Guided imagery as an effective therapeutic technique: a brief review of its history and efficacy research

Journal of Instructional Psychology , March, 2006 by Joe Utay, Megan Miller

Guided imagery is a flexible intervention whose efficacy has been indicated through a large body of research over many decades in counseling and allied fields. It has earned the right to be considered a research-based approach to helping. This article provides a brief introduction to the history of guided imagery and examples of selected research indicating its efficacy.

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Prepare to learn in an interesting way ... Some learning will be obvious and some may occur at a different level ... You are about to begin a journey back in time to meet researchers in the helping profession who will help you better understand the scientific validation for the use of guided imagery ... As you read this, you may or may not notice your rate of reading ... or rate of breathing ... As you continue feeling as relaxed and safe as you feel comfortable ... you might be curious about the topic, maybe excited, maybe you have healthy doubts too ... Whatever you are feeling about guided imagery is okay ... You are free at any time to pause to contemplate ... or move on to another article for any reason. Now better prepared, you can begin this brief primer on some history and selected research on therapeutic uses of guided imagery ...

Guided imagery was defined by Bresler and Rossman, co-founders of the Academy for Guided Imagery, as a, "range of techniques from simple visualization and direct imagery-based suggestion through metaphor and storytelling" (2003). It is not a new approach to helping but well established in Native American and other indigenous traditions; Hinduism, Judeo-Christian, and other religious traditions; and traditional Chinese medicine, to name a few historically-based uses. Though guided imagery is currently understood to be mainly an "alternative" or "complementary" therapeutic technique, it has been used in psychotherapy for over a century. So, though guided imagery has long been used in many religious and healing traditions, the focus of this review is limited to the past 100 years.

When writing on the history of guided imagery, Schoettle (1980) described many early 20th century examples of its use, starting with therapeutically working with daydreams. For example, Schoettle pointed out that Freud's psychoanalysis is based on the, "unraveling of the patient's fantasies, daydreams, and dreams" and, "continues to be a cornerstone in current analytical techniques" (p. 220). In the 1920s, Kretschmer and Desoille began using the daydream in therapy. Kretschmer referred to these inner visions as bildstreifendenken, or thinking in the form of a movie. Desoille referred to his therapeutic technique as the guided daydream (Schoettle, 1980).

Jacob Morena developed the therapeutic technique of psychodrama in the 1940s, in which trained participants, referred to as "auxiliary egos," playing key individuals in a person's life, re-enacted the patient's personal problems on stage. This can be now understood as a way of guiding the externalization of the client's internal imagery. In 1954, Hans Carl Leuner developed a technique he called experimentelles katathymes bilderleben, or experimentally introduced cathathymic imagery, and further developed psychodrama, which he called Symboldrama psychotherapy or guided affective imagery. William Swartley introduced Leuner's technique in the United States in 1965 as a diagnostic tool, calling it initiated symbol projection (Schoettle, 1980).

In the late 1960s, Joseph Wolpe introduced several imagery-related techniques in behavior-modification therapy: systematic desensitization, aversive-imagery methods, symbolic-modeling techniques and implosive therapy. Since that time there have been many advocates of guided imagery including the Simontons, Achterberg, Klapish, Lawlis, Oyle, Bresler, and Rossman (Schoettle, 1980).

Efficacy Research.

Not a lot is written on why guided imagery is often helpful. According to Nightningale (1998), guided imagery helps clients connect with their internal cognitive, affective, and somatic resources. The goal is not to provide new-and-improved images for the client, but to facilitate awareness of the imagery that already exists and guide clients to work with this imagery for their own needs (Nightingale, 1998). Regardless of explanation, it certainly has many champions in diverse areas. Guided imagery can be used to learn and rehearse skills, more effectively problem solve through visualizing possible outcomes of different alternatives, and increase creativity and imagination. It has also been shown to affect physiological processes. As described in the remainder of this section, in addition to its use in counseling, guided imagery has also been used with very positive results in sports training, rehabilitative medicine, and healthcare.

