Guided imagery, or visualization, can reduce stress, relieve pain, speed healing and help the body subdue a variety of illnesses-from high blood pressure and heart disease to insomnia and depression. Also, those of us who have the ability to visualize vividly-with powerful imagery and symbols-will see the best results.
Guided imagery has proved highly effective in the management of pain, particularly the pain associated with invasive medical procedures.
The Cleveland Clinic Foundation, in Ohio, found that patients who used a guided-imagery tape before and after colorectal surgery had significantly less pain than the controls, who received standard care. They also used less post-operative pain medication (185 mg vs 326 mg, respectively) and were much less anxious about their surgical experi-ence (Dis Colon Rectum, 1997; 40: 172-8).
Studies with patients undergoing cardiac and joint-replacement surgery had similar findings (Outcomes Manag, 2002; 6: 132-7; Orthop Nurs, 2004; 23: 335-400).
Guided imagery can also control the pain of chronic conditions such as osteoarthritis, cancer and fibromyalgia (Pain Med, 2007; 8: 359-75; Cancer Nurs, 1997; 20: 79-87; J Psychiatr Res, 2002; 36: 179-87).
In fact, visualizing pleasant images reduced the pain of fibromyalgia, while the drug amitriptyline, commonly given to fibromyalgia sufferers, had no significant advantage over a placebo(J Psychiatr Res, 2002; 36: 179-87).
Visualization is widely used by patients with cancer. It improves stress, anxiety and depression as well as some of the side-effects of chemotherapy (Psycho-Oncology, 2005; 14: 607-17; Annu Rev Nurs Res, 1999; 17: 57-84).
In women who had been treated for breast cancer, those using visualization tended to have less stress, more vigour, and an improved functional and social quality of life compared with standard care or weekly support-group sessions (Altern Ther Health Med, 1997; 3: 62-70).
Some studies also suggest that imagery can directly affect the immune system. Researchers at the Oregon Health and Science University in Portland, OR, found that breast-cancer patients using hypnosis-guided imagery for eight weeks increased their natural-killer cells-immune-system cells that play a major role in tumour rejection. However, these changes were not retained after the treatment ended, suggesting that imagery needs to be practised over the long term (J Psycho-som Res, 2002; 53: 1131-7).
Another study found that guided imagery significantly increased white blood cell counts in cancer patients,
as well as in those with AIDS, viral infections and other conditions related to a low white cell count (Appl Psycho-physiol Biofeedback, 2000; 25: 117-128).
Other medical uses
Guided imagery has been used successfully in a variety of other medical settings. It can help in stroke rehabilitation (Clin Rehabil, 2001; 15: 233- 40), limit strength loss after sports injuries (J Sport Rehabil, 2003; 12: 249-
58), control asthma symptoms (J Altern Complement Med, 2005; 11: 57-68) and help people to give up smoking for good
(J Nurs Scholarsh, 2005; 37: 245-50).
How to do guided imagery
Techniques vary but, in general, they all involve guiding the imagination towards places (environments or situations) in which the patient feels calm, safe, content, relaxed and happy. It is often combined with relaxation exercises, but relaxation is not always necessary (Psycho-Oncology, 2005; 14: 607-17). Types of imagery techniques include:
- Pain-control imagery. This aims to create a mental image of the pain, and then to transform it into something less threatening and more manageable. Another technique is to imagine the pain as something completely controllable, such as an electric current that can be 'switched off'.
- Healing imagery. Patients coping with diseases or injuries may picture themselves as healthy, happy and symptom-free. There are also scripts for particular conditions. Cancer patients, for example, may visualize a healing light shining on the tumour or affected body part, or imagine the immune system or cancer treatment attacking and destroying the cancer cells.
- Relaxation imagery. This involves creating pleasant, relaxing images that can put the mind and body to rest.
Research shows that the ability to generate mental images and become absorbed in them as if they were real is a useful predictor of how successful guided imagery will be (Res Nurs Health, 1998; 21: 189-98). While studying a group of cancer patients, psychologist Jean Achterberg discovered that she could predict which patients would recover, get worse or die, simply by examining their visualizations and rating them. Those who were successful had a greater ability to visualize vividly, with powerful imagery and symbols. They also practised their visualizations regularly (Achterberg J, Lawlis GF. Bridges of the Body Mind: Behavioral Approaches for Health Care. Champaign, IL: Institute for Personality and Ability Testing, 1980).
So, to achieve the most benefit from visualizations, it's important to focuson as much detail as possible and to strengthen the images by using all ofthe senses-sounds, smells, taste and touch-as well as sight.