Abstract Various relaxation techniques have the potential to bring about promising blood pressure (BP) reductions in essential hypertension; but the treatment gains often fall to be sustained over a prolonged period of time. Until now, behavioural treatment approaches have not included efforts to increase patient awareness of situations that provoke BP elevations. In our study, numerous BP measurements were therefore taken in various situations by approximately 120 essential hypertensives. These measures were used to acquaint the patients with their own BP variability, to help them understand psychologically induced BP-variations, and to encourage them to cope with their hyper-reactivity in general and in response to specific stressful situations. Forty-eight patients were given the opportunity to learn to relax and to cope with stressful life situations. They showed promising BP reductions after treatment and at follow-up one year later. But our diagnostic findings using these methods indicate that essential hypertensives are anything but a homogeneous group. A variety of treatment approaches may therefore be required.