What Is Visualization In Therapy? Guided Imagery and Mental Health

You may have heard about visualization in a psychology course, a therapy session, or from a sports coach, among other sources. Visualization is an increasingly common technique in both therapeutic and everyday contexts, thanks to its science-backed effectiveness. 

Visualization techniques come in many forms, but the singular concept of visualization often refers to the process of creating a visual image in one’s mind, according to the American Psychological Association (APA). 

What is visualization in simple terms?

Visualization, in its simplest form, is creating vivid mental images for a specific purpose. Many people use imagery in different aspects of daily life, picturing goals for the future, creating calming visions to relax, or pairing with positive affirmations to improve mood or confidence levels. 

Understanding the role of visualization in therapy: What is visualization in therapy?

Therapists can use a variety of visualization tools to reduce clients’ stress and anxiety, while empowering them to transform past and current challenges into opportunities to heal, self-discover, and move forward. In this article, we’ll discuss the role of visualization in therapy, followed by a discussion of four strategies that can use the power of mental imagery to improve your life journey. 

What is visualization in therapy sessions with your therapist?

Goal of visualization or mental imagery: Reduce pain, anxiety, and other symptoms

Over time, the goal of visualization – which can also be called imagery – may be to reduce pain, anxiety, and other symptoms associated with a specific memory or mental health condition. Research shows that visualization techniques can offer several therapeutic benefits. 

Therapeutic benefits of visualization exercises, guided imagery on pain, and mental health conditions such as anxiety

• Symptom management for anxiety and depression
• Physical pain reduction
• Reduced blood pressure
• Overall, a greater sense of control and well-being, both physically and emotionally

In a 2021 study, researchers studied the effects of progressive muscle relaxation, deep breathing, and guided imagery training, delivered in 20-minute sessions. After completing one of these training sessions, participants were significantly more relaxed, evidenced by their reduced heart rates and other physiological indicators, as well as their questionnaire responses. 

Although further research is still needed, other studies similarly show the value of visualization to manage daily stress, achieve goals, and manage the symptoms of specific mental health conditions. 

Why imagery can shift thoughts, emotions, and behavior in the therapeutic process

Guided visualization can be used frequently in the therapeutic process to promote a range of outcomes. It can utilize the mind-body connection to rewire neural pathways for management of trauma triggers, stress reduction, or to reinforce adaptive behaviors. 

What a guided visualization looks like with a therapist

Visualization in therapy is a collaborative process, and the therapist may ask for your input throughout. Typically, they will start by creating a quiet, restful environment. You may be asked to close your eyes if comfortable doing so. They may also tell you that you are able to stop the exercise at any point if you feel uncomfortable. The general flow of a visualization session is as follows:

• Guided relaxation exercise such as progressive muscle relaxation
• Introduction of the imagery to be used in the session
• Active guided visualization
• Encouraging sensory engagement through open-ended questions
• Facilitating reflection of the session

Afterward, the therapist may tell you what to expect in the next session or offer homework to do in between sessions. 

Benefits of visualization for mental health and daily life

Many people have heard of using guided visualization to manage anxiety, but research has found that it can be effective for several positive outcomes in daily life. 

Reduce stress response and build calm

Vivid mental images of safe and calming spaces can help to shift the nervous system response in the body. Chronic stress can cause the sympathetic nervous system (also known as the fight, flight, or freeze response) to come online, even when no danger is present. Intentionally visualizing a safe and calming environment can trick the nervous system back into parasympathetic mode (rest and digest response). 

Enhance motivation and confidence for change

The old adage “fake it until you make it” can be more than just a pithy quote on a corporate poster. Visualization is often used by individuals to build the confidence to make changes in their lives or to support goal achievement. Professional athletes will use visualization for performance enhancement, and many people practice visualization to boost confidence before a big presentation or speech. By visualizing success, you can support shifting your mindset into motivation and confidence. 

Support positive outcomes in habit-building

Neuroplasticity is the process by which the brain can relearn new behaviors. Visualizing successful change can help to create new neural pathways to reinforce these behaviors. For example, if you want to start a regular afternoon walk, you may take a few minutes in the morning to engage all of your senses in visualizing what that will feel like. Examine all of the positive feelings and experiences associated with this habit. You might associate it with a positive mantra such as “I am healthy and committed to my afternoon walk”. 

Using visualization exercises to improve the symptoms of mental health conditions, such as anxiety

Visualization can benefit people of all ages and life circumstances, including those managing specific mental health conditions. Based on current research, imagery may be an especially powerful technique for people diagnosed with the following conditions: 

• Substance use disorder and addiction
• Anxiety disorders
• Depression
• Post-traumatic stress disorder 

While you may find relief in receiving a diagnosis, the process of recovering from any mental health condition can feel scary and overwhelming. Depending on your diagnosis and other symptoms, a therapist can work with you to alleviate these fears and develop your personal “toolkit” of visualization exercises. These exercises canmake you feel safe to explore your inner space and psyche while empowering you to improve your everyday life.

The visualization process: A quick how-to guide

Here is a quick guide to setting up a regular visualization practice. You can use these ideas to create and personalize a practice that works for you. 

Set up your space and breathing

Having a specific space for your imagery experience can be helpful. It doesn’t have to be fancy or complicated, it could simply be a corner of your bedroom. Some people like to set up a small area for the ritual, decorating it with meaningful objects, crystals, or other paraphernalia. Make sure that the space is quiet and comfortable, so you can focus your mind entirely on the experience.

