Guided Imagery: A Gentle Therapy For Life’s Problems

what is guided imagery?

R..e..l..a..x..! In a word, that’s what guided imagery is. This complementary therapy is one among a clutch of related relaxation therapies like deep breathing exercises, self-hypnosis, and biofeedback. Like other relaxation therapies, guided imagery seeks to induce a relaxation response in our bodies, which in turn can help bring down your blood pressure, slow breathing, and infuse a sense of well-being – everything we need to cope with our stressful, modern lives.1

But that’s not all. With research validating the health benefits of guided imagery, this form of therapy is now being widely used by mainstream medical professionals to manage a host of physical and psychological issues.

A Little Bit Of History

Guided imagery was developed by Italian psychiatrist Dr. Roberto Assagioli. A contemporary and a student of Sigmund Freud, he developed “psychosynthesis,” a school of psychoanalysis that draws upon human spiritual traditions such as yoga and Buddhist, Jewish and Christian mysticism. During his lifetime, he refined his theories and developed guided imagery as a form

of complementary therapy.2 3

How Guided Imagery Works

There are several ways in which guided imagery is practiced:

  • Through self-direction
  • Using the services of a professional therapist
  • Through recordings

In all these options, guided imagery works in the same way – the individual learns to generate and focus on positive or feel-good images to replace stressful or unhappy thoughts and memories, or feelings of pain.4

A Typical Guided Imagery Session

Let’s walk through a typical guided imagery session run by a professional therapist.

  • The therapist will use one of several guided imagery techniques to lead the subject through imagined scenarios and experiences.
  • Typically, the subject will be asked to visualize situations and places that make them feel peaceful, secure, and relaxed. For instance, they could imagine a day at the beach or walking through a garden or watching a waterfall – the
    person’s “special or happy place.”
  • Soft background music may be used to create an atmosphere of relaxation. The music is also aimed at helping avoid distractions.
  • The therapist will then focus on constructive tension release. For instance, with a cancer patient, they may ask the subject to imagine a warm healing light falling on the area where the tumor is situated. They may also be asked to imagine the immune system finding, attacking, and destroying the cancer cells.
  • The therapist is likely to add descriptions of sounds, tastes, smells, or other sensations along with the images that are visualized.
  • As the session progresses, the subject will feel drawn in and start experiencing warmth, strength, lightness, or contentment.5

How Is It Different From Meditation?

Meditation is an umbrella term and guided imagery is one form of meditation. There are many different ways of going about meditation. While some meditation techniques involve focusing on a single thing such as breathing, others such as mindful meditation are about keeping one’s thoughts and awareness in the present. The effort is to stay in the

present and clear away thoughts about future and past events. The ancient Chinese art of tai chi or “moving meditation” combines meditation, movement, and breathing, while yoga involves focusing the mind, doing various poses, and slowing and deepening the breath. In guided imagery, a person is guided to use their imagination to generate healing images and thoughts. There are but subtle differences and it is up to the individual (or the therapist) to pick the relaxation technique that suits them best.6

Who Benefits From Guided Imagery?

Clearly, guided imagery is most effective when it comes to reducing stress and managing anxiety levels. But it is also extraordinarily versatile, in terms of the wide range of situations in which it can be practiced, either by itself or along with other relaxation techniques. Beyond the realm of stress relief and anxiety management, guided imagery can be useful in:

Pregnancy And Delivery

Stress and anxiety during pregnancy could lead to various adverse outcomes for both mother and baby. Guided imagery is being explored as a

possible technique for reducing pregnancy stress, and so far, the results have been promising. Studies show that guided imagery – even through CD recordings – can reduce stress and anxiety among mothers hospitalized for delivery.7

