Autogenic training is a self-relaxation technique developed by Germanpsychiatrist Johannes Heinrich Schultz in the 1920s and first published in 1932, involving the repetition of specific verbal formulas to induce sensations of bodily warmth and heaviness, thereby promoting deep physical and mental relaxation as a form of autosuggestion.[1][2][3]The method consists of six standard exercises, typically learned under professional guidance through individual or group sessions lasting 15–20 minutes, where practitioners sit or lie comfortably, close their eyes, and silently repeat phrases focusing sequentially on musculoskeletal heaviness, circulatory warmth in the limbs, calm heartbeat, regulated breathing, abdominal relaxation, and forehead coolness to activate the parasympathetic nervous system and counteract stress responses.[1][2] Regular practice, recommended for 20–30 minutes twice weekly over 4–6 weeks, builds proficiency and enhances the technique's efficacy without requiring external aids.[2]Autogenic training is applied in clinical settings to manage conditions such as anxiety, depression, chronic pain, migraines, insomnia, irritable bowel syndrome, and hypertension, with emerging evidence suggesting benefits for mental disorders including mild to moderate depression and high anxiety levels; as of 2025, studies continue to support its use for reducing depression and anxiety symptoms in elderly populations.[1][2][4] It is generally safe with minimal side effects, though it may not be suitable for individuals with psychotic disorders like schizophrenia, and its non-invasive nature makes it accessible for stress reduction in both medical and non-medical contexts.[2]Scientific support includes meta-analyses of over 60 studies demonstrating significant reductions in tension headaches, migraines, and blood pressure, as well as improved heart rate variability and stress management; a 2008 review of randomized controlled trials further confirmed its effectiveness in alleviating anxiety symptoms.[1][5] A 2023 systematic review highlighted its potential in treating mental disorders, underscoring the need for more large-scale trials to refine applications.[6]
Historical Development
Origins and Invention
Autogenic training was developed by German psychiatrist Johannes Heinrich Schultz during the 1920s as a method for achieving deep relaxation through self-suggestion.[1] Schultz, who had trained under neurologist Oscar Vogt at a clinic specializing in hypnosis and sleep research, drew inspiration from hypnotic suggestion therapy.[7] He observed that patients under hypnosis frequently reported physical sensations of heaviness and warmth in their limbs, which correlated with profound states of relaxation and reduced tension.[8]These clinical observations led Schultz to experiment with verbal suggestions to induce similar sensations without the presence of a hypnotist, aiming to empower patients to self-regulate their physiological responses.[7] In 1926, he presented his preliminary findings on this approach to the Medical Society in Berlin, highlighting its potential for treating conditions involving autonomic nervous system dysregulation.[8] Schultz formalized the technique as a form of autosuggestion, where individuals repeat specific phrases to evoke relaxation states that mimic those of hypnosis, thereby fostering a passive concentration on bodily perceptions.[1]The method was first systematically described in Schultz's 1932 book, Das Autogene Training (Autogenic Training), which outlined its theoretical foundations and practical application for self-induced therapeutic relaxation.[7] This publication marked the invention of autogenic training as a distinct psychotherapeutic tool, emphasizing its accessibility and independence from external intervention.[8] During the Nazi era, from 1936 to 1945, Schultz served as assistant director of the German Institute for Psychological Research and Psychotherapy in Berlin, where he integrated his work with Nazi ideologies, advocating for compulsory sterilization and the "annihilation of life unworthy of life," and conducting unethical research involving the abuse of homosexuals as subjects.[9] After World War II, Schultz continued his career in psychotherapy, teaching at the Charité hospital in Berlin until his death in 1970.
