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Therapies & Practices > Therapies > Guided imagery

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Guided imagery

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.

Evidence Table (Click Here to view Natural Standard evidence-based validated grading rationale™.)

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.	Grade
Headache Initial research suggests that guided imagery may provide added benefits when used at the same time as standard medical care for migraine or tension headache. Further study is needed before a strong conclusion can be drawn.	B
Pain Early research suggests that guided imagery may help reduce cancer pain, intravenous needle pain, nerve pain from spinal cord damage, or lower postoperative pain ratings in children. Further research is needed to confirm these results.	B
Anxiety and wound healing after surgery Initial evidence suggests that guided imagery relaxation audiotapes may reduce anxiety after surgeries, and may improve healing. More study is needed before a strong recommendation can be made.	C
Anxiety/depression in multiple sclerosis Early research suggests that the use of imagery may reduce anxiety but not depression or physical symptoms in patients with multiple sclerosis. Additional research would be helpful in this area.	C
Bulimia nervosa Evidence from early research suggests that guided imagery may be an effective treatment for bulimia nervosa, at least in the short-term. Further study is needed before firm conclusions can be drawn.	C
Fibromyalgia Initial research suggests possible reductions in pain and improvements in functioning.	C
Insomnia Early research supports the value of combined pharmacotherapy and relaxation training in the treatment of insomnia. Further research is necessary in order to make a firm recommendation.	C
Juvenile rheumatoid arthritis Cognitive-behavioral interventions for pain may be an effective adjunct to standard pharmacologic interventions for pain in patients with juvenile rheumatoid arthritis. Further research is needed to confirm these results.	C
Memory Early research suggests that guided imagery of short duration may improve working memory performance. Further research is needed before a firm conclusion can be drawn.	C
Osteoarthritis Early research suggests a reduction in pain and mobility difficulties in patients with osteoarthritis. Further research is needed before a firm conclusion can be drawn.	C
Quality of life in cancer patients Preliminary studies suggest that quality of life and sense of comfort may be improved by guided imagery techniques such as relaxation/imagery training tapes. Further research is needed before a firm conclusion can be drawn.	C
Quality of life in HIV patients Initial evidence suggests that occasional use of guided imagery techniques may improve quality of life in people with HIV. Additional research is needed in this area before a recommendation can be made.	C
Relaxation in chronic obstructive pulmonary disease (COPD) A small study reports increased relaxation outcomes in people with chronic obstructive pulmonary disease (emphysema or chronic bronchitis) who use guided imagery techniques. Additional research is needed to confirm these results.	C
Smoking cessation Based on early study, guided imagery in addition to education and counseling sessions may be helpful for long-term smoking cessation and abstinence in adult smokers. Further study is needed to confirm these results.	C
Upper respiratory tract infections Preliminary research in children suggests that stress management and relaxation with guided imagery may reduce the duration of symptoms due to upper respiratory tract infections. Additional research is needed to confirm these results.	C
Catheterization / percutaneous coronary intervention Masked prayer, music, imagery, and touch (combined) therapy did not significantly improve clinical outcome after elective catheterization or percutaneous coronary intervention in a recent study.	D
Congestive heart failure Preliminary research reports no benefits of guided imagery in congestive heart failure.	D

Bibliography

Natural Standard developed the above evidence-based information based on a thorough 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.

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. View Abstract

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. View Abstract

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. View Abstract

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. View Abstract

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. View Abstract

Kwekkeboom KL, Kneip J, Pearson L. A pilot study to predict success with guided imagery for cancer pain. Pain Manag.Nurs 2003;4(3):112-123. View Abstract

Louie SW. The effects of guided imagery relaxation in people with COPD. Occup Ther Int 2004;11(3):145-159. View Abstract

Mannix LK, Chandurkar RS, Rybicki LA, et al. Effect of guided imagery on quality of life for patients with chronic tension-type headache. Headache 1999;39(5):326-334. View Abstract

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. View Abstract

Moseley GL. Using visual illusion to reduce at-level neuropathic pain in paraplegia. Pain 2007 Aug;130(3):294-8. View Abstract

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. View Abstract

Troesch LM, Rodehaver CB, Delaney EA, et al. The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncol Nurs.Forum 1993;20(8):1179-1185. View Abstract

Tusek DL, Church JM, Strong SA, et al. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum 1997;40(2):172-178. View Abstract

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. View Abstract

Wynd CA. Guided health imagery for smoking cessation and long-term abstinence. J Nurs Scholarsh 2005;37(3):245-50. View Abstract

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.

Natural Standard Bottom Line Monograph, Copyright © 2009 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intendedfor informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Natural Standard's methodology , editorial board , and grading scales.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

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Guided imagery

Background

Theory

Evidence Table (Click Here to view Natural Standard evidence-based validated grading rationale™.)

Tradition

Tradition Theory

Safety

Attribution

Bibliography

Related Terms