Guided Imagery

Guided imagery is the conscious use of the imagination to create positive images ("healing visualizations") in order to bring about healthful changes in both the body and the mind. Creating mental images is nothing new for most people. Everyone has daydreams, perhaps of a set of new clothes or of winning the lottery. Guided imagery takes this natural process a step further. By working with a trained therapist, or using special audiotapes, you can learn to communicate more effectively with your unconscious mind, requesting that your body function in an optimal and healthy way.


The belief that the power of imagination can help people heal has ancient roots. Traditional folk healers known as shamans used guided imagery to treat ailments. In Eastern medicine, envisioning well-being has always been an important part of the therapeutic process. In Tibetan medicine in particular, creating a mental image of the healing god would improve the patient's chances for recovery. The ancient Greeks, including Aristotle and Hippocrates ("father of modern medicine") also had their patients use forms of imagery to help them heal.


It was not until the 1960s, however, that psychologists exploring the emerging field of biofeedback first began to appreciate the powers of the mind on the physical body. Through biofeedback, they could teach patients to slow heart rate, lower blood pressure, or open lungs stricken with asthma. Then, in the 1970s, O. Carl Simonton, M.D., chief of Radiation Therapy at Travis Air Force base in Fairfield, California, and psychotherapist Stephanie Matthews-Simonson, devised a program–today known as the Simonton method–that utilized guided imagery to help his cancer patients. The patients pictured their white blood cells attacking their cancer cells (sometimes in scenes that resembled the popular video game "Pac-Man"). Simonton found that the more vivid the images his patients used (for example, ravenous sharks attacking feeble little fish), the better the process worked.


Since then, a good deal of research into mind-body connections has appeared in mainstream medical literature. And while many conventional physicians remain skeptical that the mind has an actual physical effect on the reversal of an illness, guided imagery (often conducted by psychiatrists or psychologists) is now used in many medical inpatient and outpatient programs throughout the world. Furthermore, many holistically oriented psychologists and other counselors routinely employ guided imagery for stress reduction, smoking cessation, weight reduction, immune stimulation, and the relief of both physical and emotional illness.


How Does Guided Imagery Work?


Practitioners say that guided imagery works because, in terms of brain activity, picturing something and actually experiencing it are equivalent. Brain scans have verified that this is the case. Stimulating the brain with imagery can have a direct effect on the nervous and endocrine systems and can ultimately affect the immune system as well. If you picture yourself luxuriating at the beach on a tropical island, your muscles will actually relax and your skin will feel the warmth of the sun's rays. Likewise, if you imagine yourself recuperating quickly and effortlessly from gallbladder surgery, you are more likely to heal faster and with less pain.


The brain's visual cortex, which processes images, has a powerful connection with the autonomic nervous system, which controls involuntary activities such as pulse, breathing, and physical responses to stress. Soothing, uplifting images can actually slow your pulse and breathing and lower your blood pressure, as well as help trigger the release of hormones such as endorphins, which make you feel good and nurture your body's restorative powers.


Health Benefits of Guided Imagery?


While there is no scientific evidence indicating that guided imagery by itself helps to heal disease, this technique has been shown to promote relaxation and to improve quality of life. It is especially useful for conditions that are made worse by stress, such as high blood pressure, pain, and headache, as well as stress and anxiety themselves. It may also help certain eating disorders.


In a 1997 study at the University of Miami, researchers found that guided imagery helped elevate mood and decrease stress. The participants rated their moods before and after practicing guided imagery and had their blood levels of the stress hormone cortisol measured. The subjects who used guided imagery reported a significant decrease in depression, fatigue, and total mood disturbance, and measured significant decreases in cortisol, as compared to the control group.


Imagery has been successfully tested as a strategy for relieving nausea and vomiting associated with chemotherapy in cancer patients, and it has also been found to relieve stress and promote weight gain in those with cancer. Patients using the Simonton method (see "What Is It," above) have successfully used guided imagery as an adjunct therapy to conventional cancer treatments to mobilize their immune systems.


Other studies have shown that guided imagery is particularly helpful for patients preparing for and recovering from surgery. A 1996 study at the Cleveland Clinic showed that patients who used guided imagery prior to colorectal surgery had less anxiety before and less pain after the surgery than did the control group. The members of the guided imagery group used 37% less pain medication, regained their bowel function sooner, and were released from the hospital an average of a day and a half earlier. Blue Shield of California has even begun to distribute guided imagery recordings to its members scheduled for major surgery in the hope that the practice will decrease surgical complications and the pain and anxiety associated with surgery.


Actors, athletes, and public speakers also use guided imagery to prepare for important events. They say that picturing themselves performing at top form helps them do their best in reality.


What Can I Expect From Guided Imagery?


Although you can learn guided imagery techniques on your own from books, it is best to work with a practitioner or purchase an audiotape dealing with the issue important to you. If you're a creative individual, you can write your own guided imagery script, read it onto a tape, and then use the tape as your guiding tool. If you work with a practitioner, it will probably take only a couple of sessions to learn a technique that works well for you. The sessions may be as short as 30 minutes or as long as 90 minutes. It will speed the process considerably if your practitioner allows you to tape the session for home use.


During the first session, the practitioner (who may be a psychiatrist, psychotherapist, or psychologist) will take your medical history and ask you why you want to use guided imagery. The practitioner will probably ask you questions about your favorite vacation spots and times of year, and about experiences that have made you feel confident and secure. Your answers will help you and the practitioner develop images that make you feel good.


Next, the practitioner will ask you to lie on a couch or sit in a chair. You will want to wear comfortable clothing and may want to take off your shoes.


Once you're settled in, the practitioner will lead you through a breathing exercise or relaxation technique. Then, the practitioner will guide you through a visualization exercise, using all five senses and perhaps focusing on a special place where you usually feel happy and peaceful. The practitioner may suggest some ideas, but will leave most of the imagining up to you. The best images are the ones you conjure up yourself because they have personal meaning for you.


With practice, you will be able to bring up healing images quickly–anytime, anywhere. You'll be able to use guided imagery to help yourself relax during stressful moments, as well as to treat a particular health problem.


Cautions about Guided Imagery


Guided imagery generally is a safe and enjoyable experience for everyone, from children to the elderly. However, people who suffer from some form of mental illness, particularly people who are prone to hallucinations, should discuss the process in advance with a trained therapist. If you ever experience disturbing images or memories during a session, you may also wish to discuss the experience with a trained therapist.


Choose images that are pleasant to you. If you know in advance that an image may be disturbing, let your practitioner know. If you're participating in a group session, feel free to sit out the exercise.


Choosing a Guided Imagery Practitioner


There is no certification or licensing for practitioners of guided imagery, although many professionals who practice it are licensed in other areas of health care, such as psychiatry and psychology. Many psychotherapists, nurses, physical therapists, and hypnotists also offer guided imagery training. The best way to find a reputable practitioner is to seek referrals from your primary-care physician and friends you trust. Ask for references and check them. Be sure you feel comfortable with a practitioner's style before you begin to work together.


If you'd rather learn guided imagery on your own, look for a class at a local hospital, wellness center, or community center. Guided imagery tapes that help visualization are also widely available.

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