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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Are you feeling stressed? Take some deep breaths, close your eyes, and transport yourself to a peaceful place in your mind. Imagine how that place looks, feels, tastes, sounds, or smells. Relax there for a few minutes.
Now, open your eyes and notice how you feel. Do you feel more relaxed? If you do, that’s guided imagery in action.
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What is guided imagery?
Guided imagery is a stress management and relaxation technique that people can use to relieve stress and calm their bodies and minds. It is a type of mind-body exercise, like progressive muscle relaxation, mindfulness meditation, breathing exercises, and visualization.
With guided imagery, you visualize a calm, pleasant setting in your imagination and focus on it while breathing deeply, pushing out negative or stressful thoughts (Felix, 2018). It is similar to visualization meditation but different in that you’re not purely focusing on the visuals and rather focus on all five of your senses (sight, sound, taste, smell, and touch) to bring the scene to life in your mind.
Benefits of guided imagery
Guided imagery can help people calm their bodies and minds during stressful situations and provide an effective technique for improving mental well-being (Nguyen, 2018).
Compared with a control group, studies show these techniques help people reduce their stress and achieve a state of relaxation (Toussaint, 2021).
Guided imagery techniques may be beneficial as a complementary therapy to people coping with certain conditions, such as stress, anxiety and depression, pain, and trouble sleeping.
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Reduces stress and anxiety
Among people undergoing surgery, studies have shown that guided imagery meditation can reduce both subjective and objective measures of anxiety.
In a small clinical trial of people having gastric bypass surgery, those who practiced guided imagery self-reported less anxiety and tested for lower levels of cortisol (the stress hormone) in their blood (Felix, 2018).
Guided imagery works outside of a healthcare setting as well. When a group of nursing students listened to a 10-minute guided imagery exercise before taking an exam, most said it lowered their test anxiety (Grammatica, 2018).
Helps with certain mood disorders
Living with a serious health condition can contribute to depression. For people in this situation, guided imagery may help improve their mental health.
For example, some people receiving dialysis—a procedure to remove waste products from the blood when the kidneys stop working—experience anxiety and depression. According to one study, practicing guided imagery may reduce the amount of anxiety and depression they feel (Beizaee, 2018).
Cancer treatment can also cause significant anxiety and depression. In one study, a group of people undergoing chemotherapy was split into two groups. One group listened to a 20-minute audio recording of guided imagery every day for a week, and one did not (Mahdizadeh, 2019).
Those who practiced guided imagery reported reduced anxiety and depression, while the control group’s participants had no difference in their symptoms. The guided imagery group also experienced more pain relief, better appetite, and less nausea and insomnia (Mahdizadeh, 2019).
Pain is not just a physiological experience; we also experience pain on a mental and emotional level. And when we feel stressed, we may experience pain more intensely (Ahmad, 2015). Given its influence on the mind-body connection, guided imagery may alleviate your perception of pain (Carpenter, 2017).
In a study of people with terminal cancer, combining guided imagery with progressive muscle relaxation—a relaxation technique that involves tensing and relaxing each of your muscles—significantly reduced the intensity of pain they felt and the overall distress their symptoms caused them (De Paolis, 2019).
Guided imagery has also been shown to be effective in helping COVID-19 patients manage their muscle pain and anxiety (Parizad, 2021).
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More research into the effects of guided imagery specifically on sleep is needed. However, some studies have reported positive results.
For example, people with insomnia who practiced guided imagery reported improved sleep quality (Neuendorf, 2015). And in a study of people in postoperative care, those who practiced guided imagery also reported better sleep quality (Acar, 2019).
Finally, in a study of people waiting to be discharged from the hospital, participants were offered either a complimentary massage or a guided imagery recording. Both groups reported less pain and anxiety, but only those who practiced guided imagery reported less insomnia (Patricolo, 2017).
How to do guided imagery
One of the best things about guided imagery is you can start instantly. All you need is a quiet place and a few minutes to yourself. Here’s what to do (Felix, 2018; Nguyen, 2018):
- Find a quiet place where you can sit or lie down comfortably.
- Start by closing your eyes. Take several deep breaths, inhaling and exhaling deeply.
- Imagine a place. Lean into all five of your senses to make it feel immersive. For example, if you’re envisioning a beach, ask yourself:
- What do you see? Waves, palm trees, seagulls, sand, seashells.
- What do you hear? Crashing waves, a bird squawking in the distance.
- What do you feel? The sand beneath your feet, the beach towel in your hand.
- What do you smell? The ocean breeze, the scent of barbecue from a place nearby.
- What do you taste? Maybe just your mouth, perhaps some water or a cool tropical drink.
- You can imagine yourself sitting in the scene or walking through it. Relax and enjoy the landscape.
- Visualize for as long as you like. You can start with five minutes and then extend the time as you continue your practice.
- Open your eyes when you are done.
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Tips for beginners
Ready to experience the benefits of guided imagery? Try these tips:
- Make yourself comfortable. Wear loose clothing. Prop yourself up with pillows. Set your phone to silent, so you’re not disturbed.
- Start with a recording. It can be helpful to use an audio recording to guide you your first few times. Download a meditation app or search for “guided imagery” on YouTube.