Guided imagery has been used increasingly by healthcare providers in the medical field with impressive results. This is particularly true with Cancer patients but also with patients who have other medical concerns such as stroke or recurrent abdominal pain. For example, Walker, Walker, Ogston, Heys, Ah-See, Miller, Hutcheon, Sarkar, and Eremin (1999) compared two groups of Cancer patients. One group received relaxation therapy and the other received relaxation therapy with peaceful imagery. Women in the peaceful imagery group were, "more relaxed and easy going, had fewer psychological symptoms and had a higher self-rated quality of life during chemotherapy" (p. 267). These women also had, "enhanced lymphokine-activated killer cytotoxicity, higher numbers of activated T-cells and reduced blood levels of tumour necrosis factor" (p. 267). In other words, they seemed to be healthier than the group without peaceful imagery.

Always consult your physician before beginning any exercise, health or nutritionally based program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise and /or nutritional prescription. If you experience any pain or difficulty with exercises, nutritional or dietary changes in your daily regimen stop and consult your healthcare provider.

Calorie to Calorie, Cardio vs. Weight Training?

by Carol Cowden

One of the hottest topics in fitness today is what exercise will burn more fat and drop more inches cardio or weight training. I know what you are thinking right now obviously cardio burns more calories and without a doubt you are absolutely, Wrong! Calorie to calorie, pound to pound weight training will burn more calories and drop more inches than cardio.
How many of you have spent countless days and hours on the elliptical, treadmill and bike and do very little to no weight or resistance training? Have you seen progress or have you hit a plateau and does it seem like no matter how hard you work you can't seem to drop anything. I guarantee that you personally know someone who has been taking an aerobics class or spin class for over a year and they look exactly the same as they did when they began. They have probably even said to you, "I don't understand it; all this hopping around for an hour, three times a week and nothing is changing!" All they need to do is start lifting weights and they will have greater success. (Please don't sick your aerobics instructor on me.)
In truth, drop your cardio in half then double the time you are spending on the weight room floor and I guarantee you that you will begin to see a transformation almost immediately. During cardiovascular activity we burn calories as we are walking, running or on the elliptical but as soon as we step off our bodies return to normal metabolic rate fairly quickly. With weight training however when we walk out of the gym we are still burning calories at a high rate because it skyrockets our metabolic spike for an hour or two after a workout and continues to stay eleveated for 24-48 hours after! This is becuase our bodies are trying hard to help our muscles recover. Without building muscle you will have a harder time burning body fat, our body fat is only burned in the muscle. The more lean body mass we have (aka muscle) the more calories our bodies burn, even at rest! For example one pound of fat burns about 5 calories a day compared to one pound of muscle which can burn about 50 calories a day. Think of our muscles as a fireplace. The more we weight train and strengthen our muscles the hotter our fireplace will burn, the hotter it burns the more body fat disappears and the closer we get to reaching our goals!
For anyone that is looking to lose weight, sculpt your body, fit into that new dress, or just feel better about your image you may want to think about switching your exercise program to contain more weight training. Results are quicker and more visible. The results will stick by building more lean body mass and eliminating our percentage of body fat!
If I had to recommend one activity a day I would absolutely choose weight training. It can help you reach all of your health and fitness goals while toning, tightening, strengthening and even giving you a cardiovascular workout. It is the best of both worlds. If you ask me you are killing two birds with one stone!

You Can Get Happy

“Researchers have found that no matter what happens to you in life, you tend to return to a fixed range of happiness. Like your weight set-point, which keeps the scale hovering around the same number, your happiness set-point will remain the same unless you make a concerted effort to change it.” ~ Marci Shimoff from Happy for No Reason

Did you know we all have a happiness set-point? Fascinating stuff that researchers are discovering.

As Marci says: “In fact, there was a famous study conducted that tracked people who’d won the lottery--what many people think of as the ticket to the magic kingdom of joy. Within a year, these lucky winners returned to approximately the same level of happiness they’d experienced before their windfall. Surprisingly, the same was true for people who became paraplegic. Within a year or so of being disabled, they also returned to their original happiness level.”

