Guided imagery (also known as guided affective imagery, or katathym-imaginative psychotherapy (KIP)) is a
mind-body intervention by which a trained practitioner or teacher helps a participant or patient to evoke and generate
mental image
A mental image is an experience that, on most occasions, significantly resembles the experience of 'perceiving' some object, event, or scene, but occurs when the relevant object, event, or scene is not actually present to the senses. There are ...
s that simulate or recreate the sensory
perception
Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the presented information or environment. All perception involves signals that go through the nervous system ...
of sights, sounds, tastes, smells, movements, and images associated with touch, such as texture, temperature, and pressure, as well as imaginative or
mental content that the participant or patient experiences as defying conventional
sensory categories, and that may precipitate strong
emotion
Emotions are mental states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or suffering, displeasure. There is currently no scientific ...
s or
feelings in the absence of the
stimuli
A stimulus is something that causes a physiological response. It may refer to:
* Stimulation
** Stimulus (physiology), something external that influences an activity
** Stimulus (psychology), a concept in behaviorism and perception
* Stimulus (eco ...
to which correlating
sensory receptors are receptive.
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
Sound recording and reproduction is the electrical, mechanical, electronic, or digital inscription and re-creation of sound waves, such as spoken voice, singing, instrumental music, or sound effects. The two main classes of sound recording ...
,
video
Video is an electronic medium for the recording, copying, playback, broadcasting, and display of moving visual media. Video was first developed for mechanical television systems, which were quickly replaced by cathode-ray tube (CRT) syst ...
, or
audiovisual
Audiovisual (AV) is electronic media possessing both a sound and a visual component, such as slide-tape presentations, films, television programs, corporate conferencing, church services, and live theater productions.
Audiovisual service pr ...
media comprising spoken instruction that may be accompanied by music or sound.
Mental imagery in everyday life
Two ways of generating mental imagery
There are two fundamental ways by which
mental image
A mental image is an experience that, on most occasions, significantly resembles the experience of 'perceiving' some object, event, or scene, but occurs when the relevant object, event, or scene is not actually present to the senses. There are ...
ry is generated: voluntary and involuntary.
The involuntary and spontaneous generation of mental images is integral to ordinary sensory perception, and
cognition, and occurs without
volitional intent. Meanwhile, many different aspects of everyday problem solving,
scientific reasoning, and
creative activity involve the volitional and deliberate generation of mental images.
Involuntary
The generation of involuntary mental imagery is created directly from present sensory stimulation and perceptual information, such as when someone sees an object, creates mental images of it, and maintains this imagery as they look away or close their eyes; or when someone hears a noise and maintains an
auditory image of it, after the sound ceases or is no longer perceptible.
Voluntary
Voluntary mental imagery may resemble previous sensory perception and experience, recalled from
memory
Memory is the faculty of the mind by which data or information is encoded, stored, and retrieved when needed. It is the retention of information over time for the purpose of influencing future action. If past events could not be remembered ...
; or the images may be entirely novel and the product of
fantasy
Fantasy is a genre of speculative fiction involving magical elements, typically set in a fictional universe and sometimes inspired by mythology and folklore. Its roots are in oral traditions, which then became fantasy literature and d ...
.
Technique
The term ''guided imagery'' denotes the technique used in the second (voluntary) instance, by which images are recalled from
long-term or
short-term memory, or created from fantasy, or a combination of both, in response to guidance, instruction, or supervision. Guided imagery is, therefore, the assisted simulation or re-creation of perceptual experience across sensory modalities.
Clinical investigation and scientific research
Mental imagery can result from both voluntary and involuntary processes, and it comprises simulation or recreation of perceptual experience across all sensory modalities, including
olfactory imagery,
gustatory imagery,
haptic imagery, and
motor imagery. Nonetheless,
visual
The visual system comprises the sensory organ (the eye) and parts of the central nervous system (the retina containing photoreceptor cells, the optic nerve, the optic tract and the visual cortex) which gives organisms the sense of sight (th ...
and auditory mental images are reported as being the most frequently experienced by people ordinarily as well as in
controlled experiments
A scientific control is an experiment or observation designed to minimize the effects of variables other than the independent variable (i.e. confounding variables). This increases the reliability of the results, often through a comparison be ...
, with visual imagery remaining the most extensively researched and documented in scientific literature.
