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Throughout history, the power of the imagination has helped people heal. In Eastern Medicine, envisioning one's well being has always been a large part of the healing process. In Tibetan medicine for example, physicians believe that creating a mental image of the healing god improves one's chances for recovery (2). The ancient Greeks, including Aristotle and Hippocrates, also had their patients use forms of imagery to help them heal.
People continue to rely on imagery to hasten the healing process. Psychologists and neuroscientists use evidence from Positive Emission Tomography (PET) scans of the brain to demonstrate that guided imagery is effective. In a PET scan, the subject is injected with a small amount of radioactively labeled water. When an area of the brain is working hard and processing information, more blood flows through it and higher levels of the radioactive water are detected (3).
In terms of brain activity, there is ample scientific evidence that imagining an experience stimulates the visual cortex, the same region of the brain activated by the actual experience (4). Stimulating the brain with imagery can have a direct effect on the nervous and endocrine systems, which ultimately affect the immune system. Thus, in terms of brain activity, picturing something and actually experiencing it are equivalent.
Psychologists believe that relaxation, an essential part of guided imagery, is responsible for producing images and triggering the unconscious, which generates emotions (5). Research has shown that the physiological impact of relaxation is due to its inhibition of cortisol, a hormone released by the body in response to stress. A continual, prolonged release of cortisol in response to daily stresses can inhibit the immune system, which is needed to function optimally to successively combat cancer (5).
Guided imagery induces an altered state that enables messages to travel more easily from our minds to our bodies. Dr. Herbert Benson, one of the first doctors to characterize guided therapy, calls this phenomenon the "relaxation response" (6). He and his colleagues at Harvard Medical School have proven the efficacy of mind-body medicine and have founded The Mind-Body Institute. Their work is based on the inseparable connections and interactions between thoughts, the body, and the outside world. Scientific studies demonstrate the effectiveness of relaxation in the lessening of stress that can cause or exacerbate conditions such as diabetes, chronic pain, cardiac disorders, and infertility, but neglect to look at its effectiveness in treating cancer (6).
A special type of guided imagery, the Simonton Method, has been designed exclusively for use by cancer patients. Developed by oncologist O. Carl Simonton, this technique has been successful in serving as an adjunct therapy to conventional cancer treatment (7). Using the Simonton Method, the patient undergoes a period of deep relaxation under which he will mentally picture the cancer, the treatment destroying it, and most importantly, mobilization of the body's immune response fighting and destroying the cancer cells. A common exercise involves picturing the cells of the immune system as Pac-Men gobbling up and destroying the cancer cells.
The Simonton method requires that the patient interact directly with the disease, rather than maintaining a passive role as modern medical treatments do. It gives the patient self-esteem, confidence, and an improved outlook on their quality of life. Unfortunately, there is no scientific proof to support the idea that visualization or guided imagery can destroy cancer cells (7). Similarly, these methods do not prevent cancer from recurring or lengthen survival time in cancer patients.
Without the necessary studies to evaluate the effectiveness of the Simonton Method, physicians cannot claim that this treatment is successful in treating cancer. More data from clinical trials are needed before making strong claims regarding guided imagery. Rigorous scientific studies have only been able to show that imagery and visualization, like other mind-body methods, can promote relaxation.
It is especially difficult to draw concrete conclusions regarding guided imagery because it is a complex phenomenon due to its blending of inputs and outputs in the brain. Guided imagery acts as an input because we observe objects and picture them in our mind. On the other hand, however, we actively manipulate the image, making it seem more like an output of the brain. Either way, guided imagery is generated internally without regard to external stimuli. This brings me to a concept long pondered by psychologists and neuroscientists alike- how do we obtain and manipulate a picture in our head without using actual sensory input?
To fully understand the use of guided imagery as a treatment for cancer patients, we need to understand how, if possible, the brain can serve as the image as well as being responsible for experiencing the image. At present, the brain is only truly capable of experiencing the outside world, which discredits the effectiveness of guided imagery (9).
When evaluating guided therapy, there are two applications of the treatment which need to be considered. First we must look at the effect guided therapy will have on the cancer cells themselves. There is adequate evidence to demonstrate that thinking about something activates the brain, which activates the nervous system and can then affect the immune system. Thus, thinking about destroying cancer could potentially cause the cancer to go into remission. Without the scientific data to support this claim however, I do not believe guided therapy will effectively eliminate cancer cells.
On the other hand, however, I do believe cancer patients can benefit from using guided therapy in conjunction with other medical treatments. There is currently no evidence to justify this claim, but research is underway. Scientists have already shown that guided therapy promotes relaxation, and data demonstrating how it can reduce anxiety are expected. As it is an intervention focusing on the whole person, a patient using this form of treatment will be able to better manage their symptoms, cope with their distress, take better care of themselves, and maintain hope. Overall, it will have a positive impact on one's quality of life. Thus, there is no harm in using guided therapy as an adjunct to the medical treatments offered by oncologists to alleviate the symptoms associated with cancer. It cannot worsen your condition, and who knows, it may just make you feel better!
2) Whole Health MD.com: A new approach to healing , General source for alternative medicine, complementary medicine, and integrative medicine
3) The Harvard Mahoney Neuroscience Institute Letter- The Brain's Mind's Eye , Examining the connections between brain activity with imagery
3) The Representing Brain , Neural correlates of motor intention and imagery
3)3) The Mind-Body Medical Institute , Research and clinical practice of mind-body medicine
3) British Columbia Cancer Agency , Discussion on the Simonton Method of cancer therapy
3) Mental Imagery , The demystification of mental imagery
3) Mind Tools: Effective stress management , Looking at the use of mental imagery to reduce stress
3) Mental Imagery: Using your mind to help your body , Demonstrates how imagery works and its positive effects on the body