Evolution and Global Adoption
Following its initial formulation, Johannes Heinrich Schultz and Wolfgang Luthe expanded autogenic training in the 1950s through refinements that standardized the core methodology, including the six standard exercises originally developed by Schultz in the 1930s focusing on sensations of heaviness, warmth, heartbeat regulation, breathing, abdominal warmth, and forehead coolness.[1] These updates built on earlier work to enhance its applicability in clinical settings, emphasizing self-induced physiological shifts for broader therapeutic use. Schultz collaborated closely with Wolfgang Luthe during this period, culminating in the 1959 publication of Autogenic Training: A Psychophysiologic Approach in Psychotherapy, the first English-language text on the technique.[10]In the 1960s, Luthe, a German-born physician who had immigrated to Canada in 1945, further systematized autogenic training for psychotherapeutic applications, introducing concepts such as autogenic discharges—spontaneous emotional or physiological releases during practice—and integrating it into treatments for conditions like hypertension and anxiety.[10] He co-authored a seminal six-volume series, Autogenic Therapy (1969–1973), with Schultz, which detailed advanced techniques and empirical observations, solidifying its foundation in psychosomatic medicine.[10] Luthe also founded the International Committee for Autogenic Training and Therapy (ICAT) to promote standardized training worldwide.[10]Post-World War II, autogenic training gained traction across Europe, particularly in Germany where Schultz continued teaching at the University of Berlin until the 1960s, and in France, where it was incorporated into psychiatric and psychosomatic practices by the 1970s, as evidenced by instructional materials from Strasbourg-based clinicians.[11] Its spread was facilitated by the era's emphasis on psychosomatic approaches in rebuilding healthcare systems. In North America, Luthe popularized the technique in the 1960s through workshops and publications, introducing it to English-speaking audiences via his Canadian base and collaborations.[10] By the 1970s, it had reached Japan, where Luthe taught at institutions like Kyushu University and the Oskar Vogt Institute, leading to its integration into medical curricula and adaptations for cultural contexts, such as emphasizing group practice in psychosomatic medicine programs.[10][12]In the 2000s, autogenic training saw modern updates through digital formats, with online programs and guided audio resources emerging to support self-practice, enhancing accessibility beyond traditional instructor-led sessions.[8] These adaptations, including web-based tutorials and early mobile applications, reflected broader trends in telehealth and self-help therapies while preserving the core self-suggestion principles.
Core Principles and Technique
Fundamental Exercises
Autogenic training's fundamental exercises consist of six standard autosuggestions designed to induce specific sensations of relaxation in the body, as developed by Johannes Heinrich Schultz in his original method published in 1932.[1] These exercises focus progressively on different physiological areas, starting from the limbs and moving inward, to promote a state of passive concentration and bodily awareness.[13]Practitioners begin in a semi-reclined posture, such as sitting with the back supported or lying down, to minimize muscle tension and facilitate relaxation; a quiet environment free from distractions is essential to maintain focus.[1] Sessions typically last 10-15 minutes and are conducted with eyes closed, allowing for undisturbed internal attention.[14]The exercises are recited silently as repetitive verbal formulas, with each phrase repeated several times (often 3-6 repetitions) while visualizing and sensing the intended bodily state; the process builds cumulatively, incorporating prior formulas before introducing the new one.[1] The six exercises are:
Heaviness in the limbs: Focus on inducing a sensation of weight and stillness in the extremities, using phrases such as "My right arm is heavy," "My left arm is heavy," "Both my arms are heavy," "My right leg is heavy," "My left leg is heavy," and "Both my legs are heavy."[1][3]
Warmth in the limbs: Build on the heaviness sensation by evoking a feeling of gentle heat, with phrases like "My right arm is warm," "My left arm is warm," "Both my arms are warm," "My right leg is warm," "My left leg is warm," and "Both my legs are warm."[1][13]
Heart awareness: Direct attention to the cardiac rhythm for calmness, incorporating prior limb formulas and adding "My heartbeat is calm and regular."[1][14]
Breathing regulation: Shift focus to effortless respiration, using phrases that include previous elements plus "My breathing is calm and deep."[1][3]
Abdominal warmth: Promote relaxation in the solar plexus area, adding "My solar plexus is warm" to the cumulative sequence.[1][13]
Forehead coolness: Conclude with a sensation of clarity in the head, incorporating all prior phrases and ending with "My forehead is cool and clear."[1][14]
To conclude the practice, a brief post-exercise formula of intentional forgetting is used, such as passively releasing focus on the sensations and allowing the mind to drift toward normal awareness without abrupt movement.[1] This helps transition smoothly out of the relaxed state.
