|Using the power of the mind to evoke a
positive physical response, guided imagery can reduce stress and slow
heart rate, stimulate the immune system, and reduce pain.
As part of the rapidly emerging field of mind/body medicine, guided
imagery is being used in various medical settings, and, when properly
taught, can also serve as a highly effective form of self-care.
"The imagination is probably a person's least utilized health resource,"
says Dr. Martin Rossman, co-founder of the Academy for Guided Imagery.
"It can be used to remember and recreate the past, develop insight into
the present, influence physical health, enhance creativity and
inspiration, and anticipate possible futures."
All of us have experienced the effects of the imagination on the body.
Getting goose bumps while listening to a frightening story, breaking out
in chills at the thought of fingernails scratching a chalkboard, or
becoming physically aroused from a sexual fantasy, are all examples of
the body reacting to a sole stimulus-the imagination.
WHAT IS IMAGERY?
Imagery is simply a flow of thoughts that one can see, hear, feel,
smell, or taste in one's imagination. As an inner representation of
experience, as well as fantasy, imagery is rich, symbolic, and highly
Perhaps the most common human experience of imagery is worrying. Most
people worry sometimes and some people worry constantly .
"If you are a good worrier," says Dr. Rossman, "and especially if you
ever worry yourself sick, you may be an especially good candidate for
learning how to positively affect your health with imagery, as the
internal process involved in worrying yourself sick and imagining
yourself well are quite similar."
Dr. Bresler, Ph.D., L.AC., former director of UCLA Pain Center, defines
imagery as one of the two "higher order" languages of the human nervous
system--the other being the faculty of thinking in words. Imagery is a
way the nervous system stores, accesses, and processes information.
It's especially effective for maintaining the dialogue between mind and
body, which is the source of its power in the healing process.
THE HEALING POWER OF IMAGERY
Imagery has three main characteristics that lend it great value in
medicine and healing:
1. It directly affects physiology.
2. Through the mental processes of association and intuition, it
provides insight and perspective into health.
3. It has an intimate relationship with emotions, which are often at the
root of many common health conditions.
THE PHYSIOLOGICAL EFFECTS OF IMAGERY
Relax for a moment and just imagine holding a juicy, yellow lemon. Feel
its coolness, its texture, its weight in your hand. Now imagine cutting
it in half. Notice the cut surfaces and|the pale yellow pulp..the
whiteness of the inner peel, perhaps a seed or two. Take one of the two
halves and imagine lifting this lemon wedge to your mouth. Smell its
lemony scent. Now imagine biting into the lemon and sucking its sour
juice into your mouth.
What happened as you imagined doing that? Did you salivate or grimace.
Did you have any other kind of physical reaction? Most people do--much
more than if you simply asked them to salivate.
This is a simple illustration of the type of physiological response that
imagery can induce. If thinking of a lemon makes you salivate, what
other more important effects on the physiology might certain types of
imagery have? For instance, can thinking of pain relief cause
endorphins to be secreted?
Research using biofeedback, hypnosis, and meditative states has
demonstrated that people possess a remarkable range of self-regulatory
capacities. Focused imagery in a relaxed state of mind is a common and
central factor inmost of these techniques.
Imagery of various types has been shown to affect heart rate, blood
pressure, respiratory patterns, oxygen consumption, carbon dioxide
elimination, brain wave rhythms, electrical characteristics of the skin,
local blood flow and temperature of tissues, gastrointestinal motility
and secretions, sexual arousal, levels of hormones and neurotransmitters
in the blood, and immune system function.
The healing potentials of imagery go far beyond its remarkable ability
to directly affect physiology, however.
ASSOCIATIONS AND "GETTING THE BIG PICTURE"
"Recovering from or coping with a serious or chronic illness may well
demand more than simply imagining getting well," says Dr. Rossman. "It
may also require changes in your lifestyle, your attitudes, your
relationships, or your emotional state."
