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Imagery

Other common name(s): guided imagery, visualization

Scientific/medical name(s): none

Description

Imagery involves mental exercises designed to allow the mind to influence the health and well-being of the body. The patient imagines sights, sounds, smells, tastes, or other sensations to create a kind of purposeful daydream. It is used with standard medical treatment in people with cancer and other diseases.

Overview

Available scientific evidence does not support claims that imagery can influence the development or progress of cancer. Imagery can help to reduce stress, anxiety, and depression; manage pain; lower blood pressure; ease some of the side effects of chemotherapy; and create feelings of being in control.

How is it promoted for use?

Imagery is said to be a relaxation technique, similar to meditation and self-hypnosis, that has physical and psychological effects. Promoters claim it can relax the mind and body by decreasing heart rate, lowering blood pressure, and altering brain waves. Some supporters also say that imagery can relieve pain and emotional anxiety, make drugs more effective, and provide emotional insights.

Practitioners use imagery to treat people with phobias and depression, reduce stress, increase motivation, promote relaxation, increase control over one’s life, improve communication, and even to help people stop smoking. Imagery is also used in biofeedback, hypnosis, and neuro-linguistic programming.

For people with cancer, some supporters of imagery report that it can relieve nausea and vomiting from chemotherapy, relieve stress associated with having cancer, enhance the immune system, help with weight gain, combat depression, and lessen pain.

What does it involve?

There are many different imagery techniques. One popular method is called “palming.” It involves placing the palms of your hands over your eyes and imagining a color you associate with anxiety or stress (such as red) and then a color you associate with relaxation or calmness (such as blue). Picturing a calming color is supposed to make you feel relaxed and improve your health and sense of well-being. Other methods use images such as a ball of gentle healing energy forming in your chest and expanding through your body as you breathe. Some involve imagining yourself in a peaceful scene of your own choosing, such as a beach or meadow, with all the sights, sounds, smells, and sensations that complete the experience.

Another common technique is known as guided imagery and involves picturing a specific image or goal and imagining yourself achieving that goal. Athletes use this technique to improve their game. One type of guided therapy used for cancer patients is called the Simonton method, which was developed in the 1970s by O. Carl Simonton, a radiation oncologist, and Stephanie Matthews-Simonton, a psychotherapist. In the Simonton method, people with cancer are asked to imagine their bodies fighting cancer cells and winning the battle. One popular exercise is modeled on the old Pac-Man video game. Patients picture tiny Pac-Man characters eating and destroying tumor cells, just as he destroys his enemies in the game. The Simontons used this method with conventional cancer treatments.

Imagery techniques can be self-taught with the help of one of the many books or audio recordings that have been published on the subject. They can also be practiced under the guidance of a trained therapist. Imagery sessions with a health professional may last twenty to thirty minutes.

What is the history behind it?

Imagery is believed to have been used as a medical therapy for centuries. There is recorded evidence that Tibetan monks in the 13th and 14th centuries began meditating and imagining that Buddha would cure diseases. Some say the techniques even go back to the ancient Babylonians, Greeks, and Romans. The Simontons popularized imagery therapies in a best-selling 1978 book titled Getting Well Again. The book described their experiences in treating cancer patients with imagery and other therapies.

Currently, imagery is used in clinics at medical centers and local hospitals. It is often combined with other behavioral treatments.

What is the evidence?

According to some studies, guided imagery may help reduce some of the side effects of standard cancer treatment. A review of 46 studies that were conducted from 1966 to 1998 suggested that guided imagery may be helpful in managing stress, anxiety, and depression and in lowering blood pressure, reducing pain, and reducing some side effects of chemotherapy. Another review in 2002 noted that imagery was possibly helpful for anxiety, as well as anticipatory nausea and vomiting from chemotherapy. (Anticipatory or conditioned nausea or vomiting occurs when, after a few doses of chemotherapy have caused nausea or vomiting, some people have nausea or vomiting just before the next dose is to be given.) A 2006 review of clinical trials of imagery found that only 3 studies showed improvement in anxiety and comfort during chemotherapy. Two other studies showed no difference between those who used imagery and those who used other measures. In addition, a clinical trial involving women with early-stage breast cancer found guided imagery helped to ease anxiety related to radiation therapy, including fears about the equipment, surgical pain, and recurrence of cancer.

Some studies also suggest that imagery can directly affect the immune system. Although one uncontrolled, exploratory study suggested that guided imagery could improve survival for people with cancer, available scientific evidence does not support that these techniques can cure cancer or any other disease. More carefully constructed studies have shown improved quality of life in some patients, but have found no survival advantage for imagery or other psychological techniques.

Overall, imagery is considered one of the more useful psychological measures to reduce some side effects of chemotherapy. More systematic, well-designed research on guided imagery would help answer some questions about how it can best be used.

Are there any possible problems or complications?

Imagery techniques are considered safe, especially under the guidance of a trained health professional. They are best used with conventional medical treatment.

Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

Additional resources

More information from your American Cancer Society

The following information on complementary and alternative therapies may also be helpful to you. These materials may be found on our Web site (www.cancer.org) or ordered from our toll-free number (1-800-ACS-2345).

Dietary Supplements: What Is Safe?

The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management

Complementary and Alternative Methods and Cancer

Placebo Effect

Learning About New Ways to Treat Cancer

Learning About New Ways to Prevent Cancer

References

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Barrett S, Herbert V. Questionable cancer therapies. Quackwatch Web site. Accessed at http://www.quackwatch.org/01QuackeryRelatedTopics/cancer.html on May 23, 2008.

Cassileth B. The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. New York, NY: W.W. Norton; 1998.

Eller LS. Guided imagery interventions for symptom management. Annu Rev Nurs Res. 1999;17:57-84.

Huebscher R, Shuler P. Mind-body-spirit interventions. In Huebscher R, Shuler P, eds. Natural, Alternative, and Complementary Health Care Practices. St. Louis, MO: Mosby; 2003:762-787.

Kolcaba K, Fox C. The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy. Oncol Nurs Forum. 1999;26:67-72.

National Institutes of Health. Alternative Medicine: Expanding Medical Horizons: A Report to the National Institutes of Health on Alternative Medical Systems and Practices in the United States. Washington, DC: US Government Printing Office; 1994. NIH publication 94-066.

Pain control: a guide for people with cancer and their families. National Cancer Institute Web site. Accessed at http://www.cancer.gov/cancertopics/paincontrol on June 12, 2008.

Newell SA, Sanson-Fisher RW, Savolainen NJ. Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst. 2002;94:558-584.

Richardson MA, Post-White J, Grimm EA, Move LA, Singletary SE, Justice B. Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Altern Ther Health Med. 1997;3:62-70.

Roffe L, Schmidt K, Ernst E. A systematic review of guided imagery as an adjuvant cancer therapy. Psychooncology. 2005;14:607-617.

Spencer JW, Jacobs JJ. Complementary/Alternative Medicine: An Evidence-Based Approach. St. Louis, MO: Mosby; 1999.

Walker LG, Walker MB, Ogston K, Heys SD, Ah-See AK, Miller ID, Hucheon AW, Sarkar TK, Eremin O. Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy. Br J Cancer. 1999;80:262-268.

Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.

Last Medical Review: 11/01/2008
Last Revised: 11/01/2008