If there were a tool that could reduce blood pressure and cholesterol, enhance the immune system, reduce physical pain, help with insomnia and eating, alleviate panic and anxiety disorders, help with depression, reduce the need for drugs, enhance concentration, perception and cognitive performance, improve self-esteem and emotional stability, slow down the aging process and provide an overall feeling of well-being and inner peace, we would all be scrambling to get our hands on it. Yet such a tool exists. Hundreds of studies over the past 40 years have shown that guided imagery and meditation allow individuals to experience just such results. Technologies are now being used by scientists to see exactly what goes on inside the brains of Buddhist monks and other individuals who meditate intensively and regularly. Neuroscientists hypothesize that such practices actually alter the way the brain is wired, and these changes are at the heart of claims that meditation – of which guided imagery is but one form – can improve health and well-being.
Psychotherapy and Guided Imagery
In my practice as a psychotherapist, clients come to see me because they are in emotional pain of one sort or another. They are looking for relief and change, to feel better and happier. Psychotherapy offers support and tools to help clients step back, in a safe environment, and bear witness to their own experiences. I am lucky enough to have found a career I love – helping people heal in body, mind and spirit. Together, my client and I witness his or her pain without shying away from it, hearing the “stories” and taking a look at those experiences with compassion and a measure of detachment. Some of my clients have experienced deep trauma or abuse at the hands of a loved one, some are dealing with illness or disease, and many are depressed, anxious, unhappy or deeply afraid. Most feel their lives are out of control with stress and have been triggered to seek help because of a physical or emotional crisis. Whatever the reason, what they all have in common is the desire to “escape” the discomfort in which they find themselves. They just want to feel better and find more peace and happiness in their everyday lives.
I have found myself frequently turning to guided imagery, meditation and mindfulness as tools that effectively change the way people relate to their experiences. Each of these practices helps ground the person in the present, thereby breaking through the pain of looking back in the past and the fear barrier that comes with looking into the future. It seems that when someone learns to be fully present with their own experiences — paying attention to their thoughts and feelings without trying to escape — there is palpable relief and expansion that occurs in the body and mind.
You may be asking, how is guided imagery different from meditation and mindfulness? Meditation is an umbrella term that incorporates many different practices and techniques, all of which have common themes. In a 2006 article in American Psychologist, Roger Walsh and Shauna Shapiro offered the following definition: “The term ‘meditation’ refers to a family of self-regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calm, clarity and concentration.” Guided imagery is a form of meditation involving focus on invoking sensory images. Mindfulness, on the other hand, is about bringing awareness to the present moment without judgment and without hooking into our thoughts (which are a step away from the present moment). It enables us to switch out of automatic pilot into present moment awareness. Mindfulness is at the heart of Buddhism and has been popularized in the West by Jon Kabat-Zinn’s mindfulness-based stress reduction technique. This has been taught to thousands around the world.
According to studies, guided imagery is the third most commonly used mind-body therapy in the United States. Over the past few years, neuroscience has caught up with, and validated, what ancient Buddhist teachings have been saying for years. I remember going to a day of mindfulness with Thich Nhat Han, which he opened with the lines, “Be here now. Be somewhere else later. Is that so complicated?” He made it sound so simple! But I have come to believe that it IS simple, if not easy. We only need follow a three-step process:
(1) Learn to observe ourselves and become familiar with our old negative patterns. This requires developing the skill of watching ourselves with interested detachment; climbing out of our own picture so we can see it clearly. You can’t see the picture if you’re inside the frame.
(2) Pause and breathe, settling the energy from the old patterns and messages.
(3) Use a technique such as guided imagery or meditation to move towards a more relaxed state, both physically and emotionally.
Gaining cognition of how the human brain works can also help raise awareness and give understanding to an experience that feels out of control emotionally. Slowing down to take a look at our own picture gives us perspective and a sense of control over our experiences, bringing us to a deeper level of knowing and truth.
What is Guided Imagery?
Imagery is all around us in our physical world, as well as in our thoughts, minds and memories. Much of our own individual imagery is what makes us feel bad – painful images from the past can elicit the same physical and emotional response today as was experienced at the time of the event; images of the future may bring anticipatory fear of a future loss. So what is “guided” imagery? Guided imagery is a form of meditation, a way of being present and relaxed with yourself and your heart wisdom. In her book, Staying Well with Guided Imagery, Belleruth Naparstek, psychotherapist and pioneer in the field of guided imagery, defines it as “a process of deliberately using your imagination to help your mind and body heal, stay well, or perform well. It’s a kind of directed, deliberate daydream, a purposeful creation of positive sensory images – sights, sounds, smells, tastes, and feel – in your imagination.” It gently guides a person toward a relaxed state of both body and mind. It has been found to carry numerous health benefits, both physical and emotional, providing relief from stress, anxiety, trauma, grief and fear, to name but a few. In addition to several books, Belleruth Naparstek (www.healthjourneys.com) has produced guided imagery CDs for every imaginable situation, from trauma to sleep disturbance, anxiety to depression, weight loss to healthy pregnancy after extensive research conducted with Vietnam veterans and others.
