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GUIDED IMAGERY & PSYCHOTHERAPY.
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Theory, techniques, types, applications, examples of positive images used to promote healing, relaxation, cognitive restructuring, patient-therapist relationship.... More...
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Paper Abstract:
Theory, techniques, types, applications, examples of positive images used to promote healing, relaxation, cognitive restructuring, patient-therapist relationship.
Paper Introduction:
GUIDED IMAGERY & PSYCHOTHERAPY USES
Introduction
Guided imagery is a part of the field of mind/body medicine, defined as using the power of the mind to evoke a positive response. Imagery is a flow of thoughts allowing one to see, hear, feel, smell, or taste in the imagination; it is an inner representation of our experience or a fantasy, and a symbolic personal language. Imagery is viewed as the language of emotions and the interface between the mind and the body. Worry is a form of imagery that is common to most; a good worrier may be a good candidate for guided imagery. Guided imagery can provide access to cognitive structures that allow for psychotherapy to take place, it can also help heal by reducing stress, slowing the heart rate, stimulating the immune system, reducing pain, and
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Thecomplete A-Z guide to over 16 different alternative therapies.California: Halcyon Publishing. Eventually the prompt can becalled upon at will, it becomes an autogenic prompt or a self-generatedmessage to deal with the pain (Dachman & Lyons, 199 ). Itemploys the senses to collect data the mind uses to construct its world.Imagery can also be used for pain management. Leuner uses GAI as a psychotherapeutic tool torelieve physical and emotional symptoms. Shames, K. The patientcan also focus on a different physiological function such as the heartbeat;the pulse can be felt as the rhythm upon which life depends (Shames, 1996). For Samuels, when a client becomes stuck, such as in aroom of unhappy childhood memories, the goal is to let negative thoughtsout and try and focus on something else that is pleasant, to allow theclient to enter a healing space. All five inner senses are utilized; the experience isperceived as real even though it feels like a daydream. In his discussion ofguided affective imagery (GAI) he states that the therapist must beacquainted with the fundamentals as well as practical experience inpsychotherapy, and he must have training in mental imagery procedures andpsychological symbolism. (1989).Comprehensive handbook of cognitive therapy. GUIDED IMAGERY & PSYCHOTHERAPY USES Introduction Guided imagery is a part of the field of mind/body medicine, definedas using the power of the mind to evoke a positive response. Standard motifs used to explorethe psyche include the meadow, brook, mountain, house, and edge of thewoods (basic level) (Leuner, 1984). For theme visualization, theclient focuses on a theme and lets an image arise spontaneously (Freeman,Simon, Beutler, & Arkowitz, 1989). As a short-term therapeutic approach, GAI has been used to relievesymptoms such as depression with symptoms of dizziness, headaches, stomachpains, restlessness, tension, trembling of limbs, exhaustion, irritability,and cardiac palpitations, in nine sessions of 45 minutes. Theyenhance the immune system, lower blood pressure and heart rate, decreasepain, and alleviate side effects of drugs, including chemotherapy. An autogenic prompts, or a powerful image that the mind can useto attack the pain is developed. Worry is a formof imagery that is common to most; a good worrier may be a good candidatefor guided imagery. Imagery restructuring is used in the context of an understanding ofthe patient's underlying problem. Questions may help when the patientunconsciously tries to circumvent passages that indicate unpleasantconflicts or negative emotions. Samuels, M. The prompt is the key to the formula; withthe development of a powerful image to counter pain, a force is createdthat the mind and the body can respond to. Imagery can lead to happiness, health,and the healing of the spirit. New York:Harper & Row, Publishers. Anexample is a client who was experiencing overwhelming dread and obtained animage of himself trying to separate from an image of his father; thisbecame an important focus for psychotherapy (Freeman, Simon, Beutler, &Arkowitz, 1989). The therapist mayalso dictate words that challenge or contradict assumptions. When askedto imagine a meadow it was near the woods and a figure, the teacher,emerged. New York: SummitBooks. Dr. Rosenfeld's guide to alternativemedicine. His technique involves allowingthe patient to focus on a motif and develop his own flow of images, bothpositive and negative. Fritz Perls used guided imagery for discovery and restructuring. Summary involves the therapist feeding back what he haslearned from the client. Conclusion Imagery is found to be useful as a tool for psychotherapy, healing,and pain management. Directed dialogue is a method of restructuring dysfunctional beliefsand assumptions. Here the therapist guides the client to take the role