- Get in the zone. External cues may help immerse you in the mental imagery. If you envision a beach scene, play ambient sounds of rolling waves, or turn on a diffuser with a coconut scent.
- Rely on your memory. Choose a happy or serene memory rather than starting from scratch. You may find it’s easier to build on something you know rather than invent something new.
- Explore nature. Choose a peaceful scene based in nature instead of an urban environment, like a shopping mall. Studies showed that nature-based guided imagery reduces anxiety to a larger extent than urban-based scenes (Nguyen, 2018).
- Combine it with another relaxation method. When guided imagery was combined with massage, it lowered heart rate and blood pressure in a group of people about to undergo a heart operation (Armstrong, 2014). Combining progressive muscle relaxation and guided imagery also relieved stress and anxiety for people with breast cancer (Sinha, 2021).
- Adopt a no-judgment attitude. Like anything, guided imagery gets easier with time. There is no “perfect” way of doing it. Just enjoy and let your stress melt away.
- Acar, K. & Aygin, D. (2019). Efficacy of guided imagery for postoperative symptoms, sleep quality, anxiety, and satisfaction regarding nursing care: A randomized controlled study. Journal of Perianesthesia Nursing, 34(6), 1241–1249. doi:10.1016/j.jopan.2019.05.006. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31331803/.
- Ahmad, A. H. & Zakaria, R. (2015). Pain in times of stress. The Malaysian Journal of Medical Sciences, 22(Spec Issue), 52–61. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27006638/
- Armstrong, K., Dixon, S., May, S., et al. (2014). Anxiety reduction in patients undergoing cardiac catheterization following massage and guided imagery. Complementary Therapies in Clinical Practice, 20(4), 334–338. doi:10.1016/j.ctcp.2014.07.009. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25183648/
- Beizaee, Y., Rejeh, N., Heravi-Karimooi, M., et al. (2018). The effect of guided imagery on anxiety, depression and vital signs in patients on hemodialysis. Complementary Therapies in Clinical Practice, 33, 184–190. doi:10.1016/j.ctcp.2018.10.008. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30396619/
- Carpenter, J. J., Hines, S. H., & Lan, V. M. (2017). Guided imagery for pain management in postoperative orthopedic patients: An integrative literature review. Journal of Holistic Nursing, 35(4), 342–351. doi:10.1177/0898010116675462. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30208778/
- De Paolis, G., Naccarato, A., Cibelli, F., et al. (2019). The effectiveness of progressive muscle relaxation and interactive guided imagery as a pain-reducing intervention in advanced cancer patients: A multicentre randomised controlled non-pharmacological trial. Complementary Therapies in Clinical Practice, 34, 280–287. doi:10.1016/j.ctcp.2018.12.014. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30712739/
- Felix, M., Ferreira, M., Oliveira, L. F.,et al. (2018). Guided imagery relaxation therapy on preoperative anxiety: a randomized clinical trial. Revista Latino-Americana de Enfermagem, 26, e3101. doi:10.1590/1518-8345.2850.3101. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30517586/
- Grammatica, G. (2018). Guided imagery as a resource to decrease test anxiety. Creative Nursing, 24(4), 211–214. doi:10.1891/1078-4522.214.171.124. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30567961/
- Mahdizadeh, M. J., Tirgari, B., Abadi, O., et al. (2019). Guided imagery: Reducing anxiety, depression, and selected side effects associated with chemotherapy. Clinical Journal of Oncology Nursing, 23(5), E87–E92. doi:10.1188/19.CJON.E87-E92. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31538976/
- Neuendorf, R., Wahbeh, H., Chamine, I., et al. (2015). The effects of mind-body interventions on sleep quality: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2015, 902708. doi:10.1155/2015/902708. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26161128/.
- Nguyen, J. & Brymer, E. (2018). Nature-based guided imagery as an intervention for state anxiety. Frontiers in Psychology, 9, 1858. doi:10.3389/fpsyg.2018.01858. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30333777/.
- Parizad, N., Goli, R., Faraji, N., et al. (2021). Effect of guided imagery on anxiety, muscle pain, and vital signs in patients with COVID-19: A randomized controlled trial. Complementary Therapies in Clinical Practice, 43, 101335. doi:10.1016/j.ctcp.2021.101335. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33647676/
- Patricolo, G. E., LaVoie, A., Slavin, B., et al. (2017). Beneficial effects of guided imagery or clinical massage on the status of patients in a progressive care unit. Critical Care Nurse, 37(1), 62–69. doi:10.4037/ccn2017282. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28148616/
- Sinha, M. K., Barman, A., Goyal, M., et al. (2021). Progressive muscle relaxation and guided imagery in breast cancer: A systematic review and meta-analysis of randomised controlled trials. Indian Journal of Palliative Care, 27(2), 336–344. doi:10.25259/IJPC_136_21. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34511805/.
- Toussaint, L., Nguyen, Q. A., Roettger, C., et al. (2021). Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evidence-Based Complementary and Alternative Medicine, 2021, 5924040. doi:10.1155/2021/5924040. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34306146/
- Vagnoli, L., Bettini, A., Amore, E., et al. (2019). Relaxation-guided imagery reduces perioperative anxiety and pain in children: a randomized study. European Journal of Pediatrics, 178(6), 913–921. doi: 10.1007/s00431-019-03376-x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30944985/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.