Training Process and Progression
Autogenic training typically progresses through distinct phases, beginning with foundational skills and advancing to more integrative practices, with the entire basic level often requiring 3-6 weeks of consistent effort.[1][15] In the initial phase, practitioners focus on mastering the standard exercises one at a time, starting with sensations of heaviness in the limbs, followed sequentially by warmth, cardiac awareness, respiratory regulation, solar plexus warmth, and forehead coolness. This sequential approach, practiced 2-3 times daily for 10-15 minutes per session, allows for gradual internalization of each formula before combining them, helping to build passive concentration and reduce initial resistance such as muscle tension or wandering thoughts.[1][16]During the intermediate phase, which builds directly on the basic exercises, practitioners combine all standard formulas into full sessions and introduce intentional formulas tailored to specific goals, such as "My arm is warm and pain-free" for relief from discomfort. This stage emphasizes applying the relaxation state to targeted physiological or psychological needs, with sessions extending to 15-20 minutes and practiced multiple times daily to reinforce efficacy. Self-monitoring plays a key role throughout, involving journaling of bodily sensations, emotional responses, and any challenges like initial skepticism or somatic distractions, which are reviewed to refine technique and ensure safe progression.[16][17]The advanced phase, often reached after 6-12 months of regular practice, incorporates autogenic meditation for deeper visualization and autogenic abreaction to facilitate emotional release through symbolic imagery or subconscious processing. Here, sessions may involve open-ended explorations like evoking calming scenes or allowing spontaneous abreactions, always under careful self-observation to manage intensity. Guidance is particularly vital for beginners, with therapist-led sessions—typically weekly for the first 6-8 weeks—providing instruction, feedback, and troubleshooting, after which practitioners transition to independent self-practice while optionally consulting professionals for advanced elements.[16][18][1]
Physiological and Psychological Mechanisms
Biological Underpinnings
Autogenic training induces physiological changes primarily through the activation of the parasympathetic nervous system, which counteracts sympathetic arousal and leads to measurable reductions in heart rate and blood pressure. Studies have demonstrated that practicing autogenic training increases heart rate variability (HRV), a marker of enhanced parasympathetic activity, while facilitating vagal control of the heart to promote autonomic balance. This shift enhances vagal tone, contributing to greater stress resilience by restoring equilibrium between the sympathetic and parasympathetic branches of the autonomic nervous system.[19]Neurobiological evidence from electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) supports the technique's impact on brain activity, including increased alpha wave amplitude, indicative of relaxed wakefulness. Autogenic training alters cerebral activation patterns, particularly in regions involved in emotional regulation and interoception, such as the prefrontal cortex, showing similarities to effects observed in mindfulness practices. These changes are associated with modulated pain processing in somatic areas, as revealed by fMRI studies during autogenic sessions.[20][21]Hormonally, autogenic training promotes shifts that mitigate stress responses, with significant decreases in cortisol levels observed in practitioners compared to controls. These physiological adaptations collectively underpin the technique's role in fostering bodily homeostasis and aiding in pain modulation through relaxation-induced hypoalgesia.[22]The standard exercises include suggestions of warmth in the extremities to promote subjective sensations of relaxation and improved circulation, consistent with parasympathetic activation.[22]
Mental and Emotional Processes
Autogenic training employs autosuggestion as a core mechanism, wherein practitioners internally repeat standardized verbal formulas to direct focused attention toward specific bodily sensations, such as heaviness or warmth. This process of passive concentration shifts cognitive resources away from habitual rumination on stressors, fostering a heightened state of body-mind awareness by integrating sensory perceptions with mental intent.[6][23]In terms of emotional regulation, the technique promotes a neutral observation of internal feelings, allowing individuals to adopt a detached perspective on emotional fluctuations without immediate reactivity, which diminishes the intensity of anxiety-provoking responses. This metacognitive approach encourages the passive acceptance of emotions as transient phenomena, enhancing overall affective flexibility through repeated exposure to a calm observational stance.