ofan imagery figure and speak lines that are dictated. Images are found to initially appear meaningless and then graduallyunite to form imaginal sequence. Restructuring techniques help the therapist to guide the client toquestion and challenge assumptions that are identified with informationseeking techniques. Freeman, A., Simon, K. Assessment techniques help discover idiosyncratic meanings of animage. Benefitsof pain medication are enhanced by envisioning its soothing effects as itflows through the bloodstream. H. Eventually the teacher ate the food and the patient and theteacher became friendly equals. For imagery the person is instructed to begin inhaling slowly anddeeply through the nostrils, then release tensions and feel relaxed, andfinally imagine being in a room they are comfortable in. Guided affective imagery. Alternatively, the client may be asked to do asimple countdown (count from 1 to zero), with the suggestion that byreaching zero a state of relaxation will also be reached. Forexample, asking a patient to put himself into his imagined place can serveas a distraction during uncomfortable procedures or situations. Relaxation or other induction is notnecessary however it is best to have the client's eyes closed (some canwork with eyes open). Shames reports that the process begins by getting the patient into arelaxed state which allows images to flow more freely. Imagery techniques have been used to treatdepression, and to help resist cancer and control pain (Freeman, Simon,Beutler, & Arkowitz, 1989). Pain is viewed as a stormthat rages inside the body and deep within each person is a tranquilsanctuary that can be reached. (1994). The imagery work can help achieve restructuring that isoutside the conceptual reasoning system; affectively charged material isnot always easy to reach with verbal questioning (particularly with casesof strong intellectualizing styles). Patientsmay be led to a relaxed state of mind with muscle relaxation which can bedeepened with the use of breathing exercises and the reaching of animagined safe place (Shames, 1996). Patients are taught to think ofpositive images with the use of specific words and suggestions. (1996). Imagery takes the relaxed state and concentrates on images in ourinner world. Alternative Therapy The terms Imagery, Visualization, Creative Imagery, Guided Imagery,Mental Imagery, and Creative Visualization are used interchangeably andrefer to the use of images or symbols to focus the mind on workings of thebody to cause changes. The woman imagined herself as an oldlicense plate thrown into the bottom of a lake; she had no value and wasdrying up and disappearing into the earth. Kastner, M., & Burroughs, H. Samuels offers exercises such as basic relaxation, meditation, andimagery. Imagery is viewed as the language ofemotions and the interface between the mind and the body. An example ofusing GAI as a short-term crisis intervention is offered. M., Beutler, L. Prompted descriptions of what is happening are alsohelpful. New York: Thieme-Stratton Inc. It has been associated with lessening anxiety,improving mood, and controlling or easing pain. The technique is not recommended for patients withweak egos which may lead to a state of regression. The patientimagines floating upward to a place of healing light and peace and stays aslong as wanted. Open questions allow imaginings tobecome wider and more detailed. Imagery tools are more powerful when theconceptualization is well-developed and accurate. If relaxation methods are used they may include the experience ofheaviness and warmth over the body, with regulated breathing to overcomeresistance. Imageryalso affects attitude increasing feelings of confidence, control, andpower, and decreasing hopelessness, depression, and fear. For the life event visualization the client is asked to visualize aspecific event to be the focus of attention in therapy; this may include aquarrel with a spouse or a childhood memory. (199 ). GAI contents have multiple meanings;direct interpretations are avoided since they stifle the free emotionaloscillations needed for the advancement of the GAI process. Objects anddetails in the room are focused on. How guidedimagery can help you reduce pain or eliminate it altogether. (1996). W., & Arkowitz, H. An example is a client who was working on testanxiety and reported an image of his mother while taking tests. A case of obsessive-compulsive neurosis demonstrated thedisappearance of compulsive thinking after 45 sessions. Prompted dialogue is also used; in this case theclient is asked to take the role of a person or object and address anotherperson or object. Imagery is considered the dominant sensory faculty and the mind'svehicle for interpreting, organizing, and processing experience. A student whofailed an exam due to test stupor had problems with authority. Leuner (1984) also reports on guided imagery. Guided imagery techniques include getting started, assessmenttechniques, and restructuring techniques. Ina well know dreamwork seminar, Perls worked with a patient who was reachingthe end of a period of her life as a fertile woman. Harness the power of guided imagery. Links are found between mentalimages and changes in body