In
experimental
An experiment is a procedure carried out to support or refute a hypothesis, or determine the efficacy or likelihood of something previously untried. Experiments provide insight into cause-and-effect by demonstrating what outcome occurs when a ...
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
Intimidation is to "make timid or make fearful"; or to induce fear. This includes intentional behaviors of forcing another person to experience general discomfort such as humiliation, embarrassment, inferiority, limited freedom, etc and the victi ...
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; or images that recapitulate previous
distressing
Distressing (or weathered look) in the decorative arts is the activity of making a piece of furniture or object appear aged and older, giving it a "weathered look". There are many methods to produce an appearance of age and wear. Distressing is ...
events that characterize
posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats ...
.
In clinical practice and psychopathology, involuntary mental images are considered intrusive when they occur unwanted and unbidden, "hijacking attention" to some extent.
The maintenance of, or "holding in mind" imagery, whether voluntary or involuntary, places considerable demands upon cognitive
attentional resources, including
working memory
Working memory is a cognitive system with a limited capacity that can hold information temporarily. It is important for reasoning and the guidance of decision-making and behavior. Working memory is often used synonymously with short-term 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.
Mental imagery and ill health
Mental imagery, especially visual and auditory imagery, can exacerbate and aggravate a number of mental and physical conditions.
This is because, according to the principles of
psychophysiology and
psychoneuroimmunology
Psychoneuroimmunology (PNI), also referred to as psychoendoneuroimmunology (PENI) or psychoneuroendocrinoimmunology (PNEI), is the study of the interaction between psychological processes and the nervous and immune systems of the human body. It is ...
, the way an individual perceives his or her mental and physical condition in turn affects
biological processes
Biological processes are those processes that are vital for an organism to live, and that shape its capacities for interacting with its environment. Biological processes are made of many chemical reactions or other events that are involved in the ...
, including susceptibility to
illness
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
,
infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dis ...
, or
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
; 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
Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be cognitive, developmental, intellectual, mental, physical, ...
,
disorder
Disorder may refer to randomness, non-order, or no intelligible pattern.
Disorder may also refer to:
Healthcare
* Disorder (medicine), a functional abnormality or disturbance
* Mental disorder or psychological disorder, a psychological pattern ...
, or
illness
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
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.
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 posttraumatic stress disorder (PTSD),
compulsive
Compulsive behavior is defined as performing an action persistently and repetitively. Compulsive behaviors could be an attempt to make obsessions go away. The act is usually a small, restricted and repetitive behavior, yet not disturbing in a pa ...
cravings,
eating disorders such as
anorexia nervosa
Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gr ...
and
bulimia nervosa
Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eaten ...
,
spastic hemiplegia, incapacitation following a
stroke or cerebrovascular accident, restricted cognitive function and
motor control due to
multiple sclerosis,
social anxiety or phobia,
bipolar disorder
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
,
schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...
,
attention deficit hyperactivity disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...
, and depression.
Example conditions aggravated by mental imagery
The aforementioned challenges and difficulties are some of those for which there is evidence to show that an individual can aggravate the symptoms and intensify the pain or distress precipitated by the condition through generating mental imagery that emphasizes its severity.
The following elaborates the way in which such mental imagery contributes to or aggravates four specific conditions:
#
Posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats ...
#
Social anxiety
Social anxiety is the anxiety and fear specifically linked to being in social settings (i.e., interacting with others). Some categories of disorders associated with social anxiety include anxiety disorders, mood disorders, autism spectrum disor ...
#
Depression
#
Bipolar disorder
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
Posttraumatic stress disorder
Posttraumatic stress disorder often proceeds from experiencing or witnessing a
traumatic event involving
death
Death is the irreversible cessation of all biological functions that sustain an organism. For organisms with a brain, death can also be defined as the irreversible cessation of functioning of the whole brain, including brainstem, and brain ...
, serious
injury, or significant
threat
A threat is a communication of intent to inflict harm or loss on another person. Intimidation is a tactic used between conflicting parties to make the other timid or psychologically insecure for coercion or control. The act of intimidation for co ...
to others or oneself; and disturbing intrusive images, often described by the patient as 'flashbacks', are a common symptom of this condition across demographics of age, gender, and the nature of the precipitating traumatic event. This unbidden mental imagery is often highly vivid, and provokes memories of the original trauma, accompanied by heightened
emotion
Emotions are mental states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or suffering, displeasure. There is currently no scientific ...
s or
feelings and the subjective experience of danger and
threat
A threat is a communication of intent to inflict harm or loss on another person. Intimidation is a tactic used between conflicting parties to make the other timid or psychologically insecure for coercion or control. The act of intimidation for co ...
to safety in the present "here and now".
