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From DBT Skills Training Handouts and Worksheets, Second Edition  by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan. Permis -
sion to photocopy this worksheet is granted to purchasers of this book for personal use only (see copyright page for details). Purchasers may 
download a larger version of this worksheet from www.guilford.com/dbt-  
worksheets .distress tolerance WorksHeet 4a   (Distress Tolerance Handout 6b)
paired m uscle r elaxation
Due Date:       Name:                   Week Starting:  
Practice paired m uscle r elaxation (tensing your body muscles and then letting go of tension 
completely as you breathe out). Practice as many times a day as you can at first until you notice that 
when you exhale, our body automatically relaxes on its own. At this point, you have paired breathing 
out with relaxation. Once that happens, continue practicing but not as often.
Practice paired muscle relaxation as many times a day as you can, and describe your experience 
below. Check the type of practice you did: individual muscles, muscle groups, or all of your muscles at once.
DayNumber 
of times 
practiced  
paired 
muscle 
relaxationAverage 
level of 
relaxation 
before/after 
(0–100)Number of 
times used 
skill when 
tense or 
overwhelmedAverage level 
of relaxation 
before/after 
(0–100)Check which muscles 
you tensed and 
relaxed (check more 
than one if necessary)
/ /Individual muscles
Groups
All at once