physiology, including changes in the immunesystem. The patient was asked to imagine a picnic in his pockets(techniques of nourishing and satiating and reconciliation and affectionateembrace). For Leuner, the goal of GAI is the adjustment ofunconscious pathological psychodynamics; it is not a psychoanalytic curebut it is more than a symptom-centered technique. As a differentpsychotherapeutic use of imagery, the therapist asks the patient to conjureup a specific image to focus intently on enough to convince thesubconscious that it is real (Kastner & Burroughs, 1993; Rosenfeld, 1996). (1984). Rosenfeld, I. The patient may be asked to conduct a relaxation procedurehowever asking him to imagine a typical motif such as a flower, will helpincrease relaxation and deepen imagination. Feelingfocusing asks for the automatic thought accompanying a feeling; the clientis asked to focus on a specific emotion that is experienced in the sessionwith awareness increased by focusing on bodily sensations. Samuels states that we enter our inner world through an imaginaryjourney and the vehicle for the journey is a state of consciousness calledthe reverie state. (199 ). Imagery techniques in therapy allows for the access tocognitive structures that allows these structures to be worked in a mannerthat verbal techniques cannot. References Dachman, K., & Lyons, J. Reinstatement of a dream or daytime image asks the client for aspecific image that has happened before in a dream, daydream, fantasy, orprevious guided imagery. A case of phobiademonstrated a reduction of symptoms after eight sessions within a fourweek period. Strohecker, J. A technique from Gestalt therapy, prompted soliloquy can be used toobtain existential status and personal meaning; here the client is asked tobe the image. Once in the earth however, shebecame part of something where flowers or new life could grow; the patientwas guided to realize that new life could now grow from her (Freeman,Simon, Beutler, & Arkowitz, 1989). He allowed her ownthinking and exploration to take place and emerge into the restructuringthrough skillful guidance of imagery. The nature of theclient's feelings and his belief structures can be discovered throughimagery work. The client isasked to let an image arise from the feeling or to portray the feeling. New York: Plenum Press. (1993). Getting started includes themain techniques for obtaining an image to begin with; these include thevisualization of a life event or a theme, the reinstatement of a dream or adaytime image, and feeling focusing. Changes in the room are imagined,changes can be kept or changed back. The following day the student was able toremain calmer during an examination (Leuner, 1984). Alternative medicine. These visualization techniques are notrecommended for psychotic patients since they are usually bombarded withmany images already (Shames, 1996). Techniques areused for stress reduction and attitude change in conditions such as cancer,heart disease, AIDS, and arthritis. Healing with the mind's eye. Catathymic contents decode themselvesautomatically. The definitive guide.Washington: Future Medicine Publishing, Inc.----------------------- 9 This vision can then be used to assist in the healing process. Alternative healing. Directedtransformation is another method of challenging assumptions and promptedtransformation that helps give initiative to the client (the generaldirection of the change is suggested) (Freeman, Simon, Beutler, & Arkowitz,1989). The therapist guides the patient through theprocess, however the initial and restructuring images are developed by thepatient. Leuner, H. Analternative use of imagery involves relaxation techniques and the directmanipulation of the client's images and emotions. The psyche reveals itself in images. Images from dreams and fantasies giveaccess to individual personal interpretations of reality with includeddistortions. This information allows for reexamination and restructuringof beliefs and assumptions. The body is viewed as having the ability toheal itself. Summary and reframing are methods used here and incognitive therapy. Many clients prefer the visualrepresentational system (Freeman, Simon, Beutler, & Arkowitz, 1989). Pain isthen interpreted, images and terms are sought that the mind's apparatus canrecognize. Self-interpretation is found to take place spontaneously and the messages do nothave to be expressed in words; the language of images is understood byparts of the psyche and the preconscious. Reframing involves the therapist suggesting analternative formulation of a belief or assumption elicited (Freeman, Simon,Beutler, & Arkowitz, 1989). Mental imagery inshort-term psychotherapy. Pain-control imagery begins with the experience of pain. In a promptedtransformation, the therapist will suggest a change of image (Freeman,Simon, Beutler, & Arkowitz, 1989). Positive feedback is also important for thesupport and encouragement of the patient at the end of mental imagery. To deepen the relaxed state the client can be asked to pay attentionto the breath which changes the focus to the inner world; air is pulled inthrough the nose and blown out through the mouth and the exchange of oxygenand carbon dioxide also produced