Guided Imagery

What is guided imagery? Guided imagery is mental imagery (pictures in your mind) that helps you relax, reduces pain and stress, boosts the immune system, and works against the side effects of some treatments. You can do guided imagery by yourself or with a therapist. It can help you focus your mind on something pleasant to improve how you feel. It may help you cope better with a disease.

Guided imagery is not the same as visualization, which is imagining things without being told to do so. Guided imagery involves following verbal directions to imagine something or focusing on something that’s already in your mind. It’s easy and fun to learn how to practice guided imagery for yourself at home. Many people find it just as effective as other treatments for some conditions but will not cause harm when used alone or together with standard medical treatment or other complementary health approaches.

People use guided imagery by closing their eyes and picturing scenes they’ve been asked to imagine (guided) or by looking at pictures while listening to someone describe them (instructed). For example, if you pictured a peaceful beach scene from memory, you would be using guided imagery. This type of mental relaxation can help reduce stress.

Guided imagery

People also learn how to do visualization at home by looking at pictures and creating a story from them as they’re described (visualization).   For example, listening to a therapist describe a beach scene that comes from the imagination could fall into this category. Guided imagery is sometimes called visualization, but there are differences between the two techniques:

In guided imagery, the person follows directions about what to imagine and where to focus attention. In visualization, the person uses his or her own images. In guided imagery, the therapist helps guide the process by describing images out loud. In visualization, those helping may only suggest images for a person to use if needed.

In guided imagery, the person may need to actively work at imagining what’s being described, and reminders about breathing and relaxation may be needed occasionally. In visualization, it’s more passive and may involve just listening to someone describe images that appear automatically in a person’s mind.

A recent survey showed that 75% of people who practice guided imagery find it helpful for preventing or managing illness and managing pain. Here are some examples:

Boosting the immune system. Many people think of their immune systems as protecting them from harmful germs like viruses, bacteria, and parasites. But sometimes our own cells can start attacking other healthy cells because of an illness such as lupus erythematosus, rheumatoid arthritis, or other autoimmune disorders. Some studies have shown that guided imagery can help boost the immune system and reduce pain in people with rheumatoid arthritis.

Reducing stress and anxiety. Our bodies release stress hormones such as cortisol, which may make it harder for us to fight off diseases like HIV/AIDS, cancer, heart disease, and diabetes. Stress also makes our symptoms worse. Guided imagery has been used successfully to relieve anxiety and stress in people with HIV/AIDS and after surgery or chemotherapy. It’s also been effective for reducing anxiety and relieving hot flashes (sudden warm flashes on the face, neck, chest, hands) caused by menopause.

Treating insomnia. Many people say they’re unable to sleep because of racing thoughts, fears about the future, or worries about the past. Guided imagery can help some people relax and fall asleep by reducing stress and slowing down brain activity.

Managing chronic pain. Some studies have shown that guided imagery can lower pain caused by arthritis, schizophrenia, cancer, fibromyalgia, heart disease, headaches, irritable bowel syndrome (IBS), ulcerative colitis, phantom limb pain after an amputation, spinal cord injury, tinnitus, or ringing of the ears, chemotherapy- or radiation therapy-related pain following cancer treatment, and even labor pains.

People using visualization may go on to use other complementary health approaches for certain medical problems. Yet more research is needed to know if this approach works for these specific conditions.

Guided imagery is not the same as hypnosis, which involves a person being in a state of deep relaxation where they are easily influenced. Some people suggest that this type of guided imagery is relaxing but it requires more focus than normal daydreaming or mind-wandering. Guided imagery may be beneficial for some health problems like pain, anxiety, and sleep disturbance. However, there’s still limited evidence on whether visualizing can help treat medical issues such as heart disease and cancer.

What health conditions respond to guided imagery?

It’s used most often for chronic pain — especially headaches — nausea and vomiting from chemotherapy treatment; lowering blood pressure; coping with cancer; mental illness; memory problems after stroke; inflammatory bowel disease (IBD); irritable bowel syndrome (IBS); and uterine fibroids. Some people also use it to control their appetite and lose weight and stop smoking.

How is guided imagery done?