Imagery can help to develop the insight and self-awareness that it takes
to deal with a chronic or life-threatening illness in more positive and
constructive ways. This is due to the mental processes of association
and synthesis that are central to imagery.
Imagery tends to give us the "big picture" of a situation and can help
us recognize how things are related in ways we might now expect.
Becoming aware of these relationships may facilitate a shift in attitude
or behavior that can be helpful in relieving, altering, or coping with
illness or symptoms.
For example, Dr. Rossman tells of a woman whose chronic arm pain had not
responded to medical treatment for two years. She kept seeing an image
of her pain as pieces of iron. This made little sense to her until she
was asked to describe the qualities of the iron. She described it as
hard, cold, and rigid, and then immediately associated these qualities
with her grandfather, whom she had been caring for during the past two
years, as he displayed these same qualities. This association allowed
her to deal with repressed feelings about her role as a caregiver and
led to rapid resolution of her arm pain as well as a great deal of
IMAGERY AND THE BRAIN
Imagery seems to arise from unconscious processes, body processes, and
memories and perceptions from the part of the brain known as the
cerebral cortex. Some imagery, however, having to do with smell or
feelings, may arise from older, more primitive brain centers. Wherever
its origin, imagery is believed to have its effect by sending messages
from the higher centers of the brain through to the lower centers that
regulate most of a person's physiologic functions, such as breathing,
heart rate, blood flow and pressure, digestion, immunity, and
temperature, as well as waking and sleeping rhythms, hunger, thirst and
Recent research utilizing PET scans (a test involving radioactive
material that is used to examine brain tissue) indicates what parts of
the brain are active when a person is performing certain tasks. The PET
scans seem to show that the optic cortex, the same part of the brain
activated when a person is seeing, is activated when a person
Similarly, when people imagine hearing things, the auditory cortex is
active, and when they imagine feeling sensations, the sensory cortex is
active. Therefore, it appears that the cortex can create these
imaginary realities and in the absence of conflicting information, the
lower centers of the nervous system respond to this information.
This is one reason why health care professionals use sensory
recruitment, and approach that utilizes as many senses in the imagery
process as possible. Sensory recruitment increases the subjective
reality of the image and probably increases the amount of information
sent through the lower brain centers and autonomic nervous system,
making it more likely to elicit the desired response.
Emotions are powerful events in the body. They are physiologically
distinct from one another and each affects human physiology in different
ways. In fact, many physical ailments are direct manifiestations of
emotions that are locked within the unconscious. Says Dr. Rossman.
"Through imagery you can access those emotions and consciously alter
their effect on your health."
Emotions themselves are a normal, healthy response to life. Failure to
acknowledge and express important emotions, however, can be an important
factor in illnesses, and is unfortunately all too common. People often
suppress those emotions they find the most distressing, such as fear,
grief and anger.
The natural expression of emotion is often suppressed by family,
friends, and society, as well. "Yet strong emotion has a way of finding
routes of expression," says Dr. Bresler, "and if it is not recognized
and dealt with it can manifest itself indirectly in the form of physical
pain and illness,or destructive behaviors like smoking, heavy drinking,
and overworking, all of which in turn lead to serious health problems."
In fact, studies in England and the United States have found that 50 to
75 percent of all problems presented to a primary care clinic are
emotional, social , or familial in origin, though they are being
expressed by pain or illness.
By directly accessing emotions, imagery can help the individual
understand the needs that may be represented by an illness and can help
develop ways to meet those needs. Imagery is also one of the quickest
and most direct ways of becoming aware of emotions and their effects on
health, both positive and negative. For instance, one of Dr. Rossman's
patients with inflammatory bowel disease reported that she imagined her
bowels being "red, inflamed, and irritated." As this image was
explored, she became aware of how her bowels responded to the
irritation, frustration, and anger she frequently felt. By learning to
recognize what triggered her frustration, and by developing more
effective means to express herself when angry, she had progressively
less trouble with her bowels. She also learned to use simple relaxation
and imagery to imagine her own hands gently soothing her bowels with a
cooling, calming balm whenever they became upset. A few minutes of
doing this would relieve her abdominal pain and leave her feeling
relaxed and at ease.