a physiological rejuvenation. The progressivemuscle relaxation technique, having the patient tense up and then relaxeach muscle group, can be used to help focus on the body and be distractedfrom everyday worries. Visualimagery is viewed as having a powerful role; human beings represent theworld to the self in imagery and fantasy before the first word is said.Visualization allows for the capture of intricate relationships betweenfacts, beliefs, and assumptions that may not be found in verbalrepresentations. This technique hasdemonstrated the successful treatment of symptoms of dizziness, weakness,sweating, collapse, anxiety attacks, heart palpitations, depressivesyndrome with psychosomatic complaints, and hysterical structural elementsof the personality. Samuels (199 ) reports that imagery and relaxation techniques havebeen shown in research studies to affect the body's physiology. For Samuels, negative or painful images and emotions areeliminated in an effort to bring the client to a safe and healing image.An alternative function of imagery is its wide use for pain management. New York: Random House. Thetherapist does not insist that tasks be completed, however, the patient isguided toward the completion of exercises from one session to the next.The patient's creative powers are stimulated to enrich mental imagery andaction possibilities; the patient is free to develop his own images afterthe motif is introduced (Leuner, 1984). It has a powerful immune system that can be under consciouscontrol and made to operate more effectively. A conversation is held and the person leaves. You can relieve pain. This state involves feelings of relaxation.Characteristics of the reverie state coincide with those that producehealth; it viewed as evolving as the body's mechanism to heal itself andmake itself whole. Uninterruptedfantasy for imaginings important (Leuner, 1984). Imagery is aflow of thoughts allowing one to see, hear, feel, smell, or taste in theimagination; it is an inner representation of our experience or a fantasy,and a symbolic personal language. There is an equal relationship between patient and therapist.Empathic and inner accompanying identification of the therapist with themental imagery is considered a crucial point for the intervention.Overidentification is avoided. Guided imagery can provide access to cognitivestructures that allow for psychotherapy to take place, it can also helpheal by reducing stress, slowing the heart rate, stimulating the immunesystem, reducing pain, and increasing self-care (Strohecker, 1994). Information regardingthe images represents the subjects inner life; for example a cow showing upin a meadow may represent an oral motif (milk given from the cow). Next theroom undergoes a radical change and becomes a place to begin a journey(furniture disappears, roof lifts off, walls fold out). The patient is guided into the eye of thestorm; a state of readiness is achieved with relaxation techniques (Dachman& Lyons, 199 ). This prompt and imagery skills are usedto overcome or escape the pain. Next the room is returned to theoriginal state and a loved or respected person is imagined as coming tovisit in the room. Samuels describespsychotherapeutic attempts to guide the client toward a positive andhealing image. In this case specific relaxation techniques are not required; thepatient is guided toward the resolution of psychological conflicts. After feeling relaxed, the patient can be asked to visualize a safeplace. Embellishment on this place can occur with the use of sensory data. RN,59(8), 49-51. The Power of Imagery Guided imagery is used to help patients heals from anxiety, chronicpain, and other clinical procedures. The interview technique can also be used to give promptsabout information sought. Asa symptom-specific approach, pain is focused on and the client develops hisown imagery and developed solution. As images change, shifts may include changes in facialexpressions or a change of scene; this process is called transformation.Transformations give both therapist and client, information about theclients' personal meanings which must be tracked carefully. Technique involves the use of questions that guide rather than thosethat elicit a "yes" or "no" answer. Myths and symbols are a way of giving form to innerunderstanding that transcends the rational. Leuner states that relaxation techniques are not essential and thatthe session may begin by asking the patient to imagine a time-tested motif. When the imagery is vague, multisensory evocationsharpens detail; in this case the therapist guides the client to focus onthe different senses (Freeman, Simon, Beutler, & Arkowitz, 1989). Creative Imagery is the conscious creating ofpositive thoughts and images to communicate them to the body for a goalsuch as to relieve pain, cure a disease, or affect behavioral changes.Imagery is a flow of thoughts you can see, hear, feel, smell, and taste;the imagination creates a mental picture in the mind of what is desired.Guided Imagery is described as a mind-body technique which lies betweenhypnosis and biofeedback. Psychotherapy Cognitive restructuring can be done through guided imagery.
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