The Power of Guided Imagery

Imagery has a long history in the healing traditions of mankind. The knowledge that imagery or visualization is a critical component of all healing experiences is distinguished when we consider the vital roles played by placebos, suggestion, and positive expectant faith.

The term "guided imagery" is used to describe a range of techniques from simple visualization and direct imagery-based suggestion, to metaphor and story-telling. Guided Imagery is generally considered as an updated version of visualization therapy, a remarkably creative and effective way to take advantage of the mind-body connection. It's one of the natural therapies psychotherapists recommend most frequently to their patients.

Interactive Guided Imagery (IGI) utilizes imagery, the natural language of the unconscious mind. IGI is a powerful modality helping a patient/client connect with the deeper resources available to them at cognitive, affective and somatic levels. The guide's role is not to provide "better" images for the client, but to facilitate an enhanced awareness of the unconscious imagery the patient/client already has, and help clients learn to effectively work with this imagery on their own behalf. This process is capable of bringing about profound psychological and physiological change, as it simultaneously empowers and educates the patients.

The premise of this therapy is that the patient's unconscious mind has valuable information on the origin and nature of illness as well as on its potential resolution. The job of the therapist is to facilitate movement of this information into consciousness and encourage the patient to act on it.

The therapist might ask you (the patient) to picture yourself in some actual scene where you feel very comfortable and to describe the details of that scene. (People who do not visualize well can get just as much benefit by paying attention to body sensations rather than visual images.) Next, the therapist might direct your attention to the part of your body that is ailing and ask you to enter into an imaginary dialogue with it. In the interaction between you and the therapist and you and your body, opportunities open for intuitive, unconscious knowledge to bubble up into waking consciousness. The therapist can then help you interpret the information and put it to use.

Interactive Guided Imagery is an empowering method because it assumes that you have the answers. It's worth trying for a wide range of problems, from chronic infections to chronic pain. It's my first choice as a mind-body approach for allergies, certain immune conditions, skin and digestive disorders, and any persistent or mysterious medical problems. Guided-imagery therapy does not harm, is time-and-cost effective, and can often be fun.

Two California physicians, Martin Rossman and David Bresler, claimed that they developed this therapy, and have it – Interactive Guided Imagery -- registered as their special service mark (sm). They even created the "Academy for Guided Imagery" to promote it. The Academy offers training and even home study programs in this mind-body method for medical doctors and other interested health professionals. However, if they had learned the Daoism traditional "Daoyin" exercise in China or other inducing techniques in Chinese meditation, they should realize that Chinese have practiced the "guided imagery" for thousand years, and the service mark should really belong to the Chinese Daoism sages.

Physically, imagery has the ability to directly influence the autonomic nervous system, and the power of imagination can be recruited to promote specific physiological changes as an aid to healing. In addition, many studies indicate that certain imagery techniques may stimulate physiologic processes including immune and endocrine responses which can accelerate the healing process.

The IGI approach is more than just imagination. It is eclectic, holistic, humanistic and non-dogmatic, incorporating skills from many related disciplines including hypnosis, Jungian Psychology, psychosynthesis, self-actualization and ego-state psychology.

There are few physical, emotional or behavioral symptoms or illnesses that are not affected to some degree by the mind. IGI mobilizes the latent, innate healing abilities of the client to launch rehabilitation, recovery and health enrichment. IGI techniques are easy to learn with proper instruction, and carry few, if any, negative side effects when properly utilized; thus making them an ideal adjunct to any other type of therapy. It is our sincere hope that health professionals from all disciplines will begin to utilize these techniques to help their patients and clients more effectively help themselves.

There are many studies involving guided imagery in clinical settings. For example, Dr. Kwekkeboom (2003) from the University of Iowa College of Nursing, applied guided imagery to help cancer patients to relieve pain. A sample of 62 hospitalized cancer patients experiencing moderate or heavy pain completed questionnaires and used an audio-taped imagery intervention. Pain outcomes included mean pain intensity and distress, positive and negative affect, and perceived control over pain. Their multivariate models explain 10% to 52% of variance in pain outcomes, suggesting that imaging ability may be a useful variable to assess in order to determine whether guided imagery is an appropriate intervention for individual patients.

Bakke and colleagues (2002) at Oregon Health and Science University examined the effect of hypnotic-guided imagery on psychological well-being and immune function in patients with prior breast cancer. They first measured the patient's psychological profiles such as natural killer (NK) cell number and activity at baseline, then measure them again after the 8-week imagery training and at the 3-month follow-up. They found significant increases in improvement in depression (P<.04) and increase in absolute number of NK cells, but these were not maintained at the 3-month follow-up.

Halpin and the cardiac surgery team (2002) in the Inova Fairfax Hospital of Virginia implemented a guided imagery program to compare cardiac surgical outcomes between two groups of patients: with and without guided imagery. Data from the hospital financial cost/accounting database and patient satisfaction data were collected and matched to the two groups. A questionnaire was developed to assess the benefits of the guided imagery program to the participants. They found that patients who completed the guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided. From then on, guided imagery becomes a complementary means to reduce anxiety, pain, and length of stay among their cardiac surgery patients.

Eller reviewed 46 studies that used guided imagery for management of psychological and physiological symptoms, published between 1966 and 1998, and found that there was preliminary evidence for the effectiveness of guided imagery in the management of stress, anxiety and depression, and for the reduction of blood pressure, pain and the side effects of chemotherapy. However, overall results of this review demonstrated a need for systematic, well-designed studies, which explore several unanswered questions regarding the use of guided imagery. These include the effects of different imagery language, symptoms for which guided imagery is effective, appropriate and sensitive outcome measures, method of delivery of the intervention and optimum dose and duration of the intervention, and individual factors that influence its effectiveness.

Since imagery has powerful physiological consequences and also conveys important and otherwise inaccessible information from the unconscious mind, there are virtually an unlimited number of situations where it can be used in health care settings. However, according to Rossman and Bresler, the "creators" of IGI, it may be helpful to consider three major categories of use:

1.) Relaxation and stress reduction, which is easy to teach, easy to learn, and almost universally helpful to patients;

2.) Active visualization, or directed imagery, where the patient is encouraged to imagine desired therapeutic outcomes while in a relaxed, open state of mind. This affords patients a sense of participation and control in their own healing, which is of significant value by itself. In addition, visualization can be used to alleviate symptoms, stimulate healing responses in the body, modify health endangering behaviors, and provide effective motivation for making positive life changes;

3.) Receptive, or insight oriented imagery, where images are invited to enter conscious awareness where they are interactively explored to gather more information about a symptom, illness, mood, treatment, situation, or possible solution.

(Summarized by Kellogg Wong & Kevin Chen)

References:

"What is Interactive Guided Imagery" from http://www.guidedimagery.com

Bakke AC. Purtzer MZ. Newton P. "The effect of hypnotic-guided imagery on psychological well-being and immune function in patients with prior breast cancer. Journal of Psychosomatic Research. 53(6):1131-7, 2002.

Kwekkeboom KL. Kneip J. Pearson L. A pilot study to predict success with guided imagery for cancer pain. Pain Management Nursing. 4(3):112-23, 2003.

Eller LS. Guided imagery interventions for symptom management. Annual Review of Nursing Research. 17:57-84, 1999.

Halpin LS. Speir AM. CapoBianco P. Barnett SD. "Guided imagery in cardiac surgery." Outcomes Management. 6(3):132-7, 2002.