Using AT to Manage Exam Anxiety

Client: Priya, 21-year-old undergraduate student

Presenting problem: Examination stress and anxiety

Priya was a 21-year-old college student preparing for her final examinations. She experienced intense anxiety whenever exams approached. She reported symptoms such as increased heartbeat, muscle tension, difficulty sleeping, poor concentration, and repeated thoughts like “I will fail” and “I cannot handle this pressure.”

Because her physical stress reactions were affecting her academic performance, she was introduced to Autogenic Training (AT), a relaxation technique developed by Johannes Heinrich Schultz. The goal was to help her develop self-regulation skills and learn to manage her stress response.

Assessment and Preparation

Initially, Priya received psychoeducation about the interplay between psychological stress and physiological responses. She learned that anxiety often manifests as increased muscle tension, rapid breathing, and heightened cardiac activity. It was clarified that autogenic training relies on passive concentration and autosuggestion, rather than forced relaxation, to elicit a state of calm.

Priya was instructed to practice AT daily for 5–10 minutes, ideally in a quiet environment, maintaining a comfortable and relaxed sitting posture to facilitate maximum benefit.

Autogenic Training Intervention

1. Heaviness Exercise

Priya closed her eyes and repeated the phrase silently:

“My arms and legs are heavy.”

She was encouraged to focus her attention on the sensation of heaviness and bodily relaxation, which contributed to a measurable reduction in muscle tension associated with anxiety.

2. Warmth Exercise

Next, she repeated:

“My arms and legs are warm.”

She concentrated on the feelings of warmth and comfort, facilitating a transition into a physiologically calmer state.

3. Breathing Exercise

Priya practiced the suggestion:

“My breathing is calm and regular.”

She learned to observe and allow her breathing to become slow and regular, rather than attempting to control it consciously.

4. Heart Exercise

She practiced:

“My heartbeat is calm and steady.”

When Priya noticed that focusing on her heartbeat exacerbated her anxiety, she was advised to temporarily omit the heart exercise and redirect her attention to the breathing exercise until she felt more comfortable.

5. Abdominal Warmth Exercise

She repeated:

“My abdomen is warm and relaxed.”

This suggestion supported deeper physical relaxation and enhanced her sense of bodily comfort.

6. Forehead Cooling Exercise

Finally, she practiced:

“My forehead is pleasantly cool.”

This exercise promoted a sensation of mental clarity and emotional calm.

Cancellation Procedure

Upon completion of the relaxation exercises, Priya was educated on the importance of the cancellation procedure, which enables a safe and gradual return to a state of normal alertness.

She followed these steps:

• Mentally said: “My arms are firm and strong.”
• Took a few deep breaths.
• Stretched her arms and shoulders.
• Slowly opened her eyes.
• Returned to normal activities.

The cancellation procedure helped Priya avoid post-session drowsiness or dissociation, supporting a smooth transition back to daily activities.

(When she used autogenic training at bedtime for sleep, cancellation was not performed because the aim was to continue into sleep.)

Application During Exam Situations

With consistent practice, Priya developed the ability to apply an abbreviated version of AT during acute stress, such as before mock exams or in the examination environment.

When she noticed anxiety, she:

1. Put her pen down briefly.
2. Took slow breaths.
3. Repeated:
4. • “My arms and legs are heavy and warm.”
   • “My breathing is calm and regular.”
   • “I am calm and focused.”
5. Used cancellation:
6. • “Arms firm. Breathe deeply. Open eyes.”
7. Returned attention to one question at a time.

Outcome

After four weeks of consistent practice, Priya reported significant improvements in her management of anxiety symptoms. She noted decreased muscle tension, improved sleep quality, and enhanced confidence prior to examinations. She gained a new sense of agency over her stress responses through the acquisition of relaxation and self-regulation skills.

Conclusion

This case illustrates the effectiveness of autogenic training as a self-regulation intervention for anxiety management. Through passive concentration, phrase-body association, regular practice, and appropriate cancellation techniques, individuals can develop greater control over physiological and psychological stress responses.