How did you get into imagery work?

I wanted to get something out of nursing rather than have nursing take something out of me. Twenty years ago, I took a course called "Turning Point," which introduced complementary therapies to nursing practice. It was offered through the American Holistic Nurses Association. At the time, I didn't want to leave nursing, but knew I could not continue doing what I had been doing.

I decided to teach for "Turning Point" and returned to graduate school, where I saw an opportunity to focus on imagery and stress management. That's where I concentrate my practice today.

What is the difference between meditation and guided imagery?

Guided imagery was formerly called visualization. I teach integrative imagery, which takes place between a nurse guide and a client or patient. This utilizes individual life experience and imagination as opposed to predetermined images. There are many prepared visualizations. One is directing a client to a beach in Hawaii for relaxation. This picture might not work when the client is afraid of water.

I use locations or experiences of the client's own choosing. When I proceed this way, the client becomes an active participant in his/her own care. The focus shifts from a fight-or-flight to a healing response. This imagery can then be used in future situations such as disease prevention and health promotion.

How would nurses use this in their practice?

This isn't so much a specialized discipline, but an enhancement of the skills and assessments that nurses already have. Scripted imagery is not concentrated on fixing a problem, but in helping patients come up with their own coping tools for the whole person, which they can use for a lifetime. A nurse can walk into a room and begin using imagery techniques that will impact a patient within a few seconds.

Imagery is especially helpful in assessing and reducing pain. When patients are asked to describe the pain using imagery, their description offers another avenue for dealing with that pain. For example, one patient described his pain as "a dagger in my back." This offered an individualized picture and opened ways to lessen the pain.

There is scientific research showing that imagery can bring about less use of pain meds postoperatively, quicken wound healing, lower anxiety, decrease blood loss and enable an earlier discharge.

I have students working at all levels of health care and I am on staff with a cardiology and oncology medical group using imagery as part of self-care. However, imagery is not limited to these specialties alone, but can be used in preparation for surgery, anxiety and symptom relief. The possibilities are endless.

Has there been any resistance to your teachings?

Some resistance came from mainstream nurses who dismiss the process and its influence as unnecessary fluff. I have overworked nurses say, "We don't have the time" or "How can we change anything?"

The use of imagery often augments or reduces a nurse's need to "fix" the patient. Once nurses have tools to promote healing for themselves and their patients, professional issues such as burnout and oppression can be greatly reduced.

What is your favorite imagery meditation technique?

My favorite is the healing circle, where friends, family and much-loved animals past and present surround the patient. The patient can then look into each loved one's eyes and experience the affection and support from all those in the circle.

Where can one find further information on this subject?

Guided Imagery for Self-Healing: An Essential Resource for Anyone Seeking Wellness by Martin Rossman and Creative Imagery in Nursing by Karilee Halo Shames, Ph.D., RN, are both excellent books on imagery.

Terry Reed can be reached at Beyond Ordinary Nursing at (650) 570-6157 or at www.imageryrn.com