Numerous studies have been conducted that support the positive effects of such imagery on hospital patients, and on people suffering from chronic pain and trauma, stress, and many other conditions. One such randomized controlled study at the Lahey Clinic, a Tufts University Medical School teaching hospital, examined 56 patients having colorectal surgery and showed that patients using Peggy Huddleston’s book, Prepare for Surgery, Heal Faster, a relaxation tape and a one-hour workshop, were significantly calmer before surgery and left the hospital 1.6 days sooner, saving the hospital $3,200 per patient. On the second day at home, patients were using 60% less pain medication than the control group. (www.healfaster.com) Surgical patients at some major teaching hospitals – such as Duke – now receive these or similar tools as standard protocol before their procedure.
How the brain is changed by Guided Imagery.
Since our reactive stress response is a major accelerator of dis-ease, it stands to reason that reducing stress with the use of guided imagery is good for both our physical and emotional health. Guided imagery conjures up positive and healing images, engaging the senses of sight, sound, smell, taste and touch, and anchoring the participant in the present moment. It transports the participant into the present by connecting them with a new and more positive experience. With repetition, return to the new images becomes more automatic, and in time changes our automatic response to an undesirable state. Research has shown that producing the relaxation response in the body counteracts the harmful effects of the body’s stress responses (fight/flight). This was popularized by cardiologist Dr. Herbert Benson in the 1970’s. That’s where neuroscience comes in.
In his book, The Mindful Brain, Daniel Siegel, M.D., explains how consciousness plays a direct role in the harnessing of neural plasticity (the brain’s ability to alter automatic modes of neural firing which enables new neural firing patterns to occur.) Our brains literally create well-worn pathways based on neural firing patterns, thereby creating automatic, unconscious reactions. The more those pathways are used, the more habitual they become –so focusing on and feeding negative patterning serves to enhance the reactive patterns. It is as if the memory got filed in the wrong filing cabinet in the brain. If it’s in the area that houses fight/flight responses, it now causes us to be on high alert at inappropriate times. Guided imagery actually helps the brain to create new, healthy pathways to the part of our brain that houses cognitive reasoning and emotional regulation. It is the area of the brain associated with love, compassion and positive emotions. This area of the brain is fed information from all the senses, and uses this information to make useful judgments.
Advanced brain scanning equipment allows us to see actual changes in the brain after guided imagery or meditation. Although the old pathways remain, our brains can indeed be trained to redirect our responses to the new pathways. The result? Less reactivity, reduced bodily stress response (the release of adrenalin and cortisol), an increased ability to self-soothe and self-regulate, an enhanced ability to respond in a more conscious, reasoned way, and increased tolerance to situations that habitually caused us to be emotionally hijacked. Reduced stress and reactivity minimizes our health risks over time, while allowing us to engage in a more present, mindful way of living.
The effects of Guided Imagery and Meditation
Meditation and guided imagery have the opposite effect on the body to that of stress/trauma response. In other words, they foster decelerated heart rate, lowered blood pressure, slowing down of breath, and a lower production of stress hormones, not to mention an increased sense of control and well-being as the individual realizes that he or she can self-regulate feelings and create a feeling of safety. This has been shown to be especially effective for trauma victims.
While the short-term stress response (acute) is a necessary function of the human brain to protect the individual from perceived danger, a problem occurs when the individual adapts to the acute stress response and it becomes long-term (chronic). This chronic stress adaptation has the power to cause major health problems in the body. For example, increased heart rate can cause hypertension which leads to more serious disease over time. It becomes a vicious cycle until the “pause” button is pressed and reset. Learning to self-regulate when emotions threaten to overwhelm us is another important antidote to the body’s natural response to stress. Such emotions have the power to cause an “emotional hijacking,” during which time we lose cognitive functioning and the power to reason. We are in fight-flight-freeze mode, or in “crisis.” Settling these powerful emotional energies is key to regaining a sense of control over our situation, and key to our health over the long term. Continued practice of guided imagery on a regular basis helps us tap into that altered state of relaxation.