IMAGERY IN MEDICINE AND HEALING
Imagery can be a key factor in dealing with either a simple tension
headache or a life-threatening disease. It is a proven method for pain
relief, for helping people tolerate medical procedures and treatments
and reducing side effects, and for stimulating healing responses in the
body. Imagery can assist in clarifying attitudes, emotions, behaviors,
and lifestyle patterns that may be involved in producing illness. It
can also facilitate recovery, and be used to help people find meaning
in their illnesses, cope more effectively with their health problems and
come to grips with life's limitations.
Learning to relax is fundamental to self-healing, and imagery is a part
of almost all relaxation and stress-reduction techniques. For many
people, imagery is the easiest way to learn to relax, and its active
nature makes it more comfortable than other methods of relaxation.
TREATING PEOPLE RATHER THAN SYMPTOMS
Beyond simple relaxation, imagery can have specific effects in relieving
numerous common symptoms. Dr. Bresler states that because imagery is a
way of treating people rather than symptoms or diseases, it can be
applied to almost any health care concern. The following areas of
application are some examples of where imagery can be useful, but his
list is by no means complete.
Imagery is often used for relief of:
Chronic Pain, neck and back pain, allergies (including hay fever and
asthma) high blood pressure, benign arrhythmias (heartbeat
irregularities), stress-related gastrointestinal symptoms (including
chronic abdominal pain and spastic colon), functional urinary
complaints, and reproductive irregularities including premenstrual
syndrome, irregular menstruation, and even excessive uterine bleeding. I
can also accelerate healing and minimize discomfort from all kinds of
acute injuries, including sprains, strains, and broken bones, as well as
from the symptoms of the common cold, flus, and infections. Because
imagery can affect immune system function, within limits, there is a
great deal of interest among researchers of mind/body medicine for
applying it to a broad spectrum of autoimmune diseases including
rheumatoid arthritis, ulcerative colitis, and systemic lupus, and
chronic inflammatory disease with symptoms including arthritis, fatigue
and skin lesions.
Finally, a great number of people with cancer have utilized imagery as
part of their recovery process. Imagery as a tool in cancer therapy was
pioneered by radiation oncologist, O. Carl Simonton, M.D. He used
imagery as a means of reinforcing traditional medical treatments,
suggesting that his patients imagine their cancer cells as "anything
soft that can be broken down, like hamburger meat or fish eggs, and
their warrior white cells as "aggressive and eager for battle."
Dr. Simonton first employed this technique in 1971 with a throat cancer
patient whose condition has been diagnosed as "hopeless." The man was
sixty-one years old. He was extremely weak, his weight had dropped to
ninety-eight pounds, and he was having trouble breathing and
swallowing. Although he was scheduled to receive radiation treatment,
his doctors were concerned that treating him would further deteriorate
Dr. Simonton outlined a program of relaxation and imagery for the man,
instruction him to devote five to fifteen minutes three times a day.
The imagery exercise consisted of imagining the radiation treatment as
"bullets of energy" striking his cells, healthy cancerous alike, with
the healthy cells remaining healthy and the cancer cells dying off. The
man would then visualize his cancer shrinking in size and his health
returning to normal. As a result of this program, the man was able to
receive radiation treatment with minimum discomfort. Halfway through
his treatment, he began eating again, and regaining weight and
strength. Within two months, his cancer completely disappeared.
Even when cancer patients are not cured through imagery, they report
benefits from its use, including relief from anxiety and pain, increased
self-esteem, and an increased sense of control over their bodies. They
also report an increased ability to tolerate chemotherapy or radiation
therapy. In addition, by coming to grips with the illness, they are
often able to resolve personal and family issues.
