Guided imagery

Related Terms

• Biofeedback, Bonny method, direct suggestion, drawing/active imagination, dream interpretation, fantasy, game playing, imagery, interactive guided imagery, meditative relaxation technique, metaphor, story telling, visualization.

Background

• Throughout history, many cultures have used imagery for therapeutic purposes, including the Navajo, ancient Egyptians, Greeks, and Chinese. Religions such as Hinduism and Judaism have also practiced imagery. In modern times, the term "guided imagery" may be used to refer to a number of techniques, including metaphor, story telling, fantasy, game playing, dream interpretation, drawing, visualization, active imagination, or direct suggestion using imagery.
• Therapeutic guided imagery may be used to help patients relax and focus on images associated with personal issues they are confronting. Experienced guided imagery practitioners may use an interactive, objective guiding style to encourage patients to find solutions to problems by exploring their existing inner resources. Biofeedback is sometimes used with imagery to enhance meditative relaxation. Interactive guided imagery groups, classes, workshops, and seminars are available, as well as books and audiotapes.

Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• It is theorized that the process of visualizing images can evoke sensory memory, strong emotions, or fantasy that in turn may affect the mind and body in beneficial ways. Imagery techniques have been proposed to cause a number of changes in body functions, including alterations in breathing, heart rate, blood pressure, metabolism, and the gastrointestinal system, immune system, and endocrine system. Practitioners often aim to use a variety of senses, including touch, smell, sight, and sound, to achieve a tranquil state by decreasing negative physical symptoms.

Evidence

*Key to grades: 

A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

For full grading rationale, click here.

Safety

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

• Serious adverse effects have not been reported in the available scientific literature. Theoretically, intense inward focusing may cause pre-existing psychological problems or personality disorders to surface. Guided imagery should not be relied upon as a sole therapy for potentially serious medical problems. Guided imagery is usually used as a supplemental technique to other treatments, not as a replacement.
• Guided imagery techniques should not be practiced while driving or during other activity requiring strict attention. Guided imagery may trigger physical symptoms that can be brought about by stress, anxiety, or emotional upset. If practicing guided imagery produces anxiety, a qualified healthcare professional should be consulted. Similarly, people with a history of trauma or abuse should speak with a healthcare professional before using this technique.

Authors

• This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Selected References

Natural Standard developed the above evidence-based information based on a systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Baird CL, Sands L. A pilot study of the effectiveness of guided imagery with progressive muscle relaxation to reduce chronic pain and mobility difficulties of osteoarthritis. Pain Manag Nurs 2004;5(3):97-104.
2. Carr RR, Nahata MC. Complementary and alternative medicine for upper-respiratory-tract infection in children. Am J Health Syst Pharm 2006 Jan 1;63(1):33-9.
3. Chen KM, Chen MH, Hong SM, et al. Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises. J Clin Nurs 2008 Oct;17(19):2634-46.
4. Danhauer SC, Marler B, Rutherford CA, et al. Music or guided imagery for women undergoing colposcopy: a randomized controlled study of effects on anxiety, perceived pain, and patient satisfaction. J Low Genit Tract Dis 2007 Jan;11(1):39-45.
5. Fried RG, Hussain SH. Nonpharmacologic management of common skin and psychocutaneous disorders. Dermatol Ther 2008 Jan-Feb;21(1):60-8.
6. Klaus L, Beniaminovitz A, Choi L, et al. Pilot study of guided imagery use in patients with severe heart failure. Am J Cardiol 7-1-2000;86(1):101-104.
7. Kshettry VR, Carole LF, Henly SJ, et al. Complementary alternative medical therapies for heart surgery patients: feasibility, safety, and impact. Ann Thorac Surg 2006 Jan;81(1):201-5.
8. Louie SW. The effects of guided imagery relaxation in people with COPD. Occup Ther Int 2004;11(3):145-159.
9. 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 Jan-Feb;12(1):23-30.
10. Moseley GL. Using visual illusion to reduce at-level neuropathic pain in paraplegia. Pain 2007 Aug;130(3):294-8.
11. Munsch S, Michael T, Biedert E, et al. Negative mood induction and unbalanced nutrition style as possible triggers of binges in binge eating disorder (BED). Eat Weight Disord. 2008 Mar;13(1):22-9.
12. Toth M, Wolsko PM, Foreman J, et al. A pilot study for a randomized, controlled trial on the effect of guided imagery in hospitalized medical patients. J Altern Complement Med 2007 Mar;13(2):194-7.
13. Trakhtenberg EC. The effects of guided imagery on the immune system: a critical review. Int J Neurosci. 2008 Jun;118(6):839-55.
14. Weydert JA, Shapiro DE, Acra SA, et al. Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. BMC Pediatr 2006 Nov 8;6:29.
15. Wynd CA. Guided health imagery for smoking cessation and long-term abstinence. J Nurs Scholarsh 2005;37(3):245-50.

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