Social anxiety
Individuals with social anxiety have a higher than normal tendency to
fear
Fear is an intensely unpleasant emotion in response to perceiving or recognizing a danger or threat. Fear causes physiological changes that may produce behavioral reactions such as mounting an aggressive response or fleeing the threat. Fear ...
situations that involve public attention, such as speaking to an audience or being interviewed, meeting people with whom they are unfamiliar, and attending events of an unpredictable nature. As with posttraumatic stress disorder, vivid mental imagery is a common experience for those with social anxiety, and often comprises images that revive and replay a previously experienced
stressful, intimidating or harrowing event that precipitated negative feelings, such as
embarrassment
Embarrassment or awkwardness is an emotional state that is associated with mild to severe levels of discomfort, and which is usually experienced when someone commits (or thinks of) a socially unacceptable or frowned-upon act that is witnessed ...
,
shame
Shame is an unpleasant self-conscious emotion often associated with negative self-evaluation; motivation to quit; and feelings of pain, exposure, distrust, powerlessness, and worthlessness.
Definition
Shame is a discrete, basic emotion, d ...
, or awkwardness. Thereby, mental imagery contributes to the maintenance and persistence of social anxiety, as it does with posttraumatic stress disorder.
In particular, the mental imagery commonly described by those suffering from social anxiety often comprises what
cognitive psychologists describe as an "observer perspective". This consists of an
image of themselves, as though from an observing person's
perspective, in which those
suffering from social anxiety
perceive themselves negatively, as if from that observing person's point of view. Such imagery is also common among those suffering from other types of
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, who often have depleted ability to generate neutral, positive, or pleasant imagery.
Depression
The capacity to evoke pleasant and positively
affirming imagery, either voluntarily or involuntarily, may be a critical requisite for precipitating and sustaining positive
moods or feelings and
optimism
Optimism is an attitude reflecting a belief or hope that the outcome of some specific endeavor, or outcomes in general, will be positive, favorable, and desirable. A common idiom used to illustrate optimism versus pessimism is a glass filled w ...
; and this ability is often impaired in those suffering from depression. Depression consists of emotional distress and
cognitive impairment
Cognitive deficit is an inclusive term to describe any characteristic that acts as a barrier to the cognition process.
The term may describe
* deficits in overall intelligence (as with intellectual disabilities),
* specific and restricted defici ...
that may include feelings of hopelessness, pervasive sadness,
pessimism
Pessimism is a negative mental attitude in which an undesirable outcome is anticipated from a given situation. Pessimists tend to focus on the negatives of life in general. A common question asked to test for pessimism is " Is the glass half emp ...
, lack of
motivation,
social withdrawal
Solitude is a state of seclusion or isolation, meaning lack of socialisation. Effects can be either positive or negative, depending on the situation. Short-term solitude is often valued as a time when one may work, think, or rest without dist ...
, difficulty in
concentrating on mental or physical tasks, and
disrupted sleep.
Whilst depression is frequently associated with negative rumination of verbal thought patterns manifested as unspoken
inner speech
Intrapersonal communication is the process by which an individual communicates within themselves, acting as both sender and receiver of messages, and encompasses the use of unspoken words to consciously engage in self-talk and inner speech.
Intr ...
, ninety percent of depressed patients reporting distressing intrusive mental imagery that often simulates and recollect previous negative experiences, and which the depressed person often interprets in a way that intensifies feelings of despair and hopelessness. In addition, people suffering from depression have difficulty in evoking prospective imagery indicative of a positive future. The prospective mental imagery experienced by depressed persons when at their most despairing commonly includes vivid and graphic images related to
suicide, which some
psychologists and
psychiatrists
A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
refer to as "flash-forwards".
Bipolar disorder
Bipolar disorder is characterized by
manic episodes interspersed with periods of depression; 90% of patients experience
comorbid
In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary ...
anxiety disorder at some stage; and there is a significant prevalence of suicide amongst sufferers. Prospective mental imagery indicative of
hyperactivity or mania and hopelessness contributes to the manic and depressive episodes respectively in bipolar disorder.
