Visualisation and guided fantasy

Alternative techniques utilising the mechanism of suggestion and imagery include visualisation and guided fantasy. The use of visualisation is becoming increasingly widespread in psychological and general medicine, orthodox and otherwise, e.g. holistic cancer regimes and pain management. It is an infinitely flexible and, reputedly, powerful technique which can be applied creatively to meet the needs of a particular individual or group.

'Thinking in pictures as opposed to thinking with words'

Many of our greatest thinkers — e.g., Aristotle, Einstein and Jung — considered imagery a key component of creative thought processes and a vital link with the unconscious. Visualisation is held to be associated with activity in the right cerebral hemisphere, but exactly how the process works in treatment applications is unknown.

The careful application of visualisation is particularly useful in the context of an anxiety management training programme. Visualisation may be a valuable tool in helping clients to gain independent control over their symptoms. A wide variety of techniques exist, in which visualisation is used to assist in the achievement of specific goals or to promote general relaxation and self-awareness. For example, visualisation can be used to rehearse feared situations imaginally, thus bringing about a degree of desensitisation prior to exposure. It may also be used to assist in deepening relaxation in a variety of ways, e.g. to imagine the muscles softening and lengthening as they relax.

As with any technique which involves fantasy, visualisation should not be used with psychotic clients. In psychosis, the ability to distinguish reality from fantasy is impaired. Visualisation involves elements of suggestion and fantasy which may exacerbate psychotic symptoms.

Care should also be taken not to encourage dependence on the therapist through the use of such techniques. Therapist-led guided fantasy is usually more suitable for experiential and drama-related activities than for relaxation training. After all, the ultimate aim is to encourage clients to gain independent control of their anxiety symptoms.