Guided Imagery

Guided imagery seeks to make beneficial physical changes in the body by repeatedly visualizing them. A form of mind-body therapy, it has been advocated for a number of chronic conditions, including stress, anxiety, high blood pressure, and headaches, and for people undergoing conventional cancer therapy or surgery.

Although another mind-body technique, biofeedback, has been tested extensively and has been found effective for a variety of ailments, including certain types of chronic pain, guided imagery has no such track record. Currently there is no evidence that it can relieve any type of disease, though it does seem capable of promoting relaxation.

Guided imagery is taught in small classes or one-on-one. Practitioners emphasize that it's not a passive experience; you're expected to be an active participant in each session. You will be asked to wear comfortable clothing, and will either sit comfortably in a chair or lie on a table or a floor mat. The practitioner will not touch you, and no instruments will monitor you. Some practitioners use music as a background to aid relaxation.

Sessions usually begin with general relaxation exercises, then move on to a specific visualization, described by the practitioner. You'll be asked to build a detailed image in your mind, using all five senses, and then repeat the exercise with a different image. If you have a specific medical complaint, the practitioner may ask you to picture your body free of the problem. If it's a localized disorder, you'll probably be encouraged to picture the affected organs working properly, visualizing, for instance, your heart beating regularly, your lungs breathing freely, a tumor shrinking, or your legs moving strongly. For more generalized problems, you may need to picture your entire body as healthy, strong, and calm. Athletes or performers picture themselves moving well and competing or performing perfectly.

Between sessions, you can use a book or audiotape to help you practice visualization on your own.

Treatment Time: Guided imagery sessions are typically 20 to 30 minutes long, or longer as needed.

Treatment Frequency: Sessions are usually held once or twice a week, or more frequently if needed.

Also known as creative imagery, mental imagery, or creative visualization, guided imagery aims to help you focus your mind on positive images and, in so doing, work changes in your body. It is often used along with other mind-body techniques. Unlike its cousins meditation and hypnosis, guided imagery doesn't ask you to focus your mind on a single word or image, but instead takes you on a journey through several visualizations. It's been described as a "focused daydream" by some practitioners.

Like other mind-body techniques, guided imagery is based on the assumption that the mind can indeed affect the functions of the body. Exactly how this might transpire is not completely understood, but there is certainly compelling evidence that it happens. Numerous studies have confirmed the ability of both biofeedback and meditation training to lower blood pressure, control heart rate; and there is some evidence that guided imagery can do so as well. However, claims that it relieves pain, reduces anxiety, improves the effectiveness of drugs, and has psychological benefits have yet to be verified. Further studies are underway.

How can visualizing something make it so? One theory proposes that picturing something and actually experiencing it are equivalent as far as brain activity is concerned. Brain scans have verified this effect, and proponents suggest stimulating the brain through imagery can therefore have a direct effect on both the nervous and endocrine systems, ultimately producing changes in the immune system and other body functions.

Whatever the truth of the matter, if you have cancer, you should be aware of a specialized type of guided imagery called the Simonton Method. Developed by oncologist O. Carl Simonton and his wife Stephanie Matthew-Simonton, this technique is designed to help patients who are undergoing standard treatments for cancer. Emphasizing the use of imagery to complement (not replace) other therapies, it requires patients to visualize their immune systems fighting and destroying cancer cells. While considered a useful tool by many, it has not been proven to increase survival time.

Used as a supplement to standard treatments, guided imagery is generally considered safe for everyone.

There are no known side effects of guided imagery.

Guided imagery is offered by many types of practitioners, including psychologists, nurses, and social workers, as well as others with no health care background. There is no central licensing or certification required for practitioners, so it is up to you to check into the credentials of the practitioner you choose. The national organizations listed below may be helpful in locating a practitioner in your area.

If you wish, you can also try to learn guided imagery from books or audiotapes.

Practitioners say there is an incremental increase in benefit over time, so you should allow several weeks before deciding whether guided imagery is working for you. If it's not, move on to other alternatives without delay.

Because guided imagery is at best a supplement to other forms of treatment, you should also get standard care for whatever problems you're seeking to remedy.