You can do it on your own or with the help of a trained professional (a certified health professional who has met certain standards in training and experience). It’s often used along with other types of treatment, such as acupuncture, massage, meditation, herbal medicine, yoga, Reiki, music therapy, aromatherapy, homeopathy, chiropractic manipulation, and physical therapy.

What does a session of guided imagery involve?

A therapist may use either recorded instructions or live guidance to get you into a relaxed state by focusing on pleasant images. You might visualize yourself floating down a river or riding a bike up a hill while listening to calming music. In some cases, the therapist may speak suggestions to you, such as imagining that your tumor is melting away or imagining yourself healthy and cancer-free. The therapist’s aim is to help you find peace within yourself so that your body can heal itself.

There are different types of visualizations:

Guided imagery (also known as visualization). With this method, you imagine pleasant scenes in great detail, like walking down an aisle at your wedding or taking a stroll on the beach. You might also close your eyes and focus on each part of your body, thinking about how well it’s working to keep you healthy. Or you re-create a stressful situation by imagining it in all its vividness, then see yourself coping effectively with the event.

Some people prefer a combination of different methods. For example, you might use visualization to relax while listening to calming music and suggestions.

Music visualization uses slow music with a patterned vocal rhythm similar to what you’d hear in meditation or yoga. You imagine a pleasant scene while listening to the music.

Guided imagery can also be done without any specific props or images by simply closing your eyes and focusing on pleasant memories, such as spending time with family or friends or enjoying one of your favorite hobbies.

Meditation. Many people use guided imagery along with meditation (though it’s possible to do these techniques separately). Meditation is thought to enhance relaxation and heart rate variability (HRV), which is the variation in time between heartbeats — that is, the length of each heartbeat cycle. A healthy heart rate is between 60 and 100 beats per minute (bpm) — so HRV refers to variations from that number.

Meditation can help people with depression, anxiety, high blood pressure, sleep problems, stress, chronic pain, and irritable bowel syndrome. Acupuncture is sometimes done during meditation sessions.

Biofeedback. This approach involves hooking you up to electronic monitoring equipment that records your body’s functions, such as skin temperature and muscle tension. Electrodes attached to your skin send this information back to a computer screen in the therapist’s office. Your therapist provides positive reinforcement when your body achieves certain milestones, such as relaxing or lowering your heart rate. They also encourage you not to worry when your body responds to stress, such as an elevated heart rate. The idea is to help you learn to control your own anxiety.

Biofeedback has been used for chronic pain, irritable bowel syndrome, high blood pressure, migraines, and headaches related to depression or anxiety. It can also be used to treat alcohol addiction.

Meditative movement (also known as guided imagery through movement). This technique uses gentle rhythmic motions, such as rocking or head nodding, while imagining pleasant scenes. You may also use breathing techniques related to certain movements.

What are the benefits of guided imagery?

Practitioners say guided imagery can help you relax and feel more in control of yourself. Others claim that it’s a helpful way to manage pain and stress or to promote healing. Some say it can reduce anxiety, depression, and the side effects of cancer treatment. Some studies indicate that guided imagery may improve blood pressure control and help with sleep problems.

What’s the evidence?

Studies have shown that guided imagery is effective in treating nausea after chemotherapy, reducing pain, and improving function in people who have osteoarthritis of the knee. Guided imagery, either alone or as part of a relaxation program, has been shown to be useful for many chronic conditions — such as lowering high blood pressure and reducing symptoms related to irritable bowel syndrome — as well as for acute conditions like nausea from chemotherapy. Although some studies suggest that guided imagery might help reduce anxiety and depression, this hasn’t been shown in clinical trials.

There’s limited evidence that guided imagery may improve some aspects of immune function. But studies have had mixed results, so this is still uncertain. It’s not clear if guided imagery helps people with cancer live longer or better quality lives.

Finally, so what do we know? Guided imagery is generally safe and can improve symptoms of many chronic conditions. However, it’s not known if guided imagery is any more effective than other forms of stress reduction. Also, the long-term effects of using guided imagery aren’t known.

Does guided imagery work for everyone? No, but many people find it helpful. Guided imagery is an active process that may not be right for people with certain mental health conditions, such as psychosis or schizophrenia.

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