[6][24]The repetitive nature of the autosuggestive formulas in autogenic training facilitates cognitive restructuring by reinforcing adaptive thought patterns centered on self-control over relaxation states. Practitioners gradually internalize these affirmations, cultivating a sense of self-efficacy in managing physiological and mental arousal independently, which builds confidence in one's ability to initiate and sustain tranquility amid daily demands.[6][23]Central to the practice is the induction of the autogenic state, a hypnotic-like trance achieved through sustained passive concentration, which resembles light hypnosis but remains fully self-directed without external guidance. This altered state of consciousness promotes access to subconscious processes by neutralizing disruptive intrapsychic stimuli, enabling the integration of subconscious material into conscious awareness in a non-intrusive manner.[6]Over time, consistent engagement with autogenic training yields long-term enhancements in emotional intelligence, as the cumulative practice of neutral observation and autosuggestion strengthens capacities for empathy, compassion, and interpersonal cooperativeness. These developments arise from the ongoing refinement of metacognitive skills, allowing for more nuanced navigation of emotional landscapes in social contexts.[6][24]
Health Benefits and Efficacy
Key Therapeutic Benefits
Autogenic training has demonstrated significant efficacy in reducing anxiety and stress symptoms among practitioners. A meta-analysis of 11 RCTs (from a systematic review of 21 studies) indicated large reductions in anxiety scores (SMD -1.37) for short-term interventions in healthy adults, alongside moderate decreases in associated depression symptoms (SMD -0.29) for long-term use in patients.[25] These effects are attributed to the technique's ability to elicit a relaxation response that modulates the autonomic nervous system, lowering overall psychological distress.[26]In pain management, autogenic training proves effective for conditions such as tension headaches, migraines, and chronic musculoskeletal pain. A systematic review and meta-analysis of randomized controlled trials reported a moderate effect size (Hedges' g = 0.58) on pain intensity compared to passive controls, with benefits comparable to other relaxation methods but without inducing additional muscle tension.[27] Medium effect sizes were particularly noted for tension headaches and migraines in broader clinical outcome analyses.[26]For sleep enhancement, regular practice improves insomnia onset latency and overall sleep quality without reliance on medication. Prospective cohort studies have shown reductions in time to fall asleep after night awakenings and increased feelings of refreshment upon waking, with improvements sustained over several months.[28] A comprehensive meta-analysis confirmed positive effects on functional sleep disorders across multiple trials.[26]Autogenic training aids in fatigue alleviation, boosting energy levels in scenarios like burnout or post-viral syndromes. Early clinical research indicates potential reductions in fatigue alongside other symptoms in conditions such as fibromyalgia and HIV-related exhaustion, though evidence is insufficient for strong recommendations.[14]Regarding cardiovascular support, the practice yields mild reductions in hypertension and enhancements in heart rate variability. Meta-analytic evidence highlights significant benefits for mild to moderate essential hypertension and coronary heart disease management, with increases in parasympathetic activity and heart rate variability observed in both healthy and patient populations.[26][25]
Scientific Evidence and Research
A meta-analysis by Stetter and Kupper (2002) examined 73 controlled outcome studies on autogenic training published between 1952 and 1999, revealing moderate effect sizes for reducing anxiety (Cohen's d = 0.57) and pain, with overall positive outcomes across symptoms, physiological indicators, and cognitive performance compared to controls.[29]A 2023 systematic review published in the International Journal of Environmental Research and Public Health analyzed clinical evidence for autogenic training in mental disorders, finding consistent efficacy for mild depression with effect sizes ranging from 0.4 to 0.6, alongside benefits in anxiety reduction; randomized controlled trials (RCTs) also demonstrated improvements in post-traumatic stress disorder (PTSD) symptoms, such as reduced autonomic nervous activity disturbances and psychological distress in high-risk populations like firefighters.[30]Despite these findings, many trials suffer from limitations including small sample sizes—often fewer than 50 participants—which reduce statistical power and generalizability, as well as a lack of long-term follow-up data to assess sustained effects.[27][31]Post-2020 research has advanced understanding through neuroimaging, with a 2022 fMRI study showing that regular autogenic training practice alters brain activity in response to fearful visual stimuli, correlating with reduced migraine frequency and enhanced emotional regulation via changes in the amygdala and prefrontal cortex.[32] Additionally, during the COVID-19 pandemic, electronic delivery of autogenic training via online platforms demonstrated improvements in perceived stress and anxiety among participants in Spain, highlighting its adaptability to remote formats.[33]A 2024 expanded report by the SpanishMinistry of Health reviewed evidence on autogenic training, confirming moderate efficacy for reducing anxiety, managing chronic pain, and treating mild depression, while emphasizing its high safety profile with minimal adverse events across clinical studies.[34]Current research gaps include limited exploration of 21st-century digital adaptations, such as app-based or virtual reality integrations, and insufficient studies on efficacy in non-Western populations, where cultural differences in relaxation practices may influence outcomes; larger, diverse RCTs are needed to address these areas.[33]
