The Science of Guided Imagery

“Guided imagery reduces pain, anxiety, time in the hospital and health care costs for our cardiac surgical patients. The data from the Stress Free Now program implies that guided imagery impacts many more people, including those who are most in need of stress relief or pain relief.”
—Toby Cosgrove, MD, Cleveland Clinic CEO and President

In the Science of Stress, you learned how your body responds to stress. But did you know that the stressor doesn’t have to be real? Your nervous system responds to a stressor regardless of whether that stress actually exists (a near accident on the way home from work) or is imagined (dreading an event that hasn’t occurred yet). Although this may seem like a bad deal, it also works in the opposite way: Your body triggers the relaxation response whether the relaxing event is actual (a massage) or imaginary (picturing yourself lying on a secluded beach).

Guided imagery harnesses the power of your thoughts and your ability to imagine to help you achieve a profoundly relaxed state. During a guided imagery session, a trained therapist cues you to focus your awareness on calming thoughts—this can happen in person or via an audio recording. Sessions typically begin with general relaxation techniques, such as diaphragmatic breathing. Then, the therapist guides you through visualizing various relaxing scenarios. Think of it as a directed, deliberate daydream.

As you practice guided imagery, a message is sent to the emotional control center of your brain. Then, the message is passed along to your body’s endocrine, immune and autonomic nervous systems, which influence your heart rate, breathing rate and blood pressure. The relaxation response is in full swing.

The Healing Benefits

Beyond mere relaxation, guided imagery is a powerful healing tool for the body and mind. In fact, guided imagery is a well-studied integrative therapy and increasingly is used to improve patients’ experiences and health outcomes.

One study, conducted at the Cleveland Clinic, found that colorectal surgery patients who received guided imagery sessions before and after their operations had less pain, anxiety and need for pain medication than patients who did not receive them. They also left the hospital more quickly than those who didn’t use guided imagery. In another randomized controlled trial (the gold standard for research), the Cleveland Clinic Heart Surgery Study, patients who practiced guided imagery before surgery reduced their anxiety and stress by 65 percent (compared to controls). After surgery, guided imagery helped these patients reduce pain by close to 70 percent. Those who practiced guided imagery also had fewer side effects and complications, were able to eat sooner and sleep better, and went home to their families two days earlier.

Guided imagery also helps patients reduce side effects from cancer treatment. A 2008 British study found that women undergoing treatment for breast cancer who practiced guided imagery and relaxation techniques had higher levels of natural killer cells (anticancer cells) than women who didn’t practice these techniques. Guided imagery also helps patients manage headaches and reduces the frequency of migraine headaches as effectively as taking preventive medications.

These studies further prove the incredible power of thought and the importance of understanding and strengthening the mind-body connection.

With regular practice, you can begin to conjure up the deeply relaxed state a guided imagery session elicits on your own and in less time. For example, after you have been practicing guided imagery, you can take a few minutes during a busy day to close your eyes and imagine a relaxing scene that you have visited before in your guided imagery sessions. Although these mini-trips aren’t as utterly relaxing as a full guided imagery session, they can help you manage stress as it’s happening.