MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

This post is dedicated to all who claim that I never discuss anything positive about so-called alternative medicine (SCAM).

Autogenic training is a therapy developed in the 1920s by the German psychiatrist Johannes Heinrich Schultz (1884 – 1970). It is an auto-hypnotic relaxation technique popular in Germany but less so other countries. (The lack of international appreciation of autogenic training might be related to Schultz’ well-documented Nazi past. In 1935, he published an essay which supported compulsory sterilization of men to eliminate hereditary illnesses. Later he was appointed deputy director of the Göring Institute in Berlin. Through this institute, he had an active role in the extermination of mentally handicapped individuals in the framework of the ‘Aktion T4’, the Nazi’s infamous euthanasia programme.)

Autogenic training  consists of mental exercises using instructions directed at different parts of the body to control bodily perceptions, such as ‘my right foot feels warm’ or ‘my left arm feels heavy’. Patients tend to report an intense sense of relaxation during and after autogenic training. Autogenic training is taught in a series of lessons by a qualified instructor.

Autogenic training should be practised regularly and does not require further supervision. It is thus an inexpensive therapy. The technique is claimed to help for a range of (mostly stress-related) conditions. However, the evidence from clinical trials is scarce and, not least due to methodological problems, less than convincing.

This systematic review was conducted to evaluate the effectiveness of autogenic training on stress responses. A total 11 studies were included in a meta-analysis. They showed that autogenic training decreased anxiety and depression, and increased the high frequency of heart rate variability as well as a reduction of anxiety score by 1.37 points (n=85, SMD=-1.37: 95% CI -2.07 to -0.67), in the studies on short-term intervention targeting healthy adults.For depression, a reduction was noted of the symptom score by 0.29 point (n=327, SMD=-0.29: 95% CI -0.50 to -0.07) in the studies on long term intervention targeting the patient group.

The authors concluded that autogenic training is effective for adults’ stress management, and nurses will be able to effectively perform autogenic training programs for workers’ stress relief at the workplace.

I cannot access the full article because it was published in Korean. Nevertheless, I feel that the conclusions are probably correct.

Why?

Because I know (most of) the primary studies and three of the RCTs are my own.

(Yet, some of my critics continue to claim that I never conducted any positive studies of SCAM)

9 Responses to Autogenic training is an effective therapy for managing stress

  • What kind of placebo was used

    • in our trials, we used an attention control

      • With respect, attention controls like “laughter therapy” or “symptom diary” are poor at controlling questionnaire response biases for any therapy that targets changes in cognition. Recruiting undergraduate students is also likely to increase Hawthorne-like biases.

        One of your randomised studies noted “There were no significant changes in blood pressure, heart rate, ECG, or plasma catecholamines either within or between groups over the duration of the study”. Suggesting any effect is not mediated by these parameters.

        Long term changes on meaningful objective outcomes in randomised studies would suggest positive effect, but no such data has been provided.

        So after decades of research, it seems we still only have inconclusive/suggestive quality evidence on Autogenic Training.

  • three of the RCTs are my own
    Sounds highly suspect. 🙂

    Just from a few encounters with relaxation training in general I tend to think it makes sense. A more organized and formal approach makes a lot of intuitive sense.

    I do not read German so I will have to see what I can track down in English.

  • If it ‘works’ (beyond placebo), it’s not a SCAM!

  • As a young soldier in Germany in the 1980’s I was taught the “coachman” technique of sitting with hands in lap and head bowed with attention paid not to breathing but to try and find a pattern in the sounds you could hear. This apparently was about 19th century Coach drivers ability to stay awake for long periods while holding the horses in line. It was meant to help squaddies cope with hours on cold stag on the east german border.

    I fell asleep – a lot.

  • Autogenic Training track as part of the McMaster – Guided Relaxation CD.

    I have not listened to it yet. https://campusmentalhealth.ca/resource/mcmaster-guided-relaxation-cd/

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