Written by Helen Cooke and the CAM-Cancer Consortium.
Updated February 8, 2017

Autogenic therapy

Abstract and key points

  • Autogenic therapy refers to a particular technique of mental exercises involving relaxation and autosuggestion, which aims to teach individuals to switch off the fight/flight/fight stress response at will.
  • Based on three controlled and one uncontrolled clinical trial, it is not possible to draw conclusions about the effectiveness of autogenic therapy for people with cancer.
  • Autogenic therapy has a good safety record.

Autogenic therapy refers to a particular technique of mental exercises involving relaxation and autosuggestion, which aims to teach individuals to switch off the fight/flight/fight stress response at will.

Reduced state anxiety, pain, depressed mood symptoms, improved sleep parameters, improved immune function and generic quality of life have been reported in patients who participated in autogenic therapy following cancer treatment. Due to the low number of published trials (three controlled and one uncontrolled clinical trial), it is, however, not possible to draw conclusions about the effectiveness of autogenic therapy for people with cancer.

It is not possible to test the efficacy of autogenic training, due to the difficulty in creating appropriate and credible placebo conditions.

Autogenic therapy has a good safety record.

What is it ?

Autogenic therapy refers to a particular technique of mental exercises involving relaxation and autosuggestion, which aims to teach individuals to switch off the fight/flight/fight stress response at will. The term “autogenic” means generated from within. Having been taught the method, the patient is encouraged to carry out the exercises regularly as a form of self-help.1,2

Application and dosage

Autogenic therapy in its standard form involves a series of six mental exercises. The mental exercises involve the patient focusing on (a) heaviness of the limbs, (b) warmth of the limbs, (c) regularity of the heartbeat, (d) ease of breathing, (e) warmth of the abdomen, and (f) cooling of the forehead.3

Autogenic therapy is taught over a series of eight to ten weekly sessions which last approximately sixty minutes for individual sessions and up to two hours for small group sessions. People are encouraged to practice the exercises for about 10 minutes three times a day, until they have mastered the technique and can practice when needed.

The technique is taught in a quiet, comfortable setting. Participants are invited to sit or recline in a relaxed position. Once taught, it has been suggested that the exercises can be used anywhere in everyday situations which might induce stress.4

History/provider(s)

Autogenic therapy dates back to the 1930s and is a form of self-hypnosis. Johannes Schultz, a German psychiatrist and neurologist, developed autogenic therapy after having observed that some patients were able to learn to put themselves in a hypnotic state by concentrating on images of heaviness and warmth and reciting a series of phrases. He believed that their state of mental health benefited from going into such a self-generated trance-like ‘autogenic’ state.

Schultz’s work was further developed by Wolfgang Luthe (also German) who introduced additional elements, including organ-specific techniques and ‘intentional exercises’, which are supposed to affect the person’s emotional level. These latter elements are not generally included in standard autogenic training.5 Autogenic therapy is provided by autogenic therapists who have undergone training with the Autogenic Society.

Claims of efficacy/mechanism of action/alleged indication(s)

Possible mechanisms of action include cognitive, by means of its attention-focusing phrases and physiological, by means of a reduction in physiological arousal5.It has been proposed that autogenic therapy may be beneficial for people who have been diagnosed with cancer by helping them to reduce their level of stress and pain, and by assisting them to confront any fears arising from after cancer diagnosis.6

It has been claimed that autogenic therapy can be beneficial for a wide range of disorders such as high blood pressure, asthma, colitis, migraines, acute anxiety and sleep disturbances associated with stress.5

Prevalence of use

A population-based study of 4 000 cancer survivors who were followed up 10 to 24 months after their diagnosis, found that 43 percent used some form of relaxation therapy.7 No prevalence data specifically for autogenic therapy are available.

Legal issues

The British Autogenic Society4is the professional, regulatory organisation in the UK. It offers a post graduate certificate which allows people to teach autogenic training to others. There is no information available regarding the legal issues of autogenic therapy from a European perspective

Cost(s) and expenditures

Autogenic therapy is usually taught over a ten to twelve week period. The cost of sessions in the UK varies from between £30 and £60.

Does it work ?

Although the trials below indicate a reduction in state anxiety, pain, depressed mood symptoms, improved sleep parameters, improved immune function and generic quality of life in cancer patients who participated in autogenic therapy, these studies have not been reproduced and have considerable methodological limitations.

Due to the difficulty in creating appropriate and credible placebo conditions that are not obvious to research participants, double-blind studies can not be carried out for this intervention.

Controlled clinical trials

Three controlled and one uncontrolled clinical trial considered the effectiveness of autogenic therapy for cancer patients5,8,9.

