Self-Active Relaxation Therapy (SART) and Self-Regulation: A Comprehensive Review and Comparison of the Japanese Body Movement Approach

Abstract

Relaxation programs are known for their versatility, cost-effectiveness, and ability to help people obtain skills to regulate their mental states and promote and maintain health. Self-Active Relaxation Therapy (SART) is a body-oriented approach to psychological rehabilitation that grew out of the suite of movement tasks developed in the Japanese psychotherapy known as Dohsa-hou, or the body movement method. The program for SART is designed to stretch, twist, and release areas of the upper, lower, and whole body through a set of movements which are guided by the practitioner and performed “self-actively” by the client to empower them to learn to recognize points of tension in the body and act on their own to achieve a relaxed state. Numerous studies have showed that SART is associated with reduced negative mood states and enhanced body awareness. A short version of SART has been investigated as a psychological support salon activity for the elderly, mothers raising children, special needs students, and children adapting to school. The full program has also been applied in clinical settings to address or supplement treatments for psychological and developmental conditions, and longitudinally employed in community contexts to assist residents facing long-term disaster recovery circumstances in Japan. This paper reviews the research and applications of SART as a bodymind approach by critically examining evidence and research gaps for future studies, comparing it with techniques established in the literature, and positing a self-regulatory framework for SART as a tool to become aware of bodily states, regulate mood, and manage stress through the deliberate practice of relaxation.

Referencing the body for mood state regulation: an examination of stress management using Dohsa-hou as a primary prevention program for nurses

“…Dohsahou facilitates behavioral change through the execution of body movements and associated changes in feeling states of the body from the experience of relaxation and body-mediated communication with the therapist. Similar to other contemplative and mind-body approaches that aim to enhance awareness about the self, the body, mood states, and decentering, Dohsa-hou increases awareness about the body through attention to bodily sensations and processes thought to confer motor resonance 10) . The "Dohsa process" is designed to enhance a sense of agency over the body and is described as a psychological activity that leverages intentional processes to move.…”

“…Comparably, self-regulation involves the capacity to exercise control, manage health outcomes, and facilitate adaptive behavior. Together, the theory and practice of Dohsa-hou body movements and self-regulation overlap in the domain of motor control over body movements and health-related constructs for managing bodily signals and internal states 10) .…”

Promoting Self-Regulatory Management of Chronic Pain Through Dohsa-hou: Single-Case Series of Low-Functioning Hemodialysis Patients

“…Dohsa-hou was originally developed in Japan in 1966 by Gosaku Naruse from studies on the use of hypnosis to improve motor difficulties in children with cerebral palsy (Naruse, 1973). Naruse formulated the clinical observations of change into an underlying theory for Dohsa-hou, in which a coherence between the psychological and physiological process of movement is achieved when the client intends to move a body part, strives toward that goal, and realizes the movement they intended (Naruse, 1988, 1997; Kabir et al, 2018). Similar to other contemplative and bodymind approaches that target improvements in body movements, self-consciousness, mood, and decentering, Dohsa-hou increases awareness about the body through attention to bodily sensations and processes thought to confer motor resonance (Konno and Ohno, 1987; Dadkhah, 1998; Shirouzu and Koshikawa, 2011; Chervenkova, 2017; Kabir et al, 2018).…”

“…Comparably, self-regulation involves the capacity to exercise control and guide reactions, which are abilities essential to managing health outcomes and facilitating adaptive behavior. In this manner, the theory and practice of Dohsa-hou body movements and self-regulation overlap in the domain of motor control over body movements and health-related constructs for managing bodily signals and internal states (Chervenkova, 2017; Kabir et al, 2018).…”

“…Pain elicits a response of increased muscle tension, which itself produces more pain, and contributes directly to secondary problems such as sleep disturbance and immobilization (Williams and Morley, 2018). Dohsa-hou contains some elements similar to the highly specific form of graded exposure in vivo to pain-related movements in the work by Vlaeyen et al (2012), while also incorporating some elements attributed to third wave treatments (Morley and Williams, 2015; Chervenkova, 2017; Kabir et al, 2018). Dohsa-hou might endow sufferers of chronic pain with the opportunity to experience physical self-regulation and break the pain-tension cycle to handle self-regulatory demands or improve self-regulatory deficits (Solberg Nes et al, 2009).…”