Progressive Muscle Relaxation (PMR)

thdozier_10_v1Progressive Muscle Relaxation (PMR)  may be the best misophonia treatment.  Why?  Well regardless of your triggers, it helps you stay calm after a trigger and it can allow your misophonia reflex to fade away.

Try the new, FREE Misophonia Muscle Relaxation Training app on the Apple App Store or Google Play.


PMR is a technique that takes many sessions to develop the physical/neurological skill of relaxing your muscles on demand.  If you want to get the real benefit in reducing your misophonia, you need to do PMR for one hour every day for the first 4 weeks, then continue at a rate of 15 to 30 minutes a day for the next month.  I recommending using the Misophonia Muscle Relaxation Training app.  Relaxing your muscles is a skill, and even pros practice to enhance their skill.  This first video will teach you what you need to know about Progressive Muscle Relaxation.

Once you have completed 14 to 20 PMR sessions you are ready for the next exercise.  I call this Sequential Relaxation.  Here is how it is done.

Sequential Relaxation:  Close your eyes.  Think of a muscle (right fist).  Relax it completely.  Think of the next muscle (left fist) and relax it completely.  Continue until you have relaxed all the muscle groups in your body.  This exercise takes about 2 minutes.  Do it 3 times a day when you are not triggered.

You also need to practice relaxing all of your muscles as quickly as possible.  I call this Total Instant Relaxation or Rag Doll.  A rag doll has no muscle tension.  It is completely and totally relaxed.  This is what you are to do.  Follow the following script to do this exercise.

Rag Doll exercise:  Ready, relax.  Let all the relax all of your muscles.  Let the tension flow out.  As you breathe in, keep your muscles relaxes.  As you breathe out, let your muscles relax more deeply.  (You are done.)  Do this exercise 5 times a day when you are not triggered.

It is good for you to relax when you are going into a situation where you may be triggered and to relax immediately after you are triggered.  This can reduce the severity of triggers and shorten your reaction to a trigger, but it will not change your misophonia reflex.

To change your misophonia reflex, you need to relax before a trigger and then continue to relax through and after the trigger.  This sets up a Lizard Brain learning event, so reflex of misophonia can gradually decrease.  If you are great at relaxing the muscle of your Initial Physical Reflex (IPR), then the misophonic response can decay quickly, in as little as 20 to 30 minutes.

Some people have an IPR that is holding their breath.  So it is good that you breathe slowly and continuously when relaxing your muscles.  It is generally better if you breathe out slower than you breathe in. This activates your parasympathetic nervous system, which is your “rest and digest” response.

This level of muscle relaxation training and practice is a primary component of our enhanced treatment protocol, which is proving to be very effective for most people.  See

This takes time, but you will be very pleasantly surprised at how much this helps.

This first video will teach you what you need to know about Progressive Muscle Relaxation.


Here is part of an interview where Virginia talks about her experience with PMR.



At first, you should practice PMR 3 times a day.  Use one the first and second guided audio files for 3 times every day for the first 4 weeks.  You need to do PMR EVERY DAY!!!  You want your misophonia to get better, then you need to do your daily homework.

Guided Audios for Progressive Muscle Relaxation

Most thorough guided audio:  PMR by Dartmouth College  (24:50)

PMR by Arizona State University, no ssss (15:16)


 Expert Version (timed audio), after you have learned PMR, by Tom Dozier (12:38)


Short Expert Version (minimum talking, minimum times), after you are have learned PMR, by Tom Dozier (9:46)


This is the same as above, but with wind chimes (8:26)


This audio is timing only.  3-chimes for breathing, short high-pitch chime to tighten, short chime to relax.   30 seconds for breathing at start, 10 seconds to tighten each muscle group, 20 seconds to relax.  (10:35)

This audio is timing only.  3-chimes for breathing, short high-pitch chime to tighten, short chime to relax.   30 seconds for breathing at start, 7 seconds to tighten each muscle group, 15 seconds to relax.  (8:10)


This audio is timing only.  Same as above, but with wind chimes (7:35)

Click here to download the audio files from Google Drive.