You can think of your set-point like a thermostat. If it gets a little warmer in your house (i.e., you get a little happier!) the thermostat will bring your house/you down to the set-point. And, if it gets a little too cold, it’ll bring you up.

Researchers posit that 50% of our set-point comes from genetics while 10% is determined by our circumstances (like our job, marital status, wealth). “The other 40 percent is determined by our habitual thoughts, feelings, words and actions. This is why it’s possible to raise your happiness set-point. In the same way you’d crank up the thermostat to get comfortable on a chilly day, you actually have the power to re-program your happiness set-point to a higher level of peace and well-being.”

So, the good news is that we can CHANGE our set-point. Of course, that doesn’t (usually) happen with a snap of our fingers. It takes diligent, patient and persistent practice.

All that leads to the most important questions: How’s your practice?!? Are you making a *concerted* effort to change it?!?

Dr. Joe Ierano

Anatomy of a Shoe

Footwear is designed to protect your feet from injury, not to create it. However, improperly fitting shoes, whether they are too narrow, too short, or too large can cause discomfort, injury, and even permanent deformities. Although knowing the components of a proper fit are important, it’s also important to understand how these components reflect the anatomy of a shoe.

Your shoes should start with durable construction so your feet are adequately protected. They should conform to the shape of your feet; your feet should not be forced to conform to the contours of a shoe. Therefore, understanding the basic structure of shoes along with more specific considerations is critical to getting your feet the protection they need.

Structure of a Basic Shoe:

The following is a description of the basic anatomy of a shoe.

* Toe box - the very tip of the shoe that provides space for your toes. The toe box can be either rounded or pointed; these designs determine the amount of space allowed for your toes.
* Vamp - the upper, middle section of a shoe where the laces are typically found, although Velcro can sometimes take the place of laces.
* Insole and Outsole - the insole is inside of the shoe; the outsole contacts the ground. The softer the sole, the greater the shoe’s ability to absorb shock.
* Heel - the bottom area at the rear of the shoe that provides proper elevation. More pressure is put on your foot with a higher heel.
* The last section of a shoe is the area that curves in slightly to conform to the average foot shape, allowing you to decipher from the right and the left shoe.

Structure of Men’s Shoes:

The following are some characteristics specific to men’s shoes:

* Roomy Toe Box. The toe box usually has an appropriate amount of horizontal and vertical space along with a low heel (typically about half-an-inch-high).
* Hard or Soft Soles. Soles can be made of hard materials, such as leather, or soft materials such as crepe; however, softer soles tend to be more comfortable and will protect your feet and help keep them comfortable.

Structure of Work Shoes:

* Work shoes are available with varying characteristics dependent on the wearer’s occupation:
* Work boots are often made of thick leather with steel toe boxes that can be worn to protect your feet from injury.
* Boots are available with different levels of traction.

Structure of Women's Shoes:

The following are some considerations for women’s shoes:

* Low-heeled shoes (one inch or lower) with a wide toe box, are the best choice. They have a wide toe box that can support the front part of the foot.
* High-heeled, pointed-toe shoes can lead to numerous problems including discomfort or injury to the toes, ankles, knees, calves, and back .
* Most high-heeled shoes have a pointed, narrow front area that crowds and forces toes into an unnatural position.
* The higher the heel, the more stress and pressure is put on the ball of the foot and on the forefoot, causing further discomfort.
* Low-heeled shoes can also cause discomfort if they don’t fit well.

Structure of Athletic Shoes:

Since athletic shoes are meant for high levels of activity, they have some unique characteristics, including:

* Protects players from specific stresses encountered for a given sport. Variations in design, material and lacing characteristics are meant to protect your feet.
* Shoes are specific to each sport; the amount of cushioning and stability needed for different activities will determine the type of shoe recommended.
* Well-fitted shoes need to be comfortable; a good fit will reduce blisters and other skin conditions.

Source: The American Academy of Orthopaedic Surgeons.

Always consult your physician before beginning any exercise, health or nutritionally based program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise and /or nutritional prescription. If you experience any pain or difficulty with exercises, nutritional or dietary changes in your daily regimen stop and consult your healthcare provider