Principles
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 technique
A relaxation technique (also known as relaxation training) is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of pain, anxiety, stress or anger. Rela ...
s, as well as
physical medicine and rehabilitation
Physical medicine and rehabilitation, also known as physiatry, is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities. This can include conditions su ...
, 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
Media may refer to:
Communication
* Media (communication), tools used to deliver information or data
** Advertising media, various media, content, buying and placement for advertising
** Broadcast media, communications delivered over mass e ...
, the
verbal instruction consists of words, often pre-scripted, intended to direct the participant's
attention to imagined visual, auditory,
tactile
Tactile may refer to:
* Tactile, related to the sense of touch
* Haptics (disambiguation)
* Tactile (device), a text-to-braille translation device
See also
* Tangibility, in law
* Somatosensory system, where sensations are processed
* CD96
CD ...
, 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.
Stages
According to the computational theory of imagery, which is derived from
experimental psychology, guided imagery comprises four phases:
# Image generation
# Image maintenance
# Image inspection
# Image transformation
Image generation
Image generation involves generating mental imagery, either directly from sensory data and perceptual experience, or from memory, or from fantasy.
Image maintenance
Image maintenance involves the volitional sustaining or maintaining of imagery, without which, a mental image is subject to rapid
decay
Decay may refer to:
Science and technology
* Bit decay, in computing
* Software decay, in computing
* Distance decay, in geography
* Decay time (fall time), in electronics
Biology
* Decomposition of organic matter
* Tooth decay (dental caries ...
with an average duration of only 250 ms. This is because volitionally created mental images usually fade rapidly once generated in order to avoid disrupting or confusing the process of ordinary sensory perception.
The natural brief duration of mental imagery means that the active maintenance stage of guided imagery, which is necessary for the subsequent stages of inspection and transformation, requires cognitive concentration of attention by the participant. This
concentrative attentional ability can be improved with the practice of mental exercises, including those derived from guided meditation and supervised
meditative praxis. Even with such practice, some people can struggle to maintain a mental image "clearly in mind" for more than a few seconds; not only for imagery created through fantasy but also for mental images generated from both long-term memory and short-term memory.
In addition, while the majority of the research literature has tended to focus on the maintenance of visual mental images, imagery in other sensory modalities also necessitates a volitional maintenance process in order for further inspection or transformation to be possible.
The requisite for practice in sustaining
attentional control
Attentional control, colloquially referred to as concentration, refers to an individual's capacity to choose what they pay attention to and what they ignore. It is also known as endogenous attention or executive attention. In lay terms, attention ...
, such that attention remains focused on maintaining generated imagery, is one of the reasons that guided meditation, which supports such concentration, is often integrated into the provision of guided imagery as part of the intervention. Guided meditation assists participants in extending the duration for which generated mental images are maintained, providing time to inspect the imagery, and proceed to the final transformation stage of guided imagery.
Image inspection
Once generated and maintained, a mental image can be inspected to provide the basis for interpretation, and transformation. For visual imagery, inspection often involves a scanning process, by which the participant directs attention across and around an image, simulating shifts in perceptual perspective.
Inspection processes can be applied both to imagery created spontaneously, and to imagery generated in response to scripted or impromptu verbal descriptions provided by the facilitator.
Image transformation
Finally, with the assistance of verbal instruction from the guided imagery practitioner or teacher, the participant transforms, modifies, or alters the content of generated mental imagery, in such a way as to substitute images that provoke negative feelings, are indicative of suffering, or that reaffirm disability or debilitation for those that elicit positive emotion, and are suggestive of resourcefulness, ability to cope, and an increased degree of mental and physical capacity.
This process shares principles with those that inform the
clinical psychology techniques of "imagery restructuring" or "imagery re-scripting" as used in
cognitive behavioral therapy.
While the majority of research findings on image transformation relate to visual mental imagery, there is evidence to support transformations in other sensory modalities such as auditory imagery. and haptic imagery.
Outcome of image generation, maintenance, inspection, and transformation
Through this technique, a patient is assisted in reducing the tendency to evoke images indicative of the distressing, painful, or debilitative nature of a condition, and learns instead to evoke mental imagery of their identity, body, and circumstances that emphasizes the capacity for
autonomy and
self-determination, positive proactive activity, and the ability to cope, whilst managing their condition.
As a result, symptoms become less incapacitating, pain is to some degree decreased, while coping skills increase.