Clinical Applications and Limitations
Therapeutic Uses
Autogenic training serves as an adjunctive therapy for various mental health conditions, particularly in managing generalized anxiety disorder through systematic relaxation exercises that promote autonomic balance and reduce stress responses. A systematic review of controlled trials indicates that autogenic training effectively lowers anxiety levels across diverse populations, with moderate effect sizes observed in reducing both state and trait anxiety. For phobias, such as phobic postural vertigo, autogenic training has demonstrated viability as a treatment option for patients unresponsive to conventional therapies, leading to symptom alleviation through self-induced relaxation states. In cases of mild depression, autogenic training exhibits medium-range positive effects, enhancing mood and reducing depressive symptoms when integrated with standard care protocols.In physical health contexts, autogenic training provides supportive benefits for conditions like irritable bowel syndrome (IBS), where it contributes to general symptom improvement and overall well-being in affected individuals. For asthma management, particularly in chronic cases, autogenic training enhances respiratory function, with clinical improvements exceeding 15% in pretreatment values for peak expiratory flow rates among participants. Post-surgery rehabilitation also benefits from its application, as evidenced by reduced perioperative anxiety and pain in breast cancer patients undergoing surgical procedures, facilitating faster emotional and physical recovery.Athletes employ autogenic training to enhance focus and accelerate recovery, with regular practice shown to decrease competitive anxiety while boosting subjective vitality and lung capacity, thereby supporting sustained performance. In occupational settings, it aids in burnout prevention among professionals such as teachers, where pilot programs demonstrate reductions in stress perception and burnout symptoms through structured relaxation sessions. These applications leverage autogenic training's capacity for brief stress reduction, enabling better emotional regulation during high-demand periods.Pediatric adaptations of autogenic training address conditions like attention-deficit/hyperactivity disorder (ADHD) and enuresis in children, offering a non-invasive self-help technique to mitigate emotional and behavioral disturbances. Studies on mildly disturbed youth show its broadband efficacy in outpatient settings, improving overall adjustment without pharmacological intervention.[35]Autogenic training demonstrates efficacy in both group and individual formats, with no significant differences in anxiety reduction outcomes between the two approaches, allowing flexibility in delivery. Group settings particularly benefit individuals with social anxiety, fostering peer support alongside relaxation practice to enhance interpersonal comfort and symptom management.
Contraindications and Precautions
Autogenic training is contraindicated for individuals with severe psychiatric conditions, such as acute psychosis, schizophrenia, or severe dissociation, as the trance-like state induced by the technique may exacerbate symptoms or lead to destabilization.[36][37][38] In these cases, the relaxation process can potentially trigger dissociative episodes or heighten vulnerability to psychotic experiences, making professional psychiatric evaluation essential before attempting the practice.[39]For those with cardiovascular issues, precautions are necessary, particularly in cases of uncontrolled hypertension, recent cardiac events, or heart failure, where the focus on vital functions like heartbeat or circulation could induce unintended physiological shifts such as hypotension or irregular rhythms.[40][41] Practitioners should avoid self-directed exercises targeting cardiorespiratory elements without guidance from a trained therapist to prevent adverse effects, and monitoring blood pressure during initial sessions is advised for at-risk individuals.[40]During pregnancy, autogenic training is generally considered safe and may help reduce anxiety, but insufficient data exists on its specific effects, necessitating consultation with a healthcare provider for personalized adaptations to ensure no interference with prenatal care.[14][42] No harmful outcomes have been reported in studies involving pregnant participants, though modifications to exercises may be required based on individual health status.[43]Autogenic training is generally considered safe, with no side effects reported in clinical studies.[36][14]Professional oversight is crucial for beginners, especially those with a history of trauma, as the introspective nature of autogenic training may evoke overwhelming memories or emotions, increasing the risk of abreaction.[36][44] Supervised instruction from a certified therapist helps in recognizing and processing such responses safely, ensuring the technique's benefits are realized without psychological harm.[36]
