Category Archives: Autogenic Training

Is There a Link Between Prolonged Psychological Stress And Physical Pain?

Featured Image of the ocean near the beach in the sun taken by myself. 

Dear Pain Matters blog readers,

Prolonged psychological stress can perpetuate chronic pain in some patients, while other people may be prone to chronic inflammatory diseases including cardiovascular disease, type II diabetes, depression, autoimmune diseases, upper respiratory infections and poor wound healing ability.

Immune cells are normally very sensitive to circulating stress hormones (glucocorticoids including cortisol), and as such, are usually able to shut down the pro-inflammatory response in the presence of glucocorticoids.

Chronic psychological stress can reduce the circulating stress hormone’s ability to interact with its receptor leading to glucocorticoid receptor resistance (GCR).

Repeated and ongoing exposure to a long-term threatening (real or imagined) and stressful experience can lead to insufficient glucocorticoid regulation (i.e. GCR), that in turn can lead to:

  • Insufficient control over the inflammatory response towards an infection;
  • Increased duration and/or intensity of the pro-inflammatory response; and
  • Increased pain levels and other signs and symptoms of chronic diseases.  

Studies have shown that some chronic stress sufferers (e.g. parents of children with cancer, spouses of patients with brain cancer and lonely people) present with GCR (Cohen et al, 2012).

Other Biomechanisms that Influence the Pro-Inflammatory Response and its Key Role in Maintaining Chronic Pain and Inflammation-Based Diseases:

See this Blog Post for more information:

What Can Done To Reduce Prolonged Psychological Stress?:

Steps must urgently be taken to reduce repeated and ongoing exposure to a prolonged threatening (real or imagined) and stressful experience.

This brings us to all those therapies that may induce the ‘relaxation response’ and/or lead one to a calmer disposition including:


Any therapy that can induce the ‘relaxation response’ is key to diverting attention away from repeated and ongoing psychological stress.

This will strengthen the immune cells’ ability to interact with circulating stress hormones (glucocorticoids including cortisol) and shut down an exaggerated pro-inflammatory response.

Conventional pharmacological treatment also plays an important role in reducing excessive inflammation.  The effectiveness of pharmacological drugs may be further enhanced by the body’s ‘relaxation response’, leading to lower drug dosages and fewer adverse effects.

The body’s innate ability to properly control a pro-inflammatory response is key to warding off chronic pain and disease.

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.



(1) Study Finds Link Between Stress And Physical Pain

Huffington Post (03 April 2012)


(2) Clynes, Manfred

Sentics: The Touch of Emotions

250 pp, Doubleday/Anchor, New York, 1977 – Chapter 9 only

Peer-Reviewed Paper

(3) Cohen S, Janicki-Deverts D, Doyle WJ, et al.

Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk.

Proceedings of the National Academy of Sciences of the United States of America. 2012;109(16):5995-5999.



Does Autogenic Training Lead to Less Pain?

Dear Pain Matters blog readers,

As part of any pain management strategy, it is important to be able to relax (de-stress) and induce the Relaxation Response at least 2-3 times daily. 

Regular activation of the Relaxation Response may result in many benefits including:

– Reduced pain levels;

– Decreased dosages of, and more effective, pain medication;

– Improved function and mobility; and

– Healing (partial or complete).

There are many different techniques to induce the Relaxation Response including:

– Deep breathing;

– Meditation;

– (Self) Hypnotherapy;

– Visualization;

– Yoga;

– Music therapy;

– Acupuncture, and

– Qi Gong.

(More on these later.)

As pain levels decrease,

(1) due to the regular (daily) practice of relaxation techniques to engage the parasympathetic nervous system (vagus nerve); and also

(2) due to effective interventions including pain medications, nerve blocks, and/or surgery,

the pain patient will (more likely) embrace physiotherapy and physical exercise to recover function and mobility.

Many chronic pain patients find yoga beneficial, while others find that meditation and visualization helps.  To reduce pain, for example, they may visualize a beautiful beach with waves lapping onto the shore.  Other pain patients may prefer to visualize actual immune cells producing less pro-inflammatories and more anti-inflammatories (and other physiological functions).  Whatever works to reduce pain is great!

Relaxation techniques result in increased parasympathetic nervous system (vagal) activity, and hence a more balanced autonomic nervous system (including increased heart rate variability and reduced adrenaline/noradrenaline/cortisol blood levels).  This should result in reduced pain levels.


In addition to above, there are other ways to induce the Relaxation Response including Autogenic Training.

What is that?

Autogenic Training is a relaxation technique that induces the Relaxation Response.  It was first developed in the 1920’s by German psychiatrist and independent psychotherapist, Johannes Heinrich Schultz (and simplified recently).

A review paper explores Autogenic Training as a relaxation technique that may reduce pain during childbirth, headaches and migraines, back pain, cancer pain, and cardiology-related pain.  Regular Autogenic Training sessions may result in decreased pain medication (Kanji, 2000).

Autogenic Training is a form of self-hypnosis, and has (at least) 4 visualization-related components to induce the Relaxation Response:

(1) Deep breathing;

(2) Focus on relaxation;

(3) Aim to make skeletal muscles ‘heavy’ (to promote relaxation of the limbs’ voluntary muscles and reverse stress-induced tension); and

(4) Focus on ‘warming’, to increase blood flow back to the arms and legs, and away from the centre of the body (to reverse the effects of the sympathetic nervous system).

Like yoga and other relaxation techniques, once Autogenic Training is properly learned from a qualified practitioner, Autogenic Training sessions can be done by yourself anywhere that is very comfortable (at home, at work during lunch, etc).  One can do an Autogenic Training session while lying down, sitting upright in a chair, or in any other accepted position.  It is best to choose a quiet place where you won’t be disturbed.  These sessions can be done several times daily (in the morning, at lunch, and in the evening, just before you go to sleep).  Each session may last around 15 minutes, although they may also be as short as 2 or 3 minutes.

The key is to do Autogenic Training regularly (daily), 3 times a day.

Note:  Please see your physician before doing Autogenic Training. 

More studies are warranted to assess whether regular Autogenic Training sessions can lead to reduced pain levels in some pain patients.

Hope this helps….

Sabina Walker


(1) Kanji; Management of pain through autogenic trainingComplement Ther Nurs Midwifery (Aug 2000); 6(3):143-8.

(2) British Autogenic Society

For German readers:

(3) This excellent book first introduced me to Autogenic Training –

Autogenes Training (2005; 128 pages)

Authors: Dietrich Langen, Karl Mann  Prof. Dr. Med. Dietrich Langen

978-3-7742-7416-7 (ISBN)