Progressive muscle relaxation (PMR) is a technique of alternately tensing and relaxing muscles groups in sequence throughout the body. When going through muscle groups, individuals can start with the head and neck and progress to the feet, or vice versa. Similarly individuals may do one side of the body at a time, or both sides at the same time. Listening to a prerecorded script may be used to guide individuals through the process. Addition of guided imagery to PMR involves use of mental visualization and use of imagination to enhance relaxation and alter specific experiences and may or may not include direct suggestion. Individuals may use recorded scripts to guide the creation of mental images. Guided imagery can integrate techniques founded in multiple psychological theory and hypnotherapy. PMR with guided imagery has been examined for effectiveness in patients with cancer for chemotherapy-induced nausea and vomiting, anxiety, fatigue, sleep-wake disturbances, and pain.