Next, bring your body into a state of relaxation through deep breathing. A common pattern is the box breathing method. Inhale for a count of four, hold the breath for a count of four, and then release the breath for a count of four. 

Build sensory detail and hold the image

When your body has reached a place of calm, you can then start the visualization. Create vivid mental images based on your desired outcome. (For example, a peaceful scene for stress management, or a desired outcome for goal-setting). Then, go deeper. Add other sensory experiences such as taste, touch, and smell. If you are visualizing a goal, explore feelings of satisfaction, pride, or joy associated with that goal. There is no “correct” amount of time that you need to spend on your visualization experience, however consistency can be key. 

Close the practice and reflection

Finally, it’s time to close the practice. You may do this in a number of different ways. Some people like to use a positive affirmation. Others may write a journal entry about their experience. Whatever you decide to do, take a few moments to reflect on your experience and any feelings it may have invoked. 

Considerations for older adults 

Older adults may find a visualization practice intimidating because they connect it with mediation and sitting on the floor or a low surface. However, visualization can be practiced in any quiet environment, and there is no correct position to hold. You may sit in a comfortable chair, or even do your visualization before getting out of bed in the morning, or before falling asleep at night. 

Visualization exercises or guided imagery to improve your mental health and everyday life

If you feel bewildered or overwhelmed by a recent diagnosis, the following four exercises are designed to help ease the transition into your enlightened understanding of your authentic self at your own pace and comfort level. 

You can adapt these techniques to your schedule and personal preferences. They are meant to be malleable to your unique self. Feel free to explore creativity in the way you define and apply visualization to your life.

1. Progressive muscle relaxation

You may notice that your body is especially tense or sore when you are stressed, anxious, or working through other difficult emotions. Often, we do not recognize that we are holding this tension until a headache or tight neck and shoulders creep in. During these times, progressive muscle relaxation can be an especially useful tool. The basis of this practice involves actively engaging muscles to create tension, followed by the goal of a complete release of this tension. 

To experience the benefits of progressive muscle relaxation (PMR), all you need is a quiet place and your own body. By visualizing a journey through each area of the body, tensing one muscle group at a time, and then releasing the tension, PMR can promote a contrasting state of relaxation. 

2. Deep breathing with visualization

While visualization is typically distinguished from deep breathing, these techniques can be paired with mindfulness and meditationfor added benefit. By imagining yourself in a peaceful setting and taking deep breaths in a consistent manner, you can learn to calm your mind and body while directing your focus – and energy – toward positive images and feelings. 

There are many ways to integrate visualization with deep breathing, depending on how much time or energy you have available. 

Especially when paired with mental imagery, deep breathing techniques can be flexible and simple. Whether you are commuting to work or preparing for an important meeting or event, devoting a few minutes to this practice can offer you the time to slow down, check in with your breath, and relax your body. 

3. Guided imagery

Like deep breathing, guided imagery can take many forms depending on your current needs and goals. You can use guided imagery any time, in almost any setting, to settle your mind and body.

Some people simply imagine their favorite or “happy” place and gradually add more details, including what they hear, feel, see, and smell. By regularly guiding yourself through this place, you can make a daily or weekly habit of returning whenever you need to relax or recalibrate.

Other people may prefer to do guided imagery with their therapist or the guidance of an audio recording. Regardless of your preference, any form of guided imagery can ease daily stress, improve sleep quality, and reduce depression and stress over time. 

4. Palming

This visualization often involves imagining color while placing the palms of your hands over your eyes. Both real and imagined, color can have a near-immediate impact on our moods and energy levels. The simple exercise of palming can depend on common associations between colors and emotions. For example, when asked to visualize a color associated with stress, many people will choose red or a similarly intense shade.

In addition to relaxation, palming may also promote deeper sleep, heightened awareness, and enhanced memory and imagination. You can easily use this exercise throughout the day to reduce eye strain or refocus, particularly if you are spending several hours at a desk or in front of a screen.

5. Goal rehearsal to achieve specific goals or life change

When visualizing goals, consistency is an important part of restructuring your neural pathways. Try to practice every day in order to ingrain these positive outcomes in your mind. You can do a future self-visualization to reinforce a certain image of yourself. Picture your life in a year, with everything just the way you want it. Examine all the feelings associated with this life, and the pride you feel over achieving your goals. Visualize yourself performing the habits that you want to be a part of your life, and then take real-life actionable steps to support these habits. 

Using visualization or mental imagery in online therapy

Visualization is a common practice in several forms of therapy, including cognitive behavioral therapy and regression therapy. As a relatively simple and convenient technique for relaxation, visualization can be adapted to suit your needs and goals for therapy, whether you meet with a therapist online or in person.

Some people prefer to try guided imagery and other forms of visualization with an in-person therapist, but more patients are using online therapy to learn about these visualization resources and enrich their daily lives. Using a digital platform like BetterHelp, you can match with a therapist who may use a combination of imagery, deep breathing exercises, and other tools to guide their patients forward. Working through visualization and similar relaxation techniques, such as meditation and mindfulness, in online therapy may make you feel more relaxed, as exercises can be done from the comfort of your own home.

Efficacy of online therapy

Several studies indicate the value and promise of online therapies, including a 2018 pilot study of an online imagery-based treatment program for work-related post-traumatic stress disorder. This four-week online program consisted of eight 15-minute sessions with script-guided imagery and supportive music. Based on input from 35 patients, the researchers observed significant improvements in their depressed mood, anxiety, and PTSD symptoms, as well as a greater degree of relief among those with adverse childhood experiences. These results indicate the power of a relatively short online therapy to treat persistent PTSD symptoms and related concerns.