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Anxiety: Progressive Muscle Relaxation and Guided Imagery

Anxiety: Progressive Muscle Relaxation and Guided Imagery

Symptom and description

It is common to feel stress or anxiety when you have cancer. Anxiety can be a vague or uneasy feeling of distress. There are many things that can bring on these feelings, such as trips to your doctor's office, treatments for your cancer, or fears about your cancer.

Learning needs

There are many things that you can do to help your stress. Two things that are easy to learn are called progressive muscle relaxation and guided imagery. They may also help with pain, and nausea and vomiting.

These skills take practice. The more you practice these skills, the more helpful they are. Some people find it helpful to make a tape to listen to as they practice. A soothing tape of music may help. Many libraries have relaxation tapes or quiet, soothing music.


  • Find a quiet, comfortable spot to practice.

  • Sit up or lie down while you practice.

  • Have a blanket or sheet handy. Often when people are relaxed, they find they are cooler and need a light blanket.

  • Take a few minutes to think about your breathing. (You can keep your eyes open or closed.) Try to do stomach breathing. Fill your stomach as you breathe in and then breathe out. Begin to slow down, and slow your breathing down. Try to focus on your breathing.

Progressive muscle relaxation

  • Take in a deep breath. Hold that breath for a count of four, let it out, and begin to relax. Do this about four times. As you breathe in, think about good, soothing energy flowing in. As you breathe out, breathe out your stress and bad thoughts.

  • Allow your mind to focus on one body part at a time. Move from the top of your head all the way down to your toes.

  • Relax your head and your scalp. Repeat this two or three times.

  • Move down to your eyes. Relax your eyes and the muscles around your eyes. Squeeze your eyes tight for four counts, then relax. Notice the difference in your eyes and face when your eyes are squeezed and tense, and when they are relaxed.

  • Focus on your mouth. Relax your mouth. Allow it to go limp.... Move down your neck, and relax your neck mscles.... Relax your shoulders....

  • When you get to your arms, you may relax them one at a time or both at the same time. You may even choose to relax each finger, one at a time.

  • Move all the way down to your toes using this skill.

Extra tips (tips that may help body areas that are tense or painful)

  • As you move down your body, you may want to tighten and then relax certain body parts. This helps to show how different your body feels when it is tense and when it is relaxed. You can tense and then relax your eyes, hands, toes, mouth, and shoulders. You should get more relaxed as you move down your body. If you feel relaxed, you may not feel like doing this part past your mouth or shoulders.

  • Warm often feels good. Think about any part of your body being warmed by the sun. For example, if your right arm has pain, you can focus on this arm. Think about warm rays of sun on your arm as you relax.

Guided imagery

  • It is best to do this skill after you have done the progressive muscle relaxation. Once your body is relaxed, you can allow your mind to rest.

  • Before you begin, think about a special image or place. This can be a place where you have been or it can be a made-up place. Choose a relaxing place. Think about the whole scene. What does it look like? What do you hear? What do you taste or smell? Be as detailed as you like.

  • Some examples of pleasant places might include a warm, sunny beach, a sparkling lake, a walk in the woods, or a lovely snow-capped mountain.

  • Your image should be a place where you can be very relaxed. It is a place with no stress or worry. You can go to this place when you need a break.

Example of a guided imagery scene

I am lying alone on a beach in the late afternoon sun. It is nice and warm, but not too hot. The water is aqua blue, with small white caps close to the shore. The sky is light blue, with a few white puffy clouds. I am lying with my feet to the water, with the sun moving to the right of me. I can feel my warm beach towel under me and warm sand on my hands and feet. I feel the soothing sun on my body. I hear seagulls flying over me. I hear sea grass swaying in the breeze behind me. I hear some children playing in the sand, but I can't hear what they are saying. The water is gently lapping on the shore, over and over and over...


These skills are not to be used instead of pain medicine or any other type of medicine that you need. They should be used with your current treatment.

It is okay to fall asleep during either progressive muscle relaxation or guided imagery. It does not mean that it is not working. It may mean that you need the sleep. Give yourself the rest that comes with a relaxed body and mind.

Progressive muscle relaxation and guided imagery take practice to help you relax. When you feel good with these skills, they may also help with pain or nausea and vomiting.

Talk with your doctor, nurse, or someone you trust about your stress. They may be able to give you other ideas.