Comparisons with Other Methods
Key Differences from Similar Techniques
Autogenic training (AT) distinguishes itself from other relaxation techniques through its emphasis on passive autosuggestion to evoke specific physiological sensations, such as warmth and heaviness in the body, without requiring physical exertion or external aids. This self-induced method, developed by Johannes Heinrich Schultz, relies on structured verbal formulas repeated mentally to influence the autonomic nervous system, promoting a state of deep relaxation that users can access independently after initial training.[1]In contrast to progressive muscle relaxation (PMR), which involves actively tensing and then releasing muscle groups to achieve relief from tension, AT employs a passive approach where practitioners focus solely on suggestive phrases to induce relaxation without any deliberate muscle contraction. This difference in methodology—active engagement in PMR versus passive concentration in AT—can make AT feel less physically demanding, with studies showing AT to be superior in reducing electromyographic (EMG) activity and perceived ease of use for some individuals.[1][45]Unlike mindfulness meditation, which cultivates an open, non-judgmental awareness of thoughts, emotions, and sensations as they arise, AT centers on directed bodily autosuggestion to specifically target and amplify physical relaxation responses, such as slowed breathing and abdominal calm. This focused, body-oriented technique differs from mindfulness's broader attentional practice, potentially offering a more targeted entry point for those seeking physiological control over mental wandering.[1][46]Compared to biofeedback, AT is entirely self-guided and device-free, relying on internal mental exercises to regulate autonomic functions like heart rate and circulation, whereas biofeedback uses external monitors to provide real-time physiological feedback for conscious adjustment. Both aim to enhance voluntary control over involuntary processes, but AT's independence from technology allows for greater portability and accessibility in daily practice, though combining the two has shown additive benefits in conditions like headaches.[1][47]AT also diverges from traditional hypnosis by enabling users to reach a trance-like state through independent autosuggestion, without the need for an external hypnotist to induce relaxation via verbal guidance or fixation. While both involve altered states of consciousness, AT's standardized, sequential exercises promote self-reliance, making it a form of "self-hypnosis" that emphasizes personal agency over guided induction.[1][48]One key advantage of AT lies in its highly structured progression of exercises, which provides clear guidance for beginners and facilitates quicker mastery compared to less prescriptive methods like open-monitoring meditation or unstructured self-relaxation. Additionally, by prioritizing physiological sensations through autosuggestion rather than cognitive reframing or emotional processing, AT offers a straightforward pathway to somatic calm, particularly beneficial for novices who may find abstract mental techniques overwhelming. A 2023 systematic review supports AT's role as a complementary add-on in psychotherapy for mental disorders like anxiety and depression.[49][50][6]
Integration with Complementary Practices
Autogenic training (AT) is often integrated with cognitive behavioral therapy (CBT) to address somatic symptoms in anxiety treatment, enhancing the overall therapeutic impact by promoting physiological calm before cognitive restructuring exercises. A 2023 systematic review notes AT's efficacy as an add-on to psychotherapy for better outcomes in depression and anxiety.[6]In multimodal therapy, particularly within pain clinics, AT serves as a core component alongside acupuncture, medication, or other interventions to manage chronic pain more effectively by reducing reliance on analgesics and addressing psychosomatic factors. A systematic review of randomized controlled trials found AT, when incorporated into multimodal pain programs, yielded a moderate effect size (Hedges' g = 0.58) in pain reduction compared to passive controls. One trial compared AT to auricular electroacupuncture for rheumatic pain, finding the latter more effective (Hedges' g = -0.40 for AT).[27]Evidence from clinical studies supports the efficacy of relaxation techniques like AT and mindfulness practices individually for anxiety reduction, with meditation showing greater effects than AT in some reviews. Integrative approaches in psychotherapy can include AT as a foundational self-regulation tool.[51][6]AT acts as a foundational self-regulation tool in comprehensive treatment plans, where it can complement other interventions by stabilizing autonomic responses.[6]