Here are some scripts for Progressive Muscle Relaxation…/services/document.php/183466.pdf…/resources/AppendicesCC.pdf

Here is an edited transcript of the video

Video Transcript: Misophonia Treatment with Progressive Muscle Relaxation

PMR2 [NOTE:  PMR2 means slide 2 of the PowerPoint for this video.  The PowerPoint file is not available to you at this time.]

Hello, I’m Tom Dozier and this video is Misophonia treatment with PMR. PMR stands for Progressive Muscle Relaxation, and it was developed in the early 1920s by an American physician named Edmund Jacobson to help patients with stress and anxiety.  In the UK, it is known as Differential Muscle Relaxation.  There’s the phrase, “I feel very tense.” The work “tense” relates to the muscle tension, and we do have muscle tension when we feel tense. Originally PMR was a series of tightening and relaxing 200 different muscle groups in the body. But since that time we found that we get the same benefit by working only 15 to 20 muscle groups. PMR is just one way of obtaining a state of deep relaxation. I want to give credit to the source of this information, it’s from The Anxiety and Phobia Workbook by Edmund Bourne.


If we look at what it means to have a physiological state of deep relaxation versus stress or panic, this is what you will find physically or physiologically.  You will have a decrease in your heart rate, in your respiration rate, in your breathing, your blood pressure, tension in your skeletal muscles, your metabolic rate or your oxygen consumption, and you will actually have a reduction in your analytical thinking. This is not a thinking state.


There are a number of benefits from daily deep relaxation, and you get these benefits regardless of how you do the deep relaxation. Here are some of the benefits that you will get with daily progressive muscle relaxation. You get reduced generalized anxiety. It prevents the accumulation of stress. You get increased energy and productivity. You get improved concentration and memory. It reduces your fatigue and insomnia – you sleep better. It reduces psychosomatic disorders such as high blood pressure, migraines, headaches, asthma, and ulcers. And you have increased self-confidence, reduced self-blame, and increased awareness of your feelings. And the reason you have an increased awareness of your feelings is that we take our feelings from our body in a number of ways. And if your muscles are always tense then you’re losing some of the input for feelings such as feeling calm, relaxed, happy, or tense which have different states of muscle tension. So you have increased awareness of your feeling. These benefits occur from any type of daily deep relaxation.


Specifically for Progressive Muscle Relaxation and Misophonia, which is why you’re listening to this, is that with Progressive Muscle Relaxation you’re going to have an improvement in your overall sense of well-being. And anytime you have an increased level of wellness it will reduce your Misophonia symptoms. But that’s just one benefit for misophonia.  That’s not the primary reason for using Progressive Muscle Relaxation. The other benefit that you get from Progressive Muscle Relaxation specifically is it gives you the ability to relax your muscles on demand. We find that anger has a physiological component to it of tense muscles. And so if I’m angry (mentally), but my muscles are relaxed, it plays a trick on your brain. Those are inconsistent events. Tight muscles go with anger; relaxed muscles go with calm. So by just willfully relaxing your muscles after a trigger, you can drastically reduce the anger that comes from a misophonia trigger.

The other thing that you find is that you can relax your muscles before a trigger. If you know you’re in a situation where you’re going to be triggered, you can relax your muscles before the trigger and that will actually make the trigger less powerful.  It will reduce your physical reflex to the trigger.  If your initial physical reflex, (which I talked about that in another video) is a skeletal muscle contraction, then relaxing before the trigger will make that physical trigger reflex less severe.  It will actually help change your little lizard brain and progressively reduce your Misophonic symptoms – your trigger response. Also, if you want to use the Trigger Tamer, you will have much faster results if you can relax your muscles during the trigger taming process.  That will speed up the process of repatterning (rewiring) your lizard brain.


