Guided imagery
Guided imagery (also known as guided affective imagery, or katathym-imaginative psychotherapy) is a mind-body intervention by which a trained practitioner or teacher helps a participant or patient to evoke and generate mental images[1] that simulate or recreate the sensory perception[2][3] of sights,[4][5] sounds,[6] tastes,[7] smells,[8] movements,[9] and images associated with touch, such as texture, temperature, and pressure,[10] as well as imaginative or mental content that the participant or patient experiences as defying conventional sensory categories,[11] and that may precipitate strong emotions or feelings[12][13][14] in the absence of the stimuli to which correlating sensory receptors are receptive.[15][16]
The practitioner or teacher may facilitate this process in person to an individual or a group or you may do it with a virtual group. Alternatively, the participant or patient may follow guidance provided by a sound recording, video, or audiovisual media comprising spoken instruction that may be accompanied by music or sound.[17]
Clinical investigation and scientific research[edit]
Mental imagery can result from both voluntary and involuntary processes, and it comprises simulation or recreation of perceptual experience across all sensory modalities,[24] including olfactory imagery, gustatory imagery, haptic imagery, and motor imagery.[25] Nonetheless, visual and auditory mental images are reported as being the most frequently experienced by people ordinarily as well as in controlled experiments,[26] with visual imagery remaining the most extensively researched and documented in scientific literature.[27]
In experimental and cognitive psychology, researchers have concentrated primarily on voluntary and deliberately generated imagery, which the participant or patient creates, inspects, and transforms, such as by evoking imagery of an intimidating social event, and transforming the images into those indicative of a pleasant and self-affirming experience.
In psychopathology, clinicians have typically focused on involuntary imagery which "comes to mind" unbidden, such as in a depressed person's experience of intrusive unwelcome negative images indicative of sadness, hopelessness, and morbidity;[28] or images that recapitulate previous distressing events that characterize posttraumatic stress disorder.[29]
In clinical practice and psychopathology, involuntary mental images are considered intrusive when they occur unwanted and unbidden, "hijacking attention" to some extent.[30][31]
The maintenance of, or "holding in mind" imagery, whether voluntary or involuntary, places considerable demands upon cognitive attentional resources, including working memory, redirecting them away from a specific cognitive task or general-purpose concentration and toward the imagery.
In clinical practice, this process can be positively exploited therapeutically by training the participant or patient to focus attention on a significantly demanding task, which successfully competes for and directs attention away from the unbidden intrusive imagery, decreasing its intensity, vividness, and duration, and consequently alleviating distress or pain.[32][33]
Mental imagery and ill health[edit]
Mental imagery, especially visual and auditory imagery, can exacerbate and aggravate a number of mental and physical conditions.[34]
This is because, according to the principles of psychophysiology and psychoneuroimmunology, the way an individual perceives his or her mental and physical condition in turn affects biological processes, including susceptibility to illness, infection, or disease; and that perception is derived significantly from mental imagery. That is to say that in some cases, the severity of an individual's mental and physical disability, disorder, or illness is partially determined by his or her images, including their content, vividness or intensity, clarity, and frequency with which they are experienced as intrusive and unbidden.[35]
An individual can aggravate the symptoms and intensify the pain or distress precipitated by many conditions through generating, often involuntarily, mental imagery that emphasizes its severity.
For example, mental imagery has been shown to play a key role in contributing to, exacerbating, or intensifying the experience and symptoms of post-traumatic stress disorder (PTSD),[36] compulsive cravings,[37] eating disorders[38] such as anorexia nervosa[39] and bulimia nervosa,[40] spastic hemiplegia,[41] incapacitation following a stroke or cerebrovascular accident,[42] restricted cognitive function and motor control due to multiple sclerosis,[43] social anxiety or phobia,[44] bipolar disorder,[45] schizophrenia,[46] attention deficit hyperactivity disorder,[47] and depression.[48][49]
Principles[edit]
The therapeutic use of guided imagery, as part of a multimodal treatment plan incorporating other suitable methods, such as guided meditation, receptive music therapy, and relaxation techniques, as well as physical medicine and rehabilitation,[21] and psychotherapy, aims to educate the patient in altering their mental imagery, replacing images that compound pain, recollect and reconstruct distressing events, intensify feelings of hopelessness, or reaffirm debilitation, with those that emphasize physical comfort, functional capacity, mental equanimity, and optimism.
Whether the guided imagery is provided in person by a facilitator, or delivered via media, the verbal instruction consists of words, often pre-scripted, intended to direct the participant's attention to imagined visual, auditory, tactile, gustatory or olfactory sensations that precipitate a positive psychologic and physiologic response that incorporates increased mental and physical relaxation and decreased mental and physical stress.
Guided imagery is one of the means by which therapists, teachers, or practitioners seek to achieve this outcome, and involves encouraging patients or participants to imagine alternative perspectives, thoughts, and behaviors, mentally rehearsing strategies that they may subsequently actualize, thereby developing increased coping skills and ability.[76]
Requisite for absorption[edit]
In order for the foregoing process to take place effectively, such that all four stages of guided imagery are completed with therapeutic beneficial effect, the patient or participant must be capable of or susceptible to absorption, which is an "openness to absorbing and self-altering experiences".[111][112] This is a further reason why guided meditation or some form of meditative praxis, relaxation techniques, and meditation music or receptive music therapy are often combined with or form an integral part of the operational and practical use of the guided imagery intervention. For, all those techniques can increase the participant's or patient's capacity for or susceptibility to absorption, thereby increasing the potential efficacy of guided imagery.[113][114]