Requisite for absorption
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". This is a further reason why guided meditation or some form of meditative praxis, relaxation techniques, and
meditation music
Meditation music is music performed to aid in the practice of meditation. It can have a specific religious content, but also more recently has been associated with modern composers who use meditation techniques in their process of composition, or w ...
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.
As a mind-body intervention
The United States
National Center for Complementary and Integrative Health
The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), ...
(NCCIH), which is among twenty-seven organizations that make up the
National Institutes of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
(NIH), classifies guided imagery and guided meditation, as
mind–body interventions
Mind–body interventions (MBI) or mind-body training (MBT) are health and fitness interventions that are intended to work on a physical and mental level such as yoga, tai chi, and Pilates.
The category was introduced in September 2000 by the U ...
, one of five domains of medical and health care systems, practices, and products that are not presently considered part of conventional medicine.
The NCCIH defines mind-body interventions as those practices that "employ a variety of techniques designed to facilitate the mind's capacity to affect bodily function and symptoms", and include guided imagery, guided meditation and forms of meditative praxis,
hypnosis
Hypnosis is a human condition involving focused attention (the selective attention/selective inattention hypothesis, SASI), reduced peripheral awareness, and an enhanced capacity to respond to suggestion.In 2015, the American Psychologica ...
and
hypnotherapy, prayer, as well as
art therapy,
music therapy
Music therapy, an allied health profession, "is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music t ...
, and
dance therapy
Dance/movement therapy (DMT) in USA/ Australia or dance movement psychotherapy (DMP) in the UK is the psychotherapeutic use of movement and dance to support intellectual, emotional, and motor functions of the body. As a modality of the creativ ...
.
All mind–body interventions, including the aforementioned, focus on the interaction between the
brain
A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a ve ...
, body, and behavior and are practiced with intention to use the mind to alter physical function and promote overall health and
wellbeing
Well-being, or wellbeing, also known as wellness, prudential value or quality of life, refers to what is intrinsically valuable relative ''to'' someone. So the well-being of a person is what is ultimately good ''for'' this person, what is in th ...
.
There are documented benefits of mind-body interventions derived from scientific research firstly into their use in contributing to the treatment a range of conditions including
headaches,
coronary artery disease and
chronic pain
Chronic pain is classified as pain that lasts longer than three to six months. In medicine, the distinction between acute and chronic pain is sometimes determined by the amount of time since onset. Two commonly used markers are pain that continue ...
; secondly in ameliorating the symptoms of
chemotherapy-induced nausea
Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
,
vomiting
Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose.
Vomiting can be the result of ailments like food poisoning, gastroenteri ...
, and localised physical pain in patients with
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
; thirdly in increasing the perceived capacity to cope with significant problems and challenges; and fourthly in improving the reported overall
quality-of-life. In addition, there is evidence supporting the brain and
central nervous system's influence on the
immune system
The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splint ...
and the capacity for mind-body interventions to enhance immune function outcomes, including defense against and recovery from infection and disease.
Guided imagery has also demonstrated efficacy in reducing postoperative discomfort as well as
chronic pain related to cancer,
arthritis, and physical injury. Furthermore, the non-clinical uses for which the efficacy of guided imagery has been shown include managing the stress of public performance among musicians, enhancing athletic and competitive sports ability, and training
medical students
A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, Bachelor of Surgery (MBBS, MB ...
in surgical skills. The evidence that it is effective for non-musculoskeletal pain is encouraging but not definitive.
Evidence and explanation
Evidence and explanations for the effectiveness and limitations of
creative visualization
Creative visualization is the cognitive process of purposefully generating visual mental imagery, with eyes open or closed, simulating or recreating visual perception, in order to maintain, inspect, and transform those images, consequently modi ...
come from two discreet sources: cognitive psychology and psychoneuroimmunology.
Cognitive psychology
Guided imagery is employed as an adjunctive technique to psychological therapies in the treatment of many conditions, including those identified in the previous sections. It plays a significant role in the application of cognitive approaches to psychotherapy, including cognitive behavioral therapy,
rational emotive behavior therapy
Rational emotive behavior therapy (REBT), previously called rational therapy and rational emotive therapy, is an active-directive, philosophically and empirically based psychotherapy, the aim of which is to resolve emotional and behavioral prob ...
,
schema therapy
Schema therapy was developed by Jeffrey E. Young for use in treatment of personality disorders and chronic DSM Axis I disorders, such as when patients fail to respond or relapse after having been through other therapies (for example, traditional ...
