Guided Imagery is a mind-body approach that uses the minds eyeones internal processesto support healing. It is closely related to hypnosis, psychotherapy, and biofeedback, which may also incorporate the use of images as part of therapy. Also known as guided visualization, this mind-body practice has been used throughout history to change behaviors, perspectives, and physiology. [1]
A typical session might start with a person being guided through relaxation exercises. After that, the clinician and the patient begin exploring visual images, as the clinician offers various cues. Initially, a positive image might be created to help the patient relax more; for example, they may be encouraged to visit a safe or beautiful place. Sometimes the patient comes up with the image, and sometimes the practitioner does. Most often, they collaborate. Ultimately, Guided Imagery is controlled by the person experiencing it. This allows for a sense of mastery and control, which can fuel self-directed change efforts. [2]
Guided Imagery promotes an altered state of awareness. It is a means by which a person can communicate with their subconscious, or unconscious, mind. Images can distract from pain, as people work with and even alter imagery related to their discomfort; a person may visualize a change in the pains color, or replace the pain with a different feeling, such as warmth. Imagery can also induce relaxation and help people cope more effectively with stress.
As they are working with an image, a person is encouraged to be very descriptive and to use all their senses. They are also encouraged to note emotions that arise. Different people gravitate more to focusing on senses.
Imagery can affect almost all major physiologic control systems of the body, including [3] :
Imagery can be taught one-on-one or in groups. A practitioner may record a session so that their patient/client will be able to do a given activity or exercise repeatedly.
Imagery can be used to bring about general stress reduction, to focus on a specific outcome, and to gain insight, particularly by interactively exploring imagery. A person might intentionally shift the imagery, and in so doing, shift what the imagery represents.
According to the VA HSR&D group, based on a large-scale review of all imagery related studies up to March 2018, There is moderate-level confidence that Guided Imagery is effective in improving diagnosis-related outcomes in patients with arthritis or other rheumatic diseases. The levels of confidence of Guided Imagery’s effectiveness for other conditions was generally low, due to heterogeneity among the intervention modalities, high risk of bias, lack of blinding, and limited generalizability in some studies. [4]
While more study is clearly needed, Guided Imagery has shown particular promise with the following (noting that studies have their limitations) [5] [6] [7] :
A 2019 study found that a combination of PMR and Interactive Guided Imagery significantly reduced stress in cancer patients. [9]
It is possible for nearly anyone to use this technique. Some people prefer to work with a trained professional if they are using imagery to guide them through a physical or mental health issue. Professionals can teach patients to do ongoing work on their own. CDs and online downloads with imagery exercises are widely available. Refer to the Resources section at the end of this document for more information.
Guided Imagery is not advised (or should be used with extreme care) for individuals who have psychosis, hallucinations, delusions, delirium, dementia, religious beliefs that might be in conflict with the use of imagery, or a history of unprocessed trauma that might come up during the session.
A number of organizations offer information about Guided Imagery online. The VA Whole Health Mobile Apps and Online Tools suggests Health Journeys for Guided Imagery-related blogs and online imagery sessions.
Biofeedback was written by Shilagh Mirgain, PhD and Janice Singles, PsyD. (2014, updated 2020)