A randomised trial examining the effects of a multi-modal psychological sleep management programme for people with a variety of different cancers (n=229), found that Progressive Muscular Relaxation (n=80) and autogenic therapy (n=71) were equally effective in enhancing various sleep parameters and reducing the need for sleep medication8. The control group (n=78), which received only the standard rehabilitation programme, reported no changes in the use of sleep medication. Patients in all groups improved on all scales of the quality-of-life EORTC-QLQ-30 questionnaire, with the exception of pain which started at a low level and did not alter significantly. Limitations of this study include lack of a non-treatment control group.

A small randomised study (n=14) investigated the effects of autogenic therapy on salivary immunoglobulin A (sIgA) in surgical patients with breast cancer11. The participants were instructed to conduct autogenic therapy by themselves three times a day for seven days following surgery. SIgA levels were significantly higher in the intervention group than the control (usual care) group which suggests autogenic therapy may improve immune function in breast surgery patients. Limitations include a small sample size. The authors note that surgery affects physiological function including sIgA. This may affect the reliability of the results.

A pilot randomised study (n=31) assessed the effects of autogenic therapy on the psychological status and immune system responses over a two month period in women with early stage breast cancer who had undergone a lumpectomy5. Women receiving autogenic therapy in addition to home visit showed a statistically significant improvement in the Hospital Anxiety and Depression Scale (HADS) score (inter-group difference: anxiety p=0.0027, depression p=0.0001) compared to those receiving only a home visit. Limitations of this study include the small sample size and subjective evaluation of the participants’ meditative state. 

Uncontrolled clinical trials

An uncontrolled pilot study (n=30) assessing the benefits of a ten week course in autogenic therapy (n=30) concluded that participants experienced significantly reduced levels of anxiety and improved sleep patterns. The participants had a variety of different cancers, but were predominantly women with breast cancer9. This study was limited not only by the small sample size, but also the lack of a control group.

Is it safe ?

Adverse events

There are no known adverse effects.10 No adverse events were reported in the studies analysed for this summary.

Contraindications

It is suggested that autogenic therapy is not suitable for children under the age of five.2 People who are actively psychotic or with schizophrenia should refrain from putting themselves into trans-like states.10

Interactions

No known interactions.

Warnings

See contraindications.

Citation

Helen Cooke, CAM-Cancer Consortium. Autogenic therapy [online document]. http://cam-cancer.org/The-Summaries/Mind-body-interventions/Autogenic-therapy. February 8, 2017.

Document history

Assessed as up to date in February 2017 by Barbara Wider.
Updated and revised in May 2015 by Helen Cooke.
Assessed as up to date in August 2013 by Barbara Wider.
Revised in June 2012 by Helen Cooke, no new clinical trials identified.
Summary first published in August 2011, authored by Helen Cooke.

References

  1. Ernst E, Kanji N. Autogenic training for stress and anxiety: A systematic review. Complement Ther Med 2000; 8(2): 106-110.
  2. Payne, R and Donaghy, M. Fourth Edition. Payne’s Handbook of Relaxation Techniques: a practical guide for the health care professional. London: Churchill Livingstone, Elsevier, 2010.
  3. Hudacek KD. A review of the effects of hypnosis on the immune system in breast cancer patients: a brief communication. Int J Clin Exp Hypn 2007; 55(4):411-25.
  4. British Autogenic Society website. www.autogenic-therapy.org.uk [accessed 8th February 2017].
  5. Hidderley M, Holt M. A pilot randomized trial assessing the effects of autogenic training in early stage cancer patients in relation to psychological status and immune system responses. Eur J Oncol Nurs 2004; 8(1): 61-5.
  6. Kanji N. Management of pain through autogenic training. Complement Ther Nurs Midwifery 2000; 6(3): 143-8.
  7. Gansler T, Kaw C, Crammer C, Smith T. A population-based study of prevalence of complementary methods use by cancer survivors: a report from the American Cancer Society's studies of cancer survivors. Cancer 2008; 113(5): 1048-57.
  8. Simeit R, Deck R and Conta-Marx B. Sleep management training for cancer patients with insomnia. Supp Care Cancer 2004; (3): 176-83.
  9. Wright S, Courtney, U, Crowther, D A quantitative and qualitative pilot study for the perceived benefits of autogenic training for a group of people with cancer. Eur J Cancer Care 2002; 11(2): 122-130.
  10. Ernst E, Pittler M, Wider B and Boddy K. Oxford Handbook of Complementary Medicine. Oxford: Oxford University Press, 2008.
  11. Minowa C, Koitabashi K. The effect of autogenic training on salivary immunoglobulin A in surgical patients with breast cancer: a randomized pilot trial. Complement Ther Clin Pract 2014; 20(4): 193-6.