Guided Imagery

A controlled trial with abdominal surgery patients was conducted to test the effects of preoperative preparation that used guided imagery to increase patients' feelings of being able to cope with surgical stress. Twenty-six patients were prepared for surgery with a series of sessions where the counselor helped them rest their minds by focusing on a series of mental images. These 26 "imagery" patients were compared with 25 patients who received only background information about the hospital, with no imagery training.

Each group experienced similar levels of anxiety, but "imagery" patients experienced less postoperative pain than did the others, were less distressed by it, felt that they coped with it better, and requested less pain medication. Hormone levels, measured before preparation, did not differ between the two groups, but cortisol levels were lower in imagery patients immediately before and after surgery and norepinephrine levels were greater before and after surgery in imagery patients.

Several theories were proposed to interpret the results. One deals with the idea that "preoperative `worry' reduces surgical stress" by getting through the worrying in advance, and the second explores the influence of "active and passive coping" on endocrine responses to stress.

Preoperative guided imagery is usually available on request from behavioral modification or biofeedback units of hospitals.

From Psychosomatic Medicine (USA), 1995, Dept. of Clinical Psychology, Whelan Building, University of Liverpool, P.O. Box 147, Liverpool, England.

As published in the VHL Family Forum, 4:3, September 1996. For permission to reprint, please contact the VHL Family Alliance, editor@vhl.org. Further information is available from the VHL Family Alliance, info@vhl.org.