Here are some guidelines for Progressive Muscle Relaxation. First it’s best to do it twice a day if you can morning and night, especially for the first week to 10 days.  Once a day is sufficient, but it will take longer for you to get see the benefit of PMR. You need a quiet location with no distractions and 20 to 30 minutes to do Progressive Muscle Relaxation. To start it’s going to take at least 20 minutes. Once you are proficient, you can complete the exercise in 10 minutes. It is best if you do it at a regular time, and on an empty stomach. You need to find a comfortable body position using a sofa, a bed, a recliner, or lay on the floor.  You don’t want any tight clothing so loosen any tight clothing.   This is a time that you do not want to worry or think about anything else. You really want to have a more passive, detached attitude of just being there and letting it happen. You have to do the work, but you be unemotionally involved.  You want to be more of an observer than concerned or thoughtful about the exercise.  Observing the way your muscles feel is an important part of PMR.


To do a PMR session, you simply follow a guided audio.  You start with a few deep breaths.  Then you tense a muscle group for 7 to 10 seconds.  You hold it tight.  You don’t want to strain, but you want to hold it really tight. You concentrate on the muscle.  You feel and visualize the tension.  Then you abruptly relax that muscle. You keep it relax it for 15 to 20 seconds, and you feel the limpness.  You feel the lack of tension.  You note the difference between tense and relaxed. And then you repeat that for each muscle group in your body that you’re going to use for this exercise.

(PMR8 and PMR9 not included in video)


Remember there are many general benefits from Progressive Muscle Relaxation, but Progressive Muscle Relaxation is a powerful treatment for Misophonia, and that’s why you’re going to be doing it. The main benefit for Misophonia is that it lets you relax your muscles on demand.  You can only do this after you have developed the skill of relaxing your muscles.  It takes 14 days to learn the skill of relaxing your muscles, and even then, you will get better with practice.  Instead of PMR (Progressive Muscle Relaxation), maybe you should think of it as MRP (Muscle Relaxation Practice).  That is what you are doing each day, PRACTICING relaxing your muscles. You are making the neuron connections in the brain so that when you say relax you can you can relax actually relax your muscles. The ability to do this doesn’t happen, it’s a skill.  It is not a concept. So you have to plan on doing MRP for 14 times at least to make sure that you have started to develop the actual skill.  Then when you’re triggered you want to just relax.

Remember it also improves your overall general well-being, and that reduces the impact and the severity of your Misophonia.  Another great benefit is that once you’ve learned this technique, you can also use it when you know you’re going to be triggered.  This is especially beneficial of you have an initial physical Misophonia reflex that is a skeletal muscle.  If you relax those muscles before being triggered, then it will help to change your little lizard brain and reduce your misophonia.  There is at least one case of a person who eliminated his misophonia this way.

Here is your homework assignment. Go to and look up the Progressive Muscle Relaxation guided audios. There’s one there that is 25 minutes long. It’s from Dartmouth University, and I suggest that you start that one at least one time.  There is another one by Arizona State University that is 15 minutes long, and you should try that at least once.  Use one of these guided audios for the first week, because they emphasize the mental thoughts of focusing on the tightness, focusing on the relaxation that is critical to develop the neuron connections so you can relax your muscles on demand.  If you are triggered by the voice on the audio, you can use the script for PMR that is on the same web page and one of the bottom audio files.  These only have timing chimes – no words.  If you want to use one of the shorter audio files once you know what you are doing, go ahead. Practice muscle relaxation twice a day if you really want to see the improvement quickly.

Thank you for watching this video on Misophonia Treatment with PMR, Progressive Muscle Relaxation. I hope you’ve found it useful, but you will really not know how useful it is until you go try it and do it for 14 days. If you would support us in the Misophonia Treatment Institute we would greatly appreciate it. We will use those moneys for education, Misophonia awareness, research and development of treatment. So thank you very much.