A client, whom I will call Sue, arrived late to her session describing how she was feeling “in a whirlwind of chaos” and “out of control with stress” because of demands being put on her at work, and an extremely difficult situation with a parent dying of cancer. She had previously cancelled two appointments because she “didn’t have time,” had reported that she had stopped journaling, exercising, eating regularly or sleeping well. She described herself as getting “snappy” with others, feeling exhausted and getting a head cold, and feeling resentful and angry that her life seemed so out of control. She said she could literally feel the stress in her body but didn’t know what to do about it. She felt hopeless and frantic about her situation and couldn’t see a way to make it better.
After about ten minutes, I gently stopped Sue from her rapid delivery of what was going on and pointed out that since she had not drawn breath since she sat down, it might be a good time to “pause.” I invited her to close her eyes, take a deep breath and participate in a short guided imagery. She visibly relaxed in her chair, tears flowing freely. Her response to her situation was immediately changing. After the imagery, she was able to identify specific ways in which she feels her life is out of control, as well as fear and regret about her sick parent, in a more detached manner. She noticed her belief that she has to finish all her work each day for fear of displeasing her boss, her judgmental thoughts towards herself for not spending more time at home and for being short-tempered, as well as her need to please others at whatever the cost to herself. She reported noticing, during the guided imagery, feeling her breath slowing down, her heart rate decreasing, and her muscles relaxing as she listened to my voice. As soon as she was able to honor her body’s wisdom, settle her hijacked energy, and acknowledge that what she had been doing was not working, she could tap into some solutions and come up with a plan. Sue was able to witness how her response to the situation was aggravating it, based on her own automatic patterns of thinking, behavior and emotions. And more importantly, she was able to feel how she had the ability to change her feelings by mindfully paying attention in a calm, kind and relaxed manner. Sue’s situation is not unique; we can all recognize ourselves in her story.
Our bodies offer us wise messages in the form of physical sensations such as racing heart, tightness in our muscles, illness and fatigue, to name but a few, and we must learn to listen. The symptoms come from our natural bodily alarm system. Self-regulation comes with consciously paying attention to the messages of our body before we become emotionally hijacked; the sooner the better before chronic stress sets in. While mindfulness – paying attention to what is happening in the moment without judgment – is key to the process, guided imagery can help us when we have failed to pay attention and are already in the grips of an emotional hijacking. And the more we practice putting ourselves into a relaxed state, the more our brains change their neural firing patterns.
Making the switch from automatic pilot to mindful living can be greatly aided by the use of guided imagery. Strengthening this muscle requires repetition and practice, and I suggest putting aside ten to fifteen minutes a day to listen attentively and quietly. Each individual’s response will be different, but practice imprints the images and gradually changes the pathways in the brain. Even if you fall asleep, it is still believed to be effective, although listening with “relaxed but focused attention” is optimal, according to Belleruth Naparstek.
Knowing what we now know about the risks of long-term stress on our physical health and experiencing first-hand (as we all have) the effects of stress and emotional hijacking, doesn’t it make sense to take advantage of such inexpensive and effective therapies as guided imagery? We will inevitably build more familiarity with our patterns of thoughts, behaviors and emotions and open the door to new responses and new ways to manage our stress. This, in itself, will lead to a healthier and happier life, in body, mind and spirit. Jon Kabat-Zinn begins his book, Full Catastrophe Living – using the wisdom of your body and mind to face stress, pain and illness, with an invitation to the reader “to embark upon a journey of self-development, self-discovery, learning, and healing….in an effort to regain control of your health and to attain at least some peace of mind.” I offer each of you the same invitation.
Caroline Temple, MSW, LCSW, is a psychotherapist whose work with individuals, couples and groups combines her social work training and intuitive spirit guidance to encourage clients towards wholeness of body, mind and spirit. She brings a natural understanding and empathic connection, creating a safe environment in which to explore difficult and painful personal issues. Caroline combines traditional therapeutic methods such as solution-focused and cognitive therapies, with mindfulness practice. She encourages awareness of personal power and facilitates personal growth and self-esteem. Her work with abused women has led her to recognize a woman’s innate sense of connection with spirit and ability to access the wisdom within. Caroline’s practice is dedicated to a holistic approach. She teaches mindfulness skills and has produced her own CD of guided imageries, available through her website at www.mywisewoman.com. She has extensive training and experience in crisis intervention, trauma, emotional and physical abuse, grief and loss, parenting and healthy relationships. Co-author of two books, she runs divorce support groups for women and has a thriving private practice with offices in Fairfield and Norwalk. She can be reached at 203-866-9333.