they were to changes in their emotional state. They then completed a second relaxation session and a follow-up survey that specifically measured anxiety experienced during that second relaxation.
Key findings
Analysis showed that individuals with generalized anxiety disorder were more likely than controls to be sensitive to sharp negative-emotion spikes—from calm to fear or distress—and this sensitivity was strongly associated with higher anxiety during relaxation sessions. Participants with major depressive disorder also showed this pattern, though the effect was less pronounced than in the GAD group.
The pattern of results supports the idea that negative contrast sensitivity—an intolerance of abrupt increases in negative emotion—mediates the relationship between disorder status and relaxation-induced anxiety. In other words, people who fear sudden negative emotional shifts are more likely to stay worried and to experience anxiety when asked to relax.
Clinical implications
The study suggests practical steps clinicians can take to reduce RIA. Assessing relaxation-induced anxiety and targeting negative contrast sensitivity with exposure-based techniques or gradual desensitization may help patients learn to tolerate emotional shifts. Interventions such as mindfulness training that focus on staying present and allowing emotions to pass could also reduce the tendency to sustain chronic worry as a preventative strategy.
Hanjoo Kim emphasized the importance of extending research to other diagnoses. “Further study of RIA in conditions like panic disorder and persistent mild depression will clarify how widespread this issue is and which treatments are most effective,” he said.
Source:
Penn State
Media Contacts:
Katie Bohn – Penn State
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The image is in the public domain.
Original Research: Closed access
“The paradox of relaxation training: Relaxation induced anxiety and mediation effects of negative contrast sensitivity in generalized anxiety disorder and major depressive disorder”. Hanjoo Kim, Michelle G. Newman. Journal of Affective Disorders. DOI: 10.1016/j.jad.2019.08.045.
Abstract
The paradox of relaxation training: Relaxation induced anxiety and mediation effects of negative contrast sensitivity in generalized anxiety disorder and major depressive disorder
Background
The Contrast Avoidance Model proposes that people with generalized anxiety disorder fear sudden increases in negative emotion and therefore maintain worry to avoid the shock of emotional contrast. Relaxation-induced anxiety (RIA) is the paradoxical rise in anxiety some individuals experience during relaxation practice. Because similar patterns might occur in major depressive disorder, this study tested whether negative contrast sensitivity mediates the relationship between diagnostic status (GAD or MDD) and RIA.
Methods
Participants with GAD (n = 32), MDD (n = 34), and healthy controls (n = 30) completed a protocol involving relaxation practice, exposure to a negative emotional video to create emotional contrast, assessment of negative contrast sensitivity, and a second relaxation session during which RIA was measured. Mediation analyses examined whether negative contrast sensitivity explained the link between diagnostic group and RIA.
Results
Negative contrast sensitivity fully mediated the relationship between GAD and RIA and partially mediated the relationship between MDD and RIA.
Conclusions
Findings support the role of negative contrast sensitivity as a mediator of relaxation-induced anxiety in GAD and, to a lesser extent, MDD. These results have implications for the assessment and treatment of RIA in clinical practice.