Integrative Health Psychology

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Guided Imagery – a Simple yet Powerful Technique for Mind-Body Health

“Guided imagery” is a technique in which a person is literally guided on a journey of the mind, usually with the purpose of enhancing SleepSelfEsteem3 copypositive feelings and thoughts, and decreasing feelings of distress, failure, or worry. For example, many people use guided imagery to increase a sense of general well being, enhance self-esteem, foster a sense of joy, or to otherwise see themselves in a more positive light. Imagery can also be helpful with a broad range of specific issues, such as enhancing athletic or other performance, mentally rehearsing anxiety-provoking events (such as public speaking), as well as for pre-surgical preparation. Furthermore, this technique can be effective for both adults and children.

Guided imagery works by focusing and directing the imagination. Although for most people, the term calls to mind using visual imagery, this technique ideally engages all of the senses – including sight, hearing, touch, smell, even taste and sense of temperature. Imagery is similar to hypnosis in that the process fosters a temporary focus on one’s inner world, rather than the external environment, however, it may or may not include techniques like formal hypnotic induction (e.g., counting down with the explicit purpose of deepening a trance state). Because the experience is a guided one, it is a very simple process that does not require unwavering focus. In fact, imagery can even be effective when played while one is falling asleep. Yet, despite its simplicity, imagery has the capacity to deliver multiple layers of potentially healing suggestions by way of basic symbols and metaphors (the language the unconscious mind prefers to use). Not only can this approach be very effective at facilitating changes in one’s mood and self-concept, but some research has found guided imagery to positively impact physiological processes.

Imagery’s Effect on the Mind and Body

These effects can be remarkable, particularly given the nature of the technique. For example, previous research has revealed the effectiveness of guided imagery at reducing cancer-related pain, postoperative pain, depression, fatigue, and blood cortisol levels (an indicator of stress). In one study, led by Dr. Carol Ginandes, eight sessions of hypnosis via guided imagery was associated with accelerated wound healing in women who had undergone breast reduction surgery. In another study, self-hypnosis via guided imagery was shown to enhance relaxation and reduce anxiety in patients undergoing cardiac surgery. The latter is an especially important finding, as depression, and to a lesser extent, anxiety are associated with increased risk of future heart-related health problems following cardiac surgery. In another study with patients undergoing cardiac surgery, imagery used several times per day in the pre- and postoperative periods was associated with decreased length of hospital stay and pharmacy costs. So, even though this technique is simple, it can be very potent on a variety of levels.

How Does it Work?

Although it is not entirely clear how imagery works to accomplish the above, more recent research using brain imaging has found that when people actively imagine performing a behavior, such as feeling a rough object between their fingers, many of the same areas of their brains are activated as those that are engaged when actually performing the activity. Furthermore, observing someone else performing an activity (such as riding a bike) activates some of the same areas of the brain  as actually performing that activity. This is thought to occur via mirror neurons in the brain. Finally, Dr. Candace Pert talks about how our emotions affect every part of our body-mind via chemical messengers called neuropeptides. These can explain how receiving bad news can almost instantaneously cause the sensation of one’s stomach dropping, or chest tightening — again illustrating the potential effects of “simple” thoughts and feelings on our entire being. The good news is that to a significant extent, we can positively shape our emotions, perceptions, and even our physiology by what we actively imagine.

With regard to the process, one can be guided on an imaginal journey via a pre-packaged CD or MP3 download that is designed to achieve a specific aim (such reduce stress), or one can have a personally-tailored imagery session delivered by a health professional.

When to Consult a Health Professional

For many people, the former may be sufficient, but when dealing with a longstanding or severe issue, such as overwhelming anxiety, or fear that jeopardizes one’s ability to perform at work, or prevents one from flying, seeing a dentist, or having a necessary medical procedure, a tailored approach will likely be most effective and appropriate. Working with a therapist skilled in the use of this technique will also ensure that there is adequate support for any deeper emotional issues or temporary increases in anxiety that may come to light during the process. Relatedly, those who have experienced significant trauma should see a qualified mental health professional before engaging in this process. Additionally, people who tend to dissociate, have had psychotic episodes, or whose anxiety tends to increase when they attempt to relax may benefit from other approaches either first or instead of guided imagery.

In summary, guided imagery can be an appropriate, enjoyable, and very helpful technique for many people, and does not require unwavering focus to be effective. For more information about this technique, as well as imagery downloads, a good resource is

For free full text access to an article on guided imagery for patients with cardiovascular disease, visit:


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