In addition to being used to explore diseases and symptoms, imagery can
be helpful for enhancing tolerance to medical procedures such as MRI's,
bone marrow biopsies, cancer chemotherapy, and radiation. Imagery can
also help prepare people for surgery and post surgical recovery.
In fact, imagery can be applied to almost any medical situation where
problem solving, decision making, relaxation, or symptom relief is
useful. Imagery can be considered as an adjunct treatment to health
care no matter how minor the condition. According to Jeanne Achterberg,
Ph.D., establishing healing patterns is far easier when the individual
is relatively healthy than when fced with a serious disease. Once
someone is diagnosed as being seriously ill, the person often lacks the
emotional resources and belief system to imply imagery to its best
Beyond these relatively direct applications, "receptive" uses of imagery
can have profound effects on health and medical care. These typically
involve imaginary dialogues with images representing symptoms or
illnesses, or with an inner store of wisdom or healing that can provide
insight into the meaning of body sensations and symptoms. This can lead
to better understanding of how lifestyle choices and behavior are
affecting health. The following stories demonstrate how imagery can be
used to help identify thoughts and fears at the root of physical pain.
Alice was a forty-year old woman who had recently undergone cancer
surgery and radiation. However, she continued to have persistent pain
in her upper back. Because Doctors could not identify the problem, she
decided to try guided imagery with Dr. Rossman. First, he asked her to
relax and imagine herself at some beautiful place. Next she was invited
to have a dialogue with an imaginary "inner advisor." Alice asked for
an image to appear and saw a wise old man tending a fire. He looked
like Merlin the Magician. When Alice asked him about her pain, he told
her that she needed to "ask for help." Alice immediately broke into
tears, for throughout her ordeal she had never asked for help from her
husband or family. She realized that she had been afraid to ask for
help, thinking she would be too much of a burden on them. Her "Inner
advisor" then told her how much better her family members would feel if
they were included in her healing process. Finally , she imagined
asking her husband for help and having him agree to provide it. At the
end of her session, her pain had substantially decreased and she found
the courage to turn to her family for assistance.
Dr. Rossman states that the receptive use of imagery as an interface
language between, mind and body often yields the most profound healing
In a similar case, Dr. Bresler worked with a fifty two year old
cardiologist who suffered from excruciating pain in the lower back after
receiving successful treatment for rectal cancer. Further surgery was
ruled out because the area had been so heavily irradiated, and because
the man had developed tolerance to his pain medications.
Reviewing the man's medical records the Dr. read that in a psychiatric
workup the man had described his pain as "a dog chewing on my spine".
Dr. Bresler suggested guided imagery as a way to make contact with the
dog, and invited the man to imagine what the dog looked like. The
patient described a "nasty little terrier" named Skippy. During the
following sessions, Skippy began revealing critically important
information about the patient, including the fact that he had never
wanted to be a doctor but had been pressured into medical school by his
mother. As a consequence, the man resented not only his mother, but
also his patients and colleagues. Skippy told him that this hostility
had contributed to both his cancer and to his subsequent back pain.
Finally Skippy said, "you're a damn good doctor. It may not be the
career you wanted, but it's time you recognized how good you are at what
you do. When you stop being so resentful and start accepting yourself,
I'll stop chewing your spine." Following these insights, the man
experienced an immediate alleviation of his pain, and within a few more
weeks it progressively subsided to the point where he felt like a new
THE FUTURE OF IMAGERY
"One of the most appealing aspects of guided imagery," Dr. Bresler says,
"Is that it lends itself so readily to the process of patient education
and self-care." It also provides a formal methodology for increasing
personal empowerment and self-control. While research studies of its
cost-effectiveness are still underway, it appears to off significant and
effective therapeutic benefits after only a few weeks or months of
Dr. Bresler and Dr. Rossman both predict that training in guided imagery
will be an integral part of all psychotherapeutic approaches and that its
benefits will become more widely available for medical and psychological
problems and as a means of achieving greater personal insight,
creativity, and self-actualization