What is Visualization and Guided Imagery?

Guided imagery involves creating a specific imagined reality for yourself. These techniques can be self-taught or guided by a professional. The more you’re able to use your imagination and engage your senses, the greater the benefits.

For example, if you’re imagining yourself walking down a path while feeling no pain, you’d not only imagine what you could see, but also what sounds you could hear around you, perhaps bird songs or the sound of your feet hitting the pavement. You’d imagine what you could smell, like the fresh grass on either side of the path; what you could taste and what you could touch. 

You might imagine how your feet feel on the floor or how a tree felt as you reached out to touch it’s bark. You’d also take note of how you felt emotionally in that moment as you walked down the path, pain free. 

Utilizing all of your senses in this way helps to build an image in your mind which is as close to ‘real’ events as possible. If the visualization is guided, this means that a therapist or an audio will guide you towards imagining a specific scene, with a specific outcome in mind (for example, pain relief, stress release, or facing one of your fears). 

If you do the visualization on your own, you can decide before you begin what your aims are and what you are going to visualize. Just like with other forms of mindfulness and meditation, as you practice these skills become more natural.

The Science Behind Visualization

Let’s look at some science on the benefits of visualization in pain, medicine, sports and even personal success. If you’re already 100% sold on it, then feel free to skip ahead. If there’s an ounce of doubt as to what visualization can do for you, then spend an extra minute or two reading the whole way through to help feed your motivation to practice visualization. It could also help you to come up with new visualization ideas and exercises.

Visualization in pain management

Guided imagery places our mind into a state of deep relaxation, reducing the presence of stress hormones, decreasing muscle tension, and ultimately shifting our attention away from pain. Our imagination allows us to create positive, pleasant images. These images distract us from pain and provide us with a sense of comfort and control.

The more often you’re able to redirect your focus away from pain, the weaker neural pathways associated with pain become. Imagine that each time you practice a positive pain relieving visualization, the more you break the chronic pain cycle.

You can practice guided imagery in a virtually unlimited number of ways. Popular practices include imagining healthy cells fighting bad cells. You can imagine peaceful scenes. You can imagine pain releasing on each exhale. You can also reframe difficult thoughts and emotions using imagery.

That’s not all. In a practice called graded motor imagery, we can use visualization to imagine ourselves performing painful movements, pain-free. The pain-free imagined movement helps to reduce pain sensitivity, and break the association your brain has made between movements and pain.

There’s a lot of science to back up the use of guided imagery in treating chronic pain. For example, a systematic review (Giacobbi et al., 2015) evaluated seven studies on guided imagery for rheumatic conditions. All seven studies supported guided imagery as a useful modality for treating pain, with positive effects on psychological well-being, mobility, anxiety, and improved self-efficacy in managing pain and symptoms.

Guided imagery is often combined with body scan meditations, deep breathing, and music therapy. At Pathways (download links below), visualization is one of the key pain management techniques we practice. As our focus is on natural chronic pain relief, visualization is such a powerful tool in helping us to train the brain away from pain.

Visualization in other medicine

Visualizations can be used to treat many physical and mental health issues. Guided imagery is regularly used during cancer treatment. The Journal of Oncology explains that guided imagery is used to help cancer patients and can achieve, “psychophysiologic relaxation, relieve symptoms, stimulate healing responses in the body, access inner resources, and help people tolerate procedures and treatments more easily.” Another 2020 study discovered that visualization significantly reduced cancer patient’s pain levels. 

Guided imagery can be used to help patients reduce fear before surgeries and other medical procedures. One 2020 study explains that when patients are anxious before procedures (endoscopy specifically in this study), the anxiety “reduces the patient’s tolerance and cooperation and increases the likelihood of complications”. The study found that guided imagery reduced anxiety for the patients involved. 

Another study also found that visualization reduced “preoperative anxiety and acute postoperative pain in children and adults.” This means that visualization can actually help patients recover from surgery and reduce their pain levels after an operation! 

Another amazing example of visualizations being effective is in treating the after effects of a stroke. When a person has a stroke due to a blood clot in a brain artery, blood cannot reach the tissue that the artery once fed with oxygen and nutrients, and that tissue dies. This tissue death then spreads to the surrounding areas. 

However, if this person imagines moving the affected arm or leg, brain blood flow to the affected area increases and the surrounding brain tissue can be saved!

Visualization in sports

A study looking at brain patterns in weightlifters found that the patterns activated when a weightlifter lifted hundreds of pounds were similarly activated when they only imagined lifting.  In some cases, research has revealed that mental practices are almost as effective as true physical practice, and that doing both is more effective than either alone.

For instance, in his study on everyday people, Guang Yue, an exercise psychologist from Cleveland Clinic Foundation in Ohio, compared “people who went to the gym with people who carried out virtual workouts in their heads”. He found that a 30% muscle increase in the group who went to the gym. However, the group of participants who conducted mental exercises of the weight training increased muscle strength by almost half as much. That’s incredible!

What’s happening here is as follows. When you’re visualizing performing a certain activity, you’re getting those neural pathways to fire and as a result – you’re making those neural pathways stronger. Research such as the above demonstrates that not only will the neural pathways associated with particular activities become stronger, but it can actually result in real physical changes to the body. No wonder every successful sportsperson does some sort of visualization practice.

Visualization in personal success

Athletes, performers, and artists have been using guided imagery, or visualization, techniques for many years. As noted by Cumming and Williams (2012), “Imagery is one of the most popular mental techniques used by athletes and coaches to enhance performance and frequent use of imagery is a characteristic of those most successful in sport.”

Here are some people that you might be familiar with, and their thoughts on visualization. From Oprah Winfrey who says: “Create the highest, grandest vision possible for your life, because you become what you believe.”   

