Guided Imagery

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Guided imagery is a treatment therapy based on the understanding that the mind and body are intricately connected and that by training the mind physical symptoms can be improved. During guided imagery, an individual’s thoughts are directed in order to help them reach a state of relaxation and focus. Guided imagery can be accomplished through the use of an instructor or therapist, pre-recorded instructional tapes, or patient-led scripts.

By using all of the body’s senses, the body appears to respond to guided imagery as if what is being imagined is, in fact, reality. A common example often used to illustrate the mind-body interaction that can occur through the use of guided imagery is to imagine a lemon in detail. When an individual focuses intently on the way in which the lemon provokes their senses – i.e., its smell, its color, its texture – their body will likely respond to those sense perceptions. For example, as the individual continues to focus on the lemon and then envisions themselves taking a bite of it, they will frequently salivate. This illustrates how the body can physically respond to Guided Imagery

On a similar note, relaxation can be achieved through the imagination of a safe and welcoming place, such as a church or beach. By envisioning oneself in the tranquil environment, breathing in the smells, and listening to the silence or relaxing sounds, such relaxing imagery can help to promote healing, provide clarity for learning, and improve performance. Relaxation imagery can also help individuals gain control of their emotions and thoughts, which in turn can improve overall attitude, health status, and well-being.

Guided imagery is extremely safe and has no known risks. It can also be performed by essentially anyone, and although many psychologists, psychiatrists, and other healthcare providers can help administer guided imagery, a specialized instructor is not needed. However, the use of pre-recorded tapes or scripts developed explicitly for the purposes of performing guided imagery is recommended for those who wish to pursue it on their own, in order to obtain the greatest effects.

Guided imagery has been used for a variety of purposes. Its ability to promote relaxation has been used to treat high blood pressure and stress, as well as to help relieve tension associated with behavioral changes such as losing weight or smoking cessation. Guided imagery is also frequently used to help manage pain, promote overall healing, and improve athletic performance. Guided imagery has also been studied to some extent among fibromyalgia patients, and results are encouraging.

Menzies et al. (2006) demonstrated the utility of guided imagery to improve overall functioning, self-efficacy of pain management, and other symptoms among fibromyalgia patients; this study did not, however, show an association between the use of guided imagery and reduction in pain severity.  These findings were replicated in a later pilot study by Menzies & Kim (2008), which found improved self-efficacy for pain management and improved functional status among Hispanic fibromyalgia patients who received combination hypnosis and relaxation therapy.  Other researchers have also found guided imagery to be useful at improving overall functional status when used as a component of cognitive-behavioral therapy (a type of psychotherapy that shows how an individual’s thoughts and feelings affect their behaviors) (Singh et al., 1998); however, the long-term sustainability of these effects has not been conclusively proven (Williams et al., 2002).

Fors et al., (2002) investigated the use of distraction-based guided imagery, along with use of the tricyclic antidepressant amitriptyline, on fibromyalgia-related pain. The researchers randomly assigned 55 women with fibromyalgia to receive one of two therapies, or to a control group. One group received relaxation training coupled with guided imagery that promoted the use of pleasant imagery to distract the women from their pain. The other group received relaxation training and guided imagery that utilized imagery focused on each participant’s own internal pain-relieving ability. The audiotapes used to suggest this imagery during therapy described how the body’s own endorphins and inhibitory processes work to naturally limit pain. Finally, those in the control group received a blank tape with no instructions for guided imagery, and received their normal treatment. In addition, patients across all three groups were randomly assigned to receive either amitriptyline (50mg/day) or a placebo. At the conclusion of the study, the authors found that those patients in the pleasant imagery group showed significant improvements in pain when compared to the other treatment group and those in the placebo. No significant differences were found among any group with regard to amitriptyline use. In their discussion, the authors concluded that pleasant imagery was an effective method to reduce pain among fibromyalgia patients (Fors et al., 2002).

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References

1.        Bernardy K, Fuber N, Klose P, Hauser W. Efficacy of hypnosis/guided imagery in fibromyalgia syndrome – a systematic review and meta-analysis of controlled trials. BMC Musculoskelet Disord. 2011;12:133.

2.        Menzies V, Taylor AG, Bourguignon C. Effects of guided imagery on outcomes of pain, functional status, and self-efficacy in persons diagnosed with fibromyalgia. J Altern Complement Med. 2006;12(1):23-30.

3.        Menzies V, Kim S. Relaxation and guided imagery in Hispanic persons diagnosed with fibromyalgia: a pilot study. Fam Community Health. 2008;31(3):204-212.

4.        Fors EA, Sexton H, Götestam KG. The effect of guided imagery and amitriptyline on daily fibromyalgia pain: a prospective, randomized, controlled trial. J Psychiatr Res. 2002 May-Jun;36(3):179-187.

5.        Singh BB, Berman BM, Hadhazy VA, Creamer P. A pilot study of cognitive behavioral therapy in ibromyalgia. Altern Ther. 1998;4:67–70.

6.        Williams DA, Cary MA, Groner KH, et al. Improving physical functional status in patients with fibromyalgia: A brief cognitive behavioral intervention. J Rheumatol. 2002;29:1280–1286.

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