, and
mindfulness-based cognitive therapy
Mindfulness-based cognitive therapy (MBCT) is an approach to psychotherapy that uses cognitive behavioral therapy (CBT) methods in collaboration with mindfulness meditative practices and similar psychological strategies. The origins to its concept ...
.
These therapies derive from or draw substantially upon a model of mental functioning initially established by
Aaron T. Beck
Aaron Temkin Beck (July 18, 1921 – November 1, 2021) was an American psychiatrist who was a professor in the department of psychiatry at the University of Pennsylvania. , a psychiatrist and
psychoanalyst who posited that the subjective way in which people perceive themselves and interpret experiences influences their emotional, behavioral, and physiological reactions to circumstances. He additionally discovered that by assisting patients in correcting their
misperceptions and misinterpretations, and aiding them in modifying unhelpful and self-deprecating ways of thinking about themselves and their predicament, his patients had more productive reactions to events, and developed a more positive
self-concept,
self-image
Self-image is the mental picture, generally of a kind that is quite resistant to change, that depicts not only details that are potentially available to an objective investigation by others (height, weight, hair color, etc.), but also items that h ...
, or perception of themselves.
This use of guided imagery is based on the following premise. Everyone participates in both the voluntary and involuntary spontaneous generation of visual, auditory and other mental images, which is a necessary part of the way in which a person solves problems, recollects the past, predicts and plans the future, and formulates their self-perception, self-image, or the way they 'view' and perceive themselves.
However, this self-image can be altered and self-regulated with the aid of mind-body interventions including guided imagery, by which an individual changes the way he or she visualizes, imagines, and
perceives themselves generally, and their physical condition,
body image, and mental state specifically.
Psychoneuroimmunology
The term "psychoneuroimmunology" was coined by American psychologist
Robert Ader in 1981 to describe the study of interactions between psychological, neurological, and immune systems.
Three years later,
Jean Achterberg published a book called ''Imagery in Healing'' that sought to relate and correlate contemporaneous evidence from the then emerging scientific study of the way mental processes influence physical and physiological function, with particular emphasis on mental imagery, to the
folklore
Folklore is shared by a particular group of people; it encompasses the traditions common to that culture, subculture or group. This includes oral traditions such as tales, legends, proverbs and jokes. They include material culture, ranging ...
she extrapolated from a set of diverse ancient and geographically indigenous practices previously described as '
shamanism' by the historian of religion and professor at the
University of Chicago
The University of Chicago (UChicago, Chicago, U of C, or UChi) is a private university, private research university in Chicago, Illinois. Its main campus is located in Chicago's Hyde Park, Chicago, Hyde Park neighborhood. The University of Chic ...
,
Mircea Eliade
Mircea Eliade (; – April 22, 1986) was a Romanian historian of religion, fiction writer, philosopher, and professor at the University of Chicago. He was a leading interpreter of religious experience, who established paradigms in religiou ...
; and a number of
anthropologists
An anthropologist is a person engaged in the practice of anthropology. Anthropology is the study of aspects of humans within past and present societies. Social anthropology, cultural anthropology and philosophical anthropology study the norms and ...
and
ethnologists
Ethnology (from the grc-gre, ἔθνος, meaning 'nation') is an academic field that compares and analyzes the characteristics of different peoples and the relationships between them (compare cultural, social, or sociocultural anthropology). ...
.
The fundamental hypothesis of psychoneuroimmunology is concisely that the way people think and how they feel directly influences the
electrochemistry
Electrochemistry is the branch of physical chemistry concerned with the relationship between electrical potential difference, as a measurable and quantitative phenomenon, and identifiable chemical change, with the potential difference as an outco ...
of the brain and central nervous system, which in turn has a significant influence on the immune system and its capacity to defend the body against disease, infection, and ill health. Meanwhile, the immune system affects
brain chemistry and its electrical activity, which in turn has a considerable impact on the way we think and feel.
Because of this interplay, a person's negative thoughts, feelings, and perceptions, such as pessimistic predictions about the future, regretful ruminations upon the past, low self-esteem, and depleted belief in self-determination and a capacity to cope can undermine the efficiency of the immune system, increasing vulnerability to ill health. Simultaneously, the biochemical indicators of ill health monitored by the immune system feeds back to the brain via the nervous system, which exacerbates thoughts and feelings of a negative nature. That is to say, we feel and think of ourselves as unwell, which contributes to physical conditions of ill health, which in turn cause us to feel and think of ourselves as unwell.
