Saturday, April 03, 2010

Guided Imagery

Today I'm posting three guided imagery exercises I use regularly with patients and families as a means of reducing stress or anxiety. I would be remiss if I didn't review GI's effectiveness, principles, or precautions first.

Guided imagery is a two-part process. First, the user reaches a state of deep relaxation usually through breathing and muscle relaxation techniques. You might be directed to close your eyes and focus on your breathing or to release tension from your muscles, one body part at a time. Sometimes soothing music is played, although I don't do this when leading someone through an exercise. I have, however, encouraged people to purchase a CD of sounds or music they find to be soothing. I've found this to be especially helpful for people struggling with sleep.

Once the person is relaxed, imagery or visualization is introduced. Here we are only limited by our imagination. Common types are relaxation imagery, healing imagery, pain control imagery, and mental rehearsal. Guided imagery can promote relaxation, reduce stress, improve mood, control high blood pressure, alleviate pain, boost the immune system, and lower cholesterol and blood sugar levels. Not too shabby!

There are three principles behind guided imagery.
1. The Mind-Body Connection
Mind-created images can be almost as real to the body as actual, external events. It's similar to Pavlov's dog. Think of a time that you read a recipe and you started to salivate or became hungry, even though you'd just eaten. Your mind is creating images of the food described in the recipe but your body responds by drooling and becoming hungry. Your body's response will be stronger when the created image contains sight, sound, smell, feel, and taste, and even more so with an emotional component. The body understands sensory images implicitly.

2. The Altered State
We are capable of more rapid and intense healing, growth, learning and performance. We're more intuitive and creative. Our actual brainwave activity and biochemistry change, which allows us to do things we couldn't in our normal, waking state. Altered states are a part of every day life, consciously or not. You might miss your exit or wonder how you got to the other side of town, for instance. This can be a state of relaxed focus, a calm but energized alertness, a functional form of focused imagination or dreaming. Your attention is limited, or rather, concentrated on one thing. You are more sensitive to the object of your focus and less aware of whatever is going on around you. It's easier to lose track of time or miss what someone is saying to you.

3. Locus of Control
When we sense we are in control, we feel better and do better. Research has indicated that locus of control leads to higher optimism, self esteem, and ability to tolerate pain, ambiguity, and stress. Lack of control or feelings of helplessness lowers self-esteem and impacts our ability to cope as well as our optimism about the future. This describes perfectly what many patients and caregivers feel during a loved one's time on hospice and subsequent bereavement. The user is in control of guided imagery: each individual will picture and experience something unique to them. They can also decide when, where, and how to use GI, which in turn helps them feel they have some control.

Before leading someone through a GI exercise, you should assess their comfort level. They don't need to have prior experience or to even believe that this will work. However, if you're going to use The Beach, you might want to make sure they don't have any fears associated with beach, water, or drowning first. Before I begin any exercise, I let the person know that they may become sleepy or even fall asleep- and this is OK. When I have finished, they can wake up or open their eyes whenever they're ready.

Have the person get into a comfortable position, such as sitting back in a comfy chair (no stools!) or laying down in bed. Encourage them to breathe deeply, in and out. After an exercise, I will encourage the person to envision their "safe place" for a few more minutes or to describe it to me if they feel comfortable. I tell them they can go back to this place whenever they need. It might take a couple of times through the exercise before a person can do this on their own. It depends on their circumstances, strength of the GI outcome, and stress or anxiety level.

Along with The Beach, I also use Breathing Forgiveness, Love, and Peace and My Sacred Temple. Before leading someone through one of these exercises, I would encourage you read it out loud a few times to capture a soothing rhythm and cadence. Or try it out on friends and family- I'm sure they'd appreciate it!

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