Here’s a quote from actor Will Smith: “Our thoughts, our feelings, our dreams, our ideas are physical in the universe.”  

And finally, the thoughts of martial arts superstar Conor McGregor: “…when things are going good and you visualize good things happening , that’s easy. What’s not easy is to do is when things are going bad and you’re visualizing the good stuff. And that’s what I was able to do. … Visualizing good things in times of struggle, when you can do that, that really makes the law of attraction work.”

Almost every super successful person – be it successful in their personal or business life, performs visualization at some stage. We know that it already affects the neural pathways in the brain, and can result in physical changes to the body – but visualization also helps us set a clear target and reaffirm the belief that we can achieve it.

Success stories

The story of Dr Michael Moskowitz

A compelling example of visualizations being used to relieve pain is from the example of psychiatrist turned pain specialist, Dr Michael Moskowitz.  If you want the long story, click here – it’s a great and fascinating read. 

Here’s the short story: Dr Moskowitz suffered a serious accident when water-skiing. The severe injuries left him battling with crippling pain that dominated his life for 13 years. 

When all conventional methods of treatment had failed, he began researching the discovery that the brain is neuroplastic (it’s always changing and adapting) and seeing how this might relate to him. He realized that many of the areas in the brain that fire in chronic pain also process thoughts, sensations, images, memories, movements, emotions, and beliefs – when they’re not processing pain, that is. He thought that if he could practice visualizing pain relief when pain strikes, that would help him ‘reclaim’ the areas of the brain that get ‘hijacked’.

He started noticing a reduction in pain within a few weeks. Within a few months he had his first pain free periods. Within a year he was almost always pain free. He shared his discovery with his patients, helping with chronic conditions including low-back pain, cancer pain, irritable bowel, arthritis and more.

The founder of Pathways

Hi, Sandip here! I’m the founder of the Pathways website that you’re reading now, and the associated pain therapy app (update Aug 2023: Pathways is now a web app! Start our program here). Visualizing pain relief had a very profound effect when I was battling with chronic pain.

After years of intense computer use, I developed Repetitive Strain Injury (RSI) in both of my arms. Being naive, I thought the pain would pass and I continued computer use (my work depends on it) until it got to the point where I couldn’t even open a can of beans let alone type a sentence.

I realized that the pain had become chronic and for years I tried every treatment method that was recommended, and even some that I was skeptical about. From massage to ice treatment, complete rest, all sorts of supplements, acupuncture, modifying my workspace, two invasive surgeries and more.

However, what saved me was when one doctor told me that there was nothing mechanically wrong with my arms. Because I had felt pain for so long, my brain and body had learned that pain. It had become a wired response, that would activate whenever I encountered something related to my original injury (typing).

I stumbled across the article linked to the above and the process Dr Moskowitz used. This, along with a handful of other mind body techniques helped me eliminate all pain within just a few months. Life-changing.

How to Use Visualization for Pain Relief

You first need to decide whether you want to follow a guided or unguided practice, or use a combination of both (most people use both).

For unguided practices, consider what mental image feels right for you, set a timer, and begin your practice. Common visualizations are imagining pain leaving your body through each outbreath, or imagining pain as an annoying character that you talk down. 

You could also practice trying to change the shape, size and colour of pain. You might change it from red to blue, or from hard to soft, and so on. Changing the mental image we automatically create for pain, can help to change your experience of pain.

Before you begin visualization exercises, find a quiet comfortable place to sit or lie down, where you won’t be disturbed. Remove distractions so that you can focus on the visualization properly. As you pick up the skill of visualization, you’ll be able to use elements of it throughout your day, even in the face of other distractions. 

I’ll now give you an overview of a red ball visualization. This is an unguided practice, so set a timer for 5 to 10 minutes to practice this.

Red ball imagery instructions (unguided)

Prior to engaging in guided imagery, you might like to rate your pain severity before and after practice to help you track progress. You can use the pain tracking feature in our web app to do this.

Engage in deep breathing. Then, scan your body for pain and discomfort. Imagine gathering that pain into a “red ball”. Play around with the size of the ball, make it larger and smaller in your mind, and allow it to take any shape that presents itself. 

See how small you can make it. Now move it slowly further and further away from your body each time you exhale.

Continue to repeat this exercise, noticing the experience of your breath as you move the ball and change its shape, pushing this mental image of pain further away from yourself. 

Imagine different shapes for the ball of pain and different methods to get rid of it (exploding, disappearing, crumbling, or whatever comes to mind).

5 Free Guided Visualizations for Pain Relief (audios)

The following are guided visualizations/meditations designed for pain relief. For the optimal experience, use headphones, and try to find a quiet, comfortable place where you can relax, and won’t be disturbed. You can find more of these on our web app.

Guided Meditation for Self Belief

This guided meditation is designed to help you build confidence and start to believe in your own ability to manage your health and make positive, helpful choices.

Guided Breathing and Body Scan

This meditation focuses on using your breathing to be present in the moment, relaxing your mind and body. You’ll learn to relax each area of your body, visualizing all of the stress and pain leaving your body as you do so.

Guided White Light Healing Meditation

This 30 minute meditation helps you to achieve a deep state of relaxation, allowing your mind to wander and visualize as it goes. Once you’re in a state of relaxation, you will be guided through visualizing a powerful, healing white light, taking away all of the pain, stress and other symptoms from your body.

Visualize Healing Inside Your Body

This powerful visualization session helps you to visualize an overactive nervous system, and actively calm it. You will be guided through visualizing healing within your body.

Body Scan with Liquid Sunlight

During this guided imagery session, you’ll imagine your body being filled with a beautiful warm, bright liquid sunlight. You’ll visualize this sunlight taking away any pain, discomfort or tension from your body, allowing you to feel completely at ease and relaxed.