However, the interplay between cognitive and emotional, neurological, and immunological processes also provides for the possibility of positively influencing the body and enhancing physical health by changing the way we think and feel. For example, people who are able to deconstruct the cognitive distortions that precipitate perpetual pessimism and hopelessness and further develop the capacity to perceive themselves as having a significant degree of self-determination and capacity to cope are more likely to avoid and recover from ill health more quickly than those who remain engaged in negative thoughts and feelings.
This simplification of a complex interaction of interrelated systems and the capacity of the mind to influence the body does not account for the significant influence that other factors have on mental and physical well-being, including exercise, diet, and
social interaction.
Nonetheless, in helping people to make such changes to their habitual thought processes and pervasive feelings, mind-body interventions, including creative visualization, when provided as part of a multimodal and interdisciplinary treatment program of other methods, such as cognitive behavioral therapy, have been shown to contribute significantly to treatment of and recovery from a range of conditions.
In addition, there is evidence supporting the brain and central nervous system's influence on the immune system and the capacity for mind-body interventions to enhance immune function outcomes, including defense against and recovery from infection and disease.
[Sources:
*Ernst, E., Pittler, M.H., Wider, B., and Boddy, K., Mind-body therapies: are the trial data getting stronger? Alternative Therapy in Health and Medicine, Vol. 13, No. 5, 2007, pp. 62–64.
*Rutledge, J.C., Hyson, D.A., Garduno, D., Cort, D.A., Paumer, L., and Kappagoda, C. T., Lifestyle modification program in management of patients with coronary artery disease: the clinical experience in a tertiary care hospital. Journal of Cardiopulmonary Rehabilitation, Vol. 19, No. 4, 1999, pp. 226–234.
*Wahbeh H., Elsas, S. M., Oken, B.S., Mind-Body Interventions: applications in neurology. Neurology, Vol. 70, No. 24, 2008, pp2321–2328.
*Rutledge, J.C., Hyson, D.A., Garduno, D., Cort, D. A, Paumer, L., and Kappagoda, C. T., Lifestyle modification program in management of patients with coronary artery disease: the clinical experience in a tertiary care hospital. Journal of Cardiopulmonary Rehabilitation Vol. 19, No. 4, 1999, pp. 226–234.
*Mundy, E.A,. DuHamel, K.N., Montgomery, G. H., The efficacy of behavioral interventions for cancer treatment-related side effects. Seminars in Clinincal Neuropsychiatry, Vol. 8, No. 4, 2003, pp. 253–275.
*Astin, J. A., Shapiro, S. L., Eisenberg, D. M., and Forys, K. L., Mind-body medicine: state of the science, implications for practice. Journal of the American Board of Family Practice, Vol. 16, No. 2, 2003, pp. 131–147.
*Irwin, M. R., Human psychoneuroimmunology: 20 years of discovery. Brain, Behavior, and Immunity, Vol. 22, No. 2, 2008, pp. 129–139.
*Ader, R., and Cohen, N., Behaviorally conditioned immunosuppression. Psychosomatic Medicine, Vol. 37, No. 4, 1975, pp. 333–340.]
See also
*
Creative visualization
Creative visualization is the cognitive process of purposefully generating visual mental imagery, with eyes open or closed, simulating or recreating visual perception, in order to maintain, inspect, and transform those images, consequently modi ...
*
Guided meditation
*
Mental image
A mental image is an experience that, on most occasions, significantly resembles the experience of 'perceiving' some object, event, or scene, but occurs when the relevant object, event, or scene is not actually present to the senses. There are ...
*
Psychoneuroimmunology
Psychoneuroimmunology (PNI), also referred to as psychoendoneuroimmunology (PENI) or psychoneuroendocrinoimmunology (PNEI), is the study of the interaction between psychological processes and the nervous and immune systems of the human body. It is ...
*
Tulpa
Tulpa is a concept in Theosophy, mysticism, and the paranormal, of an object or being that is created through spiritual or mental powers. Modern practitioners, who call themselves "tulpamancers", use the term to refer to a type of willed imaginary ...
References
{{Dreaming
Hypnosis
Mind–body interventions
Psychotherapies
Imagination
Alternative medicine