One study examined the efficacy of self-administered guided imagery. A group of pregnant women was given a CD and booklet to practice relaxation through guided imagery at home in the weeks leading up to their delivery date. During delivery, this group was better able to handle pain and anxiety than other volunteers who did not practice guided imagery. They did better on parameters such as duration of birth, anesthesia/analgesic usage, and complications.8 Another study group of 133 women also showed that guided imagery may help

reduce anxiety at the beginning and middle stages of labor.9


There’s some evidence that guided imagery may help with this inflammatory health condition characterized by constant muscle pain, tenderness, fatigue, and other symptoms. While there’s no cure for it yet, there’s hope that guided imagery interventions can help.10 A study examining the effect of guided imagery on 72 women suffering from fibromyalgia found that while the inflammatory condition itself remained unaltered, the women were better able to cope with the stress, depression, and tiredness that fibromyalgia brings in its wake. These are perhaps the 3 most troublesome symptoms of fibromyalgia. A significant improvement was noted in the subjects’ self-efficacy in managing symptoms as well.11

In another experiment that lasted over 28 days, fibromyalgia patients trained in relaxation and guided to distract themselves from pain, by focusing on pleasant imagery, were found to have reduced pain levels compared to others who followed different therapies.12


Can the power of thought influence our perception of pain? A study of patients who were offered guided imagery before, during, and after colorectal surgery concluded that guided imagery reduces post-surgery anxiety levels, pain, and the need for painkillers. These patients also expressed a higher degree of satisfaction compared to another group who underwent conventional treatment without complementary interventions.13

This was reinforced in another study that examined the effects of guided imagery on patients who

had same-day surgical procedures. The study included 44 adults who were scheduled for head and neck procedures. The group that went through the 28-minute guided imagery session reported less pain and less anxiety, needed fewer painkillers, and spent less time in the postoperative anesthesia care unit (PACU).14

Similar results were observed among cardiac surgery patients too. In fact, some hospitals include guided imagery as a complementary technique to better manage pre- and post-operative symptoms among their cardiac surgery patients.15


Studies suggest that guided imagery can play a significant role in cancer treatments too. For instance, stress resulting from the diagnosis of cancer can negatively influence the efficacy of chemotherapy. A study of 96 breast cancer patients who were taught relaxation methods along with guided imagery recorded positive outcomes – this group scored well on quality of life, had a lower number of mood disturbances, and showed better emotional balance than a second group who only received conventional treatment. The study concluded that guided imagery and related relaxation therapy are simple and economical interventions that should be suggested to patients keen on enhancing their quality of life while undergoing chemotherapy.16

Cancer patients who self-practiced guided imagery and relaxation techniques have also been observed to experience less fatigue and sleep disturbance. However, these therapies do not significantly reduce the pain they experience, says one study.17 Guided imagery was not observed to have any positive effects on physical symptoms such as nausea and vomiting either.18


Studies show that individuals suffering from musculoskeletal pain conditions such as arthritis and other rheumatic diseases (AORD), as well as non-musculoskeletal pain, have found relief with guided imagery. Although the results for non-musculoskeletal pain are not conclusive yet, it seems to be a promising technique for AORD.19 20


Guided imagery, along with education and counseling, has proved to be useful in helping adult smokers quit cigarettes. What’s more, studies have shown that such smokers have been able to keep away from smoking in the long term.21

One study published in 1992 set out to examine how self-control behavior, through the use of complementary therapies, could be enhanced among 84 smokers trying to quit the habit. The study also sought to examine the relationship between guided imagery and self-control. The two volunteer groups who used power imagery and relaxation imagery were both successful in cutting down smoking and had significantly lower rates of relapse, compared to the control group that was not subjected to guided imagery.22

Other Areas Being Explored

The effects of guided imagery on several other conditions have been studied and continue to be studied, but results are not consistent enough to be recommended as a complementary treatment technique. Some of these conditions are asthma, depression, epilepsy, headache, high blood pressure, menopausal symptoms, menstrual cramps, post-traumatic stress disorder, and nightmares, among others.23

Is Guided Imagery A Safe Technique?

By and large, guided imagery, like other relaxation techniques is considered safe for anyone looking to reduce stress levels and experience a greater sense of well-being. It also helps that it is relatively low-cost. This popular complementary therapy is available as audio recordings and CDs. However, if you are suffering from a specific health condition, seek professional help. You can then explore guided imagery as a treatment option. From social workers and clinical psychologists to specialist guided imagery therapists, a large number of medical service providers in the United States are trained to use guided imagery. Many mainstream hospitals too have integrated guided imagery and related relaxation techniques into their healthcare programs with promising results.24